Landes, Shayna

102425(c)(2) · Infant Safe Sleep An Individual Infant Sleeping Plan [LIC 9227 (3/20)] shall be completed for each infant up to 12 months of age the provider has in care and included in the infant's file at the facility. The Individual Infant Sleeping Plan [LIC 9227 (3/20)] shall be maintained in the infant’s file and shall be available to the Department for review.

Deficient Practice Statement Based on record review, the licensee did not comply with the section cited above in which the Licensee did not file an individual sleeping plan in each of the children's file, which poses a potential health, safety or personal rights risk to persons in care. POC Due Date: 10/09/2024

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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 record review, the licensee did not comply with the section cited above in that the Licensee did not document 15 minute sleep sleep checks, which poses a potential health, safety or personal rights risk to persons in care. POC Due Date: 10/18/2024

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102417(g)(9)(A) · 1 (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. 1. The licensee shall document the drills, including the date and time of each drill. This documentation shall kept at the family child care home.

Deficient Practice Statement Based on observation and record review, the licensee did not comply with the section cited above in that the Licensee did not conduct and document current fire and disaster drills which poses a potential health, safety or personal rights risk to persons in care. POC Due Date: 10/09/2024

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101223(b)(1)(A) · (b) The center shall inform each child's authorized representative of the rights specified in (a) (1) through (8) above. (1) The center shall give each authorized representative a copy of the Personal Rights form (LIC 613A [9/96]). (A) Each authorized representative shall be asked to sign and date the acknowledgement-of-receipt statement at the bottom of the LIC 613A (9/96). This documentation shall be kept in the child's file.

Deficient Practice Statement Based on record review the licensee did not comply with the section cited above in which the children's file did not contain LIC613A which poses a potential health, safety or personal rights risk to persons in care. POC Due Date: 10/09/2024

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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 record review, the licensee did not comply with the section cited above in that the signed and dated receipt of the LIC995A form was missing from one child's file which poses a potential health, safety or personal rights risk to persons in care. POC Due Date: 07/08/2022

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