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December 28, 2022 CERTIFIED MAIL Annika Morton, Authorized Agent Little Lakers Child Care Center 19404 510th Ave Lake Crystal, MN 56055 License Number: 1105093 (Rule 3) ORDER OF CONDITIONAL LICENSE Dear Annika Morton: The Department of Human Services (DHS) is placing your license to provide child care services at Little Lakers Child Care Center located at 19404 510th Ave, Lake Crystal, MN 56055, on conditional status for two years, beginning January 3, 2023. This means you must meet certain conditions to maintain your license, detailed below. This order is based on your noncompliance with child care center licensing requirements. Details of our findings are also provided below. Our next steps and your options are also detailed. REASON FOR THE CONDITIONAL LICENSE On November 9, 2022, DHS licensors conducted a licensing review at your facility located at 19404 510th Ave, Lake Crystal, MN 56055. As a result of this licensing visit, the DHS licensors determined that your program failed to comply with the laws and rules that apply to licensed child care centers citing 38 violations. DHS has considered the nature, chronicity, and severity of these violations, as well as the health, safety, and rights of children served by the program. Nature and Severity: On November 9, 2022, DHS licensors determined 40 licensing violations. Additionally, 17 of the 38 violations are repeat violations for which you were previously cited. Numerous violations related to the health and safety of children, including: o Failure to comply with requirements related to infant care including safe sleep, items in a crib with an infant younger than one year of age, and crib safety inspections o Failure to supervise children o Failure to maintain children’s files o Failure to comply with handwashing requirements for children o Failure to maintain equipment and supplies in good repair · Chronicity: Your program received its license on November 12, 2021. In that short time, your program has demonstrated a history of noncompliance with licensing rules and statutes. The information below summarizes this history:) o December 28, 2022 - Conditional License (this order): 38 violations (17 repeat violations) o December 7, 2022 – Correction Order 4 violations (3 repeat violations) o August 23, 2022 – Correction Order 20 violations (5 repeat violations) o May 17, 2022 - Correction Order 21 violations Due to the serious and chronic nature of these violations, and the conditions in the program, which impact the health and safety of children in your care, your license to provide child care is placed on a conditional status. Licensing Violations DHS determined that your program failed to follow licensing rules and statutes, as described below. STAFF QUALIFICATIONS AND TRAINING 1. Violation: Staff distribution requirements were not maintained. A teacher or assistant teacher did not directly supervise an aide. At approximately 11:50 a.m., an aide-qualified staff person was supervising seven children alone in the Preschool 3 classroom. At least an assistant teacher-qualified staff person was required. Rule Violated: Minnesota Rules, part 9503.0040, subpart 2, item D; and Minnesota Rules, part 9503.0034, subpart 1. Repeat Violation: The license holder was cited for a similar violation in the following order: · A Correction Order dated August 23, 2022 2. Violation: The program did not have documentation on site to show that 1 of 5 (SP9) staff persons met the education requirements of the teacher job classification for which the staff person was employed. Rule Violated: Minnesota Rules, parts 9503.0032, subpart 2; and 9503.0120, item B. Repeat Violation: The license holder was cited for a similar violation in the following orders: · A Correction Order dated August 23, 2022 · A Correction Order dated May 17, 2022 3. Violation: The program did not have documentation on site to show that 1 of 1 (SP13) staff persons met the education requirements of the assistant teacher job classification for which the staff person was employed. Rule violated: Minnesota Rules, part 9503.0033, subpart 2; and Minnesota Rule, part 9503.0120, item B. 4. Violation: Program policies and procedures were not readily accessible to staff. It was determined through a conversation with an administrative staff person that program policy and procedures were stored on the center's computer, which is not accessible to staff. Statute Violated: Minnesota Statutes, section 245A.04, subdivision 14, paragraph (c). 5. Violation: The required in-service training had not been completed for 3 of 3 (SP10, SP12 and SP13) individuals (director, staff persons, substitutes, or unsupervised volunteers) for the previous concluded calendar year. There was no documentation that three staff persons (SP10, SP12, and SP13) completed the required 6 hours of in-service training for 2021. Statute Violated: Minnesota Statutes, section 245A.40, subdivision 7. 6. Violation: The program did not comply with child development and learning training requirements. Documentation was not available on site to show that 2 of 3 (SP10 and SP12) individuals (director, staff persons, substitutes, or unsupervised volunteers) completed training that was at least two hours in length. There was documentation that SP10 had only one hour of child development and learning training within 90 days of hire. (SP10) There was documentation that SP12 had only one hour of child development and learning training within 90 days of hire (SP12) Statute Violated: Minnesota Statutes, section 245A.40, subdivision 2. SUPERVISION 7. Violation: Staff did not supervise the children at all times (Toddler classroom and Preschool 1 classroom); and an infant, who was placed in a crib room to sleep, was not within sight or hearing of a staff person (Infant 2 classroom). Three children were behind the wall in the large muscle area and were out of sight of the classroom staff for approximately one minute. (Toddler classroom) The nap room was kept too dark for the staff persons to observe sleeping children safely. (Infant 2 classroom) A child was standing next to his/her cubby in the hallway alone crying. After approximately three minutes, a staff person opened the door of the classroom and asked the child why s/he was taking so long. (Preschool 1 classroom) Supervision occurs when a program staff person is accountable for the child's care and is within sight and hearing of a child at all times, so that the program staff person can intervene to protect the health and safety of the child. Rule/Statute Violated: Minnesota Statutes, section 245A.02, subdivision 18; and Minnesota Rules, part 9503.0045, subpart 1, item A. Repeat Violation: The license holder was cited for a similar violation in the following orders: · A Correction Order dated December 7, 2022 · A Correction Order dated August 23, 2022 INFANT CARE 8. Violation: All crib brand names and model numbers were not checked annually against the U.S. Consumer Product Safety Commission website listing of unsafe cribs. The crib brand name and model number for crib #1 was not checked annually in 2022. The program initially checked the crib brand name and model number for crib #1 on September 28, 2021. The program completed the next check on October 7, 2022. (Infant 1 classroom) “Annual or “annually” means prior to or within the same month of the subsequent calendar year. Statute Violated: Minnesota Statutes, section 245A.146, subdivision 3. 9. Violation: The required crib safety inspections were not completed on a monthly basis. Although the crib inspections were completed for each month in 2021, they were done on crib inspection forms for family child care programs, which do not contain all the information required for licensed child care centers. (Infant 1 classroom and Infant 2 classroom) Statute Violated: Minnesota Statutes, section 245A.146, subdivision 4. 10. Violation: The program did not comply with the requirements for reducing the risk of sudden unexpected infant death. The center did not ensure that there was nothing in the crib with an infant younger than one year of age, except for the infant's pacifier. A child under 12 months old was wearing a bib while sleeping in a crib. No items, aside from a pacifier are allowed with a child in a crib if the child is under 12 months of age. (Infant 1 classroom) Statute Violated: Minnesota Statutes, section 245A.1435, paragraph (b). Repeat Violation: The license holder was cited for a similar violation in the following order(s): · A Correction Order dated August 23, 2022 11. Violation: The program allowed an infant under six months of age who independently rolled onto his/her stomach after being placed to sleep on his/her back to remain sleeping on his/her stomach and did not have a signed statement from the parent indicating that the infant regularly rolls over at home. The DHS licensor observed a child under six months old sleeping on his/her side in a crib in the Infant 1 classroom. The staff persons in the classroom did not roll the child to his/her back. In addition, there was not a permission form stating that the child is rolling over on their own. (Infant 1 classroom) Statute Violated: Minnesota Statutes, section 245A.1435, paragraph (a). BEHAVIOR GUIDANCE 12. Violation: The written behavior guidance procedures for prohibited action must prohibit the separation of a child from the group, except within the Rule requirements. The center’s written behavior guidance policy stated that a child will be separated immediately if hurting another child. This does not meet rule requirements that no child may be separated from the group unless the license holder has tried less intrusive methods of guiding the child’s behavior and those methods have been ineffective. Rule Violated: Minnesota Rules, part 9503.0055, subpart 3, item C. PHYSICAL ENVIRONMENT 13. Violation: The program did not comply with cleanliness requirements: · the indoor space was not clean (Toddler classroom and Preschool 3 classroom); and · the outdoor space was not clean. There were two wet, soiled rags on the floor in the Toddler classroom bathroom. (Toddler classroom) Children's blankets were stored all together on top of the cots. These is not a clean and sanitary way to store children's blankets. (Preschool 3 classroom) As defined in Minnesota Rules, part 9503.0005, subpart 9, clean means 'free from dirt or other contaminants that can be detected by sight, smell, or touch.' Rule Violated: Minnesota Rules, part 9503.0140, subpart 9. 14. Violation: Areas used by the children were not in good repair. Paint was chipping and peeling off the wall behind the rocking chair in the Toddler classroom. (Toddler classroom) Paint was chipping and peeling off the wall behind the rocking chair in the group time area in the Preschool 1 classroom. A brick in the wall next to the exit door on the preschool playground was broken exposing a sharp metal edge and the wall underneath was crumbling. (Facility) Rule Violated: Minnesota Rules, part 9503.0140, subpart 20. 15. Violation: A rug or rugs were not firmly fastened to the floor (Toddler classroom). The edges of the plastic floor mat under the children's tables were curling up creating a tripping hazard. (Toddler classroom) Rule Violated: Minnesota Rules, part 9503.0140, subpart 20. Repeat Violation: The license holder was cited for a similar violation in the following order: · A Correction Order dated August 23, 2022 HAZARDS 16. Violation: The DHS licensor observed that hazardous objects were accessible to children. The cords from the window blinds in the Preschool classrooms' bathroom were not secure and were accessible to children. (Facility) Rule/Statute Violated: Minnesota Rules, part 9503.0140, subpart 17; and Minnesota Statutes, section 245A.66, subdivision 2, paragraph (e). Repeat Violation: The license holder was cited for a similar violation in the following orders: · A Correction Order dated August 23, 2022 · A Correction Order dated May 17, 2022 HEALTH AND SAFETY 17. Violation: A child's hands were not washed with soap and water: · after a diaper change (Preschool 1 classroom); · after use of a toilet (Preschool 1 classroom); and · before eating (Infant 2 classroom). A staff person in the Infant 2 classroom sat two children directly at the table and washed their hands with a damp rag prior to a meal. Children's hand must be washed with soap and water prior to eating a meal. (Infant 2 classroom) Multiple children left the bathroom without washing their hands after using the toilet or receiving a diaper change in the Preschool bathroom. (Preschool 1 classroom) Rule Violated: Minnesota Rules, part 9503.0140, subpart 13. Repeat Violation: The license holder was cited for a similar violation in the following orders: · A Correction Order dated May 17, 2022 18. Violation: The health consultant's monthly review of the infant health policies and practices was not completed monthly. There was no documentation that the health consultant's monthly review was completed in May, June, July, August, September, and October of 2022. It was determined through a conversation with an administrative staff person that visits were occurring with the health consultant but there was no documentation of these visits. Rule Violated: Minnesota Rules, part 9503.0140, subpart 2. Repeat Violation: The license holder was cited for a similar violation in the following order: · A Correction Order dated May 17, 2022 19. Violation: Food allergy information was not readily available to staff where food is: · prepared; and · served. All required allergy information was not available where food is prepared or served. The allergy information posted did not include allergy triggers, avoidance techniques, symptoms of an allergic reaction, and procedures for responding, including medication, dosages, and doctor’s contact information. (Preschool 1 classroom) Statute Violated: Minnesota Statutes, section 245A.41, subdivision 1, paragraph (d). 20. Violation: Staff did not wash tables used for meals with soap and water as required. A staff person placed two children at the table for a meal without cleaning the table. (Infant 2 classroom) Rule Violated: Minnesota Rules, part 9503.0145, subpart 3. Repeat Violation: The license holder was cited for a similar violation in the following order: · A Correction Order dated May 17, 2022 21. Violation: Menus did not comply with the nutritional requirements of the USDA. Menus did not include: · at least one whole grain rich food per day; and · the type of milk (whole, 1%, skim). The menus did not identify at least one whole grain rich food per day. The breakfast and snack menus did not identify what type of milk is served. The lunch menu identified a choice of chocolate milk as a meal component. Flavored milk does not meet USDA requirements. Rule Violated: Minnesota Rules, part 9503.0145, subpart 2. Repeat Violation: The license holder was cited for a similar violation in the following order: · A Correction Order dated May 17, 2022 22. Violation: Written parental permission had not been obtained for administering medicine. There was no documented parental permission or medication administration form for medications required for a child with an identified allergy. Rule Violated: Minnesota Rules, part 9503.0140, subpart 7, item A 23. Violation: Medication: · did not have a legible label with the child's first and last name; and · was not returned to parents or destroyed. There was a bottle of expired medicine for a child stored in the Toddler classroom. The medication had not been returned to the parent or destroyed upon expiration. (Toddler classroom) There were two containers of medication that were not labeled with a child's first and last name in the Preschool 1 classroom's first aid backpack. (Preschool 1 classroom) Rule Violated: Minnesota Rules, part 9503.0140, subpart 7, item C. Repeat Violation: The license holder was cited for a similar violation in the following order: · A Correction Order dated May 17, 2022 24. Violation: Products to control diaper rash were not labeled with the child's first and last name. A bottle of diaper cream in the Infant 1 classroom was labeled with a child's first name. A child's first and last name is required. (Infant 1 classroom) There was a package of diaper wipes that was not labeled with a child's first and last name in the Preschool classrooms' bathroom. (Preschool classroom) Rule Violated: Minnesota Rules, part 9503.0140, subpart 7, item D. Repeat Violation: The license holder was cited for a similar violation in the following order: · A Correction Order dated May 17, 2022 25. Violation: Sunscreen or insect repellent was not labeled with the child's first and last name. A bottle of sunscreen in the Infant 1 classroom was not labeled with a child's first and last name. Rule Violated: Minnesota Rules, part 9503.0140, subpart 7, item C. Repeat Violation: The license holder was cited for a similar violation in the following order: · A Correction Order dated May 17, 2022 26. Violation: The program did not comply with annual fire extinguisher inspection requirements. The fire extinguishers were last inspected in October of 2021. “Annual or “annually” means prior to or within the same month of the subsequent calendar year. Rule Violated: Minnesota Rules, part 9503.0155, subpart 16. EQUIPMENT AND SUPPLIES 27. Violation: Equipment and furniture were not in good repair. There was a rip in the diaper changing pad cover, exposing the padding underneath. (Toddler classroom) On the Preschool playground: · A red, plastic ball scooper was cracked and broken in multiple places. · A blue, plastic frisbee was cracked and broken. · A green, plastic bin was cracked on the handle causing a sharp edge. · Two wheels on a toy tricycle were cracked and broken. · A plastic toy car was missing three out of four of its wheels. The basketball hoop was bent and missing the net. (Facility) Rule Violated: Minnesota Rules, part 9503.0140, subpart 19. Repeat Violation: The license holder was cited for a similar violation in the following orders: · A Correction Order dated August 23, 2022 · A Correction Order dated May 17, 2022 28. Violation: The program did not provide the children access to interest areas on a daily basis. Children were not provided daily access to a sensory stimulation activities interest area. It was determined through a conversation with a staff person that sensory stimulation materials were kept in the other preschool classrooms and that the children in the Preschool 3 classroom get access to them several times a week, but not daily. (Preschool 3 classroom). Rule Violated: Minnesota Rules, part 9503.0045, subpart 2. Repeat Violation: The license holder was cited for a similar violation in the following order: · A Correction Order dated August 23, 2022 CHILDREN’S FILES 29. Violation: Each child's record did not contain all required information: Seven of seven (C1, C2, C3, C4, C5, C6 and C7) children's files reviewed did not contain the name, current home address, and telephone number of both parents and/or legal guardians; and Three of three (C1, C4 and C5) children's files reviewed did not contain the dates of parent conferences and a summary of conference information. Rule Violated: Minnesota Rules, part 9503.0125. Repeat Violation: The license holder was cited for a similar violation in the following order: · A Correction Order dated December 7, 2022 30. Violation: Two of six (C4 and C7) children's files reviewed did not contain documentation of a current physical examination received within 30 days of enrollment. C4 was enrolled in March of 2022, and there was no documentation of a current physical examination in the child's file. (C4) C7 enrolled at the program in May of 2022, and there was no documentation of a current physical examination in the child's file. (C7) Rules Violated: Minnesota Rules, parts 9503.0125, item G; and 9503.0140, subpart 3. 31. Violation: One of seven (C7) children's files reviewed did not contain a current immunization record, a signed notarized statement of parental objection to the immunization, or a medical exemption. C7 enrolled at the program in May of 2022, and there was no documentation of a current immunization record in the child's file. (C7) Rule Violated: Minnesota Rules, parts 9503.0125, item G; and 9503.0140, subpart 5. 32. Violation: The program did not develop an individual child care program plan (ICCPP) for 1 of 1 (C7) children's files reviewed with a known allergy. C7 was identified as having an allergy on her/his enrollment form. The program did not develop an allergy ICCPP for the child's known allergies. (C7) Statute Violated: Minnesota Statutes, section 245A.41, subdivision 1, paragraph (a). 33. Violation: There was not a written individual child care program plan (ICCPP) on file for 2 of 4 (C1 and C6) children with special needs: · that specifies methods of implementation; and · that is reviewed and followed by all staff who interact with the child. There was no documentation that staff responsible for the care of a child with special needs had reviewed and followed the child's ICCPP. (C1) C6 had a developmental delay identified on her/his health care summary. An ICCPP had not been developed by the program. (C6) Rule Violated: Minnesota Rules, part 9503.0065, subpart 3. POLICIES AND ADMINISTRATIVE RECORDS 34. Violation: The program did not have documentation of a fire drill. There was no documentation to show that a fire drill was completed in February, March, and August of 2022. Rule Violated: Minnesota Rules, part 9503.0110, subpart 3, items D and E and subpart 4, item B. 35. Violation: The program was not maintaining an accident, injury, incident, and emergency log containing to whom the accident, injury, or incident was reported. Rule Violated: Minnesota Rules, part 9503.0110, subparts 3, item I, and 4, item C. Repeat Violation: The license holder was cited for a similar violation in the following order: · A Correction Order dated December 7, 2022 36. Violation: The program did not comply with child maltreatment reporting policy and procedure requirements. The policies and procedures used by the program were not the policies and procedures developed by DHS in accordance with Minnesota Statutes, chapter 260E. Statute violated Minnesota Statutes, section 245A.145, subdivision 1. 37. Violation: The license holder did not have a written emergency plan that included accommodations for infants and toddlers. The emergency plan does not include accommodations for infants and toddlers in a shelter-in-place scenario. Statute Violated: Minnesota Statutes, section 245A.41, subdivision 3. 38. Violation: The license holder did not include the emergency plan in the program's indexed policies and procedures. The emergency plan was stored in a file in all of the classrooms. It was not included in the program's policy and procedure manual. Statute Violated: Minnesota Statues, section 245A.41, subdivision 3, paragraph (e). Immediate corrective action required You must immediately correct the violations cited above. Submit documentation to your licensor within 30 days from when you received this order explaining how you have corrected the violations. If you fail to demonstrate substantial compliance with child care requirements or with the terms of your conditional license that are provided below, DHS may take an additional licensing action, including revocation, against your license. Additionally, DHS will not approve a request to increase your licensed child care services from the date of this order until the time your conditional license expires. CONDITIONAL LICENSE TERMS In addition to the child care licensing rules and statutes, you are required to comply with the following terms: 1. Within 15 days from receipt of this order, you must provide written notification of the conditional status of your license to all parents/legal guardians. Prior to providing the written notification to all parents/legal guardians, you must submit the written notice to your DHS licensor for approval. The notification must specify the length of time of the conditional status of your license, the reasons your license was made conditional, and must include either a copy of the Order of Conditional License or an offer to provide a copy of the order upon request. 2. On an ongoing basis while your license is on a conditional status, you must maintain a list of all newly hired employees who will have direct contact with children served by the program. The documentation required under this term must be maintained onsite and made immediately available to DHS upon request. For each individual on the list, you must document the following: · the individual’s full name; · the individual’s job title; · the date of hire; · the date the individual first had direct contact with children served by the program; and · the date the background study request was submitted to DHS. 3. You must develop a system that includes using a checklist to ensure you have a record onsite for every child enrolled in your program and each record maintains all required information as specified under Minnesota Rules, part 9503.0125. Within 30 days from receipt of this order, you must submit a copy of the checklist you will use to ensure each child has a record and contains all required documentation. On an ongoing basis while your license is on conditional status, you must complete the checklist for each child enrolled in your program and maintain a copy of the completed checklist in each child’s file. 4. Within 45 days from the receipt of this order, you must ensure that the director, staff persons, substitutes, unsupervised volunteers, and any other volunteers caring for infants receive training on 245A.1435 and on reducing the risk of sudden unexpected infant death. You must maintain documentation of the completed training in each staff person’s personnel record. In addition, you must develop a system to ensure that infants are placed on their back to sleep. 5. You must develop a detailed supervision plan to ensure that children will be supervised by program staff persons at all times, consistent with the definition of supervision under Minnesota Statutes, section 245A.02, subdivision 18, and in compliance with the risk reduction plan requirements under Minnesota Statutes, section 245A.66, subdivision 2, paragraph (f), (1) through (5). Within 30 days from receipt of this order, you must submit the supervision plan to your licensor for approval. Within 30 days after the supervision plan is approved by your licensor, you must provide training to all staff on the supervision plan and maintain documentation of the training in each staff person’s personnel record. You must also ensure new hires receive the same training and document the training in each new hire’s personnel record. YOUR RIGHT TO REQUEST RECONSIDERATION You have the right to request reconsideration of this order and the cited violations. Your request must: · Be in writing · Clearly state that you are requesting reconsideration of the conditional license · List each citation you are challenging and identify what is inaccurate or incomplete about the information in the order · Supply information that is accurate or more complete · State why you believe your license should not be on a conditional status · Be made before the deadlines provided below If you are mailing your request, it must be sent by certified mail and postmarked within 10 calendar days from when you received this order. If you do not meet this deadline, you lose your right to request reconsideration. The timeline to appeal began when you received this order. Please send it to: Office of Inspector General Legal Counsel’s Office Attn: Licensing Legal Unit PO Box 64953 St. Paul, MN 55164-0953 If your request is being personally delivered, it must be received by DHS within 10 calendar days from when you received this order. Please bring it to: Office of Inspector General Legal Counsel’s Office Attn: Licensing Legal Unit 444 Lafayette Road North St. Paul, MN 55155 Conditional license stayed pending reconsideration If you request reconsideration within the timeframes described above, the terms of the conditional license will not take effect until a decision is issued by DHS. If the conditional license is affirmed on reconsideration, the terms would take effect on the date of the reconsideration decision, and run for two years from that date. You continue to be required to comply with all child care laws and rules. Posting of this licensing action You are required to place this Order of Conditional License in a place that is clearly noticeable to the people receiving services and all visitors to the facility for two years, even if you appeal. Legal authority for this licensing action This action is taken under Minnesota Statutes, section 245A.06, subdivision 1. · Child care centers are required to follow Minnesota Rules, parts 9503.0005 to 9503.0170; and Minnesota Statutes, Chapters 245A, 245C, and 260E. · The timeline to request reconsideration of the order is provided in Minnesota Statutes, section 245A.06, subdivision 4. · The requirement to post this order in a clearly visible location is required under Minnesota Statutes, section 245A.06, subdivision 8. · If a license holder files a timely reconsideration request, the terms of the conditional license are stayed pending a decision by DHS under Minnesota Statutes, section 245A.06, subdivision 4. · Minnesota Statutes, section 245A.06, subdivision 3 states that DHS may impose additional licensing actions against a license holder that does not correct the violations cited in a conditional license order. Questions If you have any further questions regarding this matter, you may contact, Meg Holmen, Supervisor, at 651-431-6534. Sincerely,
Alyssa Dotson, Deputy Inspector General Licensing Division Office of Inspector General
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