Bullfrogs & Butterflies Child Care Center Inc

Regulation: 3270.113(a)

Description: Supervised at all times

Noncompliance Area: Per staff statements and video evidence on 5/7/26 at approximately 540pm Child #1 (See LIS Code Sheet) was left alone outside in the toddler play space by staff #1. Staff #1 came inside from the outside play space with another child at 540pm, clocked out at 542pm, and immediately left the building. At approximately 544pm, Staff #2 went outside to complete a final check for closing. This is when Child #1 was found alone in the play space.

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: Per staff statements and video evidence on 5/7/26 at approximately 540pm Child #1 (See LIS Code Sheet) was left alone outside in the toddler play space by staff #1. Staff #1 came inside from the outside play space with another child at 540pm, clocked out at 542pm, and immediately left the building. At approximately 544pm, Staff #2 went outside to complete a final check for closing. This is when Child #1 was found alone in the play space.

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: 3270.31(f)(10)

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

Noncompliance Area: Staff #1's file contained a pediatric first aid and CPR training dated 2/12/26 which is more than 90 days after date of hire(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.

Regulation: 3270.123(a)(3)

Description: Services proceeded

Noncompliance Area: Child #2's most recent child service report was dated 3/2025 which is more than 6 months ago.

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(a)/3270.182(1)

Description: Health information/Initial and subsequent health reports

Noncompliance Area: Child #1's initial health assessment is dated 10/2/25 which was more than 60 days after enrollment(See LIS Code Sheet).

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. A child's record shall contain initial and subsequent health reports.

Regulation: 3270.135(a)(3)

Description: Disposable diapers

Noncompliance Area: In the bathrooms of the treehouse room and the friendly forest room there were used diapers/pull ups in the trash cans that were not hands free.

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: Staff #1's two most recent health assessments are dated 3/1/23 and 4/11/25 which are more than 24 months apart. Staff #3's most recent health assessment is dated 10/25/23 which is 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. 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: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: Staff #2's two most recent NSOR certificates are dated 2/13/20 and 2/18/25, which are more than 60 months apart.

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

Regulation: 3270.75(c)

Description: Has all items

Noncompliance Area: The first aid kit in the beehive room was missing gauze and tape.

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: In the friendly forest room, the baseboard by the tall white shelf and the window was peeling. In the bathroom of the friendly forest room in the corner between the sink and the wall was used paper towels, dirt, and debris.

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: 3270.102(a)

Description: Clean and good repair

Noncompliance Area: In the friendly forest room, there was a cracked clear plastic bin that had rough edges.

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: 3270.66(a)

Description: Locked or inaccessible

Noncompliance Area: In the treehouse room on the brown shelf next to the ABC carpet was a can of Blaster Hand Sanitizer that stated keep out of reach of children 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: 3270.104(a)

Description: Clean, good repair, proper size

Noncompliance Area: In the friendly forest room one of the shelves on the small four cube shelf was broken.

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

Regulation: 3270.65

Description: Protective Outlet Covers 5 yrs. or less

Noncompliance Area: In the Sassafras room on the projector cart was a surge strip that was plugged into a power source that was missing protective outlet covers accessible to children. In the pond room there was a surge protector on the side of the refrigerator on a low table without protective outlet covers accessible to children.

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: In the friendly forest room the drawer of the diaper table was unlock and it contained diaper cream (Desitin, Triple paste, CeraVe) that stated keep out of reach of children 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: 3270.76

Description: Building Surfaces

Noncompliance Area: In the friendly forest room there was a low metal four cube shelf that had sharp corners without corner covers/guards. In the outside preschool playground area was plastic pavilion edging that was cracked with sharp edges and possible pinch points.

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: In the friendly forest room, there was damaged plaster by the play kitchen set. In the outside young toddler play area along the bottom of the window frame was peeling paint.

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

Regulation: 3270.81

Description: Glass

Noncompliance Area: In the friendly forest room there were multiple floor to ceiling windows that did not have a visual strip of other visual identification on the glass.

Correction Required: A visual strip or other visual identification shall be placed on glass located in a traffic area, a child care space or a play space.

Regulation: 3270.82(e)

Description: Toilet and sinks proper height

Noncompliance Area: At approximately 10am on 9/29/25 it was observed in the butterfly room that the staff person was holding an infant over the sink to wash the infant's hands.

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: 3270.192(2)(iv)

Description: Transcript, diploma and letters

Noncompliance Area: The file for Staff #1 lacked proof of qualifications for education in the form of a diploma, transcript, or letter signed by a representative or the experiential, educational or training entity.

Correction Required: A facility person's record shall include acceptable verification of experience, education or training is a transcript or a diploma or a letter signed by a representative of the experiential, educational or training entity.

Regulation: 3270.192(5)

Description: Two written references

Noncompliance Area: The file for Staff #1, lacked two written, nonfamily references from individuals attesting to the suitability to serve as a facility person.

Correction Required: A facility person's record shall include two written, nonfamily references from individuals attesting to the person's suitability to serve as a facility person.

Regulation: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: The file for Staff #1 contained a Child Abuse Clearance that was obtained three days after their first day caring for children. The file for Staff #1 lacked a signed 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. TIERED LIS: 1. The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). 2. The owner and assistant director will attend in-person Existing Provider Training on Oct 22, 2025.

Regulation: 3270.133(5)

Description: Original label

Noncompliance Area: On 5/14/25, in the facility's medication cabinet in the kitchen was Genexa which had expired on 4/2025, Hylands Cough and Mucus had expired on 4/2025, Triamcinolone had expired on 8/2024, and Zarbee's Cough Syrup and Mucus had expired on 7/2024, therefore they were not in accordance with the manufacturer's original label.

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

Regulation: 3270.14/3270.21

Description: Pertinent Laws & Regulations/General Health and Safety

Noncompliance Area: On 5/14/25 Staff person #3 was observed to be caring for children unsupervised. Staff person #3 has not completed the following pre- service training required prior to caring for children unsupervised: PA Required Health and Safety for Centers-Group Child Care Part 1.

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. Until such time as the required pre- service trainings are completed, staff person #3 must be supervised, when interacting with children at a minimum by, an AGS who has completed all preservice trainings and has all qualifications to care for children unsupervised. If there are no staff person(s) available to supervise staff person #3, staff person #3 may not work in a child-care position at the

Regulation: 3270.31(f)

Description: Health and Safety Training

Noncompliance Area: On 5/7/25 it was observed that Staff person #1 has completed Pediatric first aid and CPR training, however the training was not completed through a Pennsylvania Quality Assurance System (PQAS) approved curriculum and the trainer has not provided documentation that they are PQAS-certified in that training curriculum.

Correction Required: Staff persons shall complete professional development within 90 days of hire as listed in subsections (f)1-10 or (g)1-10. Until such time as the required training has been completed, staff person #1 must be supervised, when interacting with children at a minimum by, an AGS who has completed all preservice trainings and has all qualifications to care for children unsupervised. If there are no staff person(s) available to supervise staff person #1, staff person #1 may not work in a child-care position at the facility.

Regulation: 3270.32(a)

Description: Comply with CPSL

Noncompliance Area: On 5/7/25 Staff #2's file 2 most recent mandated reporter trainings are dated 2/11/20 and 4/15/25 which is more than 60 months apart.

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: On 5/14/25 Staff #3 was observed unsupervised with children without an NSOR certificate in their file.

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 the disclosure statement and a copy of the completed clearance information required under the CPSL. Facility Person #3 may not work in a child care position at the facility.

Regulation: 3270.65

Description: Protective Outlet Covers 5 yrs. or less

Noncompliance Area: On 5/7/25, In the treehouse room a protective outlet cover was missing from the outlet outside the bathroom. On 5/14/25 in the Friendly Forest a protective outlet cover was missing from an outlet next to the diaper table.

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

Regulation: 3270.113(a)

Description: Supervised at all times

Noncompliance Area: On 4/15/25 at approximately 3:15 pm, Staff #3 was supervising 8 preschool aged children in the Beehive room. Staff #3 was observed to leave the room 3 times, taking children's nap mats to a storage area located in the hallway. Once the staff returned to the room, at least one child was permitted to leave the room unsupervised to take their nap mat to the storage area located in the hallway.

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: Continued Noncompliance: On 4/15/25 at approximately 3:15 pm, Staff #3 was supervising 8 preschool aged children in the Beehive room. Staff #3 was observed to leave the room 3 times, taking children's nap mats to a storage area located in the hallway. Once the staff returned to the room, at least one child was permitted to leave the room unsupervised to take their nap mat to the storage area located in the hallway. Previously cited on 7/9/24; 10/21/24; 11/22/24 & 1/29/25.

Correction Required: TIERED LIS: 1. 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. 2. The Legal Entity will require all staff at the facility to attend a 2 hour minimum, in person training regarding supervision of children presented by ELRC 4 within 3 months of the approval of this plan of correction. The Legal Entity will submit the training to the Department for approval prior to implementation. The training may count towards the mandatory 12 training hours required by the Department. Documentation of training for each staff will be submitted to the department within 10 days of the completion of the training. 3. The Legal Entity will require the operator, director and any staff persons who have a leadership role to participate in monthly, on site, Technical Assistance (TA) sessions with ELRC 4 for a minimum of 4 months. The TA sessions will include defining staff leadership roles in the childcare, identifying methods that each role can utilize to ensure staff understand and are implementing proper supervision of all of the children in care. Documentation of each TA session will be submitted to the Department within 10 days of the completion of the session.

Regulation: 3270.182(7)

Description: Reports of accidents, injuries and illnesses. Original report - parent same day Copy - facility accident file. Copy - child's file

Noncompliance Area: The parent was not given the injury report on the day of the incident, 3/28/25. The file for Child #1 lacked an injury report for 3/28/25. The incident report retained in the facility's accident file was incomplete.

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.

Regulation: 3270.51

Description: Similar Age Level

Noncompliance Area: On 4/15/25 at approximately 3:15 pm, Staff #3 was supervising 8 preschool aged children in the Beehive room. Staff #3 was observed to leave the room 3 times, taking children's nap mats to a storage area located in the hallway. Once the staff returned to the room, at least one child was permitted to leave the room unsupervised to take their nap mat to the storage area located in the hallway.

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: 3270.113(a)(1)

Description: Staff assigned to specific children

Noncompliance Area: At approximately 10:50am, Staff #1 and Staff #2 were observed to be supervising a group of 15 children in the preschool room. Staff #1 was able to name and identify 8 children in their group, Staff #2 identified 6 children in their group. One child was left out. Given a second attempt Staff #1 named and identified 8 children in their group and Staff #2 again named 6 children in their group. The same child was again left out. With the help from the certification representation the missing child was identified and added to Staff Person #1's group.

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: 3270.118(c)

Description: Vet's certificate required

Noncompliance Area: It was observed that there was a puppy in the preschool classroom which is the staff person's service dog and there was not any documentation of rabies immunization on file at the facility.

Correction Required: A veterinarian's certificate of current rabies immunization is required for a cat or dog at the facility. The certificate shall be on file when the cat or dog is present.

Regulation: 3270.102(a)

Description: Clean and good repair

Noncompliance Area: The Back 40 room was a clear crack bin with sharp edges on the shelf in the fenced in area of the 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: In the pond room the in the unlocked sink cabinet was loose unused garbage bags accessible to children still putting objects in their mouths. In the beehive room there were foam blocks that had teeth marks on them accessible to children still putting objects in their mouths.

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: 3270.104(a)

Description: Clean, good repair, proper size

Noncompliance Area: The tall cabinet near the emergency exit in the Back 40 was not securely attached causing it to be unstable when touched. In the Sassafras room the dress up shelf was not securely attached causing it to be unstable when touched.

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

Regulation: 3270.107

Description: Refrigerator

Noncompliance Area: The thermometer was missing from the refrigerator in the Butterfly 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: 3270.113(a)

Description: Supervised at all times

Noncompliance Area: At approximately 2pm on 11/22/24 in the back 40 room it was observed that Staff #6 was sitting by the bathroom on one side of the room, the children were napping on the other side of the room behind the fence with 2 children around the corner unable to be seen. At approximately 2:10pm on 11/22/24 in the beehive room staff #8 was on one end of the room by the entrance, there were 3 children napping at the other end of the room around the corner unable to be seen.

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: At approximately 2pm on 11/22/24 in the back 40 room it was observed that Staff #6 was sitting by the bathroom on one side of the room, the children were napping on the other side of the room behind the fence with 2 children around the corner unable to be seen. At approximately 2:10pm on 11/22/24 in the beehive room staff #8 was on one end of the room by the entrance, there were 3 children napping at the other end of the room around the corner unable to be seen.

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: 3270.119

Description: Infant sleep position

Noncompliance Area: At approximately 915am an infant was observed to be asleep in a rocker that was placed in a crib.

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.

Regulation: 3270.123(a)

Description: Signed

Noncompliance Area: Child #1's financial agreement was not signed by the operator.

Correction Required: An agreement shall be signed by the operator and the parent.

Regulation: 3270.123(a)(3)

Description: Services proceeded

Noncompliance Area: The files for child # 1,3,4,5, and 6 contained child service reports with no date making them not acceptable, provider stated they were done in February which is still more than 6 months prior. Child #2 and 7's file contained child service reports dated 2/2024 which is more than 6 months prior.

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: 3270.124(c)

Description: Each child care space

Noncompliance Area: In the back 40 room one the emergency contact information was missing from the room for one child that was in care.

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.

Regulation: 3270.124(f)/3270.181(c)

Description: Updated every 6 months/Emergency info/agreement updated 6 mos

Noncompliance Area: Child #3's two most recent emergency information update signatures are 10/10/23 and 8/6/24 which are more than 6 months apart.

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. 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: 3270.131(a)/3270.182(1)

Description: Health information/Initial and subsequent health reports

Noncompliance Area: Child #5 initial health assessment is dated 2/23/24 which is more than 60 days after enrollment(See LIS Code Sheet).

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. A child's record shall contain initial and subsequent health reports.

Regulation: 3270.135(a)(3)

Description: Disposable diapers

Noncompliance Area: In the Back 40 room the bathroom trash can that was not hands free contained a used pulled up.

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: The facility did not have a policy to address the prevention and identification of child maltreatment. The emergency plan did not address the continuity of operations.

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(c)(1)/3270.192(3)

Description: Physical examination/Health assessment, TB test

Noncompliance Area: Staff #1's file did not contain a health assessment. Staff #3's two most recent health assessments are dated 8/29/22 and 10/31/24 which are more than 24 months apart. Staff #4's two most recent health assessments are dated 8/5/22 and 9/31/24 which are more than 24 months apart. Staff #7's file contained a health assessment that was dated 8/15/23, this assessment was marked that a physical examination was not conducted making this health assessment not valid.

Correction Required: An adult health assessment must include a physical examination. 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)/3270.192(3)

Description: Mantoux TB/Health assessment, TB test

Noncompliance Area: Staff #1's file did not contain a TB test.

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. 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)(5)

Description: Physician/CRNP assessment

Noncompliance Area: Staff #2 health assessment dated 10/26/23 did not state that the person was suitable 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.

Regulation: 3270.165

Description: Menus

Noncompliance Area: The menu was not posted in the facility.

Correction Required: An operator shall conspicuously post the menu at least 1 week in advance or provide a menu to each family.

Regulation: 3270.181(c)

Description: Emergency info/agreement updated 6 mos

Noncompliance Area: Child #3 financial agreement two most recent update signatures are dated 10/10/23 and 8/6/24 which is 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: 3270.192(5)

Description: Two written references

Noncompliance Area: Staff #1's file did not contain 2 written nonfamily references. Staff #4's file contained two reference letters from the same person.

Correction Required: A facility person's record shall include two written, nonfamily references from individuals attesting to the person's suitability to serve as a facility person.

Regulation: 3270.27(c)

Description: Training regarding plan

Noncompliance Area: Staff #2's two most recent emergency plan trainings are dated 7/27/23 and 10/15/24 which are more than 12 months apart.

Correction Required: The operator shall assure that each facility person receives training regarding the emergency plan at the time of initial employment, on an annual basis and at the time of each plan update. The operator shall document the date of each training and the names of all facility persons who received the training and kept on file at the facility.

Regulation: 3270.27(e)

Description: Letter to parents

Noncompliance Area: The facility did not have a letter to provide to the parent of each enrolled child explaining the emergency procedures.

Correction Required: The operator shall provide to the parent of each enrolled child a letter explaining the emergency procedures. The operator shall also provide to the parent of each enrolled child a letter explaining any subsequent update to the plan.

Regulation: 3270.31(e)

Description: Age and Training

Noncompliance Area: Staff file #2 lacked 5 of the 12 hours of annual child care training required from 12/2022 to 12/2023. Staff file #2 contained 5 child care training hours dated 2/5/24, 3/12/24, and 4/29/24 used for correction. Staff file #4 lacked 5 of the 12 hours of annual child care training required from 12/2022 to 12/2023. Staff file #4 contained 5 child care training hours dated 3/23/24, 5/24/24, and 5/24/24 used for correction.

Correction Required: A staff person shall obtain an annual minimum of 12 clock hours of child care training.

Regulation: 3270.31(e)(4)(ii)

Description: Fire safety - 1 yr.

Noncompliance Area: Staff #3's two most recent fire safety trainings are dated 1/26/23 and 6/8/24 which are more than 12 months apart.

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.

Regulation: 3270.31(f)(10)

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

Noncompliance Area: The file for staff person #7, was observed not to have completed pre-service training within 90 days of hire (See LIS CODE SHEET). Staff #7's file contained the online portion of the pediatric first aid/CPR training dated 9/4/23, the in-person portion of the training was not completed making this training not acceptable.

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)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: The file staff #1 did not contain documentation of the receipt of being fingerprinted for DHS FBI clearance before date of hire(See LIS Code Sheet) required for provisional hiring under the CPSL. The file for staff # 2 includes state police clearances dated 10/25/18 and 11/29/23, child abuse clearances dated 11/20/18 and 12/8/23, DHS FBI clearances dated 11/28/18 and 12/1/23, all more than 60 months apart. The file for staff #3 includes state police clearances dated 6/4/18 and 9/15/23, child abuse clearances dated 6/27/18 and 9/10/23, and DHS FBI clearances dated 6/21/18 and 10/24/23, all more than 60 months apart. The file for staff person #6 included a State Police clearance dated 10/18/24 and an NSOR certificate dated 10/31/24 which is more than 45 days after hire (See LIS Code Sheet) required for provisional hiring under the CPSL.

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.

Regulation: 3270.34(a)(6)

Description: Staff evaluations

Noncompliance Area: Staff #2 two most recent staff evaluations are dated 2/15/23 and 3/27/24 which are more than 12 months apart. Staff #5's, who was hired more than 12 months prior(See LIS Code Sheet), file did not contain a staff evaluation.

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

Regulation: 3270.65

Description: Protective Outlet Covers 5 yrs. or less

Noncompliance Area: In the bathroom of the friendly forest the outlet next to the sink area was cracked and missing a protective outlet cover.

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: In the treehouse room hand sanitizer and Purell sanitizing wipes, which stated keep out of reach of children, were sitting on top of a small refrigerator 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: 3270.74

Description: Emergency Numbers Posted

Noncompliance Area: The telephone number of the nearest hospital, police department, fire department, ambulance and poison control center were not posted by the telephone in the bunny borrow room.

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: In the toddler outside place space the green outdoor carpet is coming up causing a tripping 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.

Regulation: 3270.82(h)

Description: Handwashing signs

Noncompliance Area: The diaper table in the Back 40 room did not have a hand washing sign. In the Friendly Forest room, a hand washing sign was missing near the room sink. A handwashing sign was missing above the toilet in the Beehive 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: 3270.104(a)

Description: Clean, good repair, proper size

Noncompliance Area: The shelves that held nap time items for the beehive room were not attached to the wall making them unstable. The tall white cabinet in the beehive room was not attached to the wall making it unstable when touched.

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

Regulation: 3270.113(a)

Description: Supervised at all times

Noncompliance Area: Second citation previously cited on 7/9/24. At approximately 11:55am on 10/21/24 it was observed that a preschool age child from the treehouse room was sent across the hall to the bathroom alone to change their pull up.

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: Second citation previously cited on 7/9/24. At approximately 11:55am on 10/21/24 it was observed that a preschool age child from the treehouse room was sent across the hall to the bathroom alone to change their pull up.

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: 3270.14/3270.21

Description: Pertinent Laws & Regulations/General Health and Safety

Noncompliance Area: Second citation previously cited on 7/9/24. Staff #4 has not completed the health and Safety 1 hour update training by the required date of 12/30/22.

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(c)(1)/3270.192(3)

Description: Physical examination/Health assessment, TB test

Noncompliance Area: Staff #4 initial health assessment is dated 9/7/24 which is after their date of hire(See LIS Code Sheet). Staff #5 health assessment is dated 8/16/24 which is after their date of hire(See LIS Code Sheet). Staff #6's file did not contain an initial health assessment.

Correction Required: An adult health assessment must include a physical examination. 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)/3270.192(3)

Description: Mantoux TB/Health assessment, TB test

Noncompliance Area: Staff #4 file contain a TB test that is dated 9/7/24 which is after their date of hire(See LIS Code Sheet). Staff #5 TB test is dated 8/16/24 which is after their date of hire(See LIS Code Sheet). Staff #6's file did not contain a TB test.

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. 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: 3270.162(c)

Description: Not withheld as discipline

Noncompliance Area: Per staff statements, Staff #1 has taken food away from children many times when they are not finished eating during lunch. It was reported that Staff #1 will only give the children 5-8 minutes to eat lunch before she takes the children's plates away because she wants the children to lay down for nap so that she can leave the classroom. The children will be crying or saying that they are not done and are still hungry when this happens.

Correction Required: Food may not be withheld from a child for purposes of discipline.

Regulation: 3270.192(5)

Description: Two written references

Noncompliance Area: The files for staff #3 and #6 did not contain two written, nonfamily references from individuals attesting to the person's suitability to serve as a facility person.

Correction Required: A facility person's record shall include two written, nonfamily references from individuals attesting to the person's suitability to serve as a facility person.

Regulation: 3270.31(f)

Description: Health and Safety Training

Noncompliance Area: Second citation previously cited on 7/9/24, Staff #2's file contains a 6-hour health and safety training dated 9/11/16 which is not an acceptable training.

Correction Required: Staff person(s) shall complete professional development in the topics of 3270.31(f)(1-10) within 90 days of hire. Staff person #2 will have until 15 days from POC requested date to complete the required training. Until such time as the required training has been completed, staff person # 2 must be supervised, when interacting with children, by an AGS who has completed the required training related to this citation. If there are no staff available to supervise staff person #2, staff person #2 may not work in a child-care position at the facility.

Regulation: 3270.32(a)

Description: Comply with CPSL

Noncompliance Area: Second citation previously cited on 7/9/24. Staff #6 and 7 have not completed 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 Child Protective Services). Staff person #6 and #7 will have until 15 days from POC requested date to complete the mandated reporter training. Until such time as the required training has been completed, staff person #6 and #7 must be supervised, when interacting with children, by at least an AGS who has completed the required training related to this citation. If there are no staff person(s) available to supervise staff person #6 and #7, staff person #6 and #7 may not work in a child-care position at the facility.

Regulation: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: The file for staff #3 contained a child abuse clearance dated 6/10/24, state police clearance dated 2/28/24, and a DHS FBI clearance dated 3/1/24 all are dated after their date or hire(See LIS Code Sheet). The file for staff #4 contained a child abuse clearance dated after their start date with children(See LIS Code Sheet). The file for staff #5 did not contain a copy of the completed clearance information from Michigan required under the CPSL. The file for staff #6 did not contain a state police clearance, child abuse clearance, or a copy of the completed clearance information from Texas required under the CPSL.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). Facility Person # 5 and #6 may not work in a childcare position at the facility.

Regulation: 3270.36(b)(5)/3270.192(2)(ii)

Description: HS/GED + 2 yrs/Exp, educ., training prior to facility

Noncompliance Area: Staff #6, who was working as an AGS, had a file that did not contain verification of child care experience and education prior to service at the facility.

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.

Regulation: 3270.51

Description: Similar Age Level

Noncompliance Area: *Second citation previously cited on 7/9/24. At approximately 11:55am on 10/21/24 it was observed that a preschool age child from the treehouse room was sent across the hall to the bathroom alone to change their pull up.

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: 3270.51

Description: Similar Age Level

Noncompliance Area: **Second citation previously cited on 7/9/24. At approximately 11:55am on 10/21/24 it was observed that a preschool age child from the treehouse room was sent across the hall to the bathroom alone to change their pull up.

Correction Required: **The legal entity or legal entity representative will conduct ratio and supervision checks in all classrooms at least three times a week for a period of 4 months after the date this plan of correction is accepted. The classroom checks will be documented on a form pre-approved by the department and will remain onsite for review by a representative of the department during a minimum of at least 3 unannounced monitoring visits. The legal entity will review the classroom check forms on a weekly basis and will sign off on each form.

Regulation: 3270.65

Description: Protective Outlet Covers 5 yrs. or less

Noncompliance Area: In the pond room a pink power strip accessible to children was missing protective outlet covers. In the treehouse room 2 outlet covers were missing accessible to children: one by the refrigerator and one by the children's eating tables.

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: In the upstairs hallway next to the bathroom on a low cart accessible to children was Febreze Air Mist which stated keep out of reach of 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: 3270.75(c)

Description: Has all items

Noncompliance Area: The first aid kit in the Back 40 room and the Friendly Forest room were missing adhesive bandages. The first aid kit in the Sassafras room was missing gauze.

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: 3270.95(a)/3270.95(b)

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

Noncompliance Area: The fire alarm testing log contained the following dates: 10/19/23-11/20/23, 12/18/23-1/29/24, 2/19/24-3/22/24, 4/18/24-5/24/24, and 7/12/24-8/19/24 which are more than 30 days apart.

Correction Required: Fire detection devices or systems must be in compliance with standards established under section 1016(c) of the act (62 P.S. §  1016(c)). The Director or designated staff person who is responsible for compliance with this chapter shall ensure the requirements under subsection (a) are met.

Regulation: 3270.113(a)

Description: Supervised at all times

Noncompliance Area: *Per staff statements, staff #1 has placed child #1 in the bathroom with the door closed on multiple occasions. It was reported that the child was placed in the bathroom to stop the child from hitting or biting other children when the staff was changing diapers and also when the child was not behaving.

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)

Description: Supervised at all times

Noncompliance Area: **Per staff statements, staff #1 has placed child #1 in the bathroom with the door closed on multiple occasions. It was reported that the child was placed in the bathroom to stop the child from hitting or biting other children when the staff was changing diapers and also when the child was not behaving.

Correction Required: **The legal entity will conduct a staff meeting within two months of the approval of this plan of correction. Supervision, ratio and appropriate discipline of children will be reviewed. The staff meeting agenda will also include a review of any supervision and ratio citations made by the Department within the last 12 months. The legal entity will create a dated agenda for the staff meeting and a signed attendance sheet for the meeting. The agenda and signed attendance sheet will be provided to the OCDEL-DHS representative by email within 7 days of completion of the staff meeting.

Regulation: 3270.113(a)(1)

Description: Staff assigned to specific children

Noncompliance Area: Per staff statements, staff #1 has placed child #1 in the bathroom with the door closed on multiple occasions. It was reported that the child was placed in the bathroom to stop the child from hitting or biting other children when the staff was changing diapers and also when the child was not behaving.

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: 3270.113(b)

Description: No physical punishment

Noncompliance Area: *Per staff statements and observation of classroom video footage, on 6/25/24, staff #1, grabbed the hands of child #1 and pulled, then held the child in the staff's lap, after the child continued to leave the table the other children were sitting at to do an activity.

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

Regulation: 3270.113(b)

Description: No physical punishment

Noncompliance Area: **Per staff statements and observation of classroom video footage, on 6/25/24, staff #1, grabbed the hands of child #1 and pulled, then held the child in the staff's lap, after the child continued to leave the table the other children were sitting at to do an activity.

Correction Required: **The legal entity will require all staff persons at the facility to attend a, 2 hour in person training regarding managing challenging behaviors in children presented by the ELRC within 1 month of the approval of this plan of correction. The training must be approved by the Department prior to implementation. Documentation of the completed training will be provided to the OCDEL-DHS representative by email upon completion. The training may count towards the mandatory 12 training hours required by the Department.

Regulation: 3270.113(d)

Description: No harsh language

Noncompliance Area: Per staff statements, staff #1 has yelled at child #1 using harsh language, when the child is being redirected.

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

Regulation: 3270.113(e)

Description: Restraints prohibited

Noncompliance Area: Per staff statements and observation of classroom video footage, on 6/25/24, staff #1, grabbed the hands of child #1 and pulled, then held the child in the staff's lap, after the child continued to leave the table the other children were sitting at to do an activity. Staff #1 has placed child #1 in the bathroom with the door closed on multiple occasions. It was reported that the child was placed in the bathroom to stop the child from hitting or biting other children when the staff was changing diapers and also when the child was not behaving.

Correction Required: A facility person may not restrain a child by using bonds, ties or straps to restrict a child's movement or by enclosing the child in a confined space, closet or locked room. The prohibition against restraining a child does not apply to the use of adaptive equipment prescribed for a child with special needs.

Regulation: 3270.118(a)

Description: Pet in good health/friendly

Noncompliance Area: Per staff statements, the children have been allowed to play with a dog named Nola at the facility. While playing with the dog, child # 2, was bitten on the abdomen. Child # 3, was bitten on the shoulder. Staff described the incident with child #3 as a "nip."

Correction Required: A pet or animal present at the facility, indoors or outdoors, shall be in good health and known to be friendly to children.

Regulation: 3270.14/3270.21

Description: Pertinent Laws & Regulations/General Health and Safety

Noncompliance Area: The files for staff # 3 and #5 lacked the one-hour updated health and safety training course, Pennsylvania Health and Safety Update 2022 by the deadline of 12/30/22, as required by Announcement C-22-06.

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: 3270.182(7)

Description: Reports of accidents, injuries and illnesses. Original report - parent same day Copy - facility accident file. Copy - child's file

Noncompliance Area: Per staff statements and a file review, incident reports for the following incidents were not created: incident on 6/25/24 for child #1; dog bit incident for child #2 and child #3.

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.

Regulation: 3270.31(f)

Description: Health and Safety Training

Noncompliance Area: Staff # 1 has not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): Health and Safety, Pediatric First Aid and Pediatric CPR , and Mandated Reporter Training. Staff # 2 has not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): Health and Safety, and Pediatric First Aid and Pediatric CPR .

Correction Required: Staff person(s) shall complete professional development in the topics of 3270.31(f)(1 -- 10) within 90 days of hire. Staff person #1 & #2 will have until 10/12/24 to complete the required training. Until such time as the required training has been completed, staff person #1 & #2 must be supervised, when interacting with children, by an AGS who has completed the required training related to this citation. If there are no staff available to supervise staff person #1 & #2, staff person #1 & #2 may not work in a child-care position at the facility.

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

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

Noncompliance Area: Staff person #4 has not completed mandated reporter training within the last 60 months. This is evidenced by the previously documented mandated reporter training on file being dated 7/5/19.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to Child Protective Services). Staff person #4 will have until 10/12/24 to complete the mandated reporter training. Until such time as the required training has been completed, staff person #4 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 person(s) available to supervise staff person #4, staff person #3 may not work in a child-care position at the facility.

Regulation: 3270.51

Description: Similar Age Level

Noncompliance Area: Per staff statements, staff #1 has placed child #1 in the bathroom with the door closed on multiple occasions. It was reported that the child was placed in the bathroom to stop the child from hitting or biting other children when the staff was changing diapers and also when the child was not behaving.

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: 3270.31(f)

Description: Health and Safety Training

Noncompliance Area: Staff person #1 has not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet):Pediatric First Aid, Health and Safety, and Mandated Reporter Training. Staff person #2 has not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet):Health and Safety

Correction Required: Staff person(s) shall complete professional development in the topics of 3270.31(f)(1 -- 10), 3280.31(f) (1-10), or 3290.31(g) (1-10) within 90 days of hire. Staff person #1 and 2 will have until July 5. 2024 to complete the required training. Until such time as the required training has been completed, staff person #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 person #1 and 2, staff person #1 and 2 may not work in a child-care position at the facility.

Regulation: 3270.113(a)

Description: Supervised at all times

Noncompliance Area: On March 11, 2024, from approximately 11:20 A.M. -- 11:25 A.M. three (3) Pre School-Children were on the outdoor play space in an area not visible to staff. The three (3) children were not properly supervised and the three (3) children were seen on video with their pants down touching each other's private areas. At 11:25 A.M., a staff person who witnessed this incident alerted another staff person on the outdoor play space and it was stopped.

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.