1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32 | Page 4, Continued from Page 3
Documents/Information to be updated and returned to the Licensing Office;
- Personnel Report (LIC 500)
- Designation of Administrative Responsibility (LIC 308)
- Administrative Organization (LIC 309)
- Fire Drill Log
- Children’s Roster (LIC 9040)
In the areas that were evaluated, Deficiencies were observed of the California Code of Regulations, Title 22, Division 12 at the time of the visit.
Based on LPA records reviewed, 6 of 8 children, Child# 3, 4, 5, 6, 7 and Child #8 were missing on file the California School Immunization Record (CDPH 286). The following violation was observed and is being cited in accordance with California Code of Regulations, Title 22, Division 12, and Section:101220.1(g) Immunization's, is being cited on the attached LIC 809D.
Based on LPA records reviewed, 3 of 8 children, Child# 1,5 and Child# 6 were missing on file Physician Report (LIC 701). The following violation was observed is being cited in accordance with California Code of Regulations, Title 22, Division 12, and Section: 101221(b)(8) Children’s Records, is being cited on the attached LIC 809D.
Based on LPA Staff records reviewed, all 3 Staff and Director, are missing on file Mandated Reporter Training Certificate of Completion. Per Staff# 4 verbal disclosure, does not recall completing Mandated Reporter Training Online. The following violation was observed and is being cited in accordance with California Code of Regulations, Title 22, Health and Safety:1596.8662(b)(1), Mandated Reporter Training, is being cited on the attached LIC 809D.
An exit interview was completed with Facility Representative: Charlene Meneses. 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. |