503604009-3-3-2020-04-CC-RMAS-BMCRER-20200303115757

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 503604009
Report Date: 03/03/2020
Date Signed: 03/03/2020 11:58:02 AM

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:	CCCDS - STONUM CHILD DEVELOPMENT CENTER		FACILITY NUMBER:	503604009
ADMINISTRATOR:	CAMBRIA RIVAS		FACILITY TYPE:	850
ADDRESS:	1336 STONUM ROAD		TELEPHONE:	(209) 581-9180
CITY:	MODESTO	STATE: CA	ZIP CODE:	95351
CAPACITY:	42	CENSUS: 35	DATE:	03/03/2020
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:30 AM
MET WITH:	Griselda Jimenez		TIME COMPLETED:	12:00 PM

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On 03/03/2020, Licensing Program Analyst (LPA) Rene Mancinas JR conducted an unannounced annual required inspection. LPA met with Teacher, Griselda Jimenez. There are two classrooms arranged for preschool children to utilize at this facility. LPA toured the facility, both indoors and outdoors to inspect areas accessible to children in care. There are no bodies of water on site. Firearms/weapons are not allowed or stored on premises. All children are under supervision, including visual supervision, of a teacher at all times. Disinfectants, cleaning solutions and other dangerous items shall be inaccessible to children. No poisons were observed during today’s inspection. All materials and surfaces accessible to children are toxic free. Medications, when stored at the facility, are kept in an area inaccessible to children. Children restrooms are located in each of the classrooms for children to use. All toilets, hand washing, and bathing facilities are in safe and sanitary operating conditions. All floors are clean and safe. Furniture and equipment are in good condition, free of sharp, loose, or pointed parts. Solid waste storage vessels, including moveable bins, have tight-fitting covers on, are in good repair.

Uncontaminated drinking water is available both indoors and outdoors. Menus are posted at least one week in advance, where an authorized representative can view them. Facility has one or more functioning carbon monoxide detectors that meet statutory requirements. Playground equipment is in good condition, free of sharp, loose, or pointed parts.

CCL shall notify a licensee to immediately terminate the employment of, or to remove/bar any person with specified convictions or for other reasons. The licensee shall comply with the notice. Before working or volunteering in a licensed child care facility, all individuals subject to a criminal record review have a clearance or exemption and have been associated to the facility.

(Continued on 809-C)

SUPERVISOR'S NAME: Susie Fanning	TELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Rene Mancinas	TELEPHONE: (559) 341-4524
LICENSING EVALUATOR SIGNATURE:	DATE: 03/03/2020

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/03/2020

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, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: CCCDS - STONUM CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 503604009
	VISIT DATE: 03/03/2020

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At least one person trained in CPR and Pediatric first-aid is present when children are at the facility or at off-site activities. The person, who signs the child in/out, is responsible for the child, uses their full legal signature and records the time of day. Child's admission agreement is available for review.

HOURS OF OPERATION: Monday through Friday; 06:00am to 04:00pm.

Meals/Snacks are provided to children in care. Meals/Snacks are delivered on site from a third-party vendor and served in the classrooms for children to consume. There is a kitchen area used to store food. Refrigerator is in working condition and equipped with thermometers to ensure required temperatures are being maintained. LPA did not observe any spoiled or expired foods. Food and utensils are kept separate from cleaning solutions in the kitchen area.

Required CCL forms are posted in a prominent place and are readily available for parents/public view. LPA informed Director of the Community Care Licensing Division website, which provides access to Provider Information Notices (PINs), Quarterly Updates, Mandated Reporter Training, Safe Sleep information, Lead Poisoning information, forms available for print, and information regarding Department regulations.

Per Chapter 1, Division 12, Title 22 of the California Code of Regulations no deficiencies are observed today. Notice of Site Visit to be posted for 30 days from today’s inspection. Exit interview was conducted with Teacher, Griselda Jimenez.

SUPERVISOR'S NAME: Susie Fanning	TELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Rene Mancinas	TELEPHONE: (559) 341-4524
LICENSING EVALUATOR SIGNATURE:	DATE: 03/03/2020

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/03/2020

LIC809 (FAS) - (06/04)

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