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: (b) A child experiences an accident, injury, or incident. ................................................ ..............................

On 12/21/2021, I privately spoke with Child A's Mother who reports that there have been times that Child A has been bit, hit, and was pushed down by another child which resulted in a black mark in the corner of her eye. Child A's Mother was notified of the incident, however, was not provided with an accident report. During the 12/21/2021 on-site inspection, Ms. Thomason indicated that the center most definitely completes written incident reports for injuries. If a child has a minor accident that does not cause injury or require first aid treatment, they will verbally mention the incident to the parents. Not every injury warrants a written incident report but does a verbal report to the parent. Ms. Thomason feels that it is important for the child care staff members to have regular verbal interactions with the parents and that they do a lot of talking to parents about their child's day. There is not documentation of injury reports in Child A's file because she has not experienced an injury and nothing out of the norm for a toddler. I then privately spoke with child care staff members, Alyssa Gustafson, Riley Rodriguez, Emily Melms, and Lindsay Klein via telephone regarding accident/incidents involving Child A. They did not recall there to have been any injuries involving Child A or that there were any reports in her file. I reviewed the center's written plan for how and when a parent is notified when a child experiences an accident, injury, or incident that requires first aid or medical attention. 7 The policy indicates the following: • Accidents / Injuries: o The child will be looked over for any cuts, bruising, bumps, etc. and first aid will be applied if applicable. o If the injury is minor and basic first aid is applicable, then the staff will properly address it immediately. ■ Once the child has been properly taken care of, an accident report will be filled out right away. This form, once filled out, will be looked over by the director and/or supervisor. It will then be copied, with one copy going to the child's parent/guardian, and the second copy going into the child's file. o If the injury needs medical attention, then the parent/guardian will be contacted via phone immediately by the director and/or owner and consulted with regarding how to handle the situation from there. • If medical attention is sought, then the director and/or owner will follow the proper protocols in notifying the state. • Once the child has been properly taken care of, an accident report will be filled out immediately. This form, once filled out, will be looked over by the director and/or owner. It will then be copied, with one copy going to the child's parent/guardian, and the second copy going into the child's file. ................. ..............................

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

R 400.8330 · R 400.8330 Food services and nutrition generally. (6) A center shall make water available to drink throughout the day to children 1 year of age and older.

On 12/21/2021, I privately spoke with Child A's Mother who reports that Child A had to be taken to the hospital for dehydration in July 2021. She sends Child A is sent to center with one bottle and two sippy cups and there are times when she is sent home with full cups. She has spoken with Ms. Thomason about it because the concern regarding Child A not drinking enough has been an ongoing since she moved into the toddler room. The child care staff members have informed her that Child A just does not drink a lot. They supply daily guides that document what Child A eats, but not how much she drinks. They also document diaper changes and have noted that Child A has a dry diaper for hours. During the 12/21/2021 on-site inspection, Ms. Thomason confirmed that she had been going back and forth with Child A's Mother regarding the concern that Child A is refusing to drink from cups. The center has tried providing Child A with different style cups and she will throw them. Child A does not drink much, but she does drink some while at the center. The center provides water and milk during the day and Child A's parents send juice. Child A's Mother has asked if the child care staff members would hold the cup for Child A so she does not throw it and will drink. Since the initial concern in July 2021, this has improved somewhat. Ms. Thomason also would give Child A freeze pops to help get more liquids in. I asked Ms. Thomason why just not have Child A drink from a bottle and she reported that Child A's Mother only sent cups. Ms. Thomason denied ever telling Child A's Mother to not send bottles. On 12/21/2021, I had a private telephone call with child care staff member, Riley Rodriguez, who shared drinks are offered at every meal time. She does recall Child A's Mother mentioning that Child A was not getting enough to drink. She also does remember when Child A was dehydrated. Child A's Mother indicated that Child A does not like to drink in high chair, so the child care staff members were sitting down on the floor with her to get her to drink. At nap time, Child A takes a bottle and drinks all of that. Child A is offered liquids throughout the day, but just does not like to drink much. On 12/21/2021, I had a private telephone call with child care staff member, Lindsay Klein, who recalls Child A's Mother stating that Child A prefers to not drink in the high chair, so they sit her on the floor or table and she drinks better. They give Child A time to drink either her milk in a bottle, juice or water in a sippy cup. Ms. Klein reported that Child A is provided drinks throughout the day. On 12/21/2021, I had a private telephone call with child care staff member, Emily Melms, who noted that Child A drinks milk from a bottle. Regarding any concerns rj with Child A drinking liquids, Ms. Melms had not noticed anything. She reiterated that Child A is provided with milk and water during the day.