R 400.1911 · R 400.1911 Care; supervision; children. (1) A licensee shall ensure appropriate care and supervision of children at all times. 7

On 01/20/2021, I received an incident report that had been submitted by Ms. Denise Richards to the department. The report indicated that on 01/12/2021, at approximately 10:00am, Child A had reacted to Child B (male, 2 years) attempting to hug her by screaming, flailing her arms and throwing a fit. The report indicated that about 30 minutes after this action, Child A reported that her arm/elbow hurt. Ms. Richards inspected Child A's arm and could see no bruising swelling, deformity, or indication of injury but ice was provided. Ms. Richards contacted Child A's Mother by text message at 11:12 am asking her to telephone Ms. Richards. The incident report indicated that Child A said that she had also fallen 3 off of a chair at home. Later that day after nap time, Ms. Richards observed Child A's arm to be slightly swollen and again provided ice to Child A. She discussed the incident again with Child A's Mother at pick-up. The report indicates that Ms. Richards and Child A's Mother continued communicating regarding the incident and Ms. Richards urged Child A's Mother to take Child A to the doctor the next day (01/13/2021). Ms. Richards was notified on 01/13/2021 by Child A's Mother that Child A had sustained a broken arm/elbow. Ms. Richards also included text messages between herself and Child A's Mother regarding the incident. The submitted text messages are difficult to follow and are not in a logical conversational order and contain conversation regarding Child A's Mother reporting to Ms. Richards how Child A was doing after leaving the child care home. On 01/20/2021, I spoke with Child A's Mother. She confirmed that Child A had broken her left elbow and she (Child A's Mother) had found out about the injury on 01/12/2021 when Ms. Richards had texted her at about 11:10am. She explained that Ms. Richards had informed her a little boy had laid his head on Child A's back. Child A reacted by throwing a tantrum and hitting her arms on the floor. Ms. Richards did not mention any bruising when she contacted her, but Child A was saying her arm hurt. Child A's Mother never heard back again from Ms. Richards that day after they initially spoke about the incident. When she arrived to pick Child A up at about 4:45pm, Child A's arm was slightly swollen and she observed a very small amount of bruising slightly downward from Child A's elbow, on the boney part of her forearm. Child A was upset and crying. Child A's Mother indicated that she was not overly concerned until it was obvious the next day that Child A was still in pain. Child A's Mother stated that she was not told about Child A falling off of a chair at home. My question regarding falling off the chair was the first Child A's Mother had heard this. Child A's Mother stated that she gained apprehension regarding the child care as she thought about this injury. Ms. Richards had told her that Child B tried to hug Child A. However, Child A's doctor had thought there needed to be some force behind the impact to sustain the break in the elbow. Child A's Mother wondered if Ms. Richards actually saw the incident because Ms. Richards had said that she was making pancakes in the kitchen and Child B only tried to hug Child A. Child A had said Child B landed on her and hurt her elbow; this matched what the doctor had said. Child A's Mother stated that there was a previous incident between Child A and Child B. Child B had thrown a toy a few weeks ago, which hit Child A in the face and caused bruising. Although Ms. Richards said a naughty child threw the toy, Child A had told her that it was Child B that threw the car. Child A's Mother conveyed frustration because Ms. Richards had told her that she was going to let CCSM (child care staff member) Ms. Lori Argetsinger go. Child B is causing trouble and Ms. Argetsinger allows unacceptable behavior from him, but Ms. Richards had not let Ms. Argetsinger go. This was also frustrating because Child A had not taken well to Ms. Argetsinger in general. 4 Child

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

R 400.1903 · R 400.1903 Licensee responsibilities. (1) A licensee shall be responsible for all of the following provisions: (d) Inform parents when a child care staff member is providing care in the absence of the licensee.

On 10/27/2020, Ms. Richards did not inform all parents when a child care staff member was providing care in her absence. Text messages indicate that Child A's Mother was not aware that Ms. Richards was not present in the child care home on 10/27/2021 at 9:29 am.

Open Not marked corrected in the state record

Open / not marked corrected.

R 400.1903 · R 400.1903 Licensee responsibilities. (1) A licensee shall be responsible for all of the following provisions: ®i (e) Maintain a record of the dates of licensee absences. These records must be maintained for a minimum of 4 years.

Ms. Richards did not maintain a record of the dates of her absences. Although Ms. Richards submitted dates of her absences as requested, text messages indicate that she was additionally absent on 10/28/2021 and 11/23/2021. Later conversation with Ms. Richards indicated that she did not understand what absences needed to be recorded. Therefore, Ms. Richards did not maintain a record of her absences.

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

R 400.1910 · 1 R 400.1910 Ratio of personnel to children. (1) The ratio of personnel to children present in the home at any 1 time must be not less than 1 member of the personnel to 6 children. The ratio must include all children in care who are not related to any personnel and any of the following children who are less than 6 years of age: (a) Children of the licensee. (b) Children of a child care staff member or child care assistant. (c) Children related to any member of the household by blood, marriage, or adoption.

On 01/21/2021, Ms. Richards did not ensure the ratio of child care staff members to children was not less than one child care staff member to six children. CCSM Ms. Lori Argetsinger cared for eight child care children and one related child under six years of age while Ms. Richards was not present in the home.

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.

R 400.1910 · R 400.1910 j Ratio of personnel to children. (2) For each member of the personnel, not more than 4 children shall be under the age of 30 months, with not more than 2 of the 4 children under the age of 18 months. 11

On 01/21/2021, Ms. Richards did not ensure that one child care staff member did not care for more than 4 children under the age of 30 months, with not more than 2 of the 4 children under the age of 18 months. CCSM Ms. Lori Argetsinger cared for 3 children under 18 months of age and 5 children under 30 months of age while Ms. Richards was not present in the home.

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.