Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 455405525
Report Date: 09/13/2019
Date Signed: 09/13/2019 09:15:13 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
FACILITY NAME:RAGULSKY, LESLIE FAMILY CHILD CARE HOMEFACILITY NUMBER:
455405525
ADMINISTRATOR:RAGULSKY, LESLIEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(530) 410-4412
CITY:REDDINGSTATE: CAZIP CODE:
96002
CAPACITY:14CENSUS: 1DATE:
09/13/2019
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
08:50 AM
MET WITH:Leslie RagulskyTIME COMPLETED:
09:30 AM
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A Case Management was completed by Licensing Program Analysts, Martinez and Wisehart who met with Licensee Leslie Ragulsky. The LPA's visit was to discuss an incident which occurred on 9/8/19 involving a child (C1) who jumped on the licensee's dog which resulted in the dog biting C1 in the face. The licensee contacted C1's responsible party; VC Asher vets office and animal control. The Child (C1) was medically seen and treated with antibiotics for the puncture wounds and the dog was taken to the vets office VC Asher and was signed over so the dog is no longer in the home. The dog was determined to be up to date on all shots with the exception of rabies which expired as of 2018.

The Licensee did make a phone report and a written report within the required time parameters. The LPA's determined that the licensee acted appropriately during this incident.

No deficiencies were cited during today's visit.

Notice of site visit must be posted for 30 days from today's visit.
SUPERVISOR'S NAME: Megan AvilesTELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Carrie WisehartTELEPHONE: (530) 895-5824
LICENSING EVALUATOR SIGNATURE:

DATE: 09/13/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2019
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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