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

Staff person #6 completed Health and Safety training on 3/6/25, which was not done within 90 days of employment.

Corrected Corrected by Mar 27, 2025

Category: health medication. 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. Until Pediatric CPR/First aid is completed and on file, staff #2 must be supervised by a qualified staff (AGS or higher with all trainings completed) at all times. If there is no staff to supervise staff #2, Staff #2 may not work in a child care position.

Staff #2 had Pediatric CPR/First Aide dated 2/3/23 but did not have an updated training on file.

Corrected Corrected by Mar 26, 2025

Category: supervision. Marked corrected in the state record.

3270.31(e)(4)(ii) · Staff persons shall participate, at least annually, in firesafety training conducted by a fire protection professional. Staff persons and volunteers shall receive training in maintenance of smoke detectors, the duties of facility persons during a fire drill and during a fire and the use of the facility's fire extinguishers, not including discharge of the fire suppressant agent.

Staff #3, #4, #5, #8, and #9 did not have updated fire Safety training on file.

Corrected Corrected by Mar 31, 2025

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).. LACKING REQUIRED HIRING DOCUMENTS: Facility Person # 1, 3, 4 may not work in a child care position at the facility. PROVISIONAL HIRE UNSUPERVISED: A provisional employee may not be permitted to work alone with children and must work within the vicinity of a permanent employee. 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, 3, 4 may not work in a child care position at the facility.

Staff #1 was observed to need out of state clearances, which were missing from the staff's file. Staff number 1 had a child abuse clearance dated 3/18/25, which was received after staff #1 was observed working in a child care position. Staff #1 was observed to be missing a completed disclosure statement and NSOR clearance. Staff #1 may not work in a child care position until staff #1 receives their NSOR, out of state clearances, and has a completed disclosure statement on file. Staff #4 did not have a completed FBI clearance on file. Document on file was a notification to the provider that staff #4 had applied for the FBI clearance, however results of the FBI clearance were not on file for staff #4.

Corrected Corrected by Mar 27, 2025

Category: supervision. Marked corrected in the state record.

3270.51/3270.113(a)(1) · 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. IF USING TIERED LIS: The required staff:child ratios must be maintained at all times. The legal entity must submit documentation in a format approved by DHS proving that the facility is maintaining the required staff:child ratios at all times. The legal entity will confirm continuing compliance by sending copies of the documentation to the -------- Region Office on a weekly basis for a period of three months after DHS approves the documentation format. 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.

When asked to identify primary care groups, Staff #1 identified their group as having 15 children. Staff #7 identified their care group as having 16 children. Both of which were larger than allowed by ratios.

Corrected Corrected by Mar 28, 2025

Category: supervision. Marked corrected in the state record.

3270.111(b) · The written plan of daily activities shall be posted in the group space.

Posted daily activities of the facility were observed to be missing from the facility.

Corrected Corrected by Mar 31, 2025

Category: physical safety. 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.

Emergency contact form was missing a section that indicated the address for the child's physician or source of medical care. Child #1, #2, #3, #4, and #5 were missing the address for the child's physician/source of medical care.

Corrected Corrected by Mar 31, 2025

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.

Emergency contact form on file did not have a section to list the parents work address. Child #1, #2, #3, #4 and #5 were missing the parents work address on the emergency contact form

Corrected Corrected by Mar 31, 2025

Category: recordkeeping. Marked corrected in the state record.

3270.124(b)(4)/3270.182(3) · Emergency contact information must include the written consent signed by a parent for emergency medical care. A child's record shall contain signed parental consent for emergency medical care for the child. Written consent is required prior to admission.

There was no signed parental consent for emergency medical care listed for child #2

Corrected Corrected by Mar 31, 2025

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.

Emergency contact form did not include a section to list the address for persons to whom the child can be released. Child #1, #2, #3, #4, and #5 were missing the address for the persons to whom the child can be released on the emergency contact form.

Corrected Corrected by Mar 31, 2025

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.

Staff #1 did not have a health assessment completed and on file prior to employment

Corrected Corrected by Mar 27, 2025

Category: ratio. 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.

Staff #1 did not have a TB screening completed prior to employment.

Corrected Corrected by Mar 27, 2025

Category: health medication. 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.

Parental consent for administration of minor first-aid procedures was missing for child #2.

Corrected Corrected by Mar 31, 2025

Category: ratio. 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.

Emergency plan on file did not provide for accommodations for infants, toddlers, children with disabilities, and children with chronic medical conditions.

Corrected Corrected by Mar 31, 2025

Category: recordkeeping. Marked corrected in the state record.

3270.31(f)(10) · Staff persons shall complete professional development in pediatric first aid and pediatric cardiopulmonary resuscitation within 90 days of hire. Staff person(s) shall complete professional development in the topics of 3270.31(f)(10) within 90 days of hire. Staff person #6 will have until 4/4/25 to complete the required training. Until such time as the required training has been completed, staff person #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 #6, staff person #6 may not work in a child-care position at the facility.

Staff person #6 has not completed the following required pre-service training within 90 days of their date of hire: Pediatric CPR/First Aid

Corrected Corrected by Mar 27, 2025

Category: supervision. Marked corrected in the state record.

3270.27(a)(1) · The facility shall have an emergency plan that provides for accommodations for shelter of children during an emergency including lock-down, shelter in place at the facility and shelter at locations away from the facility premises.

Facilities Emergency Plan on file did not list the shelter in place procedure in the event of an emergency.

Corrected Corrected by Mar 27, 2025

Category: recordkeeping. Marked corrected in the state record.

3270.27(a)(2) · The facility shall have an emergency plan that provides for accommodations for evacuation of children from the facility building and evacuation of children to a location away from the facility premises. The evacuation routes and evacuation plans to exit the building may be the same as those required by §3270.94 (relating to fire drills).

Emergency Plan on file did not list the procedure for evacuation in the event of an emergency.

Corrected Corrected by Mar 27, 2025

Category: recordkeeping. Marked corrected in the state record.

3270.21/3270.31(f) · Conditions at the facility may not pose a threat to the health or safety of the children. Staff persons shall complete professional development within 90 days of hire as listed in subsections (f)1-10. Staff person(s) shall complete professional development in the topics of 3270.31(f)(1 -- 10) within 90 days of hire. Listed delinquent staff persons will have 15 days from POC requested date to complete the required training. Until such time as the required training has been completed, listed staff persons must be supervised, when interacting with children, by an AGS level or higher staff member who has completed the required training related to this citation. If there are no staff available to supervise listed staff persons, listed staff persons may not work in a child-care position at the facility.

Records for Staff #5, #7, #8 and #9 did not contain evidence of the 10-hour health and safety training, or the one-hour update, if applicable. (Staff #5 had the update, but not the 10-hour training.) Records for Staff #1, #2, #3 did not contain evidence of the one-hour update required by the health and safety training on file.

Corrected Corrected by Mar 28, 2024

Category: supervision. Marked corrected in the state record.

3270.31(e)(4)(i)/3270.31(f)(10) · 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. Staff persons shall complete professional development in pediatric first aid and pediatric cardiopulmonary resuscitation within 90 days of hire.

Records for Staff # 7 and #9 did not contain evidence of completed approved CPR/1st Aid, within the 90-day requirement (Staff #7 - DOH: 08/28/2023, Staff #9 - DOH: 09/22/2023). Staff #8 does not have evidence of completed training on file within 90 days of hire. (Staff #7 and #9 submitted evidence of CPR dated 02/27/2024 - corrected.)

Corrected Corrected by Mar 28, 2024

Category: ratio. Marked corrected in the state record.

3270.31(e)(4)(ii) · Staff persons shall participate, at least annually, in firesafety training conducted by a fire protection professional. Staff persons and volunteers shall receive training in maintenance of smoke detectors, the duties of facility persons during a fire drill and during a fire and the use of the facility's fire extinguishers, not including discharge of the fire suppressant agent.

Records for Staff #2 and #5 did not contain evidence of current annual fire safety training.

Corrected Corrected by Apr 30, 2024

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). Facility Person #8 may not work in a child care position at the facility.

Record for Staff #8 did not contain NSOR results, nor evidence of submission. Records for Staff #6, #7, #8, and #9 did not contain a completed disclosure statement.

Corrected Corrected by Mar 28, 2024

Category: recordkeeping. 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.

Records for Staff #3 and #4 did not contain evidence of performance evaluations when they were due based on hire date.

Corrected Corrected by Apr 30, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.151(c)(1)/3270.192(3) · An adult health assessment must include a physical 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.

Records for Staff #7 and #9 contained current health assessments, but both were dated well after date of hire. (Staff #7 DOH: 08/28/2023, HA 01/30/2024, Staff #9 DOH: 09/22/2023, HA 10/20/2023). Record for Staff #8 contained a current health assessment, but no evidence of a TB test was found on file.

Corrected Corrected by Mar 28, 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.

Records for Staff #3. #4, #7, #9 did not contain evidence of the required two letters of reference. Record for Staff #8 contained one letter of reference.

Corrected Corrected by Mar 28, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.27(a)(6) · Emergency drills shall be conducted annually. Annual emergency drills shall be documented and on file at the facility.

Evidence of annual emergency drill or log could not be located.

Corrected Corrected by Apr 30, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.94(a)(1) · The Director or designated staff person who is responsible for compliance with this chapter shall conduct fire drills and ensure that fire drills are conducted at least once every 60 days.

Fire drill log listed the most recent documented fire drills as dated 09/07/2022 and 12/07/2022.

Corrected Corrected by Apr 21, 2023

Category: recordkeeping. 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 persons #4 and #5 have not completed the following required pre-service training within 90 days of their date of hire: 10 Hour revised health and safety training. POC REQUIRED AND DIRECTED PLAN: Staff person(s) shall complete professional development in the topics of 3270.31(f)(1 -- 10), within 90 days of hire. Staff persons #4 and #5 will have until May 5 2023 to complete the required training. Until such time as the required training has been completed, staff persons #4, #5 must be supervised, when interacting with children, by an AGS who has completed the required training related to this citation. If there are no staff available to supervise staff person #4 and #5, staff persons #4 and #5 may not work in a child-care position at the facility.

Corrected Corrected by Apr 21, 2023

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 provisional employee may not be permitted to work alone with children and must work within the vicinity of a permanent employee. 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 #4 may not work in a child care position at the facility.

Staff members #1 (expired SP 05/05/2017, FBI 06/27/2017, MR training 06/29/2017), #2 (expired SP 05/05/2017, FBI 07/18/2017, MR training 07/19/2017), #4 (no results for SP, CA, NSOR, MR training, or disclosure statement on file - hire date unclear), #5 (no disclosure statement on file), #6 (no disclosure statement on file). Staff #1 and #2 obtained clearances and trainings the same day. Remaining staff were sent to get them immediately.

Corrected Corrected by Apr 21, 2023

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

3270.151(a)/3270.151(c)(2) · 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. 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.

Record for staff #3 Did not contain a current health assessment, the last being dated 09/30/2020. Submitted completed HA dated 03/01/2023. Staff #4 did not have a health assessment or TB test on record.

Corrected Corrected by Apr 21, 2023

Category: ratio. Marked corrected in the state record.

3270.31(f) · Staff persons shall complete professional development in the following topics within 90 days of hire: (1) Prevention and control of infectious diseases (including immunization) and the establishment of a grace period that allows homeless children and children in foster care to receive services under this subchapter while their families (including foster families) are taking necessary action to comply with immunization and other health and safety requirements. (2) Prevention of Sudden Infant Death Syndrome and use of safe sleep practices. (3) Administration of medication, consistent with standards for parental consent. (4) Prevention of and response to emergencies due to food and allergic reactions. (5) Building and physical premises safety, including identification of and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water and vehicular traffic. (6) Prevention of shaken baby syndrome and abusive head trauma. (7) Emergency preparedness and response planning for emergencies resulting from a natural disaster or a man-caused event (such as violence at a child care facility) within the meaning of those terms under section 602(a)(1) of the Robert T. Stafford Disaster Relief and Emergency Assistance Act (42 U.S.C.A. § 5195a(a)(1)). (8) Handling and storage of hazardous materials and appropriate disposal of biocontaminants. (9) Precautions when transporting children. (10) Pediatric first aid and pediatric cardiopulmonary resuscitation.

The file of staff person #3 did not contain documentation of the staff person having completed the health and safety training requirements required under 3270.31(f)(1) - 3270.31(f)(9).

Corrected Corrected by May 24, 2022

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). 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. Staff Person #1, #2, and #3 must be removed from a child care position until completed clearances are on file.

Staff person #1 did not have an FBI clearance on file as required under the CPSL. Staff person #2 did not have a completed NSOR verification certificate on file as required under the CPSL. Staff person #3 did not have a DHS FBI clearance on file as required under the CPSL. The file contained a Dept. of Education FBI clearance, which does not satisfy the requirements under the CPSL. The file also did not contain a completed NSOR verification certificate.

Corrected Corrected by May 24, 2022

Category: background checks. 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 files of facility persons #1, 2, and 3 did not contain two written, nonfamily references.

Corrected Corrected by May 24, 2022

Category: recordkeeping. Marked corrected in the state record.

3270.33(d) · One or more facility persons competent in pediatric first-aid and pediatric cardiopulmonary resuscitation techniques shall be at the facility when one or more children are in care.

There was not documentation on file at the time of inspection that at least one facility person, competent in pediatric first-aid and pediatric cardiopulmonary resuscitation techniques are at the facility when one or more children are in care.

Corrected Corrected by May 24, 2022

Category: recordkeeping. Marked corrected in the state record.