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13 | Licensing Program Analyst (LPA) Dean Valencia conducted an unannounced complaint inspection on today's date, 11/2/2021, to deliver findings of a complaint investigation. LPA met with director Ayanthi R. At 10:30 AM the director guided LPA on a tour of the facility and census of children was taken. At the time of the census LPA observed 85 children and 16 staff.
Investigation of these allegations was conducted by the Division's Investigation Bureau, Investigator Renquist, badge #201. Investigator Renquist interviewed reporting party, a parent of child involved in allegations, six staff, and gathered and reviewed medical records from Hoag Urgent Care and CHOC Hospital. Based on the information gathered by Investigator Renquist, it was determined that the preponderance of evidence standard was met and the allegations are substantiated. The first substantiated allegation constitutes a violation of Health Related Services, Title 22 Regulation section 101226(b), 101226(c), and 101226(e)(3)(a). The second substantiated allegation constitues a riolation of Personal Rights, Title 22 Regulation section 101223(a)(2). (continued on LIC9099C)
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| Substantiated | Estimated Days of Completion: |
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NARRATIVE |
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During LPA's observations of children in the classrooms, LPA was able to observe that staff exhibited appropriate supervision and were within teacher to child ratios.
Staff were interviewed by LPA on 8/3/21 and 9/2/21 and during the interviews staff exhibited knowledge of supervision regulations, and protocol, and stated they are always supervising all children at all times. Parents were interviewed on 10/29/2021, and had generally positive feedback regarding the facility, and had no notable issues related to this reported allegation. From these interviews with staff and parents, and physical plant inspections and observations of the classrooms, and review of facility documentation related to the allegation there was insufficient information to create a preponderance of evidence to support this allegation.
Based on all this information the preponderance of evidence standard for this allegation was not met, therefore the above allegation is found to be unsubstantiated. From all of the available information obtained by LPA during the course of the investigation, that staff do not provide adequate supervision resulting in injury. Based on all of the information LPA was able to obtain, LPA was not able to determine that this allegation was false or untrue. Therefore, LPA cannot make the determination that this allegation is unfounded; and the most accurate finding would remain at unsubstantiated.
Although the allegation may have happened or are valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur; therefore, the allegation is unsubstantiated. Exit interview was conducted, and report was reviewed and discussed. Notice of Site Visit was posted during the visit. The facility representative 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 per day. The facility was provided a copy of their appeal rights (LIC 9058 12/15) 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
11/02/2021
Section Cited
CCR
101226(b) | 1
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7 | The licensee shall make prompt arrangements for obtaining medical treatment for any child if necessary.
This was not met as evideced by:
Based on the information gathered by Investigator Renquist, it was determined that after staff became aware of a child's | 1
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7 | The director stated that in response to the incident all staff were given a letter on 8/16/21 detailing location of allergy list in classrooms, where IMS are stored in class, and communication of allergy/food to all staff who enter into the class. Staff directly involved in incident were provided an additional letter reviewing communication and administering |
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14 | allergic reaction they did not call 911 immediately and allowed child to play outside for 10 minutes. Staff did not seek medical attention in a timely manner. This is an immediate threat to the child's/children's health, safety, and personl rights. | 8
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14 | IMS. Most staff were given pediatric CPR/first aid on 8/19/21, and administration of epi-pen and other IMS were reviewed. Also, a professional development day was conducted on the week of 8/16-8/20 where A handout was also provided about anaphalactic shock, and storage of epi-pen. All this infomration was obtained today. |
Type A
11/02/2021
Section Cited
CCR
101226(c) | 1
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7 | The licensee shall obtain emergency medical treatment without specific instructions from the child's authorized representative if the authorized representative cannot be reached immediately, or if the nature of the child's illness or injury is such that there should be no delay in getting medical treatment for the child. This was not met as evidenced by: | 1
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7 | The director stated that in response to the incident all staff were given a letter on 8/16/21 detailing location of allergy list in classrooms, where IMS are stored in class, and communication of allergy/food to all staff who enter into the class. Staff directly involved in incident were provided an additional letter reviewing communication and administering |
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14 | Based on the information gathered by Investigator Renquist, it was determined that staff were aware of a child's allergic reaction and instead of calling 911 immediately, staff let child play outside for 10 minutes, then called parent of child, who instructed the staff to properly administer an epi-pen. This is an immediate threat to the child's/children's health, safety, and personl rights.
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14 | IMS. Most staff were given pediatric CPR/first aid on 8/19/21, and administration of epi-pen and other IMS were reviewed. Also, a professional development day was conducted on the week of 8/16-8/20 where A handout was also provided about anaphalactic shock, and storage of epi-pen. All this infomration was obtained today. |
Deficiency Type
POC Due Date /
Section Number | DEFICIENCIES | PLAN OF CORRECTIONS(POCs) |
Type A
11/02/2021
Section Cited
CCR
101226(e)(3)(a) | 1
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7 | Prescription medications shall be administered in accordance with the label directions as prescribed by the child's physician. This was not met as evidecned by:
Based on the information gathered by Investigator Renquist, it was determined that staff were not properly trained on how to | 1
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7 | The director stated that in response to the incident all staff were given a letter on 8/16/21 detailing location of allergy list in classrooms, where IMS are stored in class, and communication of allergy/food to all staff who enter into the class. Staff directly involved in incident were provided an additional letter reviewing communication and administering |
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14 | administer an epi-pen and attempted to administer the epi pento a child suffering from an allergic reaction, with the cap on. This is an immediate threat to the child's/children's health, safety, and personl rights. | 8
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14 | IMS. Most staff were given pediatric CPR/first aid on 8/19/21, and administration of epi-pen and other IMS were reviewed. Also, a professional development day was conducted on the week of 8/16-8/20 where A handout was also provided about anaphalactic shock, and storage of epi-pen. All this infomration was obtained today. |
Type A
11/02/2021
Section Cited
CCR
101223(a)(2) | 1
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7 | To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs.
This was not met as evidence by:
Based on the information gathered by Investigator Renquist, it was determined that staff did not meet a child with allergy's needs. | 1
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7 | The director stated that in response to the incident all staff were given a letter on 8/16/21 detailing location of allergy list in classrooms, where IMS are stored in class, and communication of allergy/food to all staff who enter into the class. Staff directly involved in incident were provided an additional letter reviewing communication and administering |
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14 | Child sustained an allergic reaction as a result of staff oversight, and staff did not properly administer an epi-pen to the child, resulting in child needing to be hospitalized and being cared for in the emergency room.
This is an immediate threat to the child's/children's health, safety, and personl rights. | 8
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14 | IMS. Most staff were given pediatric CPR/first aid on 8/19/21, and administration of epi-pen and other IMS were reviewed. Also, a professional development day was conducted on the week of 8/16-8/20 where A handout was also provided about anaphalactic shock, and storage of epi-pen. All this infomration was obtained today. |