Little Wishes and Big Dreams Playhouse LTD

746.3503(a) - Diaper Changing Equipment - Smooth, Non-absorbent, Easy to Clean Surface

A diaper changing mat was torn.

746.1309(a) - Documented Annual Training Area - 24 Hours Required

Two out of ten staff files did not have the full 24hrs of training at review.

746.5537(a)(3) - Electronic or Battery-Operated Carbon Monoxide Detector-Document Test Date, Battery Installation Date, and Staff Name Testing and Installation

The carbon monoxide detector was not documented as being completed.

746.2407 - Infant Care Area Furnishings and Equipment -Use of Safety Straps

A caregiver had an infant in a highchair without being strapped in the seat. *This was corrected at inspection*

746.5205(1) - Fire Drill Monthly - Exit in 3 Minutes

The operation did not have documented that they conducted the fire drill for the past month.

746.1201(2) - Responsibilities of Employees and Caregivers -Relate to Children

Caregiver did not relate to a child with patience or courtesy with the interaction of making the child cry by grabbing them multiple times leaving a mark. *Dir terminated the caregiver after reviewing video*

746.2805(3) - Prohibited Punishments - Grabbing and Pulling

Caregiver grabbed a 4yr old child by the arm leaving a mark on the arm. *Dir terminated the caregiver after reviewing video*

746.1301(a)(3)(A) - Training Requirements for Employees, Caregivers, and Directors - Pediatric First Aid with Rescue Breathing

Based on the information gathered it was determined that one of the staff member's first aid certificate was expired at the time of the incident.

746.5617(a)(5) - Required Equipment in Vehicles - Fire Extinguisher

The operation had a fire extinguisher in the van, however the fire extinguisher was not secure in the van.

746.2805(3) - Prohibited Punishments - Grabbing and Pulling

A caregiver grabbed a 2yr old child by the shoulder and chin hard enough to have the 2yr old off balance. *Management terminated the caregiver when it was brought to their attention*

746.4001(5) - First Aid Kit - Inaccessible to Children

A 3yr old child had access to the first aid kit.

746.1205(a)(4) - Supervision ensures each child?s safety, well-being, including physical proximity and auditory or visual awareness of each child?s on going activity

A caregiver was unaware that a 3yr old child had acquired an aspirin from a first aid kit.

746.3807(1) - Storage of Medication - Inaccessible to Children

A 3yr old child had access to an aspirin from the first aid kit. *The child did not swallow the pill. All aspirin were removed from the first aid kits.

746.1205(a)(2) - Responsibilities of Caregivers - Know number of children responsible for

A caregiver did not know how many children were in her care when asked by CCR.

746.1205(a)(4) - Supervision ensures each child?s safety, well-being, including physical proximity and auditory or visual awareness of each child?s on going activity

A caregiver left a 3yr old child unattended in the restroom after a restroom break. Same caregiver left a different 3yr child on the indoor playground unattended while returning from that restroom break. *This caregiver is no longer with the operation. Operation had developed new plan with name to face checks.

746.3301(i) - Nutrition and Food Service - Must not serve identified foods to allergic child

An infant child was served food that was an identified allergy. *The operation has developed a new serving policy that has a picture of the child, what the allergy is, and action to take if exposed.