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.

During the renewal inspection on 09/26/24 there was Lysol observed underneath the bathroom sink in downstairs bathroom accessible to children.

Corrected Corrected by Sep 26, 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).

During the renewal inspection on 09/26/24 the file reviewed for child #1, child #2, child #3, and child #5 did not contain child service report updated every 6-months.

Corrected Corrected by Oct 31, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.123(a)(6) · An agreement shall specify the date of the child's admission.

During the renewal inspection on 09/26/24 the fee agreement reviewed for child #4 and child #5 did not specify the date of child's admission.

Corrected Corrected by Oct 31, 2024

Category: recordkeeping. 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.

During the renewal inspection on 09/26/24 the file reviewed for staff person #1, staff person #2, and staff person #3 did not contain emergency plan training.

Corrected Corrected by Oct 31, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.31(e)(4)(i) · 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.

During the renewal inspection on 09/26/24 the first aid/cpr certificate reviewed for staff person #1 and staff person #2 was an online only course which does not meet compliance with certification regulations.

Corrected Corrected by Oct 31, 2024

Category: ratio. 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.

During the renewal inspection on 09/26/24 there were missing outlet covers observed throughout the facility.

Corrected Corrected by Sep 26, 2024

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.

During the renewal inspection on 09/26/24 the emergency contact form for child #1, child #2 and child #5 was not updated with 6-month time period. The fee agreement for child #3 and child #5 was not updated with 6-month time period.

Corrected Corrected by Oct 31, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.161(d) · Potentially hazardous food brought from the child's home or provided by the facility shall be refrigerated.

During the renewal inspection on 09/26/24 child lunches were observed sitting out unrefrigerated.

Corrected Corrected by Sep 26, 2024

Category: nutrition. Marked corrected in the state record.

3270.183(a) · Child records are confidential and shall be stored in a locked cabinet.

During the renewal inspection on 09/26/24 child files were not being stored in a locked cabinet.

Corrected Corrected by Oct 31, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.94(a)(1) · The Director or designated staff person who is responsible for compliance with this chapter shall conduct fire drills and ensure that fire drills are conducted at least once every 60 days.

During the renewal inspection on 09/26/24 the fire drill log reviewed did not reflect that fire drills were conducted every 60 days. Last drill documented was 05/20/24.

Corrected Corrected by Oct 31, 2024

Category: recordkeeping. 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.

During the renewal inspection on 09/26/24 the file reviewed for staff person #1 and staff person #2 did not include 12 hours of annual childcare training.

Corrected Corrected by Oct 31, 2024

Category: recordkeeping. 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. Obtain and submit written verification of the updated emergency contact and financial agreement information for the identified children.

Several children's records did not contain financial agreement information that had been reviewed and updated within the past 6 months. (child #3- agreement)

Corrected Corrected by Sep 16, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.94(a)(9) · The Director or designated staff person who is responsible for compliance with this chapter shall conduct fire drills and ensure that a written record is maintained on file at the facility indicating the specific time of day of the drill, the hypothetical location of the fire, the evacuation time, and the names of the facility persons and the number of children who participate in the fire drill. Submit a copy of completed fire drills that contains the names of the participating facility persons.

Fire drill records did not include the names of facility persons participating.in the fire drills..

Corrected Corrected by Sep 16, 2023

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. Staff persons must complete the CCDBG training that is required prior to working with children unsupervised. Submit written verification of the completed training.

Several staff persons were observed caring for a child and their record did not contain verification of completed CCDBG training (10 hour) and/ or PA Update (1 hour) required prior to working with children unsupervised. (#1, #2 and #3)

Corrected Corrected by Jun 24, 2023

Category: supervision. 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. Obtain and submit written verification that the annual fire safety training had been conducted by a fire safety professional.

Several staff person's records did not contain written verification that the annual fire safety training had been conducted by a fire safety professional. (#1, #2 and #3)

Corrected Corrected by Jun 24, 2023

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 the health insurance policy number for the identified child. Ensure that all children's records include the health insurance information as specified in this regulation.

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

Corrected Corrected by Jun 24, 2023

Category: health medication. 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. Obtain and submit written verification of the updated emergency contact and financial agreement information for the identified children.

Several children's records did not contain emergency contact and financial agreement information that had been reviewed and updated within the past 6 months. (child #1- both) (child #2-both) (child #3- agreement) (child #4-both) CONTINUING DEFICIENCY

Corrected Corrected by Jun 24, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.94(a)(9) · The Director or designated staff person who is responsible for compliance with this chapter shall conduct fire drills and ensure that a written record is maintained on file at the facility indicating the specific time of day of the drill, the hypothetical location of the fire, the evacuation time, and the names of the facility persons and the number of children who participate in the fire drill. Submit a copy of completed fire drills that contains the names of the participating facility persons.

Fire drill records did not include the names of facility persons participating.in the fire drills.

Corrected Corrected by Jun 24, 2023

Category: recordkeeping. 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. Obtain and submit written verification of annual minimum 12 hours of child care training for the identified staff person.

Several staff person's record did not contain written verification of annual minimum 12 hours of child care training. (#1, #2 and #3)

Corrected Corrected by Jun 24, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.14 · 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. Develop and submit written policies and procedures on prevention of shaken baby syndrome, abusive head trauma and child mistreatment.

The facility lacked written policies and procedures on prevention of shaken baby syndrome, abusive head trauma and child mistreatment.

Corrected Corrected by Jan 30, 2023

Category: ratio. Marked corrected in the state record.

3270.18(a) · The legal entity shall have comprehensive general liability insurance to cover the persons who are on the premises. A current copy of the insurance policy shall be on file at the facility. Obtain and submit written verification of the facility's comprehensive general liability insurance. Ensure that a current copy of the insurance policy is on file at the facility

The facility lacked written verification of comprehensive general liability insurance to cover the persons who are on the premises. A current copy of the insurance policy was not on file at the facility at the time of the inspection.

Corrected Corrected by Jan 30, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.27(b) · The operator shall review the emergency plan at least annually and update the plan as needed. The operator shall document in writing each review and update of the emergency plan and kept on file at the facility. Submit written verification of the annual review of the emergency plan. Ensure that the plan is reviewed and updated if needed and documented in writing annually as specified.

There was no written documentation indicating that the emergency plan had been reviewed annually.

Corrected Corrected by Jan 30, 2023

Category: recordkeeping. 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. Provide and submit written verification of annual emergency plan training for the identified staff person. Ensure that all facility staff/new hires receive emergency plan training at the time of initial employment and annually.

Several staff person's records did not contain written verification of annual emergency plan training.(#1, #2 and #3)

Corrected Corrected by Jan 30, 2023

Category: recordkeeping. 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. Obtain and submit written verification of annual fire safety training for the identified staff persons.

Several staff person's records did not contain written verification of annual fire safety training. (#1, #2 and #3)

Corrected Corrected by Jan 30, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.34(b) · A director shall have attained one of the following qualification levels specified at §3270.34(b)(1) - (4). 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.

The facility director's record did not contain written verification of education and experience for their director position. (#1)

Corrected Corrected by Jan 30, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.124(f) · 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. Obtain and submit written verification of the updated emergency contact and financial agreement information for the identified children.

Several children's records did not contain emergency contact and financial agreement information that had been reviewed and updated within the past 6 months. (#1, #2 and #3)

Corrected Corrected by Jan 30, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.31(h) · All staff persons shall complete the professional development under subsection (f). Submit written verification of completion of all the required health and safety training for the identified staff person. Ensure that all staff obtain the required health and safety training.

One staff person's record lacked verification of completion of all the required health and safety training topics (#2).

Corrected Corrected by Jan 30, 2023

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

3270.94(a)(1)/3270.94(a)(9) · The Director or designated staff person who is responsible for compliance with this chapter shall conduct fire drills and ensure that fire drills are conducted at least once every 60 days. The Director or designated staff person who is responsible for compliance with this chapter shall conduct fire drills and ensure that a written record is maintained on file at the facility indicating the specific time of day of the drill, the hypothetical location of the fire, the evacuation time, and the names of the facility persons and the number of children who participate in the fire drill. Submit a record of all fire drill completed since 12/23/21. Ensure that fire drills are conducted and documented in writing in accordance with these regulations.

There was no record of fire drills being conducted since the previous renewal inspection on 12/23/21.

Corrected Corrected by Jan 30, 2023

Category: recordkeeping. 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. Obtain and submit written verification of annual minimum 12 hours of childcare training for the identified staff persons.

Several staff person's records did not contain written verification of annual minimum 12 hours of childcare training. (#1, #2 and #3)

Corrected Corrected by Jan 30, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.14 · 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. Develop and submit written policies and procedures on prevention of shaken baby syndrome, abusive head trauma and child mistreatment.

The facility lacked written policies and procedures on prevention of shaken baby syndrome, abusive head trauma and child mistreatment.

Corrected Corrected by Nov 17, 2022

Category: ratio. Marked corrected in the state record.

3270.18(a) · The legal entity shall have comprehensive general liability insurance to cover the persons who are on the premises. A current copy of the insurance policy shall be on file at the facility. Obtain and submit written verification of the facility's comprehensive general liability insurance. Ensure that a current copy of the insurance policy is on file at the facility

The facility lacked written verification of comprehensive general liability insurance to cover the persons who are on the premises. A current copy of the insurance policy was not on file at the facility at the time of the inspection.

Corrected Corrected by Nov 17, 2022

Category: recordkeeping. Marked corrected in the state record.

3270.27(b) · The operator shall review the emergency plan at least annually and update the plan as needed. The operator shall document in writing each review and update of the emergency plan and kept on file at the facility. Submit written verification of the annual review of the emergency plan. Ensure that the plan is reviewed and updated if needed and documented in writing annually as specified.

There was no written documentation indicating that the emergency plan had been reviewed annually.

Corrected Corrected by Nov 17, 2022

Category: recordkeeping. 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. Provide and submit written verification of annual emergency plan training for the identified staff person. Ensure that all facility staff/new hires receive emergency plan training at the time of initial employment and annually.

Several staff person's records did not contain written verification of annual emergency plan training.(#1, #2 and #3)

Corrected Corrected by Nov 17, 2022

Category: recordkeeping. 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. Obtain and submit written verification of annual fire safety training for the identified staff persons.

Several staff person's records did not contain written verification of annual fire safety training. (#1, #2 and #3)

Corrected Corrected by Nov 17, 2022

Category: recordkeeping. 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 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.

The facility director's record did not contain written verification of education and experience for their director position. (#1)

Corrected Corrected by Nov 17, 2022

Category: recordkeeping. Marked corrected in the state record.

3270.124(f) · 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. Obtain and submit written verification of the updated emergency contact and financial agreement information for the identified children.

Several children's records did not contain emergency contact and financial agreement information that had been reviewed and updated within the past 6 months. (#1, #2 and #3)

Corrected Corrected by Nov 17, 2022

Category: recordkeeping. Marked corrected in the state record.

3270.31(h) · All staff persons shall complete the professional development under subsection (f). Submit written verification of completion of all the required health and safety training for the identified staff person. Ensure that all staff obtain the required health and safety training.

One staff person's record lacked verification of completion of all the required health and safety training topics (#2).

Corrected Corrected by Nov 17, 2022

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

3270.94(a)(1)/3270.94(a)(9) · The Director or designated staff person who is responsible for compliance with this chapter shall conduct fire drills and ensure that fire drills are conducted at least once every 60 days. The Director or designated staff person who is responsible for compliance with this chapter shall conduct fire drills and ensure that a written record is maintained on file at the facility indicating the specific time of day of the drill, the hypothetical location of the fire, the evacuation time, and the names of the facility persons and the number of children who participate in the fire drill. Submit a record of all fire drill completed since 12/23/21. Ensure that fire drills are conducted and documented in writing in accordance with these regulations.

There was no record of fire drills being conducted since the previous renewal inspection on 12/23/21.

Corrected Corrected by Nov 17, 2022

Category: recordkeeping. 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. Obtain and submit written verification of annual minimum 12 hours of childcare training for the identified staff persons.

Several staff person's records did not contain written verification of annual minimum 12 hours of childcare training. (#1, #2 and #3)

Corrected Corrected by Nov 17, 2022

Category: recordkeeping. Marked corrected in the state record.

3270.27(a)(5) · The facility shall have an emergency plan that provides for accommodations for infants, toddlers, children with disabilities, and children with chronic medical conditions. 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 provide for accommodations for infants, toddlers, children with disabilities, and children with chronic medical conditions.

Corrected Corrected by Feb 3, 2022

Category: physical safety. 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 Feb 3, 2022

Category: physical safety. 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. Revise the letter given to parents to ensure that it explains the emergency procedures and updates to the plan as required in 3270.27 subsection a. Submit a copy of the revised letter.

The letter given to parents regarding the emergency plan did not explain the emergency procedure updates to the plan as required in 3270.27 subsection a.

Corrected Corrected by Oct 15, 2021

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

3270.51/3270.52 · When children are grouped in similar age levels, the following maximum child group sizes and ratios of staff persons apply: Infants 1:4 with a maximum group size of 8; Young toddlers 1:5 with a maximum group size of 10; Older toddlers 1:6 with a maximum group size of 12; Preschool children 1:10 with a maximum group size of 20; Young school-age children 1:12 with a maximum group size of 24; Older school-age children 1:15 with a maximum group size of 30. When children are grouped in mixed age levels, the age of the youngest child in the group determines the staff:child ratio and maximum group size in accordance with the requirements in § 3270.51 (relating to similar age level). Develop and submit a written staffing plan including provisions for staff shortages including but not limited to call outs, scheduling, lunch breaks, terminations, resignations, hiring and operational tasks that impact staffing and times of transition to ensure ongoing compliance. Submit a copy of the written staffing plan.

On 9/15/21, from approximately 3:00pm-3:30pm, staff person #1 was observed caring for a mixed-age group of 6 children- 1 infant (birth -12mos) 3 older toddler age (two years old) and 2 preschool age (3 years -1st day of K) in the main child care space. Staff person #1 verified the ages of the children.

Corrected Corrected by Oct 15, 2021

Category: ratio. Marked corrected in the state record.

3270.51/3270.52 · When children are grouped in similar age levels, the following maximum child group sizes and ratios of staff persons apply: Infants 1:4 with a maximum group size of 8; Young toddlers 1:5 with a maximum group size of 10; Older toddlers 1:6 with a maximum group size of 12; Preschool children 1:10 with a maximum group size of 20; Young school-age children 1:12 with a maximum group size of 24; Older school-age children 1:15 with a maximum group size of 30. When children are grouped in mixed age levels, the age of the youngest child in the group determines the staff:child ratio and maximum group size in accordance with the requirements in § 3270.51 (relating to similar age level). Ensure that staff/child ratios are maintained at all times.

On 9/15/21, from approximately 3:00pm-3:30pm, staff person #1 was observed caring for a mixed-age group of 6 children- 1 infant (birth -12mos) 3 older toddler age (two years old) and 2 preschool age (3 years -1st day of K) in the main child care space. Staff person #1 verified the ages of the children.

Corrected Corrected by Oct 15, 2021

Category: ratio. Marked corrected in the state record.

3270.54(a) · At least two facility persons shall be present in the facility when two or more children are in care. At a minimum, one of the facility persons shall be a staff person. Notify all facility staff of this requirement. Revise staffing schedules and routines to ensure that there are at least two facility persons shall be present in the facility when two or more children are in care. Submit a copy of the notification that includes each staff person's signature as well as a written copy of the revised staff schedule and routines. Director will ensure that the revised staff schedules and routines are followed to ensure ongoing compliance.

On 9/15/21, from approximately 3:00pm-3:30pm, 6 mixed age children - 1 infant (birth -12mos) 3 older toddler age (two years old) and 2 preschool age (3 years -1st day of K) were present in the facility with only one staff person observed in the facility caring for them. The other staff person had left for a lunch break leaving just one staff person in the facility. Staff person #1 was the only facility person present in the facility at the time of the observation.

Corrected Corrected by Oct 15, 2021

Category: recordkeeping. 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 Oct 15, 2021

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). Submit a written copy of the amended emergency plan.

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

Corrected Corrected by Oct 15, 2021

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