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.

On 11/20/24, the operator self-reported a non-functioning furnace in the downstairs preschool classroom.

Corrected Corrected by Dec 6, 2024

Category: physical safety. 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.

The file for child # 3 lacked the address of the individual designated by the parent to whom the child may be released on the emergency contact form.

Corrected Corrected by Oct 4, 2024

Category: recordkeeping. 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.

The infant/toddler room lacked an emergency transportation plan.

Corrected Corrected by Oct 4, 2024

Category: transportation. Marked corrected in the state record.

3270.133(7) · An operator is responsible to establish and maintain a medication log if prescription or nonprescription medication is administered.

The operator was not maintaining a medication log for prescriptions medication, Albuterol for child # 4.

Corrected Corrected by Oct 8, 2024

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

3270.21 · Conditions at the facility may not pose a threat to the health or safety of the children.

There was a piece of wood with two exposed screws on the floor by the sink steps in the toddler room accessible to children.

Corrected Corrected by Oct 4, 2024

Category: health medication. 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.

The file for staff #1 lacked documentation of current pediatric first-aid and pediatric CPR certification. The previous certification for staff #1 was dated 9/22/22 to 9/22/24.

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 file for staff #2 contained a current NSOR clearance dated 12/7/23. Staff #2 date of hire was 12/5/23. The file lacked documentation of the NSOR clearance application prior working with children.

Corrected Corrected by Dec 7, 2023

Category: background checks. 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.

There was an uncovered electrical outlet on the circle time wall in the preschool room accessible to children 5 years of age or younger.

Corrected Corrected by Oct 2, 2024

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.

There was a hand sanitizer labeled " keep out of reach of children". accessible to children on the floor in the in the preschool room.

Corrected Corrected by Oct 4, 2024

Marked corrected in the state record.

3270.67(d) · Trash that has been contaminated by human secretions or excrement shall be contained in closed, plastic-lined receptacles.

There was an open garbage can with contaminated by human secretions trash in pre-k room and one in the infant/toddler room.

Corrected Corrected by Oct 4, 2024

Marked corrected in the state record.

3270.75(b) · A first-aid kit must be inaccessible to children.

The first -Aid kit in the preschool room was placed on the floor accessible to children.

Corrected Corrected by Oct 2, 2024

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.

On the stairs leading to the second floor, there were 2 damaged stair covers causing a tripping hazard. The upstairs children bathroom window frame wallpaper was pulling off the wall. There was a ceiling light frame coming off the ceiling in the toddler room.

Corrected Corrected by Oct 8, 2024

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.

The second toilet in the boy's bathroom was soiled.

Corrected Corrected by Oct 4, 2024

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.

There were foam blocks with teeth marks and a cracked bin in the preschool room. There was a cracked pencil box, a cracked blue bin, and a cracked yellow bin in the pre-K room. There was a blue cracked bin in the toddler room. There was a broken garbage can with an exposed wire in the playground.

Corrected Corrected by Oct 2, 2024

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

3270.123(b)/3270.182(8) · A parent shall receive the original agreement. The facility shall retain a copy of the agreement. A child's record shall contain a copy of the initial agreement and subsequent written agreements between the parent and the operator. The parent receives the original agreement.

The files for child # 1 and 3 contained an original agreement form.

Corrected Corrected by Oct 4, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.124(b)(1) · Emergency contact information must include the name and birth date of the child.

The file for child #3 lacked the child's birthday on the emergency contact form.

Corrected Corrected by Oct 4, 2024

Category: recordkeeping. 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 file for child # 3 lacked the work addresses and telephone numbers of the enrolling parent on the emergency contact form.

Corrected Corrected by Oct 4, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.124(b)(5) · Emergency contact information must include information on the child's special needs, as specified by the child's parent, physician, physician's assistant or CRNP, which is needed in an emergency situation.

The file for child # 3 lacked the information on the child's special needs, as specified by the child's parent, physician, physician's assistant or CRNP, which is needed in an emergency situation, on the Emergency contact form.

Corrected Corrected by Oct 4, 2024

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

3270.134(a) · A staff person shall ensure that a child's hands are washed before meals and snacks, after toileting and after being diapered.

Staff # 3 did not wash the child's hands after diapering.

Corrected Corrected by Oct 2, 2024

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

3270.135(a)(3) · If disposable diapers are provided by a parent or by a facility, a soiled diaper shall be discarded by immediately placing the diaper into a plastic-lined, hands-free covered can.

Staff # 3 kept a soiled diaper on the changing table until she was done with the diaper change, instead of discarding it immediately into a plastic-lined, hands-free covered can.

Corrected Corrected by Oct 2, 2024

Category: health medication. 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.

There was a lunchbox out of the refrigerator that contained cheese. The lunchbox was on a shelf by the refrigerator in the pre-K room.

Corrected Corrected by Oct 2, 2024

Category: nutrition. Marked corrected in the state record.

3270.131(a) · The operator shall require the parent of an enrolled child, including a child, a foster child and a relative of an operator or a facility person, to provide an initial health report no later than 60 days following the first day of attendance at the facility.

The file for child # 2 an old toddler contained a current health report that was provided after 60 days. The child was in care longer that 60 days without initial health report.

Corrected Corrected by Oct 4, 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.

Although Staff #2, #5, #6, and #7 had the Pennsylvania Health and Safety Updated training at the time of the Renewal Inspection it was observed that Staff #2, #5, #6, and #7 had not completed the Pennsylvania Health and Safety Updated by the compliance date of 12/30/22 as set forth in Announcement C-22-06. The file for Staff #8 lacked the Pennsylvania Health and Safey Updated training by the compliance date of 12/30/22 as set forth in Announcement C-22-06.

Corrected Corrected by Nov 3, 2023

Category: ratio. 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 a written evaluation that was conducted in an interval greater than 12 months. Although the files for Staff #5 and #7 contained a Staff Evaluation at the time of the Renewal Inspection, it was observed that Staff #5 and #7 lacked a written evaluation within the first year of hire.

Corrected Corrected by Nov 3, 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.

The file for Staff #5 contained Emergency Plan trainings that were dated more than 12 months apart.

Corrected Corrected by Nov 3, 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.

The file for Staff #5 contained Fire Safety Trainings that were dated more than 12 months apart.

Corrected Corrected by Nov 3, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.31(f) · Staff person(s) shall complete professional development in the topics of 3270.31(f)(1 -- 10) within 90 days of hire. Staff person #3 will have until 11/3/23 to complete the required training. Until such time as the required training has been completed, staff person #3 must be supervised, when interacting with children, by an (AGS) who has completed the required training related to this citation. If there are no staff available to supervise staff person #3, staff person #3 may not work in a child-care position at the facility.

Staff Person #3 has not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): (Health and Safety Basics). Although Staff Person #7 had Health and Safety Basic training at the time of Renewal Inspection, it was observed that Staff Person #7 had not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): (Health and Safety Basics).

Corrected Corrected by Nov 3, 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). 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 may not work at the facility.

The file for Staff #3 contained an FBI Clearance and State Police Clearance without the accompanying Rap Sheets, and therefore was not a complete clearance.

Corrected Corrected by Nov 3, 2023

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

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

Although Staff #4 had Mandated reporter Training at the time of the Renewal Inspection, it was observed that Staff #4 had not completed the mandated reporter training within 90 days of their date of hire (see LIS code sheet).

Corrected Corrected by Nov 3, 2023

Category: recordkeeping. 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.

Observed three outlets on a surge protector in the Infant Classroom that lacked protective receptacle covers. These outlets were accessible to children 5 years of age or younger.

Corrected Corrected by Nov 6, 2023

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.

Observed Lysol Spray and GNC Immune Defense Gummies in an unlocked cabinet in the Middle Classroom. Observed hand sanitizer on a low interior windowsill in the Middle Classroom. These toxics were all labeled "Keep out of Reach of Children" and accessible to the children in care. Observed Lysol Spray labeled "Keep out of Reach of Children" on a low shelf in an unlocked cabinet that made them accessible to the children in care in the School Aged Classroom where Toddlers were receiving care.

Corrected Corrected by Oct 19, 2023

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.

Observed a missing face plate on an accessible electrical outlet in the School Aged Classroom. Observed a ripped carpet seam that ran the length of the Downstairs Classroom and caused a tripping hazard to the children in care. In the Downstairs Classroom a knob was observed to be missing on a low cabinet which exposed the screw underneath creating a cutting hazard.

Corrected Corrected by Nov 6, 2023

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

3270.103 · Toys and objects with a diameter of less than 1 inch, objects with removable parts that have a diameter of less than 1 inch, plastic bags and styrofoam objects may not be accessible to children who are still placing objects in their mouths.

Observed Plastic Bags and Halloween Plastic Eyeballs that were labeled, "Choking Hazard" in the School Aged Classroom where Toddlers who are still placing items in their mouths were receiving care. Observed foam shapes with bite marks in the School Aged Classroom where the Toddlers who are still placing items in their mouths were receiving care. Observed Tulle Material tied to multiple cribs in the Infant Classroom. These items pose a choking hazard to the children who are still placing items in their mouths. Observed small glue sticks labeled, "Choking Hazard" in a low unlocked drawer in the Infant Classroom that were accessible to children who are still placing items in their mouths.

Corrected Corrected by Oct 19, 2023

Category: physical safety. 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).

The file for Child #2 contained a child service form that provides information to the family about the child's growth and development in the context of the services being provided that had not been updated in the previous 6 months. The files for Child #1 and #3 contained a child service form that provides information to the family about the child's growth and development in the context of the services being provided that is deemed unacceptable.

Corrected Corrected by Nov 10, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.124(b)(4)/3270.182(3) · Emergency contact information must include the written consent signed by a parent for emergency medical care. A child's record shall contain signed parental consent for emergency medical care for the child. Written consent is required prior to admission.

The Emergency Contact Form in the file for Child #2 lacked written consent signed by a parent for emergency medical care.

Corrected Corrected by Oct 20, 2023

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.

The Emergency Contact information was not present in the Downstairs Classroom for Child #5. The child was present and receiving care in the room. The Emergency Contact information was not present in the Middle Room for the children who were present and receiving care in the room.

Corrected Corrected by Oct 23, 2023

Category: recordkeeping. 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.

The file for Child #1 contained an Emergency Contact Form that had not been updated within the last 6 months.

Corrected Corrected by Oct 23, 2023

Category: recordkeeping. 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 file for Child #2, an Older Toddler, contained Health Reports that had been updated in an interval greater than 12 months. The file for Child #3, a Preschooler, lacked an updated health report within the last 12 months. The file for Child #4, an Older Toddler, contained a health report that lacked a date; therefore, it could not be determined if it was within the last 12 months.

Corrected Corrected by Nov 10, 2023

Category: health medication. 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 implement dismissal policies in accordance with the Department of Health regulation in 28 Pa. Code § 27.77 (relating to immunization requirements for children in childcare group settings). Child #4 must be dismissed from care by close of business 10/19/23 and may only return to care when the immunization record is updated or when a parent provides a written, signed exemption letter.

The file for Child #4, enrolled for more that 60 days at the facility, did not contain documentation of a 2nd and 3rd dose of the DTAP vaccination, and an influenzas vaccination as required based on the child's age as per the ACIP recommended schedule.

Corrected Corrected by Nov 3, 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.

The file for Child #6, an infant, lacked a written formula and feeding schedule obtained from the parent.

Corrected Corrected by Oct 20, 2023

Category: nutrition. Marked corrected in the state record.

3270.182(5) · A child's record shall contain signed parental consent for administration of minor first-aid procedures by facility staff. Written consent is required prior to admission.

The Emergency Contact form for Child #2 lacked signed parental consent for administration of minor first-aid procedures by facility staff.

Corrected Corrected by Oct 23, 2023

Category: ratio. Marked corrected in the state record.

3270.192(2)(iv) · 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.

The file for Staff #3 lacked proof of qualifications for education in the form of a diploma, transcript, or letter signed by a representative or the experiential, educational or training entity.

Corrected Corrected by Nov 13, 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.

The files for staff #2, 3, 4 and 6 lack the one-hour health and safety update which was to be completed by 12/30/22.

Corrected Corrected by Jun 1, 2023

Category: ratio. Marked corrected in the state record.

3270.31(f) · Staff person(s) shall complete professional development in the topics of 3270.31(f)(1 -- 10), 3280.31(f) (1-10), or 3290.31(g) (1-10) within 90 days of hire. Staff person #5 will have 15 days from POC requested date to complete the required training. Until such time as the required training has been completed, staff person # 5 must be supervised, when interacting with children, by an AGS who has completed the required training related to this citation. If there are no staff available to supervise staff person #5, staff person #5 may not work in a child-care position at the facility.

Staff person # 5 did not complete the following required pre-service training within 90 days of their date of hire (see LIS code sheet): 10 hour health and safety training.

Corrected Corrected by Jul 12, 2023

Category: supervision. Marked corrected in the state record.

3270.31(f) · Staff persons shall complete professional development within 90 days of hire as listed in subsections (f)1-10.

Staff person # 1 did not complete the following required pre-service training within 90 days of their date of hire (see LIS code sheet): 10 hour health and safety training. There is now health and safety training on file and dated 2/20/23.

Corrected Corrected by Feb 20, 2023

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 Child Protective Services). Staff person #1 will have 15 days from POC requested date to complete the mandated reporter training. Until then, staff person #1 must be supervised, when interacting with children, by an AGS who has completed the required training related to this citation. If there are no staff person(s) available to supervise staff person #1, staff person #1 may not work in a child-care position at the facility.

Staff person #1 has not completed the mandated reporter training within 90 days of their date of hire (see LIS code sheet).

Corrected Corrected by Feb 20, 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).

Based on interviews, it was determined that there have been times in the past few months when staff have been on their personal cell phones, stepping out of the rooms, while supervising children and leaving other staff out-of-ratio.

Corrected Corrected by Jun 1, 2023

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.

Based on interviews, it was determined that there have been times in the past few months when staff leave child care spaces and their supervision groups to talk on their personal cell phones and are not supervising their assigned child care groups. During the investigation on 5.5.23, Staff #3 was observed to not be able to see, direct or assess three (3) of the five (5) children in her supervision group when they ran ahead of her and into the empty classroom for several seconds and staff was not physically present with the children.

Corrected Corrected by Jun 1, 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.

Based on interviews, it was determined that there have been times in the past few months when staff leave child care spaces and their supervision groups to talk on their personal cell phones in the hallway and therefore, were not physically present with the children in their respective groups. During an unannounced visit on 5.5.23, when asked to identify supervision groups, Staff #1 was unable to identify which children she was to be supervising until the third attempt, and only when assisted by other staff. Staff #2 was only able to identify four (4) of the eight (8) children which she was to be supervising. During an unannounced visit on 5.5.23, Staff #3 was observed to not able to see, direct or assess three (3) of the five (5) children in her supervision group when they ran ahead of her and into the empty classroom for several seconds and staff was not physically present with the children.

Corrected Corrected by Jun 1, 2023

Category: supervision. Marked corrected in the state record.

3270.14/3270.21 · A facility shall be operated in conformity with applicable Federal and State laws and regulations. State agencies whose regulations may relate to the operation of a facility include the Department of Environmental Resources, the Department of Labor and Industry, the Department of Health, the Department of Education and the Department of Transportation. Conditions at the facility may not pose a threat to the health or safety of the children. Until such time as the required pre-service trainings are completed, staff person #8 and #10 must be supervised, when interacting with children, by an AGS who has completed the required training related to this citation. If there are no staff person(s) available to supervise staff person #8 and #10, staff person #8 and #10 may not work in a child-care position at the facility.

Staff person #8 was observed to be caring for children unsupervised. Staff person #8 has not completed the following pre-service trainings required prior to caring for children unsupervised: Mandated reporter training, Pediatric first-aid/CPR training from a PQAS approved trainer, and Health and Safety Training in the topics of 3270.31(f)(1-9). Staff person #10 was observed to be caring for children unsupervised. Staff person #10 has not completed the following pre-service training required prior to caring for children unsupervised: Health and Safety Training in the topics of 3270.31(f)(1-9).

Corrected Corrected by Nov 22, 2022

Category: supervision. Marked corrected in the state record.

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

The facility had a policy and procedure to identify the prevention of shaken baby syndrome, abusive head trauma, and child maltreatment that did not address the recognition of potential signs and symptoms of shaken baby syndrome and the prevention and identification of child maltreatment as required to comply with 45 CFR 98.41(a)(1)(vi).

Corrected Corrected by Nov 22, 2022

Category: ratio. Marked corrected in the state record.

3270.31(f) · Staff person(s) shall complete professional development in the topics of 3270.31(f)(1-10) within 90 days of hire. Staff person #2 and #6 will have until 11-29-22 to complete the required training. Until such time as the required training has been completed, staff person #2 and #6 must be supervised, when interacting with children, by an AGS who has completed the required training related to this citation. If there are no staff available to supervise staff person #2 and #6, staff person #2 and #6 may not work in a child-care position at the facility.

Staff person #6 has not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): Health and Safety Training in the topics of 3270.31(f)(1-9). Staff person #2 has not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): Acceptable Health and Safety Training in the topics of 3270.31(f)(1-9).

Corrected Corrected by Nov 23, 2022

Category: supervision. Marked corrected in the state record.

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

Staff person #6 had not completed mandated reporter training within 60 months. This is evidenced by the documented mandated reporter trainings on file being dated 1-12-17 and 10-5-22.

Corrected Corrected by Nov 22, 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). 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 #7 may not work at the facility.

The file for staff person #7 lacked an FBI clearance and had an NSOR verification certificate that was dated after their start date and did not have verification of application for the FBI clearance or the NSOR verification certificate at their start date to be a provisional hire. (See LIS CODE SHEET) The file for staff person #2 had a disclosure statement that was not signed by the staff person.

Corrected Corrected by Nov 22, 2022

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 person #4 lacked a current staff evaluation completed within the last 12 months. The files for staff person #1 and #3 had a staff evaluation that exceeded 12 months between evaluations.

Corrected Corrected by Nov 22, 2022

Category: recordkeeping. Marked corrected in the state record.

3270.37(b)(1)/3270.192(2)(ii) · An aide shall have a high school diploma or a general educational development certificate. A facility person's record shall include verification of child care experience, education and training prior to service at the facility.

The file for staff person #9, functioning as an aide, lacked verification of education to qualify as an aide.

Corrected Corrected by Nov 22, 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.

In the large bathroom on the main floor, there were 2 containers of Disinfex Multi-purpose Wipes labeled "Keep out of reach of children" that were in an unlocked cabinet under the sink and were accessible to children.

Corrected Corrected by Nov 22, 2022

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/toddler room lacked sterile gauze pads.

Corrected Corrected by Nov 22, 2022

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 the middle room, there were 2 screws protruding out from the right wall near the doorway leading to the downstairs that were a potential hazard.

Corrected Corrected by Nov 22, 2022

Category: physical safety. 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.

In the preschool room, there were multiple cabinets on the left wall that had purple paint peeling in multiple areas near the handles on the cabinet doors.

Corrected Corrected by Nov 22, 2022

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

3270.82(j) · A source of running water for handwashing shall be present in infant and toddler diapering areas. If the running water does not flow directly into a drain that is connected to a sewage system, a receptacle shall be provided to contain the water used for washing. The receptacle shall be emptied into an approved sewage system at least once a day.

The infant/toddler room lacked a source of running water for handwashing near the changing table to wash hands after diapering.

Corrected Corrected by Nov 23, 2022

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.

There were multiple rest mats in the preschool room that had tears that exposed the stuffing inside.

Corrected Corrected by Nov 23, 2022

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

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

The file for child #1 had an agreement that lacked the child's arrival and departure times.

Corrected Corrected by Nov 23, 2022

Category: recordkeeping. Marked corrected in the state record.

3270.131(b)(2)/3270.182(1) · 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 child's record shall contain initial and subsequent health reports.

The file for child #2, a preschooler, lacked a current health assessment updated within the last 12 months.

Corrected Corrected by Nov 23, 2022

Category: health medication. 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 file for child #2, a 4 year old, had an immunization record that lacked verification of the Influenza vaccination being administered within the last calendar year in accordance with the schedule recommended by the ACIP and lacked exemption documentation.

Corrected Corrected by Nov 23, 2022

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

3270.134(a) · A staff person shall ensure that a child's hands are washed before meals and snacks, after toileting and after being diapered.

In the infant/toddler room, the staff stated that the 2 year olds that are still wearing diapers have their diapers changed at the changing table in the room, and the children do not have a nearby sink to wash their hands after being diapered.

Corrected Corrected by Nov 23, 2022

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.

The files for staff person #3 and #6 lacked a current health assessment completed within the last 24 months. The files for staff person #4 and #5 had a health assessment that exceeded 24 months between assessments.

Corrected Corrected by Nov 23, 2022

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 file for staff person #2 had a tuberculosis screening by the Mantoux method that was dated over a year prior to initial employment and requires a current tuberculosis screening by the Mantoux method.

Corrected Corrected by Nov 23, 2022

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

3270.152 · A facility person shall wash his hands before meals and snacks, and after toileting and after diapering a child.

In the infant/toddler room, staff person #2 was observed changing a 1 year olds diaper at the changing table in the room, and then using hand sanitizer afterwards. The staff person did not wash their hands after diapering the child, and a sink was not located near the changing table to wash their hands after diapering the child.

Corrected Corrected by Nov 23, 2022

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

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

In the infant/toddler room, there were 2 bottles in the refrigerator for an infant in the room that were not labeled with the child's name.

Corrected Corrected by Nov 23, 2022

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.

According to the fire drill log, a fire drill was not conducted at least once every 60 days between 1-6-22 to 3-10-22 and 5-9-22 to 7-11-22.

Corrected Corrected by Nov 23, 2022

Category: recordkeeping. Marked corrected in the state record.

3270.31(e)/3270.192(2)(iii) · A staff person shall obtain an annual minimum of 12 clock hours of child care training. 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 #1 lacked 8 annual hours of child care training completed within the last year. The file for staff person #4 lacked 6 annual hours of child care training completed within the last year.

Corrected Corrected by Nov 23, 2022

Category: recordkeeping. 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.

At 10:04 am in the infant/toddler room with a total of 13 children in the room, staff person #1 named 4 older toddlers in their group, staff person #2 named 4 children in their group, including 2 preschoolers and 2 older toddlers, and staff person #3 named 4 children in their group, including 3 young toddlers and 1 infant, resulting in 12 out of 13 children being named in a group and 1 child not being named in a group.

Corrected Corrected by Apr 18, 2022

Category: supervision. 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.

The file for staff person #4 lacked current emergency plan training within the last year. The files for staff person #1 and #2 had emergency plan training that exceeded a year between trainings.

Corrected Corrected by Nov 9, 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 file for staff person #5 had a disclosure statement that lacked the signature of a witness. The file for staff person #3 had state police clearances dated 11-19-15 and 12-17-20, child abuse clearances dated 11-23-15 and 12-17-20, and FBI clearances dated 11-18-15 and 8-31-21 that were over 60 months between clearances.

Corrected Corrected by Nov 8, 2021

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 files for staff person #1 and #4 had a staff evaluation that exceeded 12 months between evaluations.

Corrected Corrected by Nov 8, 2021

Category: recordkeeping. Marked corrected in the state record.

3270.62(b)/3270.62(b)(2) · Outdoor or indoor play space shall be measured at 65 square feet per child. The minimum outdoor or indoor play space required per young or older toddler is 50 square feet.

At approximately 11:15 a.m. on the outdoor toddler play space with a capacity for 6 preschoolers and 8 toddlers, there were 9 total children, including 1 preschooler, 6 toddlers, and 2 infants with 3 staff persons, resulting in the play space being overcapacity.

Corrected Corrected by Nov 8, 2021

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.

The janitor's closet door was unlocked in the hallway on the main floor with multiple toxics inside the closet labeled "Keep out of reach of children" that were accessible to children including a bottle of Clorox.

Corrected Corrected by Oct 15, 2021

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 middle room lacked soap. The first-aid kit in the school-age room lacked tweezers.

Corrected Corrected by Oct 15, 2021

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 school-age room, the refrigerator door was not closed completely due to milk containers preventing the door from closing resulting in multiple containers of milk being visibly warm and the digital thermometer reading 72° F. In the infant/toddler room, the refrigerator that stores food for the children had a thermometer that was not functioning.

Corrected Corrected by Oct 15, 2021

Category: nutrition. Marked corrected in the state record.

3270.111(b) · The written plan of daily activities shall be posted in the group space.

The daily activity schedule was not posted in the middle room.

Corrected Corrected by Oct 15, 2021

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

3270.123(a) · An agreement shall be signed by the operator and the parent.

The file for child #1 had an agreement that lacked the operator's signature.

Corrected Corrected by Oct 15, 2021

Category: recordkeeping. Marked corrected in the state record.

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

The file for child #2 had an agreement that lacked the child's admission date.

Corrected Corrected by Oct 15, 2021

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 file for child #3 had an emergency contact form that lacked the health insurance policy number.

Corrected Corrected by Oct 15, 2021

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.

The file for child #3 had an emergency contact form that lacked the address of the individual designated by the parent to whom the child may be released.

Corrected Corrected by Oct 18, 2021

Category: recordkeeping. Marked corrected in the state record.

3270.133(5) · Medication shall be stored in accordance with the manufacturer's or health professional's instructions on the original label.

In the office, there were Albuterol and 2 EpiPens for child #4 that were expired.

Corrected Corrected by Oct 15, 2021

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

3270.135(a)(3) · If disposable diapers are provided by a parent or by a facility, a soiled diaper shall be discarded by immediately placing the diaper into a plastic-lined, hands-free covered can.

In the large bathroom on the main floor, the diapering can being used to dispose of diapers had a flip lid and was not a hands-free covered diapering can.

Corrected Corrected by Oct 15, 2021

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.

In the infant/toddler room, the 2 infants in care lacked a feeding schedule.

Corrected Corrected by Oct 18, 2021

Category: nutrition. Marked corrected in the state record.

3270.182(3)/3270.182(5) · A child's record shall contain signed parental consent for emergency medical care for the child. Written consent is required prior to admission. A child's record shall contain signed parental consent for administration of minor first-aid procedures by facility staff. Written consent is required prior to admission.

The file for child #2 had an emergency contact form that lacked signed parental consent for emergency medical care for the child and signed parental consent for administration of minor first-aid procedures by facility staff.

Corrected Corrected by Oct 18, 2021

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

The file for staff person #5 had one written, nonfamily reference and lacked a second written, nonfamily reference.

Corrected Corrected by Nov 5, 2021

Category: recordkeeping. Marked corrected in the state record.