Middlesex Baby Spa, LLC

N.J.A.C. 3A:52-4.3(c) — Ensure that adequate staff/child ratios are maintained at all times including when staff are breaking for lunch in room C. There were six 3 year old children and nine 4 year old children present with 1 staff and an addition staff

Ensure that adequate staff/child ratios are maintained at all times including when staff are breaking for lunch in room C. There were six 3 year old children and nine 4 year old children present with 1 staff and an addition staff member was required to maintain ratios. Regulation: (c) The following staff/child ratios shall apply, except as specified in (d) through (f) below: Under 18 months 1:4 18 months up to 2 ½ years 1:6 2 ½ years up to 4 years 1:10 4 years 1:12 5 years and older 1:15 (d) The following staff/child ratios shall apply during rest or sleep, when the criteria listed in (d) 1, 2, and 3 below are met: Under 18 months 18 months to under 2 ½ years 2 ½ years and above 1:10 1:12 1:20 2. A sufficient number of staff members shall be in the facility and readily accessible to ensure compliance with the awake staff/child ratios specified in (c) above.

N.J.A.C. 3A:52-4.3(a) — Based on information, ensure that adequate supervision is maintained at all times throughout the center. A named staff left the classroom unsupervised to answer the center's front door.

Based on information, ensure that adequate supervision is maintained at all times throughout the center. A named staff left the classroom unsupervised to answer the center's front door. Regulation: The children shall be supervised directly by a staff member at all times, including during outdoor activities, rest and sleep, and walking through hallways. Toileting procedures shall be supervised by a staff member as appropriate for the ages and developmental needs of the children. 1. At least one staff member shall be physically present in the room or area in which children are napping and shall be able to summon other staff members without leaving the room or area. 3. Naptime preparations shall have been completed and all children 18 months or above are resting or sleeping, while all children under 18 months of age are sleeping.

N.J.A.C. 3A:52-4.8(a) — Based on information, retrain all staff from an outside source on positive guidance and discipline.

Based on information, retrain all staff from an outside source on positive guidance and discipline. Regulation: (a) Topics of orientation training shall include all of the following: 1. Supervising and tracking all children, as specified in N.J.A.C. 3A:52-4.3(a); 2. Understanding center operations, policies and procedures, as specified in N.J.A.C. 3A:52-4.5(b)3; 3. Implementing group size limits and primary caregiver responsibilities, as applicable, as specified in N.J.A.C. 3A:52-4.4; 4. Recognizing and reporting child abuse or neglect, as specified in N.J.A.C. 3A:52-4.9; 5. Evacuating the center and using the fire alarms, as specified in N.J.A.C. 3A:52-5.3(l); 6.Implementing the center’s release policy, as specified in N.J.A.C. 3A:52-6.5; 7. Implementing the center's statement of policy on the disciplining of children, as specified in N.J.A.C. 3A:52-6.6; 8. Implementing health practices, including medication administration and responding to symptoms of illness, as specified in N.J.A.C. 3A:52-7.1 through 7.11; 9. Implementing safe sleep practices to prevent Sudden Infant Death Syndrome; 10. Preventing Shaken Baby Syndrome and Abusive Head Trauma; 11. Recognizing and responding to injuries and emergencies, including the prevention of and response to emergencies due to food-related allergies and other allergic reactions; and 12. Including children with special needs in the center’s program.

N.J.A.C. 3A:52-4.8(a) — Based on information, retrain all staff on appropriate use of infant equipment.

Based on information, retrain all staff on appropriate use of infant equipment. Regulation: (a) Topics of orientation training shall include all of the following: 1. Supervising and tracking all children, as specified in N.J.A.C. 3A:52-4.3(a); 2. Understanding center operations, policies and procedures, as specified in N.J.A.C. 3A:52-4.5(b)3; 3. Implementing group size limits and primary caregiver responsibilities, as applicable, as specified in N.J.A.C. 3A:52-4.4; 4. Recognizing and reporting child abuse or neglect, as specified in N.J.A.C. 3A:52-4.9; 5. Evacuating the center and using the fire alarms, as specified in N.J.A.C. 3A:52-5.3(l); 6.Implementing the center’s release policy, as specified in N.J.A.C. 3A:52-6.5; 7. Implementing the center's statement of policy on the disciplining of children, as specified in N.J.A.C. 3A:52-6.6; 8. Implementing health practices, including medication administration and responding to symptoms of illness, as specified in N.J.A.C. 3A:52-7.1 through 7.11; 9. Implementing safe sleep practices to prevent Sudden Infant Death Syndrome; 10. Preventing Shaken Baby Syndrome and Abusive Head Trauma; 11. Recognizing and responding to injuries and emergencies, including the prevention of and response to emergencies due to food-related allergies and other allergic reactions; and 12. Including children with special needs in the center’s program.

N.J.A.C. 3A:52-4.8(a) — Based on information, retrain all staff on completing incident reports as required.

Based on information, retrain all staff on completing incident reports as required. Regulation: (a) Topics of orientation training shall include all of the following: 1. Supervising and tracking all children, as specified in N.J.A.C. 3A:52-4.3(a); 2. Understanding center operations, policies and procedures, as specified in N.J.A.C. 3A:52-4.5(b)3; 3. Implementing group size limits and primary caregiver responsibilities, as applicable, as specified in N.J.A.C. 3A:52-4.4; 4. Recognizing and reporting child abuse or neglect, as specified in N.J.A.C. 3A:52-4.9; 5. Evacuating the center and using the fire alarms, as specified in N.J.A.C. 3A:52-5.3(l); 6.Implementing the center’s release policy, as specified in N.J.A.C. 3A:52-6.5; 7. Implementing the center's statement of policy on the disciplining of children, as specified in N.J.A.C. 3A:52-6.6; 8. Implementing health practices, including medication administration and responding to symptoms of illness, as specified in N.J.A.C. 3A:52-7.1 through 7.11; 9. Implementing safe sleep practices to prevent Sudden Infant Death Syndrome; 10. Preventing Shaken Baby Syndrome and Abusive Head Trauma; 11. Recognizing and responding to injuries and emergencies, including the prevention of and response to emergencies due to food-related allergies and other allergic reactions; and 12. Including children with special needs in the center’s program.

N.J.A.C. 3A:52-4.8(a) — Based on information, retrain all staff on the center's expulsion policy.

Based on information, retrain all staff on the center's expulsion policy. Regulation: (a) Topics of orientation training shall include all of the following: 1. Supervising and tracking all children, as specified in N.J.A.C. 3A:52-4.3(a); 2. Understanding center operations, policies and procedures, as specified in N.J.A.C. 3A:52-4.5(b)3; 3. Implementing group size limits and primary caregiver responsibilities, as applicable, as specified in N.J.A.C. 3A:52-4.4; 4. Recognizing and reporting child abuse or neglect, as specified in N.J.A.C. 3A:52-4.9; 5. Evacuating the center and using the fire alarms, as specified in N.J.A.C. 3A:52-5.3(l); 6.Implementing the center’s release policy, as specified in N.J.A.C. 3A:52-6.5; 7. Implementing the center's statement of policy on the disciplining of children, as specified in N.J.A.C. 3A:52-6.6; 8. Implementing health practices, including medication administration and responding to symptoms of illness, as specified in N.J.A.C. 3A:52-7.1 through 7.11; 9. Implementing safe sleep practices to prevent Sudden Infant Death Syndrome; 10. Preventing Shaken Baby Syndrome and Abusive Head Trauma; 11. Recognizing and responding to injuries and emergencies, including the prevention of and response to emergencies due to food-related allergies and other allergic reactions; and 12. Including children with special needs in the center’s program.

N.J.A.C. 3A:52-4.8(a) — Based on information, retrain all staff on the center's supervision policy.

Based on information, retrain all staff on the center's supervision policy. Regulation: (a) Topics of orientation training shall include all of the following: 1. Supervising and tracking all children, as specified in N.J.A.C. 3A:52-4.3(a); 2. Understanding center operations, policies and procedures, as specified in N.J.A.C. 3A:52-4.5(b)3; 3. Implementing group size limits and primary caregiver responsibilities, as applicable, as specified in N.J.A.C. 3A:52-4.4; 4. Recognizing and reporting child abuse or neglect, as specified in N.J.A.C. 3A:52-4.9; 5. Evacuating the center and using the fire alarms, as specified in N.J.A.C. 3A:52-5.3(l); 6.Implementing the center’s release policy, as specified in N.J.A.C. 3A:52-6.5; 7. Implementing the center's statement of policy on the disciplining of children, as specified in N.J.A.C. 3A:52-6.6; 8. Implementing health practices, including medication administration and responding to symptoms of illness, as specified in N.J.A.C. 3A:52-7.1 through 7.11; 9. Implementing safe sleep practices to prevent Sudden Infant Death Syndrome; 10. Preventing Shaken Baby Syndrome and Abusive Head Trauma; 11. Recognizing and responding to injuries and emergencies, including the prevention of and response to emergencies due to food-related allergies and other allergic reactions; and 12. Including children with special needs in the center’s program.

N.J.A.C. 3A:52-5.3(r) — Based on information, ensure that infant equipment is used in accordance with the manufacturer's instructions. A named staff was not using the highchairs in accordance with the manufacturer's instructions and was putting 3 and 4 ye

Based on information, ensure that infant equipment is used in accordance with the manufacturer's instructions. A named staff was not using the highchairs in accordance with the manufacturer's instructions and was putting 3 and 4 year olds into them. Regulation: The center shall take any steps required by the Office of Licensing to correct conditions in the building or center that may endanger the health, safety, and well-being of the children served.

N.J.A.C. 3A:52-6.6(a) — Based on information, ensure that staff utilize positive methods of guidance and discipline. A named staff would place two named children into highchairs to manage their behaviors and continued to do so after it was being told it w

Based on information, ensure that staff utilize positive methods of guidance and discipline. A named staff would place two named children into highchairs to manage their behaviors and continued to do so after it was being told it was inappropriate. Regulation: (a) The methods of guidance and discipline used shall: 1. Be positive; 2. Be consistent with the age and developmental needs of the children; and 3. Lead to the child's ability to develop and maintain self-control. (b) Staff members shall not discipline children for failing to eat or sleep or for soiling themselves. (c) Staff shall not withhold active play time as a means of discipline unless the child's actions or behavior present a danger to themselves or others. (d) Children may be removed from a group activity to another area, provided that the child so removed is either under the supervision of another staff member or continuously visible to a staff member.

N.J.A.C. 3A:52-7.6(b)(6) — Based on information, ensure that incident reports are completed as required.

Based on information, ensure that incident reports are completed as required. Regulation: (b) The center shall maintain on file a written record of each incident resulting in an injury as specified in (a) above. These records shall include the following: 1. The name of the injured child; 2. The date, time and location of the incident; 3. The name and address of the center; 4. The name of the person completing the report; 5. The date the report was completed; and 6. A written description of the following: i. The incident; ii. The injury to the child; iii. The names of witnesses to the incident; and iv. The follow-up action taken by the center, including: (1) Application of first aid; and (2) Consultation or treatment by a licensed physician or other health care provider, if applicable. (d) Upon request of the child's parent, the center shall provide a written description of the incident by the end of the next operating day.

N.J.A.C. 3A:52-6.8(j)(1) — Based on information, ensure that the center adheres to its expulsion policy. The center failed to adhere to its expulsion policy regarding two named children.

Based on information, ensure that the center adheres to its expulsion policy. The center failed to adhere to its expulsion policy regarding two named children. Regulation: The center shall develop and follow a written policy on the expulsion of children from enrollment at the center. The expulsion policy shall include: the circumstances under which a child may be expelled; the method that the center will use to notify parents of concerns that could lead to expulsion, such as written notification or a parent conference; sufficient time limits before expulsion to enable parents to make alternative child care arrangements or to take the necessary corrective action to allow the child to remain at the center, except as specified in N.J.A.C. 3A:52-6.8(j)1iv; and circumstances that may warrant immediate expulsion of a child from the center, such as potentially dangerous behavior by a child or parent.(2) The center shall not expel a child based solely on the child’s parent making a complaint to the Office of Licensing regarding a center’s alleged violations of the licensing rules or questioning a center directly regarding policies and procedures.

N.J.A.C. 3A:52-5.3(r) — Based on information, provide a Corrective Action Plan to DCF as required.

Based on information, provide a Corrective Action Plan to DCF as required. Regulation: The center shall take any steps required by the Office of Licensing to correct conditions in the building or center that may endanger the health, safety, and well-being of the children served.

N.J.A.C. 3A:52-5.3(p) — Based on complaint#24788, cease the use of highchairs in room B.

Based on complaint#24788, cease the use of highchairs in room B. Regulation: Play equipment, materials, and furniture for indoor and outdoor use shall be of sturdy and safe construction, non-toxic, free of hazards, and used in accordance with the manufacturer’s instructions. The center may not use play equipment intended for outdoor use indoors.

N.J.A.C. 3A:52-4.8(a) — Based on complaint #24788, retrain all staff on responding to children with special needs and challenging behaviors.

Based on complaint #24788, retrain all staff on responding to children with special needs and challenging behaviors. Regulation: (a) Topics of orientation training shall include all of the following: 1. Supervising and tracking all children, as specified in N.J.A.C. 3A:52-4.3(a); 2. Understanding center operations, policies and procedures, as specified in N.J.A.C. 3A:52-4.5(b)3; 3. Implementing group size limits and primary caregiver responsibilities, as applicable, as specified in N.J.A.C. 3A:52-4.4; 4. Recognizing and reporting child abuse or neglect, as specified in N.J.A.C. 3A:52-4.9; 5. Evacuating the center and using the fire alarms, as specified in N.J.A.C. 3A:52-5.3(l); 6.Implementing the center’s release policy, as specified in N.J.A.C. 3A:52-6.5; 7. Implementing the center's statement of policy on the disciplining of children, as specified in N.J.A.C. 3A:52-6.6; 8. Implementing health practices, including medication administration and responding to symptoms of illness, as specified in N.J.A.C. 3A:52-7.1 through 7.11; 9. Implementing safe sleep practices to prevent Sudden Infant Death Syndrome; 10. Preventing Shaken Baby Syndrome and Abusive Head Trauma; 11. Recognizing and responding to injuries and emergencies, including the prevention of and response to emergencies due to food-related allergies and other allergic reactions; and 12. Including children with special needs in the center’s program.

N.J.A.C. 3A:52-4.8(a) — Based on complaint #24788, retrain all staff on the center's policy on positive guidance and discipline.

Based on complaint #24788, retrain all staff on the center's policy on positive guidance and discipline. Regulation: (a) Topics of orientation training shall include all of the following: 1. Supervising and tracking all children, as specified in N.J.A.C. 3A:52-4.3(a); 2. Understanding center operations, policies and procedures, as specified in N.J.A.C. 3A:52-4.5(b)3; 3. Implementing group size limits and primary caregiver responsibilities, as applicable, as specified in N.J.A.C. 3A:52-4.4; 4. Recognizing and reporting child abuse or neglect, as specified in N.J.A.C. 3A:52-4.9; 5. Evacuating the center and using the fire alarms, as specified in N.J.A.C. 3A:52-5.3(l); 6.Implementing the center’s release policy, as specified in N.J.A.C. 3A:52-6.5; 7. Implementing the center's statement of policy on the disciplining of children, as specified in N.J.A.C. 3A:52-6.6; 8. Implementing health practices, including medication administration and responding to symptoms of illness, as specified in N.J.A.C. 3A:52-7.1 through 7.11; 9. Implementing safe sleep practices to prevent Sudden Infant Death Syndrome; 10. Preventing Shaken Baby Syndrome and Abusive Head Trauma; 11. Recognizing and responding to injuries and emergencies, including the prevention of and response to emergencies due to food-related allergies and other allergic reactions; and 12. Including children with special needs in the center’s program.

N.J.A.C. 3A:52-6.1(b)(6)(iii) — Based on complaint #24788, ensure that children are not inactive for more than 30 minutes unless they are eating, sleeping or ill.

Based on complaint #24788, ensure that children are not inactive for more than 30 minutes unless they are eating, sleeping or ill. Regulation: iii. whenever feasible, and unless the child is eating, sleeping, needs to complete a seated activity, or is ill, children shall not be inactive for more than 30 minutes.

N.J.A.C. 3A:52-6.8(j)(3) — Maintain on file a record of parental receipt of the required OOL policies for 1 named child.

Maintain on file a record of parental receipt of the required OOL policies for 1 named child. Regulation: The center shall distribute a copy of the expulsion policy to the parent of each enrolled child and secure and maintain on file a record of each parent’s signature attesting to receipt of the policy.

N.J.A.C. 3A:52-4.1(d) — Ensure 2 named staff sign the required OOL policies. 12/8/25: 1 Received, 1 outstanding.

Ensure 2 named staff sign the required OOL policies. 12/8/25: 1 Received, 1 outstanding. Regulation: the Staff Records Checklist for the current director and all staff members currently working at the center shall be maintained on file at the center.

N.J.A.C. 3A:52-4.1(d) — Provide Mantoux results for 2 named staff. 12/8/25: 1 Received, 1 outstanding.

Provide Mantoux results for 2 named staff. 12/8/25: 1 Received, 1 outstanding. Regulation: the Staff Records Checklist for the current director and all staff members currently working at the center shall be maintained on file at the center.

N.J.A.C. 3A:52-7.3(a) — Provide annual Universal Health Records for 2 named children.

Provide annual Universal Health Records for 2 named children. Regulation: (a) For early childhood programs, the following shall apply: 1. Each child not enrolled in a public or private school shall have had a health examination performed by a health care provider within: i. Six months prior to admission, for children who are 2½ years of age or younger; or ii. One year prior to admission, for children above 2½ years of age. 2. For each child not enrolled in a public or private school, upon admission, the center shall maintain on file at the center a Universal Child Health Record (Department of Health Form CH-14) or its equivalent, updated annually, along with an immunization record , and a special care plan, if applicable. A 30-day grace period is permitted in N.J.A.C. 8:57- 4.5(e): i. For children coming from other states or countries in accordance with N.J.A.C. 8:57-4.6 and 4.7; and ii. For children who are in foster care or experiencing homelessness as defined by the McKinney-Vento Act, 42 U.S.C. § 11434a(2). 3. For children enrolled in a public or private school, the center shall obtain a written statement from each child's parent indicating: I. That the child is in good health and can participate in the normal activities of the program; and ii. Any conditions or specific needs that may require special accommodations. 4. If immunizations are contraindicated for medical reasons, the center may choose to admit the child, provided that the parent submits to the center a written statement from a health care provider attesting to the following: i. The reason the immunization is medically contraindicated; and ii. The specific time period that the immunization is medically contraindicated. 5. A child shall be exempted from a physical examination, immunization, or medical treatment if the parent objects thereto in a written statement submitted to the center, signed by the parent, explaining how the examination, immunization, or medical treatment conflicts with the child’

N.J.A.C. 3A:52-4.3(c) — Ensure that adequate staff/child ratios are maintained at all times including lunchtime, wherein the second staff member took her lunch break and left a named staff member alone with 15 children 3-4 years of age in room C. 11/7/25:

Ensure that adequate staff/child ratios are maintained at all times including lunchtime, wherein the second staff member took her lunch break and left a named staff member alone with 15 children 3-4 years of age in room C. 11/7/25: Children not present due to district school closing. Regulation: (c) The following staff/child ratios shall apply, except as specified in (d) through (f) below: Under 18 months 1:4 18 months up to 2 ½ years 1:6 2 ½ years up to 4 years 1:10 4 years 1:12 5 years and older 1:15 (d) The following staff/child ratios shall apply during rest or sleep, when the criteria listed in (d) 1, 2, and 3 below are met: Under 18 months 18 months to under 2 ½ years 2 ½ years and above 1:10 1:12 1:20 2. A sufficient number of staff members shall be in the facility and readily accessible to ensure compliance with the awake staff/child ratios specified in (c) above.

N.J.A.C. 3A:52-5.3(p) — Secure stack of cots between rooms C and D.

Secure stack of cots between rooms C and D. Regulation: Play equipment, materials, and furniture for indoor and outdoor use shall be of sturdy and safe construction, non-toxic, free of hazards, and used in accordance with the manufacturer’s instructions. The center may not use play equipment intended for outdoor use indoors.

N.J.A.C. 3A:52-4.8(a) — Ensure that all staff complete orientation training annually for 4 staff members. 11/7/25: 2 Received, 2 outstanding.

Ensure that all staff complete orientation training annually for 4 staff members. 11/7/25: 2 Received, 2 outstanding. Regulation: (a) Topics of orientation training shall include all of the following: 1. Supervising and tracking all children, as specified in N.J.A.C. 3A:52-4.3(a); 2. Understanding center operations, policies and procedures, as specified in N.J.A.C. 3A:52-4.5(b)3; 3. Implementing group size limits and primary caregiver responsibilities, as applicable, as specified in N.J.A.C. 3A:52-4.4; 4. Recognizing and reporting child abuse or neglect, as specified in N.J.A.C. 3A:52-4.9; 5. Evacuating the center and using the fire alarms, as specified in N.J.A.C. 3A:52-5.3(l); 6.Implementing the center’s release policy, as specified in N.J.A.C. 3A:52-6.5; 7. Implementing the center's statement of policy on the disciplining of children, as specified in N.J.A.C. 3A:52-6.6; 8. Implementing health practices, including medication administration and responding to symptoms of illness, as specified in N.J.A.C. 3A:52-7.1 through 7.11; 9. Implementing safe sleep practices to prevent Sudden Infant Death Syndrome; 10. Preventing Shaken Baby Syndrome and Abusive Head Trauma; 11. Recognizing and responding to injuries and emergencies, including the prevention of and response to emergencies due to food-related allergies and other allergic reactions; and 12. Including children with special needs in the center’s program.

N.J.A.C. 3A:52-4.11(b) — Ensure that CHRI background checks are completed as required for 2 staff members.

Ensure that CHRI background checks are completed as required for 2 staff members. Regulation: When the center applies for a new license or Certificate of Life/Safety Approval, the sponsor or sponsor representative shall ensure that each staff member at least 18 years of age who is or will be working at the center on a regularly scheduled basis completes the CHRI fingerprinting process specified in N.J.A.C. 3A:52-4.11(a). Within two weeks after a new staff member begins working at the center, the sponsor or sponsor representative shall ensure that the new staff member completes the CHRI fingerprinting process specified in N.J.A.C. 3A:52-4.11(a). Until the center receives the results of the CHRI background check for a new staff member, the center shall ensure oversight of that person by another staff member and ensure that the person is not alone to supervise a child or group of children.

N.J.A.C. 3A:52-4.10(a) — Ensure that CARI background checks are completed as required for the center's license renewal for 4 staff members. 11/7/25: Received 3, 1 outstanding.

Ensure that CARI background checks are completed as required for the center's license renewal for 4 staff members. 11/7/25: Received 3, 1 outstanding. Regulation: As a condition of securing a new or renewal license or Certificate of Life/Safety Approval, the sponsor or sponsor representative shall provide for himself or herself, and shall obtain from all staff members who are or will be working at the center on a regularly scheduled basis, written consent for the Department to conduct a Child Abuse Record Information (CARI) background check to determine whether an incident of child abuse or neglect has been substantiated against any such person. If a staff member refused to consent to a CARI background check, the sponsor or sponsor representative shall immediately terminate the staff member's employment at the center.