Andrew Child Care Center Llc

Regulation: 3270.107

Description: Refrigerator

Noncompliance Area: During a complaint investigation on 4/21/26, representative observed the refrigerator temperature in the infant room to be at 64 degrees.

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.

Regulation: 3270.111(a)/3270.111(c)

Description: Written plan/Promote development

Noncompliance Area: During a complaint investigation on 4/21/26, representative observed the preschool room on more than one occasion throughout the day to not be following the list of daily activities posted in this room. Children were observed to be in free play when we visited the room on 2 occasions. Representative did not observe any afternoon circle time as listed on the daily activities upon the return in the afternoon.

Correction Required: A written plan of daily activities and routines, including a time for free play shall be established for each group. The plan shall be flexible to accommodate the needs of individual children and the dynamics of the group. Daily activities shall promote the development of skills, social competence and self-esteem. Daily experiences shall recognize the child as an individual and give some choice of activities that respect personal privacy, lifestyle and cultural background.

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

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

Noncompliance Area: During a complaint investigation on 4/21/26, Staff #1 and #2 in the preschool room were unable to name all the children they were responsible for. There was a total of 16 preschoolers and staff #1 was able to name 6 preschoolers and staff #2 was able to name 7 preschoolers. There were 3 preschoolers which were unnamed during the investigation.

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. TIERED LIS: 1. Children must be supervised at all times. 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. Portion of the plan shall have an immediate correction date. 2. The Legal Entity will develop a specific supervision policy demonstrating how all staff persons will be assigned a specific group of children and will know the names and whereabouts of the children in their assigned group. The policy must include how all children present will be accounted for in the supervision groups. The policy must be submitted to the Northeast Regional Office for approval. Once the policy has been approved by the Regional Office, the policy must be reviewed with all staff. All staff will sign off that they have read and understand the policy. This portion of the plan shall have a correction date that reflects the approval and review of the policy with staff.

Regulation: 3270.151(c)(1)/3270.151(c)(2)

Description: Physical examination/Mantoux TB

Noncompliance Area: During a complaint investigation on 4/21/26, upon checking files for new staff, representative observed staff #1 health assessment on file (See code sheet for date of exam). The health assessment date appeared to be altered and the dates of the Mantoux test and reading also appeared to be altered. Staff 1 was questioned and stated that this is when their health assessment and Mantoux test occurred. The health care provider was contacted on 4/27/26 at 9:13am and reported last known visit and Mantoux testing did not occur on the date listed on the health assessment. The provider also stated they had no record of health assessment on staff #1. Staff person #1 did not have another valid health assessment on file at the facility. In addition, staff person #2 file did not have a health assessment on file at the facility.

Correction Required: An adult health assessment must include a physical examination. 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. TIERED LIS: 1. 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 shall be conducted and a report shall be written and signed by a physician, physician's assistant or CRNP. The signature must include the individual's professional title. Staff Persons 1 and 2 must obtain a valid and current Health Assessment. The operator shall provide a correction date for when this portion of the plan will be corrected. 2. The legal entity will submit initial Health Assessments of any newly hired staff/ facility persons, and any newly updated Health Assessments for all existing facility/staff persons for a period of 3 months to the NE Regional Office. During that time any initial and updated health assessment is not considered acceptable until their health assessment has been approved by the NE Regional Office. Submitted health assessments will be reviewed by the NE regional office within 1 week of submission. The operator shall provide a correction date that is a minimum of 3 months from the date an acceptable plan is received.

Regulation: 3270.166(4)

Description: Bottles labeled

Noncompliance Area: During the complaint investigation on 4/21/26, representative observed an infant bottle unlabeled for child #1.

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

Regulation: 3270.106(a)/3270.119

Description: Clean, age appropriate/Infant sleep position

Noncompliance Area: A renewal inspection was conducted on 12/15/2025. At that time, an infant was observed sleeping in an infant bouncer seat during the certification representative's naptime walkthrough. When staff were alerted to the requirement that infants must sleep in cribs, the infant was placed in a crib on their belly. There was no medical documentation on file indicating that the infant must sleep in this position.

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. 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. TIERED LIS: 1. Individual, clean, age-appropriate rest equipment shall be provided for preschool, toddler and infant children as agreed between the child's parent and the operator. The rest equipment shall be labeled for the use of a specific child and used only by the specified child. Infants shall be placed in the sleeping position recommended by the American Academy of Pediatrics unless there is a medical reason an infant should not sleep in this position. The medical reason shall be documented in a statement signed by a physician, physician's assistant or CRNP and placed in the child's record at the facility. This portion of the plan shall have an immediate correction date. 2. The legal entity must arrange for all staff/facility persons to complete the training entitled "Safe Sleep Practices for Caregivers: Reduce the risk of SUIDs" through Better Kid Care. The operator shall provide a date in which the training will be completed.

Regulation: 3270.106(f)

Description: 2 feet apart

Noncompliance Area: A renewal inspection was conducted on 12/15/2025. At that time, cribs in the Infant/Toddler area were observed to not have at least 2 feet of space on three sides. The certification representative noted this during the initial walkthrough, and no children were in the cribs at that time. Technical assistance (TA) regarding the regulation was provided to the operator. During a subsequent walkthrough of the room during naptime, two cribs in use by infants were observed to not have at least 2 feet of space on three sides.

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)(6)/3270.124(b)(7)

Description: Admission date/Name/address/phone release person

Noncompliance Area: A renewal inspection was conducted on 12/15/2025. At that time, a sample of children's files were reviewed The following information was missing on documents in children's files: Child #1:. Date of admission was missing from the fee agreement. Child#3: Release persons' addresses were missing from the emergency contact form.

Correction Required: An agreement shall specify the date of the child's admission. 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: A renewal inspection was conducted on 12/15/2025. At that time, a sample of children's files were reviewed. Most recent health assessment on file was dated 10/31/2024.

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

Description: Immunization record/Dismissal policy

Noncompliance Area: A renewal inspection was conducted on 12/15/2025. At that time, a sample of children's files was reviewed. The immunization record on file for Child #3 did not include documentation of the second dose of Hepatitis A vaccine or the fourth dose of Pneumococcal vaccine. No medical, religious, or philosophical exemption was on file. Child #3 is preschool-aged (see LIS code sheet).

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). Child #3 must be dismissed from care by close of business 12/15/2025 and may only return to care when the immunization record is updated or when a parent provides a written, signed exemption letter.

Regulation: 3270.134(a)

Description: Child's hands washed

Noncompliance Area: A renewal inspection was conducted on 12/15/2025. At that time, staff in the Infant/Toddler area were observed changing a toddler-aged child's diaper and placing the child back on the floor to play without washing the child's hands.

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

Regulation: 3270.166(4)

Description: Bottles labeled

Noncompliance Area: A renewal inspection was conducted on 12/15/2025. At that time, several unlabeled bottles were observed in the Infant/Toddler area on the bottom floor of the facility. One bottle was observed in a cabinet, and the remaining bottles were observed in the closet.

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

Regulation: 3270.192(5)

Description: Two written references

Noncompliance Area: A renewal inspection was conducted on 12/15/2025. At that time, facility persons' files were reviewed. File for facility person #2 contained 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.