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 treehouse room on the brown shelf next to the ABC carpet was a can of Blaster Hand Sanitizer that stated keep out of reach of children accessible to children.

Corrected Corrected by Nov 12, 2025

Marked corrected in the state record.

3270.102(a) · Toys, play equipment and other indoor and outdoor equipment used by the children shall be clean, in good repair and free from rough edges, sharp corners, pinch and crush points, splinters and exposed bolts.

In the friendly forest room, there was a cracked clear plastic bin that had rough edges.

Corrected Corrected by Nov 12, 2025

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 friendly forest room one of the shelves on the small four cube shelf was broken.

Corrected Corrected by Oct 29, 2025

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

3270.82(e) · Toilets and sinks shall be at proper heights for children using them or shall be easily approached by means of platforms or steps.

At approximately 10am on 9/29/25 it was observed in the butterfly room that the staff person was holding an infant over the sink to wash the infant's hands.

Corrected Corrected by Oct 29, 2025

Category: recordkeeping. 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 Sassafras room on the projector cart was a surge strip that was plugged into a power source that was missing protective outlet covers accessible to children. In the pond room there was a surge protector on the side of the refrigerator on a low table without protective outlet covers accessible to children.

Corrected Corrected by Oct 21, 2025

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 friendly forest room the drawer of the diaper table was unlock and it contained diaper cream (Desitin, Triple paste, CeraVe) that stated keep out of reach of children accessible to children.

Corrected Corrected by Oct 29, 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.

In the friendly forest room there was a low metal four cube shelf that had sharp corners without corner covers/guards. In the outside preschool playground area was plastic pavilion edging that was cracked with sharp edges and possible pinch points.

Corrected Corrected by Oct 29, 2025

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

3270.77(a) · Peeled or damaged paint or damaged plaster is not permitted on indoor or outdoor surfaces in the child care facility.

In the friendly forest room, there was damaged plaster by the play kitchen set. In the outside young toddler play area along the bottom of the window frame was peeling paint.

Corrected Corrected by Nov 3, 2025

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

3270.81 · A visual strip or other visual identification shall be placed on glass located in a traffic area, a child care space or a play space.

In the friendly forest room there were multiple floor to ceiling windows that did not have a visual strip of other visual identification on the glass.

Corrected Corrected by Oct 29, 2025

Category: physical safety. 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. TIERED LIS: 1. The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). 2. The owner and assistant director will attend in-person Existing Provider Training on Oct 22, 2025.

The file for Staff #1 contained a Child Abuse Clearance that was obtained three days after their first day caring for children. The file for Staff #1 lacked a signed disclosure statement.

Corrected Corrected by Oct 22, 2025

Category: background checks. 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.

The file for Staff #1 lacked proof of qualifications for education in the form of a diploma, transcript, or letter signed by a representative or the experiential, educational or training entity.

Corrected Corrected by Oct 1, 2025

Category: recordkeeping. Marked corrected in the state record.

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

The file for Staff #1, lacked two written, nonfamily references from individuals attesting to the suitability to serve as a facility person.

Corrected Corrected by Oct 1, 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. Until such time as the required pre- service trainings are completed, staff person #3 must be supervised, when interacting with children at a minimum by, an AGS 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 #3, staff person #3 may not work in a child-care position at the

On 5/14/25 Staff person #3 was observed to be caring for children unsupervised. Staff person #3 has not completed the following pre- service training required prior to caring for children unsupervised: PA Required Health and Safety for Centers-Group Child Care Part 1.

Corrected Corrected by Jun 2, 2025

Category: supervision. 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 or (g)1-10. Until such time as the required training has been completed, staff person #1 must be supervised, when interacting with children at a minimum by, an AGS 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.

On 5/7/25 it was observed that Staff person #1 has completed Pediatric first aid and CPR training, however the training was not completed through a Pennsylvania Quality Assurance System (PQAS) approved curriculum and the trainer has not provided documentation that they are PQAS-certified in that training curriculum.

Corrected Corrected by Jun 2, 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). 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 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.

On 5/14/25 Staff #3 was observed unsupervised with children without an NSOR certificate in their file.

Corrected Corrected by Jun 2, 2025

Category: supervision. Marked corrected in the state record.

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

On 5/7/25 Staff #2's file 2 most recent mandated reporter trainings are dated 2/11/20 and 4/15/25 which is more than 60 months apart.

Corrected Corrected by Jun 2, 2025

Category: recordkeeping. 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.

On 5/7/25, In the treehouse room a protective outlet cover was missing from the outlet outside the bathroom. On 5/14/25 in the Friendly Forest a protective outlet cover was missing from an outlet next to the diaper table.

Corrected Corrected by Jun 2, 2025

Category: health medication. 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.

On 5/14/25, in the facility's medication cabinet in the kitchen was Genexa which had expired on 4/2025, Hylands Cough and Mucus had expired on 4/2025, Triamcinolone had expired on 8/2024, and Zarbee's Cough Syrup and Mucus had expired on 7/2024, therefore they were not in accordance with the manufacturer's original label.

Corrected Corrected by Jun 2, 2025

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.

On 4/15/25 at approximately 3:15 pm, Staff #3 was supervising 8 preschool aged children in the Beehive room. Staff #3 was observed to leave the room 3 times, taking children's nap mats to a storage area located in the hallway. Once the staff returned to the room, at least one child was permitted to leave the room unsupervised to take their nap mat to the storage area located in the hallway.

Corrected Corrected by Apr 17, 2025

Category: supervision. 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.

The parent was not given the injury report on the day of the incident, 3/28/25. The file for Child #1 lacked an injury report for 3/28/25. The incident report retained in the facility's accident file was incomplete.

Corrected Corrected by Apr 30, 2025

Category: health medication. 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.

On 4/15/25 at approximately 3:15 pm, Staff #3 was supervising 8 preschool aged children in the Beehive room. Staff #3 was observed to leave the room 3 times, taking children's nap mats to a storage area located in the hallway. Once the staff returned to the room, at least one child was permitted to leave the room unsupervised to take their nap mat to the storage area located in the hallway.

Corrected Corrected by Jun 2, 2025

Category: supervision. Marked corrected in the state record.

3270.113(a)(1) · TIERED LIS: 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. 2. The Legal Entity will require all staff at the facility to attend a 2 hour minimum, in person training regarding supervision of children presented by ELRC 4 within 3 months of the approval of this plan of correction. The Legal Entity will submit the training to the Department for approval prior to implementation. The training may count towards the mandatory 12 training hours required by the Department. Documentation of training for each staff will be submitted to the department within 10 days of the completion of the training. 3. The Legal Entity will require the operator, director and any staff persons who have a leadership role to participate in monthly, on site, Technical Assistance (TA) sessions with ELRC 4 for a minimum of 4 months. The TA sessions will include defining staff leadership roles in the childcare, identifying methods that each role can utilize to ensure staff understand and are implementing proper supervision of all of the children in care. Documentation of each TA session will be submitted to the Department within 10 days of the completion of the session.

Continued Noncompliance: On 4/15/25 at approximately 3:15 pm, Staff #3 was supervising 8 preschool aged children in the Beehive room. Staff #3 was observed to leave the room 3 times, taking children's nap mats to a storage area located in the hallway. Once the staff returned to the room, at least one child was permitted to leave the room unsupervised to take their nap mat to the storage area located in the hallway. Previously cited on 7/9/24; 10/21/24; 11/22/24 & 1/29/25.

Corrected Corrected by Sep 26, 2025

Category: supervision. Marked corrected in the state record.

3270.118(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.

It was observed that there was a puppy in the preschool classroom which is the staff person's service dog and there was not any documentation of rabies immunization on file at the facility.

Corrected Corrected by Feb 20, 2025

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

3270.113(a)(1) · Each staff person shall be assigned the responsibility for supervision of specific children. The staff person shall know the names and whereabouts of the children in his assigned group. The staff person shall be physically present with the children in his group on the facility premises and on facility excursions off the facility premises.

At approximately 10:50am, Staff #1 and Staff #2 were observed to be supervising a group of 15 children in the preschool room. Staff #1 was able to name and identify 8 children in their group, Staff #2 identified 6 children in their group. One child was left out. Given a second attempt Staff #1 named and identified 8 children in their group and Staff #2 again named 6 children in their group. The same child was again left out. With the help from the certification representation the missing child was identified and added to Staff Person #1's group.

Corrected Corrected by Jan 30, 2025

Category: supervision. Marked corrected in the state record.

3270.14/3270.21 · A facility shall be operated in conformity with applicable Federal and State laws and regulations.State agencies whose regulations may relate to the operation of a facility include the Department of Environmental Resources, the Department of Labor and Industry, the Department of Health, the Department of Education and the Department of Transportation. Conditions at the facility may not pose a threat to the health or safety of the children.

The facility did not have a policy to address the prevention and identification of child maltreatment. The emergency plan did not address the continuity of operations.

Corrected Corrected by Jan 6, 2025

Category: ratio. 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 #2's two most recent emergency plan trainings are dated 7/27/23 and 10/15/24 which are more than 12 months apart.

Corrected Corrected by Nov 6, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.27(e) · The operator shall provide to the parent of each enrolled child a letter explaining the emergency procedures. The operator shall also provide to the parent of each enrolled child a letter explaining any subsequent update to the plan.

The facility did not have a letter to provide to the parent of each enrolled child explaining the emergency procedures.

Corrected Corrected by Jan 6, 2025

Category: physical safety. 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 #3's two most recent fire safety trainings are dated 1/26/23 and 6/8/24 which are more than 12 months apart.

Corrected Corrected by Nov 22, 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). LACKING REQUIRED HIRING DOCUMENTS: Facility Person # 1 may not work in a child care position at the facility.

The file staff #1 did not contain documentation of the receipt of being fingerprinted for DHS FBI clearance before date of hire(See LIS Code Sheet) required for provisional hiring under the CPSL. The file for staff # 2 includes state police clearances dated 10/25/18 and 11/29/23, child abuse clearances dated 11/20/18 and 12/8/23, DHS FBI clearances dated 11/28/18 and 12/1/23, all more than 60 months apart. The file for staff #3 includes state police clearances dated 6/4/18 and 9/15/23, child abuse clearances dated 6/27/18 and 9/10/23, and DHS FBI clearances dated 6/21/18 and 10/24/23, all more than 60 months apart. The file for staff person #6 included a State Police clearance dated 10/18/24 and an NSOR certificate dated 10/31/24 which is more than 45 days after hire (See LIS Code Sheet) required for provisional hiring under the CPSL.

Corrected Corrected by Nov 22, 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.

Staff #2 two most recent staff evaluations are dated 2/15/23 and 3/27/24 which are more than 12 months apart. Staff #5's, who was hired more than 12 months prior(See LIS Code Sheet), file did not contain a staff evaluation.

Corrected Corrected by Dec 6, 2024

Category: recordkeeping. 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 bathroom of the friendly forest the outlet next to the sink area was cracked and missing a protective outlet cover.

Corrected Corrected by Dec 6, 2024

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

3270.66(a) · Cleaning materials and other toxic materials shall be kept in an area or container that is locked or made inaccessible to children.

In the treehouse room hand sanitizer and Purell sanitizing wipes, which stated keep out of reach of children, were sitting on top of a small refrigerator accessible to children.

Corrected Corrected by Dec 6, 2024

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.

The telephone number of the nearest hospital, police department, fire department, ambulance and poison control center were not posted by the telephone in the bunny borrow room.

Corrected Corrected by Dec 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 toddler outside place space the green outdoor carpet is coming up causing a tripping hazard.

Corrected Corrected by Dec 6, 2024

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.

The diaper table in the Back 40 room did not have a hand washing sign. In the Friendly Forest room, a hand washing sign was missing near the room sink. A handwashing sign was missing above the toilet in the Beehive room.

Corrected Corrected by Dec 6, 2024

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

3270.102(a) · Toys, play equipment and other indoor and outdoor equipment used by the children shall be clean, in good repair and free from rough edges, sharp corners, pinch and crush points, splinters and exposed bolts.

The Back 40 room was a clear crack bin with sharp edges on the shelf in the fenced in area of the room.

Corrected Corrected by Dec 6, 2024

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.

Child #3 financial agreement two most recent update signatures are dated 10/10/23 and 8/6/24 which is more than 6 months apart.

Corrected Corrected by Dec 6, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.103 · 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.

In the pond room the in the unlocked sink cabinet was loose unused garbage bags accessible to children still putting objects in their mouths. In the beehive room there were foam blocks that had teeth marks on them accessible to children still putting objects in their mouths.

Corrected Corrected by Dec 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.

The tall cabinet near the emergency exit in the Back 40 was not securely attached causing it to be unstable when touched. In the Sassafras room the dress up shelf was not securely attached causing it to be unstable when touched.

Corrected Corrected by Dec 6, 2024

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

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

The thermometer was missing from the refrigerator in the Butterfly room.

Corrected Corrected by Dec 9, 2024

Category: nutrition. Marked corrected in the state record.

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

At approximately 2pm on 11/22/24 in the back 40 room it was observed that Staff #6 was sitting by the bathroom on one side of the room, the children were napping on the other side of the room behind the fence with 2 children around the corner unable to be seen. At approximately 2:10pm on 11/22/24 in the beehive room staff #8 was on one end of the room by the entrance, there were 3 children napping at the other end of the room around the corner unable to be seen.

Corrected Corrected by Dec 6, 2024

Category: supervision. Marked corrected in the state record.

3270.113(a)(1) · Each staff person shall be assigned the responsibility for supervision of specific children. The staff person shall know the names and whereabouts of the children in his assigned group. The staff person shall be physically present with the children in his group on the facility premises and on facility excursions off the facility premises.

At approximately 2pm on 11/22/24 in the back 40 room it was observed that Staff #6 was sitting by the bathroom on one side of the room, the children were napping on the other side of the room behind the fence with 2 children around the corner unable to be seen. At approximately 2:10pm on 11/22/24 in the beehive room staff #8 was on one end of the room by the entrance, there were 3 children napping at the other end of the room around the corner unable to be seen.

Corrected Corrected by Dec 6, 2024

Category: supervision. Marked corrected in the state record.

3270.119 · Infants shall be placed in the sleeping position recommended by the American Academy of Pediatrics unless there is a medical reason an infant should not sleep in this position. The medical reason shall be documented in a statement signed by a physician, physician's assistant or CRNP and placed in the child's record at the facility.

At approximately 915am an infant was observed to be asleep in a rocker that was placed in a crib.

Corrected Corrected by Dec 6, 2024

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

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

Child #1's financial agreement was not signed by the operator.

Corrected Corrected by Dec 6, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.123(a)(3) · The services to be provided to the family and the child, including the Department's approved form to provide information to the family about the child's growth and development in the context of the services being provided. The operator shall complete and update the form and provide a copy to the family in accordance with the updates regarding emergency contact information in § 3270.124(f) (relating to emergency contact information).

The files for child # 1,3,4,5, and 6 contained child service reports with no date making them not acceptable, provider stated they were done in February which is still more than 6 months prior. Child #2 and 7's file contained child service reports dated 2/2024 which is more than 6 months prior.

Corrected Corrected by Dec 6, 2024

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.

In the back 40 room one the emergency contact information was missing from the room for one child that was in care.

Corrected Corrected by Dec 6, 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.

Child #3's two most recent emergency information update signatures are 10/10/23 and 8/6/24 which are more than 6 months apart.

Corrected Corrected by Dec 6, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.135(a)(3) · If disposable diapers are provided by a parent or by a facility, a soiled diaper shall be discarded by immediately placing the diaper into a plastic-lined, hands-free covered can.

In the Back 40 room the bathroom trash can that was not hands free contained a used pulled up.

Corrected Corrected by Dec 6, 2024

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

3270.151(c)(1)/3270.192(3) · An adult health assessment must include a physical examination. 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's file did not contain a health assessment. Staff #3's two most recent health assessments are dated 8/29/22 and 10/31/24 which are more than 24 months apart. Staff #4's two most recent health assessments are dated 8/5/22 and 9/31/24 which are more than 24 months apart. Staff #7's file contained a health assessment that was dated 8/15/23, this assessment was marked that a physical examination was not conducted making this health assessment not valid.

Corrected Corrected by Dec 6, 2024

Category: health medication. 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's file did not contain a TB test.

Corrected Corrected by Dec 6, 2024

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

3270.151(c)(5) · An adult health assessment must include the physician's or CRNP's assessment of the person's suitability to provide child care.

Staff #2 health assessment dated 10/26/23 did not state that the person was suitable to provide child care.

Corrected Corrected by Nov 23, 2024

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

3270.165 · An operator shall conspicuously post the menu at least 1 week in advance or provide a menu to each family.

The menu was not posted in the facility.

Corrected Corrected by Dec 6, 2024

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's file did not contain 2 written nonfamily references. Staff #4's file contained two reference letters from the same person.

Corrected Corrected by Dec 6, 2024

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.

The file for staff person #7, was observed not to have completed pre-service training within 90 days of hire (See LIS CODE SHEET). Staff #7's file contained the online portion of the pediatric first aid/CPR training dated 9/4/23, the in-person portion of the training was not completed making this training not acceptable.

Corrected Corrected by Dec 6, 2024

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

3270.31(e) · A staff person shall obtain an annual minimum of 12 clock hours of child care training.

Staff file #2 lacked 5 of the 12 hours of annual child care training required from 12/2022 to 12/2023. Staff file #2 contained 5 child care training hours dated 2/5/24, 3/12/24, and 4/29/24 used for correction. Staff file #4 lacked 5 of the 12 hours of annual child care training required from 12/2022 to 12/2023. Staff file #4 contained 5 child care training hours dated 3/23/24, 5/24/24, and 5/24/24 used for correction.

Corrected Corrected by Dec 6, 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 #5 initial health assessment is dated 2/23/24 which is more than 60 days after enrollment(See LIS Code Sheet).

Corrected Corrected by Dec 6, 2024

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

3270.162(c) · Food may not be withheld from a child for purposes of discipline.

Per staff statements, Staff #1 has taken food away from children many times when they are not finished eating during lunch. It was reported that Staff #1 will only give the children 5-8 minutes to eat lunch before she takes the children's plates away because she wants the children to lay down for nap so that she can leave the classroom. The children will be crying or saying that they are not done and are still hungry when this happens.

Corrected Corrected by Nov 7, 2024

Category: nutrition. 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.

Second citation previously cited on 7/9/24. Staff #4 has not completed the health and Safety 1 hour update training by the required date of 12/30/22.

Corrected Corrected by Nov 14, 2024

Category: ratio. Marked corrected in the state record.

3270.31(f) · Staff person(s) shall complete professional development in the topics of 3270.31(f)(1-10) within 90 days of hire. Staff person #2 will have until 15 days from POC requested date to complete the required training. Until such time as the required training has been completed, staff person # 2 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 #2, staff person #2 may not work in a child-care position at the facility.

Second citation previously cited on 7/9/24, Staff #2's file contains a 6-hour health and safety training dated 9/11/16 which is not an acceptable training.

Corrected Corrected by Nov 3, 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). Facility Person # 5 and #6 may not work in a childcare position at the facility.

The file for staff #3 contained a child abuse clearance dated 6/10/24, state police clearance dated 2/28/24, and a DHS FBI clearance dated 3/1/24 all are dated after their date or hire(See LIS Code Sheet). The file for staff #4 contained a child abuse clearance dated after their start date with children(See LIS Code Sheet). The file for staff #5 did not contain a copy of the completed clearance information from Michigan required under the CPSL. The file for staff #6 did not contain a state police clearance, child abuse clearance, or a copy of the completed clearance information from Texas required under the CPSL.

Corrected Corrected by Oct 30, 2024

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

3270.32(a) · The operator shall comply with the CPSL and with Chapter 3490 (relating to Child Protective Services). Staff person #6 and #7 will have until 15 days from POC requested date to complete the mandated reporter training. Until such time as the required training has been completed, staff person #6 and #7 must be supervised, when interacting with children, by at least an AGS who has completed the required training related to this citation. If there are no staff person(s) available to supervise staff person #6 and #7, staff person #6 and #7 may not work in a child-care position at the facility.

Second citation previously cited on 7/9/24. Staff #6 and 7 have not completed the mandated reporter training within 90 days of their date of hire (see LIS code sheet).

Corrected Corrected by Nov 22, 2024

Category: supervision. Marked corrected in the state record.

3270.36(b)(5)/3270.192(2)(ii) · An assistant group supervisor shall have a high school diploma or a general educational development certificate and 2 years experience with children. A facility person's record shall include verification of child care experience, education and training prior to service at the facility.

Staff #6, who was working as an AGS, had a file that did not contain verification of child care experience and education prior to service at the facility.

Corrected Corrected by Oct 30, 2024

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.

*Second citation previously cited on 7/9/24. At approximately 11:55am on 10/21/24 it was observed that a preschool age child from the treehouse room was sent across the hall to the bathroom alone to change their pull up.

Corrected Corrected by Nov 21, 2024

Category: ratio. Marked corrected in the state record.

3270.51 · **The legal entity or legal entity representative will conduct ratio and supervision checks in all classrooms at least three times a week for a period of 4 months after the date this plan of correction is accepted. The classroom checks will be documented on a form pre-approved by the department and will remain onsite for review by a representative of the department during a minimum of at least 3 unannounced monitoring visits. The legal entity will review the classroom check forms on a weekly basis and will sign off on each form.

**Second citation previously cited on 7/9/24. At approximately 11:55am on 10/21/24 it was observed that a preschool age child from the treehouse room was sent across the hall to the bathroom alone to change their pull up.

Corrected Corrected by May 6, 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 pond room a pink power strip accessible to children was missing protective outlet covers. In the treehouse room 2 outlet covers were missing accessible to children: one by the refrigerator and one by the children's eating tables.

Corrected Corrected by Oct 21, 2024

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 upstairs hallway next to the bathroom on a low cart accessible to children was Febreze Air Mist which stated keep out of reach of children.

Corrected Corrected by Oct 21, 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 kit in the Back 40 room and the Friendly Forest room were missing adhesive bandages. The first aid kit in the Sassafras room was missing gauze.

Corrected Corrected by Oct 22, 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.

The shelves that held nap time items for the beehive room were not attached to the wall making them unstable. The tall white cabinet in the beehive room was not attached to the wall making it unstable when touched.

Corrected Corrected by Nov 16, 2024

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.

Second citation previously cited on 7/9/24. At approximately 11:55am on 10/21/24 it was observed that a preschool age child from the treehouse room was sent across the hall to the bathroom alone to change their pull up.

Corrected Corrected by Nov 21, 2024

Category: supervision. Marked corrected in the state record.

3270.113(a)(1) · Each staff person shall be assigned the responsibility for supervision of specific children. The staff person shall know the names and whereabouts of the children in his assigned group. The staff person shall be physically present with the children in his group on the facility premises and on facility excursions off the facility premises.

Second citation previously cited on 7/9/24. At approximately 11:55am on 10/21/24 it was observed that a preschool age child from the treehouse room was sent across the hall to the bathroom alone to change their pull up.

Corrected Corrected by Nov 21, 2024

Category: supervision. Marked corrected in the state record.

3270.151(c)(1)/3270.192(3) · An adult health assessment must include a physical examination. 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 #4 initial health assessment is dated 9/7/24 which is after their date of hire(See LIS Code Sheet). Staff #5 health assessment is dated 8/16/24 which is after their date of hire(See LIS Code Sheet). Staff #6's file did not contain an initial health assessment.

Corrected Corrected by Nov 5, 2024

Category: health medication. 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 #4 file contain a TB test that is dated 9/7/24 which is after their date of hire(See LIS Code Sheet). Staff #5 TB test is dated 8/16/24 which is after their date of hire(See LIS Code Sheet). Staff #6's file did not contain a TB test.

Corrected Corrected by Nov 1, 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.

The files for staff #3 and #6 did not contain two written, nonfamily references from individuals attesting to the person's suitability to serve as a facility person.

Corrected Corrected by Nov 1, 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.

The fire alarm testing log contained the following dates: 10/19/23-11/20/23, 12/18/23-1/29/24, 2/19/24-3/22/24, 4/18/24-5/24/24, and 7/12/24-8/19/24 which are more than 30 days apart.

Corrected Corrected by Nov 1, 2024

Category: recordkeeping. 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.

Per staff statements, staff #1 has placed child #1 in the bathroom with the door closed on multiple occasions. It was reported that the child was placed in the bathroom to stop the child from hitting or biting other children when the staff was changing diapers and also when the child was not behaving.

Corrected Corrected by Oct 15, 2024

Category: ratio. 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.

*Per staff statements, staff #1 has placed child #1 in the bathroom with the door closed on multiple occasions. It was reported that the child was placed in the bathroom to stop the child from hitting or biting other children when the staff was changing diapers and also when the child was not behaving.

Corrected Corrected by Oct 15, 2024

Category: supervision. Marked corrected in the state record.

3270.113(a) · **The legal entity will conduct a staff meeting within two months of the approval of this plan of correction. Supervision, ratio and appropriate discipline of children will be reviewed. The staff meeting agenda will also include a review of any supervision and ratio citations made by the Department within the last 12 months. The legal entity will create a dated agenda for the staff meeting and a signed attendance sheet for the meeting. The agenda and signed attendance sheet will be provided to the OCDEL-DHS representative by email within 7 days of completion of the staff meeting.

**Per staff statements, staff #1 has placed child #1 in the bathroom with the door closed on multiple occasions. It was reported that the child was placed in the bathroom to stop the child from hitting or biting other children when the staff was changing diapers and also when the child was not behaving.

Corrected Corrected by Dec 15, 2024

Category: supervision. Marked corrected in the state record.

3270.113(a)(1) · Each staff person shall be assigned the responsibility for supervision of specific children. The staff person shall know the names and whereabouts of the children in his assigned group. The staff person shall be physically present with the children in his group on the facility premises and on facility excursions off the facility premises.

Per staff statements, staff #1 has placed child #1 in the bathroom with the door closed on multiple occasions. It was reported that the child was placed in the bathroom to stop the child from hitting or biting other children when the staff was changing diapers and also when the child was not behaving.

Corrected Corrected by Oct 15, 2024

Category: supervision. Marked corrected in the state record.

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

*Per staff statements and observation of classroom video footage, on 6/25/24, staff #1, grabbed the hands of child #1 and pulled, then held the child in the staff's lap, after the child continued to leave the table the other children were sitting at to do an activity.

Corrected Corrected by Oct 15, 2024

Marked corrected in the state record.

3270.113(b) · **The legal entity will require all staff persons at the facility to attend a, 2 hour in person training regarding managing challenging behaviors in children presented by the ELRC within 1 month of the approval of this plan of correction. The training must be approved by the Department prior to implementation. Documentation of the completed training will be provided to the OCDEL-DHS representative by email upon completion. The training may count towards the mandatory 12 training hours required by the Department.

**Per staff statements and observation of classroom video footage, on 6/25/24, staff #1, grabbed the hands of child #1 and pulled, then held the child in the staff's lap, after the child continued to leave the table the other children were sitting at to do an activity.

Corrected Corrected by Nov 15, 2024

Category: recordkeeping. 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.

Per staff statements, staff #1 has yelled at child #1 using harsh language, when the child is being redirected.

Corrected Corrected by Oct 15, 2024

Marked corrected in the state record.

3270.113(e) · 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.

Per staff statements and observation of classroom video footage, on 6/25/24, staff #1, grabbed the hands of child #1 and pulled, then held the child in the staff's lap, after the child continued to leave the table the other children were sitting at to do an activity. Staff #1 has placed child #1 in the bathroom with the door closed on multiple occasions. It was reported that the child was placed in the bathroom to stop the child from hitting or biting other children when the staff was changing diapers and also when the child was not behaving.

Corrected Corrected by Oct 15, 2024

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

3270.118(a) · A pet or animal present at the facility, indoors or outdoors, shall be in good health and known to be friendly to children.

Per staff statements, the children have been allowed to play with a dog named Nola at the facility. While playing with the dog, child # 2, was bitten on the abdomen. Child # 3, was bitten on the shoulder. Staff described the incident with child #3 as a "nip."

Corrected Corrected by Sep 19, 2024

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.

Per staff statements and a file review, incident reports for the following incidents were not created: incident on 6/25/24 for child #1; dog bit incident for child #2 and child #3.

Corrected Corrected by Oct 15, 2024

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

3270.14/3270.21 · A facility shall be operated in conformity with applicable Federal and State laws and regulations.State agencies whose regulations may relate to the operation of a facility include the Department of Environmental Resources, the Department of Labor and Industry, the Department of Health, the Department of Education and the Department of Transportation. Conditions at the facility may not pose a threat to the health or safety of the children.

The files for staff # 3 and #5 lacked the one-hour updated health and safety training course, Pennsylvania Health and Safety Update 2022 by the deadline of 12/30/22, as required by Announcement C-22-06.

Corrected Corrected by Dec 6, 2024

Category: ratio. Marked corrected in the state record.

3270.31(f) · Staff person(s) shall complete professional development in the topics of 3270.31(f)(1 -- 10) within 90 days of hire. Staff person #1 & #2 will have until 10/12/24 to complete the required training. Until such time as the required training has been completed, staff person #1 & #2 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 & #2, staff person #1 & #2 may not work in a child-care position at the facility.

Staff # 1 has not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): Health and Safety, Pediatric First Aid and Pediatric CPR , and Mandated Reporter Training. Staff # 2 has not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): Health and Safety, and Pediatric First Aid and Pediatric CPR .

Corrected Corrected by Dec 6, 2024

Category: supervision. Marked corrected in the state record.

3270.32(a)/3270.192(2)(iii) · The operator shall comply with the CPSL and with Chapter 3490 (relating to Child Protective Services). Staff person #4 will have until 10/12/24 to complete the mandated reporter training. Until such time as the required training has been completed, staff person #4 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 person(s) available to supervise staff person #4, staff person #3 may not work in a child-care position at the facility.

Staff person #4 has not completed mandated reporter training within the last 60 months. This is evidenced by the previously documented mandated reporter training on file being dated 7/5/19.

Corrected Corrected by Dec 6, 2024

Category: supervision. Marked corrected in the state record.

3270.31(f) · 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. Staff person #1 and 2 will have until July 5. 2024 to complete the required training. Until such time as the required training has been completed, staff person #1 and 2 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 and 2, staff person #1 and 2 may not work in a child-care position at the facility.

Staff person #1 has not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet):Pediatric First Aid, Health and Safety, and Mandated Reporter Training. Staff person #2 has not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet):Health and Safety

Corrected Corrected by Jul 5, 2024

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.

On March 11, 2024, from approximately 11:20 A.M. -- 11:25 A.M. three (3) Pre School-Children were on the outdoor play space in an area not visible to staff. The three (3) children were not properly supervised and the three (3) children were seen on video with their pants down touching each other's private areas. At 11:25 A.M., a staff person who witnessed this incident alerted another staff person on the outdoor play space and it was stopped.

Corrected Corrected by Apr 18, 2024

Category: supervision. Marked corrected in the state record.

3270.113(a)(1) · Each staff person shall be assigned the responsibility for supervision of specific children. The staff person shall know the names and whereabouts of the children in his assigned group. The staff person shall be physically present with the children in his group on the facility premises and on facility excursions off the facility premises.

On March 11, 2024, from approximately 11:20 A.M. -- 11:25 A.M. three (3) Pre School-Children were on the outdoor play space in an area not visible to staff. The three (3) children were not properly supervised and the three (3) children were seen on video with their pants down touching each other's private areas. At 11:25 A.M., a staff person who witnessed this incident alerted another staff person on the outdoor play space and it was stopped.

Corrected Corrected by Apr 18, 2024

Category: supervision. Marked corrected in the state record.

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

The files for Child #1 and #3 both contain emergency contact forms that were lacking parent work addresses and phone numbers.

Corrected Corrected by Jan 8, 2024

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.

The facility was lacking an annual emergency drill.

Corrected Corrected by Jan 8, 2024

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.

The file for Staff #1 and #5 were lacking the 1 hour Health and Safety Update. The file for Staff #2 contained a Health and Safety training that was obtained more than 90 days after her Date of hire(See LIS code sheet)

Corrected Corrected by Jan 8, 2024

Category: ratio. Marked corrected in the state record.

3270.31(f) · Staff person(s) shall complete professional development in the topics of 3270.31(f)(1 -- 10), within 90 days of hire. Staff person #3 will have until 1/15/23 to complete the required training. Until such time as the required training has been completed, staff person #3 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 #3, staff person #3 may not work in a child-care position at the facility.

Staff person #3- has not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): (Pediatric First Aid and CPR).

Corrected Corrected by Jan 8, 2024

Category: supervision. Marked corrected in the state record.

3270.36(b)(1) · An assistant group supervisor shall have a high school diploma or a general educational development certificate and 30 credit hours from an accredited college or university in early childhood education, child development, special education, elementary education or the human services field.

The file for Staff #4 was lacking proof of education and experience.

Corrected Corrected by Jan 8, 2024

Category: supervision. 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 kit in the Caterpillar Cove was lacking band-aids.

Corrected Corrected by Dec 7, 2023

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

3270.131(e)(1) · The facility shall require the parent to provide updated written verification from a physician, physician's assistant, CRNP, the Department of Health or a local health department of ongoing vaccines administered to an infant, toddler or preschool child in accordance with the schedule recommended by the ACIP.

The file for Child #1 contained an immunization record that was lacking 2-3 rotovirus vaccines and 2 Hepatitis A vaccines. The file for Child #2 contained a health assessment with no vaccines documented and no exemption letter.

Corrected Corrected by Jan 8, 2024

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

3270.133(2) · 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.

In the Friendly Forest Classroom there was prescription triamcinolone acetonide ointment that had no written instructions from the individual who prescribed the medication.

Corrected Corrected by Jan 8, 2024

Category: ratio. Marked corrected in the state record.

3270.133(6) · A parent shall provide written consent for administration of medication or a special diet.

In the Friendly Forest Classroom there was prescription triamcinolone acetonide ointment that was lacking written consent for administration from the parent.

Corrected Corrected by Jan 8, 2024

Category: ratio. Marked corrected in the state record.

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

The file for Staff #6 contains an initial health assessment that was conducted after their date of hire.(see LIS code sheet).

Corrected Corrected by Dec 7, 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.

The file for Staff #6 was lacking proof of TB screening at initial employment.

Corrected Corrected by Jan 8, 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.

The file for Staff #3 was lacking one written nonfamily reference.

Corrected Corrected by Jan 8, 2024

Category: recordkeeping. 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 #1 was witnessed picking up a child by on arm pulling them across the floor then picking the child up by two arm and slamming the child down roughly into a chair and then pushing the chair into the table hard causing the table to push into the child's stomach.

Corrected Corrected by Oct 3, 2023

Marked corrected in the state record.

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

The file for Staff #1 contained an FBI clearance that was asking for more information therefore making it an invalid clearance because it didn't have an eligibility answer on it.

Corrected Corrected by Aug 15, 2023

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

3270.32(c) · The operator may not allow an individual to enter the facility if the operator knows that the individual has been convicted or is awaiting trial on charges involving a crime of child abuse, child neglect, physical violence or moral corruptness.

Based on conversations with the Director, the owner, and the staff person # 1 it was verified that the staff member was working while awaiting trial which makes her not eligible to work in the childcare facility.

Corrected Corrected by Aug 15, 2023

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

3270.131(d)(5) · Child # 1 must be dismissed from care by close of business 5/22/23 and may only return to care when the immunization record is updated or when a parent provides a written, signed exemption letter.

The immunization record for Child #1 was lacking one dose of DTAP, two doses of HIB, and one dose of Hepatitis A.

Corrected Corrected by May 22, 2023

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

3270.131(e)(3) · Child # 1 must be dismissed from care by close of business 5/22/23 and may only return to care when the immunization record is updated or when a parent provides a written, signed exemption letter.

The immunization record for Child #1 was lacking one dose of DTAP, two doses of HIB, and one dose of Hepatitis A.

Corrected Corrected by Aug 8, 2023

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

3270.32(a) · The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). LACKING REQUIRED HIRING DOCUMENTS: Facility Person #1 -- may not work at the facility. 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.

The file for Staff #1 contained a volunteer state police and child abuse clearances and a PDE FBI clearance. Staff #1 cannot work at the facility until the proper clearances are obtained.

Corrected Corrected by Jan 3, 2023

Category: supervision. Marked corrected in the state record.

3270.77(a) · Peeled or damaged paint or damaged plaster is not permitted on indoor or outdoor surfaces in the child care facility.

In the Back 40 room, peeling paint was observed on the wall between the two areas of the room on the green side.

Corrected Corrected by Jan 13, 2023

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

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

The file for Staff #2 contained a health assessment that was obtained after the staff's start date. The file for Staff #3 contained 2 health assessments that were more than 24 months apart.

Corrected Corrected by Jan 3, 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).

The file for staff #1 who was provisionally hired had a request date of 4-15-2021 for the NSOR. Staff #1 start date with children was 4-12-2021. The file for staff #2 who was provisionally hired had a request date of 6-14-2021 for the child abuse clearance. Staff #2 start date with children was 6-8-2021.

Corrected Corrected by Feb 25, 2022

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

3270.31(e)(4)(i)/3270.192(2)(iii) · 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.A facility person's record shall include verification of child care experience, education and training following the outset of service at the facility.

Staff #13 with a hire date of 4-7-2021 had a Pediatric First Aid/ CPR Training date of 8-5-2021 which exceeded the allowable 90 days for training after the date of hire. Staff #14 had a Pediatric First/CPR Training date of 1-19-19 and 1-21-2021 which exceeded the expiration date of 1-19-21 for the training. Staff #3 had a Pediatric First Aid/CPR training date of 2-2-2019 and 2-13-2021 which exceeded the expiration date of 2-2-2021 for the training. Staff #10 had a Pediatric First Aid/CPR training date of 1-19-2019 and 1-21-2021 which exceeded the expiration date of 1-19-2021.

Corrected Corrected by Nov 16, 2021

Category: ratio. Marked corrected in the state record.

3270.31(e)(4)(ii)/3270.192(2)(iii) · 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.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 had a fire safety training date of 5-22-19 and 1-2-21 which exceeded the annual training date of 5-22-2020. The file for staff #2 had a fire safety training date of 2-1-2020 and 9-27-2021 which exceeded the annual training date of 2-1-2021.The file for staff #9 had a fire safety training date of 2-1-2020 and 9-27-2021 which exceeded the annual training date of 2-1-2021.

Corrected Corrected by Nov 15, 2021

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 #12 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 #12 may not work in a child care position at the facility.

The file for staff #12 with a hire date of 6-8-2021 did not contain an FBI Clearance. and only had a form stating that the FBI Clearance was processed on 9-9-2021.

Corrected Corrected by Nov 15, 2021

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

Staff #4 was provisionally hired on 6-25-2021 and was not removed from a childcare position at any time. The file for staff #4 had a child abuse clearance dated 10-4-2021 which exceeds the 45 days allowed for a provisionally hired staff to obtain a clearance.

Corrected Corrected by Nov 15, 2021

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

3270.32(a)/3270.192(2)(iii) · The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). .A facility person's record shall include verification of child care experience, education and training following the outset of service at the facility.

Staff #4 with a hire date of 6-25-2021 had a file that contained a Mandated Reporter Training date of 10-1-2021 which exceeds the mandatory 90 days for the training. Staff #11 with a hire date of 8-4-2020 had a file that contained a Mandated Reporter Training date of 1-5-2021 which exceeded the mandatory 90 days for training. Staff #12 with a hire date of 6-8-2021 had a file that contained a Mandated Reporter Training date of 9-17-2021 which exceeded the mandatory 90 days for training. Staff #7 with a hire date of 6-28-2021 had a file that contained a Mandated reporter Training date of 10-26-2021 which exceeds the 90 days for training after the date of hire.

Corrected Corrected by Nov 15, 2021

Category: recordkeeping. 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.

The file for staff #3 contained a staff evaluation dated 10-2-2020 and 10-11-2021 which exceeded the annual staff evaluation date of 10-2-2021. The file for staff #5 contained a staff evaluation with a date of 8-19-2020 and 10-11-2021 which exceeded the annual staff evaluation date of 8-18-2021 .The file for staff #2 had a staff evaluation date of 7-13-2020 and 10-11-2021 which exceeded the annual staff evaluation date of 7-13-2021. The file for staff #6 had a staff evaluation date of 10-21-2019 and 4-19-2021 which exceeded the annual staff evaluation date of 10-21-2020. . The file for staff #1 contained a staff evaluation date of 5-22-2019 and 1-21-2021 which exceeded the annual staff evaluation date of 5-22-2020. Staff #15 had a staff evaluation date of 9-2-2020 and 10-1-2021 which exceeded the annual staff evaluation date of 9-2-2021.

Corrected Corrected by Nov 15, 2021

Category: recordkeeping. 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 Treehouse Room, located on the right side of the closet, a Swiffer Wet cleaning solution, labeled "Keep out of reach of children" was accessible to children.

Corrected Corrected by Nov 15, 2021

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.

In the Treehouse Room,, a spray bottle labeled "Sanitizer" was observed on the left side of the room on top of a orange cabinet and the contents were unknown. In the Back 40 Room, located on a shelf, two spray bottles that were labeled "Sanitizer" and the contents were unknown. In the Butterfly Room, one spray bottle was labeled: "Sanitizer" and one bottle was labeled "Disinfectant." Both bottles were located on a shelf and the contents of both were unknown.

Corrected Corrected by Nov 15, 2021

Category: ratio. Marked corrected in the state record.

3270.77(a) · Peeled or damaged paint or damaged plaster is not permitted on indoor or outdoor surfaces in the child care facility.

In the back of the Beehive Room, there were 5 areas of purple peeling paint and in the left corner there was one area of purple peeling paint. In the Meadow located on the back side of the wall, yellow peeling paint was observed. In the Meadow Room located underneath the back window there was paint peeling exposing the wood underneath. In the Infant Room, there was white paint peeling to the left and right of the cabinet located below the sink. In the Infant Room, there was blue paint peeling on the wall to the left of the sink. In the downstairs boys/girls bathroom, there was purple and brown peeling paint to the left of the sink.

Corrected Corrected by Nov 15, 2021

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 bathroom, located in the Butterfly Room, there was no handwashing sign above the toilet. In the upstairs blue boys/girls bathroom, there was no handwashing sign above the toilet. In the green girls/boys bathroom located upstairs, there was no handwashing sign above a toilet. In the bathroom located in the Beehive, there was no handwashing sign above the sink and the toilet.

Corrected Corrected by Nov 15, 2021

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

3270.102(a) · Toys, play equipment and other indoor and outdoor equipment used by the children shall be clean, in good repair and free from rough edges, sharp corners, pinch and crush points, splinters and exposed bolts.

In the Treehouse Room, a Little Tykes Washer had a blue lid which had a sharp crack in it. In the School Age 2 Playspace, located in a bin, there was a multicolored foam ball which was ripped producing a large hole. In the School Age Playspace, a yellow school bus had 5 areas of yellow paint that was peeled off exposing the metal underneath and 1 area that had yellow paint that was peeling and underneath the rusted metal was very rough.

Corrected Corrected by Nov 15, 2021

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

3270.106(a) · Individual, clean, age-appropriate rest equipment shall be provided for preschool, toddler and infant children as agreed between the child's parent and the operator. The rest equipment shall be labeled for the use of a specific child and used only by the specified child.

In the Treehouse Room, the Butterfly Room, and the Beehive Room the rest equipment was not labeled for the use of a specific child and based on conversations, the equipment was used daily by children.

Corrected Corrected by Nov 15, 2021

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

3270.119 · Infants shall be placed in the sleeping position recommended by the American Academy of Pediatrics unless there is a medical reason an infant should not sleep in this position. The medical reason shall be documented in a statement signed by a physician, physician's assistant or CRNP and placed in the child's record at the facility.

Child # 7 who is three months old was observed sleeping on his stomach and could not roll over on his own and there was not a medical reason for the infant sleeping in this position..

Corrected Corrected by Nov 15, 2021

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

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

Child #4 with an admission date of 5-17-2021 had an emergency contact form that did not specify the address of the individual designated by the parent to whom the child may be released. Child #5 with an admission date of 6-1-2021 had an emergency contact form that did not specify the address of the individual designated by the parent to whom the child may be released.

Corrected Corrected by Nov 15, 2021

Category: recordkeeping. Marked corrected in the state record.

3270.131(d)(5) · A health report shall include a review of the child's immunized status according to recommendations of the ACIP.

Child #1 with an admission date of 4-27-2021 had a file which did not contain an influenza immunization. Child #2 with an admission date of 3-29=2019 had a file which did not contain an influenza immunization. Child #3 with an admission date of 9-7-2021 had a file which did not contain an influenza immunization.

Corrected Corrected by Nov 15, 2021

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.

The fie for staff #7 with a hire date of 6-28-2021 had a health assessment date of 10-25-2021 which exceeded the mandatory date of 6-28-2021 for a health assessment. The file for staff #5 had a health assessment dated 2-12-2019 and 10-29-2021 which exceeds the mandatory 24 months for a health assessment. The file for staff #8 had a health assessment dated 9-4-2019 and 10-14-2021 which exceeds the mandatory 24 months for a health assessment. The file for staff #3 contained a health assessment date of 2-2-2019 and 2-13-2021 which exceeds the mandatory 24 month for a health assessment. The file for staff #2 had a health assessment dated 7-5-2019 and 11-10-2021 which exceeds the mandatory 24 months for a health assessment. The file for staff #1 had a health assessment date of 6-25-2018 and 9-1-2020 which exceeds the mandatory 24 months for a health assessment.

Corrected Corrected by Nov 17, 2021

Category: ratio. Marked corrected in the state record.

3270.31(f)(7)/3270.192(2)(iii) · Emergency preparedness and response planning for emergencies resulting from a natural disaster or a man-caused event (such as violence at a child care facility) within the meaning of those terms under section 602(a)(1) of the Robert T. Stafford Disaster Relief and Emergency Assistance Act (42 U.S.C.A. § 5195a(a)(1)).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 #2 had an emergency plan training date of 7-13-2020 and 10-11-2021 which exceeded the annual training date of 7-13-2021. Staff #13 with a hire date of 4-7-2021 had an emergency plan training date of 5-3-2021 which exceeded the mandatory date of 4-14-2021 for the training..

Corrected Corrected by Nov 16, 2021

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

3270.31(h)/3270.192(2)(iii) · All staff persons shall complete the professional development under subsection (f). A facility person's record shall include verification of child care experience, education and training following the outset of service at the facility.

Staff #4 with a hire date of 6-24-2021 had a Health and Safety Training date of 10-27-2021 which exceeds the mandatory 90 days for training after the date of hire.

Corrected Corrected by Nov 18, 2021

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