Incident investigation·November 13, 2025

On the above date and time Licensing Program Analysts (LPAs) Susan Brewer and Laura Mejorado, arrived to conduct a Case Management Inspection in response to the receipt of a self-reported unusual incident report (UIR) from the facility. The LPAs were greeted by Director Carmen Gonzalez and granted entry to tour the facility inside and out. The UIR was received by the licensing agency on 11/06/2025. It indicates that on 11/05/2025 a subject child sustained an injury while in care. The LPAs took a census of 14 children supervised by 3 staff. LPAs S. Brewer and L. Mejorado, made observations, reviewed facility records, documents and conducted interviews with pertinent parties which revealed that the incident took place during outdoor activity. Pertinent parties interviewed stated that on 11/05/2025 at approximately 4:46 PM, a subject child bumped their head on the slide while sliding on the play structure incorrectly. Pertinent parties stated the subject child sustained an open wound on the forehead and medical attention was later sought following the incident. Interviews with pertinent parties stated staff made attempts to intervene when the child was observed playing on the play structure incorrectly. Pertinent parties stated medical attention was sought as result of the injury. The LPAs inspected the play equipment in the outdoor activity area. The LPAs observed the play equipment to be age appropriate, in good condition with rounded edges and no identifiable deterioration or defective parts. However, due to subject child’s head bumping into the divider of the slide while sliding, the child sustained an injury. The LPAs conducted a review of records which indicates there was adequate supervision on the date and time of the incident with 1 staff and 5 children in ratio during the incident. See LIC809C Page 2 - Case Management Incident Based on information gathered, the LPAs determined that the incident was accidental and unintentional. In addition the supervising staff made attempts to intervene and redirect when the subject child played incorrectly on the play structure. The facility acted appropriately by administering 1st aid to treat the subject child’s injury. The facility followed their operational plan by notifying the authorized representatives of the incident. In addition, the agency self-reported the incident to the department as required. Therefore, no violations are identified at this time. However due to pertinent parties not present on today's date to interview, the licensee was informed the LPAs may return at a later date to conduct additional follow-up. No citations were issued on today's date. No Civil Penalties were issued on today's Date. An exit interview was conducted and a copy of this report was provided to Director Carmen Gonzalez. A notice of site visit was issued and must remain posted for 30 days.