St Michael's ECC

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 information at this time, there is insufficient evidence to determine that Teacher 4, Teacher 5, Teacher 6 and Teacher 7 are not conducive to the welfare of children.

View state record

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.

At the time of Child A's injury, Teachers 4, 5, 6,and 7 were all sitting together on the floor at the front of the classroom and their view of Child A was obstructed by a shelf located in the middle of the room.

View state record

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.

On 01/13/2023, I completed an unannounced onsite inspection at the center from 11:25 am — 1:20 pm and interviewed program director/licensee designee Bethany Krueger, assistant program director Lori Powell; child care staff members (CCSM's) Whitney Roe, Cathy Weiss, and Julianne Wood. Ms. Krueger never has observed Ms. Roe use inappropriate discipline toward children or get angry and yell at the children. Ms. Roe has never been disciplined for such. Nothing pertaining to the allegations was brought to her attention. Ms. Roe confirmed that she works in the room with Child A and denies that she ever used any inappropriate discipline toward him or any other child. She added that she 2 never has yelled at any of the children. Rather, she may raise her voice when the room gets loud, just to get a child's attention. All of the CCSM's that work in the room do so. No one approached her regarding the allegations. Ms. Weiss confirmed that she works in the room with Child A and never has observed Ms. Roe use inappropriate discipline toward children or get angry and yell at the children. She added that all of the CCSM's that work in the room may raise their voice toward a child, if the room is loud and it is imperative to get a child's attention, such as they are running in the room and may get hurt. She was not approached about the allegations. If she was made aware, she would report to Ms. Krueger and Ms. Powell. Ms. Wood stated that she last worked in a room with Ms. Roe in approximately November 2022. She never observed Ms. Roe use inappropriate discipline toward children or get angry and yell at the children. She was not notified of the allegations. Ms. Powell explained that she thought that Ms. Roe and Ms. Wood only worked together one day and that was in October 2022. She never observed Ms. Roe use inappropriate discipline with any of the children or yell at them because she was angry. She was not made aware of the allegations. On 02/09/2023 I called the center and interviewed CCSM Sue Main who confirmed that she works regularly with Ms. Roe. She never observed Ms. Roe use inappropriate discipline with any child. She has never heard her yell at the children when she is angry. Instead, she has witness her raise her voice only when it is loud in the room, and it is necessary to get a child's attention. She added that all of the CCSM's in the room do so. She was not made aware of the allegations and if she were, she'd report such to Ms. Krueger and Ms. Powell. On 02/09/2023 I left a voicemail message for Child A's Mother. To date, I have not heard back.

View state record

R 400.8152 · .. ......... ....... .............. ... ............ ....... ............................ . R 400.8152 l Medication; administrative p rocedures. (8) Topical nonprescription medication, including but not limited to diapering cream, triple antibiotic, sunscreen, and insect repellant, requires written parental authorization annually.

On 10/31/2022, I completed an unannounced onsite inspection at the center from 11:18 am — 2:53 pm and interviewed Ms. Krueger, assistant program director Lori Powell, and child care staff members (CCSM's) Kaydence Kaster, and Kailen Ball. Ms. Krueger stated that the last time that she worked in Child A's room she recalls his bottom being red and raw so she called his mother who verbally told her to apply any diaper cream, if needed. She grabbed another child's diaper ointment and applied it to his bottom. She recalls that Ms. Yang and Ms. Kaster were in the room at the time. She provided me with a signed statement from Child A's Mother, approving of the use of diaper ointment that she provides. However, after multiple requests, Child A' s Mother never provided diaper ointment. I notified Ms. Krueger that she is not allowed to use another child's diaper ointment on a different child and she stated that she is aware of such but made the decision at that time to apply such. She will revise the form for parents to sign to include that the center will provide the diaper ointment if parents do not provide such. Ms. Kaster explained that Child A's bottom becomes very irritated and raw. She knows that Child A's Mother uses ointment at home, as Child A arrives with residue. So, she is unclear why she will not provide it to the center. When she addresses it with her, she states that he does not need it. She has never used a child's ointment on another child. She did not observe Ms. Kruger do so. Ms. Ball recalls Ms. Kruger stepping into the room and telling them that Child A's Mother gave verbal permission to put another child's ointment on Child A. That particular day his bottom got so bad that it appeared to be bleeding. She and Ms. Krueger both put another child's Vaseline on Child A's bottom on two separate occasions. Ms. Powell has never used a child's ointment on another child. However, she recalls on the morning in question, Child A's bottom was very irritated and raw so she sent a text message to Child A's Mother who gave permission to apply another child's ointment to Child A. She understood that CCSM's did so. During my interview with Child A's Mother, she explained that she uses Vaseline on Child A at home, as needed. He comes home from the center and his bottom is never red or irritated, even when they have reported such. She will complete a new 3 form stating that she gives permission for the center to provide ointment to use on Child A. On 11/22/2022, I interviewed CCSM Brianna Dankert who stated that she kept telling Child A's Mother to bring in diaper ointment and she never did. She was not there on the day that Ms. Krueger and Ms. Ball applied another child's diaper ointment to Child A. On 11/22/2022, I interviewed CCSM Caroline Yang who confirmed that all of the CCSM's in the room kept telling Child A's Mother to bring in diaper ointment for him, yet she never did. She witnessed Ms. Krueger apply another child's diaper ointment to Child A as she received verbal permission from Child A's Mother. On 11/22/2022, I attempted calling Ms. Krueger and was unable to leave a voicemail as the phones were temporarily unavailable. I sent Ms. Krueger an email asking her to contact me for completion of the exit conference. Later in the day I received an email from Ms. Krueger explaining that the phone and internet were down for some of the day. I emailed her back and explained I would contact her after the holiday for exit conference. On 12/08/2022, I left a voicemail for Ms. Krueger in attempt at completing the exit conference. Later in the day I received a telephone call from Ms. Powell reporting that Ms. Krueger was out ill until 12/14/2022 and was ok with me completing the exit conference with her.

View state record

R 400.8182 · ..................................................................... R 400.8182 Ratio and group size requirements. .................................................. ..................................................................................................................................................................................................................................... (3) In each room or well-defined space, the maximum group size and ratio of caregivers to children, including children related to a staff member or the licensee, shall be the following: (a) For infants and toddlers, there shall be 1 caregiver for 4 children and a maximum group size of 12.

On 10/31/2022, 1 completed an unannounced onsite inspection at the center and was greeted by Lori Powell who stated that the one's and two's rooms were currently in the gym. The two of us walked to the gym and I observed 4 child care staff members (CCSM's) caring for 14 children (all under the age of 30 months). I notified program director/licensee designee Bethany Krueger, who was acting a one of the CCSM's) that they were over the maximum group size of 12. Ms. Krueger stated that this was their first time that they tried both the one's and two's rooms in the gym together and thought that they had the 2 rooms separated into 2 well-defined spaces. I observed that the children in each room were going back and forth between what the CCSM's set up as a barrier, to create 2 well-defined spaces. I pointed this out to Ms. Krueger, who agreed that their barrier was not successful in creating 2 well-defined spaces. 2 They left the gym and returned to their rooms. Ms. Krueger and I looked on the walls for a posted schedule, of which we did not find. I asked CCSM's Kaydence Kaster, Angela Sella, and Kailen Ball, who were caring for the children in the rooms if the staff schedule was posted in an area that I did not notice. They all stated that they no longer had the October 2022 schedule in the room. Ms. Krueger clarified that the one's and two's rooms are 2 separate rooms. The only time that the 2 rooms are combined is if the number of CCSM and children present allows for such. Never has one CCSM cared for 12 children in either room or when combined. She explained that she feels that they have made vast improvements to ensure that they stay within the appropriate CCSM to child ratios throughout the center. I asked her to print off the CCSM and children's attendance from 10/21/2022. Together the two of us reviewed these records which confirmed that 1 CCSM did not care for 12 children at any time. However, it was confirmed that Ms. Kaster and CCSM Brianna Dankert cared for nine children until CCSM Caroline Yang arrived. Additionally, the records confirmed that at one point during the day Ms. Kaster, Ms. Dankert, and Ms. Yang cared for 13 children. She feels that children are not being moved on paper when she or Ms. Powell move them to another room. They open both the one's and two's rooms at opening of the center until they have 12 total children and three CCSM's and then the two rooms combine to one of the two sides. I clarified for Ms. Krueger that it seems to work more successfully when a center opens one room initially and then splits to a second room when needed. Ms. Kaster confirmed that a CCSM never cares for 12 children in the one's or two's rooms, even when combined on one side. Occasionally when there are three CCSM's present they may have 13 children, but it is just for a few moments until Ms. Krueger or Ms. Powell can determine where to move children around for ratio purposes. Ms. Ball is not aware of a CCSM caring for 12 children in the one's or two's rooms, even when combined on one side. From her knowledge, Ms. Krueger or Ms. Powell will move a child to the infant room if they are younger or move a child to the three's room if there is a permission form on file. Ms. Powell thought that they had a handle on their ratio issues. She thinks children are not being moved on paper when she or Ms. Krueger move them to another room. Never has a CCSM cared for 12 children in the one's or two's rooms, even when combined on one side. On 11/22/2022, I interviewed CCSM Ms. Dankert who stated a CCSM never cares for 12 children in the one's or two's rooms, even when combined on one side. She did recall on 10/21/2022 when she and Ms. Kaster cared for nine children for a few minutes, until Ms. Yang arrived. On 11/22/2022, I interviewed CCSM Ms. Yang who said that a CCSM never cares for 12 children in the one's or two's rooms, even when the two sides are combined. 3 On the day in question, she recalled having 13 children in the room for a fe

View state record

R 400.8140 · R 400.8140 Discipline. (2) All of the following means of punishment are prohibited: (a) Hitting, spanking, shaking, biting, pinching, or inflictina other forms of corporal punishment.

On 10/25/2022, I received a telephone call from program director/licensee designee Bethany Krueger who reported that a child care staff member (CCSM) observed another CCSM pinch a child's cheeks. She then submitted the written incident report which confirmed that CCSM Brianna Dankert observed CCSM Caroline Yang pinch Child A's (male, 1 year 8 months) cheeks. Ms. Yang denied pinching Child A's cheeks and reported that Child A pinched another child's cheeks and attempted to bite this child. On 10/31/2022 1 made an unannounced onsite inspection at the center from 11:18 am — 2:53 pm and interviewed Ms. Krueger, assistant program director Lori Powell, and (CCSM's) Kaydence Kaster and Kailen Ball. Ms. Dankert and Ms. Yang were not at the center on 10/31/2022. Ms. Krueger provided me with the statement that CCSM Brianna Dankert had written. This document stated that as she was coming out of the bathroom she saw Ms. Yang bend down, pinch both of Child A's cheeks, then sit the child down onto the floor. Ms. Yang told her that Child A pinched Child B's (male, 1 year 6 months) cheeks then tried to bite him. Ms. Dankert mentioned that she observed Child A's cheeks were very red, too red for him to only be crying for a few seconds. Ms. Yang denied that she pinched Child A's cheeks and explained that his cheeks get red when he cries. Ms. Krueger did not obtain a written statement from Ms. Yang. Ms. Krueger had Ms. Dankert follow mandated reporting protocol and reported the allegations to the Michigan Department of Health and Human Services (DHHS). Ms. Krueger confirmed that Ms. Yang was on administrative leave until the determination of the investigation. She provided me with a copy of the letter that she had provided to Ms. Yang. Ms. Yang never was disciplined in the past. Ms. Krueger confirmed that she reported the incident to Child A's Mother, he continues to attend the center, and there are no cameras in the room. The other CCSM's that were potentially in the room on 10/25/2022 are Lori Powell, Ms. Kaster, 3 and Ms. Ball. Ms. Krueger was not at the center at the time of the alleged incident, so Ms. Dankert reported the allegations to Ms. Powell who then reported to her when she arrived at the center. Ms. Yang became very defensive when she discussed the allegations with her and explained that after Child A pinched Child B's cheeks, she just moved them away from one another and sat Child A down on the floor. That is when he started crying. She stated that she did not pinch Child A. Ms. Kaster did not observe the incident. She thinks that she was getting a child breakfast. She heard that Child A pinched Child B. She did see Ms. Yang move Child A onto the floor. Ms. Ball was not present at the center at the time of the incident but Ms. Dankert told her what occurred when she arrived later in the day. She kept an eye on both Child A and Child B to assure that no further pinching happened between the two children. Ms. Yang continued to act defensive the remainder of the day and kept inquiring if she was in trouble. Ms. Powell explained that she was in the office on 10/25/2022 when Ms. Dankert came and told her that she saw Ms. Yang pinch Child A's cheeks and that he was crying and his cheeks were red. She peeked into the room and observed that Child A was crying and his cheeks were red. She told Ms. Kruger about the incident when she arrived at approximately 10:00 am. On 10/31/2022, I interviewed Child A's Mother who confirmed that Ms. Krueger reported the incident to her. She added that Child A began crying prior to coming to the center after the incident. He never had a long-term mark nor received medical treatment. She confirmed that his cheeks get red when he gets upset or cries. Ms. Krueger, Ms. Kaster, Ms. Ball, and Ms. Powell all stated that they never witnessed Ms. Yang inappropriately discipline a child. On 11/22/2022, I interviewed Ms. Dankert who explained that on 10/25/2022 she was exiting the bathroom within the room and observe

View state record

R 400.8125 · .............. R 400.8125 Staff; volunteer; requirements. (1) All staff and volunteers shall provide appropriate care and su ervision of children at all times.

On August 24, 2022, I interviewed Bethany Daenzer, program director/licensee designee. Ms. Daenzer reported an alleged incident of inappropriate physical discipline between Child Care Staff Member 1 (CCSM) and Child A on August 22, 2022. CCSM 1 was working in the 1's/2's classroom, which is a large classroom split into two well defined spaces. The alleged incident occurred on the 2's side of the classroom. Ms. Daenzer was not present at the facility at the time of the alleged incident. When she came into work on August 23, 2022, Lori Powell, child care staff member/assistant director, reported the alleged incident to Ms. Daenzer. CCSM 2 reported that CCSM 1 slapped Child A on the hand for taking a cracker that did not belong to her. Ms. Daenzer spoke with all present child care staff members. The 1's room had seven child care children present and two child care staff. The 2's room had nine child care children and three child care staff, CCSM 1, CCSM 2 and CCSM 3. CCSM 2 and CCSM 3 both reported that CCSM 1 slapped Child A's hand. CCSM 1 did not remember slapping Child A's hand. After CCSM 1 spoke with Ms. Daenzer regarding concerns from August 22, 2022, CCSM 1 reported that Child A was doing well in the classroom. Ms. Daenzer did not initially tell CCSM 1 that the allegations were regarding Child A. CCSM 4 was on the 1's side of the classroom and was not aware of any concerns between Child A and CCSM 1. CCSM 5 was also present on the 1's side of the classroom and did not observe any concerns. When CCSM 1 returned to the classroom following speaking with Ms. Daenzer regarding the allegations, she stated that "someone told on her." CCSM 1 is currently on leave from the facility. Following being placed on leave CCSM 1 put in her two-week notice. Child A has not made any disclosures regarding the incident. The discipline policy for the facility is reviewed at the time of orientation for new employees and during monthly staff meetings. On August 25, 2022, I interviewed CCSM 3. CCSM 3 was present in the facility on August 22, 2022. Child A was sitting at the end of the lunch table and took a cracker from another child. CCSM 3 said to Child A "We don't' take food." CCSM 1 was at the microwave warming up Child A's lunch. CCSM 1 has been more aggressive in the last few weeks. She will grab children's arms and force them to sit down. CCSM 3 3 was sitting approximately 2-3 feet away from Child A when CCSM 1 walked over and slapped Child A's hand. CCSM 3 heard CCSM 1 slapping Child A's hand and said it was "loud." A red mark was observed on her hand prior to nap time but was gone after nap. Child A told CCSM 3 that CCSM 1 hit her. On Tuesday August 23, 2022, Child A thew a toy and CCSM 1 grabbed Child A by the overall straps slapped her hand and pinched her side. CCSM 1 will sometimes throw foam balls at the child care children in a rough manner. The facility will speak with children regarding their behavior, provide redirection or an alternative activity. Physical discipline is not allowed. On August 25, 2022, I interviewed CCSM 5. CCSM 5 was on the 1's classroom on August 22, 2022. She did not hear or see any concerns with CCSM 1. CCSM 5 does not have any concerns with how CCSM 1 handles or disciplines child care children. CCSM 5 has not observed anyone use physical discipline in the child care center. On August 25, 2022, I interviewed CCSM 4. CCSM 4 was present in the classroom on August 22, 2022 and does not recall seeing CCSM 1 slap Child A on the hand. CCSM 4 was seated at the end of two rectangle tables across from Child A. CCSM 4 has observed CCSM lthrow foam balls at child care children in an aggressive manner, Child A. Child A will sometimes cry when this occurs. CCSM 1 has been observed aggressively picking up Child A and other child care children, sitting them down hard on their buttock. This generally has occurred when children were not listening. CCSM 1 has not previously been aggressive with child care children; this was a

View state record

R 400.8125 · R 400.8125 Staff; volunteer; requirements. (5) A written statement must be signed and dated by staff and volunteers at the time of hiring or before volunteering indicating all of the following information: (a) The individual is aware that abuse and neglect of children is against the law. (b) The individual has been informed of the center's policies on child abuse and neglect. (c) The individual knows that all staff and volunteers are required by law to immediately report suspected abuse and neglect to children's protective services.

CCSM 2 and CCSM 3 failed to immediately report concerns regarding CCSM 1 using physical discipline on Child A. The incident occurred on August 22, 2022, and CCSM 2 and CCSM 3 did not report the concerns until August 23, 2022.

View state record

R 400.8125 · R 400.8125 Staff; volunteer; requirements. (1) All staff and volunteers shall provide appropriate care and su ervision of children at all times.

The center did not provide appropriate care and supervision when they left Child B on the playground unsupervised for approximately two minutes on 05/05/2022.

View state record

R 400.8125 · R 400.8125 1 Staff; volunteer; requirements. (5) A written statement must be signed and dated by staff and volunteers at the time of hiring or before volunteering indicating all of the following information: (c) The individual knows that all staff and volunteers are required by law to immediately report suspected abuse I and nealect to children's protective services.

On 05/17/2022 I completed an unannounced onsite inspection at the center from 11:00 am -2:30 pm and interviewed program director/licensee 3 designee Bethany Daenzer, assistant program director Lori Powell, and child care staff members (CCSM) 1-3. Ms. Daenzer provided me with all CCSM's signed and dated written statements confirming that the individual knows that all staff and volunteers are required by law to immediately report suspected abuse and neglect to children's protective services. She was aware of a potential child abuse situation occurring in the beginning of May 2022. Since she was not working, the following day Ms. Powell told her that CCSM4 reported that Child A was observed "scratching her privates" while saying "Daddy, daddy." The next day she met with Ms. Powell and central administrator Charles Chaveriat after speaking with CCSM4 and they determined that it was normal behavior for a toddler and did not suspect any child abuse. Child A scratches herself often in that area due to having a severe diaper rash. A representative from DHHS called the center on 05/16/2022 and spoke to her and CCSM4 regarding the allegations that were reported on 05/09/2022. Ms. Daenzer confirmed that she spoke with Child A's Mother regarding the incident. Ms. Powell stated that in the beginning of May 2022 CCSM4 reported to her that she observed Child A "scratching her privates" while saying "Daddy, daddy" and asked her if she felt any suspicions of child abuse, which she replied "no." She reminded CCSM4 that she was a mandated reporter and then she notified Ms. Daenzer. The next day the two of them met with Mr. Chaveriat and decided it was not suspicious and did not need to be reported to children's protective services. CCSM1 reported that she was not involved with any incident with Child A. However, she recalled in the beginning of May 2022 overhearing Child A say "Daddy" and pointing to her private area during a diaper change with CCSM4. At this time, she heard CCSM4 ask Child A "Daddy towel?" CCSM1 was unsure what that meant. CCSM4 approached her afterward asking her opinion if she thought it needed to be reported to children's protective services and she advised that she should document it in Brightwheel. She felt that Child A was trying to say that her daddy changes her diaper. CCSM's 2-3 were not aware of an incident with Child A. On 05/18/2022, I confirmed the log number with DHHS. On 06/21/2022, I completed telephone interviews with CCSM4, CCSM6, CCSM7, and Child A's Mother. CCSM4 stated in the beginning of May 2022, while she was changing Child A, she "touched her crotch and put her finger in it two times and said daddy." She notified Ms. Powell, but could not recall what she specifically reported, and the next day Ms. Powell, Ms. Daenzer, and Mr. Chaveriat said it was decided that it was being handled internally and did not need to be reported to children's protective services. She received a telephone call from DHHS on 05/16/2022 questioning her about the report that she made. CCSM4 clarified that she did not make a report to DHHS and someone else did so in her name. CCSM4 was terminated from the center and no longer works there. 4 CCSM6 and CCSM7 stated that they were not aware of an incident with Child A. Child A's Mother explained that she found out about the incident as she was approached by CCSM8 upon her arrival at the center and the next day she approached Ms. Daenzer. She understood that Child A was observed just scratching that area and was not aware that she inserted her finger into her vagina. She confirmed that Child A is super sensitive in her private area and scratches there all of the time. Child A often has severe diaper rashes that she is treated for. Her child will continue attending the center. On 06/27/2022, I completed a telephone interview with CCSM8. She explained that she also changed Child A and observed her "grabbing her privates, spreading her legs and saying daddy, daddy." She thought Child A wa

View state record

R 400.8182 · R 400.8182 Ratio and group size requirements. (3) In each room or well-defined space, the maximum group size and ratio of child care staff members to children, including children related to a staff member or the licensee, must be as shown in Table 4: Age Child Care Staff Max Group Size member to Child Ratio a) Infants and toddlers, 1 to 4 12 birth until 30 months of age

On 05/17/2022, Ms. Daenzer stated that she was not aware of the requirement to maintain appropriate caregiver to child ratios while the children were all asleep. She admitted that the ones room and twos room would be out of the appropriate caregiver to child ratio during naptime. I clarified that this was no longer an option and was removed from the technical assistance manual. After my review of the prior two weeks attendance, I did not see that there were any days that the 5 ones room, twos room, or school-age room were out of the appropriate caregiver to child ratio. She clarified that she is aware of one time that the ones room and twos rooms were out of ratio when a CCSM walked out on the job. She confirmed that they never have more than 28-30 school-agers in the school-age room. Ms. Powell explained that to her knowledge the center had not been out of the appropriate caregiver to child ratios in any of the rooms and are never over capacity. She was not aware of the requirement to maintain appropriate caregiver to child ratios while the children were all asleep. CCSM's 1-3 all stated that they primarily work in the ones room or twos room and they are never out of the appropriate caregiver to child ratios in any of the rooms and are never over capacity. They were not aware of the requirement to maintain appropriate caregiver to child ratios while the children were all asleep. CCSM 2-3 both work in the school-age room occasionally and they are never out of the appropriate caregiver to ratios in any of the rooms and are never over capacity. CCSM4 stated that she worked in all of the rooms except the school-age room and they are never out of the appropriate caregiver to ratios in any of the rooms and are never over capacity. CCSM6 never works in the school-age room and in the past has worked in the ones room and twos room. She primarily works in the child care preschool room. They are never out of the appropriate caregiver to child ratios in any of the rooms and are never over capacity. Child A's Mother confirmed that she has been in various rooms within the center and has never observed them to be out of the appropriate caregiver to child ratios in any of the rooms and are never over capacity. CCSM7 works primarily in the preschool room and sometimes in the school-age room. Usually, they have more teachers than needed in the school-age room. She last worked in the ones room and twos room over 1 year ago. She has never observed any of the rooms to be out of the appropriate caregiver to ratios and are never over capacity. CCSM8 admitted that there are sometimes that the ones room or twos room were out of the appropriate caregiver to child ratio for 5-10 minutes. She thought this was when a CCSM got sick and had to leave or walked out on the job. CCSM5 recalls two times that they were out of the appropriate caregiver to child ratio in the ones room or twos room for a few minutes. The one time was when a CCSM walked out on the job and another time a CCSM got very sick and had to leave. A

View state record

R 400.8182 · R 400.8182 Ratio and group size requirements. (3) In each room or well-defined space, the maximum group size and ratio of child care staff members to children, including children related to a staff member or the licensee, must be as shown in Table 4: Age Child Care Staff Max Group Size member to Child Ratio e) School-agers 1 to 18 36

The center is following the appropriate caregiver to child ratio of 1:18 in the school-age room.

View state record

R 400.8110 · R 400.8110 Applicant; licensee; licensee designee; requirements (5) The actual number and ages of children in care at any time must never exceed the number and ages of children for which the center is licensed. 7 ................. ................

The center is following the appropriate capacity in the ones room, twos room, and the school-age room.

View state record

R 400.8155 · 1 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.

The center did not have a written plan for notifying parents of incidents. They failed to report to Child A's parents that he was left unsupervised on the playground for approximately two minutes.

View state record

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: a A child is lost or left unsupervised.

The center did not notify Child B's parents that he was left on the playground unsupervised for approximately two minutes.

View state record

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. z

The center did not submit a written report to the department when Child B was left on the playground unsupervised for approximatelytwo minutes.

View state record

R 400.8182 · R 400.8182 Ratio and group size requirements. (3) In each room or well-defined space, the maximum group size and ratio of child care staff members to children, including children related to a staff member or the licensee, must be as shown in Table 4: Age Child Care Staff Maximum Group Size member to Child Ratio a) Infants and toddlers, 1 to 4 12 birth until 30 months of age

On 03/01/2022, I completed an unannounced onsite inspection at the center from 10:00 am — 12:30 pm and interviewed program director/licensee designee Bethany Daenzer, Child Care Staff Members (CCSM) Lori Powell, Jaclyn Hershey, Leah Wither, Kaydence Kaster, and Olivia Berry. Ms. Daenzer stated that on 02/25/2022 she left the center at approximately 9:00 am and Ms. Powell was acting as the program director in her absence. To the best of her knowledge, the center was not out of the appropriate CCSM to child ratio in the one's and two's rooms on 02/25/2022 or any other day. She pulled the CCSM and child attendance from that day, which confirmed 19 children were cared for total between the one's and two's rooms and 4 CCSM were present. She confirmed that the two rooms are separate, well-defined spaces and on 02/5/2022 12 children under the age of 30 months were on the two's side with Ms. Kaster and Ms. Berry and she thought that Ms. Powell was the 3rd CCSM. There were 7 children under the age of 30 months on the one's side with Ms. Hershey and Ms. Withers. She was not aware of any parents or CCSM's reporting that either room were not within the appropriate CCSM to child ratios on 02/25/2022. 2 I interviewed Ms. Hershey, Ms. Withers, Ms. Kaster, and Ms. Berry all separately and each CCSM confirmed that they worked on 02/25/2022. Ms. Hershey and Ms. Withers were on the one's side with 7 children under the age of 30 months. Ms. Kaster and Ms. Berry were on the two's side with 12 children under the age of 30 months. Ms. Powell was not in either room all day, as she only entered the foyer area a few times throughout the day. All CCSM's stated that the two's side was out of the appropriate CCSM to child ratio for most of the day on 02/25/2022. Ms. Powell stated that she thought that on 02/25/2002 she was in the two's room more than what the CCSM's reported. She recalled changing a few diapers that day (area is in the foyer of the rooms). Ms. Powell also recalled helping out during lunch (area is in the foyer of the rooms). She could not recall if she was in the one's room or two's room. I clarified for Ms. Powell that for her to be counted as a CCSM in the two's room on 02/25/2022, she would need to be in the room continuously like the other CCSM's. Ms. Powell confirmed that she was not in the two's room continuously on 02/25/2022.

View state record

R 400.8155 · R 400.8155 1 Child accidents and incidents; child and staff illness. (4) If a center becomes aware that a staff member, volunteer, or child in care has contracted a communicable disease, then the center shall notify parents and provide all of the followina information: (a) The name of the communicable disease the children were exposed to. (b) The symptoms of the disease. (c) Prevention measures as recommended by the U.S. Centers for Disease Control and Prevention (CDC) at the following website: https://www.cdc.gov/DiseasesConditions.

On 11/04/2021, I interviewed Child A's Mother who stated that on 10/20/2021 Child A was diagnosed with RSV and admitted into the intensive care unit (ICU) at Covenant hospital. She notified child care staff member Lori Powell of this at approximately 8:00 am on 10/21/2021. She also spoke with program director/licensee designee Bethany Daenzer about Child A's diagnosis on 10/22/2021. On 10/25/2021, she spoke with Ms. Daenzer and was told that she would check with Ms. Powell, to see what additional steps needed to be taken. She was also notified that Ms. Daenzer became aware on 10/23/2021 that another infant had been hospitalized with RSV. Ms. Daenzer told her that she had tried to send out a notification about RSV's presence in the center, yet there was a glitch with the Brightwheel application that they utilize. Ms. Daenzer added that she also spoke with Ms. Powell, who informed her that they do not send out notifications regarding RSV. At 10:20 am on 10/25/2021, Ms. Daenzer sent a notice regarding RSV's presence in the center via the Brightwheel application. Child A's Mother texted me a copy of this notification. Child A was discharged from the hospital on 10/28/2021, to continue recuperating at home. Child A's Mother disenrolled Child A from the center effective immediately. On 11/09/2021, I completed an unannounced onsite inspection at the center from 10:56 am - 12:00 pm and interviewed both Ms. Daenzer and Ms. Powell, separately. Ms. Daenzer and Ms. Powell confirmed on 10/21/2021, the center was notified that Child A was diagnosed and hospitalized with RSV. On 10/23/2021, they received confirmation of an additional diagnosis, and the notification regarding the presence of RSV was sent out on 10/25/2021 via the Brightwheel application. Ms. Daenzer confirmed that she had checked with Ms. Powell (who was the previous licensee designee) and was notified that historically, the center has not notified parents regarding the presence of RSV. I clarified with both that RSV is a communicable disease and they shall follow the notification process regarding such. I reviewed the Managing Communicable Diseases in Child Care Settings (BCAL PUB-11 1) with Ms. Daenzer and suggested that she review the Tuscola County Health Department website, pertaining to communicable diseases. Ms. Daenzer provided me with an acceptable corrective action plan.

View state record