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32 | Allegation #1 and #2: Interviews were conducted with teachers, teachers’ aides, directors, former directors and parents about the serious concerns regarding the dislocated arm of child # 1. Interview conducted by IB investigator Smith on 04/13/2020 with staff #1 reveal that child # 1 had been napping from 1:00pm to 3:00pm. Staff # 1 initially did not observe child # 1 having any initial injuries. During snack time at about 3:30pm, child # 1 was getting up from the snack table with the help of staff # 1. Staff #1 stated she heard and felt a “pop” noise coming from child # 1 arm, this occurred while helping child #1 get up from the table after snack time. Staff # 1 heard child # 1 whimper but did not inform the director or notify the parent. Staff # 1 and staff # 2 proceeded to do the afternoon walk around the building whereby the walk is observed on cameras to occur daily. Staff # 1 observed child #1 to be holding arm out awkwardly yet did not take any action to inform parent. Parent arrived at 05:15 pm whereby staff # 1 informed the parent to keep an eye on the left arm because he may have slept on it wrong. Staff # 1 did not report this incident to the Director until confronted and asked the next day, about the incident.
Interviews were conducted with the parent who emailed the director the night of 04/13/2020 stating that an injury occurred with child # 1, the child was seen at the Emergency Room. The director reviewed the email addressed regarding the events of the prior day with staff # 1 to get an understating to why this incident was not reported sooner. The investigation process revealed significant concerns that staff #1 did not immediately inform child #1 parent at pick up about the “pop” that was heard, and that child # 1 was observed looking uncomfortable and walking awkwardly. Furthermore staff # 1 did not inform other teachers or the director who also could have spoken with the parent which was not in child # 1 best interest.
The medical report confirmed on 04/13/2020 that child #1 sustain an injury medically known as Nursemaid Elbow. This is a radial head sub-location whereby the bone gets pulled out of place according to the medical record. The physician notes that if a child arm is pulled to hard that Nursemaid Elbow can occur and requires a medical professional to reset the bone or ligament in place. Information revealed from the interviews with staff # 1 pulling child #1 up from the snack table and the “pop” being felt and heard, appears that this is how child # 1 sustained the injury.
Allegation #3: child # 1 was bitten several times. Interviews were conducted with teachers, teachers’ aides, directors, former directors and parents.
Complainant alleged that from September 2019 through March of 2020 child # 1 had sustained five different bites. During this time period child#1’s parent was aware and informed of some of the bites, but not all significant incidents. Investigator Smith was able to obtain pictures of child #1s bites. |
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32 | Interviews were conducted with three teachers and two preschool administrators; statement were inconsistent on who was biting and if staff were aware of the bites. IB Investigator Smith requested that all the documentation be provided for the bites that child # 1 sustained, the request for the documentation was made on two separate occasions, it was not provided by the director to IB investigator Smith. A review of the file was conducted in the Regional Office and no copies of any unusual incident reports were on record of a child sustaining any bite injuries from September 2019 through March 2020. This lack of reporting significant injuries in the form of an unusual incident report is a lack of reporting requirements.
Interviews were conducted with three different teachers that could not identify who and when child # 1 was bitten. IB Investigator Smith conducted interviews with other parents whose children attend the school. Interviews confirmed that other children while in care at Shoreline Preschool have also been bitten by an unknown child at different points in time.
During the course of the investigation, it was discovered staff did not furnish unusual incident reports to IB investigator nor licensing office upon request or within regulation time frame. An unusual incident report was not provided regarding child’s nurse elbow injury. Also, unusual incident reports were not provided for injuries from October 2019 where early incidents took place up until April 27,2020 where child was walking around with arm held out due to physical discomfort.
Based on the IB and LPA investigation, the preponderance of evidence standard has been met, therefore Section 101226.3 Observation of the Child, Section 101226 Health-Related Services, and Section 101229 Responsibility/Provide Care and Supervision, and Section 101212 Reporting Requirements, allegations are found to be substantiated. California Code of Regulations, Title 22, Division 12, Chapter 1, are being cited on the attached LIC 9099D.
If the facility receives a Type 'A' violation the licensee shall post and provide copies of the report to parents/guardians of the children in care at the facility by the next business day and shall provide to the parents/guardians of children newly enrolled at the facility during the next 12 months. In addition, the licensee shall immediately post upon receipt the Proof of Correction for 30 consecutive days. The licensee is to keep Acknowledgement Receipt (LIC9224) signed by parents in each child’s file.
Exit interview was conducted. Notice of Site Visit was posted during the visit. Director was informed that the Notice of Site Visit must be posted for 30 consecutive days. Failure to post will result in civil penalties of $100. Appeal rights provided and explained. 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. |
Deficiency Type
POC Due Date /
Section Number | DEFICIENCIES | PLAN OF CORRECTIONS(POCs) |
Type A
09/04/2020
Section Cited
CCR
101226.3 | 1
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7 | 101226.3 Observation of the Child. Any unusual behavior, any injury or signs of illness requiring assessment and/or administration of first aid by staff shall be reported to the child's authorized representative and recorded…This requirement is not met as evidenced by: | 1
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7 | Per Director, a staff meeting was held August 26th, regarding communication, how to report unusual incident, and accident. Per Director, she will submit a copy of the agenda and staff attendance sheet by the POC due to 09/04/2020. |
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14 | Child # 1 was observed by staff at different points in the day while in care holding arm in an awkward manner, child looking uneasy, and staff heard child’s elbow making a popping sound. The staff did not observe child’s condition changing whereby the child was physically uncomfortable posing an immediate health and safety risk to children in care.
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Deficiency Type
POC Due Date /
Section Number | DEFICIENCIES | PLAN OF CORRECTIONS(POCs) |
Type B
09/09/2020
Section Cited
CCR
101226 | 1
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7 | 101226 Health-Related Services. Licensee shall immediately notify the child's authorized representative if the child becomes ill/sustains injury more serious than a minor cut/scratch. This requirement is not met as evidenced by:staff did not report child's injury to parents nor directorsound. | 1
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7 | Per Director, a staff meeting was held August 26th, regarding communication, how to report unusual incident, and accident. Per Director, she will submit a copy of the agenda and staff attendance sheet by the POC due to 09/09/2020. |
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14 | This lack of not informing the parent of Health-Related Services poses a potential risk to the health and safety to children in care. | 8
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Type B
09/09/2020
Section Cited
CCR
101229 | 1
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7 | 101229 Responsibility Provide Care and Supervision. The licensee shall provide care, supervision as necessary to meet the children's needs no child shall be left without the supervision of a teacher at any time. This requirement is not met as evidence child 1 was bitten multiple times, staff was not aware, poses a potential risk to safety to children in care. | 1
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7 | Per Director, she will submit her plan of action to address biting, to LPA by POC due date of 09/09/2020. |
Type B
09/09/2020
Section Cited
CCR
101212 | 1
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7 | 101212(a)(d)(1)(B)(C)Reporting Requirements.(a) Licensee shall furnish to dept reports as required by dept;(d)(1)any events..shall be reported by phone/fax..(B) any injury require medical,(C)unusual incident..threatens physical/emotiona/safety..Requirement not met as evidence..facility did not furnish unusual incident reports to IB investigator/licensing poses a potenial safety risk to children in care. | 1
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7 | Per Director, a staff meeting was held August 26th, regarding communication, how to report unusual incident, and accident. Per Director, she will submit a copy of the agenda and staff attendance sheet by the POC due to 09/09/2020. |