Heidi Luokkanen

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

On 3/26/2021 the department received a complaint stating that Child A was not being properly cleaned after diaper changes. It stated that he would arrive to preschool in the afternoon with a soiled diaper and dried feces on him. On 03/30/2021 I spoke to Child A's Mother by phone. She stated that her son goes to Ms. Luokkanen in the mornings and then is transported by bus to an early childhood special education class in the afternoon. Child A's Mother stated that Child A has issues with bowel movements. She stated that his doctor has suggested giving him Miralax when he has gone more than a few days without having a bowel movement. Child A's Mother identified that she drops Child A off at Ms. Luokkanen's home around 7:30 am and the bus picks up from her home around 11:45 am to bring him to school. The staff at the school have mentioned that Child A will occasionally come to school with dried feces on him right around his anus. She identified that school staff check his diaper when he arrives. She stated that she picks him up from 2 school around 3:00pm and he is always clean. Child A's Mother stated she is not concerned about Child A not being changed with wet diapers but is more concerned about not being properly cleaned following soiled diapers. On 03/30/2021 I completed an unannounced onsite inspection at Ms. Luokkanen's home. Ms. Luokkanen confirmed that she cares for Child A. She stated that Child A has issues going to the bathroom and still wears a diaper. She identified that Child A's Mother will give him Miralax on occasion to help with his constipation. Ms. Luokkanen stated that Child A gets picked up by the school bus at 11:45 am and is brought to school for the rest of the day. She stated her normal schedule for Child A is to put him on the potty chair at around 11:00 am. She stated he sits there for around 15 minutes where he will occasionally urinate. He has never had a bowel movement while sitting on the potty chair while at her home. She stated that Child A does not have much control over his bowel movements and will often push but not be able to go. She stated that once she gets Child A off the potty chair, she wipes him and puts a new pullup on him. She stated she feeds Child A lunch and then puts him on the bus. She identified she needed to start this early in the morning because Child A is a slow eater and she wanted to ensure he ate enough lunch before leaving for school. Ms. Luokkanen uses the Bright Wheel application to keep track of diaper changes. She provided me with Child A's records of diaper changes for 05/22/2021-05/30/2021. These records showed adequate diaper changes for Child A. She identified that Child A's Mother has access to the information on the Bright Wheel application, but she is unsure if she checks it. I spoke to Ms. Luokkanen's child care staff member Kathryn Mezzola. She stated she changes Child A's diaper and always wipes and cleans him when needed. She has never noticed any issues with Child A not being clean. She has stated that occasionally Child A will arrive to child care with a saturated diaper. On 03/31/2021 I spoke to Kelly Bagley who works at Jenison's Early Childhood Building. She stated she is there when Child A arrives to care at around 12:15 pm. She stated that he shows up daily with a wet diaper. She stated that it also appears that Child A will have had a bowel movement but was not wiped properly. She denied that he has ever shown up with a bowel movement in his diaper. On 04/30/2021 I spoke to Kelly Bagley by phone. She stated that Child A no longer attends Ms. Luokkanen's child care. She identified that Child A is in his grandmother's care prior to school. She identified that Child A still arrives to school with a wet diaper. She stated there are still times that it appears Child A had a bowel movement but was not properly cleaned. She stated that Child A has issues with bowel movements, and it is possible he's pushing while on the bus but unable to go. 3

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