Tiny Fingers Tiny Toes Early Childcare Center

The file for child #2 did not have documentation of a completed child service report with information to the family about the child's growth and development at least once every 6 months; the most recent report was dated 04/24/2024, with no subsequent reports on file.

The file for child #2 did not include documentation of a review of the emergency contact information and financial agreement at least once every 6 months; the most recent review was dated 01/12/2024 with no documentation of subsequent reviews.

Observed cleaning products being stored on a shelf directly above the counter where food was being plated to be served to the children. *Corrected at the time of the inspection.

Observed a light blue plastic slide on the playground with a crack in the platform and a crack on the step. Observed a Little Tykes playhouse (with the teal roof) with a crack in the plastic swinging counter. Observed a Little Tykes playhouse (with the faded light blue roof) with a cracked windowsill. Observed a Little Tykes playhouse (with the faded teal roof) with a cracked doorbell. *Corrected at the time of the inspection. Observed a Log Cabin playhouse with a sign that broke off, the plastic still attached to the screw created sharp edges. Observed a hole in the plastic where the sign was previously attached, and wasps were observed entering & exiting the hole.

Observed prescription medication for child #1 which did not identify the name of the child for whom the medication is intended or the written instructions from the individual who prescribed the medicine. The prescription label was not present at the facility with the medication when the medication was administered to the child on 05/08/2024 at 11:02 am.

The medication log for child #1 did not include the name of the medication to be administered. The medication log listed the devices to be used to administer the medication in lieu of the name of the medication.

The file for staff person #1 included a health assessment that was not updated within 24 months of the previous health assessment. The current health assessment on file was dated 10/13/2023 with the previous assessment dated 06/29/2021.

On 01/03/2024 at approximately 3:10 -- 3:15 pm, staff person #1 brought a group of older toddlers into the bathroom. The bathroom is located diagonally across the hall from the classroom entrance. Staff person #1 returned to the classroom at approximately 3:20 pm with a group of children leaving child #1 unsupervised in the bathroom. Staff person #1 and #2 did not notice that Child #1 did not return with the group. Child #1 was alone in the bathroom for an undetermined amount of time until found in the bathroom by the child's parent at pick-up.

***On 01/03/2024 at approximately 3:10 -- 3:15 pm, staff person #1 brought a group of older toddlers into the bathroom. The bathroom is located diagonally across the hall from the classroom entrance. Staff person #1 returned to the classroom at approximately 3:20 pm with a group of children leaving child #1 unsupervised in the bathroom. Staff person #1 and #2 did not notice that Child #1 did not return with the group. Child #1 was alone in the bathroom for an undetermined amount of time until found in the bathroom by the child's parent at pick-up.

**On 01/03/2024 at approximately 3:10 -- 3:15 pm, staff person #1 brought a group of older toddlers into the bathroom. The bathroom is located diagonally across the hall from the classroom entrance. Staff person #1 returned to the classroom at approximately 3:20 pm with a group of children leaving child #1 unsupervised in the bathroom. Staff person #1 and #2 did not notice that Child #1 did not return with the group. Child #1 was alone in the bathroom for an undetermined amount of time until found in the bathroom by the child's parent at pick-up.

Observed an aerosol spray can of Lysol Disinfectant labeled "Keep out of reach of children" on a small ledge in the upstairs hallway next to the door leading into the bathroom used by preschool age children that was accessible to children.

Observed a vinyl couch in the preschool classroom with a torn seat. Observed the table in the younger preschool classroom with the plastic edge torn off the side leaving rough edges along the perimeter of the table.

The health report on file for child #1 was not updated at least every 6 months for an infant or young toddler (see LIS code sheet), the most recent health report on file was dated 08/08/2022.

The health report on file for child #3 was not updated at least every 12 months for an older toddler or preschool child (see LIS code sheet), the current health report on file was dated 04/24/2023 with the previous health report dated 02/10/2022.

The file for child #1 (see LIS code sheet) included a record of the child's immunization status which lacked a 4th dose of DTap immunization,

The child service report (CSR) for child #1, #2 and #3 with information provided to the family about the child's growth and development was not completed at least once every 6 months. The most recent CSR for child #1 was completed on 10/21/2022. The most recent CSR #2 was completed on 10/14/2022. The most recent CSR for child #3 was completed on 10/27/2022.

The clearances for staff person #2 were not updated within 60 months of the previous clearance; the current state police clearance on file was dated 01/26/2022 with the previous clearance dated 01/10/2017, the current child abuse clearance on file was dated 04/01/2022 with the previous clearance dated 03/29/2017, the current FBI clearance on file was dated 02/01/2022 with the previous clearance dated 01/26/2017. The NSOR clearance for staff person #6 was not on file within 45 days of initial hire, the NSOR clearance on file was dated 02/07/2022.

Emergency plan training was not completed on an annual basis for staff person #1, the most recent emergency plan training was completed 02/09/2022, with the previous training completed ion 01/11/2021. Emergency plan training was not completed on an annual basis for staff person #2, the most recent emergency plan training was completed 02/15/2022, with the previous training completed ion 01/07/2021. Emergency plan training was not completed on an annual basis for staff person #3, the most recent emergency plan training was completed 02/15/2022, with the previous training completed ion 01/17/2021. Emergency plan training was not completed on an annual basis for staff person #4, the most recent emergency plan training was completed 02/10/2022, with the previous training completed ion 01/07/2021. Emergency plan training was not completed on an annual basis for staff person #5, the most recent emergency plan training was completed 02/09/2022, with the previous training completed ion01/07/2021.

Observed the staff bathroom on the second floor of the facility did not have hand washing signs Observed the sink located in the Preschool classroom did not have a hand washing sign. *Corrected at the time of the inspection.

Observed a shelf in the In the young toddler classroom which was not anchored to prevent a tip hazard.

The health assessment on file for staff person #1 was an "After Visit Summary" which did not include an examination for communicable diseases and the results of that examination.

The health assessment on file for staff person #1 was an "After Visit Summary" which did not include the physician's or CRNP's assessment of the person's suitability to provide child care.

Observed an infant sleeping with a pacifier in their mouth while attached to their clothing with a pacifier clip. The sheets in the Compact Cribs in the infant room were regular size crib sheets which created excess material.

The file for staff person #6 did not include professional development in the Health & Safety topics as required in 3270.31(f)(1) - (9) within 90 days of initial hire (see LIS code sheet); the training was completed on 02/17/2022.

Emergency contact information was not present in the young toddler classroom for all of the children receiving care in the space. *Corrected at the time of the inspection.

Pediatric first aid & CPR was not completed by staff person #7 within 90 days of hire (see LIS code sheet); training was completed on 02/01/2022.

Daily diaper changes logged in "My Kidz Day" App for Child #1, #2 and #3 document diapers were not being checked at least every 2 hours. A random sample of the diaper log has the following documented diaper changes: Child #1- 01/05/2022: 10:30 am - 12:30 pm - 3:18 pm & 01/06/2022: 09:30 am - 10:30 am - 2:40 pm. Child #2- 01/05/2022: 10:30 am - 12:30 pm - 3:14 pm & 01/06/2022: 9:30 am - 10:30 am - 2:40 pm. Child #3- 01/11/2022: 8:55 am - 11:00 am - 1:34 pm. No additional diaper changes were logged in the afternoons on the dated listed.

Observed in the stairwell next to the office: 2 folded (multi-seat) strollers, a ramp and other miscellaneous items blocking the bottom of the stairs which also leads to a outside exit. Observed an easel and high chair in front of the double doors which lead to the same stairwell next to the office.

A written statement giving the formula and feeding schedule was not obtained from the parents for the infants receiving care.

Observed the most recent fire drill documented on the fire drill log was completed on 10/21/2021.

Observed the most recent manual test of the fire detection system documented on the fire drill log was completed on 10/21/2021.