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.

Observed 2/13/2025 staff #1and 2 did not complete the one-hour health and safety training course update for staff members hired or have taken the health and safety course prior to 10/4/2022.

Corrected Corrected by Feb 13, 2025

Category: ratio. 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.

Observed 2/13/2025. Staff #1 and 4 file did not contain an approved DHS required Pediatric first aid and pediatric cardiopulmonary resuscitation (CPR) training.

Corrected Corrected by Feb 14, 2025

Category: ratio. Marked corrected in the state record.

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

Observed 2/13/2025 Staff person # 6 has not completed the following required pre-service Health and Safety training within 90 days of their date of hire.

Corrected Corrected by Feb 13, 2025

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). LACKING REQUIRED HIRING DOCUMENTS: Facility Person # 5 may not work in a childcare position at the facility. 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 #5 may not work in a child care position at the facility.

Observed 2/13/2025 Staff # 5 file did not contain a completed DHS required FBI clearance. The requirement to have the completed DHS required clearances on file was not met.

Corrected Corrected by Feb 13, 2025

Category: background checks. 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 2/13/2025 in the Women's bathroom there were Clorox wipes located in the childcare space not locked and accessible to children. In the Men's bathroom there was Clorox Bleach cleanser labeled "Keep out of Reach of Children" located under the sink unlocked and accessible to children.

Corrected Corrected by Feb 13, 2025

Category: physical safety. 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.

Observed 2/13/2025 classrooms 3 and 4 were missing items from their first aid kit. Classroom 3 were missing sterile gauze pads from first aid kit. Classroom 4 was missing tweezers and scissors from first aid kit.

Corrected Corrected by Feb 14, 2025

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

3270.124(b)(6) · Emergency contact information must include health insurance coverage and policy number for a child under a family policy or Medical Assistance benefits, if applicable.

Observed 2/13/2025 child # 3,4 and 5 file health insurance coverage information and policy number were missing from emergency contact form.

Corrected Corrected by Feb 14, 2025

Category: health medication. 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.

Observed 2/13/2025 Child # 1,2,3 & 5 files were missing a periodic review and update on their emergency contact forms.

Corrected Corrected by Feb 14, 2025

Category: recordkeeping. 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.

Observed 2/13/2025 children files #3 did not contain an updated health report on file. Child # 3 last physical was 8/29/2023.

Corrected Corrected by Feb 14, 2025

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

3270.133(1)/3270.133(5) · A prescription or nonprescription medication may be accepted only in an original container. The medication shall remain in the container in which it was received. Medication shall be stored in accordance with the manufacturer's or health professional's instructions on the original label.

Observed 2/13/2025 Child # 6 EPI Pen did not have Child's name labeled and was given without manufacture's or health professional's instructions on the original label.

Corrected Corrected by Feb 14, 2025

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.

Observed 2/13/2025 staff #4 and 5 health assessments did not contain the physician's address of where their health assessment was conducted at.

Corrected Corrected by Feb 14, 2025

Category: ratio. Marked corrected in the state record.

3270.166(4) · Disposable nursers and bottles shall be labeled with the child's name.

Observed 2/13/2025 in classroom #4 cups were not labeled to identify which cup belong to which child.

Corrected Corrected by Feb 13, 2025

Marked corrected in the state record.

3270.192(2)(ii)/3270.192(2)(iv) · A facility person's record shall include verification of child care experience, education and training prior to service at the facility. A facility person's record shall include acceptable verification of experience, education or training is a transcript or a diploma or a letter signed by a representative of the experiential, educational or training entity.

Observed 2/13/2025 staff #3 file did not contain verification of acceptable education or transcript and/or diploma or a letter signed by a representative of the experiential, educational or training entity on file during the inspection.

Corrected Corrected by Mar 13, 2025

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.

Observed 2/13/2025 staff #1 file did not contain two written, nonfamily references from individuals attesting to the person's suitability to serve as a facility person.

Corrected Corrected by Feb 14, 2025

Category: recordkeeping. Marked corrected in the state record.

3270.94(a)(1)/3270.94(a)(9) · 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. The Director or designated staff person who is responsible for compliance with this chapter shall conduct fire drills and ensure that a written record is maintained on file at the facility indicating the specific time of day of the drill, the hypothetical location of the fire, the evacuation time, and the names of the facility persons and the number of children who participate in the fire drill.

Observed 2/13/2025, Fire drills were not conducted since February 2024 to September 2024, and there was not a written record of the fire drills conducted on file.

Corrected Corrected by Feb 14, 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.

Observed 2/28/2024 staff #2 and 3 received first aid/CPR training however it was not an approved pediatric curriculum course, and the trainer is not PQAS certified.

Corrected Corrected by Feb 29, 2024

Category: ratio. 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). LACKING REQUIRED HIRING DOCUMENTS: Facility Person #1 may not work in a child care position at the facility. 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 #1 may not work in a child care position at the facility.

Observed 2/28/2024 The file for staff # 1 not contain a completed DHS required National Sex Offender Registry clearance. The requirement to have the completed DHS required clearances on file was not met.

Corrected Corrected by Feb 28, 2024

Category: background checks. 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 2/28/2024 in bathroom #2 there was cleaning material disinfectant solution and Windex below the sink where children wash hands not locked or made inaccessible to children.

Corrected Corrected by Feb 28, 2024

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.

Observed 2/28/2024 Toddler Tots classroom were missing tweezers from first aid kit.

Corrected Corrected by Feb 28, 2024

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

3270.107 · A facility shall have an operable, clean refrigerator used to store potentially hazardous foods. The refrigerator shall be capable of maintaining food at 45° F or below. An operating thermometer shall be placed in the refrigerator.

Observed 2/28/2024 in the Toddler's Tots classroom there was not an operable thermometer in the refrigerator.

Corrected Corrected by Feb 28, 2024

Category: nutrition. 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.

Observed 2/28/2024 in Toddlers Tots Classroom Staff # 3 and 5 had 7 children in their childcare space. Staff # 5 identified 3 children and staff # 3 identified 0 children, leaving 4 children unassigned.

Corrected Corrected by Feb 28, 2024

Category: supervision. Marked corrected in the state record.

3270.124(b)(6) · Emergency contact information must include health insurance coverage and policy number for a child under a family policy or Medical Assistance benefits, if applicable.

Observed 2/28/2024 child #1,3, 5 and 6 file were missing health insurance coverage information and policy numbers from emergency contact form.

Corrected Corrected by Feb 28, 2024

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

3270.131(c) · A health report must be written and signed by a physician, physician's assistant or a CRNP. The signature must include the individual's professional title.

Observed 2/28/2024 Child #4 health assessment was not signed by a physician, physician's assistant or a CRNP. The signature did not include the individual's professional title.

Corrected Corrected by Feb 28, 2024

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

3270.133(1)/3270.133(5) · A prescription or nonprescription medication may be accepted only in an original container. The medication shall remain in the container in which it was received. Medication shall be stored in accordance with the manufacturer's or health professional's instructions on the original label.

Observed 2/28/2024 Child #3 EPI Pen and Child #8 inhaler was not in its original container it was placed in a zipped locked bag without manufacture's or health professional's instructions on the original label.

Corrected Corrected by Feb 28, 2024

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

3270.135(b) · 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.

Observed 2/28/2024 in The Little Wonders classroom staff #4 did not sanitize or clean the changing table after diapering children.

Corrected Corrected by Feb 28, 2024

Category: health medication. 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.

Observed 2/28/2024 staff #3 and 5 file did not contain 12 clock hours of childcare training.

Corrected Corrected by Mar 7, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.32(a)/3270.192(4) · LACKING REQUIRED HIRING DOCUMENTS: Facility Person # 1 may not work in a child care position at the facility. 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 #1 may not work in a child care position at the facility.

Observed 7/11/2023 The file for staff # 1 not contain a completed DHS required FBI and NSOR clearance. The requirement to have the completed DHS required clearances on file was not met.

Corrected Corrected by Jul 12, 2023

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.

Observed 7/11/2023 staff # 1 medical assessment on file was dated for 6/23/2021, the medical assessment exceeded the 24-month of the signature date.

Corrected Corrected by Jul 12, 2023

Category: ratio. Marked corrected in the state record.

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

Observed 2/16/2023 Child # 1,2 5 and 6 file did not contain the date of the child's admissions on agreement form.

Corrected Corrected by Mar 2, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.124(b)(6) · Emergency contact information must include health insurance coverage and policy number for a child under a family policy or Medical Assistance benefits, if applicable.

Observed 2/16/2023 Child file #1 and 6 did not contain medical insurance coverage and policy numbers on their emergency contact form.

Corrected Corrected by Mar 2, 2023

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). PROVISIONAL HIRE UNSUPERVISED: A provisional employee may not be permitted to work alone with children and must work within the vicinity of a permanent employee. 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 #1,3,4,5 and 6 may not work in a child care position at the facility.

Observed 2/16/2023 The file of staff person #1 and4 does not contain the mandated reporter training. Staff #3 file did not contain FBI and State Police clearance, Staff #5 file did not contain NSOR clearance. Also observed staff #5 and 6 FBI clearance have not been completed within the 60 months. This is evidenced by the previously documented on file being dated 2-1-2018 (Staff #5) and 1-19-2018 (Staff #6).

Corrected Corrected by Mar 2, 2023

Category: supervision. Marked corrected in the state record.

3270.124(b)(7) · Emergency contact information must include the name, address and telephone number of the individual designated by the parent to whom the child may be released.

Observed 2/16/2023 children files # 1,2,3,4 emergency file did not contain the addresses and telephone numbers on emergency contact form.

Corrected Corrected by Mar 2, 2023

Category: recordkeeping. 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.

Observed 2/16/2023 children files # 3 and 4 did not contain an updated health report on file. Child # 3 last physical was 9-30-2021 and child #4 last physical was 11-17-2021.

Corrected Corrected by Mar 2, 2023

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

3270.151(a)/3270.151(c)(2) · 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. An adult health assessment must include tuberculosis screening by the Mantoux method at initial employment. Subsequent tuberculosis screening is not required unless directed by a physician, physician's assistant, CRNP, the Department of Health or a local health department.

Observed 2/16/2023 staff# 1 and 4 was missing a health assessment in their file. A health assessment conducted within 12 months prior to providing initial service in a childcare setting and every 24 months thereafter. Staff #1 &4 was missing a tuberculosis screening by the Mantoux method at initial employment.

Corrected Corrected by Mar 2, 2023

Category: ratio. Marked corrected in the state record.

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

Observed 2/16/2023 staff #4 file did not contain or include verification of childcare experience, education and training prior to service at the facility.

Corrected Corrected by Mar 2, 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.

Observed 2/16/2023 staff #4 file did not contain two written, nonfamily references from individuals attesting to the person's suitability to serve as a facility person.

Corrected Corrected by Mar 2, 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.

Observed 2/16/2023 Staff #7 was missing 5 hours from their annual 12 hours of childcare training.

Corrected Corrected by Mar 2, 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.

Observed 2/16/2023 child #6 file did not contain a health report on file.

Corrected Corrected by Mar 2, 2023

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