101229(a)(1) · 101229 Responsibility for Providing Care and Supervision (a) The licensee shall provide care and supervision...(1) No child(ren) shall be left without the supervision of a teacher at any time...Supervision shall include visual observation.

We will have a staff meeting coming up and this incident will be discussed during that meeting. I will provide proof of what was discussed to Licensing and a staff sign in sheet. Based on interview and record review a Child (C1) sustained an injury to their arm while in care and playing on the playground. The Staff did not observe the injury occur. This is an immediate health, safety, or personal rights risk to the persons in care. Claretta Yates NAME OF LICENSING PROGRAM MANAGER: Kuliema Calloway NAME OF LICENSING PROGRAM ANALYST: LICENSING PROGRAM ANALYST SIGNATURE: DATE: 09/22/2025 I acknowledge receipt of this form and understand my appeal rights as explained and received.

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

101212(d)(1)(C) · 101212 Reporting Requirements (d) Upon the occurrence, during the operation of the child care center of any of the events... a report shall be made to the Department... (1) Events reported shall include the following:(C)Any unusual incident...the physical....child.

There will be a staff meeting held on October 10, 2025 to cover the procedures. I will provide proof of the training and a copy of the staff sign in/out sheet to Licensing by the POC date. Based on interview and record review, on 9/12/2025, a Child (C1) sustained an injury to their arm while playing on the playground and the incident was not reported to the Licensing Department until 9/18/2025 which is a potential health, safety, or personal rights risk to the persons in care. Claretta Yates NAME OF LICENSING PROGRAM MANAGER: Kuliema Calloway NAME OF LICENSING PROGRAM ANALYST: LICENSING PROGRAM ANALYST SIGNATURE: DATE: 09/22/2025 I acknowledge receipt of this form and understand my appeal rights as explained and received.