DC D Little Lambs of Jesus & Childcare Center

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1 RICK SNYDER GOVERNOR STATE OF MICHIGAN DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS BUREAU OF HEALTH CARE SERVICES MIKE ZIMMER DIRECTOR June 8, 2015 Dana Farley St Pauls Lutheran Church 100 Luther Blvd Albion, MI RE: Lic./Reg. #: Investigation #: DC D Little Lambs of Jesus & Childcare Center Dear Mrs. Farley: Attached is the Special Investigation Report for the above referenced facility. Due to the violations identified in the report, a written corrective action plan is required. The corrective action plan is due 15 days from the date of this letter and must include the following: How compliance with each rule will be achieved. Who is directly responsible for implementing the corrective action for each violation. Specific time frames for each violation as to when the correction will be completed or implemented. How continuing compliance will be maintained once compliance is achieved. The signature of the responsible party and a date. If you desire technical assistance in addressing these issues, please feel free to contact me. In any event, the corrective action plan is due within 15 days. Failure to submit an acceptable corrective action plan will result in disciplinary action. Please review the enclosed documentation for accuracy and contact me with any questions. In the event that I am not available and you need to speak to someone immediately, please contact the local office at (269) P.O. BOX LANSING, MICHIGAN (517)

2 Per MCL g, this report and any related corrective action plans must be filed in your licensing notebook. Sincerely, Beth Gonding, Licensing Consultant Child Care Licensing Division 322 E. Stockbridge Ave Kalamazoo, MI (269) enclosure

3 MICHIGAN DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS BUREAU OF CHILDREN AND ADULT LICENSING SPECIAL INVESTIGATION REPORT I. IDENTIFYING INFORMATION License #: Investigation #: DC D Complaint Receipt Date: 05/01/2015 Investigation Initiation Date: 05/04/2015 Report Due Date: 06/30/2015 Licensee Name: Licensee Address: St Pauls Lutheran Church 100 Luther Blvd Albion, MI Licensee Telephone #: (517) Administrator: Licensee Designee: Name of Facility: Facility Address: Dana Farley, Designee Dana Farley, Designee Little Lambs of Jesus & Childcare Center 615 Dalrymple Albion, MI Facility Telephone #: (517) Original Issuance Date: 12/06/2013 License Status: REGULAR Effective Date: 06/06/2014 Expiration Date: 06/05/2016 Capacity: 92 Program Type: CHILD CARE CENTER 1

4 II. ALLEGATION(S) Caregivers in the older toddler room are not providing appropriate care and supervision which has resulted in biting incidents between Child A and other child care children. Child B and another unknown child care child were left alone in a classroom for an unknown period of time. Caregivers in the older toddler room are not changing wet diapers regularly, which has resulted in Child A developing diaper rashes. Child A was dispensed medication without written parental permission. Caregivers in the older toddler room did not properly document when medications were dispensed to Child A. The child care facility falsified Child A and B s Mother s signature on a document. Additional Findings Violation Established? No Yes No Yes Yes No Yes III. METHODOLOGY 05/01/2015 Special Investigation Intake 2015D /04/2015 Special Investigation Initiated - On Site from 10:00 AM until 11:00 AM. Unannounced on-site inspection and interviews with Program director, Dana Farley, Assistant program director Jenny Woods, and caregiver Kristen Twiss. 05/05/2015 Contact - Document Received Received more information and additional allegation regarding supervision. 05/06/2015 Contact - Telephone call made Phone contact with Jenny Woods. 05/06/2015 Contact - Document Received Received from Dana Farley. 2

5 05/22/2015 Contact - Document Received Received additional allegations/concerns. 05/26/2015 Contact - Telephone call made Left voice mail message for Child A and Child B's Mother. 05/26/2015 Contact - Telephone call received Received voice mail from Child A and Child B's Mother. 05/28/2015 Inspection Completed On-site from 11:00 AM until 11:30 AM. Unannounced on-site inspection and interview with Assistant program director Jenny Woods. 05/28/2015 Contact - Document Received Received phone call from program director Dana Farley. 06/01/2015 Contact - Telephone call made Phone contact with Child C and Child D's Mother. 06/01/2015 Contact - Telephone call made Left message for Child E's Mother. 06/01/2015 Contact - Face to Face Phone contact with Child F's Mother. 06/01/2015 Contact - Telephone call made Left message for Child G's Mother. 06/03/2015 Contact - Telephone call made Phone contact with Child E's Mother. 06/04/2015 Exit Conference ALLEGATION: Caregivers in the older toddler room are not providing appropriate care and supervision which has resulted in biting incidents between Child A and other child care children. INVESTIGATION: On 5/5/2015 I completed an unannounced on-site inspection and interviews with program director Dana Farley, assistant director Jenny Woods, and lead caregiver Kirsten Twiss. Ms. Farley and Ms. Woods immediately expressed that they believe the complaint was made by Child A and Child B s Mother. They reported that Child A (female, age 2) and Child B (male, age 4) were withdrawn by their mother from the child care facility last week. Child A and B s Mother is quite difficult to deal with, and is very threatening and aggressive. They stated that on the 3

6 day she withdrew Child A and Child B from the facility she was swearing and yelling in front of other child care parents and child care children. Child A and B s Mother threatened to take the facility down. Ms. Farley and Ms. Woods expressed that the only repeat biter they had in the older toddler room was Child A. Whenever Child A had a biting incident, it would occur quickly and caregivers would see it occur. The caregivers would always address the biting incident immediately by talking to Child A and redirecting her to another activity. Ms. Woods stated that she was working in the older toddler classroom when the last biting incident occurred. Child A just randomly bit another child. There did not appear to be any provocation or distress before Child A bit the other child. The bite was documented and Child A and Child B s Mother was notified. Ms. Farley and Ms. Woods spoke to Child A and Child B s Mother several times about the biting incidents. She would blame the biting on Child A s teething, and wanted the child care facility to let her have a pacifier all day. Ms. Farley and Ms. Woods stated that they do not allow child care children to leave pacifiers in all day. Ms. Woods and Ms. Farley stated that the biting incidents don t have anything to do with a lack of supervision. The caregivers in the classroom cannot prevent all biting incidents, especially if the child just bites without apparent provocation. Ms. Twiss is a lead caregiver in the older toddler classroom. She reported that Child A is the only child in the classroom that had repeat biting incidents. Child A had two or three biting incidents in the last week prior to her being withdrawn from the child care facility. Ms. Twiss expressed that all biting incidents are documented or reported directly to the parents. She stated that Child A does not need to be angry or upset to bite. Child A will just bite for no apparent reason. She pointed out that it is very difficult to stop a child from biting, when there is no warning before the biting occurs. She has spoken to Child A and Child B s Mother several times about Child A s biting. Child A s Mother would get very upset, and claimed that Child A never bit when she was at home. She stated that Child A s Mother felt that if the child care facility would let Child A keep a pacifier in all day, then the biting would cease. Ms. Twiss indicated that child care children in the older toddler room are only allowed pacifiers at nap time. On 5/1/2015 I received information from Child A and B s Mother. She reported that Child A has bitten a few kids in the older toddler classroom, and she is worried that this is due to a lack of supervision. Child A and B s Mother stated that Ms. Farley and the caregivers in the classroom have been unable to tell her how or why the biting incidents occurred. On 6/1/2015 I completed phone contact with Child C and Child D s Mother. Child C (female, age 1 ½) and Child D (male, age 10 months) have been enrolled at the child care facility for approximately 3 months. Child C and Child D s Mother reported that she has not had any concerns with the supervision at the child care facility. Child C is enrolled in the older toddler classroom, and has been involved in 1 biting incident. The caregivers notified her and told her what occurred. No further incidents 4

7 have occurred. She does not feel that the biting incident was due to a lack of supervision, but is rather typical for this age and development. Child C and Child D s Mother stated that she feels that the caregivers are doing a wonderful job. On 6/1/2015 I completed phone contact with Child F s Mother. Child F (male, age 22 months) has been enrolled at the child care facility for approximately 1 year. Child F is enrolled in the older toddler classroom. Child F s Mother reported that she has not had any issues or concerns with supervision in the classroom. She expressed that Child F has not been involved in any biting incidents. On 6/3/2015 I completed phone contact with Child E s Mother. Child E (male, age 2) has been enrolled at the child care facility for approximately 5 months. Child E s Mother stated that she has no issues or concerns with supervision at the child care facility. She has been very happy at the child care facility and her son loves it there. I attempted phone contact with Child G s Mother, but no return calls were received. APPLICABLE RULE R Staff and Volunteers. (1) All staff and volunteers shall provide appropriate care and supervision of children at all times. ANALYSIS: CONCLUSION: Staff provide appropriate care and supervision of child care children in the older toddler classroom. VIOLATION NOT ESTABLISHED ALLEGATION: Child B and another unknown child care child were left alone in a classroom for an unknown period of time. INVESTIGATION: On 5/5/2015 additional allegations were received that in February 2015 Child B and another unknown preschool age child were left alone in the wraparound preschool room for an unknown period of time. I received information from Child A and Child B s Mother about the incident. Child A and B s Mother indicated that on the date of the incident, she walked into Child B s preschool classroom and found him and another child alone playing with the facility s guinea pig. She reported that no caregivers were present in the classroom. Child A and Child B s Mother indicated that Ms. Farley was in the classroom next door cleaning the guinea pigs cage. She also reported that on 5/4/2015 when she withdrew her child care children from the facility Ms. Farley left the preschool children alone in the classroom to walk to the office and get paperwork for her. On 5/6/2015 I completed phone contact with Ms. Woods regarding this incident. Ms. Woods stated that she is aware of the reported incident, but was not directly 5

8 involved. She was told about the situation after it occurred, because Child A and Child B s Mother was upset and had discussed it with Ms. Farley. Ms. Woods believes that the incident occurred towards the end of the day, and there were very few children present at the child care facility. Child B and another preschool child were in the wraparound preschool classroom with a caregiver playing with the facility s guinea pig. A person rang the doorbell to the front entrance, so the caregiver exited the classroom to answer the door. Ms. Woods stated that the caregiver immediately returned to the classroom, and Child B and the other child were only alone for a minute or two. Ms. Woods stated that Ms. Farley spoke with Child A and Child B s Mother about the incident, and felt that it was managed. I explained that at no time should any child care children be left alone in a classroom. I requested that Ms. Farley contact me regarding this incident. On 5/6/2015 I received an response from Ms. Farley about the reported incident. Ms. Farley stated that she was not at the child care facility when the incident occurred. She stated that Child A and Child B s Mother contacted her the next day and told her that Child B and another child were left alone in a classroom with the guinea pig for an unknown period of time. Ms. Farley spoke to the caregivers involved, and the caregiver acknowledged leaving the two children alone for a couple of minutes to answer the front door. Ms. Farley reviewed policy about never leaving child care children alone with the caregivers involved. She notified Child A and B s Mother of the follow up, and felt the situation was managed. APPLICABLE RULE R Staff and Volunteers. (1) All staff and volunteers shall provide appropriate care and supervision of children at all times. ANALYSIS: CONCLUSION: Staff did not provide appropriate care and supervision of child care children in the preschool classroom. VIOLATION ESTABLISHED ALLEGATION: Caregivers in the older toddler room are not changing wet diapers regularly, which has resulted in Child A developing diaper rashes. INVESTIGATION: During the initial on-site inspection, Ms. Farley and Ms. Woods reported that caregivers in the infant room and older toddler room are required to check and change diapers every two hours. If a child is obviously wet or soiled, they will change sooner. Ms. Woods frequently works in the infant room and older toddler room as a caregiver. She stated Child A and Child B s Mother recently complained that Child A was soiled when she came to pick up. Ms. Woods reported that Child A was not soiled when she left the child care facility, and must have soiled herself at 6

9 pick up or shortly after. I reviewed Child A s daily report sheets, and noted that the majority displayed that Child A was changed approximately every 2 to 3 hours. I did observe that on 4/28/2015 the sheet stated that the child was wet and changed at 12:30 PM with no further documented changes occurring before the child was picked up at approximately 4:30 PM. Ms. Woods stated that she is certain that Child A would have been either checked or changed again around 2:30, but the caregiver likely failed to document on the daily sheet. If the daily sheets show a gap longer than 2 hours, then the child was likely dry when checked or the caregiver forgot to document. Ms. Woods and Ms. Farley are adamant that child care children are not left in soiled diapers. During the initial on-site inspection, Ms. Twiss expressed that child care children in the older toddler room receive diaper checks every 2 hours. She stated that they are checked at 9:30 AM, 11:30 AM (before lunch/nap), at 1:30-2:00 PM (after naps), and at 4:00-4:30 PM. She reported that if a child is not soiled, then they are not changed. Ms. Twiss stated that the children are changed whenever they are soiled, regardless of whether it occurs before the 2 hour check or in between checks. On 5/5/2015 I received ed information from Child A and Child B s Mother. She stated that on 5/4/2015 Child A was brought to the child care facility at approximately 7:30 AM. She reported that Child A s daily sheet showed a diaper change occurring at 10:00 AM and 12:00 PM. She stated that no further diaper changes were documented, and Child A had poop in her diaper at 4:30 PM pick up time. Child A and Child B s Mother indicated that this has occurred on several occasions. During phone contact with Child C and Child D s Mother, she denied any concerns with her children having diaper changes on a regular basis. She stated that Child C and Child D s daily sheets show regular diaper changes, and neither have any issues with a diaper rash or irritation. She denied any incident in which her child was left in a soiled diaper. She feels the caregivers do a wonderful job and she loves them. During phone contact with Child E s Mother, she denied any concerns with diapering. She reported that Child E has always been changed on a regular basis, and has never had a diaper rash or other concern. She reported that the caregivers always document the diaper changes on Child E s daily sheets. She stated that the caregivers do a great job. During phone contact with Child F s Mother, she denied concerns with diapering. She reported that Child F has never been soiled at pick up, and appears to be changed on a regular basis. She stated that the caregivers document her diaper changes on her daily sheet. Periodically Child F will get a little diaper rash at home and at the child care facility. She has given the child care facility written permission to apply diaper cream. The child care facility will apply the cream, and the rash goes away almost immediately. 7

10 I attempted phone contact with Child G s Mother, but no return calls were received. APPLICABLE RULE R Diapering; toileting. (6) Diapers and training pants shall be checked frequently and changed when wet or soiled. ANALYSIS: CONCLUSION: Caregivers are checking frequently or changing diapers when wet or soiled. VIOLATION NOT ESTABLISHED ALLEGATION: Child A was dispensed medication without written parental permission. INVESTIGATION: On 5/22/2015 I received information from Child A and B s Mother. She reported that in November 2014 Child A was given teething tablets on several occasions without her written permission. In April 2015, Child A was given Tylenol on two occasions without her written permission. Child A and Child B s Mother stated that she only completed written permission forms for diaper cream, bug spray, and sunscreen. On 5/28/2015 during the on-site inspection Ms. Woods acknowledged that Child A was given teething tablets on several occasions, and Tylenol on a couple occasions Child A and Child B s Mother would bring the medication to child care facility for the caregivers to dispense. Child A and Child B s Mother would then give caregivers verbal permission to dispense the medications. Ms. Woods was unable to locate written medication permission forms for Child A to receive Tylenol or teething tablets. She stated that it is likely that Child A and Child B s Mother did not complete a written medication permission form for the teething tablets and Tylenol. Ms. Farley was on a field trip at the time of this on-site inspection. On 5/28/2015 I completed phone contact with Ms. Farley. She acknowledged that Child A and Child B s Mother had not provided the child care facility with written permission to dispense teething tablets or Tylenol. She stated that Child A and Child B s Mother did provide the facility with the two medications and gave caregivers verbal permission. During phone contacts with Child C and Child D s Mother, Child E s Mother, and Child F s Mother, none reported concerns with caregivers dispensing medications without written parental permission. I attempted phone contact with Child G s Mother, but no return calls were received. 8

11 APPLICABLE RULE R Medication; administrative procedures. (2) A caregiver shall give or apply medication, prescription or nonprescription, only with prior written permission from a parent. ANALYSIS: CONCLUSION: Caregivers have dispensed oral medications to child care children without prior written permission from a parent. VIOLATION ESTABLISHED ALLEGATION: Caregivers in the older toddler room did not properly document when medications were dispensed to Child A. INVESTIGATION: On 5/22/2015 I received information from Child A and Child B s Mother that caregivers dispensed Tylenol and teething medications to Child A without documenting the time and the amount given and caregiver signature. She stated that the caregivers would only write on Child A s daily sheet that the medication was given. On 5/28/2015 during the on-site inspection, I reviewed multiple daily sheets for Child A. Several daily sheets in November contained a note that Child A was given teething tablets. The notes did include the amount of tablets provided. The notes also included general times of dispensing such as, after nap or before lunch, but did not include signature of caregiver. Two daily sheets in April contained notes that Tylenol was given to Child A. These notes did not include dosage amounts or a signature of caregiver. Ms. Woods acknowledged that proper medication forms were not used to document dosage amounts, times, or caregiver signatures. During phone contact with Ms. Farley, she acknowledged that medications were dispensed without proper documentation of dosage, times, and caregiver signatures. She stated that all caregivers have been notified of the proper procedures, and these will be followed from now on. During phone contact with Child C and Child D s Mother, Child E s Mother, and Child F s Mother, none reported concerns with medication forms or documentation. APPLICABLE RULE R Medication; administrative procedures. (9) The center shall maintain a record as to the time and the amount of medication given or applied, with the exception of subrule (8) of this rule, on a form provided by the department or 9

12 a comparable substitute approved by the department. The signature of the caregiver administering the medication shall be included. ANALYSIS: CONCLUSION: Caregivers did not provide their signatures after administering medications to Child A, and did not maintain a record as to the time or amounts of all medications dispensed to Child A. VIOLATION ESTABLISHED ALLEGATION: The child care facility falsified Child A and Child B s Mother s signature on a document. INVESTIGATION: On 5/22/2015 I received information from Child A and Child B s Mother, that she believes someone at the child care facility signed her name to a document. She reported that her name and a signature were located on the child care facility s discipline policy notification. She denies that the signature was hers, but is unable to state whose signature was on the form. On 5/26/2015 I received a voice mail message from Child A and Child B s Mother regarding this allegation. She reported that the discipline policy form contains her name and signature, but she states that someone else signed her name to the form. She stated that her husband is actually the one that received a copy of the discipline policy, not her. She feels that someone at the child care facility signed her name to the form. On 5/28/2015 during the on-site inspection, I observed the signed discipline policy. The policy was signed with Child A and Child B s Mother s signature. Ms. Woods reported that the signature was definitely not completed by her or Ms. Farley. She stated that the writing does not compare to hers or Ms. Farley s in any way. Ms. Woods stated that all forms and enrollment paperwork are given to child care parents to take home, complete, and return. She or Ms. Farley only check the forms when returned to make sure that they are all signed and completed. Ms. Woods expressed that they would not know if Child A and Child B s Mother signed the form herself, or if Child A and B s Father signed it for her. During phone contact with Ms. Farley, she stated that no one at the child care facility signed Child A and Child B s Mother s name to any form. She expressed that enrollment paperwork or other forms that need parental review, are given to parents to take home and review. After parents review and sign, the forms are returned to the child care facility. After they receive the signed forms, they are filed away. She pointed out that the discipline policy is not a required form and there would be no reason for anyone at the facility to falsify a signature on that form. She believes that 10

13 it is more likely that Child A and Child B s Father received the form, signed the mother s name, and returned it to the facility. During phone contact with Child C and Child D s Mother, Child E s Mother, and Child F s Mother, no concerns were expressed about the child care facility falsifying documents. APPLICABLE RULE R Licensee. (9) The licensee shall cooperate with any state or local department or agency inspections or investigations related to the child care license by both of the following: (b) Assuring information provided is accurate and truthful. ANALYSIS: CONCLUSION: There is insufficient information to support that the child care facility falsified any document or otherwise provided inaccurate information to the department. VIOLATION NOT ESTABLISHED ADDITIONAL FINDINGS INVESTIGATION: On 5/28/2015 I completed an unannounced on-site inspection and interview with Ms. Woods regarding other matters. During my inspection, I noted that Ms. Woods had to leave the infant classroom to speak with me in the office and lobby area. This left the infant room with 10 infants and 2 caregivers. I explained to Ms. Woods that she really should not leave the classroom at all unless the ratios are maintained. I pointed out that whenever a caregiver has to leave a classroom to answer the front door, they may be leaving a classroom out of ratio. The caregiver cannot know when answering the door if they will only be gone for a minute or longer depending on the circumstances and situation. I explained that unless they always have an extra caregiver or other staff member present to answer the front door, they are technically violating ratio requirements. Ms. Woods stated that they are planning to install security cameras at the front door with a remote locking system. This will allow them to unlock the door from the classrooms, so that ratios can be maintained in these circumstances. Ms. Woods stated that during much of the day, they have a staff member in the office who can answer the door. During phone contact with Child C and Child D s Mother, Child E s Mother, and Child F s Mother, none reported concerns with the child care facility failing to maintain appropriate ratios. 11

14 APPLICABLE RULE R Ratio and group size requirements. (3) In each room or well-defined space, the maximum group size and ratio of caregivers to children, including children related to a staff member or the licensee, shall be the following: (a) For infants and toddlers, there shall be 1 caregiver for 4 children and a maximum group size of 12. ANALYSIS: CONCLUSION: Caregivers in the infant classrooms have not maintained appropriate ratios. VIOLATION ESTABLISHED IV. RECOMMENDATION Upon receipt of an acceptable corrective action plan, I recommend that the status of the license remain unchanged. 6/8/2015 Beth Gonding Date Licensing Consultant Approved By: 6/8/2015 Yolanda Sims Date Area Manager 12

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