Little Dreamers Daycare & Preschool

Noncompliance Area: Observed child file #1, an infant, did not contain a vaccination record documenting the child's updated 6 month immunizations.

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: Observed staff file #1, a provisional hire, contained the NSOR verification letter which was dated more than 45 days after the first day working in a child care position. Observed staff file #2, contained documentation of the CPSL required mandated reporter training which was dated more than 90 days after the first day working in a child care position.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). Staff #1 and #2 have all CPSL required clearances/verifications and trainings at this time.

Noncompliance Area: Observed staff file #3, did not contain documentation of 2 years of experience with children.

Correction Required: An assistant group supervisor shall have a high school diploma or a general educational development certificate and 2 years experience with children.

Noncompliance Area: Observed 2 bottles of shaving cream, labeled keep out of the reach of children, in the preschool room's locked art and craft cabinet.

Correction Required: Arts and crafts materials shall be nontoxic.

Noncompliance Area: Observed heavy shelf/tables in the toddler and the preschool rooms which were not securely anchored. Observed a detached interior shelf in a cabinet in the school age room. Observed a heavy copier which was not securely anchored on a low preschool shelf.

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

Noncompliance Area: Observed the facility did not have written updated infant feeding schedules from the parents as the infants meal amounts, food, and needs change.

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

Noncompliance Area: Observed several loose sheets on the pack n play bottoms which are used as infant rest equipment creating an increased risk of SIDS.

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

Noncompliance Area: Observed staff file #2 contained documentation of training in the emergency plan was completed more than 2 months after the initial start in a child care position. Observed staff #3 and #4 contained annual training in the emergency plan which was completed more than 12 months after the previous 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 and kept on file at the facility.

Noncompliance Area: Observed staff file #1 did not contain documentation of an applicable degree in the human services field of study.

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.

Noncompliance Area: Observed staff file #2 did not contain documentation of 1 year of experience with children.

Correction Required: An assistant group supervisor shall have a high school diploma or a general educational development certificate, 15 credit hours from an accredited college or university in early childhood education, child development, special education, elementary education or the human services field and 1 year of experience with children.

Noncompliance Area: Observed a missing ceiling tile in the children's bathroom.

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: Observed a loose faucet in the school age bathroom. Observed a detached toilet paper holder in the children's bathroom.

Correction Required: Toilet areas and fixtures shall be cleaned daily and be in good repair.

Noncompliance Area: Based on information obtained during the course of the investigation and review of the parent handbook, it was determined that parents are to provide the children's lunch and afternoon snack and on one occassion the preschool teacher gave a child water with their lunch instead of the 20 ounce soda provided by the parent.

Correction Required: Meals and snacks may be provided by the parent, upon agreement between the parent and the operator.

Noncompliance Area: Observed in the toddler room 2 staff and 12 young toddlers. Staff #1 stated she was responsible for a group of 6 young toddlers. Staff #2 stated she was responsible for a group of 6 young toddlers.

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: Observed an unlocked low drawer on a microwave stand in the toddler room contained several small pen/marker caps which have a diameter of less than 1 inch, accessible to the toddlers receiving care in the room. .

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: Observed the initial health report in child file #1, did not contain a statement that the child is able to participate in child care and appears to be free from contagious or communicable disease.

Correction Required: 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: Observed an inhaler, in the locked medication area of the toddler room, which did not have written instructions from the person who prescribed the medication.

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: Observed mucous relief medication which did not have an established medication log, in a locked cabinet in the bathroom.

Correction Required: An operator is responsible to establish and maintain a medication log if prescription or nonprescription medication is administered.

Noncompliance Area: Observed staff file #1 contained only one written, nonfamily reference from individuals attesting to the person'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: Observed the facility did not have instructions for contacting the regional day care office posted in a conspicuous location used by parents.

Correction Required: The facility's current certificate of compliance and a copy of the applicable regulations under which the facility is certified shall be posted in a conspicuous location used by parents, with instructions for contacting the appropriate regional day care office posted at the same location.

Noncompliance Area: Observed in the toddler room, staff #2 and staff #3 with a mixed age group of children which contained 4 young toddlers, 6 older toddlers, and 4 preschool children. Observed several times, staff #2 or #3 left the room to open the main door leaving only one staff present in the toddler room with the same mixed age group of children.

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: Observed electrical outlets which did not have protective receptacle covers on a power strip cord by the preschool room refrigerator.

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

Noncompliance Area: Observed an infant placed a blue plastic toy in his mouth and when it was dropped on the floor, it was not immediately picked up to be washed, rinsed, and sanitized.

Correction Required: Toys soiled by secretion or excretion shall be cleaned with soap and water, rinsed and sanitized before being used by a child.

Noncompliance Area: Observed child file #1 did not contain written consent signed by a parent for emergency medical care or signed parental consent for administration of minor first-aid procedures by facility staff.

Correction Required: Emergency contact information must include the written consent signed by a parent for emergency medical care. 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: Observed child file #1, who is over 16 months old and has a immunization record which did not document the MMR immunization, did not contain an exemption from immunization for strong personal objection equated to a religious belief shall be documented by a written, signed and dated statement from the child's parent or guardian.

Correction Required: Exemption from immunization for religious belief or strong personal objection equated to a religious belief shall be documented by a written, signed and dated statement from the child's parent or guardian. The statement shall be kept in the child's record.

Noncompliance Area: Observed staff file #2, contained an initial health assessment which was signed and dated after providing initial service in a child care setting.

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: Observed staff file #1, contained a volunteer criminal background clearance which is not valid for employment purposes. Observed staff file #1, who has been employed for more than 90 days, did not contain documentation of being fingerprinted/fingerprint submitted receipt or a valid FBI fingerprint clearance.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). Facility Person # -1- may not work in a child care position at the facility.

Noncompliance Area: Observed in the preschool room, 409 cleaner and disinfecting wipes accessible to children in an unlocked cabinet. Observed in the preschool room hand sanitizer labeled keep out of the reach of children, accessible to children on a microwave stand. Observed in the main hallway, diaper cream and hand sanitizer labeled keep out of the reach of children, accessible to children in a diaper bag hanging on a low hook. Observed in the toddler room, diaper cream and bleach labeled keep out of the reach of children, accessible to children in an unlocked cabinet under the diaper changing table.

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: Observed exposed/loose electrical cord by the infant changing table. Observed 2 exposed/loose electrical cords by the toddler diapering area. Observed a metal bracket with a pinch point on a wooden shelf in the toddler room. Observed exposed bolts and 2 holes with rough edges on the gate post for the exit gate from the outdoor play area. Observed net fencing to separate the toddler and preschool play areas were anchored too far apart creating large gaps between the support posts and the building and the two end posts.

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: Observed a small amount of pea gravel from the preschool play area, which was in a small hole in the toddler play area. Observed there was no barrier at one part of the preschool play area to prevent the preschool pea gravel from being displaced into the toddler play area.

Correction Required: Pea gravel and other materials with a diameter of less than 1 inch may not be used in spaces where infants or toddlers receive care.

Noncompliance Area: Observed the refrigerators in all of the child care spaces did not have operating thermometers placed in the refrigerators.

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: Observed staff file #1 did not contain documentation of 2 years of experience with children.

Correction Required: An assistant group supervisor shall have a high school diploma or a general educational development certificate and 2 years experience with children.

Noncompliance Area: Observed 409 carpet cleaner accessible to children in 2 unlocked storage cabinets in the preschool room.

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: Observed peeling paint on the exterior door jam of the infant room door which exits into the play area.

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

Noncompliance Area: Observed several of the windows in the preschool room which did not have a visual strip or visual identification.

Correction Required: A visual strip or other visual identification shall be placed on glass located in a traffic area, a child care space or a play space.

Noncompliance Area: Observed the sinks in the toddler room diapering area did not have steps or platforms for the toddler age children to be able to wash their hands.

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.