Follow-up on corrections·July 23, 2021

Licensing Program Analysts (LPAs), Melchisedeck Augustin and Elpidia Hernandez Torres made an unannounced Case Management visit and met with the Center Director, Erika Ramirez (CD) to deliver this report and citations. During the course of a complaint investigation, LPA Augustin obtained evidence showing that due to a shortage in staffing, there was a lack of supervision at the facility which had a direct impact on the teacher-child ratio. LPA also obtained information pertaining to an unusual incident where a staff allegedly served two children food products to which those children were allergic. On 04/16/21 and 04/27/21, LPA interviewed two staff whose statements confirmed that on 04/26/21 at approximately 12:00pm, CD served macaroni and cheese containing egg-based noodles to two children who were allergic to the food product. Staff reported that by the time they noticed and tried to remove the plate, the children had already consumed some of the noodles which did not result to an allergic reaction. Staff also conveyed that the children’s parents were notified, and the children’s records did include doctor’s instructions on IMS medication for eggs allergies that were stored in children’s assigned class. Furthermore, staff claimed that the facility trained and discussed the children’s allergies with staff, however; some staff were uncertain if all staff received training. On 07/14/21 through 07/16/21, LPA conducted subsequent interviews with four staff (S1-S4) who indicated the facility had a staffing shortage which had a direct impact on the teacher to child ratio and a lack of supervision at times. Staff expressed they witnessed the classrooms operating out of ratio on multiple occasions in which CD would take the overflow of child(ren) by strapping children into a stroller and either keeping the stroller near her or parking the stroller in the lobby, by or in her office. S1 reported seeing only one fully qualified teacher providing care and supervision to five infants between the hours of 3:00pm to 6:00pm. S2 reported one occasion where CD supervised multiple infants from her office, while the infants were strapped in a stroller parked near her office at the same time CD conducted half hour to one hour long training for a new hire. (Continue to LIC 809-C) In addition, upon observations of the Infant classroom on 07/23/21 at 9:40am, LPAs observed an eight month old infant sleeping on their stomach on a cot. The facility did not comply with the requirements of California Code of Regulations (CCR), 101430(a)(3)(A), and 101439.1(b). The facility took several steps to address the concerns which included, transferring that child to a crib, and placed on their back. LPAs reviewed and discussed Safe Sleep Practices and regulations, as well as provided the Provider Information Notice (PIN) 20-24-CCP, and Safe Sleep Regulations. S2 further reported witnessing CD walking away from the infants to answer the facility’s entry door in which CD sometimes spent at least five minutes talking with parents while her back was turned and did not have visual observation of the children in the stroller. S3 reported in the last week, the class was out of ratio between two to three times including an incident where, S3 stood between the Infant and toddler classrooms to supervise both classrooms. Based on interviews, there is evidence to show that a staffing shortage contributed to a lack of supervision and the facility did not comply with food services requirements . The following violation(s) of the California Code of Regulations, Title 22; Division 12, sections 101429(a)(1) and 101227(3)(7)(B) were observed: see LIC 809D. Notice of Site Visit shall be posted for 30 days. Appeal Rights were provided. Reports citing Type A violations are to be provided to parents/guardians of children currently in enrolled and to parents/guardians of children newly enrolled at the facility during the next 12 months. Parents/guardians must sign Form LIC9224 to be kept in each child's file.