3280.66(a) · Cleaning materials and other toxic materials shall be stored in an original labeled container or in a container that specifies the content. Toxics shall be kept in a locked area or in an area inaccessible to children, and shall be stored away from food, food preparation areas and child care spaces.

In the Living Room childcare space, observed disinfectant wipes on an end table. In the bathroom, which is used by the children, observed 2 bottles of Bath n Body spray, 2 adult bottles of hairspray. All items were labeled as, "Keep out of reach of children" and were accessible to the children. Cat food was observed on the changing table in the bathroom used by children.

Corrected Corrected by Nov 29, 2025

Category: ratio. Marked corrected in the state record.

3280.66(c) · Toxic plants are not permitted in a child care space.

In the living room child care space, observed a toxic Peace Lily and toxic Aloe Vera plant.

Corrected Corrected by Nov 29, 2025

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

3280.52(c) · When children are grouped in mixed age levels, the age of the youngest child in the group determines the staff:child ratio and maximum group size in accordance with the requirements at §3280.52(b).

Child #1 was unsupervised while outside the GCCH waiting for a school bus and while riding a school bus to the elementary school. The child is not yet enrolled in school.

Corrected Corrected by Jun 30, 2025

Category: supervision. Marked corrected in the state record.

3280.113(a) · Children on the facility premises and on facility excursions off the premises shall be supervised by a staff person at all times. Outdoor play space used by the facility is considered part of the facility premises. TIERED LIS: 1. Children must be supervised at all times. 2. The legal entity must arrange for all facility persons to receive a minimum of two hours of training regarding supervision of children. The legal entity must have DHS approval of the training content prior to scheduling the training. 3. The legal entity must maintain 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 maintaining copies of the documentation at the facility for review as necessary.

Child #1 was unsupervised while outside the GCCH waiting for and then while riding a school bus to the elementary school. The child is not yet enrolled in school.

Corrected Corrected by Jun 30, 2025

Category: supervision. Marked corrected in the state record.

3280.113(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.

Child #1 was unsupervised while outside the GCCH waiting for and then while riding a school bus to the elementary school. The child is not yet enrolled in school.

Corrected Corrected by Jun 30, 2025

Category: supervision. Marked corrected in the state record.

3280.14/3280.20 · A facility shall be operated in conformity with applicable Federal and State laws and regulations. State agencies whose regulations may relate to the operation of a facility include the Department of Environmental Resources, the Department of Labor and Industry, the Department of Health, the Department of Education and the Department of Transportation. Conditions at the facility may not pose a threat to the health or safety of the children.

The facility's Emergency plan did not have documentation for continuity of operations and specify the role for volunteers if applicable.

Corrected Corrected by May 30, 2025

Category: ratio. Marked corrected in the state record.

3280.32(a)/3280.192(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.

The Child Abuse clearance on file for Staff person #1 was observed to be greater than 60 months. This is evidenced by 3/2/2020.

Corrected Corrected by May 30, 2025

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

3280.66(a) · Cleaning materials and other toxic materials shall be stored in an original labeled container or in a container that specifies the content. Toxics shall be kept in a locked area or in an area inaccessible to children, and shall be stored away from food, food preparation areas and child care spaces.

In the facility restroom, toxics such as hair spray were accessible to the children on the shelf by the sink.

Corrected Corrected by May 10, 2024

Category: ratio. Marked corrected in the state record.

3280.66(c) · Toxic plants are not permitted in a child care space.

It was observed that the facility had Snake tail and Peace Lily plants accessible to children.

Corrected Corrected by May 10, 2024

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

3280.75(c)/3280.133(2) · A first-aid kit must contain the following: soap, an assortment of adhesive bandages, sterile gauze pads, tweezers, tape, scissors and disposable, nonporous gloves. A staff person shall administer a prescription medication only if written instructions are provided from the individual who prescribed the medicine. Instructions for administration contained on a prescription label are acceptable.

The facility's first-aid kit contained burn cream, Poison Ivy cream and Neosporin medicine not labeled for an individual and stated "Keep out of Reach of Children".

Corrected Corrected by May 13, 2024

Category: ratio. Marked corrected in the state record.

3280.103 · 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.

The outside porch of the facility was observed to have a broken planter container and plastic bags accessible to children.

Corrected Corrected by May 13, 2024

Marked corrected in the state record.

3280.118(c) · A veterinarian's certificate of current rabies immunization is required for a cat or dog at the facility. The certificate shall be on file when the cat or dog is present.

The facility's cat "Bubba" did not have documentation of a current rabies immunization on file.

Corrected Corrected by May 2, 2024

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

3280.123(a)(3) · An agreement shall specify 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 at § 3280.124(f).

It was observed that the file for Child #2, Child #3, Child #4, and Child #5 did not have documentation of a Child Service Report done every 6 months.

Corrected Corrected by May 2, 2024

Category: recordkeeping. Marked corrected in the state record.

3280.166(1) · A written statement giving the formula and feeding schedule for an infant shall be obtained from the parent.

The file for Child#1 did not contain documentation nor was it posted giving the formula and feeding schedule from the parent.

Corrected Corrected by May 2, 2024

Category: nutrition. Marked corrected in the state record.

3280.94(a)(5) · The primary staff person or designated staff person who is responsible for compliance with this chapter shall conduct fire drills and ensure that evacuation routes are posted in a conspicuous location on each floor of the facility.

It was observed that the evacuation routes were not posted in a conspicuous location on all levels of the facility

Corrected Corrected by May 2, 2024

Category: recordkeeping. Marked corrected in the state record.

3280.166(7) · Neither bottled formula nor human milk may be heated in a microwave.

It was observed that the bottle for Child #1 was heated in the microwave.

Corrected Corrected by May 2, 2024

Category: nutrition. Marked corrected in the state record.

3280.118(c) · A veterinarian's certificate of current rabies immunization is required for a cat or dog at the facility. The certificate shall be on file when the cat or dog is present.

The facility was observed to lack a veterinarian's certificate of current rabies immunization on file for pets Bella and Sophia.

Corrected Corrected by May 20, 2024

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

3280.123(a)(5) · An agreement shall specify the persons designated by a parent to whom the child may be released.

The files for children #1, #2 and #3 were observed to contain agreements that did not specify the persons designated by a parent to whom the child may be released.

Corrected Corrected by May 13, 2024

Category: recordkeeping. Marked corrected in the state record.

3280.26(d) · The operator shall post the emergency plan in the facility at a conspicuous location.

The facility was observed to lack a posting of the emergency plan in the facility at a conspicuous location.

Corrected Corrected by Jun 6, 2024

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

3280.26(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.

The facility was observed to lack evidence that the operator sent a copy of the emergency plan and subsequent plan updates to the local municipality and to the county emergency management agency.

Corrected Corrected by May 9, 2024

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

3280.91(a) · Stairways, hallways, exits from rooms, exits from the facility and other means of egress serving as an exit shall be unobstructed.

The access to the front door egress by the stairway upstairs was observed to be mostly obstructed by the storage of boxes and other items.

Corrected Corrected by May 10, 2024

Marked corrected in the state record.

3280.123(a)(6)/3280.182(2) · An agreement shall specify the date of the child's admission. A child's record must contain the dates of application, admission and withdrawal of the child.

The file for child #2 was observed to contain an agreement that did not specify the date of the child's admission.

Corrected Corrected by May 2, 2024

Category: recordkeeping. Marked corrected in the state record.

3280.124(e) · A written plan identifying the means of transporting a child to emergency care and staffing provisions in the event of an emergency shall be displayed conspicuously in every child care space and shall accompany a staff person who leaves on an excursion with children.

The facility was observed to lack a written plan identifying the means of transporting a child to emergency care and staffing provisions in the event of an emergency displayed conspicuously in any of their child care spaces.

Corrected Corrected by May 2, 2024

Category: transportation. Marked corrected in the state record.

3280.131(b)(1)/3280.182(1) · The operator shall require the parent to provide an updated health report at least every 6 months for an infant or young toddler. A child's record must contain initial and subsequent health reports.

The file for child #4 a young toddler when enrolled was observed to contain an initial health exam dated 1/27/2020 and the next health report is dated 9/18/2020 a period greater than 6 months.

Corrected Corrected by May 2, 2024

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

3280.131(b)(2) · The operator shall require the parent to provide an updated health report at least every 12 months for an older toddler or preschool child.

The file for child #4 a preschool aged child was observed to contain Health reports that were not obtained at least every 12 months for an older toddler or preschool aged child. This was evidenced by health reports dated 07/08/21 and 04/06/23 in the file.

Corrected Corrected by May 2, 2024

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

3280.192(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.

The file for staff person #1 was observed to lack acceptable verification of education.

Corrected Corrected by May 2, 2024

Category: recordkeeping. Marked corrected in the state record.

3280.26(a)(5) · The facility shall have an emergency plan that provides for accommodations for infants, toddlers, children with disabilities and children with chronic medical conditions.

The facility was observed to have an emergency plan that failed to include a statement regarding the accommodations for infants, toddlers, children with disabilities and children with chronic medical conditions during the emergency.

Corrected Corrected by May 2, 2024

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

3280.131(a)/3280.131(c) · 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 health report must be written and signed by a physician, physician's assistant or a CRNP. The signature must include the individual's professional title.

The file for child #1 was observed to contain a health report signed by a physician, physician's assistant or a CRNP, but failed to include a date.

Corrected Corrected by May 2, 2024

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

3280.62(a) · A facility shall provide outdoor or indoor play space to be used for large muscle activity which includes running, jumping, climbing and riding.

The side porch of the facility, which is reportedly used as a play space for infants, toddlers and preschoolers, was also being used as a storage space for items not related to childcare. These items were being stored in a way that allowed for limited walking paths on the side porch and also prohibited the children from being able to run, jump, climb or ride.

Corrected Corrected by Apr 20, 2023

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

3280.14/3280.20 · A facility shall be operated in conformity with applicable Federal and State laws and regulations. State agencies whose regulations may relate to the operation of a facility include the Department of Environmental Resources, the Department of Labor and Industry, the Department of Health, the Department of Education and the Department of Transportation. Conditions at the facility may not pose a threat to the health or safety of the children.

The facility's emergency plan lacked a continuity of operations plan for the aftermath of a disaster. The facility lacked a policy and procedure regarding shaken baby syndrome, abusive head trauma and child maltreatment including ways to cope with a crying and fussy child. The file for staff #2 lacks the one hour health and safety update.

Corrected Corrected by Apr 3, 2023

Category: ratio. Marked corrected in the state record.

3280.14/3280.20 · 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 a primary 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 person # 1 and 3 were observed to be caring for children unsupervised. Staff person #1 and 3 have not completed the following pre-service training required prior to caring for children unsupervised: Staff #1 - Pediatric CPR/FA with approved curriculum and approved PQUA instructor and acceptable Health and Safety training. Staff #3 - Pediatric CPR/FA with approved curriculum and approved PQUA instructor and Health and Safety training.

Corrected Corrected by Mar 23, 2023

Category: supervision. Marked corrected in the state record.

3280.20 · Conditions at the facility may not pose a threat to the health or safety of the children. All standing water will be removed the day of the request of this plan of correction.

There was standing water accessible to children in the following areas on the side porch which is reportedly used as a play space for infants, toddlers and preschoolers: in 2 water tables and one cooler. The TV in the Living Room was not secured and could be pulled over by the children.

Corrected Corrected by Mar 27, 2023

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

3280.26(c)/3280.192(2)(iii) · The operator shall assure that each facility person receives training regarding the emergency plan at the time of initial employment, on an annual basis and at the time of each plan update. The operator shall document the date of each training and the names of all facility persons who received the training. A facility person's record shall include verification of child care experience, education and training following the outset of service at the facility.

The file for staff #1 and 2 lack emergency plan training within the past year. Last emergency plan training was dated 2/2/22. The file for staff #3 lacks emergency plan training at initial hire. There is no emergency plan training on file.

Corrected Corrected by Mar 31, 2023

Category: recordkeeping. Marked corrected in the state record.

3280.31(e)/3280.192(2)(iii) · A staff person shall obtain an annual 12 clock hours of child care training. A facility person's record shall include verification of child care experience, education and training following the outset of service at the facility.

The file for staff #1 lacked 12 hours of childcare training from 12/19/21 - 12/19/22. The file for staff #2 lacked 12 hours of childcare training from 9/21/21 - 9/21/22.

Corrected Corrected by Apr 5, 2023

Category: recordkeeping. Marked corrected in the state record.

3280.32(a)/3280.192(4) · The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). A facility person's record shall include a copy of requests for the criminal history record and child abuse registry clearance information, a copy of the disclosure statement and a copy of the completed clearance information required under the CPSL.

The file for staff #4 lacked the most current required disclosure statement required under the CPSL on or before initial rehire date in a child care position.

Corrected Corrected by Mar 3, 2023

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

3280.33(c)/3280.192(2)(iii) · One or more facility persons competent in pediatric first aid and pediatric cardiopulmonary resuscitation techniques shall be at the facility when one or more children are in care. A facility person's record shall include verification of child care experience, education and training following the outset of service at the facility.

On 3/22/23, there was no one present at the facility who was competent in pediatric first aid and pediatric CPR while children were in care.

Corrected Corrected by Mar 3, 2023

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

3280.52(c) · When children are grouped in mixed age levels, the age of the youngest child in the group determines the staff:child ratio and maximum group size in accordance with the requirements at §3280.52(b).

On 3/22/2023, observed staff person #1 leave the Playroom at approximately 10:30 AM for approximately one minute to answer the door, leave the Playroom at 11:08 AM, 11:13 AM, 12:12 PM and 1:43 PM to walk into the kitchen for approximately 15 seconds. During these times, a staff was not physically present in the Playroom to supervise the children where 1 infant and 3 toddlers were in care. Ratio 0:4.

Corrected Corrected by Mar 31, 2023

Category: supervision. Marked corrected in the state record.

3280.66(a) · Cleaning materials and other toxic materials shall be stored in an original labeled container or in a container that specifies the content. Toxics shall be kept in a locked area or in an area inaccessible to children, and shall be stored away from food, food preparation areas and child care spaces. All toxic items will be made inaccessible to children the day this plan of correction is requested.

The following toxic items were observed to be on the side porch which is reportedly used as an outdoor play area for the infants, toddlers and preschoolers: toxic ice melt, a bottle of Oxyclean, a bottle of sunscreen, an open bag of Miracle Gro plant fertilizer, and a container of weed killer. All items were marked "Keep Out of Reach of Children" and were accessible to children on the side porch. There was a can of Rustoleum spray paint accessible to children on top of a bin in the back yard.

Corrected Corrected by Mar 27, 2023

Category: ratio. Marked corrected in the state record.

3280.66(a) · Cleaning materials and other toxic materials shall be stored in an original labeled container or in a container that specifies the content. Toxics shall be kept in a locked area or in an area inaccessible to children, and shall be stored away from food, food preparation areas and child care spaces.

In the Mud Room childcare space, observed disinfectant wipes and Lysol spray. In the Living Room childcare space, observed disinfectant wipes on an end table. In the bathroom, which is used by the children, observed 2 bottles of Bath n Body spray, 2 adult bottles of deodorant and adult toothpaste. All items were labeled as, "Keep out of reach of children" and were accessible to the children.

Corrected Corrected by Mar 23, 2023

Category: ratio. Marked corrected in the state record.

3280.66(c) · Toxic plants are not permitted in a child care space.

In the living room child care space, observed a toxic Peach Lily and toxic Aloe Vera plant.

Corrected Corrected by Apr 3, 2023

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

3280.76 · Floors, walls, ceilings and other surfaces, including the facility's outdoor play space surfaces shall be kept clean, in good repair and free from visible hazards.

The following unsafe conditions and/or hazards were observed on the side porch which is reportedly used as an outdoor play area for the infants, toddler and preschoolers: there was a tall blue container containing ice melter that wobbled when touched posing a hazard to the children if it were to tip over; two tall solar floor lamps with glass shades and 1 tall lamp post being stored on the side porch that could be easily tipped over; there were multiple clay pots (some filled with dirt) being stored on the ledge of the railing to the side porch that posed a hazard if the children were to pull it over on themselves; a propane tank; 3 large bird feeders stored on the floor of the side porch which could easily be tipped over; decorative lanterns with glass panels were being stored on the ledge of the railing that could easily be pulled down; a gas grill; a car seat was being stored on top of the gas grill that could easily be pulled down; an unplugged portable space heater was leaning against a rusty metal garbage can; the lid to a storage bin being stored on the floor on which there was a brownish green substance; broken pieces of a ceiling fan being stored on bench; multiple plastic bags being stored on a bench; a crutch being stored on a bench; several wire hanging baskets being stored on a bench; and there was a metal street sign with sharp edges protruding into the side porch play area from the side yard. All of the unsafe conditions and/or hazards were accessible to the children on the side porch. The following unsafe conditions and/or hazards were observed in the back yard which is reportedly used as a play space for the school aged children: A rusty bird cage; a rusty garden hoe laying on the ground; a rusty pitch fork laying on the ground; a rusty shovel laying on the ground; a rusty metal hook used to hang decorations laying on the ground; multiple cracked clay pots on the ground; a rusty 5 gallon bucket sitting on the ground; a metal garbage can filled with empty beer cans; there were large areas of the back yard that contained jaggerbushes that were covered with sharp thorns

Corrected Corrected by Mar 3, 2023

Category: ratio. Marked corrected in the state record.

3280.76 · Floors, walls, ceilings and other surfaces, including the facility's outdoor play space surfaces, shall be kept clean, in good repair and free from visible hazards. The cooler containing multiple beer cans; the box of materials used for fishing that contained sharp fish hooks; the 5 wooden boards stacked on top of one another being stored on the ledge of the railing to the side porch on which there were sharp edges of 3 screws protruding from one of the boards will be removed from the side porch and made in accessible to children within 5 days of the request for plan of correction of this citation. The metal sheets with sharp edges accessible to children under the deck which surrounds the above ground pool and the rusty metal burn bin will be removed from the back yard and made inaccessible to children within 5 days of the request for plan of correction of this citation. A barrier to prevent the children from accessing the crawl space under the deck that surrounds the pool will be installed within 7 days of the request of plan of correction for this citation.

The following unsafe conditions and/or hazards were observed on the side porch which is reportedly used as an outdoor play area for the infants, toddler and preschoolers: a cooler containing multiple beer cans; a box of materials used for fishing that contained sharp fish hooks; there were 5 wooden boards stacked on top of one another being stored on the ledge of the railing to the side porch on which there were sharp edges of 3 screws protruding from one of the boards. The following unsafe conditions and/or hazards were observed in the back yard which is reportedly used as a play space for the school aged children: there were metal sheets with sharp edges accessible to children under the deck which surrounds the above ground pool; there was no barrier to prevent the children from accessing the crawl space under the deck that surrounds the pool; and a rusty metal burn bin.

Corrected Corrected by Apr 1, 2023

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

3280.77(a) · Peeled or damaged paint or damaged plaster is not permitted on indoor or outdoor surfaces in the child care facility.

There was peeling and chipping paint on a metal garbage can and a wooden bench that were observed to be on the side porch play space. The brown wooden post attached to a bird feeder in the back yard had multiple areas of peeling and chipping paint. There were multiple areas of chipped paint on the window ledge of a window on the side of the house accessible to children in the back yard

Corrected Corrected by Apr 23, 2023

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

3280.91(a) · Stairways, hallways, exits from rooms, exits from the facility and other means of egress serving as an exit shall be unobstructed.

Observed that the bathroom door, which leads to the laundry room, was obstructed by rest mats and a large bag of diapers. Observed that the Mud Room door, which leads to the laundry room, was obstructed by boxes of supplies.

Corrected Corrected by Mar 31, 2023

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

3280.102(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.

There was a red and yellow play equipment boat on the side porch that was covered in dirt and leaves. There was a gray toy bin on which there was a crack on the lid on the side porch posing a pinch point. There was plastic play house behind the pool on which half of the roof was collapsed. There was a Little Tikes piece of tan and pink play equipment behind the pool that was covered in thorny jaggerbushes.

Corrected Corrected by May 20, 2023

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

3280.103 · 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. The open bag of bird seed will be made inaccessible the day of the requested of this plan of correction.

There was an open bag of bird food on the floor of the side porch that contained seeds that were less than one inch in diameter. The bag was accessible to children who are still placing items in their mouths.

Corrected Corrected by Mar 27, 2023

Category: nutrition. Marked corrected in the state record.

3280.113(a) · Children on the facility premises and on facility excursions off the premises shall be supervised by a staff person at all times. Outdoor play space used by the facility is considered part of the facility premises.

On 3/22/2023, observed staff person #1 leave the Playroom at approximately 10:30 AM for approximately one minute to answer the door, leave the Playroom at 11:08 AM, 11:13 AM, 12:12 PM and 1:43 PM to walk into the kitchen for approximately 15 seconds. During these times, a staff was not physically present in the Playroom to supervise the children where 1 infant and 3 toddlers were in care.

Corrected Corrected by Jun 2, 2023

Category: supervision. Marked corrected in the state record.

3280.113(a)(1) · Each staff person shall be assigned the responsibility for supervision of specific children. The staff person shall know the names and whereabouts of the children in his assigned group. The staff person shall be physically present with the children in his group on the facility premises and on facility excursions off the facility premises.

On 3/22/2023, observed staff person #1 leave the Playroom at approximately 10:30 AM for approximately one minute to answer the door, leave the Playroom at 11:08 AM, 11:13 AM, 12:12 PM and 1:43 PM to walk into the kitchen for approximately 15 seconds. During these times, a staff was not physically present in the Playroom to supervise the children where 1 infant and 3 toddlers were in care.

Corrected Corrected by Mar 30, 2023

Category: supervision. Marked corrected in the state record.

3280.114 · Weather permitting, children shall be taken out doors daily.

Based on a conversation with the operator, the children have not gone outside daily, weather permitting, during the winter of 2022/2023.

Corrected Corrected by May 30, 2023

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

3280.115(a)(3) · An aboveground swimming pool which is not in use must be made inaccessible to children in accordance with the swimming pool barrier guidelines of the United States Consumer Product Safety Commission. The above ground swimming pool will be made inaccessible to children within 7 days of the date this plan of correction is requested.

The gate to the wooden deck that partially surrounds the above ground swimming pool in the back yard was open allowing the pool to be accessible to the children. The operator reported that school age children use the back yard as their outdoor play space. It was observed that the gate to the wooden deck that partially surrounds the above ground swimming pool was not self-closing or self-latching in accordance with the swimming pool barrier guidelines of the United States Consumer Product Safety Commission. The top of the gate attached to the wooden fence that partially surrounds the above ground pool measured 38 inches above grade. In accordance with the swimming pool barrier guidelines of the United States Consumer Product Safety Commission, the top of the pool barrier should be at least 48 inches above grade. The top of the gate that leads from the side porch to the backyard where the above ground pool is located measured 38 1/2 inches above grade. In accordance with the swimming pool barrier guidelines of the United States Consumer Product Safety Commission, the top of the pool barrier should be at least 48 inches above grade. The opening between the post of the fence that partially surrounds the above ground pool and the pool itself measured 10 1/2 inches. In accordance with the swimming pool barrier guidelines of the United States Consumer Product Safety Commission, all openings should be small enough so that a 4 inch diameter sphere cannot pass through. The top of the wooden fence that partially surrounded the above ground pool measured 44 inches above grade. In accordance with the swimming pool barrier guidelines of the United States Consumer Product Safety Commission, the top of the pool barrier should be at least 48 inches above grade.

Corrected Corrected by Apr 2, 2023

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

3280.123(a)(1)/3280.123(a)(4) · An agreement shall specify the amount of the fee to be charged per day or per week. An agreement shall specify the child's arrival and departure times.

The most current fee agreement on file for child #1 lacked the fee amount to be charged. The most current fee agreement on file for child #2 lacked the fee amount to be charged and the child's arrival and departure time.

Corrected Corrected by Apr 5, 2023

Category: recordkeeping. Marked corrected in the state record.

3280.123(a)(3) · An agreement shall specify 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 at § 3280.124(f).

The files for children #1, 2, 3, 4 and 5 lack a child service report which has been completed within the past 6 months.

Corrected Corrected by Apr 3, 2023

Category: recordkeeping. Marked corrected in the state record.

3280.123(a)(6) · An agreement shall specify the date of the child's admission.

The most current fee agreement on file for child #1 lacks the date of the child's admission.

Corrected Corrected by Apr 5, 2023

Category: recordkeeping. Marked corrected in the state record.

3280.123(b)/3280.182(8) · A parent shall receive the original agreement. The facility shall retain a copy of the agreement. A child's record must contain a copy of the initial agreement and subsequent written agreements between the parent and the operator. The parent receives the original agreement.

The fee agreements on file for children #1, 2, 3, 4 and 5 were the originals. Therefore, the original was not provided to the parent.

Corrected Corrected by Apr 5, 2023

Category: recordkeeping. Marked corrected in the state record.

3280.124(e) · A written plan identifying the means of transporting a child to emergency care and staffing provisions in the event of an emergency shall be displayed conspicuously in every child care space and shall accompany a staff person who leaves on an excursion with children.

The Living Room, Play Room and Mud Room lacked a conspicuously displayed medical emergency transportation plan.

Corrected Corrected by Apr 5, 2023

Category: transportation. Marked corrected in the state record.

3280.131(c)/3280.182(1) · A health report must be written and signed by a physician, physician's assistant or a CRNP. The signature must include the individual's professional title. A child's record must contain initial and subsequent health reports.

The initial health assessment on file for child #2 lacked a signature by a physician, physician's assistant or CRNP.

Corrected Corrected by Mar 5, 2023

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

3280.131(d)(5)/3280.131(e)(3) · Child #1 must be dismissed from care by close of business on 3/22/23 and may only return to care when one of the two criteria below have been met: · Child's immunization records are updated according to ACIP recommended schedule. · Parent provides a written, signed letter, exempting the child from the immunizations A health report shall include a review of the child's immunized status according to recommendations of the ACIP. The facility shall implement dismissal policies in accordance with the Department of Health regulation in 28 Pa. Code § 27.77 (relating to immunization requirements for children in child care group settings).

The file for child #1 lacked verification of a flu shot within the past year as in accordance with the schedule recommended by the ACIP. There was no exemption from parent on file.

Corrected Corrected by Mar 22, 2023

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

3280.131(d)(7)/3280.182(1) · 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. A child's record must contain initial and subsequent health reports.

The health report on file for child #2 lacked a statement that the child is able to participate in childcare and appears to be free from contagious or communicable disease.

Corrected Corrected by Apr 5, 2023

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

3280.133(3) · The label of a medication container shall identify the name of the medication and the name of the child for whom the medication is intended. Medication shall be administered to only the child whose name appears on the container.

In the bathroom, observed medicated Caldesene and Aquaphor. In the first aid kit, observed Neosporin. All lacked the name of the person for whom the medication was intended.

Corrected Corrected by Mar 5, 2023

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

3280.133(4) · Medication shall be stored in a locked area of the facility or in an area that is out of the reach of children.

In the bathroom, observed medicated Caldesene and Aquaphor which were accessible to the children.

Corrected Corrected by Mar 5, 2023

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

3280.95(a)/3280.95(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 primary staff person or designated staff person who is responsible for compliance with this chapter shall ensure the requirements in subsection (a) are met.

Proof of purchase of the facility's fire detectors was not located in the facility file on the day of inspection.

Corrected Corrected by Mar 31, 2023

Category: recordkeeping. Marked corrected in the state record.

3280.31(f) · Staff person(s) shall complete professional development in the topics of 3280.31(f) (1-10) within 90 days of hire. Staff person #1, 2 and 3 will have 15 days from POC requested date to complete the required training. Until such time as the required training has been completed, staff person #1, 2 and 3 must be supervised, when interacting with children, by a primary staff person who has completed the required training related to this citation. If there are no staff available to supervise staff person #1, 2 and 3 staff person #1, 2, and 3 may not work in a child-care position at the facility.

Staff persons #1, 2 and 3 have not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): Staff #1 - Pediatric CPR/FA with PQUA instructor and approved curriculum and Health and Safety training. Current Health and Safety training was the 6 hours training and dated 11/9/2018. 6 hour training acceptable from 9/30/16-6/30/18. Staff #2 - Pediatric CPR/FA with PQUA instructor and approved curriculum. Staff #3 - Pediatric CPR/FA with PQUA approved instructor and approved curriculum and health and safety training.

Corrected Corrected by Mar 23, 2023

Category: supervision. Marked corrected in the state record.

3280.131(a)/3280.182(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 must contain initial and subsequent health reports.

The initial health assessment on file for child #2 did not contain a date. Therefore, there was no way to assess if the health assessment was provided within 60 days of start date.

Corrected Corrected by Apr 5, 2023

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

3280.103 · 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.

Observed a pillow case labeled for child #5 with torn and shredded plastic.

Corrected Corrected by Mar 24, 2022

Marked corrected in the state record.

3280.124(b)(3) · Emergency contact information must include the home and work addresses and telephone numbers of the enrolling parent.

The file of child #2 lacked an emergency contact form with the home and work addresses and telephone numbers of the enrolling parent.

Corrected Corrected by Mar 24, 2022

Category: recordkeeping. Marked corrected in the state record.

3280.124(b)(7) · Emergency contact information must include the name, address and telephone number of the individual designated by the parent to whom the child may be released.

The file of child #2 lacked an emergency contact form with address of the individual designated by the parent to whom the child may be released.

Corrected Corrected by Mar 24, 2022

Category: recordkeeping. Marked corrected in the state record.

3280.131(e)(2)(i) · Exemption from immunization for religious belief or strong personal objection equated to a religious belief shall be documented by a written, signed and dated statement from the child's parent or guardian. The statement shall be kept in the child's record.

The files of children #1, #3, and #4 lacked documentation of exemption from flu immunization.

Corrected Corrected by Mar 24, 2022

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

3280.151(a)/3280.192(3) · A facility person providing direct care who comes into contact with the children or who works with food preparation shall have a health assessment conducted within 12 months prior to providing initial service in a child care setting and every 24 months thereafter. A health assessment is valid for 24 months following the date of signature, if the person does not contract a communicable disease or develop a medical problem.A facility person's record shall include a written report of initial and subsequent health assessments, including the results of initial and subsequent tuberculin skin tests, x-rays or other medical documentation necessary to confirm freedom from communicable tuberculosis.

The file for staff person #1 was observed not to contain documentation of a health assessment being completed within 12 months prior to date of hire (See LIS CODE SHEET).

Corrected Corrected by Mar 24, 2022

Category: ratio. Marked corrected in the state record.

3280.26(a)(5) · The facility shall have an emergency plan that provides for accommodations for infants, toddlers, children with disabilities and children with chronic medical conditions.

At the time of the inspection, the Emergency Plan lacked accommodations for infants, toddlers, children with disabilities and children with chronic medical conditions.

Corrected Corrected by Mar 24, 2022

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

3280.32(a)/3280.192(4) · The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). A facility person's record shall include a copy of requests for the criminal history record and child abuse registry clearance information, a copy of the disclosure statement and a copy of the completed clearance information required under the CPSL.

The file of facility person #1, identified as a volunteer since 1-3-22 lacked a current FBI clearance. The FBI clearance in file was dated 7-5-16.

Corrected Corrected by Mar 17, 2022

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

3280.151(a)/3280.192(3) · A facility person providing direct care who comes into contact with the children or who works with food preparation shall have a health assessment conducted within 12 months prior to providing initial service in a child care setting and every 24 months thereafter. A health assessment is valid for 24 months following the date of signature, if the person does not contract a communicable disease or develop a medical problem.A facility person's record shall include a written report of initial and subsequent health assessments, including the results of initial and subsequent tuberculin skin tests, x-rays or other medical documentation necessary to confirm freedom from communicable tuberculosis.

The file of facility person #1, identified as a volunteer since 1-3-22, lacked a health assessment. During the unannounced inspection, cert rep observed facility person #1 holding an infant and assisting with serving lunch. Therefore, facility person #1 was providing direct care, came into contact with the children and/or worked with food prepared and served to children in care.

Corrected Corrected by Mar 17, 2022

Category: ratio. Marked corrected in the state record.