101221(b)(5) · Child's Records (b) Each record shall contain information including, but not limited to, the following: (5) Name, address and telephone number of the child's authorized representative and of relatives or others who can assume responsibility for the child if the authorized representative cannot be reached when necessary.

Deficient Practice Statement Based on record review, the licensee did not comply with the section cited above in that, Child 1 (C1) did not have LIC 700 completed in their file, which poses a potential health, safety or personal rights risk to persons in care. POC Due Date: 12/06/2024

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

101221(b)(8)(C) · Child's Records (b) Each record shall contain information including, but not limited to, the following: (8) Medical assessment, including ambulatory status as specified in Section 101220, and the following health information: (C) A signed consent form for emergency medical treatment unless the child's authorized representative has signed the statement specified in Section 101220(f).

Deficient Practice Statement Based on record review, the licensee did not comply with the section cited above in that, Child 1 (C1) did not have LIC 627 competed in their file, which poses a potential health, safety or personal rights risk to persons in care. POC Due Date: 12/06/2024