ALAWAD, ABDULRAHMAN FAMILY CHILD CARE

Based on observation and record review, the licensee did not comply with the section cited above in 1 out of 1 personnell records which posed a potential health, safety or personal rights risk to persons in care.

Resolution: Licensee states he create a personnel file with all pertinent information for his assistant and submit to the LPA by 01/12/2026.

Based on observation record review, the licensee did not comply with the section cited above in 2 out of 2 staff not completing the mandated reporter training which poses a potential health, safety or personal rights risk to persons in care.

Resolution: Licensee states he and his assistant will take the Mandated Reporter training and submit a copy of the certificate of completion to the LPA by 01/12/2026.

Based on observations, record reviewes and Licensee's statement, the licensee did not comply with the section cited above in that eight out of eight children do not have an emergency information card, which poses as a potential health, safety or personal rights risk to children in care.

Resolution: LPA provided Licensee with one (1) blank LIC 700 form. Licensee said he will have parents complete, date and sign a LIC 700 form for the children; it will be one completed LIC 700 form for each child. Licensee stated he will provide these completed forms to the Department no later than 08/18/2023.

Based on observation, record review and Licensee's statement, the licensee did not comply with the section cited above in there is no facility roster, which poses as a potential health, safety or personal rights risk to children in care.

Resolution: LPA provided Licensee with a blank LIC 9040 Childcare Facility Rostee form. Licensee said he will comlete the LIC 9040 and provide to the Department no later than 08/18/2023.

Based on observations, record review and Licensee's statement, the licensee did not comply with the section cited above in eight out of eight children did not have a completed LIC 995A form in their daycare file, which poses as a potential health, safety or personal rights risk to persons in care.

Resolution: LPA provided Licensee with a blank LIC 995A Notification of Parents Rights form. Licensee said he will have the parents complete, date and sign this form. Licensee said he will provided the completed, dated LIC 995A forms, signed by the parents, to the Department no later than 08/18/2023.

Based on observation, record reviews and Licensee's statement, the licensee did not comply with the section cited above in eight out of eight children did not have a LIC 282 form signed by their parents, which poses as a potential health, safety or personal rights risk to persons in care.

Resolution: LPA provided Licensee with a blank LIC 282 "Affidavit Regarding Liability Insurance for a Family Child Care Home" form. Licensee said he will have the parents complete, date and sign the LIC 282 form before providing to the Department no later than 08/18/2023.