Incident investigation·November 7, 2023

An unannounced case management inspection was conducted on this date by Licensing Program Analyst (LPA), Cindy Nguyen in response to a self-reported incident dated 10/30/23. Present during today\342\200\231s inspection was the Director, Barbara Brown. Census was taken in individual classrooms. The overall census observed was 9 napping infants, 8 awake infants and 4 infant staff members. A review of adult records 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 10/30/2023 an Unusual Incident Report was filed with the Department to self-report an incident that occurred on 10/30/2023. Director called to inform that they had given Child #1 (C1) the incorrect milk bottle during feeding time. At 2:15pm when the incident occurred, staff #1 (S1) asked staff (S2) to give child #1 (C1) the bottle. S2 picked up another child, child #2 (C2) and started to feed C2 with C1\342\200\231s bottle for about 10 seconds. When S1 turned around and told S2 to stop feeding C2. S1 then took the nipple off the bottle and put a clean nipple on the bottle and fed C1. Director stated both parents were notified. Based on the information gathered from the self-reported unusual incident report, interview with one staff member, statements from the two staff and a physical plant inspection. It was determined that C1 was given the wrong milk bottle during feeding time for about 10 seconds, in which, C1 drank .5 ounces of formula milk. California Code of Regulations, Title 22, Division 12, Chapter 1, Section 101427(g)- Infant Care Food Service is being cited on the attached LIC 809D. LPA informed Director, Barbara Brown that this report dated 11/07/23, document a Type A citation which shall be posted for 30 consecutive days as there is an immediate risk to the health, safety, or personal rights of children in care. Continued on Page LIC 809-C Page LIC 809-C LPA also informed the Director, Barbara Brown to provide a copy of this licensing report dated 11/07/23 that documents any Type A citation(s) 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. Exit interview was conducted with Director, Barbara Brown. Notice of Site Visit was posted during the visit. Director 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. Director was provided a copy of their appeal rights (LIC 9058 01/16) and their signature on this form acknowledges receipt of these rights. First level appeals should be sent to the regional manager to the address listed above. End of Report.