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October 10, 2023 CERTIFIED MAIL Lisa Francisco, Authorized Agent A Child’s Place Daycare Center 3738 7th Avenue Anoka, MN 55303 License Number: 1096017 (Rule 3) ORDER OF CONDITIONAL LICENSE Dear Lisa Francisco: The Department of Human Services (DHS) is placing your license to provide child care at A Child’s Place Daycare Center, located at 3738 7th Avenue, Anoka, on conditional status for two years, beginning October 20, 2023. This means you must meet certain conditions to maintain your license, detailed below. This order is based on your noncompliance with Child Care 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 July 25, 2023, a DHS licensor conducted a licensing review at your facility located at 3738 7th Avenue, Anoka. As a result of this licensing visit, the DHS licensor determined that your program failed to comply with the laws and rules that apply to licensed child care centers, citing 18 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 July 25, 2023, a DHS licensor determined 18 licensing violations. Additionally, 9 of 18 violations are repeat violations for which you were previously cited. Several violations relate to the health and safety of children, including: o Failure to maintain staff distribution o Failure to supervise children o Failure to keep hazards away from children o Failure to comply with handwashing requirements for children and staff o Failure to comply with infant safe sleep requirements o Failure to comply with requirements related to infant care including written dietary instructions from parents, feeding schedules, daily reports, pacifier labeling, and crib safety inspections o Failure to comply with staff training requirements, including CPR, first aid, annual in-service, and child development and learning Chronicity: Your program received its license on January 14, 2019. Since that time, your program has demonstrated a history of noncompliance with licensing rules and statutes. The information below summarizes this history: o October 10, 2023 Conditional License (this order): 18 violations (9 repeat) o November 16, 2022, Fine Order: 3 Background Study violations o November 1, 2022, Correction Order: 19 violations (8 repeat) o July 28, 2021, Correction Order: 4 violations (2 repeat) o June 10, 2020, Correction Order: 32 violations (2 repeat) o April 16, 2019, Correction Order: 9 violations Commissioner’s evaluation of your program: DHS evaluated the facts, conditions, and circumstances concerning your program’s operation. Prior to receiving your license to operate A Child’s Place Daycare Center in 2019, you worked as the center director at Anoka Child Care Center (license number 803930), located at the same address. In that role, you were responsible for the daily operations of the program from 1999 to 2018. During that time, you failed to comply with licensing standards and numerous correction orders were issued. In addition, the following orders were issued to Anoka Child Care Center while you were the center director: · On October 25, 2017, the program was issued an Order of Conditional License, citing 40 violations, including failure to comply with staff training requirements, lack of supervision, hazards, lack of cleanliness, not meeting USDA guidelines, not complying with hand washing requirements, and not maintaining required policy and procedures. · On May 31, 2018, the program was issued a Temporary Immediate Suspension for significant instances of non-compliance with health and safety standards, including multiple children without supervision, inadequate staff distribution, lack of accessible personnel files and staff training records, staff-to-child ratios, unclean conditions throughout the center, hazards, and infant safe sleep violations. · On August 20, 2018, the program was issued an Order of License Revocation for not meeting the terms of the conditional license and citing 50 violations, including staff-to-child ratios, hazards, multiple children without supervision, staff training requirements, crib safety inspections, and infant safe sleep violations. Since receiving your license for A Child’s Place Daycare Center, you have continued to demonstrate noncompliance with licensing standards. Many of the violations you have been cited for in your operation of A Child’s Place Daycare Center are violations you were cited for when you directed the operation of Anoka Child Care Center. 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. Program Practices 1. Violation: Staff distribution requirements were not maintained. A teacher or assistant teacher did not directly supervise an aide. On the day of the licensing visit, the following was observed: At approximately 8:40 a.m., an aide qualified staff person was observed working alone in the infant classroom with 4 infants present. The staff person stated his/her hours for the day were 6:45 a.m.-4:30/5:00 p.m. in the infant classroom, s/he had worked alone in the infant classroom since s/he had begun his/her shift for the day, and was scheduled to work alone for the entirety of his/her shift. To meet distribution requirements a teacher was required. (Infant classroom) An aide was observed working alone in the toddler classroom with 7 toddler age children present. The staff person was under the age of 18 and worked alone in the toddler classroom from 8:00 a.m. until 8:50 a.m. when an additional aide qualified staff person arrived. To meet distribution requirements a teacher was required. Furthermore, an aide under the age of 18 must be directly supervised by a teacher or assistant teacher at all times. Two aides were observed working in the toddler classroom with 7 toddler age children present beginning at 8:50 a.m. for the day. One of the staff persons was under the age of 18. To meet distribution requirements a teacher was required. Furthermore, an aide under the age of 18 must be directly supervised by a teacher or assistant teacher at all times. (Toddler classroom) 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 November 1, 2022 • A Correction Order dated June 10, 2020 Supervision 2. Violation: Staff did not supervise the children at all times. On the day of the licensing visit, the following was observed: · From 8:51 a.m. until 8:53 a.m., the staff person responsible for the supervision of the infants left the children in the infant classroom unsupervised and entered the kitchen. · From 8:54 a.m. until 8:59 a.m., the staff person responsible for the supervision of the infants left the children in the infant classroom unsupervised and entered the kitchen to wash dishes. · From 9:00 a.m. until 9:01 a.m., the staff person responsible for the supervision of the infants left the children in the infant classroom unsupervised and entered the kitchen. (Infant classroom) · The staff person responsible for the supervision of the children in the school age classroom was observed sitting at a table in the school age classroom using a personal gaming device. The staff person was looking down at the gaming device and was not aware that the administrative staff person and the DHS licensor had entered the classroom. The children were playing around the classroom. The administrative staff person called out to the staff person on the personal gaming device to gain his/her attention. When asked, s/he stated s/he was playing tennis by him/herself on the personal gaming device. (School Age) 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. Citation: Minnesota Statutes, section 245A.02, subdivision 18 and Minnesota Rules, part 9503.0045, subpart 1, item A Repeat Licensing Violation: The license holder was cited for a similar violation in a Correction Order dated November 1, 2022. Health Practices 3. Violation: A child's hands were not washed with soap and water after a diaper change (Infant). A child's hands were not washed with soap and water after a diaper change. During the licensing visit, the DHS licensor observed a staff person change two infant's diapers. The staff person changed one child, returned the child to the floor of the classroom, picked up another child and changed the second child's diaper. The staff person did not wash either child's hands after changing the child’s diapers. Citation: Minnesota Rules, part 9503.0140, subpart 13 4. Violation: A staff person did not wash their hands with soap and water after changing a diaper. During the licensing visit, the DHS licensor observed the staff person change two infant's diapers. The staff person changed one child, returned the child to the floor of the classroom, picked up another child and changed the second child's diaper. The staff person did not wash his/her hands after changing each child. (Infant classroom) Citation: Minnesota Rules, part 9503.0140, subpart 14 Facility 5. Violation: Equipment and furniture were not in good repair. · The table with bucket seats was missing a safety strap in one of the bucket seats. (Toddler classroom) · A wooden riding toy on the outdoor playground no longer had the legs attached to it (Facility) Citation: Minnesota Rules, part 9503.0140, subpart 19 Repeat Licensing Violation: The license holder was cited for a similar violation in the following orders: • A Correction Order dated November 1, 2022 • A Correction Order dated July 28, 2021 • A Correction Order dated June 10, 2020 6. Violation: The DHS licensor observed that hazardous objects were accessible to children. The rubber mulch was pushed away from the fall areas underneath the rainbow play system on the side playground, exposing the plastic underlayment and hard surface. (Facility) Citation: Minnesota Statutes, section 245A.66, subdivision 2, paragraph (e) and Minnesota Rules, part 9503.0140, subpart 17 Repeat Licensing Violation: The license holder was cited for a similar violation in the following orders: • A Correction Order dated November 1, 2022 • A Correction Order dated July 28, 2021 • A Correction Order dated June 10, 2020 Infant and Toddler Care 7. Violation: The program did not comply with diaper changing procedure requirements. Diaper changing procedures were not posted in the diaper changing area. (Infant classroom) Citation: Minnesota Rules, part 9503.0140, subpart 12 8. Violation: Toys and equipment that were mouthed by infants and toddlers were not cleaned and disinfected when mouthed or soiled and at least daily. During the visit, the DHS licensor observed three separate infants pick up the same pacifier and put it in his/her mouth. The pacifier was not washed or taken away after it had been mouthed by each infant. (Infant classroom) Citation: Minnesota Rules, part 9503.0140, subpart 19 9. Violation: Daily written reports were not provided to parents. · Staff stated the program does not complete daily reports for children in the toddler classroom. (Toddler classroom) · Staff stated that once an infant turns 12 months of age, a daily report is no longer completed for the child/ren. (Infant classroom) Citation: Minnesota Rules, part 9503.0090, subpart 2, item D 10. Violation: The program did not have written dietary instructions from each infant's parent. Staff stated the program did not have written dietary instructions from each infant's parent. Parents tell the staff daily what the infant should eat. (Infant classroom) Citation: Minnesota Rules, part 9503.0145, subpart 7, item A 11. Violation: Each infant's feeding schedule was not available in the food preparation area. Because the program did not receive written dietary instructions from each infants’ parents, there was not a feeding schedule available for each infant. (Infant classroom) Citation: Minnesota Rules, part 9503.0145, subpart 7, item B 12. Violation: Each infant's bottle was not labeled with the child's first and last name. Each infant's bottle and/or pacifier was not labeled with the child's first and last name. A pink pacifier with no label or name was observed laying on floor. (Infant classroom) 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 June 10, 2020. 13. Violation: The required crib safety inspections were not completed on a monthly basis. Crib safety inspections were not completed in December 2022. (Infant classroom) Citation: Minnesota Statutes, section 245A.146, subdivision 4 14. Violation: The program did not comply with the requirements for reducing the risk of sudden unexpected infant death. The center did not ensure there was nothing in the crib with an infant younger than one year of age, except for the infant’s pacifier. An infant was placed in a crib with a bottle to feed him/herself. (Infant classroom) Citation: Minnesota Statues, section 245A.1435, paragraph (b) Staff Qualifications 15. Violation: The program did not comply with experienced aide requirements. The center: • did not notify parents or guardians by posting a notification in each classroom that used experienced aides, identifying which staff member was the experienced aide; and • did not maintain records of experienced aide use on-site and did not have the records available for the commissioner upon request. Citation: Minnesota Statutes, section 245A.14, subdivision 8, paragraph (b) Repeat Licensing Violation: The license holder was cited for a similar violation in a Correction Order dated June 10, 2020. Staff Training 16. Violation: The required in-service training had not been completed for 2 of 5 (SP2 and SP3) 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 the previous concluded calendar year (SP2 and SP3); • training on allergy prevention and response as required by Minnesota Statutes, section 245A.41, subdivision 1 (SP2 and SP3); • training on emergency preparedness as required by Minnesota Statutes, section 245A.41, subdivision 3 (SP2 and SP3); • training on handling and disposal of bodily fluids as required by Minnesota Statutes, section 245A.41, subdivision 2 (SP2 and SP3); • training on handling emergencies and accidents as required by Minnesota Rules, part 9503.0110, subpart 1 (SP2 and SP3); • training on health policies as required by Minnesota Rules, part 9503.0140, subpart 1 (SP2 and SP3); • training on reporting responsibilities as required by Minnesota Statutes, chapter 260E and Minnesota Rules, part 9503.0130 (SP2 and SP3); and • training on the risk reduction plan as required by Minnesota Statutes, section 245A.66, subdivision 2 (SP2 and SP3). Citation: Minnesota Statutes, section 245A.40, subdivision 7 Repeat Licensing Violation: The license holder was cited for a similar violation in a Correction Order dated November 1, 2022. 17. Violation: The program did not comply with cardiopulmonary resuscitation (CPR) training requirements. Documentation was not available on site to show that 1 of 5 (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 (SP5). 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 November 1, 2022 • A Correction Order dated June 10, 2020 18. Violation: The program did not comply with first aid training requirements. Documentation was not available on site to show that 1 of 5 (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 (SP5). 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 November 1, 2022 • A Correction Order dated June 10, 2020 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 childcare 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 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 (6). 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. 4. You must develop a system to ensure written dietary instructions are obtained from the parent or legal guardian of each infant and a feeding schedule for each infant is available in the food preparation area. Within 30 days from receipt of this order, you must submit your plan to your licensor for approval. 5. 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 center 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 2606E. · 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 Kerri Leuth Supervisor, at 651-431-2828. Sincerely,
Peggy Cunningham, Unit Manager Licensing Division Office of Inspector General
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