3270.31(f)(10)/3270.192(2)(iii) · Staff persons shall complete professional development in the topic of pediatric first aid and pediatric cardiopulmonary resuscitation within 90 days of hire. A facility person's record shall include verification of child care experience, education and training following the outset of service at the facility.

Staff person #1 did not complete pediatric first aid and CPR within 90 days of their date of hire (see LIS code sheet). The training was completed on 3/06/26.

Corrected Corrected by Jun 24, 2026

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

3270.95(a) · Fire detection devices or systems must be in compliance with standards established under section 1016(c) of the act (62 P.S. § 1016(c)).

Fire-detection system testing exceeds 30 days as evidenced by the most recent test documented on 6/19/25.

Corrected Corrected by Oct 13, 2025

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

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

Fire drill exceeds 60 days as evidenced by the most recent drill documented on 6/19/25.

Corrected Corrected by Oct 13, 2025

Category: recordkeeping. Marked corrected in the state record.

3270.75(a) · A first-aid kit shall be in a child care space.

The downstairs preschool room lacked a first-aid kit.

Corrected Corrected by Apr 23, 2025

Category: physical safety. 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.

Staff persons #1 and #2 did not have emergency plan at time of hire or annually. Staff persons #3, #4, and #5 did not have emergency plan training at time of hire.

Corrected Corrected by Apr 28, 2025

Category: recordkeeping. Marked corrected in the state record.

3270.31(e)(4)(i) · Competence is the completion of training by a professional in the field of first-aid and cardiopulmonary resuscitation (CPR). All staff persons shall renew their certification in pediatric first aid and pediatric cardiopulmonary resuscitation (CPR) on or before the expiration of the most current certification.

Staff person #7 had pediatric first-aid and CPR training dated 11/9/24, which is more than 90 days after the date of hire (see LIS code sheet).

Corrected Corrected by Apr 22, 2025

Category: ratio. 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.

Staff person #2 had fire-safety training dated 1/17/25, which is more than one year after the date of hire (see LIS code sheet)

Corrected Corrected by Apr 22, 2025

Category: recordkeeping. Marked corrected in the state record.

3270.76 · Floors, walls, ceilings and other surfaces, including the facility's outdoor play space surfaces shall be kept clean, in good repair and free from visible hazards.

Exposed toilet bolts were observed on the wall-side of toilet in upstairs pink bathroom, and on one toilet in the upstairs blue bathroom.

Corrected Corrected by Apr 22, 2025

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

3270.32(a) · The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). Facility Persons # 6, #8, and #9 may not work in a child care position at the facility.

Staff person #1 did not have disclosure statement dated. Staff person #2 had state police clearance dated 8/21/23 (no application), NSOR dated 10/17/23 (no application); disclosure statement dated 6/11/24, which are all after the date of hire (see LIS code sheet). Staff person #3 had child abuse clearance dated 6/5/24 (no application), DHS FBI clearance dated 7/22/24 (no fingerprint proof). All of these are dated after the staff person's date of hire. Staff person #3 also needs out of state clearances for Virginia. Staff person #4 had an outdated disclosure form that did not include the date it was signed. The current NSOR clearance for staff person #6 is dated 3/11/20. The current NSOR clearances for staff persons #8 and #9 are dated 2/7/20.

Corrected Corrected by Apr 22, 2025

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

3270.33(a) · A staff person or a substitute staff person shall meet one of the applicable staff qualifications for the position in which the person is performing.

Staff person #3 lacks documentation of childcare experience that would allow them to have the position of assistant group supervisor.

Corrected Corrected by Apr 22, 2025

Category: supervision. 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.

Staff persons #1 and #2 do not have documentation of annual staff evaluations, and both have been employed longer than one year (see LIS code sheet).

Corrected Corrected by Apr 23, 2025

Category: recordkeeping. Marked corrected in the state record.

3270.63 · If unsafe areas or conditions are in or near an outdoor play space, fencing or natural barriers are required to restrict children from those unsafe areas or conditions.

Wiring on the metal gate in the outdoor play space is protruding in toward the play space, presenting a hazard to children playing in the space.

Corrected Corrected by Apr 30, 2025

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

3270.65 · Protective receptacle covers shall be placed in electrical outlets accessible to children 5 years of age or younger.

In the downstairs Preschool room, there were two power strips that did not have protective outlet covers. One was located by the television, and another was located by a small sink.

Corrected Corrected by Apr 23, 2025

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 diaper changing table in the Tumbler 2 room had an unlocked cabinet that contained diaper creams labeled "Keep out of reach of children" that were accessible to children.

Corrected Corrected by Apr 25, 2025

Category: health medication. 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.

Paint on the railing outdoors by the entryway is chipped and peeling.

Corrected Corrected by May 8, 2025

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

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

The exit door for the Tumbler 2 room was obstructed by a chair in the hallway outside of the door. The exit door for the downstairs preschool room was obstructed by a vacuum and broom.

Corrected Corrected by Apr 23, 2025

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.

A cracked toy bin with sharp edges that create pinch points was present on the bottom shelf of the market toy in the older toddler space. Two cracked toy bins with sharp edges creating pinch points were present in the Tumbler 2 room. One bin contains dress-up clothing and is located below the "Never Stop Growing" board. The other cracked bin contains Magnatiles and is on a shelf that was turned in to face the wall

Corrected Corrected by Apr 23, 2025

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

3270.104(a) · Furniture must be durable, safe, easily cleaned and appropriate for the child's size, age and special needs.

One shelving unit in the upstairs preschool space and multiple shelving units in the downstairs preschool space had exposed screws protruding from the shelves. A tall shelving unit in the downstairs preschool room located against the left-side wall about halfway between the entry door and back wall, presents a tipping risk.

Corrected Corrected by May 2, 2025

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

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

In the infant space, the crib closest to entry/exit gate does not have 2 ft. of space on 2 out of 3 sides.

Corrected Corrected by Apr 24, 2025

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

3270.123(a)(1) · An agreement shall specify the amount of the fee to be charged per day or per week.

The agreement for child #3 did not include the amount of the fee to be charged.

Corrected Corrected by Apr 25, 2025

Category: recordkeeping. 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).

There were no DHS-approved child service reports for child#1-child #5.

Corrected Corrected by May 6, 2025

Category: recordkeeping. Marked corrected in the state record.

3270.124(b)(2) · Emergency contact information must include the name, address and telephone number of the child's physician or source of medical care.

The emergency contact information for child #1 did not include the telephone number of the physician or source of medical care.

Corrected Corrected by Apr 25, 2025

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

3270.131(b)(1) · The operator shall require the parent to provide an updated health report at least every 6 months for an infant or young toddler.

The health assessment for child #2 was dated 7/18/24, which is more than 12 months after the previous health assessment, dated 4/4/23.

Corrected Corrected by Apr 25, 2025

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.

Following a diaper change in Tumbler 1 room, a diaper was observed to be placed on the changing table after being removed instead of being disposed of immediately in a plastic-lined, hands-free covered can.

Corrected Corrected by Apr 23, 2025

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 file for staff person #2 did not include a health assessment. Staff person #3 had an initial health assessment dated 1/27/25, which is after the date of hire. (see LIS code sheet)

Corrected Corrected by May 1, 2025

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.

Staff person #2 had an initial TB test dated 3/6/24, which is after the date of hire. Staff person #3 had an initial TB test dated 11/29/24, which is after the date of hire. (See LIS code sheet)

Corrected Corrected by Apr 24, 2025

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.

Staff person in Tumbler 1 room was observed changing a diaper wearing disposable gloves and did not remove the gloves and wash hands after diapering the child.

Corrected Corrected by Apr 24, 2025

Category: health medication. 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 #2 contained only one written, nonfamily reference. The files for staff persons #3 and #5 lacked two written, nonfamily references.

Corrected Corrected by May 6, 2025

Category: recordkeeping. Marked corrected in the state record.

3270.31(e) · A staff person shall obtain an annual minimum of 12 clock hours of child care training.

Staff peron #1 lacked documentation of 12 hours of annual professional development between 3/24 and 3/25. They had 8.5 hours of professional development documented.

Corrected Corrected by May 8, 2025

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. Until such time as the required pre-service trainings are completed, staff person #2, #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 person(s) available to supervise staff person #2, #5, staff person #2, #5 may not work in a child-care position at the facility.

Staff person #2 was observed to be caring for children unsupervised by an AGS who has completed all pre-service training; staff person #2 has not completed the following pre-service training required prior to caring for children unsupervised: Pediatric First Aid/CPR.

Corrected Corrected by Apr 6, 2025

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): Pediatric First Aid/CPR; the training was completed on 11.9.24. Staff person #4 did not complete the following required pre-service training within 90 days of their date of hire (see LIS code sheet): Pediatric First Aid/CPR; the training was completed on 11.13.24.

Corrected Corrected by Mar 3, 2025

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

3270.192(4) · 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 in a child care position at the facility.

The file for staff person #3 did not include documentation of the PA Child Abuse clearance, obtained for the purpose of employment, prior to date of hire (See IS CODE SHEET) required for provisional hiring under the CPSL. The Child Abuse clearance was submitted to the certification representative after the conclusion of the inspection and was dated 6.5.24.

Corrected Corrected by Mar 3, 2025

Category: background checks. 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.

The most recent documented fire drill took place on 7.3.24, more than 60 days ago.

Corrected Corrected by Mar 4, 2025

Category: recordkeeping. Marked corrected in the state record.

3270.95(a)/3270.95(b) · Fire detection devices or systems must be in compliance with standards established under section 1016(c) of the act (62 P.S. §  1016(c)). The Director or designated staff person who is responsible for compliance with this chapter shall ensure the requirements under subsection (a) are met.

The most recent recorded 30-day test for the smoke detectors is dated 7.5.24, more than 30 days ago.

Corrected Corrected by Mar 19, 2025

Category: recordkeeping. Marked corrected in the state record.

3270.192(5) · A facility person's record shall include two written, nonfamily references from individuals attesting to the person's suitability to serve as a facility person.

The file for Staff person #2 and #4 includes only 1 written nonfamily reference.

Corrected Corrected by Jun 20, 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.

Adult scissors were observed in an unlocked cabinet accessible to children in the Older Toddler room.

Corrected Corrected by Jun 20, 2024

Category: ratio. Marked corrected in the state record.

3270.27(c)/3270.192(2)(iii) · 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. 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 #4 does not include verification of emergency plan training completed within 90 days of hire (See LIS Code Sheet); the training was completed on 2/2/24.

Corrected Corrected by Apr 17, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.27(e) · The operator shall provide to the parent of each enrolled child a letter explaining the emergency procedures. The operator shall also provide to the parent of each enrolled child a letter explaining any subsequent update to the plan.

The facility did not have a letter to the parents of enrolled children regarding the facility emergency plan.

Corrected Corrected by Jun 20, 2024

Category: physical safety. 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 will have until 5/22/24 to complete the required training. Until such time as the required training has been completed, 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 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 following required pre-service training within 90 days of their date of hire (see LIS code sheet): Get Started with Center-based Care: Building Blocks for Quality.

Corrected Corrected by Jun 4, 2024

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 #3 did not complete the following required pre-service training within 90 days of their date of hire (see LIS code sheet): Get Started with Center-based Care: Building Blocks for Quality; the training was completed on 6/19/23.

Corrected Corrected by Apr 17, 2024

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

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

The first aid kit in the Older Toddler room did not include tweezers. The first aid kit in the Tumbler 2 room did not include tweezers, soap, or gloves.

Corrected Corrected by Jun 20, 2024

Category: health medication. 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 #4 will have until 5/22/24 to complete the required training. Until such time as the required training has been completed, staff person #4 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 #4, staff person #4 may not work in a child-care position at the facility.

Staff person #4 has not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): Pediatric First Aid/Pediatric CPR.

Corrected Corrected by Jul 18, 2024

Category: supervision. Marked corrected in the state record.

3270.32(a)/3270.192(2)(iii) · The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). A facility person's record shall include verification of child care experience, education and training following the outset of service at the facility.

Staff person #1 completed their current mandated reporter training on 3/27/24, more than 60 months after the previous training dated 11/8/18.

Corrected Corrected by Apr 17, 2024

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 #1 includes criminal history clearances dated 11/15/18 and 3/6/24; child abuse clearances dated 11/9/18 and 3/6/24; and FBI clearances dated 11/7/18 and 3/11/24, all more than 60 months apart. The file for staff person #4 included an NSOR certificate dated more than 45 days after hire (See LIS Code Sheet) required for provisional hiring under the CPSL; the NSOR is dated 10/20/23.

Corrected Corrected by Apr 17, 2024

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

3270.33(a)/3270.192(2)(ii) · A staff person or a substitute staff person shall meet one of the applicable staff qualifications for the position in which the person is performing. 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 #3, classified as an assistant group supervisor, does not include a high school diploma or a general educational development certificate and 30 credit hours in education or a related human services field; or a high school diploma or a general educational development certificate with 15 credits in education or a related human services field and 1 year of experience with children; or a high school diploma or a general educational development certificate and 2 years experience with children

Corrected Corrected by Jun 20, 2024

Category: supervision. 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.

A bottle of White-out was observed in an unlocked cupboard, accessible to children in the Older Toddler room.

Corrected Corrected by Jun 20, 2024

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.

Peeling paint was present on the chair rail under the clock in the Older Toddler room and under the clock and the menu, on the wall bump-out in Preschool 2.

Corrected Corrected by Jun 20, 2024

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

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

There were 3 Magna Tiles in the Older Toddler room that had cracked and broken edges. In the Tumbler 1 room there was a cracked plastic bin that was labeled for animal figurines. In the outside playground, there was a purple scooting toy that had a cracked, broken edge with a plastic piece missing.

Corrected Corrected by Jun 20, 2024

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 #1, with an enrollment date of 11//12/20, does not include a child service report; the file for Child #3, with an enrollment date of 2/20/23, does not include a child service report; the file for Child #4, with an enrollment date of 2/20/23, does not include a child service report.

Corrected Corrected by Jun 20, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.124(b)(2) · Emergency contact information must include the name, address and telephone number of the child's physician or source of medical care.

The emergency contact form on file for Child #2 does not include the telephone number for the child's pediatrician/source for medical care.

Corrected Corrected by Jun 20, 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.

The emergency contact form on file for Child #3 and #4 does not include the work address and/or telephone number for the enrolling parent.

Corrected Corrected by Jun 20, 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.

There were no emergency contact forms in the Tumbler 1 classroom for the children receiving care in the room.

Corrected Corrected by Jun 20, 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.

There was no emergency transportation plan posted in the Preschool room which identifies the means of transporting a child to emergency care and staffing provisions in the event of an emergency.

Corrected Corrected by Jun 20, 2024

Category: transportation. 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 most recent 6-month review signature for the emergency contact form and the financial agreement on file for Child #1, #3, #4 is dated more than 6 months ago.

Corrected Corrected by Jun 20, 2024

Category: recordkeeping. 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.

The most recent health assessments on file for Child #3, who is a Young Toddler, is dated 4/4/23, more than 6 months ago.

Corrected Corrected by Jun 20, 2024

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

3270.131(d)(5)/3270.131(e)(3) · ·Child #1 must be dismissed from care by close of business on 5/3/24, and may only return to care when the immunization record is updated or when a parent provides a written, signed exemption letter.

The immunization record on file for Child #1, who is 18 months old, included 3 of 4 DTAP vaccinations; 3 of 4 HIB vaccinations; and 3 of 4 pneumococcal vaccinations recommended by the ACIP for a child this age.

Corrected Corrected by Jun 20, 2024

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

3270.133(4) · Medication shall be stored in a locked area of the facility or in an area that is out of the reach of children.

An inhaler labeled for the use of a specific child was observed in a child's backpack in the preschool room, making it accessible to children.

Corrected Corrected by Jun 20, 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.

While observing a diaper change in the Tumbler 2 room, a staff person was observed placing the soiled diaper on the changing table until completing the diaper change and did not immediately dispose of the diaper in a hands-free can.

Corrected Corrected by Jun 20, 2024

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

3270.95(a)/3270.95(b) · Fire detection devices or systems must be in compliance with standards established under section 1016(c) of the act (62 P.S. §  1016(c)). The Director or designated staff person who is responsible for compliance with this chapter shall ensure the requirements under subsection (a) are met.

The fire alarm 30-day test log includes test dates 6/2/23-7/3/23; 8/2/23-9/2/23; 9/2/23-10/12/23; 12/2/23-1/3/24; 2/1/24-3/8/24; and 3/8/24-4/10/24, more than 30 days apart.

Corrected Corrected by Jun 20, 2024

Category: recordkeeping. Marked corrected in the state record.

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

The initial health assessment on file for Child #4, is dated 11/16/23, more than 60 days after the enrollment date of 5/17/23.

Corrected Corrected by May 3, 2024

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

3270.131(d)(5)/3270.131(e)(3) · 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 child care group settings).

The immunization records of child #1, #2, #3, #4, #5, #6, #7 and #8 were not in accordance with the recommendations of the ACIP and acceptable letters of exemption from the child's physician or parent were not provided.

Corrected Corrected by Mar 22, 2024

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

3270.131(d)(5)/3270.131(e)(3) · 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 child care group settings).Child #2 must be dismissed from care by close of business and may only return to care when the immunization record is updated or when a parent provides a written, signed exemption letter.

2nd citation: The file for child #2, a 14 month old, was missing 1 of 2 of the following vaccinations: DTAP, HIB, Pneumococcal and Polio and did not include a flu shot. Previously cited 4/20/23.

Corrected Corrected by Jul 27, 2023

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

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

2nd citation: The last health report in the file for child #2, a 14 month-old, was 4/5/22. Previously cited on 4/20/23.

Corrected Corrected by Jul 27, 2023

Category: health medication. 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 #4 listed the child's health insurance policy number, but did not include the name of the coverage.

Corrected Corrected by Jun 30, 2023

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. Until such time as the required pre-service trainings are completed, staff person #8 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, staff person #8 may not work in a child-care position at the facility.

On 4/21, staff person #8 was observed to be caring for children unsupervised. Staff person #8 has not completed the following pre-service training required prior to caring for children unsupervised: Health and safety training.

Corrected Corrected by Jun 14, 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.

The file for staff person #5, working with children before 10/4/22, did not include the 1 hour updated health and safety training. The file for staff person #1, #2 and #6, all working with children before 10/4/22, included the 1 hour updated safety training dated 1/5/23. The file for staff person #3 and #4, both working with children before 10/4/22, included the 1 hour health and safety training update dated 3/9/23 and 1/18/23, respectively.

Corrected Corrected by Jun 14, 2023

Category: ratio. 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 only fire safety training in the file for staff person #1, hired on (SEE LIS CODE SHEET) , was dated 1/20/23.

Corrected Corrected by Jun 14, 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 #8 will have until 6/14/23 to complete the required training. Until such time as the required training has been completed, staff person #8 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 #8, staff person #8 may not work in a child-care position at the facility.

Staff person #8 has not completed the following required pre-service training within 90 days of their date of hire: 10 hour Health and Safety training.

Corrected Corrected by Jun 14, 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 #7 and #8 may not work in a child care position at the facility.

The disclosure statement in the file for staff person #7 and #8 was an outdated version of the form. On 4/21/23, staff person #8 was observed unsupervised with 4 toddlers in the Tumbler 1 room. The last two state police clearances in the file for staff person #4 were dated 3/14/17 and 6/8/22.

Corrected Corrected by Jun 30, 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).

At approximately 2:40 pm on 4/20/23, on a video monitor in the facility's office, staff person #4 and #6 were observed in the main toddler room with 8 children, a combined group of 4 young toddlers and 4 older toddlers. The children were off their rest equipment. Staff person #6 briefly went into the adjacent Tumbler 2 room, leaving staff person #4 out of ratio with the 8 children.

Corrected Corrected by Apr 20, 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.

The door to the office adjacent to the preschool room on the first floor was ajar and there was hand sanitizer, Microban and white out on the desk, which all include instructions to keep out of the reach of children.

Corrected Corrected by Apr 20, 2023

Marked corrected in the state record.

3270.66(b) · Cleaning materials and other toxic materials shall be stored in an original labeled container or in a container that specifies the content. Toxics shall be stored away from food, food preparation areas and child care spaces.

There was an unlabeled spray bottle containing clear liquid in the basket on the wall that holds the first aid kit. There was an unlabled spray bottle containing clear liquid in the infant room closet. Staff stated both bottles contained bleach water.

Corrected Corrected by Jun 14, 2023

Category: ratio. Marked corrected in the state record.

3270.106(a)/3270.119 · Individual, clean, age-appropriate rest equipment shall be provided for preschool, toddler and infant children as agreed between the child's parent and the operator. The rest equipment shall be labeled for the use of a specific child and used only by the specified child. Infants shall be placed in the sleeping position recommended by the American Academy of Pediatrics unless there is a medical reason an infant should not sleep in this position. The medical reason shall be documented in a statement signed by a physician, physician's assistant or CRNP and placed in the child's record at the facility.

Upon entering the facility at approximately 9:50 am on 4/20/23, staff person #3 was observed in the infant room with 4 children and a 4 month-old was asleep in a swing.

Corrected Corrected by Apr 20, 2023

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

3270.124(f)/3270.181(c) · The parent shall update in writing emergency contact information once in a 6-month period or as soon as there is a change in the information. A parent is required to review and update the emergency contact information and the financial agreement at least once in a 6-month period or as soon as there is a change in the information.

The last review documented by a parent on the emergency contact form in the file for child #1 was 7/27/22. The last two reviews documented by a parent on the emergency contact form in the file for child #3 were 2/10/22 and 11/5/22. The last two reviews documented by a parent on the agreement form in the file for child #3 were 5/2/21 and 11/5/22.

Corrected Corrected by Jun 30, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.106(a)/3270.119 · *The operator must develop a safe infant sleep policy. The policy will be submitted to OCDEL for approval by the certification representative before being discussed with staff or posted in the facility. Upon OCDEL's approval, the policy will be discussed in detail with all staff. Staff will then sign and date an attestation that they understand the safe sleep policy and that the policy is in effect immediately. The policy will then be posted conspicuously in the infant room.

*Upon entering the facility at approximately 9:50 am on 4/20/23, staff person #3 was observed in the infant room with 4 children and a 4 month-old was asleep in a swing.

Corrected Corrected by Jun 30, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.106(a)/3270.119 · **The operator will post conspicuous signs on each swing, bouncy seat or other non-sleep equipment in the infant room, stating that Infants cannot sleep in those pieces of equipment and must immediately be moved to their crib if they begin to fall asleep.

**Upon entering the facility at approximately 9:50 am on 4/20/23, staff person #3 was observed in the infant room with 4 children and a 4 month-old was asleep in a swing.

Corrected Corrected by Jun 30, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.113(a) · *The operator must develop a site-specific supervision and ratio policy, and the policy will be submitted to OCDEL for approval by the certification representative before being discussed with staff or posted in the facility. Upon OCDEL's approval, the policy will be discussed in detail with all facility staff. Staff will then sign and date an attestation that they understand the supervision and ratio policy and that the policy is in effect immediately. The policy will then be posted conspicuously in all rooms of the facility.

*At approximately 10:08 am on 4/20/23, on a video monitor in the facility's office, staff person #6 was observed in the toddler room with 4 young toddlers. Two children were already sitting on their knees on the table in the middle of the room and a third child was climbing onto the table at the time. Staff person #6 was sitting at the white desk in the corner eating while 3 children climbed onto the table. When the staff person wasn't looking, the 3rd child stood up on the table. The staff person got up from the desk and threw the food away and saw the 3 children were on the table, with the 3rd child still standing on it. The staff person did not remove the children from the table and that's when the certification rep retrieved staff person #2, the owner, from the preschool room and showed them the monitor. Staff person #2 was asked to call down to the room and have the staff take the children off the table, which staff person #2 did immediately.

Corrected Corrected by Jun 30, 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.

At approximately 10:08 am on 4/20/23, on a video monitor in the facility's office, staff person #6 was observed in the toddler room with 4 young toddlers. Two children were already sitting on their knees on the table in the middle of the room and a third child was climbing onto the table at the time. Staff person #6 was sitting at the white desk in the corner eating while 3 children climbed onto the table. When the staff person wasn't looking, the 3rd child stood up on the table. The staff person got up from the desk and threw the food away and saw the 3 children were on the table, with the 3rd child still standing on it. The staff person did not remove the children from the table and that's when the certification rep retrieved staff person #2, the owner, from the preschool room and showed them the monitor. Staff person #2 was asked to call down to the room and have the staff take the children off the table, which staff person #2 did immediately.

Corrected Corrected by Apr 20, 2023

Category: supervision. Marked corrected in the state record.

3270.123(a)(1) · An agreement shall specify the amount of the fee to be charged per day or per week.

The agreement in the file for child #2 did not specify the fee amount.

Corrected Corrected by Apr 20, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.131(b)(1) · The operator shall require the parent to provide an updated health report at least every 6 months for an infant or young toddler.

The last health report in the file for child #2, a 14 month-old, was 4/5/22.

Corrected Corrected by Jun 30, 2023

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

3270.131(d)(5)/3270.131(e)(3) · 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 child care group settings). Child #1, #2 and #5 must be dismissed from care by close of business 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 #1, a 6 month old, was missing 1 of 2 of the following vaccinations: Hep B, Rotovirus, DTAP, HIB, Pneumococcal and Polio and did not include evidence of a flu shot. The file for child #2, a 14 month old, was missing 1 of 2 of the following vaccinations: DTAP, HIB, Pneumococcal and Polio and di not include a flu shot. The last flu shot in the file for child #4 was dated in 2021. The files did not contain hand-written statements of exemption by a parent.

Corrected Corrected by Jun 30, 2023

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

3270.131(d)(7) · A health report shall include a statement that the child is able to participate in child care and appears to be free from contagious or communicable disease.

The health report in the file for child #3 did not include a statement that the child is able to participate in child care and appears to be free from contagious or communicable disease.

Corrected Corrected by Jun 30, 2023

Category: health medication. 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.

The health report in the file for child #3 did not 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.

Corrected Corrected by Jun 30, 2023

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.

After diapering a young toddler in the Toddler 1 room, staff person #8 washed their hands, but did not wash the child's hands.

Corrected Corrected by Jun 30, 2023

Category: health medication. 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.

Onr of the reference letters in the file for staff person #8 wasn't signed by the person who wrote it.

Corrected Corrected by Jun 30, 2023

Category: recordkeeping. Marked corrected in the state record.

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

The "infant room" was listed as the hypothetical location for consecutive fire drills on 12/1/22 and 2/1/23.

Corrected Corrected by Jun 14, 2023

Category: recordkeeping. Marked corrected in the state record.

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

The last fire drill documented on the fire drill log did not inlcude the names of the staff participating in the drill.

Corrected Corrected by Jun 30, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.95(a)/3270.95(b) · Fire detection devices or systems must be in compliance with standards established under section 1016(c) of the act (62 P.S. §  1016(c)). The Director or designated staff person who is responsible for compliance with this chapter shall ensure the requirements under subsection (a) are met.

The last two dates documented on the facility's testing log was 3/4 and 4/4/23, which is 31 days apart.

Corrected Corrected by Jun 14, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.31(e) · A staff person shall obtain an annual minimum of 12 clock hours of child care training.

The file for staff person #1 included 10 hours of training during their last full anniversary year.

Corrected Corrected by Jun 30, 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. LACKING REQUIRED HIRING DOCUMENTS: Facility Person #1 may not work in a child care position at the facility.

The disclosure statement in the file for staff person #1 was signed but not dated, so timeliness could not be assessed.

Corrected Corrected by Sep 6, 2022

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

3270.51 · When children are grouped in similar age levels, the following maximum child group sizes and ratios of staff persons apply: Infants 1:4 with a maximum group size of 8; Young toddlers 1:5 with a maximum group size of 10; Older toddlers 1:6 with a maximum group size of 12; Preschool children 1:10 with a maximum group size of 20; Young school-age children 1:12 with a maximum group size of 24; Older school-age children 1:15 with a maximum group size of 30.

At approximately 3:30 pm, there were 2 children observed in the infant room and no staff person in sight in the room. A few seconds later, staff #2 came out of the door to the staff lounge, which is off the infant room.

Corrected Corrected by Sep 6, 2022

Category: ratio. Marked corrected in the state record.

3270.55(b) · Staff persons who are on duty but are not providing child care during naptime shall remain in the child care portion of the facility premises.

Upon arriving at the facility at approximately 2 pm, staff person #2 and #3 were observed returning to the facility by car. Staff person #1, #4, #5 and #6 were observed inside the facility with 28 children. Based on conversation with the operator, staff person #7 also left the site on their lunch break. As a result of staff persons #2, #3 and #7 not being on the premises at nap time, there were not enough staff on the premises to cover awake ratios.

Corrected Corrected by Sep 6, 2022

Category: ratio. Marked corrected in the state record.

3270.78 · Rooms, hallways, stairways, outside steps, porches and ramps shall be lighted by artificial or natural light.

At approximately 2:35 pm, there was no natural or artificial light in the Tumblers room, making it too dark to see, direct or assess the 3 toddlers sleeping in the room.

Corrected Corrected by Nov 4, 2022

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

3270.106(a)/3270.119 · Individual, clean, age-appropriate rest equipment shall be provided for preschool, toddler and infant children as agreed between the child's parent and the operator. The rest equipment shall be labeled for the use of a specific child and used only by the specified child.Infants shall be placed in the sleeping position recommended by the American Academy of Pediatrics unless there is a medical reason an infant should not sleep in this position. The medical reason shall be documented in a statement signed by a physician, physician's assistant or CRNP and placed in the child's record at the facility.

Upon entering the facility at approximately 2 pm, staff person #5 was observed in the infant room with 3 children, one of which is an infant and was sleeping in a swing.

Corrected Corrected by Sep 6, 2022

Category: health medication. 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.

At approximately 2:35 pm, there was no natural or artificial light in the Tumblers room, making it too dark to see, direct or assess the 3 toddlers sleeping in the room. At approximately 3:30 pm, there were 2 children observed in the infant room and no staff person in sight in the room. A few seconds later, staff #2 came out of the door to the staff lounge, which is off the infant room.

Corrected Corrected by Sep 6, 2022

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.

At approximately 3:30 pm, there were 2 children observed in the infant room and no staff person in sight in the room. A few seconds later, staff #2 came out of the door to the staff lounge, which is off the infant room.

Corrected Corrected by Sep 6, 2022

Category: supervision. 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 TB test results in the file for staff person #3, re-hired in June 2022, was dated 11/8/18.

Corrected Corrected by Dec 16, 2022

Category: health medication. 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.

The last fire drill documented on the fire drill log was 6/3/22.

Corrected Corrected by Dec 16, 2022

Category: recordkeeping. Marked corrected in the state record.

3270.95(a)/3270.95(b) · Fire detection devices or systems must be in compliance with standards established under section 1016(c) of the act (62 P.S. §  1016(c)).The Director or designated staff person who is responsible for compliance with this chapter shall ensure the requirements under subsection (a) are met.

The documentation of the facility's 30-day testing was not available at the time of the inspection. When the log was received on 9/13/22, there were no tests documented before 8/5/22 and the only tests documented on the log were dated 8/5/22 and 9/7/22, which is more than 30 days apart.

Corrected Corrected by Dec 16, 2022

Category: recordkeeping. Marked corrected in the state record.

3270.82(i) · A toilet area, training chair area, diapering area and sink area shall be equipped with a clean, lidded waste receptacle.

The trash can at the portable sink in the front hallway was unlidded.

Corrected Corrected by Apr 26, 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 was a small tear in the vinyl of a child-sized couch in the older toddler room.

Corrected Corrected by Apr 26, 2022

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

3270.27(b) · The operator shall review the emergency plan at least annually and update the plan as needed. The operator shall document in writing each review and update of the emergency plan and kept on file at the facility.

The last two documented reviews of the emergency plan were dated more than 12 months apart.

Corrected Corrected by Apr 26, 2022

Category: recordkeeping. Marked corrected in the state record.

3270.31(f) · Staff persons shall complete professional development in the following topics within 90 days of hire: first aid/CPR.

The First-aid/CPR training in the file for staff person #8 was dated beyond their first 90 days working with children.

Corrected Corrected by Apr 26, 2022

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

3270.32(a)/3270.192(2)(iii) · The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). A facility person's record shall include verification of child care experience, education and training following the outset of service at the facility.

The last two mandated reporter trainings in the file for staff person #1 through #6 were dated more than 60 months apart.

Corrected Corrected by Apr 26, 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. Facility Person #7 and #8 may not work at a child care facility until the disclosure statement is dated..

The disclosure statement in the file for staff person #7 and #8 was signed but not dated, so it could not be verified that the statement was signed prior to working with children.

Corrected Corrected by Jun 8, 2022

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

3270.51 · When children are grouped in similar age levels, the following maximum child group sizes and ratios of staff persons apply: Infants 1:4 with a maximum group size of 8; Young toddlers 1:5 with a maximum group size of 10; Older toddlers 1:6 with a maximum group size of 12; Preschool children 1:10 with a maximum group size of 20; Young school-age children 1:12 with a maximum group size of 24; Older school-age children 1:15 with a maximum group size of 30.

At approximately 11:30 am, staff person #1 entered the front office of the facility and stated that a representative of an external agency was caring for the four toddlers in the Tumbler 1 room.

Corrected Corrected by Apr 26, 2022

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).

At approximately 11:35 am, a preschool child was observed in the downstairs bathroom, which is off the toddler room. Staff person #2 was in the toddler room with 6 older toddlers. When asked who was responsible for the child, staff person #2 stated that staff person #3, who was in the rear preschool room, was sending children to the bathroom one at a time.

Corrected Corrected by Apr 26, 2022

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.

There was a tub of Vaseline on a low shelf in the Tumbler 2 room, making it accessible to the children in care at the time. The directions included instructions to keep out of the reach of children.

Corrected Corrected by Apr 26, 2022

Marked corrected in the state record.

3270.66(b) · Cleaning materials and other toxic materials shall be stored in an original labeled container or in a container that specifies the content. Toxics shall be stored away from food, food preparation areas and child care spaces.

There was an unlabeled bottle of clear liquid in a cabinet in the infant room.

Corrected Corrected by Apr 26, 2022

Category: ratio. 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.

There were several foam peg boards with teeth marks observed on a low toy shelf in the older toddler room.

Corrected Corrected by Apr 26, 2022

Marked corrected in the state record.

3270.106(j) · Toys, bumper pads, or pillows may not be present in a crib while an infant is sleeping in the crib.

A 6 month-old infant was observed wearing a bib while soundly sleeping in a crib in the infant room.

Corrected Corrected by Apr 26, 2022

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.

At approximately 11:30 am, staff person #1 entered the front office of the facility and stated that a representative of an external agency was caring for the four toddlers in the Tumbler 1 room. At approximately 2 pm in the main toddler room during nap time, staff person #2 was unable to see the face of a sleeping child because the child's cot was positioned next to toddler climbing equipment. Approximately a minute later in the Tumbler 1 room, staff person #1 was unable to see the face of a sleeping child because the child's cot was positioned behind a small piece of furniture.

Corrected Corrected by Apr 26, 2022

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.

At approximately 11:30 am, staff person #1 entered the front office of the facility and stated that a representative of an external agency was caring for the four toddlers in the Tumbler 1 room. At approximately 11:35 am, a preschool child was observed in the downstairs bathroom, which is off the toddler room. Staff person #2 was in the toddler room with 6 older toddlers. When asked who was responsible for the child, staff person #2 stated that staff person #3, who was in the rear preschool room, was sending children to the bathroom one at a time.

Corrected Corrected by Apr 26, 2022

Category: supervision. Marked corrected in the state record.

3270.113(d) · A facility person may not use harsh, demeaning or abusive language in the presence of children.

At approximately 11:40 am, while inspecting a room on the main floor, staff #1 and #3, could be heard yelling at each other from downstairs, where there were approximately 25 toddlers and preschoolers in care in 4 different classrooms. This certification representative went downstairs and quietly informed each staff that they could not continue to yell in front of the children and went back upstairs. Approximately 2 minutes later, the same staff could again be heard yelling at each other from downstairs. This certification representative went back downstairs and quietly reminded each staff person that they cannot yell at each other in front of the children.

Corrected Corrected by Apr 26, 2022

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 information in the file for child #5 did not include any information for the child's health insurance.

Corrected Corrected by Jul 5, 2022

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

3270.131(b)(1) · The operator shall require the parent to provide an updated health report at least every 6 months for an infant or young toddler

The only health report in the file for child #4, a young toddler enrolled for approximately 13 months, was not dated, therefore it could not be determined if the health report was current.

Corrected Corrected by Jul 5, 2022

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

3270.131(e)(2)(i) · Exemption from immunization for religious belief or strong personal objection equated to a religious belief shall be documented by a written, signed and dated statement from the child's parent or guardian. The statement shall be kept in the child's record.

There was no evidence of a flu shot in the file for child #1, #2 and #5. The last flu shot in the file for child #3 was in 2020. All of the children are at least 6 months old and one of the files included written statements of exemption by a parent at the time of the inspection.

Corrected Corrected by Jul 5, 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.

When it was time to eat, 3 young toddlers were placed in high chairs without having their hands washed.

Corrected Corrected by Jul 5, 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 last two health assessments in the file for staff person #4 and #6 were dated more than 24 months apart.

Corrected Corrected by Apr 26, 2022

Category: ratio. 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.

Based on review of the fire drill log, there were two times between 4/8/21 and 4/5/22 when fire drills were conducted more than 60 days apart.

Corrected Corrected by Jul 5, 2022

Category: recordkeeping. Marked corrected in the state record.

3270.94(a)(2) · 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 different times of the day or night, or both, if applicable.

Based on review of the fire drill log, all fire drills conducted between 4/8/21 and 4/5/22 were conducted between 9:30 am and 11 am.

Corrected Corrected by Jul 5, 2022

Category: recordkeeping. Marked corrected in the state record.

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

Based on review of the fire drill log, the drills conducted between 4/8/21 and 2/14/22 listed the number of facility persons that participated in the drill, but did not list their names.

Corrected Corrected by Apr 26, 2022

Category: recordkeeping. Marked corrected in the state record.