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December 2, 2024 Lisa Francisco, Authorized Agent A Child’s Place Daycare Center 3738 7th Avenue Anoka, MN 55303 License Number: 1096017 (Rule 3) Dear Lisa Francisco: This matter arises from an Order of Conditional License, dated October 10, 2023. On November 6, 2023, the Minnesota Department of Human Services (DHS), Licensing Division, received your request for reconsideration of four of the 18 citations issued in the Order of Conditional License. The violations challenged by A Child’s Place Daycare Center (“ACP Daycare”) are addressed below. You did not dispute Citations 3 through 9, and 12 through 18. The unchallenged violations are deemed conclusive. A. Reconsideration of the Citations Identified in the Order of Conditional License 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) Rule Violated: Minnesota Rules, part 9503.0034, subpart 1; and part 9503.0040, subpart 2, item D. Repeat Violation: The license holder was cited for a similar violation in Correction Orders dated: November 1, 2022, and June 10, 2020. Your request for reconsideration: You stated that you dispute the violation as it relates to the infant room because there was an Experienced Aide working in that room. You did not dispute the citation with regard to the toddler classroom. DHS’ response: The first staff member needed to meet the required staff-to-child ratio must be a teacher. Minnesota Rules, part 9503.0040, subpart 2, item D. While an aide may work with children without being directly supervised by a teacher, the center must comply with the experienced aide requirements of Minnesota Statutes, 245A.14, subdivision 8. These requirements include that the center notifies parents or guardians by posting the notification in each classroom that uses experienced aides identifying which staff member is the experienced aide, and that the center maintains records of experienced aide usage on site and provides them to the Commissioner upon request. Minnesota Statutes, section 245A.14, subdivision 8, paragraph (b). The program was cited for not complying with the experienced aide requirement in Citation 15 and did not dispute the violation. As the requirements for using an experienced aide were not met, the aide in the infant classroom did not qualify as an experienced aide, and a teacher was required. The citation is affirmed. 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. Rule Violated: Minnesota Statutes, section 245A.02, subdivision 18 and Minnesota Rules, part 9503.0045, subpart 1, item A. Repeat Violation: The license holder was cited for a similar violation in a Correction Order dated November 1, 2022. Your request for reconsideration: You stated that you were never told that the infant room and the kitchen are separate rooms. You understand that teachers must always be within sight and sound of the children, and that is always the case in this area. You stated that the staff person was not playing with a personal gaming device, but that the staff person was turning off the gaming device that s/he and the children had been using to play together. DHS’ response: The license holder must ensure that children are supervised at all times. Minnesota Rules, part 9503.0045, subpart 1, item A. For licensed child care centers, "supervision" means when a staff person (1) is accountable for the child's care, (2) can intervene to protect the health and safety of the child, and (3) is within sight and hearing of the child at all times, with limited exceptions for school-aged children using the restroom or retrieving items from their designated storage space, sleeping infants, preschoolers using a private restroom within the classroom. Minnesota Statutes, section 245A.02, subdivision 18. The children were not asleep in the infant room, so the staff person was required to remain within sight and hearing of the children at all times. However, the staff person left the classroom to go into the attached kitchen. While you stated in your request for reconsideration that you were not aware that the infant room and kitchen were two separate rooms, the facility floor plan shows the kitchen as a separate space. In addition, during the exit interview, you acknowledged that you’ve previously discussed this issue with staff and indicated that you would do so again. Finally, you were cited for a similar supervision issue involving a staff person leaving the infant classroom to go into the kitchen in a correction order dated November 1, 2022. As the staff person left the infant classroom to enter the separate kitchen, they were not within sight and sound of the kitchen classroom to provide supervision as required. This portion of the citation is affirmed. In the school age classroom, a staff person was playing a game on a personal device while children were playing in various areas around the classroom. You stated that the staff member was not playing on the device but turning it off after using it to play with the children. However, when the DHS licensor asked the staff person which children s/he had been playing with, the staff person stated that all the children quit and that s/he was playing by himself. By playing a game on a personal gaming device while s/he was supposed to supervise children, the staff person was not providing supervision as required. The citation is affirmed. Infant and Toddler Care 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) Rule/Statute Violated: Minnesota Rules, part 9503.0145, subpart 7, item A. Your request for reconsideration: You stated that citations are inaccurate and caused by poor communication by the licensor. DHS’ response: A child care center serving infants must obtain written dietary instructions from the parent of the child. Minnesota Rules, part 9503.0145, subpart 7, item A. No documentation of written dietary instructions from parents of infants was provided during the site visit. The citation is affirmed. 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 infant's parents, there was no feeding schedule available for each infant. (Infant classroom) Rule/Statute Violated: Minnesota Rules, part 9503.0145, subpart 7, item B. Your request for reconsideration: You stated that citations are inaccurate and caused by poor communication by the licensor. DHS’ response: A center serving infants must have the infant's feeding schedule available in the food preparation area. Minnesota Rules, part 9503.0145, subpart 7, item B. The licensor did not observe feeding schedules for each infant in the food preparation area, nor were any provided during the site visit. The citation is affirmed. B. Reconsideration of the Conditional License Commissioners Evaluation Pursuant to Minnesota Statutes, 245A.04, subdivision 6, paragraph (a), before making conditional a license, the commissions shall evaluate the facts, conditions, or circumstances concerning the program's operation including (1) the program's operation, (2) the well-being of persons served by the program, (3) available evaluations of the program by persons receiving services, (4) information about the qualifications of the personnel employed by the applicant or license holder; and (5) the applicant's or license holder's ability to demonstrate competent knowledge of the applicable requirements of statutes and rules. ACP Daycare challenged the Commissioner's evaluation, which identified other violations that occurred at a separate center at the same location, for which ACP Daycare’s authorized agent (and sole controlling individual) served as the center director for several years directly before ACP Daycare became licensed at that location. While that individual was not a controlling individual of the previous program, as center director, they were responsible for the center's day-to-day operations. As such, the compliance history of ACP Daycare's sole controlling individual and authorized agent while serving as a center director at another center does fall within the scope of the Commissioner's evaluation. However, even disregarding any history of ACP Daycare's controlling individual prior to the initial licensure of ACP Daycare, the facts, conditions, and circumstances support the Order of Conditional License, as described below. Reconsideration Decision Under Minnesota Statutes, section 245A.06, subdivision 1, when issuing a conditional license, the Commissioner must consider the nature, chronicity, or severity of the violation of the law or rule and the effect of the violation on the health, safety, or rights of persons served by the program. In its request for reconsideration, ACP Daycare challenged four of the 18 citations and requested that the Conditional License be rescinded. Of the four challenged citations, all were found to be supported by the record and affirmed. In total, 18 citations were either unchallenged or affirmed on reconsideration. ACP Daycare’s recent licensing history shows that many of the violations identified and affirmed were repeat violations previously cited via correction order. · On April 16, 2019, ACP Daycare was issued a correction order that identified nine violations. · On June 10, 2020, ACP Daycare was issued a correction order that identified 32 violations, two of which were repeat violations. · On July 28, 2021, ACP Daycare was issued a correction order that identified four violations, two of which were repeat violations. · On November 1, 2022, ACP Daycare was issued a correction order that identified 19 violations, eight of which were repeat violations. · On November 16, 2022, ACP Daycare was issued an Order to Pay a Fine for three background study violations. · The present Order of Conditional License identified 18 violations, nine of which were previously cited via correction order or fine. You disputed the repeat violations listed in the citations, asserting that they were never issued to ACP Daycare. However, all the repeat violations identified in Citations 1 through 18 in the Order of Conditional License identified only similar violations from correction orders issued exclusively to ACP Daycare. The significant number of repeat violations indicates that ACP Daycare can benefit from additional compliance and licensing support. Seven repeat violations were identified and cited in a correction order issued on November 1, 2022, less than a year before the site visit that preceded the Order of Conditional License. This indicates that ACP Daycare is not correcting violations even after being ordered to do so. DHS relies on license holders to accurately report information regarding its operations and to correct violations when identified. When a license holder is unable to do so, as in this case, additional oversight is needed. The Commissioner has considered the nature, chronicity, and severity of the licensing violations and determined that a conditional license is warranted based solely on the facts, circumstances, conditions, and license history of ACP Daycare. Based on the number and serious nature of the violations and the chronicity of the repeat violations, the Commissioner believes the program can benefit from additional oversight to ensure it can gain and continue compliance with licensing regulations. Based on the following factors, the Commissioner has determined that the ACP Daycare’s record supports the Order of Conditional License: · Program Practices DHS cited one violation related to staff distribution requirements. This violation identified similar issues in two classrooms: appropriately qualified staff were not present in the infant and toddler classrooms. Staff distribution requirements are critical to ensuring that children are adequately supervised. ACP Daycare had been previously cited in 2020 and 2022 for violations involving staff distribution requirements in two prior correction orders. These violations alone, including the identified repeat violations at ACP Daycare, warrant a conditional license. · Supervision DHS cited one violation related to failure to supervise children. This was the second time in one year that ACP Daycare was cited for a similar violation. While this violation alone may not warrant a conditional license, taken as a whole with the other violations, as well as the repeat nature of this violation, it supports the conditional license order. · Health Practices DHS cited two violations related to health practices. These violations included the failure to wash children’s hands after changing their diapers and a staff person not washing their own hands after changing the children’s diapers. While these violations alone may not warrant a conditional license, taken as a whole with the other violations, they support the conditional license order. · Facility DHS cited one violation related to equipment and furniture in good repair. Two items were identified as not being in good repair, including a bucket seat in the toddler room missing a safety strap. ACP was cited for the same issue of a missing safety strap on November 1, 2022, yet did not correct the issue. In addition, DHS cited one violation for hazardous objects accessible to children. ACP Daycare was cited for similar violations in three previous correction orders. While these violations alone may not warrant a conditional license, taken as a whole with the other violations, they support the conditional license order. · Infant and Toddler Care DHS cited eight violations related to infant and toddler care. These violations include not complying with diaper changing requirements, not adequately cleaning toys and equipment, not providing daily reports to parents, not having written dietary instructions and feeding schedules for infants, not labeling infant bottles properly, missing a monthly crib inspection, and not complying with requirements for reducing the risk of sudden unexpected infant death. While these violations alone may not warrant a conditional license, taken as a whole with the other violations, however, they support the conditional license order. · Staff Qualifications DHS cited one violation related to staff qualifications. The program failed to comply with the experienced aide requirements. While this violation alone may not warrant a conditional license, taken as a whole with the other violations, however, it supports the conditional license order. · Staff Training DHS cited three violations related to staff training. Two staff persons did not meet multiple in-service staff training requirements including maltreatment reporting requirements, emergency preparedness, the program's risk reduction plan, health policies, and allergy prevention and response. In addition, another staff person did not meet CPR and first aid training requirements. While this violation alone may not warrant a conditional license, taken as a whole with the other violations, however, it supports the conditional license order. · Based on the specific factors above, an Order of Conditional License is warranted to ensure that A Child’s Place Daycare Center understands the relevant licensing requirements and can come fully into compliance. Due to the need to monitor A Child’s Place Daycare Center for compliance with applicable licensing laws and rules, and to ensure the health and safety of children served by the program, the Commissioner affirms the October 10, 2023 Order of Conditional License. The period of the conditional license is two years, beginning on the date of this letter. Because the terms of your conditional license were stayed pending a decision on your request for reconsideration, the terms of the conditional license begin from the date of receipt of this letter. C. Terms of the Conditional License 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 licensor will monitor your compliance with all applicable laws and rules. Verification of compliance may include unannounced visits. Failure to comply with the requirements in Minnesota Rules, parts 9503.0005 to 9503.0170 (DHS Rule 3), Minnesota Statutes, chapter 245A (Human Services Licensing Act), Minnesota Statutes, chapter 245C (Human Services Background Study Act), Minnesota Statutes, chapter 260E (Reporting of Maltreatment of Minors) and with the terms of your conditional license may result in further negative action, including revocation of your license. D. POSTING the Order of Conditional License Under Minnesota Statutes, section 245A.06, subdivision 8, you must post the Order of Conditional License in a place that is conspicuous to the people receiving services and all visitors to the facility for two years. This is a final agency decision and is subject to further review only by the Minnesota Court of Appeals. Please note that there are time limits for seeking review by the Minnesota Court of Appeals. See Minnesota Statutes, Chapter 606, and Minnesota Rules of Civil Appellate Procedure, Rule 115. If you have any questions regarding the Order of Conditional License, please contact Donna Gainor, Unit Supervisor, at (651) 431-6529. Sincerely,  Afsheen Foroozan, Attorney Legal Counsel’s Office Office of Inspector General
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