Programs shall staff infant and toddler programs with at least one associate or lead teacher per group.

The complainant stated that there were days in February 2026 when there were nine infants with two staff in the infant classroom. The Licensing Coordinator's review of the staff and child attendance records for the month of February 2026 revealed that on February 4, 2026, as of 8:18 a.m., there were two staff present with nine infants whose average age was 9 months, and on February 19, 2026 as of 9:48 a.m., there were two staff present with 10 infants whose average age was 10 months, when three staff were required on both days. Corrective action: All classrooms, specifically the infant room, will always maintain required staff-to-child ratios in accordance with licensing standards. At no time will a classroom exceed ratio. The Director and/or Assistant Director will actively monitor classroom ratios throughout the day using ProCare, classroom walkthroughs, and direct staff communication. All staff have been retrained on ratio requirements and the importance of maintaining compliance. Staff are required to immediately notify administration if a classroom is at or approaching ratio. Communication must occur promptly via ProCare and/or walkie-talkie. Tree Frog is committed to maintaining a safe and compliant environment for all children and will continue to take all necessary steps to ensure licensing standards are consistently met.

He-C 4002.36(b) · Correction status not published

Background record checks shall be completed in accordance with this section.

REPEAT CITATION PREVIOUSLY CITED ON NOVEMBER 28, 2023. The licensing coordinator‘s review of the program’s records and staff roster revealed one staff member who had not been determined eligible by the Unit. The director stated that this individual was a substitute and the owner confirmed that the individual had worked in the program prior to being determined eligible. This constitutes the first repeat citation and failure to comply with one directed corrective action plan regarding staff eligibility to work after completing a background record check. Corrective action: Tree Frog Learning Center did fingerprint and complete a background check for the staff member in question, but permitted the staff to begin working prior to the fingerprint appointment, submission of the background record check in NHCIS, and a determination by the Child Care Licensing Unit that the staff was eligible. Tree Frog Learning Center had no intention of omitting this step. Once the issue was identified and corrected, the staff member immediately became eligible. Tree Frog Learning Center remains committed to full compliance with all state licensing requirements and has taken steps to ensure clearer communication and verification moving forward.

He-C 4002.40(a) · Correction status not published

Licensees shall have and implement written policies regarding: The provision of meals and snacks, including when parents or guardians fail to send meals or snacks from home if the program does not provide meals or snacks.

The licensing coordinator's review of the program's policies revealed they did not have a written policy regarding the provision of meals of snacks when a child does not have them. Corrective action: Attached is the written policy as outlined in the parent handbook.

He-C 4002.15(a)(5) · Correction status not published

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

The licensing coordinator’s review of three records of injury revealed that the Center Director did not sign two to indicate they had been reviewed. Corrective action: The director will now review and sign all incident reports moving forward to ensure they are accurate and complete. Incident reports are now reviewed each morning to ensure accuracy and completeness.

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

The program shall request and maintain on file for each child documentation of immunizations in accordance with RSA 141-C:20-a, RSA 141-C:20-b, and He-P 301.14.

The licensing coordinator's review of nine children's records revealed there was no updated record of physical examination on file for one child younger than 6 years of age. Corrective action: The parent was notified and has rescheduled a new date for the physical. She also confirmed that the original date was correct for 2024 and is unsure why the pediatrician crossed it out. The parent is very adamant that the physical is from 2024. With two different dates on the form, we honestly did not notice the 2023 date. We regularly check files for accuracy, and in this case, we believe the confusion was due to an error made by the physician, not the center. We are working with the parent to ensure the correct documentation is on file. When a parent hands off a document, staff will conduct more detail reviews of the document to ensure accuracy and completeness. When an error is identified, it will be promptly addressed and corrected to avoid confusion and maintain clear, accurate records.

He-C 4002.10(d) · Correction status not published

Breast milk and prepared formula shall be stored in covered containers, labeled with the child’s name and, dated.

Prior to working with infants 12 months and younger, child care staff shall take training on prevention of SIDS and use of safe sleep practices.

The complainant's statement that that staff have not completed the required health and safety trainings. The Licensing Coordinator reviewed staff files and determined that Staff A, Staff D, and Staff E did not complete the training on prevention of SIDS and use of safe sleep practices prior to working in the infant classrooms. The Licensing Coordinator's review of the staff attendance for November and December 2024 confirmed that these three staff have worked in the infant classroom. Corrective action: The staff has completed the necessary training following the state visit. Going forward, a spreadsheet has been created to ensure that no trainings are missed.

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

The applicant, licensee, permittee, or any child care staff shall not falsify any documents, other written information, or reports issued by or required by the department under He-C 4002.

The complainant's statement that the program did not provide an injury report for an injury that occurred at the program. The licensing coordinator requested all injury reports for the child, and Staff C provided one written report for the injury. Upon reviewing the report, the licensing coordinator noted that the description of the incident was vague, and that the entire form was completed using a pen with red ink, including the parent signature. This prompted the licensing coordinator to compare the signature to the one on the child registration form for the same child and determined that they were not the same. During a telephone conversation with the owner/ approved Center Director regarding the discrepancy in signatures, it was determined that the program provided a falsified injury report to the Department at the time of visit. Corrective action: A meeting on Jan 9, 2025, was held to discuss the importance of not falsifying legal documents. It was emphasized that if an incident report was not created, honesty would have been the better approach. All staff were made aware that if this issue arises again, immediate termination will occur at Tree Frog Learning Center.

Cribs and play pens required under He-C 4002.26(c) above shall: (1) Not be stacked; (2) Be free of cracked or peeling paint, splinters, and rough edges; (3) Have no more than 2⅜ inches between slats; (4) Have no missing, loose, broken, or improperly installed parts, screws, brackets, baseboards, or other loose hardware, or damaged parts on the crib or mattress supports; (5) Not have corner posts that extend more than 1/16 of an inch above the end panels; (6) Not have holes or tears in the mesh walls or in the material that connects the walls to the bottom of the crib or play pen; (7) Have fitted sheets designed for the size mattress, including elastic corners so that there is no excess fabric with visible folds or bunching, and that do not compress the mattress; (8) Not have bumper pads, blankets, flat sheets, pillows, quilts, comforters, sleep positioners, or any soft items or toys with infants up to 12 months of age; and (9) Have mattresses which are in good repair, free of rips or tears, and fit the crib or playpen so that the space between the mattress and crib or playpen is not more than 2 adult fingers wide and does not create a suffocation hazard.

The licensing coordinator's observation of three pack and plays in the Infant classroom with loose fitting sheets, causing excess fabric with visible folds or bunching. Corrective action: New mattresses were ordered and placed in the cribs, eliminating the loose fitting sheet. The new mattresses have corrected the violation, going forward the mattresses is no longer overly small, allowing the fitted sheet to fit correctly.

He-C 4002.26(f) · Correction status not published

The program shall maintain on file for each staff member: (1) Documentation of the staff’s qualifications, including a resume, transcripts, diplomas, or any other documentation, which demonstrates their qualifications; (2) Documentation of a completed background check in accordance with He-C 4002.41; (3) A record of health screening, in accordance with (b) below; (4) Documentation of orientation, certifications, training, and professional development, as applicable; (5) Documentation verifying the staff reviewed the program’s emergency operations plan in accordance with He-C 4002.16(j); (6) Documentation verifying the staff reviewed their job description required in He-C 4002.16(e); and (7) Documentation of supervision regarding disciplinary actions or investigations specific to the staff member.

Prior to employment or residency, as applicable, and every 5 years thereafter, all child care staff, substitutes, other employees, and volunteers who may be alone with children or are included in staff to child ratios, and household members age 10 years or older, shall submit for a background record check using NH Connections.

The licensing coordinator reviewed staff attendance records and determined that four did not submit for a background record check prior to employment. The director confirmed those individuals did not submit for a background record check prior to employment. Corrective action: Everyone was instructed to either do a transfer or go get printed. Everyone has done that. I checked my teacher roster and it shows everyone but one. I just approved the transfer this morning so hoping it updates soon. Going forward I now know how to find this information and this will never happen again.

He-C 4002.41(a) · Correction status not published