R 400.8140 · R 400.8140 Discipline. (1) Positive methods of discipline that encourage self- control, self-direction, self-esteem, and cooperation must be used.

I received an incident report from licensee designee/program director (LD/PD), Barb Ackerman, on 03/03/2023. Mrs. Ackerman also attached a copy of the report from the emergency room. The report stated the incident occurred on 02/27/2023 at 9:30 AM in the toddler room. The report was completed by Child Care Staff Member (CCSM) 1. Child A was sitting on the rug when he became upset and threw his cup. CCSM 4 asked Child A to pick up his cup and take it to the counter. Child A told her no. CCSM 1 went over to help. CCSM 1 took Child A by the hand and said let's go put your cup away. He threw his feet out from under him. CCSM 1 was still holding his hand. Child A started to complain that his wrist hurt. CCSM I put him in her lap and checked his wrist. He could move it. She held him and comforted him. CCSM 3 applied ice and called Child A's Mother. Child A's Mother took him to the doctor. The report from the emergency room indicated Child A was seem for an arm injury. The diagnosis is nursemaid's elbow of left upper extremity, initial encounter. Medications include Ibuprofen. There is a fracture follow-up appointment on 03/14/2023. On 03/13/2023, 1 spoke with Child A and Child B's Mother over the telephone. She was told that Child A had thrown a cup and was asked to pick it up. Child A refused to pick up the cup and so a child care staff member (CCSM) physically touched Child A holding him by the hand to help him pick it up. Child A and Child B's Mother requested and was able to view the video from the classroom. Child A was pulled up to his knees and then sat back down. The CCSM continued to pull on his arm. It appeared to be gentle tugging as Child A was about to get up and then sat back down, Child A was not yanked, and it did not appear to be aggressive. Child A and Child B's Mother expressed concern that there was physical contact instead of a verbal redirection and this was a stronger discipline technique than what was required. Child A was taken to the emergency room. They could not rule out a fracture because the arm was so swollen. They had to wait for the swelling to go down before another x-ray could be done. There was a follow up appointment on 03/13/2023. The injury was diagnosed as nursemaid's elbow. in contact to schedule an onsite inspection. 3 On 03/15/2023, I received an email from . He arranged to conduct an onsite inspection at the center at on 3/16/2023. On 03/16/2023, I received another with similar allegations. I dismissed the complaint and am invinetsatkigea"tininggall allegations in this report. On 03/16/2023, and I conducted an unannounced onsite inspection at the center. I advised rs. Ackerman of the joint investigation, and we discussed the incident. Mrs. Ackerman denied having any concerns regarding CCSM 1. CCSM 1 was very upset by the incident and had to take a couple days off work. Mrs. Ackerman indicated she reviewed video footage of the incident and offered to make it accessible to us. CCSM 2 began working on sending the video footage and I requested. CCSM 2 did not have any additional information regarding the incident and was not interviewed. While we waited for the video footage, , and I interviewed CCSM 3 while onsite on 0 stated that CCSM 1, CCSM 4, and CCSM 5 work in the classroom with Child A. CCSM 6 is a substitute. CCSM 3 denied having any concerns with any of the CCSMs. We asked specifically about CCSM 1. CCSM 3 stated CCSM 1 is good with the children. She talks kindly and is usually gentle. She uses a soft voice and does not get loud with the children. CCSM 3 enjoys having CCSM 1 in her classroom. We asked CCSM 3 about the incident. She had stepped out of the classroom briefly and when she returned, CCSM 1 was comforting Child A. Child A came over to her as she is his primary caregiver. CCSM 1 told her what happened. Child A was doing a "whimper like cry" and saying his arm hurt. She comforted Child A and examined his arm. Child A was favoring his arm and wasn't willing to move it. She put

Open Not marked corrected in the state record

Category: ratio. 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.

Child Care Staff Members were providing appropriate care and supervision of children while in the outdoor play area.

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.

I conducted an unscheduled onsite inspection on 03/23/2021. 1 spoke with program director, Barbara Ackerman. I advised her of the allegations. Ms. Ackerman stated that lead caregiver, Sonja Churchill, texted her the evening of 03/18/2021 after she had received a text message from Child B's Mother. Child B's E Mother indicated that Child B told her that Child A touched inappropriately. Ms. Ackerman denied that either Ms. Churchill or Child Care St Member (CCSM), Kelly Buschu, had any knowledge of an incident until Ms. Churchill was notified by Child B's Mother. The alleged incident occurred in the gym during free time. There are cameras in all the other rooms, except the gym. There were 16 children present with Ms. Churchill, Ms. Buschu, and two supervised volunteers from Ms. Ackerman said she did not think I Child A could have gottet hand into Child B's pants .. while andi in the middle of the gym wi our adults supervising and no blind spoi.s. Ms. Ackerman advised that Child A has been enrolled at the center since ■ was an and there have never been any developmental or behavioral concerns. SShhee a ieves this incident has gotten blown out of proportion. The children are, years old and the need for redirection regarding this type of behavior is developmentally appropriate. Ms. Ackerman met with Child B's Mother at the center on 03/19/2021 to discuss her concerns, Child B's Mother wanted the center to report the incident to . Ms. Ackerman advised that Child B did not disclose or report any concerns to the CCSMs or anyone else at the center so they would not make a complaint without direct knowledge. Ms. Ackerman encouraged Child B's Mother to call. if Child B disclosed concerning information. She provided information on appropriate developmental expectations for preschool children and the mandated reporting manual. Ms. Ackerman also offered to have a meeting with Both Child A's Mother and Child B's Mother. I was provided with copies of the 3 documents Ms. Ackerman gave to Child B's Mother. I also obtained copies of child information cards and contact information for Ms. Churchill and Ms. Buschu. I received a telephone call from Ms. Ackerman on 03/2512021. She stated that the - had been to the center requesting several children's information. I told her I would follow up with the I spoke over the telephone with Child B's Mother. She stated that she did not have any concerns about appropriate care and supervision at the center. Child B has been attending the center for years. Her concern is that the CCSMs did not report the incident to . We discussed mandated reporting guidelines and I spoke over the telephone with Child A's Mother on 03/2512421, 1 advised her of the allegations. She was told that Child B was talking to a friend in the middle of the gym and Child A came up and puts hand in Child B's pants. She denied that Child A had ever exhibited any inappropriate or concerning behaviors. She is also concerned the= are involved since the children are only, years old. I made telephone contact with Ms. Churchill on 04/09/2021. She stated that to her knowledge, nothing happened in the gym between Child A and Child B. Child B did not report any concerns to her or Ms. Buschu. Ms. Churchill received a text message from Child B's Mother saying that Child A touched Child B's nI while in the gym. She planned to remind Child A the next day about keeping ■ hands to , appropriate personal space, and asking before touching or hugging others. These reminders are necessary with this age group at times. Child B's Mother sent another text indicating that she wanted contacted. Ms. Churchill contacted Ms. Ackerman regarding the situation. Ms. Ackerman suggested having a meeting the following morning with the families. Ms. Churchill stated that it is unlikely that these allegations are true as Child A had been misbehaving and was sitting with ■ for most of free time in the gym. The children only had approximately 10 minutes that day and barely stop

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.