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September 11, 2024 Kylie Schrader, Authorized Agent Sonnet Montessori & Child Care 8137 Rhode Island Circle Bloomington, MN 55438-1152 License Number: 1110511 (Child Care Center) Program Location: 19955 Idealic Avenue, Lakeville, MN 55044-2003
Dear Kylie Schrader: On August 22, 2024, the Minnesota Department of Human Services (DHS), Division of Licensing, received your request for reconsideration of citations 1, 3, 4, and 5 in the Correction Order (Attachment A) issued to you by the Department of Human Services on August 7, 2024. You did not request reconsideration of citation 2, and that citation is therefore affirmed and not within the scope of this review. SUMMARY OF CITATION AND RECONSIDERATION DETERMINATION:
Citation 1: Violation: The program’s policy on preventing and responding to allergies did not include procedures that state the license holder must develop an individual childcare program plan (ICCPP), 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. The program’s current policies require the parent or medical professional to create the ICCPP. It is the responsibility of the license holder to create the ICCPP using the information provided by the parent or medical provider. Request for Reconsideration. You indicate in your reconsideration request that the ICCPP was previously reviewed and approved, and you request the opportunity to adjust the policy because it did not endanger the health and safety of children in care. You also indicate you believe having parents assist in developing the ICCPP is essential to its accuracy, and you refer to a rule for which the program was not cited. Applicable Law. Minnesota Statutes, section 245A.41, subdivision 1 requires that if a child has a known allergy, the license holder must maintain current information about the child’s allergy record and develop an individual childcare program plan (ICCPP). The statute also requires that the individual childcare 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. Reconsideration Determination. The applicable statute is Minnesota Statutes, section 245A.41, subdivision 1, which requires that the license holder must develop an ICCPP. Information obtained during the licensing visit showed language in the program’s policy specifies that “the ICCPP and medication administration form must be completed by a child’s physician,” that the ICCPP be “signed and approved by the physician,” and that parents “provide a new signed ICCPP” at the beginning of the school year or when changes are needed. The policy did not contain a statement indicating that the license holder must develop an ICCPP. Although the ICCPP should be developed in coordination with a child’s family and medical provider, the program is responsible for using the information from those sources to develop a plan that is appropriate for the facility, the staff, and the needs of the child. There is therefore sufficient evidence to support the citation and it is affirmed. Citation 3: Violation: The program did not comply with cardiopulmonary resuscitation (CPR) training requirements. Documentation was not available on site to show that 3 of 7 (SP3, SP4 and SP6) 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 (SP3 and SP4); and · before unsupervised contact with a child (SP6). Specifically, training required on or before January 23, 2024, was completed on July 10, 2024, for SP3. Training required on or before August 30, 2023, was completed on July 10, 2024, for SP4. Also, SP6’s date of unsupervised contact was on July 10, 2024, and training was completed on July 20, 2024. Request for Reconsideration. You indicate in your reconsideration request that you are specifically appealing the citation as to SP6 because s/he did not have unsupervised direct contact prior to receiving the required training. You indicate the Personnel Information Form was filled out at the time of orientation, and the unsupervised date was filled out in error with the first date SP6 was in classroom training. Applicable Law. Under Minnesota Statutes, section 245A.40, subdivision 4, unless training has been completed within the previous two years, the director, staff persons, substitutes, and unsupervised volunteers must satisfactorily completion pediatric cardiopulmonary (CPR) training that meets the requirements of this subdivision. Pediatric CPR must be completed prior to having unsupervised direct contact with a child, but not to exceed the first 90 days of employment. The pediatric CPR training must cover CPR techniques for infants and children and the treatment of obstructed airways and must include hands-on practice and an observed skills assessment. Under Minnesota Rules, part 9503.0120, subpart D, the license holder must ensure that a personnel record for each staff person is maintained at the center. The personnel record for each staff must contain documentation, when applicable, that the staff person has completed required first aid and CPR training. Reconsideration Determination. Documentation provided during the licensing visit indicated SP6 had a date of unsupervised direct contact with children on July 10, 2024, which occurred before the required training was completed on July 20, 2024. No additional information or documentation was provided to the licensor at the time of the licensing visit. There is therefore sufficient evidence to support the citation and it is affirmed. Citation 4: Violation: The program did not comply with first aid training requirements. Documentation was not available on site to show that 3 of 7 (SP3, SP4 and SP6) 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 (SP3 and SP4); and · before unsupervised direct contact with a child (SP6). Specifically, training required on or before January 23, 2024, was completed on July 10, 2024, for SP3. Training required on or before August 30, 2023, was completed on July 10, 2024, for SP4. Also, SP6’s date of unsupervised contact was on July 10, 2024, and training was completed on July 10, 2024. Request for Reconsideration. You indicate in your reconsideration request that you are specifically appealing the citation as to SP6 because s/he did not have unsupervised direct contact prior to receiving the required training. You indicate the Personnel Information Form was filled out at the time of orientation, and the unsupervised date was filled out in error with the first date SP6 was in classroom training. Applicable Law. Under Minnesota Statutes, section 245A.40, subdivision 3, unless training has been completed within the previous two years, the director, staff persons, substitutes, and unsupervised volunteers must satisfactorily complete pediatric first aid training prior to having unsupervised direct contact with a child, but not exceed the first 90 days of employment. Under Minnesota Rules, part 9503.0120, subpart D, the license holder must ensure that a personnel record for each staff person is maintained at the center. The personnel record for each staff must contain documentation, when applicable, that the staff person has completed required first aid and CPR training. Reconsideration Determination. Documentation provided during the licensing visit indicated SP6 had a date of unsupervised direct contact with children on July 10, 2024, which occurred before the required training was completed on July 20, 2024. No additional information or documentation was provided to the licensor at the time of the licensing visit. There is therefore sufficient evidence to support the citation and it is affirmed. Citation 5: Violation: The individual childcare program plan (ICCPP) for 2 of 3 (C1 and C3) children with a known allergy did not contain avoidance techniques. Specifically, no appropriate avoidance techniques were listed, and actual techniques for staff persons to follow in the environment to minimize exposure to allergens must be included. Request for Reconsideration. You indicate in your reconsideration request that the ICCPP did contain avoidance techniques, which was to not serve food with the allergen. You indicate the ICCPP was developed in collaboration with the parent, and you indicate if the parent and provider agree on the techniques it should not be a violation. You also indicate the language on the ICCPP form was vague. Applicable Law. Minnesota Statutes, section 245A.41, subdivision 1, paragraph (a), requires that the individual childcare 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. Reconsideration Determination. Documentation provided during the licensing visit showed no avoidance techniques listed for C1. Although medications “Epi Pen” and “Benadryl” were listed, those are medications used to treat an allergic reaction rather than techniques used to avoid one. Although “avoid these foods” was listed under avoidance techniques for C2, that statement was not a technique because it did not describe how or in what ways staff persons would ensure the child avoided the foods. There is therefore sufficient evidence to support the citation and it is affirmed. Disposition: The Commissioner has reviewed the request for reconsideration and all the information submitted in response to the correction order. The Commissioner finds there is sufficient evidence to support the citations, and they are affirmed. Previously Ordered Corrective Action: In the Correction Order issued on August 7, 2024, you were ordered to correct the violations cited, and submit documentation of such action to your licensor. A request for reconsideration does not stay any provisions or requirements of the correction order. Minnesota Statutes, 245A.06, subdivision 2(a). If you have not done so already, please immediately comply with the previously ordered corrective actions for all uncontested and affirmed violations. 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,
Frances Simon Standing, Attorney Legal Counsel’s Office Office of Inspector General
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