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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 103900491
Report Date: 10/03/2019
Date Signed: 10/03/2019 03:23:46 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:RANGEL,LILIAFACILITY NUMBER:
103900491
ADMINISTRATOR:RANGEL,LILIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 655-4732
CITY:MENDOTASTATE: CAZIP CODE:
93640
CAPACITY:14CENSUS: 6DATE:
10/03/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Lilia RangelTIME COMPLETED:
03:45 PM
NARRATIVE
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Licensing Program Analyst (LPA) Angelica Slaughter conducted an unannounced Annual/Random inspection. LPA met with Licensee Lilia Rangel . Also present in the facility is Licensee's spouse, who is also her assistant. LPA conducted a tour of the home. Facility sketch has not been updated since modifications to home were made almost 13 years ago. Accessible areas of the home are the living room, dining room, kitchen, daycare room, hall bathroom and back yard. All other rooms in the home are made inaccessible by locked doors. A small dog and a large dog were observed during today's inspection. The large dog is kept behind a fence and is inaccessible to the children in care. Licensee understands she is responsible for the safety of children in her care around pets. There are no "bodies of water". There are no firearms in the home. No poisons were observed on the premises. Licensee was reminded that cleaning compounds, medications and other hazardous items are to be inaccessible to children. There is no fireplace or stairs in the home. The fire extinguisher is out dated and needs to be replaced. Also, the smoke detector is non-operational during this inspection. There is a working carbon monoxide indicator and adequate heating and ventilation for safety and comfort. There is a working telephone (559) 655-4732 and number was verified. Adequate supervision is being provided during this inspection. Capacity as specified on the license is being maintained. Licensee has a current roster of the children. Licensee maintains documentation of immunization for pertussis, measles and influenza for herself. Fire drills are conducted every six months per Licensee, however Licensee could not produce the fire drill log. Licensee is aware that children are never to be left in parked vehicles. All adults who reside or work in the home have a criminal record clearance or exemption. Licensee verified finger print clearances by signing LIS 531. There are no excluded individuals present at this home. Licensee is aware that upon notice from the Department, any excluded individual must be immediately removed from the home and prevented from returning to the home or having contact with children in care. Licensee’s Pediatric CPR/First Aid expires 04/28/20. Licensee completed AB 1207 Mandated Reporter Training on 11/07/18. Licensee is aware that any authorized employee of the Department may enter and inspect any place providing personal care and services at any time, with or without advance notice. Licensee confirmed that there are no Registered Sex Offenders living in the facility and/or using the facility address for their mailing address. Days and hours of operation are Monday – Friday; 6:00 AM – 6:00 PM and as arranged.

Continued on 809-C

SUPERVISOR'S NAME: Diana deLeonTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Angelica SlaughterTELEPHONE: (559) 341-3920
LICENSING EVALUATOR SIGNATURE:

DATE: 10/03/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2019
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 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: RANGEL,LILIA
FACILITY NUMBER: 103900491
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/03/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/10/2019
Section Cited

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Operation of a Family Child Care Home - Each family child care home shall conduct fire drills and disaster drills at least once every six months. The licensee shall document the drills, including the date and time of each drill. This documentation shall be kept at the family child care home.
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This requirement was not met as evidenced by this inspection. Licensee stated she conducts regular drills. Licensee could not produce a completed fire drill log. This posses a potential risk to the health, safety and/or personal rights of children in care.
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Type B
10/10/2019
Section Cited

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Operation of a Family Child Care Home - The home shall contain a fire extinguisher and smoke detector device which meet standards established by the State Fire Marshal.This requirement was not met as evidenced by this inspection. Smoke detector was non-operational during this inspection and fire extinguisher has not been serviced since 2007 according to the attached green tag. This posses a potential risk to the health, safety and/or personal rights of children in car

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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: Diana deLeonTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Angelica SlaughterTELEPHONE: (559) 341-3920
LICENSING EVALUATOR SIGNATURE:
DATE: 10/03/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/03/2019
LIC809 (FAS) - (06/04)
Page: 3 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: RANGEL,LILIA
FACILITY NUMBER: 103900491
VISIT DATE: 10/03/2019
NARRATIVE
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Incidental Medical Services (IMS) policy was discussed. There are currently no children on medications at the daycare.

LPA provided Licensee with information regarding the California Department of Social Services (CDSS) Provider Information Notices (PINs) communication system; AB 2370, Chapter 676, Statutes of 2018, requiring child care providers to inform parents and/or guardians with lead safety information, and other important resources and information links offered on the CDSS website. LPA also discussed safe sleep with Licensee.



Per Chapter 3, Division 12, Title 22 of the California Code of Regulations, the following deficiencies are found (see next page): 809 D

Licensee was provided a copy of this report and appeal rights, as well as form LIC 9213. Form LIC 9213 (Notice of Site Visit) must be posted for public view for 30 days.

THIS REPORT SHALL BE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.
SUPERVISOR'S NAME: Diana deLeonTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Angelica SlaughterTELEPHONE: (559) 341-3920
LICENSING EVALUATOR SIGNATURE:

DATE: 10/03/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2019
LIC809 (FAS) - (06/04)
Page: 2 of 3