503906833-9-17-2019-04-CC-AMEA-BG4TCJ-20190917143650

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 503906833
Report Date: 09/17/2019
Date Signed: 09/17/2019 02:37:12 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:	TERRY, JULIE FAMILY CHILD CARE		FACILITY NUMBER:	503906833
ADMINISTRATOR:	TERRY, JULIE		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(209) 522-6868
CITY:	MODESTO	STATE: CA	ZIP CODE:	95355
CAPACITY:	14	CENSUS: 8	DATE:	09/17/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	12:30 PM
MET WITH:	Julie Terry		TIME COMPLETED:	02:45 PM

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Licensing Program Analysts (LPAs) Angelica Mejia and Juvenal Moctezuma, conducted an unannounced annual/random inspection. LPAs met with Licensee Julie Terry. Also present was assistant Alexis Robles. LPAs conducted a tour of the home, inside and outside, as shown on the facility sketches (LIC 999A) provided. The rooms accessible to children in care are: bedroom #1 and #2, kitchen, bathroom, living room, dining room and back yard. Off-limits rooms are made inaccessible via locks. One dog and one cat were observed during today’s inspection and are accessible to children; licensee is aware of the safety of children around animals. Swimming pool is fenced per regulation. The pool gate is self-latching, self-closing and opens away from the swimming pool. There are no firearms kept on premises. No poisons were observed on the premises. Cleaning compounds, medications and other hazardous items are inaccessible to children. Fireplace is screened and inaccessible to children in care. There is a working fire extinguisher, smoke detector, and adequate heating and ventilation for safety and comfort. Carbon monoxide detector was not operating when tested; Licensee replaced battery before the inspection was completed. There are no stairs in the home. There is a working telephone and number was verified. Adequate supervision is being provided during this inspection. Children are supervised when outside in the play area. Capacity as specified on the license is being maintained. Licensee has a current roster of the children. Licensee maintains documentation of immunizations for the children. Licensee maintains documentation of immunizations for pertussis, measles and influenza for herself and staff. Licensee has provided parents with a copy of the Family Child Care Home Notification of Parent's Rights (LIC 995A).

Continued on 809-C

SUPERVISOR'S NAME: Duane Matsubara	TELEPHONE: (559) 650-7855
LICENSING EVALUATOR NAME: Angelica Mejia	TELEPHONE: (559) 341-6126
LICENSING EVALUATOR SIGNATURE:	DATE: 09/17/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/17/2019

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: TERRY, JULIE FAMILY CHILD CARE	FACILITY NUMBER: 503906833
	VISIT DATE: 09/17/2019

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Fire drills are conducted and documented; the last drill was conducted on 7/8/19. 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. 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 for Licensee and assistant Alexis is current and expires 3/18/20. Mandated Reporter training AB 1207 for Licensee and assistant Alexis is current and expires 3/4/21. 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. Postings such as Emergency Disaster Plan, Earthquake preparedness checklist, facility license and notification of parent’s rights poster are posted on the parent’s board. Days and hours of operation are Monday – Friday; 6:30AM – 5:30PM.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

LPA & licensee discussed the Community Care Licensing website, safe sleep regulations and Mandated Reporter Training: LPA 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

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, no deficiencies were cited.

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: Duane Matsubara	TELEPHONE: (559) 650-7855
LICENSING EVALUATOR NAME: Angelica Mejia	TELEPHONE: (559) 341-6126
LICENSING EVALUATOR SIGNATURE:	DATE: 09/17/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/17/2019

LIC809 (FAS) - (06/04)

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