3270.31(f)(10) · Staff person(s) shall complete professional development in the topics of 3270.31(f)(10) within 90 days of hire. Staff person #1 will have until 12/19/2024 to complete the required training. Until such time as the required training has been completed, staff person #1 must be supervised, when interacting with children, by an AGS who has completed the required training related to this citation. If there are no staff available to supervise staff person #1, staff person 1 may not work in a child-care position at the facility.

Staff person #1 has not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): Pediatric first aid/CPR.

Corrected Corrected by Dec 14, 2024

Category: supervision. Marked corrected in the state record.

3270.95(a)/3270.95(b) · Fire detection devices or systems must be in compliance with standards established under section 1016(c) of the act (62 P.S. §  1016(c)). The Director or designated staff person who is responsible for compliance with this chapter shall ensure the requirements under subsection (a) are met.

During an inspection on 11/21/2024, it was determined that the last fire drill was completed on 9/18/2024, making it more than 60 days since the last fire drill.

Corrected Corrected by Dec 10, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.27(c) · The operator shall assure that each facility person receives training regarding the emergency plan at the time of initial employment, on an annual basis and at the time of each plan update. The operator shall document the date of each training and the names of all facility persons who received the training and kept on file at the facility.

Staff 3 did not have emergency plan training documented within the past 12 months.

Corrected Corrected by May 17, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.192(2)(iii) · A facility person's record shall include verification of child care experience, education and training following the outset of service at the facility.

Staff 4 did not have proof of experience on file.

Corrected Corrected by May 20, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.192(5) · A facility person's record shall include two written, nonfamily references from individuals attesting to the person's suitability to serve as a facility person.

Staff 1 only had one letter of reference on file.

Corrected Corrected by May 17, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.25(a) · The facility's current certificate of compliance shall be posted in a conspicuous location used by parents. The operator shall provide the parent of each child enrolled with information on how to access the regulations in this chapter electronically and with instructions for contacting the appropriate regional child care office.

During the renewal inspection on 5/15/2024, it was observed that the facility did not have electronic access to the regulations available to the parents.

Corrected Corrected by May 16, 2024

Marked corrected in the state record.

3270.31(e) · A staff person shall obtain an annual minimum of 12 clock hours of child care training.

Staff 2 did not have 12 hours of annual training on file from the previous year. 3 hours of training was documented in 2023.

Corrected Corrected by May 22, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.113(d) · A facility person may not use harsh, demeaning or abusive language in the presence of children. Facility will develop a policy addressing staff interactions with children and review it with staff. The policy will be forwarded to DHS for approval. A staff sign in sheet, with agenda, will be forwarded to DHS after reviewing it with staff.

During the compliant investigation, it was found through interviews that staff 1's tone with the children was elevated and harsh on multiple occasions.

Corrected Corrected by May 22, 2024

Marked corrected in the state record.

3270.113(d) · A facility person may not use harsh, demeaning or abusive language in the presence of children.

During the compliant investigation, it was found through interviews that staff 1's tone with the children was elevated and harsh on multiple occasions.

Corrected Corrected by May 22, 2024

Marked corrected in the state record.

3270.31(f) · Staff persons shall complete professional development within 90 days of hire as listed in subsections (f)1-10. Staff person #3 shall complete the required one-hour 2022 update to the health and safety training by June 30, 2023.

During renewal inspection, facility person #3 and facility person #4 did not complete the required one-hour 2022 update to the health and safety training by 12/30/2022. Facility person #4 completed health and safety update on 4/30/2023. There is no record of training for facility person #3.

Corrected Corrected by May 2, 2023

Category: health medication. Marked corrected in the state record.

3270.31(f) · Staff persons shall complete professional development within 90 days of hire as listed in subsections (f)1-10.

During renewal inspection, facility person #2 did not complete the following required pre-service training within 90 days of their date of hire (see LIS code sheet): Pediatric First-Aid/CPR. Training was completed on 4/29/2023. Facility person #5 did not complete the following required pre-service training within 90 days of their date of hire (see LIS code sheet): CCDBG Health and Safety. Training was completed on 5/10/2022.

Corrected Corrected by May 2, 2023

Category: health medication. Marked corrected in the state record.

3270.123(a)(6) · An agreement shall specify the date of the child's admission.

During renewal inspection conducted 5/2/2023, there was no date of admission on Child #6's fee agreement.

Corrected Corrected by May 2, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.32(a)/3270.192(4) · The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). A facility person's record shall include a copy of requests for the criminal history record and child abuse registry clearance information, a copy of the disclosure statement and a copy of the completed clearance information required under the CPSL. Facility person #6, facility person #7, and facility person #8 may not work in a child care position at the facility until all appropriate clearances are on file at the facility, including New York clearances.

During renewal inspection conducted 5/2/2023, the following was missing from staff files. Staff are past their 45-day provisional periods (see LIS code sheets for hire dates): Facility person #6: NSOR clearance. Facility person#7: PSP Clearance results and out-of-state clearances from New York. Facility person #8: Child abuse clearance from New York.

Corrected Corrected by May 17, 2023

Category: background checks. Marked corrected in the state record.

3270.35(e) · In a facility in which more than 45 children are enrolled, a group supervisor is required for the first group of 45 enrolled children and for each group or partial group of 45 additional enrolled children.

During renewal inspection conducted 5/2/2023-6/13/2023, facility has 141 children enrolled, and a provider survey indicates that 141 children are present at the facility at the same time. Facility currently has two group supervisors. Facility needs four group supervisors.

Corrected Corrected by Jun 26, 2023

Category: supervision. Marked corrected in the state record.

3270.66(a) · Cleaning materials and other toxic materials shall be kept in an area or container that is locked or made inaccessible to children.

During renewal inspection, cleaning materials labeled "keep out of reach of children" were observed in an unlocked cabinet under the sink in Room 17 (Older Toddler room). Area was accessible to children.

Corrected Corrected by May 5, 2023

Marked corrected in the state record.

3270.76 · Floors, walls, ceilings and other surfaces, including the facility's outdoor play space surfaces shall be kept clean, in good repair and free from visible hazards.

During renewal inspection, a ceiling tile was observed to be hanging in the Gym (indoor play space).

Corrected Corrected by May 6, 2023

Category: physical safety. Marked corrected in the state record.

3270.106(a) · Individual, clean, age-appropriate rest equipment shall be provided for preschool, toddler and infant children as agreed between the child's parent and the operator. The rest equipment shall be labeled for the use of a specific child and used only by the specified child.

During renewal inspection, nap mats in the Pre-School/School-Age room were labeled; however, there was no corresponding list with names.

Corrected Corrected by May 3, 2023

Category: physical safety. Marked corrected in the state record.

3270.124(e) · A written plan identifying the means of transporting a child to emergency care and staffing provisions in the event of an emergency shall be displayed conspicuously in every child care space and shall accompany a staff person who leaves on an excursion with children.

During renewal inspection, emergency transportation plan was not displayed in Room 17 (Older Toddler room) or Room 14 (preschool room).

Corrected Corrected by May 2, 2023

Category: transportation. Marked corrected in the state record.

3270.131(d)(5)/3270.131(e)(3) · A health report shall include a review of the child's immunized status according to recommendations of the ACIP. The facility shall implement dismissal policies in accordance with the Department of Health regulation in 28 Pa. Code § 27.77 (relating to immunization requirements for children in child care group settings). Child #1, #2, #4, and #5 will be dismissed from care by close of business 5/2/2023 until either the immunization record is updated, or a parent provides a written, signed exemption letter.

During renewal inspection conducted 5/2/2023, the following children are not immunized according to the recommendations of the ACIP (see LIS code sheet for ages): Child #1: no flu vaccine. Child #2: no flu vaccine. Child #4: no flu vaccine. Child #5: no Hep A vaccine.

Corrected Corrected by May 3, 2023

Category: health medication. Marked corrected in the state record.

3270.133(4) · Medication shall be stored in a locked area of the facility or in an area that is out of the reach of children.

During renewal inspection, diaper cream was observed to be in bins below the changing tables in both the Young Toddler 1 and Young Toddler 2 rooms, which were accessible to children. Medications were labeled "Keep out of reach of children."

Corrected Corrected by May 2, 2023

Category: health medication. Marked corrected in the state record.

3270.151(a) · A facility person providing direct care who comes into contact with the children or who works with food preparation shall have a health assessment conducted within 12 months prior to providing initial service in a child care setting and every 24 months thereafter. A health assessment is valid for 24 months following the date of signature, if the person does not contract a communicable disease or develop a medical problem.

During renewal inspection, the following facility persons had a health assessment after their start date (see LIS code sheet for hire dates): Facility person #1: health assessment dated 11/2/2022. Facility person #2: health assessment dated 9/21/2022. Facility person #3: health assessment dated 9/30/2022.

Corrected Corrected by May 2, 2023

Category: ratio. Marked corrected in the state record.

3270.161(d) · Potentially hazardous food brought from the child's home or provided by the facility shall be refrigerated.

During renewal inspection, a lunchbox containing ham and eggs was observed to be unrefrigerated in the Preschool 2 room.

Corrected Corrected by May 3, 2023

Category: nutrition. Marked corrected in the state record.

3270.181(c) · A parent is required to review and update the emergency contact information and the financial agreement at least once in a 6-month period or as soon as there is a change in the information.

During renewal inspection conducted 5/2/2023, the following fee agreement and emergency contact forms were not updated within the past 6 months: Child #1: last updated 9/14/2022 Child #4: last updated 9/14/2022.

Corrected Corrected by May 8, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.182(5) · A child's record shall contain signed parental consent for administration of minor first-aid procedures by facility staff. Written consent is required prior to admission.

During renewal inspection conducted 5/2/2023, parent wrote "N/A" in space for consent for first-aid for Child #3.

Corrected Corrected by May 8, 2023

Category: ratio. Marked corrected in the state record.

3270.31(e) · A staff person shall obtain an annual minimum of 12 clock hours of child care training. Facility person #9, #10, #11, and #12 shall complete additional 5 hours of professional development which will be counted toward specified training years. Training hours completed to make up previous training year cannot be counted toward current training year.

During renewal inspection conducted 5/2/2023, the following facility persons did not receive 12 clock hours of child care training: Facility person #9 (training year 1/26/2022-1/26/2023): 7 hours annual training. Facility person #10 (training year 2/28/2022-2/28/2023): 7 hours annual training. Facility person #11 (training year 12/19/2021-12/19/2022): 7 hours annual training. Facility person #12 (training year 12/19/2021-12/19/2022): 7 hours annual training.

Corrected Corrected by Jun 22, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.20(a)(1) · The operator shall immediately notify a child's parent and shall telephone notice to the appropriate regional office within 24 hours if a child in care at the facility is hospitalized or receives emergency room treatment.

Child was taken to emergency room via ambulance on 4/26/2023. Northeast Regional Office was not notified at all until 4/29/2023.

Corrected Corrected by May 1, 2023

Category: physical safety. Marked corrected in the state record.

3270.106(a) · Individual, clean, age-appropriate rest equipment shall be provided for preschool, toddler and infant children as agreed between the child's parent and the operator. The rest equipment shall be labeled for the use of a specific child and used only by the specified child.

During complaint investigation, it was verified that children have been observed to sleep in highchairs.

Corrected Corrected by Oct 19, 2022

Category: physical safety. Marked corrected in the state record.

3270.111(c)/3270.113(e) · Daily activities shall promote the development of skills, social competence and self-esteem. Daily experiences shall recognize the child as an individual and give some choice of activities that respect personal privacy, lifestyle and cultural background. A facility person may not restrain a child by using bonds, ties or straps to restrict a child's movement or by enclosing the child in a confined space, closet or locked room. The prohibition against restraining a child does not apply to the use of adaptive equipment prescribed for a child with special needs.

During complaint investigation, it was verified that staff place children in a high chair for behavior management. Staff members admitted to using a high chair to keep Child #1, who is 3 years old, still while the group is doing circle time and other activities such as arts and crafts. Staff admitted that child is a runner and sometimes does cry when he is put in the high chair.

Corrected Corrected by Oct 19, 2022

Category: background checks. Marked corrected in the state record.

3270.123(a)(1) · An agreement shall specify the amount of the fee to be charged per day or per week.

During complaint investigation conducted 10/5/2022, agreement for Child #1 did not specify the amount of the fee to be charged. Fee agreement and emergency contact information for Child #1 were both last updated on 3/8/2022, which is past 6 months.

Corrected Corrected by Oct 19, 2022

Category: recordkeeping. Marked corrected in the state record.

3270.32(a)/3270.192(4) · The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services).A facility person's record shall include a copy of requests for the criminal history record and child abuse registry clearance information, a copy of the disclosure statement and a copy of the completed clearance information required under the CPSL. Staff #1 may not work in a child care position at the facility until appropriate clearances are on file.

During unannounced monitoring conducted 10/5/2022, Staff #1 did not have a PSP clearance on file. Child abuse clearance for Staff #1 dated 8/11/2020 is a volunteer clearance, which is unacceptable.

Corrected Corrected by Oct 5, 2022

Category: background checks. Marked corrected in the state record.

3270.151(a) · A facility person providing direct care who comes into contact with the children or who works with food preparation shall have a health assessment conducted within 12 months prior to providing initial service in a child care setting and every 24 months thereafter. A health assessment is valid for 24 months following the date of signature, if the person does not contract a communicable disease or develop a medical problem.

During unannounced monitoring conducted on 10/5/2022, Staff #1 did not have health assessment on file (see LIS code sheet for hire date).

Corrected Corrected by Oct 7, 2022

Category: ratio. Marked corrected in the state record.

3270.181(c) · A parent is required to review and update the emergency contact information and the financial agreement at least once in a 6-month period or as soon as there is a change in the information.

During unannounced monitoring conducted 10/5/2022, fee agreement and emergency contact information for Child #1 were both last updated on 3/8/2022, which is past 6 months.

Corrected Corrected by Oct 10, 2022

Category: recordkeeping. Marked corrected in the state record.

3270.77(a) · Peeled or damaged paint or damaged plaster is not permitted on indoor or outdoor surfaces in the child care facility.

On renewal inspection conducted 5/4/2022, peeling paint was observed in the School Age area on a pipe and by a window near the arts and crafts, in the Preschool 1 room by nap mats, and in the Older Toddler room in the back corner of the room. An acceptable plan of correction was received on 5/4/2022 with a correction date of 5/13/2022. On 5/26/2022 an unannounced inspection was conducted. During this inspection, peeling paint was observed in the School Age area by a window near the arts and crafts. Water-damaged plaster was observed in the Older Toddler room under a window on the back wall.

Corrected Corrected by Jun 10, 2022

Category: physical safety. Marked corrected in the state record.

3270.106(j)/3270.119 · Toys, bumper pads, or pillows may not be present in a crib while an infant is sleeping in the crib. Infants shall be placed in the sleeping position recommended by the American Academy of Pediatrics unless there is a medical reason an infant should not sleep in this position. The medical reason shall be documented in a statement signed by a physician, physician's assistant or CRNP and placed in the child's record at the facility. Legal entity will arrange for all staff to receive a minimum of 2 hours of PQAS approved, live training regarding Health & Safety Infant/Toddler Safe Sleep Position. Operator will first receive DHS approval of training content prior to scheduling the training. The training will not be conducted while children are in care.

On renewal inspection conducted 5/4/2022, an infant was observed to be sleeping in an infant seat. Staff reported that child had just fallen asleep. An acceptable plan of correction was received on 5/42022 with a correction date of 5/20/2022. On 5/26/2022 an unannounced inspection was conducted. During this inspection, an infant was observed to be sleeping in an infant seat and a pillow was in the crib of another sleeping infant.

Corrected Corrected by Jul 16, 2022

Category: health medication. Marked corrected in the state record.

3270.106(j)/3270.119 · Toys, bumper pads, or pillows may not be present in a crib while an infant is sleeping in the crib. Infants shall be placed in the sleeping position recommended by the American Academy of Pediatrics unless there is a medical reason an infant should not sleep in this position. The medical reason shall be documented in a statement signed by a physician, physician's assistant or CRNP and placed in the child's record at the facility.

On renewal inspection conducted 5/4/2022, an infant was observed to be sleeping in an infant seat. Staff reported that child had just fallen asleep. An acceptable plan of correction was received on 5/42022 with a correction date of 5/20/2022. On 5/26/2022 an unannounced inspection was conducted. During this inspection, an infant was observed to be sleeping in an infant seat and a pillow was in the crib of another sleeping infant.

Corrected Corrected by May 26, 2022

Category: health medication. Marked corrected in the state record.

3270.124(b)(6)/3270.182(3) · Emergency contact information must include health insurance coverage and policy number for a child under a family policy or Medical Assistance benefits, if applicable. A child's record shall contain signed parental consent for emergency medical care for the child. Written consent is required prior to admission.

On renewal inspection conducted 5/4/2022, record for Child #3 did not contain signed parental consent for emergency medical care. Emergency contact information for Child #7 did not contain health insurance policy number. An acceptable plan of correction was received on 5/4/2022 with a correction date of 5/13/2022. On 5/26/2022 an unannounced inspection was conducted. During this inspection, Emergency contact information for Child #7 did not contain health insurance policy number.

Corrected Corrected by May 26, 2022

Category: health medication. Marked corrected in the state record.

3270.131(e)(1) · The facility shall require the parent to provide updated written verification from a physician, physician's assistant, CRNP, the Department of Health or a local health department of ongoing vaccines administered to an infant, toddler or preschool child in accordance with the schedule recommended by the ACIP.

On renewal inspection conducted 5/4/2022, immunization records for Child #3, Child #5, Child #6, and Child #9 did not contain record of influenza vaccine or letter of exemption. An acceptable plan of correction was received on 5/4/2022 with a correction date of 5/13/2022. On 5/26/2022 an unannounced inspection was conducted. During this inspection immunization records for Child #3, Child #5, Child #6, and Child #9 did not contain record of influenza vaccine or letter of exemption.

Corrected Corrected by Jun 2, 2022

Category: health medication. Marked corrected in the state record.

3270.175(c) · Manufacturers' instructions for use of safety restraints shall be kept in the vehicle at all times.

On unannounced inspection conducted 5/26/2022, manufacturers' instructions for use of safety restraints were not in vehicle.

Corrected Corrected by Jun 17, 2022

Category: transportation. Marked corrected in the state record.

3270.27(a)(6) · Emergency drills shall be conducted annually. Annual emergency drills shall be documented and on file at the facility.

On renewal inspection conducted 5/4/2022, facility did not practice/document an emergency drill. An acceptable plan of correction was received on 5/4/2022 with a correction date of 5/13/2022. On 5/26/2022 an unannounced inspection was conducted. During this inspection, director reported that emergency drill was conducted on 5/16/2022; however, was not documented at the facility.

Corrected Corrected by May 26, 2022

Category: recordkeeping. Marked corrected in the state record.

3270.131(a)/3270.131(e) · The operator shall require the parent of an enrolled child, including a child, a foster child and a relative of an operator or a facility person, to provide an initial health report no later than 60 days following the first day of attendance at the facility. The facility may not accept or retain an infant 2 months of age or older, a toddler or a preschool child at the facility for more than 60 days following the first day of attendance at the facility unless the parent provides written verification from a physician, physician's assistant, CRNP, the Department of Health or a local health department of the dates (month, day and year) the child was administered immunizations in accordance with the recommendations of the ACIP.

On renewal inspection conducted 5/4/2022, record for Child #2 did not contain an initial health report nor written verification of administration of immunizations. An acceptable plan of correction was received on 5/4/2022 with a correction date of 5/13/2022. On 5/26/2022 an unannounced inspection was conducted. During this inspection record for Child #2 did not contain an initial health report. Child #2 did have immunization record on file during unannounced visit.

Corrected Corrected by Jun 1, 2022

Category: ratio. Marked corrected in the state record.

3270.27(a)(6) · Emergency drills shall be conducted annually. Annual emergency drills shall be documented and on file at the facility.

On renewal inspection conducted 5/4/2022, facility did not practice/document an emergency drill.

Corrected Corrected by May 13, 2022

Category: recordkeeping. Marked corrected in the state record.

3270.77(a) · Peeled or damaged paint or damaged plaster is not permitted on indoor or outdoor surfaces in the child care facility.

On renewal inspection conducted 5/4/2022, peeling paint was observed in the School Age area on a pipe and by a window near the arts and crafts, in the Preschool 1 room by nap mats, and in the Older Toddler room in the back corner of the room.

Corrected Corrected by May 13, 2022

Category: physical safety. Marked corrected in the state record.

3270.31(e)(4)(i)/3270.31(f)(10) · Competence is the completion of training by a professional in the field of first-aid and cardiopulmonary resuscitation (CPR). All staff persons shall renew their certification in pediatric first aid and pediatric cardiopulmonary resuscitation (CPR) on or before the expiration of the most current certification.Staff persons shall complete professional development in pediatric first aid and pediatric cardiopulmonary resuscitation within 90 days of hire.

On renewal inspection conducted on 5/4/2022, the following staff did not renew their certification in pediatric first-aid and CPR: Staff #1: past training expired 8/17/2021 and renewal was completed 4/23/2022. Staff #1 did complete online portion of pediatric first-aid/CPR training on 10/5/21; however, this does not result in a certified status. Staff #3: past training expired 9/21/2021 and renewal was completed 4/23/2022. The following staff completed pediatric first-aid/CPR training on 4/23/2022. Staff did not complete pediatric first-aid/CPR training within 90 days of hire: Staff #4, Staff #5, Staff #6, Staff #10

Corrected Corrected by May 4, 2022

Category: ratio. Marked corrected in the state record.

3270.31(e)(4)(ii) · Staff persons shall participate, at least annually, in fire safety training conducted by a fire protection professional. Staff persons and volunteers shall receive training in maintenance of smoke detectors, the duties of facility persons during a fire drill and during a fire and the use of the facility's fire extinguishers, not including discharge of the fire suppressant agent.

On renewal inspection conducted 5/4/2022, fire safety training was not conducted at least once annually for the following staff: Staff #1: 10/16/2019 and 5/4/2021. Staff #3: 9/18/2019 and 5/11/2021.

Corrected Corrected by May 4, 2022

Category: recordkeeping. Marked corrected in the state record.

3270.31(f) · Staff persons shall complete professional development in the following topics within 90 days of hire:

On renewal inspection conducted 5/4/2022, Staff #6 has not completed the required preservice professional development topics and has worked at the facility for more than 90 days. Staff #6 was observed to be working with another staff who has completed professional development topics.

Corrected Corrected by May 19, 2022

Category: health medication. Marked corrected in the state record.

3270.32(a)/3270.192(4) · The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). A facility person's record shall include a copy of requests for the criminal history record and child abuse registry clearance information, a copy of the disclosure statement and a copy of the completed clearance information required under the CPSL. Staff #8 may not work in a child care position at the facility until New York clearances are on file.

On renewal inspection conducted on 5/4/2022, Staff #8 has lived in New York in the past 5 years and requires out-of-state clearances. Staff #13 had clearances that expired during her employment. PSP clearances dated 3/17/2017 and 4/4/2022 and FBI clearances dated 3/20/2017 and 4/7/2022. Staff #9 did not have NSOR clearance on file.

Corrected Corrected by May 4, 2022

Category: background checks. Marked corrected in the state record.

3270.66(a)/3270.66(b) · Cleaning materials and other toxic materials shall be kept in an area or container that is locked or made inaccessible to children. Cleaning materials and other toxic materials shall be stored in an original labeled container or in a container that specifies the content. Toxics shall be stored away from food, food preparation areas and child care spaces.

On renewal inspection conducted 5/4/2022, unlabeled disinfectant spray was observed in the infant and older toddler rooms. Disinfectant spray was in the diapering area which is accessible to children.

Corrected Corrected by May 5, 2022

Category: ratio. Marked corrected in the state record.

3270.75(c) · A first-aid kit must contain the following: soap, an assortment of adhesive bandages, sterile gauze pads, tweezers, tape, scissors and disposable, nonporous gloves.

On renewal inspection conducted 5/4/2022, first-aid kit in Older Toddler room was missing gloves.

Corrected Corrected by May 13, 2022

Marked corrected in the state record.

3270.76 · Floors, walls, ceilings and other surfaces, including the facility's outdoor play space surfaces shall be kept clean, in good repair and free from visible hazards.

On renewal inspection conducted 5/4/2022, cords were observed to be hanging from mounted TVs in Preschool 1 and Preschool 2 rooms. Cords were in areas where children play, creating a hazard.

Corrected Corrected by May 13, 2022

Category: physical safety. Marked corrected in the state record.

3270.119 · Infants shall be placed in the sleeping position recommended by the American Academy of Pediatrics unless there is a medical reason an infant should not sleep in this position. The medical reason shall be documented in a statement signed by a physician, physician's assistant or CRNP and placed in the child's record at the facility.

On renewal inspection conducted 5/4/2022, an infant was observed to be sleeping in an infant seat. Staff reported that child had just fallen asleep.

Corrected Corrected by May 20, 2022

Category: health medication. Marked corrected in the state record.

3270.124(b)(6)/3270.182(3) · Emergency contact information must include health insurance coverage and policy number for a child under a family policy or Medical Assistance benefits, if applicable. A child's record shall contain signed parental consent for emergency medical care for the child. Written consent is required prior to admission.

On renewal inspection conducted 5/4/2022, record for Child #3 did not contain signed parental consent for emergency medical care. Emergency contact information for Child #7 did not contain health insurance policy number.

Corrected Corrected by May 13, 2022

Category: health medication. Marked corrected in the state record.

3270.131(e)(1) · The facility shall require the parent to provide updated written verification from a physician, physician's assistant, CRNP, the Department of Health or a local health department of ongoing vaccines administered to an infant, toddler or preschool child in accordance with the schedule recommended by the ACIP.

On renewal inspection conducted 5/4/2022, immunization records for Child #3, Child #5, Child #6, and Child #9 did not contain record of influenza vaccine or letter of exemption.

Corrected Corrected by May 13, 2022

Category: health medication. Marked corrected in the state record.

3270.135(a)(3)/3270.135(b) · If disposable diapers are provided by a parent or by a facility, a soiled diaper shall be discarded by immediately placing the diaper into a plastic-lined, hands-free covered can. Diaper changing surfaces shall be cleaned after each use by wiping the surface with a sanitizing solution or by changing a pad or other surface covering.

On renewal inspection conducted 5/4/2022, a pullup was observed in an uncovered, non-hands-free trash can in the boys' bathroom off the School-Age room. The diapering mat in the Infant room was observed with a rip in it, making it unable to be properly sanitized.

Corrected Corrected by May 5, 2022

Category: health medication. Marked corrected in the state record.

3270.166(3) · Disposable nursers shall be used for infants unless bottles are provided by the parent or unless a commercial dishwasher is used by the facility.

On renewal inspection conducted 5/4/2022, staff indicated that infants' bottles are sent by parents and washed at the facility daily. The facility does not have a commercial dishwasher..

Corrected Corrected by May 13, 2022

Marked corrected in the state record.

3270.192(5) · A facility person's record shall include two written, nonfamily references from individuals attesting to the person's suitability to serve as a facility person

On renewal inspection conducted 5/4/2022, Staff #4 does not have 2 written non-family references on file.

Corrected Corrected by May 13, 2022

Category: recordkeeping. Marked corrected in the state record.

3270.94(a)(1) · The Director or designated staff person who is responsible for compliance with this chapter shall conduct fire drills and ensure that fire drills are conducted at least once every 60 days.

On renewal inspection conducted 5/4/2022, facility's documentation reflected that fire drills occurred on 5/2/2021 and not again until 12/23/2021, 2/18/2022 and no dates since. These are past 60 days. Director reports that fire drills were occurring; however were not documented.

Corrected Corrected by May 6, 2022

Category: recordkeeping. Marked corrected in the state record.

3270.31(e) · A staff person shall obtain an annual minimum of 12 clock hours of child care training.

On renewal inspection conducted on 5/4/2022, Staff #1 completed 2 of 12 hours of annual child care training and Staff #3 completed 6 of 12 hours of annual child care training for training period of 12/19/2020-12/19/2021.

Corrected Corrected by May 4, 2022

Category: recordkeeping. Marked corrected in the state record.

3270.131(a)/3270.131(e) · The operator shall require the parent of an enrolled child, including a child, a foster child and a relative of an operator or a facility person, to provide an initial health report no later than 60 days following the first day of attendance at the facility. The facility may not accept or retain an infant 2 months of age or older, a toddler or a preschool child at the facility for more than 60 days following the first day of attendance at the facility unless the parent provides written verification from a physician, physician's assistant, CRNP, the Department of Health or a local health department of the dates (month, day and year) the child was administered immunizations in accordance with the recommendations of the ACIP.

On renewal inspection conducted 5/4/2022, record for Child #2 did not contain an initial health report nor written verification of administration of immunizations.

Corrected Corrected by May 13, 2022

Category: ratio. Marked corrected in the state record.