A Place For Grace

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.

Child A's Mother stated that she has informed the center that he is allergic to chocolate and he was given chocolate pudding on 1/26/21. She noticed that Child A gets diarrhea with certain kinds of chocolate. She informed the center of this allergy by text and they still gave him chocolate pudding. I reviewed Child A's child information card and there were no allergies listed and it was signed by Child A's Mother on 11/24/20. I also reviewed the physical form that Jenny Dumont-Radler, program director, provided me. Child A's Mother completed part of the form and she did not note any allergy information on the form. The physical form was not completed and signed by a physician. Child A's Mother did not speak with Ms. Dumont-Radler regarding any allergies. She did not submit any documents from a physician regarding any allergies for Child A. Ms. Vargas informed her that Child A's Mother reported that Child A was allergic to chocolate through Brightwheel. Brightwheel is an application for child care facilities to communicate with parents and to record attendance and other administration functions. Ms. Vargas noted that it was more dairy that would cause Child A's stomach to be upset and not necessarily chocolate. Child A's Mother would send chocolate milk for Child A to drink and other items that had chocolate as an ingredient. They have a form that they have parents complete if there is an allergy noted for a child.

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R 400.8143 · R 400.8143 Children's records (6) Within 30 days of a child's initial attendance, a center shall obtain, keep on file, and make accessible in the center a record of physical evaluation of the child that notes any restrictions and is signed by a physician or the physicians designee. An electronic record will be accepted. The physician evaluation must be performed with in 1 of the following times: (b) For toddlers, within the preceding 6 months.

On 1/29/21 and 2/2/21, I interviewed Christine Engelhardt, therapist at Game Changers. Ms. Engelhardt is Child A's therapist and Child A is brought to the agency in the afternoons from child care. On 1/26/21, Chris Volk, transporter for the agency, picked Child A up from A Place for Grace child care center. The center gets Child A's outerwear on prior to bringing the child to the door. Child A was transported to the agency directly from the child care. When Child A arrived Mr. Volk, Sara Licht, Behavioral Tech, and herself were present as they took Child A's hat and coat off him. They immediately observed a big goose egg on Child A's right forehead area. Ms. Engelhardt assessed the injury and followed concussion protocol as she was worried, he may have had a concussion. The staff at the agency kept a close eye on Child A as the afternoon went on to make sure he was okay. Ms. Engelhardt followed her agency's policy and completed necessary forms to document injury and informed necessary personnel. She then called Child A's Mother to see if the injury happened at home or if the child care center notified her. Child A's Mother did not answer the phone so she left a message. Child A's mother contacted her when she was on a lunch break and informed her that she was not aware of any injury to Child A. Mr. Volk had to return to the child care center to pick up another child about forty- five minutes later. Mr. Volk asked a staff at the center if they knew how Child A received a goose egg on his head. The staff member went and asked the caregiver if she knew what happened to Child A. The staff member returned and informed Mr. Volk that Child A threw himself on the ground and the caregiver could not get to him in time to prevent it. He did not cry so she figured he was fine. 4 On 2/1/21, I conducted an inspection at the center. I interviewed Ms. Dumont- Radler, program director. Child A was present at the center on 1/26/21 from 6:40 a.m. until 11:00 a.m. when he was picked up from the transporter from Game Changers. There was a total of six children and two caregivers while Child A was in care at the center. Ms. Dumont-Radler stated that transporter from Game Changers came to pick up Child A like they usually do in the afternoon. She got Child A ready with a hat and coat and took him to the transporter. When the transporter returned to pick up another child from the center the transporter inquired about Child A's bump on his head. She asked Gia Vargas, lead caregiver. Ms. Vargas stated that he did his hit head on the ground. She came over and took care of him. Child A appeared to be fine. Ms. Vargas did not see any injury. Ms. Vargas stated that he hit the back of his head and not the front of his head. She believes that the injury did not happen at the center and happened during the transporting of Child A to Game Changers. Ms. Dumont-Radler provided me with the parent notification policy. The policy stated that "a boo boo note will go home with your child to let you know what the injury was, and how it happened. If the injury was more serious, the parent will be notified by phone so the child can be transported to the hospital or doctor's office (i.e., needs stitches, broken bone, dislocation, etc). If a parent of emergency contact is not available, a child that needs medical attention will be transported via ambulance to the nearest hospital (along with your signed consent to provide medical care form)." The center uses the application Brightwheel to communicate with parents, take attendance, and document the children's daily information sheet. Child A's Mother was sent a "boo boo report" through Brightwheel. I interviewed Ms. Vargas, lead caregiver, in the toddler room. She recalled that Child A was upset threw himself to the ground and hit his head. It was not anything out of the ordinary. She was changing a diaper and Ms. Gunlock was feeding a child. Child A did not seem to be hurt and went to play after he threw himself on the gr

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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 1/26/21, Child A threw himself on the floor and hit his head on the floor. Ms. Vargas stated that there was only a red mark on Child A's head. Upon arrival to therapy Ms. Engelhardt observed a big goose egg on his head. Child A's Mother was not informed of the injury until that afternoon via Brightwheel. The boo boo report stated that it occurred at 9:00 a.m. The center's notification policy states that "a boo boo note will go home with child" for non-threatening injuries. Ms. Vargas and Ms. Gunlock both stated that parents are usually contacted for head injuries. Ms. Dumont-Radler and her staff failed to follow the center's parent notification policy of injuries. Ms. Dumont-Radler failed to have the written plan for notifying parents of incidents. The notification policy does not address when a parent will be notified if a child experiences incidents such as: inappropriate discipline, lost of unsupervised child, or inappropriate contact.

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R 400.8143 · R 400.8143 Children's records. ................................................. ...... ................................... (2) Child information cards must be reviewed and updated by parents at least annually and when the center becomes aware of changes. 7

Child A's child information card was not updated to include a new authorized person to pick up Child A when the center became aware that a representative from Game Changers would be picking up Child A from child care.

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