Grace Learning Center

591-1-1-.32(2) · Rule 591-1-1-.32(2) requires the Center maintain Staff:child ratios in mixed-age groups based on the age of the youngest group of children that includes more than twenty percent of the total number of children in the mixed-age group.

During a Complaint Investigation Follow Up conducted on August 22, 2022 ; It was determined based on observation that upon arrival there was a staff:child ratio of 1:14 among 5 one-year-old children and 9 two-year-old children in Room 2nd Right. A staff:child ratio of 2:14 was required.

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591-1-1-.32(2) · Rule 591-1-1-.32(2) requires the Center maintain Staff:child ratios in mixed-age groups based on the age of the youngest group of children that includes more than twenty percent of the total number of children in the mixed-age group.

During a Complaint Investigation Follow Up conducted on March 15, 2023 ; It was determined based on observation that upon arrival there was a staff:child ratio of 1:14 among ages infants through school- age children in the Cafeteria. A ratio of 3:14 was required. It was further determined that there was a staff:child ratio of 1:22 among four-year-old through six-year-old children in Room C. A staff:child ratio of 2:22 was required.

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591-1-1-.32(2) · Rule 591-1-1-.32(2) requires the Center maintain Staff:child ratios in mixed-age groups based on the age of the youngest group of children that includes more than twenty percent of the total number of children in the mixed-age group.

During a POI Follow Up conducted on May 3, 2023 ; It was determined based on observation that upon arrival a staff member that was in the Cafeteria walked to the front leaving on staff member with 14 children ranging in ages of infants through school-age children. A ratio of one staff member to six children should have been maintained. It was further determined that in the cafeteria three infants, three one-year-olds and two two-year-old children were present with one staff member.

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591-1-1-.32(4)(a) · Rule 591-1-1-.32(4)(a) requires that during the early morning times of arrival and late afternoon times of departure, infants and children younger than three (3) years may be grouped with older children so long as Staff: child ratios and group size are met based on the age of the youngest child in the group.

During a Complaint Investigation Follow Up conducted on August 22, 2022 ; It was determined based on observation that at 8:00AM infants through four-year-old children were housed together.

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591-1-1-.32(4)(a) · Rule 591-1-1-.32(4)(a) requires that during the early morning times of arrival and late afternoon times of departure, infants and children younger than three (3) years may be grouped with older children so long as Staff: child ratios and group size are met based on the age of the youngest child in the group.

During a complaint investigation conducted on October 6, 2023 During a Complaint Closure conducted on October 28, 2022 ; it was determined based on investigative findings that a two-year-old child was housed with three-year-old children throughout the day on October 4, 2022.

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591-1-1-.32(4)(a) · Rule 591-1-1-.32(4)(a) requires that during the early morning times of arrival and late afternoon times of departure, infants and children younger than three (3) years may be grouped with older children so long as Staff: child ratios and group size are met based on the age of the youngest child in the group.

During a POI Follow Up conducted on May 3, 2023 ; It was determined based on observation that upon arrival all children present for the day were housed in the cafeteria ranging in ages of infants to six-year- olds.

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591-1-1-.03(6) · Rule 591-1-1-.03(6) requires Center Staff to ensure children less than three years of age do not spend more than one-half hour of time consecutively in confining equipment, such as swings, highchairs, jump seats, carriers or walkers. Children shall use such equipment only when they are awake. Such children shall be allowed time to play on the floor daily. Infants shall have supervised tummy time on the floor daily when they are awake.

During a Complaint Investigation Follow Up conducted on March 15, 2023 ; It was determined based on observation upon arrival that an infant was awake in a carrier and the staff member moved the infant to a bouncer in which the child remained in for over one-half hour.

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591-1-1-.03(6) · Rule 591-1-1-.03(6) requires Center Staff to ensure children less than three years of age do not spend more than one-half hour of time consecutively in confining equipment, such as swings, highchairs, jump seats, carriers or walkers. Children shall use such equipment only when they are awake. Such children shall be allowed time to play on the floor daily. Infants shall have supervised tummy time on the floor daily when they are awake.

During a POI Follow Up conducted on May 3, 2023 ; It was determined based on observation that upon arrival an infant was in a rocker and remained in the rocker for over one half-hour.

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591-1-1-.12(1) · Rule 591-1-1-.12(1) requires each Employee and child in attendance to use all indoor and outdoor furniture, activity materials, and equipment in a safe and appropriate manner and in accordance with the manufacturer's instructions, recommendations, and intended use. All equipment and furniture shall be used only by the age-appropriate group of children.

During a Complaint Investigation Follow Up conducted on August 22, 2022 ; It was determined based on observation that upon arrival the center was not following manufacturer's instructions when an infant was not immediately removed upon arrival and left inside.

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591-1-1-.12(1) · Rule 591-1-1-.12(1) requires each Employee and child in attendance to use all indoor and outdoor furniture, activity materials, and equipment in a safe and appropriate manner and in accordance with the manufacturer's instructions, recommendations, and intended use. All equipment and furniture shall be used only by the age-appropriate group of children.

During a POI Follow Up conducted on May 3, 2023 ; It was determined based on observation that a staff member did not follow manufacturer's instructions when a staff member picked up a child in a bouncer and carried the child from the cafeteria to the 1R Classroom.

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591-1-1-17(7) · Rule 591-1-1-17(7) requires that children wash their hands with liquid soap and warm running water upon arrival for care, when moving from one child care group to another, upon re- entering the child care area after outside play, before and after eating meals and snacks, handling or touching food, playing in water; after toileting and diapering, playing in sand, touching animals or pets, and contact with bodily fluids and after contamination by any other means.

During a Complaint Investigation Follow Up conducted on March 15, 2023 ; It was determined based on observation that children arriving for the day were not required to wash hands throughout the center.

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591-1-1-17(7) · Rule 591-1-1-17(7) requires that children wash their hands with liquid soap and warm running water upon arrival for care, when moving from one child care group to another, upon re- entering the child care area after outside play, before and after eating meals and snacks, handling or touching food, playing in water; after toileting and diapering, playing in sand, touching animals or pets, and contact with bodily fluids and after contamination by any other means.

During a POI Follow Up conducted on May 3, 2023 ; It was determined based on observation that a child in Room D entered for the day and was not required to wash hands.

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591-1-1-.32(7) · Rule 591-1-1-.32(7) requires that children be supervised at all times appropriate to the individual age, needs and capabilities of each child. Such supervision must include, but not be limited to, indoor and outdoor activities, mealtime, naptime, transportation, field trips, and transitions between activities. "Supervision" means that the appropriate number of Staff members are physically present in the area where children are being cared for and are providing watchful oversight to the children, volunteers and Students-in-Training. The persons supervising in the child care area must be alert, positioned to maximize their ability to hear and see the children at all times, and able to respond promptly to the needs and actions of the children being supervised, as well as the actions of the volunteers and Students-in-Training, and provide timely attention to the children's actions and needs. Staff shall be attentive and participating with all children during mealtimes and shall be seated within an arm¶s length away from children thirty- six (36) months of age and younger.

During a Complaint Investigation Follow Up conducted on August 22, 2022 ; It was determined based on observation that 26 children ranging in ages from infant to four-year-old were present in the cafeteria area without adult supervision while the staff member was in the front of the building checking people in. It was further determined that upon arrival children are signed in at the front desk and are allowed to walk to their classroom without adult supervision.

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591-1-1-.32(7) · Rule 591-1-1-.32(7) requires that children be supervised at all times appropriate to the individual age, needs and capabilities of each child. Such supervision must include, but not be limited to, indoor and outdoor activities, mealtimes, naptime, transportation, field trips, and transitions between activities. "Supervision" means that the appropriate number of Staff members are physically present in the area where children are being cared for and are providing watchful oversight to the children, volunteers and Students-in-Training. The persons supervising in the child care area must be alert, positioned to maximize their ability to hear and see the children at all times, and able to respond promptly to the needs and actions of the children being supervised, as well as the actions of the volunteers and Students-in-Training, and provide timely attention to the children's actions and needs. Staff shall be attentive and participating with all children during mealtimes and shall be seated within an arm¶s length away from children thirty- six (36) months of age and younger.

During a POI Follow Up conducted on May 3, 2023 ; It was determined based on observation that a staff member in the 1R Room walked out of the class to get a child from the cafeteria to take to the class. It was further determined that the staff member in the 1R Class provided supervision for children in the 1R Class and the cafeteria. In addition, children were permitted to walk from the front door to their classrooms. Exhibit "A"

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591-1-1-.36(4)(b) · Rule 591-1-1-.36(4)(b) requires that the interior of a transportation vehicle be clean, in safe repair and free of hazardous items, objects and/or other non-essential items which could cause injury.

During a Complaint Investigation & Licensing Study conducted on July 12, 2022 ; It was determined based on observation that three of three vans/buses had trash on the floor. It was further determined that the van ending in 7172 had a hole with exposed foam on the driver's seat. In addition, the seats on the buses were in need of repair. An adverse action was previously issued for this rule violation. This rule violation is no longer appealable. No fine is being issued at this time.

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591-1-1-.36(4)(b) · Rule 591-1-1-.36(4)(b) requires that the interior of a transportation vehicle be clean, in safe repair and free of hazardous items, objects and/or other non-essential items which could cause injury.

During a Complaint Closure conducted on March 15, 2023 ; It was determined based on observation and investigative findings that van ending in tag 6935 had doors that would both not properly open in that the right side would open, but the left side would not open and children were required to enter and exit from the one door.

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591-1-1-.36(4)(f)1. · Rule 591-1-1-.36(4)(f)1. requires that all transported children be secured in a child passenger restraining system or seat safety belt in accordance with current state and federal laws and regulations and according to manufacturer's directions.

During a Complaint Investigation Follow Up conducted on March 15, 2023 ; It was determined based on observation, a staff member in the gray van loaded children for morning transportation. The children were not in a booster seat and were not in seat belts. Consultant had to instruct the staff member to ensure that the children were secured and belted in before leaving the facility.

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591-1-1-.36(4)(f)1. · Rule 591-1-1-.36(4)(f)1. requires that all transported children be secured in a child passenger restraining system or seat safety belt in accordance with current state and federal laws and regulations and according to manufacturer's directions.

During a Complaint Closure conducted on March 15, 2023 ; It was determined based on investigative findings that state laws and regulations were not followed in that children under the age of eight-years- old were not required to sit in booster seats, children on the van were not required to wear seat belts and an eleven-year-old child was being allowed to sit in the front seat of the van. Exhibit "A"

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591-1-1-.25(13) · Rule 591-1-1-.25(13) requires that potentially hazardous equipment, materials and supplies be stored in a locked area inaccessible to children.

During a Complaint Investigation & Licensing Study conducted on July 12, 2022 ; It was determined based on observation that the following hazards were accessible to children in care: Room A- A staff member's purse placed on a chair. Room C- A stapler placed on a shelf and a hanging television cord.

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591-1-1-.25(13) · Rule 591-1-1-.25(13) requires that potentially hazardous equipment, materials and supplies be stored in a locked area inaccessible to children.

During a Monitoring Visit conducted on March 2, 2023 ; It was determined based on observation that the following hazards were accessible to children in care: Room A- A broom and dust pan located by the restroom door. Room B- A broom and dust pan located by the restroom door and a mop and plungers located in one of two boys restroom. Room C- 'Lysol' located on the shelf within reach of the after school children. Room D- Plastic bags in the bottom of the unlocked diapering station. Room E- Baby wipes that read "keep out of reach of children" located on a table when entering the classroom Room F- A broom located near the door of the classroom.

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591-1-1-.30(2) · Rule 591-1-1-.30(2) requires the Center to provide a safe sleep environment in accordance with American Academy of Pediatrics (AAP), Consumer Product Safety Commission (CPSC) and American Society for Testing and Materials (ASTM) recommendations as listed in these rules for all infants. Center Staff shall place an infant to sleep on the infant¶s back in a crib unless the Center has been provided a physician¶s written statement authorizing another sleep position for that particular infant that includes how the infant shall be placed to sleep and a time frame that the instructions are to be followed. When an infant can easily turn over from back to front and back again, Staff shall continue to put the infant to sleep initially on the infant¶s back but allow the infant to roll over into his or her preferred position and not re-position the infant. Sleepers, sleep sacks and wearable blankets that fit according to the commercial manufacturer¶s guidelines and will not slide up around the infant¶s face may be used when necessary for the comfort of the sleeping infant. Swaddling shall not be used unless the Center has been provided a physician¶s written statement authorizing its use for a particular infant that includes instructions and a time frame for swaddling the infant. Center Staff shall not place objects or allow objects to be placed in or on the crib with an infant such as but not limited to toys, pillows, quilts, comforters, bumper pads, sheepskins, stuffed toys, or other soft items and shall not attach objects or allow objects to be attached to a crib with a sleeping infant, such as, but not limited to, crib gyms, toys, mirrors and mobiles.

During a Complaint Investigation Follow Up conducted on October 6, 2022 ; It was determined based on observation that an infant was sleeping with a stuffed animal in the crib.

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591-1-1-.30(2) · Rule 591-1-1-.30(2) requires the Center to provide a safe sleep environment in accordance with American Academy of Pediatrics (AAP), Consumer Product Safety Commission (CPSC) and American Society for Testing and Materials (ASTM) recommendations as listed in these rules for all infants. Center Staff shall place an infant to sleep on the infant¶s back in a crib unless the Center has been provided a physician¶s written statement authorizing another sleep position for that particular infant that includes how the infant shall be placed to sleep and a time frame that the instructions are to be followed. When an infant can easily turn over from back to front and back again, Staff shall continue to put the infant to sleep initially on the infant¶s back but allow the infant to roll over into his or her preferred position and not re-position the infant. Sleepers, sleep sacks and wearable blankets that fit according to the commercial manufacturer¶s guidelines and will not slide up around the infant¶s face may be used when necessary for the comfort of the sleeping infant. Swaddling shall not be used unless the Center has been provided a physician¶s written statement authorizing its use for a particular infant that includes instructions and a time frame for swaddling the infant. Center Staff shall not place objects or allow objects to be placed in or on the crib with an infant such as but not limited to toys, pillows, quilts, comforters, bumper pads, sheepskins, stuffed toys, or other soft items and shall not attach objects or allow objects to be attached to a crib with a sleeping infant, such as, but not limited to, crib gyms, toys, mirrors and mobiles.

During a Monitoring Visit conducted on March 2, 2023 ; It was determined based on observation that an infant was sleeping in a bouncer upon the consultant's arrival into Room F. The infant was left in the bouncer until the staff member was asked to move the infant to a crib. Exhibit "A"

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591-1-1-.25(3) · Rule 591-1-1-.25(3) requires the Center and surrounding premises to be kept clean, free of debris and in good repair. Hygienic measures such as, but not limited to, screened windows and proper waste disposal procedures shall be utilized to minimize the presence of rodents, flies, roaches and other vermin at the Center.

During a Licensing Study conducted on February 15, 2022 ; It was determined based on observation that the following items were in need of being repaired or cleaned throughout the center: Kitchen, 2nd Right Room, and 4th Left Room- floor tiles were broken. Dirt and debris was around the baseboards of the classrooms and kitchen. Pre-K Room -behind the boys' toilet there was a hole, exposed rust, and tile was missing off of the wall. Afterschool Room-blue rubber was coming off of the wall near the left side of the door.

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591-1-1-.17(8) · Rule 591-1-1-.17(8) requires staff to wash their hands with liquid soap and warm running water upon arrival for the day, when moving from one child care group to another, upon re-entering the child care area after outside play, before and after diapering each child, dispensing medication, applying topical medications, handling and preparing food, eating, drinking, preparing bottles, feeding each child, assisting children with eating and drinking, after toileting or assisting children with toileting, using tobacco products, handling garbage and organic waste, touching animals or pets, handling bodily fluids and after contamination by any means.

During a Licensing Study conducted on February 15, 2022 ; It was determined based on observation that a center staff member failed to wash her hands prior to diapering.

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591-1-1-.25(3) · Rule 591-1-1-.25(3) requires the Center and surrounding premises to be kept clean, free of debris and in good repair. Hygienic measures such as, but not limited to, screened windows and proper waste disposal procedures shall be utilized to minimize the presence of rodents, flies, roaches and other vermin at the Center.

During a Complaint Investigation & Licensing Study conducted on July 12, 2022 ; It was determined based on observation that the following items were in need of being repaired or cleaned throughout the center: Kitchen, 2nd Right Room- floor tiles were broken. Dirt and debris was around the baseboards of the classrooms and kitchen. Pre-K Room -behind the boys' toilet there was a hole, exposed rust, and tile was missing off of the wall. Afterschool Room-blue rubber was coming off of the wall near the left side of the door. 1st Left Room- toilet bolts on the bottom of the boys' toilet were exposed and greater than two threads. 4th Left Room- one of four toilets were not in working order, floor tiles were broken, and an exposed power strip located on the shelf near the television.

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591-1-1-.36(4)(b) · Rule 591-1-1-.36(4)(b) requires that the interior of a transportation vehicle be clean, in safe repair and free of hazardous items, objects and/or other non-essential items which could cause injury.

During a Licensing Study conducted on February 15, 2022 ; It was determined based on observation that three of three center vans/buses had trash on the floor. It was further determined that the van ending in 7172 had a hole with exposed foam on the driver's seat. In addition, the seats on buses were in need of repair.

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591-1-1-.36(4)(b) · Rule 591-1-1-.36(4)(b) requires that the interior of a transportation vehicle be clean, in safe repair and free of hazardous items, objects and/or other non-essential items which could cause injury.

During a Complaint Investigation & Licensing Study conducted on July 12, 2022 ; It was determined based on observation that three of three vans/buses had trash on the floor. It was further determined that the van ending in 7172 had a hole with exposed foam on the driver's seat. In addition, the seats on the buses were in need of repair.

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591-1-1-.36(7)(b) · Rule 591-1-1-.36(7)(b) requires that an emergency medical information record be maintained in the vehicle for each child being transported. The emergency medical information record for each child shall include a listing of the child's full name, date of birth, allergies, special medical needs and conditions, current prescribed medications that the child is required to take on a daily basis for a chronic condition, the name and telephone number of the child's doctor, the local medical facility that the Center uses in the area where the Center is located and the telephone numbers where the Parents can be reached.

During a Licensing Study conducted on February 15, 2022 ; It was determined based on a review of records that the following were observed to be missing from the emergency medical authorizations: -five were missing the medical facility used address. -one was missing the doctor's phone number. -one was missing if the child had any allergies.

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591-1-1-.36(7)(b) · Rule 591-1-1-.36(7)(b) requires that an emergency medical information record be maintained in the vehicle for each child being transported. The emergency medical information record for each child shall include a listing of the child's full name, date of birth, allergies, special medical needs and conditions, current prescribed medications that the child is required to take on a daily basis for a chronic condition, the name and telephone number of the child's doctor, the local medical facility that the Center uses in the area where the Center is located and the telephone numbers where the Parents can be reached.

During a Complaint Investigation & Licensing Study conducted on July 12, 2022 ; It was determined based on a review of records that the following were observed to be missing from emergency medical authorizations: -13 of 57 were missing the address of the medical facility. -One of 57 were missing the doctor's phone number. -Three of 57 were missing if the child had any allergies. -Seven of 57 were missing the father's name and contact information. -10 of 57 were missing a work phone number. -Two of 57 were missing if the child was on any medication. -Two of 57 were missing if the child had any special conditions.

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591-1-1-.17(8) · Rule 591-1-1-.17(8) requires staff to wash their hands with liquid soap and warm running water upon arrival for the day, when moving from one child care group to another, upon re-entering the child care area after outside play, before and after diapering each child, dispensing medication, applying topical medications, handling and preparing food, eating, drinking, preparing bottles, feeding each child, assisting children with eating and drinking, after toileting or assisting children with toileting, using tobacco products, handling garbage and organic waste, touching animals or pets, handling bodily fluids and after contamination by any means.

During a Complaint Investigation & Licensing Study conducted on July 12, 2022 ; It was determined based on observation that two children entered classrooms and were not required to wash hands.

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591-1-1-.26(9) · Rule 591-1-1-.26(9) requires the playground to be kept clean, free from litter and free of hazards, such as but not limited to rocks, exposed tree roots and exposed sharp edges of concrete.

During a Licensing Study conducted on February 15, 2022 ; It was determined based on observation that gum balls, pinecones, and exposed tree roots near the right side of the toddler playground slide were present.

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591-1-1-.26(9) · Rule 591-1-1-.26(9) requires the playground to be kept clean, free from litter and free of hazards, such as but not limited to rocks, exposed tree roots and exposed sharp edges of concrete.

During a Complaint Investigation & Licensing Study conducted on July 12, 2022 ; It was determined based on observation that gum balls, pinecones, exposed tree roots at the bottom of the right side toddler playground slide, and vines growing through the fencing on the left side front and back playgrounds.

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591-1-1-.26(8) · Rule 591-1-1-.26(8) requires climbing and swinging equipment to have a resilient surface beneath the equipment and the fall zone from such equipment must be adequately maintained by the Center to assure continuing resilient.

During a Complaint Investigation & Monitoring Visit conducted on August 13, 2021 ; It was determined based on observation that the large back playground had inadequate resilient surfacing in that grass was observed to be growing through the sand around the climbing equipment.

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591-1-1-.26(8) · Rule 591-1-1-.26(8) requires climbing and swinging equipment to have a resilient surface beneath the equipment and the fall zone from such equipment must be adequately maintained by the Center to assure continuing resilient.

During a Complaint Investigation & Licensing Study conducted on July 12, 2022 ; It was determined based on observation that resilient surfacing for the sliding equipment was inadequate due to grass growing throughout.

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591-1-1-.26(7) · Rule 591-1-1-.26(7) requires that climbing and swinging equipment be anchored.

During a Licensing Study conducted on February 15, 2022 ; It was determined based on observation that the yellow school bus and fire engine were not anchored.

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591-1-1-.26(7) · Rule 591-1-1-.26(7) requires that climbing and swinging equipment be anchored.

During a Complaint Investigation & Licensing Study conducted on July 12, 2022 ; It was determined based on observation that the yellow school bus and fire engine were not anchored. Exhibit "A"

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