Blanchard Family Child Care

102425(j)(2)(D)(c) · Documentation shall be maintained in the infant’s file and be available to the Department for review. Documentation shall include the following: Time of each 15-minute check

15 min sleep log was provided for review. POC cleared during this visit. One infant that was in care on visit date 9/29/25 did not have a 15 min sleep log. Warren Birks NAME OF LICENSING PROGRAM MANAGER: Ashley Calderon NAME OF LICENSING PROGRAM ANALYST: LICENSING PROGRAM ANALYST SIGNATURE: DATE: 12/10/2025 I acknowledge receipt of this form and understand my appeal rights as explained and received.

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102417(g)(4)(A) · Operation of A Family Child Care Home (g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (4) Poisons, detergents, cleaning compounds, medicines, firearms and other items which could pose a danger if readily available to children shall be stored where they are inaccessible to children. (A) Storage areas for poisons, firearms and other dangerous weapons shall be locked.

Deficient Practice Statement Based on LPA Calderon found two Raid Poison Bottles at 2:29pm and 2:31pm, Red Raid Bottle #1 for Ants and Roaches found in garage on top of the children personal belonging cabinet and a Blue Raid Bottle for Fly's found on the kitchen cabinet,, the licensee did not comply with the section cited above in 2 out of 2 which poses an immediate health, safety or personal rights risk to persons in care. POC Due Date: 09/30/2025

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102425(a)(3) · Infant Safe Sleep (a) There shall be one crib or play yard for each infant who is unable to climb out of the crib or play yard. (3) Mattresses shall be firm and covered with a fitted sheet that is appropriate to the mattress size, fits tightly on the mattress, and overlaps the underside of the mattress so it cannot be dislodged.

Deficient Practice Statement Based on LPA Calderon's observation at 1:00pm Infant Child #3 was sleeping in play yard with no firm mattress and a blanket placed under child, LPA observed no fitted sheets; the licensee did not comply with the section cited above in [1] out of [1] infant napping arrangements not meeting regulations which poses an immediate health, safety or personal rights risk to persons in care. POC Due Date: 09/30/2025

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102419(d) · Admission Procedures and Parental and Authorized Representative's Rights (d) At the time of acceptance of each child into care, the licensee shall provide the child's parent or authorized representative with a copy of the notice Family Child Care Home Notification of Parent's Rights, LIC 995A (8/06), the Caregiver Background Check Process, LIC 995E (6/05), and the Family child Care Consumer Awareness Information, LIC 9212 (10/05).

Deficient Practice Statement Based on observation 2 out of 3 files reviewed did not have LIC955A form in children files, the licensee did not comply with the section cited above in [2] out of [3] Parent Right form missing which poses a potential health, safety or personal rights risk to persons in care. POC Due Date: 10/20/2025

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102417(m)(3) · Operation of A Family Child Care Home (3) A file of affidavits signed by each parent with a child enrolled in the home. The affidavit shall state that the parent has been informed that the family child care home does not carry liability insurance or a bond according to standards established by the state.

Deficient Practice Statement Based on LPA asked Licensee if they have Liability Insurance, Per Licensee at 2:57pm informed LPA Calderon Liability Insurance in Nov 2025 will be dropped and they can't provide it at the moment due to they need to find the Liability Bond Form, Licensee stated to LPA Calderon needs the information for parents to sign the Affidavit Regarding Liability Insurance form, the licensee did not comply with the section cited above in [3] out of [3] no proof of Liability Insurance and no Affavidt form which poses a potential health, safety or personal rights risk to persons in care. POC Due Date: 10/20/2025

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102425(j)(2)(D)(c) · Infant Safe Sleep Documentation shall be maintained in the infant’s file and be available to the Department for review. Documentation shall include the following: Time of each 15-minute check

Deficient Practice Statement Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above in [count] out of [total count] [(objects) (persons)] [identifiers] which poses/posed a potential health, safety or personal rights risk to persons in care. POC Due Date:

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102419(d)(1) · Admission Procedures and Authorized Representatives Rights (d) At the time of acceptance of each child into care, the licensee shall provide the child's parent or authorized representative with a copy of the notice Family Child Care Home Notification of Parent's Rights, LIC 995A (8/06), the Caregiver Background Check Process, LIC 995E (6/05), and the Family child Care Consumer Awareness Information, LIC 9212 (10/05). (1) The licensee shall request the child's parent or authorized representative to sign and date the bottom portion of the notice form LIC 995A (8/06), which acknowledges that the parent or authorized representative has received and read the LIC 995A. The bottom portion of this form must be kept in the child’s file as proof that the parent or authorized representative has been notified of his or her rights and received a copy of the Caregiver background Check Process, LIC 995E (6/05), and the Family Child Care Consumer Awareness Information, LIC 9212 (10/05).

Deficient Practice Statement Based on LPA Calderon observation during record review child #1-#5 did not have LIC955A form in reocrds, the licensee did not comply with the section cited above in [5] out of [5] persons which poses a potential health, safety or personal rights risk to persons in care. POC Due Date: 07/31/2024

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102425(j)(2)(D)(c) · Infant Safe Sleep Documentation shall be maintained in the infant’s file and be available to the Department for review. Documentation shall include the following: Time of each 15-minute check

Deficient Practice Statement Based on observation during record review LPA Calderon did not 15 min sleep log for child #2, Licensee stated is not consistant with log for infants, the licensee did not comply with the section cited above in (1) out of (1) persons which poses/posed a potential health, safety or personal rights risk to persons in care. POC Due Date: 07/31/2024

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102416.1(d) · Personnel Records (d) All personnel records shall be maintained at the child care home and shall be available to the licensing agency for review.

Deficient Practice Statement Based on interview and record review, the licensee did not comply with the section cited above. Licensee stated that she currenlty has no staff files, which poses a potential health, safety or personal rights risk to persons in care. POC Due Date: 05/11/2023

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102417(g)(4) · Operation of A Family Child Care Home (g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (4) Poisons, detergents, cleaning compounds, medicines, firearms and other items which could pose a danger if readily available to children shall be stored where they are inaccessible to children.

Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above in LPAs observed cleaning compounds were accessible to children located in the garage and the kitchen. Photos were taken. This poses an immediate health, safety or personal rights risk to persons in care. POC Due Date: 04/11/2023

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102417(g)(1) · Operation of A Family Child Care Home (g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (1) Fireplaces and open face heaters shall be screened to prevent access by children. The home shall contain a fire extinguisher and smoke detector device which meet standards established by the State Fire Marshall.

Deficient Practice Statement Based on observation , the licensee did not comply with the section cited above. LPA observed the fire extinguisher in the living room had not been serviced since 2021, which Licensee confirmed during interview. This poses a potential safety risk to persons in care. POC Due Date: 04/25/2023

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102417(g)(3) · Operation of A Family Child Care Home (g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (3) Where children are less than five years old are in care, stairs shall be fenced or barricaded.

Deficient Practice Statement Based on observation , the licensee did not comply with the section cited above. LPAs both stairwells did have gates but were not secured. This poses a potential health, safety or personal rights risk to persons in care. POC Due Date: 04/25/2023

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102417(g)(10) · Operation of A Family Child Care Home (g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (10) A baby walker shall not be allowed on the premises of a family child care home in accordance with Health and Safety Code Sections 1596.846(b) and (c).

Deficient Practice Statement Based on observation and interview, the licensee did not comply with the section cited above. LPA observe a walker in the garage. LPA advise Licensee that walkers and saucer chairs is not safe and poses a potential health, safety or personal rights risk to persons in care. POC Due Date: 04/11/2023

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102421(a) · Child's Records (a) The licensee shall maintain, in each child's record, the signed and dated notice form required in Section 102419(d).

Deficient Practice Statement Based on interview and record review, the licensee did not comply with the section cited above. Children's files are missing (LIC) 282- Affidavit Regarding Liability Insurance, LIC 627- Consent for Medical Treatment, LIC 995A Notification of Parents’ Rights LIC 9227 poses a potential health, safety or personal rights risk to persons in care. POC Due Date: 05/11/2023

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