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 9/16/2022, 1 received an incident report stating Child A "was walking toward the teacher and tripped on the rug. The child fell into the shelf and cut open her forehead. Staff called [Child A's Mother] and asked her to pick up Child A. Staff was worried she would need stitches. Staff also called the Health Manager. The Health Manager was worried she would need stitches." The reported time of the incident was 12:20 p.m. on 9/13/2022. The report listed the date of notification of Heidi Mager and Jamie Mager as 9/12/2022. I received additional information on 9/21/2022 from Becky Sandstrom, licensee designee with multiple reports and documentation as requested attached to an email. This included a different incident report of this injury. This report listed the incident as 11:30 a.m. on 9/13/2022. This report stated, "[Child A] was walking 2 toward the teacher and tripped on a foam block during free play time. Staff called [Child A's guardian] and asked her to pick up [Child A]. Staff also called the Health Manager (Heidi Mager who agreed that the child would need stitches). Child A's Guardian and Child A's Mother picked up Child A and took her to the emergency room in Marquette." The internal incident report was also received from Ms. Sandstrom on 9/21/2022. This report, completed by Lucy Loveless, stated, "[Child A] was going to the block shelf and tripped over a foam block, hitting her head on cabinet shelf." The first aid provided was appropriate and according to their policy. An internal written statement by Christy Belmore stated: "I was sitting on the floor at work time next to the foam block shelf. I asked [Child A] to pick up the foam blocks, she wanted to show Miss Lucy what she made as she was walking she tripped over a rectangle foam block hit her right side of her eye on the foam block shelf." I completed an onsite inspection on 9/22/2022. No children were present on that date due to staffing issues. I interviewed Lucy Loveless and Christy Belmore, staff members who were present when the injury occurred. Child A was moving from one side of the classroom to another area and tripped on the rug. The block area with an area rug had been located next to the open archway between these sections of the classroom. Subsequent to this incident, the staff members moved the area rug and foam block play area to a side wall. This removed the rug and blocks from the transition between these sections of the room. This space change makes it less likely that a child would trip on the rug or a block. There were no hazards observed. Even prior to the rug and block area being relocated, there were no apparent hazards. The rug and blocks were all in good condition. Child A tripped over a foam block accidentally as she was moving quickly to talk to another staff member. Ms. Belmore was near Child A, providing appropriate supervision. Staff members applied first aid and notified Child A's mother appropriately. Ms. Loveless notified the health manager at the central office of Community Action Alger-Marquette (CAAM) on the date of the incident. I reviewed the accident and injury policies that were posted at the center. The policies were appropriate, with the exception of identifying the process of reporting to child care licensing. Photos were provided to me by Becky Sandstrom on 9/22/2022, showing a small laceration in the outer corner of Child A's right eye. There was no injury to the forehead. Photos were also received of the block area at the center. On 9/22/2022, I did leave a message for Child A's Mother on the phone number that was provided to me. No return call was received. On 9/27/2022, I returned to the center to review additional records of staff and child attendance. The center was within capacity and ratio at the time of the 9/13/2022 incident and all other dates on records that were reviewed. The attendance 3 documentation was appropriate. Child records were available and up to date. I also observed Child A, who had returned t

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

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.

The area rugs and blocks in the location of the fall had no apparent hazards.

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

R 400.8158 · 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. 4

The center was notified immediately on 9/13/2022 by the guardian that medical treatment was obtained for Child A's head injury. The guardian provided further details of the medical treatment to child center staff on 9/14/2022. The incident was not reported to the department until 9/16/2022. The licensee did not notify the department within 24 hours of an injury requiring medical treatment after notification by the guardian that medical treatment was obtained.

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 4/21/2022, an incident report was received from Becky Sandstrom, licensee designee. The report stated: 2 "On Thursday, 4/21/2022, Child A was cut on the right cheek with a pair of scissors by another child in the classroom. Child A required 7 stitches and needed to be sedated by the ER Dr. to apply the stitches. Here is the story from the teaching staff that day: Child A was at the art table with four other children cutting paper and doing table toys. One teacher, Christy Belmore, was in the other room with 11 students that were napping. Tonya Harsila, the lead teacher, was in the room with 6 students that were awake and done resting. Five children were at the art table doing art/cutting with scissors, coloring or playing with table toys. Another child was at the easel. Tonya walked over to the shelf (space that divides the two rooms) to tell something to her assistant teacher in the other room. When she turned around, she saw Child A push Child B. Child B picked up a pair of scissors and cut Child A's cheek. Child A screamed. Tonya asked Christy to help her in the other room. A teacher from next door came over and helped watch the children napping. Christy Belmore applied first aid to Child A's cut. Tonya Harsila called Child A's Mother. Child A's Mother picked Child A up from school around 3:00 p.m. She took him to MQT General Hospital's Emergency room." Written statements were received from four staff members. Tonya Harsila completed the internal incident report for the Community Action Alger- Marquette Head Start program. The information on the form included: The incident occurred at 2:25 p.m. Child A's Mother was notified by phone at 2:30 p.m. that "your child needs to get stitches." Child A was cut by Child B with scissors that were on the table that the children were using for cutting. Tonya also wrote a statement: "It was during rest time. There were 5 children at the circle table with scissors and table toys. I was telling Christy about a home visit by the bookshelf. When I turned around, Child B was pushed by Child A over a table toy ran over to get scissors and yelled to stop. Too late, he had already cut Child A's cheek. Child B took the scissors off the table and I grabbed them out of his hands. I applied wet paper towel to Child A's face. I yelled for Christy to come help she put an ice pack on Child A. We have never had a problem with Child B and violence like this before." I interviewed Tonya by phone on 4/27/2022. She explained the incident in the same manner as her written statement. Terry King was a staff member in another classroom. Her statement was written on 4/25/2022 regarding the 4/21/2022 incident. Terry King left another staff member with her students in the classroom to assist in this emergency. While Christy was providing first aid and Tonya was contacting the parent, Terry remained with the students who were awake. Terry also notified the licensee designee, Becky, by phone. 3 Child C showed Terry where Child B had cut his shirt in two places. There was a hole in his shirt in front that went through two shirts and another hole on the back of his shirt. She checked under his shirt for injuries, but there were none. Terry was told by a student that Child B had injured Child D's finger. Terry observed blood on the top of Child D's finger. The small cut was washed, and a band aid was applied. When Becky returned to the center, Terry returned to her class. Terry noted that Tonya had described how she went to the doorway of her classroom to tell Christy about a home visit and explain that she did not leave the room or turn her back on the kids. Christy Belmore was the staff member with the resting children who provided first aid to Child A. On 4/22/2022, she provided a written statement about the 4/21/2022 incident. She wrote: "I was with the nappers rubbing backs. Tonya turned her back away from the kids, standing at the edge of the bookshelf, asking me about a home visit. Tonya turned around, ran ov

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

R 400.8173 · R 400.8173 Equipment. (9) A first aid kit must be readily accessible to staff and securely stored in the center.

The child care staff members had a first aid kit readily accessible in the center that had the appropriate materials. The multipurpose towel was used quickly and the staff determined that it was the best course of action to keep the child calm and keep pressure on the cut with that material rather than try to place a bandaae on the child's face.

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.