Incident investigation·July 9, 2024

Licensing Program Analyst (LPA) Jennifer Velasco met with Facility Representative, Kaylee Agaman (Representative), for a case management visit regarding an incident that occurred on 06/26/2024. The purpose of the visit was explained to Representative. The facility representative self-reported an incident to the department on 06/27/2024 by submitting a written Unusual Incident Report (UIR) LIC 624. Per the UIR, a child (Child1) was left in the classroom without supervision for approximately 17 minutes when the children transitioned from the classroom to the outdoor play yard. The timeline of the absence of supervision was determined by facility staff (Staff1), who noticed Child1's absence from the playground and opened the door to the classroom to retrieve Child1. During today's inspection, LPA observed the classroom and play yard and interviewed staff. Representative and staff stated that face to name roll call was not done by Staff1 during the transition to outside. Representative stated that Staff1's employment at the facility was terminated 06/26/2024. Based on observation, interview, and record reviews, a Title 22 Deficiency has been issued on the attached LIC 809-D page. Representative was informed that the Type A deficiency cited today requires Representative to provide a copy of this licensing report 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. Representative was also advised that a signed Acknowledgement of Receipt of the Licensing Report (LIC 9224) must be placed in the child's file for verification. The facility has been assessed a $1000 civil penalty for this repeat occurrence of absence of supervision. Exit interview was conducted with Facility Representative Kaylee Agaman, and appeal rights were provided. A notice of site visit was given to Facility Representative, who will post it where visible to parents/guardians for 30 days.