Emily's Gnome School

R 400.1911 · R 400.1911 Care; supervision; children. (1) A licensee shall ensure appropriate care and supervision of children at all times.

On 10/30/2020, 1 received an incident report from Ms. Scholtens indicating that on the same day, Child A (male, 22 months) fell off the diaper changing table onto a cement floor. Ms. Scholtens indicated on the report that she was standing next to the table and as she leaned over to get a diaper, he flipped forward off the table, landing on his left arm and his head. Child A's Mother was contacted. Child A's Mother picked Child A up and brought him to the emergency room. On 11/03/2020, I contacted Child A's Mother about the incident. She reported that she was told immediately of the incident and that when Ms. Scholtens called her, she could hear her son crying hard in the background. She picked him up and took him to the emergency room, where it was discovered that he had broken two bones 2 in his wrist and was referred to a specialist for further treatment. Child A's Mother expressed concern with how he was able to fall from the changing table. On 11/04/2020, I completed an onsite inspection where I reviewed the incident with Ms. Scholtens and asked her to discuss it with me again. She reported that she sat Child A on the diaper changing table with his legs hanging over the front of the table. She reached down to pick up his box of diapers from under the changing table. At the time, he was wiggling around and did not want his diaper changed. When she leaned over, Child A flipped forward off the changing table, landing on his arm and the back of his head. She immediately picked him up and noted that he was not moving his left arm; he was also crying. Ms. Scholtens called Child A's Mother to tell her of the incident and she arrived within 15 minutes. Ms. Scholtens was at the home with six children at the time of the incident. I observed the diaper changing table to be a commercial style table with a changing pad, with a railing at the top and two shelves for supplies underneath. The top shelf contains labeled bins of children's supplies as well as a package of wipes. The diaper changing table sits on a cement floor. I asked Ms. Scholtens how Child A was able to flip forward if she was standing in front of the table. She reported that she stepped back and to the side to reach the shelf. She again reported that Child A was sitting up with his legs hanging over the edge of the table and denied that she was holding on to him. On 11/05/2020, I received emails from Child B's Mother, Child C's Mother, and Child D's Mother. All parents denied concerns with their children's safety while in care and denied concerns with Ms. Scholtens' care and supervision. They all expressed concern that Ms. Scholtens could lose her license over an accident. I contacted Child E's Mother and Child F and G's Mother regarding the allegations. Both parents denied concerns regarding Ms. Scholtens' care and supervision. .......... .............

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R 400.1910 · .................................................................................................................................................................................................................... R 400.1910 Ratio of personnel to children. ................................................. ............................... .................................................... (1) The ratio of personnel to children present in the home at any 1 time must be not less than 1 member of the personnel to 6 children. The ratio must include all children in care who are not related to any personnel and any of the following children who are less than 6 years of age: (a) Children of the licensee. (b) Children of a child care staff member or child care assistant. (c) Children related to any member of the household by blood, marriage, or adoption.

Ms. Scholtens did not ensure that the ratio of personnel to children never exceeds one member of personnel to six child care children. On 10/19/2020 and 10/29/2020, Ms. Scholtens was present with more than six unrelated children. An additional child care staff member would have been required to maintain the appropriate ratio.

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R 400.1906 · R 400.1906 Records of a licensee; child care staff member; child care assistant. (1) A licensee shall maintain a file for each child care staff member and each child care assistant that includes all of the following: (b) Daily records detailing arrival times and departure times at the child care home. 4

Ms. Scholtens did not ensure that her child care staff member's dated daily attendance was complete and accurate.

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R 400.1907 · R 400.1907 Child's records. (1) Prior to a child's initial attendance, a licensee shall obtain the following documents: (a) A completed child information card on a form provided by the department or a comparable substitute approved by the department.

Ms. Scholtens did not obtain completed child information cards prior to children's initial attendance. A number of child information cards were missing required information, including date of signature, allergy information, and physician contact information. One card was not obtained prior to the child's initial attendance.

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