R 400.8365 · R 400.8365 Heating; temperature. (2) The indoor temperature must be at least 65 degrees Fahrenheit in child use area in at a point 2 feet above the floor.

I conducted an unannounced on-site inspection on 12/28/2022 at approximately 1:00 PM. I interviewed Program Director, Marissa Watkins. Ms. Watkins confirmed that on 12/26/2022 there was no heat at the center. The center is located inside of Bangor Career Academy. The entire building did not have heat, however, the other programs housed inside of the building was on winter break. Kidz 'R' Kidz Learning Center was the only program still operating inside of the building on 12/26/2022. Ms. Watkins arrived at the building at approximately 7:30 AM to find there was no heat. She tried to contact both maintenance and the superintendent of the building to report the issue. Neither maintenance nor the superintendent were available. Ms. Watkins stated the temperature did not go below 65 degrees Fahrenheit. She informed parents that the heat was off and to pick up their children. The center reopened the next day, 12/27/2022. Child Care Staff Member, Stacy Foust, came into the infant/toddler room around 6:00 AM that morning and turned on some space heaters. Ms. Foust ran the space heaters until the children arrived. The temperature stayed above 65 degrees Fahrenheit in that room that day. The preschool and school aged children went to Apple Tree, a child care facility, which is located across the street from the center for the day. The infants/toddlers did not utilize Apple Tree, as it does not have the appropriate equipment for infants and/or toddlers. Ms. Watkins explained the center already has permission to use Apple Tree, as they utilize their outdoor play area. Apple Tree was on winter break and the only children using the building that day was children enrolled in Kidz 'R' Kidz Learning Center. I observed the approved rooms in the child care center on that same date. All of the rooms were at the appropriate temperature and there were no space heaters. I received an email from Program Director, Marissa Watkins. Ms. Watkins attached child information cards for my review. I called Child Care Staff Member, Madison Gil, Child B's Mother, Child C's Mother, Child D's Mother and Child E's Mother on 02/14/2023. Ms. Gil provides care in the Infant/Toddler Room. On 12/26/2022, the building did not have heat, nor could the heater be repaired that day. Parents were contacted to pick their children up early on 12/26/2022. She stated on 12/27/2022, Child Care Staff Member, Stacy Foust, came into the Infant/Toddler Room at approximately 6: 00 AM and turned-on space heaters until the first child arrived at the center. The room remained above 65 degrees Fahrenheit that entire day. 3 • Tli - • T`• l t T • . f f Tla • -r i ri• rI. f • • - r •r Prli r !! • rJI

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

R 400.8530 · R 400.8530 Hazard Areas. (8) Auxiliary heating units, such as portable combustion or electrical types, are prohibited.

Space heaters were used to heat the Infant/Toddler Room on 12/27/2022.

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

R 400.8125 · R 400.8125 Staff; volunteer; requirements. (1) All staff and volunteers shall provide appropriate care and supervision of children at all times.

I conducted an unscheduled on-site inspection on 08/29/2022 and interviewed the center's licensee designee and program director Marissa Watkins. Ms. Watkins confirmed that on 08/23/2022 Child A was found outside of the building, looking into the building through the window on the exit door near the room he had been in. It was the end of the day. Ms. Watkins and three child care staff members had been outside with all of the children and they had just come inside. The number of children was low at the time, so they were all going to one classroom and Ms. Watkins let Child Care Staff Member Lakayla Wiggins leave the room to do some cleaning before going home for the day. Ms. Watkins went to her office to do work there. Five children remained, including Child A, in the care of Child Care Staff Members Joyce DeSantiago and Martha Magdaleno. About three to four minutes after Ms. Watkins arrived in her office, just down the hall from the classroom, Ms. Wiggins walked in and advised her that Child A's Stepmother arrived to pick him up and found him outside, looking in the window of the exit door. Ms. Wiggins had finished her cleaning and had returned to the classroom to see if anything was needed before she went home. That is when she learned of the situation and then came right to Ms. Watkins. Ms. Watkins estimated that Child A could not have been out of sight of staff for more than three to four minutes. Ms. Watkins terminated Ms. DeSantiago and Ms. Magdaleno. She installed alarms on all doors. Child care staff members are doing name to face attendance every half hour and each time children go outside and come inside. Classroom doors now remain shut at all time and Ms. Watkins has been spending more time in the classrooms. While on-site, I observed the classroom and classroom door where the children were at the end of the day on 08/23/2022. I also observed the exit door where Child A was found. The doors were approximately 10-15 feet apart. On 08/30/2022 Ms. Watkins emailed copies of child and child care staff members attendance from 08/23/2022. She also emailed copies of child information records for all children present late in the day on 08/23/2022. On 10/18/2022 I interviewed Ms. DeSantiago. Ms. DeSantiago explained that it was the end of the day. Children were going home and child care staff members were being dismissed for the day as well. They had just come in from outside and were getting the children into a classroom. The two doors to the outside of the building 3 were propped open — one at each end of the hallway. One door leads to the playground and one door is the entrance/exit for parents. Ms. DeSantiago was bringing children into the room while Ms. Magdaleno was still in the hall with children. At this time Child A's Stepmother arrived to pick him up. She walked in and saw him outside the door leading to the playground, looking through the window to the inside of the building. Ms. DeSantiago stated that she knew Child A's whereabouts at all times, and she said, "my eyes were never off him". She said less than ten children were present in the care of her and Ms. Magdaleno. Ms. Wiggins had just been dismissed for the day but was still in the building. I interviewed Ms. Magdaleno on 10/18/2022. She stated that they had just come inside with the children. The children were in two buggies. They counted children before they came inside and knew that everyone was with them as they left the outdoor play area. At the time they entered the building, Ms. Wiggins, Ms. DeSantiago, and Ms. Magdaleno were present. Once inside the door, they started unbuckling the children and taking them out of the buggies. Ms. Wiggins and Ms. DeSantiago went into the classroom with children and Ms. Magdaleno stayed in the hall continuing to get children out and sending them to the classroom. As she was taking the last two children into the classroom by her hands, Child A's Stepmother arrived to pick him up. When they got in the classroom, he was no

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

R 400.8125 · R 400.8125 Staff; volunteer; requirements. (1) All staff and volunteers shall provide appropriate care and supervision of children at all times.

On December 13, 2022, I made an onsite inspection and spoke to licensee and program director, Marissa Watkins about the allegation. Ms. Watkins acknowledged that there has been a lot of illness in the center and said that she closed the center on November 11 and November 12, 2021, so that a deep clean could be performed to minimize the spread of illness and give both children and staff a chance to get healthy. She has been sending home weekly reminders for families to contact their physician if their child is sick and to keep children home until they are symptom free for 24 hours. She stated that she does not allow children to return with fevers, diarrhea, vomiting, rashes, or any COVID-19 symptoms. She said it is just impossible to send children home for every runny nose during cold and flu season. The infant toddler room is full of children who were "COVID babies" and this is the first time they have been exposed to many illnesses since they were born during the pandemic and were not exposed to as much when they were at home. Ms. Watkins has required doctor's notes if the cold symptoms seem severe and, in several cases, the physicians have released children to return to care when Ms. Watkins has had concerns. Ms. Watkins said that the staff are "constantly" wiping noses. The child care staff members will wash all the children's faces after meals and when they wake up from a nap. She stated that a lot of the infants and toddlers sleep for as long as three hours and they do not wake them up to wipe their noses while they are sleeping unless they seem to have trouble breathing. Ms. Watkins denied that any infants would have ever woken up with a blanket stuck to their face from snot because she said that infants are not allowed to have blankets in their cribs until they are over a year old. Ms. Watkins said they only have four infants enrolled and one of them is Ms. Watkin's baby. She has never seen or heard about any of them napping with a blanket or waking with snot all over their face. On December 13, 2021, Ms. Watkins took me into the infant toddler classroom, and I observed eight young children and two child care staff members. Two toddlers were napping, and I did not observe any snotty noses among the napping children. Six other children were awake and playing or being fed. Child A (male, age 10 month) had a cold and I could hear it in his breathing, but his nose was clean, and Ms. Watkins said she had a doctor's note on file to say that he was able to return to care. Another child was drooling while sitting up and playing on the floor, but she appeared happy. While I was standing in the room talking to Ms. Watkins, a child care staff member came over to the child and wiped the drool from her chin. On December 13, 2021, I spoke to child care staff members, Marcia Sieber, and Jessica Sullins. Ms. Sieber said that she has been the lead caregiver in the 3 infant/toddler classroom for over two years. She acknowledged that they have had a lot of illness in the classroom, and she pointed out tissue boxes in several places around the room. She stated that she tries to wipe noses whenever she sees that they are running, but sometimes she is busy helping another child and it may have to wait a couple minutes. She always wipes children's noses after meals and before they lay down for nap, but sometimes they wake up with dried snot on their nose. She explained that many parents pick up in the afternoons when they are outside. The cold weather makes their noses drip and sometimes children do come indoors with snot frozen to their face. She said when they get back to the room, she will wash everyone's hands and face. Ms. Sieber stated that infants are never placed in a crib with their blanket, and she did not recall any instances when a baby woke up with snot all over their face. She said that the toddlers seem to have more trouble with runny noses than the infants do during nap times. If the runny nose is extremely bad or has any colo

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

R 400.8134 · R 400.8134 1 Hand washing. (2) All staff and volunteers shall wash their hands at all of the following times: (c) Before preparing and serving food and feeding children.

On December 13, 2021, I spoke to Ms. Watkins, Ms. Sieber, and Ms. Sullins about the allegation. Ms. Watkins said that she had a staff meeting in the past couple months to review hand washing procedures and said that the child care staff members in the infant toddler room wash hands when they arrive each morning, before preparing and serving food to the children, after diapering, after messy activities, after wiping noses or handling any other bodily fluids, after handing garbage, or any other time they are soiled. They are also having the children wash their hands before and after meals and snacks, after diapering, after naps, after touching their noses, and at other times during the day. Ms. Sieber said that she washes her hands when she arrives and washes the children's hands when they arrive as well. She said that she washes her hands before and after preparing meals and feeding a child, when they come in from outdoors, after diaper changes, any anytime she wipes a child's nose, after she uses the bathroom, or any other time they get dirty or contaminated. She helps the children wash their hands before and after meals, after diapering, when they come in from outside, if they have their hands near their nose or mouth, and before giving them any medications. Ms. Sullins said she washes her hands when she arrives each day and the children also wash their hands when they arrive. She washes her hands after every diapering, before giving any medications, after wiping noses, before and after every feeding, after injuries, when they come inside from playing outdoors, and other times throughout the day. She said the children in care wash their hands after diapering, before and after they eat any meals or snacks, before nap, after they come in from outside, and any other time they are dirty. On December 27, 2021, I spoke to Child A's Mother, Child B & C's Mother, Child D & E's Mother, Child F's Mother, Child G's Mother, and Child H's Mother. Child A's Mother said she is not usually there to during mealtimes and diaper changing times to know when or if the staff are washing their hands. She said Ms. Sullins always checks Child A's diaper before he leaves, and she will use hand sanitizer after checking the diaper before handing him over to Child A's Mother. Child B & C's Mother said she is not usually there to observe staff handwashing, but she has arrived to see a child finishing a bottle and the child care staff member washed their hands afterwards. Child D & E's Mother, Child F's Mother, and Child G's Mother all denied knowing whether staff wash their hands before feedings and after diaper changes. Child D & E's Mother said when she arrives in the afternoons, they are already finished with diapering and feedings for the day. Child H's Mother said she is not there during mealtimes so she does not know if staff wash hands then, but at pick-up times she always sees the child care staff members wash their hands after diaper changes.

R 400.8134 · R 400.8134 Hand washing. ....................................... .......................... (2) All staff and volunteers shall wash their hands at all of the following times: (e) After each diapering. .................................. ..........................................................................................

On December 13, 2021, I spoke to Ms. Watkins, Ms. Sieber, and Ms. Sullins about the allegation. Ms. Watkins stated that if a child becomes ill during the day, she will contact the child's parents and send the child home. The child will wait in the office with her if they have a fever, diarrhea, vomiting, or anything else that could potentially be contagious. She does not allow children to return until they are symptom free for 24 hours. She said it has been impossible to send children home for every runny nose during cold and flu season, but she does require a doctor note if cold symptoms are severe. Ms. Sieber stated that if a child is not feeling well, she will let Ms. Watkins know and let her make the decision whether the parent needs to be contacted. The child care staff members will try to keep the child separated from the other children until the parent arrives to pick the child up. Sometimes they will stay in the room and other times they will go wait in the office. She said it depends on what is happening in the center and what the child's symptoms are. Ms. Sullins said that if a child needs to go home, she will talk with Ms. Watkins and one of them will contact the parent to come pick up the child. Ms. Sullins will try to keep the child separated from the other children in care to prevent the spread of illness until the parent arrives and clean anything they use. She stated that the child cannot return to care until they are fever or symptom free for 24 hours without the use of medication. On December 13, 2021, Ms. Wakins provided me with a copy of her illness and exclusion policy which stated that children cannot be present at the center and will be excluded if they have a fever of 100 degrees or higher, diarrhea, vomiting, or a rash until they are fever or symptom free for 24 hours without medication. Any communicable diseases such as chicken pox measles, lice, ringworm, pinkeye, scabies, etc. require documentation from a physician that the child is safe to return to care. Children over the age of two are required to wear masks except when eating meals, playing outdoors, or napping. On December 27, 2021, I spoke to Child A's Mother, Child B & C's Mother, Child D & E's Mother, Child F's Mother, Child G's Mother, and Child H's Mother. Child A's Mother said that twice when her child has been sick, she has been contacted to pick him up. Both times he was in the office with Ms. Watkins when she arrived to pick him up. Child B & C's Mother stated that she has been contacted to pick up her children when they have been sick. She said Child B was in the classroom with the other children in care and was not necessarily separated but she could not remember if there were other children around Child B. Child D & E's Mother said that once time in October 2021, she was contacted to pick up Child D when he had hand, foot, and mouth disease, and he was separated in a different room until she arrived to pick him up. 10 Child F's Mother said one time she was contacted to pick up Child F because she had an ear infection. She was in the same room but separated from the other children in care. Child G's Mother said she knows that some parents bring their children to the center when they are sick because they cannot miss work, but the center tries to keep children separated and will contact the parents if they need to pick them up. Child H's Mother stated that she has been contacted to pick up Child H before and said the center is good at following the regulations. She explained that Child H gets diarrhea frequently and they will call her if he has three loose stools, and she has to pick him up even though she knows it is not contagious. They have also contacted her to pick up Child H when he had a fever. When she has been called, he is usually waiting in another room with a child care staff member and has all of his belongings to go home.

R 400.8155 · R 400.8155 Child accidents and incidents; child and staff illness. ................................................. .. ...... ............................................... (2) A center shall ensure that a child who is too ill to remain in the group is placed in a separate area and is cared for and supervised until the parent arrives. 11

On December 13, 2021, I spoke to Ms. Watkins, Ms. Sieber, and Ms. Sullins about the allegation. Ms. Wakins stated that she closed the center on November 11 and November 12, 2021, so that a deep clean could be performed to minimize the spread of illness and give both children and staff a chance to get healthy. The child care staff members have been cleaning constantly to try to minimize the spread of illnesses. She said that they use the three-step cleaning process to wash, rinse, and sanitize the tables, countertops, toys, and other equipment in the room. They use Dawn dish soap for the wash step and are making the bleach water fresh daily and checking the concentration using test strips. They are also using Lysol wipes on some surfaces as an extra precaution for things like counters, doorknobs, and other places that are high traffic areas. Ms. Watkins said they each child has their own cubicle, so their bedding does not touch and that goes home weekly or more frequently if it gets soiled. When they were closed for the two days in November, they even washed down all of the walls. Ms. Sieber stated that she is constantly cleaning and disinfecting her room everyday whenever the children are napping, or she gets an extra moment. She said if a baby puts something in their mouth, she immediately removes the toy and places it in a 12 dirty toy bin and it is not used again until it is washed, cleaned, and sanitized using a three-step process with a bleach solution for the sanitizer. Ms. Sieber showed me where the three bottles are located and said that she washes the tables and highchairs down before and after meals and projects. She wipes the counters down, washes or sprays the toys at least daily or more frequently as necessary, and makes sure that bedding is taken home to be washed each week. The children do not share cribs or mats and they all have separate cubicles for supplies to prevent cross contamination. She explained that the center closed down for a couple days in mid- November so that a deep clean could be performed and every toy in the room was bleached and sanitized. They have kept up on that daily since then and weekly she does a deep clean after hours to be sure that all cabinet handles, trash cans, cribs, mats, and other hardware are cleaned very well. She wants to remain healthy and wants the children in care to be healthy too. Ms. Sullins stated that she sprays everything down at the end of the day with the bleach solution if it cannot be washed using the three-step process. She said if a child puts a toy in their mouth, it immediately goes to the dirty toy bin to be cleaned before it is used by another child. Every Friday night, she performs a deep clean and uses the three-step process on all handles, doors, counters, cribs, and other equipment and then also goes over it with Clorox wipes just to be sure nothing was missed. She explained that every child has a bin with their own supplies, so nothing is shared between children. On December 27, 2021, I spoke to Child A's Mother, Child B & C's Mother, Child D & E's Mother, Child F's Mother, Child G's Mother, and Child H's Mother. Child A's Mother said she usually picks up between 4:30-5:00 PM and she said one of the child care staff members are always vacuuming the floors or washing the tables at the end of the day while the children in care are in the gymnasium. Child B & C's Mother said she was not familiar with the specific cleaning practices in the center, but she has arrived to see them wiping down equipment and vacuuming. Child D & E's Mother stated that she has seen the child care staff members wiping down toys in the evenings. Child F's Mother stated that she often arrives between 5:00-5:30 PM and the child care staff members are usually cleaning before they leave for the evening. She has seen them wiping down toys and tables and vacuuming. She said the center shut down for a couple days in mid-November so they could do a deep clean of the center. Child G's

R 400.8173 · R 400.8173 Equipment. (4) Play equipment, materials, and furniture, must be all of the following: (b) Safe, clean, and in good repair.

The play equipment, materials, and furniture in the center are maintain in a clean condition. Ms. Watkins, Ms. Sieber, and Ms. Sullins all stated that they use the three-step process with a bleach solution every day to clean the toys, tables, and other equipment used by the children in care. On November 10 and 11th, 2021, the center was closed down for two days so a deep clean could be performed and everything in the room was cleaned and sanitized. Child A's Mother, Child B & C's Mother, Child D & E's Mother, Child F's Mother, Child G's Mother, and Child H's Mother all stated that they have seen child care staff members wiping down surfaces and vacuuming in the center. Child G's Mother said it smells like bleach in the classroom from cleaning. Several of the parents commented that the center had closed down in mid-November so that a deep clean could be performed in the facility.

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.