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.

Lead Caregiver 1 did not provide appropriate care and supervision when she has been verbally and physically aggressive with children. Program Director and CCSM 1 both said Lead Caregiver 1 has used a harsh tone with children and pulled them by their arms. Lead Caregiver 1 admitted she has pulled children by their arms on multiple occasions over the past year.

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

R 400.8128(1) · R 400.8128(1) Staff; volunteer; tuberculosis. A center shall keep on file at the center evidence to verify that each child care staff member and each volunteer who has contact with children at least 4 hours per week for more than 2 consecutive weeks is free from communicable tuberculosis (TB). Verification of TB status is required within 1 year before employment or volunteering.

I reviewed 22 child care staff member files, and 21 of the child care staff members had evidence of a negative TB test on file. CCSM 4 did not have evidence of a negative TB test on file, but she is not currently employed at the center and will get a TB test before she returns to employment over the holidays.

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

R 400.8125(5) · R 400.8125(5) Staff; volunteer; requirements. A written statement must be signed and dated by staff and volunteers at the time of hiring or before volunteering indicating all of the following information:

I reviewed 22 child care staff member files, and all 22 child care staff members had a written and signed statement on file at the time of hiring indicating their understanding of mandated reporting procedures.

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

R 400.8112(2)(a) · R 400.8112(2)(a) Comprehensive background check; fingerprinting. Ensure that each individual who requires an eligibility determination under subrule (1) of this rule completes, signs, and submits all of the information required in subrule (5) of this rule, and in subrule (6) of this rule if applicable, on a form prescribed by the department. The forms are available on the department's website for the child care background check system, www.michigan.gov/ccbc. The form or forms must be signed and dated prior to the individual's appointment to be fingerprinted. 3 LANDMARK BUILDING • 105 W. ALLEGAN STREET • LANSING, MICHIGAN 48933 Michigan.gov/MiLEAP

I reviewed 22 child care staff member files, and 21 child care staff members had a completed consent and disclosure form on file. CCSM 4's consent and disclosure form could not be found, but Program Director said CCSM 4 was not currently working at the center and before she could return to employment, the consent and disclosure form would be completed by CCSM 4.

Open Not marked corrected in the state record

Category: background checks. Open / not marked corrected.

R 400.8131(10) · R 400.8131(10) Professional development requirements. All child care staff members who work directly with 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.

I reviewed 22 child care staff member files. Eighteen child care staff members had current infant, child, and adult CPR/First aid training on file. Two child care staff members had expired CPR/First Aid training on file. Two child care staff members were still within 90 days of being hired.

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

R 400.8131(2) · R 400.8131(2) Professional development requirements. Child care staff members shall have training that includes information about prevention of sudden infant death syndrome and use of safe sleep practices before caring for infants and toddlers.

I reviewed 22 child care staff member files, and 21 of the 22 child care staff members employed in the center had received training in the prevention of SIDS and infant safe sleep practices before working with infants and toddlers. The one child care staff member who did not have the training does not provide any care for infants and toddlers.

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

R 400.8131(3) · R 400.8131(3) Professional development requirements. Before caring for children, all child care staff members and unsupervised volunteers who work directly with children shall be trained on prevention of shaken baby syndrome, abusive head trauma and child maltreatment, and recognition and reporting of child abuse and neglect.

I reviewed 22 child care staff member files, and all 22 child care staff members who work directly with children were trained in the prevention of shaken baby syndrome, abusive head trauma and child maltreatment, and recognition and reporting of child abuse and neglect.

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

R 400.8131(4) · R 400.8131(4) Professional development requirements. Before unsupervised contact with children, all child care staff members who work directly with children shall complete prevention and control of infectious disease training, including immunizations.

I reviewed 22 child care staff member files, and all 22 child care staff members who work directly with children had received training in the prevention and control of infectious diseases, including immunizations.

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

R 400.8131(5) · R 400.8131(5) Professional development requirements. Within 90 days of being hired, or the first day as an unsupervised volunteer, all child care staff members and unsupervised volunteers who work directly with children shall complete the following trainings, which may count toward annual professional development hours and are available at MiRegistry:

I reviewed 22 child care staff member files, and all 22 child care staff members who work directly with children completed the required trainings in MI Registry within 90 days of hire.

Open Not marked corrected in the state record

Category: supervision. 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.

The center provides appropriate care and supervision when children are playing outdoors. Child care staff members do walk around and provide for the needs of the children.

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

R 400.8380(1) · R 400.8380(1) Maintenance of premises. The premises must be maintained in a clean and safe condition and must not pose a threat to health or safety.

The premises are maintained in a clean and safe condition for children. One toilet stall is missing a door, but doors are only required for school-age children, and the school-age children have other bathrooms available for their use.

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

R 400.8125 · .............. R 400.8125 Staff; volunteer; requirements. (2) All staff and volunteers shall act in a manner that is conducive to the welfare of children.

On April 4, 2023, I spoke to the complainant by telephone about the allegation. She stated that she completed some training on the computer the first week she started employment in November 2020 but denied doing any professional development since that time except CPR training. I logged into MiRegistry while we were on the phone and could see that she had completed the 2020 annual health and safety refresher training on November 24, 2020, and the 2022 annual refresher training on September 13, 2022. She said she never completed the 2022 health and safety refresher training. I said it is an online activity that she would have had to log into her MiRegistry account for. She said that when she began employment, Ms. Robinson asked for the email address and password for the account, and she thinks Ms. Robinson logged into her account and completed the training for her. I asked the complainant why she thinks Ms. A Robinson would do that and she said that when Licensing Consultant, Jennifer Blake, was out for their renewal inspection on December 13, 2022, she overheard Ms. Robinson tell Ms. Blake that she would have to log into MiRegistry, email the training to herself, and print it out. The complainant said she was almost certain that Ms. Robinson did that for all of the child care staff members in the center. I asked the complainant if she completed training hours in-person, correspondence, or another way, and she said she did not complete any professional development. I looked at her MiRegistry account again and saw that she had completed a course called "Child Development and Guidance" for 20 clock hours of training through Care Courses and she denied taking that course and reiterated that she did not receive any training while she was employed at the center. On April 5, 2023, I spoke to Ms. Cuddahee, Ms. Robinson, CCSM 1, CCSM 3, CCSM 4, and CCSM 5 about the allegation. Ms. Cuddahee said that everyone completes the annual health and safety refresher course online annually on the computer. The 16 clock hours of annual training are not the same for all child care staff members, but they all obtain at least 16 clock hours annually. She denied that Ms. Robinson does the training for them. This year all the child care staff members received a packet from the Child Care Support Network, and they work on the packet at their own pace. Then they submit it back to the Child Care Support Network who reviews their answers and adds the training to MiRegistry. Currently they have several child care staff members who are working towards their Child Development Associate (CDA) Credential and Ms. Robinson is paying for that. Ms. Robinson denied ever completing anyone's training hours for them and said she does not have time to do that as the center director. She acknowledged that she does have the child care staff members provide her with a copy of the email address and password they used to log into MiRegistry because then it is written down if they forget it. When it is time for them to do the annual health and safety refresher training, she will get coverage for their classroom and set them up at a computer to complete it during their scheduled work hours. She said that during the onsite inspection with Ms. Blake in December 2022, the center was cited because they did not have verification of some of the online trainings in MiRegistry. Ms. Robinson said she told Ms. Blake that she would log into their MiRegistry accounts and print the verification of the completed training for their records. Ms. Robinson said everyone is required to obtain at least 16 clock hours of training annually and this year they were doing correspondence packets through the Child Care Support Network. CCSM 1 stated that she remembers doing the MiRegistry health and safety trainings online because it took her a long time to complete them. She said this year she was given a packet from the Child Care Support Network that she will complete on her own and then submit to get

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

R 400.8131 · ................. ...... R 400.8131 Professional development requirements. (6) All child care staff members who work directly with children shall complete 16 clock hours of professional development annually on topics relevant to job responsibilities that include, but are not limited to, any of the following subjects: (a) Child development and learning. (b) Health, safety, and nutrition. (c) Family and community collaboration. (d) Program management. (e) Teaching and learning. (f) Observation, documentation, and assessment. (g) Interactions and guidance. (h) Child care center administrative rules.

On April 4, 2023, I spoke to the complainant by telephone about the allegation. She stated that Child A and Child B both attend the child care center. Child A used to have a lot of behavioral issues, but he is on medication now to help him regulate his behavior. Child B is too young for medication and is hyper-active and impulsive. Child B will hit and bite other children in care. He has also hit and kicked child care staff members and does not like to take naps. The complainant said she is concerned about the safety of Child B and other children in care. Child B rj does not think before he acts and will jump off furniture and other objects and she is concerned he will injure himself. She stated that in 2020, Child B jumped off a table and hit his head on a block and needed stitches. The complainant said parents of other children in care have refused to have their child in the same room as Child B due to his aggressive behaviors. The complainant said Ms. Robinson will excuse Child B's behavior and refuses to follow the discipline policy in the parent handbook that says "unruly and aggressive children will be terminated." On April 5, 2023, I spoke to Ms. Cuddahee, Ms. Robinson, CCSM 1, CCSM 3, CCSM 4, and CCSM 5 about the allegation. Ms. Cuddahee admitted that Child B is a very hyper-active child and has issues with impulse control. She said Child A and Child B have been attending the center since they were infants and the parents have always been supportive and actively seeking support services for their children but not many physicians see preschool-aged children for behavior. Child A is now on medication that has helped his behavior, but Child B is too young for medication. She said while Child B may present more behavior challenges and likes to play rough, he is no more active than other young children in care and they can manage his behaviors. She said Child B has had a great few weeks. She can only recall Child B biting another child one time and Child B was sent home for it. Child B was pretending to be a shark and bit another child and did not think about the consequences of his actions, but Child B showed a lot of remorse for it when he realized his pretend play hurt one of his classmates. The child care staff members in Child B's room have been working with Child B to help him verbalize his needs when he wants attention rather than acting out. Ms. Robinson denied that Child A and Child B are aggressive children. She said they are active boys and have attention deficit/hyperactivity disorder. Child A is now on medication for the condition, but Child B is too young to medicate yet, so they have been trying new strategies and techniques to help him manage and regulate his behavior. Ms. Robinson described Child A and Child B as "sweet boys" and said their parents are supportive and they utilize a team approach to managing their impulsive behaviors. Mr. Robinson said she never received any complaints from child care staff members about Child B's behavior until he started in the preschool classroom. She said one time Child B was "playing shark" and bit another child. The other child put his fingers in Child B's mouth and Child B bit down on them while still pretending to be a shark. The other child's parents were contacted about the injury, and they did not have any concerns. Ms. Robinson said she could only recall one parent ever complaining about Child A after her daughter was injured during clean-up time. Child A threw some wooden blocks to get them closer to the shelf. The little girl was standing in the way and got hit by a block that Child A threw. Ms. Robinson said she does not want the boys labeled as "bad kids" because they are very loving children, and the child care center is their safe place. She admitted that some child care staff members have not always agreed with the behavior modification methods used with Child A and Child B, but she said that has been an education issue. Ms. Robinson felt she was 10 operat

R 400.8146 · R 400.8146 1 Information provided to parents. (1) A center shall provide a written information packet to each parent enrolling a child that includes at least all of the following: (d) Discipline policy.

On April 4, 2023, I spoke to the complainant by telephone about the allegation. She stated that Child E, who is CCSM 1's son, got pink eye and was allowed to remain in care because Ms. Robinson needed her to work. Within two weeks, four more children got pink eye because Child E was allowed to remain in care with a contagious disease. On April 5, 2023, I spoke to Ms. Cuddahee, Ms. Robinson, CCSM 1, CCSM 3, CCSM 4, and CCSM 5 about the allegation. Ms. Cuddahee acknowledged that Child E had pink eye but said that he had a doctor's note that allowed him to return to care after he received a certain number of doses of eye drops. Ms. Cuddahee believes another child in the center was responsible for the outbreak of pink eye because that child was sent home with red eyes and returned with a doctor's note that said it was just allergies. Ms. Cuddahee said they consistently implement their illness policy and would not allow any child to stay with a contagious illness. Ms. Robinson said CCSM 1's son, Child E, was sent home with pink eye on a Friday. CCSM 1 took him to a walk-in clinic on Saturday and he was diagnosed with pink eye. CCSM 1 immediately filled a prescription for eye drops and messaged Ms. Robinson on Sunday evening to say that the doctor's note stated that once Child E had two sets of drops in his eyes, he could return to care. Ms. Robinson agreed he could return to care with the doctor's note. The week before, another child in care had pink eye and was sent home. The child went to the pediatrician who diagnosed him with allergies and said he could return to care. Then a couple other children in care got pink eye. Ms. Robinson said the rules for illness apply to everyone in the center and she would not let Child E, or any other child, return to care without a doctor's note if they suspected the child had a communicable disease. CCSM 1 said she has had to take Child E home several times when he has become ill while at the center and denied ever being able to keep him in care when he has been sick. She said the center does not want any illnesses to spread, so if a child is sick, regardless of who it is, the child must be taken home until they are better, or they have a doctor's note allowing them to return. When Child E got pink eye, CCSM 1 said she had to take Child E to the physician and get a prescription before he could return to care. The physician stated that he needed to be on the eye drops for at least 24 hours before returning to care. Another time Child E spiked a fever while in care and was sent home. CCSM 3 said all children are sent home when they become ill while in care, including the children of child care staff members. CCSM 3 said her child attends the center and has been sent home when he has gotten sick while in care. CCSM 4 said if a child gets sick while in care, they must go home immediately. It does not matter whose child it is. She has had to take her son home multiple times because he has become sick while in care. She said when Child E got pink eye, he was sent home immediately when his eye was red and was not able to return until it was treated. 14 CCSM 5 stated that she has children who attend the center, and they cannot attend if they are sick. She will stay home with them when they are ill. She stated that Child E was diagnosed with pink eye after work hours and CCSM 1 was not allowed to bring him back to the center until the pink eye had cleared up and his eyes were no longer red, and he was on eye drops. I reviewed a copy of the center's illness policy which stated that the center operated for well children only and if a child becomes ill while in care, the child will remain with a child care staff member until the parent arrives to pick up the child. The policy states that they make every effort to reach the parent of the child when a child is ill, but after 30 minutes, they will notify the emergency contacts from the child information card. The center suggests that families have a back-up p

R 400.8155 · R 400.8155 Child accidents and incidents; child and staff illness. (5) A center shall have a written policy detailing when children, staff, and volunteers will be excluded from the center due to illness. 15

On April 4, 2023, I spoke to the complainant by telephone about the allegation. She stated that the evacuation crib in the Green Room has a broken wheel. The complainant says that the evacuation crib looks normal when you are looking at it, but if you lift the crib up to move it over a threshold, the wheel will fall off and the crib will drag on the ground. On April 5, 2023, I spoke to Ms. Cuddahee, Ms. Robinson, CCSM 1, CCSM 3, CCSM 4, and CCSM 5 about the allegation. Ms. Cuddahee said she was not aware of any complaints about the evacuation crib not working properly but she has never exited out of that room during a drill. She did admit, however, that if you pick the crib up, the wheel will slip off, and you have to put it back on. Ms. Robinson said she had not received any complaints that the evacuation crib in the toddler classroom was broken. She and I walked down to the toddler classroom and examined the wheel on the evacuation crib. The wheel sits into a groove on the crib but when the crib is picked up or went over a change in the flooring, the wheel would fall off. I reviewed the emergency plans in the room, and they indicated that the toddlers in the Green Room would line up at the door to exit the room and it did not indicate that the emergency evacuation crib would be used for emergencies. Ms. Robinson stated that all the children in the toddler room can walk. CCSM 1 said she is a child care staff member in the infant room and she has never had a problem with the evacuation crib in the infant classroom. She said she was not aware of any issues with the toddler room evacuation crib. CCSM 3 stated that the evacuation crib in the Green Room was used for a fire drill about two months ago and the wheel was broken. She stated that the evacuation crib is always used for drills if they have more than five toddlers in care. She said 16 they will use it when they have more children so they can exit quickly. If there are only five children in care, then they will walk because they can assist them more easily. CCSM 4 said she only works with older children and did not have any knowledge about the evacuation crib used by the toddlers. CCSM 5 stated that emergency evacuation cribs are not usually used in the toddler classroom. CCSM 5 said she will often help assist children in the toddler classroom exit the building quickly during a fire drill. She acknowledged that the wheel for the evacuation crib does come off, but that it will slide back on quickly and easily. On April 24, 2023, I spoke to CCSM 2 about the allegation. She said she did not know anything about the evacuation cribs in the toddler classroom. CCSM 2 said she is employed in the infant room, and she has never had an issue with the wheels on their emergency evacuation cribs falling off. On May 4, 2023, I spoke to Child A & B's Mother and Child C & D's Mother about the allegation. Neither parent said they had any knowledge about the wheels on the emergency evacuation cribs.

R 400.8161 · R 400.8161 Emergency procedures. (2) The written procedures must include all of the following: (g) A plan for how infants and toddlers will be accommodated during each type of emergency. 17

On April 4, 2023, I spoke to the complainant by telephone about the allegation. She stated that there is no shade on the playground in the summer months. She said they had umbrellas outdoors, but they broke and were not replaced. She said there is one tree in the fenced in play area, but it did not have many leaves on it. She said the space is very open and does not have any vegetation and is "just dirt." On April 5, 2023, I spoke to Ms. Cuddahee, Ms. Robinson, CCSM 1, CCSM 3, CCSM 4, and CCSM 5 about the allegation. Ms. Cuddahee said the center had umbrellas that they used last summer but they got broken and they purchased new ones, but the weather has not been nice enough yet to use them this season. Ms. Robinson stated that she typically must buy new umbrellas for the outdoor play area every spring. She said they get some natural shade from the side of the building in the morning, but in the afternoons, they need the umbrellas. She said a former child care staff member left the umbrellas up during a wind storm at the end of the summer and it destroyed the three big umbrellas they had outdoors. Ms. Robinson recently received some new picnic tables, and she has plans to pick up more umbrellas and order a dome sunshade for the outdoor play area this season. Ms. Robinson showed me the outdoor play area during the onsite inspection. I observed that there was some natural shade that was projected off the side of the building in the morning hours and one tree that would provide some natural shade in the summer months. CCSM 1 said she was not sure if they have any umbrellas because she has not needed them during the winter months with the infants and she was not employed for the center last summer. Last year Child E attended the center, and she does remember dropping off and picking up Child E and they had shade and cover while playing outside. She said the play area was partially shaded and part of it was in the sun. CCSM 3 stated that they have canopies over the tables that provide shade for the children in the summer months. She explained that they have two playground areas, and each area gets two canopies. She said the center also has two portable tent-like structures they can use anywhere outdoors that provided additional shade for the children on warm days. CCSM 4 said the center has umbrellas that they use for shade in the outdoor play area. She said that towards the end of the season a couple child care staff members did not take the umbrellas down and a big windstorm ruined them. CCSM 4 said the side of the building provides some shade as well as a couple of the play structures. She said they also make sure the children in care are well-hydrated before they go outside and apply sunscreen, so they do not get overheated or burnt. CCSM 5 stated that the center had three umbrellas that provided shade, but they were destroyed in a windstorm just before winter. She said there is still one umbrella that is used on the play area for the younger children. CCSM 5 said she was told that they were planning to get new ones for this season. On April 24, 2023, I spoke to CCSM 2 and Ms. Robinson about the allegation. CCSM 2 stated that they had umbrellas for shade in the play area, but they were taken down for the winter months and haven't been put back up yet due to the weather. She said there is some natural shade from the building, and they use that during the winter months when the children are bundled up and not outside as long. Ms. Robinson provided me with a copy of a purchase confirmation to demonstrate that on April 17, 2023, she had ordered three arched top outdoor pergolas with adjustable and retractable canopies for the outdoor play areas. She said their expected delivery date was April 24, 2023. On May 4, 2023, I spoke to Child A & B's Mother and Child C & D's Mother about the allegation. Child A & B's Mother stated that there is some natural shade on the 19 playground in a playhouse and they do use umbrellas on the tables, b

R 400.8170 · R 400.8170 Outdoor play area. (6) There must be a shaded area to protect children from excessive sun exposure, when necessary.

On April 4, 2023, I spoke to the complainant by telephone about the allegation. She stated that there is an inflatable bounce house that is used for birthday celebrations and snow days. She said it is not used frequently but will be set up in the "Romper Room" when they cannot go outdoors for inclement weather. The complainant said the bounce house has been used with infants as well as the preschool-aged children and is stored in the athletic storage area upstairs. On April 5, 2023, I spoke to Ms. Cuddahee, Ms. Robinson, CCSM 1, CCSM 3, CCSM 4, and CCSM 5 about the allegation. Ms. Cuddahee said that a bounce house was donated to the Community Education & Recreation Center (CERC) that is stored upstairs but she denied ever seeing it used in the child care center. She stated that the bounce house is only ever used for community events like the Halloween party or family day events. Ms. Robinson acknowledged that the CERC has a bounce house and said it has been used with the preschool-aged children in the center for special events like birthday celebrations. She said the toddlers might have used it one time, but it is not used frequently and can only accommodate about three children at one time. She said the bounce house was donated by a parent whose child attended the center and it is used most frequently by the CERC for kindergarten round-up each spring. Ms. Robinson stated that she did not know that bounce houses could not be used by children in care at the center and they would just get rid of it. CCSM 1 said there is a bounce house that is used by the older children in care with direct supervision for special events, but she denied ever using it with the babies. She said one time they got it out and had planned to use it with the infants, but then realized it was not what they thought it was and determined it was not appropriate for them. CCSM 3 stated that the center does have a bounce house that is used by the preschool-aged children and school-age children, but said it is not appropriate for the infants and toddlers. She did not think it was used very frequently and said the last time she remembers it being used was last calendar year. CCSM 4 denied that a bounce house was ever used with the school-age children in care. She said she has heard about a bounce house but has never seen it used and did not know where it was stored. CCSM 5 acknowledged that the center had a bounce house but said it is only used for community CERC events like the Halloween party. She said if it was used by the center, it would certainly not be used by the infants because it would not be age- appropriate for them. On April 24, 2023, I spoke to CCSM 2 about the allegation. She was aware of a bounce house in the center but said she got it out one time to use it with the infants and when she started to blow it up, she realized it was not age-appropriate for the babies and took it down and put it away. On May 4, 2023, I spoke to Child A & B's Mother and Child C & D's Mother about the allegation. Child A & B's Mother said she has never seen or heard about a bounce house in the center. She has spent a lot of time there over the years and has never seen one used. Child C & D's Mother said the center does have a bounce house, but she has not seen or heard about it being used since March 2020. She remembers it being used for a celebration or party in the center, but she did not remember which child it was 21 used for because it could have been Child D or an older sibling who no longer attends the child care center.

R 400.8173 · 1 R 400.8173 Equipment. (11) Trampolines and bounce houses must not be used by children in care at the child care center.

On April 4, 2023, I spoke to the complainant by telephone about the allegation. She stated that the ratios in the "Red Room" which is a preschool- aged classroom, are the highest and fluctuate between 12-15 children each day. The complainant said Ms. Robinson told her and CCSM 5 that they would have a third child care staff member in the room when they had 16 preschool children but that never happened. I looked up the ages and capacity in the Red Room and explained that the Red Room is licensed for 22 preschool-aged children and the ratio for that age group would be one child care staff member to eight preschool children from ages 30 months to 3 years of age and then it changes to ten children once all of the children in the room are at least 3 years of age. The complainant said there were days when she could not take a lunch break because they would have been out of ratio with too many children in care and not enough child care staff members. The complainant said that sometimes she had as many as 30 children in care of mixed ages around 3:00 PM when they combined with the "Blue Room" which is licensed for 20 preschool-aged children with the children in the "Red Room." She said that between 7:00 AM and 8:00 AM, there would only be one child care staff member to 12 children in the Red and Blue Rooms, when the majority of the children arrived. The complainant stated that there were times they needed an extra child care staff member but no one was available because of scheduling conflicts and child care staff members who were not willing to stay late to make sure they were within ratio before they left. On April 5, 2023, I spoke to Ms. Cuddahee, Ms. Robinson, CCSM 1, CCSM 3, CCSM 4, and CCSM 5 about the allegation. Ms. Cuddahee said the Red Room has a ratio of one adult child care staff member to 8 preschool children and there are 22 always two child care staff members in the room with no more than 16 children in care. Ms. Cuddahee said she is the lead child care staff member in the Blue Room and she currently only has 15 children in care with one other child care staff member in the room. She said sometimes the Red Room and Blue Room will combine at the beginning or end of the day when ratios are lower, but she denied ever being left with too many children in care. She stated there are only about 30 preschool children in attendance in those two rooms on any given day when everyone is there. She acknowledged that sometimes parents are late and child care staff members have to stay past their scheduled shift and they do not always like that, but Ms. Robinson does not let them leave until they have coverage and are within the required ratios. Ms. Robinson denied allowing the Red Room or any other rooms to be out of ratio at any time and said that the Red Room is licensed for children ages 30 months to 3 years, and they stay within a ratio of one child care staff member to 8 children in care, and only enroll 16 children in the classroom. Ms. Robinson explained that the center is only required to employ two child care staff members in the classroom, but on days when they have 16 children in care, she would usually employ a third child care staff member in the classroom to provide extra support. Ms. Robinson said Ms. Cuddahee has 12-15 preschool children enrolled in the Blue Room. On days when there is inclement weather, the Blue Room and Red Room will combine between 3:00 PM and 4:00 PM, but by that time, both rooms are down to about 8 or 9 preschool children in each room, but the room is licensed for 22 children, and they have four child care staff members. Ms. Robinson said that child care staff members can go home once they are within ratio for the classroom depending on the age of the youngest child in the room. In the mornings, Ms. Robinson said she has one child care staff member come in to work with the preschool children at 7:00 AM, two more child care staff members arrive at 7:30 AM, and a school-age child care staff member

R 400.8182 · R 400.8182 Ratio and group size requirements. (3) In each room or well-defined space, the maximum group size and ratio of child care staff members to children, including children related to a staff member or the licensee, must be as shown in Table 4: Age Child Care Staff Maximum Group Size member to Child Ratio 24 a) Infants and toddlers, 1 to 4 12 birth until 30 months of age b) Preschoolers, 30 months of age 1 to 8 16 until 3 years of age c) Preschoolers, 1 to 10 30 3 years of age until 4 years of age d) Preschoolers, 1 to 12 36 4 years of age until school-age e) School-agers 1 to 18 36

On April 4, 2023, I spoke to the complainant by telephone about the allegation. She stated that in December 2022 or January 2023, the handicapped stall door in the preschool bathroom broke when a child care staff member went to use the toilet, and the door was laying against the wall and has not yet been repaired. She said the school-age children use that bathroom when they go outdoors or combine classrooms and they do not have any privacy in that stall. On April 5, 2023, I spoke to Ms. Cuddahee, Ms. Robinson, CCSM 1, CCSM 3, CCSM 4, and CCSM 5 about the allegation. Ms. Cuddahee acknowledged that the door is broken and off the hinges. She said that a work order has been submitted to 25 have it repaired but the maintenance department services the entire school district, so they must wait until someone is available to come out and fix it. Ms. Cuddahee said most of the time, the bathroom with the broken stall is used by the preschool children and children who are potty-training. She acknowledged that the school-age children will sometimes use that bathroom but said there are two other stalls in the bathroom that do have doors and afford privacy to the school-age children. There is also another set of bathrooms that are licensed and approved in the CERC that the school-age children can use, and all those stalls have doors for privacy. Ms. Robinson said there are three stalls in the preschool bathroom and only one stall door is broken. She has submitted a work order to have the maintenance department fix it, but it has only been three or four weeks since it broke, and it is lower priority since they have plenty of other bathrooms that can be used. She acknowledged that the school-age children use that bathroom but said they can use the two stalls that have doors for privacy. She said their policy is to only let one school-age child use the bathroom at a time anyway, so it should never be an issue. Ms. Robinson said there are more approved bathrooms in the CERC hallway that are approved for the school-age children's use and all of them have doors on the bathroom stalls that provide privacy for the school-age children. I asked Ms. Robinson to take me on the tour of the facility and she showed me the preschool bathroom. I observed that the bathroom door was missing from the handicapped stall. Two other toilets in the bathroom had doors for privacy. I did not observe any sharp edges or any other hazards in the handicapped stall. CCSM 1 and CCSM 3 both said they did not know anything about a broken door in the preschool bathroom. CCSM 4 stated that she was aware that the handicapped stall door had fallen off the hinges and they were waiting on maintenance to come fix it. CCSM 4 said she works with the school-age children, and she has told them to use one of the two stalls in the bathroom with a door for privacy. She said the handicapped stall is primarily used for young preschool children who are potty-training. CCSM 5 said she is aware the handicapped stall in the bathroom is broken. Ms. Robinson put in a work order to have maintenance fix the door, but they have not been there to repair it yet. She said there are two other stalls in the bathroom that do have doors and provide privacy for the school-age children in care. On April 24, 2023, I spoke to CCSM 2 about the allegation, but she said she works in the infant room and does not have any knowledge about the bathrooms in the preschool classroom. On May 4, 2023, I spoke to Child A & B's Mother and Child C & D's Mother about the allegation. Child A & B's Mother said she is aware that one door latch was not working, or the door was not on the frame and needed to be replaced, but she did O not have any other details. She said she was not concerned because there are two other stalls in the bathroom that have doors that provide privacy for the school-age children. Child C & D's Mother stated that she had no knowledge about the allegation.

R 400.8350 · 1 R 400.8350 Toilets; hand washing sinks. (7) Toilet rooms for school-age children must provide for privacy.

On April 4, 2023, I spoke to the complainant about the allegation. She stated that the mouse infestation has been going on for over a year. She said that the center put down "safe traps" which helped but did not solve the problems. The complainant said she found a nest in the Red Room closet and knows there has also been evidence of mice in the Green Room closet. The complainant said Ms. Robinson told her that they were using Griffin Pest Control Company to manage the problem. Both Ms. Cuddahee and CCSM 5 have seen mice in the center. The upstairs storage room also has mouse droppings in the conference rooms and closets. The complainant is not sure if items are being properly cleaned and sanitized before being used with the children in care. The complainant said the fleas were an issue in November 2020 and they were brought in by another child care staff member. She is not aware of any incidents since then with fleas. The bedbugs were also brought into the center by another child care staff member in the summer of 2022. CCSM 4 found a bedbug on her and the CCSM 4 was gone for a month. The center remained open for business and the child care staff members were not allowed to tell the parents about it. 27 On April 5, 2023, I spoke to Ms. Cuddahee, Ms. Robinson, CCSM 1, CCSM 3, CCSM 4, and CCSM 5 about the allegation. Ms. Cuddahee acknowledged that they have had some issues with mice, but she said their facility backs up to the woods and is attached to a large community center and it is only natural that a few mice would try to get inside the facility when the weather is cooler. She said they have a contract with Griffin Pest Control, and they also set traps to catch them. She said the recommendation last year from Griffin Pest Control was to add brush guards to the bottoms of the doors, so they did that. She denied that there is an infestation and said they likely sneak in with so many entrances and exits to the building. Ms. Cuddahee said CCSM 4 did find what she thought was a bedbug on her one- day last summer. She was immediately sent home and could not return to work until her home was cleaned and inspected. The classroom where the bedbug was found was immediately closed, treated as a precaution, and the company did not find any bedbugs. Since no bedbugs were found, Ms. Robinson did not feel it was necessary to notify the families of children in care. Ms. Cuddahee said they may have found a couple fleas on a child from home, but it has never been an issue and the center has never been treated for fleas. Ms. Robinson denied that the center has a mouse infestation. She said every winter they have a few mice that will try to get into the center when the weather is cooler. They have a contract with Griffin Pest Control and anytime they see a mouse or evidence of one, they contact the company to treat the facility and get rid of them. They also have sticky traps that were provided by the maintenance department in the school and if a mouse is caught, they will come throw it away. Ms. Robinson denied that the center has ever had problems with bedbugs or fleas. She said two years ago during the summer months, CCSM 4 had what she thought may have been a single bedbug on her sleeve, but she was not sure. CCSM 4 was immediately sent home as a precaution, and they had a company come in to conduct preventative cleaning and they did not find any evidence of bedbugs in the center. Ms. Robinson said the parents of the children in the affected room were notified that the room was treated, and that the company did not find any evidence of bedbugs. Ms. Robinson was not aware of any allegations about fleas, and she has worked at the center as the program director for the past 11 years. Ms. Robinson took me on a tour of the facility and showed me the Red Room and the Green Room. I looked inside the closets and found them to be clean and tidy. Most of the items in the closets were in tubs and I did not see any evidence of mouse droppings. I asked

R 400.8380 · R 400.8380 Maintenance of premises. (2) The premises must be maintained so as to eliminate and prevent rodent and insect harborage.

The premises are maintained to eliminate and prevent rodent and insect harborage. There is no evidence of any mouse, bedbug, or flea infestations in the facility. The facility uses Griffin Pest Control company for their integrated pest management. Their logs indicate they have received regular integrated pest management inspections and services since at least February 2018, and any concerns have been addressed by the company.

Open Not marked corrected in the state record

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.

I received a complaint that Child B touched Child A's private parts underneath her clothing and that the child care was unaware this incident occurred. I left a message for Child A's Mother on 03/02/2022 and I conducted an unannounced onsite inspection at the child care on 03/03/2022. I interviewed Program director and Licensee Designee Mary Robinson, and Child Care Staff Member Rachel Cuddahee. I explained the allegation to Mary Robinson who stated that Child A's Mother has a history of reporting allegations against the center and against Child B. Ms. Robinson was not aware of an incident occurring between Child A and Child B and explained there were allegations previously investigated by Department of Health and Human Services as well as licensing (SIR 2021D 0208010). Child A's Mother and Father are separated and currently the children only attend when they are with Child A's Father. Ms. Robinson explained that Child A's Mother accused a staff member who wore skirts due to religious beliefs of "brainwashing" the children. The staff member was "in tears," and Ms. Robinson asked that Child A's Mother drop the children off at the door, and only interact with her as opposed to the staff. The other option was to have someone else drop off or pick up the children. I explained that the complaint was made 02/25/2022, however there was no indication of a date the incident occurred. I asked Ms. Robinson to pull the attendance records of the proceeding two weeks which showed Child A had been present 02/15, 02/16, 02/17 and 02/21. Of the days that Child A was present, Child B was present 02/16, 02/17 and 02/21. I asked Ms. Robinson what staff were 3 responsible for the school age children on those days, and she indicated that herself and Child Care Staff Members Maddy Turner and Kathy Price were responsible for the school age children. Ms. Robinson explained that the school age children are typically either in the lobby area at the tables located right outside the child care center, the gym or on the playground when they are at the child care center. Most times, Child A's Father arrives to pick the children up within an hour to an hour and a half of the children getting off the bus. All staff are aware of prior incidents with Child A and Child B and know to closely monitor them. Child A and Child B are rarely together and typically do not play together when at the child care center. I observed the child care areas that the school age children use including the lobby area with tables, the gym and the playground. There were no observed blind spots in the areas. Ms. Cudahee explained that she was the preschool teacher for Child A and Child B last year when SIR 2021D 0208010 was investigated. Ms. Cuddahee stated that she was not aware of any other incident with Child A and Child B. She added that Child A and her sister are rarely present at the center, but all staff that work with Child A and Child B are aware of their history. I spoke with Child A's Father on 03/03/2022 regarding the allegations of Child B's interactions with Child A. Child A's Father explained that he and Child A's Mother are separated and share custody of their children. Due to previous interactions with Child A's Mother and the staff at the center, the children only attend the center when they are with him. Child A's Father stated that his understanding of the incident, is that Child A's Mother was having a conversation with Child A talking about where no one should touch you and asked if anyone has touched her there. Child A stated yes and when Child A's Mother asked where, Child A stated, "her butt." Child A's Mother asked her to show her, and Child A placed her fingers under her underwear and told Child A's Mother that Child B had touched her. Child A's Father had the understanding that the incident occurred on the couch located in the lobby of the child care center at the very end of the day. He added, that when he has picked up Child A, the children are not on the

Open Not marked corrected in the state record

Category: supervision. 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.

Appropriate care and supervision were not provided when Child C was injured on two separate occasions when she fell off a toy and knocked out a tooth and when she pulled a bookshelf down and received stitches.

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

R 400.8158(3) · 1 R 400.8158(3) Incident, accident, injury, illness, death, fire reporting. (2) A license, licensee designee, or program director shall report to the department 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. 7

Child A's Mother reported that Child C received stitches on one occasion and had a tooth knocked out on another occasion from injuries that occurred at the center. Ms. Robinson did not report the injuries to the department.

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. 6"

On 07/2612021 I conducted an unannounced onsite inspection to HASS CERC Child Care Center with i ooservea the cnilaren naving rest/nap time in each classroom. Child A and d B were both present in their classroom. interviewed program director, Mary Robinson, child care staff members, Jaden Rosenberg and Rachelle Cuddahee, Child A, and Child B. I obtained child information cards, attendance, and the parent handbook, including center policies. Ms. Robinson is the program director and licensee designee at the center. She reported that there are approximately 79 children enrolled at the center, and 15 of those children enrolled in Child A and Child B's classroom. Ms. Robinson indicated she knew we were here to investigate a report that Child A was hit by Child B in the face with a block as Child A's Mother had told her she was calling to report it. Ms. Robinson reported that Child B did not maliciously throw a block at Child A but that Child B was throwing blocks at clean-up and Child A got caught in the crossfire. Child B then had to sit at a table and do a quiet activity, talk about his behavior, and was not able to use the block area for a few days. She described Child B as impulsive at times but never aggressive. Child A and Child B both have attended the center since they were really young, arrive and depart around the same time, and have always been in the same classroom. She did not have concerns with the way the child care staff handle the behaviors in the classroom nor did she have any concerns with the supervision of the children. Ms. Rosenberg is a child care staff member in Child A and Child B's classroom at the center. She was not present at the center last Friday when the incident occurred with Child A being hit with a block as she had left around 3:OOPM and the incident happened after that time. Ms. Rosenberg reported that Child A and Child B can be the best of friends and play really nice together one day and then not get along the next. She described Child B as impulsive at times and may not think before he acts but that he is never aggressive or violent ;with Child A or other children. He gets along well with children in class. Ms. Rosenberg maintains supervision in the classroom by breaking down into small groups with Ms. Cuddahee taking some of the children and Ms. Rosenberg the remaining half of children. If Ms. Rosenberg is alone in the classroom, she indicated she has the whole group of children present do a project together at the tables, so she can see every child. As for managing behaviors, such as, throwing blocks, she redirects children and talks with them about their behavior. Ms. Cuddahee has been employed with the center for and works in the classroom that Child A and Child B are enrolled in. She was present when the incident occurred last Friday and indicated that it happened close to the end of the day. There were three children in the block area playing nicely, including Child B. Child B randomly threw a block, not directed toward anyone. Child A happened to get caught in the crossfire and the block hit her cheek. She immediately had someone get ice for Child A and talked with both children. Ms. Cuddahee reported that Child A and Child B have been together at the center since they were infants and have always arrived and departed the center around the same time, so they spend a lot of time around each other. Ms. Cuddahee did not have concerns with Child A and Child B and indicated she works with Child B on some of his impulsive behaviors by talking through situations and making him think about them. She and his parents have a notebook where they write back and forth about his day because his parents want to know how he is doing. Child B is on the younger side for this classroom and Child A is older. There are some maturity differences. Ms. Cuddahee maintains supervision of all children by keeping the room set up open, so all children can be viewed. She and Ms. Rosenberg break the children into smal

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.