Alliance Child Care Center

Regulation: 3270.151(c)(5)

Description: Physician/CRNP assessment

Noncompliance Area: The Health Assessment on file for Staff Person #1 did not include an assessment by the health care provider regarding the individual's suitability to provide childcare.

Correction Required: An adult health assessment must include the physician's or CRNP's assessment of the person's suitability to provide child care.

Regulation: 3270.192(5)

Description: Two written references

Noncompliance Area: The file for Staff Person #1 did not include two written, non-family references.

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: 3270.31(e)(4)(i)

Description: Age and Training

Noncompliance Area: The most recent Pediatric First Aid/CPR on file for Staff Person #2 expired at the end of April 2026.

Correction Required: 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.

Regulation: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: Staff Person #1 was observed to be working with children during an unannounced inspection on July 8, 2026. The record for Staff Person #1 did not include the following clearances: PA State Police, PA Child Abuse, DHS FBI.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). Staff Person #1 may not work in a child care position at the facility.

Regulation: 3270.33(a)/3270.192(2)(ii)

Description: Each staff person meets quals/Exp, educ., training prior to facility

Noncompliance Area: The record for Staff Person #1 did not include written verification of their education.

Correction Required: 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.

Regulation: 3270.104(a)

Description: Clean, good repair, proper size

Noncompliance Area: A broken arm rest was observed on an adult rocking chair in the nursery. A screw was missing resulting in the arm rest detaching from the frame along the back.

Correction Required: Furniture must be durable, safe, easily cleaned and appropriate for the child's size, age and special needs.

Regulation: 3270.106(f)

Description: 2 feet apart

Noncompliance Area: A crib in use in the nursery lacked 2 feet of space on 3 sides. One side was blocked by an infant swing and another side was against a wall.

Correction Required: 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.

Regulation: 3270.123(a)(3)

Description: Services proceeded

Noncompliance Area: The agreements for children #1 and #5 do not include the services to be provided. The file for child #4 does not include documentation of sharing a child service report with the parents in the past 6 months. The most recent report on file is dated 8/2025. The files for children #2 and #3 contain services reports shared with parents at intervals greater than 6 months, but are now current.

Correction Required: 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).

Regulation: 3270.131(b)(1)/3270.182(1)

Description: Infant: updated health report every 6 months/Initial and subsequent health reports

Noncompliance Area: The file for child #1, an infant, contained consecutive health reports dated more than 6 months apart. The most recent health report on file is now current.

Correction Required: 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.

Regulation: 3270.135(a)(3)

Description: Disposable diapers

Noncompliance Area: The pedal on the hands free can located at the changing table in the pink room was not functioning and would not open the lid when pressed. Young toddlers were observed in care.

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)/3270.192(3)

Description: 12 months prior to service and every 24 months thereafter/Health assessment, TB test

Noncompliance Area: The files for staff #2, #8, and #10 contained consecutive health assessments dated more than 24 months apart. The file for staff #5 contained an initial health assessment dated 5 months after their first day in a child care position. Current health assessments are now on file.

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. A facility person's record shall include a written report of initial and subsequent health assessments, including the results of initial and subsequent tuberculin skin tests, x-rays or other medical documentation necessary to confirm freedom from communicable tuberculosis.

Regulation: 3270.181(d)

Description: Dated signature affixed

Noncompliance Area: The agreement for child #1 does not include a date with the parental signature for the most recent review.

Correction Required: Following review, a parent shall attest to the accuracy of information in the emergency contact information and the financial agreement at each review by affixing a dated signature to the record.

Regulation: 3270.31(f)

Description: Health and Safety Training

Noncompliance Area: Staff person #6 has not completed the following required pre- service training within 90 days of their date of hire : Pediatric CPR and First Aid (SEE LIS CODE SHEET)

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

Regulation: 3270.31(f)(10)/3270.192(2)(iii)

Description: Health and Safety Training - Pediatric First Aid and CPR/Exp, educ., training at facility

Noncompliance Area: Staff person #5 did not complete training in pediatric first aid and pediatric CPR within 90 days of hire. The training documentation was dated 10/27/25. (SEE LIS CODE SHEET)

Correction Required: 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.

Regulation: 3270.32(a)/3270.192(2)(iii)

Description: Comply with CPSL/Exp, educ., training at facility

Noncompliance Area: Staff person #3 did not renew mandated reporter training within 60 months. This is evidenced by the previously documented mandated reporter training on file being dated 6/16/20 and the current mandated reporter training being dated 6/18/25.

Correction Required: 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.

Regulation: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: The file for staff #1 contained an FBI clearance which was not renewed within 60 months. The previous FBI clearance on file was dated 8/05/20 and was renewed 12/04/25. The file for staff #2 contained two clearances which were not renewed within 60 months. The previous child abuse on file was dated 2/26/21 and was renewed on 3/07/26. The previous FBI on file was dated 2/26/21 and was renewed on 3/24/26. The file for staff #4 contained two clearances which were not renewed within 60 months. The previous child abuse clearance on file was dated 3/05/21 and was renewed on 3/06/26. The previous FBI was dated 3/09/21 and was renewed 3/24/26. The file for staff #5 contained a state police clearance and an NSOR clearance applied for and completed after their first day in a child care position. The state police clearance was dated 10/21/25. The NSOR was dated 11/17/25. (SEE LIS CODE SHEET). The file for staff #7 contained three clearances which were not renewed within 60 months. The previous child abuse was dated 3/05/21 and was renewed 3/07/26. The previous FBI was dated 2/27/21 and was renewed on 3/24/26. The previous NSOR was dated 8/13/20 and was renewed 8/18/25. The file for staff #9 contained a disclosure statement which was not signed by a witness and was not dated. The file for staff #10 contained two clearances which were not renewed within 60 moths. The previous child abuse clearance was dated 2/25/21 and was renewed 3/07/26. The previous FBI clearance was dated 2/26/21 and was renewed 3/24/26.

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: 3270.33(a)/3270.192(2)(ii)

Description: Each staff person meets quals/Exp, educ., training prior to facility

Noncompliance Area: The files for staff #5 and #9, designated as assistant group supervisors on the staff data sheet, did not include documentation of the qualifications required for the position. The file for staff #5 lacked proof of education. The file for staff #9 lacked verified experience with children.

Correction Required: 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.

Regulation: 3270.74

Description: Emergency Numbers Posted

Noncompliance Area: The posting displaying emergency phone numbers in each of the rooms did not include the phone numbers for the nearest police department, fire department or ambulance.

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

Regulation: 3270.76

Description: Building Surfaces

Noncompliance Area: Two stained ceiling tiles were observed in two restrooms; in the restroom connected to the yellow room and the girl's restroom in the lower hall. A displaced ceiling tile with gaps was observed in the red room. Several areas of sharp metal were observed on the corrugated aluminum siding of two counters in the school age room.

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: 3270.77(a)

Description: No peeling paint or plaster

Noncompliance Area: Peeling paint was observed on the window shutters of the playhouse in the outdoor play space off the gym.

Correction Required: Peeled or damaged paint or damaged plaster is not permitted on indoor or outdoor surfaces in the child care facility.

Regulation: 3270.82(e)

Description: Toilet and sinks proper height

Noncompliance Area: The sink in the pink room lacked platforms or steps to allow children to approach the sink. Young toddlers were observed in the room.

Correction Required: Toilets and sinks shall be at proper heights for children using them or shall be easily approached by means of platforms or steps.

Regulation: 3270.31(f)

Description: Health and Safety Training

Noncompliance Area: Staff persons #1 and #2 have not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): #1 - health and safety training and pediatric first aid/cpr; #2 - part 2 of health and safety training. Part #1 was completed late.

Correction Required: Staff person(s) shall complete professional development in the topics of 3270.31(f)(1 -- 10) within 90 days of hire. Until such time as the required training has been completed, staff persons #1 and #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 persons #1 and #2, staff persons #1 and #2 may not work in a child-care position at the facility.

Regulation: 3270.102(a)

Description: Clean and good repair

Noncompliance Area: A cracked hand rail was observed on a plastic slide in the small outdoor play space. Exposed foam padding was observed on two pink child size folding chairs in the Purple Room.

Correction Required: 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.

Regulation: 3270.103

Description: Small Toys and Objects

Noncompliance Area: An empty plastic garbage bag was accessible to children in an unlocked cabinet in the boy's restroom on the main floor. A tear which exposed the inner foam filling was observed on the diapering pad in the Pink Room.

Correction Required: 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.

Regulation: 3270.111(b)

Description: Posted in group space

Noncompliance Area: A written plan of daily activities was not posted in the gym.

Correction Required: The written plan of daily activities shall be posted in the group space.

Regulation: 3270.113(d)

Description: No harsh language

Noncompliance Area: At approximately 12:30 PM the certification representative heard staff #1 using harsh language which included shouting "Get down", "Stop it", and "You know you aren't allowed up there".

Correction Required: A facility person may not use harsh, demeaning or abusive language in the presence of children.

Regulation: 3270.123(a)(3)

Description: Services proceeded

Noncompliance Area: The agreement for child #1 and child #3 did not include the services to be provided. The file for child #4 contained consecutive service reports dated more than 6 months apart; 3/11/24 and 2/09/25) A current report is now on file. The file for child #5 did not contain a current service report. The most recent report on file was dated 8/09/24.

Correction Required: 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).

Regulation: 3270.131(b)(1)/3270.182(1)

Description: Infant: updated health report every 6 months/Initial and subsequent health reports

Noncompliance Area: The file for child #2 contained consecutive health reports dated more than 6 months apart; 5/06/24 and 12/31/24. The most recent health report on file is now current.

Correction Required: 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.

Regulation: 3270.151(a)/3270.192(3)

Description: 12 months prior to service and every 24 months thereafter/Health assessment, TB test

Noncompliance Area: The file for staff #5 did not include a health assessment. The file for staff #1 contained an initial health assessment dated after their first day in a child care position.

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. A facility person's record shall include a written report of initial and subsequent health assessments, including the results of initial and subsequent tuberculin skin tests, x-rays or other medical documentation necessary to confirm freedom from communicable tuberculosis.

Regulation: 3270.21

Description: General Health and Safety

Noncompliance Area: Adult scissors and a claw type staple remover with sharp points were accessible to children on the teacher's desk in the Red Preschool Room.

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

Regulation: 3270.31(e)(4)(i)/3270.192(2)(iii)

Description: Age and Training/Exp, educ., training at facility

Noncompliance Area: Staff #4 did not renew their certification in pediatric CPR and first aid on or before the expiration of the previous certification. The certifications are dated 6/12/22 and 9/17/24. Current training is now on file.

Correction Required: Competence is the completion of training by a professional in the field of first-aid and cardiopulmonary resuscitation (CPR). All staff persons shall renew their certification in pediatric first aid and pediatric cardiopulmonary resuscitation (CPR) on or before the expiration of the most current certification. A facility person's record shall include verification of child care experience, education and training following the outset of service at the facility.

Regulation: 3270.31(e)/3270.192(2)(iii)

Description: Age and Training/Exp, educ., training at facility

Noncompliance Area: The file for staff #2 contained 9 of the 12 required hours of annual training completed between 12/2023 and 12/2024. Three additional hours are needed. The file for staff #4 contained 6 of the 12 required hours of annual training completed between 9/2023 and 9/2024. Six additional hours are needed.

Correction Required: A staff person shall obtain an annual minimum of 12 clock hours of child care training. A facility person's record shall include verification of child care experience, education and training following the outset of service at the facility.

Regulation: 3270.31(f)/3270.192(2)(iii)

Description: Health and Safety Training/Exp, educ., training at facility

Noncompliance Area: Staff #1completed the health and safety course titled Health and Safety Basics (6 hours), but did not complete the required health and safety update course titled Pennsylvania Health and Safety Update 2022 (1 hour) training within 90 days of hire. Documentation of completing Health and Safety Training Part 1 and Part 2 is now on file.

Correction Required: Staff persons shall complete professional development within 90 days of hire as listed in subsections (f)1-10. A facility person's record shall include verification of child care experience, education and training following the outset of service at the facility.

Regulation: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: The file for staff #1 contained an NSOR certificate dated 3/10/25 which is more than 45 days after their date of hire (SEE LIS CODE SHEET). Staff #1 was not suspended after 45 days. Staff #6 did not update mandated reporter training within 60 months. This is evidenced by the previously documented mandated reporter training on file being dated 5/05/19 and the most recent training being dated 6/03/24. Current mandated reporter training is now on file. The file for staff #5 lacked a disclosure statement.

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: 3270.61(c)

Description: 40 square feet wall-to-wall

Noncompliance Area: Based on schedules posted in the classrooms and statements made by staff, the Sanctuary is used by the program every Friday. The Sanctuary has not been measured and is not included on the facility's certificate of compliance.

Correction Required: Indoor child care space is measured within permanent stationary partitions or walls. The allowable number of children in a space is determined by dividing the total square feet in a space by 40.

Regulation: 3270.62(b)

Description: Play space - 65 square feet/child

Noncompliance Area: Children were observed playing in an outdoor area which has not been measured and is not included in the facility's certificate of compliance. Based on statements made by staff, the area has been used regularly for several years. The area is located near the entry between the parking lot and two streets.

Correction Required: Outdoor or indoor play space shall be measured at 65 square feet per child.

Regulation: 3270.66(a)

Description: Locked or inaccessible

Noncompliance Area: The following toxics were observed to be accessible to children: sanitizer spray and wipes in an unlocked floor level cabinet in the Orange Room. The safety lock in place was not functioning as intended. Lysol spray in an unlocked drawer of the restroom connected to the school age loft room and used by preschoolers, and disinfecting wipes in an unlocked cabinet in the girl's restroom on the main floor.

Correction Required: Cleaning materials and other toxic materials shall be kept in an area or container that is locked or made inaccessible to children.

Regulation: 3270.76

Description: Building Surfaces

Noncompliance Area: Stained ceiling tiles were observed in the following areas; 2 in the hallway outside the gym and two in the Blue Preschool room.

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(j)

Description: Running water - diapering

Noncompliance Area: In the Orange OT Room, the diapering area was approximately 13 feet from the source of running water. The activity/meal table was located on the route children travel from the diapering area to the sink.

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

Regulation: 3270.94(a)(1)

Description: Every 60 days

Noncompliance Area: Based on the facility's fire drill log consecutive drills dated 10/15/24 and 1/13/25 were conducted 90 days apart.

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: 3270.102(a)

Description: Clean and good repair

Noncompliance Area: Foam blocks with peeling plastic were observed in the Gym, which could be hazardous to children.

Correction Required: 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.

Regulation: 3270.106(f)

Description: 2 feet apart

Noncompliance Area: Two cribs in the Nursery were observed to lack 2 feet on 3 sides, while the crib was in use.

Correction Required: 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.

Regulation: 3270.123(a)(5)

Description: Designated release persons

Noncompliance Area: The Financial Agreement form on file for Child #5 lacked the Release Person's Name.

Correction Required: An agreement shall specify the persons designated by a parent to whom the child may be released.

Regulation: 3270.123(b)/3270.182(8)

Description: Parent receives original/Copy of initial and subsequent agreements. Parent receives original.

Noncompliance Area: The Financial Agreement forms on file for Child #3 and Child #7 were the original copies, which is to be given to the parent.

Correction Required: A parent shall receive the original agreement. The facility shall retain a copy of the agreement. A child's record shall contain a copy of the initial agreement and subsequent written agreements between the parent and the operator. The parent receives the original agreement.

Regulation: 3270.124(b)(2)

Description: Physician name, address, phone

Noncompliance Area: The Emergency Contact form for Child #2 lacked an address for the child's physician or source of medical care.

Correction Required: Emergency contact information must include the name, address and telephone number of the child's physician or source of medical care.

Regulation: 3270.124(b)(3)

Description: Parent home/work address, phone

Noncompliance Area: The Emergency Contact form for Child #1 lacked a complete home address for the enrolling parent.

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

Regulation: 3270.124(b)(7)

Description: Name/address/phone release person

Noncompliance Area: The Emergency Contact forms for Child #1, Child #4, and Child #5 lacked addresses for all listed release persons.

Correction Required: Emergency contact information must include the name, address and telephone number of the individual designated by the parent to whom the child may be released.

Regulation: 3270.131(a)/3270.131(e)

Description: Health information/ACIP recommended immunization record

Noncompliance Area: The file for Child #1 did not contain an initial health assessment and written verification of immunizations within 60 days from enrollment (SEE LIS CODE SHEET). The initial health assessment and written verification of immunizations on file for Child #3 are dated 2/5/24, which is more than 60 days from date of enrollment (SEE LIS CODE SHEET). Child #1 must be dismissed from care by close of business on 4/10/24 and may only return to care when the immunization record is update or when the parent provides a written, signed exemption letter.

Correction Required: The operator shall require the parent of an enrolled child, including a child, a foster child and a relative of an operator or a facility person, to provide an initial health report no later than 60 days following the first day of attendance at the facility. The facility may not accept or retain an infant 2 months of age or older, a toddler or a preschool child at the facility for more than 60 days following the first day of attendance at the facility unless the parent provides written verification from a physician, physician's assistant, CRNP, the Department of Health or a local health department of the dates (month, day and year) the child was administered immunizations in accordance with the recommendations of the ACIP.

Regulation: 3270.133(5)

Description: Original label

Noncompliance Area: An Albuterol labeled for Child #6 with the expiration date of 1/2023 and an Epi-Pen for Child #7 with the expiration date of 1/2024, were observed in the locked medication drawer in the Office.

Correction Required: Medication shall be stored in accordance with the manufacturer's or health professional's instructions on the original label.

Regulation: 3270.135(a)(3)

Description: Disposable diapers

Noncompliance Area: Based on a discussion with staff in the Orange Room, the staff person uses their hands to open the hands-free can when disposing a diaper.

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: 3270.14/3270.21

Description: Pertinent Laws & Regulations/General Health and Safety

Noncompliance Area: Staff #5 and Staff #9 were observed working alone and did not complete the appropriate Heath and Safety training. Both Staff #5 and Staff #9 completed the 6 hour Health and Safety Basics training prior to 9/30/16, but needed the 10 hour Get Started with Center-Based Care: Building Blocks for Quality.

Correction Required: 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.

Regulation: 3270.151(a)/3270.192(3)

Description: 12 months prior to service and every 24 months thereafter/Health assessment, TB test

Noncompliance Area: The two most recent health assessments on file for Staff #2 (1/8/21 & 2/24/23) Staff #6 (11/2/21 & 1/26/24) are dated more than 24 months apart. The file for Staff #7 contained an initial health assessment dated 3/7/24, which is beyond the date of hire (SEE LIS CODE SHEET).

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. A facility person's record shall include a written report of initial and subsequent health assessments, including the results of initial and subsequent tuberculin skin tests, x-rays or other medical documentation necessary to confirm freedom from communicable tuberculosis.

Regulation: 3270.151(c)(2)

Description: Mantoux TB

Noncompliance Area: The file for Staff #7 lacked documentation of a Tuberculosis screening. The file for Staff #3 (5/4/23) and Staff #8 (3/21/23) contained documentation of a Tuberculosis screening dated after their date of hire (SEE LIS CODE SHEET).

Correction Required: 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: 3270.161(d)

Description: Potentially hazardous food refrigerated

Noncompliance Area: In the Blue Room, children's lunch boxes contained potentially hazardous food (yogurt, cheese stick, and chicken nuggets) which needed refrigerated.

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

Regulation: 3270.181(c)

Description: Emergency info/agreement updated 6 mos

Noncompliance Area: The two most recent parent updates of the Financial Agreement form on file for Child #4 (6/30/2023 & 3/1/2024) and Child #5 (8/16/23 & 4/1/2024) are dated, more than 6 months apart.

Correction Required: 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.

Regulation: 3270.21

Description: General Health and Safety

Noncompliance Area: In the Loft, adult scissors were observed were accessible to children.

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

Regulation: 3270.31(f)

Description: Health and Safety Training

Noncompliance Area: Staff person #7 had 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 (12/8/23). Staff #7 has acceptable pediatric first aid/CPR training in an approved curriculum; however, the trainer has not provided documentation that they are PQAS-certified in that training topic.

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

Regulation: 3270.31(g)

Description: Professional development certificate

Noncompliance Area: The files for Staff #1, Staff #2, Staff #4. Staff #5, and Staff #9 contained the Health and Safety Basic Training 6 Hour Course dated prior to 9/30/2016, and therefore lacked the 10 hour Get Started with Center-Based Care: Building Blocks for Quality.

Correction Required: Completion of professional development shall be documented by the signature and title of a representative of the professional development entity and include the date professional development was completed. Documentation shall be retained in the facility person's file or maintained in an electronic system as designated by the Department. Documentation of the completion of the professional development under subsection (f) taken from September 30, 2016, forward satisfies this requirement.

Regulation: 3270.32(a)

Description: Comply with CPSL

Noncompliance Area: Staff #7 did not complete the Mandated Reporter training within 90 days of their date of hire (SEE LIS CODE SHEET).

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services).

Regulation: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: The Child Abuse clearance on file for Staff #3 was dated 4/21/23, after their date of hire (SEE LIS CODE SHEET). The application for the DHS FBI clearance for Staff #3 (4/18/23) and Staff #8 (3/23/23) were dated after their date of hire. Therefore, Staff #3 and Staff #8 were incorrectly provisionally hired. (SEE LIS CODE SHEET). The disclosure statement on file for Staff #8 was dated 5/1/23, after their date of hire (SEE LIS CODE SHEET).

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: 3270.65

Description: Protective Outlet Covers 5 yrs. or less

Noncompliance Area: A power strip in the Loft lacked protective outlet covers, which was accessible to children ages 5 and younger.

Correction Required: Protective receptacle covers shall be placed in electrical outlets accessible to children 5 years of age or younger.

Regulation: 3270.66(a)

Description: Locked or inaccessible

Noncompliance Area: Lysol spray cleaner was observed under the sink in an unlocked cabinet and on the top of the toilet in the Nursery, which was accessible to children.

Correction Required: Cleaning materials and other toxic materials shall be kept in an area or container that is locked or made inaccessible to children.

Regulation: 3270.66(c)

Description: Toxic use- no contamination

Noncompliance Area: Cleaning toxics were observed uncontained and above loose diapers in the Yellow and Orange rooms, which could be hazardous to children.

Correction Required: Cleaning materials and other toxic materials shall be used in a way that does not contaminate play surfaces, food, food preparation areas and does not constitute a hazard to the children.

Regulation: 3270.67(d)

Description: Contaminated trash in closed plastic-lined receptacle

Noncompliance Area: A trash receptacle in the Orange Room contained human secretions that were not contained in a closed, plastic-lined receptacle.

Correction Required: Trash that has been contaminated by human secretions or excrement shall be contained in closed, plastic-lined receptacles.

Regulation: 3270.75(c)

Description: Has all items

Noncompliance Area: The first aid kit in the Nursery lacked an assortment of bandages.

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: 3270.76

Description: Building Surfaces

Noncompliance Area: Ripped carpet and splintered wood pieces were observed on a riser in the Loft.

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: 3270.94(a)(1)

Description: Every 60 days

Noncompliance Area: The fire drill log on file included fire drills conducted 5/15/23-7/15/23 & 7/15/23-9/15/23, more than 60 days apart.

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: 3270.131(d)(5)/3270.131(e)(3)

Description: Immunization record/Dismissal policy

Noncompliance Area: The files for Child #1 and Child #2 did not contain documentation of the Influenza vaccination in accordance with the ACIP recommendations.

Correction Required: 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).

Regulation: 3270.151(a)/3270.192(3)

Description: 12 months prior to service and every 24 months thereafter/Health assessment, TB test

Noncompliance Area: The two most recent Health Assessments in the file for Staff #1, Staff #5, and Staff #8 exceeded the 24-month renewal requirement. The file for Staff #10 did not contain documentation of a Health Assessment or Mantoux test at initial hire or thereafter.

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. A facility person's record shall include a written report of initial and subsequent health assessments, including the results of initial and subsequent tuberculin skin tests, x-rays or other medical documentation necessary to confirm freedom from communicable tuberculosis.

Regulation: 3270.192(5)

Description: Two written references

Noncompliance Area: The file for Staff #10, did not contain two, written, nonfamily references.

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: 3270.31(e)(4)(i)/3270.192(2)(iii)

Description: Age and Training/Exp, educ., training at facility

Noncompliance Area: The file for Staff #2 contained documentation of Pediatric First-Aid/CPR training on 5.7.19 and 5.20.21, which exceeded the expiration date of the previous training.

Correction Required: Competence is the completion of training by a professional in the field of first-aid and cardiopulmonary resuscitation (CPR). All staff persons shall renew their certification in pediatric first aid and pediatric cardiopulmonary resuscitation (CPR) on or before the expiration of the most current certification. A facility person's record shall include verification of child care experience, education and training following the outset of service at the facility.

Regulation: 3270.31(f)(10)

Description: Health and Safety Training - Pediatric First Aid and CPR

Noncompliance Area: The file for Staff #9 (see IS Code Sheet) contained documentation of Pediatric First-Aid/CPR training on 9.22.22, which exceeded 90 days of hire.

Correction Required: Staff persons shall complete professional development in pediatric first aid and pediatric cardiopulmonary resuscitation within 90 days of hire.

Regulation: 3270.32(a)

Description: Comply with CPSL

Noncompliance Area: The file for Staff #3 contained documentation of Mandated Reporter Training on 8.14.15 and 8.26.20, which exceeded the 60-month renewal requirement. The file for Staff #4 contained documentation of Mandated Reporter Training on 5.6.15 and 5.19.20, which exceeded the 60-month renewal requirement. The file for Staff #7 contained documentation of Mandated Reporter Training on 6.23.15 and 3.14.21, which exceeded the 60-month renewal requirement.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services).

Regulation: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: The file for Staff #3 contained State Police Clearances dated 8.8.15 and 8.25.20, and Child Abuse Clearances dated 8.19.15 and 8.21.20, which exceeded the 60-month renewal requirement. The file for Staff #6 contained FBI Clearances dated 3.4.16 and 3.9.21, which exceeded the 60-month renewal requirement. The file for Staff #7 contained State Police Clearances dated 9.25.13 and 4.9.19, Child Abuse Clearances dated 10.1.13 and 4.19.19, and FBI Clearances dated 10.1.13 and 4.11.19, which exceeded the 60-month renewal requirement.

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: 3270.63

Description: Unsafe Areas in Outdoor Space

Noncompliance Area: A black cable line, which was strung along the back of the building in the small outdoor, fenced play yard, was loose in one (1) area, hung down low, was accessible to children, and created a choking/strangling hazard for children in care.

Correction Required: 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.

Regulation: 3270.66(a)

Description: Locked or inaccessible

Noncompliance Area: A bottle of Purell Professional Surface Disinfectant, 128 oz, was located in a closet with a curtain in the school-age room, which stated, "Keep out of reach of children," and was accessible to children.

Correction Required: Cleaning materials and other toxic materials shall be kept in an area or container that is locked or made inaccessible to children.

Regulation: 3270.82(h)

Description: Handwashing signs

Noncompliance Area: A handwashing sign was not posted at two (2) toilets in the school-age room.

Correction Required: A facility person and an able child shall wash his hands after toileting and before eating. A sign on which this requirement is written shall be posted at each toilet, training chair, diapering area and sink in the facility.

Regulation: 3270.106(a)

Description: Clean, age appropriate

Noncompliance Area: The rest equipment in the gym was observed to lack labels for some of the children using the rest equipment.

Correction Required: 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.

Regulation: 3270.113(a)

Description: Supervised at all times

Noncompliance Area: During assessment of supervision and ratio in the Red Room 4/20/22 at 11 AM, one PS child was observed to be alone and unsupervised in the bathroom off the hall, outside of the Red Room.

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.

Regulation: 3270.113(a)(1)

Description: Staff assigned to specific children

Noncompliance Area: During assessment of supervision and ratio in the Red Room 4/20/22 at 11 AM, one PS child was observed to be alone and unsupervised in the bathroom off the hall, outside of the Red Room.

Correction Required: 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.

Regulation: 3270.124(b)(2)

Description: Physician name, address, phone

Noncompliance Area: The file for Child #4 contained an emergency contact form which lacked the telephone number of the child's medical provider.

Correction Required: Emergency contact information must include the name, address and telephone number of the child's physician or source of medical care.

Regulation: 3270.124(b)(3)

Description: Parent home/work address, phone

Noncompliance Area: The file for Child #1 contained an emergency contact form which lacked the home telephone number of the enrolling parent. The files for Child #3 and #5 contained emergency contact forms which lacked the work address and telephone number of the enrolling parents.

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

Regulation: 3270.124(b)(7)

Description: Name/address/phone release person

Noncompliance Area: The file for Child #2 contained an emergency contact form which lacked the full address of the release person. The file for Child #4 contained an emergency contact form which lacked the address and telephone number of the release person.

Correction Required: Emergency contact information must include the name, address and telephone number of the individual designated by the parent to whom the child may be released.

Regulation: 3270.131(b)(2)

Description: Toddler/preschool: updated health report every 12 months

Noncompliance Area: The file for Child #2 contained consecutive health reports dated more than 12 months apart.

Correction Required: The operator shall require the parent to provide an updated health report at least every 12 months for an older toddler or preschool child.

Regulation: 3270.131(e)(1)

Description: Exemption documentation from parent/guardian

Noncompliance Area: The files for Child #2 and #4 contained record of immunization history which lacked current influenza vaccinations.

Correction Required: The facility shall require the parent to provide updated written verification from a physician, physician's assistant, CRNP, the Department of Health or a local health department of ongoing vaccines administered to an infant, toddler or preschool child in accordance with the schedule recommended by the ACIP.

Regulation: 3270.135(a)(3)

Description: Disposable diapers

Noncompliance Area: During an observed diaper change in the Nursery, the hands-free mechanism of the lidded can was not operable.

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)

Description: 12 months prior to service and every 24 months thereafter

Noncompliance Area: The files for Staff #1, #4, #6 and #7 contained consecutive health assessments dated more than 24 months apart. The file for Staff #3 contained a most recent health assessment conducted more than 24 months ago.

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.

Regulation: 3270.192(4)

Description: CPSL information

Noncompliance Area: The file for Staff #3 contained documentation of current state police, child abuse and FBI clearances, yet lacked documentation of previous clearances. The clearances had been reviewed at a previous inspection.

Correction Required: 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: 3270.31(f)(10)/3270.192(2)(iii)

Description: Health and Safety Training - Pediatric First Aid and CPR/Exp, educ., training at facility

Noncompliance Area: The file for Staff #5 contained certification in pediatric first-aid and CPR obtained more than 90 days after hire.

Correction Required: Staff persons shall complete professional development in 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.

Regulation: 3270.31(f)/3270.192(2)(iii)

Description: Health and Safety Training/Exp, educ., training at facility

Noncompliance Area: The files for Staff #2 and #5 contained health and safety basics training completed more than 90 days after hire.

Correction Required: Staff persons shall complete professional development in the following topics within 90 days of hire: facility person's record shall include verification of child care experience, education and training following the outset of service at the facility.

Regulation: 3270.32(a)/3270.192(2)(iii)

Description: Comply with CPSL/Exp, educ., training at facility

Noncompliance Area: The files for Staff #2 and #5 contained documentation of mandated reporter training completed more than 90 days after hire. The files for Staff #3 and #4 contained current mandated reporter training but lacked documentation of previous mandated reporter training, making in unable to be determined if current training was completed within 60 months of previous training.

Correction Required: 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.

Regulation: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: The file for Staff #2 contained application for NSOR clearance and completed NSOR clearance, both dated after the date of hire. The file for Staff #5 contained an NSOR clearance after the date of hire, with no application for NSOR clearance present in file.

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: 3270.51

Description: Similar Age Level

Noncompliance Area: During assessment of supervision and ratio in the Red Room 4/20/22 at 11 AM, one PS child was observed to be alone and unsupervised in the bathroom off the hall, outside of the Red Room.

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.

Regulation: 3270.66(a)

Description: Locked or inaccessible

Noncompliance Area: Toxic paint and primer were observed in a unlocked closet outside the boys bathroom,.

Correction Required: Cleaning materials and other toxic materials shall be kept in an area or container that is locked or made inaccessible to children.

Regulation: 3270.75(b)

Description: Inaccessible to children

Noncompliance Area: The first-aid kit in the SA Room was observed to be accessible to children on a low shelf.

Correction Required: A first-aid kit must be inaccessible to children.

Regulation: 3270.76

Description: Building Surfaces

Noncompliance Area: Splintered wooden fence slats were observed on the left side slats of the small playground. Pieces of glass were observed on the ground near the right upper fence of the large playground. Animal feces were observed on the ground near the top fight of the large playground.

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: 3270.95(a)/3270.95(b)

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

Noncompliance Area: The proof of purchase for the interconnected fire detection system was not available at the time of the inspection.

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.

Noncompliance Area: The thermometer placed in the refrigerator in green room, blue room, red room and nursery was not operating.

Correction Required: A facility shall have an operable, clean refrigerator used to store potentially hazardous foods. The refrigerator shall be capable of maintaining food at 45 F or below. An operating thermometer shall be placed in the refrigerator.

Noncompliance Area: The agreement for child #1, #2 and #4 did not include the services to be provided to the family and the child.

Correction Required: 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).

Noncompliance Area: The agreement for child #2 did not specify the persons designated by a parent to whom the child may be released.

Correction Required: An agreement shall specify the persons designated by a parent to whom the child may be released.