Incident investigation·October 15, 2021

On 10/15/2021 @ 11:15 a.m., Licensing Program Analyst, Joelle Redding, made an unannounced visit to follow up on a self-reported incident that occurred on 10/8/21 wherein an infant (Child #1) fell from the changing table. During this visit, LPA observed the area of the changing table and spoke with the Director and Staff #2. Staff #1 was not present today but provided a written statement of events. LPA also reviewed correspondence from the parent of Child #1. Based on the information received, Staff #1 was standing right at the changing table at the time of the incident. When looking away briefly to reach down and pull out a diaper from a box stored inside the changing table, Child #1 slipped off, between the staff and the changing table, through a small opening in the barrier, falling to the laminate floor. Child #1 sustained a small bump to the back of the head and the facility provided first aid while the parent was contacted. Child #1 was evaluated by a physician later that day, cleared of any injury requiring additional attention and returned to care the following Monday. Although Staff #1 was standing right at the changing table and the changing table meets regulatory requirement, Staff #1 did not have direct hands on Child #1 and had not secured the child to the changing table, this situation could have been avoided. Therefore, a Type B deficiency will be cited on the accompanying LIC 809D as a potential hazard to children in care. Notice of Site visit was given and will remain posted for 30 days.