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32 | On 04/22/2026, the Orange County Child Care Office received a complaint alleging: day care child sustained a fracture due to staff neglect. Reporting Party (RP) stated the following: “On 4/16 between 11am and 12pm, staff #1 (S1) informed Child #1 (C1)’s parent that another child ran into C1 and C1 had a small mark on the forehead. C1 was picked up at 4:50pm, and C1 was limping. On 4/17/26, C1 refused to walk and stand up and C1 disclosed that C1 had fallen. Facility refused to admit C1 on 4/17/26 since C1 did not want to put pressure on the leg so C1 was taken to the hospital where x-rays were done and the result was normal. They placed a temporary splint on C1. On 4/21/26, C1 was taken back to CHOC ER due to C1’s knee being swollen, and in extreme pain. C1 was examined, and they stated that C1’s knee was fractured and they placed another splint on C1.
The investigation included interviews with facility staff, the child’s parent/guardian, and other relevant witnesses; a review of medical documentation; observation of the facility environment and the area where the injury was reported to have occurred; and a review of supervision practices, staff positioning, and facility records from the date of the incident.
During unannounced facility inspections on 04/24/2026 and 06/24/2026 LPA observed staff were engaging and supervising children in care. Children were sitting at the tables using paper and writing materials as staff were walking around the tables supporting children.
Medical records confirmed that on 4/17/26, C1 had an x-ray done at CHOC Emergency Department and the result indicated “No fracture or dislocation”. On 4/21/26, C1 returned to CHOC ER for right knee swelling. The results indicated X-rays were reviewed from prior ED visit showed no obvious fracture. However, given knee swelling cannot exclude possible occult fracture. Splint replaced today.
Interviewed staff and Incident report indicated that on 4/16/26 at around 11:15am, Child 2 (C2) was halfway up the play structure jumped off on C1 who was playing on the wooden steppers near the play structure. Both children fell on the ground, holding their foreheads.
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