R 400.8219(2) · R 400.8219(2) Sleeping, resting, and supervision (2) A center shall permit children under 18 months of a ge to sleep on demand.

There was insufficient evidence to show that staff were not allowing children under 18 months to sleep on demand.

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

R 400.8219(13) · R 400.8219(13) Sleeping, resting, and supervision (13) For children under school-age who do not sleep at rest time, quiet activities, such as books or p uzzles, must be provided.

There was insufficient evidence to support program staff not offering quiet activities to children under school-age during nap time.

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

R 400.8219(13) · R 400.8219(13) Sleeping, resting, and supervision (13) For children under school-age who do not sleep at rest time, quiet activities, such as books or p uzzles, must be provided.

There was insufficient evidence to support program staff not offering quiet activities to children under school-age during nap time.

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

R 400.8271(12) · R 400.8271(12) Child development program plan (12) For children with special needs, care must be provided according to the child's needs as identified by parents, medical personnel, or other relevant p rofessionals. Bureau

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

R 400.8219(2) · R 400.8219(2) Sleeping, resting, and supervision (2) A center shall permit children under 18 months of a ge to sleep on demand.

CONCLUSION: REQUIREMENT MET Rule/Statutory Violations

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

R 400.8134(6) · R 400.8134(6) Sleeping Equipment. (6) Car seats, infant seats, swings, bassinets, and p lay yards are not approved sleeping equipment.

There was insufficient evidence to support program staff were allowing children to sleep in unapproved sleeping equipment.

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

R 400.8134(13) · R 400.8134(13) Sleeping Equipment. (13) Soft objects, bumper pads, stuffed toys, blankets, quilts, comforters, and other objects that could smother a child must not be placed in, or within reach of, a crib or portable crib with a resting o r sleeping infant.

There was insufficient evidence to support that blankets were accessible to infants while they were resting or sleeping.

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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.

CONCLUSION: REQUIREMENT MET Rule/Statutory Violations

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

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. 2 LANDMARK BUILDING • 105 W. ALLEGAN STREET • LANSING, MICHIGAN 48933 Michigan.gov/MiLEAP

There was insufficient evidence supporting staff were not providing appropriate care and supervision in the infant classroom.

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

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 06/07/2023, I received a complaint alleging that, on 06/06/2023 at approximately 9:40 A.M.. Rebecca Miller was observed holding a two- year-old female child by the arms. The child was standing in front of Rebecca Miller and she held the child's biceps in a closed grip. Rebecca Miller was holding both arms tight enough for the arms to be a purple red. The child was having a tantrum and picking her own feet off the ground because Rebecca Miller was holding her so tight. She kept telling the child, "You are going to hurt your arms," over and over while she held them so tight they were red. The allegation stated that Rebecca Miller was going to hurt the child's arms, not the child. She kept telling the child, "All you have to do is go sit down." Eventually Rebecca Miller carried her in a horizontal position to the office. It is believed that she was holding the child's arms tight enough that a bruise could be left. [sill the day of t he incident and went to the center. According to his report, he spoke with a child care staff member, as Rebecca Miller was not present, who was able to identify Child A from the details of the allegation. observed Child A 2 napping and was able to see one arm that did not have bruising but could not see the other arm. contacted Child A's Mother, who had just been made aware of the "ind nt and the investigation from Rebecca Miller. Child A's Mother denied any history of concerns regarding the child care. She has never had concerns with Rebecca Miller and does not believe she would do anything to harm her child or any other. On 06/07/2023, and I completed an onsite inspection. Rebecca Miller reported that thealleged incident occurred outside the 2.5-3-year-old classroom. CCSM1 was the acting lead caregiver in the room that day, as the assigned lead caregiver was out. CCSM1 called Rebecca Miller in the office, stating that Child A had kicked another child, was told to use gentle hands and feet, and then kicked and punched CCSM1. Rebecca Miller went to the classroom to assist, asking Child A to come to the hallway, with the intent of taking her to the office to calm down. It is not uncommon for Child A to get upset with others in the room. Rebecca Miller talked with Child A in the hallway, then asked her to come to the office to sit with her until she was ready to be back with her peers. Child A continued to escalate, stomping her foot. Rebecca Miller reported that she knelt down to Child A's level to talk to her. She had her hands on Child A' arms but was not squeezing them. She stated that Child A continued to stomp her foot and then went limp like she was going to throw herself to the ground, at which point Rebecca Miller grabbed her arms. She did this because there was a bench next to where they were talking, and she was afraid Child A was going to hit her head falling to the ground. While holding her arms she then gently lowered Child A to the ground. She denied using excessive force to grip Child A's arms. She did not recall Child A's arms turning purple. She does not think she could squeeze a child's arms hard enough to cause them to turn purple. She denied holding Child A up in the air by her arms. She just caught her to control her fall and lower her safety to the floor. After this, Child A got up on her own and walked with her to the office on her own. Once she was calm, she returned to the classroom. Rebecca Miller reported that, during the incident, Child A was screaming and reaching toward the classroom. She was saying to Child A, "You're ok. We'll go back when you're done." She did not recall any other staff in the hallway during the incident. The door to the classroom was closed so CCSM1 would not have been able to see what happened. Rebecca Miller recalled seeing a parent dropping their child off to the classroom next door and noted that observing what was going on in passing could look concerning. She denied contacting Child A's Mother after the incident because this is not the type o

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

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

In investigating the allegation that Rebecca Miller provided inappropriate care of Child A, it was determined that Child A's arms did not turn purple or red, and that Rebecca Miller was not holding her arms as a form of discipline.

Open Not marked corrected in the state record

Open / not marked corrected.

R 400.8170 · R 400.8170 Outdoor play area. (13) All pieces of playground equipment that have an elevated playing or climbing surface, regardless of the height of the playing or climbing surface, must be surrounded by a shock absorbing surface and meet the guidelines defined by the Consumer Product Safety Commission (CPSC) Handbook for Public Playground Safety, ... ................ ....

Ms. Miller did not ensure that all elevated play surfaces are surrounded by a shock absorbing surface.

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

R 400.8170 · R 400.8170 Outdoor play area. (11) The playground equipment, use zones, and surfacing in the outdoor play area must be inspected by a certified playground safety inspector and an approval granted for playground equipment and areas used before issuance of an original license, upon request of the department, and before using any newly added playground equipment. The center shall provide documentation of the inspection to the department upon request and shall keep it on file at the center.

Ms. Miller did not obtain approval from a certified playground safety inspector prior to using newly added playground equipment.

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

R 400.8170 · R 400.8170 Outdoor play area. (11) The playground equipment, use zones, and surfacing in the outdoor play area must be inspected by a certified playground safety inspector and an approval granted for playground equipment and areas used before issuance of an original license, upon request of the department, and before using any newly added playground equipment. The center shall provide documentation of the inspection to the department upon request and shall keep it on file at the center. 3

I spoke with licensing consultant Linda Strube, Ms. Strube indicated that she had received an incident report that Child A was playing out the monkey bars and she fell off. There are no concerns with supervision of the child but Ms. Strube does not believe there has been a playground inspection completed or if there is ground covering placed under the equipment to meet the requirements of licensing. I completed an onsite inspection of the child care facility on 6/14/2021. During this inspection I interviewed licensee Rebecca Miller, child care staff member Phill David and child care staff member, Angie David. Ms. Miller stated that Phill David and Angie David were the caregivers on the playground with Child A when she broke her arm. Ms. Miller provided me with a playground inspection dated 12/7/2006. The inspection indicated that the composite 2 structure that the monkey bars are part of is approved for children ages 5-12 years old. Ms. Miller than showed me the playground, I measured the ground covering under the monkey bars and it ranged in spots from .5 inch to 2 inches in depth. Ms. Miller reported that they had bark delivered the middle of last summer and have some on order but they are backed up due to COVID restraints over the last year. Mr. David reported working with the school age children, he stated that Child A had learned last year how to do the monkey bars and has been proud of her accomplishment. On 5/4/2021 Mr. David was outside with the school age children; Child A was climbing on the monkey bars and he was standing in close proximity but had glanced away to observe other children playing. Mr. David heard another child ask Child A if she was alright so it caught his attention and he headed in her direction. Child A initially said that she was okay and got up to get back on the monkey bars. When she started to climb up them, she stopped and started to cry, stating that her arm hurt. Mr. David brought her to Mrs. David who was inside cleaning up from snack and had her apply first aid. Mrs. David stated that she was in the kitchen cleaning up and heard Child A come in crying, she took her to sit down and got her a class of water to drink. She then looked at her arm and asked her if she could move fingers and she could, but she was shaking when she did it. Mrs. David did not observe any swelling, she stated that she gave her a popsicle and a cold compress. Mrs. David then called Child A's mother to see if they could come get her sooner than pick up time and let her know what had happened. Child A's Mother stated that Child A's Father was on his way, and he would be there in 10 minutes. Child A's Father arrived shortly after the phone call and he took her home. Later in the evening Mrs. David spoke with Child A's Mother who stated that they had brought Child A in and she had a broken arm. Mr. David and Mrs. David stopped by Child A's home that evening to bring her some candy and she appeared to be in good spirits. I left a message for Child A's Mother on 7/28/2021, at the writing of this report the phone call had not been returned.

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

R 400.8170 · 1 R 400.8170 Outdoor play area. (16) The depth of the loose-fill surface material must be restored to its required depth when it has moved or becomes otherwise compromised.

Ms. Miller had placed loose-fill surface material under the equipment but it had been compressed and no longer meets the requirements of the department for depth. ........................... ..... .... ............................ .......................

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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 interviewed Child A's Mother on 01/20/2021. Child A's Mother reported that she received a call from Ms. Rebecca Miller after the incident had occurred. At the time of the call, Ms. Miller informed her that Child A had calmed down and seemed to be doing better. A little while later, child care staff members sent a photo expressing concern that there seemed to be some swelling near the soft spot on Child A's head. Child A's Mother then picked Child A up and brought her to the emergency room at Munson Hospital in Cadillac. Child A's Mother reported 2 that a CT scan was completed and there were no abnormal findings. The physician instructed Child A's Mother to the possibility of a delayed brain bleed. Child A did not develop any symptoms of a brain bleed. Child A's Mother stated that she knows that accidents happen and does not believe this incident was due to improper care or supervision. Grandma's House Child Care has always provided appropriate care and she does not have any concerns. I completed an onsite inspection on 01/21/2021. I interviewed program director Ms. Rebecca Miller. Ms. Miller reported that she began her day in the infant/toddler room. Ms. Amy Hill was the other child care staff member working in the infant/toddler room. This incident occurred at approximately 7:00 am. There were two infants in the room. Ms. Hill was sitting on the couch and Ms. Miller had just finished feeding Child A her bottle. Ms. Miller reported she leaves the infant/toddler room at 7:00 am to begin preparing breakfast. She placed the empty bottle on the table and stood up to walk across the room to give Child A to Ms. Hill. Ms. Miller had taken maybe one step toward Ms. Hill when Child A suddenly turned to look at Ms. Hill and fell out of Ms. Miller's arms. She was holding the baby with one arm on Child A's back and she had her other hand on the Child A's bottom. She did not think that Child A had hit her head in the fall. She believed that Child A had fallen on her back. Ms. Miller reported that Child A was immediately comforted and after she had calmed down, a text message was sent to Child A's Mother at 7:13 am. Ms. Miller explained to Child A's Mother what had happened. It was decided that child care staff members would keep an eye on Child A and call Child A's Mother if they observed anything concerning. A little while later, Ms. Hill noticed that Child A's soft spot appeared to be swollen. Child A's Mother was contacted again and she decided to take Child A to Munson Hospital. During the onsite inspection, I interviewed Ms. Amy Hill. Ms. Hill reported that Ms. Miller was feeding Child A her bottle when she arrived. After Child A had finished her bottle, Ms. Hill observed Ms. Miller get up to get a burp rag. Child A made a quick turn backwards and flip out of Ms. Miller's arms. Ms. Miller seemed engaged with caring for the baby, but Child A's movement was very quick. Ms. Miller could not react quickly enough to stop Child A from falling. Ms. Hill has never had any concerns that Ms. Miller did not provide appropriate care and supervision to children in care. Ms. Hill noticed what appeared to be slight swelling of the soft spot area and she sent a photo to Child A's Mother at 8:15 am. Child A's Mother then picked Child A up and brought her into the emergency room. I interviewed Child B's (one-year-old, female) and C's (three-year-old, male) Mother on 03/16/2021. She stated that Child C has received care at Grandma's House Childcare for approximately three years. She has had a pretty good experience with the child care staff members. Child care staff members communicate any questions or concerns through the Bright Wheel app. She has never had any concerns regarding injuries or care and supervision. 3

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.