Incident investigation·November 16, 2021

On 11/16/2021, Licensing Program Analyst (LPA) Nguyen Tran conducted an unannounced inspection to follow-up with a self-reported incident happened on 11/09/2021 regarding Personal Rights. LPA toured the facility with licensees Michael and Laura Calkins. LPA observed licensees and caring for 9 children. Licensee were operating within the licensed capacity as specified on license. A review of the Facility Personnel Report Summary on this date indicates all facility residents, staff, or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. Currently there are 3 adults and one minor living in the home. During today's inspection, LPA interviewed Licensee and reviewed record of child #1 (C1) . The unusual incident is a self-reported incident, in which Licensee forgot that C1 was allergic to dairy and gave milk to the child, causing child to have allergic reactions. Incidental Medical Service (IMS) documentation for C1 was reviewed. Based on record review and interview, on 11/09/2021, Licensee Laura Calkins, was providing milk to the children. Licensee forgot that C1 has dairy allergy and gave milk to the child. Child started to throw up after drinking the milk and Licensee came to check to find out she had accidentally gave regular milk to child instead of soy milk. Licensee immediately contacted the C1's mother, who did not want the Licensee to call 911, Licensee reported that child was throwing up and still breathing, so she did not have to administer the Epi-Pen. Parents arrived with in 8 minutes and picked child up from day care. Child returned to the day care the next day. It was determined that Licensee was aware of child\342\200\231s dairy allergy but still provided the child milk. The type A violation is being cited in accordance with California Code of Regulations, Title 22, Division 12, Section 102423 Personal Rights (a) Each child receiving services from a family childcare home shall (2) To receive safe, healthful, and comfortable accommodations, furnishings, and equipment, on the attached LIC 809D (Continue next page) (Page 2 of Report) An exit interview was completed. The report was reviewed and discussed. Appeal Rights and deficiencies were discussed. The facility representative was provided a copy of their appeal rights (LIC 9058 12/15) and their signature on this form acknowledges receipt of these rights. All appeals must be in writing and received by the Licensing office within 15 business days. If the facility receives a Type A violation, the licensee shall post and provide copies of the report to parents/guardians of the children in care at the facility by the next business day, and shall provide to the parents/guardians of children newly enrolled at the facility during the next 12 months. In addition, the licensee shall immediately post upon receipt the Proof of Correction for 30 consecutive days and provide a copy to current and enrolling parents. The licensee is to keep Acknowledgement Receipt (LIC 9224) signed by parents in each child\342\200\231s file . THE FACILITY REPRESENTATIVE WAS INFORMED THAT THE 'NOTICE OF SITE VISIT' MUST BE POSTED FOR 30 CONSECUTIVE DAYS. FAILURE TO POST WILL RESULT IN CIVIL PENALTIES OF $100.00. THE 'NOTICE OF SITE VISIT' MUST BE POSTED ON OR ADJACENT TO THE DOOR. (End of Report)