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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 490110439
Report Date: 07/31/2019
Date Signed: 08/01/2019 08:59:21 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 101 GOLF COURSE DR. STE. A-230
ROHNERT PARK, CA 94928
FACILITY NAME:LEARNING TO LEARNFACILITY NUMBER:
490110439
ADMINISTRATOR:ERIC O'NEILFACILITY TYPE:
850
ADDRESS:1300 MEDICAL CENTER DRIVETELEPHONE:
(707) 584-4224
CITY:ROHNERT PARKSTATE: CAZIP CODE:
94928
CAPACITY:109CENSUS: 59DATE:
07/31/2019
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
12:17 PM
MET WITH:Eric O'NeilTIME COMPLETED:
01:55 PM
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A case management inspection was conducted by Licensing Program Analyst (LPA) Y. Yang in response to an Unusual Incident Report involving injury to a child on 07/11/19 at approximately 05:00pm. According to the incident report, center director Eric O’Neil reported that child C1 was running in the breezeway on the playground and fell onto the cement floor as C1 was turning a corner. The center director reported that C1 landed on their right side at the time of impact. The center director reported that staff S1 was present on the playground at the time of the incident and carried child C1 back to the office for examination. The center director reported that an ice pack was provided to child C1 but child C1 refused the ice pack.

The center director reported that the child's mother was contacted and arrived at the center at 05:22pm to pick child C1 up from the center. The center director reported that the child's mother transported child C1 to a local hospital for examination the following day. The center director reported that child C1's mother contacted the center on 07/12/19 to inform the center that during the initial examination and X-Ray, it was discovered that the child sustained a broken femur and was transported to a different hospital for surgery.

During today's inspection, interviews with S1 and the center director were conducted. The playground and the breezeway were inspected at 12:45pm; no obvious tripping or slip hazards were observed. LPA observed 59 children being supervised by 8 staff members. The center director stated that children are frequently reminded that running takes place in the padded wood chip area of the playground; not on the cement area.

The incident was reported to Community Care Licensing as required. At this time, with the information available, it was determined that there is not sufficient evidence to indicate that the child's injury was caused by a violation of regulations. This report was reviewed and discussed with the center director.
Notice of Site Visit shall be posted for 30 days from today's visit.
There were no Title 22 deficiencies cited during today's inspection.
SUPERVISOR'S NAME: Alexis HollonTELEPHONE: (707) 588-5036
LICENSING EVALUATOR NAME: Yang YangTELEPHONE: 707-588-5026
LICENSING EVALUATOR SIGNATURE:

DATE: 07/31/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/31/2019
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
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