3270.32(a)/3270.192(4) · The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). TIERED LIS: 1. The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). This portion shall have an immediate correction date. 2. The legal entity must attend existing provider orientation at any regional office location. The operator shall provide a date for when this training will be completed. 3. The legal entity must send in new staff files to the DHS northeast regional office for review. The correction date for this portion of the plan shall be a minimum of 3 months from the date the regional office approves.

During renewal inspection, staff files were reviewed. Staff #1's previous NSOR is date for 7/23/2000, update was not obtained until 8/21/25. Staff #1's previous child abuse clearance is dated for 7/7/2020 and an update was not obtained until 11/13/25. Staff #1 was unable to obtain the appropriate clearances within the 60-month requirement. Staff #2's child abuse clearance is dated for 10/7/25. Staff #2 did not obtain the clearance prior to working with children. (See code sheet for date of hire).

Corrected Corrected by Apr 6, 2026

Category: background checks. 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. TIERED LIS: 1. Staff persons shall complete professional development in the topic of pediatric first aid and pediatric cardiopulmonary resuscitation within 90 days of hire. 2. The legal entity must create a written policy regarding how the facility will keep track and obtain all necessary documentation including Pediatric CPR certificates. The legal entity will need sign, date, and have this policy readily assessable for requested access. This policy must be approved by DHS before implementation. The operator shall provide a date for when this policy will be completed and reviewed by all staff.

During renewal inspection, staff files were reviewed. Staff #3 did not have Pediatric CPR training on file. Staff #4 did not complete an approved Pediatric CPR training. (See code sheets for dates of hire).

Corrected Corrected by Jan 6, 2026

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

3270.151(a) · A facility person providing direct care who comes into contact with the children or who works with food preparation shall have a health assessment conducted within 12 months prior to providing initial service in a child care setting and every 24 months thereafter. A health assessment is valid for 24 months following the date of signature, if the person does not contract a communicable disease or develop a medical problem.

Continued Non-Compliance: On 5/12/25 a renewal inspection was conducted at the facility. Staff #1 had a previous health assessment dated for 1/12/23 on file from working at a previous facility. Staff #1 did not obtain an updated health assessment prior to working at the current facility. (See code sheet for date of hire). The facility's acceptable plan of correction indicated the correction would be implemented by (6/13/25). On 7/17/25 an unannounced inspection was conducted. Staff #1 had not obtained an updated health assessment and was seen working with children.

Corrected Corrected by Jul 21, 2025

Category: ratio. Marked corrected in the state record.

3270.51/3270.52 · There were no infants in our program at the time of this inspection. the classroom held 2 young toddlers and 3 older toddlers the other 2 children on the attendance sheet were actually 3 yrs old and had begun the transition process to the preschool classroom and were not present in the classroom that day. The classroom was in compliance until the sixth child arrived and a staff person was late to work. The provider will continue to hire additional staff to ensure adequate staffing at all times. Should additional staff be unavailable or too costly provider will limit the number of children in the classroom to prevent this from occurring again. A meeting date of 8/8/2025 has been set to meet with our STARS manager to provide required continuing education to all staff. This training will be completed no later than 11/10/2025. I will form a policy addressing staff lateness and call offs and send to DHS for approval.

Based on interviews conducted as well as a review of the child sign in sheets, it was verified on 6/13/25 that staff #3 was in the infant room with 7 infants. This was cited for on SIN-00268089.

Corrected Corrected by Nov 10, 2025

Category: recordkeeping. Marked corrected in the state record.

3270.111(c)/3270.113(e) · 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. A facility person may not restrain a child by using bonds, ties or straps to restrict a child's movement or by enclosing the child in a confined space, closet or locked room. The prohibition against restraining a child does not apply to the use of adaptive equipment prescribed for a child with special needs. TIERED LIS: 1. A facility person may not restrain a child by using bonds, ties or straps to restrict a child's movement or by enclosing the child in a confined space, closet or locked room. This portion of the plan shall have an immediate correction date 2. The legal entity must arrange for all facility staff to receive a minimum of two hours of in-person training regarding behavior management. If the training cannot be done in-person, it must at least be done with a live presenter to allow the staff to ask questions and interact. The legal entity must receive approval of training content from the Department prior to scheduling the training. The operator shall provide a date for when this training will be completed.

On 6/16/25 interviews with staff and children were conducted concerning allegations that staff #1 forced child #1 onto their cot at nap time. These interviews corroborated allegations that staff #1 had pulled child #1 by the arm to put him on his cot. It was also confirmed that staff #1 told Child #1 that she would not let go of their arm unless they stayed on their cot. This was cited for on SIN-00268089.

Corrected Corrected by Oct 1, 2025

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

3270.113(c)/3270.113(d) · A facility person may not single out the child for ridicule, threaten harm to the child or the child's family and may not specifically aim to degrade the child or the child's family. A facility person may not use harsh, demeaning or abusive language in the presence of children.

Individually Interviews conducted on 6/16/25 corroborated allegations that staff #1 & #2 have ridiculed children (embarrassing children for having accidents) and utilized harsh language (yelling at children). This was cited for on SIN-00268089.

Corrected Corrected by Oct 1, 2025

Marked corrected in the state record.

3270.51/3270.52 · When children are grouped in similar age levels, the following maximum child group sizes and ratios of staff persons apply: Infants 1:4 with a maximum group size of 8; Young toddlers 1:5 with a maximum group size of 10; Older toddlers 1:6 with a maximum group size of 12; Preschool children 1:10 with a maximum group size of 20; Young school-age children 1:12 with a maximum group size of 24; Older school-age children 1:15 with a maximum group size of 30. TIERED LIS: 1. Children must be supervised at all times. This portion of the plan shall have an immediate correction date. 2. The legal entity must arrange for all facility staff to receive a minimum of two hours of training regarding supervision & ratio. The legal entity must receive DHS approval of the training content prior to scheduling the training. The operator shall provide a date for when this training will be completed. 3. The legal entity must create a ratio policy that includes how ratios will be maintained at all times including when staff call off or do not show up for work. This policy must be approved by the Department before implementation. Once approved the legal entity will discuss the policy with all staff and have each staff person sign off on the policy acknowledging that they understand their responsibilities. The Department will make no less than two unannounced visits over the next three months to ensure ratios are being maintained. The correction date for this portion of the plan shall be at minimum three months from the date the Regional Office approves the policy.

Based on interviews conducted as well as a review of the child sign in sheets, it was verified on 6/13/25 that staff #3 was in the infant room with 7 infants. This was cited for on SIN-00268089.

Corrected Corrected by Nov 10, 2025

Category: supervision. Marked corrected in the state record.

3270.111(c)/3270.113(e) · 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. A facility person may not restrain a child by using bonds, ties or straps to restrict a child's movement or by enclosing the child in a confined space, closet or locked room. The prohibition against restraining a child does not apply to the use of adaptive equipment prescribed for a child with special needs. TIERED LIS: 1. A facility person may not restrain a child by using bonds, ties or straps to restrict a child's movement or by enclosing the child in a confined space, closet or locked room. This portion of the plan shall have an immediate correction date 2. The legal entity must arrange for all facility staff to receive a minimum of two hours of in-person training regarding behavior management. If the training cannot be done in-person, it must at least be done with a live presenter to allow the staff to ask questions and interact. The legal entity must receive approval of training content from the Department prior to scheduling the training. The operator shall provide a date for when this training will be completed.

On 6/16/25 interviews with staff and children were conducted concerning allegations that staff #1 forced child #1 onto their cot at nap time. These interviews corroborated allegations that staff #1 had pulled child #1 by the arm to put him on his cot. It was also confirmed that staff #1 told Child #1 that she would not let go of their arm unless they stayed on their cot. This was cited for on SIN-00268089.

Corrected Corrected by Oct 1, 2025

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

3270.113(c)/3270.113(d) · A facility person may not single out the child for ridicule, threaten harm to the child or the child's family and may not specifically aim to degrade the child or the child's family. A facility person may not use harsh, demeaning or abusive language in the presence of children. TIERED LIS: 1. A facility person may not single out the child for ridicule, threaten harm to the child or the child's family and may not specifically aim to degrade the child or the child's family. This portion of the plan shall have an immediate correction date 2. The legal entity must arrange for all facility staff to receive the two-hour training titled: Developmentally Appropriate Practices (DAP). The legal entity must receive DHS approval of the training content prior to scheduling the training. The operator shall provide a date for when this training will be completed.

Individually Interviews conducted on 6/16/25 corroborated allegations that staff #1 & #2 have ridiculed children (embarrassing children for having accidents) and utilized harsh language (yelling at children). This was cited for on SIN-00268089.

Corrected Corrected by Oct 1, 2025

Category: recordkeeping. Marked corrected in the state record.

3270.51/3270.52 · When children are grouped in similar age levels, the following maximum child group sizes and ratios of staff persons apply: Infants 1:4 with a maximum group size of 8; Young toddlers 1:5 with a maximum group size of 10; Older toddlers 1:6 with a maximum group size of 12; Preschool children 1:10 with a maximum group size of 20; Young school-age children 1:12 with a maximum group size of 24; Older school-age children 1:15 with a maximum group size of 30. TIERED LIS: 1. Children must be supervised at all times. This portion of the plan shall have an immediate correction date. 2. The legal entity must arrange for all facility staff to receive a minimum of two hours of training regarding supervision & ratio. The legal entity must receive DHS approval of the training content prior to scheduling the training. The operator shall provide a date for when this training will be completed. 3. The legal entity must create a ratio policy that includes how ratios will be maintained at all times including when staff call off or do not show up for work. This policy must be approved by the Department before implementation. Once approved the legal entity will discuss the policy with all staff and have each staff person sign off on the policy acknowledging that they understand their responsibilities. The Department will make no less than two unannounced visits over the next three months to ensure ratios are being maintained. The correction date for this portion of the plan shall be at minimum three months from the date the Regional Office approves the policy.

Based on interviews conducted as well as a review of the child sign in sheets, it was verified on 6/13/25 that staff #3 was in the infant room with 7 infants.

Corrected Corrected by Nov 10, 2025

Category: supervision. Marked corrected in the state record.

3270.111(c)/3270.113(e) · 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. A facility person may not restrain a child by using bonds, ties or straps to restrict a child's movement or by enclosing the child in a confined space, closet or locked room. The prohibition against restraining a child does not apply to the use of adaptive equipment prescribed for a child with special needs. TIERED LIS: 1. A facility person may not restrain a child by using bonds, ties or straps to restrict a child's movement or by enclosing the child in a confined space, closet or locked room. This portion of the plan shall have an immediate correction date 2. The legal entity must arrange for all facility staff to receive a minimum of two hours of in-person training regarding behavior management. If the training cannot be done in-person, it must at least be done with a live presenter to allow the staff to ask questions and interact. The legal entity must receive approval of training content from the Department prior to scheduling the training. The operator shall provide a date for when this training will be completed.

On 6/16/25 interviews with staff and children were conducted concerning allegations that staff #1 forced child #1 onto their cot at nap time. These interviews corroborated allegations that staff #1 had pulled child #1 by the arm to put him on his cot. It was also confirmed that staff #1 told Child #1 that she would not let go of their arm unless they stayed on their cot.

Corrected Corrected by Oct 1, 2025

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

3270.113(c)/3270.113(d) · A facility person may not single out the child for ridicule, threaten harm to the child or the child's family and may not specifically aim to degrade the child or the child's family. A facility person may not use harsh, demeaning or abusive language in the presence of children. TIERED LIS: 1. A facility person may not single out the child for ridicule, threaten harm to the child or the child's family and may not specifically aim to degrade the child or the child's family. This portion of the plan shall have an immediate correction date 2. The legal entity must arrange for all facility staff to receive the two-hour training titled: Developmentally Appropriate Practices (DAP). The legal entity must receive DHS approval of the training content prior to scheduling the training. The operator shall provide a date for when this training will be completed.

Individually Interviews conducted on 6/16/25 corroborated allegations that staff #1 & #2 have ridiculed children (embarrassing children for having accidents) and utilized harsh language (yelling at children).

Corrected Corrected by Oct 1, 2025

Category: recordkeeping. Marked corrected in the state record.

3270.32(a)/3270.192(4) · The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). A facility person's record shall include a copy of requests for the criminal history record and child abuse registry clearance information, a copy of the disclosure statement and a copy of the completed clearance information required under the CPSL. Facility Person #3 may not work in a child care position at the facility.

During renewal inspection, it was observed that Staff #1 did not have mandated reporter training on file. Also, during file reviews, it was observed that staff #3 did not have any updated clearances on file. The state police, child abuse, FBI and NSOR were expired. State police clearance was dated for 7/23/19, child abuse 7/30/19, FBI 1/14/20 and NSOR 1/27/20.

Corrected Corrected by Jun 15, 2025

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.

During renewal inspection, it was observed in the preschool room's first aid kit that tweezers were missing.

Corrected Corrected by Jun 12, 2025

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

3270.151(a) · A facility person providing direct care who comes into contact with the children or who works with food preparation shall have a health assessment conducted within 12 months prior to providing initial service in a child care setting and every 24 months thereafter. A health assessment is valid for 24 months following the date of signature, if the person does not contract a communicable disease or develop a medical problem.

During renewal inspection it was observed that Staff #3 had a previous health assessment dated for 1/12/23 on file from working at a previous facility. Staff #3 did not obtain an updated health assessment prior to working at the current facility. See code sheet for date of hire.

Corrected Corrected by Jun 13, 2025

Category: ratio. 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.

During renewal inspection, it was observed that staff #1 did not have TB test results on file prior to working with children.

Corrected Corrected by Jun 16, 2025

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.

During renewal inspection, it was observed that Staff #2 did not have a second written reference on file.

Corrected Corrected by Jun 13, 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.

During renewal inspection, it was observed that the facility did not have any documentation of completing an annual emergency drill. Last documented drill that was found was on 6/2/23.

Corrected Corrected by Jun 13, 2025

Category: recordkeeping. Marked corrected in the state record.

3270.31(f)(10) · Staff persons shall complete professional development in pediatric first aid and pediatric cardiopulmonary resuscitation within 90 days of hire. 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 must be supervised, when interacting with children at a minimum by, an (AGS or primary staff person) who has completed all preservice trainings and has all qualifications to care for children unsupervised. If there are no staff person(s) available to supervise staff person #1, staff person #1 may not work in a child-care position at the facility.

During renewal inspection, it was observed that staff #1 did not complete pediatric CPR training within 90 days of hire. (See code sheet for date of hire).

Corrected Corrected by Jun 12, 2025

Category: supervision. Marked corrected in the state record.

3270.66(c) · Cleaning materials and other toxic materials shall be used in a way that does not contaminate play surfaces, food, food preparation areas and does not constitute a hazard to the children.

During an unannounced investigation, a picture was discussed with the operator that showed a bottle of carpet cleaner in the outdoor play space. Operator said she didn't know it was out there but removed it once it was brought to her attention.

Corrected Corrected by Mar 12, 2025

Category: ratio. Marked corrected in the state record.

3270.76/3270.102(c) · 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. Outdoor equipment that requires embedded mounting must be mounted over a loose-fill or unitary playground protective surface covering that meets the recommendations of the United States Consumer Product Safety Commission. The equipment must be anchored firmly and be in good repair.

During an unannounced investigation, it was observed on the outdoor play space that the fencing along the facility that acts as a protective barrier was damaged. Thus, allowing children to either crawl under the fence or get injured by the damaged fence.

Corrected Corrected by Mar 12, 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.

During an unannounced investigation, it was observed on the outdoor play space that a toy sink was cracked and not in good repair.

Corrected Corrected by Mar 12, 2025

Category: physical safety. 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.

During an unannounced investigation, it was observed that Child #1 did not have a financial agreement on file and Child #2's financial agreement was not updated within the past 6 months.

Corrected Corrected by Mar 14, 2025

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.

During unannounced visit, it was observed that the facilities BEO posting was outdated and displayed incorrect information.

Corrected Corrected by Mar 14, 2025

Category: ratio. Marked corrected in the state record.

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

During unannounced visit, it was observed that Staff #2 did not complete mandated reporter training within 90-days of hire. See code sheet for date of hire.

Corrected Corrected by Mar 14, 2025

Category: recordkeeping. Marked corrected in the state record.

3270.31(f)(10) · Staff persons shall complete professional development in pediatric first aid and pediatric cardiopulmonary resuscitation within 90 days of hire. Staff person(s) shall complete professional development in the topics of 3270.31(f)(1 -- 10), 3280.31(f) (1-10), or 3290.31(g) (1-10) within 90 days of hire. Until such time as the required training has been completed, staff person #1,2 & 3 must be supervised, when interacting with children, by a facility person who has completed the required training related to this citation. If there are no staff available to supervise staff person #1, 2, 3, staff person #1, 2, & 3 may not work in a child-care position at the facility

During unannounced visit, it was observed that Staff #1 and #2 had not completed pediatric CPR within 90-days of hire. Staff #3 did not have a pediatric CPR certificate on file. See code sheet for dates of hire.

Corrected Corrected by Mar 12, 2025

Category: supervision. Marked corrected in the state record.

3270.36(b)(5) · An assistant group supervisor shall have a high school diploma or a general educational development certificate and 2 years experience with children.

Staff #1 did not have the qualifications to be listed as an assistant group supervisor. Staff has a bachelor's degree in biology/pre veterinarian and did not have 2 years of experience with children.

Corrected Corrected by May 3, 2024

Category: supervision. Marked corrected in the state record.

3270.106(f) · At least 2 feet of space is required on three sides of a bed, cot, crib or other rest equipment while the equipment is in use.

It was observed during nap time in the infant room that there was not 2 feet on three sides of a child's cot. There was no space to measure because the child was up against furniture on all sides of the cot.

Corrected Corrected by May 6, 2024

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

3270.124(b)(2)/3270.124(b)(7) · Emergency contact information must include the name, address and telephone number of the child's physician or source of medical care. 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.

Child #1's emergency contact sheet did not have the phone number of the child's physician. Child #4 did not have the release person's address on their emergency contact sheet.

Corrected Corrected by May 30, 2024

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

3270.131(b)(2)/3270.131(e) · 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 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 did not have an updated health report on file. Child #2's vaccine chart was not attached to the health report within the file.

Corrected Corrected by May 22, 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.

Child #1 did not have a financial agreement on file. Child #3 and child #4 did not have an updated financial agreement on file. Child #3's agreement was dated for 11/1/23. Child #4's agreement was dated for 4/19/23.

Corrected Corrected by May 22, 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.

7/20/23 to 8/23/23 indicates that fire alarm testing was not done within the 30 day requirement.

Corrected Corrected by May 6, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.32(a)/3270.192(4) · The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). A facility person's record shall include a copy of requests for the criminal history record and child abuse registry clearance information, a copy of the disclosure statement and a copy of the completed clearance information required under the CPSL. Facility Person # 1 may not work in a childcare position at the facility.

While at the facility unannounced the inspector reviewed the file for staff #1 (See LIS Code Sheet for date of hire) and noted that the staff was missing either proof of a Pa Child Abuse clearance or proof of having sent for the clearance as is required.

Corrected Corrected by Sep 21, 2023

Category: background checks. 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.

While at the facility on 5/31/23 the inspector observed the file for staff person #1 and noted that this staff did not complete the required one-hour 2022 update to the health and safety training by 12/30/2022.

Corrected Corrected by Jun 7, 2023

Category: health medication. 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.

While at the facility on 5/31/23 the inspector observed the file for staff persons #2, and # 3 and noted that both staff did not have an annual evaluation on file as is required every 12 months.

Corrected Corrected by Jun 7, 2023

Category: recordkeeping. 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.

While at the facility on 5/31/23 the inspector observed the file for staff person #4 and noted that this staff had a hiring TB screening conducted outside of initial employment rendering it out of date.

Corrected Corrected by Jun 7, 2023

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

3270.123(a)(3)/3270.162(b) · 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). Meals and snacks may be provided by the parent, upon agreement between the parent and the operator.

While at the facility unannounced on 4/14/23 for the complaint investigation the inspector discussed the agreement form as well as meals provided with the director (staff #1) specific to lunches for children. The director indicated that there was a change to the agreement form and that the form itself had yet to be updated for the facility and parents.

Corrected Corrected by May 6, 2023

Category: nutrition. Marked corrected in the state record.

3270.21/3270.67(c) · Conditions at the facility may not pose a threat to the health or safety of the children. Evidence of infestation of insects or rodents in the facility is not permitted.

While at the facility unannounced on 3/28/23 for the complaint investigation the inspector observed evidence of rodents at the facility. The inspector observed rodent droppings in the pantry, on the floor and on the boxes of several food items.

Corrected Corrected by Mar 29, 2023

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

3270.106(f) · At least 2 feet of space is required on three sides of a bed, cot, crib or other rest equipment while the equipment is in use.

While at the facility unannounced on 3/28/23 for the complaint investigation the inspector observed that the cribs and nap mats in the infant and toddler room were not two feet apart on three sides as is required. The inspector measured the spacings between the cribs and nap mats and found less than 18 inches between each.

Corrected Corrected by May 9, 2023

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

3270.161(a) · Food stored, prepared or served shall be clean, wholesome, free from spoilage, free from adulteration and safe for human consumption.

While at the facility unannounced on 3/28/23 for the complaint investigation the inspector observed evidence of rodents at the facility. The inspector observed rodent droppings in the pantry, on the floor and on the boxes of several food items. Staff were able to produce several pictures showing gnaw marks on food packaging.

Corrected Corrected by Mar 29, 2023

Category: ratio. Marked corrected in the state record.

3270.166(3) · Disposable nursers shall be used for infants unless bottles are provided by the parent or unless a commercial dishwasher is used by the facility.

While at the facility unannounced on 3/28/23 for the complaint investigation the inspector was told by several staff that the facility does, in fact, handwash infant bottles and reuse these versus utilizing disposable nursers as the facility does not have a commercial grade dishwasher.

Corrected Corrected by Mar 29, 2023

Marked corrected in the state record.

3270.66(b) · Cleaning materials and other toxic materials shall be stored in an original labeled container or in a container that specifies the content. Toxics shall be stored away from food, food preparation areas and child care spaces.

While at the facility unannounced on 3/28/23 the inspector observed caps of a white powder in the pantry that was explained as mouse poison.

Corrected Corrected by Mar 29, 2023

Category: ratio. Marked corrected in the state record.

3270.76 · Floors, walls, ceilings and other surfaces, including the facility's outdoor play space surfaces shall be kept clean, in good repair and free from visible hazards.

While at the facility unannounced on 3/28/23 the inspector observed several of the ceiling tiles had signs of water damage.

Corrected Corrected by May 1, 2023

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

3270.24(a) · A staff person shall provide to agents of the Department immediate access to the facility, the children and the files and records.

While at the facility unannounced on 3/28/23 the inspector asked for access to the staff files and was told by staff that they did not have access to staff files when the director was not at the facility.

Corrected Corrected by Mar 29, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.52 · When children are grouped in mixed age levels, the age of the youngest child in the group determines the staff: child ratio and maximum group size in accordance with the requirements in § 3270.51 (relating to similar age level). The required staff: child ratios must be maintained at all times. The legal entity will ensure that ratios for each age group are posted in each room to ensure that ratio is met at all times.

While at the facility unannounced on 3/28/23 the inspector was informed by staff that the director (staff #1) consistently allows the infant/toddler room staff to leave the building for their breaks while stating they would observe the infants from the office, located in another room, leaving the infant room out of ratio.

Corrected Corrected by Mar 29, 2023

Category: ratio. Marked corrected in the state record.

3270.52 · When children are grouped in mixed age levels, the age of the youngest child in the group determines the staff: child ratio and maximum group size in accordance with the requirements in § 3270.51 (relating to similar age level). The required staff: child ratios must be maintained at all times.

While at the facility unannounced on 3/28/23 the inspector was informed by staff that the director (staff #1) consistently allows the infant/toddler room staff to leave the building for their breaks while stating they would observe the infants from the office, located in another room, leaving the infant room out of ratio.

Corrected Corrected by Mar 29, 2023

Category: ratio. Marked corrected in the state record.

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

While at the facility unannounced on 3/28/23 the inspector observed that one of the toilets was blocked off from use. When asked the staff indicated that the toilet had been broken for several weeks at present.

Corrected Corrected by Apr 28, 2023

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. The facility will demonstrate their knowledge and ability to adequately supervise children at all times by developing and implementing a supervision policy that will focus on ensuring that each child is accounted for and seen, heard, assessed and able to be directed at all times. This supervision policy must be submitted to the Department prior to implementation for approval. Once approved by the Department the director will ensure that all current employees sign off on this policy as well as any new hires.

While at the facility on 3/28/23 the inspector observed three staff in the infant/toddler room and ten mixed aged infants/toddlers. Staff #2, #3, and #4 were in the infant/toddler room with ten children. When asked to identify the children in their groups staff #2 indicated child #2 was in their group. Staff #3 indicated that children #4, #6, and #9 were in their group. Staff #4 indicated that children #5 and #10 were in their group. This left four children unaccounted for: children #1, #3, #7 and #8 unaccounted for.

Corrected Corrected by Mar 29, 2023

Category: supervision. Marked corrected in the state record.

3270.113(a)/3270.113(a)(1) · Children on the facility premises and on facility excursions off the premises shall be supervised by a staff person at all times. Outdoor play space used by the facility is considered part of the facility premises. Children must be supervised at all times. 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.

While at the facility on 3/28/23 the inspector observed three staff in the infant/toddler room and ten mixed aged infants/toddlers. Staff #2, #3, and #4 were in the infant/toddler room with ten children. When asked to identify the children in their groups staff #2 indicated child #2 was in their group. Staff #3 indicated that children #4, #6, and #9 were in their group. Staff #4 indicated that children #5 and #10 were in their group. This left four children unaccounted for: children #1, #3, #7 and #8 unaccounted for.

Corrected Corrected by Mar 29, 2023

Category: supervision. Marked corrected in the state record.

3270.191 · An individual record is required for each facility person.

While at the facility unannounced on 3/28/23 the inspector asked for access to the staff files and was told by staff that they did not have access to staff files when the director was not at the facility. The inspector requested files for the staff that were not able to be accessed and was told that staff #6 did not have a file as it had gone missing.

Corrected Corrected by May 1, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.151(c)(3)/3270.151(c)(4) · An adult health assessment must include an examination for communicable diseases and the results of that examination. An adult health assessment must include information on medical problems that might threaten the health of the children or prohibit a staff person from providing adequate care to children.

While at the facility unannounced on 6/2/22 for the renewal inspection the inspector reviewed the file for staff #3 and noted that this staff did not have a health assessment that includes an examination for communicable diseases and the results of that examination as well as information on medical problems that might threaten the health of the children or prohibit a staff person from providing adequate care to children.

Corrected Corrected by Jun 6, 2022

Category: health medication. 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.

While at the facility unannounced on 6/2/22 for the renewal inspection the inspector reviewed the file for staff #1 and staff #4 and noted both files were missing proof of education as is required.

Corrected Corrected by Jun 6, 2022

Category: recordkeeping. Marked corrected in the state record.

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

While at the facility unannounced on 6/2/22 for the renewal inspection the inspector reviewed the file for staff #2 and noted that this staff has been employed over 90 days and still does not have pediatric first aid and pediatric cardiopulmonary resuscitation as is required.

Corrected Corrected by Jun 6, 2022

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