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Community Care Facilities Licensing
FACILITY INSPECTION REPORT
HEALTH & SAFETY
KSEY-B6PRAK
FACILITY NAME
CEFA Early Learning Brentwood		SERVICE TYPES
301 Group Child Care (under 36 months)
302 Group Child Care (30 months to school age)
FACILITY LICENSE #
NGIL-ACFU6V
FACILITY ADDRESS
LM100 - 4664 Lougheed Hwy		FACILITY PHONE
(604) 565-3333
CITY
Burnaby		POSTAL CODE
V5C 5T5		MANAGER
Daylene Silbernagel
INSPECTION DATE
November 20, 2018		ADDITIONAL INSP. DATE (multi-day)
ADDITIONAL INSP. DATE (multi-day)
TIME SPENT (HRS.)
3
ARRIVAL
09:30 AM		DEPARTURE
12:30 PM		ARRIVAL
DEPARTURE
ARRIVAL
DEPARTURE
INSPECTION TYPE
Routine		# CHILDREN ENROLLED
163
Introduction

An unscheduled routine inspection was conducted to assess compliance with the Community Care & Assisted Living Act (CCALA), the Child Care Licensing Regulation (CCLR) and the relevant Director of Licensing Standards of Practice (DoLSOP). 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; Polices & Procedures; Care & Supervision; Hygiene and Communicable Disease Control; Medication; Nutrition and Food Services; Program; Records and Reporting.
As part of the Routine Inspection a Facility Risk Assessment Tool is completed and a copy is provided. The Risk Assessment includes non-compliance identified during the routine inspection and a 3 year historical” review of the facility’s compliance and operation.
Visit the CCFL website at: http://www.fraserhealth.ca/childcare for:
• Additional resources, including Child Care Links, and
• Links to the Legislation (CCALA & CCLR)
Inspection report was reviewed with manager before report was signed and printed.
Licensing would like to thank the staff and children of CEFA Early Learning Brentwood for their time and assistance during today’s inspection.
Contraventions
Previous Inspection - Contraventions observed on FIR #KSEY-AUVS8P have been corrected.
Current Inspection - Items reviewed comply with the Act, regulations & standards of practice except for those noted on supplementary pages.
Observed Violations
PHYSICAL FACILITY, EQUIPMENT AND FURNISHINGS: 11200 - CCLR s.17 - A licensee must ensure that children do not have access to any object or substance that may be hazardous to the health or safety of a child.
Observation (CORRECTED DURING INSPECTION): During inspection Licensing noted that chemicals were located in unlocked cupboards in two rooms.

Manager and staff made chemicals inaccessible during inspection.

Manager stated they will purchase child safety locks for these cupboards.
Corrective Action(s):
Date to be Corrected:

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: During inspection Licensing randomly reviewed 8 staff files and noted 2 files were missing up to date Criminal Record Approval letters.

Manager had submitted request forms to the Criminal Record Review Program in July 2018.
Corrective Action(s): Ensure up to date Criminal Record approval letters are on file for these staff persons.
Date to be Corrected: Dec. 20/18

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 (CORRECTED DURING INSPECTION): During inspection Licensing randomly reviewed 8 staff files and noted 2 staff were missing immunization status.

During inspection manager gave forms to these staff persons to complete.
Corrective Action(s):
Date to be Corrected:

RECORDS AND REPORTING: 19070 - CCLR s.57(2)(a) - A licensee must keep, for each child, a record showing the following information: (a) name, sex, date of birth, medical insurance plan number and immunization status.
Observation: During inspection Licensing randomly reviewed 20 children's files and noted 7 files were missing medical insurance information.
Corrective Action(s): Ensure missing medical insurance information is on site.
Date to be Corrected: Dec. 20/18

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: During inspection Licensing randomly reviewed 20 children's files and noted some files are missing exact start/ enrollment dates.
Corrective Action(s): Ensure exact start/ enrollment dates are on file for all children in care.
Date to be Corrected: Dec. 20/18
Comments

The following information was discussed with the Licensee at the time of the inspection:
Supervision: The Director of Licensing Standards of Practice Active Play and Safe Play Spaces speak directly to active supervision. All staff must practice active supervision, a combination of close proximity and attention, watching, and listening. Staff must be able to move through and see the entire play space. All staff must know how many children are in care at all times.
Reportable incidents: if a child is involved in a reportable incident, as per Schedule H of the Child Care Licensing Regulation, child care staff must report the incident to licensing within 24 hours. Child care staff are asked to call their Licensing Officer to make the report. If the Licensing Officer is unavailable please call (604) 587-3936 and ask to speak with the Regional Duty Licensing Officer. This telephone number is staffed during regular business hours.
Lead in the water: child care staff are being asked to help reduce the amount of lead children may be exposed to. Child care staff may do this by turning on the taps from which children access their drinking water for a few minutes every morning. A hand out regarding this topic was previously left with the manager.
During inspection Licensing discussed Schedule G(2)(d) of the CCLR in relation to including both child and adult directed art in the programming.
During inspection Licensing observed children engaged in activities outdoors as well as having circle/ educational activities/ free play inside.
During inspection Licensing observed staff persons interacting with children while they were engaged in activities, staff gave warnings before transitions as well as assisted with problem solving when necessary.
Action Required by Licensee/ManagerAction Required by Licensing Staff
Take corrective action to bring facility into compliance, Provide a written response to LicensingFollow-up Inspection Required
Due Date
Dec 20, 2018		Approximate Follow Up Date
14 Jan, 2019
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Click here for a description of each "Category" of violation displayed.