All center directors, agency administrators, site coordinators, or site directors, and all other child care staff who are responsible for the supervision of children, or who are necessary for the staff to child ratios, shall keep on file documentation of completion of a minimum of 6 hours of professional development, which shall be completed in accordance with the following: (1)  Within 90 days of the first date of employment; (2) Within 2 weeks for programs operating 3 months of the year or less; or (3) By providing documentation of previous completion.

The complainant's statement that Staff C had not completed the required Health and Safety trainings. Staff C stated that they have been working alone daily in the Baby Room since their co-teacher left in May 2025, and that they have not completed the health and safety trainings. The Licensing Coordinator's review of the daily attendance records confirmed that Staff C worked in the Baby Room without another staff present. Corrective action: All staff have completed all required health and safety trainings as of 7/23/2025. In the future, staff will complete required trainings before beginning in a classroom and will provide the Director with a copy of the completed transcript.

He-C 4002.33(a) · Correction status not published

The program shall maintain daily child attendance records, in either paper or electronic format, including the child’s full name, date of birth, and their arrival and departure times in the program and each room or group throughout the day, as applicable, recorded in real time by staff or parents.

REPEAT CITATION PREVIOUSLY CITED ON NOVEMBER 7, 2023 AND JUNE 19, 2025. The Licensing Coordinator's review of the daily staff and child attendance records for July 16, 2025 revealed that there were 18 children present and only 16 children signed in, and there were seven staff present and only two staff signed in. This constitutes the second repeat citation and failure to comply with two approved Corrective Action Plans regarding the completion of daily attendance records. Corrective action: All attendance records have been redone and children and staff have to manually sign in and rosters are checked hourly by the director. In the future, all staff and child attendance will be monitored hourly by the director.

Center-based programs shall not combine children younger than 24 months in a mixed age group which includes children older than 47 months, except: (1) For time limited, specific activities, including but not limited to meals, snacks, nap or rest time, and special occasions such as birthday or holiday celebrations or visitor presentations; (2) When there are 17 or fewer children present in the program, including a maximum of 12 preschool children, and 4 or fewer of the 17 children are younger than 3 years of age; or (3) With a department approved plan for multi-age classrooms.

REPEAT CITATION, PREVIOUSLY CITED ON FEBRUARY 7, 2025. On June 19, 2025, the licensing coordinator arrived at 9:40 a.m. and observed that 22 children were present in the main room with three staff until approximately 10:20 a.m., when 4 infants separated into their own classroom. Staff A, Staff B and Staff C stated that all children combine for morning and afternoon snack, during lunch, and when they go outside. Staff A additionally stated that the times that children are combined are reflected on the classroom schedules. The licensing coordinator's review of daily "student attendance" records for June 19, 2025, revealed that of the 22 children combined, nine children were younger than 36 months of age and of those nine children, six children were under 24 months of age. The licensing coordinator’s review of the daily class schedules for Infants, Littles and Bigs, revealed that Infants’ scheduled snack times are 8:00 a.m. and 8:30 a.m., Littles snack time is 8:30 a.m. and Bigs snack time is 9:00 a.m.; Infants and Littles lunch time is 11:30 a.m., and Bigs lunch time is 12:00 p.m.; Infants, Littles and Bigs afternoon snack is 2:30 p.m.; Infants outside time is 3:00 p.m. and Littles outside time is 3:30 p.m. and Bigs outside time is 2:00 p.m. and 3:30 p.m. The daily class schedules do not align with what Staff A, Staff B, and Staff C reported, and neither staff statements nor the daily class schedules aligned with what the licensing coordinator observed upon arrival when all 22 children present were combined in the main room from 9:40 a.m. until approximately 10:20 a.m., This constitutes a repeat citation and failure to comply with one approved Corrective Action Plan regarding combing mixed age groups. Corrective action: The children were eating snack later that day as it was supposed to be a very hot day so they played outside longer in the morning, therefore snack was delayed until 9:35-9:40. New staff were being hired for the program and children were not following their "typical" daily schedules. During the LC visit, 9 additional children were signed into the program - some of which the Director was responsible for as a group. Additional staff have since been hired and we are over staffed as of 7/7/2025. In the future, all groups will follow their schedules and other parts of the day will be adjusted accordingly. Groups will only combine if they are having meals or for a special occasion. In the event that the Director needs to be counted in ratio and/or take a group, an additional substitute staff member will attempt to be found in case a licensing visit is conducted. The program will only combine as outlined in He-C 4002.19(n).

Center-based programs shall not combine children younger than 24 months in a mixed age group which includes children older than 47 months, except: (1) For time limited, specific activities, including but not limited to meals, snacks, nap or rest time, and special occasions such as birthday or holiday celebrations or visitor presentations; (2) When there are 17 or fewer children present in the program, including a maximum of 12 preschool children, and 4 or fewer of the 17 children are younger than 3 years of age; or (3) With a department approved plan for multi-age classrooms.

Upon arrival at the program the licensing coordinator observed that 14 children were present in the main room with two staff. The licensing coordinator's review of daily child attendance records for the day of the visit revealed that six children were younger than 3 years of age. Corrective action: Additional staff have been hired and we are awaiting their BRC. In the interim staff schedules have been adjusted to have 3 or more people present by 8am. This schedule will be maintained now and in the future and we will ensure that children are not combined as stated in 4002.19(n)

He-C 4002.19(n) · Correction status not published

Programs shall staff infant and toddler programs in accordance with the following: (1) For children ages 6 weeks to 12 months, the maximum group size shall be 12 with the following minimum staffing levels: a. One associate teacher with up to 4 children; b. One associate teacher and one assistant teacher with 5 to 8 children; and c. One lead teacher and 2 assistant teachers with 9 to 12 children; (2) For children ages 13 to 24 months, the maximum group size shall be 15 with the following minimum staffing levels: a. One associate teacher with up to 5 children; b. One associate teacher and one assistant teacher with 6 to 10 children; and c. One lead teacher and 2 assistant teachers with 11 to 15 children; (3) For children ages 25 to 35 months, the maximum group size shall be 18 with the following minimum staffing levels; a. One associate teacher with up to 6 children; b. One associate teacher and one assistant teacher with 7 to 12 children; and c. One lead teacher and 2 assistant teachers with 13 to 18 children.

If any child has a serious injury while in the care of the program, consisting of fractures, dislocations, stitches, second or third degree burns, concussions, loss of consciousness, or requires emergency medical treatment or hospitalization, the family child care provider, center director, or site director shall (1) Immediately notify emergency personnel and the child’s parents; (2) Notify the department within 48 hours viaj e-mail, fax, or the NH Connections portal; and (3) Within 7 days, provide the department a written report via e-mail, fax, or the NH Connections portal, detailing the nature and circumstances of the serious injury.

On October 24, 2024, the licensing coordinator received an email from the program that on October 9, 2024, a child sustained a serious injury resulting in a fracture. The program notified the department on October 15, 2024 via submission of the required information through the NHCIS portal when the deadline to notify the department was within 48 hours after the incident. Additionally, the program has not provided the department with a written copy of the signed report of injury, which was due within 7 days after the incident. Corrective action: Due to a misunderstanding of the stated rule, the incident was reported on NHCIS within 7 days but the initial notification was not made within the required 48 hours. All signed copies of the injury reports have been submitted to both the licensing coordinator and uploaded on NHCIS. In the future, the licensing coordinator and NHCIS will be notified via email within 48 hours of the incident and all injury reports will be uploaded within the 7 day window.

He-C 4002.12(a) · Correction status not published

The center director, site director, family child care provider, and all staff used to meet staff to child ratios shall: (1) Be certified in pediatric cardiopulmonary resuscitation (CPR) and first aid within 90 days of the first date of employment; (2) Obtain certification in (m)(1) above by the American Red Cross, American Heart Association, Emergency Care and Safety Institute, National Safety Council, or other nationally recognized organization; and (3) Maintain current certifications required in (m)(1) above.

The licensing coordinator's review of five staff files revealed that one staff necessary for staff to child ratios did not maintain current certification in pediatric CPR and First Aid. Corrective action: Three additional staff members, including the one cited has since completed their skills test and training in order to obtain a current pediatric CPR and First Aid certification. These certificates have been sent to the licensing coordinator. In the future, all staff members needed for maintaining ratio will have a current CPR and First Aid certification on file. A checklist has been attached to all current and future employee files to ensure that certification is current upon hiring. Files will be reviewed by the Center Director monthly and alerts have been set up in digital calendars 30 days prior to expiration dates.

He-C 4002.20(m)(1) · Correction status not published

Any contaminated, expired, or discontinued medication, whether prescription or over-the-counter, and topical substances shall be returned to the child’s parents or, if belonging to the program, disposed of properly by authorized staff.

The licensing coordinator's observation of an expired tube of Neutrogena sunscreen in the container of sunscreens that are applied on the children. Corrective action: The sunscreen was disposed of during the visit and the child's family was notified. The sunscreen has since been replaced and a new system for tracking expiration dates has been implemented. In the future, all sunscreen will be tagged with the child's name and note the expiration date prior to going into storage. A photo of the new system/labels has been sent to the licensing coordinator.

The program shall maintain daily child attendance records, in either paper or electronic format, including the child’s full name, date of birth, and their arrival and departure times in the program and each room or group throughout the day, as applicable, recorded in real time by staff or parents.

Two licensing coordinator's review of the daily staff attendance revealed that the staff's first names were not documented, and there were three staff present and only two staff signed in for the day. Corrective action: The rosters have since been corrected to include first names. Staff members were reminded to sign in and out each day. In the future, the director will be sure to check rosters throughout the day for compliance.

He-C 4002.08(a) · Correction status not published

A written record of a health screening for all child care staff, household members and other individuals who have 5 or more hours per week of contact with children shall: (1) Be on file at the program and available for review by the department for all child care staff within 60 days of the date of hire or the date the household member or individual begins having daily contact with children; and (2) Include, at a minimum, the information on the “Child Care Personnel Health Form” (11/2017) provided by the department, or its equivalent.

Two licensing coordinator's review of four staff files revealed that one staff did not have a current health assessment on file within 60 days of their date of hire. Corrective action: The staff member has since completed a health assessment form and it is on file for review. In the future, the director will maintain a spreadsheet with staff due dates.

He-C 4002.09(b) · Correction status not published

Child care staff shall complete a written record of the injury and all first aid provided.