Incident investigation·August 13, 2024

Licensing Program Analyst (LPA) V Trinh conducted an unannounced case management incident inspection in response to a self-report Unusual Incident dated 7/15/2024. LPA met with Director, Yareli Juarez. LPA observed 60 preschool children 7 staffs in different classrooms were napping. A review of staff criminal clearance records on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. On 7/15/2024 a self reported Unusual Incident Report (UIR) was filed with the Licensing Office. The facility reported about an injury of a child. LPA met with the Center Director, Yareli Juarez for the purpose of following-up on the Unusual Incident Report of July 15, 2024. According to the incident report, Child #1 (C1) dislocated their elbow on or about 7/1/24. Facility staff stated that C1s authorized representative stated C1s elbow had a fracture; however, no medical reports were provided. C1 returned to the facility on July 3,2024. During the interviews, all interviewed staff denied observing or noticing that, C1 obtained an injury while in care at the facility. Staff #3 (S3) stated that during lunchtime at approximately 11:15 am- 11:45 am, C1 mentioned missing Mommy and that C1\342\200\231s arm was hurting. S3 checked for any marks or bruises and asked C1 to lift the arm and move around. C1 can be able to do all instructions from S3. S3 notice no marks or bruises on of C1\342\200\231s arm. All interviewed staff were aware of and could describe the facility protocol when an injury occurred and the responsibilities of reporting the incident. Continued Page 2 Page 2 LPA Trinh reviewed the Parent Handbook. The facility\342\200\231s procedure for a minor injury to a child is that staff will report the injury to the office, and the authorized representative will receive a text message about the incident. For medium injury, the director or office staff will call the authorized representative to give the information and report the event including the additional care given. For urgent injuries, the facility will make an immediate attempt to contact a parent and the designated physician. If necessary, the facility will call 911 to get immediate paramedic help. Based on the staffs interviewed, when injuries occur, no matter how minor they are, the facility will notify the authorized representative by phone, and/or with an ouch report. LPA reviewed the footage on July 1, 2024, provided by the Director Yareli Juarez, LPA did not observe any get any incident. During interviews regarding staff supervision provided to children in care, all interviewed staff give consistent responses about facility supervision procedure, including visual observation of the children and never leave a child unattended. All interviewed staff denied that any incident occurred to C1 on 07/01/2024, and there was no injury/incident report for a child on the alleged date. On 07/15/2024, LPA Trinh called seven (7) parents requesting an interview. Three (3) parents were available to be interviewed. The parents interviewed did not express any concerns related to supervision and did not provide any additional information. LPA Trinh attempted to interview the children in care, but none were qualified for the interview due to their age and lack of language skills. Based on LPA\342\200\231s observations and interviews which were conducted, there was insufficient evidence that C1 sustained an unexplained injury while in care, staff did not ensure adequate supervision was provided to child while in care, and staff did not ensure reporting requirements were followed. An exit interview was completed. The report was reviewed and discussed. Appeal Rights were discussed. The Director Yareli Juarez was provided a copy of their appeal rights (LIC 9058 12/15) and their signature on this form receipt of these rights. All appeals must be in writing and received by the office within 15 business days. 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. Failure to post Type A Reports for 30 days will result in a civil penalty of $100.00. End of the Report.