101216.3(a) · Teacher-Child Ratio (a) There shall be a ratio of one teacher visually observing and supervising no more than 12 children in attendance, except as specified in (b) and (c) below. Based on the interview and record review, the revealed that the facility does operate out of ratio. Additional documentation received shows Management was made aware. The Director understands the ratios for preschool is 1:12. Director agrees to submit a plan on how the facility will remain in Licensee did not meet the above regulation which poses an immediate safety risk to the children in care. During interviews it was disclosed the facility operates out of ratio for periods ranging from 10-25 mins about three to five days a week. On the Child Supervision Records provided by the facility compliance with the regulations. The plan should include appropriate staffing and ratios. If addtional staff are used from outside of this location in the month of October to remain in compliance the timesheets for those staff members will be due 10-31-24.

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

101216(g)(1) · Personnel Requirements (1) Except as specified in (3) below, good physical health shall be verified by a health screening, including a test for tuberculosis, performed by or under the supervision of a physician not more than one year prior to or seven days after employment or licensure.

Deficient Practice Statement Based on the record review, the Licensee did not meet the above regulation which poses a potential Health risk to the children in care. During file review the LPA was unable to review an LIC 503 Health Screening for S4 and S5. POC Due Date: 06/30/2024

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

101226(e)(4)(A) · Health-Related Services (4) Nonprescription medications may be administered without approval or instructions from the child's physician if all of the following conditions are met: (A) Nonprescription medications shall be administered in accordance with the product label directions on the nonprescription medication container(s).

Deficient Practice Statement Based on the facility tour, the Licensee did not meet the above regulation which poses a potential Health risk to the children in care. During the review of medication the LPA observed medication for C1 not in the original container and without a label. POC Due Date: 06/30/2024

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

101223(a)(2) · Personal Rights. Each child shall be accorded safe, healthful, and comfortable accommodations, furnishings, and equipment.

Based on the interview and record review, the Licensee did not meet the Director agrees to provide staff with training on, but not limited to, Personal Rights and Supervision. Memo of topics to discuss and date of training is due to the Department on or by POC due date of 11-2-2023. Training sign sheet is due within 24hrs of training listed on the memo. Director agrees to submit a Personal Rights regulation which poses an immediate Health, Safety & Personal Rights risk to the children in care. There were at least 5-7 incidents documented involving a child being bitten and scratched by other children. The Director confirmed the indicidents reported did occur while in care. written statement outlining how the facility plans to curve the behavior, ensure the facility is in compliance with the Personal Rights regulation and enforce Parent Handbook. TSP brochure was provided during this inspection.

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

101212(d)(1)(B) · (d) Upon the occurrence, during the operation of the child care center of any of the events specified in (d)(1) below, a report shall be made to the Department by telephone or fax within the Department's next working day and during its normal business hours. cont below Director agrees to read the regulation and submit a written statement of understanding. Regulation was reviewed with Director and Director understands unusual incidents that are required to be reported to Licensing. The written statement is due on or before 8-7-2023. In addition, a written report containing the information specified in (d)(2) below shall be submitted to the Department within seven days following the occurrence of such event.(1) Events reported shall include the following: (B)Any injury to any child that requires medical treatment. cont ---->>> Based on the interview & record review, the Licensee did not meet the above regulation which poses a potential Health, Safety & Personal Rights risk to the children in care. Licensee stated she wrote something on Word but never reported it to Licensing. SUPERVISOR'S NAME Aaron Ross

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

101216(g)(1) · Personnel Requirements (1) Except as specified in (3) below, good physical health shall be verified by a health screening, including a test for tuberculosis, performed by or under the supervision of a physician not more than one year prior to or seven days after employment or licensure.

Deficient Practice Statement Based on the record review, the Licensee did not meet the above regulation which poses a potential Health, Safety & Personal Rights risk to the children in care. LPA was unable to review LIC 503 or TB clearance for S1, S2, S3, S4, S7 and S8. Director was unable to provide records. POC Due Date: 07/20/2023

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

101220(a) · Child's Medical Assessments (a) Prior to, or within 30 calendar days following the enrollment of a child, the licensee shall obtain a written medical assessment of the child. This medical assessment enables the licensee to assess whether the center can provide necessary health-related services to the child.

Deficient Practice Statement Based on the record review, the Licensee did not meet the above regulation which poses a potential Health, Safety & Personal Rights risk to the children in care. LPA was unable to review a Physicians Report for C2. Director was unable to provide records. POC Due Date: 07/20/2023

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

101220.1(g)(1) · Immunizations (g) The licensee shall document each child's immunizations and shall maintain such documentation in the center for as long as the child is enrolled. (1) This requirement includes updating each child's immunization record when the child is due to receive required immunizations after enrollment in the child care center.

Deficient Practice Statement Based on the record review, the Licensee did not meet the above regulation which poses a potential Health, Safety & Personal Rights risk to the children in care. LPA reviewed immunization record for C3 which was not current. Director was unable to locate a current immunization record. POC Due Date: 07/20/2023

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

101229(a)(1) · Care and Supervision, which specifies: No child(ren) shall be left without the supervision, including visual observation, of a teacher at any time except as specified in sections 101216.2(e)(1) and 101230(c)(1).

Director agrees to submit a written plan as to how the facility will ensure a child(ren) will not be left unsupervised in the future. Director also agrees to plan and submit a scheduled date with topics of discussion for Staff Training. When training is completed Director agrees to submit the sign in/out sheet for the Based on information disclosed on the Unusual Incident Report and during interviews Child 1 was left outside without staff supervision, which poses an immediate health and safety risk to children in care. training. The scheduled date with topics to be discussed and written statement are due by POC due date. Immediate Civil Penalty of $500 is being assessed. SUPERVISOR'S NAME: Aaron Ross

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.