R 400.1911 · R 400.1911 Care; supervision; children. (1) A licensee shall ensure appropriate care and supervision of children at all times.

On May 13, 2021, I spoke to Child A's Mother about the allegation. She stated that Child A would frequently come home with dried food all over her collar and onesie. Milk would leak from the bottle onto Child A's neck, and she was not being cleaned up well after a feeding. She would send bibs and extra sets of clothing, but Child A was never changed. Over a period of two or three months, Child A had a rash on her neck that required a steroid cream to clear it up. Child A's Mother started to notice a pattern that the rash was worse during the week when Child A had been to Ms. Smith's child care home and would start to get better on the weekends. The rash continued to come and go until Child A started eating more solid foods. Child A has not had any issues with a rash since she switched providers. Child A's Mother sent me a picture of the rash on Child A's neck. A red scaly patch of skin could be seen in the crease of Child A's neck. On May 13, 2021, I spoke to Ms. Smith, Ms. Kauffman, and Ms. King about the allegation. Ms. Smith said that Child A came to her with the rash and Child A's Mother told her it was from drooling and teething. Ms. Smith acknowledged that sometimes Child A may have had "a little bit" of dried food on her because she was just learning to eat but they would always try to clean her up the best they could. They would try to put a bib on her but most of the time Child A would rip it off and did not want to wear it. She denied that milk was not being cleaned from Child A's neck after a feeding. Ms. Smith said that Child A had the rash on the side of her neck since she started attending the child care home and Child A was seen by a doctor for it and had medication. They would try to keep her neck dry, but Child A drooled a lot. Ms. Kauffman stated that Child A had a rash under her neck when she began attending the child care home. She denied ever seeing Child A with lots of dried food on her collar or onesie. She said Child A did sometimes get a little bit of baby food on her while they were feeding her, but they would try to clean it up and Child A would usually wear a bib during feedings. Ms. King stated that she was not usually there during breakfast times and Child A was often not in care on days when she makes her regular visits to the child care home, but she did not ever see children dirty after meals and it was never a concern anyone else brought to her about the program. Ms. King said she is usually there late mornings through the lunch period to provide support. On May 14, 2021, I spoke to Child B & C's Mother about the allegation. She said she had never seen any children who appeared dirty or covered in milk and food. It was never an issue when Child B or Child C (male, age 24 months) attended the child care home. 7 On July 1, 2021, I spoke to Child D's Mother, Child E & F's Mother, Child G & H's Mother, and Child I & J's Mother about the allegation. Child D's Mother, Child E & F's Mother, and Child I & J's Mother all stated they have never had any concerns about their children coming home with food all over them. Child G & H's Mother said that her children are messy when they eat, and Ms. Smith would take their shirts off or put something on over their clothing if it was going to be a messy meal. She said Child G & H would occasionally come home with some food on their clothing, but they are messy eaters at home, and she never had any concerns about it. She said their faces were always washed and clean. She could tell that someone had tried to wash any food off their clothing.

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

R 400.1911 · R 400.1911 Care; supervision; children. ............ (1) A licensee shall ensure appropriate care and supervision of children at all times. .............................. ........._. ....................................................................................

On May 13, 2021, I spoke to Child A's Mother about the allegation. Child A's Mother stated that she had arrived to pick up Child A and was standing between the two tables in the breezeway. Ms. Smith was standing in the kitchen and Child B was sitting on the floor near the door trying to take her shoes off and whining, "Can't do it, can't do it." Ms. Smith said, "You've done it before." She seemed patient with Child B. Child A's Mother and Ms. Smith continued to stand there talking. Child B continued to struggle with getting her shoes off. Then Ms. Smith sighed loudly, grabbed her shoe abruptly, and said, "This is how you do it." She then said, "This is what happens when Mommy does everything for you" and rolled her eyes. Child A's Mother said her tone of voice sounded frustrated and that she never heard her talking very kindly to Child B. On May 13, 2021, I spoke to Ms. Smith, Ms. Kauffman, and Ms. King about the allegation. Ms. Smith acknowledged that she has been working on independence skills with Child B. She said that Child B will do it herself when there is no one else around, but when Child B's Mother is there, she will do things for her rather than letting Child B do things on her own. Ms. Smith could not recall the particular day that Child A's Mother described. She said this was an everyday issue with Child B. She would always say to Child B, "Show me you can do it." "You can do it." She tried to encourage her to do things on her own. Some days Child B would do it and other days she would refuse. Ms. Smith said that she never got frustrated with Child B. When Child B would kick, scream, or "throw a fit", Ms. Smith would walk away and let Child B calm down. Sometimes she would have her come sit in the breezeway so she was away from the other children. Ms. Smith stated that if she became frustrated with a child, she would walk away and ask Ms. Kauffman to handle the situation. Ms. Kauffman denied ever seeing Ms. Smith frustrated with Child B and said she never heard her say or do anything inappropriate to Child B or any other child. Ms. Kauffman described Child B as one of those children who would do something good, you would praise her for it, and she would get upset. Sometimes Ms. Smith would have to be very firm with her, but she has never seen her yell or be disrespectful towards any child with her words or tone. Ms. Kauffman said she and Ms. Smith had been working with Child B on her independence skills but they did not always receive much support from her parents. Ms. King described Child B as a strong-willed child and said that she felt the relationship between Child B and Ms. Smith "could be strained." She never saw interactions like the allegation, but there were times when Child B would refuse to do things, sit down, scream, and cry. Ms. King said it was very hard to console Child B and get her to calm down. She had conversations with Ms. Smith about trying to find something nice about Child B to try to make a connection with her. She never heard Ms. Smith ever yell or "belittle" her or any other child in care. On May 14, 2021, I spoke to Child B & C's Mother who said Child B never mentioned the incident, but it would not surprise her if Ms. Smith talked to Child B in that way because Child B & C's Mother did not think Ms. Smith liked Child B. One day she received a text message at work from Ms. Smith to say that Child B had bucked Ms. Kauffman in the face, and she was terminating her contract. Child B & C's Mother called her back and asked her what happened. She said that Child B was seated at the table jumping up and down. Ms. Kauffman went down, and Child A went up and bumped her in the face. Child B & C's Mother said it sounded like an rj accident and she did not understand why their care was being terminated. Child B & C's Mother said she confronted her and said she felt like she did not like Child B. Ms. Smith responded and said, "I thought you were going to say that." Then Ms. Smith accused Child B & C

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

R 400.1915 · R 400.1915 Indoor space; play equipment and materials. (3) A variety of easily accessible activity choices must be available to a child that are safe and appropriate for a child at his or her stage of development. The number of choices must be based on the number of children who are permitted to attend the licensed child care home. All of the following apply to activity choices available: (c) Toys and other play equipment soiled by secretion or excretion must be cleaned with soap and water, rinsed, and sanitized before being used by a child. 12

On May 13, 2021, I spoke to Child A's Mother about the allegation. She said that she would often drop Child A off at the child care home in the mornings and her boyfriend would pick Child A up in the afternoons. On more than one occasion, Child A's Mother's boyfriend arrived to pick up Child A and as he was putting Child A in her car seat, Minor Household Member 1 (female, age 3) (MHM 1) walked over to Child A, pulled a teething toy out of her mouth, and handed it to him. He would say, "Thank you I'll take that." One time, Child A's Mother said she witnessed it at drop off. Child A had been sick with a runny nose and cough. Child A's Mother was getting Child A out of her car seat and felt something tug on the car seat. She turned around to see MHM 1 rip the teething toy out of Child A's hand and then she put it in her own mouth. Ms. Smith did not say or do anything about it. Another time she arrived and found one of Child A's teething toys lying on the floor in front of the door. She said MHM 1 always wanted to be into Child A's belongings. Child A's Mother said she finally stopped bringing teething toys over to the child care home. On May 13, 2021, I spoke to Ms. Smith, Ms. Kauffman, and Ms. King about the allegation. Ms. Smith said the child care home has their own supply of teething toys for the babies to use that are regularly cleaned and sanitized anytime they are put in a child's mouth. Child A's teething toys were kept in her diaper bag, and rarely used during the day because Ms. Smith did not want them to get lost. Anytime a toy is used and put in a child's mouth, the procedure is that she or Ms. Kauffman will put them in a bin to be washed, rinsed, and sanitized. Ms. Smith did not recall any times when she witnessed MHM 1 taking a teething toy from Child A and putting it in her mouth. Ms. Smith said she was not denying it was possible that MHM 1 took a teething toy from Child A, because MHM 1 likes to "play with the babies." Ms. Smith stated that MHM 1 does not usually put toys in her mouth, and she does not use a pacifier. Ms. Kauffman denied ever seeing MHM 1 take any teething toys from Child A and put them in her mouth. She said she did not even know Child A had a pacifier or other teething toy. She said Ms. Smith has teething toys for the children in care to use and once a child puts a toy in their mouth, the item goes in a little tub where they are cleaned and sanitized before being used by another child. She has not observed MHM 1 sucking on any teething toys and if she puts anything else in her mouth, they always put it in the tub to be washed. Ms. King said that all of the children put toys in their mouths from time to time, but she would not know which toys belong to which child when she is there, and Child A is rarely there when she is at the child care home. She said that once a toy goes into a child's mouth, Ms. Smith is very good about putting it in a toy bin to be washed and sanitized. She has witnessed Ms. Smith saying, "That's dirty" and taking a 11 used toy from a child and putting it in the bin to be washed. Then she has seen Ms. Smith wash the toys after lunch or during nap time. On May 14, 2021, I spoke to Child B & C's Mother who said that she is sure it happens with young children, but she never recalled witnessing anything like that happening. On July 1, 2021, I spoke to Child D's Mother, Child E & F's Mother, Child G & H's Mother, and Child I & J's Mother about the allegation. Child D's Mother said she does not recall ever seeing something like that happening when she has dropped off or picked up her child. Child E & F's Mother said that Ms. Smith does not let children bring toys from home. She said that most of the time, MHM 1 is in parts of the child care home that are not frequently used by the children in care. Child G & H's Mother said that Ms. Smith does not usually like them to bring toys from home. She has witnessed children put toys in their mouths while she is there, but Ms. Smith wil

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

R 400.1919 · R 400.1919 Communicable disease; immunization; mental and physical health; physician attestation; tuberculosis. (4) An individual who lives in a child care home or who cares for children in a child care home, who has a suspected or confirmed case of a communicable disease, shall not come into contact with children in the home's care. Communicable disease includes, but is not limited to, any of the following: (a) Tuberculosis. (b) Influenza. (c) Measles. (d) Whooping cough. (e) Strep throat. (f) Scarlet fever. (g) Chicken pox.

On May 13, 2021, I spoke to Child A's Mother about the allegation. She stated that in April 2021, Ms. Smith notified her that MHM 1 was sick and running a fever but the child care home would remain open. Child A's Mother brought Child A one day but then kept her home the rest of the week because she did not want Child A exposed to anything. She was upset because Ms. Smith gave MHM 1 medication and allowed her to be around the children in care. She said there were several other times when MHM 1 was sick, but Ms. Smith would let MHM 1 come outside to play with the child care children. One time both Ms. Smith and MHM 1 were ill, but Ms. Smith kept the child care home open and they were supposed to stay in a back bedroom. Child A ended up getting sick with a hoarse voice and a runny nose. There were several other times when people in the home were sick, and she was not notified. One time Mr. Kauffman had bronchitis. Another time he had to be tested for COVID. There was another time when MHM 1 got strep throat, but Child A's Mother was not made aware that MHM 1 had symptoms until after Ms. Smith took MHM 1 to the doctor and Child A could have been exposed. Child A's Mother did not feel she should have to pay for full-time care when she was not sending Child A. She and Ms. Smith got into a disagreement over payment and Child A's Mother withdrew Child A from care. On May 13, 2021, I spoke to Ms. Smith, Ms. Kauffman, and Ms. King about the allegation. Ms. Smith said that she messaged the parents the evening before when MHM 1 started running a fever and let them know what was going on so they could make a choice whether they wanted to send their children or keep them home. She said the child care home remained open and she had plenty of help to keep MHM 1 away from the children in care. The contract parents sign states that they are responsible for child care whether the child comes or not. Ms. Smith said this was 13 the first time in quite a while that MHM 1 had been sick. She took MHM 1 to the doctor and it was a sinus infection. She was running a low-grade fever, so she gave MHM 1 some medication, but MHM 1 slept most of the day and she denied ever letting MHM 1 play outdoors around the children in care. Ms. Smith said that when the family was exposed to COVID-19, she notified her families and closed immediately. Ms. Smith said that Child A's Mother would choose to keep Child A home anytime that someone in the child care home was ill. Ms. Smith said she let the parents know and it was their choice whether to send their child that day, but they were still responsible for payment if they were scheduled. She said Child A's Mother did not like that and believes the entire complaint is because they had a disagreement over payment. Ms. Smith provided me a copy of the text conversation she had with Child A's Mother who said she did not feel she should have to pay full price when Child A was only there part-time due to MHM 1's illness. Ms. Kauffman said that Ms. Smith notifies everyone right away whenever someone in the child care home is sick. She acknowledged that MHM 1 was home sick one day with a fever but said Ms. Smith kept her in the back part of the home all day and there were only a few children in care. Ms. Kauffman said this recent fever was the first time she remembers MHM 1 being sick in a long time. All of the children have had runny noses lately. Ms. Smith took MHM 1 to the doctor and they said it was a sinus infection which is not contagious. She denied that MHM 1 plays outside with the children in care when she is sick. Ms. King said that usually when someone in the household is sick, Ms. Smith will call everyone and let them know and it is their choice if they want to bring their child or keep them home. Ms. Smith try to keep MHM 1 with other household members at the other end of the home if she is sick. Ms. King said MHM 1 used to get sick a lot when she was younger, but not as much now that she is older. She said that ri

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

R 400.1961 · .. ..... ..................................... R 400.1961 Parent notification required; incidents; accidents; illness; disease; isolation. .... .......... (1) A licensee shall promptly report to a child's parent any of the following: (b) A child who is exposed to a communicable disease so the child may be observed for symptoms of the disease.

On May 13, 2021, I spoke to Child A's Mother about the allegation. She stated that Ms. Smith told her that a parent complained to her that one of the children in care was not changed at pick-up time and Ms. Smith said that she only changed children at certain times each day. If a child had a bowel movement she would change the child, but if they were just wet, she would not change them because otherwise she would be changing children constantly. Child A's Mother said that Child A did get a yeast infection one time, but she was not sure if it was because Ms. Smith was not changing her regularly or because Child A was teething. On May 13, 2021, I spoke to Ms. Smith, Ms. Kauffman, and Ms. King about the allegation. Ms. Smith said she does have scheduled times for checking diapers around 10:00-10:30 AM, after lunch, and when they wake up from nap. She said 16 she will change children any other times she notices they are wet or had a bowel movement. She stated that she does not wake children up during nap times to check them but otherwise they are checking children all the time. Ms. Smith said that Child A's diapers were always changed when she noticed she was wet or had a bowel movement. Ms. Smith stated that Child A did get a rash one time on her bottom and Child A's Mother took Child A to the doctor for it, but it was when she began eating oatmeal and other foods. Child A's doctor prescribed her an ointment and that cleared it up. No other parents have expressed concern to her about diapering except one time when there was a communication error. Ms. Kauffman stated that they will change children's diapers right away if they notice a child is wet or had a bowel movement. She said they have a regular rotation for when they check diapers. It is usually around circle time in the morning, snack time, before lunch, and after nap. Ms. King stated that if a child is potty training, they can go to the bathroom whenever they want. If the child is still in diapers, Ms. Smith and Ms. Kauffman will usually change them before they go outside between 9:30-10:30 AM, again after lunch, before nap, or anytime they notice a droopy diaper or stinky diaper. Ms. King said she is not usually there around breakfast time or after nap, but the few times she has been there during those hours, diapers have been checked. On May 14, 2021, Child B & C's Mother stated that Child C was potty training, but she never had any concerns about diapering and said he was always clean when she picked him up. On July 1, 2021, I spoke to Child D's Mother, Child E & F's Mother, Child G & H's Mother, and Child I & J's Mother about the allegation. Child D's Mother and Child E & F's Mother had no concerns about diapering. Child D & E's Mother said Ms. Smith was a big help to her in helping potty train her children. Child G & H's Mother said that her children always had new diapers and were dry when she picks them up. If she arrives early and Ms. Smith has not had a chance to change Child G's diaper, she will offer to do it before they leave. Neither of her children have ever come home with a full diaper. She said Ms. Smith will also tell her if she feels they are not going frequently enough. Child I & J's Mother said the only time her children have come home in wet diapers was when she picked them up during naptime. Then Ms. Smith told her that she may want to check them when she gets home. Her children have not had any rashes and she have no concerns about diapering.

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

R 400.1923 · 1 R 400.1923 Diapering and toilet learning. (3) Diapers or training pants must be changed when wet or soiled. l 17

On May 13, 2021, I spoke to Child A's Mother about the allegation. She said that she thought Ms. Smith's brother was helping to provide care in the child care home. She said last time she picked Child A up from the child care home, he made a comment that Child A was "fussy" and "snotty" all day. Child A's Mother was not sure how he would have known that information unless he was providing care. Ms. Smith also told her one day that her brother was in the child care area while she was making lunch. Child A's Mother said she was not aware he lived in the child care home. Ms. Smith stated that her brother, Michael Kauffman, resides in the child care home. She provided me with a copy of his fingerprint clearance information and his negative tuberculosis test. I immediately logged in the Child Care Background Check system and saw that Mr. Kauffman was eligible and attached to the child care home since October 6, 2020. Ms. Smith denied that Mr. Kauffman was ever used as a child care staff member. She said he works outside the home most of the time and never helps with the children. She said he typically works 10-12 hour days. On his occasional day off, he will lay around on the couch in the living room but he is never alone with the children, but he will talk and interact with them. Ms. Kauffman said that Ms. Smith's brother, Michael Kauffman, and Ms. Smith's husband, Matthew Smith, are the only two men that reside in the child care home. She denied that Mr. Kauffman is ever used as a child care staff member and said the only child he helps is MHM 1. Ms. King said she has only seen Mr. Kauffman three times because he is usually gone when she is there. She was not aware how much care he provides but did not think Ms. Smith was using him as a child care staff member. She stated that when she has seen him, he was going outside and was not in a child care area. She said the children did not seem to be afraid of him. On May 14, 2021, I spoke to Child B & C's Mother who said that she was aware that Mr. Kauffman resided in the child care home because Ms. Smith informed her he was moving in and they might see him around. Child B & C's Mother said she never saw him in the child care area. She only saw him passing through to private areas of the home and outside. On July 1, 2021, I spoke to Child D's Mother, Child E & F's Mother, Child G & H's Mother, and Child I & J's Mother about the allegation. Child D's Mother said she has never seen Mr. Kauffman helping with the children in care. Child E & F's Mother said Mr. Kauffman has a job outside the home and he is hardly ever at the child care home during child care hours. Child G & H's Mother said that Mr. Kauffman is usually outside with the dog or in the living room watching television, but she has never seen him in the child care use areas. Child I & J's Mother said that Mr. Kauffman is usually in the living room when she drops off or picks up her children, but he is not providing any child care. On July 1, 2020, I reviewed the case file for Ms. Smith and a Licensing Record Clearance Request (BCHS -001) was on file for Mr. Kauffman and he was in our online computer systems and listed as eligible. A copy of his negative TB test was on file.

Open Not marked corrected in the state record

Category: background checks. Open / not marked corrected.

R 400.1925 · R 400.1925 Comprehensive background check; fingerprinting. (1) Pursuant to section 5n of the act, MCL 722.115n, prior to an individual having any unsupervised contact with children, the department shall determine the individual's eligibility to be any of the following: b An adult member of the household.

On May 13, 2021, I spoke to Child A's Mother about the allegation. She stated that she had no idea what Child A's feeding schedule was 19 because it was never communicated to her. She said that she knew Child A would usually only have one 2-3 ounce bottle and a jar of baby food every day. She thought the bottle was usually given later morning and the jar of food for lunch with a little more milk. In less than a week at her new child care facility, Child A went from drinking one and half bottles of milk and one jar of baby food to three bottles of milk of two jars of baby food. Child A's Mother said Child A was always constipated and would sometimes go two or three days without a bowel movement. She took Child A to the doctor, and they tried different things, but they did not want to medicate her. She felt like a bad mother because she had to hold Child A's legs back to help her have a bowel movement. She began to notice that Child A would have more bowel movements on the weekends, and they were softer. Then she would get constipated again during the week because she was not getting enough fluids. Child A's Mother said she sent in frozen milk in bags and Ms. Smith said she bought more to keep at the child care home. Since Child A started at the new child care facility, she goes through an entire grocery bag of milk and food and needs more sent in before the end of the week where one bag of milk and food would last Ms. Smith two weeks. On May 13, 2021, I spoke to Ms. Smith, Ms. Kauffman, and Ms. King about the allegation. Ms. Smith said that Child A's Mother would supply the food in Child A's diaper bag and Ms. Smith would also buy some. Ms. Smith said that when Child A started attending the child care home, Child A's Mother was nursing her, and she refused to eat very much and was fussy. Ms. Smith would ask Child A's Mother what they could do and even called Child A's Grandmother to come one time to help. Ms. Smith said the constipation issues did not start until Child A began eating baby food. They have always fed Child A whenever she was hungry. Most days Child A would arrive with two jars of baby food in her diaper bag, and she always ate at least one jar. In the morning, Child A would drink one 2-3 ounce bottle and take another one in the afternoon. Child A's Mother started mixing juice and water together to get her to drink more and then they tried pear juice. Ms. Smith said they would offer food and milk, but Child A would refuse. Ms. Kauffman said she was aware that Ms. Smith had spoken to Child A's Mother about the constipation issues. They would offer Child A food and beverages at regular intervals and when she was fussy. Sometimes Child A would take a drink of her bottle, sometimes she would just play with it, and other times she would refuse to eat or drink, and they cannot force her. Ms. King said that she was not at the child care home often when Child A was there, but she remembers trying to feed Child A a few times and she would not drink very much. She remembers asking Ms. Smith if Child A ever finished a bottle. Child A would get fussy but refuse to eat or drink. Ms. King tried putting her in different positions and burping her. She said Child A was definitely not rushed through meals. On May 14, 2021, I spoke to Child B & C's Mother about the allegation. She said she remembers that Child C had a lot of constipation issues and she had to give him Miralax every day and since he has switched providers, she has not noticed it at all. She was not sure though if it was related to stress or lack of fluids. She said neither of her children ever came home and said they did not get enough to drink or eat. On July 1, 2021, I spoke to Child D's Mother, Child E & F's Mother, Child G & H's Mother, and Child I & J's Mother about the allegation. None of the parents expressed concern over constipation, lack of fluids, or had any other concerns about nutrition or adequate food. Child G & H's Mother said that it was Ms. Smith wh

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

R 400.1931 · R 400.1931 Food preparation and service. (1) A licensee shall ensure that all of the following requirements are met: (a) Each child shall be provided with nutritional and sufficient food pursuant to the minimum meal requirements oft eh child care food program, as administered by the Michigan department of education. These minimum meal requirements are based on the dietary guidelines for Americans made by the National Academy of Medicine, whicfh are available at htt s:llwww.fns.~~sda. ovlcacf lmeals-and-snacks. This subrule does not apply to children whose parents provide their food. 21

On May 13, 2021, I spoke to Child A's Mother about the allegation. She stated that she had concerns about the condition of the home. The child care area was always clean but several times she came to pick-up or drop-off Child A and children in care would be in the living room. Those areas of the home were dirty all the time. She said the floor was filthy with debris and cluttered with random items such as toys and shoes. The kitchen table was covered with "stuff." Food was left on plates in the kitchen. Child A's onesie would come home brown on the elbows and knees. When Child A was younger, they would lay her blanket down under her and even the blanket would come home dirty. On May 13, 2021, I spoke to Ms. Smith, Ms. Kauffman, and Ms. King about the allegation. Ms. Smith said most of the time the children in care were confined to the child care room but sometimes she would use her approved living room for napping a child in a pack-in play or at the end of the day if a parent was running late. I had Ms. Smith show me the living room space. I observed there were a couple uninflated balloons lying on the ground and I told her that was a choking hazard. She explained that they had just celebrated MHM 1's birthday and had not finished cleaning it up yet. I also observed a large pile of shoes that presented a tripping hazard near the door. The dining room table was cluttered with toys and paper. 22 There was something on the floor that the dog had chewed up and wrappers on the floor. In the kitchen I observed lots of dishes in a dish drainer and some dirty dishes in the sink and used sippy cups on the counter. Ms. Smith explained that her kitchen is small, and she was still cleaning up from lunch when I arrived. I told her that my biggest concern was the living room because there were hazards present and children have to pass through the room to use the bathroom and that it had to be maintained in a safe condition. Ms. Kauffman said that children are not in the living room except to go to the bathroom or be changed. Children are never unattended in the living room. She said she had never seen Child A's clothing dirty from playing on the floor. Ms. King stated that she has seen the living room cluttered but said that the majority of the time the children in care are in the child care part of the home which is maintained better. On May 14, 2021, I spoke to Child B & C's Mother who said that she has seen a lot of clutter in the living room. She described it as "messy" and "not a clean environment." She said the living room was disorganized with clothing and drinks scattered around. The child care room is always well maintained and clean. On July 1, 2021, I spoke to Child D's Mother, Child E & F's Mother, Child G & H's Mother, and Child I & J's Mother about the allegation. None of the parents had concerns about the cleanliness of the child care home. Child G & H's Mother said that most of the time the children in care are contained in the child care room. They only go through the living room to use the bathroom. Ms. Smith has children of her own and they are going to make messes sometimes.

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.

R 400.1932 · R 400.1932 Home maintenance and safety. (1) The structure, premises, and furnishings of a child care home must be in good repair and maintained in a clean, safe, and comfortable condition. 23

On May 13, 2021, I spoke to Child A's Mother about the allegation. She said that Child A was in the child care room sitting in a baby chair and Child B got too close to her and hit her in the head, leaving a red mark and Child A started screaming. Child A's Mother said she was upset because she did not hear about the incident from Ms. Smith until a week later or two later when she was talking to Ms. Smith about Child B. Child A's Mother said Child A did have a red mark on her head and she did not know where it came from. She was not sure if the mark came from child care or home because she was not sure when the incident in care occurred and she did not think to ask Ms. Smith if anything happened to Child A at the child care home. Another time Child A came home with a scratch on her leg, and she was not sure if it happened in care or at their home because Child A's Mother's boyfriend had picked Child A up that day. She said it looked like a cat scratch and both homes have cats. On May 13, 2021, I spoke to Ms. Smith, Ms. Kauffman, and Ms. King about the allegation. Ms. Smith said that Child B was having a temper tantrum around 10:30 AM and in the midst of it, a toy fell off a shelf and hit Child A in the head. It initially left a red spot and Child A cried. Ms. Smith watched it and the red spot went away a short time later and it never bruised. Ms. Smith said she told Child A's Mother's Boyfriend at pick up time about what happened. O Ms. Kauffman said there was an accident where Child B threw a temper tantrum and dropped or threw a toy that hit Child A in the head. Child A cried. Ms. Smith examined the child and said it was a little red. She soothed the child and looked at her again and the mark was gone. They did not notice a mark at any other time during the day and the incident occurred in the morning. Ms. Kauffman said that Ms. Smith is very good about contacting parents about injuries and if she does not feel it is something that warrants a phone call or text message, she will usually mention it at pick-up time. Ms. King said that if a child receives any injuries while in care, Ms. Smith will contact the parents by text, phone call, or tell them at pick up time unless it is serious. Then she will contact them immediately. Child B & C's Mother said she felt like she was always informed if her children got a bump or bruise while in care. Usually, Ms. Smith would text her when it happened or tell her at pick-up time. On July 1, 2021, I spoke to Child D's Mother, Child E & F's Mother, Child G & H's Mother, and Child I & J's Mother about the allegation. All of the parents indicated that Ms. Smith will also notify them if their child received an injury while in care. The delivery method sometimes varied. She might call, text, or tell the parent at pick-up time. Child E & F's Mother said she messages even about little things all the time. Child G & H's Mother said that if one of the children gets hit in the head, she will usually contact the parents right away. If it is something more minor, she will usually text or call within 1-2 hours of the event.

Open Not marked corrected in the state record

Open / not marked corrected.

R 400.1961 · R 400.1961 Parent notification required; incidents; accidents; illness; disease; isolation. (1) A licensee shall promptly report to a child's parent any of the following: (a) Any incidents, accidents, suspected illness, or other chanaes observed in the health of a child. 25

Ms. Smith reports accidents to parents of children in care. She alleges she told Child A's Father when he picked up Child A in the afternoon. Ms. Smith and Ms. King both stated that Ms. Smith will call, text, or let parents know at pick-up time about any accidents that occurred in care. Child D's Mother, Child E & F's Mother, Child G & H's Mother, and Child I & J's all felt they were made aware of any accidents involving their child. Sometimes it was by text, phone call, or at pick-up time.

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.