Inspection · 2023-06-13

Based on review and interview, facility did not ensure 7 of 10 staff records did not have a completed central registry search completed within 30 days of employment.

Evidence: The records for staff #3 (reported start date 4/5/23), staff #4 (reported start date 4/5/23), staff #5 (reported start date 4/10/23), staff #6 (start date 5/8/23), staff #7 (reported start date 5/2/23), staff #8 (reported start date 3/6/23) and staff #10 (reported start date 3/2/23) did not have a completed central registry search. Program Director confirmed final central registry search letters had not been received and did not have documentation of follow up to inquire about the delay.

Based on review, facility did not ensure staff have a negative tuberculosis screening dated within 30 days and prior to beginning employment.

Evidence: The record for staff #6 (start date 5/8/2023) had a TB screening dated 8/18/2022.

Based on observation, facility did not ensure areas and equipment of the center, inside and outside, are maintained in a clean, safe and operable condition.

Evidence: The following was observed:
1. In the young toddler room, a 2 inch by 3 inch portion was missing at the base on the 3-D brown tree on the rear wall leaving small particles of foam pieces. This was at the floor level and within reach of children.
2. In the men's bathroom used by children, 1 of 2 toilets was not operable and had a sign stating "CLOSED".
3. On the outside playground, the following pieces of equipment had missing pieces leaving exposed cracked plastic with rough edges: pink helicopter riding toy was missing the steering wheel and two plastic rocking horses were missing one of the handles.
4. On the outside playground, one side panel of the fence was leaning. A center ground post of this panel had decaying wood at the ground level.
5. On the outside playground, the paint on the fence was peeling in multiple areas around the bottom of the fence.

Based on observation, facility did not ensure hazardous substances such as cleaning materials are kept in a locked place.

Evidence: The following was observed:
1. In the young toddler room, hand sanitizer labeled "warning" and "keep out of reach of children" was stored on the diapering table.
2. In the older toddler room, bleach/water was stored in an unlocked cabinet under the diapering table.
3. In the Infant 2 room, disinfectant spray labeled "caution" and "keep out of reach of children" was stored in an unlocked cabinet under the sink.

Based on observation and interview, facility did not ensure when hazardous substances are not kept in original containers that the substitute container clearly indicates their contents.

Evidence: The following was found:
1. In the young toddler room, a green liquid was observed in a clear spray bottle that was not labeled. Staff stated it was soap water solution.
2. In the older toddler room, a yellow liquid was observed in a clear spray bottle that was not labeled. Staff stated it was soap water solution.
3. In the Infant 2 room, there were 2 clear spray bottles with liquid in each one. Staff stated one was bleach water and the other was soap water solution. The bottles were not labeled.

Based on observation, facility did not ensure restrooms have required supplies.

Evidence: The men and women's restrooms in the 2's room did not have paper towels.

Based on observation, facility did not ensure cribs meet the requirements in that there shall be no more than one inch between the mattress and the crib.

Evidence: In the infant 1 room, the following was observed:
1. Child #7 was observed sleeping in a crib. There was approximately 4.5 inches between the mattress and two corners of the crib.
2. Child #8 was observed sleeping in a crib. There was approximately 2 inches of space between the mattress and the crib.

Based on observation and interview, facility did not ensure requirements are met when diapering.

Evidence: The following was found:
1. In the infant 2 room, the sink was not operable in the diapering area. Staff stated they go into infant 1 room and wash their hands in their classroom.
2. In the young toddler room, staff stated they clean the diapering surface with soap water and the wipe the surface. Staff do not sanitize the surface as required.

Based on observation, facility did not ensure medication is labeled with the child's name.

Evidence: An over the counter mucus and cold relief medication was stored in facility medication box and it was not labeled with the child's name.

Based on observation, review and interview, facility did not ensure when an authorization for medication expires that the parent shall be notified to pick up the medication within 14 days or the parent must renew the authorization.

Evidence: A cough and cold medication was stored in the medication box for child #11. The parent authorization was signed on 5/7/2023 and had not been updated. There was no signed physician authorization for long term use. Program Director confirmed documentation.

Based on review, facility did not ensure 9 of 10 child records have documentation of required information.

Evidence: The following was found during record review:
1. The records for child #1, #2, #3, #4, #5, #6, #8 and #10 did not document the first date of attendance.
2. The record for child #2 did not have previous programs attended.
3. The record for child #3 did not have a second emergency contact and physician phone number.
4. The record for child #7 did not have parents' employment phone numbers, second emergency contact, physician information and previous programs attended.

Based on review, facility did not ensure 10 of 10 staff records have documentation of required information.

Evidence: The following was found during record review:
1. The records for staff #2, #3, #4, #5, #7, #8, #9 and #10 did not have documentation of start date of employment.
2. The records for staff #1 - #10 did not have documentation of an emergency contact (name, address and phone number) and two reference checks. The records for staff #8 and #10 had documentation of one reference check and did not have a second reference check.
3. The records for staff #2, #9 and #10 did not have documentation of orientation training. Director stated the training was done but could not locate completed paperwork.