Incident investigation·December 20, 2022

A case management visit is being conducted in response to the receipt of an Unusual Incident Report (UIR) from the facility. The UIR was received by the licensing agency on 12/12/2022. It indicates that on 12/06/2022 at approximately 1:30PM, C1 (from the LIC811) was left alone in the restroom at the facility by S1 (from the LIC811). Facility records were reviewed and client(s) S2, S3, and S4 were interviewed. Based on the information gathered, the following violations have been identified: 101229(a)(1) Responsibility for Providing Care & Supervision . This was found when it was disclosed that a child was left alone in the restroom after the supervising staff did not properly check the restroom to see if there were any children left inside. See LIC809D for a cited Type A deficiency of the California Code of Regulations, Title 22, Div. 12. 101229(a)(1). A civil penalty has been assessed during this inspection. Payment is due when billed and the check(s) or money orders shall be made payable to the "California Department of Social Services". YOU WILL RECEIVE AN INVOICE IN THE MAIL. DO NOT SEND MONEY UNTIL YOU RECEIVE YOUR INVOICE. DO NOT SEND CASH. Licensing Program Analysts (LPAs) Perla Ordones and Susan Brewer informed Director Kim Smith to provide a copy of this licensing report dated 12/20/2022 that documents any Type A citation 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 Acknowledgment of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification. An exit interview was conducted with Director Kim Smith, appeal rights discussed, and a copy of this report was provided to Director Kim Smith.