Type A issued on 12/09/24 – Fire Safety Clearance

During the visit on 12/09/24 L1 made the stand alone building in the back yard, listed as “toddler room” inaccessible by key locking the door and updated the LIC999A Facility Sketch, marking the “toddler room” off-limits, due to a denied fire clearance stating the room was not a permitted structure, without permitted electrical. During today’s inspection, LPA's toured the stand alone building, the “toddler room” observing the room to be unlocked, but not in use by children. L1 and her assistant (S1) stated that adults have used the room for non-child care use, and that it has not been used for child care since the 12/10/24 visit. S1 locked the door. LPA Mohr confirmed that the room’s door was locked.

Type B issued on 12/09/24 – Sleeping infants shall be moved to a crib or play yard as soon as possible

L1’s 12/28/24 email stated that infant, C4 will be put in a pack & play to sleep. During today’s inspection, LPA requested more details as written in the Plan of Correction. L1 provided LPA with a written statement regarding infant C4’s sleeping environment during hours of operation. LPA observed C4 and one other infant (C6) in care during today’s inspection. C6 was observed sleeping in a crib during today’s inspection. C4 did not nap while LPA's were present.

Continue on LIC809-C

Type B issued on 12/09/24 – Supervise infants while they are sleeping

During today’s inspection L1 provided LPA with a written statement on how she will comply with the regulation to supervise infants. The statement included having the infants sleep in separate bedrooms in the home, stating that L1 will keep the door open enough to be able to visually observe the infants for signs of distress.

Type B issued on 12/09/24 – Document each child’s immunizations and maintain documentation

L1’s 12/28/24 email contained immunization records and completed documentation for children C1 and C5. The email contained a statement that L1 was working on obtaining a medical exemption for immunizations for C4. During today’s visit LPA reviewed with L1 what steps have been taken to obtain a medical exemption for C4 to date. L1 stated that she has successfully added her facility information to the CAIR-ME web site and is working with the Children’s Health Defense to work on an Medical Exemption. During today’s visit LPA provided L1 with document IMM-1363 (05/24) “Instructions to Request a Medical Exemption” and IMM-1466 (4/24) “Obtaining a Medical Exemption: Guide for Parents and Physicians” to provide to C4’s parent. LPA requested that L1 obtain a letter from C4’s physician stating that they will be providing an exemption through the CAIR-ME website. L1 stated the physician that C4 visited was unable to provide a letter stating an exemption would be granted.

Type B issued on 12/09/24 – Sleep Logs for infants in care, documenting infant’s name, date and time of each 15 minute sleep check

L1’s 12/28/24 email contained documentation of sleep logs for two infants C4 and a second infant (C6) not present during the 12/09/24 visit. C4 & C6’s sleep logs were dated 12/10/24 – 12/27/24. LPA cleared the citation, after receiving the logs on 12/28/24. During today’s inspection 2 infants (C4 and C6) were observed in care. LPA requested to review current sleep logs for C4 and C6. L1 provided LPA Strother with the current sleep logs for C4 and C6. LPA observed S1 conducting sleep checks and recording the checks on the log.

Continue on LIC809-C

Type B issued on 12/09/24 – Personal Rights, children’s right to receive safe, healthful, and comfortable accommodations, furnishings, and equipment.

L1 stated that C2 and C3, who were not infants, were not able to climb out of the pack n plays they were napping in because they wear sleep sacks. Pack n Play manufacturer instructions are to discontinue use of the equipment when a child is able to climb out or when a child is 35 inches in height. Based on LPA’s observation, C2 and C3 appeared to be 35 inches in height or greater. L1’s 12/28/24 email contained a statement that C2 and C3 will begin sleeping on sleep mats. LPA requested a more detailed statement. L1 provided a statement of her understanding of the limitations on the use of pack n plays, stating that she will follow the manufacturer requirements.

Exit interview conducted and report was reviewed with licensee, Carolyn Simons.

Notice of Site Visit shall be posted for 30 days from today's visit. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.