Incident investigation·September 9, 2021

On 9/9/2021 at 9:23am, Licensing Program Analyst (LPA) Melissa Stewart arrived at the child care center to conduct an unannounced, Case Management inspection and met with Director, Tamera Davis. LPA conducted a Risk Assessment for COVID19 and all answers indicated no exposure to COVID19. LPA explained the purpose of the inspection. There were two staff (S1 and S2) supervising 20 children in the preschool classroom. Director wore a face mask. S1 and S2 wore face shields without face covering. All 20 children wore child sized face shields without face covering. On 9/8/2021 at approximately 4:30pm, Director called the Community Care Licensing Office and reported an incident which had occurred at the center earlier that same day. Per written report (LIC 624) Director explained that on 9/8/2021 at 11:50am, C1 rang the bell for lunch and that as the preschool children (ages 3-5 years) were lining up to come inside, C1 ran toward the line, tripped on C1s own feet and fell extremely hard directly on C1s left knee and then collapsed crying. S1 and S2 were outside supervising 19 children at the time of the incident. S1 witnessed C1 fall and tended to C1. S1 observed that C1 could not stand and needed medical attention. S1 called for assistance of Director who took over the care of C1 and carried C1 inside the preschool classroom and applied an ice pack. C1s parents were called. Director spoke with P1 who asked Director to drive C1 to Twin Cities Emergency Room (ER) as both parents were more than an hours drive away from the center. Director reported that she agreed to transport C1 to the hospital because the injury was non-life threatening, with no open wounds, visible hemorrhaging or bruising. Director suspected that C1s knee had been dislocated. Director and C1 arrived at the ER at 12:20pm and C1 was admitted at 12:45pm. P1 arrived at 1:15pm and P2 arrived at 2:10pm. Today, Director, S1, S2 and four (4) children were interviewed. C1 was not available for interview as C1 is still at the hospital. LPA left a voice message requesting a return call from the parent(s) of C1. Cont. on 809-C Due to insufficient information available at this time, the incident requires further investigation. LPA discussed current California Department of Public Health (CDPH) Guidance for Child Care Providers and Programs which states that Child care providers must ensure compliance with the current CDPH Guidance for the Use of Masks. As of 6/15/2021, the use of mask face coverings is required by CDPH and the Division of Occupational Safety and Health (CAL/OSHA) in child care indoor settings regardless of vaccination status. Children aged two and older should be taught and reminded to wear face coverings. LPA observed that staff and children were wearing face shields, but no attempt was being made to teach and remind children to wear face coverings as required. Non-compliance with the current CDPH guidance for face coverings was was previously addressed with Director during an inspection on 6/7/2021 during which a Technical Assistance Advisory note was given. On 7/2/2021, the current guidance was addressed in an email conversation between LPA Stewart and Director. The Guidance for Child Care Providers and Programs dated 6/29/2021 was attached to the email via pdf document. Today, LPA provided a copy of PIN 21-18-CCP and Guidance for Child Care Providers and Programs dated 6/29/2021. LPA provided one box of 50 adult sized surgical masks to Licensee. Type A deficiency cited today in accordance with the California Code of Regulations Title 22, see LIC809D. An exit interview was conducted and Plans of Corrections were reviewed and developed with the Licensee. A copy of this report and appeal rights were discussed and left with Licensee, Tamera Davis, whose signature on this form confirm receipt of these documents. Upon receipt, provide copies of this licensing report to each parent/guardian of enrolled children and to parents/guardians of newly enrolled children during the next 12 months. Acknowledgement of Receipt LIC 9224 form shall be used for this purpose. LIC 9224 after completed shall be maintained in each child's file. (LIC 9224 was provided to Licensee). LPA provided a Notice of Site Visit (LIC 9213) to be posted. FAILURE TO POST THE NOTICE OF SITE VISIT FOR 30 DAYS MAY RESULT IN A $100.00 CIVIL PENALTY This report has been amended to remove the Civil Penalty cited in error. Amendment a pproved by Licensing Program Manager (LPM) Maria Mueller on 9/14/2021.