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25 | On May 30, 2023, Licensing Program Analyst (LPA), Kuliema Calloway made an unannounced case management inspection to the Perez Family Child Care. LPA met with Licensee who granted access. The purpose of the inspection was to inform the licensee that on 4/20/2023, there was an unusual incident that occurred where Child 1 sustained an injury while in care and the facility failed to report the incident to Community Care Licensing Division.
On 5/3/2023, LPA visited the facility and observed the off limits garage was being utilized for child care and Community Care Licensing was not notified prior to making the changes, the pertinent forms LIC 995A were inside the children’s files not signed by the parents, the outside play area has uneven, deteriorating wood, paint chippings on the wood, and no cushioning material underneath the slide which is at least five feet tall.
On 5/30/23, LPA reviewed staff files and S2 and S3 did not have the required immunizations (MMR, TDAP, TB) and required Mandated Reporter training completed in the staff files.
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Deficiency Type
POC Due Date /
Section Number | DEFICIENCIES | PLAN OF CORRECTIONS(POCs) |
Type B
06/09/2023
Section Cited
CCR
102416.2(b)(1)
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7 | 102416.2 (b)(1)The licensee...report to the Department...events as specified in Health/ Safety Code Sect . 1597.467(b)(1)(A) through (b)(1)(C) that occur during the operation of the family child care...(1) Medical treatment...This requirement was not met as evidenced by: | 1
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7 | Licensee will provide a written declaration to the Department that the regulations for Reporting Requirements were reviewed and staff was trained no later than POC date of 6/9/2023. |
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14 | Based on Interview and record review, Licensee did not report an injury that occurred inside the day care home with a day care child on 4/20/23, to the Department. Which poses a potential health, safety, or personal rights risks to the persons in care. | 8
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Type B
06/09/2023
Section Cited
CCR102416.3(a)(6)
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7 | 102416.3(a)(6)Prior to making alterations or... to a family child care home ... the licensee shall notify...Dept of changed... from an area ...previously identified as "off limits" ... where care and supervision ...provided to children...This requirement was not met as evidenced by:
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7 | The Licensee will provide the Department with a copy of an updated facility sketch showing the current off limit areas no later than POC date of 6/09/23.
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14 | Based on observation and interview LPA observed the off limits garage was modified to utilize child care without prior notification to the Department. Which poses a potential health, safety, or personal rights risk to the persons in care. | 8
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Deficiency Type
POC Due Date /
Section Number | DEFICIENCIES | PLAN OF CORRECTIONS(POCs) |
Type B
06/23/2023
Section Cited
CCR
102419(d)(1)
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7 | 102419(d)(1)At the time of acceptance of each child... the licensee shall provide the child's parent... LIC 995A...(1) licensee shall request the child's parent...sign and date the bottom portion of the notice form LIC 995A. ...This requirement was not met as evidenced by: | 1
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7 | Licensee must have all parents complete the required forms in their children's files and report to the Department with proof that this was done no later than POC date of 6/23/23. |
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14 | Based on observation, record review, and interviews LPA observed the forms in several of the children's files that are in care were blank and not completed nor signed by the parents/ representative of the child. Which poses a potential health, safety, or personal rights risks of the persons in care. | 8
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Type B
06/30/2023
Section Cited
CCR102417(d)
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7 | 102417(d) The home shall provide safe toys, play equipment and materials.
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7 | Licensee will repair the play area to even the surfaces, paint the wood and provide a cushioning material (surface) that will protect the children during play. LPA will inspect the area once it is completed no later than POC date of 6/30/23. |
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14 | Based on observation and interview. LPA observed the play area to have areas of uneven, deteriorating wood, paint chippings, & no cushion material underneath the slide that is five feet tall, which poses a potential health, safety, or personal rights risks to the persons in care. | 8
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Deficiency Type
POC Due Date /
Section Number | DEFICIENCIES | PLAN OF CORRECTIONS(POCs) |
Type B
06/09/2023
Section Cited
HSC
1597.622(a)(1)
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7 | 1597.622(a) (1) Commencing September 1, 2016, 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. ...This requirement was not met as evidenced by: | 1
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7 | Licensee will provide proof to the Department that all staff have the required immunizations to work in the day care home no later than POC date of 6/9/23. |
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14 | Based on record review and interview LPA did not observe the required immunizations for S2 and S3 in their staff files and they both interact with the day care children, which poses a potential health, safety, or personal rights risk for the persons in care. | 8
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