PEREZ, EMILIO FCCH

Based on record review and interview at 1:45pm, L1 has not conducted a fire drill in the last 6 months. Last drill was conducted 01/07/2025, which poses a potential health, safety or personal rights risk to persons in care.

Resolution: Licensee stated that he will conduct a disaster drill and submit documentation with the date the drill was conducted, as well as a written statement on a plan for ensuring drills are conducted every 6 months. Licensee will submit documentation to LPA Strother at email: amy.strother@dss.ca.gov

Based on record review, L1's Mandated Reporter training expired 09/2025 and assistant S1's Mandated Reporter training expired 10/2024. Based on interview with L1 at 2:00pm, L1 and S1 have not updated their training since the certificates on file were issued, which poses a potential health, safety or personal rights risk to persons in care.

Resolution: Licensee stated that he and S1 will complete the training and submit proof to LPA Strother as well as a written statement on a plan for ensuring training is completed every two years. Licensee will submit documentation to LPA Strother at email: amy.strother@dss.ca.gov

Based on interview, the licensee did not comply with the section cited above. Assistant (S1) stated that L1 is not present on Tuesday, Wednesday and Thursday from 9:00am - 1:30pm (4.5 hours). The facilities days/hours of operation listed on file are from 6:00am - 8:00pm, M-F. L1's absences are exceeding the 20% of the hours that the facility is providing care per day which poses a potential health, safety or personal rights risk to persons in care.

Resolution: Licensee will submit a schedule of hours that he will be present in the home for each day of the week the facility is operating and update the days/hours of operation using form LIC279, if needed to LPA Strother by 09/19/2023.

Based on record review, the licensee did not comply with the section cited above in one out of two staff files reviewed. S1 did not have proof of completing the Mandated Reporter Training which poses a potential health, safety or personal rights risk to persons in care.

Resolution: Licensee will obtain a current Mandated Reporter Training certificate from S1 and also provide a copy of the Licensee's current certificate to LPA Strother by 09/19/2023. amy.strother@dss.ca.gov

Based on interview and record review, the licensee did not comply with the section cited above in. No staff present had a current pediatric first aid/CPR certificate which poses a potential health, safety or personal rights risk to persons in care.

Resolution: Licensee will ensure that one person present in the facility at all times will have a current pediatric first aid/CPR certificate. Licensee will have S1 and/or S2 complete the in person, EMSA approved training if the licensee will not be present in the home. Proof of training or proof of registration for training to be sent to LPA Strother by 09/19/23.

Based on interview and record review, the licensee did not comply with the section cited above in one out of three staff working at the facility during today's visit. S2 did not have their criminal record clearance associated to the Licensee's facility, which poses an immediate health, safety or personal rights risk to persons in care.

Resolution: S2 left the facility during LPA's visit. Assistant (S1) stated that she will inform the Licensee (L1) that he needs to have S2's clearance transferred to his facility and will do so by submitting form LIC9182 to the Santa Rosa Regional office general email: cclrpregionalofficegeneral@dss.ca.gov by 08/30/23.

Based on record review, the licensee did not comply with the section cited above in five out of five children's files reviewed. C1-C5 did not have proof of immunization or current immunizations on file and did not have form CDPH 286 onl file, which poses/posed a potential health, safety or personal rights risk to persons in care.

Resolution: Licensee will write a statement that he will not except children into care without proof of current immunization records. Licensee will submit proof of C1-C5's current immunizations to LPA Strother to include a copy of the immunization record and form CDPH 286 filled out by Licensee for C1-C5. Licensee will also submit a written plan for his enrollment procedures to include obtaining children's immunization records and verifying the required immunizations for each child on form CDPH286 prior to to the child's first day in care.

Based on record review, the licensee did not comply with the section cited above in 5 out of 5 children's files. C1-C5 did not have a signed copy of LIC282 on file and does not have a current liability insurance policy on file, which poses a potential health, safety or personal rights risk to persons in care.

Resolution: Licensee will submit proof of form LIC282 on file for children C1-C5 and a written statement on Licensee's plan for obtaining form LIC282 at the time of enrollment by 09/19/23.

Based on record review, the licensee did not comply with the section cited above in 1 out of 1 infant under 12 months files. C1, an infant under 12 months did not have form LIC9227 on file which poses a potential health, safety or personal rights risk to persons in care.

Resolution: Licensee will have C1's parent or authorized representative fill out form LIC9227 by 08/30/23 and put in C1's file, submitting proof that C1's LIC9227 has been completed to LPA Strother by 09/19/23.

Based on interview and record review, the licensee did not comply with the section cited above in one staff, (S3) did not have proof of immunity to Measles, Pertussis, Influenza (or statement declining influenza) or a TB clearance on file, which poses/posed a potential health, safety or personal rights risk to persons in care.

Resolution: Licensee will obtain proof of immunity to Measles, Pertussis, Influenza and a TB clearance form S3, prior to working in the home. Proof will be submitted to LPA Strother by 09/19/23.

Based on interview with S1 and record review, the licensee did not comply with the section cited above in that the last disaster drill was recorded 06/15/2022 and S1 was unclear when they last conducted a disaster drill which poses a potential health, safety or personal rights risk to persons in care.

Resolution: Licensee will conduct a disaster drill with the children and submit proof of the drill recorded on the drill log with date and time of drill to LPA Strother at amy.strother@dss.ca.gov by 09/19/23.