A+ Appletree Academy

Four out of six staff files reviewed are missing trainings on the following topics: -Hazardous Materials; -Administering Medications; -Emergency Preparedness; and -Building and Physical Premises Safety.

Based on the information obtained during the DFPS investigation, it was determined that operation failed to timely report to CCR an incident that took place at operation which required a child to receive medical treatment.

The operational policies reviewed were missing information on the promotion of indoor and outdoor physical activity that is consistent with Subchapter F of the minimum standards (relating to Developmental Activities and Activity Plan); the policies must include: (A) The benefits of physical activity and outdoor play; (B) The duration of physical activity at the operation, both indoor and outdoor; (C) The type of physical activity (structured and unstructured) that children may engage in at the operation; (D) Each setting in which the physical activity program will take place; (E) The recommended clothing and footwear that will allow a child to participate freely and safely in physical activities; (F) The criteria the operation will use to determine when extreme weather conditions pose a significant health risk that prohibits or limits outdoor play; and (G) A plan to ensure physical activity occurs on days when extreme weather conditions prohibit or limit outdoor play.

The lighting in the infant room during naptime was not adequate and did not allow visual supervision of all children in the room.

Two infants in the infant room were observed asleep on swings for an undetermined amount of time.

The director was missing annual training for training year 3/22/2023-3/21/2024 on the following topics: 1. Understanding building and physical premises safety, including identification and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, and vehicular traffic; and 2.Handling, storing, and disposing of hazardous materials including compliance with 746.3425 of this chapter (relating to Must caregivers wear gloves when handling blood or bodily fluids containing blood?).

The personnel records for two caregivers were not available for review at the operation during the inspection.

A caregiver's record was not available for review at the operation during the inspection. A second caregiver's training record was not available for review during the inspection.

The grass in the outdoor playground was not maintained.

Child/caregiver ratios were not met in the infant room when a caregiver was caring for five infants. The ages of the children in the group were a 4 month old, 7 month old, 9 month old, 14 month old, and 19 month old. According to the ratio chart the maximum number of children one caregiver may supervise is 4. The group was out of ratio by one child.

The feeding instructions available for review were not current for three infants who are not yet ready for table food. Two of the feeding instruction forms had a date of 8/28/2023, and a third form had a date of 9/26/2023.

The electronic child safety alarm in the transportation vehicle was not maintained. When testing the electronic child safety alarm there was no sound indicating the alarm was working properly.

There were no time sheets available for one of the directors.

One of two directors was not current on transportation safety training.

1 of 4 children's immunization records reviewed was not current.