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

Licensee will document infnats sleep every 15 minutes and send documentation via email to LPA by POC date. Based on observation, interview, record review, the licensee did not comply with the section cited above in that 2 infant children's records did not contain a documentation of a physical check every 15 minutes while sleeping which poses a potential health, safety or personal rights risk to persons in care Betty Bell NAME OF LICENSING PROGRAM MANAGER: Jeanine Lipsey NAME OF LICENSING PROGRAM ANALYST: LICENSING PROGRAM ANALYST SIGNATURE: DATE: 07/22/2025 I acknowledge receipt of this form and understand my appeal rights as explained and received.