R 400.1911 · R 400.1911 Care; supervision; children. (1) A licensee shall ensure appropriate care and supervision of children at all times.

On January 4, 2020, I received an incident report from Ms. Switzer that Child A (male, 14 months) entered the home from a breezeway after playing outside and fell down the stairs located next to the entryway into the home. I interviewed Ms. Switzer who reported that she was downstairs getting ready for lunch while her child care staff members were outside with the children. She heard the door to the breezeway open and children starting to come in. She then heard a child falling down the stairs, ran over to him, and picked him up at the bottom of the stairs. Child A cried for about five minutes, then calmed down. Ms. Switzer immediately called his mother to come pick him up. 2 In my interview with Child A's Mother, she confirmed that Ms. Switzer texted her immediately after the incident, informing her of the incident and asking her to come get Child A. Ms. Switzer told her that the children were in the breezeway taking their coats off. The children know to leave the door to the house closed until an adult opens it, but someone opened the door. Child A came in and tried to go downstairs, resulting in him falling down the stairs. Child A's Mother picked him up and took him to the ER, where he was observed for over 4 hours. He currently has a red mark on his forehead but seems to be okay otherwise. He returned to care the following day. Child A's Mother denied any concerns with the child care except that she was upset that this incident happened. She noted that Ms. Switzer said she would talk to her assistant caregivers about providing better supervision. Child care staff member Ms. Skiler Wood reported that on the day of the incident, she and child care staff member Ms. Morgan McDonald had the children playing outside. They brought them in from outside and got them out of their winter gear. As always, they stood at the door leading from the breezeway into the home with the bigger children in front and the smaller children behind them. Ms. Wood went into the home to go to the bathroom on the main floor. As she was heading to the bathroom, she heard a child falling down the stairs and ran back. When she went toward the bathroom, the bigger children headed downstairs. She denied knowing where Child A was. She denied seeing him come in, stating that Ms. McDonald had taken off his outerwear so she assumed Ms. McDonald would bring him downstairs. Ms. McDonald reported that on the day of the incident, she and Ms. Wood had nine children outside. They brought them in to the breezeway to take off their outerwear. Ms. Wood told the children to wait on the breezeway stairs, then she went inside to go to the bathroom. Ms. McDonald was still unbundling children. The older children know to stay in the breezeway until they are told to go in, but they must have followed Ms. Wood in and Child A must have been with them. She heard Ms. Switzer yell and ran inside, where she saw Child A on the floor at the bottom of the stairs. She denied knowing how many of the older children had gone downstairs before Child A. Child B's Mother denied any concerns regarding care and supervision at the child care home. Child C and D's Mother reported that Ms. Switzer is "amazing with my kids". She denied any concerns with the child care. Child E's Mother denied any concerns regarding the child care. 3

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

R 400.1932 · 1 R 400.1932 Home maintenance and safety. (3) All steps, stairs, porches, and elevated structures to which children in care have access must be protected to prevent falls and must be free of ice and snow accumulation.

In interviewing Ms. Switzer about the incident, I asked about her stairs being gated. She denied that she has ever had a gate at the top of the stairs but reported that she has a pocket door that is utilized instead of a gate. She purchased and installed a gate at the top of the stairs the same day the incident occurred. Child A's Mother denied that there is a gate at the top of the stairs. She stated that there is a pocket door that is open while children are in care because they are normally downstairs. Ms. Wood reported that the door at the top of the stairs is normally open. Ms. McDonald reported that the door at the top of the stairs in normally open. The children are normally downstairs and there is a gate at the bottom of the stairs. Child B's Mother reported that there is a newly installed gate at the top of the stairs. Child B's Mother denied knowing there was a pocket door at the top of the stairs, stating that she must have never seen it closed. Child C and D's Mother reported that the door at the top of the stairs is sometimes closed but it is usually open. Child E's Mother reported that prior to the childcare moving to the basement, the door at the top of the stairs was always closed, but since the basement became approved child use space, the door is always open. 4

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

R 400.1907 · R 400.1907 Child's record. (1) Prior to a child's initial attendance, a licensee shall obtain the following documents: (a) A completed child information card on a form provided by the department or a comparable substitute approved by the department.

Ms. Switzer did not obtain completed child information cards prior to children's initial attendance. Five child information cards were missing at least one piece of required information.

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

R 400.1925 · R 400.1925 Comprehensive background check; fingerprinting. (1) Pursuant to section 5n of the act, MCL 722.115n, prior to an individual having any unsupervised contact with children, the department shall determine the individual's eligibility to be any of the following: (d) A child care staff member.

Ms. Switzer did not fingerprint child care staff member Ms. Wood prior to Ms. Wood having unsupervised contact with children.

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.