Belleville Child Care Center

R 400.8269(1)(c) · R 400.8269(1)(c) Emergency preparedness and response planning procedures (1) Written plans and procedures for emergency preparedness and response planning for the care of children and staff in each of the following emergencies must be developed and implemented: (c) Floods. Technical Assistance Technical assistance is support and training given to the licensee/licensee designee on a specific rule. Technical assistance includes consultation on how the facility can best maintain compliance with a rule.

R 400.8269(1)(d) · R 400.8269(1)(d) Emergency preparedness and response planning procedures (1) Written plans and procedures for emergency preparedness and response planning for the care of children and staff in each of the following emergencies must be developed and implemented: (d) Power outages. Bureau

R 400.8213(1)(b) · R 400.8213(1)(b) Staff; volunteer (1) All staff and volunteers present at the center shall: (b) Act in a manner that is conducive to the welfare of children.

Based on interviews and review of allowable information, the Child Care Licensing Bureau finds that the disposition, temperament, condition, and actions of Constance Ramsey, Child Care Licensing Bureau finds that Constance Ramsey is conducive to the welfare of children.

R 400.8263(1)(b) · R 400.8263(1)(b) Child accidents and incidents; child and staff illness (1) A center shall develop and implement a written plan for how and when a parent is notified if program staff or volunteers observe any of the following: (b) A child experiences an accident, injury, or i ncident.

Based on interviews, review of Child A's record and injury/incident reports, Child A's parent were notified of injuries Child A sustained while at the childcare center.

R 400.8280(2)(a) · R 400.8280(2)(a) Discipline (2) All of the following means of punishment are prohibited: (a) Hitting, spanking, shaking, biting, pinching, o r inflicting other forms of corporal punishment.

Based on interviews, Constance Ramsey has not inflicted any form of corporal punishment toward Child A. She has not scolded or picked on Child A. She also has not squeezed Child A's arm.

R 400.8155 · ................................................................................................................................................................................................... I R 400.8155 Child accidents and incidents; child and staff illness. (4) If a center becomes aware that a staff member, volunteer, or child in care has contracted a communicable disease, then the center shall notify parents and provide all of the following information: (a) The name of the communicable disease the children were exposed to. (b) The symptoms of the disease. (c) Prevention measures as recommended by the U.S. Centers for Disease Control and Prevention (CDC) at the following website: https://www.cdc.ciov/DiseasesConditions.

On 05/19/2023, I completed an on-site inspection at Belleville Child Care Center. I spoke with John Ramsey, licensee designee, Constance Ramsey, program director, and CCSM 1 regarding the allegations. The entire center was observed. There were 23 children, ages 3 to 5 years, with five CCSMs. The center parent handbook, symptoms checklist form, child information cards and return to work medical letters were provided for review. The notice of Influenza was posted on the center entrance door on 05/19/2023. According to Mr. Ramsey and Ms. Ramsey, earlier in the month they had sent approximately 10 children home from the preschool and pre-k rooms due to various 2 reasons: fever, diarrhea, lethargic, etc. When the children are ill, the center follows their written health plan. They contact parents when a child has a temperature of over 100 degrees, intestinal disturbance by diarrhea or vomiting, any undiagnosed rash, sore or discharging eyes or ears or profuse nasal discharge. A notice is provided to the parents at pick up with their child observed symptoms. Depending on the symptom observed, depend on what is needed for them to return to the center. The children were able to return to the center with a doctor note, or being symptom free (i.e., fever, diarrhea, vomit) for 24 hours. Regarding Child A, he attended on 05/10/2023 and he had a running nose with clear nasal discharge. Child A did not have a temperature. They assumed it was allergies. Child A was not sent home because he did not meet the requirements of an ill child. Then on 05/11/2023, he came in and washed his hands and he sat down next to Ms. Ramsey. Child B was not behaving normally, and they took his temperature. Child B's temperature was 103. They contacted Child B's Mother, and she came back to pick up Child B. Child B was at the center for 10 minutes. Child A's Mother took him to the doctor, and they told her Child B had a cold. On Monday, Child B was having a hard time breathing. Child B's Mother took him to the hospital, and he was diagnosed with asthma. Later in the week, Child A was diagnosed with Pneumonia, a infection of the lungs. Six of the children returned to the center. Some of the children were taken to urgent care and the others were symptom free for 24 hours before they returned. The parents reported their children had colds. The center did not keep the medical documentation that was provided by the parents. Mr. Ramsey and Ms. Ramsey stated that the medical excuses received from the doctor office does not give a diagnosis, just a return date. Due to HIPPA, the parents do not have to disclose their child diagnosis. Four children had not returned at that time. One of the children is Mr. Ransey's son, who attends at the center. None of the children parents reported that their child was diagnosed with Influenza. Ms. Ramsey believed most of the children were tested for Coronavirus Disease (COVID-19), and Respiratory Syncytial Virus (RSV) but not for Influenza. The center is cleaned daily. They use the three-step process: of wash, rinse and sanitize the toys, tables, etc. at the center. Two CCSMs, from the preschool and pre-k rooms, was diagnosed with Influenza B. Initially, they thought they had colds, but it was later diagnosed as Influenza. CCSM 1 went to the urgent care on 05/11/2023 and was told she had a cold. She wasn't feeling well on 05/12/2023. She went back to urgent care that evening and she tested positive for Influenza B. CCSM 1 notified Ms. Ramsey of the diagnosis and she returned to work on 05/15/2023. CCSM 1 was out for five days, and she came back with doctor note. The center put a notice on the door to notify the parents that an individual at the child care center had contracted Influenza on 05/15/2023. CCSM 2 did not work 05/08/2023 and 05/09/2023 because she was not feeling well. She had a doctor note clearing her to returned to work on 05/10/2023. At that time, she was diagnosed with a sinus infection and a double ear infection. On 05/

R 400.8155 · R 400.8155 Child accidents and incidents; child and staff illness. (5) A center shall have a written policy detailing when children, staff, and volunteers will be excluded from the ce .n ....t ..e ... r due to illness.

Based on the interviews with the CCSMs, parents and the center observation, the center followed their written policy when children staff and volunteers will be excluded from the center due to illness.

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. 4

On 12/19/2022, I spoke with Paris Howard, Licensing Consultant. She said she requested the incident report from the child care center. The child care center did not report having any previous problems with the CCSM providing appropriate care. On 12/20/2022, I completed an unannounced onsite inspection at the child care center. I interviewed CCSM, Kristine Davis and spoke with John Ramsey, Program Director, on the telephone. Ms. Davis said just before I arrived at the child care center Child A threw his lunch and his cup because he didn't want it. Child A laid on the chair on his back. When he got up, he hit his forehead. Ice was applied and Child A's Father was notified of the incident. They both stated that they have never witnessed any CCSM hit a child on their forehead for not listening. They said that there are three children enrolled in the child care center with the same first name that was mentioned in the allegations, Child A (3- year-old male, Child C (3-year-old male) and Child D (3-year-old) male. Child C and Child D were not in attendance. Child D arrives after lunch. Ms. Davis explained that Child A had been in the classroom with Child B (3-year-old, female) who reported the allegation to her mother. Mr. Ramsey said he attempted to speak with Child B's Mother to get more information. He explained that she refused to speak about the information that Child B reported. She told Mr. Ramsey that she didn't want to discuss the allegations because "she works at a child care center and director's lie". Mr. Ramsey also spoke with the staff to try and figure out what may have happened and what child may have been involved. They could not confirm what child may have been involved. Ms. Davis said on 12/14/2022, Child A had a typical day. He likes to head butt and must be redirected often. Ms. Davis recalls that on the alleged date of the incident Child A kept head butting. He was told to stop head butting many times. It is reported that one of his teeth is broken from a previous incident when he was head butting. The parents are notified daily of Child A's behavior. Ms. Davis said Child C and Child D don't have behavior issues. On 12/20/2022, I spoke with Child C's Father. He said he did not have any concerns about Child C being hit in the forehead by a CCSM. Child C has never reported that any of the CCSMs have hit him on the forehead. I observed Child A during the onsite inspection. He was running around and engaging in play. I did not witness Child A head butting or slamming his head back. I did not witness any of the CCSMs interact with Child A in an inappropriate manner. 3 On 12/21/2022, I spoke with Laglora Kenley, CCSM on the telephone. She said Child A was running while the lunch table was being set up. He was knocking the plates down while he was running. Child A began spitting in the other children face. She explained that she held him around his waist (not tight or with force) to prevent him from injuring himself. Ms. Kenley stated that Child A was slamming his head back continuously. Ms. Kenley explained that Child C was not in attendance at the child care center on 12/14/2022. Child D attends the child care center after lunch. There are no behavior issues reported for Child D. On 12/21/2022, I spoke with Child B's Mother. She said she was notified to come and pick up Child B on 12/14/2022 because she was crying. When Child B's Mother arrived at the child care center, Child B told her in the car that Child A was smacked on his forehead. Child B's Mother said Child B did not mention a teacher by name. Child B's Mother said when Child B's Father arrived home from work, Child A told him about what happened, and she start crying. On 12/21/2022, I received the children's attendance records for 12/12/2022- 12/16/2022. Child B's last day was 12/14/2022. Child B was in attendance on 12/12/2022 and 12/14/2022. Child A, Child C, and Child D were also in attendance. Child D arrived at 12:00p.m. or very close to noon during t