KELLY FAMILY CHILD CARE

Based on interview and record review, the licensee did not comply with the section cited above as LPA observed that C2 was missing proof of the Consent For Emergency Medical Treatment form (LIC627) and LPA observed that C2's Identification And Emergency Information form (LIC700) was missing a signature which poses a potential health, safety or personal rights risk to persons in care.

Resolution: Licensee agrees to have C2’s authorized representative complete the LIC627 and the LIC700. Licensee agrees to maintain proof at the facility. Licensee agrees to send proof of the Plan of Correction (POC) to Community Care Licensing (CCL) by the end of the business day on the POC due date of 10/13/2025.

Based on interview and record review, the licensee did not comply with the section cited above as LPA observed that C2 and C5 were missing proof of the 15 minute sleep checks which poses a potential health, safety or personal rights risk to persons in care.

Resolution: Licensee agrees to document 15 minute sleep checks for C2, C5, and all infants enrolled in care. Licensee agrees to send proof of the 15 minute sleep checks for C2 and C5 to Community Care Licensing (CCL) by the end of the business day on the Plan of Correction (POC) due date of 10/13/2025.

Based on interview and record review, the licensee did not comply with the section cited above as LPA observed that C2 and C5 were missing proof of the Parent Notification Additional Children in Care (LIC9150) which poses a potential health, safety or personal rights risk to persons in care.

Resolution: Licensee agrees to have C2 and C5's authorized representatives sign and complete the LIC9150. Licensee agrees to send proof of the Plan of Correction (POC) to Community Care Licensing (CCL) by the end of the business day on the POC due date of 10/13/2025.

Based on observation and interview, the licensee did not comply with the section cited above as LPA observed several poisons/toxins in the Laundry room which is an area that is not key locked which poses a potential health, safety or personal rights risk to persons in care.

Resolution: Licensee agrees to ensure all poisons/toxins are placed in an area that is key locked. Licensee agrees to submit a written plan of action on how compliance will be maintained with the cited regulation. Licensee agrees to submit proof of the Plan of Correction (POC) to Community Care Licensing (CCL) by the end of the business day on the POC due date of 10/13/2025.

Based on interview and record review, the licensee did not comply with the section cited above as LPA observed that C2 and C5 were missing proof of the Family Child Care - Notification Of Parents' Rights (LIC995A) which poses a potential health, safety or personal rights risk to persons in care.

Resolution: Licensee agrees to have C2 and C5’s authorized representative complete the LIC995A and maintain proof at the facility. Licensee agrees to send proof of the Plan of Correction (POC) to Community Care Licensing (CCL) by the end of the business day on the POC due date of 10/13/2025.

Based on interview and record review, the licensee did not comply with the section cited above as LPA observed that S1 was missing proof of the required immunizations which poses a potential health, safety or personal rights risk to persons in care.

Resolution: Licensee agrees to have S1 submit proof of MMR, pertussis, and influenza vaccines as well as proof of a TB screening. Licensee agrees to send proof of the Plan of Correction (POC) to Community Care Licensing (CCL) by the end of the business day on the POC due date of 06/19/2024.

Based on interview and record review, the licensee did not comply with the section cited above as LPA observed that Licensee did not have a fire/disaster drill log and Licensee stated they have not done a fire/disaster drill in the last six months which poses a potential health, safety or personal rights risk to persons in care.

Resolution: Licensee agrees to conduct and record a fire/disaster drill. Licensee agrees to send proof of the Plan of Correction (POC) to Community Care Licensing (CCL) by the end of the business day on the POC due date of 06/19/2024.