7.1.2.2 · 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.

Upon review of staff BFIS Quality and Credential accounts and on-site staff files, it was identified that Staff A had not obtained training in pediatric first aid and infant and child CPR. Staff A has been employed at the program for nine (9) months.

Open Not marked corrected in the state record

Open / not marked corrected.

5.10.1.1.2 · Children shall be protected from choking hazards presented by cords on window coverings, electric or electronic appliances or equipment and telephones.

In the "Butterfly" room electrical cords to tow (2) lamps were observed to be loose and accessible to children. In the "Caterpillar" room, an electrical cord to a light table was observed to be loose and accessible to children.

Open Not marked corrected in the state record

Open / not marked corrected.

4.7 · The licensee, in consultation with the program director, shall establish written policies and procedures. Written information provided to parents of all children enrolled in the CBCCPP shall include, at minimum: * Assurance that parents have access to the CBCCP and their child(ren) without prior notice and have access to their children's records as required in the rule 3.4.4.6 of these regulations; * A description of information needed from parents for child's enrollment file as required in the rule 3.4.4.1 of these regulations; * A typical daily schedule of activities; * Information about fees and payment policies; * Information about hours of operation and closings; * Procedures for signing children in and out; * Procedures for emergencies as required in the rules in section 3.7 of these regulations; * Information about the nutrition, meals and meal preparation at the CBCCPP; * Safe sleep policies, as applicable; * No smoking policy; * Information about results from the test for lead in the drinking water and any plan for remediation; * CBCCPP policies on field trips, other off-site activity and transportation; * CBCCPP health policies including illness exclusions, administration of medication, and immunizations; * CBCCPP policies and practice regarding positive guidance and behavior management; * Assurance that confidentiality of child and family information is maintained; * Information about the requirement to report suspected child abuse and/or neglect as required in the rules in section 3.3 of these regulations; * Assurance that non-discrimination and respect for each child's family and culture is maintained; * CBCCPP approach to ensure wholesome growth and positive developmental experiences for children enrolled; * CBCCPP policies related to the inclusion of children with special needs and disabilities; * A description of religious activities, if any; * Information on how to access these CBCCPP regulations and other information about child development on-line; * Information concerning complaint procedures; * Information about the Child Care Consumer Line, including the telephone number (1-800-649-2642); and * CBCCPP policies and procedures related to the expulsion of children.

Upon review of the program's Family Handbook it was identified that fifteen (15) of the twenty-four (24) required components were missing or incomplete.

Open Not marked corrected in the state record

Open / not marked corrected.

5.6.2 · The program director shall ensure that only staff, who have completed a training course approved by the Division, administer medication in the CBCCPP. With written parental permission, a school age child may self-medicate under the direct supervision of staff who meets the training requirement within this rule.

Director statements reflected that over-the-counter medications had been administered before, though no staff had completed a training course approved by the Division.

Open Not marked corrected in the state record

Open / not marked corrected.

5.1.2 · 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.

Review of four (4) children's files found general health exam information to be missing from all four (4) files. Follow up communication with Staff A revealed program has not been requesting this required documentation.

Open Not marked corrected in the state record

Open / not marked corrected.

3.4.3 · A system for taking attendance, including documentation of the time when each child arrives and departs each day he/she attends the CBCCPP, shall be established. The licensee shall save all daily attendance records identifying the hours of children's attendance for at least twelve (12) months from the date that care is provided.

The Butterfly classroom was observed to have four (4) children in attendance, however only two (2) children were signed in on the attendance sheet.

Open Not marked corrected in the state record

Open / not marked corrected.

3.4.3 · A system for taking attendance, including documentation of the time when each child arrives and departs each day he/she attends the CBCCPP, shall be established. The licensee shall save all daily attendance records identifying the hours of children's attendance for at least twelve (12) months from the date that care is provided.

The attendance roster lists a check mark to identify children as in attendance for a day. Regulations require arrival and departure times to be noted for each child.

Open Not marked corrected in the state record

Open / not marked corrected.

5.2.3.4 · The licensee shall ensure that there is a sturdy diaper changing area with a clean, washable and non-absorbent surface. The diaper changing area shall not be located in the kitchen or any area where food is stored, prepared or served.

The diaper changing table had a cloth cover. Different children are placed on top of the same cloth cover for diaper changes. This is in violation of this rule because it is an absorbent surface and not able to be cleaned between each use.

Open Not marked corrected in the state record

Open / not marked corrected.

5.2.3.7 · The container for diapers shall be within arm's reach of the diaper changing area.

Lauren stated that it is her practice to dispose of diapers in plastic bags in the kitchen area trash can which is around the corner and beyond reach of the diaper changing area.

Open Not marked corrected in the state record

Open / not marked corrected.

6.2.6.1 · Staff shall be able to hear all children of pre-kindergarten age and younger at all times, shall be able to see the children with a quick glance, and shall be able to physically respond immediately.

When Licensors arrived, Lauren was in the community room with one child while another child was sleeping on a mat in the classroom with the door closed. Lauren reported that children leave the classroom and go into the community room on occasion to use bathrooms. When standing in the classroom or the doorway of the classroom, only a portion of the community room is visible and the bathrooms are not visible at all.

Open Not marked corrected in the state record

Open / not marked corrected.