Inspection · 2022-10-19

Based on observation, the center did not ensure that all areas and equipment of the center, inside and outside, were maintained in a clean, safe, and operable condition.

Evidence:
1)In the Infant B classroom, with children ranging in ages 12 months-15 months, a phone cord plugged into the wall was observed hanging down low to the floor and looped in such a way that it could cause a risk of strangulation.
2) On the Big playground, where children ages 3 and older play, there were soccer goals stored in a way that they were hanging from the post on the fence and easily reachable to children. The soccer goals have several holes in them that could cause a risk of strangulation to a child.
3) On the Toddler playground, there were 3 small platforms on springs that are 10 inches from the ground that are splitting in the middle causing a gap that could pinch a child?s fingers.
4) During inspection, the licensing inspector observed loose-fitted crib sheets in 5 cribs in the Infant A and Infant B classrooms.

Based on observation, the center did not ensure that hazardous substances such as cleaning materials were not kept in a locked place using a safe locking method that prevents access by children.

Evidence:
1) The laundry/janitorial closet in the hallway was unlocked with the key in the door knob and contained 2 gallons of bleach, glass cleaner, 2 bottles of laundry detergent, goo remover, and disinfectant.
2)In the storage/phone closet in the hallway was unlocked with the key in the door, there were 11 gallons of bleach, 4 gallons of multi-purpose cleaner, wall paint and steel cleaner stored.
3)In the Toddler A classroom, sanitizer tablets and sanitizer spray were stored in an unlocked cabinet.
4)In the Preschool 1A classroom, a gallon of bleach, sanitizer tabs and sanitizer spray were stored in an unlocked cabinet.

Based on observation, the center did not ensure that electrical outlets have protective covers.

Evidence:
1)In the Toddler A classroom, there was 1 outlet that did not have a protective cover. The outlet was within the children?s reach and easily accessible.
1)In the Pre-K A classroom, there was 1 outlet that did not have a protective cover. The outlet was within the children?s reach and easily accessible.

Based on review of documentation and interview with the staff, the center did not maintain a current and dated written list of children?s allergies, sensitivities, and dietary restrictions that was accessible to all staff in each group or area.

Evidence:
1)In the Infant B classroom, there was no dated allergy list posted for the staff.
2)In the Preschool 2A classroom, the allergy list had not been updated since 8/23/2022 and there was a child on the list who no longer attended at the center.

Based on observation, the center did not ensure that proper handwashing procedures were followed.

Evidence:
1)In the Infant A classroom, staff did not wash their hands with soap and running water after a diaper change and after contact with body fluids. After a staff member changed a soiled diaper, they touched the child?s clean clothes and another child?s blanket before washing their hands.
2)In the Toddler A classroom, children did not wash their hands with soap and running water or disposable wipes before eating lunch. Children were observed playing with a ball and crawling on the floor immediately before being called over to the table to eat.

Based on observation, the center did not ensure that disposable diapers were disposed in a storage system that is either foot-operated or used in such a way that neither the staff member?s hand nor the soiled diaper touches an exterior surface of the storage system during disposal and that the diapering surface should only be used for diapering or cleaning children.

Evidence:
1)In the Infant B classroom, the foot-operated storage system for disposal of diapers had a lock on it and was not able to be operated by foot causing the staff member to touch the exterior surface of the trash can with their hand or a soiled diaper to open the trash can.
2)In the Infant A classroom, there was tape, markers and a barrette laying on the diaper changing pad.
3)In the Toddler A classroom, there was a bowling pin laying on the diaper changing pad.

Based on review of 18 medications and medication authorizations, the center did not ensure they follow the policy for administration of medication in that the duration of the parent?s authorization shall expire or be renewed after 10 work days, that long-term medication authorization may be allowed with written authorization from the child?s physician and parent or that the center?s procedures for administering medication includes methods to prevent use of outdated medication.

Evidence:
1)A medication for Child #5 did not contain authorization from a physician, and the last authorization from the parent was on 7/12/22 exceeding 10 working days authorization.
2)An additional medication for Child #5 did not contain authorization from the child?s parent or a physician.
3)Medication for Child #6, Child #7, Child #10, Child #11, Child #12, and Child #15 did not contain authorization from the child?s parent.
4)Medication for Child #10, Child #12, Child #14, and Child #15 did not contain authorization from a physician to administer for more than 10 working days.
5)A medication for Child #6 expired on 9/30/22, a medication for Child #7 expired on 7/31/22, and a medication for Child #15 expired on 5/31/22. There was no procedure to prevent use of the outdated medication that was stored in the same container with all other medications.

Based on review of 18 medications, the center did not ensure that medication were labeled with the child?s name, the name of the medication, the dosage amount and the time or times to be given.

Evidence: There were 2 medications, Benadryl and Vatoco, that did not contain the child?s name or the dosage amount and the time to be given.

Based on review of 18 medications, the center did not ensure that they administer only those drugs that were dispensed from a pharmacy and maintained in the original, labeled container.

Evidence:
1)The medication for Child #7 was not maintained in the original, labeled container from a pharmacy. It was stored loosely in the medication box with other medications.
2)The medication Vatoco was not maintained in the original, labeled container from a pharmacy. It was stored loosely in the medication box with other medications.

Based on observation, the center did not ensure that medication be kept in a locked place using a safe locking method that prevents access by children.

Evidence: In the unlocked classroom with the faux building fronts just inside the main entrance to the center, there were 2 packets of Benadryl and 1 packet of Acetaminophen medications stored on a low shelf inside a first aid kit that was unlocked.

Based on observation, the center did not ensure that sunscreen was kept inaccessible to children under 5 years of age.

Evidence: In the unlocked classroom with the faux building fronts just inside the main entrance to the center, there were 12 sunscreens stored on a low shelf where children of all ages have access.

Based on observation, the center did not ensure that diaper cream was kept inaccessible to children.

Evidence: In the Pre-K A classroom, there were 2 diaper creams stored on a low shelf in an unlocked cabinet where children have access.

Based on documentation review, the center did not have at least one staff member in each classroom or area where children are present that had obtained first aid and cardiopulmonary resuscitation (CPR) certification.

Evidence: The file for Staff #3 did not contain documentation for completion of first aid and cardiopulmonary resuscitation (CPR) certification. During the inspection, Staff #3 was alone with 8 children ages 2- 3 years old.

Based on review of documentation, the center did not ensure they implement a monthly practice evacuation drill.

Evidence: There was no documentation for evacuation drills for August 2022 and September 2022.

Based on observation and staff interview, the center did not ensure that food brought from home was clearly dated and labeled in a way that identifies the owner.
Evidence:
1)In the Infant B classroom, there was milk, a 3 compartment container of food, and a 1 compartment container of food in the refrigerator that were not labeled with a name.
2)In the Infant B classroom, there was Oat milk and 1 container of applesauce with no name or date.

Based on observation, the center did not ensure that prepared infant formula was dated and labeled with the child?s name.

Evidence: In the Infant A classroom, 2 undated bottles were stored in the refrigerator.

Based on review of five staff records, the center did not obtain all of the required documentation for staff records.

Evidence:
1)The center did not have documentation for Staff #5 that two or more references as to character and reputation as well as competency were checked before employment.
2) The center did not have documentation for Staff #3 that they possess the education and experience required by the job position.
3) The center did not have documentation for Staff #5 of the name, address and telephone number of a person to be notified in an emergency.

Based on review of the written attendance record and interview with staff, the center did not ensure they maintained a written record of daily attendance for each group of children documenting the arrival and departure of each child in care as it occurs.

Evidence:
1)In the Infant A classroom, there were 4 children present, but the written record reflected there were 3 children present.
2)In the Infant B classroom, there were 4 children present, but the written record reflected there was 1 child present.
3)In the Toddler A classroom, there were 10 children present, but the written record reflected there were 13 children present.
4)In the Preschool 1A classroom, there were 8 children present, but the written record reflected there were 14 children present.
5)In the Preschool 2A classroom, there were 17 children present, but the written record reflected there were 11 children present.
6) In the Pre-K A classroom, there were 17 children present, but the written record reflected there were 18 children present.