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 record review, the licensee did not comply with the section cited above. LPA was provided with a disaster drill log documenting the last drill was conducted on 06/19/25, which poses a potential health, safety or personal rights risk to persons in care. POC Due Date: 05/20/2026

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.

102417(a) · Operation of A Family Child Care Home (a) The licensee shall be present in the home and shall ensure that children in care are supervised at all times. When circumstances require the licensee to be temporarily absent from the home, the licensee shall arrange for a substitute adult to care for and supervise the children during his/her absence. Temporary absences shall not exceed 20 percent of the hours that the facility is providing care per day.

Deficient Practice Statement Based on observation and interview, the licensee did not comply with the section cited above. Two children C1 and C2 from two separate families were in care today, while Licensee was not present in the home and has not been present in the home since 05/03/26, which poses a potential health, safety or personal rights risk to persons in care. POC Due Date: 05/20/2026

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

102416.1(a)(10) · Personnel Records (a) Personnel records shall be maintained on each employee and shall contain the following information: (10) A signed and dated copy of the Notice of Employee Rights [LIC 9052, (Rev. 03/03)] as required by Section 102416(a) and Section 102417.

Deficient Practice Statement Based on interview S1 and S2 do not have access to staff files, the licensee did not comply with the section cited above in that files could not be provided during today's visit, which poses a potential health, safety or personal rights risk to persons in care. POC Due Date: 05/20/2026

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

102418(g) · 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.

Deficient Practice Statement Based on interview, the licensee did not comply with the section cited above in 2 out of 2 children's files (C1 & C2). Licensee stated the children's records are locked and not available to S1 and not available for review, which posed a potential health, safety or personal rights risk to persons in care. POC Due Date: 05/20/2026

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 interview, the licensee did not comply with the section cited above in 2 out of 2 children's files (C1 & C2). Licensee stated the children's records are locked and not available to S1 and not available for review, which posed a potential health, safety or personal rights risk to persons in care. POC Due Date: 05/20/2026

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 interview, the licensee did not comply with the section cited above in 2 out of 2 children's files (C1 & C2). Licensee stated the children's records are locked and not available to S1 and not available for review, which posed a potential health, safety or personal rights risk to persons in care. POC Due Date: 05/20/2026

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 interview, the licensee did not comply with the section cited above in 2 out of 2 children's files (C1 & C2). Licensee stated the children's records are locked and not available to S1 and not available for review, which posed a potential health, safety or personal rights risk to persons in care. POC Due Date: 05/20/2026

Open Not marked corrected in the state record

Category: ratio. 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 interview and record review, the licensee did not comply with the section cited above. S1 stated she did not have current sleep logs documenting the name of infant C1, the date and the time of each 15 minute check, which poses a potential health, safety or personal rights risk to persons in care. POC Due Date: 05/20/2026

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

102371(a) · Fire Safety Clearance (a) A fire safety clearance approved by the city or county fire department, the district providing fire protection services, or the State Fire Marshal shall be required for a large family child care home.

Licensee will submit a written statement of her understanding that the second floor of the home is not to be occupied by children in care at anytime and that she has reviewed the statement with all assistants working with children in care. Based on interview with A1 C2 and L1 the licensee did not comply with the section cited above, as daycare children were brought to the off-limits second floor of the home, which poses an immediate health, safety or personal rights risk to persons in care. Statement to be emailed to LPA Strother: amy.strother@dss.ca.gov. Melchisedeck Augustin NAME OF LICENSING PROGRAM MANAGER: Amy Strother NAME OF LICENSING PROGRAM ANALYST: LICENSING PROGRAM ANALYST SIGNATURE: DATE: 03/12/2026 I acknowledge receipt of this form and understand my appeal rights as explained and received.

Open Not marked corrected in the state record

Category: background checks. Open / not marked corrected.

102370(d)(1) · (d) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing, or volunteering in a licensed facility: (1) Obtain a California clearance or a criminal record exemption as required by the Department

The

Open Not marked corrected in the state record

Category: background checks. Open / not marked corrected.

102416.5(a) · (a)The capacity specified on the license shall be the maximum number of children for whom care may be provided at any one time.

Licensee stated she will submit a statement of correction. Licensee stated she will speak to her new understanding that the capacity is 14 children to include those in the home and those children she picks up from care to make up the total number of children. Based on interview, the licensee did not comply with the section cited above. L1 stated on 12/29/25 that she has had too many children once a month since August 2025 taking some children to stay with her husband at the park. A1 and C2 stated that children were taken upstairs when an inspector came to the home to hide being over capacity, which poses an immediate health, safety or personal rights risk to persons in care. LPA Strother: amy.strother@dss.ca.gov

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.

102423(a)(4) · (a)Each child receiving services from a family child care home shall have certain rights...not limited to,...: (4)To be free from corporal or unusual punishment, infliction of pain,... threat, mental abuse, or other actions of a punitive nature, including, but not limited to: interference with eating, sleeping or toileting; or withholding shelter, clothing, medication or aids to physical functioning.

I can not correct something that we didn't do, but I will submit a written statement about my understanding of children's personal rights. Based on interview, the licensee did not comply with the section cited above. S1 and S2 have on more than once occasion pulled on children or spanked children with a sandal or their hands, or threatened to call the police on the children which poses an immediate health, safety or personal rights risk to persons in care. LPA email: amy.strother@dss.ca.gov

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

102423(a)(2) · (a)Each child receiving services from a family child care home shall have certain rights that shall not be waived... These rights include, but are not limited to,...:(2)To receive safe, healthful, and comfortable accommodations, furnishings, and equipment.

I will submit a written statement of her understanding of children's personal rights to LPA Strother. Based on interview and record review, the licensee did not comply with the section cited above. Assistants S1 & S2 restrained at least one child, A4, age three+ to a portable crib as a form of discipline on more than one occasion, which poses an immediate Health, Safety or Personal Rights risk to children in care. Email: amy.strother@dss.ca.gov

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

102417(a) · (a)The licensee shall be present in the home and shall ensure that children in care are supervised at all times. When circumstances require the licensee to be temporarily absent from the home, the licensee shall arrange for a substitute adult to care for and supervise the children during his/her absence. Temporary absences shall not exceed 20 percent of the hours that the facility is providing care per day.

Licensee will submit her understanding of needing to close when she is away on vacation and will submit a daily schedule to include the times she is away from the home. Based on interview, the licensee did not comply with the section cited above when L1 was out of the country 10/09/25 to 10/13/25, when L1 is not present on weekends, and potentially during the week while driving to and from locations throughout the day for up to 4.5 hours, leaving children in care with S2 and/or S1, which poses a potential health, safety or personal rights risk to persons in care. LPA Strother's email: amy.strother@dss.ca.gov

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

102416.2(b)(3)(C) · (b)The licensee shall report to the Department any of the events as specified in Health and Safety…1597.467(b)(1)(A) through (b)(1)(C)… (3)… "A report shall be made to the Department…following the occurrence…of any of the following events: (C)Any unusual incident or child absence that threatens the physical or emotional health or safety of any child."

Licensee stated that she will submit a written statement of her understanding that she should first call law enforcement if the intoxicated person drives away from her facility and would then report any such incident to Licensing by the next business day, submitting a written report LIC624B within 7 days. Based on interview and record review, the licensee did not comply with the section cited above. The licensee did not submit a report to the Department when a parent arrived to the facility smelling of alcohol, which poses 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(b)(3) · 102425 INFANT SAFE SLEEP(b) Cribs or play yards shall be free from all loose articles and objects. (3) There shall be no objects hanging above or attached to the side of the crib.

L1 stated that she will submit a statement of her and her assistants understanding of the requirement to remove all items from infant play yards. At 3:12pm LPA observed infant C2 sleeping in a play yard that had a star mobile attached to it. Additionally a a blanket was observed draped over the side of the pack in play, which posed a potential health, safety risk to the infant in care. Send statement to LPA's email: amy.strother@dss.ca.gov by 11/03/25. Melchisedeck Augustin NAME OF LICENSING PROGRAM MANAGER: Amy Strother NAME OF LICENSING PROGRAM ANALYST: LICENSING PROGRAM ANALYST SIGNATURE: DATE: 10/30/2025 I acknowledge receipt of this form and understand my appeal rights as explained and received.

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

102423(a)(2) · (a)Each child receiving services from a family child care home shall have certain rights that shall not be waived or abridged by the licensee regardless of consent or authorization from the child's authorized representative. These rights include, but are not limited to, the following: (2)To receive safe, healthful, and comfortable accommodations, furnishings, and equipment.

L1 stated she will use the cots or crib mattresses on the floor for children over the age of two. L1 will submit a written statement of where children will be placed to sleep and how equipment will be used for it's intended purpose. Based on observation at 9:22am, child C3 was observed asleep on top of a train table, which posed a potential health, safety or personal rights risk to persons in care. Melchisedeck Augustin NAME OF LICENSING PROGRAM MANAGER: Amy Strother NAME OF LICENSING PROGRAM ANALYST: LICENSING PROGRAM ANALYST SIGNATURE: DATE: 07/17/2025 I acknowledge receipt of this form and understand my appeal rights as explained and received.

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 be 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.

Licensee removed the medicatioin from the bathroom during today's visit. Licensee stated she will submit a plan for preventing the storage of hazardous items in areas that are accessible to children. Based on observation at 9:39am there was over the counter medication, "advanced scar gel" accessible in the right side bathroom drawer. The medication had warnings regarding calling poison control if ingested, confirming that the item is hazardous to children, which poses an immediate health and safety and personal rights risk to the children in care.

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

102423(a)(2) · (a)Each child receiving services from a family child care home shall have certain rights that shall not be waived or abridged by the licensee regardless of consent or authorization from the child's authorized representative. These rights include, but are not limited to, the following: (2)To receive safe, healthful, and comfortable accommodations, furnishings, and equipment.

Licensee made the backyard off-limits during today's inspection and updated form LIC999A yard sketch listing the backyard as off limits, submitting to LPA Strohter. Licensee will submit a statement on how the backyard will remain inaccessible to children. Based on observation at 9:44am, the backyard had multiple hazards, including: unstable deck steps, loose fence boards, leaning privacy fencing coming loose from the main fence boards, adult size garden tools stored in the children's play house, broken plastic ride on toys with sharp edges, a broken wooden chair; missing a leg and the seat, a roll of wire fencing with sharp ends which poses an immediate health and safety and personal rights risk to the children in care. Melchisedeck Augustin NAME OF LICENSING PROGRAM MANAGER: Amy Strother NAME OF LICENSING PROGRAM ANALYST: LICENSING PROGRAM ANALYST SIGNATURE: DATE: 07/17/2025 I acknowledge receipt of this form and understand my appeal rights as explained and received.

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

102425(i) · If an infant falls asleep before being placed in a crib or play yard, the provider shall move the infant to a crib or play yard as soon as possible.

Licensee stated that she will submit a statement of her understanding that infants must be placed in a crib or play yard when observed to be asleep and the responsibility to educate her assistance of all infant safe sleep regulations. Based on observation at 10:51am, LPA observed infant C1 sleeping on a sofa chair, which poses an immediate health and safety and personal rights risk to the children in care. Melchisedeck Augustin NAME OF LICENSING PROGRAM MANAGER: Amy Strother NAME OF LICENSING PROGRAM ANALYST: LICENSING PROGRAM ANALYST SIGNATURE: DATE: 07/17/2025 I acknowledge receipt of this form and understand my appeal rights as explained and received.

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

102416.5(e) · (e) If no assistant provider is present at a Large Family Child Care Home, then the licensee shall comply with the capacity requirements for a Small Family Child Care Home as specified in subsections (b) and (c).

Licensee stated she will not leave the facility if there are more than 6 children present, unless she has two eligible assistants present. Licensee will send LPA Strother a written statement stating she will always be within ratio and how she wil meet the ratio requirement to LPA Strother. Email: amy.strother@dss.ca.gov Based on observation and interview, the licensee did not comply with the section cited above. Upon LPA's arrival the Licensee was not home and the assistant was supervising 11 children alone for approximately 33 minutes, which posed an immediate health, safety or personal rights risk to persons in care.

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

102417(g)(3) · (g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (3) Where children are less than five years old are in care, stairs shall be fenced or barricaded.

LPA pointed out the open gate at the base of the stairs to assistant S1 who came over to the stairs, acknowledged the gate was open and closed the gate. Licensee will provide LPA with a written statement on how she will ensure the gate to the stairs remains closed at all times during day care hours. Based on observation, at 12:51pm, the gate at the base of the homes stair case was open, which posed an immediate health, safety or personal rights risk to persons in care. Megan Aviles NAME OF LICENSING PROGRAM MANAGER: Amy Strother NAME OF LICENSING PROGRAM ANALYST: LICENSING PROGRAM ANALYST SIGNATURE: DATE: 03/28/2025 I acknowledge receipt of this form and understand my appeal rights as explained and received.

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

102423(a)(2) · (a)Each child receiving services from a family child care home shall have certain rights that shall not be waived or abridged by the licensee regardless of consent or authorization from the child's authorized representative. These rights include, but are not limited to, the following: (2) To receive safe, healthful, and comfortable accommodations, furnishings, and equipment.

Licensee stated she will submit a written plan on how to increase supervision and a plan to intervene and prevent unsafe behavior between children. LPA observed multiple occasions where children were engaging in unsafe behavior with other children and L1 and S1 did not step in to prevent the behavior, which poses an immediate health, safety or personal rights risk to persons in care. Megan Aviles NAME OF LICENSING PROGRAM MANAGER: Amy Strother NAME OF LICENSING PROGRAM ANALYST: LICENSING PROGRAM ANALYST SIGNATURE: DATE: 03/28/2025 I acknowledge receipt of this form and understand my appeal rights as explained and received.

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

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

Licensee brought her roster current during today's visit. Licensee will submit a written statement outlining her procedure for ensuring that the roster remains current when new children are enrolled. Based on observation, interview, record review, the Licensee produced a roster, form LIC 9040 that was not complete. The roster was missing three children that are currently enrolled, including one that was present during today’s visit, C2, which poses 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) · The provider shall supervise infants while they are sleeping and adhere to the following requirements: The provider shall check and document the following:(D)Documentation shall be maintained in the infant’s file and be available to the Department for review. Documentation shall include the following a. Date. b. Infant’s name. c. Time of each 15-minute check.

Licensee stated she will review the Infant Safe Sleep regulations and begin completing Sleep Logs for the infants enrolled beginning 03/29/25. Licensee will send completed Sleep Logs for infants C1, C9 and C11 for the week of 03/29/25 - 04/04/25 to LPA Strother. amy.strother@dss.ca.gov Based on record review and interview of Licensee, three infants were in care C1, C9 and C11 and Licensee was not completing sleep logs for any of the infants in care, including C1, C9 and C11, which poses a potential health, safety or personal rights risk to persons in care. Megan Aviles NAME OF LICENSING PROGRAM MANAGER: Amy Strother NAME OF LICENSING PROGRAM ANALYST: LICENSING PROGRAM ANALYST SIGNATURE: DATE: 03/28/2025 I acknowledge receipt of this form and understand my appeal rights as explained and received.

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

102416.1(a) · Personnel Records (a) Personnel records shall be maintained on each employee and shall contain the following information

Deficient Practice Statement Based on observation and interview, the licensee did not comply with the section cited above in 2 out of 2 assistants files. L1 did not have a complete file available for assistants S1 and S2 which poses a potential health, safety or personal rights risk to persons in care. POC Due Date: 12/31/2024

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

102423(a)(2) · (a)Each child receiving services from a family child care home shall have certain rights that shall not be waived or abridged by the licensee regardless of consent or authorization from the child's authorized representative. These rights include, but are not limited to, the following: (2) To receive safe, healthful, and comfortable accommodations, furnishings, and equipment.

Licensee will submit a written statement on how she will ensure supervision, redirection of children's undesired behavior to provide a safe environment by 11/26/24. Send via email to amy.strother.dss.ca.gov. Based on interview and record reviewed, on 06/08/22 C1 was recorded on video walking back and forth on top of a child size table for 27 seconds without an adult redirecting C1’s behavior, and then jumped onto a couch where another child was sitting. This poses an immediate health and safety and personal rights risk to the children in care.

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

102417(g)(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. This requirement has not been met as evidenced by Licensee will obtain forms LIC700, LIC627, LIC995A, LIC282 for C1-C4 and C6 from the parents/guardians of C1-C4 and C6 and have the completed files by the POC due date.

Based on interview, the licensee did not comply with the section cited above in 5 out of 6 children's files requested. Licensee does not have LIC700's on file for Child 1 – Child 4 and Child 6 (C1-C4 and C6) which poses a potential health, safety or personal rights risk to persons in care Files for C1-C4 and C6 are missing the following additional forms, LIC627, LIC995A, LIC282.

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

102418(a) · Prior to admission to a family day care home, children shall be immunized against diseases as required by the California Code of Regulations, Title 17, beginning with Section 6000. This requirement has not been met as evidenced by Licensee stated she would obtain record of C1-C6’s immunizations and transcribe onto form CDPH286, placing documentation of immunization records and CDPH286 by the POC due date.

Based on record review, the were no record of immunizations for children C1-C6 on file, which poses a potential health, safety or personal rights risk to persons in care SUPERVISOR'S NAME: Alexis Hollon

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

102423(a)(2) · 102423 Personal Rights (a) Each child receiving services from a family child care home shall have certain rights that shall not be waived or abridged by the licensee regardless of consent or authorization from the child's authorized representative. These rights include, but are not limited to, the following: (2) To receive safe, healthful, and comfortable accommodations, furnishings, and equipment. This requirement has not been met as evidenced by Licensee stated that she will use a toddler size mattress covered with a fitted sheet on the floor for children C1 and C7 to sleep on side by side together from now on. Licensee showed LPA the toddler mattress and fitted sheet that will be used during the visit.

Based on observations made by LPA on 05/15/24 at 2:07pm, the licensee placed two children, C1 and C7 in the same play yard to take a nap. Manufacturer warnings of a similar product state to stop using the product when a child reaches 35 inches in height, weighs more than 30 lbs or is able to climb out. C1 and C7 observed by LPA sleeping side by side in the same play yard weigh over 30 lbs combined, this poses a potential personal rights risk to the children in care SUPERVISOR'S NAME: Alexis Hollon

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

102425(i) · 102425 Infant Safe Sleep (i) If an infant falls asleep before being placed in a crib or play yard, the provider shall move the infant to a crib or play yard as soon as possible.

L1 provided LPA with a written statement, stating that she will no longer use the infant swings, removing them from her facility. L1 wrote in the statement that she understands that infants must be placed in a crib or play yard as soon as possible when sleeping. Based on interview and record review, an infant (C1) was observed sleeping in a swing on 12/07/23 for at least 32 minutes, which posed an immediate Health and Safety risk to the infant in care.

Open Not marked corrected in the state record

Category: health medication. 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 2 areas of the home. LPA observed the cabinets under the sink in the bathroom used by children were not locked and contained cleaning compounds. LPA observed Comet, Lysol spray and carpet cleaner under the sink. Additionally the "off-limits" garage door was unlocked and accessible to children in care. Although there is a child safety gate prior to the garage door, the gate was open and LPA observed child (C9) walk through the gate, past the garage door and into the family room. LPA observed cleaning products, lighters, cigars and an ashtray in the accessible garage, which poses an immediate health, safety or personal rights risk to persons in care. POC Due Date: 11/02/2023

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 interview and record review, the licensee did not comply with the section cited above in that although the licensee stated that the last drill was conducted on 05/10/23, the licensee was not able to produce documentation of drills conducted, which poses a potential health, safety or personal rights risk to persons in care. POC Due Date: 11/08/2023

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.

102425(b)(1)(A) · 102425 Infant Safe Sleep(b) Cribs or play yards shall be free from all loose articles and objects. (1) 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.

Licensee stated that she will post the "What does a safe sleep environment look like?" handout in the room where infants sleep as a visual aid and reminder that the play yard should only have a fitted sheet present in play yard. Based on LPA observation, at 2:48pm C1 was asleep on their back in the play yard. LPA observed that C1 had a pacifier in her mouth, the pacifier had a ribbon attached to it and a clip attached to C1's shirt, which poses a potential health and safety risk to the child in care. Licensee stated she will create a visual aide demonstrating pacifiers okay, but no pacifier clips and post it in the sleep environment. L1 will send photo of visual aides posted to LPA Strother at amy.strother@dss.ca.gov SUPERVISOR'S NAME: Alexis Hollon

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

102423(a)(1) · Personal Rights (a)Each child receiving services from a family child care home shall have certain rights that shall not be waived or abridged.... These rights include, but are not limited to, the following: (1)To be treated with dignity in his/her personal relationship with staff and other persons.

Licensee will complete a training called "The Pyramid Model Goes to Family Child Care Homes" that looks at how to work with challenging behavior and Promoting Social Emotional Competence in Infants and Young Children: https://challengingbehavior.org/webinar/the-pyramid-model-goes-to-family-child-care-homes/ . Based on interview, A1 stated that he will tightly hug a child so they don’t run into the metal screen door when they cry for their parent, which poses a potential Health and Safety or Personal Rights risk to children in care. Additionally L1 will write a statement on how to handle difficult situations with children without having physical contact with them. L1 stated that she understands that she needs to train her staff on how to meet the personal rights regulations. L1 will submit written statement to LPA Strother by 04/18/23 emailing it to amy.strother@dss.ca.gov

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

102425(i) · 102425 Infant Safe Sleep (i) If an infant falls asleep before being placed in a crib or play yard, the provider shall move the infant to a crib or play yard as soon as possible.

L1 stated that she will ensure that infants will be placed in a play yard once asleep. L1 stated that she is choosing to remove all of the infant swings from the facility and discontinue using them. L1 will write a procedure for how sleep routines will be conducted for infants in care that L1 and assistants will follow. Based on record review, one out of three infants observed in infant swings on 02/21/23 were asleep in a swing, which poses a potential Health and Safety risk to infants in care. Written procedure will be provided to LPA by 03/29/23 amy.strother@dss.ca.gov

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

102425(c) · 102425(c) An Individual Infant Sleeping Plan [LIC 9227 (3/20)] shall be completed for each infant up to 12 month of age the provider has in care and maintained at the facility in the infant’s file.

Licensee stated that she will ensure that a parent or guardian of C1-C4 and of any infants under 12 months enrolled in the future will complete the LIC 9227 to be kept in the infant's file. L1 will write a procedure for enrolling infants to include forms needed and when the forms will be obtained. Based on interview, Licensee stated that she does not have form LIC9227 for any of the infants (C1-C4) in care. This poses a potential health, safety or personal rights risk to persons in care. L1 will submit copies of LIC9227 for C1-C4 to LPA along with L1's procedure for enrolling infants into care. amy.strother@dss.ca.gov SUPERVISOR'S NAME: Alexis Hollon

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

102425(j)(2)(D) · The provider shall supervise infants while they are sleeping and adhere to the following requirements: The provider shall check and document the following:(D)Documentation shall be maintained in the infant’s file and be available to the Department for review. Documentation shall include the following a. Date. b. Infant’s name. c. Time of each 15-minute check.

Licensee stated she will continue to conduct sleep checks, visually checking on C1-C4 every 15 minutes, logging C1-C4's names, date and time of each check and keep logs on file for three years for any infants in care, including C1-C4. Based on interview and record review, Licensee stated that she only has sleep logs for C1-C4 for the week of 03/06/23 and does not have record of past sleep logs available for review. This poses a potential health, safety or personal rights risk to persons in care.

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

102417(g)(7) · (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.

Licensee will obtain forms LIC700, LIC627, LIC995A, LIC282, LIC9224 (providing report dated 08/11/22) and copies of immunization records to transcribe onto CDPH286 for C1, C2 and C4 from the parents/guardians of C1, C2 & C4 and have the completed files by 03/29/23. Based on interview, the licensee did not comply with the section cited above in 3 out of 4 children's files requested. Licensee does not have LIC700's on file for C1, C2 & C4 which poses a potential health, safety or personal rights risk to persons in care. Files for C1, C2 and C4 are missing the following additional forms, LIC627, LIC995A, LIC282, Immunization records and LIC9224 for Type A citations issued on 08/11/22. SUPERVISOR'S NAME: Alexis Hollon

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

102423(a)(2) · 102423 Personal Rights (a) Each child receiving services from a family child care home shall have certain rights that shall not be waived or abridged by the licensee regardless of consent or authorization from the child's authorized representative. These rights include, but are not limited to, the following: (2) To receive safe, healthful, and comfortable accommodations, furnishings, and equipment. L1 stated that swings will be used with non-mobile infants under 25 lbs. w/restraint system used each time an infant is placed in swing. L1 understand if an infant falls asleep in the swing they will be moved as soon as possible to a crib. L1 signed a statement to the above, stating she will train assistants.

based on observations and interviews, the licensee did not follow the swing manufacturers warnings or product information guide and placed multiple children in care (C1-C4), on more than one occasion in the swings that were either beyond the maximum weight of 25 lbs, active and able to climb out and/or did not use the restraint system. This poses a potential personal rights risk or health and safety risk to the children in care

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

102423(a)(2) · (a)Each child receiving services from a family child care home shall have certain rights that shall not be waived... These rights include, but are not limited to,...:(2)To receive safe, healthful, and comfortable accommodations, furnishings, and equipment.

Same as above. Additonally Licensee is reducing the facilities hours of operation and will submit an updated LIC279, with the purpose of reducing providers stress level. Based on interviews the Licensee and assistants restrained children to a highchair as a form of disipline on more than one occasion, which poses an immediate Health, Safety or Personal Rights risk to children in care.

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.

102423(a)(4) · (a)Each child receiving services from a family child care home shall have certain rights that shall not be waived...not limited to, the following:(4)To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse, or other actions of a punitive nature...

Licensee and assistants will sign a statement that they have read and understand the Personal Rights Title 22 Regulations and will sign a statement agreeing to complete a training and train staff on the following: Personal Rights, Trauma Informed Care and Self-Care using the following materials provided in an email from LPA Strother: Based on interviews A3 hit C1 with a water bottle and a blanket while in care which poses an immediate Health, Safety or Personal Rights risk to children in care. Videos: Children’s Personal Rights in Child Care, Trauma, Brain and Relationship: Helping Children Heal, The "life-changing" story Oprah reports this week, Child Development Core Story, Part 2: Serve and Return and Self Care: What It Really Is. Read & Review: Child Trauma Toolkit for Educators. Read, Review & Do: Early Childhood Mental Health Consultation – Taking Care of Ourselves Once training has been completed by 08/12/22, submit a photo of a signed and dated statement that you and your assistants have been trained on Personal Rights, Trauma Informed Care and Self-Care concepts.

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

102425(i) · 102425 Infant Safe Sleep (i) If an infant falls asleep before being placed in a crib or play yard, the provider shall move the infant to a crib or play yard as soon as possible.

Licensee (L1) stated she will read and review the infant safe sleep regulations with assistants S1 and S2. L1 will submit a copy of the infant safe sleep regulations with a statement that they have been read and understood, signed and dated by L1, S1 and S2. LPA observed infant C1, to be asleep in an infant swing located in the living room, which poses a potential Health and Safety risk to children in care.

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

102425(b) · (b) Cribs or play yards shall be free from all loose articles and objects.

Licensee (L1) stated she will read and review the infant safe sleep regulations with assistants S1 and S2. L1 will submit a copy of the infant safe sleep regulations with a statement that they have been read and understood, signed and dated by L1, S1 and S2. LPA observed infant C1, to be placed in a pack n play that contained a blanket and a pillow, which poses a potential Health and Safety risk to children in care. SUPERVISOR'S NAME: Alexis Hollon

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

102425(i) · 102425 Infant Safe Sleep (i) If an infant falls asleep before being placed in a crib or play yard, the provider shall move the infant to a crib or play yard as soon as possible.

L1 will write an action plan to include having pack and plays set up prior to placing infants in swings, will no longer attach blankets onto swings and will move infants or other children from swings onto cots or pack and plays once asleep. L1 and 2 assistance will sign and date the action plan to be provided to LPA Strother. LPA observed 3 out 10 children (C1-C3) were observed to be asleep in infant swings located in the living room, C2 is an infant. This poses a potential Health and Safety risk to children in care. SUPERVISOR'S NAME: Alexis Hollon

Open Not marked corrected in the state record

Category: supervision. 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. At 10:04am LPA observed the bathroom cabinet below sink was accessible to children. The cabinet contained jugs of bleach, hand snaitizer, carpet cleaner and other various products used for cleaning. which poses an immediate health, safety or personal rights risk to persons in care. POC Due Date: 12/09/2021

Open Not marked corrected in the state record

Category: ratio. 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 interview and record review, the licensee did not comply with the section cited above. Licensee has three infants enrolled, Child 1-3 (C1-C3) and does not have a sleep log on file for C1-C3 which poses a potential health, safety or personal rights risk to persons in care. POC Due Date: 12/13/2021

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

102417(d) · Violation

Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above. The trampoline accessible to children in the backyard has cracked plastic around the base of the trampoline and the fabric covering the springs was observed to be torn and worn away in many areas around the equipment which poses a potential health, safety or personal rights risk to persons in care. POC Due Date: 12/13/2021

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.