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25 | Licensing Program Analyst (LPA) Vicky Williamson conducted a case management inspection to follow up on an incident. LPA met with Director, Debbie Edlebrock. On 9/26/19, the Director self- reported an incident that occurred on 9/24/19. The facility reported that child #1 was on the playground sitting in a wagon with child #2. The wagon was being pulled by child #3 on the wagon trail. Child #1 stood up in the wagon, lost his balance and fell out of the wagon onto the concrete sustaining an injury to the head. There were 3 teachers and 29 children present on the playground during the time of the incident. Interviews were conducted with the Director, staff #1, staff #2 and staff #3. Child #1 was unavailable for an interview. LPA obtained a copy of facility roster and sign in /sign out sheets for 9/24/19. LPA inspected the wagon during time of inspection. The incident requires further review.
No deficiencies cited during today’s inspection. LPA reviewed this report with the Director and an exit interview was conducted. The Director was provided a copy of their appeal rights (LIC 9058 01/16) and their signature on this form acknowledges receipt of these rights. LIC 9213 NOTICE OF SITE VISIT FORM IS REQUIRED TO BE POSTED FOR 30 DAYS. LPA observed Licensee post notice of site visit.
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