Diapers 2 Diplomas Children's Learning Center Inc

R 400.8137 · R 400.8137 Diapering; toileting. (6) Diapers and training pants must be checked frequently and changed when wet or soiled.

On 12/06/2022, I conducted a telephone interview with Complainant. Complainant stated that on 12/05/2022, Child A had a diaper rash after she was left in a soiled diaper with feces. She brought up her concerns with the program director, Nicole Sikora, who stated she would address it with the child care staff members. On 12/08/2022, I conducted an unannounced onsite inspection at Diapers 2 Diplomas. I met with Ms. Sikora and explained that a complaint had been received regarding a child not being changed properly. Ms. Sikora denied receiving any parental complaints regarding diapering. She could not think of why a complaint was made. After discussing additional allegations, Ms. Sikora stated she thought the complaint was coming from Child A's Mother who was also an employee. Child A's Mother quit on 12/05/2022. She had put in her two-week notice, but then had a very poor attitude and refused to do what was asked of her. Child A's mother was asked to work in another classroom, and she did not want to move classrooms. She then said she could no longer continue working at the center and quit on 12/05/2022. Ms. Sikora acknowledged that there was a conversation with Child A's Mother about Child A not being changed timely on 12/05/2022. Child A had been changed every two hours. Child A's Mother went to pick her up at the end of the day and Child A had had a bowel movement. Child Care Staff Member 1 did not realize that Child A was soiled when Child A's Mother arrived for pick up. Ms. Sikora denied that Child A had been left in a soiled diaper for an extended period of time. Ms. Sikora explained that Child A had only come three days in the time that Child A's Mother worked at the center. It was difficult to get a good idea of Child A's schedule because she was in care sporadically. I asked Ms. Sikora to print the infant daily records for all three days Child A was in care. Ms. Sikora provided daily sheets for 11/18/2022, 11/29/2022, 12/05/2022. On 11/18/2022 Child A's diapers were checked and changed frequently. On 11/29/2022, Child A was signed in at 8:22a.m. and signed out at 3:21p .m. Child A was changed at 9:56a.m. and 12:46p.m. indicating that there were two diaper changes in the seven hours that Child A was in care. A diaper change was not conducted between 12:46p.m. and 3:21p .m. when Child A was picked up. 3 On 12/05/2022, Child A was diapered at 9:57a.m., 1:07p.m. and 3:17p.m. Child A was napping from 11:02a.m. to 12:58p.m. which accounts for the three-hour gap between diaper changes in the morning. I then interviewed Child Care Staff Member 1. Child Care Staff Member 1 explained that on 12/05/2022, she was talking to a parent that had arrived for pick up when Child A's Mother also arrived for pick up. She had been sitting with Child A right before the first parent arrived, so she knew Child A was not soiled at that time. Child Care Staff Member 1 said it was less than 10 minutes from the time she was sitting with Child A and when Child A's Mother arrived, so she knew Child A had not been soiled for very long. Child A's Mother then changed Child A before they left. Child Care Staff Member 1 stated she checks the children every two hours but will change the children immediately if they are wet or have had a bowel movement. She denied that Child A's Mother ever expressed any concerns regarding Child A's care. I then interviewed Child Care Staff Member 2 who works in the toddler classroom. She denied knowledge of any parental complaints regarding diapering. Children are changed every two hours and she did not have any concerns that child care staff members were not changing children appropriately. On 03/28/2023, I conducted an exit interview with Racheal Flanagan, licensee designee. I informed Ms. Flanagan that based on the daily sheets provided, I had found a violation of the diapering rule for 11/29/2022 when it appeared that Child A had her diaper changed twice in a seven-hour period. Ms. Flanagan was aware of the deficiencie

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R 400.8330 · R 400.8330 Food services and nutrition generally. (3) Beverages and food must be appropriate for the child's individual nutritional requirements, developmental stages, and special dietary needs, including cultural preferences.

During the 12/06/2022 interview with Complainant, she stated that on 12/05/2022, Child A was in care for eight hours and was given one bottle of formula and one container of food. Five bottles had been sent in that day and four bottles were returned at the end of the day. Child A will normally take a minimum of three bottles a day. She spoke with Ms. Sikora about Child A not being fed appropriately and Ms. Sikora indicated she would address the situation with the child care staff members in the room. During the onsite inspection on 12/08/2022, Ms. Sikora denied that Child A's Mother or any parent had expressed concerns regarding feedings. I reviewed the daily sheets for 11/18/2022, 11/29/2022 and 12/05/2022 that Ms. Sikora provided. On 11/18/2022, Child A was signed in at 8:56a.m. and signed out at 4:59p.m. The daily sheet showed food at 9:16 a.m., bottle at 10:16a.m. and bottle at 2:30p.m. The bottle feeding was documented as "0 oz." Two bottles were given in a nearly eight- hour period. On 11/29/2022, Child A was signed in at 8:22a.m. and signed out at 3:21p .m. The daily sheet showed that food was given at 10:07a.m. and a bottle of "0 oz" was given at 10:51a .m. No additional food or bottles was documented for the day. For 12/05/2022, Child A was signed in at 9:38a.m. and signed out at 5:02p.m. Per the daily record, Child A was given a bottle at 1:00p.m. with "0 oz" and "food" at 3:07p.m. I showed Ms. Sikora that according to the daily schedule, on 11/29/2022 and 12/05/2022, Child A was given one bottle of "0 oz" and one food serving for the entire day. On 11/18/2022, Child A had two bottles and one serving of food. Ms. Sikora stated that was not possible and the child care staff members must not have documented the feedings accurately on the daily schedule. I explained to Ms. Sikora that based on the allegations and the daily schedule, I would cite a violation of the rule requiring that beverages and foods be appropriate for the child's nutritional requirements and developmental stages. I explained that it may be a documentation error, but the documentation provided showed that Child A was not fed appropriately on all three days in care. During the 12/08/2022 interview with Child Care Staff Member 1, she indicated that she thought that Child A had two bottles on 12/05/2022, but she could not remember 5 for certain how much Child A ate or how many bottles were packed that day. Child Care Staff Member 1 could not recall Child A being fussy, hungry or anything out of the ordinary on 12/05/2022. She was not familiar with Child A's schedule and explained that it was Child A's first day back in weeks and when Child A was in care the last time, Child Care Staff Member 1 was not working. During the 03/28/2023 exit interview with Ms. Flanagan, I explained that I had found a violation of the food service rule based on the daily sheets provided for Child A. Ms. Flanagan was aware of the deficiencies with the daily sheets and addressed appropriate record keeping with child care staff members. Additionally, a new app is being used that rectifies the issue with the "0 oz" shown when documenting bottle feedings.

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R 400.8137 · R 400.8137 Diapering; toileting. (1) Except where provided in subrule (2) of this rule, diapering must occur in a designated diapering area that complies with all of the following: Is washed, rinsed, and sanitized after each use.

During the 12/06/2022 interview with Complainant, she indicated that the diapering tables, eating tables and toys are not washed, rinsed, and sanitized as required by the rules. She expressed concerns that children were constantly sick because equipment was not being cleaned appropriately. During the 12/08/2022 onsite inspection, I observed Child Care Staff Member 1 clean the diapering table after diapering with (1) "light duty" cleaner, then (2) "heavy duty" cleaner and (3) water rinse. She explained the same cleaning steps are used for the tables before and after eating. Soiled toys are washed in soapy water then sprayed with sanitizer. A I then interviewed Child Care Staff Member 2 in the toddler classroom and asked her to explain the cleaning process for diapering areas and food service tables. Child Care Staff Member 2 explained that the steps as (1) "light duty" cleaner, (2) water rinse and (3) "heavy duty" cleaner. Child Care Staff Member 2 stated that soiled toys are sprayed or soaked with "heavy duty" cleaner. I asked Ms. Sikora about the cleaning steps used by child care staff and if there had been a lot of child illness at the center. Ms. Sikora indicated that the steps for cleaning diapering tables and food tables were as follows: (1) light duty cleaner, (2) water rinse and (3) heavy duty cleaner. She explained that was how she and child care staff members were trained with the new management. There had been a few illnesses like colds and some RSV in the fall, but no outbreaks at the center. I then interviewed Child Care Staff Member 3 regarding the cleaning process in the classrooms. Child Care Staff Member 3 explained that child care staff members are trained to wash the food service tables and diapering tables by using the following steps: (1) "light duty cleaner", (2) Water rinse and (3) "heavy duty" cleaner. Mouthed toys are sprayed with Purell sanitizer. I asked Ms. Sikora and Child Care Staff Member 3 to show me the products used as "light duty" and "heavy duty." Both the light and heavy duty cleaners are Envirox H2Orange2 with the "light duty" having a higher dilution ratio than the "heavy duty." After reading the bottle, I informed both Ms. Sikora and Child Care Staff Member 3 that the front of the bottle indicates the cleaner is for "Non-food contact surfaces." Ms. Sikora and Child Care Staff Member 3 indicated they would get clarification from Ms. Flanagan since the system had been used and approved at other locations. I explained that in the meantime, cleaners that state "non-food contact surfaces" are not be used on food contact surfaces. I then interviewed Child Care Staff Member 4 in the preschool classroom. She explained that food service tables are cleaned with (1) "light duty" cleaner, (2) "heavy duty" cleaner (3) water rinse and (4) sanitizer. Toys are sprayed with sanitizer. During the 12/15/2022 telephone interview with Ms. Flanagan, she acknowledged that child care staff members were not using the correct sanitizer as the third step. She indicated that child care staff members have been retrained and they are now using the Purell Surface Sanitizer for the sanitizer step. The Purell Surface Sanitizer is approved for food contact surfaces. During the 03/28/2023 exit interview with Ms. Flanagan, I explained that I had found violations of the diapering, sanitization, and equipment rules regarding washing, rinsing, and sanitizing diapering areas, food contact surfaces and soiled equipment. Ms. Flanagan indicated that child care staff members have been retrained and are now using the appropriate sanitizers and steps. 7

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R 400.8325 · R 400.8325 Sanitization. (1) All tableware, utensils, food contact surfaces, and food service equipment must be thoroughly washed, rinsed, and sanitized after each use. Multi-purpose tables must be thoroughly washed, rinsed, and sanitized before and after they are used for meals or snacks.

Child care staff members are using various steps to sanitize multi-purpose tables including multiple wash steps, but tables are not washed, rinsed, and sanitized appropriately. Additionally, a non-food contact cleaner is also being used.

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

Soiled and mouthed toys are not being washed, rinsed, and sanitized appropriately. Child care staff members are using different methods including spraying with a sanitizer or submerging the toys in a cleaner labeled non-food contact cleaner.

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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.

There was no evidence to support that Ms. Sikora provided inappropriate care and supervision of children.

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R 400.8182 · R 400.8182 Ratio and group size requirements. (7) If there are children of mixed ages in the same room or well- defined space, then the ratio and group size is determined by the age of the youngest child, unless each group of children is clearly separated and the appropriate child care staff member- to-child ratios and group sizes, if applicable, for each age group are maintained.

There was no evidence to support the center failed to maintain proper ratios. The center maintained appropriate ratios at all times.

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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 11/21/2022, I received an email from Nicole Sikora, program director, indicating that she needed to report an incident. On 11/22/2022, I emailed and spoke with Ms. Sikora regarding a child care staff member, Brooke Lilley, restraining Child A at nap time. Ms. Sikora was advised to complete and forward an incident report to me. I informed Ms. Sikora that a special investigation would be opened. On 11/22/2022, Ms. Sikora emailed the incident report, and the special investigation was opened. On 11/23/2022, I conducted a telephone interview with Ms. Sikora who stated that on 11/18/2022, a child care staff member, Ashlynn Graham, reported that she observed Ms. Lilley put her leg over Child A to keep Child A from getting off the cot at nap time. Ms. Lilley was released from employment on 11/21/2022. Child A's Mother was notified of the incident on 11/23/2022. On 11/23/2022, I conducted a telephone interview with Child A's Mother. Child A's Mother confirmed she was informed on 11/23/2022 of the 11/18/2022 incident. She was told that Child A had been restrained by a child care staff member at nap time because the child care staff member was having difficulty getting Child A to nap. Child A's Mother called the center back with more questions and was informed the child care staff member involved was released from employment. Child A's Mother was upset that she was not notified until 11/23/2022 and wanted a police investigation into the matter. I asked Child A's Mother how her experience had been with the child care center prior to this incident. Child A's Mother explained that recently there was a lot of staff turnover and Child A's lead teacher left the center. I asked Child A's Mother if she had any concerns about Ms. Lilley's interaction with Child A. Child A's Mother asked if Ms. Lilley was the child care staff member involved and I confirmed that the allegations were that Ms. Lilley held Child A down on the mat during nap time. Child A's Mother was surprised and upset hearing that the allegations were against Ms. Lilley. She denied having any concerns about Ms. Lilley's Interaction with Child A. However, the previous week Child A had said that a "teacher hurt me" and Child A had a cut on her cheek. Child A's Mother was told that on 11/17/2022, Child A had a difficult time at nap time and had thrown herself down on the cot. She received an incident report and a picture that said that Child A had "a boo boo." Additionally, Child A had started to say that she did not want to go to the center. Child A's Mother was distraught that she had not given much thought about the comment Child A made or the 11/17/2022 injury until she was informed of the 11/18/2022 incident. 4 On 11/23/2022, I conducted a follow up telephone call to Ms. Sikora to ask about the injury to Child A's face on 11/17/2022. Ms. Sikora confirmed that on 11/17/2022, Child A had bumped her chin and had a red mark on her face. I advised Ms. Sikora to make a referral to the Department of Health and Human Services regarding the 11/17/2022 mark and the 11/18/2022 incident. On 11/28/2022, I conducted an unannounced onsite inspection at Diapers 2 Diplomas in Clinton Township. Ms. Sikora indicated that she had made the referral to DHHS and was also informed by Child A's Mother that a police report was made. Ms. Sikora indicated that Ms. Lilley began working at the center in January 2022. Ms. Lilley worked in different classrooms as a floater. Ms. Sikora denied that there were any previous parental or employee complaints or concerns regarding Ms. Lilley's care and supervision of children. Ms. Sikora had addressed dress code violations and room cleanliness issues with Ms. Lilley, but never any care and supervision or discipline concerns. I asked Ms. Sikora what type of discipline is used at the center. Child care staff members are trained that no physical contact or restraining of child is allowed. Children are redirected and given a minute to calm themselves down. Ms. Sikora co

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R 400.8140 · R 400.8140 Discipline. 1 I (2) All of the followina means of punishment are prohibited: 11 (c) Restricting a child's movement by binding or tying him or her.

On 11/18/2022, Child A would not lay down at nap time or listen to Ms. Lilley. Ms. Lilley was observed physically restraining Child A on the cot by placing her leg over Child A's body on the cot.

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R 400.8158 · R 400.8158 Incident, accident, injury, illness, death, fire reporting. (2) A licensee, licensee designee, or program director shall report to the child's parent and the department, directly or via phone, fax, or email, within 24 hours of the occurrence of any of the following: (b) An incident involving an allegation of inappropriate contact.

Ms. Lilley was observed restraining Child A on 11/18/2022. The department was notified of an unspecified incident on 11/21/2022. Child A's Mother was not notified of the incident I until 11/23/2022.

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R 400.8176 · ...................... R 400.8176 Sleeping equipment. (5) A cot or a mat and a sheet or blanket of appropriate size must be provided as follows: (a) For all preschoolers 3 years of age and older in care for 5 or more continuous hours. (b) For any child in care who regularly naps. c Upon a parent's request for any child in care.

On 10/11/2021, I conducted a telephone interview with Child A's Mother who was concerned about the care Child A and the other children in care receive at the center. On one occasion, sometime in September 2021, she observed children watching a movie in the kitchen and a child had fallen asleep on the tile floor. The children were allowed to take their blankets onto the tiled floor. On 10/12/2021, I conducted an unannounced onsite inspection at Diapers 2 Diplomas. I met with child care staff member, Lauren Janusch, who works in the Prek 1 classroom. Ms. Janusch stated that the children in the Prek 1 classroom will occasionally watch a movie in the kitchen area. She denied that children nap or have fallen asleep while watching a movie and denied ever seeing a child sleeping on the tile floor. I then interviewed Ms. Minda and explained the allegations in the complaint. Ms. Minda stated that the children in the Prek 2 classroom are allowed to watch movies for a short period of time on Fridays. Ms. Minda showed me how the television was placed on a carpeted area and where the children sit when watching. She explained that the children are only allowed 30 minutes of viewing time so she has never seen children sleeping there. The current group of children in that classroom do not nap especially not during the 30 minutes of television time. I then interviewed the Prek 2 lead child care staff member, Victoria Neely. The Prek 2 classroom is located directly across the hall and at times, the Prek 2 and Prek 1 rooms may combine. Ms. Neely stated that the children will sometimes watch a movie in the cafeteria area of the kitchen. The children who watch movies do so on the carpet and although they may sometimes take their blankets with them, "those kids don't nap." She denied ever seeing any child sleeping on the tiled floor. On 11/29/2021, I conducted a telephone exit interview with Ms. Minda. I informed Ms. Minda that I had not found a violation of the sleeping equipment rule. .................

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R 400.8380 · 1 R 400.8380 Maintenance of premises. (1) The premises must be maintained in a clean and safe condition and must not pose a threat to health or safety.

During the telephone interview with Child A's Mother. She stated she was not satisfied with the cleanliness of the center. One of the program director's, Debbie Marshall, walks around barefoot. There is also mold on the carpet outside of the Prek 1 classroom. Child A's Mother complained about the mold to Ms. Marshall and she was not satisfied with the response she received from Ms. Marshall. However, when she went back to show Ms. Minda the mold, it was no longer there and "must have been cleaned up." Ms. Minda handles things professionally, but Child A's Mother was no longer satisfied with the care and removed Child A from the center. When Child A's Mother informed Ms. Marshall that they were terminating care, Ms. Marshall said "That's ok, you can be done." Child A's Mother also explained that the rooms are dirty and messy when she picks up Child A at the end of the day. When she would drop off Child A in the morning, the same mess would still be on the tables and floors from the evening before. Additionally, Child A's hands and face are often dirty at pick up. Child A's Mother stated she felt the center's overall lack of cleanliness was contributing to illnesses going around the center including a two day shutdown of the center on 09/23/2021 and 09/24/2021. Child A was repeatedly ill while at the center. During the 10/12/2021 onsite inspection, I observed all of the classrooms at the center and did not find any classrooms to be dirty or messy. The floors, counters, tables and bathrooms were clean. I also observed a small patch of what appeared to be a bleached or white area on the carpet outside of the Prek1 classroom. I did not observe any mold on the carpet. During the 10/12/2021 interview with Ms. Janusch, she indicated that she was "an opener" in the Prek 1 classroom and she has not had any problems with the room 4 being left dirty by the closing staff. Ms. Janusch did not have any concerns about the cleanliness of the center. During the 10/12/2021 interview with Ms. Minda, she confirmed that she had received a complaint about mold on the carpet, but when she went to look at the mold, it was not there. Ms. Minda stated that paint had been spilled in that area a long time ago, but she did not see how that could be mistaken for mold. Ms. Minda stated that she is currently short staff so she has been opening and closing at the center. She is helping with cleaning the classrooms at the end of the day and knows that they are not being closed dirty and opened dirty. She reminds the new child care staff members of the cleaning duties and is currently overseeing the training of new child care staff members. During the 10/12/2021 interview with Ms. Neely, she denied that her classroom, the Prek 1 classroom is ever left dirty. She stated sometimes the closers do not make sure that toys are put back on the correct shelf, but the rooms are not left dirty. She denied being aware of any mold on the carpet. On 10/27/2021, I conducted a telephone interview with Ms. Minda. I asked Ms. Minda about the allegations that children's faces are dirty and that the center has been closed due to illnesses. Ms. Minda stated that at this time of year, the children's noses are constantly runny and they try to keep the children's faces clean. She confirmed that the center closed for COVID-19 and in September, the center was closed for two days because of a stomach virus that was going around the center. She denied receiving any parental complaints about the illnesses going around the center or the cleanliness of the facility. On 11/29/2021, I conducted a telephone interview with Child B's Mother. Child B's Mother denied having any concerns about the cleanliness of the center. She indicated that although there have been illnesses going around the center, she felt it was "normal" for the age group and did not have any concerns that the illness was because of lack of cleanliness. During the 11/29/2021 exit interview with Ms. Minda, I informed her I had n

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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 07/22/2021, I conducted a telephone interview with Child A's Mother. Child A's Mother was very unsatisfied with the care Child A received while in care at the center. She was also concerned about the welfare of the other children at the center. She heard caregivers scream at children in the "Tots Room" and the "Friday before the Fourth of July" she observed a child care staff member physically grab a child by the arms to sit them down and time out is used in the toddler classroom. Child A's Mother also heard a child care staff member yell "What the hell Child B?" Child care staff members are also frequently on their phones. Child A's Mother reported her concerns to Jennifer Minda, program director and licensee designee, and Debbie Marshall, program director, on the Brightwheel app. The Brightwheel app is used to communicate with parents. On 07/28/2021, I conducted an unannounced onsite inspection at Diapers 2 Diplomas Children's Learning Center. I met with Ms. Marshall and discussed the allegations in the complaint with her. Ms. Marshall indicated that Ms. Minda was out for the day. I asked Ms. Marshall if she had received any parental complaints regarding the care of children in the toddler room. Ms. Marshall clarified that they have two toddler classrooms. The Tiny Tots classroom is for toddlers under 18 months and the Toddler 1 classroom is for children 18 months to 30 months. Ms. Marshall confirmed that on Monday, 07/26/2021, a child care staff member, Lauren Morse, informed her that Child A's Mother had expressed concerns about the care and supervision of children in the Toddler 1 classroom. Ms. Morse reported to Ms. Marshall that Child A's Mother was concerned about child care staff member, Esther Chen, "berating" a child in the classroom. I asked Ms. Marshall if she had any concerns with Ms. Chen's interaction with children. Ms. Marshall stated that there is a language barrier with Ms. Chen and she 3 "sounds harsher" when speaking to children than other caregivers might sound. She denied ever hearing Ms. Chen speak inappropriately to children or "berate" them. Ms. Morse also informed Ms. Marshall that Child A's Mother reported seeing a child get picked up by the arms and "plopped in a chair." Child A's Mother did not know the child or the child care staff member involved. Ms. Marshall asked Ms. Morse if she knew who Child A's Mother was talking about and although Ms. Morse denied knowing, Ms. Marshall suspected that Ms. Morse knew, but did not want to name anyone. Ms. Marshall stated that Child A's Mother put in her two weeks notice and informed the center that Child A would no longer be attending after 07/30/2021. Child A's Mother did not say anything to Ms. Marshall about her concerns. I asked Ms. Marshall if she had received complaints from any other parents in the Toddler 1 classroom regarding care and supervision. Ms. Marshall confirmed that other parents have requested their child be moved out of the room and expressed dissatisfaction with the care in the Toddler 1 classroom. I asked Ms. Marshall if she had ever heard a child care staff member swear at or in front of children in care. Ms. Marshall denied ever hearing staff swear in front of children. She was not aware of a child care staff member swearing at Child B. I then asked Ms. Marshall if she was aware of child care staff members in the toddler classroom using time out for discipline. Ms. Marshall was not aware of time outs in the classroom, but acknowledged that because the lead child care staff member, Dorese Ransom, has been the lead for many years, she does not check up on the room very often. Ms. Marshall stated the Toddler 1 classroom has a good group of kids with no issues so she rarely hears anything from that classroom. Ms. Marshall identified Ms. Ransom, Ms. Morse, Ms. Chen, Courtney Scharf, Erianna Sobralski and Christina Naeem as child care staff members in the Toddler 1 classroom. During the onsite inspection, I interviewed Ms. Ransom. I ask

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R 400.8137 · R 400.8137 j Diapering; toileting. (6) Diapers and training pants must be checked frequently and changed when wet or soiled.

On 07/21/2021, Child A was not changed from 11:36a.m. to 3:45p.m. and only after child care staff members were notified by Child A's Mother on the Brighwheel app that Child A had not been changed.

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R 400.8325 · R 400.8325 Sanitization. (4) Multi-use tableware and utensils must be washed, rinsed, and sanitized using 1 of the following methods: (a) A commercial dishwasher. (b) A residential dishwasher with sanitizing capability. (c) A 3-compartment sink and adequate drain boards. (d) A 2-compartment sink for washing and rinsing, a third container suitable for complete submersion for sanitizing, and adequate drain boards.

During the 07/28/2021 onsite inspection, I observed that children's dishes were being washed and rinsed in the single compartment sinks in the classrooms. The dishes were not sanitized after being washed and rinsed.

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R 400.8182 · R 400.8182 Ratio and group size requirements. (7) If there are children of mixed ages in the same room or well- defined space, then the ratio and group size is determined by the age of the youngest child, unless each group of children is clearly separated and the appropriate child care staff member- to-child ratios and group sizes, if applicable, for each age group are maintained.

On 05/03/2021, I conducted a telephone interview with Complainant. Complainant indicated that the Toddler 2 classroom should have a 1:4 child care staff member to child ratio, but the room consistently has a 1:8 child care staff member to child ratio. Complainant also indicated that the 3-year-old classroom should have a 1:8 child care staff member to child ratio, but at the end of the day, there are more than eight children present with one caregiver. Complainant stated that "everyone is short staffed", but the center opened enrollment to additional children when they were aware they were already short staffed. Complainant indicated that on Friday, 04/30/2021, ten child care staff members called in sick and the center was out of ratio. In the late afternoon on 05/04/2021, I conducted an unannounced onsite inspection. The program director, Jennifer Minda, was not in at the time of the inspection. During the inspection, I observed the following room ratios: • The Toddler 1 room had a 2:5 child care staff member to child ratio. • The Toddler 2 room had a 2:5 child care staff member to child ratio. • The Tiny Tots room was combined with the Infant room and had a 2:7 child care staff member to child ratio. • The 3-year-old (Preschool 1) room had a 1:5 child care staff member to child ratio. • The 4-year-old room (Preschool 2) had a 2:10 child care staff member to child ratio. All rooms were in ratio based on the youngest child in the room. During the 05/04/2021 onsite inspection, I interviewed the 3-year-old classroom child care staff member that was working, Dana Schoenherr. I explained to Ms. Schoenherr that a complaint was received alleging that the 3-year-old classroom was out of ratio at the end of the day. Ms. Schoenherr stated that at the end of the day, her classroom combines with the 4-year-old classroom. Ms. Schoenherr did not answer when I asked if the room was out of ratio at the end of the day or at any time during the day. I asked again if the room was out of ratio and Ms. Schoenherr hesitated to answer. She finally said that the room was not out of ratio. She stated the only time the room is out of ratio is at nap time, but all the children are sleeping. 4 During the 05/04/2021 onsite inspection, Ms. Minda arrived back at the center, and I explained that a complaint had been received regarding ratios. Ms. Minda denied that any of the classrooms were ever out of ratio. I asked if she had ten child care staff members call in sick on 04/30/2021. Ms. Minda confirmed that ten child care staff members were off on 04/30/2021, but some had been scheduled off and some had called in. Ms. Minda explained that a lot of children did not show up on 04/30/2021 so they were able to maintain ratios. She had to move children around and into different rooms throughout the day. She also removed the child care staff member, Natasha Gullette, from the front door to go into a classroom. Ms. Gullette was doings COVID-19 screenings at the entrance but was needed in the classroom. Ms. Minda stated that she always maintains ratio and is not having any trouble with ratios at closing. Ms. Minda expressed her frustration that someone made a complaint about ratios because she has had to close the center some days after child care staff members called in sick and they were short staffed. I asked Ms. Minda about the ratio and ages of children in the 3-year-old classroom. Ms. Minda stated that she follows a 1:8 child care staff member to child ratio in the 3-year-old classroom. When children under the age of 3 are starting to transition into the classroom, she follows the required 1:4 child care staff member to child ratio. She denied that there was ever a 1:8 child care staff member to child ratio when children under 3 years of age are present unless there is a waiver on file. Ms. Minda stated she has not had all parents sign waivers because she goes to the lower 1:4 child care staff member to child ratio when children younger than 3 years of age a

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R 400.8137 · 1 R 400.8137 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: (a) Is physically separated from food preparation and food service.

During the 05/04/2021 onsite inspection, I spoke with Ms. Minda about the allegation that lunch was being served from the diaper changing table in the Toddler 2 classroom. Ms. Minda stated that there was "no way" child care staff members are using the diapering table for food service. There is a kitchen area with counter space in each room that is used for food service, and she has never observed anyone use the diapering table for food service. rj During the 05/04/2021 interview with Ms. Lilley, she denied that the diapering table in the Toddler 2 classroom is ever used for food service. Toddler 2 children are potty training, and the diapering table is not being used. Ms. Lilley will occasionally set her own cup on the diapering table, but children's food and dishes are never put on the diapering table. During the 05/04/2021 interview with Ms. Sobralski, she denied that food was ever served from the diapering table in the Toddler 1 classroom. She acknowledged seeing "other rooms" put items on the diapering table like toys and books, but never food or food service equipment. On 05/05/2021, a received a telephone call from Ms. Minda. Ms. Minda stated Ms. Zwolinski informed her she knew what the allegation was about. Ms. Zwolinski informed Ms. Minda that she was serving children lunch one day when a child needed immediate attention and she put the plates down on the diapering table to quickly tend to the child. She then picked the plates back up and finished serving lunch, but lunch was not prepared and served off the diapering table. During the 06/30/2021 interview with Ms. Zwolinski, she acknowledged that she had on one occasion set some lunch plates down on the diapering table. Ms. Zwolinski stated that a child was tipping back on a chair and was going to fall so she quickly set the plates down, helped the child and finished serving lunch. She explained that it was an immediate reaction so that she could help the child and not something that she ever does. Ms. Zwolinski adamantly denied that lunch is prepped and served from the diapering table. She uses the kitchen counters for food prep. Ms. Zwolinski stated there was a child care staff member in the room at the time of the incident. Ms. Zwolinski confronted that child care staff member for playing on her phone and sitting to eat her lunch while Ms. Zwolinski was trying to serve the children lunch. Ms. Zwolinski stated the complaint was received after Ms. Zwolinski confronted the child care staff member. I asked Ms. Zwolinski the name of the child care staff member and she just stated, "she doesn't work here anymore". During the 06/30/2021 exit interview with Ms. Minda, I informed her there was insufficient evidence to support a violation of the rule. Ms. Zwolinski did not prepare and serve food from the diapering table.

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R 400.8365 · R 400.8365 Heating; temperature. (3) If temperatures exceed 82 degrees Fahrenheit, then a center shall take measures to cool the children.

During the 06/08/2021 onsite inspection, I went into each classroom and observed the temperature on the thermostats. Not all of the classrooms had thermostats. The thermostats showed a room temperature of 70-72 degrees Fahrenheit. The 3-year- old classroom was noticeably warmer than the rest of the rooms. A thermostat was not located in the 3-year-old classroom. A fan was on in the 3-year-old classroom to circulate the air. During the 06/08/2021 interviews with Ms. Marshall, Ms. Neely, Ms. Kelly and Ms. Schoenherr they each denied a problem with the air conditioning. They stated that the rooms never reached 82 degrees Fahrenheit. During the 06/08/2021 interview with Ms. Konieczko, she denied that the temperature in the classroom ever reached over 80 degrees Fahrenheit. Occasionally, the temperature at the front and the back of the room is different because the classroom is supplied by two different air conditioners. During the 06/30/2021 interview with Ms. Zwolinski, she stated that the rooms are too cold, and the air conditioning temperature is set too low. She denied having any concerns with the temperature being too hot. During the 06/30/2021 exit interview with Ms. Minda, I informed her that I had not found a violation of the heating rule. I explained that during the 06/08/2021 onsite inspection, the Preschool 3 classroom was warmer than the rest, but did not exceed 82 degrees Fahrenheit. Fans were on in the 3-year-old classroom to circulate the air. Ms. Minda acknowledged that the sun hits the 3-year-old classroom the most, so that room is warmer than the rest. There are multiple air conditioning units on the roof and some rooms share a unit. If one room changes the temperature on the thermostat, it impacts the temperature in the shared room. If child care staff members communicate with one another that the rooms are too hot or too cold, the issue could be immediately resolved. She denied there were any problems with the air conditioning units. 11

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R 400.8380 · R 400.8380 Maintenance of premises. (7) Light fixtures, vent covers, wall-mounted fans, and similar equipment attached to walls and ceilings must be easily cleanable and maintained in good repair. 12

During the 06/08/2021 onsite inspection, I observed the lights were almost completely out in both bathrooms in the 4-year-old classroom. Ms. Konieczko indicated that the lights had been that way for a long time and children do not like to use the bathroom with the door closed because it is too dark. During the 06/30/2021 onsite inspection, I observed lights were also dim or completely out in the Infant room, Tint Tots room and 3-year-old room. During the 06/30/2021 exit interview with Ms. Minda, I explained that there were lights out in several rooms and the bathroom lights in the 4-year-old classroom were so dim that it almost appeared they were not even on. Ms. Minda acknowledged that lights were out, but stated it was the actual valances and not light bulbs. She tried to hire an electrician, but due to the pandemic, she had trouble getting an electrician out to the center for service. Ms. Minda stated she has secured an electrician to fix the lights.

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R 400.8170 · 1 R 400.8170 Outdoor play area. (13) The playground equipment, use zones, and surfacing in the outdoor play area must be inspected by a certified playground safety inspector and an approval granted for playground 13 equipment and areas used before issuance of an original license, upon request of the department, and before using any newly added playground equipment. The center shall provide documentation of the inspection to the department upon request and shall keep it on file at the center.

On 06/03/2021, Child A was injured and received stitches after falling off a teeter totter. The teeter totter was a residential niece of eauinment that is not annroved for Child A's aae.

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