Inspection · 2024-08-21

Based on children records review, 1 out 3 records, the provider did not obtain documentation of a physical examination within 30 days after the first day of attendance.
Evidence:
1. Child #2 (date of enrollment 2/10/2022) did not have a physical examination in record available for review.

Based on observation and interviews, an assistant caregiver did not meet general qualifications for caregivers.
Evidence
1. Staff 1 and Staff 2 were unable to speak to Licensing in English. Provider acknowledged that Staff 1 and 2 spoke limited English and would be unable to communicate effectively with emergency personnel.

Based on observation of the physical plant, areas of the home were not maintained in a clean, safe, and operable condition.
Evidence:
1.Two rest mats were torn, and the rips exposed absorbent pad so rest mats could not be cleaned and sanitized.
2. The round carpet had ends that were bent upward and posed a tripping hazard.

Based on observation during circle time, staff did not provide a sufficient quantity and variety of play materials and equipment that shall be readily accessible to children.
Evidence:
In circle time, 9 out of the 11 children were playing with blocks and one pushed toy. The children grabbed and shoved each other for the push a large sit on car onto a few children. Staff did not provide a variety of play materials to play with until suggested by Licensing.

Based on observation and interviews, the provider did not ensure equipment and materials used by a child should be appropriate to the age, size, ability, and interest of the child.
Evidence:
1. Four two-year-old children were placed in highchairs for lunch time. Provider acknowledged these children are self-feed by staff.

Based on observation and interview, staff did not provide behavioral guidance that is constructive in nature and age and stage appropriate to redirect children to appropriate behavior. Evidence:
1. Child 2 (two-year-old) repeatedly ran around the classroom falling on children including infants, push other children, and ran pushing children away from toys, and into the children, which included two infants being hit by the car.
Staff only said no and then grabbed child by the arm to either pull child away or force child to sit down.

Based on observation, the caregiver did not maintain washing their hands with liquid soap and warm running water before preparing and serving food and before feeding or helping children with feeding.
Evidence:
1. Staff 1 and 2 did not wash hands before serving food for the children. Staff were observing self-feeding one child with a banana and then self-feed another child.

Based on observation, the provider did not ensure the diapering surface was nonabsorbent and washable.
Evidence:
1. The changing pad had a large hole in the top corner, exposing the absorbent cushion.

Based on observation, the provider did not ensure soiled disposable diapers and wipes shall be disposed of in a leak-proof or plastic lined storage system that is either foot operated or used in such a way that neither the caregiver's hand nor the soiled diaper or wipe touches the exterior surface of the storage system during disposal.
Evidence:
1. Staff 2 touched three doorknobs and used hands to lift trash can lid to dispose of diaper.

Based on observation, the provider did not ensure medications for caregivers were kept in a locked place using a safe locking method that prevents access by children.
Evidence:
1. Staff 1 medication stored prescription were on a shelf in an area accessible to children. The medication was removed from the shelf and placed in a closet. The closet door did not securely close and was not locked.