Buttons and Bows Early Learning Center

Booster seats that were involved in a vehicle accident continued to be used by children in care. The manufacturers instructions also say that any booster seat involved in an accident should not be used after a crash. This was corrected at inspection when the operation replaced the booster seats that had been involved in the accident with new ones.

The caregiver in the classroom was observed sleeping while the children were napping.

After toileting, children sat back down in the hallway until the sink in the girls bathroom was available to use for hand washing despite there being a sink in the boys bathroom that could have been used. While waiting, children were observed touching their faces and touching other people with their unclean hands.

A pot around the base of a tree on the playground has broken in multiple places resulting in a few of the edges being a shear hazard.

Four children had their diaper changed but their hands were not washed afterwards. The caregiver did not wash their hands either between diaper changes.

There were cleaning supplies accesible to children under a sink in a classroom. The safety latch was broken on the cabinet door.

A caregiver was observed changing three diapers without changing out their gloves between each diaper change.

Food was being served on the bare table for a child to eat at lunch.

Active play time outside is being withheld for discipline.

The television in the school age classroom is not anchored and poses a tipping hazard to children in care.

There are multiple pieces of flooring tile that are chipped/broken that pose a tripping hazard to children in care. Additionally, there is a large pothole out on the playground that could cause a child to trip.

There is a vent in one of the center areas that is bent upwards on one edge and causes a potential tripping hazard. Additionally, there is trash present on the floor of a classroom.

A child was left outside on the playground, alone, for approximately 2-3 minutes. This prevented staff from having auditory or visual awareness of the child and would have prevented them from intervening had a situation arose.

The operation did not have posted the two children's names that were found to have a diagnosed food allergy. **This was corrected at inspection when the staff wrote the names on the postings in the classrooms, eating area, and where the food is prepared.

One child in care did not have a food allergy plan in their file that required a plan in file by the doctor.

Two children were observed having diaper changes and did not wash hands after their diaper was changed.

During the inspection, a child wondered off and was left unsupervised as the primary caregivers/staff were not aware of the child's on going activity and did not have auditory or visual awareness of the child.

Two vans that are used to transport children did not the fire extinguisher required. One of the vans was missing the first aid kit and another van did not have the first aid kit complete. *This was corrected at inspection when the staff placed a complete first aid kit and fire extinguishers were found and placed in the vans.

The staff were observed at inspection not following their activity plan. The classrooms were observed during songs and diaper changes time. One classroom did not have the activity plan available for the group that is cared for.

Based on evidence obtained it was determined that children under the age of two were given screen time.

The most recent Child Care Regulation inspection form was not posted.

One child file was reviewed and it was missing the parent signature that provides proof of granting medical authorization in case of an emergency to the facility. One child file was reviewed and it was missing the address for the emergency contact listed by the parent in the file. One child file was reviewed and it was missing information regarding the child school attendance or a shot record in file.

One child's files was missing a health statement for a child that has been attending care longer than 12 months.

Two staff files were reviewed but there was no proof if file showing that orientation provided to related to administering medication, preventing and responding to emergencies due to food or an allergic reaction; understanding, building, and physical premises safety; handling, storing, and disposing of hazardous materials; precautions in transportation and no trainer signature was provided for this.

The operation does not have documentation of the fire drill that appears to have been conducted in April.

One child file reviewed did not have any immunizations in file.

Two children files were missing a health statement for children that have been attending care longer than 12 months.

Four child files reviewed did not have any immunizations in file.

Two children files were missing a health statement for children that have been attending care longer than 12 months.

Four staff did not have proof of current transportation training in file for review as it expired last month.

The operation did not have a current employee list printed and posted. **This was corrected at inspection when the operation printed and updated the current staff list to reflect current staff employed.

A caregiver was observed conducting diaper changes at inspection but did not wash their hands afterwards, despite wearing gloves. Additionally, children did not wash their hands after diaper changes were conducted.

A staff employed did not have the required 30 hours for the annual training and only had 14 hours that were valid during the annual training year for review.

One child file was missing any information from the parent on the special problems/food allergies section. Three children's files were missing the address for the individual listed as the emergency contact for the child. Four children files reviewed did not have any information on the section related to the health statement/doctor statement.

Two staff were missing the required topics and also did not have training related to shaken baby syndrome and abusive head trauma including understanding and using safe sleep practices and preventing sudden infant death syndrome (SIDS); and understanding early childhood brain development in their annual training year. One staff did not have all 24 hours required for annual training and were missing 8 hours of training.

One child file is still missing the health statement in the file and this child has been enrolled as of 11/7/2021. The health statement is required to be in file within 12 months of admission.

The personnel file that was missing the photo identification had this in file. The two personnel files that were missing copies of their high school diplomas had this in file. The three files that did not have the signed affidavit for employments were reviewed. Two of the three affidavits for employment were completed and one continued to not be completed/signed. **This was corrected at inspection when the director notarized the affidavit for employment at this inspection.

All three files continue to not have proof of orientation being obtained by the staff within 7 days of being hired as there were no boxes checked or signatures obtained. **This was corrected at inspection when the director and staff completed this form and updated at inspection.

The last documented monthly maintenance checklist for the building/grounds and playgrounds was completed in 10/2022 and this is required to be documented at least once a month.

Three personnel files reviewed were missing information in the file that was required. One staff file did not have a photo identification in file for review. Two staff files did not have copies of a high school diploma in file for the staff. All three files did not have the required signed affidavit for employment for the staff in file.

One children's files were missing the address for the individual listed as the emergency contact for the child. Two children's files were missing the phone number for the individual listed as the person of release for the child. Two children s files were missing any information from the parent on the special problems/food allergies section. Three children's files were missing information or did not have the authorization for emergency medical attention section complete and one childs files was missing parent signature on this section.

The fire drills, smoke detector,and carbon monoxide tests were last practiced and documented on 10/2022 and these are required to be completed once monthly. There were only three severe weather/shelter in place drills and three lockdown drills that were practiced and documented for the calendar year 2022 and there is a requirement of at least 4 drills that are to be practiced and documented.

One child file was missing the health statement in the file and this child has been enrolled as of 11/7/2021. The health statement is required to be in file within 12 months of admission.

The last children's product certification available for review was dated for 8/27/2021 and this is required to be completed annually. ***The director corrected this at inspection when she signed a new children's product certification at inspection and dated it for 1/10/2023.

All three files did not have proof of orientation being obtained by the staff within 7 days of being hired as there were no boxes checked or signatures obtained.

One child file was missing up to date immunizations.

Based on the evidence obtained during the investigation, the operation did not notify parents of a bed bug infestation that was in the classrooms.

Based on the evidence obtained during the investigation, the operation did not report an infestation of bed bugs in the facility within the required timeframe of 48 hours to Child Care Regulation.

Based on the evidence obtained during the investigation, the operation was using over the counter products to exterminate bed bugs which included: using essential oils, an alcohol and water mixture to spray, and setting off a bed bug bomb in the operation.

Based on the evidence obtained during the investigation, staff have used a tobacco based-vaporizer in the restrooms in the facility which are on the premises of the operation.

A child file was reviewed that has a diagnosed food allergy and the food allergy plan in file was not complete.

The most current sanitation inspection was last conducted on 1/5/2021 and it is required to be done at least once every 12 months and, therefore it is past due.

Two staff files reviewed but there was no proof if file showing that orientation provided to related to administering medication, preventing and responding to emergencies due to food or an allergic reaction; understanding, building, and physical premises safety; handling, storing, and disposing of hazardous materials; precautions in transportation. *The operation corrected these at inspection when the director and staff completed them at inspection.

The most current gas inspection was last conducted on 10/17/2019 and it is required to be done once every two years and, therefore it is past due.

The most current fire inspection was last conducted on 1/11/2021 and it is required to be done at least once every 12 months and, therefore it is past due.

During the walk-through, multiple classrooms were observed with outlets not covered, chemicals/cleaning supplies not stored out of reach of children. Additionally, multiple classrooms were observed with space heaters within reach of children and not mounted out of the reach of children.

Based on the evidence obtained during the investigation, children were being inappropriately disciplined by staff when children were hit with an instrument as well as yelled by staff and spoken to in a harsh manner and made to run laps while outside in the play area as form of punishment.

Based on the evidence obtained in the investigation, staff have been using their cell phone for personal use while in direct care of children.