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Community Care Facilities Licensing
FACILITY INSPECTION REPORT
HEALTH & SAFETY
ONIR-CB7TXM

FACILITY NAME
CEFA Early Learning
SERVICE TYPES
301 Group Child Care (under 36 months)
302 Group Child Care (30 months to school age)
FACILITY LICENSE #
NGIL-B3EUEF
FACILITY ADDRESS
243 - 610 6th St
FACILITY PHONE
(778) 326-2332
CITY
New Westminster
POSTAL CODE
V3L 3C2
MANAGER
Naticia Thandi

INSPECTION DATE
January 31, 2022
ADDITIONAL INSP. DATE (multi-day)
ADDITIONAL INSP. DATE (multi-day)
TIME SPENT (HRS.)
3.5
ARRIVAL
10:30 AM
DEPARTURE
01:00 PM
ARRIVAL
DEPARTURE
ARRIVAL
DEPARTURE
INSPECTION TYPE
Routine
# OBSERVED IN CARE
49

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 (DoLSoP). All care categories were inspected for compliance.

Contraventions
Previous Inspection -
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: 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 (CORRECTED DURING INSPECTION): During the inspection it was revealed that in one classrooms the bedding was located in a plastic containers above the cubbies. The bedding from several containers was touching allowing for cross contamination. Education was provided to staff.
Corrective Action(s): Please ensure a healthy and safe environment is provided at all times.
Date to be Corrected: Feb 14, 2022

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 the inspection the following was revealed:
- one staff did not have a Criminal Record Check available
- two staff did not have a site specific Criminal Record Check
Corrective Action(s): Please ensure all staff have a valid Criminal Record Check
Date to be Corrected: February 14, 2022

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: During the inspection a review of 6 random staff files revealed that one staff did not have any references.
Corrective Action(s): Please ensure that all staff files are completed.
Date to be Corrected: February 14, 2022

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 system maintained by the early childhood educator registry. (Educator or assistant certificate validation)
Observation: During the inspection a review of 6 random staff files revealed that current validation of ECE certificates were missing. There was proof that some staff have had their certificates validated in 2020 and 2021. Since then the staff have renewed their certificates and the renewed certificates were not validated.
Corrective Action(s): Please ensure all staff certificates have been validated by the early childhood educator registry.
Date to be Corrected: February 14, 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 it was revealed that the facility did not practice monthly fire drills. The last fire drill was noted to have taken place (and was recorded) on November 16, 2021. No fire drills were noted from September, October, December 2021.
Corrective Action(s): Please ensure fire drills are practiced at least once a month.
Date to be Corrected: February 14, 2022

RECORDS AND REPORTING: 19100 - CCLR s.57(2)(d) - A licensee must keep, for each child, a record showing the following information: (d) name and telephone number of a parent, medical practitioner and emergency contact.
Observation: During the inspection 10 random children's files were reviewed. One child's file was missing a doctor's name and phone number.
Corrective Action(s): Please ensure all children's files are completed.
Date to be Corrected: February 14, 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 two children who required extra support were in need of a care plan.
Corrective Action(s): Please ensure all children requiring extra support have a care plan in place to support them while at the facility.
Date to be Corrected: February 14, 2022


Comments

At the inspection dated January 31, 2022 there were 49 children and 17 staff present. At this inspection the above noted contraventions were identified. Actions required by the licensee and actions required the LO included here. As part of this Routine Inspection a Facility Risk Assessment Tool is completed and a copy is provided.

The following education/recommendations were provided:
· Medicated wipes in the first aid bag to be used only with parental permission. Special attention to be paid to the expiry date.
· Start date to be made clear on children’s files.
· Using emergency cards that state the child’s gender.
· Practicing fire drills monthly and emergency drills annually
· Reference verification for staff to be made clear by initialling and dating when the reference was called.

The following resources were provided:
· Reportable Incident Bulletin
· Reportable incident forms
· Care Plan Bulletin

Visit the CCFL website at www.fraserhealth.ca/childcare for additional resources, and links to the Legislation (CCALA and CCLR).

· This report has been written off site. No signature was needed. This report was discussed and emailed to the licensee.

Action Required by Licensee/ManagerAction Required by Licensing Staff
Take corrective action to bring facility into complianceNo action required
Due Date
Feb 14, 2022

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