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People, policies & environment
Director
Rodriguez, Adela Baca
Licensee
Rodriguez, Adela Baca
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Based on five children's (C1-C5) records reviewed at 9:33am which revealed C1 was missing LIC 627 and Immunization Record (IR) and IR not transcribed onto the CDPH 286, C4 was missing IR, and C5’s CDPH 286 was incomplete. 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.
A correction plan is recorded. No state verification date is shown.
Recorded plan of correction
The Licensee stated she would provide parents with missing licensing forms, obtain parent's signatures on the forms, obtain the children's Immunization Records (IR), and transcribe IR onto the blue CDPH 286.
Standard 102418(g)(1) · Immunizations
State severity
Type B
Corrected at visit
Not recorded
Correction due
Dec 19, 2022
Technical assistance
Not recorded
Finding source ID
ca:483002086:2022-12-09:102418(g)(1):1
Visit source ID
ca:483002086:2022-12-09:inspection
Criminal Record Clearance
Critical
Based on LPA's interview with LS which confirmed A1 moved into the home in September 2022 and A1 resided in the home for more than five days. The licensee did not comply with the section cited above which poses an immediate health, safety or personal rights risk to persons in care. An immediate $500 Civil Penalty was assessed due to LS not complying with criminal record clearance requirement.
A correction plan is recorded. No state verification date is shown.
Recorded plan of correction
The Licensee instructed A1 to get Livescan and Licensee submitted A1's completed LIC 9163 LPA, prior to LPA's departure. The Licensee stated in the future, she would ensure all adult(s) obtain an approved criminal record clearance prior to working or residing in the home.
Standard 102370(d) · Criminal Record Clearance
State severity
Type A
Corrected at visit
Not recorded
Correction due
Dec 10, 2022
Technical assistance
Not recorded
Finding source ID
ca:483002086:2022-12-09:102370(d):1
Visit source ID
ca:483002086:2022-12-09:inspection
Operation of A Family Child Care Home
Minor
Based on a review of the Licensee's disaster drill log which revealed the facility had not conducted an emergency disaster drill within the past six months. 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.
A correction plan is recorded. No state verification date is shown.
Recorded plan of correction
The Licensee stated she would conduct an emergency disaster drill, document the details of the drill on a log, complete the LIC 9098, and submit the drill log and completed LIC 9098 to the Department by 12/23/22 via mail, email or fax. Email: melchisedeck.augustin@dss.ca.gov & Fax: 707-588-5099.
Standard 102417(g)(9)(A)1 · Operation of A Family Child Care Home
State severity
Type B
Corrected at visit
Not recorded
Correction due
Dec 23, 2022
Technical assistance
Not recorded
Finding source ID
ca:483002086:2022-12-09:102417(g)(9)(A)1:1
Visit source ID
ca:483002086:2022-12-09:inspection
Standard 102369(b)(9)
Minor
Based on the Licensee's statement confirming A1 had not obtained evidence of negative TB clearance. 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.
A correction plan is recorded. No state verification date is shown.
Recorded plan of correction
The Licensee stated she would ensure that A1 obtain evidence of negative TB clearance and Licensee would submit evidence of A1's negative TB clearance to the Department by 12/23/22 via mail, email or fax. Email: melchisedeck.augustin@dss.ca.gov & Fax: 707-588-5099.
Standard 102369(b)(9)
State severity
Type B
Corrected at visit
Not recorded
Correction due
Dec 23, 2022
Technical assistance
Not recorded
Finding source ID
ca:483002086:2022-12-09:102369(b)(9):1
Visit source ID
ca:483002086:2022-12-09:inspection
Reporting Requirements
Minor
Based on LPA's interview with Licensee which revealed A1 moved into the home in September 2022, however; Licensee did not submit an updated LIC 279 to notify the Department. 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.
A correction plan is recorded. No state verification date is shown.
Recorded plan of correction
The Licensee stated she would complete and submit an updated application to the Department by 12/23/22 via mail. Santa Rosa Regional Office, 1450 Neotomas Avenue, Suite 100, Santa Rosa, CA, 95405.
Standard 102416.2(a)(2) · Reporting Requirements
State severity
Type B
Corrected at visit
Not recorded
Correction due
Dec 23, 2022
Technical assistance
Not recorded
Finding source ID
ca:483002086:2022-12-09:102416.2(a)(2):1
Visit source ID
ca:483002086:2022-12-09:inspection
Infant Safe Sleep
Minor
Based on the Licensee not furnishing evidence to prove she conducted 15 minute checks while C1 napped. 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.
A correction plan is recorded. No state verification date is shown.
Recorded plan of correction
The Licensee stated she would document 14 days worth of 15 minute checks on an Infant Sleep Log as well as complete an LIC 9098, and submit the complete Infant Sleep Log along with completed LIC 9098 to the Department by 12/23/22 via mail, email or fax. Email: melchisedeck.augustin@dss.ca.gov & Fax: 707-588-5099
Standard 102425(j)(2) · Infant Safe Sleep
State severity
Type B
Corrected at visit
Not recorded
Correction due
Dec 23, 2022
Technical assistance
Not recorded
Finding source ID
ca:483002086:2022-12-09:102425(j)(2):1
Visit source ID
ca:483002086:2022-12-09:inspection
Administration of Child Day Care Licensing
Serious
Based on the Licensee not furnishing a current AB 1207 Mandated Reporter Training certificate. The licensee did not comply with the section cited above in which poses/posed a potential health, safety or personal rights risk to persons in care.
A correction plan is recorded. No state verification date is shown.
Recorded plan of correction
The Licensee stated she would complete the online AB 1207 Mandated Reporter Training module at mandatedreporterca.com, and Licensee intends to submit a copy of her AB 1207 Mandated Reporter Training and General Training certificates to the Department by 01/23/20 via mail, email or fax. Email: melchisedeck.augustin@dss.ca.gov & Fax: 707-588-5099
Standard 1596.8662(b)(1) · Administration of Child Day Care Licensing
State severity
Type B
Corrected at visit
Not recorded
Correction due
Jan 23, 2023
Technical assistance
Not recorded
Finding source ID
ca:483002086:2022-12-09:1596.8662(b)(1):1
Visit source ID
ca:483002086:2022-12-09:inspection
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State records and provider information have separate sources. Provider claims do not establish independently verified care quality. Missing data is not evidence of an issue-free record.