Diana Caraballo Home Group Daycare

Noncompliance Area: An infant was observed sleeping in a pack-and-play that had less than 2 feet of space around three sides of the rest equipment.

Correction Required: At least 2 feet of space is required on three sides of a bed, cot, crib or other rest equipment while the equipment is in use.

Noncompliance Area: An infant was observed sleeping in a pack-and-play with a neck-pillow.

Correction Required: Toys, bumper pads, or pillows may not be present in a crib while an infant is sleeping in the crib.

Noncompliance Area: A written plan 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 front room nor the back room.

Correction Required: A written plan identifying the means of transporting a child to emergency care and staffing provisions in the event of an emergency shall be displayed conspicuously in every child care space and shall accompany a staff person who leaves on an excursion with children.

Noncompliance Area: At the time of inspection, the facility was unable to provide documentation that staff person 2 had updated her mandated reporter training. The previous training on file was dated 1/27/2015 and is no longer valid (more than 5 years old). Staff persons 1 updated her trainings, but after a period of 5 years (dated 1/27/2015 and subsequently 6/30/2020).

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services).

Noncompliance Area: The first aid kit in the front room did not include tape or soap. The first aid kit in the back room did not include soap. (CORRECTED ON SITE)

Correction Required: A first-aid kit must contain the following: soap, an assortment of adhesive bandages, sterile gauze pads, tweezers, tape, scissors and disposable, nonporous gloves.

Noncompliance Area: A drainage pipe located on the playground was loose and two rusty nails were exposed.

Correction Required: Floors, walls, ceilings and other surfaces, including the facility's outdoor play space surfaces shall be kept clean, in good repair and free from visible hazards.

Noncompliance Area: The agreements on file for children 1, 2, and 3 did not shall specify the persons designated by a parent to whom the child may be released.

Correction Required: An agreement shall specify the persons designated by a parent to whom the child may be released.

Noncompliance Area: The vaccination record on file for child 2 listed just one Hepatitis A vaccination. As the child is 3 years old, the child should have received a second Hepatitis A vaccination.

Correction Required: The facility shall require the parent to provide updated written verification from a physician, physician's assistant, CRNP, the Department of Health or a local health department of ongoing vaccines administered to an infant, toddler or preschool child in accordance with the schedule recommended by the ACIP.

Noncompliance Area: The most recent health assessment on file for staff person 1 was no longer valid as it was more than 24 months old (dated 2-20-17).

Correction Required: A facility person providing direct care who comes into contact with the children or who works with food preparation shall have a health assessment conducted within 12 months prior to providing initial service in a child care setting and every 24 months thereafter. A health assessment is valid for 24 months following the date of signature, if the person does not contract a communicable disease or develop a medical problem.

Noncompliance Area: Written notification of safe routes were not posted at a conspicuous location in the child care facility.

Correction Required: Written notification of safe routes shall be posted by the operator at a conspicuous location in the child care facility.

Noncompliance Area: During the previous year, financial agreements were updated in May of 2018, then subsequently more than 6 months later in May/June of 2019.

Correction Required: A parent is required to review and update the emergency contact information and the financial agreement at least once in a 6-month period or as soon as there is a change in the information.

Noncompliance Area: The emergency contact forms located in the the emergency backpack were past due to be updated (signatures more than 6 months old). The emergency contact forms had been updated in the master files.

Correction Required: If emergency information is updated in a master file, it shall be updated accordingly in other facility records.

Noncompliance Area: The record for staff person 1 included documentation of just 3 hours of annual training hours from the previous year.

Correction Required: A staff person shall obtain an annual minimum of 6 clock hours of child care training. A facility person's record shall include verification of child care experience, education and training following the outset of service at the facility.

Noncompliance Area: Two areas along the vinyl fence were cracked/broken (not in good repair).

Correction Required: Floors, walls, ceilings and other surfaces, including the facility's outdoor play space surfaces shall be kept clean, in good repair and free from visible hazards.

Noncompliance Area: Air freshener, Lysol wipes, Lysol sprays, and a container of cleaner were observed in areas accessible to the children in care. (CORRECTED ON SITE)

Correction Required: Cleaning materials and other toxic materials shall be stored in an original labeled container or in a container that specifies the content. Toxics shall be kept in a locked area or in an area inaccessible to children, and shall be stored away from food, food preparation areas and child care spaces.

Noncompliance Area: The gate between the kitchen and the child care space was not in use, allowing for the working stove to be accessible to the children in care. (CORRECTED ON SITE)

Correction Required: Hot water pipes and other sources of heat exceeding 110 F that are accessible to children shall be equipped with protective guards or shall be insulated to prevent direct contact.

Noncompliance Area: On 7/18/18, the operator stated child 1 was taken to the emergency room earlier in the month due to an allergic reaction that occurred at the facility. The operator failed to notify the regional office within 24 hours, and has not submitted a written report to the regional office. It had been more than 72 hours since the incident occurred.

Correction Required: The operator shall immediately notify a child's parent and shall telephone notice to the appropriate regional office within 24 hours if a child in care at the facility is hospitalized or receives emergency room treatment.The operator shall mail or deliver a written report to the appropriate regional office within 72 hours after hospitalization of a child in care, emergency room treatment of a child in care, death of a child in care, a facility fire requiring the services of a fire department

Noncompliance Area: At the time of inspection, a piece of wood was observed to be splintering off of the outdoor play-set.. A green covering on the wood play-set had a long narrow (about 1 foot in length) crack in it.

Correction Required: Toys, play equipment and other indoor and outdoor equipment used by the children shall be clean, in good repair and free from rough edges, sharp corners, pinch and crush points, splinters and exposed bolts.

Noncompliance Area: At the time of inspection, 7 children were observed sleeping in a small classroom space. Most of the children had less than 2 feet on three sides of their rest equipment.

Correction Required: At least 2 feet of space is required on three sides of a bed, cot, crib or other rest equipment while the equipment is in use.

Noncompliance Area: At the time of inspection, the agreement on file for child 7 did not specify the child's arrival and departure times.

Correction Required: An agreement shall specify the child's arrival and departure times.

Noncompliance Area: At the time of inspection, the agreement on file for child 2 did not specify the persons designated by a parent to whom the child may be released.

Correction Required: An agreement shall specify the persons designated by a parent to whom the child may be released.

Noncompliance Area: At the time of inspection, the emergency contact information on file for child 2 did not include the address of the child's physician.

Correction Required: Emergency contact information must include the name, address and telephone number of the child's physician or source of medical care.

Noncompliance Area: At the time of inspection, the emergency contact information on file for child 4 did not include the enrolling parent's work telephone number.

Correction Required: Emergency contact information must include the home and work addresses and telephone numbers of the enrolling parent.

Noncompliance Area: At the time of inspection, the emergency contact (EC) information on file for child 1 did not include the child's health insurance coverage or policy number. The EC information on file for child 4 did not include a health insurance policy number.

Correction Required: Emergency contact information must include health insurance coverage and policy number for a child under a family policy or Medical Assistance benefits, if applicable.

Noncompliance Area: At the time of inspection, the emergency contact information on file for child 7 did not include a complete address for a listed release person.

Correction Required: Emergency contact information must include the name, address and telephone number of the individual designated by the parent to whom the child may be released.

Noncompliance Area: According to documentation on file at the time of inspection, child 6 enrolled in January of 2013, but her only health assessment on file was dated 6-12-2018.

Correction Required: The operator shall require the parent of an enrolled child, including a child, a foster child and a relative of an operator or a facility person, to provide an initial health report no later than 60 days following the first day of attendance at the facility.

Noncompliance Area: At the time of inspection, the most recent health assessment on file for child 4 (preschooler) was dated 2-1-17. The health assessments on file for child 5 were dated 12-2-16, and subsequently 5-5-2018. Child 5 was a young toddler at the time the health assessment became past due.

Correction Required: The operator shall require the parent to provide an updated health report at least every 6 months for an infant or young toddlerThe operator shall require the parent to provide an updated health report at least every 12 months for an older toddler or preschool child.

Noncompliance Area: At the time of inspection, child 3 had an Epi-Pen on site. The facility was unable to provide documentation that they had obtained written parental consent for administration of medication

Correction Required: A parent shall provide written consent for administration of medication or a special diet.

Noncompliance Area: At the time of inspection, it was observed that a diaper was disposed of into an unlined trash can.

Correction Required: If disposable diapers are provided by a parent or by a facility, a soiled diaper shall be discarded by immediately placing the diaper into a plastic-lined, hands-free covered can.

Noncompliance Area: At the time of inspection, a child had arrived at approximately 9:30. The first diaper change that took place at the facility did not occur until after 12:00.

Correction Required: A staff person shall check a child's diaper at least every 2 hours and whenever the child indicates discomfort or exhibits behavior that suggests a soiled diaper. A staff person shall change a child's diaper when the diaper is soiled.

Noncompliance Area: Upon review of the children's records, the following forms were not updated within a six month period. The emergency contact form on file for child 4 was signed 5-30-17 and subsequently on 6-4-18. The agreement on file for child 6 was signed 5-30-17 and subsequently on 5-30-18. The agreements on file for children 4 and 5 were dated 6-4-18 and 5-30-18, but there was no documentation of the form being on file or being updated previously. Both children 4 and 4 have been enrolled for more than 6 months

Correction Required: A parent is required to review and update the emergency contact information and the financial agreement at least once in a 6-month period or as soon as there is a change in the information.

Noncompliance Area: At the time of inspection, the record for child 3 did not include a copy the initial agreement between the parent and the operator.

Correction Required: A child's record must contain a copy of the initial agreement and subsequent written agreements between the parent and the operator. The parent receives the original agreement.

Noncompliance Area: At the time of inspection, the record for staff person 1 did not include documentation of completing a minimum of 6 clock hours of child care training.

Correction Required: A staff person shall obtain an annual minimum of 6 clock hours of child care training.

Noncompliance Area: At the time of inspection, the record for staff person 1 did not include documentation of completing the required mandated reporter training. The staff person has been employed for more than 90 days.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). A facility person's record shall include verification of child care experience, education and training following the outset of service at the facility.

Noncompliance Area: At the time of inspection, the certification representative viewed non-compliance with the staff:child ratio 5 times throughout the morning. The first incident occurred shortly after 9:30. A staff person was working in the kitchen, and the staff person in the classroom was along with 7 children (2 two year olds, 2 four year olds, a six year old, 11 and 12 year olds). Youngest child in the group was 2, making the required ratio 1:6. The second incident occurred at approximately 11:00. The certification representative returned from the playground, and 1 staff person was alone in the classroom with 9 children (2 two year olds, 2 four year olds, a six year old, 11 and 12 year olds, 3 year old and 5 year old). Youngest child in the group was 2, making the required ratio 1:6. The third incident occurred at 11:30. A staff person took one school age child to the bathroom, leaving the remaining staff person alone with the remaining 8 children (2 two year olds, 2 four year olds, a six year old, a school age child, a 3 year old and 5 year old). Youngest child in the group was 2, making the required ratio 1:6. The fourth incident occurred at 11:35. A staff person left the room with 2 children, leaving the other staff person along with 7 children. A two year old was in the group that was in the room, making the required ratio 1:6. The fifth incident occurred at 12:00. A staff person went to the kitchen with 1 school aged child, leaving the remaining 8 children with 1 staff person. About two minutes later, a second school age child joined the staff person in the kitchen. The staff person remaining in the classroom was alone with 7 children (2 two year olds, 2 four year olds, a six year old, 3 year old and 5 year old). The youngest child in the classroom was two, making the required ratio 1:6.

Correction Required: When children are grouped in mixed age levels, the age of the youngest child in the group determines the staff:child ratio and maximum group size in accordance with the requirements at 3280.52(b).

Noncompliance Area: At the time of inspection, the following items were observed in areas accessible to the children in care. An unlocked cabinet in the bathroom (broken safety latch) contained lysol, hair mousse, diaper cream, hair conditioning spray, mouthwash and other items labeled "keep out of the reach of children." The medicine cabinet above the bathroom sink contained children's ibuprofen, mouth wash, mucinex nasal spray, and white out. Toxins (cleaning supplies) were stored underneath the changing table. The cabinet was not locked and children repeatedly walked by the changing table in order to get to the bathroom. Cleaners were stored on the window sill in the kitchen. These items were accessible to the tallest children in the facility. The children must walk through the kitchen in order to use the bathroom, the back classroom, and/or to access the playground.

Correction Required: Cleaning materials and other toxic materials shall be stored in an original labeled container or in a container that specifies the content. Toxics shall be kept in a locked area or in an area inaccessible to children, and shall be stored away from food, food preparation areas and child care spaces.

Noncompliance Area: At the time of inspection, areas of the vinyl fence were observed to be in poor repair (cracks in multiple spots). An area of the siding on the building was cracked.

Correction Required: Floors, walls, ceilings and other surfaces, including the facility's outdoor play space surfaces shall be kept clean, in good repair and free from visible hazards.

Noncompliance Area: At the time of the follow up visit for the renewal inspection, a table that was located on the playground was observed to be in poor repair. The covering was peeling off.

Correction Required: Toys, play equipment and other indoor and outdoor equipment used by the children shall be clean, in good repair and free from rough edges, sharp corners, pinch and crush points, splinters and exposed bolts.

Noncompliance Area: At the time of the follow up visit for the renewal inspection, a soiled diaper was observed in an unliddled trash can in the kitchen.

Correction Required: If disposable diapers are provided by a parent or by a facility, a soiled diaper shall be discarded by immediately placing the diaper into a plastic-lined, hands-free covered can.

Noncompliance Area: At the time of the follow up visit for the renwal inspection, a bottle of perfume (on top of an open purse), and a pack of batteries were observed in an area accessible to the children.

Correction Required: Cleaning materials and other toxic materials shall be stored in an original labeled container or in a container that specifies the content. Toxics shall be kept in a locked area or in an area inaccessible to children, and shall be stored away from food, food preparation areas and child care spaces.

Noncompliance Area: At the time of inspection, small rocks, and a smal screw were observed to be on the playground in areas assessible to infants and toddlers. CONTINUED NON-COMPLIANCE WAS OBSERVED ON 7/12.

Correction Required: Toys and objects with a diameter of less than 1 inch, objects with removable parts that have a diameter of less than 1 inch, plastic bags and styrofoam objects may not be accessible to children who are still placing objects in their mouths.

Noncompliance Area: At the time of inspection, the cots and pack & play were not labeled for individual use.

Correction Required: Individual, clean, age-appropriate rest equipment shall be provided for preschool, toddler and infant children as agreed between the child`s parent and the operator. The rest equipment shall be labeled for the use of a specific child and used only by the specified child.

Noncompliance Area: At the time of inspection, a toy shelf in the back room was oberved to be unstable.

Correction Required: Furniture must be durable, safe, easily cleaned and appropriate for the child`s size, age and special needs.

Noncompliance Area: The agreements on file for children 1-3 did not specify the services to be provided to the family and the child. (CORRECTED ON SITE), The operator was unable to locate the Child Service Reports on the day of inspection, therefore the certification representative was unable to verify that they have been completed for children 2 and 3.

Correction Required: An agreement shall specify the services to be provided to the family and the child, including the Department`s approved form to provide information to the family about the child`s growth and development in the context of the services being provided. The operator shall complete and update the form and provide a copy to the family in accordance with the updates regarding emergency contact information at 3280.124(f).

Noncompliance Area: THE AGREEMENTS ON FILE FOR CHILDREN 1-3 did not specific the child's date of admissions. CORRECTED ON SITE for children 1 and 2.

Correction Required: An agreement shall specify the date of the child`s admission.

Noncompliance Area: The emergency contact information on file for child #1 did not include the address of the chid's physician. (CORRECTED ON SITE)

Correction Required: Emergency contact information must include the name, address and telephone number of the child`s physician or source of medical care.

Noncompliance Area: A written plan identifying the means of transporting a child to emergency care and staffing provisions in the event of an emergency was not displayed conspicuously in every child care space.CONTINUED NON-COMPLIANCE OBSERVED ON 7/12.

Correction Required: A written plan identifying the means of transporting a child to emergency care and staffing provisions in the event of an emergency shall be displayed conspicuously in every child care space and shall accompany a staff person who leaves on an excursion with children.

Noncompliance Area: The operator reported re-hiring staff person 3, with an updated start date of May 25th, 2017. Her health assessment and TB test on file were dated in 2008.

Correction Required: A facility person providing direct care who comes into contact with the children or who works with food preparation shall have a health assessment conducted within 12 months prior to providing initial service in a child care setting and every 24 months thereafter. A health assessment is valid for 24 months following the date of signature, if the person does not contract a communicable disease or develop a medical problem.

Noncompliance Area: The operator did not have a file for child #4. The child was at the facility on the day of inspection. CONTINUED NON-COMPLIANCE OBSERVED ON 7/13/17.

Correction Required: An operator shall establish and maintain an individual record for each child enrolled in the facility.

Noncompliance Area: The financial agreement on file for child 2 was last signed by a parent on 8-30-16. There were no dates on the financial agreement on file for child #3 so the certification representative was unable determine when the agreement was last signed. CONTINUED NON-COMPLIANCE OBSERVED ON 7/12.

Correction Required: A parent is required to review and update the emergency contact information and the financial agreement at least once in a 6-month period or as soon as there is a change in the information.

Noncompliance Area: The record for staff person 2 did not include documentation of emergency plan training.

Correction Required: The operator shall assure that each facility person receives training regarding the emergency plan at the time of initial employment, on an annual basis and at the time of each plan update. The operator shall document the date of each training and the names of all facility persons who received the training.

Noncompliance Area: Staff person #1 and #2 did not have Affirmation Statements (Disclosures) on file at the time of inspection.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services).

Noncompliance Area: Staff person 2 is serving as a secondary staff person. At the time of inspection, she did not have any documentation of education on file.

Correction Required: A staff person or a substitute staff person shall meet one of the applicable staff qualifications for the position in which the person is performing.A facility person`s record shall include verification of child care experience, education and training prior to service at the facility.

Noncompliance Area: At the time of inspection, the trash can in the bathroom was missing it's lid.

Correction Required: Trash that has been contaminated by human secretions or excrement shall be contained in closed, plastic-lined receptacles.

Noncompliance Area: At the time of inspection, the first aid kit in the front room was missing soap, and the first aid kit in the back room was missing tweezers.

Correction Required: A first-aid kit must contain the following: soap, an assortment of adhesive bandages, sterile gauze pads, tweezers, tape, scissors and disposable, nonporous gloves.

Noncompliance Area: At the time of inspection, peeling paint was observed on the black doors on the playground area. CONTINUED NON-COMPLIANCE WAS OBSERVED ON 7/12.

Correction Required: Peeled or damaged paint or damaged plaster is not permitted on indoor or outdoor surfaces in the child care facility.