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.

There is no evidence that Teacher 4 is not conducive to the welfare of children.

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

R 400.8213(1)(a) · 2 LANDMARK BUILDING • 105 W. ALLEGAN STREET • LANSING, MICHIGAN 48933 Michigan.gov/MiLEAP 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.

Staff did not provide appropriate care and supervision when they restrained Child A. Restraint was not necessary as Child A was not around other peers during the time of restraint. There is no evidence that staff drag children.

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

R 400.8280(4) · R 400.8280(4) Discipline (4) A non-severe and developmentally appropriate restraint for an enrolled child with special behavioral or mental health issues may be used if reasonably necessary, based on a child's development, to prevent a child from harming themselves or to prevent a child from harming other individuals or property, excluding those forms of punishment prohibited by subrule (2) of this rule. The plan for when the restraint should be initiated; the actual use of the restraint, such as holding the child as gently as possible, and timed use of the restraint must be developed in collaboration with the parent or guardian with the parent or guardian giving final a pproval of the plan.

There was no plan for how or when to restrain Child A and it was not reasonable to restrain him at that point as he was not around other peers during the time of restraint.

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.

R 400.8380(1) · R 400.8380(1) Maintenance of premises. The premises must be maintained in a clean and safe condition and must not pose a threat to health or safety.

Debra Triplett was actively trying to solve the issue with overflowing toilets throughout the duration of time they were showing signs of something being wrong. Once all toilets were not working, started to craft plan for staff and children to leave the child care center, however; before closing the building the issue causing the toilets malfunction was resolved. The child care center hired sanitation company and children were not in classrooms where the toilets had overflowed.

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.

R 400.8380(1) · R 400.8380(1) Maintenance of premises. The premises must be maintained in a clean and safe condition and must not pose a threat to health or safety.

Debra Triplett was actively trying to solve the issue with overflowing toilets throughout the duration of time they were showing signs of something being wrong. Once all toilets were not working, started to craft plan for staff and children to leave the child care center, however; before closing the building the issue causing the toilets malfunction was resolved. The child care center hired sanitation company and children were not in classrooms where the toilets had overflowed.

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.

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 02/15/2023, I received an incident report and complaint, stating on 02/09/2023 Child C was sitting on a child-sized couch, stood up, and jumped off the couch. He did not land correctly and hit his face on the floor, resulting in a bloody nose. First aid was administered by the staff member in the room and Child C's Mother, who was present at the center as an employee. 2 Child care licensing consultant Ms. Linda Strube stated that Child C's Mother has concerns with supervision. Child C's Mother told Ms. Strube that the lead caregiver does a good job but was not present when the incident occurred. On 02/21/2023, I completed an onsite inspection. Licensee designee and program director Ms. Kimberley Steig reported that she was told about the incident and then reviewed the footage of the actual incident. She stated that Child C was sitting on the couch, stood up, and jumped off. His foot slipped and he "fell incorrectly," hitting his face on the floor. Child care staff member 3 (CCSM3) was the acting lead caregiver in the room at the time. Child C's Mother took him to urgent care later that night, where it was discovered that his nose was fractured. CCSM5 reported that around 4:00 PM on 02/09/2023 she was walking down the hallway and heard an adult yelling for help from a classroom, so she looked in. CCSM3 asked her for an ice pack so she got one and came back. At that point, she noticed that the injured child was Child C. CCSM3 said that Child C's nose was still bleeding and had been bleeding for about 20 minutes and she could not get it to stop. CCSM5 denied that his nose was gushing anymore but said that there was blood on his shirt and on CCSM3's hands, and bruising had already begun under his eyes. After attending to him, CCSM5 left him in the classroom because the bleeding had stopped. CCSM5 had looked into the classroom three or four times during the day and CCSM3 was always sitting at the desk. She has had concerns with CCSM3 in the past because she is always sitting in an adult chair, not interacting with the children. CCSM5 stated that she is not sure how well the children were being supervised, noting that she went back to the room around 4:50 and Child C was sitting on the floor with his blanket, crying, while CCSM3 was sitting at the desk. Child C's Mother reported that she left the center with Child C around 5:00 P.M. She later took Child C to the emergency room where he was diagnosed with a nasal fracture. Child C's Mother was told by CCSM3 that Child C had jumped off the couch, landed incorrectly, and hit his face on the floor. CCSM3 reported that she was the only child care staff member in the room on the day of the incident. The children were running around and jumping off the couch. She told them that if they did not stop, she would start putting them in cool down. They did not stop, so she sat each child down for 1-2 minutes. It was then time to clean up and a child headed to the couch, followed by Child C. CCSM3 told Child C to not jump off the couch but he did. She was sitting in a chair at the other end of the room. His foot caught on the couch and he "face planted" on the floor. CCSM3 paused, then asked if he was ok. At this point, Child C started crying. She called him over, noting that blood was "gushing" from his nose. CCSM3 got tissues, pinched his nose, and had him tip his head back. She then sent out a message on Teams to other staff members, asking for help. She looked in the hall and saw CCSMS. She asked for help and an ice pack. When CCSM5 returned, CCSM3 told her it was Child C that was injured. CCSMS came in until the bleeding stopped, at which point Child C said his nose did not hurt. CCSM3 gave him his blanket. CCSM3 clarified 3 that it was about 10-15 minutes from the time Child C fell until the time CCSM5 came in. During that time, CCSM3 was sitting with him and checking the floor and toys for blood. I asked why she waited until calling for help. She stated that she sent a message on Teams,

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

R 400.8112 · R 400.8112 Comprehensive background check; fingerprinting. (2) An applicant or licensee shall do all of the following: (e) Within the department's child care background check system, accurately complete and maintain the connection, disconnection, or withdrawn status of each individual associated with the license.

Ms. Steig did not ensure that the center's CCBC account is accurate with the connection of each individual associated with the license.

Open Not marked corrected in the state record

Category: background checks. Open / not marked corrected.

R 400.8134 · R 400.8134 Hand washing. (2) All staff and volunteers shall wash their hands at all of the following times: (g) After handling bodily fluids.

CCSM3 did not wash her hands after being exposed to Child C's bloody nose.

Open Not marked corrected in the state record

Open / not marked corrected.

R 400.8134 · R 400.8134 Hand washing. (3) Staff and volunteers shall ensure that children wash their hands at all of the following times: (d) When soiled.

Child C did not was his hands after receiving a bloody nose.

Open Not marked corrected in the state record

Open / not marked corrected.

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

On 09/16/2022, the department received an incident report and supporting documentation that Child A (female, 17 months) was left unsupervised on the playground after her class returned to the classroom. On 09/19/2022, I completed an onsite inspection. Program director Ms. Kimberley Steig was not present at the time of the incident and does not have any firsthand knowledge of what happened. Ms. Paige Henson was the acting program director at that time. Ms. Steig reported that there are cameras in the classrooms that would show how long Child A was unattended, but that she could not access the video. 2 Ms. Paige Henson reported that she was in the office when child care staff member Ms. Allison Fabian came in with Child A and said that she had found the child standing outside the glass door from the playground to the building. Ms. Henson took the child to the Toddler 1 classroom, where former child care staff member Ms. Gail Falin was present with three children. Ms. Henson looked over Child A and did not see any marks. She gave her water, then contacted her supervisors, who had all involved staff write statements about what occurred. Ms. Falin was terminated on the spot and the corporation's CEO contacted Child A's Mother and Child A's Father. Ms. Henson reported that, at the time of the incident, there was a shift in workers. Ms. Falin was outside with her class, and Ms. Juarez was working with her. Ms. Juarez was leaving to go home, as Ms. Falin was bringing children inside and Ms. Falin failed to count the children. Ms. Henson provided me with a ratio sheet that the center utilizes to prevent incidences such as this. Ms. Henson reported that Ms. Falin does not like the additional paperwork that the ratio sheet requires and that she is not always accurate with her sheet. According to the sheet, the class went outside at 3:15 P.M. and returned inside at 3:57 P.M. However, Child A was found at 3:55 P.M. Therefore, it is unknown how long Child A was left unattended on the playground. Ms. Ebennie Juarez was working in the Toddler 2 classroom with four children when, at 3:29 P.M., she was told to take her classroom to combine with the Toddler 1 class, who was on the playground. When she arrived on the playground, Ms. Juarez added her children's names to the ratio sheet. After five or ten minutes, she was told to take one of the children in her care to a different staff member and another child went with another staff member. Ms. Juarez was preparing to leave, resulting in Ms. Falin caring for four children. Ms. Juarez left briefly, then returned to the playground and asked Ms. Falin if she needed help. She then took the children's cups and two children and returned to the classroom. She left the classroom as Ms. Falin was returning and it did not register with her that Ms. Falin only had one child. Ms. Juarez reported that, based on her recollection, Child A was left unattended for approximately 5-6 minutes. Child A's Mother received a call from the corporation's CEO approximately an hour after the incident, reporting that a staff member found Child A outside and brought her in to her classroom. She was told that Child A was outside for fewer than 10 minutes, she was checked over and did not have any injuries, she was not crying, and she appeared to be in a good mood. Ms. Falin was fired that day. Child A's Mother denied that she had any concerns prior to this incident or since. Child A is still in care and the program has taken additional steps to prevent an incident like this from happening in the future. Child B's Mother denied any concerns with the level of care Child B receives. She stated that the staff are very attentive and caring. 3

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.