101419.2(b)(2)(a) · 101419.2 Infant Needs and Services Plan (b) The needs and services plan shall be in writing and shall include the following 2) Infants up to 12 months of age shall have a completed Individual Infant Sleeping Plan [LIC 9227 (3/20)], which is incorporated by reference. (A) This plan shall be signed and dated by the infant’s authorized representative. Licensee will complete the LIC 9227 with the parent of each infant that is currently enrolled (0-12mos) Licensee will submit copies of the signed forms to community care licensing by 2/12/26.

a review of records which revealed infants 0 to 12 months old do not have the LIC 9227 individual infant sleeping plan in file Monica Mathur NAME OF LICENSING PROGRAM MANAGER: Tasha Hackett-Alexander NAME OF LICENSING PROGRAM ANALYST: LICENSING PROGRAM ANALYST SIGNATURE: DATE: 02/05/2026 I acknowledge receipt of this form and understand my appeal rights as explained and received.

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.