The Children'S Courtyard #3214

591-1-1-.07(2) · Rule 591-1-1-.07(2) requires that Parents be immediately notified and specific instructions obtained until the child can be picked up or returned to the group, immediately when professional medical attention is required, or when the child experiences symptoms of moderate discomfort, or when the child is involved in an incident that puts their health and/or safety at risk 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 November 13, 2024, a 5-year-old child’s parents were not immediately notified when the child showed signs of moderate discomfort after sustaining an ankle injury. During nap time at 1:30 p.m., the child cried for seven minutes while sitting next to their cot and then stated to staff members that their ankle was hurting. Staff members assessed the child’s ankle, then elevated and iced the child’s foot. The child continued to cry intermittently. The parents were not immediately contacted. A written incident report completed by a staff member indicated that the child was crying due to pain. At 2:35 p.m., the child was picked up from the center by a parent. The parent was made aware of the child’s discomfort at that time. Professional medical attention was obtained, and the child was diagnosed with an ankle injury.

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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 an incident investigation conducted on July 21, 2023, it was determined that on June 28, 2023, a three-year- old child was inappropriately touched by another three-year-old child. A review of documentation concluded that the assigned staff did not observe what happened to the child as they had their back to the children. No injuries and no medical attention were obtained.

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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 an investigation, it was determined that on February 22, 2023, at approximately 9:40 a.m., supervision was not provided when a one-year-old child sustained a crush injury to the child's left thumb, when the diapering changing station door was closed on the child's hand. Medical attention was required.

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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 & Monitoring Visit conducted on January 3, 2023 ; It was determined based on observation that a staff member did not wash the child's hands after completing the diaper changing process in classroom First RB.

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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 an Incident Investigation & Follow Up conducted on March 8, 2023 ; It was determined based on observation that a staff member did not wash the child's hands after completing the diaper changing process in classroom RT FT.

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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 April 28, 2023 ; It was determined based on observation that a staff member did not wash the child's hands after completing the diaper changing process in classroom RT FT. Exhibit "A"

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