Abc Child Care Center #1

591-1-1-.36(10) · Rule 591-1-1-.36(10) requires that a child shall never be left unattended in a vehicle. AND

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591-1-1-.32(7) · Rule 591-1-1-.32(7) requires that children shall 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 an investigation, it was determined that on February 4, 2025, a five-year-old child was left on the center’s bus unsupervised for an undetermined amount of time. The child stated he fell asleep on the bus on the way to the center from school and was left on the bus once arriving at the center. The child tried to get off the bus, but the door was locked. The child knocked on the bus window and another parent who was passing by, heard it and notified staff that the child was left alone on the bus.

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591-1-1-.36(7)(c)2 · Rule 591-1-1-.36(7)(c)2 requires that the driver or other designated person shall immediately document in writing, with a check or other mark/symbol to account for each child listed on the passenger transportation checklist each time a child enters and exits the vehicle. The driver or other designated staff person shall document in writing with a different mark/symbol to account for each child listed on the passenger transportation checklist who was not present on the vehicle for any reason. An explanation shall be documented in writing whenever a child is transported to a field trip site but is not present on the return trip to the Center.

During an investigation, it was determined that on February 4, 2025, a five-year-old child was not accounted for during the unloading of the center vehicle. The transportation log had been completed, but was not used correctly, when a five-year-old child, who had fallen asleep, was left on the vehicle. The transportation log indicated the child exited the vehicle, but the child remained on the center's vehicle for an undetermined amount of time.

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591-1-1-.36(7)(d)1 · Rule 591-1-1-.36(7)(d)1 requires that the first check shall be conducted immediately upon unloading the last child at any location including, but not limited to, a field trip destination, arrival at the Center, and the last stop during transportation to home or school. The responsible person on the vehicle shall: physically walk through the entire vehicle; visually inspect all seat surfaces, under all seats and in all compartments or recesses in the vehicle’s interior; sign the passenger transportation checklist (s), indicating all of the children have exited the vehicle; and give the passenger transportation checklist(s) to the second designated Staff person.

During an investigation, it was determined that on February 4, 2025, the first check of the vehicle was not completed resulting in a five-year-old child being left on the center’s vehicle for an undetermined amount of time. The vehicle transportation log for the day indicated the first check had been completed and all children had exited the vehicle. A parent that was passing by heard the child knocking on the vehicle’s window and alerted staff that the child was on the vehicle and could not get off. A staff person went to the vehicle and assisted the child in getting off the vehicle.

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591-1-1-.36(7)(d)2 · Rule 591-1-1-.36(7)(d)2 requires that the second designated Staff person shall conduct a check of the vehicle immediately upon the completion of the first check of the vehicle. The responsible person shall physically walk through the entire vehicle; visually inspect all seat surfaces, under all seats and in all compartments or recesses in the vehicle's interior; and sign the passenger transportation checklist(s), indicating all of the children have exited the vehicle. There shall be continuous watchful oversight of the vehicle between the first check and second check.

During an investigation, it was determined that on February 4, 2025, a second check of the vehicle was not completed when a five-year-old child was left unattended on the center’s vehicle for an undetermined amount of time. Vehicle transportation logs for the day indicated that a second check of the vehicle was conducted and that all children had exited the vehicle. A parent who was passing by heard the child knocking on the vehicle’s window and alerted staff that the child was on the vehicle and could not get off. A staff person went to the vehicle and assisted the child in getting off the vehicle.

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591-1-1-.07(2) · Rule 591-1-1-.07(2) requires that parents must be notified of a child's incidents, illnesses or injury as follows: Immediately notify Parent(s) and obtain specific instructions until child can be picked up or returned to group. • When professional medical attention is required, or • When child experiences symptoms of moderate discomfort such as elevated temperature, vomiting or diarrhea., or When child is involved in an incident that puts their health and/or safety at risk (e.g., missing from program, left on vehicle, escaped from building/playground, etc.) Notify Parent(s) by the end of the day. • When professional medical attention is not required, or • When child experiences symptoms of less than moderate discomfort, or • When child experiences an adverse reaction to prescribed medication which does not constitute moderate discomfort.

During an investigation, it was determined that on February 4, 2025, a five-year-old child was left on the center’s vehicle for an undetermined amount of time, and the parent was not notified as required. The child notified their parent of the incident after leaving the center and arriving home. The parent notified the center of the incident on February 5, 2025.

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591-1-1-.36(4)(f)1 · Rule 591-1-1-.36(4)(f)1 requires all children transported in a vehicle provided by or used by the Center shall be secured in a child passenger restraining system or seat safety belt in accordance with current state and federal laws and regulations. The child passenger restraining system and seat safety belts must be installed and used in accordance with the manufacturer's directions for such system and used in accordance with the manufacturer’s directions with respect to restraining, seating or positioning the child being transported in the vehicle.

During an investigation, it was determined that on December 9, 2024, a five-year-old child sustained an injury to the mouth and teeth after hitting his mouth on the vehicle window, due to not being restrained properly. Staff stated the restraints on the vehicle were in working order, but the child was not buckled properly. The child was observed to be standing on the floor, in front of the seat, when the incident occurred. The injury required professional medical attention.

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591-1-1-.29(3) · Rule 591-1-1-.29(3) requires that the Director or designated person-in-charge shall report or cause to be reported to the Department within twenty-four (24) hours or the next work day: any death of a child while in the care of the Center; any serious illness or injury requiring hospitalization or professional medical attention other than first aid of a child while in the care of the Center; any situation when a child in care becomes missing, such as, but not limited to, a child who is left on a vehicle, a child who leaves the building, playground, or property, or a child who is left behind on any trip; any fire; any structural disaster; any emergency situation that requires temporarily relocating children; and any time the program’s operating status changes (i.e., open to closed or temporarily closed and temporarily closed to open).

During an investigation, it was determined that on December 9, 2024, a five-year-old child sustained an injury to the mouth and teeth that required professional medical attention and two teeth were removed. The center did not report the incident to the department within 24 hours or the next business day as required. EXHIBIT “B”

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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 September 30, 2021 ; It was determined based on a review of records that the center did not have the required emergency medical information on the vehicle for 1 of the 28 children that are transported to and from school by the center.

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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 September 21, 2022 ; It was determined based on observation that on the front right playground there were three small nails protruding from the wooden post near the white bridge. In addition the paint was peeling on the side of the post.

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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 September 30, 2021 ; It was determined based on a review of records that staff #5 who was hired in January 2021, did not complete the health and safety training as required.

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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 Monitoring Visit conducted on April 5, 2022 ; It was determined based on a review of records that the center did not have the required emergency medical information on the vehicle for 2 of the 20 children that are transported to and from school by the center.

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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 September 21, 2022 ; It was determined based on a review of records that the center did not have the required emergency medical information on the vehicle for 6 of the 26 children that are transported to and from school by the center.

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591-1-1-.36(7)(d)2. · Rule 591-1-1-.36(7)(d)2. requires that the second designated Staff person conduct a check of the vehicle immediately upon the completion of the first check of the vehicle. The responsible person shall physically walk through the entire vehicle; visually inspect all seat surfaces, under all seats and in all compartments or recesses in the vehicle's interior; and sign the passenger transportation checklist(s), indicating all of the children have exited the vehicle. There shall be continuous watchful oversight of the vehicle between the first check and second check.

During a Monitoring Visit conducted on April 5, 2022 ; It was determined based on the consultant's observation that no staff performed a second check of the vehicle after returning from the first school drop off on the morning of April 5, 2022.

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591-1-1-.36(7)(d)2. · Rule 591-1-1-.36(7)(d)2. requires that the second designated Staff person conduct a check of the vehicle immediately upon the completion of the first check of the vehicle. The responsible person shall physically walk through the entire vehicle; visually inspect all seat surfaces, under all seats and in all compartments or recesses in the vehicle's interior; and sign the passenger transportation checklist(s), indicating all of the children have exited the vehicle. There shall be continuous watchful oversight of the vehicle between the first check and second check.

During a Licensing Study conducted on September 21, 2022 ; It was determined based on a review of records that staff did not sign the transportation form to document that a second check of the vehicle was performed after transporting children from Heard Elementary on the afternoon of September 8, 2022. There were also no signatures to indicate that a second check of the vehicle was performed on the morning and afternoon of Friday September 9, 2022, for Charles Ellis Elementary, Heard Elementary, Juliette Low Elementary and Jacob G Smith Elementary.

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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 Monitoring Visit conducted on April 5, 2022 ; It was determined based on observation that on the left playground, a brick paver along the walkway was not level and secure causing a tripping hazard.

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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 September 21, 2022 ; It was determined based on a review of records that staff #2 who started working at the center on November 23, 2021 did not complete the health and safety training within the first 90 days of employment.

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591-1-1-.36(6) · Rule 591-1-1-.36(6) requires written Parental authorization for routine transportation provided by or on behalf of the Center. Written authorization must include the routine pick-up location, routine pick-up time, routine delivery location, routine delivery times and the name of any person authorized to receive the child.

During a Licensing Study conducted on September 30, 2021 ; It was determined based on review of records that the center did not have parental authorization for school transportation for 1 of the 28 children transported by the center.

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591-1-1-.36(6) · Rule 591-1-1-.36(6) requires written Parental authorization for routine transportation provided by or on behalf of the Center. Written authorization must include the routine pick-up location, routine pick-up time, routine delivery location, routine delivery times and the name of any person authorized to receive the child.

During a Monitoring Visit conducted on April 5, 2022 ; It was determined based on review of records that the center did not have parental authorization for school transportation for 2 of the 20 children transported by the center.

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591-1-1-.36(6) · Rule 591-1-1-.36(6) requires written Parental authorization for routine transportation provided by or on behalf of the Center. Written authorization must include the routine pick-up location, routine pick-up time, routine delivery location, routine delivery times and the name of any person authorized to receive the child.

During a Licensing Study conducted on September 21, 2022 ; It was determined based on review of records that the center did not have parental authorization for school transportation for 10 of the 26 children transported by the center. Exhibit "A"

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