The Reporting Party (RP) reported that Child #1 (C1) has a rash or possible infection on their face. The RP stated they are unaware of any formal diagnosis and expressed concern that the condition may be contagious, potentially placing other children at risk. The RP further indicated that staff have not excluded C1 from attending the facility or have isolated C1.

As part of the investigation, LPA Lucero conducted interviews with four (4) staff members and two (2) parents.

During staff interviews, staff acknowledged that Child #1 (C1) initially presented with what appeared to be small red bumps around the chin area. Over time, these progressed into small blisters around the mouth and chin. Staff reported that they communicated with C1’s parent (P1) and on January 20, 2026, staff were informed that C1 had been diagnosed with a skin infection but was cleared to return to the facility. Staff further stated that C1 began a course of medication, after which the condition improved and has since resolved. Staff indicated that this progression occurred over an approximate three week period, during which the condition worsened before C1 was ultimately taken to a clinic for evaluation. Staff reported that no other children contracted the infection.

Facility staff also provided pictures of C1 and believe the small bumps started around January 8, 2026.

LPA requested documentation of a physician’s clearance for C1 to return to the facility; however, staff reported that no such documentation was obtained. Staff indicated they relied on the parent’s (P1’s) verbal confirmation and stated they were aware C1 had been evaluated, as the child had been prescribed medication.

LPA interviewed P1, who verbally confirmed that C1 was taken to a doctor on January 20, 2026, after the affected area appeared to worsen. P1 stated that the child was cleared by the physician to return to the facility. P1 stated C1 remained home following the doctor visit and returned to the facility the next day. P1 explained that no physician’s clearance letter was provided to the facility because staff had not requested documentation. P1 also disclosed C1’s diagnosis to the LPA.

On 03/19/2026, staff forwarded doctor visit summary to LPA. LPA reviewed summary and did not observe it to state if C1 had clearance to return to facility.

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Based on a review of the diagnosis, it is identified as a highly contagious skin infection. Based on the research, "Children diagnosed with this condition should remain home until they are no longer contagious; typically 24 hours after beginning antibiotic treatment or until existing lesions are healing and no new lesions are present."

LPA obtained the attendance records for C1 and observed that C1 was present at the facility during the period of January 2, 2026, through January 28, 2026. The LPA also noted that C1 was recorded as attending on January 20, 2026, the same day the parent indicated C1 was taken to the doctor and stayed home.

LPA reviewed the facility’s records and confirmed that C1’s prescription medication and a completed medication authorization form were on file. The LPA noted that the prescription indicated a start date of January 21, 2026.

LPA also obtained a copy of the facility’s parent handbook. On page 37, under the section titled “Health and Medical Issues,” it states, “For the health and well-being of your child and others, your child must be kept home if he or she develops any of the following symptoms of contagious disease until the child is free of symptoms for 24 hours or the child’s physician indicates in writing that a child can return to the school (unless other directed by the local health department).” The condition observed in this case is specifically listed as one of the contagious conditions requiring exclusion.

Based on the information gathered from interviews, a review of documentation, and the absence of a physician’s clearance letter for C1, it was determined (1) staff did not ensure that a child with obvious signs of illness was not accepted into care and (2) staff did not isolate a day care child with obvious signs of illness. Therefore, the preponderance of evidence standard has been met, and the above allegations are found to be Substantiated. 1 type B deficiency is being issued; California Code of Regulations, Title 22, Section 101226.1 (a) Daily Inspection for Illness is being cited on the attached LIC 9099D.

An exit interview was conducted, and the report was reviewed with Assistant Director Rosalia Altamirano. A Notice of Site Visit was issued and must remain posted for 30 days. Appeal rights were explained. The Facility representative's signature on this form acknowledges receipt of these rights.

End of Report.