Immanuel Lutheran Preschool & Child Care

R 400.8131(12) · R 400.8131(12) Professional development requirements. When the department of licensing and regulatory affairs or the department of education publishes a notice that a new health and safety update document or a new health and safety update training activity has been published on MiRegistry, the licensee shall ensure that all personnel read and acknowledge the document or complete the activity within 6 months of the notice.

All child care staff members have not completed the Health and Safety Refresher

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R 400.8137 · R 400.8137 Diapering; toileting. (10) Toilet learning or training must be planned cooperatively between the child's regular caregivers and the child's parent so the toilet routine established is consistent between the center and the child's home.

On 02/02/2023, I conducted an unannounced on-site inspection at Immanuel Lutheran Preschool and Child Care. I met with child care staff member, Michaela Andrzejewski and an interview was conducted. Ms. Adrezejewski typically works in the toddler room however at times does assist in the infant room as well. Ms. Adrezejewski was working in the toddler room on 02/01/2023. On 02/01/2023, they did clean the room and put all the toys where they belonged. They did not remove all the toys and put them in the closet. The lead caregiver Keishan Counts did not remove any toys as a form of discipline. They were trying to teach the children how to clean up the toys, as the children typically want to get all the toys out at one time and the room gets very cluttered with toys. They are teaching the children to use different areas of the room and once they move to another area, they should clean up the toys in the area they are leaving first. This has led to the children beginning to clean up the toys on their own and they enjoy singing the "clean up" song. Regarding potty training, they have obtained the permission from each of the children's parents to begin potty training. Ms. Counts is not forcing any children to be potty trained. The parents bring in underwear and pull ups and a several changes of clothes. All the parents are on board with the potty training and are pleased with the progress. I then met with infant lead caregiver, Shelby Stewart and an interview was conducted. Ms. Stewart is currently working as the substitute program director for the next 30 days. Ms. Stewart has an Associate Degree in Early Childhood Education and meets the qualifications of program director. The center is working on selecting a new program director and are aware that they have 30 days to make an appointment with the approval of the department of the chosen replacement. Ms. Counts has begun potty training in the toddler room and has obtained permission from the parents to do so. Parents are providing underwear, pull ups and several changes of clothes. Ms. Counts is not forcing any child to be potty trained. All the parents have given their permission and are on board with the process. On 02/01/2023, Ms. Counts did reduce the number of toys that the children play with at one time, however she did not remove all the toys and place them in a closet. Ms. Counts is not disciplining the children by removing all the toys in the room. Prior to Ms. Counts becoming the toddler lead caregiver the children were allowed to just get all the toys out and play with them. Ms. Counts is trying to have some structure in the room and they have play areas. For instance, if the children are playing with blocks before they get the puzzles out, they put the blocks away. Ms. Stewart has 611 W. OTTAWA. P.O. BOX 30664. LANSING, MICHIGAN 48909 www.michigan.gov/lara . 517-335-1980 not received any complaints from any of the parents. In fact, the parents are commenting on how well Ms. Counts is doing on potty training the children. I then met with toddler lead caregiver, Keishan Counts and an interview was conducted. On 02/01/2023, she did not put all the toys away in the closet. She did rearrange the room on 02/01/2023. They are now taking toys out of bins and when they are done, she has the children play the "clean up" song and they sing and put the toys away before they begin something else. Ms. Counts just doesn't have all the toys in the entire room out all at the same time as it was getting too cluttered in the room so she did some rearranging. Ms. Counts is not forcing the children to be potty trained. She has talked personally with every parent and the parents have given permission for their child to be potty trained. The parents bring in several changes of underwear and clothing and a stock pile of pull ups to assist in the potty training. She has heard excellent feedback from the parents. I then met with child care staff member, Caroline Yang and an interview was conducte

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R 400.8140 · R 400.8140 Discipline. (2) All of the following means of punishment are prohibited: (f) Excluding a child from outdoor play or other gross motor activities. 611 W. OTTAWA. P.O. BOX 30664. LANSING, MICHIGAN 48909 www.michigan.gov/lara . 517-335-1980

The toddler lead caregiver, Keishan Counts did not remove all the toys in the room and place them in the closet as a form of discipline. On 02/01/2023, Ms. Counts did rearrange the toys in the room and place excess toys in bins. The room had become chaotic with an abundance of toys being played with at one time. Ms. Counts set up different play stations where the children can play with different groups of toys. The child care staff members are working with the toddlers on cleaning up one area before moving to another area, while they all sing the "clean up" song. The parents have indicated no concerns and have always observed an ample supply of toys being played with during drop off and pick up times.

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R 400.8122 · R 400.8122 Lead caregiver; qualifications; responsibilities. (2) At least 1 lead caregiver shall be assigned to each group of children in a self-contained or well-defined space and 611 W. OTTAWA. P.O. BOX 30664. LANSING, MICHIGAN 48909 www.michigan.gov/lara . 517-335-1980 ..................................................................... ........................... ........................................................ shall be present and providing care in the assigned group in the following manner: (a) Full time for programs operating less than 6 continuous hours. (b) At least 6 hours per day for programs operating 6 or more continuous hours.

On 01/19/2023, I conducted an unannounced onsite inspection at Immanuel Lutheran Preschool and Child Care. I met with program director, Anna Carigan and an interview was conducted. The toddler room has a child care staff member, Kieshan Counts who was promoted to the Lead Caregiver on 1/13/2023 who meets the qualifications of R400.8122(5)(g) as she has a high school diploma, 90 clock hours of training and has over 3840 hours of experience and is working on obtaining additional CEU's and/or clock hours as required and has two years from the date of hire to this position to obtain the additional training. She is unaware of two children being left alone in the toddler room on 01/17/2023 and that has not been brought to her attention. They have ample staff to cover bathroom breaks and anytime someone needs coverage they call her and either she provides coverage or there is always another floater available. I then met with child care staff member, Kieshan Counts and an interview was conducted. On 01/17/2023 she worked from 6:00 am to 4:00 pm in the toddler room and at no time were any children left alone in the toddler room. From 7:00 am to 7:56 am she had three children and one child was in the bathroom and two children were engaged in free play activities. The child that was in the bathroom she did help however the door was open and she had a clear line of site of the other two children. She did hear someone say "hello" and she replied "I am right here" however no one entered the room so she was unsure who had said that. The person may have seen the two children engaged in free play activities however the children were not alone and she had a clear line of site on them. She was able to show me the sign in sheet for 01/17/2023 and there were three children in the center until 7:56 am at which time a fourth child arrived. There has never been a time when she has left any child alone in the room. On 01/17/2023 there was no child left alone in the toddler room at any time. Another caregiver arrived in the room at 7:30 am. In regard to the lead caregiver qualifications, Ms. Counts has over 4000 hours of experience, 90 plus clock hours and has a high school diploma. She has two years to obtain additional clock hours to total 180 or 18 CEUs. She is looking at enrolling in a CDA course or enrolling in CEUs. She was just promoted to Lead Caregiver on 01/13/2023. I then met with child care staff member, Andrea Lucil-Mossner and an interview was conducted. She is a floater and usually helps in the toddler room. On 01/17/2023, she did not work at the center. She has never heard of anyone leaving children unattended in the toddler room or any room at the center. The center has floaters and the program director Ms. Carigan is always available to provide coverage as needed as well. Ms. Counts was recently promoted to Lead Caregiver in the toddler 611 W. OTTAWA. P.O. BOX 30664. LANSING, MICHIGAN 48909 www.michigan.gov/lara . 517-335-1980 room and she is aware that Ms. Counts is working to obtain additional qualifications however per the rule book she has two years to meet these requirements. I then met with child care staff member, Michaele Andrezejewski and an interview was conducted. On 01/17/2023, she arrived at work at 7:00 am and got off at 1:00 pm. From 7:00 am to 7:30 am she helped in the infant room and then went to the toddler room at 7:30am until she got off. She was working with Ms. Counts in the toddler room on 01/17/2023 from 7:30 am — 1:00 pm. When she arrived in the room at 7:30 am there were only three toddlers who Ms. Counts was caring for. Around 8:00 am another child arrived. There was never a time when any child was left alone. She just began employment on 01/16/2023. There have been floaters available every day that she has worked to assist in coverage if needed. She has never observed or heard of any child being left alone in the toddler room or any other room. Regarding the lead caregiver for the toddler room, Ms. Counts i

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

There is no evidence that any child was left alone in the toddler room on 01/17/2023 at approximately 7:30 am or any other time. I observed the sign in sheet and contacted the parents of the children in the room between 7:00 am — 8:00 am and none of the parents observed any child in the room alone and all of them observed Ms. Counts providing adequate care to the children. Further the infant lead caregiver who arrived at the center at 7:30 am and works directly across the hall did not observe any child alone in the toddler room. Another caregiver, Ms. Andrezejewski was in the infant room from 7:00 am to 7:30 am and when she arrived in the toddler room at 7:30 am, she observed Ms. Counts providing direct supervision of the three toddlers in the room and they were not left alone.

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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 11/30/2022, 1 received an email from Department of Health and Human Services (DHHS) worker Beth Belill. On 11/30/2022, I emailed Ms. Belill back to confirm the date and time of the coordinated onsite inspection. On 11/30/2022, I attempted to contact Child A's (male, age eight months) father and there was no answer. A voice mail message was left requesting a return phone call. On 11/30/2022, I received a telephone call from Child A's father and an interview was conducted. On 11/29/2022, child care staff member Andrea Lucio-Mossner was caring for Child A, and he rolled off the changing table onto the floor causing a large bruise to his head. Child A's mother works at the center and was working at the time the injury/accident occurred however was not working in the infant room. Child A can roll from back to front and front to back. Child A is a very active eight-month-old child and does not sit still. There is concern that the child care staff member did not immediately inform Child A's mother. Child A has not returned to the center since the 611 W. OTTAWA. P.O. BOX 30664. LANSING, MICHIGAN 48909 www.michigan.gov/lara . 517-335-1980 injury. Prior to this incident there have never been any concerns in the quality of care provided at the center. On 12/01/2022, I conducted an unannounced onsite inspection at Immanuel Lutheran Preschool and Child Care Center, along with Ms. Belill. I met with program director/licensee designee Anna Carigan and an interview was conducted. The incident involving Child A occurred on 11/29/2022 at approximately 4:15 p.m. and she had already left for the day and was not present at the center. Ms. Carigan is currently the lead caregiver in the infant room and works in the infant room from 6:00 am until around 1:00 pm or longer. She never leaves the infant room until the room goes down to a 1:4 ratio. She was notified of the incident in the evening after the center was closed. Ms. Lucio-Mossner was the child care staff member caring for Child A when the injury/accident occurred. Ms. Lucio-Mossner reported that she changed Child A's diaper and had his bag with his clothing on the floor and reached down to get the bag and Child A rolled off the changing table. Ms. Lucio-Mossner is a newer employee and began employment in March 2022. Prior to the incident there have never been any concerns with the quality of care provided by Ms. Lucio- Mossner. It is unclear if Ms. Lucio-Mossner notified Child A's mother however it is believed that another child care staff member did. Child A's mother is employed as a child care staff member at the center however does not work in the same room that Child A attends. Ms. Lucio-Mossner is no longer working in the infant room and has been moved to the toddler room until further notice. The reason Ms. Carigan did not notify the department of the accident/injury is that Child A did not seek medical attention. Ms. Carigan informed Child A's mother that if they sought medical attention to inform her as she would need to report it to the department. Child A's mother reported that her aunt is a retired pediatrician, and she took Child A to her, and she reported that Child A did not require medical attention. I then met with child care staff member, Jayden Zieroff and an interview was conducted. Ms. Zieroff works in the infant room. Ms. Carigan is currently the lead caregiver in the infant room. The incident/injury to Child A occurred on 11/29/2022 at approximately 4:15 pm and she was not present in the room when it happened. She had worked in the infant room earlier in the day but was moved due to the waddler room due to caregiver to child ratio needs. Ms. Lucio-Mossner called the toddler room and told another child care staff member what happened. She did witness Ms. Lucio-Mossner earlier in the day on 11/29/2022 about to change a diaper without having all the items needed within her reach. She reminded Ms. Lucio-Mossner to make sure she had all her supplies within reach before she

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R 400.8137 · 1 R 400.8137 Diapering; toileting. (1) Except as provided in subrule (2) of this rule, diapering must occur in a designated diapering area that complies with all of the following: (d) Is of sturdy construction with railings or barriers to prevent falls.

The center did not have changing tables in the infant and toddler rooms which consisted of railings or barriers to prevent falls. As a result, on 11/29/2022 Child A rolled off the changing table in the infant room and was injured. The center has since installed two new changing tables which meet the department's requirements of having railings and barriers to prevent falls. On 01/13/2023, I conducted a follow-up onsite inspection and observed the newly installed changing tables and verified they meet the department's requirements of having railings and barriers to prevent falls. ....................................................... ........................................................................................................................

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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 10/10/22, I made an onsite inspection to the child care center and spoke with Mark Bremer, Immanuel Lutheran School principal. Mr. Bremer informed me that Anna Carigan is the program director of the child care portion of the school and he does not oversee her. They had a Board of Education meeting with Ms. Carigan regarding the allegations regarding Ms. Huber. Ms. Bremer is not aware of any complaints before this one by either parents or staff members. 3 I interviewed Ms. Carigan. Ms. Carigan discussed the allegation of Ms. Huber falling asleep during nap time. Ms. Huber did state that she may have dozed off for a second during nap time while she was working at the computer. There have not been any complaints from any parents or child care staff. I interviewed Andrea Lucio-Mossner, Jayden Zieroff, Jordan Brechtelsbauer, and Lauren Sommerville child care staff members. They have never seen Ms. Huber fall asleep during nap time. I interviewed Kerni Moore, lead caregiver in the preschool room. She has not worked with Ms. Huber and is not aware of her falling asleep during nap time. I interviewed Cindy Vesterfelt, Faith Raver, and Bailey Thompson, child care staff members. They have seen Ms. Huber doze off once during nap time. She will shut her eyes for a couple of seconds and then open them. Ms. Huber admitted that she has nodded off during nap time while working on the computer. She closed her eyes for a moment and then woke herself up. She has not fallen asleep while the children were napping. I interviewed Child A and Child B's Mother, Child C's Mother, Child D's Mother, Child E and Child F's Mother, Child G and Child H's Mother, Child I and Child J's Mother and none of them witnessed Ms. Huber sleeping during nap time or had any concerns regarding the care of their children.

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R 400.8122 · ................... R 400.8122 Lead caregiver; qualifications; responsibilities. (4) Lead caregivers shall have both of the following qualifications: (a) Be at least 19 years of age. (b) Have a high school diploma or GED.

Ms. Carigan has Ms. Zieroff as a lead caregiver in the infant room. She is not nineteen years old and does not have a high school diploma or GED.

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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

One child care staff member, Ms. Lucio-Mossner was left alone with eight toddlers during nap time. At least one child was not sleeping while Ms. Huber was down the hall assisting Ms. Carigan in assembling a cabinet.

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