Di Ramos, Rassel Fcch

102417(a) Operation of a Family Child Care Home, The licensee shall be present in the home and shall ensure that children in care are supervised at all times..... Temporary absences shall not exceed 20 percent of the hours that the facility is providing care per day. Based on interviews LPA and LPM’s observation and Staff (S1 & S2) interviews, Licensee was temporary absence more than 20 percent of the hours that the facility is providing care per day, which poses a immediate health and safety risk to children in care.

102416.5(e) If no assistant provider is present at a Large Family Child Care Home, then the licensee shall comply with the capacity requirements for a Small Family Child Care Home as specified in subsections (b) and (c). Based on LPA observation and interview with S1, the licensee did not comply with the section above in that S1 was left alone with five infants and older children which poses a immediate health and safety risk to children in care.

(e) If no assistant provider is present at a Large Family Child Care Home, then the licensee shall comply with the capacity requirements for a Small Family Child Care Home as specified in subsections (b) and (c). Based on LPA observation and interview with S1, the licensee did not comply with the section above in that S1 was left alone with four infants and two children.

Inspection Authority of the Department — Based on observation and interview, the licensee did not comply with the section cited above in that S1 would not allow LPA to enter facility while children were in care to complete an inspection. LPA was denied entry for 17 minutes until LS came home. This poses an immediate health, safety or personal rights risk to persons in care.

Staffing Ratio and Capacity — Based on observation and interview, the licensee did not comply with the section cited above when LS was away from the facility, S1 was left with six infants and 2 preschool aged children which poses an immediate health, safety or personal rights risk to persons in care.

(a)Each child receiving services from a family child care home shall have certain rights that shall not be waived or abridged by the licensee regardless of consent or authorization from the child's authorized representatitve. These rights include, but are not limmited to, the following: ...(4)To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse, or other actions of a punitive nature, including, but not limited to: interference with...aids to physical functioning. Based on interviews LPA and LPM’s observation, upon arrival, two infants were observed to be restrained in port of cribs, in addition, at a later time, another infant was observed to be restrained in a port of cribs, which poses a potential health and safety risk to children in care.

(a) The licensee shall be present in the home and shall ensure that children in care are supervised at all times. When circumstances require the licensee to be temporarily absent from the home, the licensee shall arrange for a substitute adult to care for and supervise the children during his/her absence. Temporary absences shall not exceed 20 percent of the hours that the facility is providing care per day. Based on LPA observation and interview with S1 and S2, LS will be away from the facility for more than 20% of the operating hours. Facility did not comply with the section cited above. This poses a potential health, safety, or personal rights risk to the children in care.

(a) Each child receiving services from a family child care home shall have certain rights that shall not be waived or abridged by the licensee regardless of consent or authorization from the child's authorized representative. These rights include, but are not limited to, the following: ...(2) To receive safe, healthful, and comfortable accommodations, furnishings, and equipment. Based on observation, S2 did not comply with the section cited above by raising their voice and argueing with LPA in the presence of the children in care. This is a potential health, safety, or personal rights risk to the children in care.

Infant Safe Sleep — On 6/2/24, LPA observed three of five port-a-cribs being used withot a mattress. LS was given a POC of writing a statement on the importance of allowing children to lay on a mattress while using cribs. LS, S1, and S2 were all to sign and date this statement. This POC was not completed by the due date.

Infant Safe Sleep — Based on observation, the licensee did not comply with the ection cited above. On 6/2/26, LPA observed one infant asleep in a port-a-crib wrapped in a blanket and with a stuffed animal and a bottle in the crib. LPA observed three infants with bottles and toys in their crib. POC was not completed by the due date.

Infant Safe Sleep — Based on observation, the LS did not comply with the section cited above. On 6/2/26,LPA observed three of five mattresses for cribs hanging over the side of the crib while children were in the crib. POC was not completed by the due date.

Staff immunization — influenza, pertussis and measles — Based on record review, S1 did not provide proof of immunity to measles, pertussis, and a negative TB. This was partially corrected by providing proof of pertussis immunity.

(a)Each child receiving services from a family child care home shall have certain rights that shall not be waived or abridged by the licensee regardless of consent or authorization from the child's authorized representatitve. These rights include, but are not limmited to, the following: ...(4)To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse, or other actions of a punitive nature, including, but not limited to: interference with...aids to physical functioning. LPA observed two of five children who were utilizing the cribs climb out of the crib. LS stated they put them in the cribs to help keep control of them. LS agreed to provide training to all staff about never utilizing cribs as a sort of restraint for any reason. LS, S1, and S2 will sign and date acknowledgement of the training. This has not been corrected by the due date.

Infant Safe Sleep — Based on observation, the licensee did not comply with the section cited above. At 12pm, LPA observed five out of five port-a-cribs being used by children without sheets which poses/posed a potential health, safety or personal rights risk to persons in care.

Infant Safe Sleep — Based on observation, the licensee did not comply with the section cited above. At 12pm, LPA observed three of five port-a-cribs being used without a mattress.This poses/posed a potential health, safety or personal rights risk to persons in care. LPA observed three of five port-of-cribs being used without a mattress and children were laying/playing on flat wooden boards in the bottom of the cribs.

Infant Safe Sleep — Based on observation, the licensee did not comply with the section cited above. At 12pm, LPA observed one infant asleep in a port-a-crib wrapped in a blanket and with a stuffed animal and bottle in the crib. LPA observed three infants in the port-a-crib with bottles and toys. This poses/posed a potential health, safety or personal rights risk to persons in care.

Infant Safe Sleep — Based on observation, the licensee did not comply with the section cited above. At 12pm, LPA observed three of five mattresses for port-a-cribs hanging over the side of the crib while children were in the crib. This poses/posed a potential health, safety or personal rights risk to persons in care.

Mandated reporter training — Based on record review, the licensee did not comply with the section cited above in three out of three files (LS, S1-S2). Licensee was unable to provide proof of current Mandated Reporter Training Certificates which poses/posed a potential health, safety or personal rights risk to persons in care.

Staff immunization — influenza, pertussis and measles — Based on record review, the licensee did not comply with the section cited above in one out of three staff files (S1) by not furnishing proof of immunity to Measles, Pertussis, and a Negative TB test which poses/posed a potential health, safety or personal rights risk to persons in care.

Staff immunization — influenza, pertussis and measles — Based on record review, the licensee did not comply with the section cited above in one out of three staff files (S1) by not furnishing proof of influenza vaccination or influenza declination which poses/posed a potential health, safety or personal rights risk to persons in care.

Personal Rights — Based on observation, LPA observed three of five port-of-cribs being used and children were laying/playing on flat wooden boards in the bottom of the cribs, 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.

Personal Rights — Based on observation and interview, the licensee did not comply with the section cited above. LPA observed five children in port-a-cribs who were not sleeping. At 11:13am and 11:48am, LPA observed two of the five of the children climb in and out of the cribs. When LPA asked Licensee about the reasoning, LS stated it was to help keep control of them. This poses/posed a potential health, safety or personal rights risk to persons in care.

Family home — home free of safety hazards — Based on interview and record review,, the licensee did not comply with the section cited above in which the licensee has not conducted a fire drill within the last 6 months which poses/posed a potential health, safety or personal rights risk to persons in care.

Infant Safe Sleep — Based on interview and record review, the licensee did not comply with the section cited above in which C1 - C4 do not have 15 minute sleep checks, which poses/posed a potential health, safety or personal rights risk to persons in care.

Infant Safe Sleep — Based on interview andrecord review, the licensee did not comply with the section cited above in which C3 does not have and Individual Sleep Plan LIC9227, which poses/posed a potential health, safety or personal rights risk to persons in care.