3270.76 · Floors, walls, ceilings and other surfaces, including the facility's outdoor play space surfaces shall be kept clean, in good repair and free from visible hazards.

Observed 8/13/2024 there was paint chipped and damaged on the wall exiting the older and younger toddler's room.

Corrected Corrected by Aug 13, 2024

Category: physical safety. Marked corrected in the state record.

3270.14/3270.21 · A facility shall be operated in conformity with applicable Federal and State laws and regulations.State agencies whose regulations may relate to the operation of a facility include the Department of Environmental Resources, the Department of Labor and Industry, the Department of Health, the Department of Education and the Department of Transportation. Conditions at the facility may not pose a threat to the health or safety of the children.

Observed 8/13/2024 staff #3 file did not complete the one-hour health and safety training course update for staff members hired or have taken the health and safety course prior to 10/4/2022.

Corrected Corrected by Aug 18, 2024

Category: ratio. Marked corrected in the state record.

3270.32(a)/3270.192(4) · The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). LACKING REQUIRED HIRING DOCUMENTS: Facility Person # 2 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 #-2 may not work in a child care position at the facility.

Observed 8/13/2024 The file for staff # 2 not contain a completed DHS required Child Abuse and State Police clearance. The requirement to have the completed DHS required clearances on file was not met.

Corrected Corrected by Aug 13, 2024

Category: background checks. Marked corrected in the state record.

3270.34(a)(6) · A director is responsible for written evaluation of staff persons on a regular basis, a minimum of one evaluation every 12 months.

Observed 8/13/2024 staff #4 file did not contain written evaluation from the director.

Corrected Corrected by Aug 13, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.107 · A facility shall have an operable, clean refrigerator used to store potentially hazardous foods. The refrigerator shall be capable of maintaining food at 45° F or below. An operating thermometer shall be placed in the refrigerator.

Observed 8/13/2024 the operating thermometer in the refrigerator read at a temperature of 55° F above the 45° F level.

Corrected Corrected by Aug 13, 2024

Category: nutrition. Marked corrected in the state record.

3270.113(e) · A facility person may not restrain a child by using bonds, ties or straps to restrict a child's movement or by enclosing the child in a confined space, closet or locked room. The prohibition against restraining a child does not apply to the use of adaptive equipment prescribed for a child with special needs.

Observed 8/13/2024 Staff #2 had child # 1, 2 and 3 restraints to highchairs during non-feeding times.

Corrected Corrected by Aug 13, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.123(a)(4) · An agreement shall specify the child's arrival and departure times.

Observed 8/13/2024 child #5 agreement form did not specify the child's arrival and departure times.

Corrected Corrected by Aug 13, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.123(a)(5) · An agreement shall specify the persons designated by a parent to whom the child may be released.

Observed 8/13/2024 child #4 agreement form did not specify the persons designated by a parent to whom the child may be released.

Corrected Corrected by Sep 1, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.124(b)(6) · Emergency contact information must include health insurance coverage and policy number for a child under a family policy or Medical Assistance benefits, if applicable.

Observed 8/13/2024 child #5 health insurance coverage and policy number were missing from the emergency contact form.

Corrected Corrected by Aug 19, 2024

Category: health medication. Marked corrected in the state record.

3270.124(f)/3270.181(c) · The parent shall update in writing emergency contact information once in a 6-month period or as soon as there is a change in the information. A parent is required to review and update the emergency contact information and the financial agreement at least once in a 6-month period or as soon as there is a change in the information.

Observed 6/18/2024 Child # 6 file was missing a periodic review and update on their emergency contact form.

Corrected Corrected by Aug 13, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.131(b)(2) · The operator shall require the parent to provide an updated health report at least every 12 months for an older toddler or preschool child.

Observed 8/13/2024 child #6 was missing an updated health report on file, the current health report on file was dated 6/14/2023.

Corrected Corrected by Aug 13, 2024

Category: health medication. Marked corrected in the state record.

3270.151(c)(2) · An adult health assessment must include tuberculosis screening by the Mantoux method at initial employment. Subsequent tuberculosis screening is not required unless directed by a physician, physician's assistant, CRNP, the Department of Health or a local health department.

Observed 8/13/2024 staff #1 health assessment did not include a tuberculosis screening by the Mantoux method nor the results of it by physician, physician's assistant, CRNP, the Department of Health or a local health department.

Corrected Corrected by Aug 13, 2024

Category: health medication. Marked corrected in the state record.

3270.151(c)(3) · An adult health assessment must include an examination for communicable diseases and the results of that examination.

Observed 8/13/2024 staff #4 and 5 health assessment did not include an examination for communicable diseases and the results of that examination.

Corrected Corrected by Aug 13, 2024

Category: health medication. Marked corrected in the state record.

3270.192(5) · A facility person's record shall include two written, nonfamily references from individuals attesting to the person's suitability to serve as a facility person.

Observed 8/13/2024 staff #4 file did not contain two written, nonfamily references from individuals attesting to the person's suitability to serve as a facility person.

Corrected Corrected by Aug 13, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.31(e) · A staff person shall obtain an annual minimum of 12 clock hours of child care training.

Observed 8/13/2024 Staff #1 was missing 12 hours from their annual 12 hours of childcare training.

Corrected Corrected by Aug 13, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.124(b)(6) · Emergency contact information must include health insurance coverage and policy number for a child under a family policy or Medical Assistance benefits, if applicable.

Observed 8/14/2023 child #1 file health insurance coverage policy number were missing from emergency contact from.

Corrected Corrected by Aug 14, 2023

Category: health medication. Marked corrected in the state record.

3270.124(b)(7) · Emergency contact information must include the name, address and telephone number of the individual designated by the parent to whom the child may be released.

Observed 8/14/2023 child file # 2 emergency contact form were missing the addresses of the individual designated by the parent to whom the child may be released.

Corrected Corrected by Aug 14, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.131(e)/3270.131(e)(2)(i) · The facility may not accept or retain an infant 2 months of age or older, a toddler or a preschool child at the facility for more than 60 days following the first day of attendance at the facility unless the parent provides written verification from a physician, physician's assistant, CRNP, the Department of Health or a local health department of the dates (month, day and year) the child was administered immunizations in accordance with the recommendations of the ACIP. Exemption from immunization for religious belief or strong personal objection equated to a religious belief shall be documented by a written, signed and dated statement from the child's parent or guardian. The statement shall be kept in the child's record.

Observed On 8/14 /2023 observed child # 3 file did not contain an exemption letter for the influenza vaccination not completed in accordance with the schedule recommended by the ACIP.

Corrected Corrected by Aug 17, 2023

Category: health medication. Marked corrected in the state record.

3270.151(c)(3)/3270.151(c)(4) · An adult health assessment must include an examination for communicable diseases and the results of that examination. An adult health assessment must include information on medical problems that might threaten the health of the children or prohibit a staff person from providing adequate care to children.

On 8/14/2023 staff #1 and #2 health assessments did not contain an examination for communicable diseases and the results of that. The health assessments also did not include information on medical problems that might threaten the health of the children or prohibit a staff person from providing adequate care to children.

Corrected Corrected by Aug 18, 2023

Category: health medication. Marked corrected in the state record.

3280.52(c)/3280.113(a)(2) · 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 at §3280.52(b). The requirement for supervision on and off the facility premises includes compliance with the staff:child ratio requirements in §§ 3280.51--3280.53.

Observed on 5/31/2023 Continue non-compliance observed on 5/4/2023. Staff #1 was observed supervising 7 children alone (youngest age 1 and oldest 5) in Room #1. Staff 2 and Volunteer #1 and were in compliance in room #2 with 2 children.

Corrected Corrected by May 31, 2023

Category: supervision. Marked corrected in the state record.

3280.52(a)(1) · A primary staff person shall be present in a facility when six or fewer children are in care, unless the staff-child ratio specified in §3280.52(b) or (c) requires a second or third staff person.

Observed 5/4/2023 Staff #1 was supervising 9 children alone with a volunteer without a second or third staff member present.

Corrected Corrected by May 4, 2023

Category: supervision. Marked corrected in the state record.

3280.52(c)/3280.113(a) · 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 at §3280.52(b). 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.

Observed 5/4/2023 Volunteer #2 was supervising 4 children alone in another room without the supervision of staff #1. In total staff #1 had a ratio of supervising 1:9 children. Ratio of the youngest child in the group determines the staff ratio which should have been 1:6.

Corrected Corrected by May 4, 2023

Category: supervision. Marked corrected in the state record.

3280.65 · Protective receptacle covers shall be placed in electrical outlets accessible to children 5 years of age or younger.

Observed 12/19/2022 the Pre-school childcare space there were missing electrical outlet covers.

Corrected Corrected by Dec 19, 2022

Category: physical safety. Marked corrected in the state record.

3280.66(a) · Cleaning materials and other toxic materials shall be stored in an original labeled container or in a container that specifies the content. Toxics shall be kept in a locked area or in an area inaccessible to children, and shall be stored away from food, food preparation areas and child care spaces.

Observed 12/19/2022 in the bathroom there were Clorox disinfectant wipes on top of the toilet not locked in an area where it can be inaccessible to children.

Corrected Corrected by Dec 19, 2022

Category: ratio. Marked corrected in the state record.

3280.123(a) · An agreement shall be signed by the operator and the parent.

Observed 12/19/2022 child# 2 & 3 file was missing signatures on the agreement form.

Corrected Corrected by Jan 14, 2023

Category: recordkeeping. Marked corrected in the state record.

3280.123(a)(1) · An agreement shall specify the amount of the fee to be charged per day or per week.

Observed 12/19/2022 child# 2 and 3 agreement did not specify the amount of the fee to be charged per day or per week.

Corrected Corrected by Jan 14, 2023

Category: recordkeeping. Marked corrected in the state record.

3280.123(a)(4) · An agreement shall specify the child's arrival and departure times.

Observed 12/19/2022 Child # 2 agreement did not specify the child's arrival and departure times.

Corrected Corrected by Jan 14, 2023

Category: recordkeeping. Marked corrected in the state record.

3280.123(a)(5) · An agreement shall specify the persons designated by a parent to whom the child may be released.

Observed 12/19/2022 child# 2, 3, and 4 agreement form did not specify the persons designated by a parent to whom the child may be released.

Corrected Corrected by Jan 14, 2023

Category: recordkeeping. Marked corrected in the state record.

3280.123(a)(6) · An agreement shall specify the date of the child's admission.

Observed 12/19/2022 child # 6 agreement did not specify the date of the child's admission.

Corrected Corrected by Jan 14, 2023

Category: recordkeeping. Marked corrected in the state record.

3280.124(b)(6) · Emergency contact information must include health insurance coverage and policy number for a child under a family policy or Medical Assistance benefits, if applicable.

Observed 12/19/2022 child # 2,3, and 4 emergency contact did not include the policy number for the health insurance coverage.

Corrected Corrected by Jan 14, 2023

Category: health medication. Marked corrected in the state record.

3280.124(b)(7) · Emergency contact information must include the name, address and telephone number of the individual designated by the parent to whom the child may be released.

Observed 12/19/2022 child #3 and 4 emergency contact were missing addresses and telephone number of the individual designated by the parent to whom the child may be released.

Corrected Corrected by Jan 14, 2023

Category: recordkeeping. Marked corrected in the state record.

3280.166(4) · Disposable nursers and bottles shall be labeled with the child's name.

Observed 12/19/2022 there were cups and bottles unlabeled with children's names to identify which cup/bottle belong to which child.

Corrected Corrected by Dec 19, 2022

Marked corrected in the state record.

3280.131(a) · The operator shall require the parent of an enrolled child, including a child, a foster child and a relative of an operator or a facility person, to provide an initial health report no later than 60 days following the first day of attendance at the facility.

Observed 12/19/2022 child # 1 file was missing an initial health report in file, child's admissions and first day of attendance was 9/4/2022.

Corrected Corrected by Jan 14, 2023

Category: health medication. Marked corrected in the state record.

3280.67(d) · Trash that has been contaminated by human secretions or excrement shall be contained in closed, plastic-lined receptacles.

Observed 8/18/2022 in bathroom, trash can was contaminated with human secretions and did not contain a plastic-lined inside.

Corrected Corrected by Aug 18, 2022

Marked corrected in the state record.

3280.74 · The telephone number of the nearest hospital, police department, fire department, ambulance and poison control center shall be posted by each telephone in the facility.

Observed 8/18/2022 emergency telephone numbers were not posted in the facility near a telephone.

Corrected Corrected by Aug 19, 2022

Category: physical safety. Marked corrected in the state record.