Inspection · 2024-03-06

Based on record review and interviews, it was determined the center did not obtain documentation that each child in care had received immunizations as required by the State Board of Health before the child attends the center.
Evidence:
1.There was no documentation of immunizations in the record for child #1. The child began care on 5/29/24 and was in care on 6/3/2024.
2.The Director confirmed the immunization record was not in the record.

Based on record review and interviews, it was determined the center did not obtain documentation of additional immunizations once every six months for children under the age of two years.
Evidence:
1.The most current documentation of immunizations for child # 2, who was under two years of age, was dated 7/6/2023, 11 months prior.
2.The Director confirmed additional immunization documentation was not in the record.

Based on record review and interview, it was determined the center did not ensure that the required physical was in the child?s record before the child?s attendance or within 30 days after the first day of attendance.
Evidence:
1.There was no physical in the record for child #5 who was in care from 1/2/24 to 3/1/2024.
2.The Director confirmed the physical was not in the record.

Based on record review, it was determined the center did not ensure that the documentation accepted as proof of immunizations included all of the required information.
Evidence:
1.Documentation of immunizations in the record for child #5 was not signed by a physician, his designee, or an official of a local health department. It did not contain an official stamp from the physician?s office. The child's name was not included in the documentation, but was handprinted at the top of the documentation.

Based on a review of documentation and interview, it was determined that the facility did not ensure that an annual health inspection was provided.
Evidence:
1. The health inspection report available for viewing during the inspection was dated 5/3/2023. The report was more than a year old and was no longer current.
2. The Director confirmed the health inspection was not current.

Repeat Violation
Based on observation and interviews, it was determined the center did not ensure that all areas and equipment of the facility was maintained in a safe and operable condition.
Evidence:
1.There was a broken rolling cart in the four-year-old classroom.
2.There was a broken toilet seat and lid in the bathroom shared by the two and three -year-olds.
3.On the playground there was broken and jagged piece of siding on a wall of the building. The broken siding was low on the wall and accessible to children.
4.The Director confirmed the items were broken.

Based on observation, it was determined that the center did not ensure that where playground equipment is provided resilient surfacing shall comply with minimum safety standards when tested in accordance with the procedures described in the American Society for Testing and Materials F1292-99 (Compressed Loose Fill Synthetic Materials Depth Chart) and shall be under equipment with moving parts or climbing apparatus to create a fall zone free of hazardous obstacles.
Evidence:
1.The resilient surface (rubber mulch) around the slide and climbing equipment on the preschool playground was 1-2 ? in depth. This was less than the required minimum depth of 6?.
2. The Director confirmed the rubber mulch was not 6? in depth.

Based on observation it was determined the center did not ensure that children?s hands were
washed with soap and running water after toileting.
Evidence:
1.In the four-year-old classroom the inspector observed two children use the bathroom and return to the carpeted area without washing their hands.

Based on record review and interviews, it was determined that the center did not ensure that long term over the counter medication was allowed with written authorization from the child's physician and parent.
Evidence:
1.The parent of child #6 signed an authorization for Infant Tylenol on 3/18/24. The authorization did not have a physician's signature therefore, it had expired 10 working days later on 4/1/2024.
2. Child #6 was given the medication on 4/23/24 and 4/24/24, after the authorization had expired.

Based on observation and interviews, it was determined the facility did not ensure the required nonmedical emergency supplies were available on each floor of the building.
Evidence:
1.The battery-operated radio did not work.
2.There was no working flashlight.
3.The Director confirmed the radio and flashlight were not working.

Based on record review and interviews, it was determined the center did not ensure that shelter in place procedures were practiced a minimum of twice per year.
Evidence:
1.There was only one shelter in place drill conducted in 2023.
2.The Director confirmed only one drill was documented.

Self-reported
Based on record review and interviews, it was determined the center did not ensure that a written record of children?s serious and minor injuries was documented on the day of occurrence and includes all the required information.
Evidence:
1.The written record of an injury that occurred on 3/1/2024 was not completed with all required information on the day the injury occurred. The center's Injury/Incident form (written record) was completed on 3/4/2024.

Based on review of children?s records and interviews, it was determined that the center did not ensure that each child?s record contains all required information.
Evidence:
1.The record for child #1 did not contain the work phone number for the father, the physicians name and phone number and documentation of viewing the proof of identity and age of the child.
2.The Director confirmed the documentation was not in the record.