GANESAN, UMADEVI

Based on record review, licensee's Mandated Reporter Training is expired and Helper #1 has no proof that she completed the Mandated Reporter Training. This poses a potential risk to the health, safety or personal rights of children in care.

Resolution: Licensee states she and her helper will complete the Mandated Reporter Training and will submit certificates by 12/22/21.

Based on record review, Helper #1 is missing immunization in influenza or written statement declining the shot. This poses a potential risk to the health, safety or personal rights of children in care.

Resolution: Licensee states she will submit proof of immunization in influenza for Helper #1 by 11/29/21.

Based on record review, Helper #1 is missing a signed and dated Notice of Employee Rights (LIC 9052). This poses a potential risk to the health, safety or personal rights of children in care.

Resolution: Licensee states she will send a signed and dated LIC 9052 for her helper by 11/29/21.

Based on records review, Helper #1 is missing completed and signed Criminal Record Statement (LIC 508) in her file. This poses a potential risk to the health, safety or personal rights of children in care.

Resolution: Licensee states she will submit a completed LIC 508 for Helper #1 by 11/29/21.

Based on records review, Child #2 thru #5 are missing immunization records in their files. This poses a potential risk to the health, safety or personal rights of children in care.

Resolution: Licensee states she will ask parents to submit copies of children's immunization records and will submit a completed California School Immunization Record (PM 286/CDPH 286) for the four children by 12/22/21.

Based on LPA's observation and record review, Licensee's adult helper, Athira Pillai Vijayalakshmi, has been working in the home without fingerprint clearance. Athira worked in the home on the following dates: 11/15/21, 11/17/21, and 11/22/21. This poses an immediate risk to the health, safety or personal rights of children in care. Civil penalty of $300.00 was assessed during the inspection.

Resolution: Licensee states she will submit a written plan by 11/23/21 to ensure that an adult must obtain fingerprint clearance prior to working in the home. Upon receipt, licensee shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months.

Based on LPA's observation, food brought from home were not labeled with the child's name. This poses a potential risk to the health, safety or personal rights of children in care.

Resolution: Licensee states she will submit a written plan by 11/29/21 to ensure that all food or beverages brought from home will be labeled with the child's name.