Noahs Ark · Waynesboro

The file for Staff person #2 was observed to lack documentation of having completed the Pennsylvania Health and Safety Update 2022 1-hour training by December 30, 2022. This was evidenced by the only completed Pennsylvania Health and Safety training certificate present in the file was a 6-hour training certificate dated 10/30/16.

The file for child #1 was observed to contain an emergency contact form that did not include information on the child's special needs, as specified by the child's parent, physician, physician's assistant or CRNP, which is needed in an emergency situation.

The file for staff person #1 and #3 were observed to lack documentation of obtaining an annual minimum of 12 clock hours of child care training.

2nd citation. Previously cited on 4/30/24. The file of Volunteer #1 lacked a National Sex Offender Registry Certificate.

2nd citation. Previously cited on 4/23/24. Observed a cord to a baby swing which was not secured creating a potential tripping and/or strangulation hazard in the Infant Room.

On 4/23/24 observed a cord to a baby swing which was not secured creating a potential tripping and/or strangulation hazard in the Infant Room. On 4/23/24 observed 3 cribs and 3 pack 'n plays with loose sheets in the Infant Room creating a potential suffocation hazard.

The file of Staff #5 lacked a valid DHS FBI Clearance because it did not contain a disposition for all charges. The file of Volunteer #6 lacked a valid State Police Clearance because it did not have a "disseminated by" date. The file of Volunteer #6 lacked a DHS FBI Clearance and National Sex Offender Registry Certificate. The file of Volunteer #6 lacked a valid disclosure statement (SEE LIS Code Sheet). The disclosure statement on file for Volunteer #6 was not the one updated in 2020. The file of Staff #9 lacked a State Police Clearance, Child Abuse Clearance, and DHS FBI Clearance updated every 60 months. The file of Staff #9 contained a State Police Clearance dated 3/20/24 with a previous one dated 8/24/18. The file of Staff #9 contained a Child Abuse Clearance dated 3/20/24 with a previous one dated 9/4/18. The file of Staff #9 contained a DHS FBI Clearance dated 3/25/24 with a previous one dated 8/21/18.

The facility did not have an emergency plan that provides for a method for facility persons to contact parents as soon as reasonably possible when an emergency situation arises.

The facility did not have an emergency plan that provides for a method for facility persons to inform parents that the emergency has ended and to provide instruction as to how parents can safely be reunited with their children.

The file of Volunteer #6 lacked documentation of training regarding the emergency plan on an annual basis. The file of Volunteer # 6 contained documentation of emergency plan training on 10/5/22 but no documentation for 2023.

The letter provided to the parent explaining emergency procedures did not address accommodations for infants, toddlers, children with disabilities, and children with chronic medical conditions.

On 4/23/24 observed Kids Babyganics hand sanitizer on the radio/CD player stand which Indicated "keep out of the reach of children" which was accessible to children in the Pre K 2 Room.

On 4/23/24 the hot water temperature at the sink in the women's bathroom near the Pre K 1 Room was 118 degrees.

On 4/23/24 observed rust on the heat registers in the bathrooms located by the Infant Room. On 4/23/24 observed rust on the heat registers in the bathrooms located by the Director's Office. On 4/23/24 observed rust on the heat registers in the bathrooms located by the Preschool and Pre K 2 Rooms. On 4/23/24 observed raised stakes used to secure the black barriers in the Preschool/School-Age Outdoor Play Space.

The toilet in the Older Toddler Room lacked a handwashing sign.

On 4/23/24 observed a bin labeled "sports" with rough edges in Wilson 1 Room. On 4/23/24 observed a cracked LEGO and a cracked LEGO base with a corner missing creating rough edges in Wilson 2 Room. On 4/23/24 observed a cracked stencil with rough edges in Wilson 2 Room.

On 4/23/24 observed embedded equipment in the Preschool/Pre K/ School-Age Outdoor Play Space with approximately 6 to 8 inches of mulch. The Consumer Product Safety Commission recommends 9 inches of mulch as protective surface covering.

On 4/23/24 observed indoor play equipment for climbing not installed or used over a protective surface covering which does not interfere with the stability of the equipment in the Young Toddler Room.

On 4/23/24 observed rest equipment not labeled for the use of a specific child in the Infant Room.

The file of Child #2 lacked an updated health report at least every 12 months for an older toddler or preschool child. The file of Child #2 contained a health report dated 11/10/22.

Child #4, a 5-month-old, lacked Rotavirus, DTAP/DTP/TD, HIB, Pneumococcal, and Polio immunizations according to the recommendations of the ACIP. Child #4 had documentation of 1 Rotavirus immunization, 1 DTAP/DTP/TD immunization, 1 HIB immunization, 1 Pneumococcal immunization, and 1 Polio immunization. Child #7, a 6-month-old, lacked Rotavirus, DTAP/DTP/TD, HIB, Pneumococcal, and Polio immunizations according to the recommendations of the ACIP. Child #7 had no documentation of Rotavirus, DTAP/DTP/TD, HIB, Pneumococcal, and Polio immunizations. Child #9, a 20-month-old lacked DTAP/DTP/TD and MMR immunizations according to the recommendations of the ACIP. Child #9 had documentation of 3 DTAP/DTP/TD immunizations and no MMR immunization.

The files of Staff #3 and #7 lacked a health assessment conducted every 24 months. The file of Staff #3 contained a current health assessment dated 3/26/24 with a previous one dated 2/15/22. The file of Staff #7 contained a health assessment dated 10/13/21.

On 4/23/24 observed multiple lunch boxes containing potentially hazardous foods such as yogurt which were not refrigerated in the Older Toddler, Younger Toddler, and Preschool Rooms.

On 4/23/24 observed bottles which were not labeled with the child's name in the Infant Room.

The first-aid kit in the van used to transport children lacked soap.

Emergency drills were not conducted annually. The facility provided documentation of an emergency drill being conducted on 9/14/22 but did not have documentation for 2023.

Child #4 lacked a health report no later than 60 days following the first day of attendance at the facility. Child #4 who had an admission date of 3/4/24 had a health report in the file, but it was not dated.

The file of Staff #1 lacked documentation of completing the Pennsylvania Health and Safety Update within 90 days of hire (SEE LIS Code Sheet).

The file of Staff #3 lacked documentation of participating, at least annually, in fire safety training conducted by a fire protection professional (SEE LIS Code Sheet). The file of Staff #3 contained documentation of fire safety training completed on 10/24/22 but no documentation for 2023.

Volunteer #6 has not completed the mandated reporter training within 90 days of their date of hire (see LIS code sheet).

The file of Staff #5, who was designated as an assistant group supervisor, lacked documentation of 2 years of experience with children.

On 4/23/24 the written plan of daily activities was not posted in the Older Toddler Room.

The files of Children #6, #8, #9, and #10 lacked child service reports completed at least every 6 months. The file of Child #6 with an admission date of 9/27/22 contained a child service report dated 11/1/23. The file of Child #8 with an admission date of 10/31/22 contained child service reports dated 5/23/23 and 11/14/23. The file of Child #9 with an admission date of 10/24/22 contained child service reports dated 5/30/23 and 11/16/23. The file of Child #10 with an admission date of 8/29/22 contained child service reports dated 5/30/23 and 11/29/23.

Emergency contact information for Child #1 did not include the work address of the enrolling parent.

Emergency contact information for Child #5 did not include the health insurance policy number for a child under a family policy or Medical Assistance benefits, if applicable.

Emergency contact information for Child #3 did not include the complete address of the individual designated by the parent to whom the child may be released.

On 4/30/24 observed Volunteer #6's file was not stored in a locked cabinet.

The files of Staff #2, #4, #7, #8, and #9 lacked documentation of obtaining a minimum of 12 clock hours of child care training.

2nd citation. Previously cited on 6/26/23 under SIN-00225831. Observed Boudreaux's Butt Paste, Desitin, Aquaphor, Tubby Todd Sweet Cheeks Diaper Paste, Triple Paste Zinc Oxide Diaper Rash Cream, and Parent's Choice Diaper Rash Ointment which indicated "keep out of the reach of children" by the sink and changing mat which were accessible to children in the Young Toddler Room.

The file of Child #1 contained a health report which did not include a statement that age-appropriate screenings recommended by the American Academy of Pediatrics were conducted since the time of the previous health report.

The file of Staff #1, a provisional hire, did not contain documentation of the results of the PA Child Abuse Clearance prior to employment (SEE LIS Code Sheet). The file of Staff #1 contained a PA Child Abuse Clearance dated 6/27/23. The file of Staff #1 did not contain a National Sex Offender Registry Certificate. The file of Staff #6 lacked a valid State Police Clearance because it did not have a disseminated by date. The file of Staff#7 lacked an FBI Clearance updated every 60 months. The file of Staff #7 contained an FBI Clearance dated 12/6/21 with a previous one dated 12/5/16. The file of Staff #11 lacked a valid Child Abuse and Registry Check from the State(s) in which Staff #11 resided because the date of the clearance was unreadable.

The emergency plan did not address continuity of operations. The files of Staff #2, #3, #5, #8. and #9 lacked documentation of completing the Pennsylvania Health and Safety Update 2022 by December 30, 2022 (SEE LIS Code Sheet). The file of Staff #11 lacked documentation of completing the Pennsylvania Health and Safety Update within 90 days of hire (SEE LIS Code Sheet). The file of Staff #2 contained no documentation of completing the health and safety update. The file of Staff #3 contained documentation of completing the health and safety update on 5/10/23. The file of Staff #5 contained documentation of completing the health and safety update on 5/19/23. The file of Staff #8 contained documentation of completing the health and safety update on 5/10/23. The file of Staff #9 contained documentation of completing the health and safety update on 5/6/23. The file of Staff #11 contained documentation of completing the health and safety training on 7/3/17 and the health and safety update on 6/18/23.

The file of Staff #7 lacked documentation of receiving training regarding the emergency plan on an annual basis. The file of Staff #7 contained documentation of emergency plan training on 10/1/21 but contained no documentation for 2022.

On 6/26/23 observed Fresh Scent Disinfecting Wipes which indicated "keep out of the reach of children" at the changing table which were accessible to children in the Young Toddler Room. On 6/26/23 observed Boudreaux's Butt Paste, 3 Desitin, 3 Aquaphor, Tubby Todd Sweet Cheeks Diaper Paste, Triple Paste Zinc Oxide Diaper Rash Cream, and Parent's Choice Diaper Rash Ointment which indicated "keep out of the reach of children" in the drawer under the changing table which were accessible to children in the Young Toddler Room.

The urinal in the Men's Bathroom by Wilson 1, Wilson 2, and the Genesis Rooms lacked a handwashing sign.

On 6/26/23 observed a frayed farm area rug and a cracked bin containing wooden blocks in the Older Toddler Room. On 6/26/23 observed a broken green connector piece in the Pre K Room. On 6/26/23 observed cracked marble connectors in the Wilson 1 Room. On 6/26/23 observed a cracked large orange square Magna Tile and cracked pretend pizza in the Genesis Room. On 6/26/23 observed a cracked green dantoy in the grassy play space at the back of the facility.

On 6/26/22 observed embedded equipment in the Preschool/Pre K/ School-Age Outdoor Play Space with approximately 7 inches of mulch. The Consumer Product Safety Commission recommends 9 inches of mulch as protective surface covering.

On 6/28/23 observed approximately 8 inches between 2 cots and 12 inches between 2 cots in the Pre K Classroom.

The file of Child #4 lacked an updated health report at least every 12 months for an older toddler or preschool child. The file of Child #4 contained health reports dated 9/2/21 and 12/21/22.

The file of Child #1 lacked a health report which included a review of the child's immunized status according to recommendations of the ACIP. The file of Child #1 did not contain documentation of any immunizations. The file of Child #3, a 5-year-old, lacked an influenza immunization according to the recommendations of the ACIP. The file of Child #4, a 3-year-old, lacked an influenza immunization according to the recommendations of the ACIP. The file of Child #5, a 2-year-old, lacked an influenza immunization according to the recommendations of the ACIP.

The operator did not establish and maintain a medication log if prescription or nonprescription medication is administered for Child #7.

The file of Staff #11 lacked a health assessment conducted within 12 months prior to providing initial service in a child care setting (SEE LIS Code Sheet). The file of Staff #11 contained health assessment dated 6/2/21.

The file of Staff #11 lacked an initial health assessment which included a tuberculosis screening by Mantoux method at initial employment (SEE LIS Code Sheet). Staff #11 had a Mantoux read date of 6/4/21.

The file of Staff #4 contained a health assessment which did not include an examination for communicable diseases and the results of that examination.

The file of Staff #4 contained a health assessment which did not include information on medical problems that might threaten the health of the children or prohibit a staff person from providing adequate care to children.

The operator did not conspicuously post the menu at least 1 week in advance or provide a menu to each family.

The first-aid kit in the van lacked an assortment of adhesive bandages.

The Director or designated staff person who is responsible for compliance with this chapter did not conduct fire drills and ensure that the hypothetical locations of the fire were rotated around the facility for each drill such that the hypothetical location was never the same for consecutive drills.

The file of Child #1 lacked a health report no later than 60 days following the first day of attendance at the facility. Child #1 who had an admission date of 3/13/17 did not have a health report on file.

The legal entity did not have a current copy of the comprehensive general liability insurance policy to cover the persons who are on the premises on file at the facility.

Staff person #11 has not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): pediatric first aid/CPR from a PQAS approved trainer and a PQAS approved curriculum.

The files of Staff #7 and #10 lacked a written evaluation on a regular basis, a minimum of one evaluation every 12 months. The file of Staff #7 contained a written evaluation dated 7/2022 but did not contain one for 2021. The file of Staff #10 contained a written dated 7/2022 with a previous one dated 6/1/21.

The files of Staff #4 and #10, who were designated as Assistant Group Supervisors, lacked documentation of 2 years' experience with children.

The files of Children #2, #3, and #5 lacked child service reports completed at least every 6 months. The file of Child #2, with an admission date of 1/4/21, did not contain child service reports. The file of Child #3, with an admission date of 8/29/22, contained a child service report dated 5/7/23. The file of Child #5, with an admission date of 8/29/22, contained a child service report dated 5/29/23.

Emergency contact information for Child #3 lacked the work address of the enrolling parent on the emergency contact form.

Emergency contact information for Child #2 did not include information on the child's special needs, as specified by the child's parent, physician, physician's assistant or CRNP, which is needed in an emergency situation.

Emergency contact information for Child #4 lacked the complete address of the individual designated by the parent to whom the child may be released.

On 6/26/23 emergency contact information was not present for Child #6 in the Young Toddler Room when receiving care in that room.

The emergency contact and agreement for Child #2 were not reviewed and updated at least once in a 6-month period. Child #2's emergency contact and agreement were reviewed on 6/16/22 and 2/2/23.

The file of Staff #9 lacked documentation of completing professional development in pediatric first aid and pediatric cardiopulmonary resuscitation within 90 days of hire (See LIS Code Sheet). Staff #9 had documentation of completing pediatric first aid and pediatric cardiopulmonary resuscitation on 6/14/22.

The files of Staff #5, #7, and #10 lacked documentation of obtaining an annual minimum of 12 clock hours of child care training.

Based on interviews, Child #1 a younger aged toddler was offered only breast milk to drink and not offered drinking water throughout the day on March 30, 2023.

The urinal in the Men's Bathroom located in the Church Basement lacked a handwashing sign.

Observed a cracked purple square Magna Tile and a cracked green square Magna Tile in the Genesis Preschool Room.

Observed 2 cubbies in the Genesis Preschool Room which were not anchored creating a potential tipping hazard. Observed 2 bookcases to the right of the entrance in the Genesis Preschool Room which were not anchored creating a potential tipping hazard. Observed a microwave on top of a mini fridge in the Genesis Preschool Room which was not anchored creating a potential tipping hazard.

The mini fridge in the Genesis Preschool Room lacked an operating thermometer.

Staff #1, #2, #4, #5, #6, #7, #8, #9, and #10 lacked documentation of completing the Pennsylvania Health and Safety Update 2022 by December 30, 2022 (SEE LIS Code Sheet). Staff #1, #2, #4, #5, #6, #7, #8, #9, and #10 have no documentation of completing the health and safety update.

Staff person #3 has not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): 10-hour Health and Safety Training and pediatric first aid/CPR from a PQAS approved trainer and a PQAS approved curriculum.

Staff person #3 has not completed the mandated reporter training within 90 days of their date of hire (see LIS code sheet).

3rd citation. Previously cited on 6/16/22 and 9/6/22. Observed embedded equipment in the Preschool/Pre K/School-age Outdoor Play Space with approximately 2 to 4 inches of mulch. The Consumer Product Safety Commission recommends 9 inches of mulch as protective surface covering.

3rd citation. Previously cited on 6/30/22 and 9/6/22. The file of Child #1, a 33 month old, lacked Hepatitis A immunizations in accordance with the schedule recommended by the ACIP. The file of Child #1 contained documentation of one Hepatitis A immunization.

3rd citation. Previously cited on 6/30/22 and 9/6/22. The file of Staff #1 lacked documentation of completing an annual minimum of 12 clock hours of child care training.

2nd citation. Previously cited on 4/28/22. Based on interviews and video footage, Staff #1 and Staff #2 left Child #1 alone on the playground for approximately 9 minutes. Once Staff #1 and #2 realized Child #1 was not in the group in the classroom, Staff #2 went to the playground to look for Child #1.

2nd citation. Previously cited on 6/16/22. The hot water temperature at the large sink was 112 degrees and the hot water temperature at the sink by the changing table was 111 degrees in the Infant Classroom.

2nd citation. Previously cited on 6/16/22. Observed peeling paint on the swing in the Young Toddler and Older Toddler Outdoor Play Space.

2nd citation. Previously cited on 6/16/22. Observed a loose roof on a Step 2 Play House located in the Preschool/Pre K/School-Age Outdoor Play Space.

2nd citation. Previously cited on 6/16/22. Observed embedded equipment in the Preschool/Pre K/School-Age Outdoor Play Space with approximately 2 to 4 inches of mulch. The Consumer Product Safety Commission recommends 9 inches of mulch as protective surface covering.

2nd citation. Previously cited on 6/30/22. The file of Child #7 contained a health report which did not include an assessment of an acute or chronic health problem or special need and recommendations for treatment or services, including information regarding abnormal results of screening tests for vision, hearing, or lead poisoning.

2nd citation. Previously cited on 6/30/22. The file of Child #7 contained a health report which did not include a statement that the child is able to participate in child care and appears to be free from contagious or communicable disease.

2nd citation. Previously cited on 6/30/22. The file of Child #1, a 7 month old, lacked a current influenza immunization in accordance with the schedule recommended by the ACIP. The file of Child #3, a 2 year old, lacked a current influenza immunization in accordance with the schedule recommended by the ACIP. The file of Child #4, a 33 month old, lacked a current influenza immunization and Hepatitis A immunizations in accordance with the schedule recommended by the ACIP. The file of Child #4 contained documentation of one Hepatitis A immunization. The file of Child #6, a 43 month old, lacked a current influenza immunization in accordance with the schedule recommended by the ACIP. The file of Child #7, a 44 month old, lacked a current influenza immunization in accordance with the schedule recommended by the ACIP. The file of Child #8, a 11 month old, lacked Hepatitis B, DTAP/DTP/TD, HIB, Pneumococcal, Polio, and influenza immunizations in accordance with the schedule recommended by the ACIP. The file of Child #8 contained documentation of one Hepatitis B immunization, one DTAP/DTP/TD immunization, one HIB immunization, one Pneumococcal immunization, and one Polio immunization. The…

2nd citation. Previously cited on 6/30/22. An emergency drill was not conducted annually. The facility did not have documentation that an emergency drill was conducted.

2nd citation. Previously cited on 6/30/22. The facility did not have an emergency plan that provides for accommodations for evacuation of children from the facility building and evacuation of children to a location away from the facility premises. The emergency plan did not contain evacuation routes and evacuation plans or written directions to exit the building.

2nd citation. Previously cited on 6/30/22. The operator did not send a copy of the emergency plan and subsequent plan updates to the local municipality and to the county emergency management agency.

2nd citation. Previously cited on 6/30/22. The operator did not notify local traffic authorities annually in writing of the location of the facility and the program's use of pedestrian and vehicular routes around the child care facility. The operator provided documentation that the previous notification was dated 6/28/21.

2nd citation. Previously cited on 6/30/22. The facility did not have a policy that addressed the recognition of potential signs and symptoms of shaken baby syndrome and abusive head trauma, strategies for coping with a crying, fussing, and distraught child, and the prevention and identification of child maltreatment.

Continued Non-Compliance: On June 30, 2022 a renewal inspection was conducted at the facility. Staff person #3 had not completed the mandated reporter training within 90 days of their date of hire (see LIS code sheet). The facility's acceptable plan of correction indicated the correction would be implemented by August 5, 2022. On September 6, 2022, an unannounced inspection was conducted. Staff person #3 still has not completed the mandated reporter training.

2nd citation. Previously cited on 6/30/22. The file of Staff #2 lacked documentation of a written evaluation on a regular basis, a minimum of one evaluation every 12 months. The file of Staff #2 contained a written evaluation dated 6/20/21.

2nd citation. Previously cited on 6/30/22. The file of Staff #4, who was designated as an assistant group supervisor, lacked documentation of 2 years experience with children.

2nd citation. Previously cited on 6/30/22. The files of Children #1, #2, #3, #4, #5, #8, and #9 lacked the services to be provided on the agreement.

2nd citation. Previously cited on 6/30/22. The file of Child #6 lacked the persons designated by a parent to whom the child may be released on the agreement.

2nd citation. Previously cited on 6/30/22. The file of Child #6 lacked the work address of the enrolling parent on the emergency contact form.

2nd citation. Previously cited on 6/30/22. The emergency contact and agreement for Child #6 were not reviewed and updated once every 6 months with the reinstating of this regulation on 1/6/22. The emergency contact and agreement for Child #6 were signed on 2/17/21 and reviewed on 8/17/21.

2nd citation. Previously cited on 6/30/22. The files of Children #3 and #4 lacked signed parental consent for administration of minor first-aid procedures by facility staff.

2nd citation. Previously cited on 6/30/22. Staff #4 lacked documentation of child care experience prior to service at the facility.

2nd citation. Previously cited on 6/30/22. The file of Staff #3 did not contain two written, nonfamily references from individuals attesting to the person's suitability to serve as a facility person. The file of Staff #3 contained one reference.

2nd citation. Previously cited on 6/30/22. The files of Staff #1 and #2 lacked documentation of completing an annual minimum of 12 clock hours of child care training.

On 6/16/22 Staff #2 and #13 were observed working together in the Preschool Classroom. On 6/30/22 Staff #2 was observed not to have a Child Abuse Clearance from the State(s) in which Staff #2 resided in the last 5 years which made her unqualified to supervise Staff #13, a provisional hire. The files of Staff #1, #2, #3, #5, #6, #7, #8, #9, #10, #12, #13, and #14 lacked a valid disclosure statement (See LIS Code Sheet). The disclosure statement on file for Staff #1, #2, #3, #5, #6, #7, #8, #9, #10, #12, #13, and #14 was not the on updated in 2020. The file of Staff #1 lacked a signed disclosure statement at the time of providing initial care (See LIS Code Sheet). The file of Staff #1 contained a disclosure statement dated 6/1/22. The file of Staff #2 lacked documentation of application for the State child abuse and neglect registry check from the State(s) in which Staff #2 resided in the last 5 years prior to or on the date of initial hire. The file of Staff #2 did not contain State child abuse and neglect registry check from the State(s) in which Staff #2 resided. The file of Staff #5 lacked a copy of a completed State Police Clearance and Child Abuse Clearance prior to providing…

On 6/16/22 observed 2 pair of adult scissors in a plastic pencil box in the bottom bin beside the metal cabinet in the corner of the Wilson #2 Classroom which were accessible to children. On 6/16/22 observed a cord to a baby swing which was not secured creating a potential tripping and/or strangulation hazard in the Infant Classroom.

As of 6/30/22 the file of Staff #11 lacked documentation of receiving training regarding the emergency plan on annual basis. The file of Staff #11 contained documentation of emergency plan training completed on 6/10/21.

On 6/16/22 observed Sterling Lights Bingo Daubers which indicated "keep out of reach of children" in a green bin on the bottom shelf of the first closet in the Preschool Classroom which were accessible to children. On 6/16/22 observed Palmolive Dish Detergent which indicated "keep out of the reach of children" on the top shelf of the cabinet to the left of the refrigerator in the Preschool Classroom which was accessible to children. On 6/16/22 observed a red bin containing sunscreens including Neutrogena and Coppertone which indicated "keep out of the reach of children" on the bottom shelf of the cabinet to the left of the refrigerator in the Preschool Classroom which were accessible to children. On 6/16/22 observed Fix-All Adhesive which indicated "keep out of the reach of children" on the top shelf of the cabinet to the left of the refrigerator in the Preschool Classroom which was accessible to children. On 6/16/22 observed Art Naturals Hand Sanitizer which indicated "keep out of the reach of children" in the back pack on the shelf by the back entrance in the Pre K Classroom which was accessible to children. On 6/16/22 observed Germ X Hand Sanitizer which indicated "keep out of…

On 6/16/22 the hot water temperature at the handwashing sink in the Young Toddler Classroom was 125 degrees. On 6/16/22 the hot water temperature at the small handwashing sink was 118 degrees and the hot water temperature at the large handwashing sink was 142 degrees in the Older Toddler Classroom. On 6/16/22 the hot water temperature of the sink in the first bathroom was 122 degrees by the Infant Room. On 6/16/22 the hot water temperature of the sink in the 2nd bathroom was 134 degrees by the Infant Room. On 6/16/22 the hot water temperature at the large sink was 142 degrees and the hot water temperature at the sink by the changing table was 135 degrees in the Infant Classroom. On 6/16/22 the hot water temperature of the sink in the first bathroom by the Wilson #1 and #2 Classrooms was 111 degrees.

When the Preschool Classroom and Young Toddler Classroom used the Outdoor Play Space, a first-aid kit was not present. A first-aid kit was not in the Wilson #2 Classroom.

On 6/16/22 observed a first-aid kit on a cabinet by the rear entrance in the Pre K Classroom which was accessible to children.

On 6/16/22 observed peeling paint behind the table in the Infant Classroom. On 6/16/22 observed peeling paint on the swing in the Young Toddler and Older Toddler Outdoor Play Space.

On 6/16/16 the toilet in both the first and 2nd bathrooms by the Infant Classroom lacked a handwashing sign. On 6/16/22 the toilet in the first bathroom by the kitchen lacked a handwashing sign. On 6/16/22 the toilet and urinal in the 2nd bathroom by the kitchen lacked a handwashing sign.

On 6/16/22 observed a tunnel, pop up house, and rocking toys in front of the rear exit in the Infant Classroom.

On 6/16/22 observed cracked Magna Tiles in the Preschool Classroom. On 6/16/22 observed a frayed area rug by the transportation shelf in the Preschool Classroom. On 6/16/22 observed a torn corner on a red foam block in the Young Toddler Classroom. On 6/16/22 observed a pop up house with approximately a 2 inch tear in the Infant Classroom. On 6/16/22 observed a red and yellow block with torn corners in the Infant Classroom. On 6/16/22 observed a broken gas cap on a Little Tykes red and yellow cozy coupe in the Young Toddler/Older Toddler Outdoor Play Space. On 6/16/22 observed a loose roof on a Step 2 Play House located in the Preschool/Pre K/School-Age - Outdoor Play Space.

On 6/16/22 observed embedded equipment in the Preschool/Pre K/ School-Age Outdoor Play Space with approximately 2 to 4 inches of mulch. The Consumer Product Safety Commission recommends 9 inches of mulch as protective surface covering

On 6/16/22 observed foam blocks with bite marks in the Preschool Classroom. On 6/16/22 observed foam blocks and foam numbers with bite marks in the Older Toddler Classroom.

On 6/16/16 observed rest equipment not labeled for the use of a specific child in the following classrooms: Preschool, Pre K, Young Toddler, Older Toddler, and Infant.

The files of Children #2 and #10 lacked an updated health report at least every 6 months for an infant or young toddler with the reinstating of this regulation on 1/6/22. The file of Child #2 contained a current health assessment dated 5/3/22 with a previous one dated 1/25/21. The file of Child #10 contained a current health assessment dated 3/3/22 with a previous one dated 2/26/21.

The file of Child #5 lacked an updated health report at least every 12 months for an older toddler or preschool child with the reinstating of this regulation on 1/6/22. The file of Child #5 contained a current health assessment dated 3/17/22 with a previous one dated 10/13/20.

The file of Child #7 contained a health report which did not include an assessment of an acute or chronic health problem or special need and recommendations for treatment or services, including information regarding abnormal results of screening tests for vision, hearing, or lead poisoning.

The file of Child #7 contained a health report which did not include a statement that the child is able to participate in child care and appears to be free from contagious or communicable disease.

The file of Child #1, a 7 month old, lacked a current influenza immunization in accordance with the schedule recommended by the ACIP. The file of Child #3, a 2 year old, lacked a current influenza immunization in accordance with the schedule recommended by the ACIP. The file of Child #4, a 33 month old, lacked a current influenza immunization and Hepatitis A immunizations in accordance with the schedule recommended by the ACIP. The file of Child #4 contained documentation of one Hepatitis A immunization. The file of Child #6, a 43 month old, lacked a current influenza immunization in accordance with the schedule recommended by the ACIP. The file of Child #7, a 44 month old, lacked a current influenza immunization in accordance with the schedule recommended by the ACIP. The file of Child #8, a 11 month old, lacked Hepatitis B, DTAP/DTP/TD, HIB, Pneumococcal, Polio, and influenza immunizations in accordance with the schedule recommended by the ACIP. The file of Child #8 contained documentation of one Hepatitis B immunization, one DTAP/DTP/TD immunization, one HIB immunization, one Pneumococcal immunization, and one Polio immunization. The file of Child #10, a 22 month old, lacked a…

On 6/16/22 Staff in the Older Toddler Classroom did not ensure that children's hands were washed before lunch.

The files of Staff #1 and #5 lacked documentation of a health assessment being conducted within 12 months prior to providing initial service in a child care setting (See LIS Code Sheet). The file of Staff #1 contained a health assessment dated 1/3/22. The file of Staff #5 contained a health assessment dated 8/13/21.

On 6/16/22 Staff in the Older Toddler Classroom did not wash their hands before lunch.

The first-aid kit located in the van lacked soap and water.

An emergency drill was not conducted annually. The facility did not have documentation that an emergency drill was conducted.

The Director or designated staff person did not ensure that fire drills were conducted at least once every 60 days. The facility provided documentation that fire drills were conducted on 6/17/21, 7/29/21, 9/8/21, 1/13/22, 2/10/22, 3/10/22, 4/8/22, 5/4/22, and 6/2/22.

The facility did not have an emergency plan that provides for accommodations for evacuation of children from the facility building and evacuation of children to a location away from the facility premises. The emergency plan did not contain evacuation routes and evacuation plans or written directions to exit the building.

The operator did not send a copy of the emergency plan and subsequent plan updates to the local municipality and to the county emergency management agency.

As of 6/30/22 the operator did not notify local traffic safety authorities annually in writing of the location of the facility and the program's use of pedestrian and vehicular routes around the child care facility. The operator provided documentation that the previous notification was dated 6/28/21.

The facility did not have a policy that addressed the recognition of potential signs and symptoms of shaken baby syndrome and abusive head trauma, strategies for coping with a crying, fussing, and distraught child, and the prevention and identification of child maltreatment. On 6/16/22 Staff person #2 and #13 were observed to be caring for children unsupervised. Staff person #2 and #13 have not completed the following pre-service training required prior to caring for children unsupervised: health and safety training.

The file of Staff #11 lacked documentation of renewing their certification in pediatric first aid and pediatric cardiopulmonary resuscitation on or before the expiration of the most current certification. The file of Staff #11 contained documentation of first-aid and CPR training on 5/16/21 with previous training on 3/2/19.

Staff persons #2 and #8 have not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): Health and Safety and Pediatric First-aid and CPR. Staff person #5 has not completed the following required pre-service training within 90 days of hire: Health and Safety. Staff person #11 has not completed the following required pre-service training within 90 days of their hire date (see LIS code sheet): Pediatric First-aid and CPR. Staff #11, who was hired prior to the implementation of the new regulations, did not complete health and safety training within 180 days of the new regulations being implemented. The file of Staff #11 contained documentation of completing health and safety training on 7/15/21.

Staff person #6 and #12 have not completed the mandated reporter training within 90 days of their date of hire (see LIS code sheet).

Staff 1 lacked documentation of mandated reporter training completed within 90 days of start (See LIS Code Sheet). Staff #1 had documentation of completing mandated reporter training on 6/13/22.

As of 6/30/22 the file of Staff #11 lacked documentation of a written evaluation on a regular basis, a minimum of one evaluation every 12 months. The file of Staff #11 contained a written evaluation dated 6/20/21.

The file of Staff #2, who was designated as an Assistant Group Supervisor, lacked documentation of a high school diploma or general educational development certificate and 2 years experience with children. The files of Staff #3 and #5, who were designated as an Assistant Group Supervisors, lacked documentation of 2 years experience with children.

The file of Staff #12, who was designated as an aide, lacked documentation of a high school diploma or general educational development certificate.

The Preschool Classroom and Wilson #2 Classroom did not have a written plan of daily activities posted.

The files of Children #1, #2, #3, #4, #5, #8, and #10 lacked the services to be provided on the agreement.

The agreements of Children #2 and #7 lacked the child's arrival and departure times.

The files of Children #6, #7, and #9 lacked the persons designated by a parent to whom the child may be released on the agreement.

The file of Child #4 lacked the date of the child's admission on the agreement.

The file of Child #6 lacked the work address of the enrolling parent on the emergency contact form. The file of Child #8 lacked the complete work address of the enrolling parent on the emergency contact form.

When the Preschool Classroom, Young Toddler Classroom, and Older Toddler Classroom were in the Outdoor Play Space, emergency contact information for the children in those classrooms were not present in the Outdoor Play Space.

A written plan of identifying the means of transporting a child to emergency care and staffing provisions in the event of an emergency was not displayed conspicuously in the Wilson #2 Classroom.

The emergency contact and agreement for Children #2, #5, #6, #7, #9, and #10 were not reviewed and updated once every 6 months with the reinstating of this regulation on 1/6/22. The emergency contact for Child #2 was reviewed on 9/13/21 and then again on 6/16/22. The agreement for Child #2 was reviewed on 9/1/21 and then again on 6/16/22. The emergency contact and agreement for Child #5 was reviewed on 8/18/21 and then again on 6/7/22. The emergency contact and agreement for Child #6 was signed on 2/17/21 and reviewed on 8/17/21. The emergency contact for Child #7 was signed on 8/8/21. The agreement for Child #7 was signed on 9/13/21. The emergency contact for Child #9 was signed on 8/5/21. The agreement for Child #9 was signed on 9/10/21. The emergency contact and agreement for Child #10 was reviewed on 8/17/21 and then again on 6/10/22.

The files of Children #3, #4, and #8 lacked signed parental consent for administration of minor first-aid procedures by facility staff.

It was observed that the agreement was not on file at the date of enrollment. Child #7's date of admission was 8/16/21 with an agreement dated on 9/13/21. Child #9's date of admission was 8/16/21 with an agreement dated 9/10/21.

Staff #2, #3, and #5 lacked documentation of child care experience prior to service at the facility.

The file of Staff #12 did not contain two written, nonfamily references from individuals attesting to the person's suitability to serve as a facility person. The file of Staff #12 contained one reference.

The files of Staff #3, #5, and #6 lacked documentation of completing professional development in pediatric first aid and pediatric cardiopulmonary resuscitation within 90 days of hire (See LIS Code Sheet). Staff #3, #5 and #6 had documentation of completing pediatric first aid and pediatric cardiopulmonary resuscitation on 6/14/22.

The files of Staff #4 and #11 lacked documentation of completing an annual minimum of 12 clock hours of child care training.

At approximately 9:50 AM Certification Staff observed a sleeping infant placed on his/her back on a boppy pillow in the crib.

Observed Champion Air Freshener which indicated "keep out of the reach of children" on the window sill in the bathroom located between the kitchen and Infant/Young Toddler Classrooms.

***Based on interviews and video footage, Staff #1 and Staff #2 left Child #1 alone on the playground for approximately 9 minutes. Once Staff #1 and #2 realized Child #1 was not in the group in the classroom, Staff #2 went to the playground to look for Child #1.

*Based on interviews and video footage, Staff #1 and Staff #2 left Child #1 alone on the playground for approximately 9 minutes. Once Staff #1 and #2 realized Child #1 was not in the group in the classroom, Staff #2 went to the playground to look for Child #1.

**Based on interviews and video footage, Staff #1 and Staff #2 left Child #1 alone on the playground for approximately 9 minutes. Once Staff #1 and #2 realized Child #1 was not in the group in the classroom, Staff #2 went to the playground to look for Child #1.

****Based on interviews and video footage, Staff #1 and Staff #2 left Child #1 alone on the playground for approximately 9 minutes. Once Staff #1 and #2 realized Child #1 was not in the group in the classroom, Staff #2 went to the playground to look for Child #1.

*Based on interviews and video footage, Staff #1 and Staff #2 left Child #1 alone on the playground for approximately 9 minutes. Once Staff #1 and #2 realized Child #1 was not in the group in the classroom, Staff #2 went to the playground to look for Child #1.

**Based on interviews and video footage, Staff #1 and Staff #2 left Child #1 alone on the playground for approximately 9 minutes. Once Staff #1 and #2 realized Child #1 was not in the group in the classroom, Staff #2 went to the playground to look for Child #1.

***(Based on interviews and video footage, Staff #1 and Staff #2 left Child #1 alone on the playground for approximately 9 minutes. Once Staff #1 and #2 realized Child #1 was not in the group in the classroom, Staff #2 went to the playground to look for Child #1.

On 10/21/21 staff member #1 was observed through video footage forcefully pushing a child's head down onto their cot and flipping the child over onto their belly during nap time.

On 10/21/21 staff member #1 was observed through video footage alone in the young toddler child care space on their cell phone and not supervising the children during nap time.