3270.51/3270.52 · When children are grouped in similar age levels, the following maximum child group sizes and ratios of staff persons apply: Infants 1:4 with a maximum group size of 8; Young toddlers 1:5 with a maximum group size of 10; Older toddlers 1:6 with a maximum group size of 12; Preschool children 1:10 with a maximum group size of 20; Young school-age children 1:12 with a maximum group size of 24; Older school-age children 1:15 with a maximum group size of 30.

On 9/17/25 it was reported that the facility was out of ratio.

Corrected Corrected by Oct 10, 2025

Category: ratio. Marked corrected in the state record.

3270.113(a)(2) · The requirement for supervision on and off the facility premises includes compliance with the staff:child ratio requirements in §§ 3270.51--3270.55.

On 9/17/25 it was reported that the facility was out of ratio.

Corrected Corrected by Oct 10, 2025

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.

In the bathroom, a bottle of hairspray and saline eye solution labeled keep out of reach of children were observed in the unlocked medicine cabinet.

Corrected Corrected by Oct 20, 2025

Marked corrected in the state record.

3270.51/3270.113(a)(1) · When children are grouped in similar age levels, the following maximum child group sizes and ratios of staff persons apply: Infants 1:4 with a maximum group size of 8; Young toddlers 1:5 with a maximum group size of 10; Older toddlers 1:6 with a maximum group size of 12; Preschool children 1:10 with a maximum group size of 20; Young school-age children 1:12 with a maximum group size of 24; Older school-age children 1:15 with a maximum group size of 30. IF USING TIERED LIS: The required staff:child ratios must be maintained at all times. The legal entity must submit documentation in a format approved by DHS proving that the facility is maintaining the required staff:child ratios at all times. The legal entity will confirm continuing compliance by sending copies of the documentation to the -------- Region Office on a weekly basis for a period of three months after DHS approves the documentation format. 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 that Staff #1 took one child to the bathroom leaving her group of children. It was observed that Staff #2 had 12 preschool children in her group.

Corrected Corrected by Oct 20, 2025

Category: supervision. Marked corrected in the state record.

3270.75(d) · One first-aid kit per child care group must accompany children and facility persons on excursions from the facility. Each first aid kit taken on an excursion must contain a bottle of water in addition to the items specified at §3270.75(c).

A first aid kit was not observed when the children were in the outdoor play space.

Corrected Corrected by Oct 20, 2025

Category: health medication. 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.

In the green added on room, it was observed that there were cracked magnetic blocks.

Corrected Corrected by Oct 20, 2025

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

3270.124(d) · When children leave the facility on walking and riding excursions, emergency contact information specific to each child on the excursion shall accompany a staff person on the excursion.

It was observed that no documentation of emergency contact information was available in the outdoor play space.

Corrected Corrected by Oct 20, 2025

Category: recordkeeping. Marked corrected in the state record.

3270.124(c) · When children are in the facility, emergency contact information shall be present in a child care space for children receiving care in the space.

It was observed that the Emergency Contact information in the outdoor bag has not been updated for children receiving care in the space.

Corrected Corrected by Apr 21, 2025

Category: recordkeeping. 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.

The metal heating radiator located on the floor in the preschool room was observed not to have a cover exposing children in care to rough edges, sharp corners and pinch points.

Corrected Corrected by Apr 21, 2025

Category: health medication. 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.

In the facility restroom, spray air freshener and cleaning supplies were accessible to the children in the unlocked closet.

Corrected Corrected by Apr 21, 2025

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

3270.66(e) · Arts and crafts materials shall be nontoxic.

Shaving cream used for arts and crafts labeled "keep out of reach of children" was observed in the bathroom closet

Corrected Corrected by Apr 21, 2025

Marked corrected in the state record.

3270.75(d) · One first-aid kit per child care group must accompany children and facility persons on excursions from the facility. Each first aid kit taken on an excursion must contain a bottle of water in addition to the items specified at §3270.75(c).

The outdoor bag was observed not to contain a bottle of water.

Corrected Corrected by Apr 21, 2025

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

3270.124(b)(5) · Emergency contact information must include information on the child's special needs, as specified by the child's parent, physician, physician's assistant or CRNP, which is needed in an emergency situation.

The emergency contact form on file for Child #2 was observed not to list information on the child's special needs, as specified by the child's parent, physician, physician's assistant or CRNP, which is needed in an emergency situation.

Corrected Corrected by Apr 21, 2025

Category: health medication. 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.

The Emergency Contact form on file for Child #1 was observed to not contain the address of the individual designated by the parent to whom the child may be released.

Corrected Corrected by Apr 21, 2025

Category: recordkeeping. Marked corrected in the state record.

3270.131(d)(7) · A health report shall include a statement that the child is able to participate in child care and appears to be free from contagious or communicable disease.

The health assessment on file for Child #3 was observed not to have a statement that the child is able to participate in childcare and appears to be free from contagious or communicable disease.

Corrected Corrected by Apr 21, 2025

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

3270.134(a)/3270.152 · A staff person shall ensure that a child's hands are washed before meals and snacks, after toileting and after being diapered. A facility person shall wash his hands before meals and snacks, and after toileting and after diapering a child.

It was observed on the day of inspection that a staff member did not wash their hands or the infants' hands after diapering.

Corrected Corrected by Apr 21, 2025

Category: health medication. 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.

The facility fire drill log showed that the facility did not conduct fire drills every 60 days. This is evidenced by there being a gap of more than 60 days from 10/1/24 to 12/17/24.

Corrected Corrected by Apr 21, 2025

Category: recordkeeping. Marked corrected in the state record.

3270.124(b)(3) · Emergency contact information must include the home and work addresses and telephone numbers of the enrolling parent.

The files for children #1, #2 and #4 were observed to contain emergency contact forms that failed to include the home and work addresses and telephone numbers of the enrolling parent.

Corrected Corrected by Jun 14, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.124(b)(5) · Emergency contact information must include information on the child's special needs, as specified by the child's parent, physician, physician's assistant or CRNP, which is needed in an emergency situation.

The files for children #1, #2, #4 & #5 were observed to contain emergency contact forms that failed to include information on the child's special needs, as specified by the child's parent, physician, physician's assistant or CRNP, which is needed in an emergency situation.

Corrected Corrected by Jun 14, 2024

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.

The files for Children #1, #2, & #4 were observed to contain emergency contact forms that failed to include health insurance coverage and policy number for a child under a family policy or Medical Assistance benefits, if applicable.

Corrected Corrected by Jun 14, 2024

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

3270.71 · Hot water pipes and other sources of heat exceeding 110° F that are accessible to children shall be equipped with protective guards or shall be insulated to prevent direct contact.

The facility's Older Toddler room upstairs was observed to have a broken metal cover over the heating pipes exposing the hot pipes. The heater cover is located on the back wall on the same side as the stairway.

Corrected Corrected by Jun 14, 2024

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.

The facility was observed to have a first-aid kit in the Infant room that lacked tape.

Corrected Corrected by Jun 14, 2024

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.

The facility's Main room was observed to have a blue vinyl chair with two visible tears.

Corrected Corrected by Jun 14, 2024

Category: physical safety. 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.

The facility's Infant room was observed to have a refrigerator that lacked a thermometer.

Corrected Corrected by Jun 14, 2024

Category: nutrition. 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.

The facility's Dining Room was observed to lack a written plan of daily activities and routines, including a time for free play.

Corrected Corrected by Jun 14, 2024

Marked corrected in the state record.

3270.123(a) · An agreement shall be signed by the operator and the parent.

The file for child #2 was observed to lack an agreement form.

Corrected Corrected by Jun 14, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.123(a) · An agreement shall be signed by the operator and the parent.

The file for child #2 was observed to contain an agreement that lacked signatures of the operator and the parent. The file for child #4 was observed to contain an agreement that lacked a signature of the parent

Corrected Corrected by Jun 14, 2024

Category: recordkeeping. 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 files for Children #1, #2, #3, #4, & #5 were observed to lack 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 (Child Service Report).

Corrected Corrected by Jun 14, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.123(a)(6)/3270.182(2) · An agreement shall specify the date of the child's admission. A child's record shall contain the dates of application, admission and withdrawal of the child.

The file for child #3 was observed to contain an agreement that failed to specify the date of the child's admission.

Corrected Corrected by Jun 14, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.124(b)(1) · Emergency contact information must include the name and birth date of the child.

The file for Child #1 was observed to contain an emergency contact form that did not include the child's name.

Corrected Corrected by Jun 14, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.124(b)(2) · Emergency contact information must include the name, address and telephone number of the child's physician or source of medical care.

The files for children #2 & #4 were observed to contain and emergency contact form that did not include the name, address and telephone number of the child's physician or source of medical care.

Corrected Corrected by Jun 14, 2024

Category: health medication. 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.

The files for children #1, #2, #3, & #4 were observed to contain emergency contact forms that failed to include the name, address and telephone number of the individual designated by the parent to whom the child may be released.

Corrected Corrected by Jun 14, 2024

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.

The files for children #4 & #5 failed to contain documentation that the parent provided updated health reports at least every 12 months for an older toddler or preschool child. This was evidenced by Child #4's file containing only one health report dated 1/4/24 and the file for child #5 contained health reports dated 09/4/2019 and 4/25/23.

Corrected Corrected by Jun 14, 2024

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 #4 failed to contain documentation that the parent provided immunization record in accordance with the recommendations of the ACIP within 60 days following the first day of attendance at the facility. As evidenced by one immunization record dated 01/04/2024 present in the file.

Corrected Corrected by Jun 14, 2024

Category: health medication. 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.

The files for Staff #1, #2 and #3 were observed to lack verification of child care experience, education and training prior to service at the facility.

Corrected Corrected by Jun 14, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.95(a) · 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 facility was observed to have a Fire detection system testing log that indicated testing on 6/1/23 and again on 07/6/23 a period of more than 30 days.

Corrected Corrected by Jun 14, 2024

Category: physical safety. 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 #4 was observed to lack an initial health report no later than 60 days following the first day of attendance at the facility as evidenced by the lack of a health report present in the file. A child's record shall contain initial and subsequent health reports.

Corrected Corrected by Jun 14, 2024

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

3270.171(a) · An operator shall notify local traffic safety authorities annually in writing of the location of the facility and the program's use of pedestrian and vehicular routes around the child care facility.

The facility was observed to lack documentation of written notification at least annually to local traffic safety authority of the location of the facility and the program's use of pedestrian and vehicular routes around the child care facility. This is evidenced by the last written notification on file is dated 2021.

Corrected Corrected by Jun 14, 2024

Category: recordkeeping. 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.

2nd Citation previously cited on 09/18/2023. On 02/29/2024 Staff #1 and Staff #2 were observed caring for 13 napping pre-school aged children in the big room of the facility. Staff #2 named and identified 6 children as being in their group but did not utilize the hands-free method during the identification process. Staff person #1 also named and identified a group of 6 children, staff person #1 utilized the hand's free method. Neither staff person identified the 13th sleeping child as in their supervised group, leaving the child unassigned. This child's hands-free identification card was laying on the table. Staff Person #3 was observed caring for 4 sleeping older toddlers in the room at the top of the stairs. Staff person #3 was able to identify all 4 toddlers, but only had 3 hands free identification cards in her possession.

Corrected Corrected by Mar 12, 2024

Category: supervision. Marked corrected in the state record.

3270.51 · The operator will have the ratios posted in each childcare space and include the regulatory definitions of young and older toddler. A posting stating, "Children may not be left alone in any classroom" shall be posted in each measured childcare space.

**At approximately 9:50 a.m., CR observed in the larger room upstairs, staff #1 sitting in a glider chair, eating a bag of chips and staff #2 leaning against the far wall while child #1 a young toddler sat in a pack and play in the smaller room with the door closed. Child #1 was alone in the smaller room. Therefore, the child in the smaller room was not being properly supervised. From approximately 10:10 to 10:15, 6 of the 11 pre-school aged children located in the pre-school room downstairs were sitting at 2 tables on the far side of a partition wall which was pulled across the width of the room approximately halfway in the depth of the room while staff #3 was located in the front half of the room. Therefore, staff #3 could not properly supervise the children behind the partition.

Corrected Corrected by Nov 15, 2023

Category: supervision. Marked corrected in the state record.

3270.51 · When children are grouped in similar age levels, the following maximum child group sizes and ratios of staff persons apply: Infants 1:4 with a maximum group size of 8; Young toddlers 1:5 with a maximum group size of 10; Older toddlers 1:6 with a maximum group size of 12; Preschool children 1:10 with a maximum group size of 20; Young school-age children 1:12 with a maximum group size of 24; Older school-age children 1:15 with a maximum group size of 30.

*At approximately 9:50 a.m., CR observed in the larger room upstairs, staff #1 sitting in a glider chair, eating a bag of chips and staff #2 leaning against the far wall while child #1 a young toddler sat in a pack and play in the smaller room with the door closed. Child #1 was alone in the smaller room. Therefore, the child in the smaller room was not being properly supervised. From approximately 10:10 to 10:15, 6 of the 11 pre-school aged children located in the pre-school room downstairs were sitting at 2 tables on the far side of a partition wall which was pulled across the width of the room approximately halfway in the depth of the room while staff #3 was located in the front half of the room. Therefore, staff #3 could not properly supervise the children behind the partition.

Corrected Corrected by Nov 15, 2023

Category: supervision. Marked corrected in the state record.

3270.52 · When children are grouped in mixed age levels, the age of the youngest child in the group determines the staff:child ratio and maximum group size in accordance with the requirements in § 3270.51 (relating to similar age level).

*During an unannounced visit on 9-18-23, at approximately 9:50 a.m., observed staff #1 and staff #2 out of ratio in the upstairs childcare spaces due to the fact the following groups of children were present: staff #1 with 2 young toddlers and 3 old toddlers; Staff #2 with 4 young toddlers and 2 older toddlers in the larger room.

Corrected Corrected by Nov 15, 2023

Category: ratio. Marked corrected in the state record.

3270.135(e) · A staff person shall check a child's diaper at least every 2 hours and whenever the child indicates discomfort or exhibits behavior that suggests a soiled diaper. A staff person shall change a child's diaper when the diaper is soiled.

Based on conversation with staff, young and old toddlers are left in soaked or soiled diapers for more than 2 hours.

Corrected Corrected by Nov 15, 2023

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.

*At approximately 9:50 a.m., CR observed in the larger room upstairs, staff #1 sitting in a glider chair, eating a bag of chips and staff #2 leaning against the far wall while child #1 a young toddler sat in a pack and play in the smaller room with the door closed. Child #1 was alone in the smaller room. Therefore, the child in the smaller room was not being properly supervised. From approximately 10:10 to 10:15, 6 of the 11 pre-school aged children located in the pre-school room downstairs were sitting at 2 tables on the far side of a partition wall which was pulled across the width of the room approximately halfway in the depth of the room while staff #3 was located in the front half of the room. Therefore, staff #3 could not properly supervise the children behind the partition.

Corrected Corrected by Nov 15, 2023

Category: supervision. Marked corrected in the state record.

3270.113(a) · The Legal Entity will arrange for all staff employed by the facility at the time this POC is accepted to attend a minimum of 3 hours in person training on supervision conducted by ELRC Region 6 staff. The training must be approved by the Department prior to staff attending.

**At approximately 9:50 a.m., CR observed in the larger room upstairs, staff #1 sitting in a glider chair, eating a bag of chips and staff #2 leaning against the far wall while child #1 a young toddler sat in a pack and play in the smaller room with the door closed. Child #1 was alone in the smaller room. Therefore, the child in the smaller room was not being properly supervised. From approximately 10:10 to 10:15, 6 of the 11 pre-school aged children located in the pre-school room downstairs were sitting at 2 tables on the far side of a partition wall which was pulled across the width of the room approximately halfway in the depth of the room while staff #3 was located in the front half of the room. Therefore, staff #3 could not properly supervise the children behind the partition.

Corrected Corrected by Feb 28, 2024

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.

*At approximately 9:50 a.m., CR was in the larger room upstairs. CR observed 10 children in the larger room and 1 child in the smaller room. CR asked staff #1 and staff #2 to identify the children for whom they are responsible. Staff #1 named 5 toddlers: 1 young toddler and 4 older toddlers. Staff #2 named 6 toddlers: 4 young toddlers, 3 of them were in the larger room, but child #1 was alone in the smaller room and 2 older toddlers, both in the larger room. Both staff named child #2 and neither staff named child #3.

Corrected Corrected by Nov 15, 2023

Category: supervision. Marked corrected in the state record.

3270.113(a)(1) · The Legal Entity will arrange to have classroom monitoring visits within the facility during a period of 4 months by Start Up TA specialist from ELRC 6. The number of visits will be determined by the ELRC 6 staff after assessing the program and agreed upon by the provider and approved by the department.

**At approximately 9:50 a.m., CR was in the larger room upstairs. CR observed 10 children in the larger room and 1 child in the smaller room. CR asked staff #1 and staff #2 to identify the children for whom they are responsible. Staff #1 named 5 toddlers: 1 young toddler and 4 older toddlers. Staff #2 named 6 toddlers: 4 young toddlers, 3 of them were in the larger room, but child #1 was alone in the smaller room and 2 older toddlers, both in the larger room. Both staff named child #2 and neither staff named child #3.

Corrected Corrected by Nov 15, 2023

Marked corrected in the state record.

3270.113(a)(1) · The operator will develop and ensure all staff actively use a hands-free method to identify the children's names and ages assigned in their supervisory group.

***At approximately 9:50 a.m., CR was in the larger room upstairs. CR observed 10 children in the larger room and 1 child in the smaller room. CR asked staff #1 and staff #2 to identify the children for whom they are responsible. Staff #1 named 5 toddlers: 1 young toddler and 4 older toddlers. Staff #2 named 6 toddlers: 4 young toddlers, 3 of them were in the larger room, but child #1 was alone in the smaller room and 2 older toddlers, both in the larger room. Both staff named child #2 and neither staff named child #3.

Corrected Corrected by Nov 15, 2023

Category: supervision. Marked corrected in the state record.

3270.61(h) · The capacity established for an indoor space may not be exceeded.

*During an unannounced visit, cert rep observed 10 toddlers: 5 young toddlers and 5 older toddlers in the larger room located upstairs which has a capacity of 6; observed 5 toddlers: 2 young toddlers and 3 older toddlers in the smaller room located upstairs which has a capacity of 3. Based on conversation with staff, after 3:00 p.m., there are between 22 and 24 pre-school and young/old school aged children in the pre-school room which has a capacity of 14.

Corrected Corrected by Nov 15, 2023

Category: ratio. Marked corrected in the state record.

3270.61(h) · Postings of the capacity for each room will be present in all measured childcare spaces.

**During an unannounced visit, cert rep observed 10 toddlers: 5 young toddlers and 5 older toddlers in the larger room located upstairs which has a capacity of 6; observed 5 toddlers: 2 young toddlers and 3 older toddlers in the smaller room located upstairs which has a capacity of 3. Based on conversation with staff, after 3:00 p.m., there are between 22 and 24 pre-school and young/old school aged children in the pre-school room which has a capacity of 14.

Corrected Corrected by Nov 15, 2023

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.

The facility was observed to have an emergency plan that lacked a statement regarding continuity of operations. The file for staff person #5 was observed to lack verification of completing the Pennsylvania Health and Safety Update 2022 by December 30, 2022.

Corrected Corrected by Jul 20, 2023

Category: ratio. Marked corrected in the state record.

3270.51 · When children are grouped in similar age levels, the following maximum child group sizes and ratios of staff persons apply: Infants 1:4 with a maximum group size of 8; Young toddlers 1:5 with a maximum group size of 10; Older toddlers 1:6 with a maximum group size of 12; Preschool children 1:10 with a maximum group size of 20; Young school-age children 1:12 with a maximum group size of 24; Older school-age children 1:15 with a maximum group size of 30. IF USING TIERED LIS: The required staff:child ratios must be maintained at all times. The legal entity must submit documentation in a format approved by DHS proving that the facility is maintaining the required staff:child ratios at all times. The legal entity will confirm continuing compliance by sending copies of the documentation to the -------- Region Office on a weekly basis for a period of three months after DHS approves the documentation format.

On 5/16/2023 Staff person #2 was observed to be caring for 6 infants without another staff person present in the infant room.

Corrected Corrected by Jul 17, 2023

Category: ratio. Marked corrected in the state record.

3270.63 · If unsafe areas or conditions are in or near an outdoor play space, fencing or natural barriers are required to restrict children from those unsafe areas or conditions.

A former clothesline pole that was cut to ground level was observed to be rusty and protruding from the ground in the grassy area, above the swings in the outdoor play yard.

Corrected Corrected by Jul 17, 2023

Category: physical safety. 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.

Disinfectant wipes labeled keep out of reach of children, were observed to be stored in an unlocked cabinet under the sink in the upstairs bathroom in the older toddler room.

Corrected Corrected by Jun 30, 2023

Marked corrected in the state record.

3270.67(d) · Trash that has been contaminated by human secretions or excrement shall be contained in closed, plastic-lined receptacles.

The open (no lid) trash receptacle in the young toddler room was observed to contain soiled diapers.

Corrected Corrected by Jul 17, 2023

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

3270.75(a) · A first-aid kit shall be in a child care space.

The facility's young toddler room was observed to lack a first-aid kit.

Corrected Corrected by Jul 17, 2023

Category: physical safety. 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.

The chain link fence in the facility's outdoor play yard was observed to have bolt ends with sharp edges exposed.

Corrected Corrected by Jul 17, 2023

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.

The facility's Young Toddler room was observed to lack a written plan of daily activities and routines posted.

Corrected Corrected by Jul 17, 2023

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.

On 5/16/23, Staff person #1 was observed in the dining room with two infants providing them with a snack. Staff person #1 identified 4 infants as being in their care; stating that 2 of those infants were present in the dining room with them and 2 of the infants were in a separate room. Therefore, Staff person #1 was not physically present in the same room with all of the children assigned to them. On 5/16/23 Staff persons #1, #7 & #8 were observed supervising 16 older toddlers in the older toddler room. Collectively, Staff persons #1, #7 & #8 only identified 15 children leaving one older toddler not identified as being supervised by a staff person.

Corrected Corrected by Jul 17, 2023

Category: supervision. 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 files for children #1, #2, #3, #4 were observed to lack 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.

Corrected Corrected by Jul 20, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.124(b)(3) · Emergency contact information must include the home and work addresses and telephone numbers of the enrolling parent.

The file for Child #4 was observed to contain an emergency contact form that lacked work addresses and telephone numbers of the enrolling parent.

Corrected Corrected by Jul 20, 2023

Category: recordkeeping. 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.

The file for child #4 was observed to contain an emergency contact form that lacked the address and telephone number of the individual designated by the parent to whom the child may be released.

Corrected Corrected by Jul 20, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.124(c) · When children are in the facility, emergency contact information shall be present in a child care space for children receiving care in the space.

The facility's Young toddler room was observed to lack emergency contact information present during the time staff persons were providing child care in the young toddler room.

Corrected Corrected by Jul 20, 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 facility's young toddler room was observed to lack a written plan identifying the means of transporting a child to emergency care and staffing provisions in the event of an emergency displayed conspicuously.

Corrected Corrected by Jul 20, 2023

Category: transportation. Marked corrected in the state record.

3270.131(d)(4) · A health report shall include an assessment of an acute or chronic health problem or special need and recommendations for treatment or services, including information regarding abnormal results of screening tests for vision, hearing or lead poisoning.

The file for child #1 was observed to contain a health assessment that failed to include an assessment of an acute or chronic health problem or special need and recommendations for treatment or services, including information regarding abnormal results of screening tests for vision, hearing or lead poisoning.

Corrected Corrected by Jul 20, 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).

The immunization record on file for children #1 was observed to not be up to date with the recommended ACIP schedule.

Corrected Corrected by Jul 20, 2023

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

3270.131(d)(7) · A health report shall include a statement that the child is able to participate in child care and appears to be free from contagious or communicable disease.

The file for child #1 was observed to lack a health report that included a statement that the child is able to participate in child care.

Corrected Corrected by Jul 20, 2023

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

3270.131(d)(8) · A health report shall include a statement that age-appropriate screenings recommended by the American Academy of Pediatrics were conducted since the time of the previous health report required by this section.

The file for child #1 was observed to lack a health report that includes a statement that age-appropriate screenings recommended by the American Academy of Pediatrics were conducted since the time of the previous health report required by this section.

Corrected Corrected by Jul 20, 2023

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

3270.134(a) · A staff person shall ensure that a child's hands are washed before meals and snacks, after toileting and after being diapered.

On 5/16/2023 staff person #2 was observed diapering child #6, and failed to wash the child's hand after the diapering was complete. On 5/31/2023 staff person #1 was observed diapering child #5, and failed to wash the child's hands once the diapering was completed.

Corrected Corrected by Jul 20, 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 files for staff persons #3 and #5 were observed to lack a health assessment conducted within 24 months of the previous assessment. This is evidenced by health assessments present in the file for staff person #3 dated 07/08/2020 and 02/28/2023 a span of 31 months, and health assessments present in the file for staff person #5 dated 06/29/2020 and 05/08/2023 a span of 35 months.

Corrected Corrected by Jul 20, 2023

Category: ratio. Marked corrected in the state record.

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

Four bottles that lacked a label identifying which child the bottle belonged to were observed to be present in the facility's infant room.

Corrected Corrected by Jul 20, 2023

Marked corrected in the state record.

3270.61(h) · The capacity established for an indoor space may not be exceeded.

On 5-16-23 and on 5-31-23, the facility's infant room and older toddler rooms were observed to be exceeding the established capacity. On 5-16-23, staff person #2 and staff person #6 were observed providing childcare to 8 infants. On 5-31-23, staff person #1 And staff person #6 Were observed providing care to 7 infants in the infant room which has an established capacity of 6. On 5-16-23, staff person #1, staff person #7, and staff person #8 were observed providing care to 16 older toddlers in the older toddler room. On 5-31-23, Staff person #4 and staff person #7 were observed providing care to 8 older toddlers in the older toddler room which has an established capacity of 6.

Corrected Corrected by Jul 20, 2023

Category: ratio. Marked corrected in the state record.

3270.61(i) · The total number of children receiving child care services at the facility at any one time may not exceed the facility's maximum capacity.

On 5/16/2023 The facility was observed to be providing childcare services to 38 children at one time, and the facility's maximum capacity is 36.

Corrected Corrected by Jul 20, 2023

Category: ratio. Marked corrected in the state record.

3270.51 · When children are grouped in similar age levels, the following maximum child group sizes and ratios of staff persons apply: Infants 1:4 with a maximum group size of 8; Young toddlers 1:5 with a maximum group size of 10; Older toddlers 1:6 with a maximum group size of 12; Preschool children 1:10 with a maximum group size of 20; Young school-age children 1:12 with a maximum group size of 24; Older school-age children 1:15 with a maximum group size of 30. The required staff:child ratios must be maintained at all times.

Based on interviews with staff, it was disclosed that the facility is regularly out of ratio during lunch time and during staff breaks. On multiple occasions during the week of 10/31/2022 the facility was out of ratio due to one staff person being on vacation. Additionally, on 11/9/2022, multiple preschool aged children being cared for in the back-room addition, were observed leaving the classroom to use the restroom without the presence of a staff person. During interviews with staff, it was confirmed that this regularly occurs in this classroom.

Corrected Corrected by Feb 1, 2023

Category: ratio. Marked corrected in the state record.

3270.113(a)/3270.113(a)(1) · 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. Children must be supervised at all times.

On 11/9/2022, multiple preschool aged children being cared for in the back-room addition, were observed leaving the classroom to use the restroom without the presence of a staff person. During interviews with staff, it was confirmed that this regularly occurs in this classroom.

Corrected Corrected by Jan 23, 2023

Category: supervision. 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 file for staff person #1 was observed not to contain documentation of a health assessment being completed within 12 months of initial employment (See LIS Code Sheet). This is evidenced by the most recent health assessment on file being dated 05/13/2020.

Corrected Corrected by Jan 23, 2023

Category: ratio. 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 in the preschool room flooring damaged and peel up causing a tripping hazard.

Corrected Corrected by Jun 7, 2022

Category: physical safety. 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 infant/young toddler room Desitin diaper cream labeled for child #5 with an expiration date of 4/22.

Corrected Corrected by Jun 1, 2022

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). 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 of staff #1 lacked FBI clearances every 60 months due to the fact the FBI clearances on file were dated 7-15-21 and 8-24-15.

Corrected Corrected by Jun 7, 2022

Category: background checks. 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.

Observed in the large room upstairs, a green bin cracked on the side and top. Observed in the small room upstairs, 2 square and 1 triangle shaped broken Magnitiles.

Corrected Corrected by Jun 2, 2022

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.

Observed in the infant/young toddler room, a Cosco brand safari print pack and play labeled for child #6 with medium size holes on 2 side of the equipment; and a Cosco brand safari print pack and play label as #2 with a small hole on 1 side; and a Graco brand dots print pack and play labeled for child #1 with a small hole on the side. Observed in the small room upstairs, a Cosco brand pack and play with a large hole on the 1 side.

Corrected Corrected by Jun 6, 2022

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

3270.124(b)(2) · Emergency contact information must include the name, address and telephone number of the child's physician or source of medical care.

The file of child #1 lacked an emergency contact form with the telephone number of the child's physician or source of medical care. The file of child #2 lacked an emergency contact form with the address of the child's physician or source of medical care.

Corrected Corrected by Jun 7, 2022

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

3270.124(b)(3) · Emergency contact information must include the home and work addresses and telephone numbers of the enrolling parent.

The file of child #2 lacked an emergency contact form with the work address of the enrolling parent.

Corrected Corrected by Jun 7, 2022

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.

The file of child #3 lacked an emergency contact form with the health insurance policy number for a child under a family policy or Medical Assistance benefits, if applicable.

Corrected Corrected by Jun 7, 2022

Category: health medication. 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.

The file of child #1 lacked an emergency contact form with the address of the individual designated by the parent to whom the child may be released. The file of child #4 lacked an emergency contact form with the full, complete address of the individual designated by the parent to whom the child may be released.

Corrected Corrected by Jun 7, 2022

Category: recordkeeping. Marked corrected in the state record.

3270.133(6)/3270.133(7) · A parent shall provide written consent for administration of medication or a special diet. An operator is responsible to establish and maintain a medication log if prescription or nonprescription medication is administered.

Observed Ibuprofen for child #7 but no medication log or written parental consent to administer.

Corrected Corrected by Jun 6, 2022

Category: ratio. Marked corrected in the state record.

3270.166(1) · A written statement giving the formula and feeding schedule for an infant shall be obtained from the parent.

At the time of the inspection, there was no infant feeding schedule for child #1.

Corrected Corrected by Jun 9, 2022

Category: nutrition. Marked corrected in the state record.

3270.27(a)(5) · The facility shall have an emergency plan that provides for accommodations for infants, toddlers, children with disabilities, and children with chronic medical conditions.

The emergency plan lacked accommodations for infants and toddlers.

Corrected Corrected by Jun 7, 2022

Category: physical safety. 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.

There was no documentation of completing an emergency drill by 12-19-21. Furthermore, the director informed the cert rep no emergency plan drill has ever been conducted.

Corrected Corrected by Jun 7, 2022

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.

There was no documentation to show the smoke detection system has been tested every 30 days.

Corrected Corrected by Jun 7, 2022

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.

At the time of the inspection, there was no documentation of testing the smoke detection system every 30 days.

Corrected Corrected by Aug 2, 2021

Category: recordkeeping. Marked corrected in the state record.