YMCA @ Mile Tree

7.07(02), 7.07(03) — Physical Facility - Indoors

The building and fire inspections were expired at the time of the visit. Corrective action: We were able to get the new inspection certificates. Regulation: Building Inspection. Every program that is not located in a residence and every program that has a licensed capacity of more than 10 children must provide a certificate of inspection from the Department of Public Safety or the local building inspector certifying that the facility complies with the State Building Code (780 CMR). The certificate must indicate the following:, Fire Inspection. Every program not located in a residence must submit evidence of compliance with applicable fire codes. Cited during: Enhanced Monitoring Visit. Source: MA EEC child care provider record (childcare.mass.gov).

7.04(14)(c) — Postings

The allergies, medications, medical information, special diets list was not posted. Corrective action: We have updated all the allergy, medication and special diet information. It is now posted. Regulation: in a manner that protects the privacy of each child: Cited during: Enhanced Monitoring Visit. Source: MA EEC child care provider record (childcare.mass.gov).

7.11(05)(e) — Emergency Preparedness

The program did not have adequate first aid supplies available, including, but not limited to: adhesive tape, band aids, gauze pads, gauze roller bandage, disposable non-latex gloves, instant cold pack, scissors, tweezers, thermometer, and CPR mouth guard. Corrective action: We brought a First Aid bag fully stocked to Mile Tree. We coached the staff, stating they need to check the bag to ensure there are always the proper supplies. Regulation: The licensee must maintain adequate first aid supplies, including, but not limited to: adhesive tape, band aids, gauze pads, gauze roller bandage, disposable non-latex gloves, instant cold pack, scissors, tweezers, thermometer, and CPR mouth guard. Cited during: Enhanced Monitoring Visit. Source: MA EEC child care provider record (childcare.mass.gov).

7.11(03) — Health

Through interviews with staff, it was found that not all staff members were aware of the children with Individualized Health Care Plans (IHCP) and their medications. Corrective action: We have coached the staff and the Site Directors to ensure that all staff should read and understand any special needs some of the children may have, such as IEPs or IHCPs. 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: Enhanced Monitoring Visit. Source: MA EEC child care provider record (childcare.mass.gov).

7.11(05)(d)(04) — Health

The program did not have all of the emergency medications needed for the children who require them. Corrective action: We have contacted the parents and we have or will be getting all the needed medications.. Regulation: emergency or life-saving medications, such as asthma inhalers and epinephrine auto-injectors, for any children for whom they have been prescribed; Cited during: Enhanced Monitoring Visit. Source: MA EEC child care provider record (childcare.mass.gov).

7.11(02)(c), 7.11(02)(e) — Health

Medications must be accessible to staff and stored appropriately in designated locations to ensure the safety and well-being of the children. During the visit, it was observed that emergency medications were stored in multiple locations rather than in a single, clearly designated area. A staff member reported that the medications were intended to be secured in a medication box; however, the lock on the box had broken. As a result, they stated that the medications were locked inside the box despite the issue. Upon inspection, the medication box was found to be empty, and no emergency medications were readily accessible at the time of the visit. Corrective action: There are 2 resolutions 1) we will now store the medications in the First Aid Bag in separate zip lock bags properly labeled, this will eliminate the need for a separate box. 2) as stated above, we have contacted the parents and we will ensure we have all needed medications. Regulation: All prescription medications must be in the containers in which they were originally dispensed and with their original labels affixed. Over-the-counter medications must be in the original manufacturer’s packaging., Unless otherwise specified in a child’s individual health care plan, the educator must store all medications out of the reach of children and under proper conditions for sanitation, preservation, security and safety during the time the children are in care and during the transportation of children. Cited during: Enhanced Monitoring Visit. Source: MA EEC child care provider record (childcare.mass.gov).

7.11(10)(c), 7.11(10)(d), 7.11(10)(f), 7.11(10)(g), 7.11(10)(h), 7.11(10)(i), 7.11(10)(j), 7.11(10)(m), 7.11(10)(l) — Health

A staff member was observed wiping the tables with hand sanitizing wipes instead of the appropriate cleaner. Although the program had EPA-approved cleaners available, the wrong product was used. Staff must wash their hands or use gloves after completing cleaning tasks. Corrective action: We have coached the staff to ensure the are using either the proper cleaning wipes and/or the proper spray cleaner and paper towels. Regulation: The licensee must ensure that educators and children wash their hands with liquid soap and running water, using friction, in accordance with DPH guidelines. Hands must be dried with individual or disposable towels or automatic hand blow-dryers. The use of common towels is prohibited. Educators and children must wash their hands at least at the following times:, In addition, educators must wash their hands:, The licensee must ensure that equipment, materials, items or surfaces (including floors, walls and clothing used for dramatic play) are washed with soap and water and disinfected as needed to maintain a sanitary environment., All floors used by children must be swept and/or vacuumed daily., All eating surfaces must be washed and disinfected before and after each use., Where applicable, the following items, equipment and surfaces must be washed and disinfected after each use:, Toys mouthed by children must be set aside and stored after each use and may not be used by another child until they are washed and disinfected., The following must be washed and disinfected at least weekly:, The following items must be monitored for cleanliness and washed and disinfected at least daily: Cited during: Enhanced Monitoring Visit. Source: MA EEC child care provider record (childcare.mass.gov).

7.04(05)(a), 7.04(05)(b), 7.04(05)(c), 7.09(09) — Administration

The program did not have a staff records checklist available on site. Corrective action: The staff record checklist has been posted. Regulation: documentation that the employee has the qualifications required under 606 CMR 7.09, including, but not limited to, health records, as required by 606 CMR 7.09(11);, copies of licenses, certifications and registrations held, including, but not limited to, motor vehicle operator’s license (if the staff member transports children) and EEC educator qualification;, documentation of orientation, training and professional development, as required by 606 CMR 7.09(15)(d-f), 7.09(16)(c) and 7.09(17)(a), and 7.11(1), 7.09 (18)(d), and 7.09(19)(b),as applicable;, All educators must attend an orientation to early education and care approved by the Department. Cited during: Enhanced Monitoring Visit. Source: MA EEC child care provider record (childcare.mass.gov).

7.11(05)(d)(04) — Health

1) The program did not have the emergency medication of a child according to their IHCP. 2) A child's medication consent form was missing the parent’s signature. Corrective action: 1) The Site coordinator will reach out to the parent of the child and will have the medication at the program. 2) The Site coordinator will make sure the medication consent form is signed.. Regulation: emergency or life-saving medications, such as asthma inhalers and epinephrine auto-injectors, for any children for whom they have been prescribed; Cited during: Renewal - Monitoring Visit. Source: MA EEC child care provider record (childcare.mass.gov).

7.11(03) — Health

The program staff was not knowledgeable about a child's IHCP. Corrective action: The [Redacted] might of not remembered but we did get a chance to sit and review everything [Redacted] is now aware.. 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 - Monitoring Visit. Source: MA EEC child care provider record (childcare.mass.gov).

7.11(10)(c), 7.11(10)(d), 7.11(10)(f), 7.11(10)(g), 7.11(10)(h), 7.11(10)(i), 7.11(10)(j), 7.11(10)(m), 7.11(10)(l) — Health

The program used hand sanitizing wipes to clean/disinfect tables. Corrective action: After speaking with the [Redacted] accidentally grabbed the wrong wipes when picking them up at our main site. We have provided [Redacted] with the correct ones.. Regulation: The licensee must ensure that educators and children wash their hands with liquid soap and running water, using friction, in accordance with DPH guidelines. Hands must be dried with individual or disposable towels or automatic hand blow-dryers. The use of common towels is prohibited. Educators and children must wash their hands at least at the following times:, In addition, educators must wash their hands:, The licensee must ensure that equipment, materials, items or surfaces (including floors, walls and clothing used for dramatic play) are washed with soap and water and disinfected as needed to maintain a sanitary environment., All floors used by children must be swept and/or vacuumed daily., All eating surfaces must be washed and disinfected before and after each use., Where applicable, the following items, equipment and surfaces must be washed and disinfected after each use:, Toys mouthed by children must be set aside and stored after each use and may not be used by another child until they are washed and disinfected., The following must be washed and disinfected at least weekly:, The following items must be monitored for cleanliness and washed and disinfected at least daily: Cited during: Renewal - Monitoring Visit. Source: MA EEC child care provider record (childcare.mass.gov).

7.07(07)(d), 7.07(07)(e), 7.07(10), 7.07(13)(d) — Physical Facility - Outdoors

The playground does not have the proper fall zones. Corrective action: The program will no longer be using the schools playground.. Regulation: The outdoor play area must be free from hazards including but not limited to: a busy street, a parking lot, poisonous plants, water hazards, debris, broken glass, chipping, peeling or flaking paint, dangerous machinery or tools, and weather-related and environmental hazards or small objects that could present a choking hazard to young children. Any such hazard must be removed or fenced by a sturdy, permanently installed barrier which is at least four feet high or otherwise protected or removed, as appropriate., If the outdoor play space is located on a roof, it must be protected by a barrier at least seven feet high, which cannot be climbed by children., Indoor Space. The indoor space must be clean, safely maintained, well-ventilated and well-lit, of sufficient size for the children served, and must encourage play and learning., All play equipment, fences and structures must be free of entrapment hazards. Cited during: Renewal - Monitoring Visit. Source: MA EEC child care provider record (childcare.mass.gov).