Incident investigation·May 20, 2026

Licensing Program Analyst (LPA) Veronica Martinez Garza conducted an unannounced Case Management Incident inspection at the above facility on 05/20/26 at 01:00 p.m. The purpose of this inspection is to follow up on an incident that was not reported to the Department within 24 hours. At 01:07 p.m., LPA met with licensee Maria Ramirez and census was taken. Present during the inspection were licensee’s assistant’s S2 and S3. During this inspection, LPA interviewed Staff 1 (S1) thru 3 and attempted to interview child 1 (C1) thru 2. LPA obtained a copy of C1s ouch report. On 04/24/26, a child (not identified) pushed C1 who then fell and hit their right side of the head on the furniture and a cut was observed. According to S1 they were indoors preparing the children’s lunch while S2 and S3 were outdoors with the children. S1 recalls that S3 and C1 walked into the kitchen and observed that S3 had blood on their hand. S1 asked what happened and S3 replied that C2 pushed C1 and the child hit his head on the corner of the outdoor furniture. S1 stated that they immediately provided first aid by cleaning the area and applying ice. After applying ice to C1 head they called the child’s grandmother for pick up. C1 was later picked up by a family member. According to S1, C1 did not return to the facility the next day and followed up with the child’s parent/authorize representative. S1 was informed that the child was taken to the hospital where he received two or three stitches; however, S1 couldn’t recall. Per S1, C1 returned to the facility until after two days and their parent/authorized representative did not provide a doctor’s note therefore it is unknown if the child had any restrictions upon their return. Page 1 of 3 Interviews conducted with S2 revealed that they were outdoors for outdoor play with S3. Per S2, children were cleaning up and also lining up getting ready to come into the home to have lunch. S2 stated that they saw C1 crying and S3 ran towards the child. Blood was then observed coming from the back of C1 head and S2 told S3 to take the child indoors so that S1 could provide first aid. According to S2, C2 was asked what happened but the child didn’t reply but alluded that the child pushed C1. Later on, C1 revealed that C2 pushed him; however, it wasn’t intentional and it was an accident. Interviews conduced with S3 revealed and corroborated that they were outdoors for outdoor play with S2 and children were cleaning up and getting ready to line up and come indoors for lunch. According to S3, they were towards the back of the yard facing the front supervising children putting toys away and when they turned to supervise other children they turned back and observed C1 crying. S3 believes that C1 tried to take C2s spot while in line and pushed the child which caused the child to fall on the furniture. Per S3, C2 was asked what happened but the child remained quiet; however, later on the child said they pushed C1 and apologized. S3 does not think C2 intentionally pushed C1 to cause any harm. Staff interviewed corroborated that it is unknown if C1 had any restrictions upon their return since the child’s parent/authorized representative did not provide a doctor’s note. According to the staff interviewed, C1 was monitored upon their return and modified the child’s activities as a safety precaution. LPA attempted to interview C1; however, child did not speak with LPA. LPA interviewed C2 who stated that C1 tripped with a blue basket and hit their head on the furniture and denied pushing C1. C2 also stated that S2 was present when the incident occurred. LPA observed that the area where the incident occurred is age-appropriate and all materials and equipment are in good condition. The furniture where C1 hit their head does not have any sharp edges. LPA recommends that staff should ensure that all children clean up to prevent children from rushing, pushing, or running to line up. LPA provided a technical violation. LPA discussed with the licensee that unusual incident reports must be reported to the department within 24 hours. The incident occurred on 04/24/26 and was reported to the department on 05/07/26. According to the licensee, she made several attempts to notify the department within 24 hours; however, no one answered the phone. Licensee then called a resource and referral agency for guidance and told her to contact their previous analyst for assistance. Licensee was given a technical violation on 06/08/23 for reporting requirements. Page 2 of 3 The following deficiencies were cited in accordance with Title 22 of the California Code of Regulations and Health & Safety Codes. Please see 809D for documentation of deficiencies. 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, a civil penalty of $100 can be assessed. An exit interview was conducted, and a copy of this report was provided to licensee Maria Ramirez. Page 3 of 3