North Richland Hills Montessori

There was one medication past its expired date.

At the time of the inspection 1 infant under the age of 12 months was observed asleep with an additional item in the crib. The additional item was a small round sound machine.

At the time of the visit a caregiver present with children did not have an active background check.

Based on information obtained it was determined that an infant in care was left in a restrictive device for more than 15 minutes at a time.

At the time of the inspection a parent had authorized a dosage of medication that exceeded what the label stipulates the dosage to be based on the child's age. The medication had been administered twice.

Caregivers failed to provide information with incoming caregivers and a child who is diabetic was allowed access to candy and her blood glucose levels became elevated.

A child who is diabetic had access to candy while in care and her glucose levels became elevated.

Based on investigation it was found that a caregiver had received a group of children from another caregiver and was not provided information regarding specific incidents of a potty accident for a child in that group. This resulted in a parent not having the correct information when requesting it regarding the accident.

Based on information obtained through investigation it was found that a caregiver was allowing children to leave the classroom to the playground area. The caregiver was straddling the doorway to supervise the child on the playground and children inside the classroom. In doing this the caregiver loses the ability to maintain physical proximity to all children being supervised and the ability to intervene if any incidents were to occur.

Based on information obtained through investigation, it was found the operation was sending children to the playground to run around. This was in response to behaviors inside the classroom.

A caregiver administered a dosage of medication significantly higher than the prescribed dosage. The caregiver admitted to questioning the dosage but did not demonstrate good judgment when she did not verify with the parent or another staff member that the dosage was correct.

Through investigation it was found that an incorrect dosage was given to a child in excess of what is prescribed by the child's prescribing health care professional.

1 caregiver who has been employed for more than 90 days does not have a current CPR/First Aid certificate on file.

At the time of the visit a caregiver within their first 90 days of employment did not have a CPR/First Aid Training Certificate and was in a classroom unsupervised by another caregiver with a current CPR/First Aid certificate.

The operation allowed an volunteer to be present at the operation prior to receiving a background check determination of, ?Eligible?; ?Provisional Eligibility with Conditions,?; or,? Eligible with Conditions.? Their current status is pending. The volunteer was not responsible for a group of children but had access to the children in the course of her duties.

Based on information obtained a caregiver did not adequately supervise children in care when a child went into the bathroom with another child. The caregiver was engaged in classroom duties to the extent that she was not aware of the children in the class and their ongoing behavior or actions. The level of supervision was not adjusted based on the child's previous behaviors.

At the time of the inspection a jar of infant food was found opened in the cabinet in the classroom. When caregivers were asked how long it had been present they stated it had been there for a week, but not opened this week. The jar was observed to be labeled with instructions to refridgerate after opening and to discard 2 days after it was opened. The jar was thrown away immediately.

The probation condition requiring weekly observations by the director is not being met. The observations were not completed for 1 week for one of the infant rooms and none for the second.

Based on information obtained during the investigation a child was injured when a caregiver was guiding a child inside the building by grabbing or pulling the child's arm.

At the time of the inspection 2 of the 10 children's files reviewed did not have the required hearing and vision screening.

At the time of the inspection an infant, under 12 months of age, was observed laying on their back in a crib with a blanket across them. The blanket was removed from the crib at the inspection.

At the time of the inspection one classroom was observed to have peeling drywall at a window ledge and another was observed to have baseboard vynil peeled from the wall near a door. The peeling areas could be easily torn by a child and put in their mouths.

At the time of the inspection one child had 2 epi pens stored at the operation without the prescription label or orginal box they were prescribed in.

At the time of the inspection 1 caregiver did not have the required training required for working with children under 24 months of age.

At the time of the inspection 1 child did not have the required immunization record in their enrollment file.

At the time of the inspection an infant (8 months) was observed sleeping in the crib with a pacifier that has an attached plush animal. A photograph was taken. The pacifier was removed from the crib by the inspector

At the time of the inspection a caregiver still enrolled in high school was observed to be the only caregiver in the infant classroom.

At the time of the inspection 2 caregivers reported to work in classrooms with children under 24 months did not have the required training.

At the time of the inspection a caregiver was found to be without a high school diploma or equivalent. The caregiver was found to be in a class with a second caregiver.

At the time of inspection the operation did not have playground maintenance checklists or documented safety drills available for review.

At the time of inspection 2 children had incomplete food allergy plans in their file and 1 child with food allergies did not have a plan in their file.

At the time of inspection several personnel records were incomplete and missing required documentation. Of 10 records evaluated, 2 were missing preservice training, and 2 had incomplete applications without signed orientation statements.

At the time of inspection, annual training including infant training were not available for review.

At the time of the inspection the operation did not have record of the times children were signed in and out of classrooms.

At the time of the inspection a water hose was left on a sidewalk where children would walk over it in a play area. The hose was moved to the side and a plan was discussed to purchase a storage item for the water hose.

Based on information obtained through an investigation it was determined that a caregiver did not change a child's diaper for a prolonged period of time.

Based on information obtained through the investigation it was determined that caregivers did not communicate the needs of children effectively in a transition, causing a child to be left in a diaper over a prolonged period of time.

Based on information obtained through the investigation it was determined that caregivers were not provided additional training to care for a child with differing abilities.

Based on information obtained through the investigation it was determined the operation did not obtain updated records upon the re-enrollment of a child.

Based on information obtained through the investigation it was determined that the operation did not have documentation of special care needs on file and did not provide accommodations to a child with a differing ability.

Based on information obtained through the investigation it was determined a caregiver used poor judgement when telling the inspector that "montessori does not work for children like that" referring to a child of differing abilities.

At the time of inspection, annual training including infant training, CPR/First Aid certificates were not available for review.

At the time of inspection the operation did not have a current fire inspection report, playground maintenance checklists, or documented safety drills available for review.

At the time of inspection the operation had several childrens medications which were expired including: 3 Epinephrine injections 2 Albuteral/Proair inhalers 1 Prescription Topical Cream

At the time of inspection 2 children had incomplete food allergy plans in their file and 1 child with food allergies did not have a plan in their file.

At the time of inspection several personnel records were incomplete and missing required documentation. Of 10 records evaluated, 2 records were missing photo identification, 2 were missing preservice training, and 2 had incomplete applications without signed orientation statements.

At the time of inspection there were several expired medications belonging to children including medication used to treat asthma and food allergies. Expired medication included two epinephrine pens, three inhalers, and a prescription topical ointment.

The infant room was found to be over ratio (5 children/1 caregiver) on at least 2 days (6/9/22 -6/10/22).

At the time of inspection there were 2 individual instructors conducting camp programs without background checks. An art instructor from Art by Lewis and an instructor from Snapology were observed having contact and supervising groups of children in the music room without additional operation staff present.

At the time of inspection, 2 contractors were observed at the operation providing instruction to school age children without caregiver qualifications. Contractors were alone with children, unsupervised by operation staff. Contractors were reported at the operation on a weekly basis.

At the time of inspection, a 7 month old infant was in a crib with a blanket draped over one side and a stuffed toy dog on top of her back. The caregiver removed the blanket and toy from the crib.

At the time of inspection a 5 month old infant was observed sleeping in a bouncy seat. The child requires the use of a cranial helmet, however did not currently have a Sleep Exception Form signed by a physician or parent. The caregiver removed the infant and placed him on his back into a crib.

Concerns regarding the caregiver were identified by staff and reported to administrators. The operation failed to report the situation to Licensing in a timely manner.

Due to the caregivers' age and condition, the assignment to an active 4 year old class did not match her current skills or abilities.

Video was reviewed of the caregiver roughly pulling the child by the arm. Staff reported the caregiver being aggressive in disciplining the children, using rough language, face grabbing and pulling arms. The caregiver admitted that she pulled and grabbed children by their arms when disciplining.

The caregiver admitted that positive methods of discipline and guidance were not practiced in managing the behaviors of challenging children.

This rule was evaluated with regard to an investigation and has been found to be in violation. The director understands that parents can visit the child-care center any time during the child-care center's hours of operation without having to secure prior approval.