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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376628546
Report Date: 09/07/2021
Date Signed: 09/07/2021 04:20:54 PM

Document Has Been Signed on 09/07/2021 04:20 PM - 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, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME:NUNEZ, BARBARA FAMILY CHILD CAREFACILITY NUMBER:
376628546
ADMINISTRATOR:BARBARA NUNEZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(858) 230-2154
CITY:SPRING VALLEYSTATE: CAZIP CODE:
91977
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 3DATE:
09/07/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:15 PM
MET WITH:Barbara NunezTIME COMPLETED:
12:45 PM
NARRATIVE
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On 9/07/21 at 10:30am, Licensing Program Analyst (LPA) Adrian Castellon conducted an unannounced 10 day complaint inspection. There were 3 children present. LPA met with licensee Barbara Nunez and discussed the purpose of the inspection. LPA Castellon interviewed licensee Nunez

During the interview, LPA Castellon became aware that an uncleared adult has been living at the home for at least two weeks without fingerprint clearances as required. Licensee Nunez states that she was under the impression that there was a two week grace period for adults to submit prints. Licensee Nunez was also under the impression that if the adult stays in her room and has no contact with the children in care, then the adult can stay without prints being submitted. Licensee Nunez states that facility has been closed from 08/13/21 thru 08/25/21 due to a covid positive in her house.

A type A citation will be issued on today's date. This LIC809 will be used to document the citation. Please see LIC809D.
SUPERVISORS NAME: Cynthia Gray
LICENSING EVALUATOR NAME: Adrian Castellon
LICENSING EVALUATOR SIGNATURE: DATE: 09/07/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/07/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
Document Has Been Signed on 09/07/2021 04:20 PM - It Cannot Be Edited


Created By: Adrian Castellon On 09/07/2021 at 11:17 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME: NUNEZ, BARBARA FAMILY CHILD CARE
FACILITY NUMBER: 376628546

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/07/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Deficiency Dismissed
Type A
09/07/2021
Section Cited
CCR
102370(d)(1)

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Criminal Record Clearance. All individuals subject to a criminal record review as specified in Section 1596.871 prior to working, residing or volunteering in a licensed home, shall obtain a California clearance or a criminal record exemption as required by the Department. Requirement was not met as evidenced by:
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Licensee Nunez states that she will have all adults fingerprint cleared prior to the adults living or working at the daycare facility. Licensee states that she will ensure that the adult is also associated to the facility. The adult in question will submit prints on this date, per licensee Nunez.
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Licensees Nunez' admission that uncleared adult #1 was living in the home for approximately 2 months without a criminal record clearance. This poses a Potential Health and Safety risk to the clients in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Cynthia Gray
LICENSING EVALUATOR NAME:Adrian Castellon
LICENSING EVALUATOR SIGNATURE:
DATE: 09/07/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/07/2021


LIC809 (FAS) - (06/04)
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