102423(a)(4) · Personal Rights (a)(4) Each child receiving services...have certain rights...To be free from…actions of a punitive nature, including, but not limited to: interference with eating, sleeping or toileting…This regulation was not met by.... Technical Support Program brochure was provided and Supervising Children in Care and Children’s Personal Rights videos on the Department of Social Services website. Licensee self reported that Child #1 exhibited sings of fatigue including dozing off multiple times in the morning, and the child was not offered a place to rest prior to the incident, which is an immediate health and safety risk to the children in care. Licensee will offer a place to rest and call parents to see if their child is not feeling well, did not get enough rest or anything else. Licensee will continue to get a verbal report from the parents regarding their childrens' physical status. Licensee will submit a statement saying she followed the plan of correction. Bettina Engelman NAME OF LICENSING PROGRAM MANAGER Corina Beckby NAME OF LICENSING PROGRAM ANALYST LICENSING PROGRAM ANALYST SIGNATURE DATE 12/01/2025 I acknowledge receipt of this form and understand my appeal rights as explained and received.

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

102417(g)(9)(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: (9) Each family child care home shall have a written disaster plan of action prepared on a form approved by the Department. All children, age and ability permitting, and the provider, the assistant provider, and other members of the household, shall be instructed in their duties under the disaster plan. As their age and ability permit, newly enrolled children shall be informed promptly of their duties as required in the plan. (A) Each family child care home shall conduct fire drills and disaster drills at least once every six months.

Deficient Practice Statement Based on record review, the licensee did not comply with the section cited above in that she has not conducted a fire drill since 04/24, which poses/posed a potential health, safety or personal rights risk to persons in care. POC Due Date: 07/18/2025

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.

102416(c) · 102416(c) Personnel Requirements... other personnel as specified shall complete training... including pediatric cardiopulmonary resuscitation and pediatric first aid, pursuant to Health and Safety Code Section 1596.866. Licensee will write a statement stating she will no longer leave the facility during daycare hours when daycare children are present and/or will have mom take CPR class. Licensee will send CPR certificate if and when mom finishes course.

Based on file review, the licensee did not comply with the section cited above, where 2 of the 2 assistants are not CPR certified, which poses an immediatel health, safety or personal rights risk to persons in care Licensee will send CPR certificate if and when mom finishes course. SUPERVISOR'S NAME: Bettina Engelman

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

101212(d)(1)(2)(B) · ...a report shall be made to the Department... within the Department's next working day... Any injury to any child that requires medical treatment...a written report shall be submitted to the department within seven days...

LPA provided Licensee Form 624B in Chinese for future events. Licensee stated they will report to CCLD within 24 hours and submit the physical UIR within 7 days. Licensee was given the general email for UIR submitting: CCLPSAC@DSS.CA.GOV Based on record review and interview, CCLD did not receive notification of the unusual incidents that occurred, requiring medical attention, within 24 hours of the event happening. This poses a potential health, safety, or personal rights risk to children in care. Licensee will submit UIR's for 2 incidents that occurred in September and October of 2023.

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

102416.6(b)(3) · (b)For a Small Family Child Care Home, the maximum number of children for whom care may be provided at any one time...shall be one of the following(3) More than six and up to eight children...only if the criteria in Section 1597.44 of the Health and Safety Code are met. Licensee will show proof of disenrolled families to comply with regulations by POC, LPA will return to ensure compliance.

Based on observation and file review, the licensee did not comply with the section cited above, caring for 8 preschool children (2 being infants), which poses an immediatel health, safety or personal rights risk to persons in care

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

102421(b) · 102412(b) Children's Records (b) The licensee shall maintain, in each child's record, a copy of the emergency information card as required in Section 102417(g)(7).

Licensee will collect all required forms and documents from all families enrolled and future families. Licensee will maintain a file for each child and keep it for record review for up to three years. Based on interview and file review, 8 of 8 children's files were missing Medical Consent forms, Liability Forms, and/or Parent's Rights, which poses a potential Healh, Safety and/or Personal Rights risk to persons in care. SUPERVISOR'S NAME: Bettina Engelman

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.