complaint·February 27, 2023

page 2 The Regional Office received a complaint on 01/25/2023 that 1) staff did not seek medical attention for child #1(C1) and that 2) Facility did not notify authorized representative of incident. in a timely manner and 3) Facility Staff did not report incident to CCL On 12/14/22 C1 fell and hit their head on bookshelf. Facility staff did not seek medical attention for C1, facility failed to report incident to parent until Friday 12/16/22 and facility staff did not report incident to Community Care Licensing. The investigation included interviews with staff, parents, review of facility records, including but not limited to review of ouch reports, policies and procedures for reporting incidents. In reference to the allegation that staff did not seek medical attention for C1. It was found that on 12/14/22 C2 bumped into C1. According to interview with staff 2 (S2) C1 was having diaper changed when C2 ran and bumped into C1 which caused C1 to fall and hit head at edge of book shelf at approximately 9:10am. Per interviews with staff C1 was given an ice pack and notified administration as per policy for head injuries. S3 came into room to assess C1 and gave ice-pack and advised to monitor. Interviews with staff (S1)revealed that after lunch, C1 began to feel ill, vomited and had fever . Administration again was called who in turn called C1's parent for pick up due to policy when child vomit's child must be picked up. Interview with S1 and S2 indicate S1 completed the report even though s/he was not the one who observed it because s/he wanted to make sure report was given to C1's parent prior to pick up. Interview with C1's parent indicates s/he was not told about C1's head injury until Friday 12/16/22. C1's authorized representative also indicated they were called because of C1 vomiting and nothing about a head injury. C1's authorized representative. indicated medical attention was sought on 12/17/22 since they were not informed until after Doctor's hours on 12/16/22 and were advised emergency visit was too late. Review of Accident or Interaction Report indicates that C1's authorized representative was not called regarding this head injury; incident occurred at 9:10am, child was injured, treatment was necessary. Interviews with 9 out of 9 staff indicated no one called emergency personnel for this incident nor made C1's parent aware of incident so that immediate medical treatment could be sought. Based on LPAs review of records, accident/interaction report and interviews with staff and parents. which were conducted , the preponderance of evidence standard has been met, therefore the above allegation(s) is found to be substantiated. California Code of Regulations, Title 22, Division 12 and Chapter 1) are being cited on the attached LIC 9099D. page 2 of 9099a The Regional Office received a complaint on 01/25/2023 that 1) staff did not follow day care child's food diet; 2) Facility does not have age appropriate playground equipment. 3) Facility rug is dirty. The investigation included interviews with staff, parents, review of facility records, including but not limited to review of ouch reports, policies and procedures for special diets, allergies, physical plant tour. In reference to the allegation that staff did not follow day care child's food diet. LPA interviewed 9 out of 9 staff all indicated that they follow children's food diet. Diets and allergies are posted in each classroom. Two out of 9 staff indicated they were not aware of C1's parent's preference for a vegetarian diet until Thanksgiving. Interview with staff 4 who was C1's Nido teacher reports that authorized representative would bring in foods that included salmon, eggs, fish, vegetables. LPA was provided with pictures of C1 having salmon and eggs in February 2022. Further more S4 indicates s/he was never told C1 was vegetarian. Interview with S4 indicates all food is provided by parents in the Nido program. Review of records did not indicate a food allergy or food preference. LPA was unable to interview S5 regarding C1's food preferences since S5 is no loner employed with Guidepost and also failed to return LPA's call. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is unsubstantiated In reference to the allegation that the facility does not have age appropriate playground equipment. Interview with 3 out of 5 parents indicate they believe equipment is age appropriate. One of the three parents indicated they felt the equipment was too small. Parents indicated that playground equipment has been changed. Interview with Director reports equipment is age appropriate and provided copy of invoice indicating equipment is best for ages 6 to 23 months. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is unsubstantiated In reference to the allegation that the facility rug is dirty. LPA interviewed 3 out of 5 parents who did not divulge any information regarding a dirty rug. LPAs' observation on 01/13/23 and 02/27/23 do not show rugs to be dirty. Interview with 9 out of 9 staff indicate they have not had complaints from parents regarding any dirty rugs. One out of 9 staff interviewed indicated these are new rugs. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alelged violation(s) did or did not occur, therefore the allegation is unsubstantiated. Page 3 In reference to the allegation that Staff did not notify authorized representative of incident., the following was found; The investigation included interviews with staff, parents, review of facility records, including but not limited to review of ouch reports, policies and procedures for reporting incidents. It was found that on 12/14/22 C2 bumped into C1. According to interview with staff , S1 and S2 C1 was having diaper changed when C2 ran and bumped into C1 which caused C1 to fall and hit head at edge of book shelf. .Per interviews with s1 and s2, C1 was given an ice pack and notified administration as per policy for head injuries. Interviews with S! and S2 revealed that C1 began to feel ill, vomited and had fever. Administration was called who in turn called C1's parent for pick up for a separate issue, child became ill after lunch with vomit and fever.. Interview with S1 and S2 indicate S1 completed the report even though she was not the one who observed it because s/he wanted to make sure report was given to C1's parent prior to pick up. S1 and S2 state they had not been told if C1's parent was given the accident report on 12/14/22 and they do not have it with the classroom copies. Interview with S3 indicates that Lead Guides give the reports to the parents at pick up. Interview with six other staff indicate they could not recall giving a report to C1's parent. Interview with C1's parent indicates s/he was not told about C1's head injury until Friday 12/16/22 and she was told by S3 who had her sign the report on 12/16/22. Interviews with 9 out of 9 staff f who could not recall giving incident report to C1's parent and interview with C1's parent indicating s/he did not receive until two days after incident . Based on LPAs review of records, accident/interaction report and interviews with staff and parents. which were conducted , the preponderance of evidence standard has been met, therefore the above allegation(s) is found to be substantiated. California Code of Regulations, Title 22, Division 12 and Chapter 1 are being cited on the attached LIC 9099D. In reference to the allegation that Staff did not report incident to CCL. Interview with assistant Director indicates she did not report this to Community Care Licensing. Further interview with S1 and S3 indicate C1's parent notified staff that they had taken C1 to obtain medical attention. LPA's review of facility file in the Regional Office did not show an unusual incident report was made for C1 falling and hitting head on 12/14/22 even after staff were notified that parent sought medical attention. Based on LPAs review of records, accident/interaction report and interviews with staff and parents. which were conducted , the preponderance of evidence standard has been met, therefore the above allegation(s) is found to be substantiated. California Code of Regulations, Title 22, Division 12 and Chapter 1 are being cited on the attached LIC 9099D. page 4 An exit interview was conducted with director.Nichole Ontiveros, Appeal Rights were explained. The Director was provided a copy of appeal rights (LIC 9058) 01/16) 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. First level appeals should be sent to the Regional Manager to the address listed. The Notice of Site Visit was given and discussed it must be posted as required by H & S Code Sec. 1596.817. Notice of Site Visit must be posted for 30 consecutive days. Failure to post will result in civil penalties of $100.00.