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Community Care Facilities Licensing
FACILITY INSPECTION REPORT
HEALTH & SAFETY
SWAR-ABMP4E

FACILITY NAME
CEFA Walnut Grove
SERVICE TYPES
301 Group Child Care (under 36 months)
302 Group Child Care (30 months to school age)
FACILITY LICENSE #
DMIL-9U4N44
FACILITY ADDRESS
#100 - 19950 88th Ave East
FACILITY PHONE
(604) 881-2332
CITY
Langley
POSTAL CODE
V1M 0A5
MANAGER
Rebecca Medeiros

INSPECTION DATE
July 07, 2016
ADDITIONAL INSP. DATE (multi-day)
ADDITIONAL INSP. DATE (multi-day)
TIME SPENT (HRS.)
2.75
ARRIVAL
09:00 AM
DEPARTURE
11:40 AM
ARRIVAL
DEPARTURE
ARRIVAL
DEPARTURE
INSPECTION TYPE
Routine
# CHILDREN ENROLLED
87

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/health-info/health-topics/child-care/ 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 www.pssg.gov.bc.ca/criminal-record-review

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

Observed Violations
LICENSING: 10070 - CCLR s.11(4) - A licensee must display in a prominent place in the community care facility the certificate of any educator or assistant employed to work in the community care facility.
Observation: On review of staff certificates, Licensing observed that one staff currently working today did not have a certificate displayed in any of the program rooms. Manager stated that the administration staff was currently going through certificates and mounting them in frames for the wall. Staff have recently changed rooms along with groups of children so certificates are being relocated.
Corrective Action(s): Please ensure that staff certificates, of those currently employed, are displayed.
Date to be Corrected: July 21st 2016

PHYSICAL FACILITY, EQUIPMENT AND FURNISHINGS: 11010 - CCLR s.13(1) - A licensee must ensure that a healthy and safe environment is provided at all times while children are under the supervision of employees.
Observation: Licensing observed that one of the toilets in a program bathroom was leaking at the back. This is a concern for the spread of germs with children possibly standing in it.
Corrective Action(s): Please ensure that all areas that children use are healthy and safe
Date to be Corrected: July 21st 2016

PHYSICAL FACILITY, EQUIPMENT AND FURNISHINGS: 11190 - CCLR s.16(4)(b) - A licensee must ensure that all indoor and outdoor play materials and equipment accessible to children are (b) safely constructed, free from hazards and in good repair.
Observation: Licensing observed that an area rug in one of the program rooms has a turned up corner which poses a tripping hazard. In the infant/toddler playground, Licensing also observed the resilient flooring of the pathway has a few areas that are lifting, posing a tripping hazard,. There are also 2 pieces of tile missing that leaves a square hole - a young child's foot could step into that and cause a twist in the ankle.
Corrective Action(s): Please ensure that indoor and outdor play areas are safe for children to play freely.
Date to be Corrected: July 21st 2016

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 4 newer staff files, Licensing observed that 2 were missing immunization status.
Corrective Action(s): Please ensure that staff documentation is complete prior to employment.
Date to be Corrected: July 21st 2016

CARE AND/OR SUPERVISION: 14020 - CCLR s.34(2)(a) - Without limiting subsection (1), a licensee must ensure that (a) children attending a community care facility are divided into groups, with each group having no more children than that permitted in Schedule E.
Observation: Licensing observed that one staff in the group child care under 36 months was working with ECE assistant status as the 2nd staff in the program. The 2nd staff in this age group must be of ECE status.
Corrective Action(s): Please ensure staffing levels meet the requirements of Schedule E of the CCLR's.
Date to be Corrected: July 8th 2016

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: On review of a random selection of 15 child files, Licensing obsered that one was missing a medical insurance plan number.
Corrective Action(s): Please ensure that all child information is correct and complete at the time of enrolment.
Date to be Corrected: July 21st


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 Manager and 14 staff and 1 administrative staff.
Staff to child ratio was in compliance with regulations
Exemptions/Temporary placements in place refer to a group of children moving as a peer group into the group child care 30 months to school age program.
Programming is posted and available for parent review and food menus are also posted for parents.
Licensing observed Staff engaged with children during snack time and outdoor play as well as circle time with songs. Licensing observed positive interactions from the staff using gentle and calm tones.
Licensing observed the children in independent learning when getting ready for outdoors and eating snack. Children's art work is displayed in various areas of the facility.
The facility has been awarded 'Best daycare and preschool in Langley' for the second year running - congratulations!

Discussions with the Manager:-
- Licensing reviewed the online CRC process with the Manager
- Licensing provided information regarding 'Live 5210' and provided a resource package

A response in writing is required to be submitted to Licensing by the date below, outlining how the contravention(s) have been addressed.

This inspection was reviewed with the Manager
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
Jul 21, 2016

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