251.04(2)(h)7. · Policy Submitted & Implemented - Nutrition

The center's written allergy policy is not adhered to. Pg. 55 states a visual barrier for children w/ severe allergies will be provided & they will be served ahead of time when food containing allergens is served. Per staff, 2 varieties of bread pudding were served at the same time in Child #4's classroom on 11/7/25. One pudding contained dairy & sesame. Child #4 has dairy & sesame allergies and while he was served an alternate type of pudding without dairy & sesame, he began displaying allergy symptoms after the pudding w/allergens was served & he required Benadryl to treat symptoms.

Open Not marked corrected in the state record

Open / not marked corrected.

251.04(2)(m) · Health, Safety & Welfare Of Children

On 11/4/25 hummus was served for snack & was served to & consumed by Child #1 who has a sesame allergy. Epipen administered & 911 called by center. On 11/13/25 the department observed the hummus label clearly identifies sesame seeds as an ingredient. The cook reported to the department that she did not & does not always check ingredient lists for allergens. Per multiple staff, Child #1 has also been served hummus previously.

Open Not marked corrected in the state record

Open / not marked corrected.

251.04(7)(a) · Disclosure Of Personal Information

A list containing Child #2's allergens is posted in plain view in the child's classroom.

Open Not marked corrected in the state record

Open / not marked corrected.

251.05(2)(a)4.a. · Staff Record - Registry Certificate

Staff A, Staff B, and Staff C each hold the position of a child care teacher however they do not have certificates from the Registry indicating they meet the qualifications for the position of child care teacher. The Registry certificate for Staff C, who has been employed since 8/16/23, states Staff C meets the qualifications for an assistant teacher. Staff A who has been employed since 2006 does not have any positions identified on her certificate.

Open Not marked corrected in the state record

Open / not marked corrected.

251.05(2)(a)6. · Staff Record - Days & Hours Worked

Documentation of the days and hours worked by staff when the person was included in the staff-to-child ratio does not identify the classroom staff worked in when used to meet the staff-to-child ratio.

Open Not marked corrected in the state record

Open / not marked corrected.

251.05(3)(b) · Abusive Head Trauma Prevention Training

Staff A, who has been employed since 2006, and provides care and supervision to children under the age of 5, does not have documentation on file, either paper or electronic, demonstrating completion of training on preventing abusive head trauma.

Open Not marked corrected in the state record

Open / not marked corrected.

251.05(3)(c) · Cardiopulmonary Resuscitation Training

Staff B has not maintained a current certificate of completion for Infant & Child CPR with AED. The most recent CPR training completed by Staff B expired on 11/6/25.

Open Not marked corrected in the state record

Open / not marked corrected.

251.05(3)(cm) · Child Abuse & Neglect - Biennial Training

Staff A, B, C and D have not completed training on child abuse and neglect reporting requirements every 2 years as required. The trainings for Staff A, B and C expired in August 2025; the training for Staff D expired in August 2022.

Open Not marked corrected in the state record

Open / not marked corrected.

251.055(1)(a) · Supervision Of Children

Each child is not supervised by a child care worker who is within the sight and sound of the children to guide the children's behavior and activities, prevent harm, and ensure safety. Throughout the visit many instances of children being alone in the hallways outside of the supervision of their child care workers are observed.

Open Not marked corrected in the state record

Open / not marked corrected.

251.055(1)(f) · Child Tracking Procedure

A teacher who remained in the classroom with two children completing an art project while the rest of the classroom is in the outdoor play space does not have the names of the two children she is caring for documented. NOTE: This violation was corrected by the teacher during the monitoring visit when she wrote the children's names down on a piece of paper.

Open Not marked corrected in the state record

Open / not marked corrected.

251.06(2)(a) · Potential Source Of Harm On Premises

Various loose cords, including an unplugged cord from a free standing tall floor lamp, are accessible to children in multiple classrooms. Included in a Warning Letter issued 12/23/24.

Open Not marked corrected in the state record

Open / not marked corrected.

251.06(2)(d) · Access To Materials Potentially Harmful To Children

An open bag of potting soil is observed in the hallway outside of a classroom. The bag is labeled "keep out of reach of children."

Open Not marked corrected in the state record

Open / not marked corrected.

251.07(5)(b)1. · Mealtime - Staff With Children

Lunch service was observed. The staff in one of the classrooms did not sit at the table with the children during lunch.

Open Not marked corrected in the state record

Open / not marked corrected.

251.07(6)(dm)2. · Medical Log - Pages & Entries

A medical log entry on Page 244 of the center medical log book is not dated.

Open Not marked corrected in the state record

Open / not marked corrected.

251.07(6)(dm)3.a. · Medical Log - Observation Or Evidence Of Injury

A child in the Toddler 2 room is observed with scratches on their face which are reported by staff to have been noticed approximately one week ago and to have occurred outside the center however the observation has not been recorded in the center medical log book. It is further reported that staff do not regularly record in the medical log book observations of children arriving at the center for care with injuries.

Open Not marked corrected in the state record

Open / not marked corrected.

251.07(6)(dm)3.c · Medical Log - Medication Administration

Medications administered by staff are not always recorded in the medical log book. For example, Child #7 has been administered two medications daily including from September 2025-present. The medication administration is recorded on a single log sheet for certified providers rather than the medical log book as required. Medication administered to Child #6 on 7/15/25-7/17/25 was recorded on a certification log sheet rather than the medical log book and the type of medication administered was not recorded.

Open Not marked corrected in the state record

Open / not marked corrected.

251.07(6)(f)1.a. · Medication Administration - Parent Authorization

A medication authorization signed by the parent on 3/20/25 listing a start date of 3/25/25 to administer Infant Tylenol to a child does not contain the required end date. A medication authorization signed by the parent on 7/15/25 for Child #6 does not specify the times to administer two different over the counter pain relievers and does not contain a start and end date.

Open Not marked corrected in the state record

Open / not marked corrected.

251.07(6)(f)1.b. · Medication Administration - Containers & Labeling

Multiple children's medications observed in the center mediation boxes are not labeled with child's name as required. For example, a bottle to Tylenol and a bottle of Advil for Child #6 is not labelled and an inhaler for another child is not labelled. A non-expired Epi-pen for Child #2 is not labelled with the child's name and is kept in a prescription box that is labelled with the child's name and the box identifies the Epi-pen expired in May 2025.

Open Not marked corrected in the state record

Open / not marked corrected.

251.07(6)(f)5. · Medication Administration - As Labeled & Authorized

Benadryl that expired in March 2025 was administered to Child #2 following the child displaying allergy symptoms on 4/23/25 & 6/19/25.

Open Not marked corrected in the state record

Open / not marked corrected.

251.07(6)(i)1. · Washing Child's Hands & Face

Per observation of a diaper change, an infants hands were not washed following the diaper change.

Open Not marked corrected in the state record

Open / not marked corrected.

251.09(1)(c) · Infant & Toddler - Documenting Changes In Development

Child care workers failed to document changes in a child's development and routines every 3 months based on discussion with the parent. Infant & Toddler Intake forms for two children have not been updated within the last 3 months. One has not been updated since 7/8/25 and the other has not been updated since 8/7/25.

Open Not marked corrected in the state record

Open / not marked corrected.

251.09(3)(a)2. · Infant & Toddler - Food & Formula Brought From Home

Two infant bottles brought from home and observed in the refrigerator in one of the center's infant classrooms are not labeled with the child's name and dated.

Open Not marked corrected in the state record

Open / not marked corrected.

251.04(2)(m) · Violation

(Health, Safety & Welfare Of Children ) on 11/13/2025 : On 11/4/25 hummus was served for snack & was served to & consumed by Child #1 who has a sesame allergy. Epipen administered & 911 called by center. On 11/13/25 the department observed the hummus label clearly identifies sesame seeds as an ingredient. The cook reported to the department that she did not & does not always check ingredient lists for allergens. Per multiple staff, Child #1 has also been served hummus previously. $250

Open Not marked corrected in the state record

Open / not marked corrected.

251.06(2)(a) · Violation

(Potential Source Of Harm On Premises ) on 11/13/2025 : Various loose cords, including an unplugged cord from a free standing tall floor lamp, are accessible to children in multiple classrooms. Included in a Warning Letter issued 12/23/24.

Open Not marked corrected in the state record

Open / not marked corrected.

251.07(6)(dm)3.c · Violation

(Medical Log - Medication Administration ) on 11/13/2025 : Medications administered by staff are not always recorded in the medical log book. For example, Child #7 has been administered two medications daily including from September 2025-present. The medication administration is recorded on a single log sheet for certified providers rather than the medical log book as required. Medication administered to Child #6 on 7/15/25-7/17/25 was recorded on a certification log sheet rather than the medical log book and the type of medication administered was not recorded.

Open Not marked corrected in the state record

Open / not marked corrected.

251.07(6)(f)1.a. · Violation

(Medication Administration - Parent Authorization ) on 11/13/2025 : A medication authorization signed by the parent on 3/20/25 listing a start date of 3/25/25 to administer Infant Tylenol to a child does not contain the required end date. A medication authorization signed by the parent on 7/15/25 for Child #6 does not specify the times to administer two different over the counter pain relievers and does not contain a start and end date.

Open Not marked corrected in the state record

Open / not marked corrected.

251.07(6)(f)1.b. · Violation

(Medication Administration - Containers & Labeling ) on 11/13/2025 : Multiple children's medications observed in the center mediation boxes are not labeled with child's name as required. For example, a bottle to Tylenol and a bottle of Advil for Child #6 is not labelled and an inhaler for another child is not labelled. A non-expired Epi-pen for Child #2 is not labelled with the child's name and is kept in a prescription box that is labelled with the child's name and the box identifies the Epi-pen expired in May 2025.

Open Not marked corrected in the state record

Open / not marked corrected.

251.07(6)(f)5. · Violation

(Medication Administration - As Labeled & Authorized ) on 11/13/2025 : Benadryl that expired in March 2025 was administered to Child #2 following the child displaying allergy symptoms on 4/23/25 & 6/19/25.

Open Not marked corrected in the state record

Open / not marked corrected.

251.04(6)(a)6. · Child Record - Health History

Health history information on file for Child #1 and Child #2 is incomplete. The Health History and Emergency Care Plans on file for each child has the box checked stating "no specific medical condition" for each child. Child #1 has a food allergy and asthma and Child #2 has a potential food allergy. Questions #2-8 on the Health History and Emergency Care Plans have not been answered for Child #1 and Child #2.

Open Not marked corrected in the state record

Open / not marked corrected.

251.055(1)(c) · Supervision - Opening & Closing Hours

On 12/6/24 a qualified assistant child care teacher (Staff H) provided sole supervision to Infant Room 1 (G93) outside of the first two and the last two hours of center operation and outside of the center's designated naptime, not to exceed to hours.

Open Not marked corrected in the state record

Open / not marked corrected.

251.06(2)(a) · Potential Source Of Harm On Premises

Loose hanging nursery monitor cords and a looped thin rope used to hang the monitor from the wall are accessible to children when they are placed in cribs in Infant Room 2 (G95).

Open Not marked corrected in the state record

Open / not marked corrected.

251.06(2)(gm) · Premises - Well Drained, Clean, In Good Repair

Rows of ceiling tiles observed in the second floor 4K Classroom (Room 192) contain a significant amount of what appears to be black dirt and/or dust.

Open Not marked corrected in the state record

Open / not marked corrected.

251.07(5)(b)1. · Mealtime - Staff With Children

Lunch service was observed. The staff in the 4K classroom (Room 192) did not sit at the table with the children during lunch.

Open Not marked corrected in the state record

Open / not marked corrected.

251.07(6)(dm)2. · Medical Log - Pages & Entries

Lines are observed skipped and multiple entries are observed to not be signed or initialed by the person having made the entry per review of multiple center medical log books.

Open Not marked corrected in the state record

Open / not marked corrected.

251.07(6)(dm)3.c · Medical Log - Medication Administration

Per a review of center medical log books, multiple entries of medication dispensed to a child while in care do not contain the times the medication was administered and an entry dated 9/17/24 does not contain the dosage of medication administered to a child. In addition, not all medication entries have been signed or initialed by the person administering the medication.

Open Not marked corrected in the state record

Open / not marked corrected.

251.07(6)(dm)4. · Medical Log - Reviewing Injury Records

Per a review of multiple center medical log books the required 6 month review has not been not completed within the last 6 months. The most recent reviews were completed in December 2023.

Open Not marked corrected in the state record

Open / not marked corrected.

251.07(6)(f)1.a. · Medication Administration - Parent Authorization

Numerous blanket authorizations to administer over the counter pain relievers to children in care "as needed" are observed. Blanket authorizations are prohibited. A medication authorization dated 12/13/23 states to administer Tylenol to a toddler "as directed." The authorization does not identify a dose of medication to administer or the times. A medication authorization dated 9/17/24 does not specify the times to administer medication to an infant instead stating "every 4 hours."

Open Not marked corrected in the state record

Open / not marked corrected.

251.07(6)(f)1.b. · Medication Administration - Containers & Labeling

Two over the counter bottles of ibuprofen in the medication box shared by Infant Room 1 and 2 (G95 and G93) are not labeled with the child's name. An asthma inhaler for Child #1 is not labeled with the child's name. Allergy tablets for Child #1 are not labeled with the child's name.

Open Not marked corrected in the state record

Open / not marked corrected.

251.07(6)(f)6. · Current Authorizations For Medications On Premises

Two bottles of over the counter Ibuprofen in the medication box shared by Infant Rooms 1 and 2 (G95 and G93) do not have completed medication authorizations from the parent. No medication intended for use by a child in the care of the center may be kept at the center without a current medication administration from the parent.

Open Not marked corrected in the state record

Open / not marked corrected.

251.04(6)(a)6. · Violation

(Child Record - Health History ) on 12/6/2024 : Health history information on file for Child #1 and Child #2 is incomplete. The Health History and Emergency Care Plans on file for each child has the box checked stating "no specific medical condition" for each child. Child #1 has a food allergy and asthma and Child #2 has a potential food allergy. Questions #2-8 on the Health History and Emergency Care Plans have not been answered for Child #1 and Child #2.

Open Not marked corrected in the state record

Open / not marked corrected.

251.06(2)(a) · Violation

(Potential Source Of Harm On Premises ) on 12/6/2024 : Loose hanging nursery monitor cords and a looped thin rope used to hang the monitor from the wall are accessible to children when they are placed in cribs in Infant Room 2 (G95).

Open Not marked corrected in the state record

Open / not marked corrected.