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. IF USING TIERED LIS: 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.

The Director self-reported that a staff person in the young toddler room was observed to be sleeping while responsible for the supervision of 5 young toddler children in care during nap time on 3-26-25.

Corrected Corrected by Mar 27, 2025

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.

The Director self-reported that a staff person in the young toddler room was observed to be sleeping while responsible for the supervision of 5 young toddler children in care during nap time on 3-26-25.

Corrected Corrected by Mar 27, 2025

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.

The Director self-reported that a staff person in the young toddler room was observed to be sleeping while responsible for the supervision of 5 young toddler children in care during nap time on 3-26-25.

Corrected Corrected by Mar 27, 2025

Category: supervision. 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.

Staff person #1 did not complete the following required pre-service training within 90 days of their date of hire (see LIS code sheet): Pediatric First Aid/Pediatric CPR. The training was completed on 6/18/2024.

Corrected Corrected by Oct 8, 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). 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.

The state police clearance on file for staff person #1 was pending. The file for staff person #1 included an NSOR certificate dated more than 45 days after hire (See LIS Code Sheet) required for provisional hiring under the CPSL. The file for staff person #2 included a State Police clearance dated more than 45 days after hire (See LIS Code Sheet) required for provisional hiring under the CPSL.

Corrected Corrected by Oct 8, 2024

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

3270.107 · 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.

The refrigerator in the infant room had a temperature of 52° F.

Corrected Corrected by Oct 2, 2024

Category: nutrition. 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.

The emergency contact form on file for child #1 was missing the Health Insurance/MA policy #.

Corrected Corrected by Oct 2, 2024

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

3270.131(a)(3)/3270.182(1) · The initial health report for an older toddler or preschool child shall be dated no more than 1 year prior to the first day of attendance at the facility. A child's record shall contain initial and subsequent health reports.

The initial health assessments on file for Child #2 was dated 11/4/20, which was more than 1 year from their start date (SEE LIS CODE SHEET).

Corrected Corrected by Oct 8, 2024

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

3270.131(b)(2)/3270.181(c) · The operator shall require the parent to provide an updated health report at least every 12 months for an older toddler or preschool child. 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.

The updated health assessment on file for child #2 was dated 11/4/20 and 10/5/23 which were more than 12 months apart for a preschool child.

Corrected Corrected by Oct 8, 2024

Category: health medication. 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.

The 2 most recent health assessments on file for Staff person #3 were dated 9/30/21 and 10/3/23, more than 24 months apart. The health assessment on file for staff person #4 was completed more than 12 months prior to providing initial service in childcare setting, dated 9/11/22 (SEE LIS CODE SHEET). The 2 most recent health assessments on file for Staff person #5 were dated 10/29/21 and 10/31/23, more than 24 months apart.

Corrected Corrected by Oct 8, 2024

Category: ratio. Marked corrected in the state record.

3270.151(c)(2) · An adult health assessment must include tuberculosis screening by the Mantoux method at initial employment. Subsequent tuberculosis screening is not required unless directed by a physician, physician's assistant, CRNP, the Department of Health or a local health department.

The health assessment on file for staff person #4 did not state whether or not they had a communicable disease, and their previous TB test was not completed at initial employment.

Corrected Corrected by Oct 16, 2024

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

3270.32(a) · The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services).

The file for Staff #1 contained State Police Clearances dated 1.22.18 and 4.17.23, Child Abuse Clearances dated 1.22.18 and 4.12.23, and FBI Clearances dated 2.2.18 and 8.29.23, which exceeded the 60-month renewal requirement.

Corrected Corrected by Aug 29, 2023

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

3270.34(a)(6) · A director is responsible for written evaluation of staff persons on a regular basis, a minimum of one evaluation every 12 months.

The file for Staff #1 contained written evaluations dated 12.21.21 and 12.22.22, which exceeded the 12-month requirement. The file for Staff #2 contained written evaluations dated 12.20.21 and 12.22.22, which exceeded the 12-month requirement.

Corrected Corrected by Oct 16, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.74 · The telephone number of the nearest hospital, police department, fire department, ambulance and poison control center shall be posted by each telephone in the facility.

Emergency phone numbers were not posted by the telephones in the Preschool and School-Age/PS Rooms.

Corrected Corrected by Oct 6, 2023

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.

Handwashing signs were not posted at either of the two (2) toilets in the Preschool Room.

Corrected Corrected by Oct 6, 2023

Category: health medication. 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.

Broken, metal window blinds (7 slats), on the far left window by the door in the Young Toddler Room, which could be used by children to look outside, were sharp, and created a scraping/cutting hazard for children in care.

Corrected Corrected by Oct 6, 2023

Category: physical safety. 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.

The Emergency Contact form, in the file for Child #1, did not contain the enrolling parent's work address or work phone number.

Corrected Corrected by Oct 12, 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.

The Emergency Contact form, in the file for Child #2, did not contain the health insurance policy number.

Corrected Corrected by Oct 12, 2023

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

3270.124(e) · A written plan identifying the means of transporting a child to emergency care and staffing provisions in the event of an emergency shall be displayed conspicuously in every child care space and shall accompany a staff person who leaves on an excursion with children.

A written, Emergency Transportation Plan was not displayed in the School-Age Room.

Corrected Corrected by Oct 6, 2023

Category: transportation. 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.

The file for Staff #1 contained Health Assessments dated 3.2.21 and 3.15.23, which exceeded the 24-month renewal requirement. The file for Staff #2 contained Health Assessments dated 3.1.20 and 10.1.22, which exceeded the 24-month renewal requirement.

Corrected Corrected by Mar 15, 2023

Category: ratio. 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.

As reported by the operator, the school for Staff #3 burned down, and the file for Staff #3 did not contain verification of education.

Corrected Corrected by Oct 4, 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). 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.

The file for Staff #1 contained Child Abuse Clearances dated 3.3.17 and 8.31.22, which exceeded the 60-month renewal requirement. The file for Staff #2 did not contain the NSOR Certificate, and the application was dated 7.29.22 (see IS Code Sheet).

Corrected Corrected by Aug 31, 2022

Category: background checks. 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.

In the unlocked, "Adults Only" restroom off the Toddler #1 room, three (3), 1-gallon containers of Pro-Tech RTU Disinfectant, which stated "Keep out of reach of children" were located on the floor, and they were accessible to children in care.

Corrected Corrected by Oct 14, 2022

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

3270.107 · 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.

In the new refrigerators, recently purchased, operating thermometers were not placed in the refrigerator in the Toddler #1 room, two refrigerators in the preschool room, or in a refrigerator in the School-Age/PK room.

Corrected Corrected by Oct 14, 2022

Category: nutrition. Marked corrected in the state record.

3270.131(e)(1)/3270.182(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. A child's record shall contain initial and subsequent health reports.

The Immunization Record, in the file for Child #1, did not contain documentation of the Influenza Vaccine according to the ACIP recommendations.

Corrected Corrected by Oct 14, 2022

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.

The emergency contact form on file for Child #2 does not include the address or telephone number for the enrolling parent's place of employment.

Corrected Corrected by Dec 23, 2021

Category: recordkeeping. Marked corrected in the state record.

3270.131(d)(5)/3270.131(e)(1) · A health report shall include a review of the child's immunized status according to recommendations of the ACIP.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.

The most recent influenza vaccination on file for Child #1 is dated 11/6/19, more than 1 year ago.

Corrected Corrected by Dec 23, 2021

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

3270.31(e)(4)(i)/3270.192(2)(iii) · 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. A facility person's record shall include verification of child care experience, education and training following the outset of service at the facility.

The file for Staff person #3, with a hire date of 5/26/20, includes verification of pediatric First Aid/CPR training dated 8/20/21, more than 180 days following the implementation of the current regulations. The file for Staff person #4, with a hire date of 1/11/21, includes verification of completed pediatric first aid/CPR dated 8/20/21, more than 90 days after hire, as required following the implementation of the current regulations. The file for Staff person #5, with a hire date of 3/8/21, includes verification of completed pediatric first aid/CPR dated 8/20/21, more than 90 days after hire, as required following the implementation of the current regulations.

Corrected Corrected by Oct 21, 2021

Category: ratio. Marked corrected in the state record.

3270.31(e)(4)(ii)/3270.192(2)(iii) · 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.A facility person's record shall include verification of child care experience, education and training following the outset of service at the facility.

The 2 most recent fire safety trainings on file for Staff person #1, #2 are dated 2/20/20 and 9/26/21, more than 1 year apart. The initial fire safety training on file for Staff person #3, with a hire date of 5/26/20, is dated 9/26/21, more than 1 year after hire.

Corrected Corrected by Oct 21, 2021

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). 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.

The Disclosure statement on file for Staff person #6 did not include a witness signature.

Corrected Corrected by Oct 22, 2021

Category: background checks. 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.

In Preschool 3 there were broken floor tiles by the windows. There was a hole in the wall with exposed plaster in the Young Toddler room under the 3rd window.

Corrected Corrected by Dec 23, 2021

Category: physical safety. 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.

The most recent health assessment on file for Staff person #1, dated 9/27/21, is dated more than 24 months after the previous health assessment dated 5/22/19.

Corrected Corrected by Oct 21, 2021

Category: ratio. Marked corrected in the state record.

3270.151(c)(2)/3270.192(3) · An adult health assessment must include tuberculosis screening by the Mantoux method at initial employment. Subsequent tuberculosis screening is not required unless directed by a physician, physician's assistant, CRNP, the Department of Health or a local health department.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.

The initial tuberculosis test on file for Staff person #4 is dated 10/21/19, more than 12 months prior to her hire date of 1/11/21.

Corrected Corrected by Jan 12, 2022

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

3270.25(a) · The facility's current certificate of compliance shall be posted in a conspicuous location used by parents. The operator shall provide the parent of each child enrolled with information on how to access the regulations in this chapter electronically and with instructions for contacting the appropriate regional child care office.

The facility did not have verification of notifying parents of how to access the regulations electronically.

Corrected Corrected by Dec 7, 2021

Marked corrected in the state record.