102425(j)(1) · Infant Safe Sleep The provider shall supervise infants while they are sleeping and adhere to the following requirements: The provider shall physically check on the infant every 15 minutes.

Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above. LPA did not observe licensee check on infants every 15 minutes which poses/posed a potential health, safety or personal rights risk to persons in care. POC Due Date: 06/16/2023

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

102418(g)(1) · Immunizations (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. (1) This requirement includes updating each child's PM 286 (6/95) when the child is due to receive required immunizations after enrollment in the family day care home.

Deficient Practice Statement Based on record review, the licensee did not comply with the section cited above. Child 1, 3 and 4 immunization records need to be updated which poses/posed a potential health, safety or personal rights risk to persons in care. POC Due Date: 06/16/2023

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

102417(g)(7) · Operation of A Family Child Care Home (7) An emergency information card shall be maintained for each child and shall include the child's full name, telephone number and location of a parent or other responsible adult to be contacted in an emergency, the name and telephone number of the child's physician and the parent's authorization for the licensee or registrant to consent to emergency medical care.

Deficient Practice Statement Based on record review, the licensee did not comply with the section cited above. Child 2 and 6 are missing LIC627 which poses/posed a potential health, safety or personal rights risk to persons in care. POC Due Date: 06/16/2023

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.

102417(g)(8) · Operation of A Family Child Care Home (8) Each family child care home shall have a current roster of children as specified in Health and Safety Code Section 1596.841.

Deficient Practice Statement Based on record review, the licensee did not comply with the section cited above. LPA did not observe a current roster of the children which poses/posed a potential health, safety or personal rights risk to persons in care. POC Due Date: 06/16/2023

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.

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. Child 2 and 10 are missing LIC995 which poses/posed a potential health, safety or personal rights risk to persons in care. POC Due Date: 06/16/2023

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

102425(j)(2)(D) · 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

Deficient Practice Statement Based on observation and interview, the licensee did not comply with the section cited above. Licensee did not have a Safe Sleep Log which poses/posed a potential health, safety or personal rights risk to persons in care. POC Due Date: 06/16/2023

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

102425(b)(1)(A) · Violation

There shall not be anything attached to the pacifier Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above. LPA observed two infants sleeping with a pacifier with a chord attached which poses/posed a potential health, safety or personal rights risk to persons in care. POC Due Date: 06/02/2023

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.