The Learning Experience at Jenison

R 400.8335(8)(a) · R 400.8335(8)(a) Food services and nutrition; provided by center (a) Containers must be labeled with the date opened.

Opened milk containers were not labeled with the date container was opened.

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R 400.8201(2)(f) · R 400.8201(2)(f) Comprehensive background check; fingerprinting. 2 LANDMARK BUILDING • 105 W. ALLEGAN STREET • LANSING, MICHIGAN 48933 Michigan.gov/MiLEAP (f) Immediately disconnect each individual within the department’s child care background check system once the individual is no longer a licensee, licensee designee, child care staff member, or an unsupervised volunteer under the license.

There were seven individuals connected to the center in the child care background check system who were no longer employed at the time of the inspection.

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R 400.8213(1)(a) · R 400.8213(1)(a) Staff; volunteer (a) Provide appropriate care and supervision of children at all times.

A teacher picked a child up from the ground by one arm and lifted him upward by the arm.

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R 400.8251(2)(b) · R 400.8251(2)(b) Handwashing 3 LANDMARK BUILDING • 105 W. ALLEGAN STREET • LANSING, MICHIGAN 48933 Michigan.gov/MiLEAP (b) After toileting or diapering.

Program staff in four classrooms did not wash the child's hands after changing their diaper.

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R 400.8254(1)(b) · R 400.8254(1)(b) Diapering; toileting (b) Is within close proximity to a sink that is used exclusively for hand washing.

After changing an infant's diaper, a teacher washed her hands in the food preparation sink.

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R 400.8260(2) · R 400.8260(2) Medication; administrative procedures (2) Program staff shall give or apply medication, prescription or nonprescription, only with prior written permission from a parent. 4 LANDMARK BUILDING • 105 W. ALLEGAN STREET • LANSING, MICHIGAN 48933 Michigan.gov/MiLEAP

There were two medications in classrooms without written parental permission on file.

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R 400.8112(1) · R 400.8112(1) Children's records. (1) At the time of a child's initial attendance, a center shall obtain a child information card, using a form provided by the department or a comparable substitute, that is completed, signed and dated by the child's parent and 5 LANDMARK BUILDING • 105 W. ALLEGAN STREET • LANSING, MICHIGAN 48933 Michigan.gov/MiLEAP updated as changes occur. The center shall keep current hard copies of the child information cards at the center. 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 400.8134(18)(a) · R 400.8134(18)(a) Sleeping Equipment. (18) All occupied cribs, portable cribs, cots, and mats must be placed in such a manner that there is a free and direct means of egress and must be spaced as follows: (a) Cribs and portable cribs must be not less than 2 feet apart when occupied. Cribs or portable cribs with solid- panel ends may be placed end-to-end. 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(3)(c) · R 400.8269(3)(c) Emergency preparedness and response planning procedures (3) A hard copy of the plans must be posted as indicated below: (c)The plan required by subrule (1)(i) of this rule must be maintained in a place known and easily accessible to staff and volunteers. Bureau

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R 400.8113(2)(b) · R 400.8113(2)(b) Program director qualifications; responsibilities. At least 50% of the time children are in care but not less than a total of 6 hours per day for programs operating 6 or more continuous hours.

The substitute program director, CCSM1, was present at the facility for more than that required 50% of the operating hours, not less than 6 hours. She was present at the facility from 6:30am to 3:30pm, nine hours per day.

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R 400.8113(5) · R 400.8113(5) Program director qualifications; responsibilities. A substitute program director shall be appointed for a program director who has left employment or has a temporary absence that exceeds 30 consecutive workdays until return or replacement. A substitute program director shall at least meet the qualifications of lead caregiver. The department shall be notified when a substitute program director is appointed.

Sierra Zaban, licensee designee, designated CCSM 1 as the substitute program director during the transition between qualified program directors.

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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 01/26/2023, 1 spoke with face to face. stated that she spoke with Child A's Father by telephone on 01/2 23. Child s Father told her the following information. Child A came home from his second day at the center on 01104/2023 with bloody marks on the knuckles of his hands. Child A's Father took photos of the marks. On 01105/2023, Child A's Father asked the staff members if they knew what happened to Child A's knuckles when he dropped Child A off for care. No one had an explanation for the injuries to Child A's knuckles. Child A did not attend on 01/06/2023 because he was sick. Child A 2 returned to care on 01/09/2023. Child A's Father noticed when he picked Child A up on 01/09/2023 that the marks on Child A's knuckles were worse, much deeper, than the week before. Child A's Father asked the staff members what happened to Child A's knuckles. Again, no one had an explanation for the worsening of Child A's injuries. On 01/10/2023, Child A's Father picked Child A up from the center and took him home. Child A's Father noticed a bleeding scratch above Child while changing his . Child A's Father took a photo of the scAra'tsc"h.. rn 01/11/2023, Chfld A's Father went to the center and spoke to program director Genevieve DeHart about his concerns and showed her the photos. Ms. DeHart apologized to Child A's Father and told him that she would look into the matter. stated that she completed a visit at Child A's home 01/23/2023. Child 'Rat owed her the marks on Child A's hands. She observed some discoloration on the front knuckles of both of Child A's hands, but the marks were faint and would not show up in a photo. Child A's Father told her that the discoloration is where the marks were at on Child A's hands on 01/04/2023 and 01/09/2023 after he was picked up from the center. Child A's Father told her that the marks were not present at drop off on either day but were present at pick up on both days. observed a faint scratch on Child A's , but the mark was so faint it did not show up in a photo. Child A's Mother stated that the scratch was longer and bleeding the day it occurred. Child A's Father and Child A's Mother denied Child A sustained the injuries to his knuckles or the injury to at home. On 01/26/2023, I completed an on-site inspection with . We interviewed program director Genevieve DeHart, CCSM 1, and CCSM 2. Ms. DeHart stated that Child A's Father notified her of the marks on Child A's hands. She stated that CCSM 1, CCSM 2 (break relief only), and CCSM 3 were the child care staff members in the infant classroom on the days Child A attended. CCSM 1 and CCSM 3 denied knowing how Child A sustained the injuries when she asked them about it. Ms. DeHart expressed frustration about CCSM 1 and CCSM 3 not knowing how Child A got injured. She told CCSM 3, the lead caregiver, that she needed to be more aware of what is happening in the classroom. She also told CCSM 3 that she and CCSM 1 need to keep a closer eye on Child A. Ms. DeHart reported that CCSM 3 is no longer employed at the center due to unrelated matters. Ms. DeHart stated that Child A's Father contacted her on 01/10/2023 to inquire about a scratch near Child A's . She asked CCSM 1 and CCSM 3 about the scratch on Child A. Neither one of them knew how Child A sustained the scratch. She reminded them both about the importance of completing incident reports for all injuries. She held a staff meeting on 01/25/2023 to review the importance of completing incident reports with all staff members. CCSM 1 identified herself as the assistant child care staff member in Child A's classroom. She stated that she saw marks on Child A's knuckles on the afternoon of 01/06/2023. She did not work in Child A's classroom until that afternoon. She stated 3 that CCSM 3 was the only staff member who worked in Child A's classroom on that day. She asked CCSM 3 about the marks. CCSM 3 told her that she did not know what happened to Child A's knuckles. CCSM 1 stated that she was surprised that CCSM 3 did

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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 10/27/2022, I interviewed Child A's Mother by telephone. Child A's Mother stated that Child A (11-month-old, male) has come home with horrible diaper rashes that blistered and peeled and turned into a yeast infection at least once. She started to provide diapers for Child A because she initially thought he was having an allergic reaction to the center's diapers. Very few diaper changes were being recorded in the app used by center staff to document diaper changes. Staff told her that Child A's diapers were changed more frequently than what was recorded on the app, that staff just forgot to document each diaper change in the app. On 10/27/2022, I completed an on-site inspection. I interviewed licensee designee/program director Mollie Blixt, program director Tiffany Henley, and Child Care Staff Member 1 (CCSM 1), Child Care Staff Member 2 (CCSM 2), and Child Care Staff Member 3 (CCSM 3). Program director Tiffany Henley stated identified Child Care Staff Member 4 (CCSM 4), Child Care Staff Member 5 (CCSM 5), CCSM 3, and program director Genevieve DeHart as staff who have recently worked in the infant classroom. Ms. Henley took me to the Infant B classroom to show me the diapering area. Diapering procedures were posted near the changing area. A diapering schedule for each child was written on a whiteboard in the classroom. Ms. Henley stated that the children get their diaper checked/changed at least every two hours, or more often if needed. Ms. Henley explained that after a diaper is checked/changed that staff record the time for the next diaper check/change for each child on the whiteboard. Ms. Blixt stated that she has no knowledge of diapers not being changed frequently enough in the infant classroom. CCSM 1 stated that she mostly works in the toddler classroom, but she has worked in the Infant B classroom as well. She does not believe the allegation to be true. She reported that diapers are checked every two hours, when the children wake up from a nap, before the children go outside, and again at 4pm. Soiled diapers are promptly changed by staff regardless of the diapering schedule. Staff recheck diapers that are dry approximately every 30 minutes. Staff check the diapers of children with a diaper rash appropriately every hour and apply diaper cream if provided by the parents. She has no knowledge of any parent concerns regarding diapering. She has no concerns with any of her coworkers following appropriate diapering procedures. She stated that staff do their best to record diaper changes in the app, but caring for the children is their first priority. CCSM 2 stated that appropriate diaper procedures are being followed and diapers are getting changed as frequent as necessary. However, it is possible that not all 3 diaper changes are being recorded in the app because caring for the children is a bigger priority. She acknowledged that Child A had a bad diaper rash. She stated that she checked Child A's diaper every hour when he had a bad rash. CCSM 3 stated that she does not agree with the allegation. She and other staff members check diapers every two hours and every hour if a child has a diaper rash. She stated that diapers are checked before each child's scheduled pick up time. She acknowledged that Child A had a bad rash when he was on an antibiotic. She and other staff members checked Child A's diaper every hour and applied ointment at the request of Child A's Father. On 05/11/2023, I interviewed Child B's Mother and Child C's Mother by telephone. Child B's Mother stated that she is at the center quite a bit of the time. In fact, she often jokes with staff about them giving her a job. Child B (1-year-old, male) currently attends the center. She has never had an issue with Child B coming home in a soiled diaper or with a diaper rash. Child C's Mother stated that her child has never been picked up in a soiled diaper or with a diaper rash.

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R 400.8340 · R 400.8340 Food services and nutrition; provided by parents. ................................................. (9) Beverages and food must be fed only to the child for whom the item is labeled.

On 10/27/2022, Child A's Mother stated that the wrong bottles have been sent home on multiple occasions, so she wonders if Child A was fed someone else's bottles. Additionally, Child A's bottles have been sent home with other children. She denied staff ever telling her that Child A was fed the wrong bottle, or his bottle was fed to another child. On 10/27/2022, I completed an on-site inspection. I interviewed licensee designee/program director Mollie Blixt, program director Tiffany Henley, and CCSM 1, CCSM 2, and CCSM 3. Ms. Blixt stated that she had no knowledge of any child being fed the wrong bottle. Ms. Henley stated that she had no knowledge of any child being fed the wrong bottle. However, she knew about another child's empty bottles being accidentally sent home with Child A. CCSM 1 stated that she had no knowledge of any child being fed the wrong bottle or the wrong bottles being sent home with a child. CCSM 2 stated that the children like to grab at other children's bottles, so she will either put a child in a highchair with their bottle or sit next to a child while they drink their bottle. Parents have mentioned that the wrong bottle was sent home, but she denied any knowledge of any child being fed the wrong bottle. CCSM 3 stated that she had no knowledge of any child being fed the wrong bottle. She knew that the wrong bottles were sent home with Child D (1-year-old, male), but there was never a concern that Child D was fed the wrong bottle. On 05/11/2023, I interviewed Child B's Mother and Child C's Mother by telephone. They stated they have no knowledge of any child being fed the wrong bottle.

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R 400.8134 · R 400.8134 Hand washing. (2) All staff and volunteers shall wash their hands at all of the following times: (a) Prior to starting the workday at the center. (b) Prior to care of children. (c) Before preparing and serving food and feeding children. (d) Before giving medication. (e) After each diapering. (f) After using the toilet or helping a child use the toilet. (g) After handling bodily fluids. (h) After handling animals and pets and cleaning cages. (i) After handling garbage. (j) When soiled. G

On 10/27/2022, Child A's Mother stated that she has not worked a full week of work since Child A began attending the center in August. Child A has had four communicable diseases and infections since attending the center. She stated that a former staff member told her that she quit working for the center when she was asked to work when she actively had a communicable disease. She has concerns with the cleanliness of the facility and wonders if proper handwashing guidelines are being followed. She saw dried food on the seat belts of two highchairs in the Infant B classroom. 5 On 10/27/2022, I completed an on-site inspection. I interviewed licensee designee/program director Mollie Blixt, program director Tiffany Henley, CCSM 1, CCSM 2, and CCSM 3. Ms. Blixt stated that a professional cleaning company routinely deep cleans the center and staff routinely clean their classrooms, equipment, and toys. She stated that all staff have been trained on proper cleaning and sanitizing procedures as well as proper handwashing procedures for staff and children. Ms. Blixt has no concern with the cleanliness of the facility or with staff following proper handwashing procedures. She stated that the center takes all the precautions to minimize the spread of illnesses, but, unfortunately, child illnesses cannot be completely avoided, especially in a child care setting. She had no knowledge of a staff member being asked to work when they had a communicable disease. Ms. Henley stated that she does not agree with the allegations. She stated that sometimes on Monday mornings there may be some dried food on the highchair straps from the previous Friday, but staff clean the straps upon arrival. She routinely reminds staff to be sure they are following proper handwashing guidelines. She has no concerns with the cleanliness of the center of with staff following proper handwashing guidelines. She believes that the center is appropriately cleaned and sanitized on a regular basis by staff and a professional cleaning company. She had no knowledge of a staff member being asked to work when they had a communicable disease. CCSM 1 stated that every surface in each of the classrooms are cleaned and sanitized using a 3-step process with soapy water, clean water rinse, and a sanitizing agent at rest time and again at the end of the day. She stated that each classroom has a cleaning and sanitizing chart they are required to follow. Additionally, mouthed toys are routinely placed in a bin to be cleaned and sanitized and soft toys are regularly laundered. Children wash their hands upon arrival, before and after they eat, after each diaper change, and after playing outside. Likewise, staff wash their hands upon arrival, before and after feeding a child, after diapering a child, after using the restroom, and after taking the children outside. She believes that staff routinely clean and sanitize as required. She had no knowledge of a staff member being asked to work when they had a communicable disease. CCSM 2 stated that she cleans and sanitizes the highchairs before and after use, including the straps. Additionally, the rest of the classroom is cleaned and sanitized on a regular basis. She noted that the children frequently try to take each other's pacifiers, but when this occurs, she washes the pacifier with hot soapy water. She stated that parents have recently been notified of possible exposure to pink eye, colds, Respiratory Syncytial Virus (RSV), and hand-foot-mouth disease. She washes her hands upon arrival, after touching mouthed toys, after each diaper change, before and after feeding, after wiping a runny nose, after using the restroom, and after taking the children outside. The children wash their hands upon arrival, before and after eating, after diapering, and after outside play. She had no knowledge of a staff member being asked to work when they had a communicable disease. .1... .1 _ • before • - • - r r f- •' •` - b • rope • • f f l f it • : ' ' IlS ASI A

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R 400.8134 · R 400.8134 j Hand washing. (3) Staff and volunteers shall ensure that children wash their hands at all of the following times: (a) Before meals, snacks, or food preparation experiences. (b) After toileting or diapering. (c) After handling animals and pets. (d) When soiled.

Based on staff interviews, children wash their hands as required by the rule.

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R 400.8380 · R 400.8380 1 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.

Based on staff interviews, parent interviews, and an on-site inspection, the center is maintained in a clean and safe condition and does not pose a threat to health or safety.

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