• Violation

  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.

  Based on staff and parent interviews, CCSM 1 provides appropriate care and supervision of children at all times. Based on the information regarding Nursemaid's Elbow from the Mayo Clinic Health System, it cannot be determined when or how Child A sustained Nursemaid's Elbow.

  Open Not marked corrected in the state record

  Category: supervision. Open / not marked corrected.

• Violation

  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.

  I interviewed Megan Jackson via telephone regarding the allegation. Ms. Jackson explained that no child had been left alone in a restroom at the center in July of 2021 to her knowledge. I interviewed Laura Reyes via telephone on 2/6/2023. Ms. Reyes began employment at the center in February of 2021, but she had no knowledge of a child being left alone in a restroom at the center. 2 I also interviewed Sara Miller regarding the allegation via telephone on 2/6/2023. She had no knowledge of a child being left alone in a restroom at the center. I interviewed Karen Onan regarding the allegation via telephone on 2/6/2023. Ms. Onan stated that she was only aware of one incident in which Child A (Female, 3 years of age) was left alone in the restroom. She had no knowledge of any other child being left alone in a restroom at the center. The department was aware of the allegation regarding Child A. This incident occurred on 5/22/2022 and was previously investigated (SIR2022D1083017). I conducted an unannounced onsite inspection on 2/8/2023. I interviewed Megan Jackson again regarding the allegation. Ms. Jackson explained that she began employment at the center in February of 2022 and had no knowledge of a child being left alone in a restroom in July of 2021. She acknowledged that a child was left alone in a restroom on 5/22/2022 and this allegation was previously investigated. I interviewed Hannah Onan regarding the allegation via telephone on 2/13/2023. Ms. Onan had no knowledge of a child being left alone in a restroom in July of 2021. She explained that a child was left alone in a restroom on 5/22/2022, but this is the only incident that she is aware of. I spoke with Megan Jackson regarding the allegation during the onsite inspection on 2/8/2023. Ms. Jackson was not employed by the center in 2021 however; she was aware of 10/13/2021 in which a child had been left alone outdoors as she reviewed reports related to the center upon hire.

  Open Not marked corrected in the state record

  Category: supervision. Open / not marked corrected.

• Violation

  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.

  I interviewed Laura Reyes regarding the allegation on 2/6/2023 via telephone. She recalled a child being left alone outdoors in the Orange Room. However, this incident occurred on 10/13/2021 and was previously investigated by the department (SIR2022D1083004). Ms. Reyes explained that she was on her scheduled break when the incident occurred, but she learned of it when she returned from her break. I interviewed Sara Miller regarding the allegation via telephone on 2/6/2023. Ms. Miller has worked at the center for approximately three years. She had no knowledge of a child being left alone outdoors in August of 2021. However, she was aware of a child from the Orange room being left alone outdoors on 10/13/2021. Ms. Miller was not working in the Orange room when the incident occurred, but she heard about the incident from others. I interviewed Karen Onan regarding the allegation via telephone on 2/6/2023. Ms. Onan was aware of the incident occurring on 10/13/2021 in which a child was left outdoors alone, but she had knowledge of an additional incident occurring in August of 2021. I interviewed Hannah Onan regarding the allegation via telephone on 2/13/2023. She had no knowledge of a child being left outdoors alone in August of 2021.

  Open Not marked corrected in the state record

  Category: supervision. Open / not marked corrected.

• Violation

  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.

  I interviewed Megan Jackson regarding the allegation on 2/8/2023. She had no knowledge of children being left alone outdoors on 6/27/2022. She explained that if this had happened, she would have reported the incident to the department as she has when other incidents have occurred. 4 I interviewed Laura Reyes regarding the allegation. She had no knowledge of children being left alone outdoors on 6/27/2022. She was only aware of a child being left alone outdoors on 10/13/2021. I interviewed Sara Miller regarding the allegation, and she also had no knowledge of children being left alone outdoors on 6/27/2022. I also interviewed Karen Onan regarding the allegation, and she only recalled a child being left alone outdoors on 10/13/2021. She had no knowledge of children being left alone outdoors on 6/27/2022. I interviewed Hannah Onan regarding the allegation on 2/13/2023. She was also unaware of children being left alone outdoors on 6/27/2022. I was unable to contact the complainant regarding this investigation as the complaint was filed anonymously.

  Open Not marked corrected in the state record

  Category: supervision. Open / not marked corrected.

• Violation

  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 5/23/2022, Meghan Jackson self — reported that on 5/22/2022 Child A was left alone for approximately 15 -20 minutes. Ms. Jackson was not present at the center when the incident occurred, but she learned from Hannah Onan that Child A's classroom had gone outside for outdoor play and Child A was left alone in the classroom's restroom. I interviewed Child A's Mother regarding the allegation via telephone on 5/27/2022. She stated that the center had notified her of Child A being left alone at the center. Ms. Jackson was not present at the center when the incident occurred, but she spoke to Ms. Jackson regarding the incident when Ms. Jackson returned. Child A's Mother reported that she had not had issues with the center prior to this incident but she was concerned about Child A being left alone. Child A's Mother spoke to Ms. Jackson regarding action steps to prevent this from happening again, and Child A is still attending the center. I conducted an unannounced onsite inspection on 11/10/2022. I interviewed Meghan Jackson regarding the allegation. She explained that on 5/23/2022, Child A was attending the Blue Room (children aged 3) and Elizabeth Duke and Joan Antonakis were the assigned Child Care Staff Members. The Blue Room went outdoors for 2 outdoor play with Ms. Duke and Ms. Antonakis while Child A was using the restroom located in the classroom. Hannah Onan heard Child A in the restroom as she was walking through the center for observation. Child had been alone in the restroom for approximately 20 minutes alone. Ms. Duke and Ms. Antonakis did not realize that Child A was absent from the group and that she was in the restroom. Both Ms. Duke and Ms. Antonakis left employment at the center shortly after the incident occurred. I interviewed Hannah Onan regarding the allegation. She stated that on 5/23/2022, she heard Child A screaming and crying from behind the restroom door. Child A was sitting on the toilet stool fully clothed with her shoes off. Ms. Onan removed Child A from the restroom and helped her calm. Ms. Onan brought Child A to Ms. Duke and Ms. Antonakis and explained that Child A was left indoors alone. Ms. Duke and Ms. Antonakis acknowledged that they did not know that Child A was in the restroom when they left the room to go outdoors. Ms. Onan discussed appropriate supervision, room checks/scans with Ms. Duke and Ms. Antonakis. Ms. Onan stated that Child A was alone in the restroom for approximately 20 minutes.

  Open Not marked corrected in the state record

  Category: supervision. Open / not marked corrected.

• Violation

  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.

  I received a telephone call and incident report from Kristie Lange, program director, on 1213/2021 regarding the allegation. Ms. Lange reported that during a diaper change on 1212/2021, bruises were observed on Child A's leg. Per the incident report, Child Care Staff Member 3 was changing Child A's diaper at approximately 3:45PM on 12/2/2021 when she observed bruises on both of Child A's legs. Ms. Lange was contacted via telephone by Child Care Staff Member 2. Child Care Staff Member 2 informed Ms. Lange of the bruises to Child A's legs. When Ms. Lange arrived at the classroom, she observed several bruises to both of Child A's legs. Child A had bruises to her upper right thigh and there were several bruises on Child A's left leg below her knee, matching fingerprints. Ms. Lange explained in the incident report that the bruises on Child A's left leg looked as if someone grabbed Child A's leg and held it too hard. Ms. Lange acknowledged that Child Care Staff Member 2 did not '`get a chance" to talk to Child A's Mother regarding the bruises on Child A's leg prior to Child A going home for the day. At approximately 8:25PM on 1212/2021, Child A's Mother contacted Ms. Lange via telephone. Child A's Mother was preparing Child A for her bath and observed the bruises to Child A's leg. Child A's Mother asked Ms. Lange who worked with Child A during the day and inquired about the cause of the bruises. Ms. Lange reported speaking to Child A's Mother on the morning of 12/3/2021. Ms. Lange reported reminding Child A's Mother of a doctor's appointment that Child A recently had. Ms. Lange suggested that maybe the medical staff held Child A's leg to hard while administering an immunization. I interviewed Child A's Mother regarding the allegation via telephone on 12/7/2021. Child A's Mother stated that there were no bruises on Child A when she arrived at the center on 12/212021. No one from the center notified her of the bruises to Child A's legs, and she observed the bruises during the evening of 1212/2021 when she was preparing Child A for her bath. Child A's Mother stated that she believed someone at the center pulled Child A by her legs and may have pulled too hard. She did not believe that anyone intentionally hurt Child A, but someone could have accidentally caused the bruises when pulling her legs. Child A's Mother reported asking Child Care Staff Members how Child A did through the day, and she was told that everything was fine. When she observed the bruises on Child A's legs, she contacted Ms. Lange via telephone as the center was closed. Ms. Lange told Child A's Mother that she did not know anything about the bruises on Child A's legs, but she would look into the matter on 1213/2021. 1 asked Child A's Mother if Child A an immunization administered for Child A. Child A's Mother explained that Child A had a doctor's appointment on 11/30/2021. Child A had blood drawn during a previous appointment through her finger and Child A's legs were not held by the medical staff. Child A's Mother discontinued care for Child A at the center. was the initial assigned to investigate this matter by the agency. made face to face contact with Child A at her home on C] 12/3/2021. observed and took photos of the marks on Child A's legs. Per the report, there were approximately six bruises on Child A's legs. There are 5 brown brwses on her left leg that appear to be fingerprints, and one bruise on her right thigh. Child A's Mother also provided photos of the bruises to this bureau on 12/7/2021. spoke to Kristie Lange regarding the allegation via telephone on 12/3/2021. Ms. Lange stated that the bruises could have been caused at a doctor's appointment that Child A had a few days prior to them being observed at the center. She also explained that the bruises could have also been caused by Child A running around as she is a toddler. contacted the medical facility that saw Child A on 11/30/2021. He spoke Wit tReimmunization su ervisor at the facility. The superv

  Open Not marked corrected in the state record

  Category: supervision. Open / not marked corrected.

• Violation

  R 400.8146 · R 400.8146 Information provided to parents. (3) For infants and toddlers, a center shall provide parents with a written daily record that includes at least the following information: (c) Elimination patterns, including bowel movements, consistency, and frequency.

  The center did not complete an accurate daily record of Child ................ A's elimination patterns on 12/2/2021.

  Open Not marked corrected in the state record

  Category: recordkeeping. Open / not marked corrected.

• Violation

  R 400.8155 · R 400.8155 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.

  Kristie Lange and Child Care Staff Member 2 failed to follow the center's policy regarding reports made to parent involving child accidents illness, and incidents. The center's policy states that a report will be made to parents immediately and Child A's Mother was not notified when bruising was discovered on Child A's body.

  Open Not marked corrected in the state record

  Category: health medication. Open / not marked corrected.

• Violation

  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.

  I conducted an unannounced onsite inspection on 11/5/2021. I interviewed Kristie Lange regarding the allegations. Ms. Lange stated that she was unaware that Child A was left outdoors on 10/13/2021. I also spoke to Ms. Lange via telephone on 4/22/2022. She denied having knowledge of Child B leaving the Orange Room without an adult. In regard to Child C, Ms. Lange stated that Child C is difficult to get to sleep. However, Karen Onan sits beside him to help him settle. Ms. Onan does not restrain Child C. Ms. Lange reported having no issues with either Karen Onan or Hanna Onan regarding rest time at the center. I interviewed Alexandria Cortex regarding the allegations on 11/5/2021. She stated that she'd heard about Child A being left outdoors, but she had no direct knowledge of the incident because it occurred while she was taking her scheduled break. I also spoke to Ms. Cortex via telephone on 4/22/2022. She explained she had no knowledge of Child B leaving the classroom without an adult. Ms. Cortex stated that she has not worked with Child C and she had no knowledge of Child C being mishandled during rest time. I also interviewed Kyra Snyder regarding the allegations on 11/5/2021. She reported working in the Orange Room. The children in the Orange Room range in age from approximately 13 months of age — 24 months of age. She reported being outdoors with the children at approximately 2:00PM on 10/13/2021. She and Betty Gannon were counting the children as they prepared to return to the classroom. She asked Betty Gannon if they had all of the children and Ms. Gannon replied, yes. When they returned to the classroom with the children, they completed a head count of the children in care and realized that all of the children were not present. Ms. Snyder stated that she observed Child A outdoors as she looked out of the classroom window. Child A was walking around the outdoor play area looking for everyone. Ms. Snyder went outdoors and retrieved Child A. She stated that Child A was alone outdoors for approximately 1 minute. Ms. Snyder explained she had no knowledge 3 of Child B leaving the classroom alone. Ms. Snyder stated that she did not work with Child C often and she had no knowledge of him being mishandled. Ms. Snyder stated that Child Care Staff Members usually do pretty well with putting Child C down for rest time. I interviewed Karen Onan regarding the allegation on 11/5/2021. She had no knowledge of Child A being left outdoors alone. I spoke to Ms. Onan again via telephone on 4/29/2021 and she stated that she had no knowledge of Child B leaving the Orange Room alone. During the interview with Ms. Onan on 11/5/2021, she stated that Child C was having a difficult time at the center as he was transitioning from the Green Room to the Red Room. Child C will often flail his arms, run around the room, and try to hit others. Child C often ran around the room when it was rest time and on October 19, 2021, she and Hanna Onan were trying different things to soothe Child C when it was time to rest. Hanna Onan tried putting a blanket on Child C to help him calm and he didn't like it, so she removed it. Karen Onan said she tried holding Child C, but Child C is strong, so she let him up. Hanna Onan tried holding Child C while rubbing his face, but Child C continued to run which caused other children to run as well. Hanna Onan took Child C to the Wobbler Room and tried to soothe him, but he still didn't sleep. Child C was much calmer in the Wobbler Room and finished rest time well. Ms. Karen Onan denied restraining Child C. I also interviewed Lois Laroe on 11/5/2021 regarding the allegations. She stated that on 10/13/2021, she was working in the Wobbler Room. She could see the outdoor play from the window in the Wobbler Room. The Orange Room came in from outdoors and approximately 5 minutes later, someone inquired about where Child A was. Ms. Laroe stated that she then saw Ms. Snyder run to the outdoor play area to retrieve Child A. Ms. Laro

  Open Not marked corrected in the state record

  Category: supervision. Open / not marked corrected.

• Violation

  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: a) for infants and toddlers, birth until 30 months of age, there shall be 1 child care staff member for 4 children and a maximum group size of 12.

  It was alleged that the Orange Room does not maintain appropriate child care staff member to child ratios due to Alexandria Cortex and Kyra Snyder regularly leaving the room throughout each day. I interviewed Alexandria Cortex regarding the allegation via telephone on 4/22/2022. She explained that the only time she and Ms. Snyder left the classroom was for restroom breaks. Ms. Lange told Child Care Staff Members that they could leave the classroom without maintaining staff to child ratio requirements as long as they were not absent from the room for more than 5 minutes. At the time that this 5 allegation was made, Ms. Cortex stated that there were 11-13 children being cared for in the Orange Room by 3 Child Care Staff Members. The children are between 13 — 24 months of age. Ms. Cortex stated that if one Child Care Staff Member left the room, there were still two Child Care Staff Members present. I explained to Ms. Cortex that the ratio of staff to children for this age range of children is 1:4. If 1 Child Care Staff Member were to leave the room with 11-13 children present, the center would not be in compliance with the administrative rules. Ms. Cortex stated that she understood this but reiterated that Ms. Lange told Child Care Staff Members that leaving the room is ok to do as long as their absence is less than 5 minutes. I explained to Ms. Cortex that the administrative rules require that appropriate staff to child ratios be met at all times. I asked Ms. Cortex how often she and Ms. Snyder left the classroom each day. She explained that she and Ms. Snyder left the room daily and multiple times to use the restroom or get an ice pack. She stated that this occurred for at least one month. I explained to Ms. Cortex that the center has floaters for restroom and scheduled lunch breaks. Ms. Cortex explained again that Ms. Lange told Child Care Staff Members that they could leave the rooms as long as they were not gone for more than 5 minutes. I interviewed Kristie Lange regarding the allegation on 4/22/2022. I explained to Ms. Lange that I understood that there were 11-13 children being cared for in the Orange Room by 3 Child Care Staff Members at the time that the allegation was made. Ms. Lange confirmed this, but she stated that the Orange Room currently has fewer children present. I told Ms. Lange that I'd learned that during the time the allegation was made, Ms. Snyder and Ms. Lange left the room on a daily basis creating noncompliance with the administrative rules regarding staff to child ratio. Ms. Lange stated that there were three Child Care Staff Members present in the room during this time. I explained to Ms. Lange that appropriate staff to child ratio for children in this age group is 1:4 therefore; if only two Child Care Staff Members remained in the classroom with 11-13 children, appropriate ratios were not maintained. Ms. Lange stated that she understood this. I told Ms. Lange that I understood the center's policies regarding coverage in classrooms was for Child Care Staff Members to call the front desk if they needed assistance or needed to leave the room for scheduled breaks. However, I'd been told that she allowed Child Care Staff Members to comply with the center's policy only if their absence from the classroom would exceed 5 minutes. Ms. Lange stated that she told Child Care Staff Members that they could leave their assigned rooms to use the restroom if she was busy in another room and was unable to assist them. Otherwise, Child Care Staff Members would call her, and she would relieve them. I explained to Ms. Lange that I'd learned that Ms. Snyder and Ms. Cortex left the Orange Room multiple times per day for various reasons unrelated to restroom breaks. This occurred for more than one month which created noncompliance with the administrative rules in the Orange Room. Ms. Lange stated that she understood this. On 4/29/2022, I interviewed Kyra Snyder via telephone regarding the staff to child ratio in the Orange

• Violation

  R 400.8330 · R 400.8330 Food services and nutrition generally. (10) Menus must be planned in advance, dated, and posted in a place visible to parents. Food substitutions must be noted on the menus the day the substitution occurs.

  I interviewed Alexandria Cortex regarding the allegation via telephone on 4/22/2022. She stated that Ms. Snyder did occasionally bring snacks to the center that she would share with the children in the Orange Room. She explained that the snacks were typically potato chips that Ms. Snyder would bring a couple of times per week. Ms. Cortex stated that Ms. Lange issued a memo to Child Care Staff Members noting that they could not bring snacks from home to share with the child care children. I also interviewed Ms. Lange regarding the allegation via telephone on 4/22/2022. She denied having any knowledge of Ms. Snyder providing children with snacks that she brought from home. Ms. Lange also denied issuing a memo to Child Care Staff Members addressing the matter. However, when I discussed the issue approximately 10 minutes later during a conference call with Ms. Lange and Meghan Jackson, Licensee Designee, Ms. Lange acknowledged addressing the issue in a memo to Child Care Staff Members. I pointed out the discrepancy in Ms. Lange's statements and she acknowledged that she had previously denied having knowledge of the issue. She stated that she had no knowledge of Ms. Snyder providing snacks to children that were brought from home but stated that she was aware of other Child Care Staff Members bringing snacks to the center. I interviewed Lois Laroe regarding the allegation via telephone on 4/29/2021. She stated that Kyra Snyder regularly brought snacks from home such as potato chips that she shared with the children in the Orange Room. I interviewed Karen Onan regarding the allegation via telephone on 4/29/2022. She reported having no knowledge of Child Care Staff Members bringing snacks from home and providing them to the children in care. I interviewed Hanna Onan regarding the allegation on 4/22/2022 via telephone. She had no knowledge of Kyra Snyder bringing snacks from home for the children in care. I interviewed Kyra Snyder regarding the allegation via telephone on 4/29/2022. She acknowledged bringing potato chips from home. She stated that she gave the children in care "a couple." I asked Ms. Snyder how often she brought potato chips to the center to share with the children in care. She stated that she didn't give children potato chips often, but she did bring potato chips to the center and shared them with children more than once. I interviewed Betty Gannon regarding the allegation via telephone on 5/3/2022. She stated that Ms. Snyder brought in potato chips and shared them with a child in care in the Orange Room. She explained that Ms. Snyder had a relationship with this child outside of the center.

  Open Not marked corrected in the state record

  Category: nutrition. Open / not marked corrected.

• Violation

  R 400.8330 · R 400.8330 Food services and nutrition generally. (11) A center shall not serve infants and toddlers or allow them to eat foods that could easily cause choking, including but not limited to, popcorn, seeds, nuts, hard candy and uncut round foods such as whole grapes and hot dogs. rj

  I spoke to Ms. Lange via telephone on 4/22/2022. She denied having knowledge of a knife being accessible to children. I also spoke to Ms. Cortex via telephone on 4/22/2022 regarding a knife being accessible to children in the Orange Room. She denied the allegation. She stated that on one occasion she used a knife from the center's kitchen to cut apples for an activity, but the knife was never left in an area accessible to children. I interviewed Karen Onan regarding the allegation via telephone on 4/29/2022. She explained that she has not worked in the Orange Room since June of 2021. Since she does not work in the Orange Room, she would have no knowledge of a knife being accessible to children. I interviewed Hanna Onan regarding the allegation via telephone on 4/22/2021. Ms. Onan does not work in the Orange Room and would have no knowledge of a knife being accessible to children within that room. I interviewed Betty Gannon regarding the allegation via telephone on 5/3/2022. She had no knowledge of a knife being accessible to children. She explained that plastic utensils are used within all classrooms at the center, and she never observed a sharp knife in the Orange Room.

  Open Not marked corrected in the state record

  Category: nutrition. Open / not marked corrected.

• Violation

  R 400.8380 · R 400.8380 Maintenance of premises. (1) The premises must be maintained in a clean and safe condition and must not pose a threat to health or safety.

  All parties interviewed denied having knowledge of a sharp knife being accessible to children.

  Open Not marked corrected in the state record

  Category: health medication. Open / not marked corrected.

• Violation

  R 400.8158 · R 400.8158 Incident, accident, injury, illness, death, fire reporting. (2) A licensee, licensee designee, or program director shall report to the child's parent and the department, directly or via phone, fax, or email, within 24 hours of the occurrence of any of the following: (a) A child is lost or left unsupervised. ... ........... .. ...

  Child A was left alone outdoors at the center on 10/13/2021. Child A's Parents nor the department were notified within 24 hours of the incident.

  Open Not marked corrected in the state record

  Category: supervision. Open / not marked corrected.

• Violation

  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.

  It was alleged on 10/6/2021 that Kristie Lange instructs Child Care Staff Members to make children nap in order for Child Care Staff Members to take their scheduled breaks. It was also alleged that Ms. Lange does not follow up on concerns related to children and she does not assist Child Care Staff Members in the center's classrooms when needed to ensure appropriate care and supervision of the children in care. I conducted an unannounced onsite inspection on 10/6/2021. I interviewed Kristie Lange regarding the allegation. Ms. Lange stated that she has never instructed Child Care Staff Members to force children to sleep. She explained that the center employs enough Child Care Staff Members to accommodate scheduled break times, and two Child Care Staff Members are specifically designated to care for children during break coverage, and Ms. Lange assists in the classrooms herself when coverage is needed for employee breaks. She reported always being available to assist Child Care Staff Members when needed. Ms. Lange explained that she goes into the center's classrooms if she hears a child crying or hears loud noises. I asked Ms. Lange if these are the only times that she assists with children and she stated that she typically goes into each classroom regularly throughout each day spending 5-10 minutes in each classroom. I asked Ms. Lange if she recalled an incident on 8/5/2021 that involved a Child Care Staff Member yelling at a child in care. I was present at the center regarding a separate matter and was sitting in the center's office which is located several feet away from the center's classrooms. I approached the classroom area and found Ms. Lange standing near the classrooms. She acknowledged that she'd heard the Child Care Staff Member's tone and agreed that it was inappropriate. I asked Ms. Lange why she had not addressed the inappropriate tone of the Child Care Staff Member and she stated that she had "tuned it out." Ms. Lange recalled the incident but explained that she has not tuned out things since that time. She explained that the center currently utilizes a telephone system which allows Child Care Staff Members to contact her via telephone if they need assistance. Each classroom is equipped with a telephone and Child Care Staff Members can reach her when they have questions or need help. Ms. Lange stated that she follows up on all concerns that are brought to her attention related to children. I also interviewed Lois Laroe regarding the allegation on 10/6/2021. Ms. Laroe stated that she has never been told that children in care must sleep. She explained that children can engage in a quiet activity during rest time. She stated that when Ms. Lange is called to the classrooms she comes right in and will help calm children down or take children out of the room for a break. I interviewed Breanda Boersma on 10/6/2021. She stated that she has never been told to make children sleep. She explained that Ms. Lange told her that children can 3 sit on their assigned cots with a book or engage in another quiet activity during rest time. Ms. Boersma stated that she has never had to call Ms. Lange for help, but if Ms. Lange sees her struggling in the classroom, she will come in to assist. Ms. Boersma stated that Ms. Lange follows up on things whenever they are reported to her. I spoke to Karen Onan regarding the allegation via telephone on 4/5/2022. She stated that Ms. Lange has not told her to make children sleep in order to accommodate employee breaks. Ms. Onan explained that the center has enough employees to relieve Child Care Staff Members for break times. She reported that Ms. Lange checks in often in classrooms and assists Child Care Staff Members if needed. Ms. Onan explained that the center has a telephone system in place and Child Care Staff Members can call for help if needed. She stated that the center directors respond fairly quickly to requests for help when called. Ms. Onan stated that Ms. Lange calls parents right awa

  Open Not marked corrected in the state record

  Category: supervision. Open / not marked corrected.

• Violation

  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 10/6/2022 it was alleged that Lois Laroe stated to a child "I'm going to tie you up!" No additional information was provided regarding this allegation. It was also alleged that Amber Stinson and Susan Vanderwall engaged inappropriately with a small child that was climbing on a shelf. Per the complainant, Ms. Vanderwall and Ms. Stinson instructed the child to get down, and when the child didn't respond Ms. Vanderwall and Ms. Stinson grabbed the child by each of the child's arms and "ripped' the child from the shelf. Ms. Stinson and Ms. Vanderwall are no longer employed by the center. During the onsite investigation on 10/6/2022, I interviewed Ms. Laroe regarding the allegations. She denied stating that she was going to tie a child up. She explained that she has worked with both Ms. Stinson and Ms. Vanderwall, but primarily Ms. Stinson. She did not recall an incident involving either Child Care Staff Member pulling a child by the arm to remove them from a shelf, and she stated that it didn't sound like something that either Ms. Stinson or Ms. Vanderwall would do. I interviewed Breanda Boersma regarding the allegation on 10/6/2022. She recalled working with Ms. Stinson. She stated that Ms. Stinson would pull children by their arms and drag them yelling, "Get down now!" She recalled an incident in which Ms. Stinson became upset with a 1-year-old child because the child wouldn't sit in a chair. Ms. Stinson "aggressively forced" the child into the chair saying, "Sit the fuck down!" At rest time, Ms. Stinson would slap children on their backs aggressively. The slapping was so hard that it could be heard by others in the room. On 4/5/2022, I interviewed Karen Onan regarding the allegations via telephone. She had no knowledge of regarding the allegations and had no concerns regarding the handling of children at the center. On 4/6/2022, I interviewed Amber Stinson regarding the allegations via telephone. She denied pulling a child by the arm. She reported hearing Ms. Laroe state to a child that she was going to tie them up, but Ms. Stinson explained that Ms. Laroe was just joking. She stated that Ms. Laroe made the statement in a playful way to the child and the statement was not taken seriously. I interviewed Kristie Lange via telephone on 4/5/2022. She had no knowledge of Ms. Vanderwall or Ms. Stinson pulling a child's arms. She also had no knowledge of Ms. Laroe stating that she was going to tie a child up. I attempted to speak with Ms. Vanderwall on 4/7/2022 via telephone. This attempt was unsuccessful as Ms. Vanderwall's telephone number is not in service. 5

  Open Not marked corrected in the state record

  Category: ratio. Open / not marked corrected.

• Violation

  R 400.8380 · 1 R 400.8380 Maintenance of premises. (1) The premises must be maintained in a clean and safe condition and must not pose a threat to health or safety.

  I conducted an unannounced onsite inspection on 7/16/2021. I interviewed Laura Kenworthy regarding the allegation. She explained that she learned of the concern regarding mold in the orange classroom on 7/15/2021 when child care staff members brought it to her attention. She stated that there was an area of concern on a windowsill in the orange classroom. However, she was unaware that there was a concern regarding the green classroom. Ms. Kenworthy reported that Kristie Lange, program director, had already begun contacting mold remediation experts to have the area of concern assessed. I observed both the orange and green classrooms with Ms. Kenworthy on 7/16/2021. There was a small area on a windowsill in the orange classroom that was dark in color. I could not determine the presence of mold from my observation. Ms. Kenworthy thought the darkening of this area may have been caused by paint, but she could not be certain. Upon observation of the green classroom, I didn't find anything present that resembled mold. I also spoke to Kristie Lange regarding the allegation during the onsite inspection. She also reported being made aware of the concern for mold in the orange classroom on 7/15/2021 by a child care staff member. At the time of inspection, Ms. Lange had contacted several mold remediation experts for an evaluation appointment and was waiting to hear back from them regarding scheduling. I recommended that Ms. Lange contact the Kent County Health Department for assistance, and she agreed to contact the department and advise me of their recommendations. On 7/27/2021, I received an email from Russell Platte of the Kent County Health Department. Mr. Platte reported inspecting the facility on 7/21/2021. He stated that he did not observe any mold in the facility. Mr. Platte noted that there was a loose board in the windowsill of the orange room that he wasn't able to inspect underneath. On 7/28/2021, I received an email from Kristie Lange. She explained that Mr. Platte was not able to inspect underneath the loose board of the windowsill as it was missing caulk. She stated that on 7/24/2021, Sam Konetzka from the Modernistic Corporation came to the facility to inspect the areas of concern in the orange and green classrooms. Mr. Konetzka found no mold in the green classroom. Mr. Konetzka was able to remove the loose board in the orange classroom and inspect the wooden underside of the board. He found that there was a small amount of mold present due to water soaking through cracks in the caulk on the top of the windowsill. Per Ms. Lange, Mr. Konetzka stated that there was not enough mold present to cause any health concerns. He treated the wood with a mold agent that neutralized the mold and prevents the growth of any new mold. Ms. Lange forwarded a written report from the Modernistic Corporation on 7/30/2021 which outlined the remediation services performed by Mr. Konetzka. The Modernistic report states that on 7/24/2021, the wooden ledge (orange classroom) was removed, 3 and a small amount of mold growth was discovered. The mold was treated, and the entire ledge and trim were cleaned with an antimicrobial treatment. An air scrubber was used the entire time to prevent the spread of mold spores throughout the rest of the facility. All mold was successfully remediated and there is no concern for mold growth.

  Open Not marked corrected in the state record

  Category: ratio. Open / not marked corrected.

• Violation

  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.

  I attempted to contact the complainant via email on 6/3/2021. Per the written allegations received, both Child Care Staff Member 1 and Child Care Staff Member 2 forcefully handle the children in care. Child Care Staff Member 1 allegedly sat on Child A's hands and punishes children in care in other ways when they don't fall asleep. It was also reported that Child Care Staff Member 1 restrained Child D (Male, 4 years of age) with a table due to Child D running in the classroom. Child Care Staff Member 2 allegedly pulled Child B and Child C's arms as a means of punishment. I conducted an unannounced onsite inspection on 6/4/2021. I interviewed Laura Kenworthy, licensee designee and program director, regarding the allegation. Ms. Kenworthy reported having no prior issues with either Child Care Staff Member 1 or Child Care Staff Member 2 related to inappropriate discipline. She acknowledged that she has spoken to Child Care Staff Member 2 in the past regarding her use of cellular phones and other devices while caring for children. Ms. Kenworthy reported improvement in this area as she monitors the classrooms regularly. I interviewed Child Care Staff Member 1 regarding the allegation. Child Care Staff Member 1 explained she works in the Purple Room (children aged 4 years). She reported working regularly with Child A and Child B, but she rarely works with Child C. She explained that Child A has behavioral issues and often uses inappropriate language and will hit others. Child A plays roughly and has to be removed from situations to help him calm. Child B demonstrates similar behaviors. Child Care Staff Member 1 stated she will often have the children sit down to calm. I asked her about the allegation of sitting on Child A's hands because Child A wouldn't sleep during rest time. Child Care Staff Memberl stated that during rest time Child A was picking his nose and he would not stay on his sleeping mat. Child A was lying on his back and threw his blanket while continuing to pick his nose. Child Care Staff Memberl 3 stated that she continued to put Child A's hands down near his side to prevent him from picking his nose. Child A repeatedly stated, "You're hurting me" and she turned Child A over onto his stomach and patted his back. Child A stated, "You're hurting my head" but Child Care Staff Member 1 stated that she was not touching Child A's head. I asked Child Care Staff Member 1 how long this engagement with Child A lasted. She reported that she engaged Child A for approximately 20 minutes until he calmed down and went to sleep. I asked her why Child A wasn't allowed to engage in a quiet activity if he didn't want to rest or sleep. She stated that it is the center's policy that children rest for at least 20 minutes. After this time, they can do a quiet activity, but they must rest for 20 minutes. I explained to Child Care Staff Member 1 that children cannot be forced to nap or rest, and a quiet activity should be provided when children do not want to rest. Child Care Staff Member 1 stated that requiring children to rest/nap for 20 minutes was the requirement of the child care corporation. I again explained to her that forcing children to rest and/or nap is prohibited by the administrative rules. She denied restraining the children in care. She explained that she has held the legs of children when they are kicking others, but she doesn't restrain children otherwise. I asked about the allegation related to Child D, restraining Child D with a table. Child Care Staff Memberl denied the allegation. She reported that Child D has anger issues and will often slap others. When Child D slaps her, she blocks his hits and puts his hands down. Child D will laugh and will eventually calm down. Child Care Staff Member 2 was not present at the center on 6/4/2021 and was not interviewed during this inspection. I conducted a second onsite inspection on 7/16/2021. I interviewed Child Care Staff Member 2 regarding the allegations. She denied the allegat

  Open Not marked corrected in the state record

  Category: supervision. Open / not marked corrected.

• Violation

  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. M

  Child Care Staff Member land Child Care Staff Member 2 did not engage in appropriate discipline methods with the children in care. Child Care Staff Member 1 acknowledged yelling at a child in care on 8/5/2021. Child Care Staff Member 3 and Child Care Staff Member 4 have observed Child Care Staff Member 1 holding children's arms during the center's rest period. Child Care Staff Member 4 and Child C's Mother reported that Child Care Staff Member 2 holds children by their arms.

  Open Not marked corrected in the state record

  Category: ratio. Open / not marked corrected.

• Violation

  R 400.8188 · R 400.8188 Sleeping, resting, and supervision. (13) For children under school age who do not sleep at rest time, quiet activities must be provided such as reading books or putting puzzles together.

  Child Care Staff Member 1 and Child Care Staff Member 3 acknowledged that children who do not rest are not allowed to engage in a quiet activity until they have rested for 20-30 minutes.

  Open Not marked corrected in the state record

  Category: supervision. Open / not marked corrected.

• Violation

  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. ................ .............

  Program Director Laura Kenworthy did not have concerns for maintaining the child care staff member to child ratio in Ms. King's classroom. She did not remember having any issues with Ms. King leaving the room "longer than bathroom breaks." "Our policy is that if staff need to step out of the room, they call us. I haven't heard of any concerns for her doing this or witnessed it." The Blue Room classroom is located between two other classrooms and separated by half walls on both sides. Ms. Boersma said Ms. King spends a lot of time standing at the half walls and talking to the teachers in the other rooms. "She leaves me out of ratio because even when she's in here she isn't contributing. She's on her phone all the time, just sitting in the corner of the room, or standing talking to people and not looking at the kids." She repeatedly leaves the classroom for extended periods of time throughout the day. She takes bathroom breaks without calling the office for coverage or goes to the kitchen. Ms. Boersma said she has spoken to Ms. Kenworthy about this and she replied, "Yes, that sounds like Taylor. She needs to be in the room." Alexis Riggs stated that Ms. King "does leave the classroom out of ratio. Not for extended periods of time, but longer than a bathroom break." When she is in the classroom, Ms. King has a hard time staying engaged. "I feel like she's distracted a lot of the time. She lets the kids do what they want, and there's not a ton of engagement from her. I've seen her on the phone a lot in the classroom." Ms. Riggs said she has seen this recently, in the last two weeks. Skielynne Roberts said Ms. King leaves the other child care staff member in her room "out of ratio a lot." She leaves the rom several times a day, for example the previous week she was in the room from 12:00pm-4:30pm and left the room at least 5 times that afternoon." She leaves for varying amounts of time, but the room was out of ratio." "She talks over the wall a lot, it's constant. The room is out of ratio at that point, because she's not paying attention or helping with the kids." Ms. King is also on her phone often. "It's really frequent, like every single day." Ms. Roberts said she has mentioned her concerns to Ms. Kenworthy. "I didn't get a response about it." I spoke with Ms. Kenworthy and asked her again about Ms. King stepping out of the room often and leaving it out of ratio. She repeated that she hasn't had any concerns and that no one has mentioned anything to her. I told her that two staff members said they spoke with her about it recently, and she said she did not remember that. Ms. King stated that if she needs to leave the room for a bathroom break "most of the time" she asks one of the Program Directors to help. "There are very few times I'll leave the room without calling one of them." She said she leaves the room 5 approximately 2-3 times a day. "It's not an issue. Laura and Kristie are on top of not letting us go out of ratio." Ms. King said if she is out of the room longer than two minutes, she will call for someone to cover. "Out of 2-3 times a day I'm stepping out of the room, I'll call for cover 1-2 of those times. The other time it's because it's only a minute or two." I asked Ms. King about talking over the wall to coworkers. "That's not something that happens with me. I only talk about things that pertain directly to the kids in the room at that time."

  Open Not marked corrected in the state record

  Category: supervision. Open / not marked corrected.

• Violation

  ................................................................................................................................................................................... 400.8182(3)(c) Ratio and group size requirements. (3) In each room or well-defined space, the maximum group size and ratio of caregivers to children, including children related to a staff member or the licensee, shall be the following: (c) For preschoolers 3 years of age, there shall be 1 caregiver for 10 children.

  The complaint received on 04/23/2021 stated that Ms. King "will yell and scream at the children when they are having tantrums, and chooses to forcefully restrain them for extended periods rather than helping soothe the children and teach them how to cope with their feelings." Ms. Kenworthy stated that she has not had concerns for how Ms. King disciplines children in the classroom. They did have one child who was throwing things and she has seen Ms. King "help that child so he's not throwing things and hurting others by guiding him to the classroom's safe space." The staff have not had formal training on using restraints, but Ms. Kenworthy said she's "talked them through that. We shoot for them sitting on her lap if they need to." She does not have concerns regarding Ms. King's tone of voice. "She might have some language sometimes, but nothing that makes me worried." Ms. Boersma stated that she has had concerns with Ms. King's tone of voice. "She'll yell at the kids. She raises her voice and will say, "Get over here right now" and stuff like that." Ms. King is not physically harsh, but is verbally so. She hasn't seen her physically restrain a child but will tell them not to move. "She'll tell them "don't move." She will also make inappropriate comments in front of them like saying "I want to strangle them." Ms. Riggs stated she hasn't had any major concerns for how Ms. King interacts with children. "Her tone gets loud sometimes but her language is appropriate. She does use a raised voice sometimes." She has heard other staff mention concerns for Ms. King's tone. She has never seen Ms. King restrain a child. Ms. King said the only time she raises her voice in the classroom is if there is a dangerous situation. She has not noticed an issue with her tone, but says if there was her co-workers would address it. "Someone would have said something I think. No one has." Ms. King has not had to use restraint with any children in the classroom. "We have a few behavioral issues, but we just use redirection." She was taught a pretzel hold on her lap when she was hired, but doesn't have to use it. "I'll call Laura for help if I need one on one help with a child.

  Open Not marked corrected in the state record

  Category: ratio. Open / not marked corrected.

• Violation

  400.8140 Discipline. (1) Positive methods of discipline that encourage self-control, self-direction, self-esteem, and cooperation must be used. 7

  Taylor King has occasional issues with appropriate tone, but overall is using positive methods of discipline with children in care.

  Open Not marked corrected in the state record

  Category: ratio. Open / not marked corrected.

• Violation

  R 400.8112 · R 400.8112 Comprehensive background check; fingerprinting. (3) An individual may serve as a child care staff member pending an eligibility determination by the department under section 5n(8) of the act, MCL 722.115n, and shall be supervised at all times by the licensee or a child care staff member who has been determined eligible.

  On 03/18/2021 I received a complaint stating that there is a staff member who is working at Creation Kingdom and they do not have a cleared fingerprinting result. I check onto the Child Care Background Check system (CCBC) and noticed there were two employees who were in "registry check" status and one employee who was in "additional information requested" status. On 03/19/2021 I completed an unannounced visit to the child care facility. I met with child care staff member Kristi Lange. Ms. Lange stated the two individuals in the "registry check" status, Jenna VanNortick and Amaya Hansen, are not employed with the center and have been removed from the CCBC system. She stated these individuals were never employed or worked at the center. Ms. Lange stated Laura Reyes was a staff member at the child care center and was working. This was the individual that was still in "additional information" status. Ms. Lange stated Ms. 2 Reyes lived out of state in Arizona and they were waiting on documentation from Arizona to complete the background check information. Ms. Lange stated they have received a letter from the Child Care Background Check Unit that stated Ms. Reyes could work as long as she was working with another employee who was cleared in the CCBC system. Ms. Lange stated she would get the letter and provide it to me. While speaking with Ms. Lange, Program Director Laura Kenworthy arrived at the center. Ms. Kenworthy stated Ms. Reyes was approved to work at the child care as long as she was with an employee who was cleared correctly. Ms. Kenworthy provided me with the letter from the Child Care Background Check. The letter was dated for February 24,2021 and stated "he or she may be supervised by another individual who has been cleared by our background check system". Ms. Kenworthy stated Ms. Reyes has never worked alone in the classroom and has always had another individual with her. I completed an exit conference with Program Director Laura Kenworthy on 03/19/2021. I was able to view attendance records and verified Ms. Reyes was never alone in the classroom. I was provided a copy of the letter indicating Ms. Reyes was able to work while she was supervised and waiting on her results. Ms. Kenworthy stated they do not have any individuals working in the center who are not cleared through our background system. She stated they make sure all employees have what they need before they are offered a position and can work. Ms. Kenworthy stated they have been working with their regular child care licensing consultant Stacia Thrower on connecting and disconnecting individuals who are correctly and currently working. The CCBC system is accurate for their facility. On 03/19/2021 I verified the CCBC system with the child care center's current staffing plan and noted it was current and correct. On 04/13/2021 I contacted the center to speak with Laura Reyes. I was directed to Program Director Laura Kenworthy. Ms. Kenworthy stated after my visit on 3/19/2021 the background check unit sent another letter stating that Laura Reyes could not be in the facility until all her checks were completed. Ms. Kenworthy stated Ms. Reyes was sent home that day and has not returned to work. They are waiting on a letter with the State of Arizona. Ms. Kenworthy has been in contact with the CCBC unit and Sue Bancroft, CCBC worker, directly. Ms. Kenworthy stated once the letter from Arizona is sent over to her, she will be sending it to Mrs. Bancroft. Once this has been completed, Ms. Reyes can then return to working in the center. 3

  Open Not marked corrected in the state record

  Category: supervision. Open / not marked corrected.

• Violation

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

  I completed unannounced on-site inspection. I spoke with program director Laura Kenworthy about the complaint. She indicated that she received a call from a parent over the weekend concerned about her child. The parent told her that her son's teacher Ms. MacPherson told her that when she has to get her son's attention, she hits his hand. Ms. Kenworthy stated that she then talked to Ms. MacPherson who told her that when she needs to get Child A's attention, she taps him on the hand with her two fingers and calls his name, "[Child A], [Child A]." I spoke with Child A's Mother regarding the complaint. She stated that last week Friday Ms. MacPherson leaned over the half wall of the classroom and told her what 2 she reported to the director. I asked her to explain to me exactly what happened. She stated that she asked Ms. MacPherson how her son was doing. She said that Ms. MacPherson told her that she found that smacking his hand makes him listen. At the time she really didn't think anything about it but when she got home and was talking to her boyfriend about it, he said, "what do you mean she smacks his hands"? She stated that after her conversation with him she started thinking about it because around the week of New Year's Ms. MacPherson asked her if she wanted her to spank Child A's bottom, but before she could respond another staff member interjected and said to Ms. MacPherson "no, don't" "you're not allowed to do that, and you shouldn't even be asking her that and Ms. MacPherson walked away. Child A's Mother stated that at the time she didn't know if Ms. MacPherson was serious or joking. But it sounded like she said it in a more jokingly and sarcastic way. Child A's Mother explained that after talking to her boyfriend and thinking about her previous conversation with Ms. MacPherson she decided to call one of her friends whose child also attends the child care center. She said she asked her to ask her daughter if Ms. MacPherson ever hit her. She said Child B told her mother that Ms. MacPherson hits Child A and Child C on the hands but she hits her in the face and the belly. Child A's Mother stated that Child B is and when Child B's Mother asked her daughter the question "Did Ms. MacPherson hit you"? She referred to 3rd herself in the person and she repeated twice that Ms. MacPherson hit her in the face and in the belly. After her conversation with Child B's Mother, she told her that she was going to text program directors Laura Kenworthy and Kristi Lange asking one of them to call her back. She stated that Ms. Kenworthy ended up calling her and she told her about the situation. I spoke with Allyson MacPherson about the complaint. She stated that she works in the blue room as the substitute lead, but she is supposed to be the aide. Ms. MacPherson stated that the conversation came about because Child A was being his usual self which means him running around and not settling down, taking things from the other children, etc. Child A's Mother would often times reprimand him when he's not behaving. Child A's Mother told her on the same day that whatever she needs to do to get him to calm down she can do. She even told her that if she can find a way to spank him out of sight of the cameras, she doesn't care. She said that she did not spank him even though the mom said she could because she would never hit a child in that manner as a form of discipline. However, she told Child A's Mother that to get his attention or to get him to calm down she taps him on the hands, and Child A's Mother said that she was fine with it. I asked Ms. MacPherson about the allegations that she hits two other children. One she taps the same way in which she taps Child A and the other one it is reported that she hits in the face and in the belly. She denied that she taps or hits any other children to get their attention and stated she has never hit Child C or any other child. She also denied that she has hit any girls in the face or belly. She has never had

  Open Not marked corrected in the state record

  Category: supervision. Open / not marked corrected.

• Violation

  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 10/15/2020, I conducted an unannounced on-site inspection. After reviewing the complaint, Ms. Kenworthy, program director, stated that no one smells of marijuana and no one smokes marijuana to her knowledge. She stated she has never observed anyone under the influence and that none of the staff or parents have complained to her about it. I then spoke with child care staff members Karen Fetterhoff, Amber Stinson, Hannah Onan, Sara Miller, Lois Laroe, Teri Sikkenga, Taylor King, Debra Biggs, and 2 Skielynn Roberts all of whom stated that have never seen or suspected anyone to be under the influence of marijuana. Ms. Stinson stated that she knows what marijuana smells like and she has never smelled it at the center. Ms. Miller reported that it is shocking that this is even a complaint. She has never had any concerns with that at the facility. Ms. Laroe stated she has no ideal and she's not really sure what marijuana smells like so she wouldn't really know. Ms. King stated that no one she knows is using marijuana and it's never even talked about at the facility. She reported she has noticed a marijuana smell on some parents: however, never on any staff members. On 11/9/20, Child A's Mother stated she has seen no signs of marijuana use by staff. Child B's Mother stated that she has had a great experience at Creation Kingdom. She has never had much interaction with staff due to COVID to tell if anyone was under the influence of marijuana. On 11/10/20, Child C's Mother stated she had no complaints about the facility at all. Child D's Mother stated she has no knowledge of anyone being under the influence of marijuana because they don't really get to see the staff members right now due to COVID. Child E's Mother stated that she has never suspected anyone to be under the influence of marijuana in the three rooms that her daughter has been in. She stated that her daughter has been in the infant room, wobblers and the orange room and she has never smelled or seen anything concerning.

  Open Not marked corrected in the state record

  Category: supervision. Open / not marked corrected.

• Violation

  R 400.8125 · R 400.8125 1 Staff; volunteer; requirements. (1) All staff and volunteers shall provide appropriate care and supervision of children at all times. l 4

  Ms. Kenworthy reported that children are never left unattended in classrooms. Child care staff members Karen Fetterhoff, Amber Stinson, Hannah Onan, Sara Miller, Lois Laroe, Teri Sikkenga, Taylor King, Debra Biggs, and Skielynn Roberts all stated that child care children are never left unattended. Ms. Onan reported that they never leave child unattended. She stated there is usually another staff member in the room and they have walkie-talkies to call down to the front desk for assistance if they are alone and need to leave the room. She explained she has never seen children left unattended in the six years she's been working at the center. Ms. Laroe stated she has never seen children left unattended and that there is always at least one staff member in a room. Ms. Roberts stated that she hasn't seen children left unattended recently: she knows that there was a staff member several months back that would step out of the room to grab something from another room. It was reported to the director who took care of it immediately. She stated that this only happened about 3 times, but it would be quick, about 30 seconds, to grab something from the room attached by a half wall. Child A's Mother reported that she has no knowledge of this because parents are not even allowed into the facility right now due to COVID. Child B's Mother reported that she has never had issues with this. She said she always saw someone in her son's classrooms, but she never looked around at the other classrooms. Child C's Mother stated she is not aware of any children being left alone. Child D's Mother reported that there is usually more than a person in the rooms. Child E's Mother reported that she's never seen children left alone.

  Open Not marked corrected in the state record

  Category: supervision. Open / not marked corrected.

• Violation

  R 400.8158 · ..................................................................................................................................................................................................................................................... R 400.8158 Incident, accident, injury, illness, death, fire reporting. (1) In the event of the death of a child in care, a licensee, licensee designee, or program director shall do both of the following: (a) Immediately report it, in-person or via phone, directly to the child's parent. (b) Report it to the department within 24 hours, via

  Ms. Kentworthy stated as far as staff documenting and reporting incidents and injuries, they document all of them. They document them mostly through their "KID Report App" and occasionally they hand write them if they are having trouble with the app. Parents get notices through the app and/or email and then staff will print report to review with parents. Both staff and parents will sign reports and then place a copy is in the child's file. Occasionally, if the app is down staff will hand write reports, have parents review and both staff and parent will sign and then place a copy in the child's file. I then spoke with child care staff members Karen Fetterhoff, Amber Stinson, Hannah Onan, Sara Miller, Lois Laroe, Teri Sikkenga, Taylor King, and Debra Biggs about the complaint which indicated that staff members are not documenting accidents and injuries. Ms. Fetterhoff stated that she does not have any incidents or injuries in her room, but she knows that there is protocol for documentation to follow as far as she knows staff follow it. Ms. Onan stated that it depends on the staff member. She may sometimes, if she gets really busy, forget but most of the times she does it. Every blue moon she may forget to write up the report but she always reports incidents and injuries to the parents. Ms. Laroe stated that she would not know anything about staff not reporting incidents. She stated she only had one incident and she logged it on the computer. Ms. Stinson stated that they usually don't have incidents in the infant room. Ms. Miller stated that as far as she knows they are pretty good about documenting incidents and injuries. As far as she knows the other rooms are too. Ms. Sikkenga stated she is the cook, and she has no knowledge of about the documentation. Ms. King stated she personally logs everything. She immediately notifies Kristi Lange and completes the incident report. 5 Ms. Biggs stated as far as she knows everything is being documented. She documents everything. On 11/09/20, Child A's Mother stated that every time her daughter has had an incident she has been notified and she had to sign an incident report. Child B's Mother reported that her son has never had an incident or injury that would require her to sign an incident report. On 11/10/20, Child C's Mother reported no concerns about documentation. Child D's Mother stated her daughter has never had any accidents or injuries at the facility, but she hopes if she had the staff would have logged them appropriately. Child E's Mother stated she has always received documentation of accidents and injuries.

• Violation

  R 400.8330 · R 400.8330 Food services and nutrition generally. (13) If food, bottles, or beverage containers are warmed, then the warming must be done in a safe, appropriate manner.

  Ms. Kenworthly stated they have bottle warmers and that's all that they use to warm up bottles. She doesn't know how else they would be warmed up bottles because they don't use microwaves or warm under hot water. I spoke with child care staff members Karen Fetterhoff, Amber Stinson, Hannah Onan, Sara Miller, Lois Laroe, Teri Sikkenga, Taylor King, Debra Biggs, and Skielynn Roberts regarding the complaint stating that staff are not warming up bottles properly. Karen Fetterhoff stated that she and her aide Amber Stinson warm the infant bottles in the bottle warmers and that's all they use. Amber Stinson stated she warms the bottles and so does the staff in her room. As far as she knows everyone warms the bottles in the bottle warmers. Hannah Onan stated they are all trained to warm the bottle in the bottle warmers. They test the temperature of the bottles before giving it to the infant and they never hold the infant when they take the bottle out of the warmers. Lois Laroe stated that when she worked in the infants and wobblers, she warmed the bottles and she saw everyone else warm the bottles using the bottle warmers. Taylor King stated they use the bottle warmers and there no way to use it wrong. She stated that she knows the feeding rules and she follows them. Skielynn Roberts stated that she doesn't know anything about how staff are feeding the infants because she rarely works with infants. Sara Miller stated they have a bottle warmer. Staff follow the directions on the bottle warmer and then they test the bottle when it's done. Ms. Sikkenga stated she is the cook, and she has no knowledge of about the bottle warming. Ms. Biggs stated she doesn't know because she doesn't work in the room with bottles. On 11/09/2020, Child A's Mother stated that her daughter has been done using bottles for quite some time now but when she was using them she had no issues with the way the staff were warming or feeding them to her. Child B's Mother stated she never noticed any issues with the way they were warming the bottles. On 11/10/2020, Child C's Mother stated her daughter only drank cold bottles. Child D's Mother stated she never had any issue with the way the staff were warming bottles. Child E's Mother stated that they warmed the bottles correctly. She stated her daughter was a very picky eater and she would not have drank the bottles if they were not warmed up properly. 7

  Open Not marked corrected in the state record

  Category: nutrition. Open / not marked corrected.

Mold is present in the orange and green classrooms at the facility.

Disposition: Substantiated

Child Care Staff Member 1 and Child Care Staff Member 2 forcefully handle and physically discipline the children in care and administrators ignore the behavior when they are made aware.

Disposition: Substantiated

Child care staff member Taylor King does not maintain the child care staff member to child ratio when she regularly leaves the classroom. Ms. King yells and screams at children in care and forcefully restrains them. 1

Disposition: Substantiated

A staff member is working in the facility without receiving their fingerprinting results.

Disposition: Substantiated

Child Care Staff Member, Allyson McPherson disciplines Child A (3 years) by hitting him on his hand when he does not listen.

Disposition: Substantiated

Multiple child care staff members are under the influence of marijuana. Child Care staff members left child care children completely unattended in rooms. Child care staff members are not documenting and logging injuries or incidents. Child care staff members do not warm up bottles.

Disposition: Substantiated