Incident investigation·June 29, 2023

On June 29, 2023, Licensing Program Analyst (LPA) Monique Ayala conducted an unannounced Case Management inspection at the above facility. A COVID-19 risk assessment was assessed prior to entering the facility. LPA met with director, Celeste Salinas who guided LPA on a tour of the facility. LPA observed 21 children in care with 12 staff members. The purpose of the inspection is to follow up on 2 incident reports that were reported to the department. The first incident occurred on 05/15/2023 and was reported to the department on 05/15/2023. The second incident report occurred on 05/18/2023 and was reported to the department on 05/19/2023. Both incidents were reported timely to the department. Brief Summary: On 05/18/2023 at 11:40AM, Child #1 (C1) was playing out in the toddler yard. C1 was trying to climb up on a structure, as C1 was climbing a staff member (no longer working at the facility) told C1 to get down. C1 slipped and fell on the side of her head and one arm was behind her. C1 got up by herself and was crying. C1 sustained a broken left arm. During this inspection, LPA interviewed Staff #1 (S1), Staff #2 (S2), obtained a copy of internal incident report, sign in sheets for children that were present in C1's classroom the day of the incident and a copy of the facility roster. LPA spoke with C1's mother (Parent #1 (P1)) who stated that C1 sustained a broken elbow and required surgery. Based on interviews with S1 and S2, C1 was climbing the Tic Tac Toe portion of the climbing structure when S1 started to tell C1 not to climb the structure. C1 had started to being climbing when she fell and landed on her head with her arm bending. Per S1 and S2, C1 stood up and started to cry but was able to walk and was coherent. S1 called P1 to notify her of the incident that had occurred. C1 was given an ice pack and waiting for P1 on a cot where S1 sat next to C1 continuing to assess C1. LPA reviewed sign in sheets for children and staff that were in attendance the day of the incident; LPA observed there were 6 children and 3 staff members in the classroom/outside. There are no deficiencies being cited for the first incident as this was an incident that occurred fast and was unable to be prevented. Per S1 he witnessed the incident occur and took the proper measures to ensure C1 received the proper first aid care. For the incident that occurred on 05/15/2023, LPA interviewed Child #2 (C2), Staff #4 (S4), attempted to interview Child #3 (child did not qualify) and attempted to interview Staff #3 (S3) but LPA was unable to leave a voicemail due to mailbox being full. Brief Summary: On 05/15/2023, the HR director called regarding an investigation of S3. Another staff member was concerned that S3 while redirecting C3 by pulling C3's hand in a rough manner. C2 was having a hard time during nap time and S3 had child bouncing on cot to release energy. Based on interviews conducted, C2 stated that S3 would grab and squeeze his arm when C2 was not following directions. When LPA asked C2 about bouncing on the cot with S3, C2 stated, "yeah she squeezed my hand". The facility is being cited a Type B deficiency in accordance with Title 22 Regulations, please see LIC809D. The Notice of Site Visit (LIC 9213) \342\200\223 must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00. Exit interview was conducted with Celeste Salinas, Appeal rights explained & provided.