Small Hands Big Hopes Academy

Four staff files were reviewed. Two files are missing preemployment affidavit (Form 2912), one file is missing valid high school diploma and one file is missing SIDS/Shaken Baby training certificate.

An infant was observed asleep on a floor bouncer for an undetermined amount of time. Note: The caregiver moved the infant to a crib during the inspection.

The director did not have a complete training record available for review at the operation.

Ratios were not met when a caregiver was caring for a total of 10 children of varying ages. The ages of the children were One infant, and Nine children between 18 months-4 years of age. According to the ratio chart when 12 or fewer children are present two caregivers were required with the group of children based on the number of children and age of children.

Proper supervision was not established as there was only one caregiver in the building caring for 10 children of varying ages. The children were divided into two groups and in different rooms. The caregiver was observed in the infant room supervising 5 children and leaving 5 other children in the pre-k area unsupervised. This prevented the caregiver from having adequate physical proximity and auditory or visual awareness of each child in care.

A group of children of varying ages did not have their hands washed before eating the morning snack. NOTE: This was addressed during inspection and children's hands were washed.

A caregiver was allowed to be present in the operation and have director contact with children in care prior to the operation receiving notice from the CBCU (Centralized Background Check Unit) regarding the person s eligibility. Note: The Person left the operation during the inspection.

There were no records available for review for two children in care. 3 of 5 children's immunization records reviewed were not current. Note: The records missing for the two children were brought to the center and were reviewed.

A group of children including a child under the age of 2 were watching television during breakfast.

Soiled diapers were being disposed of in a trash can with no lid/cover in the infant room. Note: This was CORRECTED during the inspection as the trash can was replaced with one that had a lid.

Proper supervision was not established as there was only one caregiver in the building caring for 11 children of varying ages. The children were divided into two groups and in different rooms. Four infants and a toddler were observed in the infant room. Four toddlers and two pre-k children were observed in the pre-k area asleep on floor mats. The caregiver was observed in the infant room leaving the children in the pre-k area unsupervised.

Ratios were not met when a caregiver was caring for a total of 11 children of varying ages. The ages of the children were Four infants 0-17 months old, and Seven children between 18 months-4 years of age. According to the ratio chart two caregivers were required with the group of children based on the number of children in each age category.

The operational policies reviewed were missing the following information: Promotion of indoor and outdoor physical activity that is consistent with Subchapter F of this chapter (relating to Developmental Activities) your policies must include: (A) The benefits of physical activity and outdoor play; (B) The duration of physical activity at your operation, both indoor and outdoor; (C) The type of physical activity (structured and unstructured) that children may engage in at your operation; (D) Each setting in which your physical activity program will take place; (E) The recommended clothing and footwear that will allow a child to participate freely and safely in physicalactivities; and (F) A plan to ensure physical activity occurs on days when extreme weather conditions prohibit or limit outdoor play.

A caregiver did not have current training in pediatric first aid with rescue breathing and choking.

A small television in the infant room was not anchored or strapped to prevent from tipping over. A sand box in the outdoor area was not properly maintained as the sand box was filled with standing water. Note: The television was removed and stored away. The sand box containing water was emptied during the inspection.

A caregiver's record was not available for review during the inspection. 1 of 3 records reviewed was missing the caregiver's education documentation.

A caregiver did not have current training in pediatric cardiopulmonary resuscitation (CPR).

A designated fire exit door was blocked with children's equipment. Note: This was addressed with director and the equipment was removed.