Inspection · 2023-03-15

Based upon review of documentation, staff interview and observation, the facility has not ensured that any child for whom emergency medication has been prescribed is always in the care of a staff member who has medication administration training (MAT) certification.
Evidence:
1. From 2:00 PM until 2:30 PM, child 1, child 2 and child 3, all of whom have allergies that may require the administration of epinephrine, were in care without a MAT certified caregiver.
2. Staff 1 acknowledged that staff 1 is the only caregiver with MAT certification and that she does not arrive until around 2:30 PM.

Based upon records provided, the facility has not ensured that there is an annual fire inspection from the fire official having jurisdiction.
Evidence:
The most recent fire marshal inspection provided is dated 11/10/2021.

Based upon observation, the facility has not ensured that when staff are supervising children, they ensure their care and protection.
Evidence:
Based upon documentation, the facility has three children with food allergies. At snack time, the children are provided with a snack but are also allowed to eat whatever is still in their lunch boxes that they brought to public school.
Staff 1 told the group of 23 children that if they had anything with peanuts or peanut butter to move to another table at the far end of the cafeteria. No staff checked to ensure that there were no peanut products being eaten near the children with allergies.

Based upon observation, the facility has not ensured that when children are in ongoing mixed age groups, the staff-to-children ratio applicable to the youngest child in the group applies to the entire group.
Evidence:
When a group of children moved from the gymnasium to the cafeteria for snack, there were 23 children, aged 4 years and older, with two staff. The required ratio for children to staff in a group with 4 year old children is no more than 10 children per staff person. As the children were eating, three additional children joined the group with the two staff, totaling 26 children with two staff.

Based upon review of medication stored for emergency administration to the children, the facility has not followed their own policy requiring parent authorization for any medication to potentially be administered to the child by program staff.
Evidence:
There was diphenhydramine stored for potential administration to child 3. There was no written parent authorization for the diphenhydramine to be administered.

Based upon observation and staff interview, the facility has not ensured that when medication expires, the parent is notified and the medication is returned to the parent within 14 days.
Evidence:
1. There was epinephrine for potential emergency administration to child 2. The epinephrine expired in December 2022 and was not returned to the parent.
2. Staff 1 acknowledged that the epinephrine for child 2 had expired and the parent was not notifed.

Based upon review of records, the facility has not ensured that lockdown procedures are practiced at least annually.
Evidence:
Based upon the records provided, there was no lockdown drill conducted last school year and no lockdown drill has been conducted this school year.

Based upon review of records, the facility has not ensured that children's records include all required information.
Evidence:
The record provided for child 2 did not include any information regarding the parents or the parent contact information. The record also did not include the names, addresses and telephone numbers for two persons to be contacted in an emergency when a parent cannot be reached.