The Learning Garden, Inc

“During the inspection, a ratio of 1 child care staff member(s) for 10 children was determined to have occurred for the toddler group when the situation in number(s) 4 below occurred: 1. A child care staff member stepped out of the room. 2. A child care staff member had not arrived at work on time. 3. Children were present who were not scheduled to be there. 4. Achild care staff member was unable to work. 5. A child was injured in that group. 6. A child arrived in the group before a second staff member was scheduled to arrive with the group. 7. Two groups were combined, and the program did not follow the ratio for the youngest child in the group. 8. A child was transitioning to the next older age group, and the program did not follow the ratio for the youngest child in the group. 9. Ratio was doubled for more than two hours while children were napping. 10. Ratio was doubled while children were napping for a group that included at least one infant. 11. Ratio was doubled while children were napping and there were not enough staff members in the building to meet staff/child ratio. 12. Ratio was doubled in the school age group to allow access to the program, however, the program does not serve only school age children. 13. Both child care staff members did not have a working communication device when one staff member left the group to allow access to the school age only program. 14. The child care staff member did not return to the group after allowing access to the school age only program. 15. Other [ ]. Additional child care staff members must be hired or current child care staff members must be rescheduled to maintain compliance. Provide staff training. Submit the program’s corrective action plan, which includes a statement that training was provided, to the Department to verify compliance with the requirements of this rule.”

“During the inspection, it was determined the program did not meet the requirements for keeping an attendance record as listed in number(s) 2 below: 1. No attendance record was being maintained. 2. The attendance record was not being consistently completed. In the SA room AM 3. The record did not include the name of at least one child. 4. The record did not include the birth date of at least one child. 5. The record did not include the assigned group. 6. The record did not include the child’s weekly schedule. 7. The record did not include the time (hours and minutes) of each child’s arrival and departure to the program, including transportation by the program. 8. The original attendance record was not kept at the program for a period of one year. Submit the program’s corrective action plan to the Department to verify compliance with the requirements of this rule.”

“In review of the staff records, it was determined that the medical statements for the employees listed on the Employee Record Chart did not meet the requirements as listed in number(s) 5c below. 1. A medical statement was not on file for at least one employee; 2. The medical statement(s) on file did not have a date of examination within 12 months of the employee’s first day of employment; 3. Date of examination was missing; 4. Signature, business address, or telephone number of the licensed physician, physician assistant, advanced practice nurse, certified midwife, or certified nurse practitioner who completed the examination was missing; 5. A statement was missing that verifies the employee is: a. Physically fit for employment in a program caring for children; b. Immunized against Tetanus, Diphtheria, Pertussis (Tdap); c. Immunized against Measles, Mumps, and Rubella (MMR); 6. Tuberculosis (TB) screening/test information was missing: a. Documentation of the screening process to determine if the employee resided in a country identified by the world health organization as having a high burden of TB and arrived in the United States within the five years preceding the date of application for employment. b, Results of a TB test for employees meeting both criteria in 6a. c. Results of additional testing for employees with a positive TB test. d. Written statement, signed by a representative of the TB control unit, that the employee's TB is no longer infectious or the individual is receiving a TB treatment regimen for employees with a positive TB test. Submit the program’s corrective action plan, which includes a copy of the completed employee medical statement, or TB results/documentation, to the Department to verify compliance with the requirements of this rule.”

“During the inspection, it was determined that unsanitary conditions, as noted in number(s) 6 below, were in the Gym/SA restroom: 1. There was no liquid soap. 2. There was no toilet paper. 3. There were no paper towels. A, The toilet cleaning brush was accessible to the children. 5. The plunger was accessible to the children. 6. The toilet(s) were not flushed. 7. The trash was not emptied from the day before. 8. There was a strong urine odor. 9. Other [ ]. The restroom(s) must be kept sanitary at all times. Technical assistance was provided at the time of the inspection, and as discussed, please correct this rule noncompliance. A written response for this rule noncompliance is not required at this time.”

“During the inspection, it was determined that breast milk provided by the parent was not stored appropriately as noted in number(s) 1 below: 1. Not labeled with infant's name, date pumped, and date bottle was prepared; 2. Not immediately refrigerated or frozen; 3. Stored at room temperature longer than eight hours; 4. Stored at the program for more than five days after it was expressed; 5. Stored longer than two weeks in the freezer compartment of the refrigerator; 6. Stored longer than six months in the refrigerator/freezer; 7. Stored longer than twelve months in the deep freezer; 8. Other [ ]. Submit the program’s corrective action plan to the Department to verify compliance with the requirements of this rule.”

“In review of the staff records, it was determined that at least one child care staff member did not meet the annual professional development requirement as noted in number(s) 1 below: 1. The child care staff member(s) had not completed at least six hours of professional development. 2. Documentation did not demonstrate the person who provided the training met the trainer qualifications as stated in the rule. 3. Training topic did not meet the requirements listed in appendix A of this rule. 4. Documentation of training did not meet the requirements of this rule. 5. The substitute(s) had been used more than ninety days annually between July first and June thirtieth and had not completed at least six hours of professional development 6. Other [ ]. Submit the program’s corrective action plan to the Department to verify compliance with the requirements of this rule.”