The Learning Experience

N.J.A.C. 3A:52-4.3(c) — Ensure that adequate staff/child ratios are maintained at all times. There were 17 children with 1 staff.

Ensure that adequate staff/child ratios are maintained at all times. There were 17 children with 1 staff. 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)(1) — Ensure that children are adequately tracked at all times and staff are aware of the number of children in their care. Staff stated they had 12 children when there were 10.

Ensure that children are adequately tracked at all times and staff are aware of the number of children in their care. Staff stated they had 12 children when there were 10. Regulation: The center shall develop and implement an Office of Licensing-approved method to keep track of the location and ensure the safety of all children at all times when under the center’s supervision, including the transfer of supervision from and to parents during arrival and departure and the utilization of off-site locations, including playgrounds and field trips.

N.J.A.C. 3A:52-4.8(a) — Based on complaint #25107, retrain staff on diaper policy.

Based on complaint #25107, retrain staff on diaper 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 complaint #25107, retrain staff on playground supervision.

Based on complaint #25107, retrain staff on playground supervision. 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 #25107, retrain staff on ratios.

Based on complaint #25107, retrain staff on ratios. 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:52-7.7(a)(3)(iv) — Ensure tables are washed and disinfected before each meal.

Ensure tables are washed and disinfected before each meal. Regulation: Tables used by the children for eating shall be washed and disinfected before each meal.

N.J.A.C. 3A:52-6.3(b)(3)(iv)(1) — Ensure that each child's bottle is labeled with the child's name and date.

Ensure that each child's bottle is labeled with the child's name and date. Regulation: Feeding requirements for centers serving children less than 18 months of age are as follows: for bottles, each child's bottle(s) shall be labeled with the child's name and dated.

N.J.A.C. 3A:52-7.8(a)(1) — Ensure that children wash their hands with soap and running water as required including before the intake of food.

Ensure that children wash their hands with soap and running water as required including before the intake of food. Regulation: Handwashing requirements are as follows: the center shall ensure that children three months of age and older wash their hands with soap and running water before intake of food; immediately after using the toilet or having diapers changed; immediately after coming into contact with blood, fecal matter, urine, vomit, nasal secretions, or other body fluids or secretions; immediately after coming in contact with an animal's body secretions; and immediately after outdoor play. (2)for children under three months of age or for those children three months of age and older wherein hand washing with soap and running water may not be developmentally appropriate, the center may use an alternate means for hand washing, including but not limited to disposable baby wipes.

N.J.A.C. 3A:52-7.5(b)(10) — Ensure Epi-pens and inhaare not expired. 1 child

Ensure Epi-pens and inhaare not expired. 1 child Regulation: (9) The center shall develop and follow a policy on the administration of medication and health care procedures to children, which shall include the following provisions: before administering a health care procedure associated with a child’s health condition, such as the use of a blood glucose monitor, nebulizer, or epinephrine pen, the center shall ensure that all staff members who administer the procedure are taught to do so by the child’s parent or another appropriately-trained person. There shall be at least two staff members present at the center who are trained in such health care procedures. 10. The center shall store prescribed epinephrine pens in their original boxes with the child’s name and prescription. A special care plan or other documentation from a health care provider shall accompany the epinephrine pen. If two epinephrine pens are required, both shall be available. Each center under the jurisdiction of N.J.S.A. 18A:40-12.5 shall store back-up epinephrine pens on site consistent with the requirements stated at N.J.S.A. 18A:40- 12.5.e(1).

N.J.A.C. 3A:52-7.5(b)(10) — Ensure inhaler prescriptions are not expired. 1 child.

Ensure inhaler prescriptions are not expired. 1 child. Regulation: (9) The center shall develop and follow a policy on the administration of medication and health care procedures to children, which shall include the following provisions: before administering a health care procedure associated with a child’s health condition, such as the use of a blood glucose monitor, nebulizer, or epinephrine pen, the center shall ensure that all staff members who administer the procedure are taught to do so by the child’s parent or another appropriately-trained person. There shall be at least two staff members present at the center who are trained in such health care procedures. 10. The center shall store prescribed epinephrine pens in their original boxes with the child’s name and prescription. A special care plan or other documentation from a health care provider shall accompany the epinephrine pen. If two epinephrine pens are required, both shall be available. Each center under the jurisdiction of N.J.S.A. 18A:40-12.5 shall store back-up epinephrine pens on site consistent with the requirements stated at N.J.S.A. 18A:40- 12.5.e(1).

N.J.A.C. 3A:52-7.5(b)(10) — Ensure medication on the care plan is at the center. 4 children

Ensure medication on the care plan is at the center. 4 children Regulation: (9) The center shall develop and follow a policy on the administration of medication and health care procedures to children, which shall include the following provisions: before administering a health care procedure associated with a child’s health condition, such as the use of a blood glucose monitor, nebulizer, or epinephrine pen, the center shall ensure that all staff members who administer the procedure are taught to do so by the child’s parent or another appropriately-trained person. There shall be at least two staff members present at the center who are trained in such health care procedures. 10. The center shall store prescribed epinephrine pens in their original boxes with the child’s name and prescription. A special care plan or other documentation from a health care provider shall accompany the epinephrine pen. If two epinephrine pens are required, both shall be available. Each center under the jurisdiction of N.J.S.A. 18A:40-12.5 shall store back-up epinephrine pens on site consistent with the requirements stated at N.J.S.A. 18A:40- 12.5.e(1).

N.J.A.C. 3A:52-6.4(a) — Based on complaint #24934 ensure children are not being patted hard on the back during nap. Staff was retrained.

Based on complaint #24934 ensure children are not being patted hard on the back during nap. Staff was retrained. Regulation: (a) For early childhood programs, the center shall provide opportunities for daily rest and sleep as follows: 2. For children from 13 to 18 months of age, the center shall provide daily rest and sleep according to the child's physical needs and ensure that blankets or pillows do not cover the child's face. 4. For children over the age of 18 months and under the age of four years, the center shall provide: i. Daily rest or sleep for each child who attends the center for four or more consecutive hours; ii. Daily rest or sleep for each child who attends the center for fewer than four consecutive hours, but whose individual physical needs call for a rest period while the child is at the center

N.J.A.C. 3A:52-7.6(a) — Ensure that parents are notified immediately when: including when a child bumps his or her head.

Ensure that parents are notified immediately when: including when a child bumps his or her head. Regulation: (a) The center shall take immediate necessary action to protect the child from further harm and shall immediately notify the child's parent(s) when one of the following occurs while the child is in the center’s care: 1. A child is bitten and the skin is broken; 2. A child sustains a head or facial injury, including when a child bumps his or her head; 3. A child falls from a height greater than the height of the child; or 4. An injury requiring professional medical care occurs.

N.J.A.C. 3A:52-4.3(a)(1) — Ensure that children are adequately tracked at all times and staff are aware of the number of children in their care. Room 109 stated they had 21 children when there wee 20.

Ensure that children are adequately tracked at all times and staff are aware of the number of children in their care. Room 109 stated they had 21 children when there wee 20. Regulation: The center shall develop and implement an Office of Licensing-approved method to keep track of the location and ensure the safety of all children at all times when under the center’s supervision, including the transfer of supervision from and to parents during arrival and departure and the utilization of off-site locations, including playgrounds and field trips.

N.J.A.C. 3A:52-4.3(a)(1) — Ensure that children are adequately tracked at all times and staff are aware of the number of children in their care. Room 113 stated they had 6 children when there were 7.

Ensure that children are adequately tracked at all times and staff are aware of the number of children in their care. Room 113 stated they had 6 children when there were 7. Regulation: The center shall develop and implement an Office of Licensing-approved method to keep track of the location and ensure the safety of all children at all times when under the center’s supervision, including the transfer of supervision from and to parents during arrival and departure and the utilization of off-site locations, including playgrounds and field trips.

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 grab the children's arms in an aggressive manner.

Based on information, ensure that staff utilize positive methods of guidance and discipline. A named staff would grab the children's arms in an aggressive manner. 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:52-4.8(a) — Based on information, retrain all staff on the center's discipline policy.

Based on information, retrain all staff on the center's discipline 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 1. The center's supervision policy and 2. The center's discipline policy.

Based on information, retrain all staff on 1. The center's supervision policy and 2. The center's discipline 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 discipline policy.

Based on information, retrain all staff on the center's discipline 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:52-6.6(a) — Based on information, ensure that staff utilize positive methods of guidance and discipline. A named staff patted a named child's back in a rough manner while attempting to console the child.

Based on information, ensure that staff utilize positive methods of guidance and discipline. A named staff patted a named child's back in a rough manner while attempting to console the child. 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:52-6.6(a) — Based on information, ensure that staff utilize positive methods of guidance and discipline. A named staff grabbed a named child's arm, injuring it.

Based on information, ensure that staff utilize positive methods of guidance and discipline. A named staff grabbed a named child's arm, injuring it. 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:52-4.3(a) — Based on information, ensure that adequate supervision is maintained at all times throughout the center, including in the bathrooms.

Based on information, ensure that adequate supervision is maintained at all times throughout the center, including in the bathrooms. 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:52-5.2(d) — Provide a current fire certificate as required.

Provide a current fire certificate as required. Regulation: An applicant seeking the renewal of a license or of a Certificate of Life/Safety Approval to continue operating a center shall obtain and maintain on file a fire safety inspection certificate for the building based on a fire inspection conducted within the preceding 12 months. If the center prepares meals, the applicant seeking renewal shall obtain and maintain on file a satisfactory Sanitary Inspection Certificate, as specified in N.J.A.C. 8:24, indicating that the kitchen is in compliance with the applicable requirements of the State Sanitary Code, based on a sanitary inspection conducted within the preceding 12 months.

N.J.A.C. 3A:52-7.11(a) — Based on complaint 24600, ensure children remain out until they ae symptom free.

Based on complaint 24600, ensure children remain out until they ae symptom free. Regulation: (a) Each center shall develop a written policy on the management of communicable diseases. This policy shall include the following: 1. The list of illnesses and symptoms of illness for which a child will be separated from the group and possibly sent home, as specified in N.J.A.C. 3A:52-7.1(c); 2. The list of diseases for which a child will not be readmitted to the center unless accompanied by a statement from the child's health care provider, as specified in N.J.A.C. 3A:52-7.1(d); and 78 3. Assurance that during any outbreak of an excludable disease at the center, as specified in N.J.A.C. 3A:52-7.1(d), each parent whose child may have been exposed to the disease shall receive a written notice of the outbreak.

N.J.A.C. 3A:52-7.11(a) — Based on complaint 24600, ensure parents are notified of outbreaks of communicable diseases in accordance with the center's communicable disease policy.

Based on complaint 24600, ensure parents are notified of outbreaks of communicable diseases in accordance with the center's communicable disease policy. Regulation: (a) Each center shall develop a written policy on the management of communicable diseases. This policy shall include the following: 1. The list of illnesses and symptoms of illness for which a child will be separated from the group and possibly sent home, as specified in N.J.A.C. 3A:52-7.1(c); 2. The list of diseases for which a child will not be readmitted to the center unless accompanied by a statement from the child's health care provider, as specified in N.J.A.C. 3A:52-7.1(d); and 78 3. Assurance that during any outbreak of an excludable disease at the center, as specified in N.J.A.C. 3A:52-7.1(d), each parent whose child may have been exposed to the disease shall receive a written notice of the outbreak.