Little Dreamers Academy Llc

Noncompliance Area: The doors of the play sink and refrigerator were not securely attached to the equipment creating pinch points. Exposed nails were accessible to children on the door of the play sink.

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: The right hand door on the video cabinet was not secured to the cabinet creating pinch points. The cabinet sits on the floor and is accessible to children.

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

Noncompliance Area: The files for the following children did not contain documentation of any completed child services reports; child #1 enrolled since 8-21-19, child #2 enrolled since 9-4-18, and child #3 enrolled since 8-21-19. The reports were due prior to the regulation being suspended due to COVID-19.

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 file for child #1 contained emergency contact information which did not include written consent signed by a parent for emergency medical care.

Correction Required: Emergency contact information must include the written consent signed by a parent for emergency medical care. A child's record must contain signed parental consent for emergency medical care for the child. Written consent is required prior to admission.

Noncompliance Area: The file for child #3 contained emergency contact information which did not include the health insurance policy number under which the child is covered.

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: The files for children #3 and #5 contained emergency contact information which did not include the address of the individuals 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 file for child #2 contained emergency contact information and an agreement which have not been updated since 8-21-19. The file for child #3 contained emergency contact information and an agreement which have not been updated since 6-3-19. These updates were due prior to the regulation being suspended due to COVID-19.

Correction Required: The parent shall update in writing emergency contact information once in a 6-month period or as soon as there is a change in the informationA 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 file for child #2 contained an initial health report conducted more than 60 days after the child's first day of attendance. The health report on file is now current.

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: The file for child #3 contained a health report which did not include a review of the child's immunized status. The file did not contain any immunization records.

Correction Required: A health report shall include a review of the child's immunized status according to recommendations of the ACIP.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 file for child #4, who is 18 months old, contained a immunization record which lacked documentation of having received the influenza vaccine in the past 12 months.

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 file for child #1 did not contain signed parental consent for administration of minor first-aid procedures by facility staff.

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

Noncompliance Area: The file for staff #2 lacked documentation of completing the required 6 annual hours of training.

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: The file for staff #1 contained expired documentation of completing mandated reporter training. The training was last completed on 4/28/15. Based on documentation on file, staff #2, with a start date of 6/24/19, did not complete mandated reporter training within the required 90 days. The training was completed on 10/4/19.

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 file for staff #1 contained clearances which were not updated within the required 60 month time period. The initial state police clearance was obtained on 5-11-15 and was updated on 6-22-20. The initial child abuse clearance was obtained on 5-5-15 and was updated on 6-25-20. All clearances on file for staff #1 are now current and valid.

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: Two electrical outlets in the front room, accessible to children 5 years old or younger, lacked protective covers.

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

Noncompliance Area: The last documented fire drill conducted at the facility occurred on 10-19-19.

Correction Required: A fire drill shall be held at least every 60 days. Staff persons, volunteers and children in attendance shall participate in the fire drill and shall exit the facility, weather permitting.A written record shall be kept of the date, the time of day, the hypothetical location of the fire, the evacuation time, the names of facility persons and the number of children participating in the fire drill.

Noncompliance Area: A cracked plastic sink basin was observed on a play kitchen sink. The sink also had a protruding screw where the faucet was removed.

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: The refrigerator in the main room lacked a thermometer.

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: The files for children #1 - 5, all enrolled for longer than 6 months, did not contain documentation that child service reports were completed and shared with the family.

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 file for child #3 contained emergency contact information which did not include the 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 file for child #5 contained emergency contact information which did not include the work address of the enrolling parent.

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

Noncompliance Area: The files for children #3 and #5 contained emergency contact information which did not include health insurance coverage and policy number. The file for child #1 contained emergency contact information which did not include a 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: The files for children #1, #3, and #5 contained emergency contact information which did not include the address of the individual designated by the parent to whom the child may be released. The file for child #5 also lacked the telephone number of the individual 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 for child #2 was not present in the main room. Child #2 was observed in care in the room.

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 file for child #5, enrolled for longer than 60 days, did not contain a health report. The file for child #4 contained an initial health report which was conducted 9 months after 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.A child's record must contain initial and subsequent health reports.

Noncompliance Area: The file for child #1, a young toddler, did not contain a heath report updated within the last 6 months.

Correction Required: The operator shall require the parent to provide an updated health report at least every 6 months for an infant or young toddlerA child's record must contain initial and subsequent health reports.

Noncompliance Area: The file for child #5, enrolled for longer than 60 days, did not contain an immunization record.

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 file for child #1, 16 months old, contained an immunization record which lacked documentation of receiving the MMR and Varicella vaccines. The record also lacked documentation of receiving an influenza vaccine after the child turned 6 months old. The files for children #2 and #3 lacked documentation of receiving the influenza vaccine within the past 12 months.

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 files for staff #1 and #2 contain health assessments which were not updated within 24 months. The most recent health assessments on file for both staff are now current.

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.A facility person's record shall include a written report of initial and subsequent health assessments, including the results of initial and subsequent tuberculin skin tests, x-rays or other medical documentation necessary to confirm freedom from communicable tuberculosis.

Noncompliance Area: Visibly spoiled milk was observed in the refrigerator in the main room. The milk was labeled with a best buy date of May 21, 2019.

Correction Required: Food stored, prepared or served shall be clean, wholesome, free from spoilage, free from adulteration and safe for human consumption.

Noncompliance Area: The files for children #1 - 5 contained emergency contact information and agreements which have not been updated within the last 6 months. The most recent updates for each child occurred on the following dates; child #1 6/11/18, child #2 8/27/18, child #3 10/3/18, child #4 8/27/18, and child #5 12/4/18.

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 files for children #1 and #3 do not contain signed parental consent for emergency medical care or the administration of minor first aid.

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

Noncompliance Area: Based on documentation at the facility the emergency plan was not reviewed within the last 12 months. The last documented review occurred 5/2/18.

Correction Required: The operator shall review the emergency plan at least annually and update the plan as needed. The operator shall document in writing each review and update of the emergency plan and kept on file at the facility.

Noncompliance Area: The file for staff #3 did not include documentation of completing the annual 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.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 files for staff #1 and #3 contained expired CPR training certificates. Based on statements made by the operator, both staff have worked alone as the only staff person at the facility while children were in care.

Correction Required: One or more facility persons competent in first-aid techniques shall be at the facility when one or more children are in care.

Noncompliance Area: A green extension cord in the main room, accessible to children 5 years of age or younger, lacked a protective cover.

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

Noncompliance Area: A reusable bottle containing Lysol All Purpose cleaner not labeled with the contents was observed in the cabinet in the play space.

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: Based on documentation at the facility, fire drills were not held every 60 days. The last 3 documented fire drills occurred on 7/13/18, 3/28/19, and 6/13/19.

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

Noncompliance Area: Deflated latex balloons were observed in an open box on the floor of the main child care space where infants and toddlers were receiving care. A plastic cup with cherry seeds was observed on the tray of a high chair in the main room and was accessible to the toddlers in care.

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 facility lacked a written plan of daily activities and routines.

Correction Required: A written plan of daily activities and routines, including a time for free play shall be established for each group. The plan shall be flexible to accommodate the needs of individual children and the dynamics of the group. The written plan of daily activities and routines shall be posted in a traffic area used by parents.

Noncompliance Area: The file for child #1, enrolled since 8-7-17 and the file for child #3, enrolled since 10-13-17, did not include forms approved by the department to provide information to the family about the child's growth and development in the context of the services being provided.

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 agreement for child #5 did not specify the date of the child's admission.

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

Noncompliance Area: The file for child #2 contained the original agreement.

Correction Required: A parent shall receive the original agreement. The facility shall retain a copy of the agreement.

Noncompliance Area: The files for child #1, child #3, and child #5 contained emergency contact information which 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: The files for children #2, #3, #4, and #5 contained emergency contact information which did not include the addresses of the individuals 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: At the time of the inspection, emergency contact information for the child receiving care in the main room was not present in the care space.

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 file for child #1, enrolled for more than 60 days, did not include a health report.

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 must contain initial and subsequent health reports.

Noncompliance Area: The file for child #4 contained a health report which was not signed by a physician, physician's assistant or a CRNP.

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.

Noncompliance Area: The file for child #1 contained a health report which did not include a review of the child's immunized status.

Correction Required: A health report shall include a review of the child's immunized status according to recommendations of the ACIP.

Noncompliance Area: Fluticasone Propionate nasal spray and Aleve were accessible to children in an unsecured bag belonging to staff on a shelf in the gross motor room.

Correction Required: Medication shall be stored in a locked area of the facility or in an area that is out of the reach of children.

Noncompliance Area: The files for staff #2 and #4 lacks health assessments conducted within the past 24 months.

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.A facility person's record shall include a written report of initial and subsequent health assessments, including the results of initial and subsequent tuberculin skin tests, x-rays or other medical documentation necessary to confirm freedom from communicable tuberculosis.

Noncompliance Area: The facility lacked a posed menu. Based on statements made by staff, a menu is not being provided to the families.

Correction Required: An operator shall conspicuously post the menu at least 1 week in advance or provide a menu to each family.

Noncompliance Area: The facility lacked written statements provided by the parents giving the formula and feeding schedule for the infants in care.

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

Noncompliance Area: A bottle for an infant in care was not labeled with the child's name.

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

Noncompliance Area: The files for children #1 and #3 contained emergency contact information and financial agreements which were not updated at least once in a 6-month period. The documents for child #1 were last updated on 8-7-17. The documents for child #3 were last updated on 10-13-17.

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 file for staff #2 lacks documentation of training regarding the emergency plan in the last 12 months. The file for staff #4, hired 3-17-16, lacks documentation of any 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. 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: On 6-18-18 at approximately 10:00 AM, two staff were present at the facility with 12 children of mixed ages; 8 preschoolers, 3 young toddlers, and 1 infant. Staff #4 left the main child care room to answer the door in the gross motor room leaving all 12 children with staff #5. When asked to name their primary care groups, staff #4 named the 3 young toddlers and 1 infant. Staff #5 named the 8 preschoolers. However, based on statements made by the operator, staff #5 did not meet the qualifications of a staff person. Staff #5 qualified as a volunteer.

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

Noncompliance Area: The files for staff #1, #3, and #4 lack documentation of obtaining the required 6 annual 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: On 6-18-18 at approximately 10:00 AM, two staff were present at the facility with 12 children of mixed ages; 8 preschoolers, 3 young toddlers, and 1 infant. Staff #4 left the main child care room to answer the door in the gross motor room leaving all 12 children with staff #5. When asked to name their primary care groups, staff #4 named the 3 young toddlers and 1 infant. Staff #5 named the 8 preschoolers. However, based on statements made by the operator, staff #5 did not meet the qualifications of a staff person. Staff #5 qualified as a volunteer.

Correction Required: A volunteer shall be supervised by a staff person.

Noncompliance Area: On 6-18-18 at approximately 10:00 AM, two staff were present at the facility with 12 children of mixed ages; 8 preschoolers, 3 young toddlers, and 1 infant. Staff #4 left the main child care room to answer the door in the gross motor room leaving all 12 children with staff #5. When asked to name their primary care groups, staff #4 named the 3 young toddlers and 1 infant. Staff #5 named the 8 preschoolers. However, based on statements made by the operator, staff #5 did not meet the qualifications of a staff person.

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: A tank for filling helium balloons labeled keep out of reach of children was observed in the main care space. Tropic Sun sunblock labeled keep out of reach of children was accessible to children in the gross motor room in an open diaper bag.

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: An area of flaking rust was observed on the bottom right hand corner of the exit door of the gross motor room.

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 facility lacked documentation of conducting a fire drill in the last 60 days. The last documented fire drill was August 2017.

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

Noncompliance Area: The facility lacked an adequate supply of dramatic play materials in the new child care space.

Correction Required: Play equipment and materials shall include materials for dramatic role playing.

Noncompliance Area: The facility lacked active comprehensive liability insurance. The policy expired on 2/8/17 and has not yet been renewed.

Correction Required: The legal entity shall have comprehensive general liability insurance to cover the persons who are on the premises. A current copy of the insurance policy shall be on file at the facility.

Noncompliance Area: The facility's emergency plan was last reviewed on 3/15/17.

Correction Required: The operator shall review the emergency plan at least annually and update the plan as needed. The operator shall document in writing each review and update of the emergency plan and kept on file at the facility.

Noncompliance Area: The file for staff #1 lacked documentation of receiving training regarding the emergency plan on an annual bais. The last documented training occurred 4/27/17.

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. 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 facility was using an unmeasured room as child care space. The space can not yet be measured and approved for use because the facility lacks an amended occupancy permit.

Correction Required: Indoor child care space is measured within permanent stationary partitions or walls. The allowable number of children in a space is determined by dividing the total square feet in a space by 40.

Noncompliance Area: A piece of loose trim with exposed, sharp nails was placed in the window sill 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.

Noncompliance Area: The file for staff #1 contained a health assessment that was not completed on or before their first day in a child care position. The health assessment on file is now current.

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 file for staff #1, with a start date of 04-27-2017, contained a child abuse clearance that was completed on 06-05-2017. The file did not contain proof of applying for the child abuse clearance on or before their first day in a child care position. The file for staff #1 contained an FBI clearance completed on 05-10-2017. The file did not contain proof of applying for the child abuse clearance on or before their first day in a child care position.

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 file for staff #1, designated as primary staff, did not include proof of 2 years of experience with children.

Correction Required: A primary staff person shall have attained a high school diploma or a general educational development certificate and 2 years of 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 10:30 AM, 1 child was observed in care. The child was being supervised by staff designated as primary staff, but who lacked the documentation of experience required for the position. There was no primary staff at the facility.

Correction Required: A primary staff person shall supervise the performance of a secondary staff person

Noncompliance Area: Two cribs used by infants were not 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 files for child #2, #4, and #5 contained agreements which were not signed by the operator. The agreement for child #5 also lacked a signature from the parent.

Correction Required: An agreement shall be signed by the operator and the parent.

Noncompliance Area: The files for child #2 and child #4 contained agreements which lacked the fee to be charged per day or per week.

Correction Required: An agreement shall specify the amount of the fee to be charged per day or per week.

Noncompliance Area: The files for child #2 and child #4 contained agreements which 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: The files for child #2 and child #4 contained agreements which 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: The files for child #2, #4, and #5 contained agreements which did not specify the date of the child's admission.

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

Noncompliance Area: The file for child #3 lacked a copy of the agreement.

Correction Required: A parent shall receive the original agreement. The facility shall retain a copy of the agreement.

Noncompliance Area: The file for child #3 lacked emergency contact information.

Correction Required: Emergency contact information is required for each enrolled child. Emergency contact information shall reference who shall be contacted in an emergency.

Noncompliance Area: The files for child #1 and child #5 contained emergency contact information which did not include information regarding health insurance coverage.

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: The files for child #1, #2, #4, and #5 contained emergency contact information which lacked the address of the individuals designated by the parent to whom the children 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 file for child #5, who has been enrolled for longer than 60 days, lacked an initial health assessment.

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: Desitin, which lacked the name of the child for whom it was intended, was observed in the restroom cabinet.

Correction Required: The label of a medication container shall identify the name of the medication and the name of the child for whom the medication is intended. Medication shall be administered to only the child whose name appears on the container.

Noncompliance Area: A bottle used by an infant in care was not labeled with the child's name.

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

Noncompliance Area: The files for child #2 and child #5 do not contain parental consent for emergency medical care for the child.

Correction Required: A child's record must contain signed parental consent for emergency medical care for the child. Written consent is required prior to admission.

Noncompliance Area: The files for child #2 and child #5 do not contain parental consent for administration of minor first-aid procedures by facility staff.

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

Noncompliance Area: The file for Staff #1 does not include 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: Loose crib sheets, which pose a suffocation risk, were observed in two cribs used by infants.

Correction Required: Conditions at the facility may not pose a threat to the health or safety of the children.