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May 9, 2023 Monique Latrena Stumon, Authorized Agent School Readiness Learning Academy North 2503 LOWRY AVE N Minneapolis, MN 55411-1010 License Number: 1088993 (Child Care Ctr) Program Location: 2503 Lowry Ave N, Minneapolis, MN 55411 Dear Monique Latrena Stumon: The Minnesota Department of Human Services (DHS), Division of Licensing, received your request for reconsideration of Citations 2, 4, 5, 6, 7, and 8 from the Correction Order issued to you by the Department of Human Services on June 16, 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 2. 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; • each staff person who is responsible for carrying out the individual child care program plan review and follow the plan. Documentation of a staff person's review must be kept on site; • 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; 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 you updated the allergy plan to include the wording from Minnesota Statues, section 245A.41, and reviewed the changes with staff and had staff sign off on the changes. You stated that you will continue to collect allergy information in the initial application, you have no children with allergies, and you have adopted the new form. You attached the updated policy to your request for reconsideration. Applicable Law. The license holder shall develop program policies and procedures necessary to maintain compliance with licensing requirements under Minnesota Statutes and Minnesota Rules. Minnesota Statutes, section 245A.04, subdivision 14, paragraph (a). 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. Your request for reconsideration acknowledges that your allergy policy was updated to come into compliance with statutory requirement. The policy on site during the licensing visit did not comply with the requirements identified in the citation. During the licensing visit, the now-updated policy was not on-site. The record supports the violations, and Citation 2 is affirmed. Citation 4. Documentation was not available on site to verify that before starting assigned duties 1 of 2 (SP1) individuals (director, staff persons, substitutes, or unsupervised volunteers) received orientation training on: • allergy prevention and response as required by Minnesota Statutes, 245A.41, subdivision 1 (SP1); • emergency preparedness as required by Minnesota Statutes, 245A.41, subdivision 3. (SP1); and • handling and disposal of bodily fluids as required by Minnesota Statutes, 245A.41, subdivision 2 (SP1). Your Response. You stated that SP1 started out at a second location and their documentation remained at that other site, you attached the documentation to your request for reconsideration. Applicable Law. The license holder must provide training to staff related to their duties in implementing the program’s policies and procedures. Minnesota Statutes, section 245A.04, subdivision 14, paragraph (b). The child care center license holder must ensure that the director, staff persons, substitutes, and unsupervised volunteers are given orientation training and successfully complete the training before starting assigned duties; completion of the orientation must be documented in the individual's personnel record. Minnesota Statues, section 245A.40, subdivision 1. The license holder must ensure that a personnel record for each staff person is maintained at the center, including documentation that the staff person has completed orientation. Minnesota Rules, part 9503.0120, subpart C.
Reconsideration Determination. Personnel records, including documentation that orientation was completed, is required to be maintained at the center. In this case, you acknowledge that the documentation that SP1 completed orientation training on allergy prevention and response and emergency preparedness was not at the center. Instead, the documentation was at another center location. The record supports the violation, and Citation 4 is affirmed. Citation 5. The program did not comply with cardiopulmonary resuscitation (CPR) training requirements. Documentation was not available on site to show that 1 of 2 (SP1) 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 (SP1). Your Response. You stated your request for reconsideration included documentation that shows compliance with CPR training, and that the American CPR Care Association confirmed that all of their training includes Adult, Child, and Infant CPR, First Aid and Bloodborne Pathogens certification. All staff receive this training bi-annually. Applicable Law. Pediatric CPR training must cover CPR techniques for infants and children and the treatment of obstructed airways, and include instruction, hands-on practice, and an in-person, observed skills assessment under the direct supervision of a CPR instructor. Minnesota Statutes, section 245A.40, subdivision 4, paragraph (c). Pediatric CPR training must be completed prior to having unsupervised direct contact with a child, but not to exceed the first 90 days of employment or within the previous two years. Minnesota Statutes, section 245A.40, subdivision 4. The license holder must ensure that a personnel record for each staff person is maintained at the center, including documentation that the staff person has completed first aid and CPR training. Minnesota Rules, part 9503.0120, subpart D.
Reconsideration Determination. The documentation you provided states that SP1 completed a pediatric CPR course on June 22, 2022. However, the DHS site visit was on June 15, 2022. As such, SP1 did not have the required training complete at the time of the site visit. Further, there was no other documentation in SP1’s personnel record that SP1 completed this training within the previous two years, or within 90 days of employment. The record supports the citation, and Citation 5 is affirmed. In addition, after reviewing the website for the company through which certification was provided, American CPR Care Association, the certification does not include a hands-on practice or an in-person, observed skills assessment under the direct supervision of a CPR instructor. From the website (https://cprcare.com/faq/): Does your course require on outside-hands-on or skills test? No. Our interactive training includes step-by-step video demonstrations and detailed illustrations that allow you to practice along at your own pace. This training method will cover and build the skills required to perform CPR, execute basic First Aid procedures, and know how to react when you come into contact with blood. You will be certified upon successfully completing our comprehensive online quiz. This training is not sufficient to satisfy the requirement that the training include hands-on practice, and an in-person, observed skills assessment under the direct supervision of a CPR instructor. Please contact your DHS licensor to discuss this issue and ensure compliance with this requirement. Citation 6. The program did not comply with first aid training requirements. Documentation was not available on site to show that 2 of 2 (SP1 and SP2) 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 (SP1); and • within the previous two years (SP2). Your Response. You stated that in your request for reconsideration you included documentation that shows compliance with CPR training, including documentation that American CPR Care Association confirmed that all of their training includes Adult, Child, and Infant CPR, First Aid and Bloodborne Pathogens certification. You stated that all staff receive this training bi-annually, but are also scheduled to retake training. Applicable Law. Pediatric first aid training must be repeated at least every second calendar year. First aid training under this subdivision must be provided by an individual approved as a first aid instructor. Minnesota Statutes, section 245A.40, subdivision 3, paragraph (b). First aid training must be completed prior to having unsupervised direct contact with a child, but not to exceed the first 90 days of employment or within the previous two years. Minnesota Statutes, section 245A.40, subdivision 3, paragraph (a). The license holder must ensure that a personnel record for each staff person is maintained at the center, including documentation that the staff person has completed first aid and CPR training. Minnesota Rules, part 9503.0120, subpart D.
Reconsideration Determination. During the licensor’s visit, there was no documentation on site show that SP1 completed first aid training within 90 days of the start of work or within the previous two years. In addition, the training documentation for SP1 submitted with the request for reconsideration was dated, June 22, 2022, several days after the June 15, 2022 site visit. During the licensor’s visit, there was no documentation on site show that SP2 completed pediatric first aid training within the previous two years. The documentation you provided in your request for reconsideration was not in SP2’s personnel record, as required. The record supports the violation for both SP1 and SP2, and Citation 6 is affirmed. In addition, none of the documentation that you provided or in the relevant personnel records references pediatric first aid, or infants and children. The CPR portion of the online training course includes references to child and infant CPR, but there is no reference or indication that the first aid portion includes pediatric first aid. Please contact your DHS licensor to discuss this issue and ensure compliance with this requirement. Citation 7. The license holder did not have a written emergency plan that included accommodations for infants and toddlers.
Your Response. You stated your emergency plan was not available on the day of the licensing visit. However, you updated it to include the following accommodation for infants and toddlers: “all babies can be placed in one rolling bed and transported out of the emergency exit door.” The updated plan was attached to the request for reconsideration. Applicable Law. A licensed child care center must have a written emergency plan for emergencies that require evacuation, sheltering, or other protection of a child, and the plan must be written on a form developed by the commissioner and include accommodations for infants and toddlers. Minnesota Statutes, section 245A.41, subdivision 3, paragraph (a), subparagraph (8).
Reconsideration Determination. In your request for reconsideration, you acknowledged that you did not have a compliant emergency plan available on site. The emergency plan available on site during the licensing visit did not have accommodations for infants and toddlers. The record supports the violation, and Citation 7 is affirmed. Citation 8. 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 Your Response. You stated that while the emergency plan was not available on the day of the licensing visit, you showed the DHS licensor all documentation of staff completion of the plan. Applicable Law. License holders must review and update the emergency plan annually, and documentation of the review must be maintained in the program’s administrative records. Minnesota Statutes, section 245A.41, subdivision 3, paragraph (d).
Reconsideration Determination. License holders must review and update the emergency plan annually. This annual review and update is required to ensure that the emergency plan is current and meets any updated requirements. This requirement is different than training staff on the emergency plan. The documentation you provided indicates that staff were trained on the plan, however, there was no documentation in your request for reconsideration, or on-site during the licensing visit, that the emergency plan was reviewed and updated in 2021. Disposition: The Commissioner has reviewed the relevant laws and all of the information you submitted in response to the Correction Order. Citations 2, 4, 5, 6, 7, and 8 are 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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