Inspection · 2023-04-26

Based on record review, the center did not ensure to obtain central registry results for each staff that were not dated more than 90 days prior to the start of employment.

Evidence:
1. The record of staff #5 (employed: 01/20/2023) contained central registry findings dated 10/19/2022.

Based on a review of staff records, the center did not ensure that each staff record contains all required information.

Evidence:
The records for staff #1 (employed: 03/13/23), staff #2 (employed: 01/30/23), staff #4 (employed: 03/20/23), and staff #5 (employed: 01/20/23) did not contain documentation of two or more references before employment.

Based on a review of children's records, the center did not ensure that each child's record contained documentation of immunizations required by the State Board of Health before the child can attend the center.

Evidence:
The record for child #2 (enrolled: 01/30/23), documentation of immunizations was not received until 03/27/23.

Based on a review of children's records, the center did not ensure that each child shall have a physical examination by or under the direction of a physician before the child's attendance or within one month after attendance.

Evidence:
The records for child #3 (enrolled: 03/01/23) and child #5 (enrolled: 03/01/23), did not have a physical examination.

Based on observation, the center did not ensure all hazardous substances such as cleaning materials insecticides and pesticides, were kept in a locked place using a safe locking method that prevents access by children.

Evidence:
In room #3, one container of Lysol labeled ?Caution? and ?Keep Out of Reach of Children?; one container of Glade spray labeled ?Caution? and ?Keep Out of Reach of Children?; one container of Bleach labeled ?Danger? and ?Keep Out of Reach of Children?; and one spray bottle of bleach and water were in an unlocked cabinet. On the countertop, one container of Glade spray labeled ?Caution? and ?Keep Out of Reach of Children? was not kept in a locked place using a safe locking method that prevents access by children.

Based on observation and interviews, the center did not ensure that children under 10 years of age always shall be within actual sight and sound supervision of staff.

Evidence:
1. Staff #1 was observed standing in-between room #1 and room #2. Room #1 and room #2 are approximately 15 feet across from each other. Room #1 did not have lights on and there were no windows for natural light. Staff #1 did not have actual sight supervision of the 4 two year old children in room #1 and the 6 three year old children in room #2.
2. Staff #3 stated that staff #1 was standing in between the classrooms while staff #3 answered the center door.

Based on observation and interview, the center did not ensure the maximum group size limitations were followed when children were in care.

Evidence:
1. In room #3, there were a total of 13 children observed as one group during the inspection. The maximum group size limitation for children ages birth-16 months is 12. At approximately 12:50 PM a total of 13 children were being supervised by three staff members.
2. Staff #3 stated that one of the children naps in room #2 however staff #3 did not want to leave that child alone in room #2 when she answered the center door.

Based on observation and interview, the center did not ensure that all medications shall be kept in a locked place, using a safe locking method that prevents access by children.

Evidence:
1. One epinephrine injection (EPIPEN), was in an unlocked upper kitchen cabinet.
2. The director acknowledged that the EPIPEN was in an unlocked cabinet.

Based on observation, the licensee did not ensure the prepared infant formula shall be refrigerated, dated, and labeled with the child's name.

Evidence:
In room #3, there were two bottles sitting on a table that were not dated or labeled with the child's name. In room #4, a baby bottle was observed in the refrigerator with an orange substance. The bottle was not dated and labeled with the child?s name.