Kaiulani Child Care

Noncompliance Area: The fee agreement for Child #1 did not specify persons designated by the 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 file for Child #2, who enrolled at the facility on 3/11/19, did not contain a valid health assessment on file until 1/29/2020. The file for Child #3, who enrolled at the facility on 11/23/15, did not contain a valid health assessment until 1/23/2019. According to facility director, the old health assessments had been removed from the children's files, but were unable to be located.

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.A child's record shall contain initial and subsequent health reports.

Noncompliance Area: A booster seat in the 2011 Gray Toyota van was observed to have expired at the end of 2019. This booster seat was on a seat in the vehicle for use by a child.

Correction Required: Manufacturers' instructions for use of safety restraints shall be kept in the vehicle at all times.

Noncompliance Area: The first-aid kit in the 2017 Ford van was observed to be missing gloves, soap and water.

Correction Required: A first-aid kit, including the contents as specified in 3270.75 (relating to first-aid kit) shall be in the vehicle when children are being transported.

Noncompliance Area: The emergency contact forms in the binder in the preschool classroom have not been updated in accordance with the master file for all children. The emergency contact forms in this binder were dated from January/February 2019.

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

Noncompliance Area: Staff #1, #2 and #3 all have mandated reporter training on file from January, 2015, but none of the three staff have proof that they have updated the training within the required 60 months.

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

Noncompliance Area: Staff #4, who has been employed at the facility since 2/28/18, does not have an annual evaluation completed within the last 12 months. Date of last evaluation: 2/22/2019.

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: A portable telephone was observed in the science area of the preschool area in the back building of the facility, but the emergency telephone numbers were not posted near this telephone.

Correction Required: The telephone number of the nearest hospital, police department, fire department, ambulance and poison control center shall be posted by each telephone in the facility.

Noncompliance Area: The turf on the small outside playspace next to the back building was observed to be buckling, posing a tripping hazard for children on the playground. The edge of this turf was also observed to be peeling away from the step into this playground.

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 front door to the front building of the facility was observed to be locked and deadbolted from the inside, obstructing this emergency exit.

Correction Required: Stairways, hallways, exits from rooms, exits from the facility and other means of egress serving as an exit shall be unobstructed.

Noncompliance Area: An ointment in the diapering area of the front building of the facility was observed to have expired in 06/2019. Two medications, Children's Motrin and Zarbee's Cough Syrup, were observed to be stored in the refrigerator in the front building of the facility, though the manufacturer's instructions indicate to store at room temperature.

Correction Required: Medication shall be stored in accordance with the manufacturer's or health professional's instructions on the original label.

Noncompliance Area: Staff #1 began working on 12/2/19 but no proof of initial emergency plan training is on file.

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: A light cover above the School-age area in the back building was observed to be 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: The last documented fire drill on file at the facility is 10/22/19, which is beyond the 60-day requirement.

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: During a complaint visit conducted on 7/25/19, Staff #3 admitted that a school age child was placed in time-out, forgot that the child was in time-out, and had the child in time-out for approximately 10 minutes.

Correction Required: Daily activities shall promote the development of skills, social competence and self-esteem. Daily experiences shall recognize the child as an individual and give some choice of activities that respect personal privacy, lifestyle and cultural background.

Noncompliance Area: During an unannounced monitoring visit conducted on 7/19/19, Staff #7 identified four children in her primary supervision group. Three of the children were physically present in the same classroom as this staff person, but one child identified was in a separate, adjacent classroom with Staff #8, and therefore unable to be properly supervised by Staff #7. During the same inspection on 7/19/19, Staff #1 had a group of 12 children in his primary, assigned group, but this staff person was unable to name 4 children in the group, admitted to not knowing the children's names, and had to ask the children their names.

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. Children must be supervised at all times. Each staff person shall be assigned the responsibility for supervision of specific children. The staff person shall know the names and whereabouts of the children in his assigned group. The staff person shall be physically present with the children in his group on the facility premises and on facility excursions off the facility premises.

Noncompliance Area: During an interview with the Director on 7/19/19, she admitted that Staff #1 and Staff #2 help at the facility, but neither of these individuals have a record at the facility with any paperwork.

Correction Required: An individual record is required for each facility person.

Noncompliance Area: During an unannounced monitoring visit on 7/19/19, the files for Staff #8 and #9 were reviewed. Both staff files were missing two written non-family references attesting to each individual's suitability to serve as a facility person.

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: During a complaint visit on 7/19/19, Staff #1 was observed to be working in child care with children. During an interview with the Director, she admitted that this individual was only 16 years old. The Director also admitted that Staff #2 helps at the facility, and is only 17 years old.

Correction Required: A staff person shall be 18 years of age or older.

Noncompliance Area: During an unannounced monitoring visit on 7/19/19, Staff #8, a provisional hire, was observed to be working in the infant classroom alone. During an unannounced monitoring visit on 7/25/19, Staff #10, a provisional hire, was observed to be working in the toddler classroom with Staff #9, an employee who is an aide, and unable to supervise staff based on this qualification.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). A provisional employee may not be permitted to work alone with children and must work within the vicinity of a permanent employee.

Noncompliance Area: During an unannounced monitoring visit conducted on 7/19/19, the file for Staff #9 was reviewed. This staff person was observed acting as an aide at the facility, and counted in ratio. The individual's file only contained proof of a minimum 8th grade education, and did not contain documentation of the experience needed to qualify at this level.

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.An aide shall have a minimum of an 8th grade education and 2 years of experience with children.

Noncompliance Area: During an unannounced monitoring inspection on 7/25/19, Staff #9 and Staff #10 were observed to be working together in a classroom with children, without any additional staff present in the classroom. Staff #9 and Staff #10 both qualify as aides, and are therefore unable to be supervising each other.

Correction Required: An aide or a combination of aides shall be supervised at all times by a staff person qualified at minimum as an assistant group supervisor.

Noncompliance Area: During a complaint visit on 7/19/19 at 11:40 a.m., Staff #4 was observed to be working with, and identified 12 children in his primary group. Out of the 12 children, 10 children were identified to be preschool-aged children, and 2 children were identified to be school-age children, a ratio that would require at least 2 staff to be present with the group. An additional staff person did not arrive at the facility until 12 p.m.

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. 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: During an unannounced monitoring inspection on 7/19/19, the Director identified a group of children as being on a field trip to the Colonial Sports Bowling alley. The Director stated that Staff #5 was the only staff person present on the excursion. Staff #6 had been present at the excursion, and was responsible for providing transportation, but Staff #6 arrived back at the child care facility during the inspection, leaving Staff #5 at the bowling alley alone. This was confirmed through an interview with the Director.

Correction Required: At least two facility persons shall be present when children are on an excursion away from the facility. At a minimum, one of the facility persons shall be a staff person.

Noncompliance Area: Children's soiled clothing was observed in plastic grocery bags and placed in low shelves, accessible to children, in the diapering room of the front building. Children in this building range from infants to older toddlers, and many are still placing objects in their mouths.

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: The fee agreements for Child #2 and Child #7 do not contain designated release persons. The fee agreements for Child #6 and Child #7 do not contain a date of admission.

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

Noncompliance Area: Emergency contact information for Child #2, Child #5 and Child #6 does not contain full health insurance coverage information for the children. A copy of the children's insurance cards were not observed in the files.

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: Child #7, a 4 year old, has a health assessment on file from 8/15/17, but the parent has not provided a valid, updated health assessment since. The child should have had an updated health assessment provided to the facility during 2018.

Correction Required: The 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: The health reports on file for Child #3, Child #4 and Child #6 are only a summary of each child's visit, and not valid health assessments signed by a medical professional. These summaries do not include statements that each child is able to participate in child care and appears to be free from contagious or communicable diseases.

Correction Required: A health report must be written and signed by a physician, physician's assistant or a CRNP. The signature must include the individual's professional title. A health report shall include a statement that the child is able to participate in child care and appears to be free from contagious or communicable disease.

Noncompliance Area: The immunization report on file for Child #1, a 2 year old, does not include a vaccination for Influenza, and a letter of exemption from the parent is not present in the child's file. The immunization report on file for Child #5, a School-Age child, shows the last immunization for Influenza was completed 11/21/17, and proof of an updated vaccine since that date was not provided; a letter of exemption from the parent is not present in the child's file. The immunization report on file for Child #4,a 10-month old, only includes vaccines provided to the child as of the 3-month-old mark, and proof of updated, required immunizations to date were not provided by the parent. The immunization report on file for Child #6, a 3 year old, does not include a vaccination for Influenza, and a letter of exemption from the parent is not present in the child's file. The immunization report on file for Child #7, a 4 year old, shows the last immunization for Influenza was completed 11/30/17, and proof of an updated vaccine since that date was not provided; a letter of exemption from the parent is not present in the child's file.

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: Staff #2, who has been employed at the facility since 12/10/16, had not updated her health assessment within the required 24 months. Previous health assessment: 12/7/16; Updated health assessment: 2/18/19.

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: Staff #1 was hired and began working on 1/3/19, but does not have proof of a valid TB test with a negative reading on file as of the date of the inspection on 3/26/19.

Correction Required: An adult health assessment must include tuberculosis screening by the Mantoux method at initial employment. Subsequent tuberculosis screening is not required unless directed by a physician, physician's assistant, CRNP, the Department of Health or a local health department.

Noncompliance Area: Staff #1 was observed during diapering of the children in her group. Though the staff person assisted each child in washing his/her hands after each diaper, the staff was not observed to place soap on her own hands and wash them between each diaper.

Correction Required: A facility person shall wash his hands before meals and snacks, and after toileting and after diapering a child.

Noncompliance Area: When the certification representative arrived at the front building at approximately 9:40 a.m., the cooked food for children's lunches was observed hot, covered in foil, and on the counter in the kitchenette room. The bowls were observed to contain pasta with meat sauce, cut fruit, and ham sandwiches, which are food requiring refrigeration. The food remained present at the counter, and was not yet served to children until lunch time, which had not yet occurred when the certification representative left the building approximately 11:15 a.m.

Correction Required: Potentially hazardous food brought from the child's home or provided by the facility shall be refrigerated.

Noncompliance Area: A bottle was observed in the refrigerator in the front building, but the bottle was not labeled with a child's name.

Correction Required: Disposable nursers and bottles shall be labeled with the child's name.

Noncompliance Area: According to an interview with the Director, the local traffic safety authorities have not been notified in writing of the location and routes around the facility in the past year.

Correction Required: An operator shall notify local traffic safety authorities annually in writing of the location of the facility and the program's use of pedestrian and vehicular routes around the day care facility.

Noncompliance Area: Manufacturer's instructions for Cosco brand booster seat were not observed in the 2004 Toyota Sienna, but the booster seat was present and able to be used by children.

Correction Required: Manufacturers' instructions for use of safety restraints shall be kept in the vehicle at all times.

Noncompliance Area: Scissors and tweezers were not present in the first-aid kit in the 2011 Toyota vehicle used for transportation.

Correction Required: A first-aid kit, including the contents as specified in 3270.75 (relating to first-aid kit) shall be in the vehicle when children are being transported.

Noncompliance Area: Emergency contact forms for Child #1 and Child #2 did not contain signed parental consent for emergency medical care or minor first-aid.

Correction Required: A child's record shall contain signed parental consent for emergency medical care for the child. Written consent is required prior to admission.A child's record shall contain signed parental consent for administration of minor first-aid procedures by facility staff. Written consent is required prior to admission.

Noncompliance Area: A water cooler in the first room of the front building, an area used by children and staff that is accessible, had a hot-water feature. The water that was dispensed by this button was measured to reach 165 degrees Fahrenheit.

Correction Required: Hot water temperature, in areas accessible to children, may not exceed 110 F.

Noncompliance Area: Blind cords in the large room of the back building were observed to be hanging low, in reach of children, and posed a strangulation hazard. Peeling paint was observed around the door frame on the small playground, accessible to children. A board was observed to be loose on this door on the small playground, in reach of children, posing a pinch hazard.

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

Noncompliance Area: An emergency exit from the facility in the front, road-side room of the front building was observed to be obstructed by children's play equipment and small climbing mats.

Correction Required: Stairways, hallways, exits from rooms, exits from the facility and other means of egress serving as an exit shall be unobstructed.

Noncompliance Area: During naptime, multiple cots in the toddler and preschool areas were observed to be less than 2 feet apart on three sides when being used. Many of the cots were touching other cots used by children.

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: The thermometer in the refrigerator read 60 degrees, though the refrigerator and contents felt cold.

Correction Required: A facility shall have an operable, clean refrigerator used to store potentially hazardous foods. The refrigerator shall be capable of maintaining food at 45 F or below. An operating thermometer shall be placed in the refrigerator.

Noncompliance Area: An inhaler was observed on site for Child #2, but a prescription label or instructions from the physician were not present at the site.

Correction Required: A staff person shall administer a prescription medication only if written instructions are provided from the individual who prescribed the medicine. Instructions for administration contained on a prescription label are acceptable.

Noncompliance Area: An Epi-pen for Child #1 was observed on site without written consent from the parent to administer the medication. Saline nasal solution was observed on site for Child #5 without written consent from the parent to administer the medication.

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

Noncompliance Area: Two car seats were observed in the van for use by children, but the manufacturer's instructions were not present.

Correction Required: Manufacturers' instructions for use of safety restraints shall be kept in the vehicle at all times.

Noncompliance Area: Emergency contact and fee agreement forms for Child #3, #4 and #5 have not been updated within the last 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: A review of emergency contact forms present in areas of the child care where children were receiving care, as well as in the van, had not been updated in accordance with the 6-month updates required on the master file.

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

Noncompliance Area: File for Staff #3 does not contain two written, nonfamily references.

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: Record for Staff #1, who began working in child care on 12/16/16, has a child abuse clearance completed for volunteer purposes on 10/31/16, and not a clearance obtained for employment purposes. Record for Staff #2 did not contain a signed disclosure statement.

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. Facility Person #1 may not work in a child care position at the facility.

Noncompliance Area: Cords for a CD Player and computer were observed in the preschool area unsecured to the wall, and in reach of children. The blue picnic table on the playground was observed to have cracked, sharp plastic edges. The log cabin playhouse on the playground was observed to have cracked, sharp plastic on the door jam. The bottom of the siding of the building was observed to be cracked in multiple places, and is accessible to children. Paint on the wooden door frames on the outside of the doorframe to the playground, and around the doors on the small area of the playground was observed to be chipping and accessible to children.

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.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: THERE ARE EXPOSED BOLTS ON THE GATE TO THE YOUNG TODDLER PLAY AREA OF THE PLAYGROUND. THERE WAS A RIPPED CRIB SHEET ON ONE OF THE CRIB MATTRESSES USED BY THE CHILDREN.

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: THERE IS EXPIRED DESITIN (12/16) ABOVE THE CHANGING TABLE.

Correction Required: A staff person shall administer a prescription medication only if written instructions are provided from the individual who prescribed the medicine. Instructions for administration contained on a prescription label are acceptable.

Noncompliance Area: STAFF PERSON #1 DOES NOT HAVE TB TEST RESULTS CONDUCTED WITHIN 12 MONTHS OF DATE OF HIRE ON FILE AT THE FACILITY.

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.An adult health assessment must include tuberculosis screening by the Mantoux method at initial employment. Subsequent tuberculosis screening is not required unless directed by a physician, physician's assistant, CRNP, the Department of Health or a local health department.

Noncompliance Area: STAFF PERSON #2 HAD A VOLUNTEER STATE POLICE CLEARANCE ON FILE AT THE FACILITY. (DATE OF HIRE: 12/16/16)

Correction Required: 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 #2 may not work in a child care position at the facility until clearance is obtained.

Noncompliance Area: ONE STAFF WAS OUT OF RATIO AT BEGINNING OF INSPECTION UNTIL ANOTHER STAFF HAD ARRIVED BACK AT THE CENTER FROM PICKING UP A CHILD. THE STAFF HAD A MIXED GROUP OF 8 CHILDREN WITH THE YOUNGEST CHILD BEING 1 YEAR OF AGE.

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). STAFF MUST MAINTAIN PROPER STAFF:CHILD RATIOS FOR MIXED GROUPS AT ALL TIMES. THE LEGAL ENTITY MUST ARRANGE FOR ALL FACILITY STAFF TO RECEIVE 2 HOURS PQAS APPROVED TRAINING REGARDING PROPER RATIOS OF CHILDREN IN MIXED GROUPS. It does not matter if the PQAS approved training is through the regional Key. The legal entity must receive DHS approval of the training content prior to scheduling the training.

Noncompliance Area: THERE WAS LYSOL LABELED KEEP OUT OF REACH OF CHILDREN IN AN UNLOCKED CHANGING TABLE THAT IS ACCESSIBLE TO THE CHILDREN. THERE WAS HAND SANITIZER LABELED KEEP OUT OF REACH OF CHILDREN ON A CHILD'S BACKPACK THAT IS ACCESSIBLE TO THE CHILDREN.

Correction Required: Cleaning materials and other toxic materials shall be kept in an area or container that is locked or made inaccessible to children.

Noncompliance Area: THERE ARE ANTS IN THE STAFF BATHROOM AND GIRLS BATHROOM.

Correction Required: Evidence of infestation of insects or rodents in the facility is not permitted.

Noncompliance Area: THE TRASH CANS IN THE BATHROOM AND CLASSROOMS WERE NOT PLASTIC-LINED.

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

Noncompliance Area: THE HOT WATER IN THE BOYS BATHROM AND STAFF BATHROOM REACHED 122 F.

Correction Required: Hot water temperature, in areas accessible to children, may not exceed 110 F.

Noncompliance Area: THERE IS RIPPED CARPETTING ON THE PRESCHOOL PLAYSPACE CREATING A TRIPPING HAZARD. THERE IS SHARP, BROKEN SIDING ALONG THE BACK OF THE BUILDING ON THE PRESCHOOL PLAYGROUND AND ALONG THE BASE OF THE BUILDING ON THE TODDLER PLAYGROUND.

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.