KLASSIC KIDS DAY CARE - LOMA PORTAL

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 7/7/2025, at 1:20pm., Licensing Program Analyst (LPA) Cindy Meier conducted an unannounced case management inspection regarding a self reported incident. LPA met with Facility Representative, Site Director, Susan Hansen. LPA discussed the purpose of the inspection and was led on a tour of the facility. There were twenty-five (25) children present with four (4) staff members. Site Director, Susan Hansen reported to Community Care Licensing that on 6/12/2025 at 11:45am there were twenty-four (24) children playing outside with two (2) staff supervising, when child #1 (C1) who was playing on the monkey bars on the climbing structure, lost their grip, fell and landed on their right arm. Staff #1 (S1) stated she was approximately 3 feet away when C1 fell. S1 attended to C1 and escorted C1 to the classroom for further evaluation and first aid. Staff #2 (S2) remained with the other children and Staff #3 went to the playground to assist the supervision and ratio. C1’s parents were notified and C1 was picked up later in the day. Staff administered first aid to C1 until the parents picked up C1. C1 was later evaluated at the hospital and diagnosed with a fractured arm. LPA observed the climbing structure and monkey bars and made note of the manufacturer’s label on the structure stating the equipment is designed and appropriate for ages 5 – 12. C1 is younger than 5 years of age. Due to the manufacturer’s age restriction label, the facility was out of compliance which poses an immediate risk to the health, safety, or personal rights of children in care as C1 was younger than 5 years of age. NAME OF LICENSING PROGRAM MANAGER: Jason Garay NAME OF LICENSING PROGRAM ANALYST: Cindy Meier LICENSING PROGRAM ANALYST SIGNATURE: DATE: 07/07/2025 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/07/2025 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 4 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 req

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 7/7/2025, at 1:20pm., Licensing Program Analyst (LPA) Cindy Meier conducted an unannounced case management inspection regarding a self reported incident. LPA met with Facility Representative, Site Director, Susan Hansen. LPA discussed the purpose of the inspection and was led on a tour of the facility. There were twenty-five (25) children present with four (4) staff members. Site Director, Susan Hansen reported to Community Care Licensing that on 6/12/2025 at 11:45am there were twenty-four (24) children playing outside with two (2) staff supervising, when child #1 (C1) who was playing on the monkey bars on the climbing structure, lost their grip, fell and landed on their right arm. Staff #1 (S1) stated she was approximately 3 feet away when C1 fell. S1 attended to C1 and escorted C1 to the classroom for further evaluation and first aid. Staff #2 (S2) remained with the other children and Staff #3 went to the playground to assist the supervision and ratio. C1’s parents were notified and C1 was picked up later in the day. Staff administered first aid to C1 until the parents picked up C1. C1 was later evaluated at the hospital and diagnosed with a fractured arm. LPA observed the climbing structure and monkey bars and made note of the manufacturer’s label on the structure stating the equipment is designed and appropriate for ages 5 – 12. C1 is younger than 5 years of age. Due to the manufacturer’s age restriction label, the facility was out of compliance which poses an immediate risk to the health, safety, or personal rights of children in care as C1 was younger than 5 years of age. NAME OF LICENSING PROGRAM MANAGER: Jason Garay NAME OF LICENSING PROGRAM ANALYST: Cindy Meier LICENSING PROGRAM ANALYST SIGNATURE: DATE: 07/07/2025 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/07/2025 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 4 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 req