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 4 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: htt s:iiwww.cdc. ov/DiseasesConditions.

On 08/21/2023, I received a complaint that a child was exposed to hand, foot, and mouth disease. On 08/23/2023, I completed an onsite inspection. There were two child care staff members (CCSM) present. I interviewed CCSM 1.1 asked CCSM 1 if she was aware that a child in the center had hand, foot, and mouth disease. She said yes, a preschool parent called program director, Ms. Ayoka Mobley on 08/10/2023, and told her that her daughter caught hand, foot, and mouth disease. She said Ms. Mobley sent out a message on Bright Wheel along with a letter informing the parents that a child caught the disease. CCSM 1 showed me the Bright Wheel communication and the letter that was sent out. CCSM 1 said child CCSM 2 did a deep cleaning of the preschool room, and the room was shut down for three days. CCSM 1 said then on 08/16/2023, another parent called and told Ms. Mobley that their child caught hand, foot, and mouth disease. She said Ms. Mobley sent another message out on Bright Wheel as well as a letter to the parents telling them there was another outbreak of hand foot and mouth disease. CCSM 1 said, they shut the toddler room down until Monday, 08/21/2023, and CCSM 2 did another deep cleaning of the toddler room. While onsite, I interviewed child CCSM 2. CCSM 2 said the center was called by a parent of a preschooler on 08/10/2023 stating her daughter had hand foot and mouth disease. She said Ms. Mobley sent a message on the Bright Wheel App letting the parents know about the exposure and she emailed a letter explaining what the disease was all about, what the symptoms were and who to contact if further information was needed. CCSM 2 showed me the message and letter that was sent out from her cell phone. CCSM 2 said she deep cleaned the preschool room as well as the equipment and the children did not return to the preschool room until Monday, 08/14/2023. CCSM 2 said Ms. Mobley received another call on 08/16/2023 that Child A, (3-year-old, female) from the toddler classroom, had hand, foot, and mouth disease. She said Ms. Mobley sent another message on the Bright Wheel App letting the parents know about the exposure and a letter explaining information about the disease. CCSM 2 said she deep cleaned the toddler classroom, and they did not return into the toddler room until Monday 08/21/2023. On 8/23/2023, I left a message for Child A's Mother. Child A is the toddler who contracted hand, foot, and mouth disease. I identified myself and the nature of my call. I did not receive a returned telephone call. On 08/23/2023, I contacted three parents who have children in the toddler and preschool classrooms. Child B, (3-year-old, male), Child C, (4-year-old male), and Child D's, (4-year-old male), parents all informed me they received two notices on the center's means of communication, Bright Wheel, that the center had hand, foot and mouth disease and a letter describing the symptoms. They all confirmed they received these notices on 08/10/2023 and 08/16/2023. All three parents said they were aware their children were moved to different classrooms so that the rooms could be deep cleaned and sanitized. 3 On 08/30/2023, I contacted Ms. Mobley, program director. Ms. Mobley said she received two telephone calls from two different parents, within six days of each other stating their child contracted hand, foot, and mouth disease. Ms. Mobley said she received the first call on 08/10/2023 from a parent in the preschool room. Ms. Mobley said she immediately moved the children to a preschool classroom on the second floor that was closed and had not been utilized so that the room with the exposure could be deep cleaned and sanitized. Ms. Mobley said when she received the notice that the toddler classroom had an exposure, she closed their room completely on Thursday, 08/17/2023 and Friday, 08/18/2023. Ms. Mobley said there are three children enrolled in the toddler room and all three of them did not come to school the two days the room was closed. While the

Open Not marked corrected in the state record

Category: health medication. 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 03/02/2022, Child A and B's Mother alleged that none of the staff members at the center were CPR and First Aid certified. During the onsite inspection on 03/07/2022, I reviewed and verified valid CPR and First Aid training certificates for all CCSMs employed by the center. I also verified previous CPR and 4 First Aid training records for CCSMs. There has never been a lapse in training. All CCSM's have always been trained.

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

R 400.8131 · R 400.8131 Professional development requirements. (10) All child care staff members who work directly which children are required to be trained in first aid and pediatric, child, and adult cardiopulmonary resuscitation (CPR) within 90 days of being hired. Prior to issuing a license to operate a child care center, and prior to the renewal of a license, the department shall verify that at least 50% of the child care staff members who work directly with children are currently certified in first aid and pediatric, child, and adult CPR. Each of these child care staff member's first aid and CPR certificates must be valid and retained on file in the center.

On 03/02/2022, Child A and B's Mother stated that the staff is not cleaning the facility. Child A and B are picked up when the facility is closing. When Child A, Child B, and their mother leave the center, the staff walks out with them. This leads her to believe that cleaning is not occurring. Child B is also always sick. Child A and B's Mother believes it is because the center is not being cleaned properly. The center also does not notify her when other children become ill. In October 2021, when her son was diagnosed with hand foot and mouth disease Child A and B's Mother notified Ms. Mobley and was told by Ms. Mobley that there was another child who also had hand foot and mouth. Child A and B's Mother felt that at some point Ms. Mobley should have notified her and then the other parents of this. On 03/07/2022, I spoke with child care staff members LaDonna Young, Sasha Montgomery, Brandy Young, Kiya Nelson, and licensee Ayoka Mobley. They all provided the same cleaning procedures and routine. They have materials that children use specifically in the morning that are cleaned at rest time. Then they have materials that children use in the afternoon that are cleaned during the last hour of the day. Therefore, staff can walk out with children and parents at the end of the day. A cleaning company comes to clean the rooms daily in the evenings. The center also uses a sanitizing machine to spray the equipment and rooms two to 5 three times a week. I observed a daily cleaning schedule that was posted in each classroom. I observed the center to be clean and safe. I also observed a wide variety of cleaning materials for staff to use. Ms. Mobley informed me that she notifies parents of communicable diseases and illness through the bright wheel app and personal text messages. Ms. Mobley is not sure why Child B is constantly sick, but Child A is not, and they live in the same household. I reviewed the past three notices that were provided to parents regarding communicable diseases through the bright wheel app. One notice was regarding a COVID case. Another message was sent to families informing them of a positive hand foot and mouth case. The other message was to let parents know that a few children had runny noses. There has been no other communicable disease from kids or staff within the past six months. On 03/15/2022, I conducted telephone interviews with Child C's (1-year-old, male) Mother, Child D's (1-year-old, female) Mother, and Child E's (3-year-old, male) Mother. They all stated that they had no concerns about the health or safety of their children. They also verified that they receive notifications about illnesses of staff and children. They are notified through the bright wheel app, text messages from the licensee, or told in person by staff members during pick up and drop off. They all agreed that when their child first began attending the center, they were constantly sick with runny noses and mild colds but attributed it to them being in a daycare setting. None of their children have been sick in the past 90 days. They also did not feel the centers cleanliness was a concern or added to their child's illnesses.

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

R 400.8155 · R 400.8155 1 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: htt s://www.cdc. ov/DiseasesConditions. C~

On 03/02/2022, Child A and B's Mother stated that when she picks Child B up from the center at 5:30 p.m. he appears to be very hungry. Child B is usually fussy. This leads her to check the app to see the last time he was given food. The app usually shows that the center is only feeding Child B at lunch and then no other time after that. The children eat lunch at 12:00 p.m. and are picked up at 5:30 p.m. She feels that her children should be given a snack or, "something" before she picks them up. Child A and B's Mother confronted Ms. Montgomery about her son being hungry when she picks up in the evening. Ms. Montgomery told her that her own kids are also always hungry after school, and she must hurry up and feed them so Child A and B's Mother should do the same. On 03/07/2022, during my onsite inspection I reviewed the menu for the months of February and March. All menu's contained breakfast, a morning snack, lunch, and an afternoon snack. I observed enough food onsite to be provided to children. I reviewed the bright wheel app that is used to document infant and toddler feedings for the month of February 2022 and the first week of March 2022 for all infants and toddlers enrolled. I found inconsistencies in the afternoon snack being documented by staff. Child B did have several days in which he did not have an afternoon snack documented. All CCSMs stated that children are given afternoon snacks immediately after waking up from rest time. Ms. Mobley stated that after rest time classrooms combine or CCSMs move rooms. CCSMs who are in the preschool 7 classroom forget to document the meals for the infants and toddlers because they don't have to do it for the preschoolers. On 03/15/2022, I conducted telephone interviews with Child C's Mother Child D's Mother and Child E's Mother. They all felt that their child was given enough food to eat while at the center. They all knew that their child receives two snacks and lunch. All parents stated that they are notified by the app of the meals their child receives.

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

R 400.8380 · 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.

The center was clean and safe during inspection and did not pose a threat to the health and safety of the staff or children in care.

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

R 400.8335 · R 400.8335 Food services and nutrition; provided by center. (1) Food and beverages provided by a center must be of sufficient quantity and nutritional quality to provide for the dietary needs of each child according to the minimum meal requirements of the child and adult care food program (CACFP), as administered by the Michigan department of education, based on 7 CFR part 226, 1-1-18 edition, (2018) of the United States Department of Agriculture, Food and Nutrition Service, CACFP, and is hereby adopted by reference. A copy can be obtained at no cost from CACFP at http://www.fns.usda.gov/cacfp/meals-and-snacks. In addition, a copy is available for inspection and distribution at no cost at the Michigan Department of Licensing and Regulatory Affairs, Bureau of Community and Health Systems, Child Care Division, 611 West Ottawa Street, Lansing, MI 48933.

The center provides the minimum meal requirements as stated by of the child and adult care food program (CACFP).

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

R 400.8146 · R 400.8146 Information provided to parents. .................. (3) For infants and toddlers, a center shall provide parents with a written daily record that includes at least the following information: (a) Food intake time, type of food, and amount eaten. (b) Sleeping patterns indicating when and how long the child slept. (c) Elimination patterns, including bowel movements, consistency, and frequency. (d) Developmental milestones. (e) Changes in the child's usual behaviors.

Review of the written daily record for Infants and toddlers, showed that the food intake is not always being documented. Child B had several days in which he did not have an afternoon snack documented.

Open Not marked corrected in the state record

Category: nutrition. Open / not marked corrected.

R 400.8188 · R 400.8188 Sleeping, resting, and supervision. (11) Infants and toddlers who fall asleep in a space that is not approved for sleeping shall be moved to approved sleep equipment appropriate for their age and size. Z

There was a child (1-year-old, female) in a bouncer who was not moved to approved sleep equipment. A bouncer is not approved sleeping equipment.

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

R 400.8140 · ........................................ I R 400.8140 Discipline. (2) All of the following means of punishment are prohibited: (d) Inflicting mental or emotional punishment, such as humiliating, shaming, or threatening a child.

On November 10, 2021, I initiated this investigation via telephone with the complainant. The complainant stated on November 8, 2021, they heard a child care staff member of Friendship Childcare in the hallway with Child A who was crying. The child care staff member told Child A, "I'm going to take you downstairs with the Boogey Man!". When she said this, Child A cried louder. The complainant could not see if Child A was being hit or not. On December 2, 2021, during an unannounced onsite inspection, I interviewed child care staff members Brandy Young, LaDonna Young and Sasha Montgomery. The program director Ayoka Mobley was not present. Brandy Young stated that she remembered the date in question and is aware of the incident. She identified Child A as being in the classroom next door to her class and suggested I speak with the staff in his room. Ms. Young stated that the restrooms the children use are downstairs. The program director spoke with the staff regarding appropriate discipline techniques. Ms. L. Young said that Child A is in her classroom. She said that Ms. Montgomery took Child A in the hallway because Child A was "acting up" in class. She did not hear what Ms. Montgomery said to Child A once they were out of the classroom. Ms. L. Young denied ever hearing Ms. Montgomery being intimidating or threatening to children in care. Their boss, Ms. Mobley talked to them regarding appropriate discipline. Ms. Montgomery said Child A was having a tantrum and throwing chairs, so she took him into the hallway to calm him down. She admitted to telling Child A she was going to give him to the Boogey Man. She stated that her voice may have been raised however, she was not speaking in an angry tone. Ms. Montgomery also stated that Ms. Mobley has discussed appropriate discipline techniques with her after this incident. I observed Child A, who was present at the child care center. He appeared to be clean and happy. On January 13, 2022, Ms. Mobley said she was aware of the incident and that she has reiterated appropriate disciplinary techniques with her staff.

Open Not marked corrected in the state record

Open / not marked corrected.