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.

Documentation that staff was free from communicable diseases was not available for staff #1 and #2. Documentation of the suitability to provide child care was not available for staff #1 and #2.

Corrected Corrected by Jan 9, 2026

Category: health medication. 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.

Two written, non-family references were not available for staff #1.

Corrected Corrected by Jan 8, 2026

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.

Documentation showed a fire detection system test conducted on 12/5/25 and again on 1/6/26, which exceeds the requirement that the fire system be tested at least every 30 days.

Corrected Corrected by Jan 15, 2026

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 #1 was observed to be caring for children unsupervised. According to CR observations and reports by the program, staff person #1 had not completed the following pre-service training required prior to caring for children unsupervised: Pediatric First Aid/CPR. Training completed 10/1/25, see LIS for Date of Hire.

Corrected Corrected by Oct 1, 2025

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. Facility Person #2 may not work in a child care position at the facility.

Documentation of a completed NSOR clearance at the time of initial employment was not available for Staff #2. NSOR clearance was obtained 9/26/25. Staff #2 is an aide and did not work alone with children.

Corrected Corrected by Sep 26, 2025

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

3270.64/3270.91(a) · Outside walkways shall be free from ice, snow, leaves, equipment and other hazards. Stairways, hallways, exits from rooms, exits from the facility and other means of egress serving as an exit shall be unobstructed.

During a fire drill, a hose was observed to be laid across the sidewalk directly outside of the emergency exit door. Approximately 5 portions of hose created a hinderance to the evacuation of the cribs. Corrected on site by moving the hose to the grass.

Corrected Corrected by Oct 7, 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.

Tweezers were not available in the first aid kit in the transitional kindergarten emergency bag. Corrected on site by adding tweezers to the first aid kit.

Corrected Corrected by Oct 7, 2025

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.

A portion of the window frame was missing from the window in transitional kindergarten room. Sharp surfaces were observed due to the missing frame. Corrected on site by covering the sharp area with several layers of tape. The windowsill in the transitional kindergarten was observed to have dust and a dead bug in the corners. Corrected on site by wiping the windowsill.

Corrected Corrected by Oct 7, 2025

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

3270.101(c)/3270.101(c)(2) · Play equipment and materials shall include the items specified at §3270.101(c)(1) - (6). Play equipment and materials shall include toys and materials for cognitive development.

An adequate number of books was not available in the DPS 1 classroom. Corrected on site by adding more books to the bookshelf.

Corrected Corrected by Oct 7, 2025

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.

The Lego table in the preschool classroom was observed to be soiled with remnants of what appeared to be playdough, dust, and dirt/crumbs.

Corrected Corrected by Oct 15, 2025

Category: physical safety. 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.

Documentation of enrolling parent's work address and phone number was not available for child #5.

Corrected Corrected by Oct 15, 2025

Category: recordkeeping. Marked corrected in the state record.

3270.124(b)(4)/3270.182(3) · Emergency contact information must include the written consent signed by a parent for emergency medical care. A child's record shall contain signed parental consent for emergency medical care for the child. Written consent is required prior to admission.

Documentation of written consent for emergency medical care at the time of enrollment was not available for child #3, child #4, and child #5.

Corrected Corrected by Oct 15, 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.

Emergency contact forms for 3 children were not available in the infant room. Corrected on site by adding the forms to the classroom.

Corrected Corrected by Oct 7, 2025

Category: recordkeeping. 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.

Documentation that emergency contact forms had been updated within 6 months was not available for child #2 and child #5. Documentation that financial agreements had been updated within 6 months was not available for child #1, child #2, and child #5.

Corrected Corrected by Oct 15, 2025

Category: recordkeeping. Marked corrected in the state record.

3270.131(b)(1)/3270.131(e) · The operator shall require the parent to provide an updated health report at least every 6 months for an infant or young toddler. 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.

Updated health assessment and immunization records were not available for child # 1. The child's last health assessment on file is dated 5/2/24 - the child's 18-month check-up.

Corrected Corrected by Oct 15, 2025

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.

Documentation that the child is free from communicable diseases and able to participate in child care was not available for child# 3.

Corrected Corrected by Oct 15, 2025

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.

Documentation showed staff #3 had a health assessment dated 9/22/25, which was greater than 24 months from the previous heath assessment dated 4/20/23. Documentation showed staff #4 had a health assessment dated 9/22/25, which was greater than 24 months from the previous heath assessment dated 8/23/23. Documentation showed staff #5 had a health assessment dated 8/20/24, which was greater than 24 months from the previous heath assessment dated 4/13/21.

Corrected Corrected by Sep 22, 2025

Category: ratio. Marked corrected in the state record.

3270.181(e) · If emergency information is updated in a master file, it shall be updated accordingly in other facility records.

Up-to-date emergency contact forms were not available for 3 children in the toddler room. Up-to-date emergency contact forms were not available for 7 children in the pre-K room

Corrected Corrected by Oct 15, 2025

Category: recordkeeping. Marked corrected in the state record.

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

Written consent for minor first aid was not available for child #2, child #3, child #4, and child #5.

Corrected Corrected by Oct 15, 2025

Category: ratio. Marked corrected in the state record.

3270.31(f)(10) · Staff persons shall complete professional development in the topic of pediatric first aid and pediatric cardiopulmonary resuscitation within 90 days of hire.

Staff person #2 had not completed the following required pre- service training within 90 days of their date of hire (see LIS code sheet for DOH): Pediatric first aid/CPR. CPR completed 10/1/25.

Corrected Corrected by Oct 1, 2025

Category: health medication. 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.

Initial health assessment documentation was not available for child #1 (first health assessment dated 5/2/24) and child #4 (first health assessment dated 3/12/25) - See LIS for dates of enrollment.

Corrected Corrected by Oct 15, 2025

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

3270.65 · Protective receptacle covers shall be placed in electrical outlets accessible to children 5 years of age or younger.

Outlet covers were observed to be missing from the outlets in the transitional kindergarten room. Corrected on site by installing outlet covers.

Corrected Corrected by Sep 12, 2025

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.

Trashcan lids were observed to be broken in the transitional kindergarten room and the preschool classroom.

Corrected Corrected by Oct 3, 2025

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

3270.182(7) · A child's record shall contain reports of accidents, injuries and illnesses involving a child in care at the facility. The original report shall be given to the parent on the day of the incident. The second copy of the report shall be retained at the facility in an accident file. The third copy of the report shall be retained at the facility in the child's file.

Documentation of an incident between two children was not available in the child files. Evidence that an incident report was provided to both parents at the time of the incident was not available.

Corrected Corrected by Oct 3, 2025

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

3270.183(b) · A facility person may not disclose information concerning a child or family, except in the course of inspections and investigations by agents of the Department.

An allergy list was observed to be posted on an outer cabinet door, making it visible to all. Corrected on site by moving it to the inside of the cabinet door.

Corrected Corrected by Sep 12, 2025

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

Provider reported that staff #1 was missing the NSOR clearance.

Corrected Corrected by Oct 3, 2025

Category: background checks. 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 #1 may not work in a child care position at the facility.

Staff #1 was noted to be working with children without complete out-of-state (FL & GA) background clearance checks on file. COS by removing staff from ratio.

Corrected Corrected by May 28, 2025

Category: ratio. 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.

Documentation available at the time of the visit showed fire detection systems testing had occurred on 3/4/25 and again on 4/24/25, exceeding the requirement that fire system testing occur every 30 days.

Corrected Corrected by May 15, 2025

Category: recordkeeping. Marked corrected in the state record.

3270.27(a)(3)/3270.27(a)(4) · The facility shall have an emergency plan that provides for a method for facility persons to contact parents as soon as reasonably possible when an emergency situation arises. The facility shall have an emergency plan that provides for a method for facility persons to inform parents that the emergency has ended and to provide instruction as to how parents can safely be reunited with their children.

The full written emergency plan was missing information on how parents will be contacted in the event an emergency situation arises, that an emergency has ended, and instructions for how to safely reunite with their children. The emergency plan parent letter was missing information on how to inform parents will be contacted in the event an emergency situation arises, that an emergency has ended, and instructions for how to safely reunite with their children.

Corrected Corrected by Mar 3, 2025

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

3270.35(d)/3270.35(e) · A director may not function as a group supervisor in a facility in which more than 45 children are enrolled. In a facility in which more than 45 children are enrolled, a group supervisor is required for the first group of 45 enrolled children and for each group or partial group of 45 additional enrolled children.

After file review, it was determined that the facility has 1 group supervisor and a director, but is missing a second group supervisor as is required based on enrollment.

Corrected Corrected by Apr 25, 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.

During the inspection, the door to the staff bathroom, located in a child bathroom was open. Cleaning sprays, perfume, and other cleaning products were accessible to children. CORRECTED ON SITE.

Corrected Corrected by Feb 3, 2025

Marked corrected in the state record.

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

During the inspection, a snake plant (Sansevieria) was observed in the infant room. This plant is toxic to children. CORRECTED ON SITE

Corrected Corrected by Feb 3, 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.

At the time of the inspection, it was observed that a working lidded trash can was not available in the child bathroom in the lobby area. CORRECTED ON SITE.

Corrected Corrected by Feb 3, 2025

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

3270.111(c)/3270.113(a) · 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. 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. Provider agrees to participate in technical assistance and support provided by the ELRC for a minimum of four visits. The topics for the technical assistance must include child supervision and engagement, classroom management, age-appropriate child development activities, and any other topics deemed appropriate by the ELRC staff during onsite observations.

During the observation and previous observations, children were observed climbing on shelves and tables, running around the classroom, throwing and dumping toys, while teachers swept the floor, changed diapers, and cleaned up after the children. Staff were not directing the activities of the children.

Corrected Corrected by Apr 30, 2025

Category: supervision. Marked corrected in the state record.

3270.192(2)(iv) · 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.

Staff #1 had a degree on file not recognized by the department. Foreign degree for staff #1 must be evaluated to determine the level of education staff #1 has completed.

Corrected Corrected by Mar 3, 2025

Category: recordkeeping. 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.

At the time of inspection, documentation that an emergency drill had occurred in the last 12 months was not available.

Corrected Corrected by Feb 5, 2025

Category: recordkeeping. Marked corrected in the state record.

3270.27(f) · The operator shall send a copy of the emergency plan and subsequent plan updates to the local municipality and to the county emergency management agency.

At the time of inspection, documentation showing that the emergency plan had been sent to the local municipality and to the county emergency management agency was not availalbe.

Corrected Corrected by Feb 17, 2025

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 on file showing that an emergency drill was conducted within the past 12 months.

Corrected Corrected by Dec 23, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.27(a)(3) · The facility shall have an emergency plan that provides for a method for facility persons to contact parents as soon as reasonably possible when an emergency situation arises.

The full written emergency plan and the emergency plan parent letter was missing information on how parents will be contacted in the event an emergency situation arises.

Corrected Corrected by Dec 23, 2024

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

3270.27(a)(4) · The facility shall have an emergency plan that provides for a method for facility persons to inform parents that the emergency has ended and to provide instruction as to how parents can safely be reunited with their children.

The full written emergency plan and the emergency plan parent letter was missing information on how to inform parents that an emergency has ended.

Corrected Corrected by Dec 23, 2024

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

3270.27(b) · The operator shall review the emergency plan at least annually and update the plan as needed. The operator shall document in writing each review and update of the emergency plan and kept on file at the facility.

Emergency plan on file was not updated to include location specific information. Emergency plan on file contained a template for specific locations to fill in location specific details, which were not completed in the written emergency plan on file.

Corrected Corrected by Dec 23, 2024

Category: recordkeeping. Marked corrected in the state record.

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

Staff #5, #7, #8, and #9 did not receive emergency plan training within 12 months of the previous training.

Corrected Corrected by Dec 23, 2024

Category: recordkeeping. 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.

Staff #6 had fire safety training dated 10/17/23 and updated on 11/1/24, which is greater than 12 months.

Corrected Corrected by Dec 23, 2024

Category: recordkeeping. 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 until 1/1/24 to complete the required training. Until such time as the required training has been completed, staff person #1 must be supervised, when interacting with children, by an AGS who has completed the required training related to this citation. If there are no staff available to supervise staff person #1, staff person #1 may not work in a child-care position at the facility

Staff #1 did not have the 1 hour health and safety update on file.

Corrected Corrected by Dec 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. Facility Person #3 may not work in a child care position at the facility.

Staff #3 had a state police clearance with "Pending" results, which is not accepted as a completed clearance. Staff #3 may not be on the facility premises until clearance is obtained and on file.

Corrected Corrected by Dec 23, 2024

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.

There was no staff evaluation on file for staff #3

Corrected Corrected by Dec 23, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.35(d)/3270.35(e) · A director may not function as a group supervisor in a facility in which more than 45 children are enrolled. In a facility in which more than 45 children are enrolled, a group supervisor is required for the first group of 45 enrolled children and for each group or partial group of 45 additional enrolled children.

After file review, it was determined that the facility has 1 group supervisor and a director, but is missing a second group supervisor as is required.

Corrected Corrected by Jan 15, 2025

Category: supervision. Marked corrected in the state record.

3270.65 · Protective receptacle covers shall be placed in electrical outlets accessible to children 5 years of age or younger.

In the DPS room, an outlet cover was observed to be missing on Christmas lights that were observed to be accessible to children. Corrected on Site. In the Preschool bathroom beside the School Aged Room, an outlet cover was observed to be missing.

Corrected Corrected by Dec 23, 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.

The first aid kid located in the infant room was observed to be missing tweezers.

Corrected Corrected by Dec 23, 2024

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 DPS room, a red bean bag was observed to be peeling and in disrepair.

Corrected Corrected by Dec 23, 2024

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.

In the Preschool room, a written plan of daily activities was observed to be missing.

Corrected Corrected by Dec 23, 2024

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).

Child #1 did not have a dated child service report on file. Child #3 was enrolled on 4/22/22 and had a child service report dated 10/17/24. Child #5 was enrolled on 6/12/22 and had a child service report dated 9/26/24 Child #8 was enrolled on 7/6/21 and had a child service report dated 9/25/24. All Child Service Reports listed above were not updated within 6 months.

Corrected Corrected by Dec 30, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.124(b)(4)/3270.182(3) · Emergency contact information must include the written consent signed by a parent for emergency medical care. A child's record shall contain signed parental consent for emergency medical care for the child. Written consent is required prior to admission.

Signed parental consent for emergency medical care was not on file for child #2 and #7

Corrected Corrected by Dec 30, 2024

Category: recordkeeping. 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.

Emergency contact form for child #1 was dated 4/9/24 and there was no update on file. Emergency contact form for child #3 was updated on 4/22/24 and again on 11/13/24, which is greater than 6 months. Emergency contact form for child #5 was updated on 4/17/24 and again on 11/12/24, which is greater than 6 months.

Corrected Corrected by Dec 30, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.131(b)(1) · The operator shall require the parent to provide an updated health report at least every 6 months for an infant or young toddler.

Child #1 had a health assessment dated 7/18/23 and updated on 4/23/24, which is greater than 6 months.

Corrected Corrected by Dec 30, 2024

Category: health medication. 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.

Child #3 had a health assessment dated 1/5/23 and updated 8/5/24

Corrected Corrected by Dec 30, 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.

Child #3 was enrolled on 4/22/22 and did not have record of immunizations until 1/5/23.

Corrected Corrected by Dec 30, 2024

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.

In the DPS room, staff #2 was observed to change a child's diaper and did not wash the child's hands after the diaper was changed.

Corrected Corrected by Dec 30, 2024

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.

Staff #3 had a health assessment dated 11/1/24, which was not updated within 24 months.

Corrected Corrected by Nov 1, 2024

Category: ratio. Marked corrected in the state record.

3270.151(c)(3) · An adult health assessment must include an examination for communicable diseases and the results of that examination.

Health assessment for staff #9 did not indicate results of any communicable diseases.

Corrected Corrected by Dec 30, 2024

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

3270.152 · A facility person shall wash his hands before meals and snacks, and after toileting and after diapering a child.

In the infant room, staff #1 was observed to give an infant a bottle prior to the staff washing their hands. Staff #1 did not wash hands before or after giving a bottle to the infant. In the DPS room, staff #2 was observed to change a child's diaper and did not wash their hands after the diaper was changed.

Corrected Corrected by Dec 30, 2024

Category: health medication. 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.

Agreement form for child #1 was dated 10/10/23 and updated 11/12/24, which is greater than 6 months. Child #3 was enrolled on 4/22/22 and the agreement was updated on 11/13/24 Agreement form for child #5 was updated on 4/17/24 and again on 11/12/24, which is greater than 6 months. Agreement form for child #8 was previously updated on 12/27/23 and updated again on 11/12/24, which is greater than 6 months.

Corrected Corrected by Dec 30, 2024

Category: recordkeeping. Marked corrected in the state record.

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

Child #2, #4, and #7 were missing signed parental consent to administer minor first aid procedures.

Corrected Corrected by Dec 30, 2024

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.

Staff #3, #4, #5, and #6 did not have hours of experience documented.

Corrected Corrected by Jan 15, 2025

Category: recordkeeping. Marked corrected in the state record.

3270.192(2)(iv) · 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.

Staff #1 had a degree on file not recognized by the department. Degree for staff #1 must be evaluated to determine the level of education staff #1 has completed. Staff #3 did not have record of education on file.

Corrected Corrected by Dec 30, 2024

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.

Fire detection testing was observed to be completed on 8/27/27 and again on 9/27/24, which is greater than 30 days.

Corrected Corrected by Dec 23, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.27(a)(2) · The facility shall have an emergency plan that provides for accommodations for evacuation of children from the facility building and evacuation of children to a location away from the facility premises. The evacuation routes and evacuation plans to exit the building may be the same as those required by §3270.94 (relating to fire drills).

The facilities full written emergency plan did not include written details on the plan to evacuate to an alternate location

Corrected Corrected by Dec 23, 2024

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

3270.27(f) · The operator shall send a copy of the emergency plan and subsequent plan updates to the local municipality and to the county emergency management agency.

Emergency plan on file was not sent to the county emergency management agency.

Corrected Corrected by Dec 23, 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.

Child #3 was enrolled on 4/22/22 and the earliest health assessment on file was dated 1/5/23.

Corrected Corrected by Dec 30, 2024

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

3270.166(2) · New foods shall be introduced to an infant only after consultation with the child's parent.

An infant was given the wrong type of food by staff. The infant was supposed to receive breast milk but was given a formula bottle by staff.

Corrected Corrected by Dec 30, 2024

Category: nutrition. 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 Preschool bathroom near the exit to the playground cleaning supplies were observed underneath a changing table with a broken cabinet lock, making the cleaning materials accessible to children. Corrected on site.

Corrected Corrected by Sep 6, 2024

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 bathroom near the exit to the outdoor playground, a changing table was observed with a dirty changing pad on it. Corrected on site.

Corrected Corrected by Sep 6, 2024

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.

In the preschool bathroom next to the exit to the outside playground, the front part of a heater was observed to be separated from the wall, leaving a gap.

Corrected Corrected by Sep 8, 2024

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

3270.25(b) · The operator shall post a copy of each inspection summary issued by the Department in a conspicuous location used by parents. The inspection summary shall remain posted until an agent of the Department verifies that each regulatory noncompliance item cited on the inspection summary has been corrected.

During a site visit, the previous inspection summary with outstanding violations was observed to be missing. Inspection Summary was not posted in a conspicuous location.

Corrected Corrected by Aug 12, 2024

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 and #2 may not be on the facility premises until all clearances are obtained and on file. 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 and 2 may not be on the facility premises until all clearances are obtained and on file.

Staff #1 was observed to be missing an NSOR clearance. It was also determined that staff #1 resided in Puerto Rico within the past 5 years and clearances were not on file. Staff #2 was observed to be missing an NSOR clearance. Staff #1 and #2 may not be on the facility premises until all clearances are obtained and on file.

Corrected Corrected by Jul 30, 2024

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 PreK room, sunscreen was observed to be accessible to children. Sunscreen was located in a cabinet with a door, however the door lock was broken, making the sunscreen accessible to children.

Corrected Corrected by Jul 30, 2024

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 PreK room, DPS room, and Preschool room, a closet door was observed to have a broken lock.

Corrected Corrected by Jul 30, 2024

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.

In the Preschool bathroom near the playground exit, a waste receptacle was observed to be missing a lid.

Corrected Corrected by Jul 30, 2024

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 # 1 may not be on premises 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 be on the premises at the facility.

Staff #1 had an out of state criminal clearance and out of state sex offender clearance on file, but was observed to be missing an out of state child abuse clearance. Facility person #1 may not be on facility premises until all required clearances are obtained.

Corrected Corrected by Jun 20, 2024

Category: background checks. 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 DPS classroom a large folding bookshelf was observed to be peeling and splintering. In the DPS classroom, a large cabinet near the sink was observed to have water damage. The shelf was observed to have peeling and cracking sides and the fiberboard was observed to be damp and deteriorating.

Corrected Corrected by May 24, 2024

Category: physical safety. 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 room, an open, unsecured staff purse was observed to be accessible to children.

Corrected Corrected by Apr 26, 2024

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

Disclosure statement on file for staff #2 was observed to be missing the date it was signed.

Corrected Corrected by Apr 29, 2024

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

3270.102(a)/3270.103 · 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. Toys and objects with a diameter of less than 1 inch, objects with removable parts that have a diameter of less than 1 inch, plastic bags and styrofoam objects may not be accessible to children who are still placing objects in their mouths.

In the infant room, a red and orange foam horseshoe block was observed to be in disrepair. Corners of the block were observed to be peeling, leaving foam exposed and accessible to children. In the Toddler B room, a red bean bag chair was observed to be ripped and in disrepair. Pieces of foam were observed to be coming out of the rip, accessible to children.

Corrected Corrected by Apr 26, 2024

Category: physical safety. 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.

Staff #2 was observed to be missing a valid health assessment on file.

Corrected Corrected by Apr 26, 2024

Category: ratio. Marked corrected in the state record.

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

Staff #1 was observed to be missing two written, nonfamily references from individuals attesting to the person's suitability to serve as a facility person.. Staff #2 was observed to be missing one written, nonfamily references from individuals attesting to the person's suitability to serve as a facility person. One reference was observed in the staff's file.

Corrected Corrected by Apr 29, 2024

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.

During a site visit on 3/8/24, it was determined that there was no record of fire detection testing and the facility was issued a citation. A follow up visit was conducted on 4/26/24 and the fire detection testing log was reviewed. Fire detection testing was documented as completed on 3/12/24 and was not updated, which shows that testing was not completed within 30 days.

Corrected Corrected by Apr 26, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.74 · The telephone number of the nearest hospital, police department, fire department, ambulance and poison control center shall be posted by each telephone in the facility.

In the Toddler A classroom, emergency telephone number were observed to be missing. In the DPS classroom, emergency telephone number were observed to be missing.

Corrected Corrected by Mar 18, 2024

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.

In the preschool bathroom located in the hallway, a light switch cover was observed to be cracked. In the preschool classroom, a ceiling tile was observed to be cracked and in disrepair. In the same room, a plastic cover to the ceiling lights by the door was observed to be cracked an have a hole in it.

Corrected Corrected by Mar 10, 2024

Category: physical safety. 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 infant room, a glider chair near the door was observed to have lose armrests, creating a pinch point for children.

Corrected Corrected by Mar 10, 2024

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.

17 children were observed to be in the Preschool bathroom at the same time during bathroom breaks. Children were observed sitting on the floor of the bathroom waiting their turn..

Corrected Corrected by Mar 9, 2024

Category: background checks. 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.

In the Toddler A room, an emergency transportation plan was observed to be missing.

Corrected Corrected by Mar 12, 2024

Category: transportation. Marked corrected in the state record.

3270.151(c)(2)/3270.192(3) · 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. 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.

Staff #1 did not have a TB test completed before initial employment.

Corrected Corrected by Mar 19, 2024

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

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

Staff #2 did not have 2 written, nonfamily references on file that attested to the staff's suitability to serve as a facility person.

Corrected Corrected by Mar 10, 2024

Category: recordkeeping. Marked corrected in the state record.

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

There was no record of fire drills completed at the facility.

Corrected Corrected by Mar 10, 2024

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 record of fire detection testing being completed at the facility.

Corrected Corrected by Mar 8, 2024

Category: recordkeeping. Marked corrected in the state record.

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

Facility did not have the notice of revocation posted in a conspicuous location.

Corrected Corrected by Mar 8, 2024

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 # 2 may not be on the facility premises.. 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 #2 may not be on the facility premises.

Staff person #2 was observed to be missing a Child Abuse clearance and an FBI clearance and was documented on a classroom tracking sheet as working in the Toddler B classroom on 9/18/23 from 7:23 AM- 12:07 PM and again from 1:05 PM until 4:14 PM. Staff #2 was documented as working in the Toddler B classroom on 9/19/23 from 8:42 AM until 9:25 AM. Staff #2 was documented in the Infant A classroom on 9/26/23 from 7:30 AM until 8:34 AM. Staff number 2 may not be on the facility premises until all clearances are received and on file.

Corrected Corrected by Oct 27, 2023

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

3270.34(a)/3270.34(a)(1) · A director is responsible for the general management of the facility, including the minimum duties described at §3270.34(a)(1) - (6). A director is responsible for administering finances, personnel, maintenance, meal planning and preparation and transportation. DIRECTED PLAN OF CORRECTION: The facility Director must send all new hire staff's files to the department for review prior to the staff working at the facility for a period of 90 days. Upon initial hire, the facility Director will send all CPSL documents, health assessment and TB screening, Verification of education and experience, and 2 written, nonfamily references. Once the files are reviewed and approved, the new staff will be permitted to work while being directly supervised in the facility. The facility Director will then be required to send documentation of completed Mandated Reporter training, completed Health and Safety training, completed Pediatric CPR/First Aid, and completed Emergency Plan training for all new hired staff within 90 days of the staff's start date.

Violation previously cited on inspection summary from 5/18/23 visit and directed plan was verified as not implemented during a site visit on 7/6/23. Violation cited again on 7/11/23 and directed plan was verified as not implemented on 9/27/23 during a site visit. Management was notified in person on 9/14/23 of the directed plan in place that requires all new hire files be sent to DHS for review prior to working. On 9/20/23 an email was sent informing management that staff #2 and staff #3 were not yet cleared to work in the classroom. In the email, management was told that staff #2 was missing a child abuse clearance, FBI clearance, verification of education and experience, a completed health assessment and 2 written nonfamily references. Management was told that staff #2 was not cleared to work in a classroom. In the same email to management on 9/20/23, management was informed that staff #3 was missing verification of education and experience and 2 written, nonfamily references. Management was told that staff #3 was not cleared to work in the classroom. During a site visit on 9/27/23, classroom tracking sheets, referred to by the organization as CSR forms, were reviewed. On the CSR dated 9/21/23 from the Toddler B classroom, Staff #3 is listed as working in the classroom from 2:30 PM until 6:05 PM. According to the form, staff #3 was unsupervised in the classroom from 5:12 PM until 6:05. On the CSR dated 9/26/23 from the infant A room, staff #2 was signed in as working in the classroom from 7:30 AM until 8:34 AM. On the CSR dated 9/19/23, staff #2 was signed in as working in the Toddler B room from 8:42 until 9:25. On 9/18/23 Staff number 2 was signed in as working in the Toddler B room from 7:23 AM until 12:07 PM and again from 1:05 PM until 4:14 PM.

Corrected Corrected by Jan 17, 2024

Category: supervision. 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.

File for staff #3 was missing verification of experience prior to the staff working in the classroom.

Corrected Corrected by Oct 27, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.192(2)(iv) · 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.

Staff #2 did not have verification of education on file prior to starting work in the classroom. Staff #3 did not have verification of education on file prior to working in the classroom.

Corrected Corrected by Oct 27, 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.

File for staff #3 did not contain 2 written, nonfamily references prior to the staff working in the classroom.

Corrected Corrected by Oct 27, 2023

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.

As previously cited on 5/4/23, Staff number 1 did not have a health assessment on file. Staff number 2 had a health report that indicated that the staff person has a communicable disease. No explanation of the communicable disease was provided and there was no updated health assessment on file.

Corrected Corrected by Aug 25, 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.

Staff number 2 did not have verification of education on file prior to employment.

Corrected Corrected by Aug 25, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.25(b) · The operator shall post a copy of each inspection summary issued by the Department in a conspicuous location used by parents. The inspection summary shall remain posted until an agent of the Department verifies that each regulatory noncompliance item cited on the inspection summary has been corrected.

Inspection Summaries were not observed to be posted in a conspicuous location. Inspection summary was observed to be located in a stack of papers on the director's desk.

Corrected Corrected by Oct 6, 2023

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.

File for staff #4 did not contain verification of experience.

Corrected Corrected by Oct 6, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.32(a)/3270.192(4) · The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). LACKING REQUIRED HIRING DOCUMENTS: Facility Person #2 and #4 may not be on the facility premises 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 #2 and #4 may not be on the facility premises until all CPSL documentation is obtained.

Staff #2 was observed to be working in the DPS classroom and the file for staff #2 was observed to be missing a completed child abuse clearance and receipt of application, completed FBI clearance and receipt of application, and a signed and dated disclosure statement. Staff #2 is not permitted on the facility premises until all clearances are obtained. Staff #4 was observed to be working in the Young Toddler 1 classroom. File for staff #4 did not contain a completed Child Abuse clearance or complete disclosure statement. Staff #4 is not permitted on the facility premises until all clearances are obtained.

Corrected Corrected by Jul 10, 2023

Category: supervision. Marked corrected in the state record.

3270.34(a)/3270.34(a)(1) · A director is responsible for the general management of the facility, including the minimum duties described at §3270.34(a)(1) - (6). A director is responsible for administering finances, personnel, maintenance, meal planning and preparation and transportation., DIRECTED PLAN OF CORRECTION: The facility Director must send all new hire staff's files to the department for review prior to the staff working at the facility for a period of 90 days. Upon initial hire, the facility Director will send all CPSL documents, health assessment and TB screening, Verification of education and experience, and 2 written, nonfamily references. Once the files are reviewed and approved, the new staff will be permitted to work while being directly supervised in the facility. The facility Director will then be required to send documentation of completed Mandated Reporter training, completed Health and Safety training, completed Pediatric CPR/First Aid, and completed Emergency Plan training for all new hired staff within 90 days of the staff's start date.

Violation previously cited on inspection summary from 5/18/23 visit and directed plan was verified as not implemented during a site visit on 7/6/23. Staff #1 was informed in person on 5/11/23, in writing on 5/16/23 and on a video call on 6/6/23, that a facility person may not be on the facility grounds if the provisional period has expired and the facility person is missing clearances. On 7/6/23 staff person #2 was observed in the DPS classroom and observed to be missing clearances. Staff #1 was informed on 5/11/23, 5/16/23, and 6/6/23 that new staff could not be on the facility grounds until all clearances were obtained. Directed plan of correction was issued to require facility to have all new hire staff files reviewed before permitting the staff to be in the classroom. On 7/6/23, staff #2 was observed working in the DPS room on the facility grounds and the file for staff #2 had not been reviewed by DHS prior to observing the staff working. Staff #2 was observed to be missing a completed FBI clearance, completed child abuse clearance, disclosure statement, health assessment, and TB screening upon onsite review of staff #2 file on 7/6/23. On 7/6/23, staff #4 was observed to be working in the Young Toddler 1 classroom. File for staff #4 was not reviewed by DHS before staff #4 was observed in a classroom. Onsite review of file for staff #4 resulted in the observation of a missing child abuse clearance, completed disclosure statement, missing health assessment and TB, and missing verification of experience.

Corrected Corrected by Oct 6, 2023

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.

In the Young Toddler 1 room, staff #3 reported that she did not have a primary care group. 12 children were observed in the room. One teacher listed a primary care group of 5 children, another teacher listed a primary care group of 4 children, leaving staff #3 with the remaining 3 children. Staff #3 did not know that she had an assigned care group of children and was not able to name the remaining 3 children in the classroom.

Corrected Corrected by Jul 6, 2023

Category: supervision. 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.

Staff #2 was observed to be missing a health assessment and TB screening. Health assessment and TB screening was not completed before initial employment. Staff #4 was observed to be missing a health assessment and TB screening. Health assessment and TB screening was not completed before initial employment.

Corrected Corrected by Oct 6, 2023

Category: ratio. Marked corrected in the state record.

3270.151(c)(2) · 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.

TB test on file for staff #4 was dated 6/3/22, which was not obtained within 12 months prior to employment. Staff #2 did not have a TB screening on file.

Corrected Corrected by Oct 6, 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). LACKING REQUIRED HIRING DOCUMENTS: Facility Person # 2 and 3 are not permitted on the facility premises 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 #2 and 3 are not permitted on the facility premises.

As previously cited on 5/11/23, staff #2 was observed in the facility. Staff #2 did not have a completed FBI clearance or completed NSOR clearance on file at the time of inspection. Staff #2 may not be on the facility premise until all clearances are obtained. Staff #3 did not have a completed disclosure statement on file. Disclosure statement on file was not signed, dated, or signed by a witness. Staff #3 may not be on the facility premises until disclosure statement is completed.

Corrected Corrected by Jun 21, 2023

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

3270.34(a)/3270.34(a)(1) · A director is responsible for the general management of the facility, including the minimum duties described at §3270.34(a)(1) - (6). A director is responsible for administering finances, personnel, maintenance, meal planning and preparation and transportation. DIRECTED PLAN OF CORRECTION: The facility Director must send all new hire staff's files to the department for review prior to the staff working at the facility. Upon initial hire, the facility Director will send all CPSL documents, health assessment and TB screening, Verification of education and experience, and 2 written, nonfamily references. Once the files are reviewed and approved, the new staff will be permitted to work while being directly supervised in the facility. The facility Director will then be required to send documentation of completed Mandated Reporter training, completed Health and Safety training, completed Pediatric CPR/First Aid, and completed Emergency Plan training for all new hired staff within 90 days of the staff's start date.

Staff #1 was informed in person on 5/11/23 and in writing on 5/16/23, that a facility person may not be on the facility grounds if the provisional period has expired and the facility person is missing clearances. On 5/11/23 and staff person #2 was observed to be missing clearances. Staff #1 was informed on 5/11/23 and 5/16/23 that staff #2 could not be on the facility grounds until all clearances were obtained. On 5/18/23, staff #2 was observed working in the kitchen on the facility grounds. Staff #2 was observed to be missing a completed FBI clearance and a completed NSOR clearance on 5/18/23.

Corrected Corrected by Sep 6, 2023

Category: supervision. Marked corrected in the state record.

3270.34(a)/3270.34(a)(1) · A director is responsible for the general management of the facility, including the minimum duties described at §3270.34(a)(1) - (6). A director is responsible for administering finances, personnel, maintenance, meal planning and preparation and transportation. DIRECTED PLAN OF CORRECTION: Facility Director and the District Leader will be required to attend the Existing Provider Orientation on 7/13/23.

Staff #1 was informed in person on 5/11/23 and in writing on 5/16/23, that a facility person may not be on the facility grounds if the provisional period has expired and the facility person is missing clearances. On 5/11/23 and staff person #2 was observed to be missing clearances. Staff #1 was informed on 5/11/23 and 5/16/23 that staff #2 could not be on the facility grounds until all clearances were obtained. On 5/18/23, staff #2 was observed working in the kitchen on the facility grounds. Staff #2 was observed to be missing a completed FBI clearance and a completed NSOR clearance on 5/18/23.

Corrected Corrected by Jul 13, 2023

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. Facility Person #1 and 2 may not work at the facility until completed clearances are on file.

Staff number 1 was observed working in a childcare position. File for staff number 1 was reviewed and was observed to be missing a child abuse clearance, FBI clearance, and NSOR clearance. Staff #1 may not work in the facility until all clearances are obtained. Management was notified on 5/16/23 that staff #1 may not work at the facility until clearances are obtained and on file. On 5/4/23 during an unannounced monitoring visit, staff #2 was observed working with children without a completed FBI clearance on file. Management was informed that staff #2 could not work in a childcare position until the clearance was obtained and on file. On 5/11/23, during an inspection, staff number 2 reported that she was a lead teacher working in the classroom in Toddler A and had been working in the classroom all week. Management was asked to show the FBI clearance for staff #2 and was not able to produce the FBI clearance on file for review. Staff #2 may not work at the facility until the FBI clearance is obtained and on file.

Corrected Corrected by May 19, 2023

Category: background checks. 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.

On the middle playground, Older Toddlers were observed playing in an area that contained loose mulch surfacing. A 2 year old child was observed putting mulch in the child's mouth while on the playground.

Corrected Corrected by May 19, 2023

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

3270.113(b) · A facility person may not use any form of physical punishment, including spanking a child.

Staff number 1 grabbed a child by the shirt collar and carried the child to a different area of the room after the child had hit another student.

Corrected Corrected by May 19, 2023

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. Until such time as the required pre-service trainings are completed, staff person #1 and #3 must be supervised, when interacting with children, by an (AGS, primary staff person, or family child care home staff person) who has completed the required training related to this citation. If there are no staff person(s) available to supervise staff person #1 and #3, staff person #1 and #3 may not work in a child-care position at the facility.

Staff #1 was observed caring for children unsupervised in the Preschool room. Staff #1 did not have health and safety training on file. Staff #2 was observed caring for children unsupervised in the Young Toddler 1 room. Staff #2 did not have completed mandated reporter training on file at the time of inspection. Mandated Reporter training was completed on 5.5.23. Staff #3 was observed caring for children unsupervised in the Young Toddler 2 room. Staff #3 did not have completed Mandated Reporter training on file. Mandated Reporter training was completed on 5.5.23

Corrected Corrected by May 19, 2023

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). Facility Person # 1,2,3 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 #1,2,3 may not work in a child care position at the facility.

Staff persons #1 was observed working unsupervised with children in the Preschool room. Staff number 1 did not have an FBI clearance on File. Staff #1 may not work in a child care position until the clearance is obtained. Staff person #2 was observed working unsupervised with children in the Young Toddler 1 room. Staff person #2 does not have an NSOR clearance on file. Staff person #2 did not have completed mandated reporter training on file at the time of inspection. Mandated Reporter training was completed on 5/5/23. Staff person number 2 may not work in a child care position until clearance is obtained. Staff person #3 was observed working in the Young Toddler 2 room unsupervised. Staff person #3 did not have a completed FBI clearance or completed state police ("Results Pending" status) clearance on file. Staff person #3 was missing completed Mandated Reporter training. Staff person #3 may not work in a child care position until clearances are obtained.

Corrected Corrected by Jun 8, 2023

Category: supervision. 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.

Staff #1, 2, and 3 did not have a completed health assessment or TB screening on file. Staff #1,2, and 3 were observed caring for children.

Corrected Corrected by May 19, 2023

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.

Staff person #1 was observed caring for 5 young toddlers unsupervised. Staff Person #1 did not have a completed state police clearance on file.

Corrected Corrected by May 19, 2023

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.

In the PreK room, staff were not assigned specific children for supervision. Staff were not able to name individual children in their specific supervision group when asked.

Corrected Corrected by May 19, 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.

In the Discovery Preschool Room (DPS), the CSR tracking sheet dated 4/19/23 indicated that from 7:35 AM until 9 AM, there was 1 staff in the classroom. At a head count check completed at 8:30 AM, 11 children were marked as being present and 1 teacher was listed as being present in the classroom. Two staff had initialed the column indicating that 11 children were in care at 8:30 AM, however one of the staff who had initialed the column is listed as signing out of the classroom at 7:35.

Corrected Corrected by May 19, 2023

Category: ratio. Marked corrected in the state record.

3270.31(e)(4)(i)/3270.31(f) · 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 within 90 days of hire as listed in subsections (f)1-10.

Pediatric CPR/First Aide for staff number 1 was dated 2/25/19 and not updated within 2 years. Pediatric CPR/First Aide for staff number 5 was dated 10/8/22, which was not within 90 days of hire. Pediatric CPR/First Aide for staff number 7 was dated 10/18/22, which was not within 90 days of hire. Pediatric CPR/First Aide for Staff number 9 was dated 10/18/22, which was not within 90 days of hire.

Corrected Corrected by Jan 25, 2023

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.

Staff person number 1 had a state police clearance dated 2/1/17 and updated on 11/30/22, FBI clearance dated 1/16/17 and updated 2/7/22, which are greater than 60 months. Staff person number 4 had an FBI clearance dated 10/21/22 and NSOR clearance dated 10/19/22, which was after the staff's start date. Staff Person number 8 had a receipt for the state police clearance but clearance was not on file. Updated on 12/20/22. Staff person number 9 had an NSOR clearance dated 4/12/22, FBI clearance dated 4/5/22, and a Child Abuse clearance dated 4/6/22, which were not completed before the staff's hire date.

Corrected Corrected by Jan 25, 2023

Category: background checks. 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.

In the infant room, the first aide kit was observed to be missing soap. In the Discovery Preschool Room, the first aid kid was observed to be missing Band-Aids.

Corrected Corrected by Jan 25, 2023

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

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

Date of admission was not listed on the agreement form for child number 4

Corrected Corrected by Jan 25, 2023

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.

In the infant room, a hole was observed in the ceiling tile near the vent. Window frames and window sills were observed to be dirty and dusty in the infant room. In the Young Toddler Room, a water spot was observed on the ceiling tile. In the Preschool room, window frames were observed to be dirty and dusty. In the PreK room, window frames were observed to be dirty and dusty. In the School Aged room, windows were observed to be dirty and dusty.

Corrected Corrected by Jan 25, 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.

In the Prek bathroom, handwashing signs were not posted.

Corrected Corrected by Jan 25, 2023

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 infant room, a rocking chair was observed with a torn seat cover, leaving a foam cushion exposed and within reach of children.

Corrected Corrected by Jan 25, 2023

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 Young Toddler room, it was observed that cots were not labeled. In the Discovery Preschool room, it was observed that cots were not labeled.

Corrected Corrected by Jan 25, 2023

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

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

Agreement form for child number 5 was not signed by the parent.

Corrected Corrected by Jan 25, 2023

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).

Child Service report was not on file for child 2, 3, 4, and 6. Child Service report was not dated and signed for child 7

Corrected Corrected by Jan 25, 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.

Emergency form for child 2 did not include the parent's home address. Emergency form for child 5 did not have the parents home address or work phone number

Corrected Corrected by Jan 25, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.124(b)(4) · Emergency contact information must include the written consent signed by a parent for emergency medical care.

Emergency contact form for child 3 did not include parental consent for emergency medical care

Corrected Corrected by Jan 25, 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.

Emergency contact form for child 3 did not include the address of release persons.

Corrected Corrected by Jan 25, 2023

Category: recordkeeping. 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.

Medication for child number 1 was observed to be expired. On 12/28/22, the medication was observed with an expiration date on 11/22/22.

Corrected Corrected by Jan 25, 2023

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.

Staff number 3 had a health assessment dated 11/3/19 and updated on 2/20/22, which is greater than 24 months. Staff number 4 had a health assessment dated 10/29/22 and a TB screening completed on 10/31/22, which was after the staff's start date. Staff number 8 had a health assessment dated 2/18/20 and renewed on 4/22/22, which is greater than 24 months.

Corrected Corrected by Jan 25, 2023

Category: ratio. Marked corrected in the state record.

3270.151(c)(2) · 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.

Staff number 6 had a health assessment dated 7/23/20, which was not completed within 12 months of hire. TB updated on 12/30/22.

Corrected Corrected by Jan 25, 2023

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

3270.151(c)(3) · An adult health assessment must include an examination for communicable diseases and the results of that examination.

Health Assessment for staff number 7 did not include an examination for communicable diseases and the results of that examination.

Corrected Corrected by Jan 25, 2023

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

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

Emergency contact form for child 3 did not include consent for minor first aide.

Corrected Corrected by Jan 25, 2023

Category: ratio. Marked corrected in the state record.

3270.192(2)(iv) · 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.

File for staff number 2 did not include documentation of education. File for staff number 8 did not include documentation of education.

Corrected Corrected by Jan 25, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.136(d) · A facility person who knows of a communicable disease for which 28 Pa. Code Chapter 27 (relating to communicable and noncommunicable diseases) requires reporting, or who knows of a group expression of an illness which may be of public concern, whether or not it is known to be of a communicable nature, shall report it promptly to the appropriate division of the Department of Health as specified in Chapter 27, or to a local department of health.

Multiple positive cases of the flu were present in the facility in December and the operator confirmed that she did not report positive cases of the flu to the Department of Health

Corrected Corrected by Jan 27, 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. Children must be supervised at all times. Director will be required to schedule and complete Existing Provider Orientation on October 6, 2022.

Staff #1 returned to the playground with 5 out of 6 children in her primary care group, leaving child #1 in the bathroom unsupervised for about 1 minute.

Corrected Corrected by Oct 6, 2022

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. Children must be supervised at all times.

Staff #1 returned to the playground with 5 out of 6 children in her primary care group, leaving child #1 in the bathroom unsupervised for about 1 minute.

Corrected Corrected by Jul 25, 2022

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 alleged that staff #1 returned to the playground with 5 out of 6 children in her primary care group, leaving child #1 in the bathroom unsupervised for about 1 minute.

Corrected Corrected by Jul 25, 2022

Category: supervision. Marked corrected in the state record.

3270.112 · Infants and toddlers shall be provided stimulation by being held, rocked, talked to, played with and carried.

Staff person #1 ignored infants when they cried.

Corrected Corrected by May 11, 2022

Category: recordkeeping. 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.

Staff person #1 put infants in a ball pit and was then witnessed being on her phone by other staff members, resulting in a lack of supervision.

Corrected Corrected by May 11, 2022

Category: supervision. Marked corrected in the state record.

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

Staff person #1 yelled and screamed at the infants.

Corrected Corrected by May 11, 2022

Category: recordkeeping. Marked corrected in the state record.

3270.166(5) · An infant 6 months of age or younger shall be held while being bottle fed.

Staff person #1 propped bottles up to feed young infants while the infants were laying on the floor in a "boppy."

Corrected Corrected by May 11, 2022

Category: recordkeeping. 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. 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.

Facility self-reported: On 4-1-2022 around 3:10PM, Child #1 (an older toddler) was left unsupervised by Staff #1 in the hallway for 5 minutes when the group transitioned to another classroom.

Corrected Corrected by Apr 1, 2022

Category: supervision. Marked corrected in the state record.

3270.113(a)/3270.113(a)(1) · Children must be supervised at all times. The legal entity must arrange for all facility staff to receive a minimum of two hours of training regarding supervision of children. The legal entity must receive DHS approval of the training content prior to scheduling the training. The training may not count toward the annual 12 hour training requirement. Documentation of completed training must be submitted to the regional office and kept on file at the facility.

Facility self-reported: On 4-1-2022 around 3:10PM, Child #1 (an older toddler) was left unsupervised by Staff #1 in the hallway for 5 minutes when the group transitioned to another classroom.

Corrected Corrected by Jun 30, 2022

Category: supervision. Marked corrected in the state record.

3270.113(a)/3270.113(a)(1) · Children must be supervised at all times. The legal entity must submit documentation in a format approved by DHS proving that the facility procedure for counting children is followed at all times e.g., a checklist. The legal entity will confirm continuing compliance by sending copies of the documentation to the Regional Office of Child Development and Early Learning on a weekly basis for a period of three months after DHS approves the documentation format.

Facility self-reported: On 4-1-2022 around 3:10PM, Child #1 (an older toddler) was left unsupervised by Staff #1 in the hallway for 5 minutes when the group transitioned to another classroom.

Corrected Corrected by Oct 13, 2022

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.

It was verified that on 02/23/22 staff #2 and #3 were left out of ratio with 13 children in an older toddler room .

Corrected Corrected by Apr 21, 2022

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. 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.

Child #1 was left unsupervised in the hallway, outside the school age classroom for 4 minutes.

Corrected Corrected by Apr 4, 2022

Category: supervision. Marked corrected in the state record.

3270.123(a)(4) · An agreement shall specify the child's arrival and departure times.

The fee agreement for child #2-#6 did not specify the child's arrival and departure times.

Corrected Corrected by Nov 12, 2021

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 emergency contact information for child #5 did not include the release persons address.

Corrected Corrected by Nov 15, 2021

Category: recordkeeping. Marked corrected in the state record.

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

The fee agreement for child #3 did not specify the fee amount to be charged.

Corrected Corrected by Nov 14, 2021

Category: recordkeeping. 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.

In the School Age room, it was observed that the Epi-Pen for Child #1 expired 4/2020.

Corrected Corrected by Nov 8, 2021

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

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

The file for child #2 did not contain an initial health assessment.

Corrected Corrected by Nov 15, 2021

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