+ How does Medi-Cal determine how many hours my child receives?

Based on the written Plan of Treatment (POT), approved by the child’s primary care Physician. Medi-Cal analyzes the medical and developmental needs of each child and deems appropriate allotment of hours.

+ Will this take away from IHSS Hours or Respite Hours?

No. We are a Title 22 skilled nursing facility and our reimbursement from Medi-Cal has ZERO impact on both IHSS and respite hours.

+ I stay home, will my child qualify?

Yes, your child qualifies by their medical diagnosis not by your employment status.

+ Will Medi-Cal ever take away or increase my hours?

A new Plan of Treatment (POT) is required every 180 days where Medi-Cal re-evaluates the child’s medical needs and allocates hours accordingly.

+ If I don’t have Medi-Cal does my child qualify?

If your child has a qualifying medical diagnosis Loretta’s Little Miracles will assist the legal guardian in applying for a Medi-Cal waiver.

This waiver does not change the parents/legal guardians insurance, only provides medically necessary Medi-Cal benefits to the child.

+ My child does NOT have diagnosis - will they qualify?

Hypotonia, developmental delays, genetic disorders, oral aversion and Failure to thrive are often the initial diagnoses of the child’s deficits/global delays which may qualify the child for Medi-Cal allotted hours.

+ My child does not have a developmental delay, do they qualify?

Yes, your child may still qualify for services if they meet the Medi-Cal medical qualifications.

+ My child has NO medical problems but does have developmental delays. Does my child qualify.

Possibly, if your child has a chromosomal or chronic condition your child may still qualify. Contact us and we will discuss more with you.

+ My child has autism or behavioral problems do they qualify?

We are a licensed nursing facility not a psychiatric facility. However, if your child has a medical diagnosis in conjunction they may qualify if they are not a threat to other children or themselves in our communal daycare setting.

Treatment & Care

+ My child has seizures, are they safe to be in your care?

Yes - seizure management is part of our daily care. The child’s Physician will provide a seizure protocol which our specialized nursing team follows through monitorization, routine medication, seizure log and rescue meds.

+ My Child is on hospice, can they attend?

Children on hospice with approved medical conditions from Medi-Cal do qualify for nursing care hours. Giving the caregiver physical and emotional reprieve.

+ Does my child receive one-on-one care?

Loretta’s Little Miracles is a communal Pediatric Day Health Care Facility regulated by Title 22 nursing staffing ratios. However, if your child requires more one-on-one care for certain periods of time we can make arrangements.

During our enrichment activities children are often assisted one-on-one hand-over-hand.

+ What do I need a Physician Order for?

  • All medications or alterations in medications dosage/frequency
  • Over the counter medications i.e. Motrin, Tylenol, Benadryl, vitamins
  • Creams/Ointments - Desitin and other topical creams

+ Do you provide meals?

Meals are prepared by a registered dietician and are provided and served in various forms (pureed to small bites).

+ My Child has sensory issues, will they be ok in this communal daycare setting?

Many medically fragile children can become agitated by noise, light and other stimulators. We do provide quiet rooms/outlets, but we will discuss with you if this environment is not the best/safest scenario for your child.


+ Do you come to my home?

No, you have to transport the child to LLM Pediatric Day Health Care facility to receive the comprehensive medical and socialized care that we hope you child flourishes in.

+ Do you provide Transportation?

No, but you can arrange school bus pick-up and after-school drop-off through First Student.

+ Can my child be bussed to you?

Yes! Before and After School your child can be picked up and dropped off at LLM giving you time to get ready before work, run errands, go to your other child’s baseball game, work or take a nap. You can arrange services through First Student.


+ My child is enrolled! How do I schedule them to attend?

Each month we require families to submit a monthly schedule so we can make staffing modifications to meet your needs.

However, we know that life is unpredictable, especially with a child with special needs. Even though we ask you to fill out a monthly schedule, we also allow you to call in to add-on as needed providing there is appropriate staffing.

+ What do I need to bring for child?

  • Medications: Prescription and over the counter (Physician Orders are Required)
  • Durable Medical Equipment (Suction machine, wheelchair, AFO/Splints)
  • Medical Supplies (Mic-Key’s, tubings, catheters, nebulizer masks, aerochambers)
  • Formula
  • Specialized diet needs
  • Diapers
  • Wipes
  • 3 changes of clothes (appropriate for weather conditions)

  • Toothbrush and tooth paste
  • Coping toys/lovies

+ Can my child come every weekend?

Weekend Date Nights and Overnights have limited capacities and you are required to sign-up ahead of time.

+ Can my child’s interventionalists, therapists and behaviorists come to your facility?

Yes, we welcome your child’s care team to provide treatment at our facility as they educate our staff at the same time on how to work with your child.

+ What days are you typically closed?

  • Mother’s Day
  • Father’s Day
  • Easter
  • 4th of July
  • Thanksgiving
  • Christmas
  • New Years Day

+ Are you open during the summer/school holidays?

Yes, we have the same hours of operation throughout the year.

Health & Safety

+ How do you prevent my child from getting sick?

Medically fragile children are often immunocompromised, and we do our best to protect them from infection while they are in our care.

Medically fragile children of all ages often do not have the ability to tell us how they are feeling.

Upon arrival:

  • Each child’s temperature is taken to ensure there is not any infection causing fever.
  • Licensed Vocational Nurse conducts nursing/physical assessment.
  • Temperature is taken routinely during their stay and charted.
  • If a child is presenting with a cough, rash, runny stool or other communicable infection(s) we isolate the child and call the legal guardian immediately to pick up the child.
  • Children cannot return for 48hrs. when prescribed antibiotics. This is to ensure we protect the health of other children.
  • Lice - we have a no nit policy. Your child cannot return until they have not one live or dead in their hair.

+ What is a communicable disease or contagious virus?

It is our job at to make all children at Loretta's Little Miracles stay healthy, therefore we have put into place health protocols to protect your child and others.

Any communicable disease (ex. TB, Hepatitis, MRSA, etc.) or contagious viruses (ex. Flu, cold) are not permitted to be at LLM.

+ Are you a locked facility?

Yes, our front door is locked at all times and front desk administration checks in/out children.

A locked parking gates closes at 8pm to ensure our parking lot is a safe place to load your child in the evenings.

+ Who can pick-up my child?

Only those who have been noted on the Emergency Contact form or if legal guardian gives authorization in writing. They will be required to provide their drivers license for us to release child to their care.

Other Questions

+ Can my other children attend the daycare?

No, not if they do not have qualifying medical diagnosis.

+ What should I do when I am not consumed by taking care of my child?

  • Activities of Daily Living to keep you and your family healthy (errands, go to the doctor, attend your other children’s activities etc.)
    • Reduce your medically fragile child’s exposure to germs
  • Be Still - Sleep!
    • Sleep is something caregivers of medically fragile children typically forfeit.
    • A sleep deprived caregiver causes anxiousness and poor health for you and your entire family.
  • Nutrition - Healthy meal planning takes time, effort and energy.
  • Keep in touch with your support system!
    • Focus on relationships: spend quality time with your significant other, your other children, and friends and family.
  • Self-care: You are a better caregiver to your family when you feel replenished.