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.

A renewal inspection occurred at the facility. A review of staff files was conducted. Regulation requires staff to update their health assessments at least every 24 months. The following staff did not update their health assessments at least every 24 months: Staff #1 (previous 1/26/23, current 2/20/25), Staff #3 (previous 9/14/21, current 11/15/23), Staff #4 (previous 7/8/22, current 11/14/24) and Staff #6 (previous 3/7/22, current 10/21/24) Regulation also requires staff to have a health assessment on file prior to providing child child care. See the code sheet for the date of hire. The following staff did not have on file a health assessment prior to providing child care: Staff #2.

3270.151(a)/3270.192(3) · Corrected Apr 10, 2025

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

A renewal inspection occurred at the facility. A physical site review was conducted. Regulation requires cleaning material and other toxic materials to be kept in an area either inaccessible to children or locked. In the lower-level right room, a container labeled Arm & Hammer Moisture Absorber and Odor Eliminator was observed on the floor, to the left side of the cubbies, that indicated the need to be stored out of reach of children. This product was accessible to children and children were observed receiving care in the child care space during this inspection.

A facility person may not use any form of physical punishment, including spanking a child. 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.

An incident occurred on 11/26/24 and roughly a 5-minute video clip of the incident was viewed. On the video, Staff #1 was observed forcefully pulling Child #1 by the arm on several occasions, forcefully pushing Child #1's legs away several times, forcing Child #1 and another child down on to their matt at nap time and forcefully moving Child #1 as they lay on their back to laying on their stomach. Staff #1 was also observed picking Child #1 up by the arms and legs and dropping the child to the ground. Staff #1 was also observed restraining, using their leg, Child #1 to their nap matt. The Child #1 is viewed on several occasions, without success, attempting to get away from Staff #1 and out from under the leg of Staff #1.

3270.113(b)/3270.113(e) · Corrected Nov 26, 2024

A facility person may not use any form of physical punishment, including spanking a child. 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. The Legal Entity/Director must update existing supervision policies for staff. The updated policies must include specific expectations for supervision of children at naptime, including developmentally appropriate interactions. The policies and procedures must clearly indicate that staff are prohibited from using physical punishment or restraints in dealing with children at the facility. The Legal Entity/Director will submit the updated policies to the Northeast Regional Office for approval. Once approved, all existing staff and new hires must be trained on the approved policies and procedures, and it must be documented in their files.

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.

See SIN 00256046

3270.32(c) · Corrected Feb 26, 2025

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

See SIN 00256046

3270.71 · Corrected Feb 26, 2025

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.

See SIN 00256046

3270.76 · Corrected Feb 26, 2025

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.

See SIN 00256046

3270.113(a) · Corrected Feb 26, 2025

If emergency medical care is needed for a child, the parent shall be contacted as soon as practical in the best interest of the child. If the parent cannot be reached, the operator shall record in writing the reason emergency care was required and the attempts made to inform the parent.

See SIN 00256046

Floors, walls, ceilings and other surfaces, including the facility's outdoor play space surfaces shall be kept clean, in good repair and free from visible hazards. The facility shall have no occurrences of non-compliance related to visible hazards at the facility's physical site, which includes the facility's outdoor play space. The operator shall demonstrate compliance at unannounced visits over the next 3-months.

On 11/21/24, an incident occurred where Child #1 received 3rd degree burns on 40% of their body. Child #1 was in a pack and play located behind a mini refrigerator, which had a microwave stacked on top of it, and a crock pot, which contained hot water, on top of that. The cord for the crock pot ran down the rear of the refrigerator/microwave, accessible to Child #1 in the pack and play. Child #1 was able to pull the crock pot down on themselves. Child #1 was burned by the hot water that was contained within the crock pot.

3270.76 · Corrected Jun 21, 2025

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. The Legal Entity or Director will review and update supervision policies to include supervision at nap time so that all children can be seen, heard, directed and assessed properly, which also includes the placement of rest equipment in relation to staff's vision. This supervision policies must be submitted to the Department prior to implementation for approval. Once approved by the Department, the director will ensure that all current employees and any new hires are trained on this policy.

On 11/21/24, an incident occurred where Child #1 received 3rd degree burns on 40% of their body. Child #1 was in a pack and play located behind a mini refrigerator, which had a microwave stacked on top of it, and a crock pot, which contained hot water, on top of that. The cord for the crock pot ran down the rear of the refrigerator/microwave, accessible to Child #1 in the pack and play. Child #1 was able to pull the crock pot down on themselves. Child #1 was burned by the hot water that was contained within the crock pot. Staff #3, #4 and #5 were on the front side of the refrigerator/microwave/crock-pot stack. Based on the location of the pack and play behind this stack, and the physical location of the staff at the time of the incident, staff were unable to properly supervise Child #1.

A facility person who has been named as perpetrator in a founded/an indicated report of child abuse may not be present in the facility.

Staff #1, #2 and #3 have been named as perpetrators in indicated reports of child abuse.

20.71(b)(5) · Corrected Mar 7, 2025

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 2 room, there was an area of the baseboard heating unit that was separated creating a pinch point.

3270.76 · Corrected Mar 22, 2024

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.

There was spill in the infant room refrigerator that hadn't been cleaned up.

3270.107 · Corrected Mar 19, 2024

Emergency contact information must include the home and work addresses and telephone numbers of the enrolling parent.

Child #1's emergency contact information was missing the parents work address and telephone numbers.

3270.124(b)(3) · Corrected Mar 19, 2024

Emergency contact information must include the written consent signed by a parent for emergency medical care. A child's record shall contain signed parental consent for emergency medical care for the child. Written consent is required prior to admission.

Child #1 did not have signed parental consent for emergency medical care.

3270.124(b)(4)/3270.182(3) · Corrected Mar 19, 2024

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

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.

On 5/3/23, a few faint mildew spots were observed on a ceiling tile in the older toddler room.

3270.76 · Corrected May 15, 2023

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.

On 5/3/23, 2 young toddlers were observed sitting in highchairs to watch TV from 10:15 am to 10:55 am. They did not have any food or other activity. They were watching TV.

3270.111(c)/3270.113(e) · Corrected May 3, 2023

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

On 5/3/23, there were 9 gallon-size cans of paint in two open boxes in the main entry area of the facility. All of the children present walked through this area to get to their respective classrooms.

3270.66(a) · Corrected May 3, 2023

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

On 5/3/23, a preschool child was observed blowing their nose and throwing the tissue into a trash can with no lid.

3270.67(d) · Corrected May 15, 2023

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.

On 5/3/23, a damaged ceiling was observed in the office. The children were observed going through the office to exit the building during a fire drill at 11:11 am. Staff admitted that children go through the office to go out to the play areas.

3270.76 · Corrected May 15, 2023

Toilet areas and fixtures shall be cleaned daily and be in good repair.

On 5/3/23, there was some water on the floor around the base of the toilet in the first-floor bathroom.

3270.82(g) · Corrected May 12, 2023

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. The swings and the wooden ship structure shall be made inaccessible and will not be used by the children until such time as the loose impact absorbing material meets the recommendations of the United States Consumer Product Safety Commission. For these pieces of equipment there needs to be six inches of the recycled rubber material under the swings and wooden ship structure.

On 5/3/23, owner verified that there is an embedded swing set and an embedded wooden ship climber/slide on the preschool playground. The loose-fill surfacing that is on the playground is recycled rubber. The required depth of shredded/recycled rubber is six inches. At the inspection on 5/3/23 there was less than one inch of loose-fill impact absorbing material underneath the swings and wooden ship structure.

Outside walkways shall be free from ice, snow, leaves, equipment and other hazards.

During renewal inspection on 3/27/23 cert rep observed pipe/drainage work being done around the side and back of building. There are wide trenches. The children have to walk around these trenches and under pine trees to get to the playground in the back. There are no barricades or fencing around the open trenches.

3270.64 · Corrected Apr 10, 2023

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. Peeled or damaged paint or damaged plaster is not permitted on indoor or outdoor surfaces in the child care facility.

During renewal inspection on 3/27/23 cert rep observed damaged paint in the bathroom on the main floor by the light switch.

3270.76/3270.77(a) · Corrected Apr 3, 2023

Emergency contact information must include the home and work addresses and telephone numbers of the enrolling parent.

During renewal inspection on 3/27/23 cert rep reviewed several children's files. CHILD # 1 emergency contact form did not include enrolling parent's work address and phone number. CHILD #2 emergency contact form did not include enrolling parent's work address and phone number.

3270.124(b)(3) · Corrected Apr 3, 2023

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

During renewal inspection on 3/27/23 cert rep reviewed several children's files. CHILD #2 emergency contact form did not include information on disability.

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.

RS stated that their child was injured at the center and RS signed an incident report. RS did not remember the date of the incident. RS was not given a copy of the incident report. When interviewed, director stated that they put the reports in the children's files and only give it to the parent if the parent requests it. TA was provided regarding incident reports.

3270.182(7) · Corrected Mar 1, 2023

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

During unannounced complaint investigation on 2/9/23, I checked the sink vanity cabinet in the baby room. The cabinet had doors on it, but the doors did not have any type of lock on them. There was a bottle of Odo-Ban, a bottle of peroxide, a sanitizing spray, and 8 containers of sunscreen under the cabinet. These items were accessible to children.

3270.66(a) · Corrected Feb 9, 2023

Staff persons shall complete professional development in pediatric first aid and pediatric cardiopulmonary resuscitation within 90 days of hire. STAFF #2 will have until March 10, 2023 to complete the required training. Until such time as the required training has been completed, STAFF #2 must be supervised, when interacting with children, by an AGS or GS who has completed the required training relating to this citation. If there are no staff available to supervise STAFF #2, STAFF #2 may not work in a childcare position at the facility.

During unannounced complaint investigation on 2/9/23, I reviewed all staff files. STAFF #2 has not completed the following required pre-service training within 90 days of their date of hire (see code sheet for date of hire): Pediatric first aid and pediatric CPR.

3270.31(f)(10) · Corrected Feb 14, 2023

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

During renewal inspection on 3/1/22 CR reviewed several staff files. STAFF # 2 Mandated Reporter training was dated 9/14/16. MR training is valid for 60 months.

3270.32(a) · Corrected Mar 8, 2022

A child's record shall contain signed parental consent for emergency medical care for the child. Written consent is required prior to admission. A child's record shall contain signed parental consent for administration of minor first-aid procedures by facility staff. Written consent is required prior to admission.

During renewal inspection on 3/1/22 CR reviewed several children's files. CHILD # 1 emergency contact form did not include signed parental consent for emergency medical care and signed parental consent for administration of minor first-aid procedures by facility staff.

3270.182(3)/3270.182(5) · Corrected Mar 4, 2022

Peeled or damaged paint or damaged plaster is not permitted on indoor or outdoor surfaces in the child care facility.

During renewal inspection on 3/1/22 CR observed damaged paint in the PS/T3 room under the coats and by the air purifier.

3270.77(a) · Corrected Mar 1, 2022

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. 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.