Kidzoo Child Care Center & Preschool

Noncompliance Area: A high chair toy in the upstairs preschool room was observed to have a sticky substance on it, which was corrected on site.

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.

Noncompliance Area: On 8/10/2020, the file of facility person #1 contained mandated reporter training dated 6/2/15. The file did not contain updated mandated reporter training. The training was not completed every 60 months, as required under the CPSL. Continued non-compliance: on 10/20/2020, the file of facility person #1 contained mandated reporter training dated 6/2/15. The file still did not contain updated mandated reporter training. On 10/20/2020, facility person #2 was observed to be outside alone with a group of 6 preschool children. The file of facility person #2 did not contain a completed NSOR verification certificate, as required under the CPSL. Although the legal entity has an approved waiver to hire provisionally effective 1/3/2020, the requirement for a provisional employee to work within the vicinity of a permanent employee was not met.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). PROVISIONAL HIRE UNSUPERVISED: A provisional employee may not be permitted to work alone with children and must work within the vicinity of a permanent employee. 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.

Noncompliance Area: An outlet was observed to be uncovered in the school age room, where children 5 years of age receive care. Corrected on site.

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

Noncompliance Area: On 9/18/2020, a SANIS can was observed to be stored in an area accessible to children in the school age room. Continued non-compliance: On 10/20/2020, a SANIS can was again observed to be stored in an area accessible to children in the school age room. Corrected on site.

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

Noncompliance Area: Cleaning solution was observed to be stored in a container that did not specify the contents, which was corrected on site.

Correction Required: 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.

Noncompliance Area: On 9/18/2020, it was observed that tree roots were sticking up out of the ground, creating a trip hazard on the outdoor toddler play space. Continued non-compliance: On 10/20/2020, tree roots were still observed to be sticking up out of the ground, creating a trip hazard on the outdoor toddler play space. Also on 9/18/2020, it was observed that the wall was peeling by the bathroom in the school age classroom. Continued non-compliance: On 10/20/2020, the wall was again observed to be peeling by the bathroom in the school age classroom, which was corrected on site.

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.

Noncompliance Area: The file of facility person #1 contained mandated reporter training dated 6/2/15. The file did not contain updated mandated reporter training. The training was not completed every 60 months, as required under the CPSL.

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

Noncompliance Area: Bingo markers, labeled to be kept out of reach of children, were observed in the upstairs preschool classroom and in the 2nd green downstairs preschool classroom. Corrected on site.

Correction Required: Arts and crafts materials shall be nontoxic.

Noncompliance Area: The most recent health assessment in the file of facility person #3 was dated 1/27/2017.

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.

Noncompliance Area: The files of facility persons #3, 4, 5, and 6, all hired prior to September 30, 2019, did not contain completed NSOR verification certificates on the date of inspection. Facility persons #3 and #4 were present on the day of inspection. Facility persons #5 and #6 had worked in a child care position after 7/1/2020, per the director. The requirement to have completed NSOR verification certificates on file, as per the CPSL, was not met. The file of facility person #2, hired 2/20/2012, contained a completed NSOR verification certificate dated 7/7/2020. Per director report, facility person #2 had worked in a child care position after 7/1/2020. The requirement to have a completed NSOR verification certificate on file, as per the CPSL, was not met as of July 1, 2020. The file of facility person #1, hired 6/29/2020, contained a completed NSOR verification certificate dated 7/7/2020. The file did not contain documentation of the request for the NSOR verification certificate. Although the LE has an approved waiver on file effective 1/3/2020, the requirement to have copies of the request for clearances on file prior to hire was not met.

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. Facility persons #3, 4, 5, and 6, must be removed from childcare position by close of business. All required clearances must be obtained before facility person #3, 4, 5, and 6 may resume a child care position.

Noncompliance Area: Damp Rid, labeled to be harmful if swallowed, was observed to be in a closet accessible to children in the school age room, which was corrected on site.

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

Noncompliance Area: Exposed electrical wires were observed to be accessible in a closet in the school age room, which was corrected on site.

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.

Noncompliance Area: A training toilet in the toddler bathroom was observed to be dirty, which was corrected on site. A large crack was observed in a little tikes playhouse on the mulched outdoor play space.

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.

Noncompliance Area: Mulch was observed to have spread from the adjacent play space onto the play space where toddlers receive care.

Correction Required: Pea gravel and other materials with a diameter of less than 1 inch may not be used in spaces where infants or toddlers receive care.

Noncompliance Area: Plastic bags were observed to be accessible in the bathroom used by toddlers, which was corrected on site.

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.

Noncompliance Area: Child #1, an infant, was observed to be sleeping in a swing, which was corrected on site.

Correction Required: 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.

Noncompliance Area: It was observed that written instructions from the individual who prescribed Albuterol, which was being stored at the facility for the use of child #2, were not on site at the facility. It was observed that written instructions from the individual who prescribed Alcon eye drops, which were being stored at the facility for the use of child #3, were not on site at the facility.

Correction Required: A staff person shall administer a prescription medication only if written instructions are provided from the individual who prescribed the medicine. Instructions for administration contained on a prescription label are acceptable.

Noncompliance Area: Acetaminophen and cough syrup were observed to be stored at the facility, and neither medication was labeled with the name of the child for whom the medication is intended. At the time of inspection, it was unknown who the medications were intended for.

Correction Required: The label of a medication container shall identify the name of the medication and the name of the child for whom the medication is intended. Medication shall be administered to only the child whose name appears on the container.

Noncompliance Area: It was observed that an EpiPen was being stored at the facility for the use of child #6, and written consent for the administration of the EpiPen was not on file at the facility. It was observed that ventolin was being stored at the facility for the use of child #5, and written consent for the administration of the ventolin was not on file at the facility.

Correction Required: A parent shall provide written consent for administration of medication or a special diet.

Noncompliance Area: The medication log for child #4's Ibuprofen, which had been administered per documentation on the log, did not include a requirement for refrigeration.

Correction Required: A medication log shall include a requirement for refrigeration of medication.

Noncompliance Area: On 3/3/2020, it was observed that there was not an operable fire detection system because the provider stated that the system was in disrepair, and a replacement part had been ordered, but was not yet able to be installed. The individual smoke detectors did not sound when tested. This condition at the facility poses a threat to the health or safety of children.

Correction Required: Conditions at the facility may not pose a threat to the health or safety of the children. Demonstration of Compliance with 34 Pa. Code 403.23 is required. If the provider is not able to demonstrate or document an operable fire detection system a complaint will not be filed until it is determined that the fire detection system is inoperable. If determined inoperable the agent of the Department will file a complaint with the appropriate municipal office to request an additional fire safety inspection by the appropriate agency to verify compliance with 34 Pa. Code 403.23 and per Chapter 20.35(c). The provider will demonstrate an operable fire detection system to an agent of the department.

Noncompliance Area: It was observed that the facility's emergency plan was not posted in a conspicuous location, which was corrected on site.

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

Noncompliance Area: The file of facility person #1, hired 12/30/19, does not contain a completed NSOR verification certificate and does not contain a copy of a request for the NSOR verification certificate or a signed disclosure statement. Although the LE has an approved waiver on file effective 12/30/19, the requirement to have a copy of the request for the NSOR verification certificate and a signed disclosure statement on file was not met. The file of facility person #2, hired 12/30/19, does not contain a completed NSOR verification certificate and does not contain a copy of a request for the NSOR verification certificate or a signed disclosure statement. Although the LE has an approved waiver on file effective 12/30/19, the requirement to have a copy of the request for the NSOR verification certificate and a signed disclosure statement on file was not met. The disclosure statement was corrected on site. The file of facility person #3, hired 6/17/19, did not contain a completed state police clearance for employment purposes, as required under the CPSL. The clearance on file was for volunteer purposes, rather than employment purposes, which was corrected on site. The file also did not contain a disclosure statement, as required under the CPSL, which was corrected on site. The file of facility person #4, hired 9/23/19, does not contain completed state police, child abuse, or FBI clearance information required under the CPSL, and does not contain copies of requests for child abuse, state police, or FBI clearance information or a signed disclosure statement required for provisional hiring under the CPSL. The file of facility person #5, hired 12/18/19, does not contain a completed NSOR verification certificate and does not contain a copy of a request for the NSOR verification certificate or a signed disclosure statement. The file did not contain a completed state police clearance for employment purposes, as required under the CPSL. The clearance on file was for volunteer purposes, rather than employment purposes. Although the LE has an approved waiver on file effective 12/30/19, the requirement to have a copy of the request for the NSOR verification certificate and a signed disclosure statement on file was not met. The file of facility person #6 contains child abuse, state police, and FBI clearances more than 60 months old. The child abuse clearance is dated 2/23/15, the state police clearance is dated 2/5/15, and the FBI clearance is dated 1/26/15. Updated clearances are not on file. The file of facility person #7 contains child abuse, state police, and FBI clearances that were updated more than 60 moths from the expiration of the previous clearances. State police clearances are dated 3/1/14 and 10/15/19. Child abuse clearances are dated 5/8/14 and 10/23/19. FBI clearances are dated 4/29/14 and 10/17/19.

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. Facility employees #1, 2, 5, and 6 must be removed from childcare position by close of business. All required clearances must be obtained before facility person #1, 2, 5, and 6 may resume a child care position.

Noncompliance Area: Vaping fluid was observed to be accessible to children in the preschool classroom, inside a backpack on the floor. Sunscreen was observed to be accessible to children in the first pre-K classroom. Both were corrected on site.

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

Noncompliance Area: Water temperature in the toddler room sink was observed to measure 111 degrees Fahrenheit.

Correction Required: Hot water temperature, in areas accessible to children, may not exceed 110 F.

Noncompliance Area: Mold was observed on far wall of the indoor play space, next to the downstairs exit.

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.

Noncompliance Area: A small patch of peeling paint was observed on the baseboard in the school-age classroom. Corrected on site.

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

Noncompliance Area: Per documentation on the facility's fire drill log on 1/27/2020, a fire drill had not been completed since 11/14/19.

Correction Required: A fire drill shall be held at least every 60 days. Facility persons and children in attendance shall participate in the fire drill. Facility persons and children shall exit the building, weather permitting.

Noncompliance Area: The current emergency contact form, which contained updated information since the previous emergency contact form, on file for child #1 was dated 9/15/19, however per report from staff person #1, was not on file at the facility until 11/8/19. The previous emergency contact form, was dated 11/5/18.

Correction Required: 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

Noncompliance Area: On 11/8/19, between 5:55 and 5:58 AM, staff person #1 was responsible for caring for 10 children, including children between the ages of 2 years old and school-age.

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 legal entity must submit documentation in a format approved by DHS proving that the facility is maintaining the required staff:child ratios at all times. The legal entity will confirm continuing compliance by sending copies of the documentation to the Central Region Office on a weekly basis for a period of three months after DHS approves the documentation format. The documentation may be included on the same format as required to prove continued compliance with 3270.113(a)/3270.113(a)(1).

Noncompliance Area: On 11/8/19, between 5:55 and 5:58 AM, child #1, a school-age child, left the facility premises and walked home. Staff person #1 did not see the child leaving the facility, and was unaware that the child had left the facility. Staff person #1 noticed the child was missing and searched for the child between 5:57 and 6:00 AM. The child's whereabouts were unknown for approximately 30 minutes. The mother of child #1 called the facility approximately 6:30 AM to inform the facility that the child had walked home, which is approximately two miles from the facility.

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.

Noncompliance Area: The file of facility person #1, hired 6/24/19, does not contain a health assessment. It contains only results of a tuberculin skin test.

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.

Noncompliance Area: The emergency contact forms present for children #1 - 4 were dated more than 6 months old at the time of inspection. They were dated between 8/24/17 and 11/2/18.

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. If emergency information is updated in a master file, it shall be updated accordingly in other facility records.

Noncompliance Area: The file of facility person #1 contains only one written, nonfamily reference.

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

Noncompliance Area: The lifeguard certification on file for facility person #1, the facility's lifeguard at the time of inspection, expired 6/1/19.

Correction Required: Competence in lifeguard training is demonstrated by completion of lifeguard training, including first-aid training and cardiopulmonary resuscitation (CPR) for child and infant. A facility person's record shall include verification of child care experience, education and training prior to service at the facility.

Noncompliance Area: There is not documentation that the person who completed water safety training for all staff members present at the time of inspection is a certified lifeguard.

Correction Required: Competence in water safety instruction is demonstrated by the completion of basic instruction in water safety from a certified lifeguard.

Noncompliance Area: The file of facility person #1, hired 6/24/19, does not contain a completed FBI clearance as required under the CPSL and does not contain a copy of the request for the FBI clearance or a signed employee disclosure statement as required for provisional hires under the CPSL.

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. Facility Person #1 may not work in a child care position at the facility.

Noncompliance Area: Mulch was observed on the ground of the toddler outdoor play space.

Correction Required: Pea gravel and other materials with a diameter of less than 1 inch may not be used in spaces where infants or toddlers receive care.

Noncompliance Area: Sharp, cracked plastic was observed on the bottom border of the white plastic fence on the toddler outdoor play space.

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.

Noncompliance Area: It was observed that the facility's current certificate of compliance was not posted in a conspicuous location used by parents.

Correction Required: The facility's current certificate of compliance and a copy of the applicable regulations under which the facility is certified shall be posted in a conspicuous location used by parents, with instructions for contacting the appropriate regional day care office posted at the same location.

Noncompliance Area: A cracked toy truck was observed on the outdoor play area with mulch. Cracks were observed in a playhouse on the outdoor play area with mulch. A torn stuffed animal was observed in the school-age classroom. All were corrected on site.

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.

Noncompliance Area: Small crayon pieces and doll shoe magnets, less than one inch in diameter, and matchbox cars with removable parts less than one inch in diameter were observed to be accessible to an older toddler, which was corrected on site.

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.

Noncompliance Area: It was observed that in the purple downstairs preschool room, there was not 2 feet of space on three sides of a cot during nap time, which was corrected on site.

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.

Noncompliance Area: In the downstairs purple preschool classroom, it was observed that at nap time, a staff member was unable to see all children in the room due to nap mat placement when the 2nd staff member had to leave the room, which was corrected on site.

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.

Noncompliance Area: The emergency contact forms for children #4 and #8 were current and updated at the time of inspection, however they were dated more than one year from the date of the previous update. The last child service report on file for child #7 was dated 1/18/18.

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). 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

Noncompliance Area: The emergency contact form for child #1 did not include an address or phone number for the child's 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.

Noncompliance Area: The emergency contact form for child #1 did not include a complete home address for the enrolling parent. The emergency contact form for child #4 did not include a complete work address for the enrolling parent.

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

Noncompliance Area: The emergency contact forms for children #1, #3, #7, and #9 did not include the children's health insurance coverage information. The emergency contact forms for children #2, #5, #6, and #8 did not include health insurance coverage or policy number information.

Correction Required: Emergency contact information must include health insurance coverage and policy number for a child under a family policy or Medical Assistance benefits, if applicable.

Noncompliance Area: The emergency contact forms for children #1, #2, #4, and #8 did not include complete addresses for the release persons listed.

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.

Noncompliance Area: There were not emergency contact forms in the downstairs purple preschool classroom, which was corrected on site. Multiple emergency contact forms in the child care space throughout the center were not the most updated copy, as they were dated more than 6 months old.

Correction Required: When children are in the facility, emergency contact information shall be present in a child care space for children receiving care in the space. If emergency information is updated in a master file, it shall be updated accordingly in other facility records.

Noncompliance Area: The health assessment on file for child #3, a young toddler, was not signed by the medical professional that completed the assessment. The health assessment was also not dated, therefore it is unable to be determined if the health assessment was obtained within the correct time-frame.

Correction Required: The initial health report for a young toddler must be dated no more than 6 months prior to the first day of attendance at the facility. A health report must be written and signed by a physician, physician's assistant or a CRNP. The signature must include the individual's professional title.

Noncompliance Area: The last health assessment on file for child #7, a pre-school aged child, was dated more than 12 months old at the time of inspection, and an updated health assessment was not on file.

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.

Noncompliance Area: The parent of child #10 had provided written permission for administration of saline spray, however the parent had indicated an end date of 12/7/18, and updated written permission was not on file at the time of inspection.

Correction Required: A parent shall provide written consent for administration of medication or a special diet.

Noncompliance Area: There were current health assessments on file for staff persons #1 and #7, however they were dated more than 24 months from the dates of the previous health assessments. The file of staff person #10, hired 10/8/18, contained tuberculosis screening results, however they were dated 10/10/18, and therefore were not on file at the time of hire. The file of staff person #12, hired 8/20/18, contained a health assessment dated 9/7/18 and tuberculosis screening results dated 9/10/18, therefore they were not on file at the time of hire. The file of staff person #13, hired 10/4/18, contained tuberculosis screening results dated 7-20-17, which is more than one year prior to the staff person's start date. The most recent health assessment on file for staff person #16 was dated 12/5/16, and an updated health assessment was not on file. The file of staff person #18, hired 8/17/18, contained a health assessment and tuberculosis screening results dated 8/19/18, and therefore it was not on file at the time of hire. The file of staff person #19, hired 8/27/18, contained a health assessment dated 9/4/18 and tuberculosis screening results dated 9/7/18, and therefore they were not on file at the time of hire. The file of staff person #17, hired 8/7/18, contained a health assessment dated 8/14/18 and tuberculosis screening results dated 8/16/18, therefore they were not on file at the time of hire.

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.

Noncompliance Area: The health assessment on file for staff person #17 indicates that the staff person has communicable diseases, and does not include information on how it might threaten the health of the children. The health assessment on file for staff person #18 did not include results of examination for communicable diseases.

Correction Required: An adult health assessment must include an examination for communicable diseases and the results of that examination. An adult health assessment must include information on medical problems that might threaten the health of the children or prohibit a staff person from providing adequate care to children.

Noncompliance Area: The health assessments on file for staff persons #17 and #18 do not include the medical provider's assessment of the person's suitability to provide child care.

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

Noncompliance Area: Per the menu, some of the scheduled breakfasts included only items from the grain and fruit/vegetable food groups. They did not include an item from a third food group.

Correction Required: Breakfast prepared at the facility for children of toddler age or older shall have at least one item from three of the following four food groups: dairy, protein, fruit and vegetable, grain.

Noncompliance Area: The current copy of the facility's liability insurance was not on file at the time of inspection. The copy on file at the time of inspection expired January 2018.

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.

Noncompliance Area: There were no written references attesting to staff person #3's suitability to serve as a facility person, and there were no written references on file for staff person #18. There was only one written nonfamily reference on file for staff person #17.

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

Noncompliance Area: The instructions for contacting the central region day care office were not posted in a conspicuous location utilized by parents at the time of inspection.

Correction Required: The facility's current certificate of compliance and a copy of the applicable regulations under which the facility is certified shall be posted in a conspicuous location used by parents, with instructions for contacting the appropriate regional day care office posted at the same location.

Noncompliance Area: There was not documentation that staff person #11 had been trained in the emergency plan since 11/21/17.

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.

Noncompliance Area: The emergency plan was not posted in a conspicuous location at the time of inspection.

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

Noncompliance Area: There was not documentation of 6 hours annual training on file for staff persons #4 or #8.

Correction Required: A staff person shall obtain an annual minimum of 6 clock hours of child care training.

Noncompliance Area: All staff had current fire safety training at the time of inspection, however fire safety training was not updated within one year from the date of previous fire safety training for staff persons # 1 - 9, #14 - 16, and #20. The dates of fire safety training for these staff members were 12/14/16 and 1/29/18.

Correction Required: 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.

Noncompliance Area: The state police clearance for staff person #10 did not include the staff person's AKA name. The file of staff person #11 hired 11/8/17 does not contain completed mandated reporter training, as required under the CPSL. The file of staff person #14, hired 9/23/13, contains an FBI clearance more than five years old. Staff person #14's FBI clearance is dated 12/2/13. The file of staff person #12, hired 8/20/18, had a disclosure statement dated 8/27/18 and a state police clearance dated 9/4/18, and there was not a copy of request for the state police clearance prior to the staff person's start date. The file of staff person #17, hired 8/7/18, contained a state police clearance dated 8/9/18, a child abuse clearance dated 8/21/18, and an FBI clearance dated 8/17/18, and there were not copies of requests for any of the clearances prior to the staff person's start date. The copy of request for the FBI clearance was dated 8/17/18. The file of staff person #17 included current mandated reporter training, however it was dated 12/13/18, and therefore was not completed within 90 days of hire. The file of staff person #19, hired 8/27/18, contained a disclosure statement dated 8/31/18, a state police clearance dated 8/30/18, a child abuse clearance dated 9/10/18, and an FBI clearance dated 9/5/18, and there were not copies of request for the clearances prior to the staff person's start date. The FBI clearance request date was 9/5/18.

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. LACKING REQUIRED HIRING DOCUMENTS: Facility Person #14 may not work in a child care position at the facility

Noncompliance Area: There was not a staff evaluation on file for staff person #11, and that staff person had been employed more than one year.

Correction Required: A director is responsible for written evaluation of staff persons on a regular basis, a minimum of one evaluation every 12 months.

Noncompliance Area: The files for staff persons #17 and #18, both being utilized as assistant group supervisors, did not contain an acceptable combination of education and experience. Both staff files contained documentation of high school diplomas. The file for staff person #17 contained only 2073 hours of experience and the file for staff person #18 contained no documentation of experience.

Correction Required: An assistant group supervisor shall have a high school diploma or a general educational development certificate and 2 years experience with children. A facility person's record shall include verification of child care experience, education and training prior to service at the facility.

Noncompliance Area: An outlet, accessible to preschool children, was observed not to be covered on a plugged-in string of lights in the upstairs preschool classroom, which was corrected on site.

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

Noncompliance Area: At the time of inspection, it was observed that sunscreen and disinfectant was accessible to children in a closet in the 1st green downstairs preschool room. Hand sanitizer was observed to be accessible on the wall of the 2nd green downstairs preschool room and the school age classroom.

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

Noncompliance Area: The radiators in the 2nd green preschool room and purple preschool room downstairs were observed to measure 112 degrees in temperature, and were accessible to children.

Correction Required: Hot water pipes and other sources of heat exceeding 110 F that are accessible to children shall be equipped with protective guards or shall be insulated to prevent direct contact.

Noncompliance Area: The first aid kit in the blue van, used to transport children, did not contain 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. A first-aid kit, including the contents as specified in 3270.75 (relating to first-aid kit) shall be in the vehicle when children are being transported.

Noncompliance Area: Loose cords were observed to be accessible to infants, creating a choke hazard, which was corrected on site. Loose string lights were observed in the upstairs preschool classroom, creating a choke hazard, which was corrected on site. Sharp cracks were observed in the plastic along the bottom of the fence around the outdoor toddler play space.

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.

Noncompliance Area: Peeling paint was observed on the far right wall of the 1st downstairs green preschool room. Peeling plaster was observed behind a toilet in the upstairs preschool room. Both were corrected on site.

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

Noncompliance Area: There was not a hand-washing sign by the toilet in the school-age classroom, which was corrected on site.

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.

Noncompliance Area: Per the fire drill log, a fire drill was conducted on 4/19/18, and the next was conducted 6/22/18. Also, at the time of inspection, the last documented fire drill was 9/25/18. Per staff report, an additional fire drill had been conducted prior to inspection, however it was not documented on the fire drill log. By 12/13/18, the last fire drill had been documented on the log.

Correction Required: A fire drill shall be held at least every 60 days. Facility persons and children in attendance shall participate in the fire drill. Facility persons and children shall exit the building, weather permitting. A written record shall be kept of the date, the time of day, the hypothetical location of the fire, the evacuation time, the names of facility persons and the number of children participating in the fire drill.

Noncompliance Area: On 5/29/18, the mulch under the embedded equipment on the mulched play area (except for under the dome-shaped climber) did not measure 9 inches in depth, as required by the United States Consumer Product Safety Commission. Continued non-compliance: on 8/17/18, the mulch under the rockers, the car equipment, and the slide on the playground still did not measure 9 inches in depth at the time of inspection, as recommended by the United States Consumer Product Safety Commission.

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.

Noncompliance Area: On 5/29/18, mulch was observed on the outside play space designated for the use of toddlers. Continued non-compliance: on 8/17/18, mulch was still observed on the outside play space designated for the use of toddlers.

Correction Required: Pea gravel and other materials with a diameter of less than 1 inch may not be used in spaces where infants or toddlers receive care.

Noncompliance Area: Per staff report, a toddler, child #2, had been left outside on the toddler play area "a few months ago", not being able to be seen or supervised by other staff. There were other staff outside, but those staff members did not know that the child was outside. Staff confirmed that staff member #6 had been written up on 6/15/18 and suspended for a toddler being unsupervised, but the staff did not know the child's name.

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. TIERED LIS: 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.

Noncompliance Area: At the time of inspection, staff persons #4 and #5 had not been assigned the responsibility for supervision of specific children.

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.

Noncompliance Area: At the time of inspection, the emergency contact forms were not in the child care space for the children receiving care in the school-age classroom.

Correction Required: When children are in the facility, emergency contact information shall be present in a child care space for children receiving care in the space.

Noncompliance Area: On 5/29/18, the medication log for Ventolin for the use of Child #1 did not include a requirement for refrigeration at the time of inspection. Continued non-compliance: On 8/17/18, the medication log for Ventolin for the use of Child #1 still did not include a requirement for refrigeration.

Correction Required: A medication log shall include a requirement for refrigeration of medication.

Noncompliance Area: On 5/29/18, there was not a health assessment on file at the time of inspection for staff person #3. Continued non-compliance: On 8/17/18, there was still not a health assessment on file for staff person #3, and there were also not results of a tuberculin skin test on file for staff person #3.

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.

Noncompliance Area: On 5/29/18, there were not any written references on file for staff persons #3 at the time of inspection. Continued non-compliance: On 8/17/18, there were still not any written references on file for staff person #3.

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

Noncompliance Area: At the time of inspection, it was observed that the inspection summaries from inspections on 5/29/18 and 7/19/18, both of which had cited regulatory noncompliance items for which corrections had not yet been verified by the Department, had not been posted in a conspicuous location utilized by parents.

Correction Required: The operator shall post a copy of each inspection summary issued by the Department in a conspicuous location used by parents. The inspection summary shall remain posted until an agent of the Department verifies that each regulatory noncompliance item cited on the inspection summary has been corrected.

Noncompliance Area: Per staff report, staff person #1, who as of the time of inspection was to be supervised at all times per the approved safety plan, was sometimes left alone with children while the supervising staff member had to use the restroom, and no other staff were available to step in to supervise.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). SAFETY PLAN: The operator is required to submit to the Children and Youth Agency a plan of supervision or alternate arrangement as required by the Child Protective Services Law.

Noncompliance Area: On 5/29/18, Staff person #2, being utilized as an assistant group supervisor (AGS), had documentation of 21 college credits on file, but no documentation of experience on file. Staff person #3, also being utilized as an AGS, did not have any documentation of education or experience on file at the time of inspection. Continued non-compliance: On 8/17/18, staff person #2 had documentation of 21 college credits on file and documentation of 1064 hours of child care experience on file. Staff person #3 still did not have any documentation of education or experience on file.

Correction Required: An assistant group supervisor shall have a high school diploma or a general educational development certificate, 15 credit hours from an accredited college or university in early childhood education, child development, special education, elementary education or the human services field and 1 year of experience with children. A facility person's record shall include verification of child care experience, education and training prior to service at the facility.

Noncompliance Area: On 5/29/18, the hot water temperature in the toddler bathroom and the sink in the toddler classroom was observed to measure at 112 degrees Fahrenheit at the time of inspection. Continued non-compliance: on 8/17/18 the hot water temperature was still measured at 112 degrees Fahrenheit.

Correction Required: Hot water temperature, in areas accessible to children, may not exceed 110 F.

Noncompliance Area: The white plastic fence on the toddler outside play area was observed to have sharp, cracked plastic around the bottom of the fence. Also, the top of one of the corners of the same fence was observed to be disconnected from the rest of the fence due to a broken connector, therefore the fence was leaning away from the play space. Fabric was observed to be exposed under the mulch on the outside play area, creating a trip hazard.

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.

Noncompliance Area: Peeling paint was observed above the sink in the toddler classroom and on the door at the top of the stairs leading from the downstairs to the upstairs, both of which were corrected on site. Peeling paint has previously been cited on 12/11/17, 2/13/18, 2/16/18, and 5/29/18, and provider has not followed the submitted plans of correction.

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

Noncompliance Area: A plastic bag in the toddler classroom was observed to be within the reach of the toddlers, hanging from a coat hook under the cubby shelves, which was corrected on site.

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.

Noncompliance Area: At the time of inspection, an electrical outlet accessible to children in the infant room was observed not to have a protective receptacle cover, which was corrected on site.

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

Noncompliance Area: A tricycle was observed on the mulched play area to have a torn rubber wheel. A stuffed Mickey Mouse toy was observed to have a rip in it, exposing the foam inside in the toddler classroom. The back of a kitchen toy in the toddler room was observed to have sharp, broken plastic exposed. Cracked plastic was observed in the outdoor play house on the mulched play area. Broken hula hoops and a broken soccer ball were observed on the mulched play area. Sharp, cracked plastic balls were observed in the toddler room. The back of the green couch in the school age room was observed to be in disrepair. All were corrected on site.

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.

Noncompliance Area: The mulch under the embedded equipment on the mulched play area (except for under the dome-shaped climber) did not measure 9 inches in depth, as required by the United States Consumer Product Safety Commission.

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.

Noncompliance Area: Mulch was observed on the outdoor toddler playground, which was confirmed by the director to be in use as a toddler play area.

Correction Required: Pea gravel and other materials with a diameter of less than 1 inch may not be used in spaces where infants or toddlers receive care.

Noncompliance Area: A plastic bag was observed to be accessible in a drawer the bathroom used by toddlers and a plastic bag was observed to be accessible to children in the toddler room, as it was hanging from a coat hook in the classroom, within reach of the toddlers. All plastic bags were corrected on site.

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.

Noncompliance Area: A pre-school age child was observed to be resting in a chair, unsupervised by staff in the purple preschool classroom downstairs. The lights were off in the classroom, and no staff were present in the classroom with the child. The other children and staff were in the adjacent room, and not able to see the child. The child's chair was moved at the time of inspection so that staff could see the child.

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.

Noncompliance Area: The medication logs for child #1's Ventolin and child #2's saline mist did not include a requirement for refrigeration.

Correction Required: A medication log shall include a requirement for refrigeration of medication.

Noncompliance Area: There was not a health assessment on file for staff person #1 or staff person #2 at the time of inspection, and there were not tuberculin skin test results on file for staff person #1.

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. 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.

Noncompliance Area: There were no written, nonfamily references on file for staff persons #1 and #2 at the time of inspection.

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

Noncompliance Area: Staff person #1's state police and child abuse clearances were volunteer clearances, not employment clearances. Staff person #2 did not have a signed disclosure statement on file at the time of inspection, which was corrected on site. Staff person #2 was employed 11 months at the time of inspection, and did not have mandated reporter training on file.

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