LSP Four Points, Inc.

746.623(1)(A) - Immunizations-Immunization record must include the child's name and birth date · Medium Low

During an audit of immunization records, it was determined that 39 children were missing the medical professional's signature and/or did not have the required immunization frequency documented.

746.3701(8) - Safety-Hinged Lid Storage Containers Safe · Medium High

The outdoor storage box(s) did not have ventilation holes.

746.3803(b) - Medication Authorization Expires on First Anniversary · Medium High

A child's Allergy Action plan had expired.

746.3809 - Medication No Longer Used · Medium

Two medications were out of date.

746.1613(a) - Reduction of child/caregiver naptime ratio by 50% allowed, If 13 or more children in care, children are 18 mo. or older and other standards met · Medium

Ratio was reduced at nap time in a classroom that included and infant aged child.

746.3803(a)(1) - Medication Authorization - Signed and Dated · Medium High

Medical authorization forms were missing parent signature and had expired signature from a medical professional.

746.605(12)(B)(i) - Required Admission Information - Reasonable Accommodations or Modifications · Medium High

Admission information did not include information on special needs.

746.605(16) - Required Admission Information - Water Activity Permission · Medium High

Admission information was missing the required information for water safety.

746.1201(5) - Responsibilities of Employees and Caregivers-Report Suspected Child Abuse, Neglect or Exploitation · High

A caregiver did not report suspected abuse promptly.

746.2805(1) - Prohibited Punishments - Corporal Punishment · High

A caregiver pinched a child, twisted a child's arm, and squirted a child in the face with a spray bottle as punishment.

746.2805(2) - Prohibited Punishments - Associated with Food, Naps, or Toilet Training · High

A caregiver punished children for bathroom accidents.

746.2805(5) - Prohibited Punishments - Humiliating, Rejecting, Yelling · High

A caregiver humiliated children in the presence of their peers

746.1201(1) - Responsibilities of Employees and Caregivers -Demonstrate Competency, Good Judgment, Self-control · High

A caregiver did not demonstrate good judgement when she allowed a child to go outside in excessively hot weather without shoes on.

746.1601 - Child/ Caregiver Ratio - 13 or More Children · Medium High

One classroom was out of ratio as one caregiver was caring for fourteen 2-year-old children which is three over the allowed number of children in that age group to be cared for by one caregiver.

746.2421(b) - Written Feeding Instructions - Review and Update Every 30 Days · Medium

Three infants did not have current feeding instructions reviewed by a parent/guardian in the last 30 days.

746.3401(a) - Annual Sanitation Inspection · Medium High

The operation did not have a sanitation inspection done within the last 12 months.

746.3805(b)(1) - Administering Medication - Original Container with Child's Name, Date · Medium High

One child's Epinephrine Auto-Injector was not in the original packaging.

746.5101(a) - Annual Fire Inspection - Before Initial Permit Issued and Every 12 Months · High

The operation did not have a fire inspection conducted within the last 12 months.

746.5205(4) - Documentation of Drills · Medium

The operation did not have complete documentation of their fire drills, monthly inspections of their CO2, Smoke Detectors, or their fire extinguishers. This was corrected at inspection by the director when the drills and monthly inspections were documented.

746.603(a)(4) - Children's Records - Immunizations · Medium

Two children did not have current immunization records.

746.605(16) - Required Admission Information-Completed Food Allergy Plan · Medium High

One child's emergency allergy plan was incomplete as it was missing one of the two medications listed by the physician.

746.2419(6) - Requirements for Feeding Infants - Label Bottles/Cups · Medium High

There was one unlabeled cup in the classroom refrigerator which belonged to a child. The caregiver labeled it when asked to do so during inspection.

746.1201(1) - Responsibilities of Employees and Caregivers -Demonstrate Competency, Good Judgment, Self-control · High

A caregiver demonstrated a lapse in judgment by mistakenly providing an infant with a bottle intended for another child.

746.2419(6) - Requirements for Feeding Infants - Label Bottles/Cups · Medium High

There were unlabeled and undistinguishable bottles in the fridge.

746.2421(b) - Written Feeding Instructions - Review and Update Every 30 Days · Medium

Ten infants did not have up-to-date feeding instructions.

745.641 - AP Background check results - Must receive notification prior to allowing subject to be present at your operation · High

A caregiver was present in a classrom without an eligible background check,

746.501(a)(25) - Written Operational Policies - Breastfeeding Provisions · Low

The operation's operational policies did not include a section for nursing mothers.

746.501(a)(28) - Written Operational Policies - Vaccine Preventable Diseases · Medium

The operation's operational policies did not include a section on vaccine-preventable diseases for employees.

746.605(6) - Required Admission Information - Emergency Contact · Medium High

One child's admission paperwork did not include any information on who should be contacted in an emergency or any contact information.

746.605(7) - Required Admission Information - Release Information · High

One child's admission paperwork did not include names and telephone numbers of persons other than a parent to whom the child may be released to.

746.3401(a) - Annual Sanitation Inspection · Medium High

Sanitation inspection was not up to date.

746.1201(1) - Responsibilities of Employees and Caregivers -Demonstrate Competency, Good Judgment, Self-control · High

During an investigation there was sufficient evidence to support that a caregiver did not demonstrate good judgment and self-control while interacting with children in care. This incident was self-reported by the center who immediately terminated the employee.

746.5101(a) - Annual Fire Inspection - Before Initial Permit Issued and Every 12 Months · High

A fire inspection associated with the fire department and Fire Marshall has not been conducted within the last 12 months.

746.3501(2) - Diaper Changing Steps- Cleanse Child with Individual Cloths · Medium High · No longer displayed by the state

During an investigation it was found that a caregiver did not thoroughly cleanse a child after a diaper change.