....................... ....................... R 400.8158 Incident, accident, injury, illness, death, fire reporting. (4) A licensee, licensee designee, or program director shall submit a written report to the department of the occurrences outlined in subrules (1), (2), and (3) of this rule, in a format provided by the department, within 72 hours of the verbal report to the department. 4

The center failed to provide the department with a written report after Child A sought medical treatment after falling while in child care.

R 400.8158 · Correction status not published

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.

On 07/18/2023, I conducted an onsite inspection at the center. I interviewed the program director, Elizabeth Schnoes. She stated on 07/11/2023 two CCSMs took 15 school age children, ages 6— 11 years old, on a field trip to Heritage Park. While at the park Child A fell off a ladder. Child A cried for a while but returned to regular activity once back at the center. She complained to CCSM1 who had her to sit at the table so that first aid could be administered. She had no bruises or abrasions. An internal incident form was completed, and a phone call was made to the parent. The center was later informed that Child A was seen by a physician. 2 While at the center I interviewed CCSM2. She said she was at the park when Child A fell. She hurt herself but seemed better once consoled. CCSMs kept an eye on her and offered her first aid once back at the center. Parents were called and notified on the childcare communication application called HiMama. She also called Child A's Mother and spoke with her when she picked Child A up. No one thought Child A had suffered a broken bone. On 07/18/2023, I interviewed Child A's Mother over the phone. She said Child A fell from the ladder of a playscape during a field trip at a park and landed on her back and elbow. When Child A's Father picked her up that afternoon, she was unable to move her arm at the elbow joint and was in a lot of pain and crying. Child A's Father notified her of the injury and immediately took her for an exam to see if a bone was broken. Child A's Mother called the childcare center to find out why they were not notified of the fall and the center stated the arm didn't look injured, so they didn't make a report to her. She said she was not notified by the center while Child A was at the center. Child A's Father was told about the fall, but the center did not take the injury as serious as it was. Child A's arm was placed in a cast due to being fractured. I shared with her that a childcare center is required to notify parents when there is a change in the health of a child. The center said they notified her by phone, but Child A's Mother said she did not receive a phone call. On 07/18/2023, I interviewed CCSM1 over the phone. The field trip was the late morning, she said she was dealing with another group of children when she turned and saw Child A on the ground. She was crying and saying she fell. She said she fell and hurt her arm. No swelling but a little red. CCSM1 had she sat at a picnic table to rest. Child A was able to move her arm after 10 minutes. The elbow was a little red but no swelling. CCSM1 said she called Child A's Mother and left a message. She did not put notification in the communication app, HiMama. She added that she did not think CCSM2 posted on the application either. On 07/26/2023 an exit conference was held over the phone with Elizabeth Schones. The center does not have a written plan of how and when to notify a parent when a child experiences an accident or injury. I offered consultation regarding communication to parents. After a phone call attempt a child care staff member should call the next person on the child information card until verbal communication is made. Additional communication could have been made on the HiMama. The communication plan should be written and reviewed with all childcare staff members. I shared with Mrs. Schones the findings and she agreed to submit a corrective action plan. 3