LICENSING: 10050 - CCLR s.11(1) - A licensee must display in a prominent place in the community care facility both the licence, including any terms or conditions of the licence, and the name of the manager.
Observation: During the inspection it was noted that the licence and the manager's name was not displayed.
Corrective Action(s): Please ensure that the licence and the manager's name are displayed in a prominent area.
Date to be Corrected: January 26, 2022
STAFFING: 12190 - CCLR s.22(2)(b) - A licensee must ensure that each employee (b) practices implementing the fire drill system at least once each month.
Observation: During the inspection the manager stated that fire drills were practiced twice per semester.
Corrective Action(s): Please ensure that fire drills are practiced and recorded monthly.
Date to be Corrected: January 26, 2022
STAFFING: 12200 - CCLR s.22(2)(c) - A licensee must ensure that each employee (c) practices implementing the emergency plan at least once each year.
Observation: During the inspection it was noted that the emergency evacuation plan was not practiced.
Corrective Action(s): Please ensure that the emergency evacuation plan is practiced annually.
Date to be Corrected: January 26, 2022
POLICIES AND PROCEDURES: 13020 - CCLR s.22(1)(b) - A licensee must: (b) have an emergency plan that sets out procedures to prepare for, mitigate, respond to and recover from any emergency.
Observation: During the inspection of thee physical facility was noted that a fire extinguisher was not available. Manager stated that she did not know where the fire extinguisher might be located.
Corrective Action(s): Please ensure that a fire extinguisher is available to mitigate, respond and recover from any emergency.
Date to be Corrected: January 26, 2022
POLICIES AND PROCEDURES: 13060 - CCLR s.56(1)(d) - A licensee must keep current records of each of the following: (d) written policies and procedures that are intended to guide employees in the care and supervision of children.
Observation: During the inspection the manager was unable to provide the policies and procedures related to care and supervision of children.
Corrective Action(s): Please ensure that all policies and procedures are available to all staff.
Date to be Corrected: January 26, 2022
RECORDS AND REPORTING: 19030 - CCLR s.55(2)(a) - A licensee must notify the medical health officer within 24 hours after (a) a child is involved in, or may have been involved in, a reportable incident described in Schedule H while under the care or supervision of the licensee.
Observation: During the inspection the log book was reviewed and it was noted that a reportable incident was documented but not reported to the licensing officer.This is a repeat contravention.
Corrective Action(s): Please ensure all reportable incidents are reported within 24 hours after the child was involved in the incident.
Date to be Corrected: January 26, 2022
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 the inspection a review of 10 random children's files was conducted and it was noted that 10 children were missing the gender and the immunization record.
Corrective Action(s): Please ensure all children's files are completed.
Date to be Corrected: January 26, 2022
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 the inspection a review of 10 random children's files revealed that 10 children were missing the enrollment date.
Corrective Action(s): Please ensure all children's files are complete.
Date to be Corrected: January 26, 2022
RECORDS AND REPORTING: 19210 - CCLR s.58(1)(a) - A licensee must keep, for each child requiring extra support, a current care plan showing the following information: (a) the diagnoses relevant to the child's requirement for extra support, as made by health care professionals.
Observation: During the inspection it was revealed that a child requiring extra support did not have a care plan.
Corrective Action(s): Please ensure that all children requiring extra support have a care plan.
Date to be Corrected: January 26, 2022
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