• Violation

  R 400.8330(9) · R 400.8330(9) Food services and nutrition generally. A center shall not deprive a child of a snack or meal if the child is in attendance at the time when the snack or meal is served.

  Child care staff have not withheld food from Child A. He often dumps food onto the table or ground, but he is provided additional food when this happens.

  Open Not marked corrected in the state record

  Category: nutrition. Open / not marked corrected.

• Violation

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

  Appropriate care and supervision is provided during meal time. Child A has successfully grabbed food off children’s plates, but staff are supervising children and attempt to prevent occurrences.

  Open Not marked corrected in the state record

  Category: supervision. Open / not marked corrected.

• Violation

  R 400.8330(24)(c) · R 400.8330(24)(c) Food services and nutrition generally. Sitting with toddlers during meal times.

  Child care staff in the peach classroom do not sit with toddlers during meal times.

  Open Not marked corrected in the state record

  Category: nutrition. Open / not marked corrected.

• Violation

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

  Appropriate care was not provided on 11/22/2024. Lead Caregiver 1 handled Child A in a rough manner by taking him by the hand and pulling him toward the carpet and trying to maintain him in a sitting position causing Child A to fall. Lead Caregiver 1 was also observed sitting on the table watching children wrestle on the rug.

  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.

  I received a text message from licensee designee Julia Pratt- Buckham on 6/5/2023 at 6:02 p.m. stating that there are issues going on at the center and will provide details tomorrow. I received a telephone call from licensee designee Julia Pratt-Buckham informing me that Child Care Staff Member 2 CCSM2) has made an allegation that Child Care Staff Member 1 (CCSM1 ) Child A shelf, picked Child A up and placed him in a chair and then Child A's Child A tried to get out of the chair. According to Julia Pratt-Buckham, CCSM2 has been inconsistent with the details of her observations as CCSM2 also reported that Child A shelf when trying to run into CCSM1's arms for a hug. Child A's Parents have"popi ures of the injuries. Law enforcement is involved. I instructed Julia Pratt-Buckham to contact Michigan Department of Health and Human Services (MDHHS) to immediately report the incident. I received a telephone call from Rm6 6/6/2023. Child A's Father reported o the police department that child A shelf. Child A has and and his I spoke on the telephone with on 6/6/2023. 1 agreed to meet him at the child care center aPp.m. I made an onsite inspection at the child care center on 6/612023 wit Child A's Mother, CCSM1I MMan Child are staff ember 3 ( ) were interviewed. Child A's Mother is also a child care staff member at the child care center. She works in a classroom on the other side of the center and cannot see into Child A's classroom. Child A's Mother noticed that Child A's when she picked him up from CCSM1 's classroom on 6/2/2023. CCSM2 texted her later that evening to report that CCSM1 Child A's shelf around the time of graduation earlier that day. C i s Mother then looked for injuries and on Child A's She held up her phone to show pictures of the Io serve near the I also saw a on Child A's I was unable to decip er rom the photos ' y was caused by an Child A's Mother agreed to email us copies of the photos and text messages she received from CCSM2. Child A was not able to verbalize the cause of his injuries to his mother. Child A's Mother reported the allegations to Child Care Staff Member 5 (CCSM5) on 6/5/2023. Child A's Mother did not report any other concerns regarding CCSM1, however mentioned that CCSM1 has previously expressed frustration with Child A's CCSM2 is the lead caregiver in the preschool classroom located next to CCSM1's classroom and has been employed at the center for approximately one year. According to CCSM2, on 6/2/2023 at approximately 2:45 p.m. CCSM2 was getting her class ready for graduation when she looked over the half-wall and observed Child A running away from CCSM1. She heard CCSM1 tell Child A t*Sto* and n CCSM1 Child A with Child Auto the side and Child A was on a ground crying and CCSM1 crying, you are one. CCSM2 called over the wall to CCSM1 stating `Chill. We don't do that." After some time passed, CCSM2 looked over the wall again and observed CCSM1 carrying Child A in the cradle position and placed him in a chair. Child A tried to get up from the chair and run and CCSM1 used Child A and place him back into the chair. CCSM1 then squatted to eye level hand on Child A's- and the The Child A's position and Child A was to b CCSM2 attempted to report liner concerns to CCSM3 on 6/212023, but CCSM3 said they can discuss her concerns on Monday 6/5/2023. CCSM2 informed us that CCSM1 has a history of being rough with children. He uses a loud voice to get children's attention, he lifts and places children on their cot roughly and pulls children down the slide by their pant leg. She has reported these concerns to management on multiple occasions. CCSM1 is the lead caregiver in the 3-year-old classroom. He has been employed at the center since October 2022. He is often the only staff member in the classroom. CCSM1 reported that it is center policy that male staff members cannot change diapers. On 6/2/2023 at approximately 3:00 p.m., CCSM1 swapped classrooms with Child Care Staff Member 4 (CCSM4) so that CCSM4 can ch

  Open Not marked corrected in the state record

  Category: ratio. Open / not marked corrected.

• Violation

  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.

  Child care staff did not push Child A into a shelf or grab the back of his. CCSM1 and CCSM4 report that CCSM1 was not in the classroom at the time of injury. CCSM1 and CCSM4 report that Child A's was accidental. The small on Child A's were not deemed suspicious by the medical examiner and was not proven to be adult nail marks. The above Child As was a result of an "aacccciidental fall.

  Open Not marked corrected in the state record

  Category: recordkeeping. Open / not marked corrected.

• Violation

  R 400.8134 · R 400.8134 1 Hand washing. (2) All staff and volunteers shall wash their hands at all of the following times: (d) Before giving medication.

  I made an unscheduled onsite inspection at Sprout Early Care & Preschool on 6/1/2023 and spoke with Child Care Staff Member 1 (CCSM1), Child Care Staff Member 2 (CCSM2), Child Care Staff Member 3 (CCSM3) and licensee designee Julia Pratt-Buckham. CCSM1 is an administrator at the child care center. CCSM1 informed me that it is the center's policy to wear gloves and change them after every sunscreen application. According to CCSM1, staff are following center procedure. CCSM2 is an assistant to the program director. She stated that parents provide sunscreen for their children and staff changes their gloves before each application. CCSM3 is the lead caregiver in the Happy Apple classroom that provides care for children ages 30-36 months. She has been employed at the center since November 2022. CCSM3 wears gloves when applying sunscreen and changes them before each application. I spoke with licensee designee Julia Pratt-Buckham in the parking lot as I was leaving the child care center. According to Ms. Pratt-Buckham, staff comply with these licensing rules and believes the center is being targeted due to the number of complaints they have recently received. I spoke on the telephone with Child A's Mother and Child B's Mother on 7/5/2023 and Child C's Mother on 7/6/2023. None of the parents expressed concerns regarding sunscreen application. Child A's Mother informed me that staff wash hands when needed. Child B's Mother and Child C's Mother stated that they are not aware of hand washing practices for child care staff.

  Open Not marked corrected in the state record

  Category: health medication. Open / not marked corrected.

• Violation

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

  CCSM1 and CCSM2 informed me that it is center policy that staff change diapers within one hour of arrival and then again, every two hours or as needed. CCSM2 informed me that CCSM3 does a great job changing diapers promptly. Many of the children in the Happy Apple classroom are toilet training. Some childrer wear diapers and others wear pull-ups. CCSM3 stated that she takes children to the bathroom every 45 minutes and changes their diaper/pull-up every two hours or when soiled. Child A's Mother informed me that Child A's diapers are changed when soiled. Child B's Mother stated that staff change diapers promptly, however, diaper changes are not always documented on the written daily record to reflect this. Child B does not have a diaper rash and the diapers she provides the center are used up quickly. Child C's Mother did not express any concerns about diaper changing and Child C does not have issues with diaper rash.

  Open Not marked corrected in the state record

  Category: recordkeeping. Open / not marked corrected.

• Violation

  R 400.8320 · R 400.8320 Food preparation. (4) Staff shall minimize bare-hand contact with foods that will be cooked.

  I interviewed CCSM1 while she was preparing lunch. She was wearing gloves during the entire interview. CCSM1 stated that it is the center's policy to always wear gloves when handling food. She has not witnessed staff violating this policy. CCSM2 and CCSM3 informed me that staff wear gloves when handling food and beverages. 4

  Open Not marked corrected in the state record

  Category: ratio. Open / not marked corrected.

• Violation

  R 400.8320 · R 400.8320 Food preparation. (5) Ready to eat foods must not be prepared or served using bare hands.

  Staff wear gloves and use utensils when preparing/serving ready to eat foods. I observed staff wearing gloves when serving lunch on 6/1/2023.

  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 received an incident report from program director Amanda Swager on 3/24/2023. In the report, Ms. Swager informed me that on 3/23/2023 at approximately 10:30 a.m. she found Child A by herself in the hallway outside the gym door. Child A was not upset and asked Ms. Swager to let her in the gym. Ms. Swager opened the gym door and found Child Care Staff Member 1 (CCSM1) and the rest of her group of children. I made an unscheduled onsite inspection at Sprout Early Care & Preschool on 3/24/2023 and spoke with CCSM1 and CCSM2. CCSM1 had a combined group the morning of 3/23/2023 and he was feeling a little overwhelmed. His normal group of children later resumed, and they went to the gym. CCSM1 told Child A to grab her water bottle but forgot to wait for her and proceeded to the gym. The class was in the gym for approximately two to three minutes before Ms. Swager came in with Child A. CCSM1 cares for 3-year-old children and he was responsible for ten children that morning. CCSM2 works as an assistant to the program director. Child A's Parents were notified of the incident. CCSM2 is the lead caregiver and the only staff member in the 3-year-old classroom. He has been employed at the center for three months. Attendance records showed that there were ten children present in the 3-year-old classroom at 10:30 a.m. on 3/23/2023. I spoke on the telephone with licensee designee Julia Pratt-Buckham on 3/24/2023. According to Ms. Pratt-Buckham, the center has a number of protocols in place such as counting children and documenting name to face to prevent an incident like this from occurring. The center also trained staff on supervision last week. I attempted telephone contact with Child A's Mother and Child B's Mother on 4/13/2023. I left messages requesting a return call. I have not received a return call from either parent. 3 I spoke on the telephone with Child C and Child D's Mother on 4/13/2023 and Child E's Mother on 4/17/2023. Neither parent expressed concerns regarding the care and supervision provided at the child care center.

  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: .................................... ABE Child (w Staff Mtuiiber to Child patio,, .ae Child C are Staff iellilhi'to Cliild R:atitt thou Sine E bfium and to&fter.. birth until .n 1 to 4 12 al tunntl)s of age ............... E~trs~:lroolz~ts. 30 u)ontlis of age I to S 16 b) tttilii J 1'eXt~ t>#"ape Piescto)leir. 3 yeai c of age tnittl 4 1 to 10 Not applicable c) •ear<. of a e ( Prewlaoolel~..1 y ai's of age until l to 12 Not a pl.ical)l6 d) 41ioal-ae Sclxx~l-sgrs Ito 14 Not applicable

  Child care licensing consultant Carrie Harris spoke on the telephone with program director Amanda Swager about the allegations on 12/22/2021. Ms. Swager said they had low numbers today in both infant classrooms. The Infant 1 room only had two children in care so they combined them with the Infant 2 classroom. She stated that they only had a total of eight children with two staff members so they were within their limits. Ms. Swager said that the ninth child was moved up into a toddler classroom for the day. She said the 1:4 ratio was adhered to at all times and that it was no different than when they combine groups of children in the early mornings or late evenings. On 12/28/2021 Program Director Amanda Swager emailed me attendance records for the infant classrooms. The records indicated that there were eight children and two staff members in the combined infant classroom on 12/22/2021. I received a telephone call from licensee designee Julia Pratt-Buckham. Ms. Pratt- Buckham believes the complaint came from a disgruntled employee whom they are having insubordinate issues with. According to Ms. Pratt-Buckham, the center was compliant with ratio rules on 12/22/2021. I made an unscheduled onsite inspection at Appletree Christian Learning Center on 1/3/2022. Program director Amanda Swager reiterated that the infant classrooms were within ratio the entire day on 12/22/2021. There were six open classrooms during the time of the inspection. All classrooms were compliant with ratio requirements. 3 I spoke on the telephone with Child A and Child B's Mother, Child C's Mother and Child D's Mother on 1/13/2022. All of the children attend either Infant 1 or Infant 2 classrooms. All parents informed me that the center is following ratio requirements. I spoke on the telephone with child care staff member Hannah Roon on 1/14/2022. Ms. Roon was working in the infant classroom on 12/22/2021. She does not recall the classroom being out of ratio that day and mentioned that there are typically only eight infants present each day. I spoke on the telephone with child care staff member Alexandria Herbert on 1/18/2022. Ms. Herbert was working in the infant classroom on 12/22/2021 and recalls only eight infants being in the classroom that day. At one point during the day a ninth child arrived, however, there were three staff members in the classroom at the time. The child was moved to another classroom before the third staff member left the classroom. Ms. Herbert informed me that she is the acting lead caregiver in the infant classroom and attests the classroom is always compliant with ratio requirements.

  Open Not marked corrected in the state record

  Category: ratio. Open / not marked corrected.

• 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. ..............

  Program director Amanda Swager informed child care licensing consultant Carrie Harris that since the pandemic some foods are not available that they have listed on the menu. The center is also short-staffed and do not have a cook right now. In an effort to maintain ratio, some days they have to serve cereal and other easy-to-serve foods to the children. These foods still meet the food requirements. Ms. Swager also said they try to post substitutions whenever there are changes to the menu. Julia Pratt-Buckham informed me that there has been supply issues that has resulted in the center having to substitute various items on the menu. For example, she has not been able to order pineapple or chicken nuggets in a month. Substitutions are posted and listed in the Applegram. On 12/29/2021 Amanda Swager emailed me the menu for December. The menu indicated that breakfast, lunch and two snacks are offered daily with a wide variety of foods listed. I observed the menu posted near the entrance on 1/3/2022. Amanda Swager informed me that substitutions are posted, but the center also notifies families individually of any changes to the menu on their child's Applegram. An Applegram is an electronic document provided to parents/guardians that includes children food intake as well as their sleep and elimination patterns. She showed me an example from 12/22/2021. The Applegram listed each food offered and the percentage of each item the child consumed. It shall also be noted that the food listed on the Applegram was consistent with what was listed on the menu for that day. Child A and Child B's Mother did not express any concerns about the food provided to her children. She knows that there is a menu posted put does not check to see if substitutions are added to the menu. She receives the Applegram daily that lists all the food her children consume throughout the day. Child C consumes puree and bottles only, therefore, Child C's Mother is not familiar with the menu or food provided by Appletree. Child D's Mother does not have any concerns about the food provided by Appletree. Child D eats everything they give her. Child D's Mother has observed the menu posted at the entrance and indicates that substitutions are noted. She also informed me that all food consumed by Child D is also listed on the Applegram. Neither Hannah Roon nor Alexandria Herbert expressed any concerns about the meals/snacks provided to children at Appletree. They both indicated that certain foods, such as goldfish crackers, are chocking hazards and are often substituted 5 with either graham crackers or cheese and crackers in the infant classroom. Neither staff member has knowledge if substitutions are noted on the posted menu, but both staff members document all substitutions on the Applegrams provided to parents.

• Violation

  R 400.8335 · R 400.8335 1 Food services and nutrition; provided by center. (1) Food and beverages provided by a center must be of sufficient quantity and nutritional quality to provide for the dietary needs of each child according to the minimum meal requirements of the child and adult care food program (CACFP), as administered by the Michigan department of education, based on 7 CFR part 226, 1-1-18 edition, (2018) of the United States Department of Agriculture, Food and Nutrition Service, CACFP, and is hereby adopted by reference. A copy can be obtained at no cost from CACFP at http://www.fns.usda.gov/cacfp/meals-and-snacks. In addition, a copy is available for inspection and distribution at no cost at the Michigan Department of Licensing and Regulatory Affairs, Bureau of Community and Health Systems, Child Care Division, 611 West Ottawa Street, Lansing, MI 48933.

  Food and beverages provided by the center is of sufficient quantity and nutritional quality to meet the dietary needs of each child.

  Open Not marked corrected in the state record

  Category: health medication. 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: Table 4 Child Care Staff Member to Child Ratios Child Care Staff Maximum Age Member to Child Group Ratio Size Infants and toddlers, (a) birth until 30 months 1 to 4 12 of age Preschoolers, 30 (b) months of age until 1 to 8 16 3 years of age 4 Preschoolers, 3 years Not (c) of age until 4 years 1 to 10 Applicable of age Preschoolers, 4 years Not (d) of age until school- 1 to 12 Applicable age Not (e) School-agers 1 to 18 Applicable

  I made an unscheduled onsite inspection at Appletree Christian Learning Center on 11/19/2021. Program director Amanda Swager was away from the center on her lunch break. Child care staff member Olivia Tresemer works as an assistant to the director. She informed me that they schedule staff to be within ratio although the center is sometimes out of ratio in the mornings because staff arrive late. I walked around the center and observed that all classrooms were within ratio. Heather Meyers is a child care staff member in the infant classroom. Ms. Meyers works four days a week from 7:30 a.m. until 5:30 p.m. She informed me that the infant room maintains ratio requirements. Audrey Parcheta is a child care staff member in the 3-year-old classroom and works from 8:45 a.m. until 3:00 p.m. She informed me that there are typically 6-7 children in the classroom with her. I sent an email to program director Amanda Swager and licensee designee Julia Pratt-Buckham. I requested that they gather attendance records for staff and children during the last two weeks. I made a scheduled onsite inspection with Amanda Swager and Julia Pratt-Buckham on 12/3/2021. I was provided a large stack of documents that included time cards, contracted schedules, and staff/children attendance records. During the two-week time frame there were six instances in which a classroom was out of ratio ranging from 3 to 30 minutes between 7:30 a.m. and 8:30 a.m. Three classrooms were out of ratio on 11/10/2021 and one classroom was out of ratio on 11/15/2021, 11/16/2021 and 11/17/2021. It shall be noted that the classrooms exceeded ratio by just one child. The majority of the instances were a result of staff calling in sick or arriving at the center past their scheduled time. Ms. Pratt-Buckham informed me that staff shortages are a major obstacle and they have had to close three classrooms and 3 have 71 children on a waiting list as a result. She believes they are doing everything they possibly can to meet this rule requirement, however, there are some things that are just out of her control. Administrators are continuously recruiting and hiring staff. Unfortunately, some of the staff call in sick, arrive late or quit. Directors are having to work in the classrooms to help maintain ratio. They borrow staff from their center in Kalamazoo. In reviewing the contracted schedules, Ms. Pratt-Buckham has also noticed that parents are dropping off their children earlier than what was agreed upon. She will be addressing these timing issues with both staff and parents. I spoke on the telephone with Child A and Child B's Mother on 12/20/2021. Child A is enrolled in the infant room. The infant room maintains ratio requirements. Child B is 35 months old. Child B's classroom sometimes feels like there are a lot of children or not enough staff, however, she has never actually counted. I spoke on the telephone with Child C and Child D's Mother on 12/20/2021. Child C and Child D are both in the infant room. When Child C and Child D's Mother arrives with both infants this causes the classroom to be out of ratio momentarily, however, additional staff come into the classroom within a few minutes. This rarely happens as there are usually two staff members in the classroom when she arrives between 7:15 a.m. and 7:30 a.m. I left messages for Child E's Mother and Child F's Mother on 12/20/2021 and 12/21/2021 however neither parent returned my call.

  Open Not marked corrected in the state record

  Category: ratio. Open / not marked corrected.

• Violation

  R 400.8182(3) · R 400.8182(3) 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: TABLE 4 Child Care Staff Member to Child Ratios Age Child Care Staff Maximuru Member to Child Ratio Group Size 1: Infants and toddlers, biith until 30 1 to 4 12 a) months of age Preschoolers, 30 months of age 1 to 8 16 L_. until 3 nears of age t Preschoolers.3 years of age until 4 1 to 10 Not applicable c years of age { Preschoolers. 4 }ears of age until 1 to 12 Not applicable d school-age ( School-alters 1 to IS Not applicable e) 4

  I made an unscheduled onsite inspection at Appletree Christian Learning Center on 8/26/2021. I interviewed Program directors Amanda Swager and Morgan Marshall and lead caregivers Julia Walker and Hannah Roon. Program directors Amanda Swager and Morgan Marshall informed me that the 4- year-old preschoolers located in the Pratt classroom maintain a 1 to 12 ratio. The 3- year-old preschoolers located in the Terance classroom maintain a 1 to 10 ratio. When these classrooms are combined, they maintain a 1 to 10 ratio. Appletree Christian Learning Center has been experiencing a staff shortage. The center has had to close classrooms and turn away families. Ms. Swager and Ms. Marshall hired additional staff this week and have adjusted staff schedules in order to maintain ratio requirements. They currently have three staff out this week due to illness. According to Ms. Marshall and Ms. Swager, staff will notify them as soon as a classroom is out of ratio and then one of them will step in until additional staff arrive. This issue typically happens in the mornings between 7:30 a.m. and 8:00 a.m. Julia Walker is the lead caregiver in the Terance classroom. Ms. Walker informed me that the Terance classroom always maintains a ratio of 1 staff member for every 10 children. According to Ms. Walker, there are times the Pratt classroom will exceed ratio requirements and program directors have to step in to help. Hannah Roon is the lead caregiver in the Pratt classroom. Ms. Room said that the Pratt classroom has only been out of ratio for a few minutes at a time. Program directors are always present at the child care center when the numbers get high in her classroom and assist when needed. I observed the Pratt and Terance classrooms while onsite. There was 1 staff member and 10 children in the Pratt classroom and 2 staff members with 12 children in the Terance classroom. Both classrooms were compliant with ratio requirements. I attempted telephone contact with Child A's Mother and Child B's Mother on 9/30/2021. I left messages for both parents but did not receive a return call. I spoke on the telephone with Child C's Mother on 9/30/2021. Child C's Mother informed me that preschool classrooms are typically combined in the mornings. She observes two staff members caring for less than 20 children. I made a scheduled onsite inspection at the child care center on 10/1/2021 to go over attendance records for the week of 8/16/2021 through 8/20/2021 with licensee 3 designee Julia Pratt-Buckham and program director Amanda Swager. The only ratio concern occurred on 8/20/2021. There was one staff member signed into the combined Pratt/Terance classroom from 6:55 a.m. until the second caregiver arrived at 8:45 a.m. There was a maximum of 14 children attending this combined classroom for a portion of the morning. Program director Morgan Marshall arrived at 6:48 a.m. and child care staff member Ashley Newburry arrived at 6:23 a.m. that morning. Neither staff member was signed into any of the classrooms during that time frame. Ms. Pratt-Buckham and Ms. Swager informed me that staff occasionally forget to sign into the classroom when they step in briefly to help maintain ratio requirements. They believe this is what happened on 8/20/2021. I spoke on the telephone with Child D's Mother on 10/4/2021. Child D's Mother stated that there are usually two staff in the classroom. On the rare occasion that she only sees one staff member when dropping off Child D, she assumes that a staff member is assisting a child in the restroom or has momentarily stepped out of the classroom. She has never noticed the classroom to be in violation of ratio requirements. I spoke on the telephone with Child E's Mother on 10/4/2021. Child E has been attending child care at Appletree Christian Learning Center for three years. It appears that they are always abiding by ratio requirements. Staff appear to be cognizant of this rule as she has observed them discussing ratio and moving children

  Open Not marked corrected in the state record

  Category: ratio. Open / not marked corrected.

• Violation

  R 400.8182 · ............... R 400.8182 Ratio and group size requirements. (7) If there are children of mixed ages in the same room or well-defined space, then the ratio and group size is determined by the age of the youngest child, unless each group of children is clearly separated and the appropriate child care staff member-to-child ratios and group sizes, if applicable, for each age group are maintained.

  When classrooms are combined, the child care center maintains ratio of the youngest child in the room.

  Open Not marked corrected in the state record

  Category: ratio. Open / not marked corrected.

• Violation

  R 400.8330 · 1 R 400.8330 Food services and nutrition generally. (7) Infants and toddlers shall be fed on demand.

  I initiated an unscheduled onsite inspection at Appletree Christian Learning Center on 7/30/2021. Program director Morgan Marshall and child care staff members Emma Kloosterman, Kaitlyn Dean and Ashley Newburry were interviewed. Morgan Marshall informed me that Emma Kloosterman and Kaitlyn Dean are breakers and were asked to cover the infant room on 7/27/2021 while infant staff member Ryann Guthrie left for a medical appointment. Ms. Guthrie did not return from her appointment as anticipated, therefore, Ms. Kloosterman and Ms. Dean provided care in the infant room for the remainder of the day. Ms. Marshall provided me a copy of the Applegram for Child A and Child B on 7/27/2021. An Applegram is the written daily record that is electronically provided to parents. The Applegrams indicated that Child A began feedings at 9:25 a.m. and 4:15 p.m. and Child B began feedings at 8:55 a.m. and 11:40 a.m. Ms. Marshall informed me that there are issues with the tablets saving Applegram entries, therefore, the times of feedings may not be accurate. Ms. Marshall stated that Child C left Appletree Christian Learning Center to attend a child care closer to home. Child C's Parents never made a complaint to her regarding feedings. Emma Kloosterman is a cook and breaker. She is not normally in the infant room and was not aware of the infants' feeding schedules. Ms. Kloosterman does not remember specific feeding times but does recall seeing Child B's bottle sitting out. Because she did not know how long the bottle had been sitting out, Ms. Kloosterman retrieved a new one out of the refrigerator. Ms. Kloosterman was shown a copy of the Applegrams. Ms. Kloosterman stated that Child A and Child B may have had 3 additional feedings, but staff frequently have problems with the tablets saving entries. Kaitlyn Dean is also a breaker and has only worked in the infant room one time prior to 7/27/2021. She was initially asked to step in to cover for a staff member that left for a doctor appointment, however, ended up staying in the room for the remainder of the day. Ms. Dean reported that child care staff member Taylor Troop was also helping in the infant room for part of the time. Ms. Dean recalls feeding Child A at 4:15 p.m., but is not sure if she was fed in between 9:25 a.m. and 4:15 p.m. Ms. Dean recalls spending a lot of time with Child A that day. Child A was happy and did not act hungry or fussy. She does not understand why someone would say that Child B was fed too much. Ms. Dean informed me that entries in the tablet often disappear. New tablets were requested a few months ago. I spoke on the telephone with licensee designee Julia Pratt-Buckham on 8/4/2021. Ms. Pratt-Buckham believes the tablets work fine and the problem is user error. The user must click save in order for the entry to save onto the Applegram. I spoke on the telephone with Child Care Staff Member Taylor Troop on 8/10/2021. Ms. Troop informed me that the lead caregiver was off that day and it was just Ms. Guthrie and herself in the infant room that morning. Ms. Guthrie left at noon for a doctor appointment, so Ms. Kloosterman and Ms. Dean stepped in to help. Ms. Troop recalls feeding Child A either puree or yogurt that day after her nap so she knows there was at least one feeding that had not been recorded on her Applegram. She also recalls trying to feed Child B around 3:45, however, she mistakenly warmed the bottle and Child B refused it. She placed it back in the refrigerator and asked either Ms. Kloosterman or Ms. Dean to feed Child B once the bottle cools. Ms. Troop informed me that Child C was often sick therefore feeding was a struggle most of the time she attended the child care center. I spoke on the telephone with Child A's Mother on 8/10/2021. Child A's Mother stated that staff do a great job and she did not have any concerns regarding feedings in the infant room. I left a voicemail message for Child B's Mother on 8/10/2021. Child B's Mother did not return my call. I sp

  Open Not marked corrected in the state record

  Category: nutrition. Open / not marked corrected.

• Violation

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

  According to the Applegram dated 7/27/2021, Child A's diapers were changed a total of eight times, almost every hour that she was awake. This included seven wet diapers and one bowel movement. Child care staff members Emma Kloosterman and Kaitlyn Dean both informed me that they frequently checked diapers and changed them when soiled during their time in the infant room on 7/27/2021. None of the parents interviewed expressed any concerns regarding the frequency of diaper changing in the infant room.

  Open Not marked corrected in the state record

  Category: recordkeeping. 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. C~

  Program director Morgan Marshall told me that Ashley Newburry has been a child care staff member at Appletree Christian Learning Center for approximately two years. She has never heard Ashley yell at children or seen her handle them roughly. I interviewed child care staff member Ashley Newburry on 7/30/2021. Ms. Newburry is the lead caregiver in the Faris Room. She admits to having to raise her voice at times because it can get loud in the room but denies yelling at them. She informed me that she has absolutely never handled children roughly. Child D is her friend's daughter. She loves Child D and is more playful with her but states that she has never handled her roughly. Child D's Mother has never expressed any concern to her about how she handles Child D. Licensee designee Julia Pratt-Buckham denied ever hearing Ms. Newburry yell at children or seen her handle them roughly. Parents and staff have never made those types of complaints regarding Ms. Newburry. Child care staff member Taylor Troop acts as an assistant to the program director and spends time in each classroom. She has never had any concerns regarding Ms. Newburry. Child A's Mother stated that she has never heard staff yell or seen them handle children roughly. Child C's Mother stated that when she was an employee at the child care center, she had heard staff yell at children. She concluded that it is part from frustration and also to be heard. She acknowledged that the classrooms can be loud at times. Child C's Mother has never witnessed staff handle children roughly. I spoke on the telephone with Child D's Mother. Child D's Mother is also a child care staff member and her classroom is located directly across from Faris and can see directly into the room. She has never heard yelling or observed staff being rough with children.

  Open Not marked corrected in the state record

  Category: ratio. Open / not marked corrected.

The Pratt and Terance preschool classrooms are often out of ratio.

Disposition: Substantiated

On 7/27/2021, Child A had not been fed for seven hours and Child B was fed too much. Child C left the child care center because she was not being fed properly. On 7/27/2021, Child A's diapers were only changed every two hours. Child care staff member, Ashley Newburry, yells at children and grabs them roughly. She has roughly grabbed Child D.

Disposition: Substantiated