Smart Start Dev & Learning Center LLC

R 400.8213(1)(a) · R 400.8213(1)(a) Staff; volunteer (1) All staff and volunteers present at the center shall: (a) Provide appropriate care and supervision o f children at all times.

Based on the interviews with the Licensee Designee, child care staff, and parents the staff provided appropriate care and supervision of the children.

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R 400.8213(1)(b) · R 400.8213(1)(b) Staff; volunteer (1) All staff and volunteers present at the center shall: (b) Act in a manner that is conducive to the welfare o f children.

Based on the interviews with the Licensee Designee, child care staff, and parents the staff acted in a manner that was conducive to the welfare of the children. Repeat

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R 400.8179 · R 400.8179 Program. (12) For children with special needs, care must be provided according to the child's needs as identified by parents...

On 7/21/23, the department received a complaint stating that Child A was sent home with diapers that were not his. Child A has very sensitive skin and needs to use diapers and wipes that are specifically meant for him. Child A can get rashes if he wears any other diapers or uses any other type of wipes. On 7/21/23, I interviewed Child A's mother who said that on 7/19/21, Child A came home with diapers that did not belong to him, and Child A developed a rash after this. Child A's mother said that this problem has been happening off and on for the past several months, and she has told the previous program director, Mr. Demetree and the staff members several times that Child A cannot wear any other type of diapers or use any other type of wipes. Child A's mother said that it is fine for a few days, but the same thing happened on 7/19/23. Child A's mother said that she feels that they were using the wipes that were not specifically given for him. She has not seen them use other wipes on him but was informed by CCSM 1 that some staff members sometimes use wipes on him that are not meant for Child A. On 7/21/23, I interviewed CCSM 1 who said that she has seen the staff members using the wrong diapers and wrong wipes sometimes. She said that she had personally told the staff members, CCSM 2, CCSM 3, and CCSM 4 to use the diapers that were specifically meant for Child A. CCSM 1 said that Mr. Demetree was the program director at that time, and this had happened several times. CCSM 1 said that she had also seen some staff members (she was not aware of the names) use the wrong wipes on Child A. This would create a rash on Child A and Child A's mother would complain. CCSM 1 said that this happened because some of the staff members were not trained on labeling stuff, and sometimes the staff members had to walk to the preschool room to get Child A's diapers since Child A would be in preschool room at the end of the day and his belongings would be moved there. CCSM 1 said that she was not sure what happened on 7/19/23 since she was not in the building. On 7/21/23, I interviewed the program director, Ms. Parr who stated that she took over as program director about three months ago, and she was not aware of any previous complaints about Child A going home in the wrong diapers. Ms. Parr said that Child A's mother never approached her with the complaint, and Child A's mother would always supply diapers for Child A. Ms. Parr said that Child A had diapers at the center when Child A's mother came to the center the next day to pick up Child A's belongings. According to the attendance records, CCSM 5 was the staff member who was in the classroom at the time Child A left for the day. Ms. Parr was the 3 closer for the center that day, but she did not change his diaper. At the end of the day, all children are combined in the preschool room for pick up, and Child A's mother picked Child A up from the preschool room. On 7/26/23, I interviewed CCSM 2 who said that she works at the center three days per week. She worked on 7/19/23 and changed Child A's diaper in the morning. She used Child A's specific wipes and diapers. She said that she left at 3 pm that day and Child A was still at the center. CCSM 2 said that all the diapers for the children are in their cubbies in the infant/toddler room (2 well defined spaces in a large room. The two spaces are divided by gates) and she did not have to walk to any other space or another classroom to get diapers. CCSM 2 said that she had not heard of any complaints about wrong diapers for Child A before. On 7/26/23, I interviewed CCSM 3 who said that they use the center supply of diapers only if there is a shortage of diapers provided by the parent. CCSM 3 said that she was not sure if she changed Child A's diapers on 7/19/23. She said that she is well aware that Child A has specific wipes and diapers and would not use any other diaper except when there are no diapers in his cubby. CCSM 3 said that she has not heard of

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R 400.8137 · 1 R 400.8137 Diapering; toileting (3) Diapering supplies must be within easy reach of the designated diapering area.

On 7/21/23, the department received a complaint stating that Child A did not receive a daily report for Child A for about a month. On 7/21/23, I interviewed Child A's mother who said that she had not been receiving daily reports for Child A for a month. She said that before the new program director took over, she would receive the daily reports on a regular basis but not anymore. She said that she had not mentioned this to Ms. Parr or Mr. Demetree or any of the staff members. On 7/21/23, I interviewed CCSM 1 who said that the staff members stopped doing the daily reports after the new program director, Ms. Parr, took over since she did not care about the reports. On 7/26/23, I interviewed Ms. Parr who said that the staff members work on the daily report diligently, and the closer usually hands them to the parents or sometimes they are left in the cubbies for the parents to pick up. Ms. Parr said that Child A's mother had not come to her for a daily report at any time or even made a complaint with her. Ms. Parr said that she ensures that the staff members complete the daily report. Ms. Parr said that she has conversations with Child A's mother on a daily basis when she comes to pick up Child A, but she has not heard her asking for the daily report or complaining about it. On 7/26/23, I interviewed CCSM 2, who said that she does the daily reports regularly. She said that there were some days that she could have skipped but not for a month. CCSM 2 said that last week, Ms. Parr reiterated to all staff members to complete the daily reports. On 7/26/23, I interviewed CCSM 3 who said that she always does the daily reports diligently. CCSM 3 said that she takes help from other staff members due to language issues, but she gets them done. CCSM 3 either puts the reports in children's bags or gives them to the closer to give to parents. CCSM 3 said that she does not miss doing the reports. On 7/26/23, I interviewed CCSM 4 who said that she completes the daily report on a regular basis and hands them over to the parents herself. She said that she has done that whenever she is a closer, and most of the time she closes the center. On 7/27/23, Ms. Demetree said that Child A's mother did not complain to him about the daily reports at all. He said that he was not aware that this was an issue at the center. On 8/4/23, CCSM 5 said that she completes the daily reports every day but sometimes she forgets to hand them to the parents. CCSM 5 said that she does that when she is the closer, but other times, she has forgotten to give them to the parents. She said that she does not leave the daily reports in their cubbies but hands them over to the closer to give it to parents. On 8/28/23, I conducted an exit conference with licensee designee, Mr. Demetree who said that they had already fixed the issue with the daily reports. They are currently using the application called Brightwheel for the daily reports where the parents can see all the entries as and when the event happens.

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R 400.8146 · R 400.8146 Information provided to parents. (3) For infants and toddlers, a center shall provide parents with a written daily record that includes at least the following information: (a) Food intake time, type of food, and amount eaten.

As stated by CCSM 1, CCSM 2 and CCSM 5 there were days when they had forgotten to provide the daily reports to the parents.

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R 400.8146 · R 400.8146 Information provided to parents. (3) For infants and toddlers, a center shall provide parents with a written daily record that includes at least the following information: 7 (b) Sleeping patterns indicating when and how long the child slept.

As stated by CCSM 1, CCSM 2 and CCSM 5 there were days when they had forgotten to provide the daily reports to the parents.

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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. 4 I

On 01/11/2023, I spoke to Child A's Mother. Child A's Mother stated that Child A had an allergic reaction to peanut butter on 12/07/2022 when he ate peanut butter and apples during snack time at Smart Start Development Center. The allergic reaction consisted of redness and small bumps around the outer edges of Child A's mouth. Child A's Mother indicated that Child Care Staff Member, Tori Miller did not contact her regarding the allergic reaction by a phone call, rather she sent a text message asking if Child A was allergic to peanut butter. Child A's Mother stated that Ms. Miller sent her photographs of Child A and sent her a menu with the food items Child A 2 consumed on the date of the incident. Child A's relative picked up Child A and brought him home. Child A's Mother gave Child A an antihistamine and the redness and bumps diminished. Child A's Mother stated that she was unaware that Child A had a peanut allergy, and she did not notify the center that Child A had a known allergy because she did not know he did. Child A's Mother expressed frustration that Ms. Miller did not attempt to call her by phone when Child A faced a possible medical emergency. On 01/17/2023, I conducted an unannounced onsite inspection at Smart Start Development Center. Separately, I interviewed Child Care Staff Member, Tori Miller (assistant program director), Child Care Staff Member Jade Humphrey (assistant toddler staff member), and Program Director, Demetree Henry. Mr. Henry stated that Child A was enrolled in the Toddler room and attended care for about a month, November 2022 through December 2022. The lead toddler staff member, Tamesha Phillips who worked in that classroom during the time period in which Child A was enrolled, is no longer employed at the child care facility. I interviewed Ms. Miller. She stated that she called Child A's Mother twice on 12/07/2022 to inform her that Child A had redness and bumps around his mouth. She said Child A's Mother did not answer the phone or return her phone call, so she sent text messages. Ms. Miller said she took Child A's temperature, provided water, and stayed with the child. Ms. Miller stated that the child did not appear lethargic or have labored breathing, rather it was just a topical reaction around Child A's mouth that was observed. Ms. Miller stated that she did not receive a return call or text message from Child A's Mother. Child A's relative picked him up a few hours after the initial call and they left the center. Ms. Miller asked Child A's Mother if Child A's allergic reaction was confirmed by a physician the next day, 12/08/2022. Child A's Mother informed her that Child A was not taken to a physician for follow up and that Child A was treated at home. Center staff nor Child A's Mother could confirm if Child A had an allergic reaction to peanut butter or any other substance Child A may have come into contact with at the child care facility. Ms. Miller stated the information regarding what Child A ate and the redness and bumps that appeared around his mouth was written on Child A's daily sheet that went home with Child A. She did not have a copy of this daily sheet on file. I interviewed Ms. Humphrey. She has worked in the toddler classroom for the last two months. She stated she provided care to Child A on 12/07/2022. She said Child A was fine the entire day. He did not eat peanut butter at snack time. He did not want to eat. He rubbed his face on her sweatshirt. After he did this, she observed redness. Ms. Humphrey did not observe red bumps or hives around Child A's mouth. Ms. Humphrey said she told Ms. Miller about the redness, and she contacted Child A's Mother. She said there was no allergy information regarding Child A posted in the classroom and she was never informed if Child A had an allergy. She reiterated that Child A did not eat peanut butter on 12/07/2023. An incident report was not 3 completed. She said incident reports are completed for serious injuries and incidents like a c

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R 400.8155 · 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: (a) Changes in a child's health. (b) A child experiences an accident, injury, or incident. (c) A child is too ill to remain in the group.

On 01/17/2023 I interviewed Ms. Miller. She stated that children in the infant and toddler rooms are assigned a primary caregiver. She said these lists are posted in each classroom. I interviewed Ms. Humphrey. She said that she is assigned a small group of children. These children are the same daily. Child A was in her group. I received copies of the primary care lists. Each enrolled child has an assigned primary caregiver. This information is posted for parents in classrooms. 5

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R 400.8185 · R 400.8185 Primary care. (2) The center shall implement a primary care system so that each infant and toddler has a primary caregiver.

A primary care system for infants and toddlers is implemented. Each infant and toddler has an assigned primary caregiver.

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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.

A prohibited means of punishment was used. On 10/31/2022 Ms. Thompson is observed on video footage placing her hands on Child A's shoulders and pushing him downward into his chair.

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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.

Positive methods of discipline that encourages self-control, self- direction, self-esteem, and cooperation were not used. Ms. Thompson was observed by other staff members using methods of discipline that were not consistent with Child A's development. A meeting was held to speak with Ms. Thompson about her interactions with Child A, however negative methods of discipline persisted as described by Mr. Henry, Ms. Phelps, Ms. Miller, and Ms. Hensley. REPEAT VIOLATION ESTABLISHED SIR Report Dated 06/13/2022 Corrective Action Plan Dated 06129/2022 REPEAT VIOLATION ESTABLISHED SIR Report Dated 0/9/14/2022 Corrective Action Plan Dated 09/23/2022

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R 400.8140 · R 400.8140 Discipline. (2) All of the following means of punishment are prohibited: (d) Inflicting mental or emotional punishment, such as humiliating, shaming, or threatening a child.

A prohibited means of punishment was used. On 10/31/2022 Ms. Thompson was observed on video footage, putting her face close to Child A's face and yelling, "Sit!" Ms. Miller, Ms. Phelps, Mr. Henry, and Ms. Hensley all reported that Ms. Thompson has yelled, shamed, and threatened Child A.

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R 400.8113 · R 400.8113 Program director qualifications; responsibilities. (3) All program directors are responsible for the general management of the center, including the following minimum responsibilities: (a) Developing; implementing and evaluating program and center policies. (b) Administering day-to-day operations, including being available to address parent, child, and staff issues. (c) Monitoring staff; including annual evaluations. 4

On 04/27/2022 1 completed an on-site inspection to the center. When I arrived, program director Demetree Henry was not at the center, however, he arrived shortly after staff called him to inform him that I was there. I discussed the complaint with Mr. Henry. He stated he had been told by staff members Toneisha Thompson and 2 Erica Hathaway about the incident on 04/20/2022 and he spoke with staff Linda Holland. Ms. Holland told him Child A was not listening and she grabbed Child A by the arm and placed her hands on his cheeks to get him to look at her, but she denied squeezing his face or pushing her finger into his forehead. Mr. Henry stated because Ms. Holland grabbed Child A and because of problems with staff getting along, he has not had Ms. Holland or Ms. Hathaway come back to work. Mr. Henry stated Ms. Holland usually worked with staff Tori Miller in the preschool room and they were not getting along. Ms. Miller had told him prior to this incident that Ms. Holland was "rough" and grabbed some of the children by the arm, so he spent time observing Ms. Holland in the classroom, but he did not see Ms. Holland grab any child or use any prohibited discipline. I asked Mr. Henry if he reported the incident with Ms. Holland and Child A to Licensing, and he stated he had not reported it and did not know he should have reported it. I interviewed staff Toneisha Thompson. She stated she works in the infant room and the toddler room, and she had not worked with Ms. Holland in the preschool room. Ms. Thompson stated on 04/20/2022 she was in the infant room and the doors of the infant room and preschool room were open. She looked down the hallway and could see through the doorway of the preschool room Ms. Holland put Child A in the time- out chair and grab Child A's face. She could hear Ms. Holland say, "I'm talking to you, I need you to listen". The hallway is about 50 feet long from the infant room doorway to the preschool room doorway. The time out chair is in the preschool room directly across from the from the doorway so someone standing in the doorway of the infant room could see/hear someone standing/sitting in the time out chair of the preschool room. I interviewed staff Tori Miller. She stated she has worked in the preschool room since September 2021 and Ms. Holland started working at the center and in the preschool room at the end of March 2022. Ms. Miller stated she observed Ms. Holland be "aggressive" with some of the children by grabbing them by the arm and forcing them to sit down in a chair or on the floor. Ms. Miller stated at first, she tried to talk to Ms. Holland about it, but it did not stop so she informed Mr. Henry about it. Ms. Miller stated last week on 04/20/2022 around 11a m she took several children down the hall to the bathroom. Ms. Holland was still in the classroom with a few of the children, including Child A. Ms. Miller heard Child A screaming and when she returned to the classroom, she saw Ms. Holland hit Child A's forehead with her hand, grab Child A's face, and yell at Child A. Ms. Miller stated Ms. Hathaway then came into the room and tried to get Ms. Holland to step out of the classroom to speak with her, but Ms. Holland refused. Mr. Henry was not at the center at the time, so Ms. Miller called him to tell him what was going on, and he returned to the center and spoke with Ms. Holland. Ms. Miller stated neither Ms. Holland nor Ms. Hathaway have been back at the center since the incident. 3 On 05/02/2022 I interviewed staff Erica Hathaway. She stated on 04/20/2022 she was working in the toddler room when Ms. Thompson told her Ms. Holland had grabbed Child A by the arm and face and hit Child A's forehead with her fingers. Ms. Hathaway stated she went over to the preschool room to try and speak with Ms. Holland, but Ms. Holland refused to talk. Mr. Henry was not at the center at the time, but someone called him, and he came back. The staff told Mr. Henry what happened, and Mr. Henry spoke with Ms. Holla

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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.

Ms. Holland used prohibited punishment on Child A. She grabbed Child A by the arm and face. Staff stated Ms. Holland also pushed on Child A's forehead with her fingers. .......................

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R 400.8158 · R 400.8158 Incident, accident, injury, illness, death, fire reporting. (2) A licensee, licensee designee, or program director shall report to the child's parent and the department, directly or via phone, fax, or email, within 24 hours of the occurrence of any of the following: (b) An incident involving an allegation of inappropriate contact.

Mr. Henry did not report the incident involving an allegation of inappropriate contact with Ms. Holland and Child A to Licensing as required.

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R 400.8158 · 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.

Mr. Henry did not submit a written report to Licensing as required.

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R 400.8176 · R 400.8176 Sleeping equipment. (13) Soft objects, bumper pads, stuffed toys, blankets, quilts, comforters, and other objects that could smother a child must not be placed in, or within reach of, a crib or porta-crib with a resting or sleeping infant.

On 04/27/2022 two sleeping infants, Child B and Child C, had blankets placed with them in cribs.

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R 400.8330 · R 400.8330 Food services and nutrition generally. (22) Infants or toddlers shall not have bottles, beverage containers, or food in sleeping equipment. I

On 04/27/2022, a sleeping toddler, Child D, had a bottle in the crib with him.

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