Mc Donald Learning Center · 1017 Holden Avenue, Infant Center, Big Bear City

101416.5(b): There shall be a ratio of one teacher for every four infants in attendance. This requirements was not met as evidence by: 1 Per Licensee, the Center will know how many children will be in care and the facility will be staffed to meet the ratio. A staff training will be completed a copy of the training sign in sheet will be provided to the Department. The Center was within ratio by 08:08am. Based on LPA observation, the Licensee did not ensure a ratio of one teacher to every four infant infants in attendance was being met when at 7:50am, S1 was alone and supervising five awake infants. This poses an immediate risk to the health and safety of persons in care. 8

101416.5 (b) Staff-Infant Ratio: There shall be a ratio of one teacher for every four infants in attendance. This requirements was not met as evidence by: 1 Per facility representative, a plan will be submitted to the Department by the close of business on 10.31.24 to address how the Center will maintain the staff to infant ratios. Based on LPA observation, the Licensee did not ensure a ratio of one teacher to every four infant when S1 was alone and supervising seven awake infants. This poses an immediate risk to the health and safety of persons in care. 8

Based on record review, and interviews, the licensee did not ensure, infant care aides (S1 and S2) were working under direct supervision of a fully qualified teacher on 3/21/24. This poses an immediate risk to the health and safety of persons in care.

Based on LPAs observation, record review, interviews, S1 and S2 were working as infant aides in the infant room. S1 and S2 were not being supervised by director, assistant director or fully qualified teacher. This poses a potential risk to the health and safety of persons in care.

Based on record review, the licensee did not comply with the section cited above in three of four staff files (S1, S2, S3) reviewed did not complete the renewal of the mandated reporter training every two years as required, which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on record review, the licensee did not comply with the section cited above in three of out of five infant files review did not have the needs and service plans updated at least quarterly or as often as necessary. Needs and Service plans were being completed every four to six months, which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on record review, the licensee did not comply with the section cited above in two of five infant files reviewed did not have documentation of their immunizations, which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on LPAs observation and record review on November 22, 2022, S2 was working as an infant aide in the infant room. S2 was working under S1, who is not a director, assistant director or a fully qualified teacher. This poses a potential risk to the health and safety of persons in care.

Based on LPA observation, interview and record review, the licensee did not comply with the section cited above in when Child 1 (C1) an infant under 12 months was observed by LPA to be sleeping on their stomach inside a crib for approximately 15 minutes. Staff 1 (S1) did not return C1 to their back for sleeping. C1 did not have a LIC 9227 on file. This poses an immediate health, safety or personal rights risk to persons in care.

Based on LPA record review, the licensee did not comply with the section cited above when at the time of the inspection the Center did not have at least one staff member who had an in-person pediatric CPR and pediatric first aid certification. All staff present had current online CPR/First aid training which did not meet the Health and Safety Code. This poses/posed a potential health, safety or personal rights risk to persons in care.

Based on record review, the licensee did not comply with the section cited above in five of five infant files for children under 12 months of age did not contain a completed Infant Safe Sleep Plan (LIC 9227) which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on record review, the licensee did not comply with the section cited above in 10 of 10 infant files reviewed were missing documentation of the 15 minute checks which poses/posed a potential health, safety or personal rights risk to persons in care.