102416.1(a)(10) · Personnel Records (a) Personnel records shall be maintained on each employee and shall contain the following information: (10) A signed and dated copy of the Notice of Employee Rights [LIC 9052, (Rev. 03/03)] as required by Section 102416(a) and Section 102417.

Deficient Practice Statement Based on record review, the licensee did not comply with the section cited above in 3 out of total 3 staff missing LIC 9052 form which poses/posed a potential health, safety or personal rights risk to persons in care. POC Due Date: 05/12/2026

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

102425(j)(2)(D)(a) · 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: Date.

Deficient Practice Statement Based on record review, the licensee did not comply with the section cited above in recording 15-minute check date 4/28/25 to 5/2/2025 which poses/posed a potential health, safety or personal rights risk to persons in care. POC Due Date: 05/09/2025

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.