Summary of Complaint Investigation #PCS1004105 Visit The visit conducted today did include monitoring of the agency's compliance with Licensing Rules and Regulations. Technical Assistance Provided: 1.TA provided to take coat rack and desk out of the infant room for adequate crawling space for infants. 2.TA provided to put up personal items away and inaccessible to children. 3.TA provided to ensure to complete daily sheets that include feeding, diapering, and SIDs check for infants daily. 4.TA provided to ensure to remove pack n play and replace it in the infant room. 5. TA provided to find another location to store children's diaper bags. 6.TA provided to ensure staff are signing in and out daily and if leaving the agency on a break. 7.TA provided on Group Rules and ensure to read and abide by licnesing rules. 8.TA provided to ensure all staff are in eLicensing Portal and TNPAL. Violations were received and include: 1.Supervision x 2 Safe Sleep Correct Action Plan (CAP)were not completed onsite completed. Violation details can be observed below. FS observed during a complaint investigation a 6 month old asleep in a pack n play laying on their stomach without their name labeled by crib as a roller/flipper. During an observation for a complaint investigation, FS upon request was not provided a daily sheet for SIDs Check on infants that were asleep. A 6 month old infant was observed asleep in a pack n play.

Disposition: Yes

See Below for Detailed Information Observation: During an unannounced visit for a complaint. FS observed the sign in/out sheet and that all the signatures were the same. A staff did admit to signing each child in and out everyday. Children were not signed into the agency by a parent, guardian, or representative, and a time of entry. 1240-04-01-.11 SUPERVISION

Disposition: Yes

See Below for Detailed Information

Disposition: Not Applicable