Inspection · 2023-10-11

Repeat Violation
Based on a review of records, one staff record did not contain documentation of a negative tuberculosis screening submitted at the time of employment and conducted within the previous 30 calendar days.
Evidence:
Staff A's record contain a TB result dated 11/03/22. (DOH: 11/1/22)

Repeat Violation
Based on a review of orientation, one staff record did not contain documentation of orientation prior to working alone with children or within seven days of assuming job responsibilities.
Evidence:
Staff B's record did not contain documentation of orientation. (Date of Hire (DOH): 1/17/22)

Repeat Violation
Based on a review of orientation documentation, documentation did not contain all required information.
Evidence:
2 of 3 staff records reviewed did not contain documentation of the required Child Abuse and Neglect training. (Staff B.C).

Based on a review of documentation and staff statement, children with emergency medications were not always in the care of a staff member who meets the requirements for medication administration.
Evidence:
There is one staff person currently certified in Medication Administration Training (MAT). The staff stated they are present at the center from approximately 10:00 am - 2:25 PM daily. There are multiple emergency medications on site. On 10/11/23 the staff member left the center at approximately 2:25PM. Children with emergency medications were present at the center at that time.

Based on observation, a staff person did not ensure care, protection and guidance of a child in care.
Evidence:
A staff member was observed picking up at pacifier off the floor and placing it in the mouth of an infant. The staff member had just completed a diaper change and had not washed their hands before picking up the pacifier.

Repeat Violation
Based on a review of medications, the center failed to follow their policy for and procedure required by the standards..
Evidence:
The center did not follow the policy for prevention of use of outdated medications.
An Avi-Q present at the center was expired. (10/10/23).

Based on observation, one child's medication was not stored locked.
Evidence:
One medication in the infant room was stored in the medication notebook, not locked in the Infant A room. (Child 1)

Based on a review of medications, parents were not notified that medication needed to be picked up after the medication authorization expired. After 14 days the medication was not disposed of.
Evidence:
Child #3's medication authorization for Motrin expired in January 2023. the medication was present in the center today.

Based on a review of records, one staff record did not contain documentation of first aid and cardiopulmonary resuscitation certification.
Evidence:
Staff B, working alone with children, did not have current first aid/CPR certifications.

Based on a review of documentation, documentation of monthly emergency evacuation drills has not been maintained.
Evidence:
There was no documentation of a monthly emergency evacuation drill having been conducted in September 2023.

Based on observation a child was allowed to drink while walking around.
Evidence:
One infant in the Infant B room was observed walking around while drinking from a bottle.

Repeat Violation
Based on a review of records, child records do not contain all required information.
Evidence:
4 child records were reviewed.
*1 of 4 records did not contain an allergy action plan for a diagnosed food allergy. (Child 2)
*2 of 4 records did not contain updated information in the child's record. Allergy action plans are date 9/29/22. (Children # 3, 4)

Repeat Violation
Based on a review of records, staff records did not contain all required information.
Evidence:
3 staff records were reviewed.
*Staff A's record included one reference that was provided by a relative (Not acceptable).
*Staff C's record did not contain documentation of an emergency contact.