|
February 15, 2023 CERTIFIED MAIL Kassondra Kubesh, Authorized Agent Teeny Bubbles Childcare & Learning Center LLP 17140 State Highway 371 Brainerd, MN 56401-6817 License Number: 1087174 (Child Care Center) ORDER OF CONDITIONAL LICENSE Dear Kassondra Kubesh: The Department of Human Services (DHS) is placing your license to provide at childcare at Teeny Bubbles Childcare & Learning Center LLP located at 17140 State Highway 371 Brainerd, MN on conditional status for two years, beginning February 25, 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 December 19, 2022, DHS licensors conducted a licensing review at your facility located at 17140 State Highway 371, Brainerd, MN 56401. 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 center, citing 24 violations. DHS has considered the nature, chronicity, and severity of these violations, as well as the health, safety, and rights of children by the program. · Nature and Severity: On December 19, 2022, DHS licensors determined 24 licensing violations. Additionally, 15 of the 24 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 background study requirements (addressed in a separate Order to Pay a Fine on January 18, 2023) o Failure to comply with requirements related to infant care including placing infants to sleep on their backs, bottle labeling, annual crib checks, documentation of crib brand names and model numbers, and monthly crib safety inspections o Failure to keep hazardous items away from children o Failure to maintain staff distribution requirements o Failure to comply with staff training requirements, including CPR, first aid, and annual in-service o Failure to comply with emergency preparedness requirements o Failure to comply with USDA requirements o Failure to comply with handwashing requirements for children · Chronicity: Your program has demonstrated a history of noncompliance with licensing rules and statutes. The information below summarizes this history: o February 15, 2023 Conditional License (this order): 24 violations (15 repeat violations) o January 18, 2023 Order to Pay a Fine $200 (one background study violation) o January 20, 2023 Order to Pay a Fine: $200 (one background study violation) o January 20, 2023 Correction Order: 5 violations (4 repeat violations) o October 6, 2022 Correction Order: 10 violations (7 repeat violations) o March 4, 2022 Correction Order: 3 violations (2 repeat violation) o December 27, 2021 Correction Order: 12 violations (7 repeat violations) o August 13, 2021 Correction Order: 1 violation (1 repeat violation) o September 11, 2020 Correction Order: 1 violation o December 27, 2019 Order to Pay a Fine: $ 200 (two background study violations) o November 22, 2019 Correction Order: 19 violations (10 repeat violations) o April 25, 2019 Determination of Maltreatment $2,000 (maltreatment, failure to report and Order to Pay a Fine: maltreatment, one background study violation) o November 20, 2018 Order To Pay a Fine: $400 (two background study violations) o October 30, 2018 Correction Order: 21 violations (1 repeat violation) o February 21, 2018 Correction Order: 6 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 served 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. PROGRAM PRACTICES 1. Violation: Staff distribution requirements were not maintained. A teacher or assistant teacher did not directly supervise an aide. There were two aide qualified staff persons caring for eight infants in the infant classroom. (Infant classroom) One aide qualified staff person was caring for four pre-toddler aged children in the pre-toddler classroom. (Pre-toddler classroom) One teacher qualified staff person was required in each classroom to meet the staff-child distribution requirement. Citation: Minnesota Rules, part 9503.0034, subpart 1; and part 9503.0040, subpart 2, item D Repeat Licensing Violation: The license holder was cited for a similar violation in the following orders: · A Correction Order dated October 6, 2022 · A Correction Order dated March 4, 2022 · A Correction Order dated December 27,2021 · A Correction Order dated November 22, 2019 · A Correction Order dated October 30, 2018 · A correction Order dated February 21, 2018 STAFF QUALIFICATIONS AND TRAINING 2. Violation: The program did not have documentation on site to show that 1 of 1 (SP5) staff persons met the education requirements of the assistant teacher job classification for which the staff person was employed (SP5). Citation: Minnesota Rules, part 9503.0033, subpart 2; and part 9503.0120, item B Repeat Licensing Violation: The license holder was cited for a similar violation in a Correction Order dated November 22, 2019. 3. Violation: The required in-service training had not been completed for 1 of 1 (SP5) individuals (director, staff persons, substitutes, or unsupervised volunteers) for the previous concluded calendar year. In-service training did not include the required number of in-service training hours for calendar year 2021 (SP5). Citation: Minnesota Statutes, section 245A.40, subdivision 7 Repeat Licensing Violation: The license holder was cited for a similar violation in the following orders: · A Correction Order dated November 22, 2019 · A Correction Order dated October 30, 2018 4. Violation: The program did not comply with cardiopulmonary resuscitation (CPR) training requirements. Documentation was not available on site to show that 2 of 7 (SP4 and SP5) individuals (director, staff persons, substitutes, or unsupervised volunteers) had satisfactorily completed the required pediatric CPR training including the treatment of obstructed airways and a hands-on skill assessment: · within 90 days of the start of work or within the previous two years (SP4); · within the previous two years (SP5); and · before having unsupervised contact with a child (SP4). Citation: Minnesota Statutes, section 245A.40, subdivision 4 and Minnesota Rules, part 9503.0120, subpart D Repeat Licensing Violation: The license holder was cited for a similar violation in the following orders: · A Correction Order dated October 6, 2022 · A Correction Order dated December 27, 2021 5. Violation: The program did not comply with first aid training requirements. Documentation was not available on site to show that 2 of 7 (SP4 and SP5) individuals (director, staff persons, substitutes, or unsupervised volunteers) completed pediatric first aid training: · within 90 days of the start of work or within the previous two years (SP4); · within the previous two years (SP5); and · before having unsupervised direct contact with a child (SP4). Citation: Minnesota Statutes, section 245A.40, subdivision 3 and Minnesota Rules, part 9503.0120, subpart D Repeat Licensing Violation: The license holder was cited for a similar violation in the following orders: · A Correction Order dated October 6, 2022 · A Correction Order dated December 27, 2021 INFANT CARE 6. Violation: Each infant's bottle was not labeled with the child's first and last name. Citation: Minnesota Rules, part 9503.0145, subpart 7, item D Repeat Licensing Violation: The license holder was cited for a similar violation in a Correction Order dated October 30, 2018. 7. Violation: The program did not have documentation of brand names and model numbers for every crib that is used by or accessible to any child in care. Citation: Minnesota Statutes, section 245A.146, subdivision 2, paragraph (a) Repeat Licensing Violation: The license holder was cited for a similar violation in a Correction Order dated December 27, 2021. 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. All crib brand names and model numbers were not checked in 2021. (Infant classroom) “Annual or “annually” means prior to or within the same month of the subsequent calendar year. Citation: Minnesota Statutes, section 245A.146, subdivision 3 9. Violation: The required crib safety inspections were not completed on a monthly basis. Crib safety inspections were not completed in December 2021 for all of the cribs. (Infant classroom) Citation: Minnesota Statutes, section 245A.146, subdivision 4 10. Violation: The program did not place all infants to sleep on their backs and did not have documentation from an infant's physician or advanced practice registered nurse directing an alternative sleeping position. One staff person stated that an eight-month-old infant was laid on their tummy to sleep. All infants 12 months and younger are required to be laid on their backs to sleep. Citation: Minnesota Statutes, section 245A.1435, paragraph (a) HEALTH AND SAFTEY 11. Violation: Meals did not comply with the nutritional requirements of the USDA. DHS licensors observed 1% milk being served to children under age two in the pre-toddler classroom. USDA requires children under two to be served whole milk. Citation: Minnesota Rules, part 9503.0145, subpart 4 Repeat Licensing Violation: The license holder was cited for a similar violation in a Correction Order dated December 27, 2021. 12. Violation: Menus did not comply with the nutritional requirements of the USDA. Menus did not include: · fluid milk; · at least one whole grain rich food per day; · the name of the breakfast cereal to confirm sugar limits are not exceeded; and · the type of milk (whole, 1%, skim). Citation: Minnesota Rules, part 9503.0145, subpart 2 13. Violation: Water bottles were used to provide drinking water to children and the program did not have a policy for cleaning and sanitizing water bottles. Citation: Minnesota Statutes, section 245A.14, subdivision 17 14. Violation: Medication did not have a legible label with the child's first and last name. Several bottles of unlabeled medication were found in the infant and pre-toddler classrooms. Citation: Minnesota Rules, part 9503.0140, subpart 7 (C) 15. Violation: The program did not comply with cleanliness requirements; the indoor space was not clean (Pre-toddler classroom). A box of baked goods and several used diapers were stored on the diaper changing table. The diaper changing table is not a clean surface to store things. (Pre-toddler classroom: Infant/Toddler 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.' Citation: Minnesota Rules, part 9503.0140, subparts 9 and 11 16. Violation: Children did not have access to toilet paper in bathroom #1 (Preschool classroom). Citation: Minnesota Rules, part 9503.0140, subpart 15 17. Violation: A child's hands were not washed with soap and water after a diaper change (Infant classroom). Citation: Minnesota Rules, part 9503.0140, subpart 13 Repeat Licensing Violation: The license holder was cited for a similar violation in a Correction Order dated October 6, 2022. 18. Violation: A staff person did not wash their hands with soap and water after changing a diaper (Infant classroom). Citation: Minnesota Rules, part 9503.0140, subpart 14 Repeat Licensing Violation: The license holder was cited for a similar violation in a Correction Order dated October 6, 2022. CHILDREN’S FILES 19. Violation: Each child's record did not contain all required information: · One of five (C1) children's files reviewed did not contain the names and telephone numbers of anyone authorized to take the child from the program; and · One of five (C1) children's files reviewed did not contain the names, addresses, and telephone numbers of two persons to be contacted if a parent cannot be reached in an emergency or when there is an injury requiring medical attention. Repeat Licensing Violation: The license holder was cited for a similar violation in a Correction Order dated October 30, 2018. Citation: Minnesota Rules, part 9503.0125 20. Violation: One of four (C3) 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. Repeat Licensing Violation: The license holder was cited for a similar violation in the following orders: · A Correction Order dated November 22, 2019 · A Correction Order dated October 30, 2018 Citation: Minnesota Rules, part 9503.0125, item G; and part 9503.0140, subpart 5 HAZARDS 21. Violation: The DHS licensor observed that hazardous objects were accessible to children. · Diaper creams were stored in a low container under the diaper changing table and accessible to children in the pre-toddler classroom. · A container of Clorox wipes was stored on a shelf in the preschool classroom accessible to children. · Garbage bags were stored in the preschool bathroom accessible to children. Repeat Licensing Violation: The license holder was cited for a similar violation in a Correction Order dated October 30, 2018. Citation: Minnesota Statutes, section 245A.66, subdivision 2, paragraph (e) and Minnesota Rules, part 9503.0140, subpart 17 POLICIES AND ADMINISTRATIVE RECORDS 22. Violation: The license holder did not have a written emergency plan that included accommodations for infants and toddlers. Citation: Minnesota Statutes, section 245A.41, subdivision 3 23. Violation: The license holder did not review and update the emergency plan annually. There was no documentation to verify that an annual review and update of the center's emergency plan was done in 2021. "Annual" or "annually" means prior to or within the same month of the subsequent calendar year. Citation: Minnesota Statutes, section 245A.41, subdivision 3, paragraph (d) Repeat Licensing Violation: The license holder was cited for a similar violation in a Correction Order dated December 27, 2021. 24. Violation: The relocation site and evacuation route was not posted in a visible place as a part of the written procedures for emergencies and accidents in Minnesota Rules, part 9503.0140, subpart 21. Citation: Minnesota Statutes, section 245A.41, subdivision 3, paragraph (f) Repeat Licensing Violation: The license holder was cited for a similar violation in the following orders: · A Correction Order dated December 27, 2021 · A Correction Order dated November 22, 2019 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 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. On a monthly basis while your license is on conditional status, you must complete staffing patterns that identify every staff person and his/her job title included in the staff-to-child ratio for each classroom and maintain all completed staffing patterns onsite. The staffing information must be documented on the enclosed form titled “Staffing Patterns,” must be completed separately for each classroom, and must include the total number of children in attendance each hour for each classroom. The documentation must include the time each person takes their break, if applicable, and identify the name of the person who replaces them. Staffing patterns must be completed at the beginning of each month and made immediately available to the Commissioner upon request. Within 30 days from the receipt of this order, you must develop a plan to ensure staff to child ratios are maintained at all times and submit the plan to your licensor for approval. 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: Commissioner, Department of Human Services 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: Commissioner, Department of Human Services 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 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 Donna Gainor, Supervisor, at 651-431-6529. Sincerely,
Peggy Cunningham, Unit Manager Licensing Division Office of Inspector General
|
