DURAN, MARIA C.

Based on observation and interview, the licensee did not comply with the section cited above INFANT SAFE SLEEP (g) An infant’s head shall not be covered while sleeping. which poses an immediate health, safety or personal rights risk to persons in care.

Resolution: The licensee must ensure that infants are not completely covered from head to toe with a bedsheet or blanket during nap time. The licensee shall review the safe sleep regulations outlined in Title 22 and submit a written plan to ensure that all staff members are knowledgeable about safe infant sleep practices to prevent such incidents from happening again. A follow-up visit will be necessary to verify that the licensee has addressed the identified deficiency.

Based on record review, the licensee did not comply with the section cited above which poses/posed a potential health, safety or personal rights risk to persons in care.

Resolution: Licensee and staff will all ensure to have mandated reporter training completed and will send certificates to LPA by 5/28/25.

Based on interview and record review, the licensee did not comply with the section cited above which poses/posed a potential health, safety or personal rights risk to persons in care.

Resolution: Licensee will ensure all staff has proof of immunizations prior to employment and place in staff files and will send proof to LPA by 5/28/25.

Based on observation,interview and record review, the licensee did not comply with the section cited above, which poses/posed a potential health, safety or personal rights risk to persons in care.

Resolution: Licensee must not use any off limit areas during operating hours. If licensee plans to use any off limit areas licensee must notify licensing for approval before any changes can be made. Licensee must provide an acknowledgment of facility sketch signed and dated of all limit and off limit areas to LPA by 5/28/25.

At 2:50PM., Based on record review, interview and observations, LPA confirmed licensee operating over capacity with 12 children (6 infants) in care. This poses an immediate health and safety risk to children in care.

Resolution: Licensee will reduce infant-age children to required limit of 4, by the due date: 3/8/2024. Licensee will submit updated: LIC9040, Client Roster to the Department. Proof of correction will be submitted via email.

At 2:00PM., Based on record review, observations, and interview, LPA confirmed child’s file (C7) missing from facility records. This poses a potential health and safety risk to children in care.

Resolution: Licensee will ensure all children files, with required forms, are stored in facility records by the due date: 3/11/2024.

At 1:30PM., Based on observations, interview, and record review, LPA confirmed individual present (S3) without criminal record clearance or association. This poses an immediate health and safety risk to children in care.

Resolution: Licensee will ensure all assistant (S2) receive criminal record clearance and association by the due date: 3/8/2024. Proof of correction will be submitted to the Department via email.