Exis Gonzalez Sivira Family Child Care

CCR 102417(g)(4) · Type B

(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (4) Poisons, detergents, cleaning compounds, medicines, firearms and other items which could pose a danger if readily available to children shall be stored where they are inaccessible to children. This requirement is not met as evidenced by: Based on observation, the licensee did not comply with the section cited above. LPA observed barricaded stairs in the home. LPA observed shampoo/conditioner and Pledge cleaning spray in the backyard accessible to children which poses/posed a potential health, safety or personal rights risk to persons in care.

CCR 102418(a) · Type B

(a) Prior to admission to a family day care home, children shall be immunized against diseases as required by the California Code of Regulations, Title 17, beginning with Section 6000. This requirement is not met as evidenced by: Based on record review, the licensee did not comply with the section cited above child 6 does not have immunization records on file which poses/posed a potential health, safety or personal rights risk to persons in care.

CCR 102418(g)(1) · Type B

(g) The licensee shall document each child's immunizations as required by the California Code of Regulations, Title 17, Section 6070, and shall maintain such documentation for as long as the child is enrolled. (1) This requirement includes updating each child's PM 286 (6/95) when the child is due to receive required immunizations after enrollment in the family day care home. This requirement is not met as evidenced by: Based on record review, the licensee did not comply with the section cited above. Child 2, 5, 7, and 9 immunization records need to be updated which poses/posed a potential health, safety or personal rights risk to persons in care.

CCR 102369(b)(9) · Type B

Evidence of a current tuberculosis clearance, not more than one year prior to or seven days after initial presence in the home, for any adult in the home during the time that children are under care. This requirement is not met as evidenced by: Based on interview and record review, the licensee did not comply with the section cited above. Staff 2 does not have a current tuberculosis test on file which poses/posed a potential health, safety or personal rights risk to persons in care.

CCR 102419(d)(1) · Type B

(d) At the time of acceptance of each child into care, the licensee shall provide the child's parent or authorized representative with a copy of the notice Family Child Care Home Notification of Parent's Rights, LIC 995A (8/06), the Caregiver Background Check Process, LIC 995E (6/05), and the Family child Care Consumer Awareness Information, LIC 9212 (10/05). (1) The licensee shall request the child's parent or authorized representative to sign and date the bottom portion of the notice form LIC 995A (8/06), which acknowledges that the parent or authorized representative has received and read the LIC 995A. The bottom portion of this form must be kept in the child’s file as proof that the parent or authorized representative has been notified of his or her rights and received a copy of the Caregiver background Check Process, LIC 995E (6/05), and the Family Child Care Consumer Awareness Information, LIC 9212 (10/05). This requirement is not met as evidenced by: Based on record review, the licensee did not comply with the section cited above. Child 7 is missing LIC995 which poses/posed a potential health, safety or personal rights risk to persons in care.

CCR 102417(g)(9)(A)1 · Type B

(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (9) Each family child care home shall have a written disaster plan of action prepared on a form approved by the Department. All children, age and ability permitting, and the provider, the assistant provider, and other members of the household, shall be instructed in their duties under the disaster plan. As their age and ability permit, newly enrolled children shall be informed promptly of their duties as required in the plan. (A) Each family child care home shall conduct fire drills and disaster drills at least once every six months. 1. The licensee shall document the drills, including the date and time of each drill. This documentation shall kept at the family child care home. This requirement is not met as evidenced by: Based on observation and interview, the licensee did not comply with the section cited above. LPA did not observed a current fire and disaster drill log. Licensee stated they completed drill 11/21/2023 but forgot to document. which poses/posed a potential health, safety or personal rights risk to persons in care.

HSC 1597.622(a)(1) · Type B

(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. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year. This requirement is not met as evidenced by: Based on record review, the licensee did not comply with the section cited above. LPA observed assistant Naomi is missing measles immunization. which poses/posed a potential health, safety or personal rights risk to persons in care.

CCR 102418(a) · Type B

(a) Prior to admission to a family day care home, children shall be immunized against diseases as required by the California Code of Regulations, Title 17, beginning with Section 6000. This requirement is not met as evidenced by: Based on record review, the licensee did not comply with the section cited above. Child 5, 10, and 11 are missing immunization records which poses/posed a potential health, safety or personal rights risk to persons in care.

CCR 102418(g)(1) · Type B

(g) The licensee shall document each child's immunizations as required by the California Code of Regulations, Title 17, Section 6070, and shall maintain such documentation for as long as the child is enrolled. (1) This requirement includes updating each child's PM 286 (6/95) when the child is due to receive required immunizations after enrollment in the family day care home. This requirement is not met as evidenced by: Based on record review, the licensee did not comply with the section cited above. Child 1, 3 and 7 immunization records need to be updated which poses/posed a potential health, safety or personal rights risk to persons in care.

CCR 102419(d) · Type B

(d) At the time of acceptance of each child into care, the licensee shall provide the child's parent or authorized representative with a copy of the notice Family Child Care Home Notification of Parent's Rights, LIC 995A (8/06), the Caregiver Background Check Process, LIC 995E (6/05), and the Family child Care Consumer Awareness Information, LIC 9212 (10/05). This requirement is not met as evidenced by: Based on record review, the licensee did not comply with the section cited above. Child 10 is missing LIC995 which poses/posed a potential health, safety or personal rights risk to persons in care.

CCR 102417(g)(8) · Type B

(8) Each family child care home shall have a current roster of children as specified in Health and Safety Code Section 1596.841. This requirement is not met as evidenced by: Based on record review, the licensee did not comply with the section cited above. LPA did not observed a current roster of the children which poses/posed a potential health, safety or personal rights risk to persons in care.