Ballad Health Center for Early Learning - Johnson City

1240-04-01-.11 Supervision

A supervision lapse occured at the agency. — Visit: Incident or Injury Investigation,Safety Plan Served,Technical Assistance — Action taken: The agency will retrain and review name-to-face rosters with staff members. The director reviewed transitions to the restroom, counting, and supervision with all staff to ensure supervision requirements, as well as utilizing a visual system to remind educators of children's whereabouts in the classroom.

1240-04-01-.11 Supervision

A supervision lapse occurred at the agency. — Visit: Complaint Investigation,Technical Assistance,Safety Plan Served — Action taken: The agency retrained and reviewed name-to-face rosters with staff members. The director reviewed transitions to the restroom, counting, and supervision with all staff to ensure supervision requirements.

1240-04-01-.09 Incident Reporting

Agency did not report an incident to TDHS on the same day as required. — Visit: Complaint Investigation,Technical Assistance,Safety Plan Served — Action taken: The agency and the agency director will report all known incidents to the TN DHS licensing consultant as stated in the licensing rules and regulations.

1240-04-01-.09 Incident Reporting

The agency did not provide documentation to the parent/guardian on the same day as the incident. — Visit: Complaint Investigation,Technical Assistance,Safety Plan Served — Action taken: The agency will document all incidents and injuries on Incident Forms and will notify families as soon as possible, as required by the licensing rules and regulations.

1240-04-01-.10 Duty to Report Child Abuse and Neglect

Agency did not report to Department of Children's Service's immediately as required. — Visit: Complaint Investigation,Technical Assistance,Safety Plan Served — Action taken: The director will report all incidents and injuries to the Department of Children's Services, and the Department of Human Services as required by the licensing rules and regulations.

1240-04-01-.06 Staff

Management did not follow reporting requirements as required by TDHS. — Visit: Complaint Investigation,Technical Assistance,Safety Plan Served — Action taken: The director will report incidents and injuries to DHS prior to gaining permission from management at the facility, as required by licensing rules and regulations.

1240-04-01-.15 Program Language and Literacy Development

Violation cited due to additional information received by CACL on November 24, 2025 involving an incident that occurred on June 17, 2025. — Visit: Follow-up visit,Technical Assistance — Action taken: The agency is aware and understands that if an inappropriate interaction is observed, the agency will report to DCS and DHS as required by licensing rules. Director and management will not conduct their own investigations of any observed incidents that may rise to a reportable incident. As a proactive measure, the Director will review video footage and conduct unannounced classroom observations and have discussions with staff for reflection and improvements.

1240-04-01-.15 Program Language and Literacy Development

Violation cited due to additional information received by CACL on November 24, 2025 involving an incident that occurred on May 22, 2025. — Visit: Follow-up visit,Technical Assistance — Action taken: The agency is aware and understands that if an inappropriate interaction is observed, the agency will report to DCS and DHS as required by licensing rules. Director and management will not conduct their own investigations of any observed incidents that may rise to a reportable incident. As a proactive measure, the Director will review video footage and conduct unannounced classroom observations and have discussions with staff for reflection and improvements.

1240-04-01-.15 Program Language and Literacy Development

Violation cited due to additional information received by CACL on November 24, 2025 involving an incident that occurred on May 23, 2025. — Visit: Follow-up visit,Technical Assistance — Action taken: The agency is aware and understands that if an inappropriate interaction is observed, the agency will report to DCS and DHS as required by licensing rules. Director and management will not conduct their own investigations of any observed incidents that may rise to a reportable incident. As a proactive measure, the Director will review video footage and conduct unannounced classroom observations and have discussions with staff for reflection and improvements.

1240-04-01-.11 Supervision

A child was left in the classroom unsupervised for 2 minutes following a diaper change. — Visit: Incident or Injury Investigation,Safety Plan Served,Technical Assistance — Action taken: The director will ensure all staff complete mandatory supervision training. To prevent supervision lapses in the future stratgies will be implemented such as- when removing children from the large group, the staff will communicate "I have _____. You have _____." Upon returning to the group, the teachers will conduct a name-to-face count.

1240-04-01-.10 Duty to Report Child Abuse and Neglect

The agency did not report suspected child abuse to the Department of Children's Services as required. — Visit: Complaint Investigation,Safety Plan Served,Technical Assistance — Action taken: Agency will follow all rules and regulations to ensure compliance.

1240-04-01-.09 Incident Reporting

Agency did not report an incident to the parents/guardians of the child. — Visit: Complaint Investigation,Safety Plan Served,Technical Assistance — Action taken: Agency will follow all rules and regulations to ensure compliance.

1240-04-01-.09 Incident Reporting

A suspected child abuse incident was not reported to DHS as required. — Visit: Complaint Investigation,Safety Plan Served,Technical Assistance — Action taken: The agency will follow all rules and regulations to ensure compliance.

1240-04-01-.11 Supervision

One child was left in the adjoining classroom bathroom unsupervised for 5 minutes. — Visit: Incident or Injury Investigation,Safety Plan Served,Technical Assistance — Action taken: To prevent this violation again, the agency will be participating in a supervision training conducted by CCR&R (Child Care Resource & Referral). The agency will ensure that with a transition of educators in the classroom, a name-to-face count will be conducted. Teachers at the agency agree to communicate how many children they have at all times and will announce how many children they are taking to and from the group. For example, if an educator is taking two children to the restroom, they will tell their partner teacher "I have 2, you have _____." They will then communicate the same when returning to the group.