372006368-7-5-2022-10-CC-PBER-CGKNM4-20220722103429

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 372006368
Report Date: 07/05/2022
Date Signed: 07/05/2022 03:18:35 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/16/2022 and conducted by Evaluator Otsanya Cameron

COMPLAINT CONTROL NUMBER: 10-CC-20220616143652

FACILITY NAME:	ST. MARY, STAR OF THE SEA PRESCHOOL		FACILITY NUMBER:	372006368
ADMINISTRATOR:	JORDAN JACKSON		FACILITY TYPE:	850
ADDRESS:	515 WISCONSIN AVENUE		TELEPHONE:	(760) 722-7475
CITY:	OCEANSIDE	STATE: CA	ZIP CODE:	92054
CAPACITY:	40	CENSUS: 11	DATE:	07/05/2022
		UNANNOUNCED	TIME BEGAN:	12:55 PM
MET WITH:	Patricia Corral		TIME COMPLETED:	03:36 PM

ALLEGATION(S):

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Child hit another child with a log causing injury
Licensee did not make prompt arrangements for obtaining medical treatment

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Otsanya Cameron arrived at the facility to conclude an investigation into the above allegations. LPA toured the facility and conducted census. An initial visit was conducted on 06/23/22 and extended at that time.

It was alleged that 1).Child hit another child with a log causing injury. 2)Licensee did not make prompt arrangements for obtaining medical treatment

During the course of the investigation, Interviews were conducted and facility files were reviewed. Additonally, LPA conducted a physical plant inspection of outdoor activity space. Interviews were conducted with staff members in which 1 of 2 staff stated they witnessed the object being thrown and fall down to the ground, but did not actually see it hit the day care child. Immediately after, a day care child began to run away from the area of the play structure and the staff asked if they were hurt by the log.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Pauline Beschorner	TELEPHONE: (951) 782-6641
LICENSING EVALUATOR NAME: Otsanya Cameron	TELEPHONE: (951) 970-1388
LICENSING EVALUATOR SIGNATURE:	DATE: 07/05/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/05/2022

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 10-CC-20220616143652

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: ST. MARY, STAR OF THE SEA PRESCHOOL	FACILITY NUMBER: 372006368
	VISIT DATE: 07/05/2022

NARRATIVE

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Staff immediately approached the child and saw there was an injury and commenced first aid. Staff contacted the center director via walkie-talkie, who immediately took over providing First aid and took child to office and notified the Authorized representative via telephone. The center Director then completed and unusual incident report and contacted Community Care Licensing Regional Office.

During physical plant inspection LPA did observe logs identified in this complaint which are present throughout the playground. LPA also observed during inspection a first aid kit accessible to staff during outdoor play time Located in the shed. Interviews revealed that morning walk-through inspections of the playground are conducted by staff before outdoor play Daily. During the time of the incident there were 19 children with Two Staff and the center was operating within ratio. Although the incident did occur, there was no violation of any regulation.

In regards to the allegation: Licensee did not make prompt arrangements for obtaining medical treatment

During file review, it was observed that all staff present during the reported unusual incident, have obtained CPR/FIRST AID certifications that are current and valid. LPA did observe a signed medical consent for treatment form, however, LPA did not observe any additional documentation or directives given from a doctor or licensed professional to take any additional measures for an similar or related incident. It was reported that Director was given verbal instruction by authorized representative to call 911 If child was pale or lips turned blue , When notified about the incident. However, based on interview, this did not occur. Interviews revealed that the appropriate action based the initial and immediate assessment of staff was taken. According to staff the injury was not life threatening and the first aid rendered was sufficient. There is nott sufficient evidence to corroraborate the above mentioned allegations and therefore it is unsubstantiated. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the allegation did or did not occur, therefore the allegation is UNSUBSTANTIATED. An exit interview was conducted with Director Patricia Corral, appeal rights discussed and provided along with a copy of this report.

SUPERVISOR'S NAME: Pauline Beschorner	TELEPHONE: (951) 782-6641
LICENSING EVALUATOR NAME: Otsanya Cameron	TELEPHONE: (951) 970-1388
LICENSING EVALUATOR SIGNATURE:	DATE: 07/05/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/05/2022

LIC9099 (FAS) - (06/04)

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