Arborwood South Early Learning Center

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 December 5, 2022, I made an unannounced onsite inspection to the child care center. I discussed the allegations in the complaint with the program director Stephanie Baliff. Ms. Baliff stated that on December 1,2022 Child A began running around the classroom and screaming. Child Care Staff Member (CCSM) 1 picked Child A up and covered his mouth and nose with her hand to stop Child A from screaming. CCSM 2 saw CCSM 1 do this and told CCSM 1 to uncover Child A's Mouth and put him down. CCSM 1 put him down and pushed Child A away from her and Child A fell over. Later in the day CCSM 1 walked out of the center quitting her job. CCSM 1 worked at the center approximately three and a half weeks. During the onsite inspection I interviewed CCSM 2. CCSM 2 stated that she was working in the classroom with CCSM1 when Child A started running around the classroom and screaming. CCSM 2 explained that Child A was running and screaming because he has some behavioral problems. CCSM 2 went on to state 2 that Child A was screaming and running when CCSM 1 picked him up and put her hand over Child A's mouth and told him to stop screaming. CCSM 2 stated at the time this was occurring she was sitting on the floor with another child. When she saw what CCSM 1 did, she told CCSM 1 to stop and put Child A down. CCSM 1 put Child A down and pushed him away from her causing him to fall over. CCSM 2 stated that, Child A was not hurt, and she was able to comfort him and calm him down. During the onsite inspection I interviewed CCSM 3. CCSM 3 stated that she was in the classroom at the time of the incident but did not see what happened. She heard Child A yelling and heard him call CCSM 1, "the B word", Child A was yelling and then his yelling sounded muffled. She heard CCSM 2 say, "put him down." CCSM 2 stated at the time of incident she was near the desk with her back to them dealing with another one of the children. During the onsite inspection I viewed the classroom where the incident occurred to visually assess where the incident occurred. CCSM 2 pointed out where CCSM 1 was with Child A when she pushed away from her causing him to fall. During the onsite inspection on December 5, 2022, I discussed the findings of the investigation with Ms. Baliff. Ms. Baliff stated that they planned on terminating CCSM 1's employment, however she walked out of the center the same afternoon of the incident and did not return, essentially quitting her job. On April 6, 2022, I conducted an exit conference with the licensee designee Cortney Last. We discussed the findings of the investigation and the corrective action plan. Ms. Last stated that they had already provided the child care staff members additional training on how to care for children when they are acting out, they also went over their policies regarding restraint. Ms. Last will put all of the information regarding the steps they took to assure nothing like this occurs again into a corrective action plan. ..........

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R 400.8140 · R 400.8140 Discipline. (2) All of the following means of punishment are prohibited: (a) Hitting, spanking, shaking, biting, pinching, or inflicting other forms of corporal punishment. (b) Placing any substances in a child's mouth, including but not limited to, soap, hot sauce, or vinegar. (c) Restricting a child's movement by binding or tying him or her. (d) Inflicting mental or emotional punishment, such as humiliating, shaming, or threatening a child. (e) Depriving a child of meals, snacks, rest, or necessary toilet use. (f) Excluding a child from outdoor play or other gross motor activities. (g) Excluding a child from daily learning experiences. (h) Confining a child in an enclosed area, such as a closet, locked room, box, or similar enclosure. (i) Time out must not be used for children under 3 years of age.

CCSM 1 restricted Child A's movement and ability to speak by picking him up, holding him and covering his mouth with her hands to stop him from screaming.

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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.

I interviewed Ms. VanDaele, licensee designee. She stated that Child A (age 6, male) is autistic with limited verbal skills. He attended the child care half days. On 3/29/22, she received a note that Child A's Mother wanted to disenroll Child A. Ms. Retli, Special Education Teacher Consultant, contacted his mother. According to Child A's Mother, Child A has started removing his clothes at home and has started "wetting" the bed. Child A sees a therapist to assist Child A with learning "compliance tasks." Child A's Mother discussed Child A's recent behavior changes, and the therapist asked if anyone could be "touching" him inappropriately. Child A's Mother asked Child A if anyone at the child care has touched his "pee pee," and he said "Yes" but only when "messy or dirty." Child A's Mother asked Child A who touched him, to which he replied "Ms. Cassie", referring to child care staff member (CCSM), Ms. Martin. Child A did not provide any other information. Child A's Mother does not believe that Ms. Martin is "touching him" inappropriately, but with his disability, her name is the only name that he knows at the child care. Child A's Mother took Child A to the doctor, and there were no signs of "infection or abuse." Child A has also started saying," It's okay, trust me." Ms. VanDaele stated that in addition to following up with Ms. Retli after she spoke with Child A's Mother, she also contacted the CCSMs that have assisted Child A's room in using the bathroom including the Program Director and Site Lead, Ms. Bailiff; main classroom teachers and CCSMs, Ms. Martin and Ms. Anthony; Family Partnership Specialist and CCSM Ms. Drake; program secretary and CCSM, Ms. Shankleton; and program floater and CCSM, Ms Hurst. None of CCSMs reported any concerns. The children are never unsupervised. Child A is "pretty well potty 3 trained," but he still requires assistance with wiping if he has a bowel movement. Child A did not have bowel movements at the center until about 1 months ago. 1/2 Since then, Child A was having one or two bowel movements daily at the center, despite only being there a half a day. When Child A had a bowel movement, the CCSM's encouraged him to wipe himself first before they assisted him with wiping. Child A required no additional cleaning assistance if he only urinated. Ms. Martin and Ms. Shankleton never assisted in wiping Child A, despite Child A saying the name of Ms. Martin. The CCSMs in the room do not refer to bowel movements as "messy or dirty" to the children. They also do not say "It's okay, trust me." The children are normally taken to the bathroom in a group as the bathrooms are in the hallway of the elementary school. The bathroom contains stalls to provide for privacy. Child A walked out of the stall in the past with his pants down and he was redirected to pull up his pants himself. Child A is also taken to the bathroom individually as he would have bowel movements during non-group trips to the bathroom. Child A did not express any concerns with using the restroom. He did not express any concerns regarding interacting with the CCSMs. Child A has not removed his clothes while at the child care center. Ms. VanDaele believes that the children receive good care and supervision. She does not believe that any of the CCSMs acted inappropriate in their care of Child A. She does not believe that the CCSMs are responsible for Child A's recent change in behaviors. Ms. VanDaele provided me with the written statements provided by the above-named individuals. Child A's Mother disenrolled Child A from the center. I interviewed Child A's Mother. Child A attended the center a few months last school year, as well as this school year. Over the last two weeks, Child A started to wet the bed again at home, despite being potty trained for over a year. He has started removing his clothes while at home and urinated on her bed. In addition, Child A started to say, "It's ok, trust me.", which is usual for him. Child A is diagnosed wit

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

I interviewed Ms. VanDaele, licensee designee. On 2/8/2022, Child A received a "Mr. Goodbar" from child care staff member (CCSM) Ms. Raetzel. According to Ms. VanDaele, Ms. Raetzel did not realize that this type of candy bar contained nuts. When she realized that it contained nuts, she had Child A spit out the candy and rinse his mouth. Child A was monitored closely, and he did not have an allergic reaction. Child A is especially scared of nuts. Even a picture of a nut will cause him to hyperventilate. Child A overheard a CCSM say the word nut, and this caused him to have a panic attack. An ambulance was called, but no additional treatment was needed as he did not have an allergic reaction and he was medically fine. In addition, Child A's Mother also did not seek any further medical treatment. Ms. VanDaele stated that when Child A was first enrolled in the fall, his mother indicated that he did not have any allergies. However, since initial enrollment, she has frequently changed suspected food allergies. Child A's Mother recently encouraged the center to have Child A try different foods which were previously suspected food allergies. Despite this, peanuts have always remained on the list of suspected allergies. Child A's Mother did not give permission for Child A to eat peanuts. Child A's Mother has not produced any medical documentation, nor provided any medication support for the verbally reported allergies. Ms. VanDaele stated that all the CCSMs take potential allergies in children seriously, and that this was an unfortunate accident. Ms. VanDaele is using this incident as a teachable moment for the CCSMs about the importance of not bringing food from home, and to review the center's emergency procedures regarding allergies. In addition, she has also spoke with Child A's Mother and requested medical documentation of Child A's allergies. I interviewed Child A's Mother. Child A has attended the center since September 2021. She stated that Child A has numerous allergies to foods, including nuts and peanuts. She also told the center that he was allergic to eggs and wheat; however, he has begun to outgrow those allergies. Child A also recently ate humus at home, and he had a reaction. The occurred the week of January 31st. She did not make the center aware of this allergy until 2/8/22. He is also allergic to cats. Child A's allergic reactions vary in severity. Child A's Mother stated that she told CCSMs Ms. Taylor and Ms. Raetzel of his allergies, including his nut allergy. Child A's Mother stated that on 2/8/2022, the center contacted her and told her that Child A ate some peanuts, and that the ambulance was on site. When she arrived at the center, she was told that Child A did not fully ingest the peanut and that he was okay. Child A did not have an allergic reaction. Ms. Taylor told her that Ms. Raetzel was handing out candy to the children. Child A took a bite of chocolate with a nut. It was recognized immediately, and he spit it out. Child A's Mother spoke with Ms. Raetzel. 3 Ms. Raetzel was "very upset, regretful, and remorseful" about giving Child A the candy. She said that she was sorry. Child A's Mother stated that she took Child A to the doctor the next day, not for eating the peanut, but because he had continued congestion and drainage from before the incident. The doctor prescribed a nebulizer to treat his asthma and Zyrtec as an allergy medication. Child A's Mother stated that she plans to follow up with an allergist to determine if Child A should have an Epi pen, but this has been denied in the past. Child A's Mother believes that this was an accident, and that she does "not hold anything against them." Child A still attends the center, and he "loves his teachers." Child A's Mother described the CCSMs as "wonderful" and that she believes that they take good care of him. She believes that the CCSMs are mindful about Child A's medical needs and that they would not deliberately do anything to harm him. She believes th

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