Incident investigation·September 30, 2024

Page 1 of 2 Licensing Program Analyst (LPA), Mahnaz (Nancy) Malek conducted an onsite case management inspection for the purpose of investigating an incident that the facility self reported to our office on 9/24/2024. LPA met with director, Barbara Brown. LPA took census. There were a total of 15 infants and toddlers with 5 staff in two different rooms. There were 5 awake infants with two staff in the infant room, and there were 10 toddlers with 3 staff in the Toddler Room. Two other infant/toddler rooms were not in use. A review of the Facility Personnel Report Summary on this date indicates all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. According to the self incident report, on 9/23/2024, Staff # 1 was changing a 16 months old child's diaper on a diaper changing table. S1 had child stand up to pull the child's pants up, child fell forward hitting the head on the floor. Child had bumps on the forehead. Today LPA interviewed the staff who were either involved or had information regarding the incident. S1, S2, S3, S4, and S5 were interviewed. S1 and S2 were in the room with 8 toddlers when the incident happened on 9/23/2024 around 3:00 pm. S1 stated the following: I was changing the child's diaper after nap time. I was going to pull the child's pants up while child was standing on the diaper changing table. Child slipped on the disposable paper on the diaper changing table while grabbling to my shoulder. I tried to catch the child but I was not stable enough to catch the child. Child fell on the floor and got injured on the forehead, eyelid and lower lip. Continued on page 2 Page 2 of 2 S2 was present in the room but did not observe the incident but heard a stump noise on the floor. S3 and S4 observed the child after the incident. LPA confirmed the process of changing diapers with staff in the toddler room today. They stated they are not supposed to have a child stand up on the diaper changing table. The director stated she has put a sign on the diaper changing not to let the staff have toddlers stand on the diaper changing table. According to interviews, reviewing the written self report incident dated 9/23/2024, and Child Supervision Record (CSR), and admission of S1 the facility has violated the personal rights of children. In the areas that were evaluated, the following deficiency of personal rights- section 101223(a)(2) was observed of the California Code of Regulations, Title 22, Division 12 on today's investigation regarding the incident. Please see next page LIC 809D for detail of deficiency. Barbara Brown, the director was informed that the “Notice of Site Visit” must be posted for 30 consecutive days. The “Notice of Site Visit” must be posted on or adjacent to the door. Failure to post will result in Civil Penalties of $100.00. LPA Malek informed the director, Barbara Brown that this report dated 9/30/2024 documents type A citation shall be posted for 30 consecutive days as there is immediate risks to the health, safety, or personal rights of children in care. Also, LPA Malek informed the director, Barbara Brown to provide a copy of this licensing report dated 9/30/2024 that documents any Type A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification. The director, Barbara Brown, was provided with a copy of their appeal rights (LIC 9058) and their signature on this form acknowledges receipt of these rights. All appeals must be in writing and received by the Regional Office within 15 business days. The exit interview was conducted with director, Barbara Brown. End of report.