R 400.8201(1)(c) · R 400.8201(1)(c) Comprehensive background check; fingerprinting. (c) A child care staff member.

During the on-site inspection, there was a staff member present with school age children and volunteers who were not entered into the background check system and found to be eligible.

Open Not marked corrected in the state record

Category: background checks. Open / not marked corrected.

R 400.8112(2)(a) · R 400.8112(2)(a) Children's records. (a) A certificate of immunization showing a minimum of 1 dose of each immunizing agent specified by the department of health and human services.

During the on-site inspection two out of ten child records reviewed had children who did not have a certifcate of immunization on file.

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

R 400.8201(2)(c) · R 400.8201(2)(c) Comprehensive background check; fingerprinting. (c) Provide to the department, on request, a copy of the individual’s completed and signed form or forms.

During the on-site inspection the staff files were locked and unable to be accessed. I was not able to view the consent and disclosure forms for any staff members.

Open Not marked corrected in the state record

Category: background checks. Open / not marked corrected.

R 400.8216a(13) · R 400.8216a(13) Professional development requirements (13) When the department publishes a notice that a new health and safety update document or a new health and safety update training activity is published on MiRegistry, the licensee shall ensure that all identified staff or volunteers in the notice read and acknowledge the document or complete the activity within the timeframe indicated in the notice.

During the onsite inspection one out of six staff records reviewed had a staff member that did not complete the health and safety refresher for 2024.

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

R 400.8335(5) · R 400.8335(5) Food services and nutrition; provided by center (5) Formula must be commercially prepared and ready-to-feed.

During the on-site inspection I did not observe any ready to feed formula in the infant room. Additionally, I observed two cans of powder fomula, one Similac and one Enfimil. The staff member in the infant room confirmed that the infants are feed the cans of formula.

Open Not marked corrected in the state record

Category: nutrition. Open / not marked corrected.

R 400.8112(3) · R 400.8112(3) Children's records. (3) When a child under school-aged whose immunizations cannot be completed due to medical reasons, including, but not limited to, a dose waiting period, within 4 months after admittance, a child may remain enrolled for a reasonable length of time that is consistent with good medical practices. The center shall verify additional immunization requirements are current as specified by the department of health and human services unless there is a signed medical exemption filed certifying that the child is in the process of complying with all immunization requirements. The medical exemption must be on file with the center until it can be replaced with proof that the vaccines for which an exemption was granted have been received or the medical exemption has expired. 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.

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

R 400.8161(5) · R 400.8161(5) Maintenance of premises. (5) There must be no flaking or deteriorating paint on interior and exterior surfaces or on equipment accessible to children. 6 LANDMARK BUILDING • 105 W. ALLEGAN STREET • LANSING, MICHIGAN 48933 Michigan.gov/MiLEAP 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.

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

R 400.8269(2)(i) · R 400.8269(2)(i) Emergency preparedness and response planning procedures (2) The written procedures must include all the following as applicable to the type of emergency: (i) A plan for how children with chronic medical conditions will be accommodated during an emergency. 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.

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

R 400.8269a(1) · R 400.8269a(1) Food (1) A written plan for the prevention of and response to emergencies due to food and allergic reactions must be developed and implemented to include a child care plan, prevention measures, and emergency procedures. 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.

Open Not marked corrected in the state record

Category: nutrition. Open / not marked corrected.

R 400.8269a(2)(a) · R 400.8269a(2)(a) Food (2) The child's care plan must include all of the following, at a minimum: (a) The child's name with a list of their food allergies. 7 LANDMARK BUILDING • 105 W. ALLEGAN STREET • LANSING, MICHIGAN 48933 Michigan.gov/MiLEAP 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.

Open Not marked corrected in the state record

Category: nutrition. Open / not marked corrected.

R 400.8269a(2)(b) · R 400.8269a(2)(b) Food (2) The child's care plan must include all of the following, at a minimum: (b) The names, doses, and methods of medication administration the child should receive if there is a reaction. 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.

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.

R 400.8330(10) · R 400.8330(10) Food services and nutrition generally (10) Menus must be planned in advance, dated, and made available to parents. Food substitutions must be noted on the menus the day the substitution occurs. Bureau

Open Not marked corrected in the state record

Category: nutrition. Open / not marked corrected.

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

Based on the interviews of staff and parents of children in care. The staff provide appropriate care and supervision. Technical assistance was provided regarding following up with children to ensure their belongings are placed in the correct cubby during drop off and sent home with the correct coat at the end of the day.

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

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

On Mav 31. 2023. 1 initiated the investigation via telephone with statea mat sne naa attemptea to make contact on-site at the child care facility, however, the program director was not present. We arranged a collateral inspection for the following day. On June 1; 2023, during an unannounced inspection, the program director, Erika Murray, childcare staff members (CCSM) 1 and CCSM 2 were interviewed. Mrs. Murray stated that Child A was disenrolled from care on May 22, 2023, due to this situation. She reported that Child A is breast fed. His bottles come to care with him pre-mixed with milk and a thick substance that appears to be cereal. Child A has a hard time sucking the thick substance from the bottle's nipple, causing him to cry because he is not getting any food. Mrs. Murray reported that she has called and asked Child A's Mother to supply the breast milk bottles without the cereal, but she refuses. Instead, she comes to pick him up from care. Child A was enrolled in care on April 19, 2023. He only attended childcare approximately 10 times as he did not come daily. His last day was May 22, 2023. On June 1, 2023, CCSM1 reported that she works in the classroom that Child A was enrolled in. Child A would be one of the first to arrive and one of the last to get picked up. She said that Child A cried most of the day as if he had He would not take the bottles that were provided by his mother. CCSM1 explained that, according to Child A's Mother, the bottles had a mixture of breast milk and baby food in them. The substance in the bottle was very thick and Child A refused to drink it. Based on this behavior, there had been several conversations with Child A's Mother and CCSMs. CCSM1 reported that babies are fed on demand. Breakfast is given at 8:00am and all other meals are on-demand. CCSM 1 admitted that full bottles were sent home with Child A because he refused to eat what was sent. Child A qualified for the Matrix food program, therefore they were able to provide him with baby snacks. Child A's Mother provided the name of a Gerber baby formula that she approved to give him in the absence of her breast milk. The formula was not located due to low stock. On June 1, 2023, CCSM2 reported that Child A cried all day and refused to drink his bottle. She said the bottle appeared to have applesauce in it. She reported that Child A's Mother told them that it was breast milk, but it was too thick to be breast milk. Due to Child A not wanting to eat and crying a lot, she held and rocked him a lot to soothe him. CCSM 2 said that she spoke to Child A's Mother about his crying and refusal to eat. On June 5, 2023, Child A's Mother reported that four of her children have attended childcare at this facility. She stated that there have been some instances in the past Ica that has caused her some concern. Child A's Mother reported that when she was notified that Child A was refusing to take the bottles, she wanted to come feed him, but was refused access. She stated that Child A is breast fed but has taken Gerber Breast Milk as well. Child A's Mother reported that she supplied the childcare with two bottles with breast milk and cereal in them and three bottles with formula and food in them. She stated that Child A drinks the bottles at home. She was concerned that Child A was in childcare for 8 hours a day without eating. On June 5, 2023, Child B's Mother reported that she does not have any concerns with meals at this childcare facility. She stated that she packs Child B's male) food, and he eats it. She reported that Child B is doing well in childcare. On June 5, 2023, Child C's Father stated that Child C female) is well fed and cared for while in childcare. Child C is breast fed and the breast milk is provided to the center. Child C's Father did not have any concerns with meals. On June 21, 2023, Pre-Disposition conference via Teams with

Open Not marked corrected in the state record

Category: nutrition. Open / not marked corrected.

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

On 05/03/2022, the department received an incident report from the program director, Erika Murry. The report indicated that Child A finger got caught in the door as another student put his fingers on the other side of the door. Child A was taken to the hospital and diagnosed with a fractured finger. I interviewed Child A's Mother by telephone. She stated she had arrived to pick up Child A at about 4:30 p.m. She was waiting in the lobby for them to bring Child A out. She saw the director, Ms. Erica ran to the back, then she came out and stated Child A finger got closed in the door. They wrapped her finger in a paper towel as it was still bleeding. Ms. Erica told her she should take Child A to get medical attention. Child A's Mother took her to Children's Hospital. She was diagnosed with a fractured 2 finger. She has to wear a splint for six weeks. Child A's Mother stated she believes it was an accident. All her children have attended the center and she has not had any problems. On 5/9/2022, I conducted an inspection at the center. I interviewed CCSM, Kiersma Turner. She stated it was the end of the day and the front desk had called to say Child A's Mother was there to pick her up. She got Child A ready and was carrying her out. When she got to the door, Child B (1-year-old male) was at the door. She put Child A down to move Child B away from the door and back into the room. Child A was outside the room and Child B was inside the room. As she closed the door to keep Child B in the room, she did not see that Child A had her hand in the door. She immediately called for the program director, and they applied first aid before taking her to her mother. She stated Child A's finger was bleeding and split open at the tip across the nail bed. I interviewed CCSM, Aaliyah Edwards. She was the second person in the classroom. She recounted the scenario as Ms. Turner. She stated it was an accident. Ms. Turner did not know Child A had her hand in the door until she screamed. I interviewed the program director, Erica Murray. She stated she was called down to the toddler classroom because Child A finger was closed in the door. She applied first aid. She stated she knew it was bad and told Child A's Mother to take her to get medical treatment. Ms. Murray stated Child A is still attending the center. She provided me with a copy of the report from the emergency room. The ER report states Child A has a fractured finger. The course of treatment is for her to wear a splint for approximately three weeks. 3 ................

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

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. (b) A child experiences an accident, injury, or incident. (c) A child is too ill to remain in the group.

On 4/19/2022, 1 conducted an unannounced investigation a a Franklin Wright Settlement child care facility, we interviewed the program director Erica Murray. She stated Child A was playing with a shopping cart when she slipped on a toy hitting her face on the shopping cart. She received a cut near her left eye. The CCSM, Dieredra Ford, applied soap and water, and ice to the cut. She stated Child A's Mother was informed of the injury and given an incident report at pick-up. The injury occurred about 11:00 a.m. and Child A was picked up between 4:30 p.m.-4:50 p.m. Ms. Murray stated it was up to the CCSM's discretion on when to contact a parent. This policy is written in the parent handbook. We interviewed CCSM, Ms. Ford. She stated Child A was playing with the shopping cart and tried to get into the cart. She slipped on a toy and fell hitting her face against the cart. She had a scratch on the side of her eye. Ms. Ford cleaned the area with soap and water, and applied ice. She applied ice to keep the swelling down. She stated the cut was not bleeding and Child A continued playing and having a normal day. She stated she did not call Child A's Mother because the injury did not appear to be serious. She spoke to Child A's Mother at pick up and told her what happened. She stated Child A's Mother replied "Oh, she's rough like that." Child A's Mother read and signed the incident report. When they left Child A's face was not swollen and it was just a scratch. I reviewed the illness accident policy of the center given to me by Ms. Murray. it stated in part, "Superficial injuries will be washed with soap and water, covered with a bandage, or treated with ice. Parents will be told about minor injuries when they pick their child up." . Child A present with a mild abrasion and slight swelling. The injury was consistent with her falling against the shopping cart. There were no concerns of abuse and neglect. On 5/6/2022. I completed a case conference with On 5/20/2022, l spoke with Child A's Mother by telephone. Her complaint was the center did not notify her immediately of the injury. She was informed at pickup and iven an incident report to sign. She was examined y the doctor. During the examination, she was unable to answer the doctors questions because she was not 3 asked Child A's Mother if she contacted the center to get more information and she stated she had not and just removed her children from the center. On 5/20/2022, I spoke to by telephone. She stated i A's Mother contacted er by phone stating RsMeremoved her children from the center due to Child A's injury and not immediately being contacted. In the picture she saw of Child A's injury appeared to be just a scratch and some slight swelling. This is not something the center would have contacted her about, so she did not have any further information.

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

R 400.8158 · 1 R 400.8158 Incident, accident, injury, illness, death, fire reporting. (3) A licensee, licensee designee, or program director shall report to the department, via phone, fax, or email, within 24 hours of notification by a parent that a child received medical treatment or was hospitalized for an injury, accident, or medical condition that occurred while the child was in care.

Ms. Murray stated the center was not notified by Child A's Mother that she took Child A to seek medical attention. Child A's Mother stated she did not inform the center she took Child A to seek medical attention.

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.