Mark's Meadow After School Day Care

7.11(02)(l)(05), 7.11(02)(l)(04), 7.11(02)(l)(03), 7.11(02)(l)(02), 7.11(02)(l)(01) — Medication

The program did not have current written parental consent for the administration of medication required by an IHCP. Corrective action: Met with the parent and obtained written consent for the administration of the medication listed on their IHCP. This includes the medication order from the pharmacy.. Regulation: Type of Medication: Topical, non-Prescription (not applied to open wounds or broken skin) Written Parental Consent Required: Yes, renewed annually Health Care Practitioner Authorization Required: No. Items not applied to open wounds or broken skin may be supplied by program with notification to parents of such, or parents may send in preferred brands of such items for their own child(ren)’s use. Logging Required: No for items not applied to open wounds or broken skin., Type of Medication: Topical, non-Prescription (when applied to open wounds or broken skin) Written Parental Consent Required: Yes, renewed annually Health Care Practitioner Authorization Required: No in FCC. Yes in Large and Small Group. Must be in original container with original label containing the name of the child affixed Logging Required: Yes, including name of child, dosage, date, time, & staff signature, Type of Medication: Unanticipated Non-Prescription for Mild Symptoms (e.g., acetaminophen, ibuprofen, antihistamines) Written Parental Consent Required: Yes, renewed annually Health Care Practitioner Authorization Required: No in FCC. Yes in Large and Small Group. Must be in original container with original label containing the name of the child affixed Logging Required: Yes, including name of child, dosage, date, time, & staff signature, Type of Medication: Oral Non-Prescription Written Parental Consent Required: Yes, renewed weekly with dosage, times, days and purpose Health Care Practitioner Authorization Required: No in FCC. Yes in Large and Small Group. Must be in original container with original label containing the name of the child affixed Logging Required: Yes, including name of child, dosage, date, time, & staff signature. Missed doses must also be noted along with the reason(s) why the dose was missed., Type of Medication: All Prescription Written Parental Consent Required: Yes Health Care Practitioner Authorization Required: Yes. Must be in original container with original label containing the name of the child affixed. Logging Required: Yes, including name of child, dosage, date, time, & staff signature. Missed doses must also be noted along with the reason(s) why the dose was missed. Cited during: Monitoring Visit. Source: MA EEC child care provider record (childcare.mass.gov).

7.11(03) — Health

The Individual Health Care plan (IHCP) for one child with a medical condition had an expiration date of 8/15/25. Corrective action: Contacted parent and received an updated and current IHCP for Child with medical condition.. Regulation: Individual Health Care Plans The licensee must maintain as part of a child’s record, an individual health care plan for each child with a chronic medical condition, which has been diagnosed by a licensed health care practitioner. The plan must describe the chronic condition, its symptoms, any medical treatment that may be necessary while the child is in care, the potential side effects of that treatment, and the potential consequences to the child’s health if the treatment is not administered. Cited during: Monitoring Visit. Source: MA EEC child care provider record (childcare.mass.gov).

7.04(18)(d)(01) — Administration

Three Educator’s files did not include a copy of the BRC Sutability. Corrective action: The Director ensured that all staff files included a letter of suitability. The Director will file a copy of the letter of suitability for all new hire and renewals, and check for the letter when completing the staff records checklist.. Regulation: a current staff records check list that reflects all regular employees, Cited during: Renewal - Full Review Visit. Source: MA EEC child care provider record (childcare.mass.gov).

7.04(07) — Administration

Review of the children’s records revealed that files did not include emergency medical consent Corrective action: Director reviewed the children's records to ensure that the files include emergency medical consent. Director will utilize the children's checklist to make sure that Emergency Medical Consent are in the children's records.. Regulation: Children’s Records. The licensee must maintain an individual written record for each child that includes: Cited during: Renewal - Full Review Visit. Source: MA EEC child care provider record (childcare.mass.gov).

7.04(04)(a)(01), 7.04(04)(a)(02) — Care of Children

On the day of the visit Educators did not know how many children they were responsible for. One Educators reported having 16 children but upon counting it was learned there were 25 children in the group Corrective action: The Program Director reminded all Educators to maintain a running total of children in their group at all times. We revised the group leader attendance sheet with a section for adding children who join a group after attendance is taken to make this more effective.. Regulation: daily attendance records indicating each child’s attendance, including arrival and departure times;, a method of knowing exactly who is present on the premises at any given point in the day. Cited during: Renewal - Full Review Visit. Source: MA EEC child care provider record (childcare.mass.gov).

7.10(05) — Care of Children

There was an assistant group leader alone, assigned to supervise a group of 12 school age children Corrective action: The Director reminded all staff of the roles and responsibilities of Group Leader and Assistant Group Leader, including the requirement that children are not to be left alone with Assistant Group Leaders. Educators must follow the daily group schedule.. Regulation: Supervision of Children: In addition to interacting with children as required by 606 CMR 7.05, all licensees and educators must exercise appropriate supervision of the children in their care in order to ensure their health and safety at all times. Such supervision must include, but not be limited to, indoor and outdoor activities, mealtimes, naptime, transportation, field trips, and transitions between activities. Cited during: Renewal - Full Review Visit. Source: MA EEC child care provider record (childcare.mass.gov).

7.11(02)(j), 7.11(02)(l) — Health

The program didn’t have parental concert for the administration of rescue medication required by an IHCP Corrective action: Director met with the parent and had them fill out the missing Medication Consent form stating that the child does not require medication. Director will utilize the children's checklist to make sure Medication Consent forms have parental consent for administration of rescue medication.. Regulation: Each time a medication is administered, the educator must document in the child’s record the name of the medication, the dosage, the time and the method of administration, and who administered the medication, except as noted in (k) below., All medications must be administered in accordance with the consent and documentation requirements specified below: Cited during: Renewal - Full Review Visit. Source: MA EEC child care provider record (childcare.mass.gov).

7.11(03) — Health

Review of children’s records revealed that an IHCP was missing parent signature, names of staff who received training in administering the treatment. Corrective action: The Program Director had the parent sign the IHCP and has updated the IHCP to specify which four staff members are trained to administer the treatment. The Director will ensure that all IHCP forms are signed by checking the form when completing the children's checklist.. Regulation: Individual Health Care Plans The licensee must maintain as part of a child’s record, an individual health care plan for each child with a chronic medical condition, which has been diagnosed by a licensed health care practitioner. The plan must describe the chronic condition, its symptoms, any medical treatment that may be necessary while the child is in care, the potential side effects of that treatment, and the potential consequences to the child’s health if the treatment is not administered. Cited during: Renewal - Full Review Visit. Source: MA EEC child care provider record (childcare.mass.gov).