Buttons & Bows Too Childcare Llc

“During the inspection, group size limitations were not maintained for the group of toddlers as it was determined there were 16 children grouped together. The group size shall not exceed twice the maximum number of children allowed per Child Care Staff Member. 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 the barrier between the play and sleeping space did not meet the requirements as noted in number 1 below: 1. No barrier had been provided 2. The barrier did not prevent the infants from entering the sleeping area. 3. The barrier was not safe. 4. The barrier was not sturdy. 5. The barrier impaired staff's ability to see and hear all sleeping infants in their cribs. 6. The barrier was inadequate. 7. Other [ ]. 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 required at this time.”

“During the inspection, equipment was determined to be unsafe, hazardous to children, or in need of repair as noted in number 1 below: 1. Manufacturer's guidelines for the infant bouncer seats were not followed in that infants that could sit up on own were placed in bouncer seats. 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.”

“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 5b, 5c and 6a 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.”

“During the inspection, it was determined that a medication, medical food or topical product was at the program which had not been labeled with the child's name. 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 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 quarterly inspections of one or more outdoor play area(s) and equipment had not been completed and documented as required, using the JFS 01281 “Child Care Playground Inspection Report” form. 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 2, 5bc 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 at least one child care staff member had not completed required health and safety training as noted in numbers 1 and 4 below: 1. Child abuse and neglect recognition and prevention training was not completed within sixty days of hire. 2. First aid training was not completed within ninety days of hire. 3. Cardiopulmonary resuscitation (CPR) training was not completed within ninety days of hire. 4. The child abuse and neglect recognition and prevention training was expired. 5. The first aid training was expired. 6. The CPR training was expired. Refer to the Employee Record Chart for the name(s) of the child care staff member(s) who must complete the required health and safety training(s). Submit the program’s corrective action plan to the Department to verify compliance with the requirements of this rule.”