McAuley Children's Center And Preschool

R 400.8161(1) · R 400.8161(1) Maintenance of premises. (1) The premises must be maintained in a clean and safe condition and must not pose a threat to health o r safety.

There is no evidence that the premises are not maintained in a clean and safe condition that does not pose a threat to health and safety.

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R 400.8254(1)(f) · R 400.8254(1)(f) Diapering; toileting (1) Except as provided in subrule (2) of this rule, diapering must occur in a designated diapering area that complies with all of the following: (f) Is cleaned and disinfected after each use.

There is no evidence that the diapering station is not cleaned and sanitized after each use.

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R 400.8263(4)(a) · R 400.8263(4)(a) 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, the center shall notify parents and provide all of the following information: (a) The name of the communicable disease t he children were exposed to.

Program Administrator notified parents through the Brightwheel app when a child was diagnosed with Hand, Foot, and Mouth disease.

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R 400.8263(4)(b) · R 400.8263(4)(b) 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, the center shall notify parents and provide all of the following information: (b) The symptoms of the disease.

The program administrator notified parents of the symptoms of Hand, Foot, and Mouth disease through the Brightwheel app.

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R 400.8330(7) · R 400.8330(7) Food services and nutrition generally ( 7) Infants and toddlers shall be fed on demand.

There is no evidence that infants are not fed on demand, and in cooperation with the parents.

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R 400.8330(21) · R 400.8330(21) Food services and nutrition generally ( 21) Bottle propping is prohibited.

There is no evidence that bottles are propped during feeding. Infants are held and/or rocked during bottle feedings.

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R 400.8131(5) · R 400.8131(5) Professional development requirements. Within 90 days of being hired, or the first day as an unsupervised volunteer, all child care staff members and unsupervised volunteers who work directly with children shall complete the following trainings, which may count toward annual professional development hours and are available at MiRegistry: 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.

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R 400.8152(3) · R 400.8152(3) Medication; administrative procedures. All medication must be in its original container, stored according to instructions, and clearly labeled for a named child, including all nonprescription topical medications described in subrule (8) of this rule. Bureau

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R 400.8188 · R 400.8188 Sleeping, resting, and supervision. (4) Infants shall be placed on their backs for resting and sleeping. 12

An infant was placed on their side to sleep. *Reminder* All infant staff must retake safe sleep training. The date of this training must be included in your corrective action plan.

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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 08/02/2023, I received a complaint with an incident report attached, reporting that, on 07/28/2023 (Friday) Child A (female, 8 months) fell from a changing table. The parents were called immediately, per policy. Child A appeared to be fine, but Child A’s Mother took her to the emergency room to be sure. She was observed for four hours and then released. The center was informed on Sunday that the child was seen by her pediatrician Saturday and was sent to Devos Children’s Hospital for further examination before being released. The staff member had the child sitting up, cleaning her up after the child threw up on herself and a staff member. The staff member reached for a towel and the child toppled over and fell. That same day, I contacted Child A’s Mother. She reported that on Friday afternoon she received a telephone call saying that Child A had fallen, she needed immediate medical attention, and that a parent needed to get to the center as soon as possible. She was told that Child A fell head first off a changing table, her eyes were rolling back in her head, and she had been screaming inconsolably since it happened. Child A’s Mother arrived at the center within a few minutes and walked to the Emergency Room across the street with Child A. Child A’s Mother further clarified that she received a missed call from an unknown number at 1:49 P.M. and the same number called back at 2:00 P.M. When she answered and discovered a staff member was calling her from a personal cell phone. Child A’s Mother called Child A’s Father enroute at 2:03 P.M. and discovered that the same number had attempted to call him as well. She does not know what time she arrived at the center, but was in the emergency room by 2:15 P.M. She clarified that the staff member left her a voicemail, called her husband, did not get an answer, and called her phone back. She did not know the number calling and staff normally communicate via the Brightwheel app. She was upset that staff would call from an unknown number in an emergency. Child A’s Mother reported that it was Child Care Staff Member 2 (CCSM2) who called her, and she thinks CCSM2 is the lead caregiver in the room. As it was reported to her, Child A had thrown up on herself and her primary caregiver, CCSM1. CCSM1 put Child A on the table and reached for a towel. Child A leaned forward and fell to the floor, falling on her forehead/the crown of her head. I asked if she has any other concerns with the center and Child A’s Mother reported that she wishes that they would rinse out empty bottles after use and that they used to have issues with communication but identified no further concerns. The center uses the Brightwheel app to communicate with parents throughout the day. In a follow-up telephone call, Child A’s Mother confirmed that it was approximately 20 minutes from the time she received the first telephone call to the time she got to the center. She stated that, based on the message she received that it was a medical emergency and she needed to get there immediately, coupled with the fact 3 that staff were unable to reach her for nine minutes, she thinks that staff should have called an ambulance or walked Child A across the street to the emergency room. I completed an onsite inspection on 08/03/2023. Program director Ashley Curtis was not present when I arrived, but Taylor Hunter, an assistant director at another center owned by the same licensee, was in charge and provided me access to staff and a private room. CCSM1 reported that on the day of the incident, she fed Child A baby food, Then she took Child A out of the high chair and to a rocking chair, where she fed her a bottle. She then burped her when Child A threw up all over herself and CCSM1. CCSM1 took her to the changing table and sat her on the changing table pad. She wiped Child A’s clothes down, then reached down for the burp rag bin that was at about knee-height. She was still right in front of Child A and does not know if maybe Child A re

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R 400.8113 · R 400.8113 Program director qualifications; responsibilities. (3) All program directors are responsible for the general management of the center, including the following minimum responsibilities: (a) Developing, implementing, and evaluating program and center policies.

Center policy for diapering states that one hand must be on the child at all times. Ms. Curtis did not ensure that her staff follow this policy when CCSM1 took her hand off Child A, allowing Child A to fall to the floor.

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R 400.8152 · R 400.8152 Medication; administrative procedures. (6) A child care staff member shall give or apply any prescription or nonprescription medication according to the directions on the original container, unless otherwise authorized by a written order of the child’s physician. 10

Ashley Curtis did not obtain written authorization from Child A’s physician prior to administering medication.

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R 400.8152 · R 400.8152 Medication; administrative procedures. (9) A center shall maintain a record as to the time and the amount of medication given or applied, with the exception of medications described in subrule (8) of this rule, on a form provided by the department or a comparable substitute approved by the department. One form per medication is required. The signature of the child care staff member administering the medication must be included.

Ashley Curtis did not ensure that a record of medication provided was maintained on a form approved by the department. Medication administration was only documented in Brightwheel. Ashley Curtis did not ensure that the signature of the child care staff member who administered the medication is on the form. CCSM1 denied that she administered the medication for all the times indicated.

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R 400.8185 · R 400.8185 Primary care. (4) Information regarding a child's food, health, and temperament must be shared daily between primary caregivers when more than 1 primary caregiver is assigned to any infant or toddler.

Ashley Curtis did not ensure that information about infants and toddlers is shared between caregivers. A caregiver in the room on 08/03/2023 was not aware that Child A had medical needs or medication.

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MCL 722.120 Investigation, inspection, and examination of conditions, books, records, and reports; access by department, bureau of fire services, or local authorities; records; report; forms; confidentiality; disclosure of information; availability of confidential records; child information cards to be provided to department; failure of licensee to cooperate with investigation, inspection, or examination. (1) The department may investigate, inspect, and examine conditions of a child care organization and may investigate and examine the books and records of the licensee. The licensee shall cooperate with the department's investigation, inspection, and examination by doing all of the following: (c) Providing accurate and truthful information to the department, and encouraging witnesses, such as staff and household members, to provide accurate and truthful information to the department.

Ashley Curtis did not ensure that all documentation provided to the department was accurate and truthful. She provided the department a medication permission form that was backdated and had multiple pieces of incorrect information.

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R 400.8112 · 1 R 400.8112 Comprehensive background check; fingerprinting. (1) Pursuant to section 5n of the act, MCL 722.115n, before an individual has unsupervised contact with children, the department shall determine the individual's eligibility to be any of the following: (a) A licensee. (b) A licensee designee. (c) A child care staff member. (d) A child care aide. (e) An unsupervised volunteer. 4

I completed an onsite inspection on 04/14/2022. I interviewed program director Ms. Marie Knight. Ms. Knight reported that she has been in this position since 02/28/2022. She received training for the program director position for about one and a half days, and she has been learning things as she goes along. Ms. Angela Scott is the licensee designee of McAuley Children's Center and Little Bear Child Care. Ms. Alisha Wise and Ms. Lexis Knight were hired as child care staff members. They were both fingerprinted on 04/07/2022. Mr. Mark Cronkhite is an unsupervised volunteer and he was fingerprinted on 03/31/2022. Ms. Wise, Ms. Knight, and Mr. Cronkhite all began working at the facility before they had been determined to be eligible by the Child Care Background Check system. Ms. Knight reported that she reached out to the program director at Little Bear Child Care and was told that new child care staff members could begin working as soon as they were fingerprinted. Ms. Knight stated that licensee Ms. Scott reported the same thing. While I was at the center, Ms. Knight provided child care staff member schedules. I reviewed the schedules and the Child Care Background Check (CCBC) system. • Mr. Mark Cronkhite was connected in CCBC on 04/18/2022. He worked at the facility on 04/11/22, 04/12/22, 04/14/22, and 04/14/22. • Ms. Alisha Wise was connected in CCBC on 04/26/22. She worked at the facility on 04/08/22, 04/11/22, 04/12/22, and 04/13/22. • Ms. Lexis Knight is still pending in CCBC. She worked at the facility on 04/07/22, 04/08/22, 04/11/22, 04/12/22, 04/13/22, and 04/14/22. On 04/20/2022, I returned a call to Ms. Knight. We discussed the rule regarding comprehensive background checks and when a child care staff member can work in a center under an unsupervised or supervised position. On 05/13/2022, I interviewed licensee Ms. Angela Scott regarding the allegations. Ms. Scott stated that it was her understanding that child care staff members could begin working in a supervised capacity once fingerprinting was completed and their status in the Child Care Background Check system was listed as pending. Ms. Scott 3 stated that the rulebook and technical assistance manual states that an individual may begin working under supervision pending an eligibility determination. On 05/13/2022, I interviewed child care staff member Ms. Mirissa Hartoon. Ms. Hartoon stated that Mr. Mark Cronkhite, Ms. Lexis Knight, and Ms. Alisha Wise were working under supervision prior to being determined to be eligible by the Child Care Background Check system. After my visit to the center on 04/14/2022, they did not work until their eligibility was determined. Ms. Hartoon stated that Ms. Lexis Knight is still not working because her background checks have not come back yet On 05/13/2022, I interviewed child care staff member Ms. Ashley Curtis. Ms. Curtis has been employed at McAuley Children's Center and Preschool since March 2022. She works in the one to two-year-old classroom. Ms. Curtis stated that Mr. Cronkhite, Ms. Lexis Knight, and Ms. Wise were working at the center when they were listed on CCBC as pending. They stopped working after I was at the facility. Mr. Cronkhite and Ms. Wise are now working, but Ms. Knight is not working because they are waiting for an eligibility determination from CCBC. On 05/13/2022, I interviewed child care staff member Ms. Tracie Ferguson. Ms. Ferguson reported that she was aware that Mr. Cronkhite, Ms. Knight, and Ms. Wise were working before they were determined to be eligible in the CCBC system. Ms. Ferguson stated that she was hired as a child care staff member about six weeks ago, and she was also working before she was determined to be eligible in the CCBC system. She stated that the program director believed that child care staff members could work under supervision once they were listed as pending in the CCBC system.

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R 400.8182 · R 400.8182 1 Ratio and group size requirements. group (3) In each room or well-defined space, the maximum size and ratio of child care staff members to children, including children related to a staff member or the licensee, must be as shown in Table 4: TABLE 4 Child Care Staff Member to Child Ratios Age Child Care Stuff Maximum Member to Child Ratio Gros Size ( hdants and taddleis. bijTh tutti1 30 1 to 4 I _ a) months of age ( Preschoolers. 30 months of a`te I to S 16 b) until 3 yeais of age Preschoolers. 3 ; eaas of age until 4 1 t010 Not applicable c years of a e Preschoolers. 4 years of age until Ito 12 Not applicable d) school-age { School-ageis 1 t0 18 Not applicable e

Ms. Knight reported that due to staff shortages, some of the child care staff members from McAuley Children's Center have been working at Little Bear Child Care. While there have not been any instances of the facility operating out of ratio, this has made it difficult to maintain ration without additional child care staff members. At the time of this onsite inspection, all rooms were within the child care staff member to child ratios. I reviewed the attendance records for children and child care staff members. The attendance records are for the entire center and are not broken down by classroom. I was unable to determine by reviewing the attendance records if the center was out of ratio. Ms. Scott reported that she does not know about child care staff member to child ratio being maintained at McAuley Children's Center and Preschool, but she does know that there are more than enough child care staff members to ensure that ratio is always maintained. Ms. Knight has not brought up any concerns regarding not being able to maintain ratio. Ms. Hartoon, Ms. Curtis, and Ms. Ferguson stated that child care staff member to child ratios are always maintained. On 05/13/2022, I interviewed Child A's (one-year-old, female) Mother. Child A has received care at McAuley Children's Center and Preschool since January 2022. She has noticed that child care staff members are often doing things on their phone and not paying close enough attention to the children. Child A's Mother does not have any concerns regarding child care staff member to child ratio being maintained. On 05/13/2022, I interviewed Child B's (one-year-old, male) Mother. Child B has received care at McAuley Children's Center and Preschool since March 2021. Chilc B's Mother stated that she has noticed that there is a significant amount of turnover in child care staff members, and she has wondered how new child care staff members are trained so quickly. Child B's Mother reported having a conversation with a child care staff member who stated that there were 12 children in Child B's 5 room that day. Child B's Mother expressed concern that there were too many children in the classroom; however, the child care staff member told her that they were within ratio. On 05/13/2022, I interviewed Child C's (one-year-old, male) Mother. Child C's Mother reported that Child C began attending McAuley Children's Center and Preschool in June 2021. The child care staff members at the facility have been amazing, but she has noticed a lot of staff turnover. She has observed a lot of child care staff members leaving, and not a lot of replacements coming in.

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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 center due to illness.

On 03/29/2021, I received two complaints noting concerns that the center had allowed individuals who either tested positive for COVID-19 or displayed symptoms of COVID-19 to remain at the center. On 03/31/2021, I received a third complaint noting similar concerns as the first two complaints. The complaint also noted that the center was not cleaned after two separate COVID-19 exposures that required the center to close. On 04/08/2021, I completed an on-site inspection. Upon my arrival, child care staff member (CCSM) 10 stated she just sent home an ill child care staff member. I interviewed CCSM 10 regarding the allegation. She routinely sends staff members and children home according to the center's illness exclusion policy. The center is routinely cleaned and sanitized by staff. Additionally, the center is routinely sanitized by a specialized machine designed to eliminate an array of bacteria and viruses. She has no knowledge of any individual who was sick and remained at the center. On 04/08/2021, I received the center's illness exclusion policy for staff and children from CCSM 10 via email. The center's policy states that staff and children shall be excluded from the center when the following symptoms are exhibited: fever over 101.0 degrees, vomiting, diarrhea (more than two times in an hour), eye discharge, excessive cough and/or nasal discharge (green or yellow in color), any unidentified 3 rash. The center's illness policy states that parents will be called "within the hour" to pick up their child when too ill to remain at the center. On 06/29/2021, I conducted separate telephone interviews with CCSM 2 and CCSM 3. CCSM 2 stated she subbed at the center when a child had a false positive COVID-19 result. The child was sent home due to an elevated temperature. The classroom she worked in was thoroughly cleaned after the child went home. She defined thoroughly cleaned as washing, rinsing, and sanitizing all surfaces, toys, materials, and equipment accessible to children. All soft objects and bedding were stripped and washed. She has no knowledge of any individual who was sick and remained at the center. CCSM 3 stated that a child was sent home with symptoms of COVID-19. The child was taken to the doctor by his/her parent. A rapid COVID-19 test was administered and showed a positive result. An additional test was sent in to a laboratory for further testing, which showed a negative result. CCSM 3 has no knowledge of any individual who was sick and remained at the center. If children in her classroom are sick, they are sent home immediately. To her knowledge, staff are also sent home if they are sick. Her classroom was routinely cleaned. The "fogger" machine has been used in her classroom. On 06/29/2021, I contacted Complainant 3 by telephone. Complainant 3 stated he/she was at work and unable to talk. Complainant 3 requested I email him/her my contact information so he/she could call me on either 07/01/2021 or 07/02/2021. On 06/29/2021, I emailed Complainant 3 my contact information. On 06/29/2021, I left CCSM 1 a voicemail requesting a return call. I have not received a return call from CCSM 1 as of the date of this report. On 06/29/2021 and 06/30/2021, I left voicemails for Complainant 2 requesting a return call. I have not received a return call as of the date of this report. On 06/30/2021, I sent Complainant 2 an email request regarding the investigation. I have not received an email reply from Complainant 2 as of the date of this report. On 06/30/2021, I left voicemails for CCSM 6, CCSM 7, and CCSM 8 requesting a return call. I have not received a return call as of the date of this report. On 06/30/2021, I conducted separate telephone interviews with Complainant 1, CCSM 6, and CCSM 4. Complainant 1 stated that CCSM 11, CCSM 10, CCSM 9, and CCSM 11's own children were present in the center although they all tested positive for COVID-19. Complainant 1 stated that two children who subsequently tested positive for COVID-19 wer

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R 400.8155 · 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.gov/DiseasesConditions.

The center informed parents of known COVID-19 positive cases for two children who attend the center. CCSM 4 was not present in the center during the three days prior to her positive test result. CCSM 10 and CCSM 11 were not present in the center during the 48 hours prior to their positive test results. Based on the CDC recommendations, the center was not required to inform parents of the positive COVID- 19 test result for CCSM 4, CCSM 10, or CCSM 11.

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R 400.8125 · R 400.8125 Staff; volunteer; requirements (5) A written statement must be signed and dated by staff and volunteers at the time of hiring or before volunteering indicating all of the following information: (c) The individual knows that all staff and volunteers are required by law to immediately report suspected abuse and neglect to children's protective services.

On 12/07/2020, child care licensing consultant Ms. Jennifer Vander Lugt and I discussed information about the special investigation intake allegations. She stated that on 12/03/2020, licensee designee Ms. Angela Scott contacted her by phone to report concerns about Child A that warranted a call to Michigan Department of Health and Human Services (MDHHS.) Ms. Vander Lugt reminded Ms. Scott that reasonable suspicion is enough to make a report and they did not need to know for certain something happened. She advised Ms. Scott that this call should take place immediately. Approximately one hour later, she called Ms. Scott to follow up. Ms. Scott explained that program director Ms. Katie Halmhuber was in the process of making the report to MDHHS. On the morning of 12/04/2020, she followed up again with a phone call to Ms. Scott and left a message for a return call. She then tried calling Ms. Halmhuber but was unable to leave a message. She called an alternate number for Ms. Halmhuber that turned out to be Ms. Scott's phone number and did not leave a message. Shortly after this, Ms. Scott texted Ms. Vander Lugt and said that Ms. Halmhuber would call her back shortly. At 12:32PM, Ms. Vander Lugt texted Ms. Scott stating, "Can you call me ASAP, I need to follow up on the concern from last night." Ms. Scott did not respond. Ms. Vander Lugt waited a bit, then called Ms. Halmhuber and was finally able to speak with her. She asked if Ms. Halmhuber contacted MDHHS regarding Child A. She did not answer the question directly. Instead, she reported that she was glad they waited to report their concerns because Child A's Mother brought in a doctor's that did not look right. Ms. Halmhuber explained that she was still working on the report to MDHHS. Ms. Vander Lugt advised her to complete the report process and call her back afterwards. When Ms. Halmhuber called Ms. Vander Lugt back, she explained that the reason she did not file the report the night before was because she had the information pulled up on her computer and was so tired, she fell asleep in front of her computer. When she woke up, the session had timed out. On 12/09/2020, I conducted an unannounced onsite inspection at McAuley Children's Center and Preschool. During the inspection, I conducted interviews with child care staff members Ms. Lena Reed and Ms. Crystal Lamphere, program director Ms. Katie Halmhuber, and licensee designee Ms. Angela Scott. Ms. Reed stated that she is the lead caregiver in Child A's classroom. She became concerned about Child A during the first week of November when she started exhibiting extreme behaviors. These behaviors included throwing herself down on the floor in a corner of the room and screaming, trying to push the stack of cots over, kicking staff, and throwing things at staff. On 11/23/2020, Child A complained of pain to the point of being inconsolable. She showed Ms. Reed a rash in a concerning 3 location. Ms. Reed discussed the rash with Child A and B's Mother that evening. On 11/24/2020, Child A came back to care and was in so much pain and discomfort, she called Child A and B's Mother to ask her to pick Child A up early. Child A and B's Mother told Ms. Reed that she took Child A to the doctor and they were sending in a prescription cream for her rash. Child A and B's Mother never sent the cream for her, and Child A continued to cry and scream in pain each day she was in care. Ms. Reed spoke to her co-worker Ms. Lamphere about Child A. She learned that Child A and B's Mother told her a different story about Child A's condition and treatment. This information raised additional red flags about Child A that warranted a call to MDHHS. On 12/03/2020, Child A was in so much pain that Child A and B's Mother was called again to pick her up early because there was nothing else center staff could do for her. During the onsite inspection, Ms. Lamphere stated that she works as a child care staff member in Child A's classroom and has a good relationship wi

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R 400.8155 · R 400.8155 Child accidents and incidents; child and staff illness. (1)A center shall have a written plan for how and when a parent is notified when personnel observe any of the following: (b) A child experiences an accident, injury, or incident.

On 11/2012020 Child Care Staff Member 1 (CCSM 1) stated that, approximately ago accidentally fed Child A Child A is to and and has an fon is the so she is not normally in the classroom. Therefore, does not believe was aware of Child A's to Child Care Staff Member 5 advised____________ about r A's t0 after Child A ingested some of the CCSM 1 is concerned that Child A's parents were not notified of the accidental in estion. CCSM 1 talked to about notifying Child A's parents, u explicitly instructed er not to inform Child A's parents on the Brightwheel app. advised her to notify Child A's parents at pick up. CCSM 1 left the center before Child A was picked so she advised CCSM 5 to make sure Child A's parents were made aware of the incident at pick up. CCSM 1 is not sure if the notification ever occurred. The Eu center does not have an allergy list posted in the kitchen, although CCSM I has requested it repeatedly. Angela Scott, owner and licensee designee, told CCSM 1 to mind her own business when she brought it to her attention. CCSM 1 reminded Child Care Staff Member 4 (CCSM 4), the center cook, that Child A has a and daily because CCSM 4 would frequently forget to make Child A an a erns roe specific to ■ Child A's parents documented on the Brightwheel app that they have begun Child A with at home, but explicitly stated that Child A is not to be aiven at the center. CCSM 1 forwarded me a Bri htwheel communication dated 10/29/2020 from Child A's Father, which states, is still not allowed to have - or - at daycare though. Only the _ we have at home." On 11120/2020, CCSM 1 stated that CCSM 2 frequently fed Child B food offered by the center even though parents ssly directed not to. CCSM 1 explained that Child B was and was in the process of having done, so paren s vd intake closely monitored and reeor ed. it 's parents would send food but would allow staff to supplement diet with some of the foods served by the center. Child B's parents would tell sta on a daily basis what foods from the menu Child B was allowed to have. CCSM 2 often fed Child B the prohibited foods anyway, stating, "Look, fine.- CCSM 2 did not accurately document the foods Child B ingested. CCSM 2 fedChild B foods parents did not want to eat for a three-week timeframe in M 2 stopped feeding ild B foods ■ arents requested Pno!Mony after parents requested staff send a photo of after each mea. On 11120/2020 1 completed an on-site inspection and explained the allegations to - . I interviewed CCSM 2, Child Care Staff Member 3 oow~ (CCSM 3), CCSM 4, CCSM 5, and Child Care Staff Member 6 (CCSM 6), owner and licensee designee Angela Scott, and CCSM 2 stated she was not aware of Child A ingesting but she was aware of ~ _ and ■ = She also believes Child A has an for She was aware of Child B's and . Child s parents provide E food, but staff can supp emen die with center food selected by the family. M 2 denied feeding Child B foods was not supposed to have. She believes CCSM 3 and Ms. Scott informed Chi 's parents that Child B may eat food from the other children's plates from time to time. She does not recall telling a coworker that Child B was "fine" after feeding ■ prohibited foods. stated that Child A has a :nd whichE has been for. She was aware o before Child ingested the I s parents have been out with Child A at Wome. hild A's parents told the center that it would e okay if Child A had little bit of ■ at the center. On 11/04/2020, Child A reached over and grabbed the from a nearby shelf and ingested them before could react. CCSM 5 was supposed to notify Child A's parents at pick up timeRalotut the incident; however, failed to follow up with CCSM 5 to ensure arent notification occurre . has only seen Child B eat the food parents provide for U; however, it is possible that Child B has ingested foo rom the other children's plates. Staff try to feed Child B towards the end of meal time to minimize■ from grabbing food from other plates. CCSM 3 stated she was not aware of th

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R 400.8330 · R 400.8330 Food services and nutrition generally. (4) A center shall ensure a child who has special dietary needs is provided with snacks and meals in accordance with the child's 8 ........ ..... ..............................._. ............................................................................ ...................................... needs and with the instructions of the child's parent or licensed health care provider.

On 11/20/2020, CCSM 1 stated two children with a temperature over 100.4 degrees and ongoing deep coughs were kept in care, which goes against the center's illness policy. CCSM 1 vomited twice on 11/17/2020 but was not allowed to go home. told CCSM 1 that she must stay unless she started running a fever. CCSM I ad a fever of 102 degrees on 11/18/2020 but was not allowed to go home. M 1's tem erature was taken three different times and remained consistent. told her if she went home, she would have to make it up on her day*OM On 11/20/2020, 1 completed an on-site inspection and interviewed CCSM 2, CCSM 3, CCSM 4, CCSM 5, CCSM 6, owner and licensee designee Angela Scott, and ■ CCSM 2 stated she has sent home children from her classroom according to the center's illness exclusion policy, but she cannot speak for the other classrooms. CCSM 3; CCSM 4, and CCSM 5 stated they have no knowledge of ill children or staff being allowed to stay at the center. CCSM 5 stated that the thermometers are "weird." An initial temperature check with the thermometer will register a fever, but a follow up temperature check 20 minutes later will register a normal temperature. She further stated that if children or staff are sick or maintaining a fever, they are sent home. CCSM 6 stated children who have a fever but are on an antibiotic are not sent home. She also reported a staff member forced to stay at work after vomiting twice. She finds the guidance on when to send a child or staff member home has been "cloudy" lately because the center's policy is not consistently being followed. ~1 stated she disagrees with the allegation. Temperature checks have "een done ever one to two hours in the past two weeks. Children and staff are sent home when they have a fever over 100.4 degrees. She offered for CCSM 1 to go home when she was running a fever, but CCSM 1 decided to stay because she did not want to make the time up on her day off. Ms. Scott stated that ill children and staff are being sent home to her knowledge. She advised staff to wait ten minutes to retake temperatures if they feel it is a false reading because the thermometer has been providing inconsistent readings. Staff have been sending children with fevers home left and right lately. On 11/20/2020, Child A's Father stated the center is extra cautious regarding fevers to the point of annoyance. For instance, he had to get a note from his child's doctor for a low-grade fever when his ■ was teething. On 01/08/2021, CCSM 7 stated she absolutely disagrees with the allegation. The center is "very on top of things" regarding illness. On 01/11/2021, I reviewed the "Illness Policy for Staff, Children, and Volunteers" in the center's handbook, which states, "It is our policy that sick children must be kept home. Diseases spread rapidly in a group of children, even in clean environments such as ours. Guidelines for excluding sick children and staff', including but not limited to a fever over 101.0 degrees and vomiting.

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R 400.8155 · R 400.8155 Child accidents and incidents; child and staff illness. (1)A center shall have a written plan for how and when a parent is notified when personnel observe any of the following: (a) Changes in a child's health.

On 1112012020, CCSM 1 stated that and CCSM 2 refer to Child B, who is as' Child C h- old,~ ) who is of , was re erre o as y CC when oatfteWndeedc tehn . CCSM 1 stated that she overheard CSM 2 describe Child as ` . CCSM 2 also described' 191 's as CCSM 2 indicated that Child `s took up . CCSM 1 finds the pet names for Child B and Child and the inappropriate statements regarding Child A's and Child C's _ to be very unprofessional and demeaning to the children and their families. On 1112012020, 1 completed an on-site inspection and interviewed CCSM 2, CCSM 3 CCSM 4 CCSM 5, and CCSM 6, owner and licensee designee Angela Scott, and CCSM 2 stated that Child C's Father was , and Child C Ve "e bsewa died, so when she swaddle ,she would refer o as a !W She denied there being any racial correlation to the re nce. She eterm ` "to explain to other child care staff members how Child C liked to be comforted. CCSM 2 admitted that she and have referred to Child B as' "I asked CCSM 2 how and Child B's parents wou reel Re" eir children were being referred to in such a manner. CCSM 2 stated that she does not think they would like it. She agreed that if a parent would not approve of something being said to or about their child, that it probably should not be said. CCSM 2 stated she never really looked at it as a racial thing, but she now sees it differently. She agreed that she could benefit from antibias training as a part of her annual professional development training requirements. She admitted to commenting about the size of Child A's , stating, She does not recall commenting on Child C's CCSM 2 agreed thatit would be good practice not to verbalize every observation 11 M she makes throughout the day, especially about children's CCSM 2 stated she loves the children and would never intentionally hurt them in any way. stated she was aware of CCSM 2 inappropriately referring to Child C as her a addressed the matter immediately and put a stop to it. She is not aware of anyone referring to Child B as She is not aware of inappropriate comments being made about any child's CCSM 3 stated she has only heard refer to Child B as She does not like it when does this. Child C liked to be wrapped up like a . She heard CCSM 2 refer to Child C as her "little I when attended the center. She did not consider CCSM 2 referring to Child as a as name calling. When CCSM 3 first started at the center, she heard make inappropriate comments about the size of children's such as "this kid has a ', or "this kid has a CCSM 4 stated she has no knowledge of pet names or inappropriate statements made about children's_ CCSM 5 stated she has heard refer to Child B as months ago, but she has not hear t in alongtime. She has noMnowe"gage"o ild Wbeing referred to as a' " or inappropriate statements made about children's CCSM 6 heard CCSM 2 refer to Child C as a "little "and reported it to right away. immediate addressed it with CCSM 2. CCSM 6 did not hear CCSM 2 refer to Child C as a or any again. She also heard CCSM 2 and refer to Child as' She has heard coworkers mention things about children's during but she could not recall who. She never used the derogavto"rpy et s or made inappropriate comments about the children's denied referring to Child B as " She has mentioned o things smells like barbeque sauce. I advised thatseveral staff members have overheard her, and CCSM 2 refer to Child B as' " She stated, "Not that I can think of have I referred tom as a , u have heard [CCSM 21 say it." mentioned to her that SM 2 was referring to Child C as a denied making inappropriate comments about children's during . She was very surprised to hear of anyone behaving in such a manner. On 11/2012020, Child A's Father stated that although there is a certain level of professionalism expected he has no concerns with pet names or the comment made about Child He simply stated, "Well, A's w. 12 On 01/08/2021, Child B's Mother stated the center recently informed her that staff sometimes refer to Child

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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 center due to illness. ...............................................

The center failed to follow its own Illness Exclusion Policy for Staff. Children, and Volunteers when Child Care Staff Member 1 was not allowed to go home after vomiting twice on 11/17/2020 or when she had a temperature over 101.0 degrees on 11/18/2020.

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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.

and failed to provide appropriate care and supervision of Child B, who is of ,when they referred to ■ as ` :' did not provide appropriate care and supervision of Child C, who is of when she referred to IN as a "little failed to provide appropriate care an PsupervWision%ci ren when she made ina ropriate comments about children's_ during ..

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