3270.111(c) · 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.

Based on staff interviews and a review of video footage from 4.16.26, it was determined that school aged children were aggressively throwing balls in the play space while preschool age children were present and families were entering or exiting the space/building. Children aged 3-11 were observed in the play space while the school aged children were aggressively throwing balls. Given the developmental differences between these ages, aggressive physical activity by school agers is not developmentally appropriate in the presence of preschool children.

Corrected Corrected by May 14, 2026

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

3270.113(a) · Children on the facility premises and on facility excursions off the premises shall be supervised by a staff person at all times. Outdoor play space used by the facility is considered part of the facility premises. TIERED LIS: 1. Children on the facility premises and on facility excursions off the premises shall be supervised by a staff person at all times. (This plan of correction will have an immediate correction date.) 2.The LE will require all current staff persons to complete the Better Kid Care training "Supervision: Teamwork' within 14 days of acceptance of the plan of correction. All newly hired staff for the next 4 months will also complete the training within 10 days of hire. Training certificates will be submitted to DHS cert rep within 7 days of completion. (LE will provide a correction date that is 4 months from the submission date of the plan of correction.) 3. The LE will create a supervision policy that includes the importance of teamwork to meet the 4 areas of supervision: see, hear, direct and assess. The LE will submit the supervision policy to the DHS representative for review within 30 days of acceptance of the plan of correction. The supervision policy will be included in the staff handbook and all current staff will sign an acknowledgement of receiving the written policy. (LE will provide a correction date within 30 days.) 4.The LE will hold monthly staff meetings for 4 consecutive months following acceptance of the supervision policy. Each meeting agenda will include a review of the facility supervision policy and a review of the training in #2 as well as discussion of location of staff within each facility child care space. The meeting agenda and staff sign in sheets will be submitted to the Department within 10 days of the monthly meeting. (LE will provide a correction date that is 4-5 months from the submission date of the plan of correction.)

It was observed on facility video that for approximately 5 minutes, child #1 and child #2 engaged in unsupervised play activities which included pulling down their pants and using a play saw to touch their buttocks while staff person #1 and staff person #2 were at the far end of the preschool classroom and could not adequately see, hear, direct and assess child #1 and child #2.

Corrected Corrected by Apr 30, 2026

Category: supervision. Marked corrected in the state record.

3270.113(a)(1) · Each staff person shall be assigned the responsibility for supervision of specific children. The staff person shall know the names and whereabouts of the children in his assigned group. The staff person shall be physically present with the children in his group on the facility premises and on facility excursions off the facility premises.

It was observed on facility video that for approximately 5 minutes, child #1 and child #2 engaged in unsupervised play activities which included pulling down their pants and using a play saw to touch their buttocks while staff person #1 and staff person #2 were at the far end of the preschool classroom and could not adequately see, hear, direct and assess child #1 and child #2.

Corrected Corrected by Jan 5, 2026

Category: supervision. Marked corrected in the state record.

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

The facility fire drill log identified that the most recent consecutive fire drills were conducted on 8/29/2025 and 10/31/2025 which exceeded 60 days between fire drills.

Corrected Corrected by Jan 5, 2025

Category: recordkeeping. 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.

The facility fire alarm test log identified that the most recent consecutive alarm tests were conducted on 9/26/2025 and 10/31/2025 which exceeded 30 days between alarm tests.

Corrected Corrected by Jan 5, 2025

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.

The file for staff person #6 contains documentation of current emergency plan training that was completed greater than 12 months after the previous training. The training is now current.

Corrected Corrected by Jul 30, 2025

Category: recordkeeping. Marked corrected in the state record.

3270.31(e)(4)(i) · 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.

The file for staff person #6 contains current PFA/PCPR certification that was completed after the expiration date of the previous certification evidenced by certifications dated 2/28/23 and 6/30/25. The certification is now current.

Corrected Corrected by Jul 30, 2025

Category: ratio. Marked corrected in the state record.

3270.31(e)(4)(ii) · Staff persons shall participate, at least annually, in firesafety 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.

The file for staff person #5 is lacking fire safety training completed within the first 12 months of employment. The file does contain documentation of current fire safety training.

Corrected Corrected by Jul 30, 2025

Category: recordkeeping. Marked corrected in the state record.

3270.32(a) · The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services).

The files for staff persons #2 and #3 contain a current mandated reporter training that was completed greater than 60 months after the previous mandated reporter training. The trainings are now current.

Corrected Corrected by Jul 30, 2025

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 #8 may not work in a child care position at the facility.

The file for staff person #2 contains current NSOR verification that was received greater than 60 months after the previous NSOR evidenced by verifications on file dated 1/14/2020 and 1/16/2025. The verification is now current. The file for staff person #4 who was provisionally hired (see LIS code sheet) is lacking documentation of an NSOR verification within 45 days of hire. The file does contain a current NSOR verification. The file for staff person #7 who was provisionally hired (see LIS code sheet) is lacking documentation of an NSOR verification within 45 days of hire. The file does contain a current NSOR verification. The file for staff person #8, hire date (see LIS code sheet), contains a criminal history clearance that is lacking a dissemination date and is therefore not valid.

Corrected Corrected by Jul 30, 2025

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

3270.34(a)(6) · A director is responsible for written evaluation of staff persons on a regular basis, a minimum of one evaluation every 12 months.

The file for staff person #1 contains a current annual review that was conducted greater than 12 months after the previous annual review evidenced by documentation of reviews completed 2/19/24 and 3/31/25. The file is now current.

Corrected Corrected by Jul 30, 2025

Category: recordkeeping. Marked corrected in the state record.

3270.151(a)/3270.192(3) · 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. A facility person's record shall include a written report of initial and subsequent health assessments, including the results of initial and subsequent tuberculin skin tests, x-rays or other medical documentation necessary to confirm freedom from communicable tuberculosis.

The file for staff person #1 contains a current health assessment that was conducted greater than 24 months after the previous health assessment evidenced by health assessments on file dated 12/20/2024 and 2/3/2025. The file is now current.

Corrected Corrected by Jul 30, 2025

Category: ratio. Marked corrected in the state record.

3270.14/3270.21 · A facility shall be operated in conformity with applicable Federal and State laws and regulations.State agencies whose regulations may relate to the operation of a facility include the Department of Environmental Resources, the Department of Labor and Industry, the Department of Health, the Department of Education and the Department of Transportation. Conditions at the facility may not pose a threat to the health or safety of the children.

Staff person #1 completed a valid health & safety training prior to 10/31/2022 but has not completed the required 1-hour PA Health & Safety Update 2022.

Corrected Corrected by Feb 17, 2025

Category: ratio. Marked corrected in the state record.

3270.27(d) · The operator shall post the emergency plan in the facility at a conspicuous location.

The provider was not able to locate the site specific facility emergency plan during the inspection.

Corrected Corrected by Feb 14, 2025

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

3270.31(e)(4)(i) · 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.

The file for staff person #1 contains PFA/CPR training that expired 3/23/2024 and is lacking current PFA/CPR training.

Corrected Corrected by Feb 17, 2025

Category: ratio. Marked corrected in the state record.

3270.33(a)/3270.192(2)(ii) · A staff person or a substitute staff person shall meet one of the applicable staff qualifications for the position in which the person is performing. A facility person's record shall include verification of child care experience, education and training prior to service at the facility.

The file for staff person #2, serving as an AGS, contains documentation of high school graduation and 15+ college credits in a human service field but is lacking documentation of one year of child care experience.

Corrected Corrected by Feb 14, 2025

Category: recordkeeping. 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.

Observed a tube of calmoseptine diaper rash ointment labeled 'keep out of reach of children' in a mesh pocket of a backpack hanging in a hallway cubby accessible to children in care.

Corrected Corrected by Feb 14, 2025

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

3270.66(b) · 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.

Observed a basin of blue liquid identified by staff as sanitizing solution to be on the counter near the bathroom sink and lacking a label identifying the contents of the basin. The container of sanitizing tablets which was stored under the sink in a locked cabinet stated, 'keep out of reach of children'.

Corrected Corrected by Feb 3, 2025

Category: ratio. Marked corrected in the state record.

3270.76/3270.77(a) · 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. Peeled or damaged paint or damaged plaster is not permitted on indoor or outdoor surfaces in the child care facility.

Observed several areas of damaged and peeling plaster and paint on the walls in the front play space.

Corrected Corrected by Feb 14, 2025

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

3270.82(i) · A toilet area, training chair area, diapering area and sink area shall be equipped with a clean, lidded waste receptacle.

Observed classroom and bathroom waste receptacles to have lids that were visibly soiled with what appeared to be dried on food waste.

Corrected Corrected by Feb 3, 2025

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

3270.111(c) · 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.

Based on video observation, Staff #1 and #2 were not responding to Child #1 while screaming or during times when other children were throwing toys, arts and craft materials and bins at Child #1.

Corrected Corrected by Jan 5, 2025

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

3270.113(a) · The legal entity must arrange , Supervision Technical Assistance from their Early Learning Resource Center. The TA should include guidance on identifying and eliminating supervision blind spots in the childcare and gross motor spaces. The Legal entity shall send proof of completion to the assigned certification representative within 7 days of completion. All directors and facility staff shall attend. Proof of completion shall include attendance sign-in sheet, as well as trainer acknowledgement.

**Based on video observation from 9/13/24. In the School-Age Classroom, Child #1 was throwing toys, arts and craft materials, and bins throughout the room, while staff# 1 & staff # 2 's backs were turned. Child #1 then sat on a toy shelf and screamed while other children taunted, threw, kicked stuff from the floor at her to try to get her to stop screaming, all while the Staff # 1 and Staff #2 had their backs to the whole situation the entire time unaware of what was going on.

Corrected Corrected by Jan 5, 2025

Category: supervision. Marked corrected in the state record.

3270.113(a) · Children on the facility premises and on facility excursions off the premises shall be supervised by a staff person at all times. Outdoor play space used by the facility is considered part of the facility premises.

*Based on video observation from 9/13/24. In the School-Age Classroom, Child #1 was throwing toys, arts and craft materials, and bins throughout the room, while staff# 1 & staff # 2 's backs were turned. Child #1 then sat on a toy shelf and screamed while other children taunted, threw, kicked stuff from the floor at her to try to get her to stop screaming, all while the Staff # 1 and Staff #2 had their backs to the whole situation the entire time unaware of what was going on.

Corrected Corrected by Jan 5, 2025

Category: supervision. Marked corrected in the state record.

3270.31(e)(4)(i) · 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.

The file for staff person #4 contains current PFA/PCPR training completed after the previous training expired. The training is now current.

Corrected Corrected by Jul 16, 2024

Category: ratio. Marked corrected in the state record.

3270.31(e)(4)(ii) · Staff persons shall participate, at least annually, in firesafety 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.

The file for staff person #4 contains current fire safety training that was completed greater than 12 months after the previous training. The training is now current.

Corrected Corrected by Jul 16, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.31(f) · Staff person(s) shall complete professional development in the topics of 3270.31(f)(1 -- 10) within 90 days of hire. Staff person #3 will have until 7/31/2024 to complete the required training. Until such time as the required training has been completed, staff person #3 must be supervised, when interacting with children, by an AGS, GS or director who has completed the required training related to this citation. If there are no staff available to supervise staff person #3, staff person #3 may not work in a child-care position at the facility.

Staff person #3 has not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): PFA/PCPR.

Corrected Corrected by Jul 23, 2024

Category: supervision. 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.

The file for staff person #3, hire date (see IS code sheet) contains a DOE FBI clearance which is not accepted for employment in child care and the file is lacking verification of request for DHS FBI clearance prior to start date in a child care position and is lacking a completed DHS FBI clearance within 45 days of working in a child care position. The file does contain a current DHS FBI clearance. The file for staff person #5, hire date (see IS code sheet) lacks verification of request for DHS FBI clearance and request for NSOR verification prior to caring for children. The file does contain current DHS FBI clearance and current NSOR verification.

Corrected Corrected by Jul 16, 2024

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

3270.32(a) · The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services).

The file for staff person #1, hire date (see IS code sheet) is lacking mandated reporter training within 90 days of hire as required under CPSL. The file does contain current mandated reporter training.

Corrected Corrected by Jul 16, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.66(d) · Toxic plants are not permitted in a child care space.

Observed in the infant room a philodendron plant hanging from the ceiling. The philodendron is on the Caring for Our Children: National Health and Safety Performance Standards list of poisonous plants.

Corrected Corrected by Jul 16, 2024

Category: health medication. 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.

Observed on the wall in the front corner of the indoor play space a small area of peeling paint.

Corrected Corrected by Jul 16, 2024

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

3270.124(f)/3270.181(c) · The parent shall update in writing emergency contact information once in a 6-month period or as soon as there is a change in the information. 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.

The files for child #1 and #2 contain emergency contact information and financial agreements whose most recent updates occurred greater than 6 months after the previous update. The forms are now current.

Corrected Corrected by Jul 16, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.131(d)(5)/3270.131(e) · A health report shall include a review of the child's immunized status according to recommendations of the ACIP. 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.

The file for child #1, preschool aged, is lacking an immunization report and has been in attendance for greater than 60 days. Child #1 must be removed from care until an up-to-date immunization report or exemption letter is obtained.

Corrected Corrected by Jul 16, 2024

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

3270.133(3) · The label of a medication container shall identify the name of the medication and the name of the child for whom the medication is intended. Medication shall be administered to only the child whose name appears on the container.

Observed medications (Equate pain reliever, Equate Allergy Relief and Lubricant Eyedrops) lacking the names of the persons for whom they were intended hanging in a blue holder on the back of the restroom door.

Corrected Corrected by Jul 16, 2024

Category: health medication. 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.

The fire test log identified that the facility alarm was tested on 5/28/2024 and then again on 7/1/2024, exceeding 30 days between tests.

Corrected Corrected by Jul 16, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.131(a)/3270.182(1) · 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. A child's record shall contain initial and subsequent health reports.

The file for child #1, preschool aged, is lacking a child health report and has been in attendance for greater than 60 days.

Corrected Corrected by Jul 16, 2024

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

3270.113(a) · Children on the facility premises and on facility excursions off the premises shall be supervised by a staff person at all times. Outdoor play space used by the facility is considered part of the facility premises.

On 5/03/24, at approximately 4:45 PM, three preschool children, child #1, #2, and #3, were unsupervised while playing under the climber in the gym. Staff #1 and #2 were present in the child care space, however, supervision was obstructed by the placement of large foam blocks.

Corrected Corrected by May 22, 2024

Category: supervision. 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.

Based on the facility's fire drill log, the last fire drill was conducted over 60 days ago on 3/07/24.

Corrected Corrected by May 22, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.31(e)(4)(i)/3270.192(2)(iii) · 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. A facility person's record shall include verification of child care experience, education and training following the outset of service at the facility.

The files for staff #2 and #3 contained expired pediatric CPR and First Aid certification dated 3/31/22.

Corrected Corrected by Jun 21, 2024

Category: ratio. 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 #1 will have 15 days from POC requested date 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, then 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): health and safety topics 1-9.

Corrected Corrected by May 23, 2024

Category: supervision. Marked corrected in the state record.

3270.32(a) · The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). Staff person #4 will have 15 days from POC requested date to complete the mandated reporter training. Until such time as the required training has been completed, staff person #4 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 person(s) available to supervise staff person #4, then staff person #4 may not work in a child-care position at the facility.

Staff #4 has not completed the mandated reporter training within 90 days of their date of hire (see LIS code sheet)

Corrected Corrected by May 24, 2024

Category: supervision. Marked corrected in the state record.

3270.31(g)/3270.192(2)(iii) · Completion of professional development shall be documented by the signature and title of a representative of the professional development entity and include the date professional development was completed. Documentation shall be retained in the facility person's file or maintained in an electronic system as designated by the Department. Documentation of the completion of the professional development under subsection (f) taken from September 30, 2016, forward satisfies this requirement. A facility person's record shall include verification of child care experience, education and training following the outset of service at the facility.

The file for staff #3 contained health and safety training dated 8/14/2016 which is prior to the date of validity as stated in the regulations.

Corrected Corrected by Jun 25, 2024

Category: health medication. 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.

The facility lacked documentation of conducting tests of the fire alarm system at least every 30 days.

Corrected Corrected by May 22, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.14/3270.21 · A facility shall be operated in conformity with applicable Federal and State laws and regulations.State agencies whose regulations may relate to the operation of a facility include the Department of Environmental Resources, the Department of Labor and Industry, the Department of Health, the Department of Education and the Department of Transportation. Conditions at the facility may not pose a threat to the health or safety of the children. Staff Person #2, #3, #4 and #13 will have until 7.29.23 to complete the required 1-hour health and safety training update.

The file for Staff Person #2, #3, #4 and #13 lacked verification that they had completed the required 1-hour health and safety training update prior to 12.30.22 as required by Federal Regulation. The 1-hour health and safety training update on file for Staff Person #4 was completed on 7.3.23.

Corrected Corrected by Jul 28, 2023

Category: ratio. Marked corrected in the state record.

3270.21 · Conditions at the facility may not pose a threat to the health or safety of the children.

In the PreK Counts Classroom, a pair of adult scissors were observed in an unlocked drawer. The height of the drawer would allow accessibility to children receiving care in the space. Loose crib sheets were observed on two cribs in the ITCS classroom.

Corrected Corrected by Jul 10, 2023

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

3270.31(e)(4)(i) · 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.

The updates to the Pediatric First Aid and CPR trainings on file for Staff Person #2, #7, #8 and #13 were not completed before the certificate expiration. The current training on file for Staff Person #2 was completed in February 2023. The prior training expired in January 2023. There was a gap between expiration and training date. The current training on file for Staff Persons #7 and #8 was completed in March 2023. The prior training expired in January 2022. The current training on file for Staff Person #13 was completed in February 2023. The prior training expired in November 2022.

Corrected Corrected by Jul 14, 2023

Category: ratio. Marked corrected in the state record.

3270.31(f) · Staff person(s) shall complete professional development in the topics of 3270.31(f)(1-10) within 90 days of hire. Staff person #11 will have until 7.29.23 to complete the required training. Staff Person #11 is not permitted to work at the child care facility at this time (refer to 3270.32(a).

Staff person #11 has not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): 31(f)(1-9).

Corrected Corrected by Jul 28, 2023

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

3270.32(a) · The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). Facility Person #8, #9, #10, #11, #12 and #13 may not work at the facility. A provisional employee may not be permitted to work alone with children and must work within the vicinity of a permanent employee.

The file for Staff Person #2 lacked verification that they had been fingerprinted for their FBI Clearance prior to starting at the facility. The fingerprint receipt on file was dated 1 month after starting. The file for Staff Person #2 lacked a current disclosure statement required at the time of their hire. The disclosure statement on file was an older version and does not meet the requirements of the CPSL. The file for Staff Person #8 lacked a current FBI Clearance. The current FBI Clearance expired on 10.4.22. The updates to the State Police Clearance exceeded 60 months between clearances dated 10.13.17 and 6.20.23. The updates to the Child Abuse Clearance exceeded 60 months between clearances dated 10.4.17 and 6.20.23. The files for Staff Persons #9 and #10 lacked out of state clearances for a State that they have resided in within the last 5 years. The file for Staff Person #10 also lacked a FBI Clearance for DHS purposes. The FBI Clearance on file was completed for Department of Education and is not acceptable for employment in a child care facility. Staff Person #10 was observed alone with a group of 9 preschool age children. The file for Staff Person #11 lacked a completed State Police Clearance, Child Abuse Clearance, FBI Clearance and NSOR Certificate. The file lacked a request for their State Police and Child Abuse Clearance prior to starting at the facility. Staff Person #11 has exceeded 45 days in a child care taking position (refer to LIS Code Sheet). The file for Staff Person #12 lacked verification that they had been fingerprinted for their FBI Clearance prior to starting at the facility. A completed FBI Clearance was not on file prior to starting. The file for Staff Person #13 lacked a current FBI Clearance. The FBI Clearance on file expired on 6.11.23.

Corrected Corrected by Jul 28, 2023

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

3270.32(a) · The operator shall comply with the CPSL and with Chapter 3490 (relating to Child Protective Services). Facility person #1 and #13 will have until 7.29.23 to complete the mandated reporter training. Until such time as the required training has been completed, facility 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 person(s) available to supervise facility person #1, facility person #1 may not work in a child-care position at the facility. Staff Person #13 may not work at the facility (refer to additional 32(a) citation).

Facility person #1 and Staff Person #13 has not completed mandated reporter training within the last 60 months. This is evidenced by the previously documented mandated reporter training on file being dated 10.9.16 for Facility Person #1 and 6.11.18 for Staff Person #13.

Corrected Corrected by Jul 28, 2023

Category: supervision. Marked corrected in the state record.

3270.33(a)/3270.192(2)(ii) · A staff person or a substitute staff person shall meet one of the applicable staff qualifications for the position in which the person is performing. A facility person's record shall include verification of child care experience, education and training prior to service at the facility.

The files for Staff Person #5 and #12, identified as an Assistant Group Supervisors, lacked verification of experience to qualify them for the position. The file for Staff Person #7, identified as a Group Supervisor, lacked verification of education to qualify them for the position.

Corrected Corrected by Jul 28, 2023

Category: supervision. Marked corrected in the state record.

3270.34(a)(6) · A director is responsible for written evaluation of staff persons on a regular basis, a minimum of one evaluation every 12 months.

The file for Staff Person #2 lacked an evaluation that was completed prior to 1.10.23. This was not within 12 months of the Staff Person's hire date (refer to LIS Code sheet).

Corrected Corrected by Jul 28, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.66(a)/3270.133(4) · Cleaning materials and other toxic materials shall be kept in an area or container that is locked or made inaccessible to children. Medication shall be stored in a locked area of the facility or in an area that is out of the reach of children.

A hanging organizer was observed on the back of the unlocked staff restroom in the Indoor Gross Motor room. Over the counter Medications were observed in the organizer pockets and could be accessible to children should they enter the unlocked restroom. An Air Freshener was observed on a low table in the staff restroom. All items were labeled Keep Out of Reach of Children. Children were observed to be playing in the hallway outside the restroom door.

Corrected Corrected by Jul 14, 2023

Category: health medication. 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.

The first aid kit in the ITCS room was missing Gauze.

Corrected Corrected by Jul 10, 2023

Category: health medication. 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.

In the Indoor Gross Motor classroom damaged plaster was observed on the lower wall to the right of the front door (upon entrance to the facility).

Corrected Corrected by Jul 14, 2023

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

3270.82(h) · A facility person and an able child shall wash his hands after toileting and before eating. A sign on which this requirement is written shall be posted at each toilet, training chair, diapering area and sink in the facility.

Hand washing signs were missing from the toilet and sink in one of the restrooms in the Indoor Gross Motor room.

Corrected Corrected by Jul 14, 2023

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

3270.102(c) · Outdoor equipment that requires embedded mounting must be mounted over a loose-fill or unitary playground protective surface covering that meets the recommendations of the United States Consumer Product Safety Commission. The equipment must be anchored firmly and be in good repair.

The mulch under the embedded equipment in the Preschool Play Space did not have the required 9 inches of mulch.

Corrected Corrected by Jul 10, 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.

In the ITCS Classroom an unlabeled crib and pack and play reported to be in use for children in care was observed.

Corrected Corrected by Jul 10, 2023

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

3270.111(c) · 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.

The daily activity schedule was not posted in the ITCS Classroom.

Corrected Corrected by Jul 10, 2023

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

3270.123(a)(3) · The services to be provided to the family and the child, including the Department's approved form to provide information to the family about the child's growth and development in the context of the services being provided. The operator shall complete and update the form and provide a copy to the family in accordance with the updates regarding emergency contact information in § 3270.124(f) (relating to emergency contact information).

The file for Child #1, #4 and #5 lacked a current assessment of the child's growth and development.

Corrected Corrected by Jul 28, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.123(b) · A parent shall receive the original agreement. The facility shall retain a copy of the agreement.

The agreements on file for Children #2 and #3 were observed to contain an original agreement.

Corrected Corrected by Jul 10, 2023

Category: recordkeeping. 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.

The written emergency transportation plan posted in the Classrooms was missing staffing provisions in the event of an emergency.

Corrected Corrected by Jul 14, 2023

Category: transportation. Marked corrected in the state record.

3270.131(b)(2) · The operator shall require the parent to provide an updated health report at least every 12 months for an older toddler or preschool child.

The file for Child #6, an older toddler, lacked an updated health report that had been completed within the last 12 months. The most recent health assessment on file was dated 1.28.22.

Corrected Corrected by Jul 16, 2023

Category: health medication. 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). Children #1, #2, #4, #5 and #6 will be dismissed from care at the close of business on 7.10.23.

The immunization record on file for Child #1 lacked verification that the child had received the ACIP recommended Hepatitis A vaccination. The immunization record on file for Child #2 lacked verification that the child had received the ACIP recommended Influenza vaccination. The immunization record on file for Child #6 lacked verification that the child had received their 4th dose of DTAP and Pneumococcal as recommended by the ACIP. The files for Children #4 and #5 lacked immunization records for the children. Written exemptions were not on file at the time of the inspection.

Corrected Corrected by Jul 18, 2023

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

3270.135(a)(3) · 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.

A disposable diaper was observed in the restroom garbage can located in the Indoor Gross Motor room. The garbage can in place was not hands-free allowing for appropriate disposal of soiled diapers. The hands-free can in place at the changing table in Toddler Classroom was in place on the other side of the steps where staff were observed to stand for changing. The steps blocked access allowing the Staff to immediately discard a soiled diaper into the can.

Corrected Corrected by Jul 14, 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.

The health assessments on file for Facility Person #1 exceeded 24 months between examinations on 7.10.19 and 6.20.22. The health assessments on file for Facility Person #2 exceeded 24 months between examinations on 3.16.20 and 4.20.22. The health assessments on file for Facility Person #7 exceeded 24 months between examinations on 7.26.18 and 8.11.21.

Corrected Corrected by Jul 10, 2023

Category: ratio. Marked corrected in the state record.

3270.151(c)(3)/3270.151(c)(5) · An adult health assessment must include an examination for communicable diseases and the results of that examination. An adult health assessment must include the physician's or CRNP's assessment of the person's suitability to provide child care.

The health assessment on file for Staff Persons #6 and #12 lacked information that they were examined for communicable diseases and the results of that examination and the physician's assessment of their suitability to provide child care.

Corrected Corrected by Jul 28, 2023

Category: health medication. 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.

A lunch box containing a Go-gurt dairy product was observed on the counter area in Preschool 2.

Corrected Corrected by Jul 10, 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.

The updates to the emergency contact form and financial agreements on file for Children #1 and #5 exceeded 6 months since last review. The forms were dated 12.27.22 for Child #1 and 12.19.22 for Child #5.

Corrected Corrected by Jul 10, 2023

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.

The file for Staff Person #4 lacked two written, nonfamily references attesting to their suitability to serve as a facility person. The file for Staff Person #13 lacked one of their two written nonfamily references attesting to their suitability to serve as a facility person.

Corrected Corrected by Jul 13, 2023

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.

The file for Staff Person #2 lacked 6 of their required 12 hours of child care training in their respective training year of 12.19.21-12.18.22. The file for Staff Person #7 lacked 12 hours of child care training in their respective training year of 12.19.21-12.18.22. The file for Staff Person #8 lacked 6.5 of their 12 hours of child care training in their respective training year of 12.19.21-12.18.22. The file for Staff Person #13 lacked 12 hours of child care training in their respective training year of 8.27.21-8,26.22.

Corrected Corrected by Jul 28, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.131(a) · 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 file for Children #1, #4 and #5 lacked an initial health assessment within 60 days of starting at the facility (refer to LIS code sheet).

Corrected Corrected by Jul 28, 2023

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

3270.21 · Conditions at the facility may not pose a threat to the health or safety of the children.

An approximately 4'x2' wooden shelving unit in the Preschool room and an approximately 4'x2' wooden shelf with a flat screen monitor placed atop, each in areas accessible to children, were observed to be tipping hazards, which could cause blunt force trauma injuries.

Corrected Corrected by Sep 19, 2022

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

3270.27(c)/3270.192(2)(iii) · 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. A facility person's record shall include verification of child care experience, education and training following the outset of service at the facility.

Although the files for Staff #5 and #6 contained documentation of the completion of emergency plan training in the past year, the previously completed trainings for each staff member were dated more than 12 months prior.

Corrected Corrected by Sep 19, 2022

Category: recordkeeping. Marked corrected in the state record.

3270.31(f)/3270.192(2)(iii) · Staff persons shall complete professional development within 90 days of hire as listed in subsections (f)1-10.A facility person's record shall include verification of child care experience, education and training following the outset of service at the facility.

The file for Staff #2 contained documentation of the completion of Health and Safety Basics training that was completed more than 90 days after Staff #2's first date in a child care position.

Corrected Corrected by Sep 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. Facility Person #4 may not work in a child care position at the facility.

The file for Staff #1 contained an FBI clearance that was dated as processed after Staff #1's first date in a child care position. The file for Staff #1 did not contain documentation that fingerprinting had been completed as a part of the FBI clearance process on or before Staff #1's first date in a child care position. The file for Staff #2 contained an NSOR verification that was completed more than 45 days following the staff member's first date in a child care position. The file for Staff #4, who has been employed in a child care position for more than 45 days, did not contain an NSOR verification. The files for Staff #5 and #6, whose first dates in child care positions were 04/17/2019 and 10/09/2017 respectively, contained NSOR verifications that were completed after July 01, 2020. The file for Staff #8 contained an NSOR verification that was completed more than 45 days following Staff #8's first date in a child care position. The file for Staff #11 contained an NSOR verification that was completed after Staff #11's first date in a child care position. The file for Staff #11 did not contain documentation that an NSOR verification request had been submitted.

Corrected Corrected by Jul 21, 2022

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

3270.34(a)(6) · A director is responsible for written evaluation of staff persons on a regular basis, a minimum of one evaluation every 12 months.

The files for Staff #1, #3, #6, #8, and #10 did not contain written performance evaluations completed in the past 12 months.

Corrected Corrected by Sep 19, 2022

Category: recordkeeping. Marked corrected in the state record.

3270.76/3270.82(g) · 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.Toilet areas and fixtures shall be cleaned daily and be in good repair.

A toilet used by children in care in the toddler restroom was observed to have an exposed, upwardly facing bolt on one side of the base of the toilet in an area accessible to children in care.

Corrected Corrected by Sep 19, 2022

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

3270.102(a) · Toys, play equipment and other indoor and outdoor equipment used by the children shall be clean, in good repair and free from rough edges, sharp corners, pinch and crush points, splinters and exposed bolts.

An approximately 2' high faux yield traffic sign was observed in an area accessible to children in care in the PreK room. Two outwardly facing, exposed bolts were observed on the back of the sign. An approximately 3' high, metal hose reel was observed in an area accessible to children in the Preschool play space. A sharply edged piece of metal was protruding from side of the reel. Also in an area accessible to children, in the indoor play space, an exposed bolt was observed on the inside of the door of an approximately 6' high cabinet. Contact with exposed bolts or sharply edged metal could cause laceration and/or puncture injuries.

Corrected Corrected by Sep 19, 2022

Category: ratio. Marked corrected in the state record.

3270.102(e) · Pea gravel and other materials with a diameter of less than 1 inch may not be used in spaces where infants or toddlers receive care.

A storage container of foam blocks was observed in an area accessible to children who are still placing objects in their mouths in the Toddler B room. Bite marks were evident in several of the blocks. In the ages 1-3 play space, pieces of mulch that were less than 1" in size were observed in areas accessible to children who are still placing things in their mouths. It appeared that the pieces of mulch were washing into the area from an adjacent play space as a result of rain drainage.

Corrected Corrected by Sep 19, 2022

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

3270.111(a) · A written plan of daily activities and routines, including a time for free play shall be established for each group. The plan shall be flexible to accommodate the needs of individual children and the dynamics of the group.

A written plan of daily activities was not posted in the Toddler A room.

Corrected Corrected by Sep 19, 2022

Marked corrected in the state record.

3270.124(f)/3270.181(c) · The parent shall update in writing emergency contact information once in a 6-month period or as soon as there is a change in the informationA 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.

The files for Child #1, #2, #4, #5, #6 and #7, who each have been in care at the facility for more than six months, did not contain documentation that emergency contact information and financial agreements were reviewed by a parent/guardian in the past six months.

Corrected Corrected by Sep 19, 2022

Category: recordkeeping. Marked corrected in the state record.

3270.131(d)(5) · A health report shall include a review of the child's immunized status according to recommendations of the ACIP.

The files for Child #3 and #7, who each have been in care at the facility for more than 60 days, did not contain immunization records. The files for Child #5 and #6 did not contain documentation of influenza vaccines administered in the past year.

Corrected Corrected by Sep 19, 2022

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.

The files for Staff #5 and #6 contained current health assessments; however, the previously completed health assessment for each staff was dated as administered more than 24 months prior to current assessments. The file for Staff #9 contained a health assessment that was completed following Staff #9's first date in a child care position.

Corrected Corrected by Sep 19, 2022

Category: ratio. Marked corrected in the state record.

3270.131(a) · 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 files for Child #3 and #7, who each have been in care at the facility for more than 60 days, did not contain health assessments.

Corrected Corrected by Sep 19, 2022

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

3270.82(h) · A facility person and an able child shall wash his hands after toileting and before eating. A sign on which this requirement is written shall be posted at each toilet, training chair, diapering area and sink in the facility.

The Preschool 2 room bathroom was lacking handwashing signs at the toilet and sink.

Corrected Corrected by Aug 24, 2021

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

3270.82(i) · A toilet area, training chair area, diapering area and sink area shall be equipped with a clean, lidded waste receptacle.

The girl's bathroom off of the multi-purpose room is lacking a covered trash container.

Corrected Corrected by Aug 26, 2021

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

3270.104(a) · Furniture must be durable, safe, easily cleaned and appropriate for the child's size, age and special needs.

In the Preschool 2 room the surface of the science shelf was visibly damaged with a rough edge.

Corrected Corrected by Aug 26, 2021

Marked corrected in the state record.

3270.27(a)/3270.27(d) · The facility shall have an emergency plan.The operator shall post the emergency plan in the facility at a conspicuous location.

The provider was unable to locate the facility emergency plan.

Corrected Corrected by Aug 23, 2021

Category: physical safety. 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.

The files for staff persons #1,2,3,4,5 and 6 do not contain documentation of training regarding the facility emergency plan at the time of initial hire. The files for staff #2 and 6 do contain current emergency plan training.

Corrected Corrected by Aug 23, 2021

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 Persons # 1,2,3,4,5,6,10, 11 and 13 may not work in a child care position at the facility.

The file for staff person #1, hire date 6/14/2020, contains a verification of FBI fingerprinting dated 6/13/2021 but does not contain a completed FBI clearance and has exceeded the 45 day provisional hire period. The file for staff person #3, hire date 7/19/2021, is lacking verification of FBI fingerprinting prior to employment and does not include a completed FBI clearance. The file also contains verification of request for NSOR verification dated 7/26/2021 which is after the initial date of employment and does not contain a completed NSOR verification. The file for staff person #4, hire date 6/21/2021, is lacking verification of request for criminal history clearance and FBI fingerprinting prior to initial employment and does not contain a completed FBI clearance. The files for staff persons #1,2,3,4,5,6,10 and 13 all contain electronically signed disclosure statements which are not valid under CPSL. The file for staff person #11 contains a disclosure statement that was not witnessed.

Corrected Corrected by Aug 23, 2021

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

3270.32(a)/3270.192(2)(iii) · The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). A facility person's record shall include verification of child care experience, education and training following the outset of service at the facility.

The files for staff persons #7 and #14 contain current mandated reporter training that was completed greater than 60 months after the previous training. The files are now current. The file for staff person #10, hire date 5/13/2021, does not contain verification of mandated reporter training and has been employed for greater than 90 days. The file for staff person #12 contains mandated reporter training that expired 1/15/2021 and does not contain a current training.

Corrected Corrected by Sep 28, 2021

Category: recordkeeping. Marked corrected in the state record.

3270.33(a)/3270.192(2)(ii) · A staff person or a substitute staff person shall meet one of the applicable staff qualifications for the position in which the person is performing.A facility person's record shall include verification of child care experience, education and training prior to service at the facility.

The files for staff persons #1 and #6 serving as assistant group supervisors are lacking the required education and experience to qualify as AGS.

Corrected Corrected by Aug 23, 2021

Category: supervision. Marked corrected in the state record.

3270.34(a)(6) · A director is responsible for written evaluation of staff persons on a regular basis, a minimum of one evaluation every 12 months.

The files for staff persons #7,8 and 9 are lacking a written evaluation completed during the previous 12 month period.

Corrected Corrected by Aug 23, 2021

Category: recordkeeping. 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.

Observed stained and damaged ceiling tiles in the Preschool 2 room.

Corrected Corrected by Aug 24, 2021

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

3270.131(b)(2) · The operator shall require the parent to provide an updated health report at least every 12 months for an older toddler or preschool child.

The file for child #3, preschool aged, is lacking an updated health report completed during the 12 months preceding the suspension of the regulation due to the pandemic.

Corrected Corrected by Aug 25, 2021

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

3270.131(e) · 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.

The file for child #2 is lacking an immunization report and has been in attendance for greater than 60 days. The child may not attend the child care program until a record of immunizations is obtained.

Corrected Corrected by Aug 24, 2021

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.

The files for child #1 and #4, both preschool aged, are lacking verification of a flu shot received during the previous 12 month period. The file for child #3, preschool aged, contains verification of only 1 of required 3 Hep B, 3 of required 4 DTAP, HIB and pneumococcal, 0 of required 1 of MMR and varicella and 0 of required 2 Hep A vaccinations as required by the ACIP.

Corrected Corrected by Aug 24, 2021

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

3270.133(2) · A staff person shall administer a prescription medication only if written instructions are provided from the individual who prescribed the medicine. Instructions for administration contained on a prescription label are acceptable.

Observed in the Preschool 2 room prescription medication diazapam rectal gel that did not include a prescription label or instructions for administering.

Corrected Corrected by Jul 30, 2021

Category: ratio. Marked corrected in the state record.

3270.133(3) · The label of a medication container shall identify the name of the medication and the name of the child for whom the medication is intended. Medication shall be administered to only the child whose name appears on the container.

Observed in the Preschool 2 room diazepam rectal gel and allergy relief medication that do not contain the name of the child for whom it is intended.

Corrected Corrected by Jul 30, 2021

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

3270.133(5) · Medication shall be stored in accordance with the manufacturer's or health professional's instructions on the original label.

Observed in the Preschool 1 room an expired Epinephrine Injection device.

Corrected Corrected by Jul 30, 2021

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

3270.133(6) · A parent shall provide written consent for administration of medication or a special diet.

Observed in the Preschool 2 room Allergy Relief medication without written parental consent for administration.

Corrected Corrected by Jul 30, 2021

Category: ratio. Marked corrected in the state record.

3270.151(a)/3270.192(3) · 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.A facility person's record shall include a written report of initial and subsequent health assessments, including the results of initial and subsequent tuberculin skin tests, x-rays or other medical documentation necessary to confirm freedom from communicable tuberculosis.

The file for staff person #3 is lacking a health assessment. The file for staff person #4 is lacking an initial health assessment at the time of hire but has a current health assessment. The files for Staff #7 and 12 are lacking health assessments completed during the previous 24 month period.

Corrected Corrected by Aug 26, 2021

Category: ratio. Marked corrected in the state record.

3270.131(a)/3270.182(1) · 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. A child's record shall contain initial and subsequent health reports.

The file for child #2, preschool aged, is lacking a health assessment and has been enrolled for greater than 90 days.

Corrected Corrected by Aug 26, 2021

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

3270.151(a)/3270.192(3) · 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.A facility person's record shall include a written report of initial and subsequent health assessments, including the results of initial and subsequent tuberculin skin tests, x-rays or other medical documentation necessary to confirm freedom from communicable tuberculosis.

The file for facility person #1, serving as the facility lifeguard, is lacking a current health assessment.

Corrected Corrected by Jul 30, 2021

Category: ratio. Marked corrected in the state record.