Childrens Courtyard-Rufe Snow

Infant bottles were not labeled with the child's name.

The operation did not notify licensing of a change in the director in writing by the required 5 days of the change.

The operation has failed to pay outstanding background check fees.

The infant classroom was indicated, on sign-in sheets, to be out of ratio in the mornings for an average of 10-20 minutes.

I observed children under 2 years old watching a cartoon.

2 of the 10 children's records were missing updated immunization records.

Operation was missing the Keeping Children Safe poster. This was corrected at inspection when the director posted it.

3 of the 10 staff records reviewed were missing the notarized Employee Affidavit.

This standard was evaluated as part of an investigation and was deficient based on the preponderance of evidence. A caregiver placed her leg on top of a child in attempt to make them be still and take a nap.

A current fire inspection was not available for review at the time of the inspection.

3 infant parents have instructed to give medication when the label states to ask a doctor for their age range.

I observed medication that is expired and no longer used present at the operation during my inspection.

2 children with diagnosed food allergies are missing a food allergy emergency plan.

A bottle was left unlabeled, and it resulted in an infant getting fed the wrong bottle. Bottles were observed to be labeled during my visit.

Based on information gathered it was determined there is reasonable evidence to believe a caregiver was under the influence of alcohol while caring for children.

The playground equipment on the toddler playground is chipping in several places. This is exposing raw wood that children have directo access to.

I observed 2 highchairs in the infant 2 classroom without safety straps.

3 caregivers, who work out of ratio, stated that they often work out of ratio for an extended amount of time because one teacher is late.

3 caregivers stated that they have observed infants sleeping in restrictive devices. 2 caregivers stated that they let infants sleep in restrictive devices for a period of time to ensure they were asleep before moving them.

4 caregivers express concern as toys are often visibly dirty and are concerned that the toys are not being cleaned. 1 caregiver stated that she sprays the toys with bleach water, but do not wipe them down and she does not do the deep clean on Friday afternoons as it seems overwhelming.

The current proof of liability insurance was not available for review.

The safety documentation was not available for review at the time of the inspection.

The training records for 10 of 10 reviewed files were not available for review at the time of inspection.

The CPSC form was not available for review at the time of the inspection.

There was an individual present and caring for children without an eligible background check.

1 of the 10 children's records needs updated shot records.

There are 7 children present without updated infant feeding instructions.

The facility did not report positive cases of COVID within the two day time frame.

Due to an error in communication a class was not served breakfast and not served any food until lunch. The children went without food service for more then 4 hours. The facility has tightened there food service schedule to ensure all of the children eat breakfast.

The caregiver changed the diapers of the older children when they were standing up. As a result a child was not cleaned thoroughly. The teacher was instructed that when a diaper is being changed as a result of a bowel movement, they must use the changing table.

One caregiver did not have trainings in the topics of, administering medication, preventing and responding to emergencies due to food or an allergic reaction, and handling, storing, and disposing of hazardous materials

Two caregivers did not have the required two hours of transportation training.

A child safety alarm in one of the transportation vehicles was not working.

A fire drill was not conducted in the month of August.

Immunization records are not up to date per audit records from the Department of State Health Services (DSHS).