3270.36(b)(5) · An assistant group supervisor shall have a high school diploma or a general educational development certificate and 2 years experience with children. Obtain and submit written verification of education and experience for the identified staff person. Ensure that all staff records have written verification of education and experience for their positions.

One staff person's record did not contain written verification of education for their assistant group supervisor position. (2)

Corrected Corrected by Mar 26, 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. Staff person cannot work unsupervised with children until the PA Update has been completed. Submit written verification of the required CCDBG training (PA Update) for the indicated staff persons.

One staff person were observed caring for a child and their record did not contain verification of completed required CCDBG training (1 hr. Pa Update) (#1).

Corrected Corrected by Mar 26, 2025

Category: supervision. 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). Complete and submit a current up-to-date child service report for the indicated child. Ensure that child service reports are completed for all children as specified in this regulation.

One child's records did not contain a child service report that had been completed within the past 6 months. (#4)

Corrected Corrected by Mar 26, 2025

Category: recordkeeping. Marked corrected in the state record.

3270.124(b)(6) · Emergency contact information must include health insurance coverage and policy number for a child under a family policy or Medical Assistance benefits, if applicable. Obtain and submit a written copy of the missing health insurance information for the identified child. Ensure that all children's records contain emergency contact information as specified in these regulations.

One child's emergency contact information did not include health insurance coverage and policy number information. (#1)

Corrected Corrected by Mar 26, 2025

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

3270.131(b)(1) · The operator shall require the parent to provide an updated health report at least every 6 months for an infant or young toddler. Obtain and submit a current up-to-date health report for the indicated child. Ensure that an updated health report is obtained every 6 months for children from infant to young age.

One child's record did not contain a health report completed within the past 6 months as required for a child from infant to young toddler age. (#2)

Corrected Corrected by Mar 26, 2025

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

3270.131(b)(2) · The operator shall require the parent to provide an updated health report at least every 12 months for an older toddler or preschool child. Obtain and submit a current up-to-date health report for the indicated child. Ensure that an updated health report is obtained every 12 months for children older toddler to preschool age.

One child's record did not contain a health report completed within the past 12 months as required for children older toddler age to preschool age. (#3)

Corrected Corrected by Mar 26, 2025

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

3270.133(2)/3270.133(3) · A staff person shall administer a prescription medication only if written instructions are provided from the individual who prescribed the medicine. Instructions for administration contained on a prescription label are acceptable. The label of a medication container shall identify the name of the medication and the name of the child for whom the medication is intended. Medication shall be administered to only the child whose name appears on the container. . Obtain the original labeled container for the child's medication and ensure that all medication is received in the original labeled container with the child's name before administering.

A facility staff person administered albuterol to a child and the medication was not in its original container and was not labeled with the child's name (#1)

Corrected Corrected by Mar 26, 2025

Category: ratio. Marked corrected in the state record.

3270.133(7)(i) · A medication log shall include the name of the medication. Amend the medication log to include the name of the medication. Submit a copy of the revised medication log for verification of compliance. Amend the medication log to include the name of the medication. Submit a copy of the revised medication log for verification of compliance.

Albuterol medication was administered to a child on 11/18/24, 2/5/25, and 2/5/25 and the medication log did not include the name of the medication. The medication log listed the medication as "inhaler". (child #1)

Corrected Corrected by Feb 26, 2025

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

3270.182(5) · A child's record shall contain signed parental consent for administration of minor first-aid procedures by facility staff. Written consent is required prior to admission. Obtain and submit written verification of signed parental consent for administration of minor first-aid procedures by facility staff prior to admission for the indicated child. Ensure that this information is in all children's records.

One child's record did not contain written verification of signed parental consent for administration of minor first-aid procedures by facility staff prior to admission

Corrected Corrected by Mar 26, 2025

Category: ratio. Marked corrected in the state record.

3270.27(a)(1) · The facility shall have an emergency plan that provides for accommodations for shelter of children during an emergency including lock-down, shelter in place at the facility and shelter at locations away from the facility premises. Submit a written copy of the amended emergency plan.

The facility's emergency plan did not provide for shelter of children during an emergency including lock down procedures. Amend the facility emergency plan to include lock down procedures.

Corrected Corrected by Mar 26, 2025

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

3270.27(a)(2) · The facility shall have an emergency plan that provides for accommodations for evacuation of children from the facility building and evacuation of children to a location away from the facility premises. The evacuation routes and evacuation plans to exit the building may be the same as those required by §3270.94 (relating to fire drills). Amend the facility emergency plan to include accommodations for infants, toddlers, children with disabilities, and children with chronic medical conditions. Submit a written copy of the amended emergency plan.

The facility's emergency plan did not include provide for accommodations for infants, toddlers, children with disabilities, and children with chronic medical conditions.

Corrected Corrected by Mar 26, 2025

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

3270.21/3270.113(a) · Conditions at the facility may not pose a threat to the health or safety of the children. Children on the facility premises and on facility excursions off the premises shall be supervised by a staff person at all times. Outdoor play space used by the facility is considered part of the facility premises. TIERED LIS: Children must be supervised at all times by 1/13/25. The legal entity must revise policies and procedures regarding medication administration and storage to ensure the safety of children in care by 1/13/25. The legal entity must arrange for all staff person to receive a minimum of two hours of DHS approved training regarding supervision of children. The legal entity must submit written verification of the completed training, by 2/13/25.

On 12/30/24, a staff observed two children pick up a pill from the floor, placed it in their mouths and spit it out. Staff were unaware of where the pill came from.

Corrected Corrected by Jan 13, 2025

Category: supervision. Marked corrected in the state record.

3270.70(a)/3270.76 · The indoor temperature shall be at least 65° F. 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. Repair or replace the heating unit and ensure that the indoor temperature is at least 65° F throughout the facility. Children cannot return to care in any part of the building where the temperature is not at least 65° F. Submit written verification of the completed repair.

The heater servicing one part of the building was in disrepair causing a classroom to lack heat. The temperature was below 65° F.

Corrected Corrected by Feb 13, 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). LACKING REQUIRED HIRING DOCUMENTS: 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. Revise and submit written policies and procedures regarding CPSL hiring requirements to ensure that all new hires and volunteers have the required CPSL clearance documentation prior to working with children and to ensure ongoing compliance with the CPSL.

The facility was not in compliance with the CPSL and with Chapter 3490 (relating to protective services): Several staff person's records did not contain the required CPSL hiring documents. (#4-first day working with children 11/27/23-no CHILD ABUSE prior to working with children(11/29/23; no proof of request for NSOR prior to working with children-completed 11/29/23) (#6-hired 11/17/23- no proof of completed CHILD ABUSE and completed STATE POLICE or FBI prior to working with children; no proof of request for NSOR prior to working with children) (#7- first day working with children 5/1/23- no proof of request or completed FBI prior to working with children-completed 2/24/24; mandated reporter training completed more than 90 days after hire 1/9/14)

Corrected Corrected by May 7, 2024

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

3270.34(b)(1) · A director shall have attained a bachelor's degree from an accredited college or university in early childhood education, child development, special education, elementary education or the human services field and 1 year of experience with children. Obtain and submit written documentation of educational equivalency to verify that the bachelor's degree meets the educational qualifications for group supervisor. Ensure that all staff records have written verification of education and experience for their positions.

One staff person's record did not contain written verification that their bachelor's degree was in early childhood education, child development, special education, elementary education or the human services field as it was conferred in a foreign country and required an equivalency. (#2 and #5)

Corrected Corrected by May 7, 2024

Category: supervision. Marked corrected in the state record.

3270.35(b)(2) · A group supervisor shall have a bachelor's degree from an accredited college or university, including 30 credit hours in early childhood education, child development, special education, elementary education or the human services field and 1 year of experience with children. Obtain and submit written verification of related credits for the identified staff person. Ensure that all staff records have written verification of education for their positions.

One staff person's record did not contain written verification that their bachelor's degree included 30 credit hours in early childhood education, child development, special education, elementary education or the human services field for their group supervisor position. (#1)

Corrected Corrected by May 7, 2024

Category: supervision. 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. Empty the bucket of water and ensure that all containers of water are immediately emptied after each use. Notify all staff of this requirement and submit written notification of staff notification.

A bucket of standing water observed in the upper-level hallway presented a safety hazard to the children in care.

Corrected Corrected by Mar 27, 2024

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

3270.80(a) · Inside and outside stairs with three or more steps shall be equipped with a handrail. Install a handrail and submit written verification of the installation.

The stairs leading to the outside play area had more than 3 steps and lacked a handrail.

Corrected Corrected by May 7, 2024

Marked corrected in the state record.

3270.123(a)(3) · The services to be provided to the family and the child, including the Department's approved form to provide information to the family about the child's growth and development in the context of the services being provided. The operator shall complete and update the form and provide a copy to the family in accordance with the updates regarding emergency contact information in § 3270.124(f) (relating to emergency contact information). Submit an updated agreement for the identified children that contains this information. Ensure that all children's agreements include services to be provided as specified in this regulation.

Several children's records did not include services to be provided to the family and child. The area on the agreement forms in which to write this information was blank. (#1, #2, #4 and #5)

Corrected Corrected by May 7, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.124(b)(6) · Emergency contact information must include health insurance coverage and policy number for a child under a family policy or Medical Assistance benefits, if applicable. Obtain and submit a written copy of the missing health insurance information for the identified child. Ensure that all children's records contain emergency contact information as specified in these regulations.

One child's emergency contact information did not include health insurance coverage and policy number information. (#1)

Corrected Corrected by May 7, 2024

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

3270.131(b)(2) · The operator shall require the parent to provide an updated health report at least every 12 months for an older toddler or preschool child. Obtain and submit a current up-to-date health report for the indicated child. Ensure that an updated health report is obtained every 12 months for children older toddler to preschool age.

One child's record did not contain a health report completed within the past 12 months as required for children older toddler age to preschool age. (#2)

Corrected Corrected by May 7, 2024

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

3270.131(c) · A health report must be written and signed by a physician, physician's assistant or a CRNP. The signature must include the individual's professional title. Obtain and submit a current up-to-date health report that contains the signature and professional title of the physician, physician's assistant or a CRNP. Ensure that all children's records include a properly signed health report as specified in this regulation.

One child's record did not contain a current up-to-date health report that had been signed by a physician, physician's assistant or a CRNP. (#1)

Corrected Corrected by May 7, 2024

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

3270.182(3)/3270.182(5) · 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. Obtain and submit written verification of signed parental consent for emergency medical care and for administration of minor first-aid procedures by facility staff prior to admission for the indicated children. Ensure that this information is in all children's records.

Several children's records did not contain the parent's signature indicating written consent for emergency medical care and administration of minor first-aid procedures by facility staff. (#2-both, #3-both and #5-emergency medical care)

Corrected Corrected by May 7, 2024

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.

During renewal inspection, cert rep observed damaged plaster and paint on the blue wall next to the bathroom in the "Butterflies" older toddler room.

Corrected Corrected by Mar 9, 2022

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.

During renewal inspection, cert rep observed missing handwashing sign at the sink in the "Tadpole" young toddler classroom.

Corrected Corrected by Mar 9, 2022

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