102417(g)(9) · (g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (9) Each family child care home shall have a written disaster plan of action prepared on a form approved by the Department.

Licensee agrees to complete LIC610 and to post it by the parent area or phone by 11/22/23. Licensee agrees to submit a copy of LIC610 to LPA Jimenez by 11/22/23 via email to Martina.Jimenez@dss.ca.gov Based on observation, the licensee did not comply with the section cited above due to the facility not having an emergency disaster plan available in the home for review which poses/posed a potential health, safety or personal rights risk to persons in care.

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

102417(g)(4) · (g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (4) Poisons, detergents, cleaning compounds, medicines, firearms and other items which could pose a danger if readily available to children shall Licensee shall submit a written statement on how licensee will prevent future incidents, to CCLD by 11/22/2023, via email: Martina.Jimenez@dss.ca.gov be stored where they are inaccessible to children. LPA observed the laundry closet located in the day-care room unsecured upon arrival. LPA observed disinfecting wipes on the floor in the day-care room accessible to child in care. which poses/posed a potential health, safety or personal rights risk to persons in care. SUPERVISOR'S NAME Maria Mueller

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

102417(g)(9)(A)(1) · (A) Each family child care home shall conduct fire drills and disaster drills at least once every six months. 1. The licensee shall document the drills, including the date and time of each drill. This documentation shall kept at the family child care home. Licensee agrees to conduct an emergency drill by 11/22/23 and submit written proof to LPA Jimenez by 11/22/23 via email at Martina.Jimenez@dss.ca.gov

Based on observation and record review, the licensee did not comply with the section cited above in that the Licensee reported not conducting or documenting emergency drill logs which poses/posed a potential health, safety or personal rights risk to persons in care

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

102425(j)(2)(D)(c) · 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.

Based on observation and Licensee submit a written statement on how licensee will prevent future incidents to CCLD by 11/22/23, via email: Martina.Jimenez@dss.ca.gov Licensee will start document 15 minute checks for every infant that is enrolled in the facility. record review, the licensee did not comply with the section cited above in that Licensee is not checking or documenting very 15 minutes when an infant is sleeping which poses/posed a potential health, safety or personal rights risk to persons in care. SUPERVISOR'S NAME: Maria Mueller

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

102425(b)(1)(A) · Pacifiers shall be allowed in the crib or play yard if the following provisions are in place (A)There shall not be anything attached to the pacifier.

Based on LPAs observation of the pacifier with an attached stuff animal Licensee will submit a written statement on how licensee will prevent future incident to CCLD by 11/22/23, via email: Martina.Jimenez@dss.ca.gov which poses/posed a potential health, safety or personal rights risk to persons in care. SUPERVISOR'S NAME: Maria Mueller

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

102425(f) · An infant shall not be swaddled while in care.

Upon arrival LPA observed C1 swaddled in the crib, which poses/posed a potential health, safety or personal rights risk to persons in care Licensee shall submit a written statement on how licensee will prevent future incidents, to CCLD by 11/22/2023, via email: Martina.Jimenez@dss.ca.gov SUPERVISOR'S NAME: Maria Mueller

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

102417(g)(1) · Operation of A Family Child Care Home (g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (1) Fireplaces and open face heaters shall be screened to prevent access by children. The home shall contain a fire extinguisher and smoke detector device which meet standards established by the State Fire Marshall.

Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above in the fire extinguisher in the facility was purchased on 4/9/20 which poses/posed a potential health, safety or personal rights risk to persons in care. POC Due Date: 09/13/2022

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.

102417(g)(4) · Operation of A Family Child Care Home (g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (4) Poisons, detergents, cleaning compounds, medicines, firearms and other items which could pose a danger if readily available to children shall be stored where they are inaccessible to children.

Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above in that LPA observed propane tank in the outdoor play yard, BBQ with another propane tank attached, spray paint and paint bottles, and broken equipment accessible to children in the outdoor yard which poses/posed a potential health, safety or personal rights risk to persons in care. POC Due Date: 09/13/2022

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.

102417(g)(9) · Operation of A Family Child Care Home (g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (9) Each family child care home shall have a written disaster plan of action prepared on a form approved by the Department. All children, age and ability permitting, and the provider, the assistant provider, and other members of the household, shall be instructed in their duties under the disaster plan. As their age and ability permit, newly enrolled children shall be informed promptly of their duties as required in the plan.

Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above due to the facility not having an emergency disaster plan available in the home for review which poses/posed a potential health, safety or personal rights risk to persons in care. POC Due Date: 09/13/2022

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.

102417(g)(9)(A) · 1 Operation of A Family Child Care Home (g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (9) Each family child care home shall have a written disaster plan of action prepared on a form approved by the Department. All children, age and ability permitting, and the provider, the assistant provider, and other members of the household, shall be instructed in their duties under the disaster plan. As their age and ability permit, newly enrolled children shall be informed promptly of their duties as required in the plan. (A) Each family child care home shall conduct fire drills and disaster drills at least once every six months. 1. The licensee shall document the drills, including the date and time of each drill. This documentation shall kept at the family child care home.

Deficient Practice Statement Based on observation and record review, the licensee did not comply with the section cited above in that the Licensee reported not conducting or documenting emergency drill logs which poses/posed a potential health, safety or personal rights risk to persons in care. POC Due Date: 09/13/2022

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.

102425(j)(2)(B) · Infant Safe Sleep The provider shall supervise infants while they are sleeping and adhere to the following requirements: The provider shall check and document the following: Signs of distress which includes but is not limited to flushed skin color, increase in body temperature and restlessness.

Deficient Practice Statement Based on observation and record review, the licensee did not comply with the section cited above in that Licensee is not checking or documenting very 15 minutes when an infant is sleeping which poses/posed a potential health, safety or personal rights risk to persons in care. POC Due Date: 09/13/2022

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

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, the licensee did not comply with the section cited above in a bedroom identified as off-limits is now used as a napping room. Licensee stated that this change was not reported to our office which poses/posed a potential health, safety or personal rights risk to persons in care. POC Due Date: 09/13/2022

Open Not marked corrected in the state record

Category: supervision. 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 observation and record review, the licensee did not comply with the section cited above in that out of the three (3) infants present, Licensee only had one (1) emergency card which poses/posed a potential health, safety or personal rights risk to persons in care. POC Due Date: 09/13/2022

Open Not marked corrected in the state record

Category: ratio. 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 observation and record review, the licensee did not comply with the section cited above in there are no immunization records for the three (3) infants present during this inspection which poses/posed a potential health, safety or personal rights risk to persons in care. POC Due Date: 09/13/2022

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

102421(b) · Child's Records (b) The licensee shall maintain, in each child's record, a copy of the emergency information card as required in Section 102417(g)(7).

Deficient Practice Statement Based on observation and record review, the licensee did not comply with the section cited above in that there are no children files with necessary documentation available for review which poses/posed a potential health, safety or personal rights risk to persons in care. POC Due Date: 09/13/2022

Open Not marked corrected in the state record

Category: health medication. 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 observation and record review, the licensee did not comply with the section cited above in the facility does not have a current and up to date facility roster which poses/posed a potential health, safety or personal rights risk to persons in care. POC Due Date: 09/13/2022

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 observation and record review, the licensee did not comply with the section cited above in none of the children present had a child file with LIC995A signed and on record which poses/posed a potential health, safety or personal rights risk to persons in care. POC Due Date: 09/13/2022

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

102417(m)(3) · Operation of A Family Child Care Home (3) A file of affidavits signed by each parent with a child enrolled in the home. The affidavit shall state that the parent has been informed that the family child care home does not carry liability insurance or a bond according to standards established by the state.

Deficient Practice Statement Based on observation and record review, the licensee did not comply with the section cited above in that no children present have signed affidavits from parent/guardian regarding facility not carrying liability insurance which poses/posed a potential health, safety or personal rights risk to persons in care. POC Due Date: 09/13/2022

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.

102425(j)(2)(D)(c) · 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

Deficient Practice Statement Based on observation and record review, the licensee did not comply with the section cited above in that the Licensee is not checking on napping infants every 15 minutes and is not documenting the checks which poses/posed a potential health, safety or personal rights risk to persons in care. POC Due Date: 09/13/2022

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.