RP provided copies of subject child’s daily reports from the facility’s electronic communication application. The daily reports are updated throughout the day by staff members and provide details of the child’s feeding, diaper changes and nap schedule. RP states that subject child was continuously returning home with diaper rashes from the facility. This prompted RP to create a log using the information provided by the staff on the application. The subject child attended the facility for a total of 29 days. 16 out of 29 days, the subject child did not receive a diaper change for over 2.5 hours. Subject child was not interviewed due to being a non-verbal infant.

During LPA’s initial 10-day visit, Director and 4 staff were interviewed. Director stated that all staff are trained on diaper changing procedures upon hire. Director states that the teachers take turns or assign one another different shifts to change each child’s diaper. Director states all staff are aware the children’s diaper’s need to be changed every 2 hours. During the interviews with the 4 staff, 1 out of 4 staff members stated changing the children every two hours. 2 out of 4 staff mentioned “or on an as needed basis”. 3 of out of 4 stated they follow their schedule. The schedule is a small piece of paper taped to a cabinet near the changing table. It is labeled with staff names next to a time slot; 8:15am, 10:00am, 2:00pm and 4:00pm. The facility’s resting time begins at 11:30am and can last up to two hours, depending what time the child wakes up.

On 12/14/2022, the Director held a “Diaper Training and Personal Rights” all staff meeting as part of a plan of correction for an unrelated investigation. LPA audited the daily reports for 2 other children for 7 days, beginning the day after the training, 12/15/2022. Child #1, 6 out of 7 days, did not have a diaper change for over 2.5 hours. Two of those incidents the child had a bowel movement. On day 6, staff noted they “noticed bad rash” and applied diaper rash cream.

Child #2, 7 out of 7 days, did not receive a diaper change for over 2.5 hours. On one occasion, the child was not changed for 3 hours and 50 minutes. LPA interviewed a total of 11 out of 16 parents who were contacted. 1 out of 11 parent’s statement corroborated this complaint allegation that their child’s diaper was not being changed often at the facility which also resulted in diaper rashes.

Based on LPAs record review and all interviews conducted, the preponderance of evidence standard has been met, therefore the above allegation(s) is found to be substantiated. California Code of Regulations, Title 22, Division 12, 101428(b)(2), are being cited on the attached LIC9099D.

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LPA Castanon informed Director Nicole Carreon that this report dated 02/27/2023 documents one Type A citation which shall be posted for 30 consecutive days as there are immediate risks to the health, safety, or personal rights of children in care. LPA Castanon also informed the Director to provide a copy of this licensing report dated 02/27/2023 that documents any Type A citations to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

Exit interview was conducted with Director Nicole Carreon. 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. Director was provided a copy of their appeal rights (LIC 9058) and their signature on this form acknowledges receipt of these rights. First level appeals should be sent to the regional manager to the address listed above.

End of Report

During interview with Reporting Party (RP), it is believed that three incidents that resulted in injuries to the subject child were caused by inadequate supervision by staff. On 10/19/2022, during picture day in a different classroom, the subject child was sitting on a chair waiting to have their photo taken when they leaned forward, fell against their face and injured the inside of their lips. RP states the there was a lack of safety harness and staff supervision. The second incident on 10/31/2022, during the morning outside playground time, the subject child was attempting to climb the structure but lost balance and fell on their cheek. RP states the injury was extensive and included abrasions to the forehead and left upper eyelid and provided LPA with photos. Later that afternoon, the child tripped over a rug and bumped the right side of their forehead on a couch.

On 12/19/2022, during LPA’s visit, observation was conducted in Infant Room 3 and the infant playground area. During observation, facility was operating within its licensed capacity. Staff held different activities throughout the time of LPA’s visit. If a child did not want to engage in a certain activity with a staff member, there was an alternate activity being offered with another staff member in another area of the room. All staff communicated respectfully and patiently. LPA observed staff being very attentive to the children in care. LPA did not observe inadequate supervision being provided; all children were being closely monitored.

RP states they observed perishable food left on the counter for an undetermined amount of time, subject child underneath the snack table consuming dropped food left on the ground, subject child consuming food provided by the facility instead of food brought from home, food being offered to child all at once and not in increments throughout the day and food being served directly on the table, not on a dish.

LPA observed Infant Room 3 during two feeding periods. During both feeding sessions, LPA observed children being fed directly by a staff member. Other children who could eat on their own had their food on paper plates or moved their food directly to the table. LPA observed spillage on the floor after children were finished eating. One staff held an activity in the library area for the children to congregate calmly. At this time, another staff member immediately began sweeping the floor and wiping the snack tables. LPA did not observe children attempt to eat food from the floor. The food preparation area was clean and sanitary. LPA did not observe any food left out on the counters.

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LPA inquired about protocol if a child refuses to eat the food provided to them or if parent requests are followed. Director stated that the meals brought from home are priority over facility meals. The child will be offered all other food options provided from home. If the child still refuses to eat, the staff will wait a few minutes to offer the meal again before offering the food options provided by the facility. Director stated that children are always accommodated with any food requests from parents. Infant serves and needs plans are updated quarterly and allows parents to establish any changes in feeding.

Based on LPA’s observation and interviews conducted, the allegation #1 staff do not provide adequate supervision resulting in daycare child sustaining injuries, #2 Staff are not providing adequate food service and #3 staff do not follow daycare child’s meal plan may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is unsubstantiated.

Exit interview was conducted. The Notice of Site Visit was posted. Facility representative was informed that the Notice of Site Visit must be posted for 30 consecutive days. Failure to post will result in civil penalty of $100. Director was provided a copy of their appeal rights (LIC 9058) and their signature on this form acknowledges receipt of these rights.

End of Report