The Learning Tree West

R 400.8112(5) · R 400.8112(5) Children's records. (5) A record of a physical evaluation performed within the preceding 13 months after initial attendance for infants, toddlers, and preschoolers must be retained on file and made accessible in the center within 30 days after a child’s initial attendance. The evaluation must note any restrictions and be signed by a physician or the physician’s designee. An electronic record from a physician’s office is accepted.

Two of ten children records reviewed did not have physical evaluations on file at the center.

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R 400.8341(1) · R 400.8341(1) Drinking water management plan; water sampling, testing, and remediation; filtered water; records (1) Pursuant to section 3i of the act, MCL 722.113i, no later than January 24, 2025, the center shall develop and implement a drinking water management plan, conduct water sampling and testing after filters have been installed, conduct remediation as needed, and retain records.

The center failed to develop and implement a drinking water management plan.

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R 400.8341(2) · R 400.8341(2) Drinking water management plan; water sampling, testing, and remediation; filtered water; records 3 LANDMARK BUILDING • 105 W. ALLEGAN STREET • LANSING, MICHIGAN 48933 Michigan.gov/MiLEAP (2) Pursuant to section 3j of the act, MCL 722.113j, no later than October 24, 2025, the center shall comply with the requirements of the duties of a center under the drinking water management plan, including ensuring that drinking water furnished to children for human consumption is from a filtered faucet or other filtered source meeting the standards required in section 3j(b) of the act, MCL 722.113j.

CONCLUSION: REQUIREMENT NOT MET CORRECTIVE ACTION PLAN: We will purchase and install water filters for consumptive faucets. Faucets will be labeled according to consumption. After filters are installed, we will conduct water sampling and conduct remediation as needed. Records will be maintained. We will purchase and install water filters for consumptive faucets. After filters are installed, we will conduct water sampling and conduct remediation as needed. Records will be maintained. Carol Gatewood (center owner) and Lee Pierson (facilities manager) DATE COMPLIANCE WILL BE 02/28/2026 ACHIEVED BY: 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 400.8530(10) · R 400.8530(10) Hazard Areas (10) The center shall not store combustible materials within the central heating plant or fuel-fired water heater rooms or in basements containing fuel-fired heating equipment, without a proper fire separation. Bureau

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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.

February 6,2023, I conducted a telephone interview Child A's Mother and she said she had some concerns regarding Child A's care at Learning Tree West Childcare Center. She said on February 3, 2023, her son nearly swallowed CCSM 1's medication (Nitrofurantioin) because it fell out of her pocket. Luckily CCSM1, was able to prevent him from ingesting the medication, however, the entire situation was mishandled. Child A's Mother spoke with program director, Savannah Edmondson-Klump on February 3, 2023 who notified her about the incident regarding Child A. Ms. Edmondson-Klump told her that there was no policy in place that addressed staff medication being brought into the classrooms. She was not given an incident report the day of the incident; her son was not seen by medical staff, nor was poison control called. Child A's Mother said CCSM 1's actions were irresponsible and the facilities mishandling of the situation. Child A's Mother said normally, an incident report is given to parents when a child is picked up, but staff deviated from that standard of care in this instance. She said there has been incidents in the past with her other child and she was called immediately and given an incident report upon pick up. She called the regional director to voice her concerns of how the incident was mishandled and never got a response. On February 6, 2023, she received an email from Mrs. Edmondson-Klump that encompassed an incident report and new policy that addressed staff medication. Child A's Mother said the facility has been in a steady decline since they changed management and she is currently looking for another facility to enroll her children in. On February 13, 2023, and unannounced onsite inspection was conducted at The Learning Tree Child Care Center. Director Savannnah Edmondson-Klump was interviewed and said the incident happened as the complaint details. She said CCSM 1 and CCSM 2 were in the classroom during the time of the incident. The pill 3 was CCSM 1's medication, and she pulled the pill out of his mouth. After she pulled the pill out of his mouth, she informed management. Child A's Mother was told what happened and given an incident report. Prior to this incident there was no policy in place for staff members and their medication. Since then, The Leaning Tree Child Care Center developed a personal medication policy for staff, effective immediately. All staff had to review, sign and date the new policy and procedure as acknowledgement. Disciplinary action was taken against CCSM for in the incident. I reviewed The Learning Tree Child Care Center person medication policy on February 18, 2023, and the policy said the following in part. "If medication needs to be taken during working hours, employees are to notify an administrator so time can be arranged for employee to leave the classroom and take medication in the staff lounge or in their car. Employees will be expected to be off the clock during this time. Personal medication is not to be in the classroom, even if it is being stored in employees' purse or bag. If an employee needs to have medication inside the center, it must be kept in a personal bag or purse in the staff lounge. This policy is to be strictly adhered to at all times. Failure to do so will result in disciplinary action up to and including termination." On February 18, 2023, I reviewed a copy of the Incident Report associated with Child A. The Incident Report is dated for February 3, 2023, with the time of incident at 10:45am. It says the disciplinary action was taken for the employee involved and an updated medication procedure was implemented. This document was signed by director Savannah Edmondson-Klump. On February 13, 2023, I interviewed child care staff member CCSM 2. CCSM 2 said she is the lead teacher and CCSM 2 were working together in the classroom, Infant 2 on February 3, 2023. CCSM 2 was near the front of the classroom, and she was at the back of the classroom tending to a student. While at th

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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 08/26/2022, I spoke with the Witness. It is reported that Child A fell and hit his head on the bookshelf. Child A became disorientated and sleepy. According to the Witness, Savannah Edmondson-Klump, program director, and Ms. Tara Abner, assistant program director, notified Child A's Mother of the incident and told her that Child A was happy and playing. The Witness stated that this was not true and told Child A's Mother that the information that was reported to her regarding Child A was not accurate. On 09/28/2022, I completed an unannounced onsite inspection. I interviewed Savannah Edmonson-Klump, program director, and Andrea Majewski, regional director. Ms. Edmonson-Klump said on 08/24/2022, she was informed by child care staff member (CCSM), Baily Washington that Child A bumped his head in his classroom. After the courtesy call was made, Ms. Bailey thought Child A should be sent home and thought he was showing signs of a concussion. Ms. Edmonson- Klump said she brought Child A up to the lobby to spend a few minutes with him and watch him for anything that seemed out of the ordinary. During this time, he was happy, walking as normal, and no longer crying. He had no signs of a concussion. Ms. Edmonson-Klump then viewed video footage from the classroom with Tara. She said while standing near a shelf, Lorenzo attempted to grab a toy and lost his balance causing him to fall. He bumped the side of his head/ear on the shelf nearest to him. Bailey Washington was feeding another infant a bottle, and Paula Warnet, CCSM, was changing another child's diaper. Ms. Warnet finished changing a child's diaper and picked up Child A after he bumped his head. Child A was consoled, ice was applied, and he returned to play as normal. Ms. Abner contacted the parents to explain what happened and told them that he bumped his head. The teachers wrote an accident report. Ms. Washington told Ms. Edmonson- Klump and Ms. Abner that Child A should be sent home. Ms. 3 Washington became very upset after hearing that Child A was not going home. She then contacted several parents in her classroom, this was reported to Ms. Edmonson- Klump when she began to receive phone calls from a concerned parent. Child A was picked up from the child care center and his parents decided to take him to get checked out. Child A returned first thing the next morning, cleared of a concussion by the doctor. Ms. Edmondson-Klump also reached out via email to his family to let them know she was comfortable with them reviewing the footage should they choose. They did not review the footage. Ms. Edmondson-Klump said later, it was reported to her that former child care staff member, Bailey Washington contacted families from her personal phone to tell them she and Ms. Abner did not tell the truth about Child A having a concussion. The families begin to contact Ms. Edmonson- Klump about what they heard from Ms. Washington. Ms. Edmonson-Klump explained to all the families that she told the truth, and all of the child care center's injury procedures were followed. Ms. Washington is no longer employed at the child care center. Ms. Washington was terminated three weeks prior to this interview. Ms. Majewski said when she arrived at the child care center on 08/24/2022, Ms. Edmonson-Klump and Ms. Abner were reviewing video footage. Ms. Edmonson- Klump explained that Child A bumped his head in the classroom, and they were reviewing the footage. Ms. Edmonson-Klump told her Child A was in the office with her for observation. She observed Child A to be happy and playing normally. 4 On 10/03/2022, I interviewed Ms. Paula Warnet, CCSM. She stated that Child A had just learned how to walk a couple of months prior to the incident. He tripped while walking and hit his head on the edge of the shelving unit. Child A was crying, he appeared tired, and his eyes were not focused. They informed Ms. Abner of the incident, and the incident report was completed. The parents were notified of the incident. I re

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R 400.8155(1) · R 400.8155(1) Child accidents and incidents; child and staff illness. (1)A center shall have a written plan for how and when a parent is notified when personnel observe any of the following: (b) A child experiences an accident, injury, or incident.

On 08/26/2022, I spoke with the Witness. There is low staffing in the morning between 7:45 a.m.- 8:10 a.m., the Infant 1 room was out of ratio on 08/22/2022. It is reported that there is usually not enough teachers present. Ms. Edmondson and Ms. Abner will have the staff sign them in however they never come into the classroom to be included in the count. On 09/28/2022, I observed the CCSM to child ratio in the Infant 1 and Infant 2 classrooms. There were no concerns. Ms. Edmondson-Klump said the adult to child ratio of 1:4 is always maintained. If the teacher finds that the ratio is going to go above 1:4 the front desk is called so that another CCSM can go down to the classroom to assist. She has never requested that her name or any other staff name be placed on the roster who is not present in the classroom. On 10/03/2022, I spoke with Ms. Warnet, she is a CCSM in the Infant 2 room. She said the Infant 2 classroom maintains a 1:4 ratio. I reviewed the attendance records for the Infant 1 and Infant 2 classroom during the week of 08/22/2022, the attendance sheets documented that the adult to child of 1:4 ratio was maintained in both rooms. On 12/7/2022, I spoke with Ms. Abner. She stated that there has not been any issues with ratio in the Infant 1 and Infant 2 classrooms. They use the Pro Care app to monitor attendance an ensure that the 1:4 ratio is maintained. She has never requested that her name or any other staff name be placed on the roster who is not present in the classroom. On 12/13/2022, I spoke with Ms. Amy Albright (CCSM). She is the lead caregiver in the Infant 1 classroom. She said the Infant 1 classroom maintains a 1:4 ratio at all times. Ms. Albright explained that if she foresees that she may need additional staff to maintain the ratio she will contact one of the administrators for assistance. She has never been asked to put a staff member down on the attendance roster who did not come into the classroom to assist.

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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 licensee. (a) Infants and toddlers, birth until 30 months of age shall maintain a 1 to 4 child care staff member to child ratio, with a maximum group size of 12. Based on the interviews, observations, and attendance records reviewed there is insufficient evidence to conclude that the 1 to 4 ratio of child care staff member to child ratio, with a maximum group size of 12 was not maintained.

On 08/26/2022, The Witness stated that the handwashing policy at the child care center was followed to use wipes for the infants who had to be lifted in the infant classroom. It is reported that the staff were written up for not using the handwashing sink to wash the infants hands, who had to be lifted up to the sink by staff. According to the Witness, when the staff begin to use the wipes, they were told that they must use the sink to wash the infant's hands, or they will be written up. On 09/28/2022, Ms. Edmonson-Klump said Ms. Washington was not comfortable washing the infant's hands at the sink. She wanted to change the child care center practice to use wipes instead of washing hands. Ms. Washington was provided guidance and coaching regarding washing the children's hands in the infant classroom. I reviewed the handwashing policy for the child care center. The handwashing policy explained how to wash hands, when hands should be washed, and when teachers should ensure that children wash their hands. There was a signed copy that indicated that Ms. Washington reviewed the handwashing procedure. On 10/03/2022, I interviewed Ms. Warnet. She said they wash the children's hands with soap and water before snack, meals, and diaper changes. On 11/29/2022, I spoke with Ms. Edmondson-Klump regarding the staff being written up for not using the handwashing sink to wash the children's hands in the Infant 2 classroom. She explained that the staff are not written up however they received written observations to support the expectations of "The Top Banana Program". Ms. Edmondson-Klump explained that the child care center has an incentive program in place for staff, called The Top Banana Program. At The Learning Tree, they believe in creating a supportive environment through feedback, training, and quality assurance. One of the many ways to assure quality is in place is through unannounced camera observations. Cameras are installed in every classroom and throughout all areas of the center. Each camera has audio and video recording. On 12/7/2022, I spoke with Ms. Abner. She explained that "The Top Banana Program" is to ensure that the child care center is giving great quality care as they promise their families. The program is based on policies and rules be adhered to so that great quality is maintained. The curriculum director monitors the program and progress of the classrooms. If there is a tie breaker required, they use other rules (i.e. deep cleaning and handwashing) to determine the winner. The classroom with the highest score receives a bonus. The staff is not written up, the observations from the curriculum director are written on the form.

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R 400.8134 · R 400.8134 Toilet; hand washing sinks. (5) Staff may wash children's hands with non-toxic disposable wipes in the following situation: (a) When the child is too heavy to hold for hand washing.

Based on the interviews with staff and documents reviewed, their child care center is compliant with handwashing for infants. The center's policies are to wash all children's hands with soap and water, however, using disposable wipes are also permitted.

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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.

Staff provided appropriate care and supervision to the children are the center. CCSM do not recall any incidents where two children were fighting over a toy, and they did not properly intervene. Random interviews with parents resulted in no reported concerns.

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R 400.8140 · R 400.8140 Discipline. (2) All of the following means of punishment are prohibited: 4 (a) Hitting, spanking, shaking, biting, pinching, or inflictina other forms of corporal punishment.

Staff denied allegations of yanking children by the wrist, pointing in their faces, or forcefully bumping them to make them move. The complainant could not identify the alleged victims and stated no child was ever hurt or had any bruised. Random interviews with parents resulted in no reported concerns.

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R 400.8155 · R 400.8155 Child accidents and incidents; child and staff illness. (4) If a center becomes aware that a staff member, volunteer, or child in care has contracted a communicable disease, then the center shall notify parents and provide all of the following information: (a) The name of the communicable disease the children were exposed to.

On 4/20/2021, I conducted an unannounced inspection at the center. I interviewed licensee designee, Andrea Majewski. Ms. Majewski informed me that there were positive cases of Covid reported in the center. She stated that once notification was received, the Health department was contacted. All rooms were cleaned and closed immediately for quarantine. Children and staff of those classrooms were asked to quarantine for 14 days. Emails were sent out immediately informing families of children in those classrooms. An additional email was sent out to all families in the entire center. Ms. Majewski stated that all safety protocols were followed. On 4/20/2021, I interviewed complainant. Complainant stated that she was concerned the center was not following protocol in reporting positive Covid cases. Complainant stated that she was informed by another parent during drop off that Transitional preschool had a positive case of Covid reported. Complainant was not aware and had not received notification. On 4/20/2021, I reviewed the emails that were sent to families individually and center wide informing them of the positive Covid cases that had been reported. 2 ...............

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