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25 | On September 22, 2021 at 12:38PM, Licensing Program Analyst (LPA) Brigitte Tsutaoka conducted an unannounced Case Management - Incident inspection regarding the self reported incident involving a child who placed a bead up their nose. LPA disclosed the purpose of inspection and was greeted by Director Jessica Krall who guided LPA on a tour of the facility. Upon entry, LPA counted 26 children in care with 6 staff.
During inspection, LPA interviewed Director, Staff 1, and Child 1. Staff 2, who had also witnessed incident, was not present during inspection. On 9/07/2021 during nap time, Child 1 found a bead near his napping area on the ground and placed it inside his right nostril. Staff 1 and Staff 2 immediately came over to Child 1 as he was favoring his nostril and rubbing his nose. Director overheard the conversation among Staff 1, Staff 2, and Child 1 and heard one of the staff ask about a bead inside Child 1's nose.
Director requested Child 1 and Staff 2 come into the adjacent classroom, and observed the bead inside Child 1's nose. The bead was visible with a flashlight and was white in color. There was no visible injury to the nostril nor any bleeding. Director immediately called Parent 1 to pick up Child 1. Parent 1 came to the facility at 12:30PM and took Child 1 to the emergency room at 2:25PM. Parent 1 and Child 1 stayed at the emergency room until 9:00PM without being seen and came back the following day. On 9/08/2021, Parent 1 and Child 1 went to the Ears, Nose, and Throat specialist to schedule the procedure to remove the bead on 9/09/2021. On 9/09/2021, Parent 1 took Child 1 to the appointment to have the procedure performed, but by that point the bead had dislodged and moved to the intestines. Child 1 received x-rays to determine the placement of the bead. No procedure was required and Child 1 came to the facility after the appointment.
Director provided LPA a copy of the manufacturer's ordering website page which stipulates beads are permissible for children ages 3 and up. Child 1 is of age and eligible to play with beads according to his age. LPA also observed Child 1's file which did not indicate any developmental delays that would prevent Child 1 from safely playing with beads or using beads in crafting.
Based on evidence obtained and interviews conducted, no deficiencies were noted and no citations will be issued today. An exit Interview was conducted, a copy of this Report, Appeal rights and a Notice of Site visit were provided to the Director. |