• Type A

  102425(b) · 102425 INFANT SAFE SLEEP (b) Cribs or play yards shall be free from all loose articles and objects. This regulation was not met as evidenced by: LPAs observed an infant napping in a ... The Licensee removed the blanket from the Pack 'N Play. The Licensee will read the Safe Sleep packet provided by the LPAs. The Licensee will sign the bottom of the packet indicating that the packet was reviewed and send a photo to LPA Tedlos. ...Pack 'N Play with a blanket. This poses an immediate health, safety, or personal rights risk to children in care. Karyn Guerra NAME OF LICENSING PROGRAM MANAGER Jennie Tedlos NAME OF LICENSING PROGRAM ANALYST LICENSING PROGRAM ANALYST SIGNATURE DATE 05/21/2026 I acknowledge receipt of this form and understand my appeal rights as explained and received.

  Open Not marked corrected in the state record

  Category: health medication. Open / not marked corrected.

• Type B

  102416.2(a)(2) · 102416.2 Reporting Requirements (a) The licensee shall report the following information the Department by telephone or fax within the Department's next business day...(2) Any change in household composition including adults moving in or out of the home and anyone living in the home... Licensee completed LIC 279 and LIC 279B during the inspection. LPA cleared the deficiency and provided a clearance letter during the inspection. ... who reaches his or her 18th birthday. This regulation was not met as evidenced by: LPAs learned that there was a new adult resident living in the home and Licensing was not notified. This poses a potential health, safety, or personal rights risk to children in care. Karyn Guerra NAME OF LICENSING PROGRAM MANAGER Jennie Tedlos NAME OF LICENSING PROGRAM ANALYST LICENSING PROGRAM ANALYST SIGNATURE DATE 05/21/2026 I acknowledge receipt of this form and understand my appeal rights as explained and received.

Disposition: Unsubstantiated