Carringtons Daycare

Noncompliance Area: In the Infant room a Pack N Play Playard was observed to not be labeled for the use of a specific child.

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: The child file for Child #3 and Child #4 contained an emergency contact information form that lacked the health insurance name and 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: Prior to the COVID suspension effective on 3/6/20 the child file for Child #4, who has an enrollment date of 1/3/20, lacked an initial health report on file no later than 60 days following the first day of attendance.

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: Prior to the COVID suspension effective on 3/6/20 the child file for Child #4, who has an enrollment date of 1/3/20, lacked a copy of their immunization record on file no more than 60 days following the first day of attendance.

Correction Required: The facility may not accept or retain an infant 2 months of age or older, a toddler or a preschool child at the facility for more than 60 days following the first day of attendance at the facility unless the parent provides written verification from a physician, physician's assistant, CRNP, the Department of Health or a local health department of the dates (month, day and year) the child was administered immunizations in accordance with the recommendations of the ACIP.

Noncompliance Area: The child file for Child #2, who is an older toddler, contained a copy of their immunization status which lacked an annual influenza vaccination as recommended by the ACIP; the child was last vaccinated for influenza on 8/29/19. The child file for Child #3, who is an older toddler, contained a copy of their immunization status which lacked an annual influenza vaccination as recommended by the ACIP; the child was last vaccinated for influenza on 1/10/19. The child file for Child #5, who is an older toddler, contained a copy of their immunization status which lacked an annual influenza vaccination as recommended by the ACIP.

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 staff file for Staff person #4, lacked a valid health assessment; the health assessment on file was a child health assessment thus did not include an examination for communicable diseases and the results nor did it include the suitability of Staff person #4 to provide adequate care to children.

Correction Required: An adult health assessment must include an examination for communicable diseases and the results of that examination. An adult health assessment must include information on medical problems that might threaten the health of the children or prohibit a staff person from providing adequate care to children.

Noncompliance Area: Child #6, who is an infant, lacked a written feeding schedule from the parent.

Correction Required: A written statement giving the formula and feeding schedule for an infant shall be obtained from the parent.

Noncompliance Area: The child file for Child #3, who has an enrollment date of 5/29/19 contained a financial agreement and emergency contact information form that were not reviewed and updated by the parent at least once in a 6 month period; the financial agreement form and emergency contact information form were last reviewed and signed by the parent on 5/29/19. The child file for Child #5, who has an enrollment date of 4/29/19 contained a financial agreement and emergency contact information form that were not reviewed and updated by the parent at least once in a 6 month period; the financial agreement form and emergency contact information form were last reviewed and signed by the parent on 4/29/19.

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. Following review, a parent shall attest to the accuracy of information in the emergency contact information and the financial agreement at each review by affixing a dated signature to the record.

Noncompliance Area: The staff file for Staff person #3 lacked one non family reference.

Correction Required: A facility person's record shall include two written, nonfamily references from individuals attesting to the person's suitability to serve as a facility person

Noncompliance Area: The staff file for Staff person #1, who has a start date working with children of 7/31/19, lacked documentation of having received emergency plan training at time of initial hire as well as on an annual basis. The staff file for Staff person #2, who has a start date working with children of 10/1/19, lacked documentation of having received emergency plan training at time of initial hire as well as on an annual basis. The staff file for Staff person #3, who has a start date working with children of 11/14/19, lacked documentation of having received emergency plan training at time of initial hire as well as on an annual basis. The staff file for Staff person #4, who has a start date working with children of 9/24/19, lacked documentation of having received emergency plan training at time of initial hire as well as on an annual basis. The staff file for Staff person #5, who has a start date working with children of 9/16/19, lacked documentation of having received emergency plan training at time of initial hire as well as on an annual basis. Staff person #7 reported that staff were trained on the emergency plan at time of hire but that the initial trainings were not documented in writing. In the emergency plan binder an emergency plan training document containing staff signatures was observed however there was no date on the document thus making it difficult to determine if the annual emergency plan training was done timely.

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 and kept on file at the facility.

Noncompliance Area: The staff file for Staff person #2, who has a start date working with children of 10/1/19, and Staff person #3, who has a start date working with children of 11/14/19, contained mandated reporter training dated 4/19/20 which was not completed within 90 days following the outset of service at the facility. The staff file for Staff person #4, who has a start date working with children of 9/24/19, contained mandated reporter training dated 6/18/20 which was not completed within 90 days following the outset of service at the facility.

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: The staff file for Staff person #1, Staff person #4, Staff person #5, Staff person #6 and Staff person #7 all lacked a valid National Sex Offender Registry (NSOR) certificate on file by 7/1/20 as required per the Child Protective Service Law (CPSL); the NSOR certificates on file are dated 8/5/20. The staff file for Staff person #2, who has a start date working with children of 10/1/19, and Staff person #3, who has a start date working with children of 11/14/19, lacked a copy of the application for NSOR and/or the NSOR certificate on file as required per the CPSL; the NSOR certificates on file are dated 8/5/20.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). A facility person's record shall include a copy of requests for the criminal history record and child abuse registry clearance information, a copy of the disclosure statement and a copy of the completed clearance information required under the CPSL.

Noncompliance Area: The staff file for Staff person #1, who has a start date working with children of 7/31/19, lacked a minimum of one written staff evaluation every 12 months.

Correction Required: A director is responsible for written evaluation of staff persons on a regular basis, a minimum of one evaluation every 12 months.

Noncompliance Area: The staff file for Staff person #1, Staff person #2, Staff person #3, and Staff person #5, all considered assistant group supervisors, lacked proof of a high school diploma or GED on file.

Correction Required: An assistant group supervisor shall have a high school diploma or a general educational development certificate and 2 years experience with children. A facility person's record shall include verification of child care experience, education and training prior to service at the facility.

Noncompliance Area: In the downstairs gym an electrical outlet to the left of the table was observed to be missing one protective cover.

Correction Required: Protective receptacle covers shall be placed in electrical outlets accessible to children 5 years of age or younger.

Noncompliance Area: In the downstairs gym the first-aid kit was observed to lack 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: In the main childcare room, at approximately 10:15am, staff person #1 claimed to be responsible for 6 children of mixed ages (1 young toddler and 5 older toddlers) causing staff person #1 to not be in compliance with staff: child ratios.

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 in 3270.51 (relating to similar age level).

Noncompliance Area: The first-aid kit in the gym lacked soap.

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: 2ND CITATION: At approximately 10:43am, upon opening the basement door, an older toddler was observed in the basement hallway, by herself with no adult supervision, while two staff and twelve other children were inside the gym which was around the corner from where child was found by herself. PREVIOUSLY CITED ON 8/5/19.

Correction Required: Children on the facility premises and on facility excursions off the premises shall be supervised by a staff person at all times. Outdoor play space used by the facility is considered part of the facility premises.

Noncompliance Area: **In the gym, at approximately 10:50am, two staff and 13 children of mixed ages (6 older toddlers and 7 preschool aged children) were observed. Staff person #1 was asked to identify and name the children whom she was responsible for and staff person #1 named 5 children. Staff person #2 was asked to identify and name the children whom she was responsible for and staff person #2 named 7 children thus leaving one child unaccounted for. Both staff were then asked again to identify and name the children whom they were responsible for. Staff person #1 named 5 children and Staff person #2 named 7 children thus still leaving one child unaccounted for.

Correction Required: Legal entity must arrange for all facility staff to receive a minimum of three hours of training regarding supervision of children. The legal entity must receive DHS approval of training content prior to scheduling training. Proof of training will be submitted upon completion and may not be counted towards annual training hours. Compliance will be verified through multiple onsite unannounced inspections

Noncompliance Area: At approximately 10:50am, 13 children of mixed ages (6 older toddlers and 7 preschool aged children) were observed to be utilizing the basement gym and the emergency contact information for those 13 children were not present in the child care space in which they were receiving care.

Correction Required: When children are in the facility, emergency contact information shall be present in a child care space for children receiving care in the space.

Noncompliance Area: 2ND CITATION: At approximately 10:43am, upon opening the basement door, an older toddler was observed in the basement hallway, by herself with no adult supervision, while two staff and twelve other children were inside the gym which was around the corner from where child was found by herself. PREVIOUSLY CITED ON 8/5/19.

Correction Required: When children are grouped in similar age levels, the following maximum child group sizes and ratios of staff persons apply: Infants 1:4 with a maximum group size of 8; Young toddlers 1:5 with a maximum group size of 10; Older toddlers 1:6 with a maximum group size of 12; Preschool children 1:10 with a maximum group size of 20; Young school-age children 1:12 with a maximum group size of 24; Older school-age children 1:15 with a maximum group size of 30.

Noncompliance Area: The gym was observed to lack a first-aid kit.

Correction Required: A first-aid kit shall be in a child care space.

Noncompliance Area: In the young toddler area of the main child care space a red plastic toy bin was observed to have a piece of plastic broken off and missing from the corner causing a sharp corner from the broken plastic.

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: In the young toddler area of the main child care space one white plastic shelving unit and two white wooden shelving units were observed to not be securely fastened and could be a potential tipping hazards if a child were to climb on the structure.

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

Noncompliance Area: At approximately 9:48am Staff #3 was observed to take one young toddler into the infant room, which is adjacent to the young toddler area of the main child care space, to change that child's diaper thus leaving 3 other young toddlers alone with no adult supervision in the young toddler area of the main child care space causing the facility to not be in compliance supervision. At approximately 12:15pm, during nap time in the older toddler area of the main child care space, Staff person #4 was observed to be on her phone looking at Facebook and not properly supervising the children she was responsible for. Also at approximately 12:15pm, during nap time in the preschool area of the main child care space, toy shelving units through out the area, which were approximately waist high, were observed to obstruct Staff person #2's view of some of the children napping due to the positioning of their cots and the positioning of Staff person #2 causing Staff person #2 to not properly be able to see, direct, and access those children while they napped.

Correction Required: Children on the facility premises and on facility excursions off the premises shall be supervised by a staff person at all times. Outdoor play space used by the facility is considered part of the facility premises.

Noncompliance Area: The child file for child #4 contained an emergency contact information form that lacked name, address and telephone number of the child's physician or source of medical care.

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: The child file for child #4 contained an emergency contact information form that lacked the addresses of the individuasl designated by the parent to whom the child may be released.

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: The emergency contact information forms for four young toddlers were observed to be kept in the infant room, which is adjacent to the young toddler area of the main child care space, and not in the main child care space where the four young toddlers were receiving care at that time..

Correction Required: When children are in the facility, emergency contact information shall be present in a child care space for children receiving care in the space.

Noncompliance Area: The child file for child #1, who is a young toddler and was enrolled in care on 4/29/19, contained an initial health report dated 8/21/18, which was more than 6 months prior to the first day of attendance at the facility.

Correction Required: The initial health report for a young toddler must be dated no more than 6 months prior to the first day of attendance at the facility.

Noncompliance Area: The child file for child #1, who is a young toddler, lacked an updated health report; the most recent health report on file is dated 8/21/18.

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

Noncompliance Area: The child file for child #1, who is an young toddler, contained a copy of their immunization status which lacked the following immunization doses as recommended by the ACIP: the third and fourth dose of Haemophilus influenza type b (Hib) vaccination, the third and fourth dose of Pneumococcal conjugate (PCV13) vaccination, and the third dose of Diphtheria, tetanus, & acellular pertussis (DTAP). Child #1 is also missing the Inactive Polio virus (IPV), Measles, mumps, and rubella (MMR), Varicella (VAR), and Hep A vaccinations as recommended b the ACIP. The child file for child #2, who is an young toddler, contained a copy of their immunization status which lacked the following immunization doses as recommended by the ACIP: the third and fourth dose of Haemophilus influenza type b (Hib) vaccination, the third and fourth dose of Pneumococcal conjugate (PCV13) vaccination, and the third dose of Diphtheria, tetanus, & acellular pertussis (DTAP). Child #2 is also missing the Rotavirus vaccination as recommended by the ACIP.

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 staff file for staff person #1 lacked documentation of the required 6 clock hours of child care training for their anniversary year of April 2018-2019. The staff file for staff person #2 lacked documentation of the required 6 clock hours of child care training for their anniversary year of July 2018-2019.

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

Noncompliance Area: The staff file for staff person #1 lacked a valid disclosure statement; the disclosure statement on file lacked a witness's signature causing it not to be valid. The staff file for staff person #2, lacked a valid State Police clearance; staff person #2's first name was spelled wrong on the State Police clearance causing it not to be a valid clearance. The staff file for staff person #3, who has a start date working with children of 5/1/19 and was a provisional hire, contained a State Police clearance dated 5/2/19 and the file did not contain a copy of having applied for a State Police clearance prior to working with children as required for provisional hiring under the CPSL. The staff file for staff person #3 contained a Child Abuse clearance dated 5/15/19 and lacked the proper documentation of a copy of the completed and mailed request for the Child Abuse clearance as required for provisional hiring under the CPSL; the request on file did not contain a date thus was unable to determine when the request was mailed. The staff file for staff person #3 also lacked a valid FBI clearance on file and there was no copy of the receipt of payment for a FBI clearance on file as required for provisional hiring under the CPSL; only a pre-enrolled notice with an appointment date to be fingerprinted of 8/19/19 was on file. The staff file for staff person #3 also lacked mandated reporter training. The staff file for staff person #4, who has a start date working with children of 5/21/19 and was a provisional hire, contained a State Police clearance dated 7/29/19 and the file did not contain a copy of having applied for a State Police clearance prior to working with children as required for provisional hiring under the CPSL. The staff file for staff person #4 also lacked a valid FBI clearance on file and there was no copy of the receipt of payment for a FBI clearance on file as required for provisional hiring under the CPSL; only a pre-enrolled notice with an appointment date to be fingerprinted of 7/31/19 was on file. The staff file for staff person #5, who has a start date working with children of 7/26/19 and was a provisional hire, lacked a valid FBI clearance on file and there was no copy of the receipt of payment for a FBI clearance on file as required for provisional hiring under the CPSL; only a pre-enrolled notice with an appointment date to be fingerprinted of 7/31/19 was on file.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). LACKING REQUIRED HIRING DOCUMENTS: Facility Person #3, #4, and #5-- may not work in a child care position at the facility. A facility person's record shall include a copy of requests for the criminal history record and child abuse registry clearance information, a copy of the disclosure statement and a copy of the completed clearance information required under the CPSL. Facility Person #3, #4, and #5--- may not work in a child care position at the facility.

Noncompliance Area: The staff file for staff person #5, who is listed as a Group Supervisor, lacked documentation of a bachelor's degree from an accredited college or university in early childhood education or the human services field.

Correction Required: A group supervisor shall have a bachelor's degree from an accredited college or university in early childhood education, child development, special education, elementary education or the human services field. A facility person's record shall include verification of child care experience, education and training prior to service at the facility.

Noncompliance Area: The staff file for staff person #3, who is considered an Assistant Group Supervisor, lacked documentation of 2,500 hours of child care experience; only 1,623 hours of child care experience was documented. The staff file for staff person #4, who is considered an Assistant Group Supervisor, lacked documentation of 2,500 hours of child care experience; only 909 hours of child care experience was documented.

Correction Required: An assistant group supervisor shall have a high school diploma or a general educational development certificate and 2 years experience with children.A facility person's record shall include verification of child care experience, education and training prior to service at the facility.

Noncompliance Area: At approximately 9:48am Staff #3 was observed to take one young toddler into the infant room, which is adjacent to the young toddler area of the main child care space, to change that child's diaper thus leaving 3 other young toddlers alone in the young toddler area of the main child care space causing the facility to not be in compliance with staff:child ratios.

Correction Required: When children are grouped in similar age levels, the following maximum child group sizes and ratios of staff persons apply: Infants 1:4 with a maximum group size of 8; Young toddlers 1:5 with a maximum group size of 10; Older toddlers 1:6 with a maximum group size of 12; Preschool children 1:10 with a maximum group size of 20; Young school-age children 1:12 with a maximum group size of 24; Older school-age children 1:15 with a maximum group size of 30.

Noncompliance Area: Since the facility opened on 4/29/19 a fire drill was observed to not be held at least every 60 days; the first fire drill that was held was dated 7/31/19.

Correction Required: A fire drill shall be held at least every 60 days. Facility persons and children in attendance shall participate in the fire drill. Facility persons and children shall exit the building, weather permitting.

Noncompliance Area: The downstairs bathroom sink that will be utilized by the children lacked a platform or steps to allow the children easy access.

Correction Required: Toilets and sinks shall be at proper heights for children using them or shall be easily approached by means of platforms or steps.

Noncompliance Area: The downstairs bathroom that will be utilized by the children lacked a hand washing sign inside one toilet stall and at the sink.

Correction Required: A facility person and an able child shall wash his hands after toileting and before eating. A sign on which this requirement is written shall be posted at each toilet, training chair, diapering area and sink in the facility.