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Type A citation - immediate risk to health, safety, or personal rights

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25On 02/20/26 at 9:07 AM Licensing Program Analyst (LPAs) J.C. Valdez and Ryan Grimes conducted an unannounced case management visit, to follow up on a self-reported incident that occurred on 1/29/26. LPA met with the Director Deborah Durham and explained the purpose of the visit. LPA observed 19 children and 7 staff members in 3 classrooms. Facility is within ratio and capacity. All staff present were fingerprint cleared and associated to the facility. Facility self-reported an incident, that occurred on 01/29/26, wherein child (C1) complained about their arm hurting to a staff member (S1) at approximately 11:00AM. According to witness statements, (C1) did not show any physical signs of injury. (S2) was also present during the time of the incident. At approximately 12:00PM, (S2) called the Center Director Deborah Durham to inspect (C1). (D1) directed (S2) to provide an ice pack to (C1). An ice pack was provided and staff continued to monitor (C1). At approximately 12:25PM the mother (P1) of (C1) was notified and came to pick up (C1) at 12:58 PM. (P1) took (C1) to the emergency room. The facility followed up with (P1) regarding (C1’s) condition on 01/30/26. Per the LIC 624, (C1) was placed in a sling and splint during the emergency room visit and a follow-up appointment needed. On 02/06/26 LPA Grimes called (D1) to follow up on the incident. During follow up call, (D1) advised LPA Grimes that (C1) had an additional medical appointment on 02/05/26. (C1) was placed in a cast for 3 weeks. (C1) returned to school on 02/06/26. (continued next page) NAME OF LICENSING PROGRAM MANAGER: Keturah Lane NAME OF LICENSING PROGRAM ANALYST: Juan Carlos Valdez LICENSING PROGRAM ANALYST SIGNATURE: DATE: 02/20/2026 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/20/2026 This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC809 (FAS) - (06/04)Page: 1 of 3 FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form. DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies: Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care. Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care. PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency. CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given. CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25On 02/20/26 at 9:07 AM Licensing Program Analyst (LPAs) J.C. Valdez and Ryan Grimes conducted an unannounced case management visit, to follow up on a self-reported incident that occurred on 1/29/26. LPA met with the Director Deborah Durham and explained the purpose of the visit. LPA observed 19 children and 7 staff members in 3 classrooms. Facility is within ratio and capacity. All staff present were fingerprint cleared and associated to the facility. Facility self-reported an incident, that occurred on 01/29/26, wherein child (C1) complained about their arm hurting to a staff member (S1) at approximately 11:00AM. According to witness statements, (C1) did not show any physical signs of injury. (S2) was also present during the time of the incident. At approximately 12:00PM, (S2) called the Center Director Deborah Durham to inspect (C1). (D1) directed (S2) to provide an ice pack to (C1). An ice pack was provided and staff continued to monitor (C1). At approximately 12:25PM the mother (P1) of (C1) was notified and came to pick up (C1) at 12:58 PM. (P1) took (C1) to the emergency room. The facility followed up with (P1) regarding (C1’s) condition on 01/30/26. Per the LIC 624, (C1) was placed in a sling and splint during the emergency room visit and a follow-up appointment needed. On 02/06/26 LPA Grimes called (D1) to follow up on the incident. During follow up call, (D1) advised LPA Grimes that (C1) had an additional medical appointment on 02/05/26. (C1) was placed in a cast for 3 weeks. (C1) returned to school on 02/06/26. (continued next page) NAME OF LICENSING PROGRAM MANAGER: Keturah Lane NAME OF LICENSING PROGRAM ANALYST: Juan Carlos Valdez LICENSING PROGRAM ANALYST SIGNATURE: DATE: 02/20/2026 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/20/2026 This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC809 (FAS) - (06/04)Page: 1 of 3 FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form. DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies: Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care. Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care. PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency. CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given. CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when