GRETCHEN WHITMER GOVERNOR STATE OF MICHIGAN DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS LANSING ORLENE HAWKS DIRECTOR April 1, 2019 Denise Campbell Bright Horizons Children's Centers LLC 200 Talcott Avenue South Watertown, MA 02472 RE: License #: Investigation #: DC630374197 2019D0429015 Bright Horizons at St Joseph Mercy Hospital Dear Ms. Campbell: 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 (248) 975-5053. 611 W. OTTAWA P.O. BOX 30664 LANSING, MICHIGAN 48909 www.michigan.gov/lara 517-335-1980
Per MCL 722.113g, this report and any related corrective action plans must be filed in your licensing notebook. Sincerely, Jennifer Lietz, Licensing Consultant Bureau of Community and Health Systems 4th Floor, Suite 4B 51111 Woodward Avenue Pontiac, MI 48342 (517) 899-5987 enclosure
MICHIGAN DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS BUREAU OF COMMUNITY AND HEALTH SYSTEMS SPECIAL INVESTIGATION REPORT I. IDENTIFYING INFORMATION License #: Investigation #: DC630374197 2019D0429015 Complaint Receipt Date: 02/15/2019 Investigation Initiation Date: 02/15/2019 Report Due Date: 04/16/2019 Licensee Name: Licensee Address: Licensee Telephone #: Administrator: Licensee Designee: Name of Facility: Facility Address: Bright Horizons Children's Centers LLC 200 Talcott Avenue South Watertown, MA 02472 Unknown Denise Campbell, Designee Denise Campbell, Designee Bright Horizons at St Joseph Mercy Hospital 161 Bassett Street Pontiac, MI 48341 Facility Telephone #: (248) 858-6667 Original Issuance Date: 03/13/2015 License Status: REGULAR Effective Date: 09/13/2017 Expiration Date: 09/12/2019 Capacity: 160 Program Type: CHILD CARE CENTER 1
II. ALLEGATION(S) Child A (16-month-old, male) was given a snack he is allergic to, and he had an allergic reaction resulting in medical attention. Center staff did not record Child A s snack correctly on his daily sheet. Violation Established? Yes Yes III. METHODOLOGY 02/15/2019 Special Investigation Intake 2019D0429015 02/15/2019 Special Investigation Initiated - Telephone Interviewed Child A's Mother via telephone. 02/15/2019 Contact - Document Received Incident report, a phone call, and email from director Alaina Recore. 02/21/2019 Inspection Completed On-site From 1:40 to 2:50 PM. Interviewed director Alaina Recore and caregivers David Modock and Tanesha Barr. Received documents and looked at Child A's medication & medication forms. 02/21/2019 Exit Conference With director Alaina Recore. 02/21/2019 Inspection Completed-BCAL Sub. Compliance ALLEGATION: Child A (16-month-old, male) was given a snack he is allergic to, and he had an allergic reaction resulting in medical attention. INVESTIGATION: Director Alaina Recore self-reported that Child A was given a Nutri-grain bar that contained dairy. Child A is allergic to dairy. Child A was given the snack by caregiver David Modock around 3:30 PM on 2/14/2019. After snack, Mr. Modock left for the day and caregiver Tanesha Barr was with Child A. Around 4:30 PM, Ms. Barr called the front office and told Ms. Recore that Child A seemed to be having a hard time breathing and he was wheezing and coughing. Ms. Recore went to the classroom and observed Child A. They administered his allergy medication according to his health form and called his mother. Ms. Recore also called Mr. Modock to find out what Child A ate because she knew his daily sheet was not 2
correct. It said he ate cheese puffs, a chocolate chip cookie, and oranges, which he cannot have. Mr. Modock told her he ate a Nutri-grain bar. Ms. Recore found the wrapper in the garbage and saw it contained dairy. Child A s Mother arrived at the center within ten minutes. She decided to take him to the hospital across the street. Ms. Recore asked if she wanted Child A s epi-pen and his mother said, No. Ms. Recore contacted Child A s Mother later that evening to check on Child A. He was doing fine, and they set up an appointment to meet on Monday 2/18/19. During the meeting, they talked about what happened and how to prevent it from happening again. Ms. Recore stated Child A s Mother will bring all his food and he is only allowed to eat his food brought to the center. They will be retraining staff on which allergies Child A has and will remind them of the severity of his allergies. Caregiver David Modock stated he was aware of Child A s allergies. Before distributing snack, he looked at the Nutri-grain bar and did not notice that it said contains milk at the very bottom of the label. He gave the snack to Child A and then after snack, he left for the day. About an hour later, he received a call from Ms. Recore asking what Child A ate for snack. He told her, and she told him what happened. Mr. Modock stated he feels awful about what happened. He stated he followed protocol and did exactly what he was supposed to do before giving Child A his snack but misread the label. Caregiver Tanesha Barr stated when Mr. Modock left for the day, she was in the room with Child A. She stated about an hour after snack, she noticed Child A had a congestive cough and was having trouble breathing. She stated he was crying too. She called Ms. Recore and told her what was happening with Child A. Ms. Recore came to the classroom. She found out what he ate and gave him medication and contacted his mother. Child A s Mother arrived at the center quickly and took over. Child A s Mother stated the center called her and told her Child A was having trouble breathing. She works nearby and arrived at the center quickly. She was informed he had been given a Nutri-grain bar with dairy. She was also informed they gave him his allergy medicine. She stated Child A has had allergic reactions to foods before but has only had hives. This is the first time he has had trouble breathing, so she decided to take him to the hospital next to the center. While in the ER, Child A was given steroids; they did not give him an epi-pen. Child A s breathing returned to normal and they returned home later that evening. Child A s Mother stated he will return to the center for care. She stated she knows accidents happens. She understands it is hard to feed Child A because of his allergies, and she does not want the staff to be scared to feed him. She wants him to be as normal as possible. She stated the center will no longer give him processed food. During my on-site inspection, I reviewed Child A s medications and medication permission forms. He has an epi-pen with the pharmacy label and an over- the- 3
counter antihistamine with his first and last name on it in the classroom s medication bin. His medication permission slips were with the medication, and it was recorded that the antihistamine was given to him on 2/14/2019. APPLICABLE RULE R 400.8330 Food services and nutrition generally. (4) A center shall ensure a child with special dietary needs is provided with snacks and meals in accordance with the child s needs and with the instructions of the child s parent or licensed health care provider. ANALYSIS: CONCLUSION: The center was aware of Child A s allergies; however, he was given a food item he was allergic to. VIOLATION ESTABLISHED ALLEGATION: Center staff did not record Child A s snack correctly on his daily sheet. INVESTIGATION: Child A s Mother stated she had to ask what Child A ate for pm snack and what time he ate it because it was not recorded correctly on his daily record. She stated it said he had cheese puffs, a chocolate chip cookie, and oranges. She knew they would not have given him this food. She stated his food intake is recorded incorrectly all the time. She used to ask about it, but now she just knows they really did not give him what everyone else eats. Child A s food intake is recorded on an app the center uses, and she can look at it throughout the day. Child A s snack on 2/14/2019 was not recorded on the app. The director Ms. Recore stated the center uses an app called Teaching Strategies to record the children s daily activities. She admitted many times food is input incorrectly for children with allergies. She stated when you put snack in for the child at the top of the class list, it is recorded that way for all the children on the list. The caregivers are supposed to go to the children who did not eat that snack and manually correct it to what the child ate; however, they have not been doing that. She stated on 2/26/2019 they are having a staff meeting to retrain caregivers on how to input food correctly in the app. APPLICABLE RULE R 400.8146 Information provided to parents. (3) For infants and toddlers, parents shall receive a written daily record that includes at least the following information: 4
(a) Food intake; time, type of food, and amount eaten. ANALYSIS: CONCLUSION: Child A s pm snack and the time it was eaten was not recorded correctly on his daily record. VIOLATION ESTABLISHED IV. RECOMMENDATION Upon receipt of an acceptable corrective action plan, I recommend no change in the license status. 03/29/2019 Jennifer Lietz Date Licensing Consultant Approved By: 04/01/2019 Jacquelin Sharkey Date Area Manager 5