Explorers Learning Center Tan

R 400.8137 · R 400.8137 1 Diapering; toileting. (6) Diapers and training pants must be checked frequently and changed when wet or soiled.

On 05/30/2023, I received a complaint alleging that Child A (female, 9 months) is not being cared for properly by CCSM1. The complaint alleged, in part, that CCSM1 only changes Child A's diaper twice a day and that, due to Child A sitting in a soiled diaper for long periods of time, she had a rash on her bottom. The complaint denied that Child A required medical treatment and the rash was being treated with a topical cream. On 06/01/2023, I completed an onsite inspection. CCSM1 confirmed that she is the lead caregiver for Child A. Child A has historically been present Monday through Friday, but lately has only been present on Mondays and Fridays. CCSM1 reported that center staff check diapers at least hourly and that she changes them if they are even a little wet. She joked that staff say she "over changes." She reported that Child A had a rash but denied that it was bad, stating, "I think mom was really paranoid about it." When asked why she thought that it was because Child A's Mother had asked about it on Brightwheel. CCSM1 stated that they were using Aquaphor on Child A's rash but then Child A's Guardian sent in different cream. According to CCSM1 the rash has since gone. CCSM2 has been the lead caregiver in the room for approximately one month but has been working full time in the center since January. Until last week, Child A was present Monday- Friday but would leave for three hours or so on Wednesday and Friday. Her schedule has recently changed, and she is not present as much. I informed CCSM2 that the allegation states that Child A is only being changed twice a day, resulting in a diaper rash. CCSM2 denied that any child would be present for a whole day and only have that number of diaper changes. She stated that someone may have forgotten to enter information in Brightwheel but that it would be impossible to know who. Staff try to keep up with Brightwheel in real time, but also check it at naptime. The previous Tuesday, they had a staff member from another center filling in and it was more hectic. CCSM2 has started using a whiteboard to remind staff when diaper changes are due. On 05/26/2023, Child A's Guardian asked them to use cream on a diaper rash. On 05/30/2023, Child A's Mother was asking about the rash, which was fine by that point. CCSM2 reported that CCSM1 "overchanges" diapers, changing them when they are the slightest bit damp. CCSM1 is always diligent about entering her diaper changes in Brightwheel or asking another staff member to do it for her. CCSM3 started working in this center in January 2023, but has worked with this licensee group for 2 years. Diapers are checked at least every two hours. I informed her of the allegations, and she denied there is any way that is true. She denied that she has ever observed a child sitting in a dirty diaper. CCSM3 has not seen Child A since last week, but Child A did have a very faint diaper rash that CCSM3 noticed on Friday (05/26/2023). They were putting cream on it, and it did not seem to bother her at all. I asked her how she thought the Brightwheel could be inaccurate, and she stated that entries must have been missed. The primary caregiver normally does the entries for their children, but sometimes will ask others to help. CCSM1 is very strict about diaper changes and changes children any time they are even a little wet. 3 Ms. Kelley reported that the center's policy is that diapers are checked at least every hour and that they are changed when soiled. Staff are expected to keep Brightwheel updated and are normally good about doing this. Ms. Kelley provided me with Brightwheel records for Child A. Child A's record for 05/26/2023 shows that she was present from 8:52 A.M. — 5:10 P.M. and had four diaper changes. Her record from 05/30/2023 shows that she was present from 8:19 A.M. — 5:12 P.M. and had three diaper changes. Ms. Kelley also provided me with Child A's Brightwheel messages from those two days. On 05/26/2023, Child A's Mother sent a message asking ho

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R 400.8330 · R 400.8330 Food services and nutrition generally. (7) Infants and toddlers shall be fed on demand.

The allegation states that Child A only receives one bottle per day. CCSM1 reported that infants are fed on demand. Parents often submit what they would like their child's eating schedule to be, but center staff does not adhere to that if an infant is hungry. Child A comes with 3 8oz bottles daily and drinks 2-3 of those. She also eats fruit and cereal in the morning and vegetables and cereal in the afternoon. Meals are documented on Brightwheel. CCSM2 reported that center staff feed infants on demand. Parents can submit a schedule and staff will try to adhere to it as much as possible. I informed CCSM2 that the allegation states that Child A is only being fed one bottle per day and she denied that any child would be present for a whole day and only have that number of bottles. She again stated that someone may have forgotten to enter information in Brightwheel but that it would be impossible to know who, and that staff try to keep up with Brightwheel in real time, but also check it at naptime. CCSM3 reported that infants are fed on demand. She denied that this allegation could be true. She stated that they always feed on demand because babies cry when they are hungry. Parents send in premade, labeled bottles and any that are not fed during the day are sent home at the end of the day. All children in care have a laminated paper hanging on the wall indicating any sleep needs, their food requirements, any allergies, their contracted times of attendance, and parent/guardian names. Child A's sheet indicates that she eats a premade 8 oz. bottle every 4 hours with fruit or vegetables before each. Ms. Kelley also confirmed that infants are fed on demand and denied there is any way an infant could be present for a whole day and only be fed one bottle. Child A's Brightwheel record from 05/26/2023 shows that she had a bottle in the midmorning, followed by a food, food at lunchtime followed by a bottle, and a bottle in the afternoon. Her record from 05/30/2023 shows that she had an 8oz. bottle in the morning, a bottle and food in the early afternoon, and food and a snack in the late afternoon. These times appear to be within normal eating times for an infant of her age. I requested that Ms. Kelley provide me with mealtime records from the previous month and she provided records from a day where Child A ate two bottles and had food once, and one day where she had three bottles and one meal of food. I attempted to contact Child A's Guardian to see if she had any concerns about the amount of food Child A is being provided while in care, but she has not returned my calls. Child B's Mother reported that parents are notified within half an hour of feedings via Brightwheel. She denied any concerns regarding feeding or otherwise. 5

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R 400.8113 · R 400.8113 Program director qualifications; responsibilities. (2) A program director shall be present in the center in the following manner: (b) At least 50% of the time children are in care but not less than a total of 6 hours per day for programs operating 6 or more continuous hours.

The center's program director is not present in the center at least 50% of the time children are in care, and at least 6 hours per day.

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R 400.8110 · R 400.8110 Applicant; licensee; licensee designee; requirements. (6) The licensee or licensee designee shall maintain accurate daily records detailing arrival times and departure times for each child care staff member, child care aide, and volunteer.

Ms. Kelley does not maintain accurate daily arrival and departure times for all child care staff members. As Ms. Rife's attendance does not appear to be accurate, it is not possible to tell how much time she spends onsite.

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