NARRATIVE |
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25 | Licensing Program Analyst (LPA) Valencia conducted an on site inspection for the purpose of a Case Management Incident inspection, in response to an Unusual Incident Report submitted to the Licensing office on 10/25/21. An Unusual Incident Report UIR LIC624 form was submitted to the Licensing office on 10/25/21 detailing that a a child, child #1 (see Confidential Names List LIC811), ingested a food that the child was allergic to, was given Benadryl, then an epinephrine device, and 911/emergency services called and child taken to CHOC. During today's inspection, LPA conducted a physical plant inspection, interviewed director and 3 other staff, interviewed an adult #2, and gathered and reviewed documentation related to the incident. It was determined from the information available to LPA during the inspection, that the a child #1 ingested a food, and began sustaining symptoms of allergic reaction. A staff #1 and staff #2 witnessed onset of symptoms. Symptoms began to continue and increase in severity. An adult #1 was called who instructed staff #1 to administer Benadryl. Symptoms continued to worsen. A staff #3 and director entered classroom and witnessed symptoms of child, and called emergency services. It was then determined that a staff #2 should administer the child's prescribed epinephrine pen. Symptoms immediately subsided once the epinephrine was given. An adult#2 and emergency services arrived and child #1 was transported to CHOC. It was determined from interview that from onset of first symptoms to administration of epinephrine device, was approximately 18 to 20 minutes. Child #1 has since returned to care at the facility. Upon review of child's medical documentation, it was determined that the facility did not have the child's medical orders/prescription information on file to review. LPA has determined from the information gathered that facility violated Title 22 Regulations regarding Health Related Services 101226(b), 101226(c) and 101226(e)(3)(a) and also Personal Rights 101223(a)(2). A printout of Title 22 Regulations Health Related Services and Personal Rights was reviewed and provided for the director. In response to this incident director will be sending all staff information related to Incidental Medical Services (IMS) and administration of epinephrine devices. Director will be obtaining medical order/prescription information from child #1's authorized representatives. All of this information and corrections in response to the violations cited and incident, will be submitted to LPA promptly. (continued on LIC809C) |
Deficiency Type
POC Due Date /
Section Number | DEFICIENCIES | PLAN OF CORRECTIONS(POCs) |
Request Denied
Type A
11/02/2021
Section Cited
CCR
101226(b)
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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 interviews and info gathered by LPA Valencia, it was determined that after a staff #1 and staff #2 became aware of a child's | 1
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7 | The director stated that in response to the incident on 10/25/21 all staff will be given a letter 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. A Guidline for Anaphalactic shock will reviewed with all staff and posted in all classrooms. Proof of all of |
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14 | allergic reaction they did not call 911 immediately nor administetred an epinephrine pen. An adult #1 was called and advised staff to give Benadryl. Staff did not seek appropriate 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 | these corrections will be submitted to LPA promptly, and on file. |
Request Denied
Type A
11/02/2021
Section Cited
CCR101226(c)
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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 on 10/25/21 all staff will be given a letter 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. A Guidline for Anaphalactic shock will reviewed with all staff and posted in all classrooms. Proof of all of |
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14 | Based on interviews and info gathered by LPA Valencia, it was determined that staff failed to obtain prompt and appropriate medical treatment for a child's serious allergic reaction. This is an immediate threat to the child's/children's health, safety, and personl rights.
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14 | these corrections will be submitted to LPA promptly, and on file. |
Deficiency Type
POC Due Date /
Section Number | DEFICIENCIES | PLAN OF CORRECTIONS(POCs) |
Request Denied
Type A
11/02/2021
Section Cited
CCR
101226(e)(3)(a)
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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 evidenced by:
Based on interviews and information gathered by LPA Valencia, it was determined that the facility does not have medical orders or | 1
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7 | The director stated that in response to the incident on 10/25/21 all staff will be given a letter 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. A Guidline for Anaphalactic shock will reviewed with all staff and posted in all classrooms. Proof of all of |
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14 | prescription information information from child #1's doctor. This information is to be on file and reviewable at all times a child with IMS is in care. This is an immediate threat to the child's/children's health, safety, and personl rights. | 8
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14 | these corrections will be submitted to LPA promptly, and on file. |
Request Denied
Type A
11/02/2021
Section Cited
CCR101223(a)(2)
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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 interviews and information gathered by LPA Valencia, 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 on 10/25/21 all staff will be given a letter 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. A Guidline for Anaphalactic shock will reviewed with all staff and posted in all classrooms. Proof of all of |
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14 | Child sustained a severe allergic reaction to food ingested, for approximately 18 to 20 minutes before being given the appropriate medical response from the facility, a prescribed epinephrine pen. This is an immediate threat to the child's/children's health, safety, and personl rights. | 8
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14 | these corrections will be submitted to LPA promptly, and on file. |