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25 | Licensing Program Analysts (LPAs), Melchisedeck Augustin and Elpidia Hernandez Torres made an unannounced Case Management visit and met with the Center Director, Erika Ramirez (CD) to deliver this report and citations. During the course of a complaint investigation, LPA Augustin obtained evidence showing that due to a shortage in staffing, there was a lack of supervision at the facility which had a direct impact on the teacher-child ratio. LPA also obtained information pertaining to an unusual incident where a staff allegedly served two children food products to which those children were allergic.
On 04/16/21 and 04/27/21, LPA interviewed two staff whose statements confirmed that on 04/26/21 at approximately 12:00pm, CD served macaroni and cheese containing egg-based noodles to two children who were allergic to the food product. Staff reported that by the time they noticed and tried to remove the plate, the children had already consumed some of the noodles which did not result to an allergic reaction. Staff also conveyed that the children’s parents were notified, and the children’s records did include doctor’s instructions on IMS medication for eggs allergies that were stored in children’s assigned class. Furthermore, staff claimed that the facility trained and discussed the children’s allergies with staff, however; some staff were uncertain if all staff received training.
On 07/14/21 through 07/16/21, LPA conducted subsequent interviews with four staff (S1-S4) who indicated the facility had a staffing shortage which had a direct impact on the teacher to child ratio and a lack of supervision at times. Staff expressed they witnessed the classrooms operating out of ratio on multiple occasions in which CD would take the overflow of child(ren) by strapping children into a stroller and either keeping the stroller near her or parking the stroller in the lobby, by or in her office. S1 reported seeing only one fully qualified teacher providing care and supervision to five infants between the hours of 3:00pm to 6:00pm. S2 reported one occasion where CD supervised multiple infants from her office, while the infants were strapped in a stroller parked near her office at the same time CD conducted half hour to one hour long training for a new hire. (Continue to LIC 809-C) |
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32 | In addition, upon observations of the Infant classroom on 07/23/21 at 9:40am, LPAs observed an eight month old infant sleeping on their stomach on a cot. The facility did not comply with the requirements of California Code of Regulations (CCR), 101430(a)(3)(A), and 101439.1(b). The facility took several steps to address the concerns which included, transferring that child to a crib, and placed on their back. LPAs reviewed and discussed Safe Sleep Practices and regulations, as well as provided the Provider Information Notice (PIN) 20-24-CCP, and Safe Sleep Regulations.
S2 further reported witnessing CD walking away from the infants to answer the facility’s entry door in which CD sometimes spent at least five minutes talking with parents while her back was turned and did not have visual observation of the children in the stroller. S3 reported in the last week, the class was out of ratio between two to three times including an incident where, S3 stood between the Infant and toddler classrooms to supervise both classrooms.
Based on interviews, there is evidence to show that a staffing shortage contributed to a lack of supervision and the facility did not comply with food services requirements. The following violation(s) of the California Code of Regulations, Title 22; Division 12, sections 101429(a)(1) and 101227(3)(7)(B) were observed: see LIC 809D. Notice of Site Visit shall be posted for 30 days. Appeal Rights were provided.
Reports citing Type A violations are to be provided to parents/guardians of children currently in enrolled and to parents/guardians of children newly enrolled at the facility during the next 12 months. Parents/guardians must sign Form LIC9224 to be kept in each child's file.
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Deficiency Type
POC Due Date /
Section Number | DEFICIENCIES | PLAN OF CORRECTIONS(POCs) |
Type A
07/24/2021
Section Cited
CCR
101429(a)(1)
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7 | In addition to Section 101229, the following shall apply: Each infant shall be constantly supervised and under direct visual observation and supervision by a staff person at all times.
This requirement is not met as evidenced by: Based on | 1
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7 | Director stated she now communicates with the teachers and conducts individual meetings with staff to discuss supervision requirements. Director stated she would check on the classrooms every 15 minutes and she intended to obtain additional staff o support the classrooms and to ensure that the classes are adequately staff. |
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14 | interviews which showed that a staffing shortage contributed to a lack of supervision. | 8
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14 | The Licensee would submit a written plan to detail how the facility intended to comply with supervision requirements by 07/24/21 via mail, email or fax.
Email: melchisedeck.augustin@dss.ca.gov |
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Deficiency Type
POC Due Date /
Section Number | DEFICIENCIES | PLAN OF CORRECTIONS(POCs) |
Type B
08/13/2021
Section Cited
CCR
101227(3)(7)(B)
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7 | A child shall not be served any food to which the child's record indicates he/she has an allergy.
This requirement is not met as evidenced by: Based on interviews that showed that the facility did not comply with food services requirements. | 1
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7 | Director stated she will let staff and new hire know about children's allergies list and willl create document which staff would have to acknowledge they were trained and received training, and the Director will produce a written plan which would be implemented and the Director intends to conduct staff training. |
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14 | This posed a potential health and safety risk to the children in care. | 8
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14 | The agenda and staff signature for the training would be submitted to the Department by 08/13/21.
email: melchisedeck.augustin@dss.ca.gov
Fax: 707-588-5099 |
Type B
08/13/2021
Section Cited
CCR101430(a)(3)(A)
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7 | Staff shall place infants up to 12 month of age on their backs for sleeping.
This requirement is not met as evidenced by: Based on LPAs' observations of an eight month old infant sleeping on their stomach on a cot in the infant class at 9:40am. This poses a potential health and safety risl to that child in care. | 1
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7 | Director stated she intends to train all staff on Safe Sleep Practices. The Director will submit a copy of the training topic & agenda, staff siganture page pertaining to the training. The POC would be submitted to the Department by 08/13/21. |
Type B
08/13/2021
Section Cited
CCR
101439.1(b)
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7 | A crib or portable-crib meeting United States Consumer Product Safety Commission safety standards shall be provided for each infant who is unable to climb out of a crib.
This requirement is not met as evidenced by: Based on LPAs' observation of an eight month old infant sleeping on a cot in the infant classroom at 9:40am. | 1
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7 | Director stated she intends to train all staff on Safe Sleep Practices. The Director will submit a copy of the training agenda, staff siganture page pertaining to the training. The POC would be submitted to the Department by 08/13/21. |