Little Country Kids Day Care

R 400.8143(5) · R 400.8143(5) Toilets; hand washing sinks.

The hot water in the Zoo Room measured at 131 degrees Fahrenheit.

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R 400.8201(1)(c) · R 400.8201(1)(c) Comprehensive background check; fingerprinting.

Two child care staff members had unsupervised contact with children and have not been fingerprinted and determined eligible by the department.

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R 400.8269(1)(c) · R 400.8269(1)(c) Emergency preparedness and response planning procedures (1) Written plans and procedures for emergency preparedness and response planning for the care of children and staff in each of the following emergencies must be developed and implemented: (c) Floods. Technical Assistance 2 LANDMARK BUILDING • 105 W. ALLEGAN STREET • LANSING, MICHIGAN 48933 Michigan.gov/MiLEAP 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.

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R 400.8269(1)(d) · R 400.8269(1)(d) Emergency preparedness and response planning procedures (1) Written plans and procedures for emergency preparedness and response planning for the care of children and staff in each of the following emergencies must be developed and implemented: (d) Power outages. 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.

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R 400.8269(1)(e) · R 400.8269(1)(e) Emergency preparedness and response planning procedures (1) Written plans and procedures for emergency preparedness and response planning for the care of children and staff in each of the following emergencies must be developed and implemented: (e) Extreme weather events. 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.

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R 400.8269(1)(f) · R 400.8269(1)(f) Emergency preparedness and response planning procedures (1) Written plans and procedures for emergency preparedness and response planning for the care of children and staff in each of the following emergencies must be developed and implemented: (f) Other natural or man-made disasters. 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.

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R 400.8335(8)(a) · R 400.8335(8)(a) Food services and nutrition; provided by center 3 LANDMARK BUILDING • 105 W. ALLEGAN STREET • LANSING, MICHIGAN 48933 Michigan.gov/MiLEAP (8) All of the following apply to milk: (a) Containers must be labeled with the date opened. Bureau

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R 400.8137 · R 400.8137 Diapering; toileting. (6) Diapers and training pants must be checked frequently and changed when wet or soiled.

On 03/10/2022, I spoke to the complainant who stated they were informed that Child A and Child B do not have their diapers changed enough throughout the day causing them to have accidents on their clothes. On 03/10/2022, I spoke to Child A, B and C's mother via phone who stated that Child B is two years old and still in diapers. Child A, B and C's mother could not recall what day or week, just that it was a couple weeks ago that Child B had soaked 2 through three outfits in one day. Two of the diapers were bowel movements and one was pee. Due to Child B not having any more clothes in the bag, someone at the center put Child B in a 4-year-old's underwear and had Child B walk around like that the remainder of the day. No one contacted her to let her know that Child B needed more clothes. When Child B was getting picked up, Tracie Richardson told Child A, B and C's mother that Child B had diarrhea up her back continuously. Child A, B and C's mother stated she does not feel this was the issue and feels that Child B was not changed enough in the day. Child A, B and C's mother stated she did not have any daily sheets for Child B as she was never provided one. She stated that she could not find any of Child A's daily sheets and believed she may have thrown them away. Child A, B and C's mother stated that a child should not go through that many outfits in one day if they are being changed regularly. She stated she has spoken to Autumn Smith, lead caregiver, and does not believe her when she says she changes the children. On 03/15/2022, I made an unannounced onsite inspection at Little Country Kids. I interviewed Autumn Smith, Linda Manson-Dempsey and Tracie Richardson. First, I spoke to Ms. Smith who stated that she writes down and documents how many times a diaper is changed, how much a child eats, and how long a child sleeps on their daily sheets. At this time, she was able to show me all four children in the classroom's daily sheets. All sheets were viewed to be filled out and up to date. Each child had been changed at least once if not twice. Each child had also had one bottle at this time. Ms. Smith stated that if a child soaks through their clothes, each child has extra clothes in their bags in the room. She stated if they do not have any extra clothes, Ms. Manson-Dempsey will call their parents and either let them know or request them to bring more to the center. Ms. Smith denied ever putting Child B in someone else's underwear to walk around in. She stated that Child B was not potty trained so there is no way she would put underwear on Child B. Ms. Smith stated that she writes on the daily sheets, and when a child leaves, their parent is provided the sheet. She stated she does not make copies of them and was only able to show me the children that were there that day. I walked into the toddler classroom and was able to see all daily sheets for the three toddler children in the classroom. The sheets were filled out appropriately and were all up to date. Lead caregiver Noelani Fry stated she always makes daily sheets for each child and then will provide the parent the sheet at the end of the day. Ms. Fry did not have any information relating to Child B and stated she did not know about the incident. I then spoke to Ms. Manson-Dempsey who stated that Child B's diapers were too tight, and even though this was brought up to the parent's multiple times, they never brought in new ones and became upset that the center requested new diapers. At naptime, Child B would take a nap. Even if changed right before nap, she would pee through the diaper. Therefore, the parents brought in a lot of clothes because it would happen. If Child B peed through the diaper, Ms. Smith would change her 3 clothes, so she was not sitting in wet clothes all day. Ms. Manson-Dempsey could not recall the exact day, but stated it was two weeks ago, Child B had three "blow outs" and pooped through her clothes. Child B was never put in underwear; she had on a diaper

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R 400.8140 · R 400.8140 Discipline. (1) Positive methods of discipline that encourage self- control, self-direction, self-esteem, and cooperation must be used.

On 03/10/2022, I spoke to Child A, B and C's mother who stated that she has personally never heard Ms. Smith swear or talk down to children; however, she was told by Child C that Child C heard Ms. Smith tell Child A to "shut the F up" because Child A wouldn't stop crying. She stated Child C is four years old and able to speak about what was heard. Child A, B and C's mother stated that she does not know when this happened or why, but when she pulled her children from the center, Child C told her this and she believed it happened. On 03/15/2022, during my onsite inspection and interview with Ms. Smith, she denied ever swearing at or around a child. She stated she has never used the F word or told a child to shut up. Ms. Smith stated that she is the infant lead caregiver, and they cry all the time; that's what babies do when they need something. Ms. Smith stated she felt she had a good relationship with all the children in her room and their parents. She stated she has never had a parent complain to her or come to her about her behavior or attitude. All the children are happy to come in and never cry out of fear when they arrive. Ms. Smith stated she felt it showed that the children trust her as well. Ms. Smith stated that the older children are not in her room and at no time has she had the infants with the preschool children. Ms. Smith stated she was provided a copy of the discipline policy when she was hired, it states to not use foul language or physical discipline with children. She stated redirection is used with children. Next, I spoke to Ms. Manson-Dempsey, and she stated no one has ever used foul language like that with a child. She stated she would never allow a staff member to continue working if a parent complained about a staff member swearing at a child. Ms. Manson-Dempsey stated that Ms. Smith is quiet and kind with all the children. She has never heard her swear at anyone let alone a child. Ms. Manson-Dempsey provided me a copy of the staff handbook and the discipline policy. The policy states that staff will not use foul language and will use redirection to help children throughout the day. Then, I spoke to Ms. Richardson who also denied ever hearing Ms. Smith swear at a child. She stated that Child C was in her room and there is no time that Child C would be with the infants. Ms. Richardson stated she is not in Ms. Smith's room to hear her all day; however, she knows her attitude and behavior and Ms. Smith would never say that to a child. Ms. Richardson stated she was provided a copy of the discipline policy at hire, and it states to not use foul language or physical discipline with children. She stated redirection is to be used. On 03/22/2022, I spoke to Child D's mother via phone, and she stated that she has never had issues with Ms. Smith, and all of her children throughout the years have loved being with Ms. Smith. Child D's mother stated that Child D absolutely loves going into Ms. Smith's room and would run to her once they arrived at the center. She also stated that she used to work at the center years ago and worked in the room next to Ms. Smith. She stated she has never heard Ms. Smith swear, yell, or 5 use any inappropriate language with a child. Child D's mother stated Ms. Smith is the best to have with the infants because she is so patient.

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

On 03/10/2022, 1 spoke to Child A, B and C's mother who stated that Child A is a year and a half and is on solely bottles. Child A still receives a bottle every three hours when at home. However, the child care staff stated that they can only provide Child A one bottle at rest time. During the day Child A is to have a sippy cup only; however, Child A does not know how to use one, so he does not drink all day. Child A, B and C's mother stated she has spoken to Ms. Smith and Ms. Manson-Dempsey about this being a concern. She was told by both that this was the rule, and Child A would have to only use a sippy cup. She stated when she picks up the children, Child A is always so thirsty and drinks a full bottle immediately in the car. Therefore, she feels Child A does not drink all day. On 03/15/2022, during my onsite inspection, I spoke to Ms. Smith, and she stated that she has never given a child only one bottle all day. She stated she writes on all children's daily sheets how much they eat and drink each day and has never sent a child home without feeding them all day. Ms. Smith stated that she has given Child A multiple bottles in the day, and they just recently started working on using a sippy cup. She stated she has not taken bottles away from Child A but now feeds Child A more finger foods and works with Child A on using a sippy cup. Ms. Smith stated that Child A has never been neglected with her. She stated Child A, B and C's mother has never complained or spoken to her about a concern with bottles. She stated she knew that they were working on sippy cups. Next, I spoke to Ms. Manson-Dempsey who stated that if a child has a bottle at the center, they will fill it with milk once they are over 12 months old. She stated Child A was working on using a sippy cup through out the day as he is a year and a half year's old. Child A, B and C's mother would have Child A come in with chocolate milk or apple juice and wanted him to have chocolate milk all day. She was A informed that Vitamin D milk is provided to him. Child A, B and C's mother was also upset that Child A could not walk around with his bottle. She was informed that this was a licensing rule, and a child cannot walk around with a bottle. Ms. Manson- Dempsey stated Child A, B and C's mother did not seem to care about this and continued to be upset that Child A could not walk around with chocolate milk in the morning. I then spoke to Ms. Richardson who stated that Child A, B, and C's mother would allow all her children to come in with chocolate milk in the morning and then would ask if they would provide a refill with chocolate milk. She stated she has told Child A, B and C's mother multiple times that they do not use chocolate milk and only have regular milk for the children. Ms. Richardson stated that she does not know about Child A not receiving a bottle all day long but stated that she has seen Child A in a highchair eating at lunch time when the door is open between her room and the infant room. Ms. Richardson stated she does not feel that Ms. Smith has ever not fed a child all day, and if that would happen, the child would be screaming all day- which has never happened.

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R 400.8112 · R 400.8112 Comprehensive background check; fingerprinting. (1) Pursuant to section 5n of the act, MCL 722.115n, before an individual has unsupervised contact with children, the department shall determine the individual's eligibility to be any of the following: (c) A child care staff member. I

On 02/08/2022, I spoke to the complainant via phone, who stated they were hired and worked unsupervised with children without being fingerprinted. The complainant stated they were not asked to go get fingerprints and was still able to work in a classroom. On 02/09/2022, I made an unannounced onsite inspection at Little Country Kids Day Care and interviewed all staff present. First, I interviewed Licensee Lisa Manson- Dempsey, and she stated that she had hired Staff Member A and their first and only day working was 02/02/2022. She stated the Staff Member A was previously employed at a child care center and was already in the CCBC system and was listed as eligible. Ms. Manson-Dempsey stated she had not switched her over to her center yet but knew that she was confirmed in the system. I was able to confirm that Staff Member A was on CCBC and eligible. She stated that Staff Member A was not working unsupervised as she was with Michael Smith most of the time or with Autumn Smith and Noelani Fry in the infant and toddler classroom. Ms. Manson- Dempsey was reminded to make sure to add all staff once they are hired and not wait until after they are working with the children. I next spoke to preschool lead caregiver Tracie Richardson, and she stated that Staff Member A only worked one day last week on 02/02/2022. She stated Staff Member A worked in the infant room with Ms. Smith all morning and then worked in the toddler room with Ms. Fry. She stated she does not know anything about fingerprinting of other staff. Ms. Richardson has been at the center since before fingerprinting and stated she was fingerprinted at the beginning. Then I spoke with toddler lead caregiver Noelani Fry, and she stated that she does not know anything about fingerprinting and who has been or not. She stated she 3 was fingerprinted prior to working with children and that is all she can go from. Ms. Fry stated Staff Member A worked last week for one day only and she worked with Ms. Smith all morning. At naptime, she was in the room alone until Ms. Smith came back from break. The infant and toddler room are connected with a door, and they did have the door open, so Ms. Fry was able to see in the room and assist if the new staff member needed anything. Ms. Fry stated that was the only time the staff member was alone with children. Next, I spoke to infant lead caregiver Autumn Smith who stated that when she was first hired, she was fingerprinted, and she has never heard that someone worked without being fingerprinted. She stated that Staff Member A worked last week only for one day. Ms. Smith stated Staff Member A worked in her room with her; however, she only had three children that day, so the staff member was not needed for ratio; she was just helping and learning the classrooms. Ms. Smith stated she left at rest time for about an hour or an hour and half, and during that time Ms. Fry helped in the classroom and she did not feel that Staff Member A was ever left alone.

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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 02/08/2022, I spoke to the complainant via phone, who stated that the infant and toddler classrooms are connected by a door, and the staff members allow the children to walk back and forth, and the staff members will go between the classrooms leaving children alone. The complainant also expressed concerns that Ms. Smith and Ms. Fry will leave their classrooms for an unknown amount of time, and the children are alone. On 02/09/2022 during my onsite inspection I spoke to Ms. Manson-Dempsey who stated that the infant and toddler classrooms do have a door that connect them, and 4 they do help each other out when needed such as when one needs to use the bathroom or grab the mop for cleaning. Ms. Manson-Dempsey stated that the children do not go back and forth, and they keep the classrooms separate. All the classroom staff provide appropriate supervision in their classrooms. She stated that most of the time she is not in a classroom and can assist in any room if they need help. Next, I spoke to Tracie Richardson, and she stated her classroom is right next to the toddler and infant rooms and they all have connecting doors. She stated the doors to each room stay closed all day and she believes the infant and toddler room door stays closed as well. Ms. Richardson stated Ms. Smith and Ms. Fry do help each other out when needed such as bathroom breaks or if someone needs something. They are so close together that it is the easiest way to help. She stated the children are never left unattended and staff do not leave their rooms to talk to other staff members in different rooms. Ms. Smith and Ms. Fry are usually alone in their rooms. If they need assistance Ms. Manson-Dempsey will come and help out in whatever room needs it. If Ms. Fry is going to grab the mop from the room next door, Ms. Smith will stand between the rooms for the quick minute. This happens rarely; only if there isn't an extra staff. I have provided technical assistance for this and reminded the staff and Ms. Manson- Dempsey that staff cannot leave the classroom unsupervised. I then spoke with Noelani Fry, and she stated she has a door that connects her room to the infant room; however, it is not left open. Se stated that the children do not go back and forth, and they keep everything separate. Ms. Fry stated that she and Ms. Smith do help each other out when someone needs to use the restroom or grab something from the kitchen. While I was in the classroom, I observed the door closed to the infant room. The children were not standing by the door and did not appear to want to go into the other room. Next, I spoke to Autumn Smith, she stated that she has a door in her room that connects to the toddler classroom and to the preschool room. She stated parents and staff use both doors to enter her room. Ms. Smith stated that she does not keep either door open and allow children to come and go from room to room. She stated that with babies on the floor or children sleeping on demand, this would not make her room realistic to have other children coming in and out. Ms. Smith stated she does ask Ms. Fry for assistance if she needs to use the bathroom. She stated food and cleaning supplies are brought to her, so she doesn't leave for them often either. On 03/15/2022, I made a second unannounced visit at the center. I initially walked to the back of the building towards the infant and toddler classroom. The door was closed, and each classroom was operating on their own. 5

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R 400.8137 · R 400.8137 Diapering; toileting. (1) Except as provided in subrule (2) of this rule, diapering must occur in a designated diapering area that complies with all of the following: (f) Is washed, rinsed, and sanitized after each use. I

On 02/08/2022, I spoke to the complainant who stated they viewed the changing tables not being cleaned between changes, and when they are cleaned the three-step process is not being used. The changing table was cleaned with a rag and bleach and the rag was reused daily. The complainant stated when they asked Ms. Manson-Dempsey about it, she stated, "This is how we do it here". On 02/09/2022, during my onsite inspection; Ms. Manson-Dempsey stated that she uses bleach and soap which she confirmed is the three- step process for changing tables and they use a rag with bleach for the tables. She stated, instead of paper towels, they will use a rag. She stated that the sanitarian, Aaron Aum ock, came out for her environmental inspection in 2018, told her it was acceptable to use a rag while sanitizing the tables. She stated she has done this since and even with a new inspection in 2020, it was never corrected, and she felt this was still acceptable. Ms. Manson-Dempsey stated she will continue to use the three-step process and use paper towel instead of a rag. She stated the infant room is the only one who uses a rag for the changing table with bleach only, but this will stop today. Next, I spoke to Ms. Richardson, and she stated that she has always used the three- step process with her preschool room tables. She stated that she does not use a rag for the bleach but uses paper towels. Ms. Richardson stated that she does not know how the changing tables are cleaned in the infant or toddler rooms. She believes they are using the three-step process as that is how they are trained to do it. Next, I spoke to Ms. Fry, and she stated when she cleans the changing table, she wipes the table clean with water and paper towel and then uses a Clorox wipe to clean the table off and then will spray with bleach and let it air dry. Ms. Fry uses Clorox disinfecting wipes. The directions on the wipes say if wipes are being used to disinfect to wash first and then use as many wipes needed to clean surface. Ms. Fry will do this and then spray bleach and let air dry to make sure the tables are sanitized. She stated she was always told to use the three-step process. Ms. Fry stated she has not used a rag to clean for a while. When she first started, she did use a rag but lately she has not and always and uses a Clorox wipe and then bleach and water. Ms. Fry stated she thinks that other staff members do the same; however, she is not in their rooms to confirm it is always used. I then spoke to Ms. Smith who stated that she has always used the three-step process, and with the bleach and water step, she has used a rag. The rag is only for the sanitizing step and not for cleaning the tables or changing tables. Ms. Smith stated that she always cleans the changing table after every diaper change. She stated she cleans, sanitizes, and then lets it air dry when completed. She does not feel that anyone leaves changing tables, highchairs or eating tables dirty. I then spoke to the older toddler lead caregiver Michael Smith who stated he uses the three-step process for cleaning. He stated he does not use a rag for the tables. Mr. Smith stated that he does not have a changing table in his room. During my onsite, I observed Clorox wipes and spray bottles with bleach and water in them. A bleach rag was viewed in the infant room and Ms. Smith removed the rag and stated she will continue to use paper towel from here on out. On 03/15/2022, during my onsite inspection, I viewed all staff using the three-step process and no longer using rags for the bleach. All staff stated they have only used paper towels and nothing reusable.

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R 400.8140 · R 400.8140 Discipline. (2) All of the following means of punishment are prohibited: (i) Time out must not be used for children under 3 years of age.

On 02/08/2022, I spoke with the complainant who stated that they observed Ms. Smith put Child A in time out due to walking out of the classroom. Child A is little over a year old and should not be placed in time out due to their age. The complainant stated Child A was put on the floor against the wall. She did not give a specific time but stated Child A would sit there "for a long time". The complainant stated they also heard Ms. Smith speak inappropriately to Child A telling her how bad she was and continued to scold her on what she does wrong every day. The complainant also stated that they viewed Ms. Manson-Dempsey grab Child C's arm and yell at the child due to the child talking during nap time. The complainant stated Child C refused to put socks on, and Ms. Manson-Dempsey continued to yell at Child C instead of talking and assisting the child. The child was not physically injured or bruised; the complainant just felt it was inappropriate discipline for her to put her hands on Child C. On 02/09/2022, during my onsite inspection and speaking to Ms. Manson-Dempsey, she stated that the infant and toddler classrooms do not use time out and she has never seen or heard Ms. Smith or Ms. Fry use time out with the children. She stated their discipline policy states that discipline should be age appropriate and time out should not be used with children under three. Child A is a runner and does like to leave the classroom if given the opportunity. When Child A does this, the staff members have to remind her not to leave the room and bring her back. Ms. Manson-Dempsey stated that in the preschool classroom, she or Ms. Richardson will have children sit at the table to calm down or to talk to one on one, but they do not use actual time out with any of the children. She stated this is not something they use in the center. Ms. Manson-Dempsey provided me a copy of their discipline policy. The policy states their goal is to keep all children safe. For staff members to work with children to learn and understand their emotions. The policy also states that at no time will physical or verbal abuse be used for discipline. The policy does not state anything about time out. Ms. Manson-Dempsey denied any allegations of putting her hands on Child C or using inappropriate language with any child. She states she does not care if children do not wear shoes while inside; however, she does have a rule they have to have socks on. Child C came in daily with crocks and no socks, even if there was a foot of snow outside. Since his crocks were wet, he would take them off. She stated she told Child C he had to have his shoes on, and he got upset. She repeatedly denied swearing or speaking down at a child. I then spoke to Ms. Richardson who stated she has never seen Ms. Fry or Ms. Smith use time out with any of the children in their classroom. She stated Child A likes to run out of the room, but all the staff are working with Child A to let her know she cannot do this. None of the staff members have put Child A in time out for this as Child A is not even two and would not know what that means. Ms. Richardson stated she has been provided the discipline policy and it states they are not to use physical or verbal abuse for any type of discipline. She stated it does not state anything about time out, but it does state that staff are to communicate with children about their emotions. Next, I spoke to Ms. Fry, and she stated Child A just moved into her classroom within the last week or so. She stated that Child A likes to run out the door and into the preschool room. She is still getting used to being in a big room and staying in there. Ms. Fry stated for discipline, she will talk to the children and sometimes has them sit down. She stated she did not have a copy of the discipline policy on hand but knew she was provided one before. Ms. Fry was reminded that children in her class are not to be sitting in time out as that's not appropriate for their age. She stated sh

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R 400.8182 · R 400.8182 Ratio and group size requirements. (7) If there are children of mixed ages in the same room or well-defined space, then the ratio and group size is determined by the age of the youngest child, unless each group of children is clearly separated and the appropriate child care staff member-to-child ratios and group sizes, if applicable, for each age group are maintained. I

On 02/08/2022, I spoke to the complainant who stated that the school age children and preschool children were all together on 02/02/2022 due to there being a snow day at the public schools. The complainant stated there were a lot of children with only one staff most of the time due to Ms. Manson-Dempsey not staying in the classroom and going to her home, which is located on the property. The complainant did not know how many children were actually in the classroom as the complainant was not in the room and did not count, however; it appeared to be "way too many". 10 On 02/09/2022, during my onsite inspection I observed each classroom and the ratios. The Infant room-birth to 12 mo. (1:4 ratio) had four children with one staff member. The Toddler room- 12 mo. To 2.5 years (1:4 ratio) had three children with one staff member. The Older Toddler room- 2.5 years -3-3.5 years (1:8 ratio) had six children with one staff member. The Preschool room- 3-5 years (1:10 ratio) had eight children with one staff member. The school age children were no longer at the center. However, in the morning there were seven children with one staff member. I asked Ms. Manson-Dempsey to provide me with a copy of the attendance sheet for 02/02/2022 and she was able to provide me with a copy of the whole week. On 02/02/2022 the attendance stated: The Infant room: two children with one staff member (Ms. Smith) as well as new employee assisting. The Toddler room: four children with one staff member (Ms. Fry). The Older Toddler room: six children with one staff member (Mr. Smith). The Preschool/School age children: 12 children with two staff members (Ms. Richardson and Ms. Manson-Dempsey). While reviewing all attendance sheets, all classrooms were in ratio at all times of the day. The preschool/school age children were in ratio at all times. Ms. Manson-Dempsey stated that the classrooms were in ratio at all times. When Ms. Smith left at lunch, the center was still in ratio as the new employee was still back there, and she and Ms. Fry worked together for the hour. The classrooms were in ratio during this time. The day was a little chaotic due to the school agers not having school; however, the preschool and school agers all stayed in the main room and were combined to keep everyone in ratio. I next spoke to Ms. Richardson who stated she did not feel that on 02/02/2022 any of the classrooms were out of ratio. She stated it was a little more than normal due to the school agers being there all day, but the preschool/school agers classroom was only at 12 and they had two staff members: herself and Ms. Manson-Dempsey. She stated Ms. Manson-Dempsey did not leave the building and leave her out of ratio. She stated she will stay in the classroom with them the whole time if needed. Ms. Manson-Dempsey may have had to walk into her office or the kitchen for something but both rooms are right off the main room, and she can still appropriately supervise from both areas. Ms. Richardson stated they do not keep attendance in the classroom and only Ms. Manson-Dempsey does it at her desk. I then spoke to Ms. Fry who stated that she has no idea if any of the preschool rooms or other classrooms are out of ratio as she is in the back of the building and only sees her classroom and the infant room. She stated that when Ms. Smith left for her break, their classrooms were still in ratio as she put the kids together for nap time and they only had six children total with her and the new employee. Ms. Fry 11 stated she does not recall Ms. Manson-Dempsey leaving the building that day as she was in the classroom with the preschool and school age children all day. Next, I spoke to Ms. Smith who stated that she does not feel any of the classrooms are out of ratio throughout the days. She stated she does not remember 02/02/2022 but feels she only had a couple kids. Ms. Smith stated that when she left for break that day, she was not leaving her class out of ratio either. I then spoke to Mr. Smi

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R 400.8188 · R 400.8188 Sleeping, resting, and supervision. (13) For children under school age who do not sleep at rest time, quiet activities must be provided such as reading books or putting puzzles together.

On 02/08/2022, I spoke to the complainant, who stated that all the school age children had to lie down for nap time on 02/02/2022 for three hours and were not provided anything to do. The complainant stated the children were not allowed to get off their mats from 12 pm to 3 pm or they were yelled at and in trouble. On 02/09/2022, during my onsite inspection, I spoke to Ms. Manson-Dempsey regarding this, and she stated that after lunch the children lie on their cots until about 3:00 PM. She stated about 90% of the children in the preschool and school age room will fall asleep and sleep until they are woken up. If a child wakes up early, they will play with whatever they already have at their cots until it is time to get up. She stated the children all bring something from home or grab something from the center such as a stuffed animal of some sort to sleep with. This is also their toy when they get up. If a child wants to get up, they will find something quiet for them to do. Ms. Manson-Dempsey stated she does encourage all children to take a nap or at least rest on a cot during quiet time. She stated on 02/02/2022 Child C did not want to lie on a mat or be quiet during rest time. It was also Child C's first day, so Child C was told the rules on how rest time works and that all children five and under need a little quiet time. Child C did not feel they should have to rest and did get upset. Child C ended up lying down and playing with a small toy on their mat during the whole rest time and the child was fine. I then spoke to Ms. Richardson, and she stated that the children lie down right after lunch, which is about 12:45 PM and get up about 2:45 PM. She stated that if a child does not sleep or want to sleep, they are given books to read on their cot or get to play with a "stuffy". Ms. Richardson denied ever forcing a child to lie on their cot and sleep for three hours. She stated she always gives them something to do. Ms. Richardson stated most of the children do sleep, and she must wake almost all of them up when rest time is over because they like this time. She stated even the school-agers like to lie down for a bit. Ms. Richardson stated that the school-age children are not there during the day, and if so (rarely) she has never forced them to sleep for three hours. She stated, "That would be impossible". Next, I spoke to Ms. Fry, and she stated that all the children in her room lie on mats and all of them sleep the whole time. She stated the older kids that do not lie on their mats with books or a stuffed animal. Ms. Fry denied ever seeing a staff member force a child to lie down with nothing to do. She stated she also does not think rest time is three hours. She stated, for her especially, it's about two hours. Ms. Smith and Mr. Smith stated neither of them knew what the preschool classroom did at nap time as they are in their rooms. Ms. Smith stated with the babies do not have a designated time and Mr. Smith stated all his kids lie on mats and all will sleep at least two hours each day. 13 During my onsite I observed children's cubbies with their stuffed animals or small toy they use during rest time. Almost all the children had an item in their cubbies. The children that didn't, Ms. Richardson stated they are able to pick from the shelves.

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R 400.8335 · R 400.8335 Food services and nutrition; provided by center. (8) All of the following apply to milk: (a) Containers must be labeled with the date opened..

On 02/08/2022, I spoke to the complainant via phone, who stated that the milk located in the kitchen was not labeled after it was opened. No further information was provided. On 02/09/2022, during my onsite inspection, I went to the kitchen and observed multiple containers of milk in the refrigerator. One milk was opened, and it was labeled correctly with the date opened. The other containers were not opened at this time. Ms. Manson-Dempsey stated the only other room that would have milk in it would be the infant classroom. I went to this room next, and when I opened the refrigerator, the milk was open and labeled with 02/08/2022. At this time, I interviewed Ms. Smith and she stated she always labels the milk the moment she gets it. She stated she will either grab it in the morning or someone will bring it to her if she needs one. Ms. Manson-Dempsey was interviewed next, and she stated that Ms. Richardson will always make sure that the milk containers are labeled as soon as they are opened and put in the kitchen. She stated she would not know if the milk was not labeled in the infant room unless she was looking for it. But she always feels her staff are great at doing this. 14 I next spoke to Ms. Richardson, and she stated she always labels the milk as soon as it is opened. She stated this is something she stays up on and does not feel it is ever missed. Then, I interviewed Ms. Fry and she stated that milk is always labeled with its open date on it. She stated she does not see this ever being an issue. Mr. Smith stated the same, stating he has never seen the milk in the refrigerator opened and not labeled. On 03/15/2022, during my second onsite inspection, I observed all the refrigerators, and all of the milk containers were labeled with a date they were opened.

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R 400.8340 · R 400.8340 Food services and nutrition; provided by parents. (7) Milk and other beverages furnished in a multi-day supply must be labeled with the child's first and last name and the date of opening and be returned to the parent or discarded 7 days after opening.

On 02/08/2022, I spoke to the complainant via phone, and who stated that on 02/02/2022 the bottles in the infant classroom were not labeled and it was unknown who the bottles were to go to. The complainant stated they did not know how many children were in the infant room at this time. On 02/09/2022, during my onsite inspection I observed the infant classroom refrigerator. All bottles were labeled with a first and last name. There were three sets of bottles for the infants that took bottles in the classroom. Ms. Smith stated she always makes sure the bottles are labeled when the children arrive. She stated if the parents forgot, she always labels them before they go in the refrigerator. Ms. Smith stated on 02/02/2022, she was running late and when she arrived, she had forgot to label her son's bottles. He was the only child in the infant room that day that took a bottle and she did end up labeling them once she realized. She stated it was her error and she corrected it. Ms. Smith stated the new employee had realized and asked her about the bottles and that was when she immediately did it. Ms. Smith stated this was the only time and it only happened because they were her bottles. She said since she had forgot to label them at home, she used tape and put his last name on the bottles. 15 I interviewed Ms. Manson-Dempsey next, and she stated that the bottles are always labeled in the infant room. She stated that she helps in there if needed and has never not known whose bottles are who's. Ms. Manson-Dempsey stated she does know about the one-time Ms. Smith forgot to label her bottles in the morning. She stated she knows about it because Ms. Smith told her that she did it. She stated she was running late and completely forgot. The reason Ms. Smith told her was because she felt bad since she was training the new employee and then she was the one who forgot to label her child's bottles. The bottles were labeled and corrected once noticed. Next, I interviewed Ms. Richardson and she stated she has no idea about the bottles since she does not work in the room. She stated she did hear about the one-time Ms. Smith forgot to label her son's bottles. Ms. Richardson stated she only knows about it because they were all talking about it due to being the new employees first day. She stated it was talked about because it is something that never happens. Next, I interviewed Ms. Fry who stated that she has never noticed bottles in the infant room not labeled. She stated they are always labeled before arriving or Ms. Smith will label them upon arrival. Ms. Fry did not know about an incident on 02/02/2022 of bottles not being labeled.

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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. 17

On 02/08/2022, I spoke to the complainant who stated that in the kitchen of Little Country Kids there were mouse feces all over the counter and in the drawers where the children's silverware is located. She stated no one ever cleaned it and it was evident it had been there for a long time. 16 On 02/09/2022, during my onsite inspection I observed the kitchen and all the drawers. The kitchen counter and floors were clear of any mouse feces. I opened all drawers, and two drawers did have mouse feces in the very back of them. There were approximately five to ten pebbles of feces viewed in the two drawers. The two drawers had silverware in it; the silverware was in a container in the drawer. No food was in either drawer. It was not on the silverware or near the food. Ms. Manson-Dempsey stated this has always been a problem since the facility is "In the country". She stated she will have a service coming out to help with this. Ms. Manson-Dempsey stated there is not a mouse or rat problem and they make sure to keep the kitchen always cleaned. She stated she cleans out every drawer and deep cleans weekly to make sure there is nothing left out for mice to get in. The silverware is cleaned prior to being used for an extra step as well. Next, I spoke to Ms. Richardson, and she stated the mice are a constant battle. She stated she and Ms. Manson-Dempsey clean out the drawers daily and make sure that the ground and counter tops are always kept up. She stated there is never mice throughout the center or a problem. The field behind the center will attract mice to the center in the colder months. She did not feel it was a problem and stated that the kitchen is always very clean. Next, I spoke to Ms. Fry and then Ms. Smith who both stated that they have never seen mice in the building and did not know or see mice feces in the kitchen. Both stated they clean their rooms and highchairs regularly and have never had an issue with rodents in their rooms. I then interviewed Mr. Smith who confirmed he has never seen a rodent in the building and has never seen mice feces in the kitchen or felt the kitchen was not clean. On 04/14/2022, I spoke to Ms. Richardson who stated last month the center had the roof and siding fixed. During this, a hole was found in the storage room directly next to the kitchen. The hole was fixed and ever since the center has not had any mice issues, no feces in the kitchen or drawers.

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