Little Nest CDC LLC

Based on the evidence obtained during the investigation, the operation has failed to properly notify parents of minor injuries their children receive while in care.

Based on the evidence obtained during the investigation a child was able to leave the classroom on their own on two separate occasions in one day. On one occasion, one caregiver did not have auditory or visual awareness of the child which allowed the child to leave the classroom. One another occasion, another caregiver failed to have adequate physical proximity to the child which prevented them from being able to intervene appropriately.

An incident/illness report was not completed when a child was hospitalized. **This was corrected at inspection when it was completed by the staff at inspection.

Children were observed having meal and snack without water being available during these times by staff.

Bottle propping was observed for a younger child when the caregiver used a blanket to prop the bottle for the child during feeding time.

Based on the evidence obtained during the investigation, a caregiver did not wash hands after wiping a child's nose.

One staff member was observed at inspection conducting diaper changes but did not wash her hands after changing a diaper. Additionally, the young infant did not have their hands cleaned with an individual wipe after their diaper change.

Multiple classrooms have outlets that require outlet covers. Some outlets have automatic internal locks but these outlets did not have those and did not have outlet covers. Additionally, the barrier to the swing set on the playground has posts that have risen up and have created trip hazards. Three classrooms have cords extending down from a shelf that has the potential to pull items down if a child was to tug on the extended cord. The outlet covers were replaced at inspection and the hanging cords were removed.

The younger children playground requires additional loose fill in the use zone of the kids trax slide. The amount of loose fill in the use zone various from 0-3 inches but does not have the required 6 inches of loose fill in the use zone. The spring based teeter totter also requires 6 inches of loose fill and various from 0-4 inches of loose fill. The swing set additionally requires 6 inches of loose fill and varies from 0-4 inches of loose fill in the use zone.

An infant was observed at inspection asleep in a restrictive device.

A bassinet was observed at inspection as sleep equipment for a 6 month old infant. The manufacturer instructions specifies this sleep equipment is for 0-5 month olds. Additionally, a bassinet of 11.5 inches in height from the sleep surface to the top of the rail does not meet the play yard guidelines of at least 22 inches required.

Multiple caregivers did not have information to show each child's age in the classrooms they using during morning arrival at the start of the day. One caregiver did not know the names of each of the children she was responsible for. Another caregiver has an incomplete list and did not have all of the children she was responsible for listed and did not know the age of the youngest in her group.

Multiple diaper changes were observed and the diaper changing surface was not sanitized in between diaper changes sessions or at the end of the diaper changes.

Multiple children were observed having their diaper changed but did not have their hands washed after. In another classroom, a caregiver was observed wiping the noses of multiple children and did not wash her hands at all.

One children's records when reviewed did not have current immunizations in the file.

Evidence obtained during the investigation confirms staff at the operation had suspicions of children in care being Abused and Neglected outside the daycare and did not make a report to the Texas Department of Family and Protective Services.

Two children in care did not have admission information available for review at inspection.

During the walkthrough, a tire was observed in the use zone of the swings, which were also being used by children, therefore the use zone was not free of hazards.

Based on the evidence obtained during the investigation, a child was left unsupervised outside on the playground area. The caregiver responsible for the child was not aware that the child was left in the playground area until after arriving to the classroom and therefore, did not have physical proximity. The caregiver was not aware of the child's ongoing activities and did not have auditory or visual awareness of the child, and there was no staff present on the playground responsible for the child.

Based on the evidence obtained during the investigation, the operation failed to report a situation that placed a child at risk within the required of 48 hours of the incident occurred. A child was left unsupervised in the playground area without any staff supervision and main caregiver was not aware of the child's ongoing activities.

A classroom was observed with all the children having their snack directly on the table and there was no sanitary holder between the snack and the table - such as a napkin or plate.

During the walkthrough, three tires were observed stacked one on top of another and they were underneath a swing, therefore, the use zone of the swing was not free of hazards.

Based on the evidence obtained, the ouch report did not have all of the same required information as the Child Care Regulation Incident/Illness Report Form as it was lacking a date of when the incident occurred as well as parent signature on the form for when a child was injured and required medical treatment for the injury.

Based on the evidence obtained during the investigation, the operation notified a parent of a child injury that required medical treatment by a health care professional about five hours after the incident occurred.

Based on the evidence obtained during the investigation, a child under two years of age was participating in screen time.