Li, Feng Juan

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 observation, the licensee did not comply with the section cited above in 2 pack and plays do not have the appropriate tight fitted sheet which poses/posed a potential health, safety or personal rights risk to persons in care. POC Due Date: 08/16/2024

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102416.3(a)(6) · Alterations to Existing Building or Grounds (a) Prior to making alterations or additions to a family child care home or grounds, the licensee shall notify the Department of the proposed changed, including, but not limited to, the following: (6) Any change from an area of the family child care home previously identified as "off limits" to an area where care and supervision will be provided to children in care.

Deficient Practice Statement Based on observation, interview and record review, the licensee did not comply with the section cited above in providing care to an off limits area without notifying Licensing which poses/posed a potential health, safety or personal rights risk to persons in care. POC Due Date: 08/16/2024

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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 1 out of 5 children were missing the LIC995 in their file which poses/posed a potential health, safety or personal rights risk to persons in care. POC Due Date: 08/16/2024

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102369(b)(9) · Evidence of a current tuberculosis clearance, not more than one year prior to or seven days after initial presence in the home, for any adult in the home during the time that children are under care.

Deficient Practice Statement Based on interview and record review, the licensee did not comply with the section cited above in Licensee's brother does not have a current TB clearance on file prior to moving in the the Family Child Care Home which poses/posed a potential health, safety or personal rights risk to persons in care. POC Due Date: 08/16/2024

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101418(g) · (g) The licensee shall document each child's immunizations as required by the California Code of Regulations, Title 17, Section 6070, and shall maintain such documentation for as long as the child is enrolled. Licensee will obtain immunization records for both children and submit copy to LPA Pringle.

Through record review it was found that two infants in care were missing immunization records which poses a potential risk to the health and safety of the children in care SUPERVISOR'S NAME: Jason Jang

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