Incident investigation·July 21, 2023

On 7/21,2023 Licensing Program Analyst (LPA) Julie Baptista conducted an unannounced case management visit to review incident that occurred on 6/16/2023. LPA explained purpose of inspection and took a census. Licensee and assistant (S2) were watching children play in back yard when LPA arrived. On 6/16/2023, Child #1 was washing hands in the restroom while standing on a small stool in front of sink. Licensee and one assistant (S1) were present on 6/16/23. Assistant was in the doorway of restroom while child #1 was washing hands. Child #1 stepped off the stool backwards and stumbled. Child complained of ankle pain. Staff immediately came to the aid of child and looked for swelling and signs of injury. Staff did not see any swelling at this time. Parent was notified of incident and was advised of monitoring. Child walked on foot to the park with staff and other children shortly after. Staff noticed that child began to limp and continued to monitor child. Child's ankle began to show signs a half hour later of swelling. Parent was called to pick up child. Parent advised licensee initially that doctor diagnosed with a sprained ankle at noon that day. Licensee was advised the next day, on 6/17/23, by parent that x-rays revealed a closed fracture. Licensee and parent continued to communicate during the next few weeks. Child recovered at home and returned to day care on 7/13/23. Licensee requested a doctor note clearing child with no restrictions before child could return to care. LPA and licensee discussed children using a two-step stool with handles that licensee has instead of the single-step stool. The single-step stool is adequate for the task however the stool with handles may add a level of security for smaller children to hold on to as they step down. This Facility met all reporting requirements as specified in Title 22 Regulation 101212 - Reporting Requirements. The incident is an isolated incident and not a result of lack of care and supervision. Per California Code of Regulations, Title 22, Division 12, Chapter 1, no deficiency is being cited during today's inspection. This report is to be made available to the public upon request. LIC 9213 Notice of Site Visit to be posted for 30 days.