CT DBA AppleTree Rockford

R 400.8125(2) · PR19-R 400.8125(2) Staff; volunteer; requirements. All staff and volunteers shall act in a manner that is c onducive to the welfare of children.

Based on the investigation, CCSM 2 is conducive to the welfare of children.

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R 400.8125(1) · PR19-R 400.8125(1) Staff; volunteer; requirements. All staff and volunteers shall provide appropriate c are and supervision of children at all times.

CCSM 2 did not provide appropriate care and supervision of Child A when she was sent home with the wrong family. The center failed to follow the correct pickup procedures resulting in Child A being picked up by the wrong family. Child A was with the wrong family for approximately two hours due to distance traveled.

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R 400.8125(1) · PR19-R 400.8125(1) Staff; volunteer; requirements. All staff and volunteers shall provide appropriate c are and supervision of children at all times.

Based on interviews with center staff members, it was not confirmed that Teacher 2's interactions with Child A were forceful or inappropriate.

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R 400.8188(13) · PR19-R 400.8188(13) Sleeping, resting, and supervision. For children under school age who do not sleep at rest time, quiet activities must be provided such as r eading books or putting puzzles together.

Children in the Terance classroom were not offered quiet activities for all the non-sleepers during nap time. New Rule 400.8219(13)

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R 400.8125(2) · R 400.8125(2) Staff; volunteer; requirements. All staff and volunteers shall act in a manner that is conducive to the welfare of children.

Based on the investigation, CCSM 2 is conducive to the welfare of children.

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

CCSM 2 did not provide appropriate care and supervision of Child A when she was sent home with the wrong family. The center failed to follow the correct pickup procedures resulting in Child A being picked up by the wrong family. Child A was with the wrong family for approximately two hours due to distance traveled.

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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.

Child A was separated from the group due to his behavior which is humiliating and shaming punishment.

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R 400.8140 · R 400.8140 Discipline. (2) All of the following means of punishment are prohibited: (g) Excluding a child from daily learning experiences.

Child A was excluded from the daily learning experiences that were offered to the other children in his classroom.

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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.

On 07/06/2023, I spoke with Child A’s Mother via telephone who reported that Child A was disenrolled by the center, so he is no longer attending. She explained that the center had an issue with staffing, and she estimated that Child A has had 15 different caregivers since he started attending there in 2 September 2022. Child A’s Mother said that Child A has an Individualized Education Plan (IEP), had a physical health condition, delayed speech development and has some behavior issues. She said that he was hyper and was hitting himself and other children and was pulling children’s hair. She said that the center asked for a behavior meeting and wrote a behavior plan during the meeting, but she never got a copy of it. After the behavior meeting, they began sending Child A home when he had behavior issues and when he had three incidents. The center recommended Child A use fidget toys, so she provided the center with them. She said that the first behavior plan did not say anything about Child A being sent home after three incidents. She said that the plan was updated, and she thinks they made a new plan that may have included him being sent home but was not sure since she did not receive a copy of it. Child A’s Mother said that she was not sure if the center ever implemented the plan or not. The center was reporting to her that Child A had unprovoked behavior issues. Child A had trouble with transitions, so she made suggestions for staff to use to help Child A. The center was relying on the fidget toys that she provided for him. Child A’s Mother explained that she had a concern in December about how a former child care staff member had aggressively handled Child A when pulling him off another child. She was observing the live camera feed and saw Child A start hitting himself after being pulled off and the child care staff member just walked away and did not intervene with Child A hitting himself. She called the director and addressed her concern. She tried to tell the center staff that Child A needed help to engage with other children and he would hit when bored. She watches the feed to observe Child A’s behavior. On 06/26/2023, she observed Child A being isolated from the rest of the children in his classroom and being made to play at the table with the toys she had provided and some from the center. She observed him also reading a book by himself. She said that every time he got up from the table and tried to join the children, CCSM 1 brought him back to the table. She saw Child A try to walk past CCSM 1 and she put her hand and foot up to stop him. Child A went around to the other side, and she got him and brought him back to the table. Child A’s Mother watched the live feed for 45 minutes and took some screenshot and screen recordings. The director then contacted Child A’s Mother and warned her not to record the live feed. Child A’s Mother said that she had previously asked the child care staff members to work on teaching her son how to play with others. Child A’s Mother said that she had a Zoom meeting scheduled with the center in May, but it was canceled right before the meeting. Emily VanderGalien called her and told that the center would not continue to care for Child A after June. Child A’s Mother had hoped that Child A could continue attending part time. She said that she was not aware and was never told that Child A would be disenrolled if he was sent home twice in a week. Child A’s Mother sent me copies of two videos that she screen recorded, screenshots, incident reports, and forwarded emails that she had exchanged with Emily VanderGalien. The first video, which is one minute three seconds long, starts with Child A sitting at a table playing with playdough and the rest of the children are playing on the 3 carpeted half of the classroom. He gets up from the table, walks to the edge of the carpet and hesitates. He then walks onto the carpeted area. CCSM 1 goes to him, turns him and guides him by his shoulders back to the

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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 were not used with Child A when he was sent home due to his behavior issues.

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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.

On 8/24/2022 I spoke to Child A's Mother. She stated that most of her issues with the center started back in July of 2022, when Child A moved to, new classroom, room. On 8/11/2022, after arrivin home from the center, she gave Child A tah baet and noticed a very large bruise o upper ear. She estimated the ear bruise to be approximately a inch long. e took a photo of the bruise to 1/2 document it and will send it to Ime. There was no explanation of what happened to ■ given by staff. Child A's Mother was concerned about the bruise and the lack of explanation, so she reached out to the center via email and set up an in-person meeting for the following week. The week of 8/15/2022, she met with the program 3 director Abbey Caniff and her supervisor, Becky Ryscamp. The directors reported that they spoke to the lyric staff, and they did not know what happened to Child A's ear. They reported to her that their action plan was to observe and supervise the classroom more often, and to give additional tips and training to staff on supervision. Child A's Mother called Child A's doctor about the injury, and it was suggested to make a report as the doctor felt they would not be able to look at the bruise in time before it was faded. Child A's Mother noted that she believes that all the bruising on Child A is a result staff not supervisin the children well enough and she does not believe staff have physically harme(. She feels it is a lack of supervision. She has no specific staff person she feels may have caused the bruising. Child A's Mother stated that earlier in the week of 8/11/2022, she noticed all the bruises and bite marks. The bruises look like "typical bruises from being a toddler," and all four were approximately the size of a dime. She does not recall the specific date that she noticed each bruise/bite, other than the first one she noticed the week of 8/11/2022 was either the leg or the arm bruise. The blood blisters were a few tiny pin prink sized marks by Child A's underarm. She didn't receive any explanations from staff on these incidents either. Child A has had other minor bruises in the past, but she feels this is normal for a toddler and she didn't have concerns with supervision as much as she does since Child A had so many marks in one week. On 8/24/2022, I received photos of Child A's ear bruise, a bite mark or back, and a bruise orn left arm via email. The photos show a bruise on the top o Child A's right ear that is very dark purple. It is located on the top o ear where the upper ear is attached to the face and is about a inch wide. Thep oto of the bruise on 1/2 Child A's left forearm appears very small and light in color. The photo of Child A's back shows a small line on the left side of upper back that is about a inch long. 1/2 Child A's Mother noted the photos may not e very clear due to the screen on her phone being cracked. 25/2022, I completed an unannounced on-site inspection at the center with We interviewed program director Abbey Caniff. Oereported thatshe has been the program director since May 2022. Ms. Caniff was informed of the investigation surrounding supervision concerns at the center. Ms. Caniff stated that prior to the meeting with Child A's Mother, she had no knowledge of there being supervision issues in the lyric classroom. She reported that in July, supervision training was provided to all staff and administration is working on ensuring that the training tools are being implemented. The program director and assistant program director are also conducting walk-throughs in classrooms in the morning and afternoon. These walk throughs consist of walking into the classroom, checking in with staff on how things are going, and looking at how the children are doing and how the classroom activities are going. There is a checklist on what administration looks at during a walk through. Ms. Caniff also reported administration is doing more observations in the lyric classroom specifically 4 since Child A's Mother

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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.

I spoke to Child A's Mother on 8/24/2022. She indicated that back in January and February of 2022, she had concerns that Child A ingested a wet 9 wipe or cotton balls while at the center. One time in January and one time in February, Child A digested something that appeared to be white fibers. Child A was very backed up for a couple of days each time and Child A's Mother found the white fibers in Child A's stool. This was when Child A was in the faris classroom. Child A's Mother noted that she did not specifically speak to staff or the program director about this at the time, other than saying to staff in passing "please be careful, I think ate a wipe". On 8/25/2022, „and l completed an unannounced on-site inspect€on Pe NcePeR. ,R s IaR was asked about Child A possibly ingesting a wipe or cotton balls. Ms. Caniff stated that at the meetinQ she and her supervisor had with Child A's Mother, she reported Child A back in the winter of 2022. Ms. Caniff noted that she was not employed ate center during that time but stated that the incident would have happened in the faris classroom as that was the classroom Child A was placed in at the time. She reported there are in the lyric or faris classrooms. In the lyric room, there is a garbage nloocaWtedu ner t he changing station, but there is a lid on that garbage can. She acknowledged there is no lock on that garbage can. Cleaning wipes and diaper wipes are kept in a locked cupboard in both rooms. The only way a child could get any sort of wipe would be if they got it out of the trash can. She stated she would need to find out who the staff were that worked in the faris classroom back in January and February 2022. She reported that child care staff members were in that classroom at the time the incident occurred. and I interviewed assistant program director Kayla Woolworth. She was Rasasked ut Child A possibly ingesting nonfood items such as wipes. She stated that a few weeks ago, Child A's Mother had mentioned to her that Child A likes to put things in mouth, and then she gave the example of possibly eating a wipe when was in the faris room. Ms. Woolworth stated at she told the staff to keep a closer eye on wipes and tissues and to make sure Child A isn't grabbing anything from the changing/bathroom area. She noted that she believes is ingested anything in that room, it would probably be tissues because everything else like the diaper wipes, cleaning wipes and garbage can are inaccessible to children. and I interviewed child care staff member ~. She was asked qaaboouu t any concerns with Child A ingesting non-food items. She denied that this has ever been a concern or that she has been told to watch out for this. She stated she has never observe ingest nonfood items. All garbage, Kleenexes and wipes are inaccessible to chTldren in her classroom. and I interviewed child care staff member . She was asked about any knowledge of Child A ingesting non-food items. She reported that on Child A's "Get to know me" sheet that is completed when children are admitted or move classrooms, it is written that, has ingested cotton balls and wipes. was asked if she knew about this being on Child A's form when first came into her ID] room, or if this is something she just learned about. She admitted that she recently heard someone talking about this being an issue, so she reviewed *form. She does not recall who she talked to about it, but she believes this was after administration met with Child A's Mother recently. She noted that the garbage, wipes, and tissues are kept out of children's reach in the lyric room. I reviewed Child A's file. On a document called" et to know me" dated 612012022, Child A's Mother noted ■ sticks everything it mouth. Please watt closely. There were a few instances where either ate cotton balls or wipes. V were e aware because couldn't go to the bathroom and then the next day there were chunks in ■bowel movements." I contacted child care staff members , who cared for Child A in

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R 400.8137 · R 400.8137 Diapering; toileting. (6) Diapers and training pants must be checked frequently and changed when wet or soiled.

On 8/25/2022 and I completed an unannounced on- site inspection at the center. Prior to walking into the center informed me that she spoke to Child A's Mother, who informed her that Child Wa ad a "really bad" diaper rash the last few weeks, and that it seems to clear u during the weekend when Child A is at home, but it seems to worsen when is at the center. Child A's Mother told that she had to get a doctor note to ge changed more often and that must use prescription rash cream to clear i up. I also received an email from i d A's Mother on 8/25/2022, which stated "Sorry I didn't think to tell you about the diaper rash. I didn't think of it untilil left me a message asking if there was anything else she needed to know. Attached are the pictures I sent her. picture was taken on 8/11. At that point had already had a diaper rash for a few weeks, and we had already gone throug a medicated prescription cream. That weekend it was almost cleared up again, but by mid-week it was bad again. We took to the doctor on 8/18 again. They said it didn't appear to be a yeast infection anymore, but a bad diaper rash. It appeared to them as though ■wasn't getting changed enough, was sitting in ■stool too long, or 11 that they were wiping too hard. They gave me a doctor note to give to the Wda care. It just said to make sure to change every 2 -3 hours, to change right after a stool, and to apply cream every change (the normal diaper rash cream that I tcU provided). They were hoping that would help. I gave the note day care the next day on 8/19. ■ was only there a half day an didn't return until this Tuesday. Picture 20220823070319 was taken Tuesday mornin before school. Picture 20220824_195748 was taken yesterday whey got home from school. Please call if you have questions." It should be noted that the photos were of Child A's ,so they remained""""". and I interviewed program director Abby Caniff, Re reported a Child A has a nonprescription cream that Child A's Mother requested to be used at each diaper change. Their policy is to change diapers every two hours. If a parent requests, then diaper changes can occur more frequently. Child A is prone to getting diaper rashes, so has a topical cream that is unmedicated that is applied. She denied that they have a doctor's note on file for a specific medical cream. She noted on Child A's initial "Get to know me" form thati gets diaper rashes easily. She reviewed■ medical information, and the facility has only been provided with over-the-counter Aquaphor cream. Any change in medical needs must be directly communicated to administration and a prescription permission form would be completed. and I interviewed child care staff member . ■ was asked about changing Child A's diaper. She stated that she doesn't "tyyppiiccaally anges diaper because she is not Child A's primary caregiver, and noted it was typically who changes She is aware that has a chronic diaper rash because she saw messages tha hild A's Mother sent recently via their Nurture app indicating that diaper rash clears over the weekends, and it ets worse at the center. She also noted that Child A's Mother stated in the app that needs to be using the prescription diaper cream, but they never received a prescription diaper cream. Whenever anything prescription-related is received, it is immediately given to administration to be put into a medication box and staff, administration; and the parent signs that the medication was received. stated that they change the children's diapers at least every ours. She RePiaChild A has been having diaper changes every hour per Child A's Mother's request. However. In rash apparently got better so Child A's Mother said that they could changcU diaper every 2 hours again. and I interviewed child care staff member . She was asked about Child A's diaper rashes. stated that diaper ras es have been an - ongoing problem since Child A was in the fans room. She stated that she found out last week that Child A's Mother uses a p

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