PHILLIPS BROOKS NURSERY SCHOOL

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 03/28/25 at approximately 8:45am, Licensing Program Analyst (LPA) Katie Krenn arrived at the facility for a case management visit following up on an Unusual Incident (UIR) that the facility self reported on 03/17/25. LPA met with the Assistant Director Zac Oldenberg, Associate Head of School for Academics Sara Poplack, Associate Head of School Olana Khan and explained the purpose of today's visit. Later the Head of the School, Diane Rosenberg joined the meeting. In addition to the administrative staff, LPA observed nine teachers and 55 preschool children (ages 3-5) LPA did a physical plant inspection, which included four classrooms, an outdoor play area, and a multi-purpose room. LPA did not find any areas of non-compliance. Based on the facility's investigation they think that the incident occurred on January 23, 2025. The incident involved one child (C1) and one substitute teacher (T1). C1 reported the event to their parents some time after it happened. The day after the C1 told their parents on 02/12/25, the parents reported the incident to the school. The facility investigated the matter conducting interviews with all the parties involved. The facility concluded that both sides of the story could be true. C1 claimed that T1 had intentionally violated their personal rights, T1 has stated that the interaction had been accidental. LPA inquired why the facility did not contact licensing in a timely matter. The facility said that they had reported to a different agency and was told by that agency, that the agency would contact licensing. NAME OF LICENSING PROGRAM MANAGER: Daniel J Oquendo NAME OF LICENSING PROGRAM ANALYST: Katie Krenn LICENSING PROGRAM ANALYST SIGNATURE: DATE: 03/28/2025 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/28/2025 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

Type B citation - potential risk if not corrected

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 03/28/25 at approximately 8:45am, Licensing Program Analyst (LPA) Katie Krenn arrived at the facility for a case management visit following up on an Unusual Incident (UIR) that the facility self reported on 03/17/25. LPA met with the Assistant Director Zac Oldenberg, Associate Head of School for Academics Sara Poplack, Associate Head of School Olana Khan and explained the purpose of today's visit. Later the Head of the School, Diane Rosenberg joined the meeting. In addition to the administrative staff, LPA observed nine teachers and 55 preschool children (ages 3-5) LPA did a physical plant inspection, which included four classrooms, an outdoor play area, and a multi-purpose room. LPA did not find any areas of non-compliance. Based on the facility's investigation they think that the incident occurred on January 23, 2025. The incident involved one child (C1) and one substitute teacher (T1). C1 reported the event to their parents some time after it happened. The day after the C1 told their parents on 02/12/25, the parents reported the incident to the school. The facility investigated the matter conducting interviews with all the parties involved. The facility concluded that both sides of the story could be true. C1 claimed that T1 had intentionally violated their personal rights, T1 has stated that the interaction had been accidental. LPA inquired why the facility did not contact licensing in a timely matter. The facility said that they had reported to a different agency and was told by that agency, that the agency would contact licensing. NAME OF LICENSING PROGRAM MANAGER: Daniel J Oquendo NAME OF LICENSING PROGRAM ANALYST: Katie Krenn LICENSING PROGRAM ANALYST SIGNATURE: DATE: 03/28/2025 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/28/2025 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