746.1601 · Child/ Caregiver Ratio - 13 or More Children

During the follow up inspection 6 children were left with 1 caregiver in the infant room. The specified age group was 0-11 months and the child to caregiver ratio should've been 4:1, the operation was over in ratio by 2 children. Note: The provider added a caregiver to the infant room during the inspection.

Corrected Corrected by Feb 22, 2023

Category: ratio. Marked corrected in the state record.

746.1201(1) · Responsibilities of Employees and Caregivers -Demonstrate Competency, Good Judgment, Self-control

A caregiver was observed grabbing an infant up by the arm while she was holding another child in her other arm during the follow up inspection. Note: Discussed with the caregiver and the director the risk of picking infants up by the arm. Infants and toddlers should be picked up from underneath the arm as their muscles are very fragile.

Corrected Corrected by Feb 22, 2023

Marked corrected in the state record.

746.1203(4) · Responsibilities of Caregivers - Supervision of Children

During the follow up inspection 8 children were left unsupervised in the pre-kindergarten classroom while a caregiver left to take another child to the infant classroom.

Corrected Corrected by Feb 22, 2023

Category: supervision. Marked corrected in the state record.

746.1316(a) · Transportation Safety Training -Director and Employee Complete 2 Hours Annually

Documentation of current training in transportation safety for 2 caregivers was not available for review during the inspection.

Corrected Corrected by Feb 10, 2023

Category: transportation. Marked corrected in the state record.

746.2415(b) · AP Cribs - Only Snug Fitting Sheet and Crib Mattress Cover Allowed if Infant Younger than 12 Months of Age

A 3 month old was observed in a crib with a boppy pillow. A 7 month old was observed in a crib with a bottle. Note: The provider removed these items from the crib during the inspection.

Corrected Corrected by Feb 8, 2023

Marked corrected in the state record.

746.1315(a) · Each Caregiver and the Director Must Have Current Training in pediatric first aid with rescue breathing and choking.

1 out of 10 staff files evaluated was missing current CPR and First Aid training. The caregivers training expired in December 2022.

Corrected Corrected by Feb 15, 2023

Category: recordkeeping. Marked corrected in the state record.

746.3407 · Maintenance of Building, Grounds and Equipment

During the inspection, dead insects were observed in the cabinets of the boys restroom. Urine stains were observed at the bottom of the toilet in the toddler restroom.

Corrected Corrected by Feb 15, 2023

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

746.501(a)(18) · Written Operational Policies - Promotion of Physical Activity

The following information was missing from the operational policies: (A) The benefits of physical activity and outdoor play (B) The duration of physical activity at your operation, both indoor and outdoor (C) The type of physical activity (structured and unstructured) that children may engage in at your operation (D) Each setting in which your physical activity program will take place (F) A plan to ensure physical activity occurs on days when extreme weather conditions prohibit or limit outdoor play.

Corrected Corrected by Feb 15, 2023

Category: ratio. Marked corrected in the state record.

746.2419(6) · Requirements for Feeding Infants - Label Bottles/Cups

A grey bottle in the infant room was not labeled with the childs first name and last initial.

Corrected Corrected by Feb 15, 2023

Marked corrected in the state record.

746.2421(b) · Written Feeding Instructions - Review and Update Every 30 Days

The infant feeding instructions for one child in care had not been updated and signed since November 2022.

Corrected Corrected by Feb 15, 2023

Marked corrected in the state record.

746.1309(e) · Documented Annual Training- Required Content

9 out of 10 staff files evaluated did not contain the following training topics: Understanding and Responding to Food Allergies Handling, Storing and Disposing of Hazardous Materials Understanding Building and Physical Premises Safety

Corrected Corrected by Feb 15, 2023

Category: recordkeeping. Marked corrected in the state record.

746.1601 · Child/ Caregiver Ratio - 13 or More Children

5 children were left with 1 caregiver in the infant room during the inspection. The specified age group was 0-11 months and the child to caregiver ratio should've been 4:1. Note: The provided added a caregiver to the infant room during the inspection.

Corrected Corrected by Feb 8, 2023

Category: ratio. Marked corrected in the state record.

746.1605 · Child/Caregiver Ratio - 18 Months Difference in Age

During the inspection a 15 month old infant was observed in the same classroom with 3 and 4 year olds. Note: It was discussed that infants cannot be combined with this age group and the provider moved the infants to the infant classroom.

Corrected Corrected by Feb 8, 2023

Category: ratio. Marked corrected in the state record.

746.5617(a)(2) · Required Equipment in Vehicles - Emergency Medical Information

Documentation of authorization for emergency medical treatment and emergency contact information was not available for all of the children being transported in both of the daycare vans. Note: This was corrected during the inpection.

Corrected Corrected by Feb 8, 2023

Category: transportation. Marked corrected in the state record.

746.613(b) · Immunization Records, Exceptions, and Exemptions Current

Four out of ten children were missing current immunization records in their file.

Corrected Corrected by Jun 24, 2022

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

746.4003(a) · First Aid Kit - Incomplete Kit

The first aid kit located in the operation was missing scissors. The first aid kit in the operation's van was missing tape and scissors. Note: Corrected when the missing items were added to the first aid kits.

Corrected Corrected by Jun 17, 2022

Marked corrected in the state record.