Milestones Early Learning - Wilson

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.

Program Staff provided appropriate care and supervision. There were no reports of staff bringing Child A outside in an inappropriate or rough manner. When Child A refused to put his outdoor gear on, it was brought outside for him to put on when cold.

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R 400.8164(2) · PR19-R 400.8164(2) Telephone service. During the hours the center is in operation, a phone number known to the public and available to parents to provide immediate access to the center must be p rovided.

Milestones Early Learning – Wilson has experienced brief phone outages; however, parents have always been promptly notified and provided with an alternative way to contact the center.

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R 400.8128(1) · R 400.8128(1) Staff; volunteer; tuberculosis. A center shall keep on file at the center evidence to verify that each child care staff member and each volunteer who has contact with children at least 4 hours per week for more than 2 consecutive weeks is free from communicable tuberculosis (TB). Verification of TB status is required within 1 year before employment or volunteering.

During my on-site inspection CCSM 3 did not have a TB test on file.

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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 02/07/2023, I received a written complaint alleging that preschool staff Child Care Staff Member 3 (CCSM 3) and Child Care Staff Member 4 (CCSM 4) have pulled chairs away from the children, made inappropriate comments about male genitalia in front of the children, made children sit in soiled underpants as punishment, discouraged or made fun of children when they answered something incorrectly, made children sit with their heads down for extended periods of time, put a child in the bathroom for an hour due to behavior issues, and refused food to children for behavior issues. The complaint indicates that these concerns were shared with Ms. Clark, assistant program director Child Care Staff Member 5 (CCSM 5), and behavior analyst Child Care Staff Member 6 (CCSM 6). On 02/13/2023, I completed an on-site inspection. I interviewed program director Lauren Clark, assistant program director CCSM 5, and CCSM 6. I also observed in the preschool classroom for approximately three hours. Ms. Clark and CCSM 5 denied having knowledge of CCSM 3 or CCSM 4 pulling chairs away from the children, making inappropriate comments about male genitalia in front of the children or otherwise, making children sit in soiled underpants as punishment, discouraging or making fun of children, making children sit with their heads down for any period of time, putting a child in the bathroom for any length of time for discipline, or refusing to give children food for any reason. They stated that they have not received any additional concerns from anyone since my last visit at the center on 12/08/2023. Ms. Clark stated that she has observed in the classroom more frequently and has watched the live feed only cameras more often since my last visit. She has not observed anything concerning in her in-person or camera observations. CCSM 6 stated that she is an executive director from the Milestones central office. She has observed in the preschool classroom for approximately 45 minutes to 1 hour on 08/16/2022, 09/15/2022. 10/13/2022, 12/13/2022, and 01/25/2023. Through her observations she has provided CCSM 3 and CCSM 4 with problem-solving strategies for the children and has modeled language for them as well. She described CCSM 3 and CCSM 4 as being very structured, but a bit inflexible. She stated that they tend to get overwhelmed by challenging behaviors, but they are willing to learn new skills. 3 I observed CCSM 3 and CCSM 4 from 9:53am until 12:53pm. I observed large group, story time, gross motor play (music and movement), a second large group, a third large group, a fourth large group, a fifth large group, small group stations, clean up, handwashing, lunch, toileting, handwashing, and rest time. CCSM 3 and CCSM 4 were good about providing the "why" in their requests of children. For example, "If you sit on your bottom, there will be room for everyone to sit." They were very patient as children took turns describing their socks during large group. They were attentive to children who were sad or upset, offering encouragement and hugs. They counted and completed their name-to-face attendance for the children before and after each transition from one room to another. The transition between small group stations were not very smooth. The children transitioned to five large groups within a span of one hour; therefore, the children sat for a significant amount of time in that hour. The transitions between small group stations occurred approximately every 10 minutes. This did not seem to be adequate time for children to fully engage in the materials at each station. The last small group station transition lasted less than five minutes due to it almost being time for lunch. During lunch time, a child spilled milk on their plate of food. CCSM 4 made a new plate for the child. CCSM 3 repeatedly asked children to take "no thank you bites", especially if they asked for additional servings. CCSM 3 repeatedly told a child to turn around in her chair and put her feet on the f

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R 400.8140 · R 400.8140 Discipline. (2) All of the following means of punishment are prohibited: (e) Depriving a child of meals, snacks, rest, or necessary toilet use. G

Based on interviews with the Complainant, Child A's Father, and Child D's Father, CCSM 3 and CCSM 4 deprived Child A and Child D of food brought from home on more than one occasion. Based on parent and staff interviews, CCSM 3 and CCSM 4 have not deprived children of necessary toilet use or made children sit in soiled underpants as punishment.

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R 400.8140 · R 400.8140 Discipline. (1) Positive methods of discipline that encourage self-control, self-direction, self-esteem, and cooperation must be used.

Based on interviews with the Complainant and Child A's Father, CCSM 4 failed to use positive methods of discipline when she pretended to flush Child A's stuffed animal down the toilet when Child A was not doing what she wanted. Based on staff interviews, parent interviews, and an on-site observation, CCSM 3 and CCSM 4 have not made children put their heads down for any period of time or put a child in the bathroom for any length of time as discipline.

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R 400.8131 · 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 F member's first aid and CPR certificates must be valid and retained on file in the center.

On 12/19/2022 I conducted an unannounced on-site inspection to the facility. I met with Lauren Clark, program director, regarding the reported allegations. Ms. Clark stated she has 25 child care staff members, of those 25, 8 have been employed more than 90 days. All staff have CPR training as they previously had certification however it is not currently valid. The licensed facility has 50% of the staff with valid CPR certification.

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R 400.8161 · R 400.8161 Emergency procedures. (5) A fire drill program, consisting of at least 1 fire drill quarterly, must be established and implemented.

On 12/19/2022 at the time of the unannounced on-site inspection I asked Ms. Clark about the allegation that emergency drills are not practiced or documented. She explained she has conducted emergency drills; however, she has not kept a log of them. On 12/19/2022 at the time of the on-site inspection Ms. Clark was not able to provide me with verification of training for staff on emergency procedures. She told me all staff are trained in this area as part of their new staff orientation. On 12/22/2022 Ms. Clark emailed me verification of completed training for staff on emergency procedures on 09/15/2022 through Secure Education Consultants.

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R 400.8161 · R 400.8161 Emergency procedures. (6) A tornado drill program, consisting of at least 2 tornado drills between the months of March through November, must be established and implemented.

Lauren Clark stated she has conducted tornado drills as required under the rule.

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R 400.8161 · R 400.8161 j Emergency procedures. (7) A written log indicating the date and time of fire and tornado drills must be kept on file at the center.

On 12/19/2022 Lauren Clark, program director, told me there was no log indicating the date and time of fire and tornado drills. I

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R 400.8161 · R 400.8161 Emergency procedures. (8) Each child care staff member shall be trained at least twice a year on his or her duties and responsibilities for all emergency procedures referenced in subrule (1) of this rule.

Lauren Clark, program director, has had staff trained twice a year on emergency procedures.

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R 400.8140 · R 400.8140 Discipline. (2) All of the following means of punishment are prohibited: (e) Depriving a child of meals, snacks, rest, or necessary toilet use.

On 12/08/2022, I completed an on-site inspection. I interviewed program director/licensee designee Lauren Clark, Child Care Staff Member 1 (CCSM 1), Child Care Staff Member 2 (CCSM 2), Child Care Staff Member 3 (CCSM 3), and Child Care Staff Member 4 (CCSM 4). Ms. Clark stated that she has heard these allegations before, but she talked with staff and found no evidence that these things were occurring. She stated that staff will save a child's plate in the 2 refrigerator if they are not hungry or if they fall asleep and offer them their plate once they wake up. She watched the live-stream only cameras from approximately five days, but she did not see anything of concern. CCSM 1 and CCSM 2 stated that they have no knowledge of either allegation because they do not work in the preschool classroom. CCSM 3 stated that she works in the preschool classroom She has never taken a child's chair away from them during meals or otherwise, nor has she witnessed anyone take a child's chair away. However, if a child is tipping in a chair or kicking at the chairs, she will have the child stand for one to two minutes, or until the child is calm, before giving them their chair back. She has never taken or withheld food from the children, nor has she witnessed anyone take or withhold food from the children. However, some children with extreme behaviors have thrown their food, so she has taken their plates until they calmed down. She stated that no child has ever missed a meal. CCSM 4 stated that she is the lead caregiver in the preschool classroom. She has thrown the children's food away when they are almost done and start throwing their food, they try feeding another child their food, they display a lack of manners, or they are restless and ready to move on. These things typically occur at the end of lunch. She stated that no child has ever missed a meal. On 02/15/2023, I completed an on-site observation in the preschool classroom. I observed for approximately three hours, including lunch time. I did not observe any food being taken away prematurely from children, nor did I observe children being made to stand at lunch time or otherwise. On 05/22/2023, I interviewed Child B's Mother by telephone. She stated that she has no knowledge of the preschool staff throwing the children's food away or threatening to make the children stand for meal times. In fact, Child B (4-year-old, female) often received additional servings at meal times. Child B enjoyed her time in the preschool classroom. Child B's Mother stated that she has no concerns regarding the allegations or otherwise. On 05/22/2023, I interviewed Child A's Mother by telephone. She stated that she had no knowledge of the preschool staff throwing the children's food away or threatening to make the children stand for meal times. On 05/22/2023, I interviewed Child C's Mother by telephone. She stated that she had no knowledge of the preschool staff throwing the children's food away or threatening to make the children stand for meal times. Child C (3-year-old, female) has not come home hungry from the center, nor has she reported anything concerning. Child C's Mother stated that she has no issues with the care and supervision Child C has received at the center. She believes that the staff provide good care to Child C. 3

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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.

Based on staff interviews, parent interviews, and an on-site observation, CCSM 3 and CCSM 4 provide appropriate care and supervision when children are behaving in an unsafe manner in their chairs at meal times. CCSM 3 and CCSM 4 remove the children from their chairs until they have calmed down to prevent them from hurting themselves or others.

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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. 5

Based on staff interviews and an interview with Child A's Mother, staff provided appropriate care and supervision of Child A when they requested that Child A take a break in the office when she became overstimulated in the classroom.

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R 400.8167 · R 400.8167 Indoor space. (3) A center shall provide a floor plan of all child use areas to the department at initial licensure and before making structural changes or adding any child use space. Only space that has received prior approval for child use by the department may be used for child care.

Based on staff interviews, the office has been used as child use space on at least two occasions. The office has not been approved by the department for child use space.

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