Staff who are counted in the staff/child ratios and auxiliary staff left alone with children and/or counted in staff/child ratio as specified in the rule 6.2.1.8 of these regulations shall obtain training in pediatric first aid and in infant and child CPR within three (3) months of beginning work in the CBCCPP and remain currently certified.

Several staff members did not renew their First Aid and CPR certification by the expiration date. There were several staff who did not have First Aid and CPR certificates in BFIS or on site. The program was given time to submit the missing documents after the visit. At the time this report was generated, those documents had not yet been received.

7.1.2.2 · Not corrected

The licensee shall ensure that all new staff and auxiliary staff, prior to working with children in the CBCCPP; and any new individual designated as the representative of the licensee shall submit a Records Check Authorization form to the Division and shall submit to fingerprinting at a location designated by the Division after having received the Fingerprinting Authorization Certificate by the Division.

The program had three (3) staff of the program, all employed for longer than six (6) months, that did not complete the required fingerprint supported background clearance as required.

7.2.2 · Not corrected

The licensee, in consultation with the program director, shall establish written program policies and procedures and provide these to staff and to auxiliary staff left alone with children and/or counted in staff/child ratio as specified in the rule 6.2.1.8 of these regulations during an orientation training session approved by the Division prior to being left alone with children. Trainees under eighteen (18) years of age and other staff not left alone with children shall complete the orientation training within at least one (1) month of their first date of working with children. Complete written information and the orientation training session shall include: Basic knowledge of child growth and development; Routine and emergency health protection of children including health related exclusions; Safety and sanitation requirements including handling and storage of hazardous materials and disposal of bio contaminants; Positive behavior management; Supervision of children; Child accident and injury procedures including building and physical premises safety; Safe sleep practices; Administration of medication requirements; Emergency and evacuation requirements; Nutrition and food safety including prevention of and response to emergencies due to food and allergic reactions; Recordkeeping; Transportation and child passenger safety; Release of children; Respectful engagement of families; Preventing, recognizing, and reporting child abuse and neglect; including information about the signs and symptoms of sexual abuse, sexual violence, grooming processes, recognizing the dangers of child sexual abuse, and other predatory behaviors of sex offenders; Recognition of and response to the symptoms of common childhood illnesses; Preventing the spread of infectious disease; Providing developmentally appropriate activities and experiences for children; Inclusion of children with special needs; Guidelines for volunteers, partner staff, auxiliary staff, and business managers; Responsibility to comply with current applicable licensing regulations; Staffing requirements to include opening and closing; and Ensuring children have extra clothes and diapers available.

Eight (8) staff are missing documentation of completing Orientation training. It is not documented in BFIS and was not available in staff files at the time of this visit.

Within six (6) months of the initial date of employment, staff working with children and the program director shall maintain an up- to-date BFIS Quality and Credential Account. Documentation, verification of qualifications and all annual professional development activities as specified in the rules in sections 7.3 and 7.4 of these regulations shall be submitted to NLCDC to be verified and maintained in BFIS.

A review of the BFIS Quality and Credential accounts of staff who have been with the program more that 6 months reflected that several staff accounts do not have the following required documentation; verification of qualifications, professional development, and current first aid and CPR certification.

3.4.7.3 · Not corrected

General Health Examinations: Within forty-five (45) days of enrollment, the licensee shall obtain documentation of the child's age appropriate well care exam from the parent. Documentation shall include information regarding any health conditions and medications that may impact the care of the child.

A review of 10 randomly selected files for children who have been enrolled more than 45 days showed that 9 files did not include documentation of a General Health Exam signed by a pediatrician.

5.1.2 · Not corrected

Each child's file shall be complete with all required information within the first week that the child begins to attend care. The required annual physical shall be obtained within forty-five (45) days of enrollment as required in rule 5.1.2 of these regulations.

Of the twenty-five percent of children's immunization records reviewed, two children attending the program since January and March of this year do not have immunization information onsite at the program.

3.4.4.2 · Not corrected