Incident investigation·September 9, 2022

Licensing Program Analyst (LPA) Anomeh Eivazian conducted an unannounced case management inspection on 09/09/2022, due to an incident that occurred on Monday May 2, 2022 and Thursday May 5, 2022. LPA arrived at the facility at 10:20 a.m. and met with Particia Chambers, Director who guided analyst on a tour of the facility. Alleged Incidents took place on 05/02/2022 and 05/05/22. Incident was reported via FAX on 05/27/22. Original LIC 624 Unusual Incident/Injury Report form was received by the Department on 05/27/22 at 3:22 p.m. via FAX. The facility did not report the incident within the required 24 hour time frame. LPA observed the area where alleged incidents took place on 05/02/22 and 05/05/22. Classroom floor is covered with carpet. During this inspection LPA conducted interviews with staff#2, staff#3 and staff#4. Per staff#3, on 05/02/22 staff#3 was in classroom with staff#1. Per staff#3, staff#3 was in mat area and tapping on two infants to fall asleep, at the same time staff#1 was on the chair with child#1. Per staff #3, child#1 drank milk and staff #1 was tapping on child#1's back to help child#1 burp. At that time staff#3 heard child#1 was crying, turned around and noticed child#1 slipped off the staff#1's lap and reached the floor. Per staff#3, child#1 was checked by staff#1 and staff #3 and did not observe any marks or injury on child#1. This incident was not reported to child#1's parent until facility director was informed on 05/26/22 that on 05/02/22 while staff#1 fell asleep, child#1 slipped off the staff#1's lap while sitting. Per staff#4, on 05/05/22 while staff#4 was inside the classroom with staff#1 and folding laundry, in a way seeing staff#1. Staff#4 observed staff#1 was feeding child#1 while sitting on a chair, turned the child#1 face down to the ground and tapped on child#1's back for burp, at that time staff#1 had fallen asleep and child#1 was dropped down on the floor on face. Per staff#4, this incident was reported to the facility next day. REPORT CONTINUES ON NEXT PAGE 1 of 2 Per staff#2, on 05/05/22 staff#1 dropped child#1 from a sitting position while had fallen asleep. Staff#4 was present in the classroom. Per staff#2, staff#1 does not work at this school anymore. Ratio and staffing were in accordance of Title 22 Code of Regulations at the time of the both incidents on 05/02/022 and 05/05/22. There were 5 infants with two staff on 05/02/22 and 05/05/22 at the time of incident. LPA issued the Confidential Names List (LIC 811) to the licensee during this inspection. The Confidential Names List documents the staff and children involved with the incidents documented in this report. The following deficiencies listed on the attached LIC 809 (deficiency page) are being cited in accordance with California Code of Regulations Title 22. Deficiencies that are being cited need to be cleared to protect the children\342\200\231s health & safety. The Notice of Site Visit (LIC 9213) was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. Exit interview conducted and report was reviewed with the director, Patricia Chambers at 12:30 p.m.. REPORT END 2 of 2