13.7 · Staff and children shall all wash their hands with soap under warm, running water: * before they eat or prepare food * after they use the toilet * after handling animals * after playing outside.

During the visit, it was observed that at least 19 children used hand sanitizer prior to eating snack, rather than washing their hands under warm running water. The onsite program administrator was also observed to use hand sanitizer, rather than washing hands with warm running water, prior to serving snack to the children.

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5.40 · Before the expiration date on the card, training for First Aid and CPR shall be validated by the American Red Cross, American Heart Association or other equivalent, state- recognized organization, and the specific certification documentation maintained in the appropriate Afterschool Child Care Program Staff file.

A review of staff files and staff BFIS accounts reflected that Staff A, B, C, D, and E had CPR and first aid certifications that were expired. Program Administrator confirmed that the listed staff had expired CPR and first aid certifications. Additionally, the program was unable to produce documentation of Staff F's current CPR and first aid certifications. All staff listed have worked with the program for more than 3 months.