3270.113(a)(1) · Each staff person shall be assigned the responsibility for supervision of specific children. The staff person shall know the names and whereabouts of the children in his assigned group. The staff person shall be physically present with the children in his group on the facility premises and on facility excursions off the facility premises.

While assessing supervision and ratio during an unannounced monitoring inspection on 8/3/23, there were 20 YSA children in the room. Staff person #1 named 7 children; Staff person #2 named 6 children; and Staff person #3 named 6 children, leaving Child #1 unnamed by any staff person. RECITED FROM SIN-00226687: While assessing supervision-ratio at inspection on 6/29/23, 3 staff persons were observed with a group of 27 school-age children. Staff person #1 named 9 children, Staff person #2 named 8 children, and Staff person #3 named 9 children, leaving 1 child unaccounted for.

Corrected Corrected by Aug 9, 2023

Category: supervision. Marked corrected in the state record.

3270.31(f) · Staff persons shall complete professional development within 90 days of hire as listed in subsections (f)1-10.

Staff person #4 did not complete the following required pre-service training within 90 days of their date of hire (see LIS code sheet): (Get Started with Center-Based Care; Building Blocks for Quality); the training was completed on 4/13/23. Staff person #2 did not complete the following required pre-service training within 90 days of their date of hire (see LIS code sheet): (Pediatric First Aid/CPR); the training was completed on 5/16/23.

Corrected Corrected by Jul 7, 2023

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

3270.32(a) · The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services).

Staff person #4 did not complete the mandated reporter training within 90 days of their date of hire (see LIS code sheet); the training was completed on 4/13/23.

Corrected Corrected by Jul 7, 2023

Category: recordkeeping. 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). 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.

The file for Staff person #5 includes FBI clearances dated 6/26/18 and 6/27/23, more than 60 months apart. The file for Staff person #6 includes Child Abuse clearances dated 9/17/15 and 10/14/20, more than 60 months apart.

Corrected Corrected by Jul 7, 2023

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

3270.102(a) · Toys, play equipment and other indoor and outdoor equipment used by the children shall be clean, in good repair and free from rough edges, sharp corners, pinch and crush points, splinters and exposed bolts.

There were several broken ball and socket linking toys that had rough edges.

Corrected Corrected by Jun 29, 2023

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

3270.113(a)(1) · Each staff person shall be assigned the responsibility for supervision of specific children. The staff person shall know the names and whereabouts of the children in his assigned group. The staff person shall be physically present with the children in his group on the facility premises and on facility excursions off the facility premises.

While assessing supervision-ratio at inspection on 6/29/23, 3 staff persons were observed with a group of 27 school-age children. Staff person #1 named 9 children, Staff person #2 named 8 children, and Staff person #3 named 9 children, leaving 1 child unaccounted for.

Corrected Corrected by Jun 29, 2023

Category: supervision. Marked corrected in the state record.

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

The agreement on file for Child #1 does not include the child's arrival time, and the agreement on file for Child #3 does not include the child's departure time.

Corrected Corrected by Jul 7, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.123(a)(6)/3270.182(2) · An agreement shall specify the date of the child's admission. A child's record shall contain the dates of application, admission and withdrawal of the child.

The agreement on file for Child #2, Child #4, and Child #6 does not include the child's date of admission.

Corrected Corrected by Jul 7, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.124(b)(2) · Emergency contact information must include the name, address and telephone number of the child's physician or source of medical care.

The emergency contact form on file for Child #5 does not include the address for the child's pediatrician or source of medical care.

Corrected Corrected by Jul 7, 2023

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

3270.151(a)/3270.192(3) · A facility person providing direct care who comes into contact with the children or who works with food preparation shall have a health assessment conducted within 12 months prior to providing initial service in a child care setting and every 24 months thereafter. A health assessment is valid for 24 months following the date of signature, if the person does not contract a communicable disease or develop a medical problem. A facility person's record shall include a written report of initial and subsequent health assessments, including the results of initial and subsequent tuberculin skin tests, x-rays or other medical documentation necessary to confirm freedom from communicable tuberculosis.

The 2 most recent health assessments on file for Staff person #6 are dated 8/14/20 and 8/30/22, more than 24 months apart.

Corrected Corrected by Jul 7, 2023

Category: ratio. Marked corrected in the state record.

3270.151(c)(3)/3270.192(3) · An adult health assessment must include an examination for communicable diseases and the results of that examination. A facility person's record shall include a written report of initial and subsequent health assessments, including the results of initial and subsequent tuberculin skin tests, x-rays or other medical documentation necessary to confirm freedom from communicable tuberculosis.

The current health assessment on file for Staff person #7 indicates that the staff person has a communicable/contagious disease, with no additional information given.

Corrected Corrected by Jul 25, 2023

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.

The file for Staff person #7 includes only 1 written nonfamily reference.

Corrected Corrected by Jul 20, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.131(a)/3270.182(1) · 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. A child's record shall contain initial and subsequent health reports.

The initial health assessment on file for Child #3, with an enrollment date of 6/19/23, is not dated by the examining health care provider, making it invalid.

Corrected Corrected by Jul 31, 2023

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

3270.133(5) · Medication shall be stored in accordance with the manufacturer's or health professional's instructions on the original label.

There was a bottle of Benadryl labeled for use by a specific child which had an expiration date of 12/2020.

Corrected Corrected by Jun 28, 2022

Category: ratio. Marked corrected in the state record.

3270.131(c) · A health report must be written and signed by a physician, physician's assistant or a CRNP. The signature must include the individual's professional title.

The current health assessment on file for Child #3 does not include the date that the doctor signed the form, making it invalid.

Corrected Corrected by Aug 5, 2022

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

3270.31(f) · Staff persons shall complete professional development in the topics of 3270.31(f)(10) within 90 days of hire. Staff person #2, #8 must do one of the following: provide documentation that the trainer has become PQAS-certified or at least is on the waiting list, request the instructor provide documentation, such as their Pediatric First-Aid/CPR Instructor Card from the PQAS-approved organization or the approved curriculum organization, that the instructor is approved to offer Pediatric First-Aid/CPR training on behalf of their organization, or receive pediatric first-aid/CPR training in an approved curriculum by a PQAS-certified trainer.

Staff persons #2, #8 have acceptable pediatric first aid/CPR training in an approved curriculum; however, the trainer has not provided documentation that they are PQAS-certified in that training topic.

Corrected Corrected by Aug 24, 2022

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

3270.133(2) · A staff person shall administer a prescription medication only if written instructions are provided from the individual who prescribed the medicine. Instructions for administration contained on a prescription label are acceptable.

There was an EpiPen on site labeled for use by a specific child that did not include the instructions for administration from the individual who prescribed the medication.

Corrected Corrected by Jul 5, 2022

Category: ratio. Marked corrected in the state record.

3270.31(f) · Staff person(s) shall complete professional development in the topics of 3270.31(f)(1 -- 10) within 90 days of hire. Staff person #2, #4 , #5, #6 will have until 8/20/22 to complete the required training. Until such time as the required training has been completed, staff person #2, #4, #5, #6 must be supervised, when interacting with children, by an AGS or higher, who has completed the required training related to this citation. If there are no staff available to supervise staff person #2, #4, #5, #6, staff person #2, #4, #5, #6 may not work in a child-care position at the facility.

Staff person #2, #4, #5, #6 have not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): Get Started with Center-based Care: Building Blocks For Quality.

Corrected Corrected by Aug 20, 2022

Category: supervision. 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). 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 #7 may not work in a child care position at the facility.

The child abuse clearance on file for staff person #7 was obtained for volunteer purposes(See IS CODE SHEET) making it invalid under the CPSL.

Corrected Corrected by Aug 5, 2022

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

3270.33(a)/3270.192(2)(ii) · A staff person or a substitute staff person shall meet one of the applicable staff qualifications for the position in which the person is performing.A facility person's record shall include verification of child care experience, education and training prior to service at the facility.

The file for Staff person #6, classified as a group supervisor, does not include a bachelor's degree in education or a related human services field; a bachelor's degree including 30 credit hours in education or a human services field and 1 year of experience with children; or an associate's degree in education, or a related human services field and 2 years of experience with children; or an associate's degree, including 30 credit hours in education or a related human services field and 3 years of experience with children. The file for Staff person #8, classified as a director, does not include a bachelor's degree in education, or a related human services field, and 1 year of experience with children; or a bachelor's degree, including 30 credit hours in education or a related human services field and 2 years of experience with children; or an associate's degree in education or a related human services field and 3 years of experience with children; or an associate's degree in education or a related human services field and 4 years of experience with children.

Corrected Corrected by Aug 10, 2022

Category: supervision. Marked corrected in the state record.

3270.124(b)(2) · Emergency contact information must include the name, address and telephone number of the child's physician or source of medical care.

The emergency contact form on file for Child #1 does not include the address for the child's physician/source of medical care.

Corrected Corrected by Aug 10, 2022

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

3270.124(b)(3) · Emergency contact information must include the home and work addresses and telephone numbers of the enrolling parent.

The emergency contact form on file for Child #2 does not include the telephone number for the enrolling parent.

Corrected Corrected by Aug 10, 2022

Category: recordkeeping. 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.

The emergency contact form on file for Child #2 does not include the complete address for all listed release persons.

Corrected Corrected by Aug 10, 2022

Category: recordkeeping. Marked corrected in the state record.

3270.151(a)/3270.192(3) · A facility person providing direct care who comes into contact with the children or who works with food preparation shall have a health assessment conducted within 12 months prior to providing initial service in a child care setting and every 24 months thereafter. A health assessment is valid for 24 months following the date of signature, if the person does not contract a communicable disease or develop a medical problem.A facility person's record shall include a written report of initial and subsequent health assessments, including the results of initial and subsequent tuberculin skin tests, x-rays or other medical documentation necessary to confirm freedom from communicable tuberculosis.

The 2 most recent health assessments on file for Staff person #1 are dated 6/5/18 and 6/7/21, more than 24 months apart.

Corrected Corrected by Aug 10, 2020

Category: ratio. Marked corrected in the state record.

3270.31(e)/3270.192(2)(iii) · A staff person shall obtain an annual minimum of 12 clock hours of child care training.A facility person's record shall include verification of child care experience, education and training following the outset of service at the facility.

The file for Staff person #3 does not include verification of 12 hours of annual training between 12/19/20-12/19/21, as per Announcement C-21-09.

Corrected Corrected by Aug 10, 2022

Category: recordkeeping. Marked corrected in the state record.

3270.31(e)(4)(i) · Competence is the completion of training by a professional in the field of first-aid and cardiopulmonary resuscitation (CPR). All staff persons shall renew their certification in pediatric first aid and pediatric cardiopulmonary resuscitation (CPR) on or before the expiration of the most current certification.

The staff file for Staff person #2 contained first-aid training dated 5/18/21 which did not indicate that it was pediatric first-aid. The staff file for Staff person #3, Staff person #4, and Staff person #6 lacked valid pediatric first-aid training; the first-aid training on file was an online only training which is not accepted.

Corrected Corrected by Sep 16, 2021

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 #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.

The staff file for Staff person #1 lacked documentation of having applied for and received a State criminal history check, a State sex offender registry check, and a State child abuse and neglect registry check from the State in which they resided in within the previous five years as required by the Child Protective Service Law (CPSL). The staff file for Staff person #3, who has a start date working with children of 3/17/19, contained an NSOR certificate dated 8/17/20 which was not on file by 7/1/20 as required by CPSL. The staff file for Staff person #4, who has a start date working with children of 8/29/11, contained an NSOR certificate dated 9/23/20 which was not on file by 7/1/20 as required by CPSL.

Corrected Corrected by Sep 16, 2021

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.

The staff file for Staff person #5 lacked a staff evaluation for 2020; the dates of the last two staff evaluations on file were 6/5/19 and 6/3/21.

Corrected Corrected by Aug 5, 2021

Category: recordkeeping. 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.

The child file for Child #1 contained an emergency contact form that lacked the name, address and telephone numbers of the individuals designated by the parent to whom the child may be released.

Corrected Corrected by Aug 5, 2021

Category: recordkeeping. Marked corrected in the state record.

3270.182(3) · A child's record shall contain signed parental consent for emergency medical care for the child. Written consent is required prior to admission.

The child file for Child #1 contained an emergency contact form that lacked signed parental consent for emergency medical care for the child.

Corrected Corrected by Aug 5, 2021

Category: recordkeeping. Marked corrected in the state record.

3270.182(5) · 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.

The child file for Child #1 contained an emergency contact form that lacked signed parental consent for administration of minor first-aid.

Corrected Corrected by Aug 5, 2021

Category: ratio. Marked corrected in the state record.

3270.182(6) · A child's record shall contain signed parental consent for transportation, walking excursions, swimming and wading.

The child file for Child #1 contained an emergency contact form that lacked signed parental consent for transportation, walking excursions, swimming and wading.

Corrected Corrected by Aug 5, 2021

Category: transportation. Marked corrected in the state record.