3270.111(a) · A written plan of daily activities and routines, including a time for free play shall be established for each group. The plan shall be flexible to accommodate the needs of individual children and the dynamics of the group.

The Middle Infants Classroom lacked a written plan of daily activities and routines

Corrected Corrected by Oct 23, 2024

Marked corrected in the state record.

3270.52 · 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 approximately 1:10 PM, the fire alarm in the facility was activated. During the evacuation it was observed that Staff #2 was supervising 8 children including 2 older toddlers and 6 young toddlers.

Corrected Corrected by Oct 23, 2024

Category: supervision. Marked corrected in the state record.

3270.55(b) · Staff persons who are on duty but are not providing child care during naptime shall remain in the child care portion of the facility premises.

At approximately 1:10 PM, the fire alarm in the facility was activated. During the evacuation four staff who were on duty but were not providing childcare during naptime were observed reentering the facility premises after leaving the facility premise to purchase lunch. Due to the four staff leaving the premises, it was observed that Staff #2 was left out of ratio during the fire evacuation with 8 children including 2 older toddlers and 6 young toddlers.

Corrected Corrected by Oct 23, 2024

Category: ratio. Marked corrected in the state record.

3270.74 · 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.

The Preschool Readiness Classroom 3 lacked the telephone numbers of the nearest hospital, police department, fire department, ambulance and poison control center posted by the telephone.

Corrected Corrected by Oct 23, 2024

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

3270.75(c) · A first-aid kit must contain the following: soap, an assortment of adhesive bandages, sterile gauze pads, tweezers, tape, scissors and disposable, nonporous gloves.

The first aid kit located in the Preschool Classroom lacked sterile gauze pads.

Corrected Corrected by Oct 22, 2024

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

3270.102(g) · Children's toys and equipment, including furniture and rest equipment, described as hazardous by the United States Consumer Product Safety Commission may not be used by children at the facility and may not be on the premises at the facility. At the time of inspection, the operator shall submit to the Department written affirmation on a form provided by the Department stating that the facility is in compliance with this requirement.

In the Preschool Classroom there was a pillowcase that was ripped on three of the four corners and not in good repair. This pillowcase covered a vinyl pillow.

Corrected Corrected by Oct 22, 2024

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

3270.103 · Toys and objects with a diameter of less than 1 inch, objects with removable parts that have a diameter of less than 1 inch, plastic bags and styrofoam objects may not be accessible to children who are still placing objects in their mouths.

In the Young Toddler and the Preschool Classroom there were multiple rest mats that were ripped and had exposed foam. These items were accessible to the children in are who are still placing items in their mouths.

Corrected Corrected by Oct 23, 2024

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.

*At approximately 10:30 AM in the Preschool Classroom, Staff #3 identified 5 Preschool Aged children as part of their assigned group. At this time, Staff #4 identified 4 Preschool Aged children as part of their assigned group. Cert Rep observed 10 Preschool Aged children receiving care in the classroom, therefore leaving Child #9 not identified as being in an assigned primary group.

Corrected Corrected by Oct 28, 2024

Category: supervision. Marked corrected in the state record.

3270.113(a)(1) · **The director will conduct random assessments of each classroom at least 3 times per week, at various times of the day, for the next 2 months. During the assessment, the director will ask each staff person in each classroom to identify the children that are in their group, and are therefore, responsible for. The director will document all assessments in a log, including the date, time, staff persons, number and ages of children. The log must first be submitted to the Certification Representative. The completed logs will be made available to DHS representatives upon request.

**At approximately 10:30 AM in the Preschool Classroom, Staff #3 identified 5 Preschool Aged children as part of their assigned group. At this time, Staff #4 identified 4 Preschool Aged children as part of their assigned group. Cert Rep observed 10 Preschool Aged children receiving care in the classroom, therefore leaving Child #9 not identified as being in an assigned primary group.

Corrected Corrected by Dec 25, 2024

Category: recordkeeping. 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 Forms for Child #1, #3, #5, and #6 lacked the enrolling parents work address and telephone number.

Corrected Corrected by Oct 23, 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.

The Emergency Contact Form for Child #2 lacked the health insurance coverage policy number for the child.

Corrected Corrected by Oct 23, 2024

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

3270.124(c) · When children are in the facility, emergency contact information shall be present in a child care space for children receiving care in the space.

The Emergency Contact information was not present in the PreK Room for Child #7. The child was present and receiving care in the room.

Corrected Corrected by Oct 23, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.124(e) · A written plan identifying the means of transporting a child to emergency care and staffing provisions in the event of an emergency shall be displayed conspicuously in every child care space and shall accompany a staff person who leaves on an excursion with children.

The Preschool Readiness Classroom lacked a written plan identifying the means of transporting a child to emergency care and staffing provisions in the event of an emergency.

Corrected Corrected by Oct 23, 2024

Category: transportation. Marked corrected in the state record.

3270.131(b)(2)/3270.182(1) · The operator shall require the parent to provide an updated health report at least every 12 months for an older toddler or preschool child. A child's record shall contain initial and subsequent health reports.

Although the files for Child #4 and #5, preschool aged children, contained Health Reports at the time of the Renewal Inspection, it was observed that the Health Reports for Child #4 and #5 were updated in an interval greater than 12 months.

Corrected Corrected by Oct 22, 2024

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

3270.166(1) · A written statement giving the formula and feeding schedule for an infant shall be obtained from the parent.

The file for Child #8, an infant, lacked a written formula and feeding schedule obtained from the parent.

Corrected Corrected by Oct 23, 2024

Category: nutrition. Marked corrected in the state record.

3270.192(2)(iv) · A facility person's record shall include acceptable verification of experience, education or training is a transcript or a diploma or a letter signed by a representative of the experiential, educational or training entity.

The file for Staff #1 contained transcripts in a foreign language and therefore their credentials could not be determined.

Corrected Corrected by Nov 25, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.61(h) · The capacity established for an indoor space may not be exceeded.

At approximately 11:00 AM, 9 children were observed receiving care in the Preschool Readiness 2 Classroom space that has a designated maximum capacity of 8.

Corrected Corrected by Oct 23, 2024

Category: ratio. Marked corrected in the state record.

3270.65 · Protective receptacle covers shall be placed in electrical outlets accessible to children 5 years of age or younger.

In the Preschool Readiness Room an electrical outlet located on the wall in the dress up area was observed to lack one protective cover. In the Preschool Room an electrical outlet on the wall in the block area was observed to lack one protective cover.

Corrected Corrected by Oct 20, 2023

Marked corrected in the state record.

3270.75(c) · A first-aid kit must contain the following: soap, an assortment of adhesive bandages, sterile gauze pads, tweezers, tape, scissors and disposable, nonporous gloves.

In the Preschool Readiness Room the first-aid kit was observed to lack scissors.

Corrected Corrected by Oct 20, 2023

Marked corrected in the state record.

3270.106(a) · Individual, clean, age-appropriate rest equipment shall be provided for preschool, toddler and infant children as agreed between the child's parent and the operator. The rest equipment shall be labeled for the use of a specific child and used only by the specified child.

In the Young Toddler Room six mats used for sleeping were observed to not be labeled for the use of a specific child.

Corrected Corrected by Oct 20, 2023

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

3270.113(a) · 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.

*At approximately 10:25am in the Young Infant Room an 11-month-old infant was observed sleeping on a mat on the floor which was located on the outside of an 'L' shaped room divider made up of multiple column post panels, a solid plywood panel, and a see thru panel. Staff person #1 and Staff person #2 were observed to be inside the 'L' shaped room divider and given how they were positioned inside of the divider, the solid plywood panel on the room divider created a visual barrier impeding both staff's ability to adequately supervise the 11-month-old infant who was sleeping on the opposite side of the 'L' shaped room divider.

Corrected Corrected by Oct 20, 2023

Category: supervision. Marked corrected in the state record.

3270.113(a) · The operator will develop a layout of the infant room to include positioning of stationary staff, furniture placement, the divider and movement (if necessary) and rest equipment. This layout must allow for all staff in the room to see, hear, direct and assess each child in the room.

**At approximately 10:25am in the Young Infant Room an 11-month-old infant was observed sleeping on a mat on the floor which was located on the outside of an 'L' shaped room divider made up of multiple column post panels, a solid plywood panel, and a see thru panel. Staff person #1 and Staff person #2 were observed to be inside the 'L' shaped room divider and given how they were positioned inside of the divider, the solid plywood panel on the room divider created a visual barrier impeding both staff's ability to adequately supervise the 11-month-old infant who was sleeping on the opposite side of the 'L' shaped room divider.

Corrected Corrected by Dec 15, 2023

Category: supervision. Marked corrected in the state record.

3270.131(b)(1) · The operator shall require the parent to provide an updated health report at least every 6 months for an infant or young toddler.

The child file for Child #1, who is a young toddler, was observed to contain health reports that were conducted more than 6 months apart; those health report dates are dated 9/16/22 and 8/26/21. The child file for Child #2, who is a young toddler, was observed to contain health reports that were conducted more than 6 months apart; those health report dates are dated 9/21/22 and 2/15/22.

Corrected Corrected by Oct 20, 2023

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

3270.181(c) · 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.

The child file for Child #3 contained a current financial agreement and emergency contact form that were not reviewed and updated by the parent every 6 months. The dates of review for the financial agreement form were 8/7/23, 1/1/23, 8/8/22, 12/19/21 and for the emergency contact form were 8/6/23, 1/1/23, 8/8/22, 12/19/21.

Corrected Corrected by Oct 20, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.131(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.

The child file for Child #4, contained an initial health report that is dated more than 60 days after initial enrollment.

Corrected Corrected by Oct 20, 2023

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

3270.51 · When children are grouped in similar age levels, the following maximum child group sizes and ratios of staff persons apply: Infants 1:4 with a maximum group size of 8; Young toddlers 1:5 with a maximum group size of 10; Older toddlers 1:6 with a maximum group size of 12; Preschool children 1:10 with a maximum group size of 20; Young school-age children 1:12 with a maximum group size of 24; Older school-age children 1:15 with a maximum group size of 30.

According to staff statements, on 5/23/23 at approximately 11:00am, as Staff #1 and #2 transitioned their group of 8-9 young toddlers from the outside playground to return inside, Child #1 separated from the group and was eventually observed outside unsupervised and alone for an undetermined amount of time (3-4 minutes). At this time Staff: Child ratio was 0:1.

Corrected Corrected by May 23, 2023

Category: supervision. Marked corrected in the state record.

3270.113(a) · 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.

According to staff statements, on 5/23/23 at approximately 11:00am, as Staff #1 and #2 transitioned their group of 8-9 young toddlers from the outside playground to return inside, Child #1 separated from the group and was eventually observed outside unsupervised and alone for an undetermined amount of time (3-4 minutes).

Corrected Corrected by May 23, 2023

Category: supervision. 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.

According to staff statements, on 5/23/23 at approximately 11:00am, as Staff #1 and #2 transitioned their group of 8-9 young toddlers from the outside playground to return inside, Child #1 separated from the group and was eventually observed outside unsupervised and alone for an undetermined amount of time (3-4 minutes).

Corrected Corrected by May 23, 2023

Category: supervision. Marked corrected in the state record.

3270.113(a)(1) · **Director must arrange for staff to complete the following trainings from Better Kid Care: Infant-Toddler Care: Quality Supervision, Supervision: Counting Children, Supervision: Moving Children, and Supervision: Playground Supervision. Proof of training will be submitted upon completion and may be counted towards annual training hours. Compliance will be verified through an unannounced inspection.

*According to staff statements, on 5/23/23 at approximately 11:00am, as Staff #1 and #2 transitioned their group of 8-9 young toddlers from the outside playground to return inside, Child #1 separated from the group and was eventually observed outside unsupervised and alone for an undetermined amount of time (3-4 minutes).

Corrected Corrected by May 31, 2023

Category: supervision. Marked corrected in the state record.

3270.131(b)(1)/3270.182(1) · The operator shall require the parent to provide an updated health report at least every 6 months for an infant or young toddlerA child's record shall contain initial and subsequent health reports.

The child file for Child #1, who was a young toddler at the time, was observed to contain an updated health report dated 9/21/22 which was conducted more than 6 months from the previously dated 7/29/21 health report on file.

Corrected Corrected by Oct 11, 2022

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).

The staff file for Staff person #1 contained current mandated reporter training dated 7/21/21 which was not renewed within 60 months from the previously existing mandated reporter certificate dated 1/23/16.

Corrected Corrected by Oct 11, 2022

Category: recordkeeping. Marked corrected in the state record.

3270.131(b)(2)/3270.182(1) · The operator shall require the parent to provide an updated health report at least every 12 months for an older toddler or preschool child.A child's record shall contain initial and subsequent health reports.

The child file for Child #2, who is a preschool aged child, was observed to lack an updated health report; the most recent health report on file is dated 5/27/21.

Corrected Corrected by Oct 13, 2022

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

3270.135(a)(3) · If disposable diapers are provided by a parent or by a facility, a soiled diaper shall be discarded by immediately placing the diaper into a plastic-lined, hands-free covered can.

In the Young Toddler room, at approximately 11:20am, a soiled diaper was observed on top of the changing table and had not been immediately discarded into a plastic-lined hands-free covered can.

Corrected Corrected by Oct 11, 2022

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

3270.181(c) · 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.

The child file for Child #3 contained a financial agreement form that was not reviewed and updated by the parent at least once in a 6-month period; the dates of the two most recent updates were 8/22/22 and 1/31/20 for the financial agreement

Corrected Corrected by Oct 11, 2022

Category: recordkeeping. Marked corrected in the state record.

3270.31(f)/3270.31(f)(10) · Staff persons shall complete professional development in the following topics within 90 days of hire: Pediatric first aid and pediatric cardiopulmonary resuscitation.

The file for staff person #1, with a start date of 1-6-21, had pediatric first-aid and CPR training dated 7-11-21 that was over 90 days after their start date.

Corrected Corrected by Oct 26, 2021

Category: health medication. 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.

In the pre-K 1 room, there were multiple sleep mats with tears in multiple areas that exposed the stuffing inside.

Corrected Corrected by Oct 21, 2021

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

3270.103 · Toys and objects with a diameter of less than 1 inch, objects with removable parts that have a diameter of less than 1 inch, plastic bags and styrofoam objects may not be accessible to children who are still placing objects in their mouths.

In the middle infant room, there were two sleep mats with tears in multiple areas that exposed the stuffing inside and had small pieces coming apart that were less than 1 inch in diameter and were accessible to children who are still placing objects in their mouths. On the outdoor toddler play space, the poured-in-place surface had multiple areas with loose beads coming apart from the surface that were less than 1 inch in diameter and were accessible to children who are still placing objects in their mouths.

Corrected Corrected by Oct 21, 2021

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

3270.27(a)(5) · The facility shall have an emergency plan that provides for accommodations for infants, toddlers, children with disabilities, and children with chronic medical conditions.

The facility's emergency plan lacked a plan that provides for accommodations for infants and toddlers.

Corrected Corrected by Oct 19, 2021

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