101430(a)(3)(A)(4)(a) · Infant Care Activities (A) Staff shall place infants up to 12-months of age on their backs for sleeping. (4) Infants with an Individual Infant Sleeping Plan [LIC 9227 (3/20)] that have Section C of the form completed and signed by an authorized representative shall be placed on their back when first laid down to sleep. In the event the infant changes position, the infant may remain in the alternative position. (a) Upon staff observation that the infant is capable of rolling from their back to their stomach and stomach to their back, the provider shall fill out Section D of the Individual Infant Sleeping Plan [LIC 9227 (3/20)], notify the authorized representative, and obtain the authorized representative's signature on the individual sleeping plan no later than the next business day following observation.

Deficient Practice Statement Based on observation and record review, the licensee did not comply with the section cited above in 2 out of 5 children (C3-C4) LPA observed C3 and C4 asleep on their stomach and Provider did not complete Individual Infant Sleep Plan LIC9227 Section D that stated the infants were observed by staff to be capable of rolling from their back to their stomach and their stomach to their back which poses an immediate health, safety or personal rights risk to persons in care. POC Due Date: 10/31/2025

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

101174(d) · Disaster and Mass Casualty Plan (d) Disaster drills shall be conducted at least every six months.

Deficient Practice Statement Based on observation and record review, the licensee did not comply with the section cited above as DL did not provide documention of disaster drills conducted in the last six months which poses/posed a potential health, safety or personal rights risk to persons in care. POC Due Date: 11/07/2025

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

101216(g)(1) · Personnel Requirements (1) Except as specified in (3) below, good physical health shall be verified by a health screening, including a test for tuberculosis, performed by or under the supervision of a physician not more than one year prior to or seven days after employment or licensure.

Deficient Practice Statement Based on record review, the licensee did not comply with the section cited above in 2 out of 5 staff (S1-S2) did not have tuberculosis test results which poses/posed a potential health, safety or personal rights risk to persons in care. POC Due Date: 11/21/2025

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

101216(g)(2) · Personnel Requirements (2) Each person specified in (g) above shall have a health-screening report signed by the person performing the screening. This report shall indicate the following

Deficient Practice Statement Based on record review, the licensee did not comply with the section cited above in 2 out of 5 staff (S1-S2) did not posses a health-screening report which poses/posed a potential health, safety or personal rights risk to persons in care. POC Due Date: 11/21/2025

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

101429(a)(2)(C)(4) · Responsibility for Providing Care and Supervision for Infants (C) Documentation shall be maintained in the infant’s file and be available to the Department for review. Documentation shall include the following: (4) Initials of person who conducted each check

Deficient Practice Statement Based on record review, the licensee did not comply with the section cited above in 5 out of 5 children (C1-C5) did not have staff initials on which staff conducted each check, which poses/posed a potential health, safety or personal rights risk to persons in care. POC Due Date: 11/21/2025

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

101238(a)(1) · (a) The child care center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors. (1) The licensee shall take measures to keep the center free of flies, other insects, and rodents.

Director stated she will create a plan of operation including securing the possible entry area for rodents and to ensure rodent and rodent feces will be removed from the facility including all classrooms and kitchen. Director will submit the plan of operation to LPA by 08/11/2025. Based on interviews from CD, AD & Staff, rodent feces have been observed on site, which poses a potential health, safety or personal rights risk to persons in care.

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.

101223(a)(3) · (a) The licensee shall ensure that each child is accorded the following personal rights (3) To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse or other actions of a punitive nature including but not limited to: interference with functions of daily living including eating, sleeping or toileting; or withholding of shelter, clothing, medication or aids to physical functioning. Director terminated the Teacher on July 29, 2022. Based on Director and Staff interviews which corroborated the facility did not comply with the requirements of personal rights. This poses/posed a potential health, safety and/or personal rights risk to the children in care.

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

101212(a)(d)(1)(C) · (a) Each licensee or applicant shall furnish to the Department reports as required by the Department including, but not limited to, the following (d) Upon the occurrence, during the operation of the child care center of any of the events specified in (d)(1) below, a report shall be made to the Department by telephone or fax within the Department's next working day and during its normal business hours. In addition, a written report containing the information specified in (d)(2) below shall be submitted to the Department within seven days following the occurrence of such event. (1) Events reported shall include the following (C) Any unusual incident or child absence that threatens the physical or emotional health or safety of any child. Director will always email to CCL UIR's and not through post office mail. UIR occurred on 07/12/2022 and UIR was received to CCL on 08/03/2022. This poses a potential safety to the children in care, SUPERVISOR'S NAME Alexis Hollon

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

101429(a)(1) · In addition to Section 101229, the following shall apply: Each infant shall be constantly supervised and under direct visual observation and supervision by a staff person at all times.

Based on Director stated she now communicates with the teachers and conducts individual meetings with staff to discuss supervision requirements. Director stated she would check on the classrooms every 15 minutes and she intended to obtain additional staff o support the classrooms and to ensure that the classes are adequately staff. interviews which showed that a staffing shortage contributed to a lack of supervision. The Licensee would submit a written plan to detail how the facility intended to comply with supervision requirements by 07/24/21 via mail, email or fax. Email: melchisedeck.augustin@dss.ca.gov SUPERVISOR'S NAME: Leslie Lepori

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

101227(3)(7)(B) · A child shall not be served any food to which the child's record indicates he/she has an allergy.

Based on interviews that showed that the facility did not comply with food services requirements Director stated she will let staff and new hire know about children's allergies list and willl create document which staff would have to acknowledge they were trained and received training, and the Director will produce a written plan which would be implemented and the Director intends to conduct staff training. This posed a potential health and safety risk to the children in care. The agenda and staff signature for the training would be submitted to the Department by 08/13/21. email: melchisedeck.augustin@dss.ca.gov Fax: 707-588-5099

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

101430(a)(3)(A) · Staff shall place infants up to 12 month of age on their backs for sleeping.

Based on LPAs' observations of an eight month old infant sleeping on their stomach on a cot in the infant class at 9:40am. This poses a potential health and safety risl to that child in care Director stated she intends to train all staff on Safe Sleep Practices. The Director will submit a copy of the training topic & agenda, staff siganture page pertaining to the training. The POC would be submitted to the Department by 08/13/21.

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

101439.1(b) · A crib or portable-crib meeting United States Consumer Product Safety Commission safety standards shall be provided for each infant who is unable to climb out of a crib.

Based on LPAs' observation of an eight month old infant sleeping on a cot in the infant classroom at 9:40am Director stated she intends to train all staff on Safe Sleep Practices. The Director will submit a copy of the training agenda, staff siganture page pertaining to the training. The POC would be submitted to the Department by 08/13/21. SUPERVISOR'S NAME: Leslie Lepori

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.