Suncrest Day Care Center

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.

The groundcover in the fall zones of the playground equipment is suitable to protect from possible injury.

R 400.8170(10) · R 400.8170(10) Outdoor play area. An outdoor play area and any equipment located on the center's premises must be maintained in a safe condition and inspected daily before use to ensure that no hazards are present.

There were 2 pieces of metal sticking out with sharp edges and a broken riding toy on the playground.

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 July 7, 2023, I received a voicemail and an Incident Report regarding this incident. On July 11, 2023, I made an unannounced onsite inspection to the child care center. I interviewed program director and licensee designee Jessica McCaslin. She reported that Child A started whining while being taken for a walk in the medical care facility attached to the child care. This occurred when waiting for the elevator. Caregivers initially thought that the buggy seat belt was too tight n Child A and loosened it. Once this was done, Child A stopped whining. When Child A was removed from the buggy after the walk, Child A did not want to put weight on her left foot. Child A's mother was contacted, and she took Child A for medical treatment. It was determined that Child A 2 did not have a break or fracture in her foot but that her ankle was possibly sprained. Ms. McCaslin reviewed facility video footage and it looked like Child A's foot had caught on the fire door as they took the buggy through the door that separates and child care from the medical facility. While at the center, I was able to view the video of the incident. It showed a caregiver pushing a buggy containing children going through double doors. Child A is seen seated in the front left-side seat of the buggy and her foot appears to come in contact with the door as it is opening. Ms. McCaslin confirmed that Child A still attends the center. She identified the two caregivers who had their children in buggies and went on a walk around the medical care facility on July 6, 2023, and I was able to interview both of them during my onsite inspection. Child Care Staff Member 1 (CCSM1) said that two of the toddler classrooms had combined to walk around the medical care facility. She had four children in her buggy and CCSM2 had four children in her buggy. CCSM1' s buggy was first to go through the doors. The doors have a passcode to enter on the wall and once this is entered, the doors buzz, and you are able to open the doors, but the doors do not open by themselves. CCSM1 stated that they usually push the doors open with the buggies. They did not realize that Child A's foot came into contact with the door as it was opening until they viewed the video. After going through the double doors, they were at the library waiting to go upstairs in the medical care facility and Child A began to whine. They thought that her buggy seatbelt might have been too tight, so they loosened them for her, and Child A stopped whining and seemed to be okay. CCSM2 estimated that they were walking around the medical care facility visiting residents for approximately 20 minutes. When they arrived back in the child care area and removed the children from the buggies, Child A did not want to put weight on her left foot. Child A's mother was contacted, and Child A was taken for a medical evaluation. CCSM2 stated that on July 6, 2023, her buggy was the first to go through the double doors to the medical care facility portion of the building. She had been trained to push the door open with the buggy in order to get through the doors. Child A was crying after this, and she thought that her straps in the buggy might be too tight, so they were loosened, and Child A stopped crying. They walked around upstairs at the medical care facility for approximately 30 minutes and Child A appeared to be fine during this time. It wasn't until Child A was removed from the buggy didn't want to put weight on her left foot that they realized Child A may have been injured. Child A's mother was contacted and picked up Child A and took her to the ER. Child A's mother confirmed that Child A my have suffered a hairline fracture to her foot. Child A still attends the child care. She was somewhat concerned regarding the fact that no one knew what had happened to Child A until the video was viewed and that the video was not initially viewed as Ms. McCaslin was not working that day. 3

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 April 11, 2023, program director Jessica McCaslin self-reported to me that early on the same date, Child A showed his penis to Child B while on the playground. I received an Incident Report regarding this the same day. On April 12, 2023, I made an unannounced onsite inspection to the child care center. Program director Jessica McCaslin was on break, so I interviewed Child Care Staff 2 Member 1 (CCSM1), who was present on the playground when the incident occurred. There were 14 children present on the playground at the time. At the time of the incident, only CCSM1 was on the playground. The second caregiver was inside prepping for lunch. CCSM1 estimated that the assistant caregiver had been inside of the building for approximately 10 minutes before the incident occurred. CCSM1 showed me the spot on the playground where she was standing when the incident occurred. She was in the middle of the playground and the incident happened on the one side of the playground. It should be noted that the playground is against the building and is long and narrow. It is approximately 70 ft. X 25 ft. The incident happened approximately 25 ft. from where CCSM1 was standing. She did not see the incident but was immediately informed by Ms. McCaslin. The incident was observed by CCSM2, who was in the infant room at the time. The childcare is in the lower level of a medical care facility and four of the classrooms have large windows that look directly out on to the playground. CCSM2 knocked on the window when she was Child A showing his penis to Child B and the children immediately ran. Per CCSM1, Child A has a history of exposing himself. A few months prior, CCSM1 saw Child A with his penis sticking out of his pants. Another time, Child A was on the couch in the classroom, and he had his penis exposed. No other children were around Child A when each of these incidents occurred and CCSM1 addressed it with Child A both times. After the incident, Ms. McCaslin spoke to Child A and she spoke to Child B. Child B only told her "I didn't do anything." She spoke to Child B's father and pick up and informed him of what had happened. And gave him an incident report. She also spoke to Child A's mother at pick up and she confirmed that Ms. McCaslin had contacted her regarding the incident. Child A's mother told her that Child A never does this behavior at home. I interviewed program director Jessica McCaslin when she returned to the center. She confirmed that the incident between Child A and Child B was witnessed by CCSM2. She walked into the infant room shortly after the incident and was informed by CCSM2 what she had just witnessed on the playground through the window. She spoke to Child A who told her that he was afraid of Child B but would not say anything else. When she told this to Child A's mother, she told her that Child A will say he is afraid when there is something he does not want to do. She also spoke to Child B who told her that Child A showed him his penis. While at the center I spoke with CCSM2. Through the window in the infant room where she was working, she says Child A and Child B talking. Child B pointed at his private area and Child A pulled out his penis. CCSM said that she immediately knocked on the window and both children ran. I attempted to contact both Child A and Child B's parents. As of the date of this report, I have not heard back from Child A's parents. Child B's mother had no concerns about the center and feels that they do great with Child B. 3

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

On April 12, 2023, 1 observed an infant sleeping in a bouncer seat.

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 staff member or the licensee, must be as show in table 4: Age Child Care Staff Maximum Group Size member to Child Ratio a) Infants and toddlers, 1 to 4 birth until 30 months of age b) Preschoolers, 30 months 1 to 8 of age until 3 years of age c) Preschoolers, 3 years of 1 to 10 until 4 years of age d) Preschoolers, 4 years of 1 to 12 age until school-age

The Preschool classroom was out of ratio at the time of the April 3, 2023, incident between Child A and Child B as there were 14 children on the playground with one caregiver. On April 12, 2023, 3 of the 5 classrooms at the facility were out of ratio. This appears to be a regular occurrence during staff breaks/lunch.

R 400.8330 · R 400.8330 Food services and nutrition generally. (22) Infants shall not have bottles, beverage containers, or food in sleeping equipment.

I observed a child in the infant room was placed in a crib with a bottle. I