XIAO FAMILY CHILD CARE

Based on the record review, the Licensee did not meet the above regulation which poses a potential health risk to the children in care. During the children’s file review the LPA was unable to review LIC 9150 Parent Notification Additional Children in Care

Resolution: Licensee agrees to obtain signed LIC 9150 for all children enrolled. Licensee agrees to submit LIC 9150 for C1, C2, C3, C4, C5 and C6 on or by the POC due date of 1-22-2026.

Based on the record review, the Licensee did not meet the above regulation which poses a potential health risk to the children in care. During the children’s file review the LPA was unable to review immunizations on a PM 286 form.

Resolution: Licensee understands the children’s immunizations must be transferred to the PM 286 form for all children enrolled. Licensee agrees to submit a completed PM 286 for C1, C2, C3, C4, C5 and C5 to the Department on or by POC due date of 1-22-2026.

Based on the record review, the Licensee did not meet the above regulation which poses a potential safety risk to the children in care. During the facility tour the LPA reviewed a roster that was not current.

Resolution: Licensee understands all children enrolled must be listed on the facility roster. Licensee corrected during inspection.

Based on the record review, the Licensee did not meet the above regulation which poses a potential health risk to the children in care. During the children’s file review the LPA was unable to review LIC 282 Affidavit Regarding Liability Insurance for Family Child Care Home. Licensee stated she has liability insurance but was unable to locate the documentation.

Resolution: Licensee agrees to obtain signed LIC 282 for all children enrolled. Licensee agrees to submit LIC 282 for C1, C2, C3, C4, C5 and C6 or a copy of the current liability policy on or by the POC due date of 1-22-2026.

Based on the observation and interview, the Licensee did not meet the above regulation which poses an immediate Health, Safety & Personal Rights risk to the children in care. Upon arrival there were 12 children present. At approximately 9:40AM three children were dropped off putting the Licensee over capacity with 15. The Licensee stated a child who does not regularly attend, showed up. The Licensee was over capacity for approximately 10 minutes.

Resolution: During the inspection one child was picked up. Licensee agrees to submit a written statement of understanding. The statement should include a plan to ensure she is always in compliance with the capacity. Statement is due on or by POC due date of 1-16-2026.

Based on the record review, the Licensee did not meet the above regulation which poses a potential health and safety risk to the children in care. During the staff review the LPA was unable to review a current EMSA approved CPR/1st Aid certificate.

Resolution: Licensee understands at least one staff present and working with the children must have a current EMSA approved CPR/1st Aid certificate on file. Licensee agrees to have S1 and S2 complete training and submit the certificate of completion to the Department on or by POC due date of 1-30-2026.

Based on the record review, the Licensee did not meet the above regulation which poses a potential health risk to the children in care. During the staff file review the LPA was unable to review a TB clearance for S2.

Resolution: Licensee understands all adults residing, working or volunteering in the home must have a TB clearance on file and available for review during the inspection. Licensee agrees to obtain proof od TB clearance and submit to the Department on or by POC due date of 1-22-2026.

Based on the record review, the Licensee did not meet the above regulation which poses a potential health risk to the children in care. During the children’s file review the LPA was unable to review immunizations for C1.

Resolution: Licensee understands all children must have immunizations prior to enrollment. Immunization records must be on file and available for review during the inspection. Licensee agrees to obtain immunization records for C1 and submit to the Department on or by the POC due date of 1-22-2026.

Based on record review, the Licensee did not meet the above regulation which poses a potential Health and Safety risk to the children in care. During the staff file review LPA was unable to review a current Mandated Reporter certificate for S1. The certificate on file expired 6-24-23.

Resolution: Licensee understands all staff providing supervision and care must have a current Mandated Reporter certificate on file. Licensee understands Mandated Reporter must be re taken every two years. Licensee agrees to complete training at www. Mandatedreporterca.com and submit the certificate of completion to the Department on or by 3/31/24.

Based on record review, the Licensee did not meet the above regulation which poses a potential Health risk to the children in care. During the staff file review LPA was unable to review immunizations for C1 and C3.

Resolution: Licensee understands all children enrolled must have current vaccinations on file and available for review. Licensee agrees to obtain immunizations for C1 and C3 and send to Department on or by 3/31/24.

Based on the observation, record review and, interview, the Licensee did not meet the above regulation which poses an immediate Health, Safety & Personal Rights risk to the children in care. During the facility tour LPA observed S2 providing supervision and care to the children enrolled, however, S2 is not associated to the facility. Licensee stated, “not yet” when asked for association documentation.

Resolution: Licensee understands all individuals shall have a Criminal Record Clearance and be associated to the facility prior to working, residing, or volunteering in a licensed facility. Licensee agrees to obtain a Criminal Record Clearance or submit a Criminal Background Clearance Transfer Request for S2 by 3/25/24. $500 assessed