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Community Care Facilities Licensing
FACILITY INSPECTION REPORT
HEALTH & SAFETY
SWAR-AS2MMD

FACILITY NAME
Flying Kites Child Care Center - Wix Brown
SERVICE TYPES
303 Preschool (30 months to school age)
305 Group Child Care (School Age)
FACILITY LICENSE #
LSEO-ABSL9Z
FACILITY ADDRESS
23851 24th Ave
FACILITY PHONE
(604) 308-1446
CITY
Langley
POSTAL CODE
V2Z 3A3
MANAGER
Jayshree Reddy

INSPECTION DATE
October 11, 2017
ADDITIONAL INSP. DATE (multi-day)
ADDITIONAL INSP. DATE (multi-day)
TIME SPENT (HRS.)
2.5
ARRIVAL
08:45 AM
DEPARTURE
11:06 AM
ARRIVAL
DEPARTURE
ARRIVAL
DEPARTURE
INSPECTION TYPE
Routine
# CHILDREN ENROLLED
14

Introduction

An unscheduled routine inspection was conducted to assess compliance with the Community Care and Assisted Living Act (CCALA), the Child care Licensing Regulations (CCLR) and the relevant Director of Licensing Standards of Practice (DLSOP).
Evidence for this report was based on the Licensing Officer’s observations, review of the facility records and information provided by the facility staff at the time of inspection.

The following areas were reviewed:
Licensing
Physical Facility
Staffing
Policies and Procedures
Care and supervision/Hygiene and medication
Nutrition
Program
Child Records and reporting

As part of this Routine Inspection, a Facility Risk Assessment Tool is completed and a copy is provided to the facility.
The Risk Assessment includes any non-compliance identified during the routine inspection and a 3 year ‘historical’ review of the facility’s compliance and operation and is used to determine inspection frequency.

Visit the CCFL website at http://www.fraserhealth.ca/childcare
for additional resources, and links to the Legislation (CCALA and CCLR)
Useful websites to consider:
Regulations and Act at www.health.gov.bc.ca/ccf
Criminal Records Checks at www2.gov.bc.ca/gov/content/safety/crime-prevention/criminal-record-check
Healthlink BC at https://www.healthlinkbc.ca/hlbc/files/documents/healthfiles/hfile69e.pdf

Contraventions
Previous Inspection - Contraventions observed on FIR # have been corrected except for those noted on supplementary pages.
Current Inspection - Items reviewed comply with the Act, regulations & standards of practice except for those noted on supplementary pages.

Observed Violations
STAFFING: 12040 - CCLR s.19(1)(a) - A licensee must not employ a person in a community care facility unless the licensee or, in the case of a person who is not the manager, the manager has first met with the person and obtained all of the following: (a) a criminal record check for the person.
Observation: On review of all staff files, Licensing observed 1 staff only had a CRC from Ontario and a signed form for the Criminal Records Review Program (CRRP). In discussion, Licensee stated that this staff has applied at the CRRP but has yet to receive it and there is no evidence to show it has been received by the CRRP.
Corrective Action(s): As this staff works alone, please provide a health and safety plan as to how the risk will be mitigated until it arrives
Date to be Corrected: October 17th 2017

STAFFING: 12050 - CCLR s.19(1)(b) - A licensee must not employ a person in a community care facility unless the licensee or, in the case of a person who is not the manager, the manager has first met with the person and obtained all of the following: (b) character references in respect of the person.
Observation: On review of al staff files (4), Licensing observed that 2 staff was missing character references. Licensee stated they have been checked but a record is not in place as to their suitability information gained from the references
Corrective Action(s): Please ensure staff are fully screened prior to working with children.
Date to be Corrected: October 17th 2017

STAFFING: 12070 - CCLR s.19(1)(d) - A licensee must not employ a person in a community care facility unless the licensee or, in the case of a person who is not the manager, the manager has first met with the person and obtained all of the following: (d) copies of any diplomas, certificates or other evidence of the person's training and skills.
Observation: On review of staff files, Licensing observed that 2 staff did not have responsible adult status. Licensee stated that 1 staff is currently enrolled on an ECE course online and will provide evidence when applying for a staff exemption of a staffing plan. The other staff will be part of that staffing plan which Licensing will approve once received.
Corrective Action(s): Licensing will email exemption application for Licensee to apply.
Date to be Corrected: October 17th 2017

STAFFING: 12090 - CCLR s.19(1)(f) - A licensee must not employ a person in a community care facility unless the licensee or, in the case of a person who is not the manager, the manager has first met with the person and obtained all of the following: (f) evidence that the person has complied with the Province's immunization and tuberculosis control programs.
Observation: On review of all staff files, Licensing observed that 2 were missing immunization status
Corrective Action(s): Please ensure staff are fully screened prior to working with children
Date to be Corrected: October 17th 2017

STAFFING: 12140 - CCLR s.19(4)(a) - A licensee must not employ a person in a community care facility as (a) an educator or an assistant unless the person holds a certificate issued under Division 2 [Employee Qualifications], which must be verified by the licensee using a system established and maintained by the director of the early childhood educator registry,
Observation: Licensing reviewed staff files and observed all those with ECE certificates have not been validated with the ECE Registry.
Corrective Action(s): Please ensure all certificates are validated and a record is kept
Date to be Corrected: October 17th 2017

POLICIES AND PROCEDURES: 13100 - DLSOP Active Play - The Licensee must develop and implement an Active Play Policy to engage children in daily active play, consisting of un-facilitated play and facilitated games and activities.
Observation: Licensing review policies and the active play policy was not in the handbook. Licensee stated that she will email a copy to Licensing once complete
Corrective Action(s): Please ensure this policy is created and provided to both parents and staff
Date to be Corrected: October 17th 2017

POLICIES AND PROCEDURES: 13120 - DLSOP Active Play - The Licensee must develop and implement a Screen Use Policy to guide employees in the use of screen time activities.
Observation: On review of facility policies, Licensing observed that the screen time policy is missing from the handbook. Licensee stated that parents have been informed of the screen time for the facility but a policy needs to be available for both staff and parents.
Corrective Action(s): Please email a copy of the completed policy to Licensing
Date to be Corrected: October 17th 2017

RECORDS AND REPORTING: 19080 - CCLR s.57(2)(b) - A licensee must keep, for each child, a record showing the following information: (b) date of enrolment in the community care facility.
Observation: On review of 5 children's files Licensing observed that 2 were missing enrolment dates
Corrective Action(s): Please ensure all children's files are complete
Date to be Corrected: October 17th 2017

RECORDS AND REPORTING: 19220 - CCLR s.58(1)(b) - A licensee must keep, for each child requiring extra support, a current care plan showing the following information: (b) the courses of action recommended by health care professionals to address the needs of the child requiring extra support.
Observation: On review of children's files, Licensing observed that all children requiring medication for medical conditions did not have a care plan in place which describes the child's symptoms and the course of action to be taken by the staff to meet the child's needs. Medication consent forms were in place but did not have all the necessary information to appropriately guide staff.
Corrective Action(s): Please ensure care plans are created for all children requiring additional assistance. Licensing will email a care plan resource to assit in this requirement
Date to be Corrected: October 17th 2017


Comments

The operation of the facility is in compliance with current regulations of the Community Care and Assisted Living Act (CCALA) and the Child Care Licensing Regulation (CCLR) apart from any listed above

On site today was the Licensee to assist with the inspection. One staff was with 5 before school age children and the preschool program began at 9.15am with 1 staff and 4 children.
Staff to child ratio was in compliance with regulations
Licensing observed Staff engaged with children using appropriate language and guidance.
Licensing observed the children in free play, circle time and snack time.

Discussions with the Licensee/Staff:-
- Licensing reviewed emergency evacuation drill and policy with the Manager and staff
- Licensing discussed the requirements of Section 19 of the CCLR's and prior screening of staff and the requirement for site specific criminal record checks.
- Licensing recommends an audit of staff files to ensure accuracy and compliance and recommends adding a checklist to the front of each file to assist in that system.

A response in writing is required to be submitted to Licensing by the date below, outlining how the contravention(s) have been addressed.
A follow up inspection will be conducted due to the number and nature of the contraventions.

This inspection report was reviewed with the Licensee
If you have any concerns or further questions regarding the content of this report, please contact your Licensing Officer. (Contact details provided)
Thank you for your time today

Action Required by Licensee/ManagerAction Required by Licensing Staff
Take corrective action to bring facility into compliance, Provide a written response to LicensingNo action required
Due Date
Oct 17, 2017

Click here for FAQ About Inspections.
Click here for a description of each "Category" of violation displayed.