Incident investigation·January 23, 2023

On date and time listed above Licensing Program Analysts (LPA) Justin Giese conducted an unannounced visit to the facility to follow up on the submission of an Unusual Incident Report (UIR) that was received by the Regional Office on 12/06/2022. LPA met with Director, Maria Medina, to discuss the purpose of the visit. On 12/06/2022 Facility Staff self-reported an incident where a child in care reported to staff that their teeth felt loose. UIR stated staff asked the child to show them the loose tooth. For documentation purposes staff noted the Child\342\200\231s statement on an internal incident/accident form. Staff did not observe the child to have incurred an accident/injury to cause the tooth to come loose, nor did they notice the child was in discomfort, bleeding or in pain. The child remained in care for the duration of the AM session and was released to their parent/guardian. UIR stated the parent/guardian of the Child contacted the facility that same afternoon and reported the Child\342\200\231s tooth was cracked and bleeding. Due to facility closure for observation of the holiday schedule, LPA made initial unannounced visit to follow up on submission of this UIR on 01/03/2023. At time of visit LPA interviewed facility staff and reviewed documents. Staff interviews disclosed the Parent/guardian of the child informed facility staff the child was seen by a physician/dentist and would need medical attention and a modified soft foods diet. To meet such accommodations, the facility requested submission of medical documentation from parent/guardian to better meet the child\342\200\231s needs and informed the child would not be able to attend the facility without these documents. The child remained absent from the facility for the duration of that week and period of holiday closure from 12/16/2022 to 01/03/2023. At time of visit on 01/03/2023 LPA was informed the child had not returned to the facility nor had the facility received the proper medical documentation. On 01/16/2023 LPA contacted the facility via telephone and was informed the child had returned to the facility on 01/16/2023 with no restrictions. LPA was informed the child\342\200\231s parent/guardian provided the facility with a handwritten note stating the child was free from medical/dental restrictions and they no longer required a soft food modified diet. LPA was provided this document via email. Based on LPA observations and interview there appear to be no violations of Title 22. Facility documented the Child reporting to staff their tooth felt loose, informed the parent/guardian and documented their concerns with the submission of a UIR. Parent/guardian fulfilled the facility\342\200\231s request and released the child back to the facility with no restrictions. An exit interview was conducted, LPA provided Director with a copy of this report and a notice of site visit on 01/23/2023. Notice of site visit must be displayed for the next 30 days.