R 400.8161(1)(e) · R 400.8161(1)(e) Emergency procedures. Crisis management including, but not limited to, intruders, active shooters, bomb threats, and other man-made 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.

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

R 400.8143(1) · R 400.8143(1) Children's records. 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 and signed by the child's parent. The center shall keep it on file and accessible in the center. Bureau

Open Not marked corrected in the state record

Category: recordkeeping. 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.

On June 21, 2023, I completed an unannounced onsite inspection and interviewed child care staff member (CCSM) 1, CCSM 2, and CCSM 3. CCSM 1 reported that the program director, Samantha Michael, is on vacation this week. CCSM 1 recently became aware of the issues with Child A, but she has not witnessed any of the incidents. She believes CCSM 3 spoke with Child A's mother regarding the incidents. CCSM 1 said they have had Child A in care since he was an infant and just recently started having some behavior issues. The issues mostly include being rough with other children and knocking stuff down in the classroom. There is no history of inappropriate contact with other children. CCSM 1 reported she is unsure which staff members saw these reported incidents, but they all occurred on the playground in the afternoon after she had left for the day. Since these incidents, they have ensured that Child A is shadowed by a lead caregiver at all times. They have setup a conference with Child A's parents for when Samantha Michael returns. CCSM 2 reported that she has had concerns with Child A recently because he appears to be acting out for attention. She has pulled Child A aside and tried talking with him about good choices, but she does not work full time and is not the main person who provides his care. CCSM 2 reported that CCSM 3 and CCSM 4 are Child A's main caregivers, but since these incidents CCSM 1 and CCSM 3 have been splitting their time providing him direct supervision. CCSM 2 has not witnessed any of these incidents. CCSM 3 reported he has not observed the incidents, but they have been reported to him by staff because he is the lead onsite in the afternoons. He said the first incident happened in late May. Child A took Child B out behind the pirate ship on the playground, they were fully clothed, and an aid came around the pirate ship and saw Child A pushing Child B's head down towards his private parts and was doing a thrusting motion. CCSM 3 reported it to the director and talked with Child A's mother and Child B's father. CCSM 3 said about a week later Child A pulled Child C's pants and underwear down in front of all the staff and children on the playground. He is not positive if parents were informed of this incident. CCSM 3 said the most recent incident happened a few days ago. CCSM 3 was notified when Child D's mother sent 3 him a message through their communication application, Brightwheel. Child D's mother told him that Child A would not stop grabbing Child D's bottom when they there on the playground. He asked him to stop, and he would not. Child D told his mother that staff members could see it happening on the playground and did nothing to stop it. CCSM 3 reported he is the only lead caregiver after 4:00pm and there are only aides on the playground in the afternoon. Samantha Michael's used to stay until close a few days a week, but she is always gone by 4:00pm now. CCSM 3 said Child A now has a lead caregiver dedicated to shadowing him since these incidents started. On July 10, 2023, I made telephone contact with Samantha Michael. She reported that a meeting did take place with Child A's mother and father on June 26, 2023. They were given a new policy laying out steps that will be taken to address "child direction" issues. The parents reported Child A has started counseling and they are receptive to working with the facility to address his behavior. Since the meeting and having Child A shadowed, they have had no further incidents. Samantha Michael reported that she was informed of all the incidents and either herself or CCSM 3 talked with the parents when they happened. She reported Child A has not had issues like this previously, but he has had minor issues of hitting or acting out, trying to make the other children laugh. Samantha Michael's agreed to email me the new child direction policy and provide phone numbers for the aids that work on the playground in the afternoon. On July 14, 2023, Samantha Michael emailed

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. 4

I received an anonymous complaint stating that Child Care Staff Member (CCSM) 1 would lay on Child A during nap time if he was not laying still. Child A could be heard saying "I can't breathe, you're choking me." CCSM 1 would say, "no I'm not. You're fine." I conducted an unannounced onsite inspection on 03/27/2023, and interviewed Program Director Samantha Michaels, CCSM 2 and CCSM3. When I explained the allegations to Ms. Michaels, she had never heard any concerns with CCSM 1, or any reports of CCSM 1 laying on children to keep them still at nap time. CCSM 1 was not present at the child care center and was out on an extended leave of absence for personal reasons. I asked Ms. Michaels what the normal nap time routines were, and she explained that staff will put up curtains, play nap time music and pat the children's backs. All preschool children that nap are in the music room with staff. If children do not want to nap, they are able to get a book. Ms. Michaels provided me with the discipline policy for review and explained that staff are to encourage children to solve problems and help them to solve the issues themselves when having conflicts. At no time should staff restrain a child, and if a child is to that point herself or the assistant director would intervene. CCSM 2 regularly works in the preschool nap room with CCSM 1 and reported that she has seen her lay over Child A to get him to lay still and has heard her say, 'if you don't lay still, I am going to put my leg on top of you." CCSM 2 could not be certain if CCSM 1 had body weight on Child A, or if Child A was injured. CCSM 2 was not aware of any staff or parents bringing concerns to Ms. Michael adding that she did not say anything to CCSM 1 when she witnessed this. I asked CCSM 2 if it is normal practice to lay on a child or place a leg on them to get them to lay still at nap. She replied that it is not their normal practice and staff should go around patting backs if children want it. CCSM 3 reported that she has no concerns with CCSM 1 and had never witnessed her lay on Child A or put a leg on Child A. However, she stated that CCSM 1's words will get "harsh" when it comes to Child A. CCSM 3 also had not witnessed Child A say that he was not able to breathe, adding that Child A and some other children do not regularly nap, but will rest quietly. CCSM 4 also worked in the nap room with CCSM 1, however she no longer worked at the center at the time of the inspection. She was not able to be reached by the completion of the investigation. On 03/27/2023, I interviewed Child A's Father who reported that he had not heard anything concerning from Child A, but he would have Child A's Mother speak to him 3 that evening regarding nap time and any staff members laying on him. I received an email from Child A's Father the following day 03/28/2023, in which Child A's Mother had spoken with Child A, and Child A reported that CCSM 1 "lays over him at nap" and "it hurts." Child A's Father gave me permission to interview Child A. On 04/12/2023, I interviewed Child A, 4.5 years old. Child A was able to be interviewed and answered all questions. He reported that CCSM 1 "is not nice" and she will pat my back and then "lays on me and it hurts my body." Child A reported that CCSM 1 will lay over him with her arm on his belly and with her leg on his belly. He stated that no other staff have done this, and he did not tell any teachers that CCSM 1 was "hurting him," adding that he tells her to "stop, but she doesn't stop." While onsite, I spoke with Ms. Michaels and interviewed CCSM 1. Ms. Michaels reported that since CCSM 1 returned to work, she was no longer working with Child A. I informed Ms. Michaels that Child A reported that CCSM 1 had laid on him at nap time. I interviewed CCSM 1 and informed her of the allegations. She said that she "doesn't really lay on him" but that she does put her arm over him, and he will then arch his back up touching her arm with his back or chest. As soon

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

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

Positive methods of discipline were not used when child care staff members witnessed CCSM 1 "laying on" Child A to get him to lay still, and telling Child A she was going to put her leg on him.

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.

R 400.8140 · R 400.8140 Discipline. ......................... .... (2) Non-severe and developmentally appropriate discipline or restraint may be used when reasonably necessary, based on a child's development, to prevent a child from harming himself or herself or to prevent a child from harming other persons or property, excluding those forms of punishment prohibited by subrule (2) of this rule.

Developmentally appropriate discipline or restraint was not used when CCSM 1 was "laying on" Child A to get him to lay still.

Open Not marked corrected in the state record

Open / not marked corrected.

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

On 03/14/2023, I had a telephone interview with Child A's Mother. She reported that Child A, age 2.5 is enrolled in the transitional preschool room and did not regularly have his pull up changed when soiled. Child A's Mother stated that since Child A had moved from the toddler room to the 3- and 4-year-old preschool space upstairs, she has not received communication regarding Child A's toilet training or diapering. Child A's Mother spoke with child care staff members regarding her concern that she was picking up Child A with very wet pull ups that were not being changed. Child A's Mother said that she had spoken with Child B's Mother in the transitional preschool room who reported having similar issues with Child B's diaper not being changed when soiled. On 03/27/2023, I conducted an unannounced onsite inspection and interviewed Program Director Samantha Michael and Child Care Staff Member (CCSM) 1. Ms. Michael was aware of an incident with diapering in the transitional preschool room. She reported that Child B's Mother arrived to the center and Child Care Staff Members witnessed Child B waddling and his diaper "exploded" because it was so full of urine. Ms. Michael reported that Child Care Staff Member 2, the lead transitional preschool teacher at that time, stated she was not aware that she was supposed to be changing diapers or pull ups. CCSM 2 no longer worked at the center and CCSM 1 had since began working as the transitional preschool lead teacher. Ms. Michael explained the diapering policies stating that staff members take transitional preschool children to the restroom every two hours for a pull up or diaper change, and for those actively toilet training, every 30-45 minutes. All accidents, dry diapers and pullups, and toileting is logged in brightwheel. I interviewed Child Care Staff Member 1 who reported that she had been the Transitional Preschool teacher for about two weeks since CCSM 2 left. CCSM 1 explained that she has a list of all the transitional preschool children with their toileting needs including nap time diapering, how often the children sit on the toilet and how often they need to be changed. Also, she sets an alarm on her phone for the children as well to ensure they all get to the toilet to be successful. She reported that she is not aware of any parents having an issue with soiled diapers. During the onsite inspection, I observed CCSM 1 complete toileting for four transitional preschoolers, and all immediately tracked in brightwheel for parent communication. I also reviewed the posted diapering policy in the restroom. On 4/3/2023, I received a copy of the transitional preschool children's brightwheel records from the week of 2/27/2023 and 3/13/2023. Upon reviewing the daily sheets, there were several days children's pull ups were not checked every two hours. Child C's pull up changes on 2/27/2023 were logged at 9:43am, 12:02pm, 2:00pm and 4:20pm. Child D had toilet times or diapering logged at 9:45am, 1:00pm and 4:10pm. On 03/15/2023, three of the six children in care only had one toilet entry, two children 3 only had two entries and one child had three entries. I explained to Ms. Michael that while Rule 400.8146(3) only requires a daily record for infants and toddlers, if staff were going to use the brightwheel app to log transitional preschool toileting and pull up changes, they should use it consistently or not use it at all as it may be confusing for parents to interpret. On 04/10/2023, I interviewed Child B's Mother, Child C's Mother and Child D's Mother. Child B's Mother reported that she arrived one day to pick up Child B and found him with a diaper that was so saturated with urine, it was coming apart. Child B's Mother felt that since the incident and since CCSM 2 has left the center there has not been an issue adding that CCSM 1 is "great" with diapering and communicating any toilet learning. Child C's Mother reported that a while ago, she felt that the brightwheel app was not consistent a

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

R 400.8137 · 1 R 400.8137 Diapering; toileting. (10) Toilet learning or training must be planned cooperatively between the child's regular caregivers and the child's parent so the toilet routine established is consistent between the center and the child's home.

On 03/14/2023, I interviewed Child A's Mother who had concerns with the toilet training and diapering that was occurring in the transitional preschool room at the child care center. Child A's Mother reported that since Child A moved from the toddler room, the toilet learning plan was not communicated to her and she was "not really aware" of what the staff were doing pertaining to toilet learning. On 03/27/2023, I conducted an unannounced onsite inspection and interviewed Program Director Samantha Michael and Child Care Staff Member 1. Ms. Michael reported that the center did not have a formal toilet learning plan, but there was a transitional preschool handbook and the staff "regularly do diapering or have children sit on the toilet." I interviewed CCSM 1 who reported she was not aware of any toilet learning plan between the center and the parents. CCSM 1 explained that since she began working in the transitional preschool room "a few weeks ago," she has worked to establish a predictable routine, and tracks all toileting to communicate home to the parents. She added that she talks with parents at pick up regarding the children's toileting progress. On 04/03/2023, Ms. Michael sent me a copy of the transitional preschool handbook which states all children would be potty trained before moving to the three and four preschool program. I explained to Ms. Michael that the handbook or the guidelines for moving into the transitional preschool program should be updated to indicate that they will do toilet training in the preschool program or children would stay in the toddler program. I added that there should also be information communicated to allow parents and the staff members to work together, and to practice the same toilet learning routines at home and at the center. Ms. Michael reported that she planned to immediately communicate information to the parents, and to develop a plan with CCSM 1 and transitional preschool parents. I interviewed Child B's Mother, Child C's Mother and Child D's Mother on 04/10/2023. All parents reported that they were not aware of how toilet learning is being completed at the child care center. Child B's Mother added that she knows that CCSM 1 has worked hard to maintain communication and consistency. In one instance, Child B was having issues using the toilet, and CCSM 1 reached out to ask what they could do between home and center to help Child B.

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

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 b) Preschoolers, I to 8 16 30 months of age until 3 years of age On 3/27/2023, I observed the maximum group size for preschool children not being honored when 22 children aged 30 months to 5 years were all present in a well-defined space. ..........

On 03/14/2023, I spoke with Child A's Mother who reported that since Child A has moved from the toddler room to the upstairs preschool space, there are more than 16 children in a well-defined space. She explained that the child care will allow children to go from room to room as they please using a bracelet system to track the number of children in a well-defined space, however the bracelets and room counts are set up for ages three and up, not two and a half years which has a different maximum group size requirement. Child A's Mother could not recall a time that she counted more than 16 children, however she felt certain that the maximum group size of 16 is not being tracked and honored for the transitional preschool children. On 03/27/2023, during the onsite inspection, I explained to Program Director Samantha Michael the allegation that the maximum group size for two-and-a-half- year-olds, was not being honored. Ms. Michael explained that there are seven total children enrolled in the transitional preschool and instead of getting to go from room to room as they please like the three- and four-year-olds, they all stay together with CCSM 1. She explained that there are not more than 16 children in a room at a time, and they even eat in their own room to keep the group size under 16. I interviewed CCSM 1 who is the transitional preschool teacher. CCSM 1 was aware of the maximum group size of 16. She stated that her group of preschoolers stay together as they move from room to room and staff ensure there are not more than 16 children in a space. During the onsite inspection I observed the children getting ready for nap time in which all of the children that take a nap go to the large gross motor room, and the children that do not nap, go to the science room. During this time, I observed 22 children ages two and a half to five years in the gross motor room for a nap. I explained to Ms. Michael that the maximum group size is required to be always honored, including nap times. I interviewed Child B's Mother, Child C's Mother and Child D's Mother who all reported that they did not have concerns with the group sizes of children at the child care center. On 04/17/2023, Program Director Samantha Michael reported that the center was no longer going to have the transitional preschool program. The center plans to keep children in the toddler room until they are potty trained and old enough to have a waiver to be in a three year old classroom.