Inspection · 2023-12-14

(Repeat Violation) Based on a review of nine child records, the facility failed to obtain documentation that each child has received immunizations prior to the child's first attendance. Evidence: the record for child #2 (date of first attendance: 2/4/2021) did not have documentation of immunizations.

(Repeat Violation) Based on a review of nine child records, the facility failed to obtain documentation that each child has received a physical examination prior to the child's first attendance or within one month after attendance. Evidence: the record for child #2 (date of first attendance: 2/4/2021), child #5 (date of first attendance: 10/4/2022) and child 7 (date of first attendance: 8/23/2023) did not have documentation of a physical examination.

Based on staff interview, the facility failed to inform all staff who work with children of children?s allergies, sensitivities and dietary restrictions. Evidence: when asked, not all staff could state which children in the group had allergies, sensitivities and/or dietary restrictions.

Based on review of documentation, the facility failed to maintain a current written list of all children?s allergies, sensitivities, and dietary restrictions. Evidence:
1) The list posted in the classrooms was dated: 8/24/23
2) Staff confirmed that there were children in attendance and/or enrolled since then with allergies, sensitivities and restrictions that were not included on the list
3) Staff confirmed there were children on the list who no longer are enrolled
4) Child #1 (date of first attendance: 9/7/2023) has a diagnosed food allergy and is not included on the written list

(Repeat Violation) Based on observation, not all handwashing procedures were followed, as required. Evidence: an infant was observed during a diaper change and their hands were not washed with soap and water afterwards.

Based on review of eight medications and authorization forms, the facility did not ensure when an authorization for medication expires, the parent is notified that the medication needs to be picked up within 14 days or the parent must renew the authorization. Evidence: the medication authorization form for child #2 expired 6/30/2022, the medication authorization for child #10 expired 11/26/2023 and the medication authorization form for child #11 expired on 11/29/2023. The medication has not been returned to the parents nor have the medication authorization forms been renewed.

Based on observation and review of documentation, the facility failed to have at least one staff in each classroom where children are present, with current certification in CPR and first aid. Evidence: the record for staff #4, who was observed working alone in the infant classroom, did not have documentation of CPR and first aid training. The record for staff #2, who was observed alone in the toddler/two?s classroom, did not have documentation of an approved CPR/first aid training program. The record for staff #3, who was observed working alone in the early preschool classroom had CPR/first aid certification dated: 11/7/17 and was expired.

Based on review of documentation, not all shelter in place procedures were practiced a minimum of twice per year. Evidence: there was no documentation of a shelter-in-place drill during the past year.