A Touch of Home - Oakland

R 400.8216a(13) · R 400.8216a(13) Professional development requirements (13) When the department publishes a notice that a new health and safety update document or a new health and safety update training activity is published on MiRegistry, the licensee shall ensure that all identified staff or volunteers in the notice read and acknowledge the document or complete the activity within the timeframe indicated in the notice.

I reviewed 10 teacher files and 2 teachers did not complete the 2024 Refresher.

View state record

R 400.8269a(1) · R 400.8269a(1) Food (1) A written plan for the prevention of and response to emergencies due to food and allergic reactions must be developed and implemented to include a child care plan, prevention measures, and emergency procedures. Bureau

View state record

R 400.8176(6) · R 400.8176(6) Sleeping equipment. Car seats, infant seats, swings, bassinets, and play yards are not approved sleeping equipment.

Child Care Staff Members are allowing infants to sleep in swings. Child B's mother, Child E's mother and Child F's mother have seen infants sleeping in swings.

View state record

R 400.8340 · R 400.8340 Food services and nutrition; provided by parents. (9) Beverages and food must be fed only to the child for whom the item is labeled.

On 08/14/2023, I received an email from Interim Program Director Hailey Bontreger reporting that Child A had been fed Child B's bottle by mistake. On 08/22/2023, I received the required incident report form from Hailey Bontrager which stated that both Child A's Mother and Child B's Mother had been notified and that Child A's Mother declined any medical testing to be completed. I provided technical assistance and reminded her that per rule 400.8158(4) incident reports must be received within 72 hours. On 08/22/2023, I left a message for Child A's Mother and received a return telephone call from Child A's Mother on 08/25/2023. Child A's Mother reported that she was aware of the incident and was promptly notified by the child care center. Child A's Mother added that she has stickers with Child A's first and last name on all bottles, adding that the center "is very diligent with labeling bottles." Child A's Mother stated that she has no concerns with the child care center regarding feeding of children. On 08/29/2023, I conducted an unannounced onsite inspection and interviewed Interim Program Director Hailey Bontrager. Hailey Bontrager reported that on 08/14/2023, Child Care Staff Member (CCSM) 1 and CCSM 2 both reported that they had not looked at the name on the bottle when preparing to feed Child A which is not the center's regular practice. Hailey Bontrager explained that the child care center's practice is to look at the name on the bottle when retrieving it from the refrigerator, show everyone in the room, then say the name on the bottle out loud. Since the incident the center has updated their policies to require child care staff members to state the name on the bottle when removing it from the refrigerator, when removing it from the warmer and prior to feeding the child. The additional staff member in the room will reply with the child's name that is being fed confirming that is the child in the staff member's arms. CCSM 1 was not present at the center the day of the inspection and CCSM 2 no longer worked at the center. I observed labels with first name, last name and date on the 6 children's bottles the day of the inspection. CCSM 1 contacted me on 08/30/2023, and I conducted a telephone interview. CCSM 1 reported that on the day of the incident, Child A had woken from a nap, and she immediately began preparing Child A's bottle. CCSM 1 removed it from the refrigerator and placed it in the warmer without checking the label. CCSM 1 then gave the bottle to CCSM 2 to feed to Child A, without checking the label. Child A took approximately a 15- minute break from eating, and when CCSM 2 picked up the bottle to start feeding her again, CCSM 1 and CCSM 2 noticed it was the incorrect labeled bottle. Child A had consumed approximately 2 ounces of a mix of oat milk and breast milk however she is usually formula fed. CCSM 1 explained that both bottles were labeled that day, however Child A and Child B had brought the same bottle which led to the confusion. CCSM 1 reported that since the incident she will say the child's name on the bottle when removing it from the refrigerator, the warmer and before feeding, even if she is in the room alone. 3 On 09/14/2023, I interviewed Child B's Mother and Child C's Mother. Both parents reported that they have no concerns with the child care center's feeding practices. Additionally, Child C's Mother reported that staff are "very on top of labeling bottles" and staff will send multiple reminders, or label bottles themselves. On 08/30/2023 and 09/14/2023 I attempted to leave a message for CCSM 2, on both occasions the voicemail was full. On 09/14/2023, 1 left a message for Child D's Mother and I did not receive a return call by the completion of the investigation.

View state record

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.

On 06/22/2022, Program Director Melissa Messer contacted me to self-report an incident explaining that during a transition to come inside from the playground, children had been miscounted and Child A was left outside for a "short amount of time." On 06/27/2022, I conducted an unannounced inspection and interviewed Program Director Melissa Messer. Ms. Messer explained she arrived to the child care center, and went to drop off her child (Child B) to Child Care Staff Member Ashley Smith's room. At the time of Child B's drop off, Ms. Smith was outside with nine children aged three years old and in the process of reentering the building. As the children came in the room, Ms. Messer stated that she saw Ms. 2 Smith counting children and began asking Ms. Smith various questions pertaining to the day. During this time, Child B went into the room to be with his friends and mixed into the count which caused Ms. Smith to count nine children. Ms. Messer reported that about a minute or less after, she sat down to put sunscreen on Child B, and saw Child A at the door of the classroom outside. Ms. Messer expressed that she felt like she had distracted Ms. Smith when she arrived, and she should not have let Child B go into the room until she saw the transition of reentering the room was complete. Ms. Messer promptly contacted Child A's Mother and Father and reported that Child A seemed fine and was not upset or harmed. On 06/27/2022, I interviewed Child Care Staff Member Ashley Smith who is the lead teacher for the three-year-old classroom. Ms. Smith explained that she was doing an activity outside with towels and had taken all of the children outside with her to hang towels on the fence. As she was reentering the room, Ms. Messer arrived with Child B as she was counting children. She counted nine children and did not think about Child B entering the room. Ms. Smith stated that she then sat down to put sunscreen on the children to go back out to the playground, and as she was recounting the children, she quickly realized she was missing Child A, and saw her at the door outside. Ms. Smith immediately brought Child A inside and reported that she was "fine and not crying" however after everyone rushed to her and was "making a big deal" Child A started to cry due to all the attention. Ms. Smith said that Ms. Messer immediately contacted Child A's Mother and Father, and she spoke with Child A's Mother that day at pick up. Ms. Smith explained that Child A can sometimes go into "la-la land," but she acknowledged that is not a reason for this to happen, and she has been "extremely aware" of where Child A is during transitions since. On 07/25/2022, I interviewed Child A's Mother, Child C's Mother and Child D's Mother. Child A's Mother reported that she saw a message come through on the Brightwheel App stating that Ms. Smith miscounted children when reentering the room from outside and Child A had been left outside for less than a minute. Child A's Mother explained that she later spoke with Ms. Smith, who explained that another child had arrived which is what led her to miscount children and make the mistake. Child A's Mother added that Child A said she was not scared, has not mentioned the incident since and that it seems to not have affected her. Child A's Mother has not had concerns prior to this incident and stated that she appreciated that Ms. Smith was honest and "owned" the incident. Child C's Mother and Child D's Mother bother reported that they have no concerns with care and supervision of children at the child care center. Child C's Mother added that Child C would tell her if anything occurred, and that she has never witnessed inattentive staff at drop off or pick up. 3

View state record

R 400.8152 · R 400.8152 Medication; administrative procedures. (6) A child care staff member shall give or apply any prescription or nonprescription medication according to the directions on the original container, unless otherwise authorized by a written order of the child's physician.

On 2/2/2021, I received an email from the new center director Melissa LaFevre notifying me that on 2/1/2021, Child A was administered a higher dosage of pain reliever than what was written on the instructions. Ms. LaFevre explained that Child A's Mother noticed the dosage on the app and called the center requesting that they contact Poison Control. Poison Control was contacted and the were advised to monitor the child, but the dosage given would not harm him, however he may experience some nausea. I interviewed Child A's Mother on 2/2/2021. She had signed a form that morning for Tylenol and put that the dosage was 2.5 ml. Later in the day she noticed the staff entered into the app that they had administered 5 ml, so she immediately contacted the center to clarify. She was told the staff member accidentally administered 5 ml after looking at the wrong medication, and she was referring to the amoxicillin that 2 Child A had just finished taking which was a 5 ml dose. Child A's Mother asked the center to contact poison control, who instructed them to watch for discomfort. She reported that Child A was fine adding that she felt it was an honest mistake. I conduced an onsite inspection on 3/17/2021, and interviewed Program director Melissa LaFevre, Assistant director Ashley Cox and Child Care Staff Member Sam Wakefield. At the time of the inspection there was no medication being administered in the child care center. Ms. Wakefield explained that she was the only staff member in the infant room on 2/1/2021 with four infants. She noticed Child A was not feeling well and remembered that Child A's Mother had stated that they could give him some Tylenol that was kept in Child A's bag. Ms. Wakefield could not locate the medication form that Child A's Mother had completed for the Tylenol. She referred to the app and saw the last medication that Child A had received and gave him the dose that was recorded. The last medication recorded in the app was the amoxicillin that was 5 ml which is double the dosage for Tylenol. Ms. Cox reported that she and Ms. LaFevre were in the preschool room on 2/1/2021, and Ms. Wakefield was in the infant room with four infants. Child A's Mother had completed a medication form for Tylenol that morning, however in the rush of drop off, the form was set down in the front office and not taken back to the infant room. I asked what the usual medication administration procedure was, and Ms. Cox explained that the parent will complete the form, which will be taken to the child's room. Usually, the center director or herself will administer medication and if they are not present, the lead in the room or a staff member will. When administering medication staff should be reading the form, verbally saying child's name, dosage and medication to another staff member who will then double check the information prior to administering the medication. On the day of the incident, Ms. Wakefield did not ask anyone else to check the medication and was the only staff in the room. Ms. LaFevre stated that administration will now be the only ones administering medication which is herself and Ms. Cox to ensure that the medication process is more streamlined and there are less people administering medication. I asked to review the forms completed by Child A's Mother and staff. I reviewed the permission for the Tylenol, however the form for the amoxicillin could not be located. Ms. Cox believed that it was placed by the bottle warmer and had gotten wet. Ms. Cox sent me a screen shot of Child A's medication section in the app showing the administration of 5 ml of amoxicillin the week prior to 2/1/2021. During the exit conference I explained that in the future, staff should not administer medication unless they have the physical copy of the medication permission form to refer to as opposed to referring to the app. I also advised them that they should make sure to check the instructions on infant Tylenol as it generally states to refer to doct

View state record

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 a complaint through the on-line complaint system on 01/19/2021. The complainant stated Child A was picked up from the child care center 01/05/2021. It was discovered when Child A arrived home that she did not have on a diaper or underwear. I made an unannounced on-site inspection to the facility on 01/22/2021 at 4:38 PM. I interviewed Assistant Program Director, Ashley Cox. Ms. Cox stated the incident where Child A was sent home with no underwear or diaper happened on 01/05/2021. Child A's Father did not have any issue with the care Child A was receiving until 01/15/2021, when he was informed that Child A's care would be suspended, as her tuition was delinquent. Ms. Cox stated that he became very upset and had a threatening demeanor. The Program Director, Hannah Ohl, and the other Child Care Staff Members felt that it was best to discharge Child A because of Child A's Father's behavior. Ms. Cox did not believe there was an issue with supervision of the children in care. Ms. Cox then gave me a written statement typed up by Program Director, Hannah Ohl, copies of Child Information Cards and the Child Care Staff Member's telephone numbers. I reviewed the notes given to me by Ashley Cox on that same date. The notes were written by Program Director, Hannah Ohl. The notes stated that on 01/05/2021, Child A's Father picked up Child A at the end of the day. Child A's Father contacted the child care center and spoke with Child Care Staff Member, Sarah Giammaria, shortly after getting Child A home. Child A's Father explained that when he arrived home, he discovered that Child A did not have on any underwear or a diaper. Ms. Giammaria apologized and stated she would have either the Program Director, Hannah Ohl or Assistant Program Director, Ashley Cox contact Child A's Father the next day. Child A's Father contacted the child care center on 01/06/2021 at approximately 10:48 AM to state that no one had contacted him to discuss the issue regarding Child A being sent home with no diaper or underwear. Program Director, Hannah Ohl spoke with Child A's Father and apologized for Child A being sent home without a diaper or underwear. Ms. Ohl explained to Child A's Father that as Child A is being potty trained, she will often, take off her own pull up and throw it in the garbage. Child A is allowed to go into the bathroom by herself to use the bathroom. On 01/15/2021, Child A's Father was contacted by Assistant Program Director, Ashley Cox. Ms. Cox told Child A's Father that he had an outstanding balance. Ms. Cox informed Child A's Father that because of the past outstanding balance, Child A's care was being suspended until Child A's balance was paid off. On that same date, I also reviewed a thread of e-mails from Assistant Program Director, Ashley Cox, Program Director Hannah Ohl and Child A's Father. The e- mails were from 01/15/2021 until 01/17/2021. The subject was regarding the issues that Child A's Father had with the center's Child Care Staff Member lack of 3 supervision and diapering. The emails also addressed the center's decision to discharge Child A due to late payments and Child A's Father's behavior. I attempted contact with Child A's Father on 02/12/2021. I left a voice mail requesting a return call. I have not received a return call to date. On 03/09/2021, I made contact with Child B's Mother, Child C's and Child D's Mother, Child E's Mother, Child G's Mother, Child Care Staff Members Sara Giammaria and Makenna Lopez and Assistant Program Director, Ashley Cox. Child B's Mother and Child G's Mother did not have any concerns. Child C's and Child D's Mother stated there have been some incidents where Child C was injured while at the center. She stated it was nothing that she would make a complaint about, but she was still concerned that there was some lack of supervision. Child E's Mother stated that her child has also come home twice the week prior without under wear. She also stated that Child E came home with marker all

View state record

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.

On 11/1812020, I received a phone call from program director Hannah Ohl indicating that Child As Mother had sent a message on 11/14/2020 stating that she had noticed a bruise on Child A's lower back/upper bottom area. Child A's Mother asked if the center was aware of where it may have come from or if an injury occurred at the center. Ms. Ohl explained that they did not see the message until Monday 11/16/2020. On Monday morning, she asked child care staff member Makenna Lopez if she was aware of an injury that occurred with Child A. Ms. Lopez stated that Child A i ) was sitting on the carpet unassisted 2 and rolled backwards. did not act injured and she did not notice a bruise. On Wednesday 11/18/202 , Child A's Mother reported that she took Child A to the doctor and had them look at the bruise on Child A's back. The doctor informed Child A's Mother that she would need to report the incident to the Ms. Ohl added that had come to the center to interview her and to see Child A. On 11/23/2020, Ms. Ohl reported that she interviewed child care staff members Makenna Lopez and Sam Wakefield as they were the staff with Child A on the day of the alleged incident. Ms. Lopez reported that the only incident that she could think of was when Child A was sitting up and fell backwards. However, to her knowledge. did not back.. bumped head. She did not notice anything else that hiti happened or any other time that ild A was crying as may have been injured. ifl Child care staff member Sam Wakefield reported that she was Child A's primary M caregiver on the day of the alleged incident and she could only recall that Child A rolled backwards when playing and bumped the back of head. After■ rolled back, she checked head for injuries but not back. 0th Ms. Lopez and Ms. Wakefield denied witnessing any other staff handle Child A roughly. On 12/22/2020, 1 interviewed Ms. Ohl and she indicated that Child A's Mother had let her know in passing that the "case was dropped" and they found that Child A had a I spoke with Child A's Mother on 12/22/2020, and she indicated that she had no concerns with the child care facility or with the care and supervision provided.

View state record