503605759-8-29-2019-04-CC-JPAO-BFHPG8-20190829111755

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 503605759
Report Date: 08/29/2019
Date Signed: 08/29/2019 11:18:04 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:	RANSOM, EDITH		FACILITY NUMBER:	503605759
ADMINISTRATOR:	RANSOM, EDITH		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(209) 527-9798
CITY:	MODESTO	STATE: CA	ZIP CODE:	95358
CAPACITY:	14	CENSUS: 10	DATE:	08/29/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	09:15 AM
MET WITH:	Edith Ransom - Licensee		TIME COMPLETED:	11:30 AM

NARRATIVE

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On 8/29/2019, Licensing Program Analysts (LPAs), Joseph Pacheco and Angelica Mejia, conducted an unannounced annual random inspection. LPAs met with Licensee, Edith Ransom. Licensee has two dogs that are kept in off-limits areas of the home. There are no firearms or ammunition at this home. There is a working fire extinguisher, smoke detector, carbon monoxide indicator, and adequate heating and ventilation for safety and comfort. There is a fireplace in the living room of the home that is not in use during day care hours. Fire drills have NOT been conducted and documented at least once every six months. LPAs reminded Licensee of this requirement during today's inspection. There is a working telephone and number was verified. Adequate supervision is being provided during this visit. Children are supervised when outside in the unfenced play area. Capacity as specified on the license is being maintained. Licensee has a current roster of the children. Licensee maintains documentation of immunization's for the children. Licensee is aware that children are never to be left in parked vehicles. All individuals residing at the home have criminal background/fingerprint clearances. 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. Pediatric CPR/First Aid are current and expires on 7/21/2020. AB 1207 Mandated Reporter certification is current and expires on 6/30/2020. 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 advanced notice. IMS policy was discussed.

During inspection LPA inspected areas where infant’s sleep. LPAs informed Licensee of Safe Sleep practices for infants and how to provide Safe Sleep environments. LPAs informed Licensee to visit the Department’s website (www.ccld.ca.gov) for updates and changes related to licensing regulations and procedures.

Hours of operation are Monday – Friday 07:00 – 05:00pm.

CONTINUED ON 809-C

SUPERVISOR'S NAME: Diana deLeon	TELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Joseph Pacheco	TELEPHONE: (559) 341-4457
LICENSING EVALUATOR SIGNATURE:	DATE: 08/29/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2019

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: RANSOM, EDITH	FACILITY NUMBER: 503605759
	VISIT DATE: 08/29/2019

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LPAs & licensee discussed the Community Care Licensing website. LPAs and Licensee discussed new additions to the website that include the new PIN (Provider Information Notification) and information for providers including the Quarterly Update that informs licensees of new legislation and regulations. Please follow these steps go to http://www.cdss.ca.gov/, click on “information and resources” click “Community Care Licensing” Click “quarterly updates” click “Child Care advocates program” and register to PIN. LPA left a copy of A Child Care Provider’s Guide to Safe Sleep. Lead safety information was provided in accordance with AB 2370, Chapter 676, Statues of 2018.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, the following deficiencies were cited today. (See LIC809-D)

THIS REPORT SHALL BE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.
LIC 9213 NOTICE OF SITE VISIT FORM IS REQUIRED TO BE POSTED FOR 30 DAYS.

SUPERVISOR'S NAME: Diana deLeon	TELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Joseph Pacheco	TELEPHONE: (559) 341-4457
LICENSING EVALUATOR SIGNATURE:	DATE: 08/29/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2019

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: RANSOM, EDITH	FACILITY NUMBER: 503605759
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 08/29/2019

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 09/06/2019 Section Cited	1 2 3 4 5 6 7	Operation of a Family Child Care Home. 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. This requirement was not met as evidenced by: Licensee stating to LPA that she has not been conducting and documenting fire drills as
	8 9 10 11 12 13 14	required every six months. This item poses a potential risk to the health, safety, or Personal rights of children in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7
	1 2 3 4 5 6 7

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 deLeon	TELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Joseph Pacheco	TELEPHONE: (559) 341-4457
LICENSING EVALUATOR SIGNATURE:	DATE: 08/29/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2019

LIC809 (FAS) - (06/04)

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