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April 5, 2023 Rachel Jee Crowley, Authorized Agent Tierra Encantada – Dodd Inc. 2700 30th Ave South Minneapolis, MN 55406-1606 License Number: 1110729 (Child Care Ctr) Program Location: 835 VIKINGS PKWY, Eagan, MN 55121-0000 Dear Rachel Jee Crowley: The Minnesota Department of Human Services (DHS), Division of Licensing, received your request for reconsideration of Citation 1 from the Correction Order issued to you by the Department of Human Services on August 18, 2022. You did not request reconsideration of any other citation, therefore, those citations are final and not subject to review SUMMARY OF CITATIONS AND RECONSIDERATION DETERMINATION: Citation 1. The program's policy on preventing and responding to allergies did not include procedures that state: · the license holder must develop an individual child care program plan, which includes a description of the allergy, specific triggers, avoidance techniques, symptoms of an allergic reaction, procedures for responding to an allergic reaction, including medication, dosages, and a doctor’s contact information; · at least once each calendar year or following any changes made to allergy-related information in the child's record, the license holder must update the child's individual child care program plan and inform each staff person who is responsible for carrying out the individual child care program plan of the change. The license holder must keep on site documentation that a staff person was informed of a change; · a child's allergy information must be available at all times including on site, when on field trips, or during transportation. A child's food allergy information must be readily available to a staff person in the area where food is prepared and served to the child; and · the license holder must contact the child's parent or legal guardian as soon as possible in any instance of exposure or allergic reaction that requires medication or medical intervention. The license holder must call emergency medical services when epinephrine is administered to a child in the license holder's care. Your Response. You stated that the Center’s Administration Manual on site does have those policies stated and provided copies. Applicable Law. A child care center’s risk reduction plan must include policies that minimize the risk of harm or injury to children, including feeding children foods to which they are allergic. Minnesota Statutes, section 245A.66, subdivision 2, paragraph (d), subparagraph (8). Pursuant to Minnesota Statutes, section 245A.41, subdivision 1, license holder must that if a child has a known allergy, the license holder must maintain current information about the allergy in the child's record and develop an individual child care program plan as specified in Minnesota Rules, part 9503.0065, subpart 3. The individual child care program plan must include but not be limited to a description of the allergy, specific triggers, avoidance techniques, symptoms of an allergic reaction, and procedures for responding to an allergic reaction, including medication, dosages, and a doctor's contact information. In addition, the license holder must also comply with the following requirements: At least once each calendar year or following any changes made to allergy-related information in the child's record, the license holder must update the child's individual child care program plan and inform each staff person who is responsible for carrying out the individual child care program plan of the change. The license holder must keep on site documentation that a staff person was informed of a change. A child's allergy information must be available at all times including on site, when on field trips, or during transportation. A child's food allergy information must be readily available to a staff person in the area where food is prepared and served to the child. The license holder must contact the child's parent or legal guardian as soon as possible in any instance of exposure or allergic reaction that requires medication or medical intervention. The license holder must call emergency medical services when epinephrine is administered to a child in the license holder's care. Minnesota Statutes, section 245A.41, subdivision 1. The license holder shall keep program policies and procedures readily accessible to staff and index the policies and procedures with a table of contents or another method approved by the commissioner. Minnesota Statutes, section 245A.04, subdivision 14. Reconsideration Determination. During the site visit, the DHS licensor reviewed the policies in the center’s policy and procedure binder. The binder contained a policy titled, “Allergy Policy,” with the subtitle “Center staff.” That policy was the only allergy policy available to the licensor during the site visit. That policy was missing some of the items required by Minnesota Statutes, section 245A.41, subdivision 1, as cited. Regarding the policy you provided as part of your request for reconsideration, a hard copy of that additional policy was not available on site during the site visit. During the exit interview, after the DHS licensor identified deficiencies in the available allergy policy, the administrative staff present during the exit interview told the DHS licensor that there may be an additional policy available on the computer and that it could be printed. The policy provided as part of the request for reconsideration was not accessible to staff, as required by Minnesota Statutes 245A.04, subdivision 14, as it was not in the center’s policy and procedure binder, and during the site visit was only accessible by computer, and only because it was mentioned as an identified violation. That is not sufficient to meet the requirement that policies and procedures be kept readily accessible to staff. The record supports the citation, and it is affirmed. Disposition: The Commissioner has reviewed the relevant laws and all of the information you submitted in response to the Correction Order. Citation 1 is supported by the record and affirmed. This is a final agency decision. The Commissioner appreciates your response and encourages you to continue to work cooperatively with your licensor to ensure the safety and well-being of the children you serve. Sincerely,  Afsheen Foroozan, Attorney Legal Counsel’s Office Office of Inspector General
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