Little Arrows Childcare Center, Llc

“During the inspection, it was determined the program’s written policies and procedures provided to the parents/guardians and employees was missing items: The following was observed as missing: center name, address, email address and phone number; written security plan that ensures that access to the center is limited to parents and guardians of children in care and authorized persons; social media policy including, but not limited to, addressing publication of child photos or other identifying information, if applicable; usage of emergency medical devices and emergency medications, including but not limited to Automated External Defibrillators (AED) and Naloxone, if applicable. Revise the program’s written policies and procedures to include the missing information. Submit the program’s corrective action plan, which includes the revised written policies and procedures, to the Department to verify compliance with the requirements of this rule.”

“During the inspection, it was determined the program’s emergency preparedness and response plan (EPRP) did not meet the requirement or was missing the information. The following was observed as missing: medical or dental emergencies, including emergency transportation; emergency numbers for medical, dental, and transport-related emergencies in addition to 9-1-1; procedures for assisting infants, toddlers, and children with special needs and/or health conditions; emergency contact information for parents and the program; procedures for notifying and communicating with parents regarding the location of children if evacuated; procedures for communicating with parents during loss of communications when no phone or internet service is available; the location of supplies and procedures for gathering necessary supplies for staff and children if required to shelter in place; updating the plan on a yearly basis; contact with local emergency management officials Make the necessary revisions to the EPRP. Submit the program’s corrective action plan, which includes the revised information, to the Department to verify compliance with the requirements of this rule.”

“In review of the children’s records, it was determined the program did not meet the requirements for caring for at least one child, indicated on the Children Records Review, with a condition that requires a JFS 01236 "Child Medical/Physical Care Plan" as noted in number 1 below: 1. No plan was on file. (Page 1) 2. Child’s name was missing. 3. Name of the condition was missing. 4. Indication if medication or medical food is required was missing. 5. Signs, symptoms or situations that require staff to take action were missing. 6. Activities, foods, environmental conditions to avoid were missing. 7. Training instructions for procedures for staff to follow were missing or incomplete. (Page 2) 8. Child's name was missing or not attached. 9. Child's date of birth was missing or not attached. 10. Child's weight was missing or not attached. 11. Name of the medication/medical food was missing or not attached. 12. Dosage of medication/medical food to be administered was missing or not attached. 13. Time for medication/medical food to be administered was missing or not attached. 14. Expiration date for medication/medical food was missing or not attached. 15. Symptoms that require staff to administer medication/medical food were missing or not attached. 16. Specific instructions to administer the medication/medical food were missing or not attached. 17. Actions to be taken if the symptoms do not subside were missing or not attached. 18. Physician's signature was missing or not attached. 19. The date of the physician's signature was missing or not attached. (Page 3) 20. Child's name was missing. 21. Instructions regarding emergency evacuation, if applicable, were missing. 22. Signature of parent granting permission to implement the plan and verifying training was missing. 23. Date of parent signature was missing. 24. Certified Professional Trainer information was missing. 25. Signature of certified professional who trained the program staff was missing, if parent was not the trainer. 26. Date of trainer signature was missing. 27. Printed name(s)of child care staff member(s) who have received instructions for care and/or have been trained to perform the procedure were missing. 28. Signature(s) of child care staff member(s) who have received instructions for care and/or have been trained to perform the procedure were missing. 29. Date of staff signature was missing. 30. Administrator/Provider signature was missing 31. Date of administrator/Provider was missing. (Page 4) 32. Child's name was missing. 33. Name of medication or medical food was missing. 34. Date the medication/medical food was administered was missing. 35. Time medication/medical food was administered was missing. 36. Dosage of medication/medical food that was administered was missing. 37. Signature of person administering medication/medical food was missing. 38. The plan was not followed or implemented. 39. The plan was not able to be implemented due to conflicting information. 40. None of the child care staff members trained in the procedures on the JFS 01236 were onsite when a child requiring the plan was present. 41. Child care staff members trained in the procedures on the JFS 01236 were not scheduled to be present the entire the time the child requiring the plan was onsite. 42. None of the child care staff members trained in the procedures on the JFS 01236 accompanied the child requiring the plan during a trip. 43, Achild care staff member who had not been trained in the procedures on the JFS 01236 performed the procedure. 44, Medication listed in the procedures to follow was not onsite available to administer as instructed and alternate instructions for this situation were not included on the plan. Provide staff training. Submit the program’s corrective action plan, which includes a copy of the completed JFS 01236, to the Department to verify compliance with the requirements of this rule.”

“During the inspection, it was determined that children were not being properly supervised as noted in number 3 below: 1. Child(ren) were not within both sight and hearing of a child care staff member during indoor play. 2. Child(ren) were not within both sight and hearing of a child care staff member during outdoor play. 3. Children were not within both sight and hearing of a child care staff member more than once. 4. Staff were not physically present in the space and near enough to respond and reach the child(ren) immediately. 5. Other: [ ]. Children must be supervised according to rule and within both sight and hearing of a child care staff member at alltimes. Provide staff training. Submit the program’s corrective action plan, which includes a statement that training was provided, to the Department to verify compliance with the requirements of this rule.”

“During the inspection, it was determined that unsanitary conditions, as noted in number 6 below, were in the Preschool/School Age restroom: 1. There was no liquid soap. 2. There was no toilet paper. 3. There were no paper towels. 4. The toilet cleaning brush was accessible to the children. 5. The plunger was accessible to the children. 6. The toilet(s) were not flushed. 7. The trash was not emptied from the day before. 8. There was a strong urine odor. 9. Other [ ]. The restroom(s) must be kept sanitary at all times. Technical assistance was provided at the time of the inspection, and as discussed, please correct this rule noncompliance. A written response for this rule noncompliance is not required at this time.”

“During the inspection, equipment was determined to be unsafe, hazardous to children, or in need of repair as noted in numbers 5 and 8 below: 1. Manufacturer's guidelines for the [ ] were not followed in that [ ]. 2. The straps were missing on the [_ ]. 3. The straps were attached, but were not used onthe [ ]. 4. The straps were attached and were used, but were not used in a safe manner. 5. The equipment had sharp points or corners. 6. The equipment had splinters. 7. The equipment had protruding nails, 8. The equipment had loose or rusty parts. 9. The equipment had paint which contains lead or other poisonous materials. 10. The equipment had hazardous features. 11. A fan was unstable and could easily tip over. 12. A fan had openings a finger could enter. 13. The pipes from the heat pump felt hot to the touch 14. A space heater felt hot to the touch 15. The position of a space heater was a tripping hazard 16. The air conditioning unit was not enclosed and was accessible to children on the playground. 17. A ball pit, trampoline, inflatable bounce house, inflatable slide, or inflatable equipment used for climbing and bouncing was used. 18. Other [ ]. Submit the program’s corrective action plan to the Department to verify compliance with the requirements of this rule.”

“Children in care shall be protected from any items and conditions which threaten their health, safety, and well-being. During the inspection, it was determined that at least one area of the program or at least one piece of equipment had chipping or peeling paint. Submit the program’s corrective action plan to the Department to verify compliance with the requirements of this rule.”

“During the inspection, it was determined that children were not protected from item(s) or condition(s) which may threaten their health, safety, or well-being as noted in numbers 6 and 13 below: 1. Surge protectors/outlets did not have childproof receptacle covers. 2. Open pull cords that are not closed loop. 3. Toys or other items small enough to be swallowed were present in the space where infants and/or toddlers were in care. 4. Electrical/extension cords attached to an object that would not likely result in a severe injury if pulled. 5. Stacked chairs. 6. Employee purse. 7. Diaper bags. 8. Television not securely anchored. 9. Small or lightweight pieces of shelving units are not securely anchored to the wall. 10. Smoke detector needing batteries replaced. 11. An area rug did not have a nonskid backing. 12. An area rug presented a tripping hazard. 13. A floor surface that was unsafe in that there is a large missing piece in bathroom floor-chipping and dips down creating hazard, 14. No platform was provided for the sink or toilet in the [ ] classroom. 15. The platform provided for the sink or toilet in the [ ] classroom was not sturdy. 16. The platform provided for the sink or toilet in the [ ] classroom posed a safety hazard in that [ ]. 17. Telephone cords. 18. Staff member stepped over a barrier/gate while holding a child. 19. Emergency exits were blocked by the following classroom furniture: [ ]. 20. A mercury thermometer was being used to take a child’s temperature. 21. Methods of ventilation used did not provide protection from rodents, insects, or other hazards. 22. Other [ ]. Provide staff training. Submit the program’s corrective action plan, which includes a statement that training was provided, to the Department to verify compliance with the requirements of this rule.”

“During the inspection, it was determined that at least one piece of equipment, furnishings, or material at the program was not constructed of materials to facilitate cleaning as noted in number 1 below: 1. The material had a tear-couches in Preschool and Toddler classrooms. 2. The material was not washable. 3. The material was porous. 4. The surface was cracked. 5. The surface was repaired, but in a manner that still did not facilitate cleaning. 6. Other [ ]. Equipment, furnishings, and furniture shall be constructed of materials to facilitate cleaning. Technical assistance was provided at the time of the inspection, and as discussed, please correct this rule noncompliance. Awritten response for this rule noncompliance is not required at this time.”

“In review of the staff records, it was determined that the medical statements for the employees listed on the Employee Record Chart did not meet the requirements as listed in number SC. below. 1. A medical statement was not on file for at least one employee; 2. The medical statement(s) on file did not have a date of examination within 12 months of the employee’s first day of employment; 3. Date of examination was missing; 4. Signature, business address, or telephone number of the licensed physician, physician assistant, advanced practice nurse, certified midwife, or certified nurse practitioner who completed the examination was missing; 5. A statement was missing that verifies the employee is: a. Physically fit for employment in a program caring for children; b. Immunized against Tetanus, Diphtheria, Pertussis (Tdap); c. Immunized against Measles, Mumps, and Rubella (MMR); 6. Tuberculosis (TB) screening/test information was missing: a. Documentation of the screening process to determine if the employee resided in a country identified by the world health organization as having a high burden of TB and arrived in the United States within the five years preceding the date of application for employment. b. Results of a TB test for employees meeting both criteria in 6a. c. Results of additional testing for employees with a positive TB test. d. Written statement, signed by a representative of the TB control unit, that the employee's TB is no longer infectious or the individual is receiving a TB treatment regimen for employees with a positive TB test. Submit the program’s corrective action plan, which includes a copy of the completed employee medical statement, or TB results/documentation, to the Department to verify compliance with the requirements of this rule.”

“In review of the staff records, it was determined that at least one child care staff member did not meet the annual professional development requirement as noted in number 1 below: 1. The child care staff member(s) had not completed at least six hours of professional development. 2. Documentation did not demonstrate the person who provided the training met the trainer qualifications as stated in the rule. 3. Training topic did not meet the requirements listed in appendix A of this rule. 4. Documentation of training did not meet the requirements of this rule. 5. The substitute(s) had been used more than ninety days annually between July first and June thirtieth and had not completed at least six hours of professional development 6. Other [ ]. Submit the program’s corrective action plan to the Department to verify compliance with the requirements of this rule.”

“In review of the children's records, it was determined that the JFS 01236 “Child Medical/Physical Care Plan for Child Care” did not meet the requirements of the rule as noted in number 1 below: 1. The JFS 01236 had not been updated as needed and at least annually. 2. A separate JFS 01236 had not been used for each condition. 3. The program used an old version of the JFS 01236. Submit the program’s corrective action plan to the Department to verify compliance with the requirements of this rule.”

“During the inspection, it was determined that medication, medical foods and/or topical products did not meet the requirement(s) for administering medication, medical foods, and/or medical products as noted in number 2 below: 1. The medication, medical food, or topical product was no longer needed and had not been removed from the program. 2. Topical product had expired and had not been removed from the program. 3. The prescription label had expired. Submit the program's corrective action plan to the Department to verify compliance with the requirements of this rule.”

“In review of the staff records, it was determined that the medical statements for the employees listed on the Employee Record Chart did not meet the requirements as listed in numbers 5 and 6 below. 1. A medical statement was not on file for at least one employee; 2. The medical statement(s) on file did not have a date of examination within 12 months of the employee’s first day of employment; 3. Date of examination was missing; 4. Signature, business address, or telephone number of the licensed physician, physician assistant, advanced practice nurse, certified midwife, or certified nurse practitioner who completed the examination was missing; 5. A statement was missing that verifies the employee is: a. Physically fit for employment in a program caring for children; b. Immunized against Tetanus, Diphtheria, Pertussis (Tdap); c. Immunized against Measles, Mumps, and Rubella (MMR); 6. Tuberculosis (TB) screening/test information was missing: a. Documentation of the screening process to determine if the employee resided in a country identified by the world health organization as having a high burden of TB and arrived in the United States within the five years preceding the date of application for employment. b, Results of a TB test for employees meeting both criteria in 6a. c. Results of additional testing for employees with a positive TB test. d. Written statement, signed by a representative of the TB control unit, that the employee's TB is no longer infectious or the individual is receiving a TB treatment regimen for employees with a positive TB test. Submit the program’s corrective action plan, which includes a copy of the completed employee medical statement, or TB results/documentation, to the Department to verify compliance with the requirements of this rule.”

“In review of the staff records, it was determined that child care staff member(s) did not meet the requirements for completing the online orientation training as noted in number 1 below: 1. The training was not completed within 30 days of starting employment at the program as a child care staff member. 2. Documentation of completing the training after December 31, 2016 was not on file. 3. Completion of the training was not verified in the OPR. 4. A child care staff member had sole responsibility of children and had not completed the online orientation. Submit the program’s corrective action plan to the Department to verify compliance with the requirements of this rule.”

“In review of the staff records, it was determined that at least one child care staff member did not meet the annual professional development requirement as noted in number 1 below: 1. The child care staff member(s) had not completed at least six hours of professional development. 2. Documentation did not demonstrate the person who provided the training met the trainer qualifications as stated in the rule. 3. Training topic did not meet the requirements listed in appendix A of this rule. 4. Documentation of training did not meet the requirements of this rule. 5. The substitute(s) had been used more than ninety days annually between July first and June thirtieth and had not completed at least six hours of professional development 6. Other [ ]. Submit the program’s corrective action plan to the Department to verify compliance with the requirements of this rule.”