5.5 Monitoring and Enforcement of Licensing and Health and Safety Requirements

5.5.1 Inspections for licensed CCDF providers Licensing inspectors must perform at least one annual, unannounced inspection of each licensed CCDF provider for compliance with all child care licensing standards, including an inspection for compliance with health and safety and fire standards. Lead Agencies must conduct at least one pre-licensure inspection for compliance with health, safety, and fire standards of each child care provider and facility in the State/Territory. a. Licensed CCDF center-based providers i. Does your pre-licensure inspection for licensed center-based providers assess compliance with health standards, safety standards, and fire standards? [x] Yes. [ ] No. If no, describe: ii. Identify the frequency of annual unannounced inspections for licensed center- based providers addressing compliance with health, safety, and fire standards: [x] Annually. [ ] More than once a year. If more than once a year, describe: [ ] Other. If other, describe: iii. Does the Lead Agency implement a differential monitoring approach when monitoring licensed center-based providers? [x] Yes. If yes, describe how the differential monitoring approach is representative of the full complement of health and safety requirements. The licensing consultant may use the Child Care Center Compliance Records (BCAL 4601) to make notes and observations during the inspection. The licensing consultant will review the following documents during the on-site inspection: medical forms for any assistant caregivers; Tuberculosis (TB) test results for any assistant caregivers (copies of the actual test results are required, if not, documented on the Licensing Medical Clearance Request form); discipline policy; emergency procedures, including floor plan; and proof of required training. Before leaving, the licensing consultant discusses cited rule violations with the applicant. If the child care home is substantially non-compliant or is in violation of specific health and safety rules, to assure the provider is in compliance with the health and safety requirements, follow up unannounced inspections may take place as needed. Annual interim inspections include observing caregiving staff during interactions with the children and assuring positive interactions, the daily activity program is appropriate, ratio and capacity rules are followed, diapering procedures and safe sleep practices are followed, smoke detectors still work, and fire extinguishers are current. Training requirements for ongoing training and professional development are inspected. [ ] No. If no, describe: iv. Identify which department or agency is responsible for completing the inspections for licensed center-based providers. MiLEAP - Child Care Licensing Bureau b. Licensed CCDF family child care providers i. Does your pre-licensure inspection for licensed family child care homes assess compliance with health standards, safety standards, and fire standards? [x] Yes. [ ] No. If no, describe: ii. Identify the frequency of annual unannounced inspections for licensed family child care homes addressing compliance with health, safety, and fire standards: [ ] Annually. [ ] More than once a year. If more than once a year, describe: [x] Other. If other, describe: On September 29, 2023, the agency received preliminary notice of a non-compliance related to inspections. Non compliances include lack of enforceable standards for all required health, safety, and fire components including requirements for the prevention and response to emergencies due to food and allergic reactions, continuity of operations for all subcomponents of Emergency Preparedness and Response, requirements for first aid to be pediatric or age appropriate, and lack of all 11 Health and Safety topics, preservice/orientation training, ongoing training, child: staff ratios, or group size during each annual inspection. The agency needs additional time to meet this requirement. The agency rule is being updated and all components of Health and Safety will be included. The agency was missing Health and Safety component thus indicating that all areas of inspection would not have been checked for compliance. With the revisions planned, it is expected that this policy will meet all requirements and be in compliance by January 2026 iii. Does the Lead Agency implement a differential monitoring approach when monitoring licensed family child care providers? [x] Yes. If yes, describe how the differential monitoring approach is representative of the full complement of health and safety requirements. The licensing consultant may use the Child Care Home Checklist (BCAL 4601) to make notes and observations during the inspection. The licensing consultant will review the following documents during the on- site inspection: medical forms for any assistant caregivers; TB test results for any assistant caregivers (copies of the actual test results are required, if not, documented on the Licensing Medical Clearance Request form); discipline policy; emergency procedures, including floor plan; and proof of required training. Before leaving, the licensing consultant discusses cited rule violations with the applicant. If the child care home is substantially non-compliant or is in violation of specific health and safety rules, follow up unannounced inspections may take place as needed. Annual interim inspections include observing caregiving staff during interactions with the children and assuring positive interactions, the daily activity program is appropriate, ratio and capacity rules are followed, diapering procedures and safe sleep practices are followed, smoke detectors still work, and fire extinguishers are current. Training requirements for ongoing training and professional development are inspected. [ ] No. If no, describe: iv. Identify which department or agency is responsible for completing the inspections for licensed family child care providers. MiLEAP - Child Care Licensing Bureau. c. Licensed in-home CCDF child care providers i. Does your Lead Agency license CCDF in-home child care (care in the child’s own home) providers? [x] No. [ ] Yes. If yes, does your pre-licensure inspection for licensed in-home providers assess compliance with health, safety, and fire standards? [ ] Yes. [ ] No. If no, describe: ii. Identify the frequency of annual unannounced inspections for licensed in-home child care providers for compliance with health, safety, and fire standards completed: [ ] Annually. [ ] More than once a year. If more than once a year, describe: [x] Other. If other, describe: N/A - Michigan licensed in home providers are license exempt iii. Does the Lead Agency implement a differential monitoring approach when monitoring licensed in-home child care providers? [ ] Yes. If yes, describe how the differential monitoring approach is representative of the full complement of health and safety requirements. [x] No. iv. Identify which department or agency is responsible for completing the inspections for licensed in-home providers. N/A - Michigan licensed in home providers are license exempt 5.5.2 Inspections for license-exempt providers Licensing inspectors must perform at least one annual monitoring visit of each license-exempt CCDF provider for compliance with health, safety, and fire standards. Inspections for relative providers will be addressed in subsection 5.8. Describe the policies and practices for the annual monitoring of: a. License-exempt CCDF center-based child care providers i. Identify the frequency of inspections for compliance with health, safety, and fire standards for license-exempt center-based providers: [x] Annually. [ ] More than once a year. If more than once a year, describe: [ ] Other. If other, describe: ii. Does the Lead Agency implement a differential monitoring approach when monitoring license-exempt center-based providers? [x] Yes. If yes, describe how the differential monitoring approach is representative of the full complement of health and safety requirements. Military and Tribal centers are exempt from licensing because they are located on federal land and operate under their own licensing rules and regulations. For those who also serve Child Development and Care Fund (CCDF) children they are asked to annually self­ certify that they are in compliance with all of the required health and safety requirements and that they are monitored for compliance. [ ] No. iii. Identify which department or agency is responsible for completing the inspections for license-exempt center-based CCDF providers. Military and Tribal Authority. Lead agency ensures they self-certify they are in compliance. b. License-exempt CCDF family child care providers i. Identify the frequency of the inspections of license-exempt family child care providers to determine compliance with health, safety, and fire standards: [x] Annually. [ ] More than once a year. If more than once a year, describe: [ ] Other. If other, describe: ii. Does the Lead Agency implement a differential monitoring approach when monitoring license-exempt family child care providers? [x] Yes. If yes, describe how the differential monitoring approach is representative of the full complement of health and safety requirements. Military and Tribal centers are exempt from licensing because they are located on federal land and operate under their own licensing rules and regulations. For those who also serve Child Development and Care Fund (CCDF) children they are asked to annually self- certify that they are in compliance with all of the required health and safety requirements and that they are monitored for compliance. [ ] No. iii. Identify which department or agency is responsible for completing the inspections for license-exempt family child care providers. Military and Tribal Authority. Lead agency ensures they self-certify they are in compliance. 5.5.3 Inspections for CCDF license-exempt in-home child care providers Lead Agencies may develop alternate monitoring requirements for care provided in the child’s home that are appropriate to the setting. This flexibility cannot be used to bypass the monitoring requirement altogether. a. Describe the requirements for the annual monitoring of CCDF license-exempt in-home child care (care in the child’s own home) providers, including if monitoring is announced or unannounced, occurs more frequently than once per year, and if differential monitoring procedures are used. License Exempt - Unrelated Providers have an annual visit that is conducted by trained coaches under the supervision of the Early Childhood Investment Corporation (ECIC), a grantee for the Lead Agency. The initial visit is announced. Ongoing annual visits are unannounced. During the annual health and safety visit, coaches review the License Exempt Provider Health & Safety Standards via the Standards and Annual Health & Safety Checklist for compliance. The checklist aligns directly with the license exempt provider standards and covers mandatory health and safety training topics taught in the LEPPT training. Coaches also connect the license exempt providers to additional resources and training. If a standard is found to be non­ compliant a Corrective Action Plan (CAP) is completed, and the coach completes an additional unannounced visit. If further noncompliance is identified the case is reviewed by the Lead Agency to determine next steps, which may include closure of the provider. Non-compliant high-risk standards that have been identified are reported to the Lead Agency along with copy of the CAP. The Policy Team enters into the database and reviews the database to identify if the provider had previous non-compliance findings. If previous findings have been identified the team will review length of time since last occurrence, if it is the same occurrence and type of violation and will consider closing the provider, monitor the CAP and/or recommend additional training. High Risk Health and Safety Standards are identified on the Standards and Annual Health & Safety Checklist and parents are able to see see on posted reports any non-compliance items for the provider along with the CAP. b. List the entity(ies) in your State/Territory responsible for conducting inspections of license-exempt CCDF in-home child care (care in the child’s own home) providers: Early Childhood Investment Corporation (ECIC) and Great Start to Quality Resource Centers 5.5.4 Posting monitoring and inspection reports Lead Agencies must post monitoring and inspection reports on their consumer education website for each licensed and CCDF child care provider, except in cases where the provider is related to all the children in their care. These reports must include the results of required annual monitoring visits and visits due to major substantiated complaints about a provider’s failure to comply with health and safety requirements and child care policies. A full report covers everything in the monitoring visit, including areas of compliance and non-compliance. If the Lead Agency does not produce any reports that include areas of compliance, the website must include information about all areas covered by a monitoring visit. The reports must be in plain language or provide a plain language summary Lead Agency and be timely to ensure that the results of the reports are available and easily understood by parents when they are deciding on a child care provider. Lead Agencies must post at least 3 years of monitoring and inspection reports. a. Does the Lead Agency post: i. [x] Pre-licensing inspection reports for licensed programs. ii. [ ] Full monitoring and inspection reports that include areas of compliance and non-compliance for all non-relative providers eligible to provide CCDF services. iii. [x] Monitoring and inspection reports that include areas of non-compliance only, with information about all areas covered by a monitoring visit posted separately on the website (e.g., a blank checklist used by monitors) for all non-relative providers eligible to provide CCDF services. If checked, provide a direct URL/website link to the website where a blank checklist is posted: On September 29, 2023, the agency received preliminary notice of a non-compliance related to posting inspection reports for license child care programs Non compliances were due to posting only non-compliances rather than the full inspection report and not making 3 years' worth of inspection reports available on the consumer education website. The agency needs additional time bring this section into compliance and will be requesting a transitional waiver. iv. [ ] Other. Describe: b. Check if the monitoring and inspection reports and any related plain language summaries include: i. [x] Date of inspection. ii. [x] Health and safety violations, including those violations that resulted in fatalities or serious injuries occurring at the provider. Describe how these health and safety violations are prominently displayed: Displayed in a table on the front page of the renewal report cover sheet the Health and Safety violations are listed. This information is also listed in a table format on the Special Investigation Report and the Interim Report. License Exempt Provider Health and Safety Checklist full report is posted for a minimum of three years on the Great Start to Quality website provider search using the Provider ID. iii. [x] Corrective action plans taken by the Lead Agency and/or child care provider. Describe: Licensed providers that have a Corrective Action Plan (CAP) have it posted as a downloadable link on the statewide website search for licensed provider centers and homes. These are posted for a minimum of three years. License Exempt Providers Corrective action plans are posted for a minimum of three years on the Great Start to Quality website using the license exempt provider’s Provider ID. iv. [ ] A minimum of 3 years of results, where available. v. If any of the components above are not selected, please explain: Due to system migration issues, including 3 years' worth of licensing reports on the GSQ website is not possible, however CDC will continue to add new inspection reports as the system allows. c. Lead Agencies must post monitoring and inspection reports and/or any related summaries in a timely manner. i. Provide the direct URL/website link to where the reports are posted: License exempt provider reports are posted License Exempt Provider Search - Great Start to Quality. License provider reports are found Statewide Facility Search (site.com) https://greatstarttoquality.org/lep-search/ Licensed provider reports can be located. https://cclb.my.site.com/micchirp/s/statewide-facility-search ii. Identify the Lead Agency’s established timeline for posting monitoring reports and describe how it is timely: Reports are posted within 90 days of visit. d. Does the Lead Agency certify that the monitoring and inspection reports or the summaries are in plain language that is understandable to parents and other consumers? [x] Yes. [ ] No. If no, describe: e. Does the Lead Agency certify that there is a process for correcting inaccuracies in the monitoring and inspection reports? [x] Yes. [ ] No. If no, describe: f. Does the Lead Agency maintain monitoring and inspection reports on the consumer education website? [x] Yes. [ ] No. If no, describe: 5.5.5 Qualifications and training of licensing inspectors Lead Agencies must ensure that individuals who are hired as licensing inspectors (or qualified monitors designated by the Lead Agency) are qualified to inspect child care providers and facilities and have received health and safety training appropriate to the provider setting and age of the children served. Describe how the Lead Agency ensures that licensing inspectors (or qualified monitors designated by the Lead Agency) are qualified and have received training on health and safety requirements that are appropriate to the age of the children in care and the type of provider setting. All child care licensing consultants have a master's degree in early childhood education, child development, or related field. Upon being hired, all licensing consultants attend a week-long new consultant training that covers PA 116 of 1973, child care center licensing rules, child care family and group home rules, role of a regulator, policies, inspections, required paperwork, disciplinary action for providers, and the database of licensed providers information. All consultants also attend training twice a year to receive updates and policy changes. License exempt providers Health and Safety Visits are completed by Coaches from Early Childhood Investment Corporation. All coaches are required to have an Associate's Degree or equivalent work experience in social work or a related field, such as early childhood education, psychology, or family studies. Additionally, at least one year of experience in the early childhood field is necessary. This includes working directly with families from diverse backgrounds, providing training, coaching, and mentoring to adult learners, working directly with license-exempt child care providers, and providing subsidized child care as a licensed or license-exempt provider. 5.5.6 Ratio of licensing inspectors Lead Agencies must ensure the ratio of licensing inspectors to child care providers and facilities in the State/Territory are maintained at a level sufficient to enable the Lead Agency to conduct effective inspections of child care providers and facilities on a timely basis in accordance with federal, State, and local laws. Provide the ratio of licensing inspectors to child care providers (i.e., number of inspectors per number of child care providers) and facilities in the State/Territory and include how the ratio is sufficient to conduct effective inspections on a timely basis. Michigan's child care licensing system is organized into eight regions with each region having 14-17 child care licensing consultants based on the number of child care facilities in each region. In addition, there are two licensing consultants who "float" between regions as needed to address special investigations or to support pre- licensure and annual monitoring visits. Michigan continues to strive for consultant/provider ratios that meet the needs of all child care providers to assure children are safe and healthy in child care. As part of the performance agreement between Child Care Licensing Bureau (CCLB) and the Department, monthly reports are received that provide the consultant/provider ratio by region in order to ensure we are maintaining caseloads of at least 1:95. Current licensing consultant to provider ratio is 1:65 with a total of 120 consultants.