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.

During renewal inspection 02/22/2023, emergency plan on file at the facility had not been reviewed and updated to remove staff who were no longer present at the facility and identify current staff responsibilities in the event of an emergency.

Corrected Corrected by Mar 1, 2023

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: STAFF PERSON #3 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. STAFF PERSON #3 MAY NOT WORK IN A CHILD CARE POSITION AT THE FACILITY.

During renewal inspection 02/22/2023, file of staff person #3 did not contain completed FBI clearance; staff person has been employed more than 45 days and is no longer a provisional hire. File contained receipt dated 08/31/2022.

Corrected Corrected by Mar 10, 2023

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

3270.76/3270.77(a) · 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 02/22/2023, wall next to toilet in 3rd floor bathroom closest to the LadyBugs classroom was cracked and damaged and in need of repair.

Corrected Corrected by Mar 10, 2023

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

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

During renewal inspection 02/22/2023, underneath changing table pad in 3rd floor bathroom closest to the LadyBugs classroom was covered in debris and needed to be cleaned; changing table pad was ripped with exposed foam.

Corrected Corrected by Mar 1, 2023

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

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

During renewal inspection 02/22/2023, children in Caterpillars classroom on the 2nd floor did not have 2 feet of space on three sides at nap time.

Corrected Corrected by Feb 23, 2023

Category: physical safety. 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.

During renewal inspection 02/22/2023, emergency contact forms on file for child #1 did not include health insurance policy number; emergency contact form on file for child #3 did not include health insurance coverage information.

Corrected Corrected by Mar 1, 2023

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.

During renewal inspection on 02/22/2023, emergency contact form on file for child #1 did not include release person's addresses.

Corrected Corrected by Mar 1, 2023

Category: recordkeeping. 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.

During renewal inspection 02/22/202, immunizations on file for child #2 did not contain verification of annual influenza vaccination.

Corrected Corrected by Mar 10, 2023

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

3270.166(1) · A written statement giving the formula and feeding schedule for an infant shall be obtained from the parent.

During renewal inspection on 02/22/2023, staff in Glow Worns 1 and Glow Worms 2 classrooms were not aware of written statements obtained from parents giving formula and feeding schedules at time of enrollment of infants in care.

Corrected Corrected by Mar 1, 2023

Category: nutrition. Marked corrected in the state record.

3270.192(2)(ii)/3270.192(2)(iv) · A facility person's record shall include verification of child care experience, education and training prior to service at the facility. 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.

During renewal inspection 02/22/2023, file for staff person #1 did not contain acceptable verification of high school diploma; document on file did not contain district/area or location from where diploma was obtained and did not contain legible signatures to identify administrators signing document.

Corrected Corrected by Mar 10, 2023

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.

During renewal inspection 02/22/2023, file of staff person #1 and #2 contained references without any signature and/or contact information so that staff persons suitability to serve as a facility person could be verified.

Corrected Corrected by Mar 6, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.27(f) · The operator shall send a copy of the emergency plan and subsequent plan updates to the local municipality and to the county emergency management agency.

During renewal inspection 02/22/2023, facility was unable to provide documentation that emergency plan had been sent to local municipality and emergency management agency.

Corrected Corrected by Mar 7, 2023

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

3270.51 · The legal entity must arrange for all facility staff to receive a minimum of two hours of training regarding staff: child ratios. The legal entity must receive DHS approval of the training content prior to scheduling the training.

During unannounced inspection 11/09/2022, staff person #1 in the Glow Worms 2 room was observed with 5 children, ranging from age of 7 months to 1 year. The correct staff:child ratio based on age is 1:4.

Corrected Corrected by Dec 30, 2022

Category: ratio. 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. THE REQUIRED STAFF:CHILD RATIOS MUST BE MAINTAINED AT ALL TIMES.

During unannounced inspection 11/09/2022, staff person #1 in the Glow Worms 2 room was observed with 5 children, ranging from age of 7 months to 1 year. The correct staff:child ratio based on age is 1:4.

Corrected Corrected by Nov 22, 2022

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. The legal entity must arrange for all facility staff to receive a minimum of two hours of training regarding supervision of children. The legal entity must receive DHS approval of the training content prior to scheduling the training.

During unannounced inspection 11/09/22, 4 children aged 2 to 2.5 years old were observed in the Dragonflies room unsupervised. Staff person #2 came into room from hall bathroom stating staff person stepped out the room "real quick" to do something.

Corrected Corrected by Dec 30, 2022

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. CHILDREN MUST BE SUPERVISED AT ALL TIMES.

During unannounced inspection 11/09/22, 4 children aged 2 to 2.5 years old were observed in the Dragonflies room unsupervised. Staff person #2 came into room from hall bathroom stating staff person stepped out the room "real quick" to do something.

Corrected Corrected by Nov 9, 2022

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). LACKING REQUIRED HIRING DOCUMENTS: STAFF PERSON #1 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. STAFF PERSON #1 MAY NOT WORK IN A CHILD CARE POSITION AT THE FACILITY.

During unannounced inspection 10/28/22, file of staff person #1 contained FBI clearance not completed through DHS. Staff person #1 is beyond provisional hire period. THIS IS CONTINUED NON COMPLIANCE

Corrected Corrected by Nov 9, 2022

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

3270.61(b) · Indoor child care space may not be used simultaneously as play space.

During unannounced inspection 10/28/22, indoor play space located on basement level had Butterflies classroom equipment, furniture and toys in rear area of play space. Staff person #1 indicated Butterflies classroom periodically uses area as child care space for a couple hours a day. THIS IS CONTINUED NON COMPLIANCE.

Corrected Corrected by Nov 9, 2022

Category: recordkeeping. 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.

During unannounced inspection 10/28/22, ceiling tiles in Glow Worms 2 room above clock and by smoke detector had visible water stains. THIS IS CONTINUED NON COMPLIANCE

Corrected Corrected by Oct 31, 2022

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

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

During unannounced inspection 10/28/22, changing table located in third floor bathroom closest to the Ladybugs classroom was in disrepair; door on table was off and propped against table posing a potential hazard.

Corrected Corrected by Nov 15, 2022

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.

During unannounced inspection 10/28/22, infant in Glow Worms 2 room was observed sleeping in bouncy seat which is not recommended sleep position according to American Academy of Pediatrics.

Corrected Corrected by Nov 2, 2022

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

3270.124(c)/3270.124(d) · When children are in the facility, emergency contact information shall be present in a child care space for children receiving care in the space. When children leave the facility on walking and riding excursions, emergency contact information specific to each child on the excursion shall accompany a staff person on the excursion.

During unannounced inspection 10/28/22, emergency contact forms located in classrooms and travel bags did not reflect updated emergency contact forms on file for children. THIS IS CONTINUED NON COMPLIANCE

Corrected Corrected by Nov 3, 2022

Category: recordkeeping. Marked corrected in the state record.

3270.166(4) · Disposable nursers and bottles shall be labeled with the child's name.

During unannounced inspection 10/28/22, bottles located in Glow Worms 1 and Glow Worms 2 were not labeled with the children's names. THIS IS CONTINUED NON COMPLIANCE

Corrected Corrected by Nov 9, 2022

Marked corrected in the state record.

3270.181(c) · A parent is required to review and update the emergency contact information and the financial agreement at least once in a 6-month period or as soon as there is a change in the information.

During unannounced inspection 10/28/22, emergency contact and financial agreements on file for child #1 and #2 had not been reviewed and/or updated in required 6 month intervals. THIS IS CONTINUED NON COMPLIANCE

Corrected Corrected by Nov 14, 2022

Category: recordkeeping. Marked corrected in the state record.

3270.75(c) · A first-aid kit must contain the following: soap, an assortment of adhesive bandages, sterile gauze pads, tweezers, tape, scissors and disposable, nonporous gloves.

During renewal inspection 09/27/22, first aid kit located in Ladybugs room did not contain all required items (missing Band-Aids/tweezers/gloves) ; first aid kit in Dragonflies room did not contain all required items (missing Band-Aids/gauze).

Corrected Corrected by Sep 30, 2022

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.

During renewal inspection 09/27/22, ceiling tiles in Glow Worms 2 room next to vent in area near emergency exit had visible water stains.

Corrected Corrected by Oct 14, 2022

Category: physical safety. 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.

During renewal inspection on 09/27/22, last documentation of review and/or update of emergency plan was dated 06/30/2021.

Corrected Corrected by Oct 7, 2022

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: STAFF PERSON #2 and #4 MAY NOT WORK IN A CHILD CARE POSITION 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. 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. STAFF PERSON #2 and #4 MAY NOT WORK INA CHILD CARE POSITION AT THE FACILITY.

During renewal inspection 09/27/22, file of staff person #2 did not contain completed FBI clearance completed through DHS; file of staff person #4 did not contain completed FBI clearance; file of staff person #4 only contained confirmation of request on 09/21/22 and staff person #4 is beyond 45 day provisional hire period.

Corrected Corrected by Oct 14, 2022

Category: supervision. Marked corrected in the state record.

3270.34(b)(1)/3270.192(2)(iv) · 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.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.

During renewal inspection on 09/27/22, file of staff person #1 did not contain copy of degree or official transcripts confirming bachelor's degree to qualify staff person for position performing (DIRECTOR).

Corrected Corrected by Oct 3, 2022

Category: recordkeeping. Marked corrected in the state record.

3270.61(b) · Indoor child care space may not be used simultaneously as play space.

During renewal inspection on 09/27/22, indoor play space located on basement level had Butterflies classroom equipment, furniture and toys in rear area of play space. Staff person #1 indicated Butterflies classroom periodically uses area as child care space for a couple of hours a day.

Corrected Corrected by Oct 10, 2022

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.

During renewal inspection 09/27/22, shaving cream labeled KEEP OUT OF REACH OF CHILDREN was observed on a low shelf in the Dragonflies room; Sunscreen was located on a low shelf in the Caterpillars room; Clorox wipes and Bleach solution were on a shelf in the first bathroom on the third floor between the Dragonflies and Ladybugs rooms that was accessible to children.

Corrected Corrected by Oct 3, 2022

Marked corrected in the state record.

3270.67(c) · Evidence of infestation of insects or rodents in the facility is not permitted.

During renewal inspection 09/27/22, ants were observed on the window sill of the first window on the left in the Ladybugs room on the third floor.

Corrected Corrected by Sep 29, 2022

Marked corrected in the state record.

3270.72(d) · Windows or doors above the ground floor that open directly to the outdoors and are accessible to children shall be constructed, modified or adapted to limit the opening to 6 or fewer inches.

During renewal inspection on 09/27/22, the three (3) windows in Ladybugs room on the 3 floor opened 2 feet wide and had not been modified to limit opening to 6 inches or less.

Corrected Corrected by Oct 14, 2022

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

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

During renewal inspection 09/27/22, sink in first third floor bathroom between the Dragonflies and Ladybugs rooms was inoperable; hot water faucet in second bathroom on third floor could not be turned off completely leaving water partially running.

Corrected Corrected by Oct 14, 2022

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

3270.124(c)/3270.124(d) · When children are in the facility, emergency contact information shall be present in a child care space for children receiving care in the space.When children leave the facility on walking and riding excursions, emergency contact information specific to each child on the excursion shall accompany a staff person on the excursion.

During renewal inspection 09/27/22, emergency contact forms located in classrooms and travel bags did not reflect updated emergency contact forms on file for children.

Corrected Corrected by Oct 4, 2022

Category: recordkeeping. Marked corrected in the state record.

3270.166(4) · Disposable nursers and bottles shall be labeled with the child's name.

During renewal inspection 09/27/22, bottles located in Glow Worms 1 and Glow Worms 2 were not labeled with the children's names.

Corrected Corrected by Sep 30, 2022

Marked corrected in the state record.

3270.181(c) · A parent is required to review and update the emergency contact information and the financial agreement at least once in a 6-month period or as soon as there is a change in the information.

During renewal inspection 09/27/22, emergency contact and financial agreements on file for child #1 and #2 had not been reviewed and/or updated in required 6 month intervals.

Corrected Corrected by Oct 10, 2022

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

During renewal inspection 09/27/22, file of staff person # 3 did not contain two (2) written non family references attesting to staff person's suitability.

Corrected Corrected by Sep 30, 2022

Category: recordkeeping. Marked corrected in the state record.

3270.15(b) · The legal entity shall maintain ongoing compliance with the applicable requirements prescribed by the Department of Labor and Industry in 34 Pa. Code § 403.23 and under section 1016(c) of the act at all times following issuance of any certificate of compliance issued by the Department under this chapter.

During renewal inspection 09/27/22, Certificate of Occupancy posted at location indicated areas of use as rear basement, first and second floors, however, it was observed child care being given in 2 out of three classrooms on the third floor with the third classroom set up and ready to receive children.

Corrected Corrected by Sep 29, 2022

Marked corrected in the state record.

3270.27(a)(6) · Emergency drills shall be conducted annually. Annual emergency drills shall be documented and on file at the facility.

During renewal inspection 09/27/22, there was no documentation available showing emergency drills are conducted annually at facility.

Corrected Corrected by Oct 7, 2022

Category: recordkeeping. Marked corrected in the state record.

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

During renewal inspection 09/27/22, file of staff person #4 did not show completion of Pediatric First Aid and CPR from a PQAS certified trainer using an acceptable curriculum within 90 days of hire.

Corrected Corrected by Oct 10, 2022

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

3270.94(a)(3) · 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 during various program activity times.

During renewal inspection 09/27/22, fire drill log showed fire drills were not being conducted during various program activities.

Corrected Corrected by Oct 3, 2022

Category: recordkeeping. Marked corrected in the state record.

3270.94(a)(4) · The Director or designated staff person who is responsible for compliance with this chapter shall conduct fire drills and ensure that the hypothetical locations of the fire are rotated around the facility for each drill such that the hypothetical location is never the same for consecutive drills.

During renewal inspection 09/27/22, hypothetical locations for fire drills did not reflect locations around the facility.

Corrected Corrected by Oct 3, 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.

During renewal inspection 09/27/22, file of staff person #2 did not contain 12 hours of annual child care training. File of staff person #2 contained 8 hours of annual child care training.

Corrected Corrected by Sep 29, 2022

Category: recordkeeping. Marked corrected in the state record.

3270.34(c) · A director shall be employed by a facility and be present at the facility site a minimum of 30 hours per week.

During the complaint investigation the certification representative asked for the director, the assistant director informed the certification representative that the director only works two days a week and is not available.

Corrected Corrected by Mar 22, 2022

Marked corrected in the state record.

3270.181(a) · An operator shall establish and maintain an individual record for each child enrolled in the facility.

During the complaint investigation the certification representative interviewed staff #1, they informed the representative that last month a staff had to bring their child. The child was not enrolled and did not have a file.

Corrected Corrected by Mar 22, 2022

Category: recordkeeping. Marked corrected in the state record.

3270.76/3270.77(a) · 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.

At the time of inspection, peeling paint was observed in the yellow wall on the right side of the Lady Bugs Room. Broken plaster was also observed in the infant classroom near the changing table.

Corrected Corrected by Nov 5, 2021

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). SAFETY PLAN: The operator is required to submit to the Children and Youth Agency a plan of supervision or alternate arrangement as required by the Child Protective Services Law. LACKING REQUIRED HIRING DOCUMENTS: Facility Person # 1 may not work in a child care position 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. A facility person's record shall include a copy of requests for the criminal history record and child abuse registry clearance information, a copy of the disclosure statement and a copy of the completed clearance information required under the CPSL. Facility Person #1 may not work in a child care position at the facility.

At the time of the facility inspection, the file for staff #1 did not have written proof of complying with all CPSL requirements. The file was missing written proof of a receipts or the reports for FBI and NSOR.

Corrected Corrected by Nov 10, 2021

Category: supervision. Marked corrected in the state record.

3270.34(c)/3270.192(2)(ii) · A director shall be employed by a facility and be present at the facility site a minimum of 30 hours per week.A facility person's record shall include verification of child care experience, education and training prior to service at the facility.

At the time of inspection on 10/25/21, the file for staff #1 did not have written proof of a transcript to support the position of facility director.

Corrected Corrected by Oct 29, 2021

Category: recordkeeping. Marked corrected in the state record.

3270.35(d) · A director may not function as a group supervisor in a facility in which more than 45 children are enrolled.

Facility staff informed OCDEL staff at the time of inspection there were 61 children enrolled in the program. On 10/25/21, between 2-3pm; staff #1 was observed working in the infant classroom.

Corrected Corrected by Oct 29, 2021

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 infant and young toddler classroom on the first level of the facility; electrical outlets were cover in green tape. In the infant classroom, the green tape was partially covering the outlets while items were plugged-in.

Corrected Corrected by Oct 29, 2021

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.

During the diaper change on 10/25/21, hand sanitizer was left on the changing table in the infant room.

Corrected Corrected by Oct 25, 2021

Category: health medication. 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 infant room was missing soap.

Corrected Corrected by Oct 25, 2021

Marked corrected in the state record.

3270.91(a) · Stairways, hallways, exits from rooms, exits from the facility and other means of egress serving as an exit shall be unobstructed.

At the time of inspection on 10/25/21, a book shelf with book on it was blocking the entrance to the young toddler classroom on the first floor of the facility.

Corrected Corrected by Oct 25, 2021

Marked corrected in the state record.

3270.106(a)/3270.119 · 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.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.

Upon arrival at the onset of the inspection on 10/25/21, facility children #1 and #2 was observed sleeping in bouncy chairs. This type of equipment is not approved for sleeping for children under the age of one-yr-old.

Corrected Corrected by Oct 25, 2021

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

3270.107/3270.161(d) · 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. Potentially hazardous food brought from the child's home or provided by the facility shall be refrigerated.

On 10/25/21, there was no thermometer in the refrigerator used to store bottles and formula in the young toddler classroom as required by regulation.

Corrected Corrected by Nov 5, 2021

Category: nutrition. 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.

During the facility inspection on 10/25/21, the file for staff #1-start date-10/25/21; who was observed holding children while working in the infant room between 2-3pm did not have written proof of a health assessment.

Corrected Corrected by Nov 9, 2021

Category: ratio. Marked corrected in the state record.

3270.166(4) · Disposable nursers and bottles shall be labeled with the child's name.

In the infant and young toddler classrooms , there were children's bottles that were not labeled for individual use.

Corrected Corrected by Oct 25, 2021

Marked corrected in the state record.

3270.181(a) · An operator shall establish and maintain an individual record for each child enrolled in the facility.

The was no file on site at the facility for child #3. The child was observed with an open laptop on the first and second level of the child care facility.

Corrected Corrected by Oct 26, 2021

Category: recordkeeping. 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. TIERED LIS: Children must be supervised at all times.

Per online observation provided by the facility. One facility classroom shows one staffer in the classroom with their back to the classroom children and a second classroom where there is no staffer present in the footage, and the classroom children are gathered playing near a book shelf and playing with toys. Some children are napping, but more than half of the children are not napping and playing.

Corrected Corrected by Oct 25, 2021

Category: supervision. Marked corrected in the state record.

3270.135(e) · A staff person shall check a child's diaper at least every 2 hours and whenever the child indicates discomfort or exhibits behavior that suggests a soiled diaper. A staff person shall change a child's diaper when the diaper is soiled.

A facility children was sent home at the time of pick-up with soiled clothing. The parent discussed this matter with the assistant director (who submitted a written statement to these allegations) and sent photos to OCDEL via email of the soiled clothing and the child's potential diaper rash.

Corrected Corrected by Oct 15, 2021

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

3270.34(a)/3270.35(d) · A director is responsible for the general management of the facility, including the minimum duties described at §3270.34(a)(1) - (6).A director may not function as a group supervisor in a facility in which more than 45 children are enrolled.

During the facility inspection, the director was working in the preschool classroom. The facility has 66 children enrolled.

Corrected Corrected by Sep 8, 2021

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.

At the time of inspection, in the two classrooms on the second floor. The wood floors were damaged and splintered; which could pose a hazard to the children in care.

Corrected Corrected by Oct 9, 2021

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

3270.106(a)/3270.119 · 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.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 the time of inspection on 9/8/21, a infant child was observed sleeping in a bounce-style chair. The OCDEL-certification representative shared the observation with the, classroom staff, facility assistant and executive director.

Corrected Corrected by Sep 9, 2021

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