Apple Pie Day Care

Regulation: 3270.133(7)(i)

Description: Name of medication

Noncompliance Area: The medication log for two children did not include the name of the medication. (#3- log dated 9/3/25) (#4 log dated 5/22/25 (#5 log dated 7/16/25

Correction Required: A medication log shall include the name of the medication. Amend the child's medication log to ensure that it includes and name of the medication. Submit a copy of the amended log. Revise and submit policies and procedures regarding proper completion of the medication log to ensure that the medication log contains the name of the medication.

Regulation: 3270.133(7)(iv)

Description: Amount to administer

Noncompliance Area: The medication log for two children did not shall include the amount of medication to be administered. (#1 -log dated 8/18/25) (#2-log dated 1/16/25) (#4-log dated 3/30/25) (#5 log dated 4/1-4/30/25)

Correction Required: A medication log shall include the amount of medication administered. Amend the child's medication log to ensure that it includes the amount of medication to be administered. Revise and submit policies and procedures regarding proper completion of the medication log to ensure that the medication log contains the amount of medication to be administered.

Regulation: 3270.133(7)(v)/3270.133(7)(vi)

Description: Date of administration/Time of administration

Noncompliance Area: The medication log for several children did not include the date and time for the medication to be administered. Amend the child's medication log to ensure that it includes the date and time for the medication to be administered. Revise and submit policies and procedures regarding proper completion of the medication log to ensure that the medication log includes the date and time for the medication to be administered. Operator will review and monitor all medication logs to ensure that they are properly completed. A facility staff person administered albuterol to a child and the

Correction Required: A medication log shall include the date of administration. A medication log shall include the time of administration.

Regulation: 3270.95(b)

Description: Director or designated staff person ensure compliance

Noncompliance Area: Operator lacked written documentation on file indicating that the fire alarm system has been tested every 30 days as required under Fire Act of July 14, 2020. This information was documented on the fire drill logs as required.

Correction Required: The Director or designated staff person who is responsible for compliance with this chapter shall ensure the requirements under subsection (a) are met. The fire alarm system must be tested every 30 days as required under Act 62. Submit written documentation verifying that the system has been tested as specified. Ensure that the system is tested , documented in writing and retained with the fire drill records as required in ACT 62.

Regulation: 3270.113(b)

Description: No physical punishment

Noncompliance Area: On 5/15/25, the operator acknowledged that a staff person became frustrated with a toddler and grabbed and pulled the child's arm.

Correction Required: A facility person may not use any form of physical punishment, including spanking a child. The legal entity must arrange for all staff persons to receive hands-on DHS approved training in supervision of children that includes how to effectively cope with frustration when working with challenging children. Submit written verification of the completed training.

Regulation: 3270.113(b)

Description: No physical punishment

Noncompliance Area: On 2/27/25, the facility acknowledged observing a staff person grabbing a child by the arm and slamming a child into a chair.

Correction Required: A facility person may not use any form of physical punishment, including spanking a child. TIERED LIS: Children must be supervised at all times by 2/27/25. The legal entity must arrange for all facility staff to receive 2 hours of hands-on DHS approved training in supervision of children that includes how to effectively cope frustration when working with children. Submit written verification of the completed training by 3/37/25.

Regulation: 3270.113(a)

Description: Supervised at all times

Noncompliance Area: On 12/2/24, a child sustained an injury while in care at the facility and the staff person assigned responsibility for supervision of the child had no knowledge of how the injury occurred.

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: Children must be supervised at all times by 12/23/24. The legal entity must arrange for all facility staff to receive a minimum of two hours of training regarding supervision of children. The legal entity must arrange for all facility staff to receive a minimum of two hours of DHS approved training regarding supervision of children including the requirement that staff must be physically present and be able to see, hear and assess and direct the activity of the children by 1/23/25. Submit written verification of the completed training for all facility staff persons.

Regulation: 3270.27(a)(5)

Description: Emergency plan

Noncompliance Area: The facility's emergency plan did not provide for accommodations for infants, toddlers, children with disabilities, and children with chronic medical conditions.

Correction Required: The facility shall have an emergency plan that provides for accommodations for infants, toddlers, children with disabilities, and children with chronic medical conditions. Amend the facility emergency plan to include accommodations for infants, toddlers, children with disabilities, and children with chronic medical conditions. Submit a written copy of the amended emergency plan.

Regulation: 3270.51/3270.52

Description: Similar Age Level/Mixed Age Level

Noncompliance Area: On 3/7/24 at approximately 3:45pm, staff person #1 was observed caring for a mixed age group of 14 young/older school age children in the school age classroom near the entrance. Staff person #1 verified the ages of the children.

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.The required staff:child ratios must be maintained at all timesWhen children are grouped in mixed age levels, the age of the youngest child in the group determines the staff:child ratio and maximum group size in accordance with the requirements in § 3270.51 (relating to similar age level). The required staff:child ratios must be maintained at all times. The facility must arrange for facility staff to receive DHS approved training in proper staff:child ratios and develop a written staffing plan including provisions for staff shortages and times of transition to ensure ongoing compliance. Submit written verification of completed training for all facility staff persons and a copy of the written staffing plan.

Regulation: 3270.51/3270.52

Description: Similar Age Level/Mixed Age Level

Noncompliance Area: On 3/7/24 at approximately 3:45pm, staff person #1 was observed caring for a mixed age group of 14 young/older school age children in the school age classroom near the entrance. Staff person #1 verified the ages of the children.

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

Regulation: 3270.113(b)

Description: No physical punishment

Noncompliance Area: During complaint investigation on 8/3/23, cert rep discovered Staff 1 pulled a child by the arms and dislocated her shoulder.

Correction Required: A facility person may not use any form of physical punishment, including spanking a child.

Regulation: 3270.102(a)

Description: Clean and good repair

Noncompliance Area: During renewal inspection, cert rep observed a broken gray plastic bin holding toys, as well as damaged areas of the artificial turf located on the outdoor playground.

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(a)

Description: Clean, age appropriate

Noncompliance Area: During renewal inspection, cert rep observed damage to Cot #1 in the upstairs older toddler room.

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: 3270.107

Description: Refrigerator

Noncompliance Area: During renewal inspection, cert rep observed a spill inside the refrigerator located in the play area adjacent to the infant room.

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: 3270.178

Description: Transportation First Aid Kit

Noncompliance Area: During renewal inspection, cert rep observed the first aid kit on the short school bus was missing soap.

Correction Required: 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.

Regulation: 3270.75(d)

Description: On excursions

Noncompliance Area: During renewal inspection, cert rep observed a missing first aid kit while children were outside of their classroom on the playground.

Correction Required: One first-aid kit per child care group must accompany children and facility persons on excursions from the facility. Each first aid kit taken on an excursion must contain a bottle of water in addition to the items specified at §3270.75(c).

Regulation: 3270.77(a)

Description: No peeling paint or plaster

Noncompliance Area: During renewal inspection, cert rep observed peeled or damaged paint and plaster on the corner by the cubbies in the upstairs preschool room and in the upstairs younger toddler room (Bees, the far and close walls).

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

Noncompliance Area: During complaint investigation, cert rep discovered the facility self-reported that on 3/2/2020 Staff 1 did swing a child from off of the furniture and across the room.

Correction Required: A facility person may not use any form of physical punishment, including spanking a child.

Noncompliance Area: During complaint investigation on 12/4/19, cert rep discovered a facility person had pinched a student.

Correction Required: A facility person may not use any form of physical punishment, including spanking a child.

Noncompliance Area: During renewal inspection on 12/4/19, cert rep observed missing daily activities schedule posted in the Pre-K room

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

Noncompliance Area: During renewal inspection on 12/4/1, cert rep observed damaged paint and plaster on walls in the Kindergarten room as well as in the older toddler room.

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

Noncompliance Area: During renewal inspection on 11/5/18, cert rep observed first aid kits in the infant room, preschool room, and both young toddler rooms missing tape, and the first aid kit in the after school care room missing tweezers, gauze and adhesive 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.

Noncompliance Area: During complaint investigation on 11/5/18, cert rep discovered Child 1 was left unattended on a rooftop playground for approximately two hours.

Correction Required: The legal entity must arrange for all facility staff to receive a minimum of two hours of training regarding supervision of children. The legal entity must receive DHS approval of the training content prior to scheduling the training.

Noncompliance Area: One child's emergency contact form did not include information on the child's special needs which are needed in an emergency situation. The facility used a computer generated form and did not gather emergency treatment information related to the child's severe egg and milk allergy. (#1)

Correction Required: Emergency contact information must include information on the child's special needs, as specified by the child's parent, physician, physician's assistant or CRNP, which is needed in an emergency situation. Revise the form so that this information can be included as required or use the Department approved emergency contact information form which has a provision for this information. Ensure that this information is included in all children's records.

Noncompliance Area: One child's record lacked emergency contact information as specified in these regulations. (#1)

Correction Required: Emergency contact information is required for each enrolled child. Emergency contact information must reference who shall be contacted in an emergency. Obtain and submit the required emergency contact information for the identified child. Ensure that all children's records contain emergency contact information as specified in these regulations.

Noncompliance Area: One child's emergency contact information did not include the name, address and telephone number of the child`s physician or source of medical care. (#2)

Correction Required: Emergency contact information must include the name, address and telephone number of the child's physician or source of medical Obtain and submit a written copy of the missing health insurance information for the identified child. Ensure that all children's records contain emergency contact information as specified in these regulations care.

Noncompliance Area: One child's emergency contact information did not include health insurance coverage and policy number information. (#2)

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. Obtain and submit a written copy of the missing health insurance information for the identified child. Ensure that all children's records contain emergency contact information as specified in these

Noncompliance Area: One child has been enrolled for more than 60 days and their record did not contain a current, up-to-date health report. (#2)

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. Obtain and submit a current up-to-date health report for the indicated child. Ensure that all children's records include a current, up-to-date health report within 60 days of enrollment.

Noncompliance Area: One child has been enrolled for more than 60 days and their record did not include written verification of current up-to-date immunizations. (#2)

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). In accordance with the Department of Health regulations, the child cannot return to care until written verification of current up-to-date immunizations have been obtained and submitted. Submit a copy of the current up-to-date immunizations for the indicated child.

Noncompliance Area: One staff person's health assessment was not signed by a physician, physician's assistant or CRNP and did not include the individual's professional title. (#1)

Correction Required: 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. Obtain and submit a current up-to-date health assessment signed by a physician, physician's assistant or CRNP that includes the individual's professional title.

Noncompliance Area: On 11/27/17, a child sustained an injury and the facility failed to provide the parent a report of the incident on the day of the incident. (#1)

Correction Required: A child's record shall contain reports of accidents, injuries and illnesses involving a child in care at the facility. The original report shall be given to the parent on the day of the incident. The second copy of the report shall be retained at the facility in an accident file. The third copy of the report shall be retained at the facility in the child's file. Ensure that parents are provided the original report on the day of the incident. Revise and submit written policies and procedures to ensure that parents are provided the original incident report on the date of the incident.

Noncompliance Area: An aide was observed in a classroom caring for a group of 4 preschool age children alone and without being minimally supervised by an assistance group supervisor.(#2)

Correction Required: An aide or a combination of aides shall be supervised at all times by a staff person qualified at minimum as an assistant group supervisor. Aides cannot be left alone with children. Assign, minimally, an assistant group supervisor to supervise an aide at all times. Develop and submit written policies and procedures to ensure that an aide will never work alone with children and will be supervised at all times.

Noncompliance Area: One bathroom used by children lacked a lidded waste receptacle.

Correction Required: A toilet area, training chair area, diapering area and sink area shall be equipped with a clean, lidded waste receptacle. Obtain a lidded waste receptacle for the bathroom. Ensure that all bathrooms used by children contain a lidded waste receptacle.