Routine inspection·June 8, 2021

Licensing Program Analyst (LPA), Ryan Chan conducted an onsite inspection for the purpose of an Annual Random. LPA and teacher Ms. Erica Benavides toured the facility inside and outside and the floor and yard plan (LIC 999) were verified. The overall census observed was 2 staff and 6 infants. During the inspection it was determined the facility is operating within its licensed capacity and within compliance of staffing ratios. Facility hours are 7a.m.- 6p.m., Monday through Friday. A review of the Facility Personnel Report Summary on this date indicates all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. During the inspection of the indoor activity space, items which could pose a danger to children (detergents, cleaning compounds, and medications) were observed to be stored out of the reach of children. Poisons/Hazardous Items are not kept on the premises. Food is prepared on site; lunch and snacks are provided if parent does not provide milk or formula. Food prep areas were clean and sanitary. Food is properly stored. Menus were posted where they could be reviewed by parents. Floors, equipment, and furniture were clean and were observed to be in good repair and free of sharp edges. There is drinking water available to children indoors and outdoors provided by the licensee by cups and pitcher. The children's bathrooms are clean and sanitary. Infants sleep in cribs individually, bedding is stored individually and is taken home daily to be washed by parents. The facility has conducted an emergency drill within the past six months. The facility has a working carbon monoxide detector and fire extinguisher. Facility met all posting requirement. Staff files were reviewed for staff present during the facility inspection on this date, 2 out of 2 staff files were reviewed. Health screening and immunizations as required were reviewed. Beginning September 1, 2016, Health and Safety (H&S) 1597.622 states, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. Contined on page 2 Page 2 Proof of immunization against pertussis, measles for staff were reviewed, 1 of 2 staff did not have their immunization card on file and 2 of 2 staff did not have proof of influenza vaccine or a written declaration to decline influenza vaccine and was not in compliance. 1 of 2 staff did not have a Health Screening Report on file and was not in compliance. Beginning March 31, 2018, H&S Code 1596.8662 requires all directors and employees to complete mandated reporting training, and to renew the training every two years. Of the records reviewed, 2 of 5 staff did not have mandated reporter training and was not in compliance. At least one staff member present possesses current EMSA approved Pediatric CPR/First Aid certifications, which expires 08/2021. Ms. Benavides was informed that the Criminal Record Statement (LIC 508) has been updated, and the facility must now use the new form with revised date of 7/20. Ms. Benavides was also informed that the LIC 508 must be submitted with all Criminal Background Clearance Children's records were reviewed, and there was a separate, complete and current record for each child : A random sample of 3 infants files were reviewed for documentation of the child’s name, address, and telephone number of the child’s authorized representative and of relatives or others that can assume responsibility for the child if the authorized representative cannot be reached when necessary (LIC 700) and a medical assessment. Other forms reviewed were LIC 701 (Physician’s Report), LIC 702 (Child’s Preadmission Health History), LIC 627 (Consent for Emergency Medical Treatment) and were all in compliance. LPA observed 1 from 0-12 months of age, facility did not have form LIC 9227 Individual Infant Sleeping Plan in the child’s file which was not in compliance. Sign in/out procedure was reviewed for compliance. The person who signs the child in and out uses their full legal signature and records the time of the day. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. Continued on page 3 Page 3 The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm The outdoor activity space was inspected for compliance. The playground was enclosed by a fence at least four feet in height. The surface of the outdoor activity space was well maintained and free of hazards. Drinking water in the outdoor activity space is provided by cups and pitcher. The outdoor equipment and toys were in good repair and free of sharp edges. There are no bodies of water present at the facility. The facility grounds were safe, sanitary and in good repair. The facility representative was informed that Licensing Quarterly Updates are available at www.ccld.ca.gov facility representative may request to be added to an email list to receive a Quarterly Update by contacting the Child Care Advocate at childcareadvocatesprogram@dss.ca.gov or at www.ccld.ca.gov LPA provided Guardian Information and website info: https://www.cdss.ca.gov/inforesources/cdss-programs/community-care-licensing/caregiver-background-check/guardian Information on the additional nutrition training, immunization requirements for children, and Health Schools Act ( http://www.cdpr.ca.gov/docs/pestmgt/schoolipm.htm ) were provided. The facility representative was informed, and website given, about the California Child Care Disaster Plan has been posted to the UCSF California Childcare Health Program website: cchp.ucsf.edu/content/disaster-preparedness Also provided was information about the E-Learning Modules available at https://ccld.childcarevideos.org A copy of the California Department of Social Services Lead Information Brochure was explained and provided to the facility representative. Continued on page 4 Page 4 A copy of the 2016 “A Child Care Providers Guild to Safe Sleep” was provided to the facility representative . English: https//www.cdph.ca.gov/programs/SIDS/Documents/SIDSchildcaresafesleep.pdf AAP: https://www.healthychildren.org/English/ages-stages/baby/sleep/Pages/A-Parents-Guide-to-Safe-Sleep.aspx NIH: https://safetosleep.nichd.nih.gov/safesleepbasics/environment/room/text_alternative Safe to Sleep Campaign: https://safetosleep.nichd.nih.gov/materials · Always place infants on their backs for sleeping · Use only a tight-fitting sheet on the crib or play yard mattress · Do not hang any items from the crib or above the crib · Keep all items, including blankets, out of the crib or play yard · Pacifiers may be used as long as they do not have items attached to them · Infants should not be swaddled or have any items covering them while sleeping · The temperature of the room should be comfortable enough for an adult to wear a t-shirt and not be too hot or too cold A copy of the Provider Information Notice (PIN) 20-06-CCP Social and Physical Distancing Guidance and Healthy practices for childcare facilities in response to the global coronavirus (COVID-19) pandemic written in collaboration with the CA Department of Education. A copy of COVID-19 posters and Essential workers list. PIN 21-08-CCLD announces the resumption of on-site mandated regular inspections, also known as “annual inspections. Please post/keep this PIN in the facility/home where parents, authorized representatives, and children in care can easily access it and distribute the Companion Guide PIN Summary for Children in Care Fact Sheet (located at the end of the PIN) to their authorized representative. LPA provided facility representative a copy of the PIN. Based on LPAs r ecord reviews the following violation s were observed and are being cited in accordance with California Code of Regulations, Title 22, Division 12, Chapter 3, Section 101217(a)(11) and 101419.2(b)(2) are b eing cited on the attached LIC 809D. Health and Safety Code 1596.8662(b)91) and 1596.7995(a)(1) are also being cited on the attached LIC 809D. Continued on page 5 Page 5 101217 Personnel Records (a) The licensee shall ensure that personnel records are maintained on the licensee, administrator and each employee. Each personnel record shall contain the following information: (11) A health screening as specified in Section 101216(g). 1596.8662 Availability of information regarding detecting and reporting child abuse and neglect; training for mandated reporter who is licensed day care provider, administrator, or employee of a licensed child day care facility; proof of completion (b) (1)   On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training. 1596.7995 Employees or volunteers at day care center; immunization requirements; records; exemptions (a) (1) Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year. 101419.2 Infant Needs and Services Plan (b) The needs and services plan shall be in writing and shall include the following: (2) Infants up to 12 months of age shall have a completed Individual Infant Sleeping Plan [LIC 9227 (3/20)], which is incorporated by reference. Continued on page 6 Page 6 An Inspection and exit interview was completed with facility representative. The report was reviewed and discussed. Appeal Rights and deficiencies were discussed. The facility representative was provided a copy of their appeal rights (LIC 9058) and their signature on this form acknowledges receipt of these rights. All appeals must be in writing and received by the Regional Office within 15 business days The facility representative was informed that the “Notice of Site Visit” must be posted for 30 consecutive days. The “Notice of Site Visit” must be posted on or adjacent to the door. Failure to post will result in Civil Penalties of $100.00.