Twinkling Star Childcare

The safety lock on the bathroom cabinet was not functioning properly leaving 3 cleaning materials accessible to children; Windex, toilet bowl cleaner, and Zep.

A stained area was observed on the ceiling of room 3, the infant/toddler room.

The files for children #1 and #2 did not contain documentation of sharing a child service report with the parents within the last 6 months. The last documentation on file for each child was dated 3/08/24.

The file for staff #1 contained 3 of the 12 required annual training hours completed between 4/17/23 and 4/17/24.

Staff person #1 was observed to be caring for children unsupervised. Staff person #1 has not completed the following pre-service training required prior to caring for children unsupervised: Pediatric CPR and First Aid from an approved instructor.

Electrical outlets on power strips in rooms 1 and 2, accessible to children 5 years of age or younger, lacked protective covers.

Broken/unattached straps were observed on a mini trampoline in the outdoor play space.

There was evidence of gnat infestation in the facility near and around the sink and on the walls in the middle room and in the bathroom.

A child was observed wiping their nose on a tissue then disposing the used tissue into a garbage can that lacked a cover.

The first aid kits located in the middle room and the infant room lacked tape in the first aid kits.

There were strips of Styrofoam in the outdoor play area that were accessible to the children who still put objects in their mouths.

The infant room and the main room refrigerators where children's food is stored lacked an operable thermometer in each refrigerator.

Child file #3 contained health reports dated 8/23/22 and 8/24/23 which was not updated every 6 months as required for a young toddler. (See LIS CODE SHEET)

There was Tylenol and other medications in the unlocked 2nd drawer of a filing cabinet in the middle room that was accessible to the school aged children while in care.

Child #5 had medication at the facility that lacked a medication log with written consent by the parent for administration of the medication while at the facility.

The facility lacked documentation of completion of fire drills every 60 days from 9/11/23-12/10/23.

The facility lacked documentation of testing of the interconnected fire system every 30 days from 9/11/23-12/10/23.

Child file #2 contained a health report dated 10/13/23 which was more than 60 days after the child's first day of attendance at the facility. (See LIS CODE SHEET) Child file #4 lacked an initial health report within 60 days of the child's first day of attendance at the facility. (See LIS CODE SHEET)

Staff file #2 lacked documentation of a staff evaluation completed by the director at a minimum of every 12 months. (See LIS CODE SHEET)

Child files #1, #2, #3 and #4, contained copies of child service reports dated 3/8/24 which was conducted more than 6 months since previous child service reports were completed and given to the parents.

Child files #1, #2 and #3 lacked documentation of review and update by parent of the financial agreement forms in the child's file every 6 months.

Staff file #1 contained documentation of 9 of the 12 hours required for child care training completed annually between 12/19/22 and 12/19/23.

3rd CITATION: On 2/1/24, the operator lacked documentation available at the facility of the updated sections in their emergency plan that include the operators plans for continuity of operations in response to an emergency to maintain compliance with 45 CFR § 98.41(a)(1)(vii) per Announcement C-22-04. PREVIOUSLY CITED ON 8/25/23 and 11/1/23.

3rd CITATION: On 2/1/24, the operator lacked documentation available at the facility of the updated letter to parents explaining the lock-down procedures and how the plan addresses accommodations for infants, toddlers, children with disabilities and children with chronic medical conditions that were included in the updated emergency plan. PREVIOUSLY CITED ON 8/25/23 and 11/1/23.

Per observation and staff statements, on 11/1/23, Staff #1 was caring for 1 older toddler and 3 preschool aged children in the front room. Staff #2 was caring for 1 infant, 2 young toddlers and 1 older toddler in the infant/toddler room. Staff #1 stepped out of the front room through an exterior door from the office into the parking lot. Staff #1 closed the door and was outside for approximately 2 minutes. During that time, the children she was caring for were in the front room unsupervised and without a staff person present. Later on 11/1/23, Staff #1 was caring for 1 infant, 2 young toddlers and 1 older toddler in the infant/toddler room. Staff #1 left the room to go to the kitchen for the infant's bottle. The children were left in the room with no staff present.

**Per observation and staff statements, on 11/1/23, Staff #1 was caring for 1 older toddler and 3 preschool aged children in the front room. Staff #2 was caring for 1 infant, 2 young toddlers and 1 older toddler in the infant/toddler room. Staff #1 stepped out of the front room through an exterior door from the office into the parking lot. Staff #1 closed the door and was outside for approximately 2 minutes. During that time, the children she was caring for were in the front room unsupervised and without a staff person present. Later on 11/1/23, Staff #1 was caring for 1 infant, 2 young toddlers and 1 older toddler in the infant/toddler room. Staff #1 left the room to go to the kitchen for the infant's bottle. The children were left in the room with no staff present. PREVIOUSLY CITED ON 7/28/23

***Per observation and staff statements, on 11/1/23, Staff #1 was caring for 1 older toddler and 3 preschool aged children in the front room. Staff #2 was caring for 1 infant, 2 young toddlers and 1 older toddler in the infant/toddler room. Staff #1 stepped out of the front room through an exterior door from the office into the parking lot. Staff #1 closed the door and was outside for approximately 2 minutes. During that time, the children she was caring for were in the front room unsupervised and without a staff person present. Later on 11/1/23, Staff #1 was caring for 1 infant, 2 young toddlers and 1 older toddler in the infant/toddler room. Staff #1 left the room to go to the kitchen for the infant's bottle. The children were left in the room with no staff present. PREVIOUSLY CITED ON 7/28/23

*Per observation and staff statements, on 11/1/23, Staff #1 was caring for 1 older toddler and 3 preschool aged children in the front room. Staff #2 was caring for 1 infant, 2 young toddlers and 1 older toddler in the infant/toddler room. Staff #1 stepped out of the front room through an exterior door from the office into the parking lot. Staff #1 closed the door and was outside for approximately 2 minutes. During that time, the children she was caring for were in the front room unsupervised and without a staff person present. Later on 11/1/23, Staff #1 was caring for 1 infant, 2 young toddlers and 1 older toddler in the infant/toddler room. Staff #1 left the room to go to the kitchen for the infant's bottle. The children were left in the room with no staff present. PREVIOUSLY CITED ON 7/28/23

On 11/1/23, the operator lacked documentation available at the facility of the updated sections in their emergency plan that addresses volunteer emergency preparedness training, and the operators plans for continuity of operations in response to an emergency to maintain compliance with 45 CFR § 98.41(a)(1)(vii) per Announcement C-22-04. PREVIOUSLY CITED ON 8/25/23

On 11/1/23, the operator lacked documentation available at the facility of the updated letter to parents explaining the lock-down procedures and how the plan addresses accommodations for infants, toddlers, children with disabilities and children with chronic medical conditions that were included in the updated emergency plan. PREVIOUSLY CITED ON 8/25/23

On 11/1/23, the operator lacked documentation available at the facility of a policy and procedure to identify the prevention of Shaken Baby Syndrome, Abusive Head Trauma, and Child Maltreatment to maintain compliance with 45 CFR 98.41(a)(1)(vi) and in accordance with Announcement C-22-03. PREVIOUSLY CITED ON 8/25/23

On 11/1/23, designated staff person did not have access to Child file #2 and updated child service reports completed every 6 months. PREVIOUSLY CITED ON 8/25/23

On 11/1/23, designated staff person did not have access to Child file #2 to verify the emergency contact was updated to include the written consent signed by the parent for emergency medical care for the child. PREVIOUSLY CITED ON 8/25/23

The facility lacked copies of the emergency contact forms for Child #3, #4, #5 and #6 in the rooms were the children were receiving care.

The facility lacked individual records for Child #3, #4, #5 and #6 who were present and receiving care on 11/1/23.

On 11/1/23, the designated staff person did not have access to Child file #2 to verify the emergency form was updated to include the written consent signed by the parent for administration of minor first-aid procedures by a staff person to the child. PREVIOUSLY CITED ON 8/25/23

The operator lacked updated sections in their emergency plan that addresses volunteer emergency preparedness training and the operators plans for continuity of operations in response to an emergency to maintain compliance with 45 CFR § 98.41(a)(1)(vii) per Announcement C-22-04.

The operator a lacked letter to parents explaining the lock-down procedures and how the plan addresses accommodations for infants, toddlers, children with disabilities and children with chronic medical conditions that were included in the updated emergency plan.

The preschool room had a bottle of bleach water on the hand towel dispenser that was accessible to the children in care.

There were gnats that came from the handwashing sink drain all over the wall in the preschool room.

The open window in the bathroom lacked a screen.

The sink in the infant room lacked a platform or step for the children to easily use the sink.

The stepping stone walking blocks in the outdoor play space were broken and had rough and sharp edges that posed a hazard to the children. The riding toy truck in the infant space lacked a seat exposing the motor mechanics to the children.

Staff person #1 was observed using their hand to lift the lid of the hands free can while changing the child's diaper.

Staff file #1 contained health assessments dated 3/12/21 and 7/27/23 which exceeded the 24 months as required for an updated health assessment.

The operator lacked a policy and procedure to identify the prevention of Shaken Baby Syndrome, Abusive Head Trauma, and Child Maltreatment to maintain compliance with 45 CFR 98.41(a)(1)(vi) and in accordance with Announcement C-22-03.

Child file #1 lacked the operator signature on the agreement form.

Child file #2 lacked copy of a child service report completed every 6 months as required and given to the parents.

Child file #2 lacked the written consent signed by the parent for emergency medical care for the child on the emergency contact form.

Child file #2 lacked the written consent on the emergency contact form signed by the parent for administration of minor first-aid procedures by a staff person to the child.

On 7/28/23, Staff #1 answered the door, leaving 1 young toddler, 4 preschool children and 2 young school age children in the preschool room without an adult present. Upon entry, there were 2 young school age children observed alone and remained in school age room without an adult present as Staff #1 went back into the preschool room. Staff #2 was present in the infant room with 1 young toddler. Staff #1 identified 3 preschool children and 3 young school age children in their supervision group. Staff #2 identified 1 young toddler in their supervision group. Leaving 1 young toddler, 2 preschool children and 1 young school age child not identified in a supervision group.

On 7/28/23, Staff #1 answered the door, leaving 1 young toddler, 4 preschool children and 2 young school age children in the preschool room without an adult present. Upon entry, there were 2 young school age children observed alone and remained in school age room without an adult present as Staff #1 went back into the preschool room. Staff #2 was present in the infant room with 1 young toddler. Staff #1 identified 3 preschool children and 3 young school age children in their supervision group. Staff #2 identified 1 young toddler in their supervision group. Leaving 1 young toddler, 2 preschool children and 1 young school age child not identified in a supervision group.

On 7/28/23, Staff #1 answered the door, leaving 1 young toddler, 4 preschool children and 2 young school age children in the preschool room without an adult present. Upon entry, there were 2 young school age children observed alone and remained in school age room without an adult present as Staff #1 went back into the preschool room. Staff #2 was present in the infant room with 1 young toddler. Staff #1 identified 3 preschool children and 3 young school age children in their supervision group. Staff #2 identified 1 young toddler in their supervision group. Leaving 1 young toddler, 2 preschool children and 1 young school age child not identified in a supervision group.

On 7/28/23, there were 8 children including 1 young toddler, 6 preschool children and 1 young school aged child present in the preschool room that measures for 7 during naptime, all of whom were not resting on rest equipment.

Staff #4 file contained a receipt for a PDE FBI clearance request dated 9/11/22 but lacked a valid DHS FBI clearance. Staff #5 file contained a receipt for DHS FBI clearance request dated 8/17/22 but lacked a valid DHS FBI clearance. (See LIS CODE SHEET)

Staff file #4 lacked the results of the TB results prior to initial hire. (See LIS CODE SHEET)

Staff person #3 was observed to be caring for children unsupervised. Staff person #3 has not completed the following pre-service training required prior to caring for children unsupervised: Health and Safety topics and pediatric first-aid/CPR training.

PREVIOUSLY CITED ON 4/25/22, Staff file #3 lacked a signed and dated disclosure statement in the file.

At approximately 2:25 pm, staff #2 was observed outside of the facility while staff #3, an aide, was left unsupervised with 1 young toddler, 1 older toddler and 2 preschool children who were napping in the preschool room.

Staff file #3 lacked a signed and dated disclosure statement in the file.

The plastic bin being used as a sink in the wooden kitchen set was cracked and broken. The triangle trampoline in the outdoor toddler play space was torn and the material was threadbare. The plastic piece covering the front wheel on the tricycle in the toddler outdoor play space was cracked and had sharp edges.

The cots in the preschool room did have 2 feet of space on three sides while children were napping on them.

The refrigerator in the school age room did not contain an operable thermometer.

Child file #1 lacked an updated health assessment every 12 months as required for an older toddler.

Staff #2 used a wipe to clean a young toddler and did not wash the young toddlers hands after diapering the child.

The hands free diapering can was kept in cabinet under the diaper changing table, staff #2 opened the cabinet door with soiled diaper in hand and disposed of soiled diaper in the can by opening the lid with soiled diaper in hand.

The facility lacked documentation of annual traffic letter with routes used to facility sent to the local traffic authorities.

Staff file #1 contained Mandated reporter training certificates dated 12/26/16 and 7/14/22 which exceeded the 60 months as required by CPSL.

Staff file #1 contained documentation of 6 of the 12 hours required of child care training completed between 12/19/20 and 12/19/21.

Staff file #2 lacked a current health assessment conducted within 24 months of 7/29/19 last health assessment.

Staff file #1 lacked a signed disclosure statement and a valid NSOR verification.