Prime Care Learning Center Ii

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 & Monitoring Visit conducted on April 11, 2024 ; It was determined based on observation that on Bus AWF2553 the fourth seat on the driver side had a twelve inch tear on the seat exposing the interior foam.

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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 January 9, 2025 ; It was determined based on observation that Vehicle PED9357 had exposed foam on the back of the second to last seat on the passenger side. It was further observed that the front passenger seat and the last seat on the driver side had torn seat covers with exposed foam.

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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 July 19, 2024 ; It was determined based on observation that in Building 2- 1st Left a child was sleeping in the crib with a blanket covering their body.

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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 & Licensing Study conducted on January 9, 2025 ; It was determined based on observation that in Building 2 -1st Left there was an infant sleeping in a crib with a blanket covering their body and the infant was propped up with a Boppy Pillow. Exhibit "A"

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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 Complaint Closure conducted on September 8, 2022 ; It was determined based on a complaint investigation, a staff member left eight four-year-old children unattended twice during the morning hours for approximately three to five minutes each time in a classroom on August 30, 2022.

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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 Licensing Study conducted on March 28, 2023 ; It was determined based on observation that a teacher walked out of the classroom leaving fifteen children unsupervised for approximately for four- six minutes. Furthermore, there was a child who briefly walked out of classroom to the front corridor for approximately four minutes.

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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 Complaint Investigation Follow Up conducted on April 19, 2023 ; It was determined based on observation that a student walked out of the Pre-K 1 classroom to the front corridor for approximately five minutes 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 Complaint Closure conducted on May 1, 2023 ; It was determined based on investigative finding that on April 10, 2023, while in the classroom, a five-year-old child was written on by other students with a marker on their shirt, back, legs, and buttocks while under the supervision of their teacher. Exhibit "A"

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591-1-1-.15(3) · Rule 591-1-1-.15(3) requires baby bottles and formula to be labeled with the individual child's name; supplied by the Parent daily in bottles; and refrigerated at a temperature of forty (40) degrees Fahrenheit or less. Only the current day's formula or breast milk shall be served. If formula must be provided by the Center, only commercially prepared, ready-to-feed formula shall be used. Refrigerated or frozen breast milk shall only be heated or thawed under warm running water or in a container of warm water.

During a Licensing Study conducted on March 28, 2023 ; It was determined based on observation that in the 1st Left Infant and Ones classroom the bottles and cups were not refrigerated and stored in children's personal bags. Furthermore, a staff member stated that they prepared bottles using powdered Enfamil formula.

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591-1-1-.15(3) · Rule 591-1-1-.15(3) requires baby bottles and formula to be labeled with the individual child's name; supplied by the Parent daily in bottles; and refrigerated at a temperature of forty (40) degrees Fahrenheit or less. Only the current day's formula or breast milk shall be served. If formula must be provided by the Center, only commercially prepared, ready-to-feed formula shall be used. Refrigerated or frozen breast milk shall only be heated or thawed under warm running water or in a container of warm water.

During a Complaint Investigation Follow Up conducted on April 19, 2023 ; It was determined based on observation that in the 1st Left Infant and Ones classroom the bottles and cups were not refrigerated and stored in children's personal bags. Furthermore, a staff member stated that they prepared bottles using powdered Enfamil formula.

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591-1-1-.10(4) · Rule 591-1-1-.10(4) requires that if diapers are changed on a diaper changing surface, the surface shall be smooth, nonporous, and equipped with a guard or rails to prevent falls. Between each diaper change, the diaper changing surface shall be cleaned with a disinfectant and dried with a single-use disposable towel.

During a Licensing Study conducted on March 28, 2023 ; It was determined based on observation that in the 1st Right Infant room the changing pad had tears.

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591-1-1-.10(4) · Rule 591-1-1-.10(4) requires that if diapers are changed on a diaper changing surface, the surface shall be smooth, nonporous, and equipped with a guard or rails to prevent falls. Between each diaper change, the diaper changing surface shall be cleaned with a disinfectant and dried with a single-use disposable towel.

During a Complaint Investigation Follow Up conducted on April 19, 2023 ; It was determined based on observation that in the 1st Right Infant room the changing pad had tears.

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591-1-1-.12(2) · Rule 591-1-1-.12(2) requires that all equipment and furniture be free from hazardous conditions such as, but not limited to, sharp rough edges or toxic paint; and be kept clean.

During a Licensing Study conducted on March 28, 2023 ; It was determined based on observation that the following hazards were observed: -1st Right easel is missing a wheel -3rd Left Red and Green sofas in the reading area have tears

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591-1-1-.12(2) · Rule 591-1-1-.12(2) requires that all equipment and furniture be free from hazardous conditions such as, but not limited to, sharp rough edges or toxic paint; and be kept clean.

During a Complaint Investigation Follow Up conducted on April 19, 2023 ; It was determined based on observation that the following hazards were observed: -1st Right easel is missing a wheel -3rd Left Red and Green sofas in the reading area had tears

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591-1-1-.33(3) · Rule 591-1-1-.33(3) requires each Staff member with direct care responsibilities to complete health and safety orientation training within the first 90 days of employment. The state-approved training hours obtained will count toward required first year training hours. The training must address the following health and safety topics: prevention and control of infectious diseases (including immunizations); prevention of sudden infant death syndrome and use of safe sleeping practices; administration of medication, consistent with standards for parental consent; prevention of and response to emergencies due to food and allergic reactions; building and physical premises safety, including identification of and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, and vehicular traffic; prevention of shaken baby syndrome, abusive head trauma and child maltreatment; emergency preparedness and response planning for emergencies resulting from a natural disaster or a human-caused event (such as violence at a child care facility); handling and storage of hazardous materials and the appropriate disposal of bio contaminants; precautions in transporting children; recognition and reporting of child abuse and neglect; and child development.

During a Licensing Study conducted on March 28, 2023 ; It was determined based on a review of documents that five out of ten staff members did not have evidence of the ten hour health and safety orientation training.

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591-1-1-.33(3) · Rule 591-1-1-.33(3) requires each Staff member with direct care responsibilities to complete health and safety orientation training within the first 90 days of employment. The state-approved training hours obtained will count toward required first year training hours. The training must address the following health and safety topics: prevention and control of infectious diseases (including immunizations); prevention of sudden infant death syndrome and use of safe sleeping practices; administration of medication, consistent with standards for parental consent; prevention of and response to emergencies due to food and allergic reactions; building and physical premises safety, including identification of and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, and vehicular traffic; prevention of shaken baby syndrome, abusive head trauma and child maltreatment; emergency preparedness and response planning for emergencies resulting from a natural disaster or a human-caused event (such as violence at a child care facility); handling and storage of hazardous materials and the appropriate disposal of bio contaminants; precautions in transporting children; recognition and reporting of child abuse and neglect; and child development.

During a Complaint Investigation Follow Up conducted on April 19, 2023 ; It was determined based on a review of documents that five out of ten staff members did not have evidence of the ten hour health and safety orientation training.

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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 Complaint Closure conducted on September 8, 2022 ; It was determined based on a complaint investigation, a staff member left eight four-year-old children unattended in a classroom on August 30, 2022.

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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 Licensing Study conducted on March 28, 2023 ; It was determined based on observation that a teacher walked out of the classroom leaving fifteen children unsupervised. Furthermore, there was a child who briefly walked out of class.

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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 Complaint Investigation Follow Up conducted on April 19, 2023 ; It was determined based on observation that a student walked out of the Pre-K 1 classroom without adult supervision. 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 May 4, 2021 ; It was determined based on observation that the following hazards were accessible to children in care: -Building 1- 2nd Right: A staff member’s purse, Spic and Span cleaner, and hand sanitizer were located on top of a child sized shelf. A pair of adult scissors were located on top of the teacher’s desk within reach of children. Further, an unlocked cabinet contained Lysol wipes and a bottle of refill soap with the label “keep out of reach of children” was on top of the cabinet. -Building 2- 4th Left: A staff member’s purse was located underneath the teacher’s desk within reach of children.

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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 March 31, 2022 ; It was determined based on observation that Building 1-first right classroom had an unlocked cabinet with cleaning supplies accessible to children.

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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 May 4, 2021 ; It was determined based on observation that in Building 1-2nd Right, a cabinet door was disconnected from the cabinet on the back side of the room and was leaning against the cabinet.

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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 March 31, 2022 ; It was determined based on observation that a dead roach was observed in a lower cabinet in the kitchen. In addition, a broken toilet handle was observed in a child's bathroom in building 1.

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591-1-1-.20(1) · Rule 591-1-1-.20(1) requires Personnel to obtain specific written authorization from the child's physician or parent in order to dispense prescription or non-prescription medications, except for first aid. Such authorization will include when applicable, date; full name of the child; name of the medication; prescription number, if any; dosage; the dates to be given; the time of day to be dispensed; and signature of parent.

During a Complaint Closure conducted on November 3, 2021 ; It was determined based on an investigation that on October 8, 2021, medication was not given to a one-year-old child as authorized. The child was to have received medicine twice a day and only received it once.

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591-1-1-.20(1) · Rule 591-1-1-.20(1) requires Personnel to obtain specific written authorization from the child's physician or parent in order to dispense prescription or non-prescription medications, except for first aid. Such authorization will include when applicable, date; full name of the child; name of the medication; prescription number, if any; dosage; the dates to be given; the time of day to be dispensed; and signature of parent.

During a Complaint Investigation & Licensing Study conducted on March 31, 2022 ; It was determined based on review of medication records, that medication was not dispensed as requested. Medication record indicated medication should be dispensed three times a day and was documented as being dispensed once a day and was dispensed beyond the dates authorized. Exhibit "A"

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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 Complaint Investigation & Licensing Study conducted on May 4, 2021 ; It was determined based on observation that in Building 2-2nd Right, a child went to the restroom located outside of the classroom without supervision. The child was observed to exit the classroom, close the classroom door, and no staff member was observed in the hallway during this time.

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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 Complaint Investigation Follow Up conducted on October 18, 2021 ; It was determined based on observation that in the 4th left classroom 18 students were left unsupervised while the teacher went to the kitchen for a drink for approximately three minutes.

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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 Complaint Closure conducted on November 3, 2021 ; It was determined based on an investigation that on October 8, 2021, children were observed to be unsupervised in the two front classrooms for an undetermined amount of time. Exhibit "A"

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591-1-1-.03(9) · Rule 591-1-1-.03(9) requires center staff to refrain from engaging in, or allowing children or other adults to engage in, activities that could be detrimental to a child’s health or well-being, such as but not limited to, horse play, rough play, wrestling, and picking up a child in a manner that could cause injury.

During an investigation, it was determined that on April 23, 2021, a seven-year-old child was continuously shaking a playhouse causing the roof to collapse and fall on him, inuring his hand. The staff member did not redirect the child’s behavior. The child required professional medical attention as a result of the incident. 3. Rule 591-1-1-/07(2) requires Center Staff to immediately notify Parents and obtain specific instructions until the child can be picked up or returned to the group when professional medical attention is required, or when the child experiences symptoms of moderate discomfort such as elevated temperature, vomiting or diarrhea and to notify Parents by the end of the day when professional medical attention is not required, when the child experiences symptoms of less than moderate discomfort or when the child experiences an adverse reaction to prescribed medication which does not constitute moderate discomfort. During an investigation, it was determined that on April 23, 2021, a seven-year-old child sustained a crushed thumb when the child shook a playhouse and the roof collapsed onto the child’s finger. The staff were aware of the incident and completed an incident report, but it was not provided to the parent. The parent was not notified of incident at the time of the incident or at pick up. The child required professional medical attention as a result of the incident.

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