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R 400.8216a(13) · R 400.8216a(13) Professional development requirements 2 LANDMARK BUILDING • 105 W. ALLEGAN STREET • LANSING, MICHIGAN 48933 Michigan.gov/MiLEAP

One staff member did not complete the 2024 ongoing training.

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R 400.8222(4)(a) · R 400.8222(4)(a) Capacity; ratio and group size requirements

Two staff members were observed caring for nine infants and toddlers in the infant room.

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R 400.8222(8) · R 400.8222(8) Capacity; ratio and group size requirements

CONCLUSION: REQUIREMENT NOT MET CORRECTIVE ACTION PLAN: We will maintain ration at all times. In the infant and toddler room and other rooms. DATE COMPLIANCE WILL BE September 18,2025 ACHIEVED BY: Rule/Statutory Violations

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R 400.8251(1)(e) · R 400.8251(1)(e) Handwashing

A staff member in the infant room was observed not washing their hands after changing a child's diaper.

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R 400.8251(2)(b) · R 400.8251(2)(b) Handwashing

A child's hands were not washed after a diaper change in the infant room.

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R 400.8254(1)(f) · R 400.8254(1)(f) Diapering; toileting

The diaper area in the infant room was not properly disinfected after a child was changed.

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R 400.8269(1)(c) · R 400.8269(1)(c) Emergency preparedness and response planning procedures (1) Written plans and procedures for emergency preparedness and response planning for the care of children and staff in each of the following emergencies must be developed and implemented: (c) Floods. 4 LANDMARK BUILDING • 105 W. ALLEGAN STREET • LANSING, MICHIGAN 48933 Michigan.gov/MiLEAP Technical Assistance Technical assistance is support and training given to the licensee/licensee designee on a specific rule. Technical assistance includes consultation on how the facility can best maintain compliance with a rule.

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R 400.8274(1) · R 400.8274(1) Primary care for infants and toddlers (1) As used in this rule, primary teachera€? means the child care staff member to whom the care of a specific infant or toddler is assigned. The primary teacher is responsible for direct care, verbal and physical interactions, primary responses to the child's physical and emotional needs, and continued interaction with the child's parents regarding the child's experiences. Technical Assistance Technical assistance is support and training given to the licensee/licensee designee on a specific rule. Technical assistance includes consultation on how the facility can best maintain compliance with a rule.

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R 400.8274(2) · R 400.8274(2) Primary care for infants and toddlers (2) The center shall implement a primary care system so that each infant and toddler has a primary teacher. Technical Assistance Technical assistance is support and training given to the licensee/licensee designee on a specific rule. Technical assistance includes consultation on how the facility can best maintain compliance with a rule.

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R 400.8274(4) · R 400.8274(4) Primary care for infants and toddlers (4) Primary teachers' schedules for each infant or toddler must be documented and provided to parents. Bureau

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R 400.8122 · R 400.8122 1 Lead caregiver; qualifications; responsibilities. (5) Lead caregivers shall meet I of the following qualifications shown in Table 3 of this rule.

On 11/18/2022, I completed an unannounced onsite inspection. I spoke with CCSM, Qur'an Raheem who shared she is an office assistance and a CCSM. At the time of my initial contact, Ms. Johnson was not at the center. I asked Ms. Raheem about the lead caregiver for the toddler classroom. She shared that she and Ms. Johnson are both taking turns as the lead caregiver in the classroom due to the previous CCSM no longer being employed. She shared this happened approximately 2 weeks ago. She provided me with a current CDA for herself and shared Ms. Johnson was already qualified as she was approved as a program director. Ms. Johnson arrived shortly after my arrival. I informed her of the allegations and asked about the toddler classroom having a lead caregiver. She shared 2 weeks ago the assigned lead caregiver left employment, and due to it being abruptly, she and Ms. Raheem had to fill in. She shared it has been difficult to find qualified lead caregivers, however, she will continue to look for one. She shared at this time both she and Ms. Raheem qualify as a lead caregiver. She provided verification of their educational requirements. Ms. Raheem currently has an active preschool CDA, and Ms. Johnson has a Bachelor's Degree in Child Development. Ms. Johnson understands if she and Ms. Raheem stay in the role of lead caregiver in the toddler classroom, they have 6 months to obtain the requirements of R400.8122(7) which states "lead caregivers for infants and toddlers shall have 3 semester hours, 4.5 CEUs, or 45 hours of MiRegistry approved infant and toddler development and care practices within 6 months of hire." While onsite, Ms. Johnson enrolled both herself and Ms. Raheem into Care Courses to obtain the 4.5 CEU's.

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R 400.8122 · R 400.8122 Lead caregiver; qualifications; responsibilities. (7) Lead caregivers for infant and toddlers shall have 3 semester hours, 4.5 CEU's, or 45 hours of MiRegistry approved infant and toddler development and care practices within 6 months of hire. These semester hours or CEUs may satisfy a portion of the requirements of subrule (6) of this rule. ........ ................................

Ms. Johnson and Ms. Raheem provided current CPR documentation for each child care staff member employed. I was able to verify all seven employees listed in the child care background system to the roster Ms. Johnson provided (including 2 identified volunteers).

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R 400.8131 · 1 R 400.8131 Professional development requirements. (10) All child care staff members who work directly which children are required to be trained in first aid and pediatric, child, and adult cardiopulmonary resuscitation (CPR) within 90 days of being hired. Prior to issuing a license to operate a child care center, and prior to the renewal of a license, the department shall verify that at least 50% of the child care staff members who work directly with children are currently certified in first aid and pediatric, child, and adult CPR. Each of these child care staff member's first aid and CPR certificates must be valid and retained on file in the center. 4

On 11/18/2022, I spoke with Ms. Johnson about notification to parents during communicable disease outbreaks at the facility. She shared the center does a "great" job with keeping their parents informed. She provided an example of the documentation that's posted in the entry way where parents drop off and pick up. The required information with the exception of the prevention measures. I provided technical assistance to Ms. Johnson for future parent notifications. She shared she also communicates with parents when she sees them, and at times if a child isn't present, she sends text messages with the required information. She denied any parent ever expressing concerns regarding lack of communication. On 11/21/2022, I spoke with Child A's mother. She shared her daughter recently had hand, foot, and mouth disease. She shared Ms. Johnson does a good job with communication. She found out that another child had hand, foot and mouth disease from a family member who was employed at the facility. At the time of the notification her child wasn't at the facility so she said, "Maybe that's why I didn't receive any paperwork." She shared Ms. Johnson did recently sent out parent information about a recent Respiratory Syncytial Virus (RSV) case at the facility. She denied having any concerns or additional information to share. On 11/21/2022, I spoke with Child B's mother. She shared the facility does inform parents when there is something "going on at the center." She was recently informed about a hand, foot and mouth incident. She shared her child was one of the children who contracted it. She isn't sure if it was from the center or somewhere else. She received written documentation via text at the time because her children were not present at that specific time (due to them contracting hand, mouth and foot). I asked if she's had concerns regarding communication from the center. She denied having any concerns. On 11/21/2022, I spoke with Child C's mother. She shared, "I received stuff about hand, foot and mouth, covid and RSV this year." She was not sure of the dates; however, she 5 went on to share "they always give out a ton of notices." She denied having any concerns regarding the communication of the center. On 12/12/2022, I spoke with Child D's mother. She confirmed knowledge of communicable disease outbreaks. She could not recall the specific dates but recalled seeing communication by the sign-in sheet during drop off. She shared she's never had concerns regarding lack of communication by the facility. On 12/12/2022, I completed an exit interview with Ms. Johnson. She was informed of the outcome of the investigation. She denied having any concerns. She shared both herself and Ms. Raheem completed the infant/toddler CEU courses.

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R 400.8155 · 1 R 400.8155 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 following 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: htti)s://www.cdc.aov/DiseasesConditions.

The facility communicates with parents via a paper document (and on some occasions text message communication) when there is a known communicable disease contacted by an enrolled child.

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