R 400.8330(4) · R 400.8330(4) Food services and nutrition generally. A center shall ensure a child who has special dietary needs is provided with snacks and meals in accordance with the child's needs and with the instructions of the child's parent or licensed health care provider.

The center provided Child E with food that was appropriate for his individual nutritional requirements, developmental stages, and special dietary needs. Child E does not have any known food allergies.

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

R 400.8125(2) · R 400.8125(2) Staff; volunteer; requirements. All staff and volunteers shall act in a manner that is conducive to the welfare of children.

Program Director, Lead Caregiver 2, CCSM 1, CCSM 2, and CCSM 3 acted in a manner that is conducive to the welfare of children. There is no evidence they pulled out Child A’s braid.

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

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

Lead Caregiver 1, Lead Caregiver 2, and CCSM 2 provided appropriate care and supervision of Child B. There is no evidence to support that Lead Caregiver 1, Lead Caregiver 2, and CCSM 2 scratched Child B's face.

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

R 400.8125(2) · R 400.8125(2) Staff; volunteer; requirements. All staff and volunteers shall act in a manner that is conducive to the welfare of children.

Lead Caregiver 1, Lead Caregiver 2, and CCSM 2 acted in a manner that is conducive to the welfare of children. There is no evidence to support that Lead Caregiver 1, Lead Caregiver 2, and CCSM 2 scratched Child B's face.

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

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

Program Director, Lead Caregiver 2, CCSM 1, CCSM 2, and CCSM 3 provided appropriate care and supervision to Child A. There is no evidence to support that Child A's braid was pulled out by a child care staff member.

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

R 400.8179(7) · R 400.8179(7) Program. When awake, use of confining equipment for infants must be minimized, not to exceed 30 minutes at a time.

On 02/07/2025, Child B was confined to the bouncy chair from 6:06 AM to 7:01 AM.

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

R 400.8176(6) · R 400.8176(6) Sleeping equipment. Car seats, infant seats, swings, bassinets, and play yards are not approved sleeping equipment.

On 02/07/2025, Lead Caregiver 2 placed Child B in the bouncy seat when she was asleep. A bouncy seat is not approved sleeping equipment.

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

R 400.8188(11) · R 400.8188(11) Sleeping, resting, and supervision. Infants and toddlers who fall asleep in a space that is not approved for sleeping shall be moved to approved sleep equipment appropriate for their age and size.

On 02/07/2025, Child B fell asleep in Lead Caregiver 2's arms and was then placed asleep in a bouncy seat. Child B was not moved to approved sleep equipment after falling asleep.

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

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

On 02/07/2025, Lead Caregiver 2 did not provide appropriate care and supervision when she left the preschool classroom three times leaving Child A and Child B unattended.

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

R 400.8182(1) · R 400.8182(1) Ratio and group size requirements. At least 2 adults, 1 of whom is a child care staff member, shall be present at all times when at least 3 children between the ages of birth and 3 years of age are present. A second child care staff member is required when needed to comply with subrule (3) of this rule.

On 02/07/2025, there were not 2 adults, 1 of whom is a child care staff member, present at all times when at least 3 children between the ages of birth and 3 years of age were present. Lead Caregiver 2 was alone in the center with two infants and two preschool children from 6:30 AM to 7:00 AM.

Open Not marked corrected in the state record

Category: ratio. 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 5/8/2023, I completed an unannounced on-site inspection at the child care center. I informed program director Kelly Maldonado of the allegations. Ms. Maldonado said she has noticed there are times where Child Care Staff Member 1’s (CCSM 1) tone of voice changes if she is becoming tired or cranky. Ms. Maldonado has worked with CCSM 1 on her tone of voice. She described CCSM 1’s tone of voice as stern, not mean. Ms. Maldonado said she has never heard CCSM 1 raise her voice or yell at children. Ms. Maldonado has encouraged CCSM 1 to be gentler with the children. She has not had any concerns that CCSM 1 would physically harm a child. Ms. Maldonado provided an example where CCSM 1 will grab a child by the wrist to lead them instead of holding their hand. Ms. Maldonado said CCSM 1 is very conscious of her tone of voice. CCSM 1 has asked for feedback on her tone of voice and interactions with children to assure she is speaking and interacting appropriately. Ms. Maldonado recalled one instance where CCSM 1 was holding an infant in one arm while rocking the infant. CCSM 1 then reached down with her free arm to pick up another infant to place the second infant from the floor to a bouncy seat. Ms. Maldonado said she does not believe CCSM 1 handled either infant in a manner that would hurt or harm the children. Ms. Maldonado encouraged CCSM 1 to use both hands when handling infants and to handle one infant at a time just to be extra safe. Ms. Maldonado has not observed or been informed of any other instances where CCSM 1 has pulled on children. If she had any concerns that CCSM 1 had harmed a child, or was a risk of harm to children, she would not keep her as a child care staff member (CCSM). I interviewed Child Care Staff Member 2 (CCSM 2). CCSM 2 said she works in various classrooms and interacts with CCSM 1 quite often. CCSM 2 said on occasion CCSM 1 has a tone of voice that can come across as impatient. When CCSM 1 has that tone of voice she sounds more impatient than mean. CCSM 1 does not always have an impatient tone of voice and she is able to change her tone if another CCSM points out that her tone is taking a negative turn. A CCSM might point out a child’s specific behavior as not nice, but never call the child themselves naughty or not nice. CCSM 2 said she has never seen CCSM 1 pull or yank on any children. There was one occasion where she observed CCSM 1 grab the back of a child’s shirt. However, CCSM 1 did this out of necessity to keep the child out of a dangerous situation. CCSM 2 said if she ever heard CCSM 1 or any other CCSM speak to a child or handle a child in a way that made her feel uncomfortable, she would address her concerns directly with the CCSM, then follow-up with Ms. Maldonado. I interviewed Child Care Staff Member 3 (CCSM 3). CCSM 3 said she works in the infant room and has worked with CCSM 1 often. CCSM 1 has a lot of experience working with children. CCSM 3 has observed CCSM 1 to appear frustrated at times if she is in a situation where all the babies are crying at the same time. CCSM 3 has never seen or heard CCSM 1 take her frustration out on children. CCSM 3 has never 611 W. OTTAWA • P.O. BOX 30664 • LANSING, MICHIGAN 48909 www.michigan.gov/lara • 517-335-1980 heard CCSM 1 call a child naughty or pull or yank on a child to get the child to move. CCSM 3 said she has never felt uncomfortable with the way CCSM 1 speaks to or interacts with the children. I interviewed Child Care Staff Member 4 (CCSM 4). CCSM 4 said she is the assistant program director. When CCSM 1 first started at the center both she and Ms. Maldonado had to speak to CCSM 1 about her tone of voice. CCSM 4 described CCSM 1’s tone of voice as “short” rather than mean. She noticed CCSM 1’s voice would take on a short tone when she was becoming physically tired. CCSM 4 believes CCSM 1 has gained control of managing her tone of voice for quite some time. CCSM 4 has never observed CCSM 1 to pull on or mishandle children. CCSM 4 often observes

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

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 5/8/2023, I completed an unannounced on-site inspection at the child care center. I informed program director Kelly Maldonado of the allegations. Ms. Maldonado has not heard of any incidents involving CCSM 1 squeezing a child’s cheeks causing the child to spit out milk. She has never heard CCSM 1 call a child “naughty.” I interviewed CCSM 2. CCSM 2 said she works in various classrooms and interacts with CCSM 1 quite often. CSM 2 has never heard CCSM 1 or any other CCSMs call children “naughty.” She has not observed or heard about any incidents where CCSM 1 squeezed a child’s cheeks causing him to spit out milk. I interviewed CCSM 3. CCSM 3 said she works in the infant room and has worked with CCSM 1 often. CCSM 3 has never heard CCSM 1 call a child naughty. CCSM 3 did not witness or hear about CCSM 1 squeezing a child’s cheeks causing him to spit out milk. I interviewed CCSM 4. CCSM 4 said she is the assistant program director. She has never heard CCSM 1 call children naughty. CCSM 4 believes if CCSM 1 ever called a child naughty it would most likely be in a joking manner. She recalls CCSM 1 611 W. OTTAWA • P.O. BOX 30664 • LANSING, MICHIGAN 48909 www.michigan.gov/lara • 517-335-1980 talking about an incident where she was a changing a child’s diaper and the child urinated on CCSM 1. CCSM 1 was not angry at the child, she was laughing about the incident. On 9/25/2023, I spoke to CCSM 1 by telephone. I asked CCSM 1 if she has ever squeezed a child’s cheeks forcing him to spit milk out onto the table. CCSM 1 laughed and said she has never done such a thing. I asked CCSM 1 if she tells children they are “naughty.” CCSM 1 said if she ever uses that term, she uses it in a joking way. She does not call a child “naughty,” but has labeled a specific behavior as naughty.

Open Not marked corrected in the state record

Category: ratio. 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 5/8/2023, I completed an unannounced on-site inspection at the child care center. I informed program director Kelly Maldonado of the allegations. Ms. Maldonado said CCSM 2 has a naturally loud voice. She has never heard CCSM 2 use a tone of voice that would be described as mean to children. Ms. Maldonado has encouraged CCSM 2 to walk up to children to speak to them as opposed to redirecting children from across the room unless she is trying to get a child’s attention to avoid a dangerous situation. CCSM 2 is very conscious that she needs to tone down her loud voice. CCSM 2 thanked Ms. Maldonado for pointing out situations where CCSM 2 could use a quieter voice. CCSM 2 transitioned from working with older children to working with younger children. CCSM 2 has learned that interacting with younger children is quite different than working with older children. CCSM 2 is very open to suggestions on how to work effectively with the younger children. Ms. Maldonado said she has never had a CCSM who is so open to constructive criticism and suggestions as CCSM 2. Ms. Maldonado said CCSM 2 611 W. OTTAWA • P.O. BOX 30664 • LANSING, MICHIGAN 48909 www.michigan.gov/lara • 517-335-1980 actively engages both verbally and physically with all the children. Ms. Maldonado has never had any concerns regarding CCSM 2’s interactions with children. I interviewed CCSM 2. CCSM 2 described her tone of voice as her “dad voice.” CCSM 2 said she has learned to be very conscious of her tone of voice since she transitioned from working with older children to working with younger children. She did not consider that younger children might find her tone of voice to be intimidating until she started working with them. he does not get offended if Ms. Maldonado or another CCSM points out to her that her voice tone is rising without her being aware. She welcomes the feedback, and it helps her be more aware of patterns and situations where she needs to focus on her voice tone. CCSM 2 said she believes she has a good handle on her tone of voice and only uses her loud voice if she is required to get the attention of a child immediately if they are about to put themselves or another child in a dangerous situation. I interviewed CCSM 3. CCSM 3 said she has never worked in a classroom with CCSM 2, so she is not aware of how CCSM 2 speaks to children. She has never heard any other CCSMs express concerns about the way CCSM 2 speaks to children. I interviewed CCSM 4. CCSM 4 described CCSM 2 as a very “blunt” person when she tries to get her point across. CCSM 2 is not trying to be malicious, it’s just her personality. There are times when CCSM 2 has a strong tone of voice, but she takes constructive criticism very well and works hard to keep her tone of voice under control.

Open Not marked corrected in the state record

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 5/8/2023, I completed an unannounced on-site inspection at the child care center. I informed program director Kelly Maldonado of the allegations. Ms. Maldonado said she has a former CCSM who believed “she could do whatever 611 W. OTTAWA • P.O. BOX 30664 • LANSING, MICHIGAN 48909 www.michigan.gov/lara • 517-335-1980 she wanted.” Ms. Maldonado said on 5/3/2023, she was in Child A’s classroom during the transition from nap time to snack time. Most of the children were sitting at the tables eating snack. The former CCSM was sitting at a table with a group of children. The CCSMs were attempting to wake Child A, but he was having a difficult time waking. Ms. Maldonado asked the CCSMs to allow Child A to sleep a little longer because he didn’t seem ready for his nap to end. Ms. Maldonado returned to her office. A couple minutes later she observed on the live feed video of Child A’s classroom that the former CCSM left her group of children alone at the table where they were eating their snack to go across the room and pick up Child A. Ms. Maldonado returned to the classroom where she observed Child A to be crying while the former CCSM was holding him. Ms. Maldonado asked the former CCSM why she picked up Child A when Ms. Maldonado asked the CCSMs to allow him to sleep longer. The former CCSM told Ms. Maldonado she picked up Child A because he was crying. Ms. Maldonado pointed out that Child A was crying because he was not yet ready to get up from his nap. Ms. Maldonado informed the former CCSM that is not appropriate for her to leave a group of children alone at a table to go pick up a sleeping child that Ms. Maldonado specifically asked the CCSMs to allow to sleep longer. The former CCSM believed Ms. Maldonado was angry that the former CCSM was comforting Child A, when, Ms. Maldonado was angry that the former CCSM disregarded her instructions to allow Child A sleep until he was ready to wake on his own. Ms. Maldonado said she did not raise her voice to the former CCSM, and the interaction lasted only a few minutes, not 10 minutes. Ms. Maldonado said the former CCSM often did things at inappropriate times. She provided an example where the former CCSM focused on creating a bulletin board instead of following the classroom schedule or interacting with the children. I interviewed CCSM 2. CCSM 2 said she was working in the classroom adjacent to Child A’s classroom, so she heard the interaction between Ms. Maldonado and the former CCSM on 5/3/2023. CCSM 2 said the former CCSM had an ongoing history of “doing whatever she wanted.” CCSM 2 said she could tell by Ms. Maldonado’s voice that she was frustrated with the former CCSM for leaving a group of children alone at a table to pick up a sleeping child after Ms. Maldonado asked her to let the child sleep longer. Ms. Maldonado’s voice was slightly louder than her usual voice, but she was not yelling at the former CCSM. The interaction between Ms. Maldonado and the former CCSM lasted only a few minutes. I interviewed CCSM 3. CCSM 3 said she has never observed or heard of any situations where Ms. Maldonado yelled at any of the CCSMs. I interviewed CCSM 4. CCSM 4 said Child A’s classroom is near the office. On 5/3/2023, CCSM 4 was in the office and heard Ms. Maldonado tell the former CCSM to let Child A continue to sleep until he is ready to get up. A couple minutes later Ms. Maldonado returned to the office. About a minute later Ms. Maldonado looked at the monitors and saw the former CCSM leave a table full of children to go pick up Child A who appeared from the live video feed to still be sleeping. Ms. Maldonado immediately returned to Child A’s classroom. CCSM 4 heard Ms. Maldonado ask the 611 W. OTTAWA • P.O. BOX 30664 • LANSING, MICHIGAN 48909 www.michigan.gov/lara • 517-335-1980 former CCSM why she picked up Child A. CCSM 4 did not hear any more of the interaction. If Ms. Maldonado was yelling CCSM 4 said she would have heard more of the interaction. Ms. Maldonado returned to the offic

R 400.8176 · R 400.8176 Sleeping equipment. (6) Car seats, infant seats, swings, bassinets, and play yards are not approved sleeping equipment.

On 5/8/2023, I completed an unannounced on-site inspection at the child care center. I informed program director Kelly Maldonado of the allegations. Ms. Maldonado said all the CCSMs have been trained on safe sleep practices and she believes they all follow the safe sleep guidelines. Ms. Maldonado pointed out the monitor in her office that shows live feed video footage of all the classrooms. Ms. Maldonado said CCSM 4 is her assistant program director. Both Ms. Maldonado and CCSM 4 monitor the live feed video often and make unannounced appearances in every classroom several times throughout the day. Ms. Maldonado believes if the CCSMs were not following safe sleep practices, she or CCSM 4 would observe it either on the live feed video or during in person visits to the classroom. Ms. Maldonado provided me with staff files where I confirmed the infant CCSMs completed safe sleep training. I interviewed CCSM 2. CCSM 2 said when she works in the infant classroom, the CCSMs follow the safe sleep guidelines. If an infant appears to be getting sleepy while in a rocker or swing, all the CCSMs place the infant in a crib before the infant falls asleep. Sometimes, infants fall asleep quickly with no indication that they are tired. In this situation, CCSMs place the infant in a crib as soon as they realize the infant is asleep. 611 W. OTTAWA • P.O. BOX 30664 • LANSING, MICHIGAN 48909 www.michigan.gov/lara • 517-335-1980 I interviewed CCSM 3. CCSM 3 said she has never seen an infant sleep in a swing or a rocker. Infants only sleep in cribs. She believes all the CCSMs take safe sleep seriously and they all follow the guidelines consistently. I interviewed CCSM 4. CCSM 4 said she has never seen infants sleep in a swing or rocker for an extended period. When she is in the classroom or watching the live feed video, she observes CCSMs move infants to a crib as soon as they are getting sleepy or as soon as the CCSMs notice the infant has fallen asleep. On 5/8/2023 I observed the infant classroom, all the infants who were asleep were in approved sleeping equipment.

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

MCL 722.120 Investigation, inspection, and examination of conditions, books, records, and reports; access by department, bureau of fire services, or local authorities; records; report; forms; confidentiality; disclosure of information; availability of confidential records; child information cards to be provided to department; failure of licensee to cooperate with investigation, inspection, or examination. (3) A licensee shall keep the records the department prescribes regarding each child in its control and care and shall report to the department, if requested, the facts the department requires with reference to the children upon forms furnished by the department. Except as otherwise provided in this subsection and subsection (4), records regarding children and facts compiled about children and their parents and relatives are confidential and disclosure of this information must be properly safeguarded by the child care organization, the department, and any other entity in possession of the information… 611 W. OTTAWA • P.O. BOX 30664 • LANSING, MICHIGAN 48909 www.michigan.gov/lara • 517-335-1980

On 5/8/2023, I completed an unannounced on-site inspection at the child care center. I informed program director Kelly Maldonado of the allegations. Ms. Maldonado said she has never gossiped to parents or CCSMs about anybody. Ms. Maldonado said she communicates relevant information to CCSM 4 regarding a child or family, but only if the information is necessary such as child having a change in their typical arrival or departure time. Ms. Maldonado only provides information to CCSM 4 because CCSM 4 is her assistant program director, and it is helpful for both of them to be aware of what is happening throughout the day. The only incident Ms. Maldonado could recall was a challenging interaction she recently had with a parent. After the interaction Ms. Maldonado mentioned that after some consideration, she believed she could have handled the situation a different way that could have resulted in a better resolution. Ms. Maldonado only said she felt she could have handled the situation different; she did not disclose any details of the situation. In interviewed CCSM 2. CCSM 2 said she had never heard Ms. Maldonado gossip about any parents to other parents or CCSMs. Ms. Maldonado only reports 611 W. OTTAWA • P.O. BOX 30664 • LANSING, MICHIGAN 48909 www.michigan.gov/lara • 517-335-1980 necessary information about parents or families to the CCSMs. CCSM 2 provided an example where if Ms. Maldonado is having difficulty getting a hold of a parent she needs to speak with, she asks the CCSMs to let the parent know she needs to speak with them if one of the CCSMs sees or talks to the parent. Ms. Maldonado does not disclose the reason she needs to talk to the parent, only that she is having a hard time getting a hold of them. I interviewed CCSM 3. CCSM 3 said she has never heard Ms. Maldonado gossip about anybody to parents or CCSMs. I interviewed CCSM 4. CCSM 4 said she has never heard Ms. Maldonado gossip about parents to other parents or CCSMs. Since CCSM 4 is often at the front desk, Ms. Maldonado provides her with necessary and relevant information regarding children or parents in case CCSM 4 is at the front desk and Ms. Maldonado is not present. CCSM 4 has never observed Ms. Maldonado speak to, or about parents in an unprofessional manner.

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: i.... TABLE Child Care Staff Member to Child Ratios Age Child Care Staff Maximum .................... .._. ..!.e...m....b..e...r. ..t.o... .C...h...i.l..d.. ..R...a...t.i o Gros size { intants and toddlers. birth until 30 Ito 4 12 a) months of age Preschoolers. 30 Hnonth of age i to 8 16 b) until 3 years of age { Preschoolers. 3 years of age until 4 1 to 10 Not applicable C years of age ( Piechoolets. 4 ;ears of age moil 1 t0 12 Not applicable d) school-age is ( School-alters 1 to Not applicable e

An on-site inspection was conducted at the center during nap time. There were six children with one child care staff member in the preschool classroom, six infants with two child care staff members in the infant classroom, three young toddlers with one child care staff member in the transition room, and six toddlers with two child care staff members in the toddler room. The center was in compliance with the child care staff member to children ratio in all classrooms. Ms. Kelly Maldonado, program director, stated that the center follows the required child care staff member to children ratio at all times. Usually either she, or another child care staff member from the office, will replace the child care staff member for their break. Child Care Staff Member 1 stated that the center is always in compliance with the child care staff member to children ratio requirements. A child care staff member always comes into the classroom to cover the breaks. Child Care Staff Member 1 had no knowledge of a classroom not complying with the child care staff member to children ratio requirements. Child Care Staff Member 2 stated that she always gets relived by another child care staff member, usually someone from the office, when it is time for her break. She was not aware of any classrooms not being in compliance with the child care staff member to children ratio. Child Care Staff Member 3 stated that every child care staff member that goes on break gets replaced by another child care staff member while they are gone. She was not aware of classrooms not following the child care staff member ratio requirements. Child Care Staff Member 4 stated that she has been instructed in the past to go to break without a replacement. This has occurred because there was not enough child care staff members to give breaks. There was always at least one child care staff member in the classroom. Child Care Staff Member 5 stated that the classrooms always comply with the child care staff member to children ratio requirements. Child care staff members from the office relieve the child care staff members for their breaks. She was not aware of any classroom not complying with the child care staff member to children ratio requirements. Child Care Staff Member 6 stated that the child care staff member to children ratio is always followed in the classrooms. 3 Child Care Staff Member 7 stated that a child care staff member is always sent into the classroom to cover her breaks. She has not witnessed a classroom not complying with the child care staff member to children ratio requirements. The center has even had child care staff members from the sister site nearby come to the center so that there was enough child care staff members to cover breaks. Child Care Staff Member 8 stated that the child care staff member to children ratio is always followed in the classrooms. A child care staff member always comes into the classroom to cover breaks. Child A's Mother stated that she doesn't count the children when she is at the center, but there are always two child care staff members in the classroom when she is at the center. Child B's Mother stated that she has always witnessed at least one child care staff member per four children in the infant classroom.

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.

R 400.8330 · 1 R 400.8330 Food services and nutrition generally. (4) A center shall ensure a child who has special dietary needs is provided with snacks and meals in accordance with the child's needs and with the instructions of the child's parent or licensed health care provider.

Ms. Maldonado stated that Child A's Mother initially approached her about having Child A use a different milk aside from cow's milk due to having some digestive issues. Ms. Maldonado informed Child A's Mother that she needed a doctor's note in order to change Child A's milk in order to meet the food program 4 requirements. Ms. Maldonado provided Child A's Mother with the form for Child A's doctor to complete regarding making changes to Child A's diet. Child A's Mother submitted the form with a doctor's statement. Child A was to receive lactose free milk instead of cow's milk. Later Child A's mother submitted an additional statement to indicate that Child A was no longer able to have fruit juice as well. Water was listed as the acceptable substitute. Ms. Maldonado stated that she was not aware of Child A being served dairy or juice after receipt of the doctor's notes. She added that the classroom child care staff members are very good about making sure that Child A is served the appropriate foods. Child A's Mother stated that she spoke to Ms. Maldonado about Child A no longer being served cow's milk as it was upsetting her stomach and she kept getting sent home sick. Ms. Maldonado told Child A's Mother that she needed a doctor's note and gave her the paperwork to be completed. The doctor completed the paperwork for Child A to no longer be served dairy and later added fruit juice. Child A's Mother stated that she is not aware of Child A consuming dairy or fruit juice after the doctor's note was submitted. There have been a few times that dairy products have been documented on Child A's daily sheet, but Child A's Mother was not sure if Child A was served those items, or they were just noted because they were on the menu for that day as she did not inquire about it. Child A's Mother did not have concerns regarding the food that Child A is provided at the center. Child Care Staff Member 2 stated that she is aware of Child A's food restrictions. Child A cannot have dairy and has a special milk that she drinks. She is also not allowed to have fruit juice, so when juice is offered, Child A is given water or a fruit substitute. Fruit juice is not served to the children in care often. Child Care Staff Member 2 was not aware of Child A being served food that she is not able to consume. There is a sign posted in the classroom to remind staff of Child A's food restrictions. Child Care Staff Member 3 stated that she is aware that Child A cannot drink milk or dairy products. She has a separate milk that is served to her. She was not aware of Child A being served food that she cannot consume. Child Care Staff Member 4 stated that Child A cannot have dairy. She has lactose free milk that she drinks. At first Child A's Mother requested that Child A not be served milk. Ms. Maldonado requested that Child A's Mother provide a doctor's note so that she could follow that request. She was not aware of Child A being served food that she cannot eat since obtaining a doctor's note. Child Care Staff Member 5 stated that she is aware that Child A cannot have cow's milk. She has a lactose free milk that she drinks. Child Care Staff Member 5 does not care for Child A often but was not aware of her being served food that she is not supposed to consume. 5 Child Care Staff Member 6 stated that that Child A has a lactose free milk that she is provided due to not being able to drink cow's milk. Child A also can't have cheese. When they serve cheese for a meal, they will either substitute the cheese with something else or just remove it. Child Care Staff Member 6 stated that the center child care staff members always make sure to follow Child A's food restrictions. Child Care Staff Member 7 stated that Child A cannot have dairy. She has a special milk that she drinks. She also cannot have cheese. For example, that day for lunch they had tuna melts. Child A was served a ham sandwich instead. Child A also cannot have fruit juice. Fruit juice is replaced with water

R 400.8188 · R 400.8188 1 Sleeping, resting, and supervision. (11) Infants and toddlers who fall asleep in a space that is not approved for sleeping shall be moved to approved sleep equipment appropriate for their age and size.

Ms. Maldonado stated that she is not aware of infants being allowed to sleep in bouncy seats or any other unapproved spaces. She frequently monitors the infant classroom throughout the day and has not noticed an issue with infants not being moved from an unapproved sleep surface right away when they fall asleep. She communicates this rule requirement with the infant child care staff members often. Child Care Staff Member 1 stated that infants are not left in bouncy seats or swings to sleep. They are moved to a crib when they fall asleep. Child Care Staff Member 2 stated that she has worked in the infant classroom a few times. She has never witnessed infants being allowed to sleep in bouncy seats. On a few occasions an infant has fallen asleep in Child Care Staff Member 2's arms and she placed the infant in their crib to sleep. Child Care Staff Member 3 stated that if infants fall asleep in a bouncy seat or other unapproved sleeping area they are moved as soon as the child care staff member notices that they are asleep. Child Care Staff Member 4 stated that she has witnessed infants sleeping in a bouncy seat when she has been in the infant classroom. This has been for a few minutes. She was not sure how long the infants were asleep for prior to her entering the classroom. Child Care Staff Member 5 stated that she occasionally works in the infant classroom. When infants fall asleep in unapproved sleep space, such as a swing or bouncy seat, they are moved to a crib as soon as a child care staff member notices that they have fallen asleep. Sometimes that cannot happen immediately if the child care staff members are engaged in other care duties, such as changing a diaper, but the infant is moved as soon as the child care staff member can move them. Child Care Staff Member 6 stated that she does not work in the infant classroom. Child Care Staff Member 7 stated that she has never worked in the infant classroom. She walked in the infant classroom one time to get a vacuum. No infants were asleep. Child Care Staff Member 8 stated that infants that fall asleep in a space that they are not supposed to sleep in are moved to a crib as quickly as possible as soon as a child care staff member notices that the infant is asleep. Sometimes if she is changing a diaper and an infant fell asleep in a swing, she has to wait until she is done changing the child to move the sleeping infant. She has never witnessed infants being allowed to sleep in an unapproved sleep space. Child A's Mother and Child B's Mother both stated that they have not noticed infants sleeping in bouncy seats or swings when they have been at the center. 7

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

R 400.8330 · R 400.8330 1 Food services and nutrition generally. (21) When feeding, child care staff members shall hold infants, except when infants resist being held and are able to hold their bottle.

Ms. Maldonado stated that there are two older infants in the infant classroom that do not always want to be held during feedings. They are able to hold their bottles on their own, so they are permitted to do so. They are either placed in a high chair or a bouncy seat to drink their bottle. Younger infants are always held during feeding. Child Care Staff Member 1 stated that there are a few older infants in the infant classroom that refuse to be held while being fed a bottle. Those older infants are placed in a bouncy seat or high chair to drink their bottle. Child Care Staff Member 2 has not witnessed an infant hold their own bottle for a feeding. Child Care Staff Member 3 stated that there are a few older infants that refuse to be held during feedings and they are allowed to sit in a highchair or swing and drink their bottle. The smaller infants are always held during a feeding. Child Care Staff Member 4 stated that she has witnessed older infants who could self-feed drinking bottles in a bouncy seat. Child Care Staff Member 5 stated that infants are held while being fed. There are a few infants in the classroom that resist being held and are able to feed themselves. These infants are able to feed themselves in a bouncy seat or high chair. Child Care Staff Member 6 stated that she does not work in the infant classroom. Child Care Staff Member 7 has not witnessed infants drinking bottles in the infant classroom. Child Care Staff Member 8 stated that there are two older infants in the infant classroom that do not always want to be held while being fed. Those infants are able to hold their own bottles. The child care staff members will allow those infants to sit in a high chair or bouncy seat to drink their bottle when they don't want to be held. This does not occur at every feeding. Child A's Mother stated that she has never noticed an infant feeding themselves a bottle in the infant classroom. Child B's Mother stated that she was not aware of Child B feeding himself a bottle at the center due to not wanting to be held but stated that he is older and able to hold a bottle on his own. She has never witnessed a younger infant holding their own bottle or a bottle being propped for an infant to feed themselves.

Open Not marked corrected in the state record

Category: nutrition. 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 January 19. 2021, I completed an unannounced onsite inspection at the center. Kelly Maldonado, program director, explained that Ms. Perry does have a tone to her voice that can sound rough. But that is just her voice when she is excited or trying to get the children's attention. Ms. Maldonado stated that she has never seen Ms. Perry "rip" a child away from another staff member and does not believe she would ever do anything to physically harm any of the children. I took a walk around the center, doing observation in each room. The classrooms were appropriately staffed regarding child to child care staff member ratio and I did not see any behaviors on the part of staff members that were concerning. Ms. Perry was interacting and handling children appropriately. She did not pick any child up by the pants or "rip" any child from another staff member's arms. I had also completed the renewal inspection on this facility on December 1, 2020. During that inspection, I did observation in all of the rooms, and went to the infant room twice. During my first visit to the infant room, all three infants were crying and Ms. Perry was trying to meet all of their needs. When talking to one of the infants, Ms. Perry's tone did go up, but it did not appear to have a negative effect on the infants. Her body language and words were appropriate. I later went back to the room to observe again, and Ms. Perry was very appropriate rocking one infant and talking to the others. She was engaging with the other two infants. Rosamond Odamtten, staff member, said she has worked with Ms. Perry in the infant room. She confirmed that Ms. Perry's tone goes up when all of the infants need attention at the same time, but she is never inappropriate with the infants. Ms. Odamtten has never seen Ms. Perry pick up a child by the pants or "rip" children from another staff member's arms. Jenesse Fernandez, staff member, has never witnessed Ms. Perry be physically inappropriate with any of the children. Ms. Fernandez stated, "Linda is very loving towards the children. Her voice does carry, but she doesn't say anything mean. The kids like her." Ms. Fernandez said she has not seen Ms. Perry pick up any children by their pants or "rip" a child from another staff member's arms. Linda Perry, staff member, was very upset with the allegations made against her. She said her voice does rise and sound stern when she is anxious or frustrated. But she does not believe she has ever been inappropriate in anyway with any of the children and has certainly not "ripped" them out of anyone's arms. Ms. Perry adamantly denied ever picking up a child by their pants. She said she has worked in child care centers for over 20 years and no one has ever made allegations against her. Child A's Mother referred to Linda Perry as "very sweet." She said Ms. Perry is her favorite of the staff and her child loves Ms. Perry. She was very surprised anyone would suggest Ms. Perry might harm one of the children. Child B's Mother said Ms. Perry is a strong Christian woman. I have never seen her 3 strict with the children. Child B's Mother added that she really trusts Ms. Perry to care for her child.

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

R 400.8182 · ......................................................................... J 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 Ratio (a) Infants and toddlers, 1 to 4 birth until 30 months of age

An allegation in the complaint was "the facility seems to be understaffed". During my onsite inspections on December 1, 2020 and January 19, 2021, the rooms were appropriately staffed with the correct number of child care staff members to child ratios. Ms. Maldonado reported that all of the staff know the appropriate child to child care staff member ratio for all classrooms and those ratios are maintained. She said they only have one classroom with an enrollment over 10, and that is the preschool room. Ms. Maldonado said she is adamant that the appropriate ratios are maintained. I reviewed the children's attendance sheet and the staffing plan which supported Ms. Maldonado's statement that the required ratios are maintained. Rosamond Odamtten said she cannot recall anytime that her room has been out of ratio. She said they are given instructions to immediately notify Ms. Maldonado if something occurs where the room has become out of ratio. Jenesse Fernandez stated that she could not recall seeing any of rooms out of ratio. Ms. Fernandez said they have been told how important it is to be in ratio and to notify Ms. Maldonado if they have concerns. I asked Linda Perry if she knew what the ratio for each room was and if she has seen any of the rooms out of ratio. Ms. Perry stated that ratio is always maintained. She added that sometimes children from different rooms are combined into one room due to staffing, but ratio is always determined by the youngest child. 4 I interviewed Child A's Mother. She has not noticed the infant room, or the other classrooms being out of ratio. Child B's Mother knew the ratio for the infant room and has never noticed it being out of ratio. She did not know the ratios for the other classrooms.

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.

R 400.8182 · R 400.8182 j 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 Ratio b) Preschoolers, 30 months 1 to 8 to three years.

The center employs sufficient staff to maintain the required one child care staff member to eight 30-month-old preschool children. ............... ..... ..................................................................... ...........................

Open Not marked corrected in the state record

Category: ratio. 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 Ratio c)Preschoolers, 3 years of 1 to 10 age until 4 years of age

The center employs sufficient staff to maintain the required one child care staff member to ten 3-year-old preschool aged children.

Open Not marked corrected in the state record

Category: ratio. 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 Ratio d) Preschoolers, 4 years of 1 to 12 age until school-age

The center employs sufficient staff to maintain the required one child care staff member to twelve 4-year-old preschool aged children.

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.