Medication shall be stored in accordance with the manufacturer's or health professional's instructions on the original label.

On 10/24/24 certification representative verified that the facility had an expired epi-pen for child # 1 that was noticed when the child an allergic reaction. The epi-pen was not used, and an ambulance was called to take child to then hospital.

3270.133(5) · Corrected Oct 24, 2024

The staff:child ratio while toddlers and preschoolers are napping is one staff person to 10 young toddlers, one staff person to 12 older toddlers, one staff person to 20 preschool children.

On 10/24/24 at unannounced inspection certification representative observed 21 children napping in the pre-k classroom with one staff person.

3270.55(a) · Corrected Oct 31, 2024

Toilet areas and fixtures shall be cleaned daily and be in good repair.

On 6-26-24 during renewal inspection Certification Representative noticed that 2 toilets in the facility were broken.

3270.82(g) · Corrected Jul 26, 2024

An agreement shall specify the persons designated by a parent to whom the child may be released.

On 6-26-24 during renewal inspection Certification Representative noticed that child #1 agreement form did not indicate designated pick-up person for child # 1.

3270.123(a)(5) · Corrected Jul 26, 2024

A written statement giving the formula and feeding schedule for an infant shall be obtained from the parent.

On 6-26-24 during renewal inspection Certification Representative noticed that there was no infant feeding schedule for an infants in the infant room.

3270.166(1) · Corrected Jul 25, 2024

Children on the facility premises and on facility excursions off the premises shall be supervised by a staff person at all times. Outdoor play space used by the facility is considered part of the facility premises.

On October 31, 2023, staff person # 1 had her group of 5 toddlers outside, when transitioning back to the inside classroom she left one toddler on the outside playground by himself for two minutes.

3270.113(a) · Corrected Dec 4, 2023

Staff persons shall complete professional development within 90 days of hire as listed in subsections (f)1-10. Staff persons shall complete professional development in pediatric first aid and pediatric cardiopulmonary resuscitation within 90 days of hire.

At the time of the inspection the inspection staff person #1, having served the facility over 90 days, was lacking a current valid pediatric first aide certificate

3270.31(f)/3270.31(f)(10) · Corrected Jul 7, 2023

The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). Facility Person # 1 may not work in a child care position at the facility. A facility person's record shall include a copy of requests for the criminal history record and child abuse registry clearance information, a copy of the disclosure statement and a copy of the completed clearance information required under the CPSL.

At the time of the inspection the record of staff person #1 did not have a NSOR clearance.

3270.32(a)/3270.192(4) · Corrected Jun 16, 2023

When children are grouped in mixed age levels, the age of the youngest child in the group determines the staff:child ratio and maximum group size in accordance with the requirements in § 3270.51 (relating to similar age level).

At the time of the inspection the older toddler room was occupied with 16 children and in the care of one fully qualified staff person.

3270.52 · Corrected Jun 9, 2023

Emergency contact information must include health insurance coverage and policy number for a child under a family policy or Medical Assistance benefits, if applicable.

At the time of the inspection the following children's records were lacking insurance policy information. Child #2, #3, #5, #6

Children on the facility premises and on facility excursions off the premises shall be supervised by a staff person at all times. Outdoor play space used by the facility is considered part of the facility premises. Children must be supervised at all times.

At the time of the inspection there were three groups of children in the large muscle plays pace. A total of 32 children in care with 4 staff persons on the playground with them. Certification Representative did observe a group of 4 preschool aged children who entered the playground from inside the facility; these children were unaccompanied when they arrived in the large muscle play space, and they were around the corner of the "L shaped" playground not within the sight of any of the staff. On the other side of the playground Certification representative did observe a different group of 5 preschool children unsupervised and climbing on the side of the embedded play equipment with

3270.113(a) · Corrected Feb 6, 2023

The legal entity shall have comprehensive general liability insurance to cover the persons who are on the premises. A current copy of the insurance policy shall be on file at the facility.

At the time of the inspection the provider did not have a current documentation proving the comprehensive general liability insurance to cover the persons who are on the premises.

3270.18(a) · Corrected Jul 1, 2022

A child's record shall contain signed parental consent for emergency medical care for the child. Written consent is required prior to admission.A child's record shall contain signed parental consent for administration of minor first-aid procedures by facility staff. Written consent is required prior to admission.

At the time of the inspection the record of child #5, who was in care at the facility at the time of the inspection, was lacking the parental consents for emergency and for administration of minor first-aid procedures by facility staff medical care required prior to admission.

3270.182(3)/3270.182(5) · Corrected Jun 29, 2022

The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). Facility Person # 1 may not work in a child care position at the facility. A facility person's record shall include a copy of requests for the criminal history record and child abuse registry clearance information, a copy of the disclosure statement and a copy of the completed clearance information required under the CPSL. Facility Person # 1 may not work in a child care position at the facility.

At the time of the inspection the record of staff person # 1 , having worked at the facility for over 45 days, did not have the required FBI fingerprint clearance information following regulatory guidelines.

3270.32(a)/3270.192(4) · Corrected Jun 29, 2022

A facility person may not use any form of physical punishment, including spanking a child.

On 11/17/21 Staff member #1 was observed by staff members #2 and #3 "grabbing child #1 by the wrist" and pulling the child by the arm lifting them off of the floor.

3270.113(b) · Corrected Dec 10, 2021

Children on the facility premises and on facility excursions off the premises shall be supervised by a staff person at all times. Outdoor play space used by the facility is considered part of the facility premises. Children must be supervised at all times. The legal entity must arrange for all facility staff to receive a minimum of two hours of training regarding supervision of children. The legal entity must receive DHS approval of the training content prior to scheduling the training. facility person may not use any form of physical punishment, including spanking a child.

On 11/17/21 Staff member #1 was observed by staff members #2 and #3 "grabbing child #1 by the wrist" and pulling the child by the arm lifting them off of the floor.

3270.113(a)/3270.113(b) · Corrected Dec 10, 2021