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 inspection on 5/19/25 the file record for staff person #1 did not include a health assessment conducted within 12 months prior to initial service, the health assessment date observed was 9/14/23, TB test date 11/17/21 (date of hire: see code sheet).

Corrected Corrected by Jun 19, 2025

Category: ratio. Marked corrected in the state record.

3270.52 · 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).

Ongoing non-compliance- During the inspection on 2/14/25 staff persons # 1 and 2 were observed with 13 children, the youngest child was an infant.

Corrected Corrected by Feb 14, 2025

Category: ratio. Marked corrected in the state record.

3270.52 · 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). The required staff:child ratios must be maintained at all times.The legal entity must submit documentation in a format approved by DHS proving that the facility is maintaining the required staff:child ratios at all times. The legal entity will confirm continuing compliance by sending copies of the documentation to the -------- Region Office on a weekly basis for a period of three months after DHS approves the documentation format.

Ongoing non-compliance- During the inspection on 2/14/25 staff persons # 1 and 2 were observed with 13 children, the youngest child was an infant.

Corrected Corrected by May 14, 2025

Category: ratio. Marked corrected in the state record.

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

During the inspection on 2/14/25 staff persons #1 and 2 were observed with thirteen children. Staff person #1 stated that they had 8 children, staff person #2 stated that they had 4 children.

Corrected Corrected by Feb 14, 2025

Category: supervision. Marked corrected in the state record.

3270.52 · 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).

During the inspection on 2/7/25 the facility was observed having three staff and 24 children, the youngest child was an infant at 10:44 am.

Corrected Corrected by Feb 7, 2025

Category: ratio. Marked corrected in the state record.

3270.123(a)(4) · An agreement shall specify the child's arrival and departure times.

During the inspection on 8/9/24 the file record for child # 2 did not include an agreement that specified the child's arrival and departure times.

Corrected Corrected by Aug 9, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.75(d) · One first-aid kit per child care group must accompany children and facility persons on excursions from the facility. Each first aid kit taken on an excursion must contain a bottle of water in addition to the items specified at §3270.75(c).

During the inspection on 8/9/2024 the transportation first aid kit did not include a water bottle.

Corrected Corrected by Aug 9, 2024

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

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

During the inspection on 8/9/24 the file record for child #1 did not include the work address and work telephone number of the enrolling parent on the emergency contact form.

Corrected Corrected by Aug 16, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.124(c) · When children are in the facility, emergency contact information shall be present in a child care space for children receiving care in the space.

During the inspection on 8/9/2024 the Infant/ Toddler area did not have emergency contact information present in a child care space for child #2 and 3 receiving care in the space.

Corrected Corrected by Aug 9, 2024

Category: recordkeeping. 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 inspection on 8/9/2024 the file for staff person #1 did not include a health assessment conducted within 12 months prior to initial service, the health assessment date observed was 4/6/23 (date of hire: code sheet).

Corrected Corrected by Sep 9, 2024

Category: ratio. 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 the inspection on 8/9/2024 the file record for staff person#1 did not include two written, non-family references from individuals attesting to the person's suitability to serve as a facility person.

Corrected Corrected by Aug 23, 2024

Category: recordkeeping. Marked corrected in the state record.

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

Staff person #1--- has not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): (Pediatric First Aid/ CPR).

Corrected Corrected by May 2, 2024

Category: ratio. Marked corrected in the state record.

3270.32(a)/3270.192(4) · The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). LACKING REQUIRED HIRING DOCUMENTS: Facility 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. Facility Person #1--- may not work in a child care position at the facility.

During the inspection on 4/17/2014 the file record for staff person #1 included a state police clearance that was not completed (did not include record results) and did not include a NSOR. Staff person #1--may not work in a child care position.

Corrected Corrected by Apr 17, 2024

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

3270.37(b)(3)/3270.192(2)(ii) · An aide shall have a minimum of an 8th grade education and 2 years of experience with children. A facility person's record shall include verification of child care experience, education and training prior to service at the facility.

During the inspection on 4/17/2024 the file records for staff person #1 did not include verification of child care experience, and education prior to service at the facility.

Corrected Corrected by May 8, 2024

Category: recordkeeping. 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 inspection on 4/17/2024 the file record for staff person #1 did not include an initial health assessment.

Corrected Corrected by May 17, 2024

Category: ratio. Marked corrected in the state record.

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

Staff person #1-- has not completed mandated reporter training within the last 60 months. This is evidenced by the previously documented mandated reporter training on file being dated (10/18/18).

Corrected Corrected by Feb 10, 2024

Category: recordkeeping. Marked corrected in the state record.

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

During the inspection on 1/26/2024 the file records for staff person #1 did not include verification of education prior to service at the facility.

Corrected Corrected by Feb 9, 2024

Category: supervision. 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 the inspection on 1/26/2024 the file record for staff person#1 did not include two written, non-family references from individuals attesting to the person's suitability to serve as a facility person.

Corrected Corrected by Feb 9, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.31(h) · All staff persons shall complete the professional development under subsection (f).

During the inspection on 1/26/2024 the file records for staff person #1 did not include the required updated one-hour health and safety training..

Corrected Corrected by Feb 2, 2024

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

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

Staff person #7-- was observed to be caring for children unsupervised. Staff person #7-- has not completed the following pre-service training, pediatric first aid/cpr required prior to caring for children unsupervised:

Corrected Corrected by Sep 1, 2023

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: Facility Person # 3 & 7-- 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 #3 & 7--- may not work in a child care position at the facility.

During the inspection on 8/17/2023 the file record for staff person #3 did not include a child abuse clearance. The file record for staff person #7 did not include a NSOR clearance, staff person #7 was observed providing direct childcare children. Staff Persons #3 & 7--- may not work in a childcare position at the facility.

Corrected Corrected by Sep 17, 2023

Category: supervision. Marked corrected in the state record.

3270.52 · 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). Provider will obtain ratio training for each staff person from Better Kid Care.

During the inspection on 8/17/2023 staff person #5 helped serve lunch leaving staff person #3 and 6 alone with 20 children, the youngest child was a young toddler.

Corrected Corrected by Aug 17, 2023

Category: ratio. 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 inspection on 8/17/2023 cleaning solution was observed accessible to children.

Corrected Corrected by Aug 17, 2023

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 the inspection on 8/17/2023 the playpens in the Infant Area did not have at least 2 feet of space on three sides while in use.

Corrected Corrected by Aug 17, 2023

Category: physical safety. 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. Provider will obtain supervision training for each staff person from Better Kid Care.

During the inspection on 8/17/2023 staff person #7 left 4 infants alone unsupervised to go into the kitchen to get a bottle.

Corrected Corrected by Aug 17, 2023

Category: supervision. Marked corrected in the state record.

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

During the inspection on 8/17/2023 staff person #4 did not have an assignment or responsibility for supervision of specific children.

Corrected Corrected by Aug 17, 2023

Category: supervision. Marked corrected in the state record.

3270.131(d)(8) · A health report shall include a statement that age-appropriate screenings recommended by the American Academy of Pediatrics were conducted since the time of the previous health report required by this section.

During the inspection on 8/17/2023 the file records for child #2 did not include a health assessment that included a statement that age-appropriate screenings recommended by the American Academy of Pediatrics were conducted since the time of the previous health report required by this section.

Corrected Corrected by Sep 17, 2023

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

3270.134(a)/3270.152 · A staff person shall ensure that a child's hands are washed before meals and snacks, after toileting and after being diapered. A facility person shall wash his hands before meals and snacks, and after toileting and after diapering a child. Provider will obtain handwashing training for staff person #7 from Better Kid Care.

During the inspection on 8/17/2023 staff person #7 was observed conducting a diaper series of 1 child, child #3 and did not wash the child's hands after being diapered. Staff person #3 did not wash their hands after diapering a child.

Corrected Corrected by Aug 24, 2023

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

3270.135(b) · Diaper changing surfaces shall be cleaned after each use by wiping the surface with a sanitizing solution or by changing a pad or other surface covering. Provider will obtain diaper changing for staff person #7 from Better Kid Care.

During the inspection on 8/17/2023 staff person#7 was observed conducting a diaper series and did not clean the surfaces after each child.

Corrected Corrected by Aug 24, 2023

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

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

During the inspection on 8/17/2023 the file record for staff person #6 included a staff health assessment (dated: 3/7/2023). By letter dated 8/29/2023 the dates of the health assessment for staff person #6 was confirmed by the doctor's office to be fraudulent.

Corrected Corrected by Sep 17, 2023

Category: ratio. 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 the inspection on 8/17/2023 the file records for #child 2, 3, 4 and 5 did not include a written statement giving the formula and feeding schedule for an infant obtained from the parent.

Corrected Corrected by Aug 24, 2023

Category: nutrition. Marked corrected in the state record.

3270.171(b)/3270.171(c) · Safe pedestrian crossways, pick-up and drop-off points and bike routes shall be appropriately determined in the vicinity of the facility and communicated to the children and parents in writing. Written notification of safe routes shall be posted by the operator at a conspicuous location in the child care facility.

During the inspection on 8/17/2023 the facility did not have a safe routes plan posted.

Corrected Corrected by Aug 24, 2023

Marked corrected in the state record.

3270.61(h) · The capacity established for an indoor space may not be exceeded.

During the inspection on 8/17/2023 22 children were observed receiving direct childcare in the Red room which is licensed for 15 children at any one time.

Corrected Corrected by Aug 17, 2023

Category: ratio. 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 the inspection on 8/17/2023 it was determined that the operator did not send a copy of the emergency plan and subsequent plan updates to the local municipality and to the county emergency management agency.

Corrected Corrected by Aug 31, 2023

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

3270.31(e)(4)(i)/3270.31(f)(10) · 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. Staff persons shall complete professional development in pediatric first aid and pediatric cardiopulmonary resuscitation within 90 days of hire.

During renewal inspection on November 16, 2022, the record of Staff #1 did not include documentation of pediatric first-aid and CPR completed within 90 days of hire.

Corrected Corrected by Nov 18, 2022

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 on November 16, 2022, Certification Representative observed areas of chipped paint in the preschool room and the play space.

Corrected Corrected by Nov 16, 2022

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

3270.131(b)(1)/3270.182(1) · The operator shall require the parent to provide an updated health report at least every 6 months for an infant or young toddler. A child's record shall contain initial and subsequent health reports.

During renewal inspection on November 16, 2022, the record of child #1 did not include a health assessment conducted within 6 months of previous health assessment (dated 4-6-22).

Corrected Corrected by Nov 17, 2022

Category: health medication. 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 on November 16, 2022, the operator confirmed that they had not sent a copy of the facility emergency plan to the local municipality and the county emergency management agency.

Corrected Corrected by Nov 17, 2022

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