Y Care Ii

Regulation: 3270.75(a)

Description: In child care spaces

Noncompliance Area: The inspector observed that the first aid kits from the largest classroom (big room) and preschool rooms were missing.

Correction Required: A first-aid kit shall be in a child care space.

Regulation: 3270.76

Description: Building Surfaces

Noncompliance Area: The inspector observed that the storage shed in the outside, fenced, play area, was in disrepair.

Correction Required: 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.

Regulation: 3270.124(b)(3)

Description: Parent home/work address, phone

Noncompliance Area: Durning the unannounced inspection that began on 3/11/25 the inspector observed the file for child #1 and found that this file was missing the required work phone number for the enrolling parent.

Correction Required: Emergency contact information must include the home and work addresses and telephone numbers of the enrolling parent.

Regulation: 3270.135(a)(3)

Description: Disposable diapers

Noncompliance Area: Durning the unannounced inspection that began on 3/11/25 the inspector observed that both the infant and toddler rooms did not have hands-free covered garbage cans for diaper disposal.

Correction Required: 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.

Regulation: 3270.151(a)/3270.151(c)(2)

Description: 12 months prior to service and every 24 months thereafter/Mantoux TB

Noncompliance Area: During the renewal inspection the inspector observed the file for staff #1 and #7 and found that these staff had both begun direct care with children before obtaining a health assessment and TB screening as is required. Staff #8 did not update their health assessment every 24 months as evidenced by a previous health assessment dated 2/25/22 and a current dated 10/22/24,

Correction Required: 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. 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.

Regulation: 3270.166(3)

Description: Disposable nursers or parents

Noncompliance Area: Durning the unannounced inspection that began on 3/11/25 the inspector spoke with the infant room staff, and it was stated that the staff wash bottles for repeated use throughout the day.

Correction Required: Disposable nursers shall be used for infants unless bottles are provided by the parent or unless a commercial dishwasher is used by the facility.

Regulation: 3270.166(4)

Description: Bottles labeled

Noncompliance Area: Durning the unannounced inspection that began on 3/11/25 the inspector observed bottles in the infant room to not be labeled with a child's name.

Correction Required: Disposable nursers and bottles shall be labeled with the child's name.

Regulation: 3270.171(c)

Description: Safe routes posted

Noncompliance Area: Durning the unannounced inspection that began on 3/11/25 the inspector did not observe safe routes posted in a conspicuous location at the facility

Correction Required: Written notification of safe routes shall be posted by the operator at a conspicuous location in the child care facility.

Regulation: 3270.18(a)

Description: On file at facility

Noncompliance Area: Durning the unannounced inspection that began on 3/11/25 the director was unable to produce proof of comprehensive general liability insurance.

Correction Required: The legal entity shall have comprehensive general liability insurance to cover the persons who are on the premises. A current copy of the insurance policy shall be on file at the facility.

Regulation: 3270.192(5)

Description: Two written references

Noncompliance Area: During the renewal inspection the inspector observed the file for staff #4 and found that this staff did not have two written, nonfamily references from individuals attesting to the person's suitability to serve as a facility person.

Correction Required: 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.

Regulation: 3270.25(a)

Description: Availability of certificate of compliance and applicable regulations

Noncompliance Area: Durning the unannounced inspection that began on 3/11/25 the inspector did not observe any information on how to access the regulations electronically nor instructions for contacting the appropriate regional childcare office. The director was consulted and stated that this information was not posted.

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

Regulation: 3270.27(a)(5)

Description: Emergency plan

Noncompliance Area: Durning the unannounced inspection that began on 3/11/25 the inspector reviewed the emergency plan for the facility and found that it did not address accommodations for infants, toddlers, children with disabilities, and children with chronic medical conditions.

Correction Required: The facility shall have an emergency plan that provides for accommodations for infants, toddlers, children with disabilities, and children with chronic medical conditions.

Regulation: 3270.27(a)(6)

Description: Emergency plan

Noncompliance Area: Durning the unannounced inspection that began on 3/11/25 the inspector asked for documentation for the annual emergency drill and the director stated that they were unaware that an annual drill was required.

Correction Required: Emergency drills shall be conducted annually. Annual emergency drills shall be documented and on file at the facility.

Regulation: 3270.27(c)

Description: Training regarding plan

Noncompliance Area: Durning the unannounced inspection that began on 3/11/25 the inspector reviewed the staff files and found that staff #1 through #8 did not have proof of emergency plan training on file.

Correction Required: 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.

Regulation: 3270.27(d)

Description: Plan posted

Noncompliance Area: Durning the unannounced inspection that began on 3/11/25 the inspector did not observe the emergency plan posted in a conspicuous location at the facility.

Correction Required: The operator shall post the emergency plan in the facility at a conspicuous location.

Regulation: 3270.27(e)

Description: Letter to parents

Noncompliance Area: Durning the unannounced inspection that began on 3/11/25 the director was unable to produce proof of the parent letter for enrolled children explaining emergency procedures.

Correction Required: 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.

Regulation: 3270.27(f)

Description: Emergency plan

Noncompliance Area: Durning the unannounced inspection that began on 3/11/25 the director was unable to produce proof of the emergency plan being sent to the local municipality and the county emergency management agency.

Correction Required: The operator shall send a copy of the emergency plan and subsequent plan updates to the local municipality and to the county emergency management agency.

Regulation: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: During the renewal inspection the inspector observed the file for staff #8 and found that this staff did not update their clearances every 60 months as evidenced by a previous Pa State Police dated 10/1/19 and a current dated 8/2/24, a Pa Child Abuse previously dated 10/9/19 and a current dated 12/5/24, a previous FBI dated 10/3/19 and a current dated 8/5/24. Staff #7 (see LIS Code Sheet for DOH) was working in direct care for months with children and did not have a Pa State Police clearance on file until 8/27/24 and a NSOR was not obtained until 10/21/24.

Correction Required: 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.

Regulation: 3270.76

Description: Building Surfaces

Noncompliance Area: Durning the unannounced inspection that began on 3/11/25 the inspector observed the top rail of the outdoor fencing in the children's play area to be rusted and within reach of children.

Correction Required: 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.

Regulation: 3270.82(g)

Description: Clean and good repair

Noncompliance Area: Durning the unannounced inspection that began on 3/11/25 the inspector observed the potty chair in the older toddler room to be ripped, exposing the foam underneath, rendering the surface unable to be cleaned.

Correction Required: Toilet areas and fixtures shall be cleaned daily and be in good repair.

Regulation: 3270.113(a)/3270.113(a)(1)

Description: Supervised at all times /Staff assigned to specific children

Noncompliance Area: An unannounced inspection was conducted at the facility and the following information was obtained through staff interviews: On 10/18/23, when Staff # 5 was in the room with the mixed age group of 23 toddler and preschool age children. it was brought to the attention of Staff # 5 by an outside visiting agency that a child had left the room unsupervised. It was reported this child was found and brought back to the room by another staff member. On a date unknown. but approximately two weeks prior to 10/18/23, the toddler-age children were in the outdoor play area. Staff # 2 admitted 2 children left her supervision and ratio group and entered the building without knowing they had left. Staff # 5 found both children after they entered the building.

Correction Required: 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. Each staff person shall be assigned the responsibility for supervision of specific children. The staff person shall know the names and whereabouts of the children in his assigned group. The staff person shall be physically present with the children in his group on the facility premises and on facility excursions off the facility premises. The legal entity must submit documentation in a format approved by DHS proving that the facility procedure for counting children is followed at all times e.g., a checklist. The legal entity will confirm continuing compliance by sending copies of the documentation to the Regional Office of Child Development and Early Learning on a weekly basis for a period of three months after DHS approves the documentation format.

Regulation: 3270.113(a)/3270.113(a)(1)

Description: Supervised at all times /Staff assigned to specific children

Noncompliance Area: An unannounced inspection was conducted at the facility and the following information was obtained through staff interviews: On 10/18/23, when Staff # 5 was in the room with the mixed age group of 23 toddler and preschool age children. it was brought to the attention of Staff # 5 by an outside visiting agency that a child had left the room unsupervised. It was reported this child was found and brought back to the room by another staff member. On a date unknown. but approximately two weeks prior to 10/18/23, the toddler-age children were in the outdoor play area. Staff # 2 admitted 2 children left her supervision and ratio group and entered the building without knowing they had left. Staff # 5 found both children after they entered the building.

Correction Required: 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. 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. Children must be supervised at all times.

Regulation: 3270.113(a)/3270.113(a)(1)

Description: Supervised at all times /Staff assigned to specific children

Noncompliance Area: An unannounced inspection was conducted at the facility and the following information was obtained through staff interviews: On 10/18/23, when Staff # 5 was in the room with the mixed age group of 23 toddler and preschool age children. it was brought to the attention of Staff # 5 by an outside visiting agency that a child had left the room unsupervised. It was reported this child was found and brought back to the room by another staff member. On a date unknown. but approximately two weeks prior to 10/18/23, the toddler-age children were in the outdoor play area. Staff # 2 admitted 2 children left her supervision and ratio group and entered the building without knowing they had left. Staff # 5 found both children after they entered the building.

Correction Required: 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. Each staff person shall be assigned the responsibility for supervision of specific children. The staff person shall know the names and whereabouts of the children in his assigned group. The staff person shall be physically present with the children in his group on the facility premises and on facility excursions off the facility premises. The legal entity must arrange for all facility staff to receive a minimum of three hours of PQAS-approved, live training, regarding supervision and ratios of children. The legal entity must receive DHS approval of the training content prior to scheduling the training.

Regulation: 3270.21/3270.76

Description: General Health and Safety/Building Surfaces

Noncompliance Area: An unannounced inspection was conducted at the facility and the following information was obtained through staff interviews. On 10/18/23, a rainstorm had occurred and during this storm, water began leaking into the preschool classroom. This leak caused the light fixture to detach from the ceiling on one side. The preschool children were unable to receive care in this classroom due to the leak and falling light fixture.

Correction Required: Conditions at the facility may not pose a threat to the health or safety of the children. 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.

Regulation: 3270.52/3270.113(a)(2)

Description: Mixed Age Level/Supervision on and facility premises

Noncompliance Area: An unannounced inspection was conducted at the facility and the following information was obtained through staff interviews. On 10/18/23, Staff # 5 and # 8 were in a mixed-ratio group of 23 older toddler and preschoolers for approximately 30 minutes from 11:00-11:30a.m. During this time, Staff # 8 left this group of children to get children's lunches, leaving Staff # 5 with the 23 children. At roughly 11:45a.m., this room contained 4 teachers with 33 young toddler, older toddler and preschool age children. On 10/18/23 it was stated by Staff # 1 and Staff # 5 indicated the correct numbers of children were taken to the bathroom to maintain staff:child ratios which left the other staff out of ratio. Staff # 5 also indicated that most mornings before her second staff person arrives, she is often out of ratio with 12 preschool children.

Correction Required: When children are grouped in mixed age levels, the age of the youngest child in the group determines the staff:child ratio and maximum group size in accordance with the requirements in § 3270.51 (relating to similar age level). The requirement for supervision on and off the facility premises includes compliance with the staff:child ratio requirements in §§ 3270.51--3270.55. The legal entity must submit supervision/ratio documentation in a format approved by DHS proving that the facility is maintaining the required staff:child ratios at all times. The legal entity will confirm continuing compliance by sending copies of the documentation to the Northeast Region Office on a weekly basis for a period of three months after DHS approves the documentation format.

Regulation: 3270.52/3270.113(a)(2)

Description: Mixed Age Level/Supervision on and facility premises

Noncompliance Area: An unannounced inspection was conducted at the facility and the following information was obtained through staff interviews. On 10/18/23, Staff # 5 and # 8 were in a mixed-ratio group of 23 older toddler and preschoolers for approximately 30 minutes from 11:00-11:30a.m. During this time, Staff # 8 left this group of children to get children's lunches, leaving Staff # 5 with the 23 children. At roughly 11:45a.m., this room contained 4 teachers with 33 young toddler, older toddler and preschool age children. On 10/18/23 it was stated by Staff # 1 and Staff # 5 indicated the correct numbers of children were taken to the bathroom to maintain staff:child ratios which left the other staff out of ratio. Staff # 5 also indicated that most mornings before her second staff person arrives, she is often out of ratio with 12 preschool children.

Correction Required: When children are grouped in mixed age levels, the age of the youngest child in the group determines the staff:child ratio and maximum group size in accordance with the requirements in § 3270.51 (relating to similar age level). The requirement for supervision on and off the facility premises includes compliance with the staff:child ratio requirements in §§ 3270.51--3270.55. The legal entity must arrange for all facility staff to receive a minimum of three hours of PQAS-approved, live training, regarding supervision and ratios of children. The legal entity must receive DHS approval of the training content prior to scheduling the training.

Regulation: 3270.52/3270.113(a)(2)

Description: Mixed Age Level/Supervision on and facility premises

Noncompliance Area: An unannounced inspection was conducted at the facility and the following information was obtained through staff interviews. On 10/18/23, Staff # 5 and # 8 were in a mixed-ratio group of 23 older toddler and preschoolers for approximately 30 minutes from 11:00-11:30a.m. During this time, Staff # 8 left this group of children to get children's lunches, leaving Staff # 5 with the 23 children. At roughly 11:45a.m., this room contained 4 teachers with 33 young toddler, older toddler and preschool age children. On 10/18/23 it was stated by Staff # 1 and Staff # 5 indicated the correct numbers of children were taken to the bathroom to maintain staff:child ratios which left the other staff out of ratio. Staff # 5 also indicated that most mornings before her second staff person arrives, she is often out of ratio with 12 preschool children.

Correction Required: When children are grouped in mixed age levels, the age of the youngest child in the group determines the staff:child ratio and maximum group size in accordance with the requirements in § 3270.51 (relating to similar age level). The requirement for supervision on and off the facility premises includes compliance with the staff:child ratio requirements in §§ 3270.51--3270.55. The required staff:child ratios must be maintained at all times.

Regulation: 3270.51/3270.52

Description: Similar Age Level/Mixed Age Level

Noncompliance Area: During a site visit on 4/10/2023, staff admitted to being out of ratio on 3/31/23 from 8:30-9 a.m. According to records provided to the Department, the preschool class had 1 staff with a mixed-aged group of 11 toddlers/preschoolers. This ratio would require at least 2 staff. At 8:45 a.m., the preschool class had 1 staff with a mixed-aged group of 13 toddlers/preschoolers. This ratio would require at least 2 staff.

Correction Required: 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. When children are grouped in mixed age levels, the age of the youngest child in the group determines the staff:child ratio and maximum group size in accordance with the requirements in § 3270.51 (relating to similar age level). The required staff:child ratios must be maintained at all times.

Regulation: 3270.51/3270.52

Description: Similar Age Level/Mixed Age Level

Noncompliance Area: During a site visit on 4/10/2023, staff admitted to being out of ratio on 3/31/23 from 8:30-9 a.m. According to records provided to the Department, the preschool class had 1 staff with a mixed-aged group of 11 toddlers/preschoolers. This ratio would require at least 2 staff. At 8:45 a.m., the preschool class had 1 staff with a mixed-aged group of 13 toddlers/preschoolers. This ratio would require at least 2 staff.

Correction Required: 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. When children are grouped in mixed age levels, the age of the youngest child in the group determines the staff:child ratio and maximum group size in accordance with the requirements in § 3270.51 (relating to similar age level). The required staff:child ratios must be maintained at all times. The legal entity, director or supervisor will develop a policy to ensure appropriate ratios are always maintained when unforeseen circumstances arrive such as staff calling off or staff running late. The legal entity, director or supervisor will also develop a policy for staff and how they should handle situations when parents do not follow their agreed upon drop-off and pick-up times. These policies will be submitted to the Regional Office for review and, upon approval, will be reviewed with all staff. Staff will sign off that they have reviewed and understand these policies and this documentation will remain on file at the facility.

Regulation: 3270.134(a)/3270.152

Description: Child's hands washed/Adult Hygiene

Noncompliance Area: A renewal inspection occurred at the facility. A physical site review was conducted. The diaper changing procedure was viewed in the toddler room. After each change, the staff and children's hands were not washed.

Correction Required: A staff person shall ensure that a child's hands are washed before meals and snacks, after toileting and after being diapered. A facility person shall wash his hands before meals and snacks, and after toileting and after diapering a child.

Regulation: 3270.161(d)

Description: Potentially hazardous food refrigerated

Noncompliance Area: A renewal inspection occurred at the facility. A physical site review as conducted. Children's lunchboxes were found at the preschool room that contained dairy and meats. These items were not refrigerated.

Correction Required: Potentially hazardous food brought from the child's home or provided by the facility shall be refrigerated.

Regulation: 3270.27(a)(6)

Description: Emergency plan

Noncompliance Area: A renewal inspection occurred at the facility. A review of the facility's emergency plan and attachments was conducted. At the time of the inspection, the facility was unable to provide documentation that an annual emergency drill had been conducted by the facility.

Correction Required: Emergency drills shall be conducted annually. Annual emergency drills shall be documented and on file at the facility.

Regulation: 3270.31(f)

Description: Health and Safety Training

Noncompliance Area: A renewal inspection occurred at the facility. A review of staff files was conducted. Staff person # 2 has not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): pediatric first aid and CPR

Correction Required: 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 4/7/23 to complete the required training. Until such time as the required training has been completed, staff person # 2 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, staff person # 2 may not work in a child-care position at the facility.

Regulation: 3270.75(c)

Description: Has all items

Noncompliance Area: A renewal inspection occurred at the facility. A physical site review was conducted. The first aid kit in the preschool room was missing tweezers and soap.

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

Regulation: 3270.94(a)(1)

Description: Every 60 days

Noncompliance Area: A renewal inspection occurred at the facility. A review of the facility's fire drill log was conducted. Fire drills that occurred between 11/7/22 and 1/9/23 were not conducted at least once every 60 days.

Correction Required: 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.

Regulation: 3270.95(a)/3270.95(b)

Description: Devices must be compliant/Director or designated staff person ensure compliance

Noncompliance Area: A renewal inspection occurred at the facility. A review of the facility's fire safety system testing log was conducted. Testing of the facility's fire safety system were not conducted at least every 30 days between the following dates: 5/2/22-6/3/22 6/3/22-7/5/22 8/1/22-9/2/22 9/2/22-10/3/22 10/3/22-11/7/22 10/3/22-11/7/22 11/7/22-1/9/23 1/9/23-2/14/23

Correction Required: 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.

Regulation: 3270.102(c)

Description: Outdoor equip.- protective surfacing

Noncompliance Area: A renewal inspection occurred at the facility. A physical site inspection was conducted. A Little Tikes Clever Climber Cut Loose was found in the outdoor play area and per the instructions for mounting this piece of equipment, it indicates that this piece of equipment must be installed over an impact-absorbing surface. This play equipment was mounted over grass and not an impact-absorbing surface per mounting instructions.

Correction Required: Outdoor equipment that requires embedded mounting must be mounted over a loose-fill or unitary playground protective surface covering that meets the recommendations of the United States Consumer Product Safety Commission. The equipment must be anchored firmly and be in good repair.