Hudsonville-Georgetown

R 400.8134(4) · R 400.8134(4) Hand washing. Guidelines for hand washing must be posted in food preparation areas, in toilet rooms, and by all hand washing sinks.

Bathroom sinks did not have handwashing guidelines posted.

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R 400.8152(5) · R 400.8152(5) Medication; administrative procedures. A child care staff member shall keep all medication out of the reach of children and shall return it to the child's parent or destroy it when the parent determines it is no longer needed or it has expired. 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 400.8170(16) · R 400.8170(16) Outdoor play area. The depth of the loose-fill surface material must be restored to its required depth when it has moved or becomes otherwise compromised. Bureau

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R 400.8125(1) · 1 R 400.8125(1) Staff; volunteer; requirements. (1) All staff and volunteers shall provide appropriate care and supervision of children at all times.

On March 6, 2023, I spoke with Child C and D's Mother on the telephone. She stated she arrived to pick up Child C and Child D at approximately 5:30pm on February 24, 2023. When she arrived, she noticed Child C's nose was very swollen and there were several scratches on his face. She said she could tell he would need medical attention as soon as she saw him. She was given an incident report stating that Child C had slipped on the ice and landed on his face earlier in the day. She spoke with site supervisor CCSM 2 and asked them what had happened. She said CCSM 2 told her the children were out on the playground and Child C had slipped on ice and landed on his face. Child C and D's Mother informed me that Child C was diagnosed with a fracture on the bridge of his nose and is scheduled to see and ear, nose, and throat specialist to ensure the fracture won't cause issues as he gets older. Child C and D's Mother was concerned about why the children had been allowed to go outside due to there being severe ice storms the previous two days and everything was covered with thick ice. She is aware that the children did not go out on the playground during the school day due to the amount of ice on the playground and concerns with safety. She noticed other incident reports with other injuries when she arrived to pick up Child C. She was concerned that she was not called right after the incident had happened. The incident report stated that Child C had fallen at approximately 2:00 or 2:30pm. She arrived to pick up Child C at approximately 5:00pm. She questioned CCSM 2 about why she had not been called. She said CCSM 2 gave her many reasons why they thought Child C's nose was not broken. She stated she is concerned about how staff are trained on safety issues and program policies. She emailed and met with CCSM 2 and program director, Jill Zink about these concerns and that both have followed up and responded to her concerns. Child C and D's Mother feels the injury could have been avoided. She stated that "Ms. Zink is great, and the program is nice." Child C and D's Mother informed me she had taken a photograph of Child C on the day of the injury. I asked her to send me photos of Child C's injury and the emails she sent to and received from CCSM 2 and Ms. Zink. I received the photograph and emails on March 8, 2023. The photograph and emails are on file with this report. On March 6, 2023, I made an unannounced on-site inspection at the child care center. I spoke with multi-site school age program director Jill Zink. Ms. Zink stated she was not present during the afternoon session on February 24, 2023. She is aware the children were playing in the front playground and another child saw Child D slip and fall. This child told CCSM 2 that Child D had been injured. She said CCSM 2 told her the injury "didn't look bad" and there was some bleeding. CCSM 2 "cleaned up" Child C and gave him an ice pack. He was able to blow his nose and then went back to play. Ms. Zink stated that they did not allow the children to go 3 outside during the morning school session on February 24, 2023, because the school principal had informed staff by email not to use the playgrounds that day. She said she told one staff member that they would not be going outside due to the condition of the playgrounds because some of the children were asking. Ms. Zink said she asked CCSM 2 why they had gone out on the playgrounds in the afternoon. CCSM 2 told her they did not see the email from the principal prior to their work shift. On March 7, 2023, I made a second on-site inspection at the child care center. I spoke with site supervisor CCSM 2, CCSM 3, and program director Jill Zink. CCSM 2 stated they was present on February 24, 2023, and on the playground when Child C was injured. CCSM 2 was standing the playground and Child C was playing on a soccer field nearby. They did not see him fall but she saw Child D (female, age 8) and Child G (female, age 7) helping Child C walk in their

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R 400.8155(1)(b) · R 400.8155(1)(b) Child accidents and incidents; child and staff illness. (1) A center shall have a written plan for how and when a parent is notified when personnel observe any of the following: (b) A child experiences an accident, injury, or incident.

On March 6, 2023, I spoke with Child C and D's Mother on the telephone. When she arrived that evening to pick up Child C and Child D, she noticed Child C's nose was very swollen and there were scratches on his face. She said she could tell he would need medical attention. She feels she should have been called right away about Child C's injury. On March 6, 2023, I spoke with Ms. Zink. Ms. Zink gave me the injury policy for the program. The policy says, "in cases of serious injury/illness, any head injury... parents will be contacted as soon as possible." Ms. Zink stated she asked CCSM 2 why the parents were not called. She said CCSM 2 did not think "it was more than a bump". Ms. Zink has told all staff that any injuries to the head require a call to the parents. I asked Ms. Zink to provide me with the incident reports for February 24, 2023. There were three incident reports: • 2:40pm Child E "slipped on the ice and hit the back of her head." • 2:50 pm Child C "fell and hit his nose on the ground. His nose began to bleed." • 2:50pm Child F "slipped and fell on the ice, cutting her cheek." Ms. Zink stated that she and CCSM 2 met with Child C and D's Mother on Tuesday, February 28, 2023, to inform her to their plan moving forward. Ms. Zink stated the plan was that staff have been retrained on a number of safety and parent concerns. This training took place on Tuesday, February 28, 2023. The training included safety and parent concerns. There were concerns about staff not greeting parents, supervising children when on playgrounds and in the cafe, etc. I asked Ms. Zink to send/provide me information concerning the training that was presented to staff. On March 7, 2023, I received verification of the training topics that were discussed with staff on February 28, 2023. The topics include calling parents when there are any head/faced injures, greeting parents, providing direct supervision of children during programming, placing themselves where they can see the entrance to the rooms so they can see when individuals enter their space. Staff that were present on February 23, 2023, received this training. On March 7, 2023, I spoke with CCSM 2. She said that when Child C and D's Mother arrived to pick up Child C and Child D another staff member greeted her and gave her the incident report. Child C and D's Mother came to her directly to discuss the incident. She said Child C and D's Mother was frustrated because she did not get a phone call after Child C was injured. CCSM 2 said she informed Child C and D's Mother of the first aid she provided and that they did not see any signs his nose was broken. CCSM 2 said they sent an email later apologizing about not calling after Child C fell. Child C and D's Mother informed CCSM 2 that Child C had a broken nose. CCSM 2 said they felt bad that Child C had been so seriously injured and that they would ensure to call in the future if there were any other serious injuries. CCSM 2 stated other children were hurt that day. Child E (female, age 9) fell and hit her head on the ice. Child E's Mother arrived to pick up Child E right after it happened. And Child F (female, age 5) slipped and received a cut on her cheek. She said that she did not follow up on the children that were injured during the rest of the day. I asked CCSM 2 if there was a policy for head injuries. CCSM 2 they are aware now that the policy says parents should be called if there are any injuries to the head. On March 7, 2023, I spoke with CCSM 3. CCSM 3 stated the policy of any injury is to go to the supervisor for them to assess next steps. If needed an "ouch report" will be filled out. I asked CCSM 3 what to do if either CCSM 2 or Ms. Zink are gone who would they ask then. He responded they are "usually always there." He stated that all staff were re-trained on policies and emergency procedures. I mentioned that when I was at the center on March 6, neither Ms. Zink nor CCSM 2 were present. I asked who is in charge when they are gone. H

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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 February 22, 2022, 1 spoke with Child A's Mother on the telephone. She stated that on February 17, 2022, she received an email from Child A's teacher, Jennifer Baker, informing her that Child A had been injured and that the school was trying to reach her. She also received a phone call from the school office letting her know that Child A had been injured during before school care and would need medical attention. Child A's Mother said she arrived at the school at 8:30am and Child A was with the office personnel. She took Child A to receive medical attention and he was diagnosed with a broken nose. He has an appointment to see and ear, nose, and throat specialist on February 24, 2022, to see if he needs surgery. Child A's Mother had no concerns with how staff handled the incident and how quickly they contacted her. She was concerned because she received three different accounts of what happened to Child A and does not know how he was 2 injured. She said that Child A's Father is "very upset" about the incident and injury. I let her know that he could call me if he had more information to share. At the time of writing this report, I have not received a phone call from him. Child A's Mother said she received an incident report from the before school staff and a follow up email from the before school program director, Jill Zink. The information contained in those communications is not the same. She said that Child A told her Child B sat on top of him on purpose. I requested that she send me a photograph of the incident report via text and to forward me the email she received from Ms. Zink. She said that she also had a photograph of Child A after his injury. I requested she send that to me as well. Child A's Mother sent all the requested information after our phone call ended. The incident report Child A's Mother received from the before school staff is dated February 17, 2022, and states the incident happened at 8:25am. It states, "[Child A] was playing capture the flag in the gym when he collided with another student and hit his nose on the floor." The email sent to Child A's Mother from Jill Zink states, "I wanted to follow up with you about the incident the (sic) occurred today in the gym at before school care. [Child A] was playing capture the flag and he was diving to get back to his side when another person fell on top of him causing his nose to hit the floor. We immediately applied pressure to his nose as it was starting to bleed and then we also applied some ice. This was when you were called as it was starting to bruise already." The photographs of Child A show small red marks near the bridge and tip of his nose. His nose appears to be swollen and bruised. The photographs and copies of the incident report and email are filed with this report. On March 1, 2022, I made an on-site inspection to the school. I spoke with program director, Jill Zink and site supervisor, Kylie Fisher. Ms. Zink stated that on February 17, 2022, she was in the gymnasium when the incident occurred. The time of the incident was at 8:25am. The children were playing capture the flag and she saw Child A diving back along the floor to his side of the gym. Child B was near Child A. Ms. Zink does not know if Child A hit Child B's feet or if Child B lost her balance but Child B fell backwards and landed on Child B's head. Ms. Zink said that it was a "100% accident." Child B immediately said, "I didn't mean to.." and was remorseful that Child A had been injured. Ms. Zink stated that there are not behavior concerns with either Child A or Child B. She confirmed that Child A is a small for his age and that Child B is a fourth grader. Ms. Zink said that after first aid had been applied, she attempted to call Child A's Mother but she did not answer the calls. Ms. Zink said she walked Child A to his classroom and let Child A's Teacher know that he had been injured and she could not reach his mother. She said that Child A's Teacher said she would email his mothe

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R 400.8112(1) · R 400.8112(1) 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: (a) A licensee. (b) A licensee designee. (c) A child care staff member. (d) A child care aide. (e) An unsupervised volunteer.

On February 22, 2022, I spoke with Child A's Mother on the telephone. She said that she picked up Child A from the school office at 8:30am. She did not know the names of the staff in the office. On March 1, 2022, Ms. Zink said she took Child A to the office to wait for his mother at approximately 8:40am. She said that she left him with Amy Hoekstra and Audrey Straub, who are secretaries for the school. The before school program dismisses at 8:35am and staff leave around 8:40am. Ms. Zink said that she left the school at 8:50am and that the office personnel told her that Child A's Mother was on her way to pick him up. Kylie Fisher said that they dismiss children from the before school care program between 8:35-8:40am. On March 3, 2022, I spoke with office personnel at Georgetown Elementary School. Ms. Staube confirmed that Child A was left in the office at 8:40am on February 17, 2022, and that Ms. Hoekstra was in the office with her that day. She said that school sign in/out sheets document that Child A's Mother picked him up at 9:20am on that day. On March 3, 2022, I reviewed the Child Care Background Check system. Ms. Hoekstra has been found eligible in the system.

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R 400.8125(1) · R 400.8125(1) Staff; volunteer; requirements. (1) All staff and volunteers shall provide appropriate care and supervision of children at all times.

On February 1, 2021 1 made an unannounced on-site inspection at the child care center. During my on-site inspection I observed arrival, snack, and free time, and dismissal. There were two staff and 33 children in care. I spoke with multi-site director, Jill Zink and child care staff membeWr. Ry,an McIntosh. When I explained the allegation, Ms. Zink stated that Child A ages) has pushed, kicked, and hit other children. The child has been in the program for years and these behaviors have recently escalated. Child A's Parents are also seeing similar behaviors at home. Ms. Zink stated that some parents and staff have raised concerns about behaviors exhibited by Child A. Ms. Zink stated she has been able to pinpoint some triggers and has been able to redirect Child A `most times." They have recently started removing children from the room if Child A starts having an outburst and throwing toys. Ms. Zink stated that she has spoken with Carrie Ondersma who is the assistant director of the Hudsonville Early Childhood Program. They have created a to help reduce and redirect behaviors. This has been implements s. Zink provided me a copy of the and child information cards for the children whose parents have raised concerns. Child care staff member, Ryan McIntosh stated he n working regularly at this site in , prior to that he was a in the district. He has observe i d A eiling or will "lightly ap or is children. There was an incident in when Child A "sat in a corner and yelled for an hour.' Children have stated they are `afraid" of Child A. He stated that they "need to have three staff' to be able to support all the children in care. During my time observing the program. Child A did not exhibit any hitting, kicking, or yelling behaviors. Staff provided appropriate care and supervision. On February 2, 2021 1 spoke with child care staff member, Linda DeYoung on the telephone. She stated that she feels appropriate care and supervision are jeopardized by the behaviors exhibited by Child A. has hurt children and disrupted programming. There was an incident in where Child A "body slammed Child D and gave black eye. S. a Dung stated there was another incident on . She and child care staff member, Julia Legno were providing care to children. While children were playing, Child A knocked over children's toys, knocked children off benches and pushed tables toward children. This happened again at the end of , Ms. Zink was not at the site and Ms. Legno had to call Ms. Zink to have her come help. Ms. DeYoung stated that Ms. Ondersma has spoken with the before and after staff about Child A's behavior and let them know they are 'working on it." There is a in place and has been in effect "for a .° The includes suggestions to try and strategies to use when Child s behaviors esca ate. She stated that the strategies "sometimes work." Sometimes when they try to talk to Child A, iC] screams and runs away." She stated that Ms. Zink is there during the and is the third person on-site. On February 5, 2021 1 spoke with staff member, Julia Legno on the telephone. She stated she has been working at Georgetown since . She stated that Child A can be "disruptive". She has seen l§ scream, yell, push children, throw toys, and rip up papers. There was an inc ent in where she and Ms. DeYoung were in the cafeteria with the children. Child A was knocking things off the tables and "shoved" a table where two children were playing. She had to call Ms. Zink, who was at another facility. Ms. Zink came to offer support. They have been trying the and it is "hit or miss." Ms. Legno stated she does not feel trained or experienced enough to handle the behaviors Child A is exhibiting. On February 8, 2021 1 spoke with Child B and C's Father and Mother on the telephone. Child B and C's Father stated that when asked, Child B and C stated Child A will "pick on kids." Child B and C's Father stated that Child C age years) stated Child A is loud, will take toys, and push tables around. Child B

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