Upon arrival, LPA met with Director Rosaura Castillo, to whom the purpose of the inspection was announced. The Director guided LPA on a tour of the facility and conducted a census.

In the Ducks room, LPA observed 20 children with four staff; Owls room, 22 children with five staff; Koalas room, two children with four staff; and Flamingos room, eight children with four staff.

During the course of the investigation, LPA interviewed C1, two staff members (S1 and S2), and C1's parent (P1) regarding the circumstances surrounding the incident. LPA also obtained the following documents: LIC 500 Staff Roster, LIC 9040 Child Care Facility Roster, and photo of pinecone.

During interview, C1 stated C1 was playing with pinecones while outside and another child was also playing with a pinecone. C1 stated a pinecone hit C1's head and caused a scratch. When asked where the pinecone came from, C1 stated it came from the tree. C1 stated S1 assisted C1 and provided an ice pack. C1 reported C1's head hurt following the incident but was feeling better at the time of interview.

S1 stated the incident occurred during an off-campus walking field trip to a grassy hill area within walking

• Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

• Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

S1 stated the area was inspected following the incident and photographs were taken and provided to the Director. S1 stated the trees located within the immediate area where C1 was injured did not contain pinecones; however, pine-producing trees were located outside/behind the immediate area. S1 stated it was unknown how the pinecone came to be in the area and indicated it was possible the pinecone may have been carried or dropped by an animal. S1 reported no prior incidents or concerns involving pinecones in the area. Following the incident, staff discussed remaining observant while in the open area and being mindful of their proximity to trees.

During a separate interview, S2 stated C1 and another child had been observed playing with pinecones prior to the incident. S2 observed the children tossing pinecones and kicking them like a ball. S2 stated S2 attended to the other child after the child reported C1 had thrown a pinecone at him. Approximately 10 seconds later, S2 heard C1 crying. S2 did not personally observe the pinecone strike C1 and could not confirm how the pinecone made contact with C1.

S2 stated pinecones can be present in the grassy hill area and that children have previously shown interest in and played with natural items. S2 stated children are instructed before entering the grassy hill area not to throw natural items and are reminded to safely explore them. Following the incident, staff reinforced safety expectations with the children and reminded children to request a ball if they wanted to throw an object.

LPA subsequently interviewed P1. P1 stated C1's parents were contacted immediately following the incident by staff and the Director. P1 was informed that a pinecone struck C1's head, resulting in a cut near C1's scalp. P1 stated the facility initially believed the pinecone may have fallen from a tree. P1 was informed that paramedics were called as a precaution due to the injury involving C1's head. P1 subsequently spoke directly with the responding paramedics regarding their assessment of C1.

P1 stated that upon seeing C1, the injury was no longer actively bleeding and appeared more consistent with

Based on interviews conducted and information obtained during the investigation, LPA was unable to independently determine the exact manner in which the pinecone made contact with C1. Although S2 observed C1 and another child playing with pinecones prior to the incident, S2 did not witness C1 being struck. S1 was positioned directly next to C1 when the incident occurred and observed an object fall and strike C1. Information obtained during the investigation indicated that the trees within the immediate area where C1 was injured did not contain pinecones; however, pine-producing trees were located outside/behind the immediate area. It could not be determined how the pinecone came to be in the immediate area or how it ultimately made contact with C1.

The investigation established that staff were present and supervising C1 at the time of the incident. S1 was positioned directly next to C1 and immediately responded when C1 was injured. The facility provided first aid, promptly notified C1's parents, contacted paramedics for further assessment, inspected the area following the incident, and reinforced safety expectations regarding natural items with the children.

Based on the information obtained, the incident appears to have been an isolated accidental occurrence. The information obtained does not establish that a lack of care and supervision contributed to C1's injury, and there is insufficient evidence to establish a violation of Title 22 regulations.

No deficiencies are being cited as a result of today's inspection. The incident investigation is concluded.

A notice of site visit was given. Appeal rights provided.

Exit interview conducted and report was reviewed with the Director Rosaura Castillo. A copy of this report was provided and must be posted for 30 days.