Incident investigation·September 9, 2025

Licensing Program Analyst (LPA) T. Tran made an unannounced Case Management Incident visit to the Evergreen Early Head Start. On 08/19/25, the facility reported an incident to the childcare licensing department regarding a child who had an injury during outdoor recess. Upon arrival, LPA met with the Site Supervisor, Candice Bondad. We toured the facility, LPA observed proper care and supervision. During today\342\200\231s visit, LPA completed staff and child\342\200\231s files review. LPA obtained personnel report, attendance sheet on 8/19/25, child\342\200\231s record, and doctor's note. LPA conducted interviews with staff, child, and others. Based on the information that was gathered through interviews and record reviews, there were 10 children with two staff present when the incident occurred. Per staff, during the morning recess, C1 (see LIC 811) was playing tag with a peer. Staff in the proximity observed the child stumbled and fell hitting the mouth on the edge of the children's benches. Staff immediately calmed the child and applied an ice pack to the wounded area. The child\342\200\231s parent was contacted in a timely manner. Child was taken to the dentist for medical care. C1 able to return to school on 8/25/25 without any restrictions from the doctor. Therefore, based on the available information it does not appear this incident was the result of a Title 22 violation for lack of care and supervision. No further action is required for this incident report. No deficiency was cited at this time. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the facility representative, Candice Bondad.