R 400.8125 Staff; volunteer; requirements. (1) All staff and volunteers shall provide appropriate care and supervision of children at all times.

On 05/10/2023, I conducted an unannounced onsite inspection at Kid Town. I interviewed Ms. Ayesh regarding the two incidents. Ms. Ayesh stated during the 05/05/2023 incident, she received a call on the walkie talkie indicating there was an emergency on the playground. Child A had fallen off from the top of the slide. She went to the playground and observed Child Care Staff Member 1 holding Child A. Child A appeared pale and shaken so she brought him to the office where she put ice on his head and called Child A's Mother. Child A's Mother arrived within 20 minutes. She later called Child A's Mother to follow up on how he was doing and Child A's Mother indicated he had started vomiting so she was seeking medical attention. On 05/09/2023, Ms. Ayesh was at the front desk when she received another call on the walkie talkie indicating there was an emergency on the playground. Ms. Ayesh initially thought it was a prank, but when she went outside, Child B was at the picnic table and "very shaken." Ms. Ayesh asked him what happened, and he could not explain how he was injured. Child B did not want to go inside and wanted to still play. Ms. Ayesh picked up Child B and he began to cry loudly. He said his leg hurt and when she tried to sit him in a chair, he cried and said it hurt. Ms. Ayesh iced Child B's leg and called Child B's Mother. Child B's Father arrived within 30 minutes and immediately took Child B to the emergency room where it was confirmed that Child B had a broken leg. Ms. Ayesh stated the accidents were both recorded on the security cameras and were available to view. Ms. Ayesh and I then reviewed the 05/05/2023 and 05/09/2023 playground accidents. On the 05/05/2023 video, I observed Child A playing on the climber. Child A can then be seen going down the circular slide then falling out over at the top curve of the slide. Child A fell head first onto the ground which was about five feet from the ground. Child Care Staff Member is less than ten feet away from the climber and she immediately ran to Child A after he fall. On the 05/09/2023 video, Child B is playing on a metal truck play structure that has rubber wheels. The metal truck is at ground level with some elevated climbing areas. Child B stood on the rubber wheel, which is less than 24 inches off the ground and jumped. Child B landed on the ground and immediately appears to be in 3 pain and cannot get up. There were two caregivers visible in the immediate area who appeared to be actively supervising the children. One of the caregivers was less than 10 feet away from Child B. During the onsite inspection, I inspected the outdoor play area with Ms. Ayesh . Pea gravel is used as the soft surface material on the playground. There were several areas on the playground that had ample amounts of pea gravel. However, the fall zones of the climber, the swings and the truck had become compacted. There was a thin layer, less than one inch of visible loose pea gravel with the rest of the pea gravel heavily compressed beneath the loose pea gravel. I explained to Ms. Ayesh that the pea gravel that had been moved to other areas or had been compressed, needed to be restored when moved or compressed. During the onsite inspection, I interviewed Child Care Staff Member 1. Child Care Staff Member 1 was present during both accidents. She explained that during the first incident, she was watching the children on the playground when she saw Child A fall off of the top of the slide and land on his face. He would not stand on his own she called the office. They applied ice to his head and called home since he may have been concussed. Child A has since returned to care and is much better. Child Care Staff Member 1 explained that during the second incident, she and Child Care Staff Member 2 were both outside with the children and two additional teachers were outside with their classroom. Child B jumped off of the tire and immediately would not stand or bear weight on his leg. She called Ms. Ayes