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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 444416407
Report Date: 06/08/2022
Date Signed: 06/08/2022 10:04:35 AM

Document Has Been Signed on 06/08/2022 10:04 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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:BRUCE, KIMBERLYFACILITY NUMBER:
444416407
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 6CENSUS: 6DATE:
06/08/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
08:55 AM
MET WITH:Kimberly BruceTIME COMPLETED:
10:15 AM
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Licensing Program Analyst (LPA), Cortney Nelson, met with Licensee, Kimberly Bruce, to conduct inspection for capacity increase at Family Child Care Home (FCCH). Upon arrival, there were 6 children (3 infants/ 3 preschool age) present which is compliant with current home capacity requirements. Licensee's daughter, Mackenzie Bruce, was additionally present assisting with the children. Hours of operation are Monday-Friday 8:00AM-5:00PM.

Licensee states that adults over the age of 18 living in the home are: herself, her spouse (Jason Bruce), her daughter (Makenzie Bruce) and her son (Brody Bruce). All adults have criminal record clearances and signed criminal record statements (LIC508).

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

LPA conducted tour of inside of FCCH during today's inspection and home was observed to be clean, orderly, and safe for the day care children. Off limits inside of the home include: entire bottom floor, laundry room, and kitchen. Smoke alarm and carbon monoxide detectors are functioning and FCCH is equipped with 3A40BC fire extinguisher. Fire pull station is properly installed next to fire extinguisher in the kitchen. Fire Clearance for large capacity was conducted and approved on 5/31/2022 by Scotts Valley Fire Prevention. There are no conditions for fire clearance approval. There are currently 5 play pens to be used by children during nap time and Licensee states that she will plan to purchase more if needed for additional children with large capacity. All food is prepared and provided for children by the FCCH.
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Cortney Nelson
LICENSING EVALUATOR SIGNATURE: DATE: 06/08/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/08/2022
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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: BRUCE, KIMBERLY
FACILITY NUMBER: 444416407
VISIT DATE: 06/08/2022
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LPA conducted tour of outside of FCCH during todays inspection. Off limits outside the home include: detached garage, storage room, lower deck, and all areas outside of fenced deck area for children. Licensee states that lower deck that was previously added to on-limits outside is now being utilized by family puppy and will not be utilized by the children moving forward. LPA advised that if Licensee decides to resume using the lower deck to let Licensing know and submit updated facility sketch (LIC999A). Deck for children's use has BBQ and heat lamp which are fenced off and inaccessible to children. LPA reminded Licensee that BBQ and heat lamp should not be used while children are present at the facility.

A file review was conducted for the staff that will be assisting Licensee at the home for large capacity. LPA advised Licensee that any staff member who will be alone with the children must have current CPR/First-Aid certificates. LPA obtained copy of children's roster (LIC9040) and reminded Licensee to update roster and paperwork for children prior to enrollment at the home. LPA reviewed capacity and staffing requirements for large family child care home with Licensee and provided copy of regulation. (CCR-102416.5 Staffing Ratio and Capacity)

Supervision of children was discussed with the Licensee and she understands that she must be home during day care hours and ensure that children are supervised at all times. The Licensee states that she does not transport any day care children. LPA reminded Licensee that children should not be left unattended in parked vehicles and that car seats shall only be used for transportation and shall not be used for sleeping.

Exit interview conducted and report was reviewed with the Licensee, Kimberly Bruce.

As a result of todays inspection, no deficiencies were cited. LPA advised Licensee that increase in capacity will be given upon manager review and final approval.

A NOTICE OF SITE VISIT WAS GIVEN AND MUST REMAIN POSTED FOR 30 DAYS. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Cortney Nelson
LICENSING EVALUATOR SIGNATURE:

DATE: 06/08/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/08/2022
LIC809 (FAS) - (06/04)
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