Incident investigation·October 8, 2024

Amended Report On 10/08/24, at 12:30 pm, Licensing Program Analyst (LPA) Shushanik Safaryan conducted an unannounced Case Management inspection for the purpose of following up on an unusual incident report received by the Department. Upon arrival, LPA met with Site Coordinator Director, Chelsea Piatetsky, to whom the reason was explained. A tour of the facility was provided. There were children present during the inspection. The census was taken. There were 23 children and 2 staff members. On 09/12/24, an unusual incident report was submitted to the Department regarding a child sustaining an injury on the facility grounds. C1 was playing on the monkey bars at the playground structure when C1 missed the bar and fell. C1 was seen by a doctor who confirmed that C1 had a broken elbow needing a full arm cast. During the investigation, LPA observed the area where the incident took place. Obtained pictures of monkey bars, band-aid report, interviewed staff members, and children. Ten children were present with 1 staff member at the time of the incident. S1 stated that they were positioned on the other side when the incident took place. Per S1, they observed C1 when C1 was already sitting on the floor. C2, C3 stated being next to C1 during the incident and observed C1 on the monkey bar when C1 fell. C1 stated they were on the last monkey bar when their hands slipped, and they fell, landing on their hand. During the interviews with children, information was disclosed that S1 was sitting when the incident occurred and was observed on the phone. This is the 2 nd incident that has occurred since 06/29/2017 regarding a child getting injured while using the monkey bars. As a reminder, the facility was provided with a Technical Advisory. Page 1 of 2 The Notice of Site Visit (LIC 9213) must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. An exit Interview was conducted, a copy of this report, along with Notice of Site visit and Appeal Rights, were explained and provided to the Facility Representative, Chelsea Piatetsky, on 10/08/24. Page 2 of 2