591-1-1-.32(7) · Rule 591-1-1-.32(7) requires that children shall be supervised at all times appropriate to the individual age, needs and capabilities of each child. Such supervision must include, but not be limited to, indoor and outdoor activities, mealtimes, naptime, transportation, field trips, and transitions between activities. "Supervision" means that the appropriate number of Staff members are physically present in the area where children are being cared for and are providing watchful oversight to the children, volunteers and Students-in-Training. The persons supervising in the child care area must be alert, positioned to maximize their ability to hear and see the children at all times, and able to respond promptly to the needs and actions of the children being supervised, as well as the actions of the volunteers and Students-in- Training, and provide timely attention to the children's actions and needs. Staff shall be attentive and participating with all children during mealtimes and shall be seated within an arm’s length away from children thirty-six (36) months of age and younger.

During an investigation, it was determined that on April 24, 2023, staff did not prevent a four-year-old child from touching a hot curling iron that was accessible to the children in care, while in the infant room. The four- year-old child was in the infant room due to his severe allergies and his class being outside on the playground. A parent came into the infant room and asked if they could fix their child’s hair. The parent plugged in a curling iron that was accessible to the four-year-old child. After being redirected multiple times and told not to touch the curling iron, the child touched the curling iron, which resulted in severe burns to the hand. The child received professional medical attention on April 24, 2023. On April 28, 2023, additional medical treatment was obtained.

Open Not marked corrected in the state record

Open / not marked corrected.

591-1-1-.25(13) · Rule 591-1-1-.25(13) requires that potentially hazardous equipment, materials and supplies shall be stored in a locked area inaccessible to children. Examples of items to be stored include non-food related products under pressure in aerosol dispensing cans, flammable and corrosive materials, cleaning supplies, poisons, insecticides, office supplies and industrial-sized or commercial buckets with a capacity of three gallons or more or any other similar device with rigid sides which would not tip over if a toddler fell into the container head first.

During an investigation, it was determined that on April 24, 2023, hazards were not kept inaccessible to children when a four-year-old child sustained serious burns on their right hand and fingers when they touched a hot curling iron. The parent of another child plugged in a curling iron that was accessible to the four-year-old child. The burns were treated with cold water and a cold towel. The child received professional medical attention on April 24, 2023. On April 28, 2023, additional medical treatment was obtained.

Open Not marked corrected in the state record

Open / not marked corrected.

591-1-1-.32(4) · Rule 591-1-1-.32(4) requires that for Centers with a licensed capacity of 19 or more, children under three (3) years of age shall be housed in separate physical areas from older children and cannot be mixed with older children except at the following times and circumstances.

During an investigation, it was determined that on April 24, 2023, a four-year-old child was placed in a classroom with infants and one-year-old children while their class went outside, due to allergies. While in the classroom, the child sustained serious burns on their right hand and fingers when they touched a hot curling iron. The child received professional medical attention on April 24, 2023. On April 28, 2023, additional medical treatment was obtained.

Open Not marked corrected in the state record

Open / not marked corrected.

591-1-1-.29(3) · Rule 591-1-1-.29(3) requires that the Director or designated person-in-charge shall report or cause to be reported to the Department within twenty-four (24) hours or the next work day: any death of a child while in the care of the Center; any serious illness or injury requiring hospitalization or professional medical attention other than first aid of a child while in the care of the Center; any situation when a child in care becomes missing, such as, but not limited to, a child who is left on a vehicle, a child who leaves the building, playground, or property, or a child who is left behind on any trip; any fire; any structural disaster; any emergency situation that requires temporarily relocating children; and any time the program’s operating status changes (i.e., open to closed or temporarily closed and temporarily closed to open).

During an investigation, it was determined that on April 24, 2023, a four-year-old child sustained serious burns on their right hand and fingers when they touched a hot curling iron. The child received professional medical treatment after being picked up. This incident was not reported to the Department as required.

Open Not marked corrected in the state record

Open / not marked corrected.

591-1-1-.25(13) · Rule 591-1-1-.25(13) requires that potentially hazardous equipment, materials and supplies shall be stored in a locked area inaccessible to children. Examples of items to be stored include non-food related products under pressure in aerosol dispensing cans, flammable and corrosive materials, cleaning supplies, poisons, insecticides, office supplies and industrial-sized or commercial buckets with a capacity of three gallons or more or any other similar device with rigid sides which would not tip over if a toddler fell into the container head first.

During a Complaint Investigation & Licensing Study conducted on February 20, 2024 ; It was determined based on a review of records that the following hazards were observed to be accessible: -D-Left Hall 1R: Under an unlocked cabinet beneath the sink, dish liquid, bubble bath and wipes packaging were accessible. A teacher's purse was also located on the top of a plastic storage bin. A tape dispenser with a sharp edge was also observed to be accessible on a shelf near the teacher's desk area. -E left hall back: Plastic bags were observed to be accessible in children's cubbies and book bags. A can of off was observed on the black filing cabinet. A tube of sunscreen and wipes packaging which read, keep out of reach of children were observed in a child's bag. Also, on the large bookshelf, there were adult scissors and tape dispenser with a sharp edge and a stapler on the art shelf.

Open Not marked corrected in the state record

Open / not marked corrected.

591-1-1-.25(13) · Rule 591-1-1-.25(13) requires that potentially hazardous equipment, materials and supplies shall be stored in a locked area inaccessible to children. Examples of items to be stored include non-food related products under pressure in aerosol dispensing cans, flammable and corrosive materials, cleaning supplies, poisons, insecticides, office supplies and industrial-sized or commercial buckets with a capacity of three gallons or more or any other similar device with rigid sides which would not tip over if a toddler fell into the container head first.

It was determined that on April 24, 2023, hazards were not kept inaccessible to children when a four-year-old child sustained serious burns on their right hand and fingers when they touched a hot curling iron. The parent of another child plugged in a curling iron that was accessible to the four-year-old child. The burns were treated with cold water and a cold towel. The child received professional medical attention on April 24, 2023. On April 28, 2023, additional medical treatment was obtained.

Open Not marked corrected in the state record

Open / not marked corrected.

591-1-1-.32(4) · Rule 591-1-1-.32(4) requires that for Centers with a licensed capacity of 19 or more, children under three (3) years of age shall be housed in separate physical areas from older children and cannot be mixed with older children except at the following times and circumstances.

It was determined based on observation, that on February 20, 2024, there was an eight-year-old present with two and three-year-olds in the D-Left Hall 1R classroom and it was not the first or last hour of the day.

Open Not marked corrected in the state record

Open / not marked corrected.

591-1-1-.32(4) · Rule 591-1-1-.32(4) requires that for Centers with a licensed capacity of 19 or more, children under three (3) years of age shall be housed in separate physical areas from older children and cannot be mixed with older children except at the following times and circumstances.

It was determined that on April 24, 2023, a four-year-old child was placed in a classroom with infants and one- year-old children while their class went outside, due to allergies. While in the classroom, the child sustained serious burns on their right hand and fingers when they touched a hot curling iron. The child received professional medical attention on April 24, 2023. On April 28, 2023, additional medical treatment was obtained. 7. A. Rule 591-1-1-.32 (7) requires that children shall be supervised at all times appropriate to the individual age, needs and capabilities of each child. Such supervision must include, but not be limited to, indoor and outdoor activities, mealtimes, naptime, transportation, field trips, and transitions between activities. "Supervision" means that the appropriate number of Staff members are physically present in the area where children are being cared for and are providing watchful oversight to the children, volunteers and Students-in-Training. The persons supervising in the child care area must be alert, positioned to maximize their ability to hear and see the children at all times, and able to respond promptly to the needs and actions of the children being supervised, as well as the actions of the volunteers and Students-in- Training, and provide timely attention to the children's actions and needs. Staff shall be attentive and participating with all children during mealtimes and shall be seated within an arm’s length away from children thirty-six (36) months of age and younger. It was determined based on an investigation that on February 5, 2024, at 5:20 p.m., a two-year-old child was left on the playground unsupervised for an undetermined amount of time.

Open Not marked corrected in the state record

Open / not marked corrected.

591-1-1-.32(7) · Rule 591-1-1-.32(7) requires that children shall be supervised at all times appropriate to the individual age, needs and capabilities of each child. Such supervision must include, but not be limited to, indoor and outdoor activities, mealtimes, naptime, transportation, field trips, and transitions between activities. "Supervision" means that the appropriate number of Staff members are physically present in the area where children are being cared for and are providing watchful oversight to the children, volunteers and Students-in-Training. The persons supervising in the child care area must be alert, positioned to maximize their ability to hear and see the children at all times, and able to respond promptly to the needs and actions of the children being supervised, as well as the actions of the volunteers and Students-in- Training, and provide timely attention to the children's actions and needs. Staff shall be attentive and participating with all children during mealtimes and shall be seated within an arm’s length away from children thirty-six (36) months of age and younger.

It was determined based on investigative findings that on February 7, 2023, a staff member left the classroom with one of the children leaving the other children unattended in classroom E. C. Rule 591-1-1-.32 (7) requires that children shall be supervised at all times appropriate to the individual age, needs and capabilities of each child. Such supervision must include, but not be limited to, indoor and outdoor activities, mealtimes, naptime, transportation, field trips, and transitions between activities. "Supervision" means that the appropriate number of Staff members are physically present in the area where children are being cared for and are providing watchful oversight to the children, volunteers and Students-in-Training. The persons supervising in the child care area must be alert, positioned to maximize their ability to hear and see the children at all times, and able to respond promptly to the needs and actions of the children being supervised, as well as the actions of the volunteers and Students-in- Training, and provide timely attention to the children's actions and needs. Staff shall be attentive and participating with all children during mealtimes and shall be seated within an arm’s length away from children thirty-six (36) months of age and younger. During an investigation, it was determined that on April 24, 2023, staff did not prevent a four-year-old child from touching a hot curling iron that was accessible to the children in care, while in the infant room. The four- year-old child was in the infant room due to his severe allergies and his class being outside on the playground. A parent came into the infant room and asked if they could fix their child’s hair. The parent plugged in a curling iron that was accessible to the four-year-old child. After being redirected multiple times and told not to touch the curling iron, the child touched the curling iron, which resulted in severe burns to the hand. The child received professional medical attention on April 24, 2023. On April 28, 2023, additional medical treatment was obtained.

591-1-1-.32(4) · Rule 591-1-1-.32(4) requires that children under three years old be housed in separate physical areas from older children and cannot be mixed with older children except at specified times and circumstances.

During a Complaint Investigation & Licensing Study conducted on February 20, 2023 ; It was determined based on observation that a four-year-old child was housed with infants and one-year-old children in classroom A-1R.

Open Not marked corrected in the state record

Open / not marked corrected.

591-1-1-.32(4) · Rule 591-1-1-.32(4) requires that children under three years old be housed in separate physical areas from older children and cannot be mixed with older children except at specified times and circumstances.

During a Complaint Investigation & Licensing Study conducted on February 20, 2024 ; It was determined based on observation that there was an eight-year-old present with two and three-year-olds in the D-Left hall 1R classroom and it was not the first or last hour of the day.

Open Not marked corrected in the state record

Open / not marked corrected.

591-1-1-.32(1) · Rule 591-1-1-.32(1) requires the Center to maintain the required Staff:child ratios as follows: under 1 year or under 18 months if not walking = 1:6; 1 year and walking = 1:8; 2 years = 1:10; 3 years = 1:15; 4 years = 1:18; 5 years = 1:20;and 6 years and older = 1:25. A Center must establish groupings of children for care with maximum group sizes as follows: under 1 year = 12; under 18 months/not walking = 12; 1 year and walking = 16; 2 years = 20; 3 years = 30; 4 years = 36; 5 years = 40; and 6 years and older = 50.

During a Complaint Investigation Follow Up conducted on May 9, 2023 ; It was determined that upon arrival, there was one staff person with 11 one-year-old children in room 1L-front. Two staff persons were required.

Open Not marked corrected in the state record

Open / not marked corrected.

591-1-1-.32(1) · Rule 591-1-1-.32(1) requires the Center to maintain the required Staff:child ratios as follows: under 1 year or under 18 months if not walking = 1:6; 1 year and walking = 1:8; 2 years = 1:10; 3 years = 1:15; 4 years = 1:18; 5 years = 1:20;and 6 years and older = 1:25. A Center must establish groupings of children for care with maximum group sizes as follows: under 1 year = 12; under 18 months/not walking = 12; 1 year and walking = 16; 2 years = 20; 3 years = 30; 4 years = 36; 5 years = 40; and 6 years and older = 50.

During a Complaint Investigation & Licensing Study conducted on February 20, 2024 ; It was determined based on observation that the ratio was 1:23 with seven four-year-old, four five-year-old and 12 six year-olds on the playground. The children were from the E left hall back classroom where a ratio of 2:23 was needed.

Open Not marked corrected in the state record

Open / not marked corrected.

591-1-1-.14(2) · Rule 591-1-1-.14(2) requires a Staff member who is trained in CPR and first aid to be on the premises and on any field trip whenever any child is present. In addition, Staff who provide direct care to children must satisfactorily obtain certification in first aid and CPR by December 29, 2016 if employed prior to September 30, 2016 and within 90 days of their hire date if employed after September 30, 2016.

During a Complaint Investigation & Licensing Study conducted on February 20, 2023 ; It was determined based on review of records that staff #9, date of hire May 4, 2022, did not have evidence of current certification in first aid and CPR on file.

Open Not marked corrected in the state record

Open / not marked corrected.

591-1-1-.14(2) · Rule 591-1-1-.14(2) requires a Staff member who is trained in CPR and first aid to be on the premises and on any field trip whenever any child is present. In addition, Staff who provide direct care to children must satisfactorily obtain certification in first aid and CPR by December 29, 2016 if employed prior to September 30, 2016 and within 90 days of their hire date if employed after September 30, 2016.

During a Complaint Investigation & Licensing Study conducted on February 20, 2024 ; It was determined based on a review of records that staff #5, hired on April 3, 2023, did not have evidence of CPR. The CPR course was completed online.

Open Not marked corrected in the state record

Open / not marked corrected.

591-1-1-.33(3) · Rule 591-1-1-.33(3) requires each Staff member with direct care responsibilities to complete health and safety orientation training within the first 90 days of employment. The state-approved training hours obtained will count toward required first year training hours. The training must address the following health and safety topics: prevention and control of infectious diseases (including immunizations); prevention of sudden infant death syndrome and use of safe sleeping practices; administration of medication, consistent with standards for parental consent; prevention of and response to emergencies due to food and allergic reactions; building and physical premises safety, including identification of and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, and vehicular traffic; prevention of shaken baby syndrome, abusive head trauma and child maltreatment; emergency preparedness and response planning for emergencies resulting from a natural disaster or a human-caused event (such as violence at a child care facility); handling and storage of hazardous materials and the appropriate disposal of bio contaminants; precautions in transporting children; recognition and reporting of child abuse and neglect; and child development.

During a Complaint Investigation & Licensing Study conducted on February 20, 2023 ; It was determined based on review of records that staff #4, date of hire June 3, 2022, staff #6, date of hire March 24, 2022, and staff #7, date of hire February 10, 2021, and staff #12, date of hire November 14, 2022, did not have evidence of health and safety orientation training on file.

Open Not marked corrected in the state record

Open / not marked corrected.

591-1-1-.33(3) · Rule 591-1-1-.33(3) requires each Staff member with direct care responsibilities to complete health and safety orientation training within the first 90 days of employment. The state-approved training hours obtained will count toward required first year training hours. The training must address the following health and safety topics: prevention and control of infectious diseases (including immunizations); prevention of sudden infant death syndrome and use of safe sleeping practices; administration of medication, consistent with standards for parental consent; prevention of and response to emergencies due to food and allergic reactions; building and physical premises safety, including identification of and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, and vehicular traffic; prevention of shaken baby syndrome, abusive head trauma and child maltreatment; emergency preparedness and response planning for emergencies resulting from a natural disaster or a human-caused event (such as violence at a child care facility); handling and storage of hazardous materials and the appropriate disposal of bio contaminants; precautions in transporting children; recognition and reporting of child abuse and neglect; and child development.

During a Complaint Investigation & Licensing Study conducted on February 20, 2024 ; It was determined based on review of records that staff #4 hired on March 24, 2022, and staff #6, date of hire October 24, 2023, did not have evidence of health and safety orientation training on file. Exhibit "A"

Open Not marked corrected in the state record

Open / not marked corrected.