Incident investigation·June 14, 2022

Licensing Program Analyst (LPA) Rita Ramos conducted an unannounced case management inspection on 06/14/22 due to an incident that occurred at the facility on 05/27/22. LPA met with Alida Garcilazzo, Site Facilitator, who guided LPA on a tour of the facility. There were 34 children and 7 staff present upon arrival. LPA was later met by Dr. Veronica Bloomfield, Program Director. The purpose of the visit was to follow-up on an incident that was reported to the department. LPA conducted interviews and obtained documentation during this visit. The incident that occurred on 05/27/22, was reported to the Department on 06/02/22, via fax. The facility did not report the Unusual Incident to the Department within the required 24 hours of occurrence. LPA informed Program Director, that although the incident occurred on Friday 05/27/22, and the school was closed 05/30/22 in recognition of Memorial Day, the facility should have reported the incident by 05/31/22 which would be the next business day. Information reported to the Department indicated that Child #1 sustained an injury that required medical attention. . Based upon information received from the interviews conducted and documentation obtained, it was determined that Staff #3 was out of ratio when Child #1 sustained the injury which poses an immediate health and safety risk to children in care. Per Program Director and Site Facilitator, this facility is a Title 5 program. Title 5 programs that are funded by the Department of Education are required to maintain a 1:8 teacher child ratio at all times. Documentation provided to LPA indicates that Staff #3 was singularly caring for 9 to 10 children at the time of the incident. ----------Page 1 of 2 The following deficiencies listed on the attached LIC 809D are being cited in accordance with California Code of Regulations Title 22. A copy of this report shall be provided to the parent/guardian of children currently enrolled by the next business day or immediately upon return. A copy of this report shall also be provided to the parent/guardian of any newly enrolled children for the next 12 months (1 year). The Acknowledgement form must be maintained in each child\342\200\231s file immediately upon receipt from parent. Director was provided with a copy of the parent Acknowledgement of Receipt of Licensing Reports Form during this visit. 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. Exit interview was conducted with Dr. Veronica Bloomfield, Program DIrector, including, but not limited to Provider Rights, Appeal Procedures A copy of the LIC 9224 - Acknowledgement of Receipt of Licensing Reports was provided during this visit. ---Page 2 of 2