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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 406216539
Report Date: 09/16/2024
Date Signed: 09/17/2024 06:55:04 AM

Document Has Been Signed on 09/17/2024 06:55 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME:NUNEZ SHOGREN AKA BAMBINI DAYCAREFACILITY NUMBER:
406216539
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 3DATE:
09/16/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:00 PM
MET WITH:Adriana Nunez ShogrenTIME VISIT/
INSPECTION COMPLETED:
02:15 PM
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On 9/16/2024 at 1:00 PM, Licensing Program Analyst (LPA) Gigi Reyes conducted an unannounced Case Management Inspection at the above Family Child Care Home. (FCCH) LPA met with Licensee/applicant, Adriana Nunez Shogren and discussed the purpose of the inspection. Applicant/Licensee operates from Monday to Friday from 6:00 AM to 5:00 PM and provide care to children ages 3 months to 15 years old.

On May 15, 2024, Applicant/Licensee submitted an application to Community Care Licensing (CCL) requesting an increase in FCCH capacity from 8 to 14 day care children.
The daycare operates in a basement of the 4 storey home. The bathroom designated for children's use is located on the second floor of the residence. Licensee/applicant accompany children as they need to use the bathroom. Control of Property was reviewed.
On August 14, 2024, San Luis Obispo County Fire Department granted the fire safety clearance as required for capacity increase. Fire extinguisher was purchased on 7/17/2024, combination carbon monoxide and smoke detectors was observed in the home.
.
Continued on LIC 809C
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Gigi Reyes
LICENSING EVALUATOR SIGNATURE: DATE: 09/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/16/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: NUNEZ SHOGREN AKA BAMBINI DAYCARE
FACILITY NUMBER: 406216539
VISIT DATE: 09/16/2024
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Pediatric CPR and First Aid expires on 1/12/2025 while Mandated Reporter Training certificate expired on 5/4/2024. Issuance of license for Large FCCH is pending completion of the Mandated Reporter Training per AB 120, certificate must be submitted to the department no later than 9/26/2024.

No deficiency was cited, a Technical violation was issued.

Notice of Site Visit was issued and must be posted for 30 days.

Exit interview conducted and report was reviewed with applicant/licensee, Adriana Nunez-Shogren.
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Gigi Reyes
LICENSING EVALUATOR SIGNATURE:

DATE: 09/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/16/2024
LIC809 (FAS) - (06/04)
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