Incident investigation·August 24, 2023

On 08/24/2023, Licensing Program Analyst (LPA) Valerie Mireles and Licensing Program Manager Cynthia Brannon met with Center Supervisor Norma Aranda for an unannounced case management inspection. A complete file review was conducted prior to today's inspection. LPA toured the facility, and a census was taken. The purpose of today's inspection was to address an unusual incident that took place at the facility on 07/27/2023. An Unusual Incident Report was submitted to the Fresno Community Care Licensing (CCL) Office regarding an incident that occurred, on 07/27/2023, involving a daycare child that fell while running near the outdoor play structure resulting in the child sustaining a fractured nose. On 08/24/2023, LPA and LPM spoke with Staff #1, who reportedly witnessed the incident as it occurred and was in proximity of the child when the incident occurred. According to the staff, the child was dancing then ran towards the outdoor play structure and fell onto the step of the play structure. Initially, the child cried and complained of pain to her nasal area. Per Staff #1 and Staff #2, no visible bruising and or bleeding occurred, but there was minor swelling; therefore, first aid was administered. Immediately after the incident, the child\342\200\231s parent was notified. Per Staff #2, child was taken to the emergency room and saw a physician on the date of the incident and was diagnosed with a fracture to child\342\200\231s nose. Per physician, child was placed on physical activity restriction until 09/12/2023. A care plan was developed between Staff #2 and the school nurse to provide the child with activities at home until the child\342\200\231s return to the facility. On 08/24/2023, LPA and LPM observed the outdoor play area and structure where the incident took place. The outdoor play structure was inspected and was in good condition with no visible defects. At the time of the incident there were two teachers present and five children present at the outdoor play structure where the incident occurred; therefore, adequate supervision and teacher-child ratio was in place. Continued to LIC809-C Based on the information obtained, LPA and LPM determined staff handled the incident correctly and reporting requirements were met. After interviewing staff and reviewing facility records, LPA determined this was a one-time occurrence; and facility staff took appropriate measures to address the child\342\200\231s injury, following proper policies and procedures and no regulations were violated. Per the California Code of Regulations, Title 22, Division 12, Chapter 1, no deficiency was cited during today\342\200\231s inspection. Exit interview conducted with the Site Supervisor, Norma Aranda. This report shall be made available to the public upon request. LIC 9213 Notice of Site Visit is provided and required to be posted for 30 days.