Inspection · 2022-03-09

Based upon review of staff records and staff interview, the facility has not ensured that tuberculosis screenings for newly hired employees are completed within the last 30 calendar days prior to the date of employment.
Evidence:
1. According to the record provided, staff 2 was hired on 1/24/22. The tuberculosis screening in the record is dated 9/27/21.
2. Staff 1 verified that the tuberculosis screening of staff 2 was not obtained within 30 calendar days prior to the date of employment.

Based upon observation and staff interview, the facility has not ensured that areas and equipment are maintained to be safe.
Evidence:
1. The horizontal metal door handle on the door leading from the middle classroom to the small room usually used for lunch service was not connected to the door. The metal handle was heavy and could injure a child if it fell upon them.
2. Staff 1 acknowledged that the door handle was not connected and placed the handle in her pocket.
3. Two crib sheets in use in cribs were observed to have holes in them.

Based upon observation, the facility has not ensured that hazardous substances are kept in locked places using safe locking methods that prevent access by children.
Evidence:
The door to the upstairs staff break room was unlocked. The cabinet under the sink in the breakroom was also not locked. There were containers of bleach and other cleaning fluids with warning labels stored in the unlocked cabinet under the sink.

Based upon observation, the facility has not ensured that when staff are supervising children, they always ensure their care and protection.
Evidence:
1. While observing the preschool classroom upstairs in the facility, a child sitting at the table vomited into his mask and onto the table. Staff 6 who was sitting at the table with the children did not comfort the child nor make any attempt to clean the child or move the children beside the child out of the way of contamination.
2. When entering the infant room at 10:42 AM, there were two infants sleeping in wooden restaurant style high chairs. Both infants were hanging over the sides of the high chairs with their heads on the bare wood.

Based upon observation and staff interview, the facility has not ensured that staff-to-child ratios are maintained incompliance when children are in care.
Evidence:
1. Upon arrival at the facility at 10:42 AM, there were 12 children in a combined grouping of infants up to age 16 month old children, requiring a 4 to 1 child to staff ratio, in care with 2 staff on duty (staff #4 and staff #3). Staff 1 acknowledged the ratio noncompliance and placed a third teacher (staff #2), on duty within 10 minutes.
2. There were 8 children, ages 16 months through 3 years, requiring a 5 to 1 child to staff ratio, in the care of 1 staff (staff #5) from 10:42 AM until nap time at 12:15 PM. Staff 1 acknowledged the ratio non-compliance.

Based upon observation, the facility has not ensured that infants are provided with stimulation and language development activities, including but not limited to staff reading, talking to, showing pictures to, naming objects for, playing and engaging in positive interactions, etc.
Evidence:
From the inspector's arrival at 10:42 AM until 12:15, the staff in the infant room did not provide any stimulation or language development activities. Staff interaction was observed to be picking up the toys and intercepting children who were fighting over the same toys. No teacher directed activities were offered nor were staff speaking directly with the children.

Based upon observation and interviews, the Licensee has not demonstrated operational responsibility for ensuring that the center's activities, services, and facilities are maintained in compliance with the standards and the center's own policies and procedures that are required by these standards.
Evidence:
Violations were found in six out of the eight areas of the standards for licensed child day centers to include administration, physical plant, staffing and supervision, programs, special care provisions and emergencies, and special services. Violations cited require the authority , resources or supervision of a licensee and impact the care, safety and wellbeing of the children enrolled.
Violations cited in the areas of administration, staffing and supervision, programs, special care provisions and emergencies and special services require a level of responsibility, knowledge, skills, and/or abilities beyond those of the direct care staff or aides.

Based upon observation, the facility has not maintained a current written list of all children's allergies, sensitivities and dietary restrictions that is dated and kept confidential in each room or area where children are present.
Evidence:
1. There were sticky notes on a wall in the kitchen. One note had child 1's name and the words "blueberries/berries". A second note for child 2 said
"pineapples/blueberries and a third note for child 3 said "no milk". The notes were not dated and there was no additional information indicating whether each child had a diagnosed allergy, a dietary restriction or a food sensitivity.
2. There were no written lists of children with allergies, sensitivities or dietary restrictions kept in the classrooms where children were present.

Based upon observation, the facility has not ensured that children's personal articles are individually assigned.
Evidence:
A child's pacifier was laying on the floor of the infant room. The pacifier was not labeled as to which child the pacifier belonged.

Based upon observation and staff interview, the facility has not ensured that cribs are identified for use by a specific child.
Evidence:
A crib, identified by staff as being assigned to a new infant child 4, who began attending this week, was not identified for use by this infant.

Based upon observation, the facility has not ensured that filled comforters are not used by children under 2 years of age.
Evidence:
There were two cribs occupied by resting infants in the infant room. There was a filled blanket draped over the side of one of the occupied cribs and a filled sleep sac animal draped over the end of the second occupied crib.

Based upon review of documentation, the facility has not ensured that the documentation of emergency evacuation drills included all required information.
Evidence:
The record of evacuation drill provided did not include the method used for notification of the drill and any special conditions simulated.

Based upon observation and staff interview, the facility has not ensured that when food is brought from home, the food container is clearly dated and labeled in a way that identifies the owner.
Evidence:
1. There were 2 lunch boxes on a table in the kitchen. One box had a child's name but no date and the second box did not have a name nor the date.
2. There were 2 lunch boxes on a desk in the office area. One box had a child's name but no date and the second box did not have a name nor a date.
3. Staff 1 acknowledged that all four lunch boxes noted above were not labeled as required.

Based upon review of records and staff interview, the facility has not ensured that the record for each child on formula contains the brand of formula and the child's feeding schedule.
Evidence:
1. The record provided for child 4, 7 months old and on formula, who began attending this week, did not include the child's brand of formula and feeding schedule.
2. Staff 1 verified that the infant records did not include the child's brand of formula and current feeding schedule.

Based upon review of children's records and staff interview, the facility has not ensured that the record for each child contains all required information.
Evidence:
1. The record provided for child 4 did not have documented the child's first date of attendance.
2. Staff 1 verified that the record did not have indicated child 4's first date of attendance.

Based upon observation and staff interview, the facility has not ensured that for each group of children there is a written record of daily attendance that documents the arrival and departure of each child in care as it occurs.
Evidence:
1. Each group of children had a document on which there was a check mark for the children in care. Dates of arrival and departure were not entered, nor did the record indicate when children were moved into and out of combined groupings of children.
2. Staff 1 acknowledged that the attendance records did not indicate times, nor did they add or remove children as groupings were combined in the early AM of late PM.