Inspection · 2023-07-11

Based on observation and staff interview, the Provider did not ensure they post the findings of the most recent licensing inspection of the facility.

Evidence: The findings of the most recent licensing inspection of the family day home was not posted.

Based on review of a 3 Household member records, the Provider did not obtain documentation of a completed sworn disclosure statement for each Household member at the time of move-in.

Evidence: The record for Household member #1 (date of move in 5/24/23) did not contain documentation of a completed sworn disclosure statement at the time of move-in.

Based on interview and review of Provider and caregiver records, the Provider did not ensure that the assistant who is left alone with children have a current certification in cardiopulmonary resuscitation (CPR) and First aid.

Evidence: The Provider stated that Caregiver #2 who has been alone with children has not completed First Aid or CPR training.

Based on review of Household member records, the Provider did not obtain a report documenting the absence of tuberculosis for each adult Household member.

Evidence: The record for Household member #3 (move in date 5/24/23) did not contain a report documenting the absence of Tuberculosis. The Provider stated that this has not yet been completed.

Based on review of Provider and Caregiver records, the Provider did not orient the substitute provider or assistant on the required topics by the end of their first week of assuming job responsibilities.

Evidence: There was no documentation and the Provider stated that they had not oriented Caregiver #2 (start date 4/15/23) on the required topics by the end of their first week of assuming job responsibilities.

Based on observation, the provider did not ensure that potentially poisonous substances were stored in an area inaccessible to children.

Evidence: Bleach wipes were stored on a shelf in the unlocked bathroom accessible to children.

Based on observation, the Provider did not cover all unused electrical outlets accessible to children under five years of age with child-resistant protective covers.

Evidence:
1)In the home entry area, there is an unused outlet accessible to children without a protective cover.
2)In the infant sleeping room where the crib sits against the wall, there is an unused outlet accessible to children without a protective cover.
3)In the eating area, there are 2 unused outlets accessible to children without a protective cover.

Based on observation, the Provider did not ensure that children under two years of age and children over two years of age who are not developmentally ready to climb or descend stairs without supervision shall not have access to stairs.

Evidence:
1)There was no barrier to block children under the age of 2 years old from climbing or descending a set of wood stairs on the main level of the home.
2)Three of the children in care were playing on the stairs during the inspection, one of the children was under the age of 2 years old.
3)The stairs leading up to the deck from the swingset area do not have a barrier to block children from ascending the stairs.

Description: Based on review of the written attendance record and interview with the Provider, the Provider did not ensure they maintained a written record of children in attendance each day.

Evidence:
During the inspection in was determined there were 4 non-household children present, but the written record reflected there were 3 non-household children present.

Based on review of 4 child records, the Provider did not obtain all of the required documentation for the children?s records.
Evidence:
1)The record for Child #3 did not contain the name, address, and telephone number of 2 designated persons to contact in case of an emergency if the parent cannot be reached. The child had only 1 designated emergency contact listed.
2)The record for Child #4 did not contain the policy number of the child?s medical insurance as required.

Based on review of 4 child records, the Provider did not obtain required documentation of parental review of the Provider?s policies for administration of medications, whether or not the Provider maintains liability insurance, and the provisions of the family day home emergency preparedness and response plan.

Evidence: The record for Child #4 (start date 11/1/22) did not contain documentation of parental review of the Provider?s policy related to whether or not the provider maintains liability insurance.

Based on observation and interview with staff, the Provider did not ensure that medications, including refrigerated medication and medication for caregivers and household members, was kept in a locked place using a safe locking method that prevents access by children.

Evidence:
The Provider had Insulin and Amoxicillin stored on a shelf in the door of the refrigerator that was not locked.

Based on review of 4 child records, the Provider did not conduct an annual review of children?s emergency contact information and the parent?s acknowledgment of the review.

Evidence:
1)The record for Child #1 did not contain documentation of an annual review of the child?s emergency contacts, nor did the records contain parent acknowledgment of the review. The last recorded documentation of the review of the child?s emergency contact information was on 8/23/2020.

2)The record for Child #2 did not contain documentation of an annual review of the child?s emergency contacts, nor did the records contain parent acknowledgment of the review. The last recorded documentation of the review of the child?s emergency contact information was on 8/6/2021.
3)The record for Child #3 did not contain documentation of an annual review of the child?s emergency contacts, nor did the records contain parent acknowledgment of the review. The last recorded documentation of the review of the child?s emergency contact information was on 3/30/2022.

Based on documentation and Provider interview, the Provider did not ensure that each caregiver receives training regarding emergency evacuation, emergency relocation and shelter-in-place procedures by the end of their first week of assuming job responsibilities, on an annual basis, and at the time of each plan update.

Evidence: There was no documentation in the file and the Provider stated that Caregiver #2 (start date 4/15/23) has not received training for emergency evacuation and relocation as well as training on shelter- in-place procedures.

Based on documentation and Provider interview, the Provider did not practice monthly emergency evacuation drills with the children in care.

Evidence: The Provider stated and the documentation on file shows that there were no emergency evacuation drills completed in June 2023.

Based on review of 4 child records, the provider did not ensure they obtained documentation of additional immunizations for a child who is not exempt from the immunization requirements once every 6 months for children under the age of two years.

Evidence:
1)The record for Child #2 (DOB 5/28/21) did not contain immunizations once every 6 months. The last documentation contained in the record was dated 9/20/22.
2) The record for Child #4 (DOB 8/3/22) did not contain immunizations once every 6 months. The last documentation contained in the record was dated 10/4/22.

Based on observation, the Provider did not ensure that bottles be refrigerated and labeled with the child?s full name and the date, if more than one infant is in care.

Evidence: The bottles for Child #4 and Child #5 were not labeled with the child?s name and date.