Summary of Monitoring Visit The visit conducted today included monitoring of the Agency's compliance with Licensing Rules and Regulations. It also included a review of the QRIS. Observation: On January 6, 2022, Child Care Licensing received a complaint, and an investigation has been initiated involving this Agency. Accordingly, a Safety Plan is being implemented during the investigative period. The Safety Plan will remain in effect until the complaint investigations are completed, and the outcome is determined. Little House Child Care Center understands that it must abide by the terms of the Safety Plans until it is lifted in writing by TDHS. Little House Child Care Center understands that the failure to abide by the terms of the Safety Plans will result in legal enforcement action against the Agency license, including the summary suspension of the license to operate. Technical Assistance Given: Choking Prevention – Upon entering the 18 Months – 2 Years classroom, LC Rogers observed a pacy clip attached to a child. Director removed the pacy clip from the child and placed the clip out of reach. As a reminder, (f) children shall not be permitted to wear teething necklaces, pacifiers, or any item around their neck or attached to their clothing that are potentially hazardous and associated with choking. Technical Assistance: Behavior Management and Guidance – (a) Behavioral interventions shall be developmentally appropriate, with consideration given to the attention spans and skills of individual children. (b) Discipline shall be reasonable, appropriate, and in terms the child can understand. (c) Potentially shaming, humiliating, frightening, verbally abusive, injurious discipline methods, and/or techniques that isolate the child are prohibited. (d) Discipline shall not be related to food, rest, or toileting. Food shall not be used or withheld as a form of discipline. Active play opportunities shall not be withheld from children who have misbehaved. (e) Spanking and all types of corporal punishment are prohibited. (f) Mechanical and chemical restraints are prohibited. (g) Educators shall focus upon positive behavior and on the individual child's strengths. (h) The Educator shall address each incident of unacceptable behavior by using methods of positive guidance and discipline to help the child manage his/her behavior. (i) Each time a child is engaging in unacceptable behavior the Educator shall first redirect the child's attention and substitute a desirable activity prior to disciplining the child. (j) Less restrictive, positive behavior management techniques shall be employed before using time-out. (k) Time-out may be used to intervene with a child whose behavior is disruptive to the group or hurtful to other children and who does not respond to Educator redirection or guidance. 1. Time-out shall be reasonable and developmentally appropriate and shall not include restraint or seclusion. 2. The length of each time-out session shall be based on the age of the child and shall not exceed one (1) minute per each year of age of the child; provided, however, that no child under thirty six (36) months shall be placed in time out. 3. Time-out shall take place in an appropriate location within sight of the Educator. 4. Restraining devices such as high chairs, cribs, or car seats shall not be used for time-out. 5. Redirection or a similar approach shall be used for children younger than thirty six (36) months of age. (l) Physical Restraint and Seclusion. The following is not considered physical restraint and is considered acceptable: 1. Physical touch associated with prompting, comforting, or assisting that does not prevent the service recipient's freedom of movement or normal access to his or her body. 2. Physical restraint and seclusion are emergency safety interventions, not therapeutic techniques, and are implemented in a manner designed to protect the child/youth's safety, dignity, and emotional well-being. 3. The use of physical restraint is allowed only in the case of an emergency when the child/youth is at imminent danger of self-harm or of harming others and no other option exists to protect the safety of the child/youth and staff members. Technical Assistance Given: 1240-04-01-.18 Emergency Preparedness – During today's visit, LC Rogers reviewed Emergency Preparedness Plan and reviewed 1240-04-01-.18 with Director. 1240-04-01-.18 Emergency Preparedness. (1) All persons or entities operating a child care agency as defined in this chapter, excluding drop-in child care centers and those programs and facilities exempt from licensing as provided in T.C.A. § 71-3-503, shall, in consultation with appropriate local authorities and local emergency management, develop a written multi-hazard plan to protect children in the event of emergencies, including, but not limited to, fires, tornados, earthquakes, chemical spills, and floods. Such plans must address the following components: evacuation, relocation, shelter-in-place and lock down, staff and volunteer emergency preparedness training and practice drills, communication and reunification with families, continuity of operations, and accommodation of infants and toddlers, children with disabilities, and children with chronic medical conditions. (2) All child care agencies shall also inform parents and guardians of children attending the child care agency of the plan. The child care agency shall comply with all other requirements related to emergency preparedness provided under T.C.A. § 71-3-517. Technical Assistance Given: Childcare Northeast TN + Sub Pool Community Collaboration – The substitute teacher pool, or the "sub-pool", was built to answer the growing need for Child Care Educators and Substitutes in our area. Learn more about ChildcareNortheastTN.com, the Substitute Teacher Pool, and the support services it offers our community in Northeast Tennessee at childcarenortheasttn.com. If you want to learn more about joining the substitute teacher pool service, you can email childcare@ftdd.org or call (423) 979-2582. Technical Assistance Given: WAGE$® Flyer – The Child Care WAGE$® Program is an education-based salary supplement program for Child Care Educators employed in DHS Licensed Child Care Agencies. This program provides eligible Educators an annual award, issued in two parts, based on specific qualifications. To apply or learn more, visit the WAGE$ website at www.tnwages.org. Violations Received: None