Carol Leone Gymnastics And Daycare

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 of Child #1 did not receive an Incident Report on 8.26.25, following a noticed bruise on Child #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.

Regulation: 3270.102(a)

Description: Clean and good repair

Noncompliance Area: In the Grasshopper Room, in the clear, plastic bin containing Barbie Dolls, which was approximately 24" x 18", the plastic was broken, which created a scraping/cutting hazard for children in care.

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: 3270.124(b)(3)

Description: Parent home/work address, phone

Noncompliance Area: The file for Child #1 did not include the enrolling parent's work phone number.

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

Regulation: 3270.133(6)/3270.133(7)

Description: Written consent/Medication log

Noncompliance Area: In the Dragonfly B Room, the Medication Log for Child #2 had expired, and the medication was still available for administering to the child, without valid, written parental consent.

Correction Required: A parent shall provide written consent for administration of medication or a special diet. An operator is responsible to establish and maintain a medication log if prescription or nonprescription medication is administered.

Regulation: 3270.151(a)/3270.192(3)

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

Noncompliance Area: The two (2) most recent Health Assessments in the file for Staff #9, Staff #12, and Staff #22 exceeded the 24-month renewal requirement.

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

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

Noncompliance Area: The file for Staff #1 contained documentation of four (4) hours of child care training between 12.19.23 and 12.18.24, which did not meet the annual minimum of 12 hours. The file for Staff #2 contained documentation of two (2) hours of child care training between 11.4.23 and 11.3.24, which did not meet the annual minimum of 12 hours. The file for Staff #3 contained documentation of four (4) hours of child care training between 12.19.23 and 12.18.24, which not meet the annual minimum of 12 hours. The file for Staff #5 contained documentation of two (2) hours of child care training between 12.19.23 and 12.18.24, which did not meet the annual minimum of 12 hours. The file for Staff #7 contained documentation of two (2) hours of child care training between 12.19.23 and 12.18.24, which did not meet the annual minimum of 12 hours. The file for Staff #8 contained documentation of three (3) hours of child care training between 12.19.23 and 12.18.24, which did not meet the annual minimum of 12 hours. The file for Staff #9 contained documentation of eight (8) hours of child care training between 12.19.23 and 12.18.24, which did not meet the annual minimum of 12 hours. The file for Staff #14 contained documentation of four (4) hours of child care training between 12.19.23 and 12.18.24, which did not meet the annual minimum of 12 hours. The file for Staff #16 contained documentation of four (4) hours of child care training between 12.19.23 and 12.18.24, which did not meet the annual minimum of 12 hours. The file for Staff #17 contained documentation of eight (8) hours of child care training between 11.8.23 and 11.7.24, which did not meet the annual minimum of 12 hours. The file for Staff #19 contained documentation of seven (7) hours of child care training between 12.19.23 and 12.18.24, which did not meet the annual minimum of 12 hours. The file for Staff #20 contained documentation of one (1) hour of child care training between 8.25.24 and 8.24.25, which did not meet the annual minimum of 12 hours. The file for Staff #21 contained documentation of six (6) hours of child care training between 8.1.24 and 7.31.25, which did not meet the annual minimum of 12 hours. The file for Staff #22 contained documentation of two (2) hours of child care training between 12.19.23 and 12.18.24, which did not meet the annual minimum of 12 hours. The file for Staff #23 contained documentation of four (4) hours of child care training between 12.19.23 and 12.18.24, which did not meet the annual minimum of 12 hours.

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

Regulation: 3270.32(a)

Description: Comply with CPSL

Noncompliance Area: The file for Staff #6 (see IS Code Sheet) contained an NSOR Certificate dated 8.5.25, which exceeded the start date with children. The file for Staff #8 contained NSOR Certificates dated 9.25.19 and 4.9.25, which exceeded the 60-month renewal requirement. The file for Staff #9 contained FBI Clearances dated 2.12.19 and 3.18.24, and NSOR Certificates dated 11.1.19 and 11.5.24, which exceeded the 60-month renewal requirement. The file for Staff #10 (see IS Code Sheet) contained an NSOR Certificate dated 7.30.25, which exceeded the start date with children. The file for Staff #11 (see IS Code Sheet) contained an NSOR Certificate dated 3.13.25, which exceeded the start date with children. The file for Staff #13 (see IS Code Sheet) contained an NSOR Certificate dated 3.18.25, which exceeded the start date with children. The file for Staff #14 contained Child Abuse Clearances dated 9.28.19 and 4.18.25, FBI Clearances dated 10.2.19 and 10.25.24, and NSOR Certificates dated 11.1.19 and 4.9.25, which exceeded the 60-month renewal requirement. The file for Staff #16 contained Child Abuse Clearances dated 7.8.19 and 8.1.24, and NSOR Certificates dated 11.21.19 and 4.10.25, which exceeded the 60-month renewal requirement. The file for Staff #18 (see IS Code Sheet) contained an NSOR Certificate dated 3.25.25, which exceeded the start date with children. The file for Staff #19 contained NSOR Certificates dated 11.6.19 and 4.10.25, which exceeded the 60-month renewal requirement. The file for Staff #23 contained FBI Clearances dated 12.31.18 and 2.13.24, and NSOR Certificates dated 10.9.19 and 12.9.24, which exceeded the 60-month renewal requirement. The file for Staff #24 contained NSOR Certificates dated 9.29.19 and 4.10.25, which exceeded the 60-month renewal requirement.

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

Regulation: 3270.65

Description: Protective Outlet Covers 5 yrs. or less

Noncompliance Area: In the Staff Lounge Room, a power strip which was located to the left of Drawer #1, was missing three (3) of the six (6) receptacle covers, which were accessible to children 5 years of age or younger. In the Indoor Gym, two (2) outlet covers were missing from the outlet to the left of the mirror wall, which were accessible to children 5 years of age or younger.

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

Regulation: 3270.66(a)

Description: Locked or inaccessible

Noncompliance Area: In an unlocked cupboard in the Dragonfly A Room, the following toxics were accessible to children: 2 Oxi-Clean Carpet & Rug Spray (24 oz. each), 2 Dawn Dishwashing Liquid (5.8 oz. and 90 oz.), Sani Save Cleaner Spray, Clorox Wipes (1 lb. 7oz.), Lysol Cleaner Spray (32 oz.), 2 Windex Spray (23 oz. and 32 oz.), Members Mark Hand Soap (80 oz.), Super Sorb (12 oz.), Oxy-Steam Carpet (96 oz.), Scrubbing Bubbles (25 oz.), and 70% Isopropyl Alcohol (32 oz.), all of which stated, "Keep out of reach of children." In an unlocked drawer in the Staff Lounge Room, the following toxics were accessible to children: Diluted Bleach and Sani Save, 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: 3270.66(b)

Description: Original container

Noncompliance Area: In the white cupboard, on the back wall in the Caterpillar Room, there was a spray bottle marked Changing Table, with unknown contents.

Correction Required: Cleaning materials and other toxic materials shall be stored in an original labeled container or in a container that specifies the content. Toxics shall be stored away from food, food preparation areas and child care spaces.

Regulation: 3270.75(b)

Description: Inaccessible to children

Noncompliance Area: In the Dragonfly A Room, the first-aid kit was located in a drawer with a broken latch, which made the first-aid kit accessible to children. In the Staff Lounge Room, the first-aid kit was located in unlocked drawer #4, which was accessible to children.

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

Regulation: 3270.76

Description: Building Surfaces

Noncompliance Area: In the Staff Lounge Room, on the blue wall, peeling wallpaper was located near the baseboard.

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 Roly Polies Nap Room, on the left side of the wall, white paint was flaking near the baseboard.

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

Regulation: 3270.82(h)

Description: Handwashing signs

Noncompliance Area: A handwashing sign was not posted at the toilet in the Bumble Bee Annex restroom.

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: 3270.113(b)

Description: No physical punishment

Noncompliance Area: Based on discussion with staff and video evidence, on 7/16/2025, staff #1 picked child #1 up off the floor by their arm and carried the child by the arm approximately 3 to 4 yards to another area of the classroom. This occurred after Child #1 was believed to have bitten or pinched another child in the classroom.

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

Regulation: 3270.14/3270.21

Description: Pertinent Laws & Regulations/General Health and Safety

Noncompliance Area: Staff persons #1 and #2 were observed to be caring for children together in the Bumblebees Annex classroom unsupervised. Staff person #1 has not completed the following pre- service training required prior to caring for children unsupervised: Pediatric first aid and pediatric CPR Staff person #2 has not completed the following pre- service training required prior to caring for children unsupervised: Pediatric first aid and pediatric CPR, mandated reporter and health and safety topics

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 persons #1 and #2 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 and #2, staff persons #1 and #2 may not work in a child-care position at the facility.

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/CPR training.

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: Staff person #1 has not completed 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). 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: 3270.113(a)

Description: Supervised at all times

Noncompliance Area: During the supervision and ratio check a sleeping infant aged child was left in the Rolly Polly Left Side room sleeping alone, while staff person was in Rolly Polly Right Side room with 3 other infants. This left the child in the Rolly Polly Left Side Room unsupervised.

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(e)

Description: Restraints prohibited

Noncompliance Area: Staff #1 put his arms and upper body over child #1 to restrict his movement on his cot.

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: 3270.51

Description: Similar Age Level

Noncompliance Area: During the supervision and ratio check a sleeping infant aged child was left in the Rolly Polly Left side room sleeping alone, while staff person was in Rolly Polly Right side room with 3 other infants. This made the ratio in the Rolly Polly Left side room 0:1.

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: 3270.102(a)

Description: Clean and good repair

Noncompliance Area: Mats, located in the Dance Floor room, contained rips and exposed foam, which were not in good repair.

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: Several small stones, less than 1 inch in diameter, were located in the Toddler Play Area, and were accessible to children who are still placing 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: 3270.123(a)

Description: Signed

Noncompliance Area: The Agreement, in the file for Child #5, did not contain the signature of the operator.

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

Regulation: 3270.123(a)(4)

Description: Arrival/departure times

Noncompliance Area: The Agreement, in the file for Child #1, did not specify the child's arrival or departure times.

Correction Required: An agreement shall specify the child's arrival and departure times.

Regulation: 3270.124(b)(2)

Description: Physician name, address, phone

Noncompliance Area: The Emergency Contact form, in the files for Child #2 and Child #3, did not contain the phone number of the child's physician or source of medical care.

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

Regulation: 3270.124(e)

Description: Written emergency plan posted

Noncompliance Area: An Emergency Transportation Plan was not displayed in the Dragonfly A or Dance Floor rooms.

Correction Required: A written plan identifying the means of transporting a child to emergency care and staffing provisions in the event of an emergency shall be displayed conspicuously in every child care space and shall accompany a staff person who leaves on an excursion with children.

Regulation: 3270.131(b)(2)/3270.182(1)

Description: Toddler/preschool: updated health report every 12 months/Initial and subsequent health reports

Noncompliance Area: The Health Assessment, in the file for Child #4, was dated 6.30.23, and none thereafter, which exceeded the 12-month requirement.

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

Regulation: 3270.133(5)

Description: Original label

Noncompliance Area: In the Butterflies Room, expired medication was observed: Infant Tylenol which expired on 8/24, Equate Children's Pain Reliever which expired on 7/24, and Ibuprofen 100-Dye Free which expired on 6/24.

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

Regulation: 3270.151(c)(2)/3270.192(3)

Description: Mantoux TB/Health assessment, TB test

Noncompliance Area: The file for Staff #18 (see IS Code Sheet) did not contain documentation of a tuberculosis screening at initial re-employment, as the one in the file is dated 6.3.16.

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

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

Noncompliance Area: The file for Staff #1 did not contain 12 hours of child care training during 12 months, as only 8 hours were documented from 12.19.22 to 12.18.23. The file for Staff #2 did not contain 12 hours of child care training during 12 months, as only 10 hours were documented from 12.19.22 to 12.18.23. The file for Staff #4 did not contain 12 hours of child care training during 12 months, as only 6 hours were documented from 12.19.22 to 12.18.23. The file for Staff #5 did not contain 12 hours of child care training during 12 months, as only 6 hours were documented from 6.13.23 to 6.12.24. The file for Staff #6 did not contain 12 hours of child care training during 12 months, as only 6 hours were documented from 12.19.22 to 12.18.23. The file for Staff #8 did not contain 12 hours of child care training during 12 months, as only 6 hours were documented from 12.19.22 to 12.18.23. The file for Staff #11 did not contain 12 hours of child care training during 12 months, as only 6 hours were documented from 5.23.23 to 5.22.24. The file for Staff #12 did not contain 12 hours of child care training during 12 months, as only 6 hours were documented from 12.19.22 to 12.18.23. The file for Staff #13 did not contain 12 hours of child care training during 12 months, as only 6 hours were documented from 12.19.22 to 12.18.23. The file for Staff #14 did not contain 12 hours of child care training during 12 months, as only 8 hours were documented from 12.19.22 to 12.18.23. The file for Staff #15 did not contain 12 hours of child care training during 12 months, as only 8 hours were documented from 12.19.22 to 12.18.23. The file for Staff #19 did not contain 12 hours of child care training during 12 months, as only 6 hours were documented from 12.19.22 to 12.18.23. The file for Staff #20 did not contain 12 hours of child care training during 12 months, as only 6 hours were documented from 12.19.22 to 12.18.23. The file for Staff #21 did not contain 12 hours of child care training during 12 months, as only 6 hours were documented from 12.19.22 to 12.18.23. The file for Staff #22 did not contain 12 hours of child care training during 12 months, as only 11 hours were documented from 8.30.23 to 8.29.24.

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

Regulation: 3270.32(a)

Description: Comply with CPSL

Noncompliance Area: The file for Staff #3 (see IS Code Sheet) contained an NSOR Certificate dated 4.8.24, with no application available, which exceeded the first date of working with children. The file for Staff #7 (see IS Code Sheet) contained an NSOR application dated 7.8.24, which exceeded the first date of working with children. The files for Staff #7 (see IS Code Sheet) and Staff #9 (see IS Code Sheet) did not contain any out-of-state clearances, and the 45-day provisional hire period has been exceeded. The file for Staff #10 (see IS Code Sheet) contained an FBI Clearance dated 4.5.24, and an NSOR Certificate dated 5.20.24, with no application available, which exceeded the first date working with children. The file for Staff #13 contained Child Abuse Clearances dated 4.26.19 and 5.1.24, which exceeded the 60-month renewal requirement. The file for Staff #17 contained an invalid FBI Clearance dated 8.19.24, as it was not issued by DHS, and the previous one dated 9.3.19 has expired. The file for Staff #18 did not contain a valid FBI Clearance.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). Staff #7, Staff #9, Staff #17, and Staff #18 may not work in a child care position at the facility.

Regulation: 3270.74

Description: Emergency Numbers Posted

Noncompliance Area: Emergency telephone numbers were not posted by the telephone in the Dance Floor 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: 3270.75(c)

Description: Has all items

Noncompliance Area: The First-Aid kit, located in the Dance Floor room, did not contain band-aids.

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: Sharp, loose wire, at the bottom of the fence along the road-side, in the Infant Play Area, created a scraping/cutting hazard for children in care. A hole was located on the surface of the Infant Play Area, which created a tripping hazard for children in care.

Correction Required: Floors, walls, ceilings and other surfaces, including the facility's outdoor play space surfaces shall be kept clean, in good repair and free from visible hazards.

Regulation: 3270.77(a)

Description: No peeling paint or plaster

Noncompliance Area: Peeling paint was located by the door frames in the Toddler Play Area.

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

Regulation: 3270.76

Description: Building Surfaces

Noncompliance Area: The electrical box, mounted approximately 4' high, in Room #2-#3, had sharp, metal corners, creating a scraping/cutting hazard for children in care.

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: 3270.107

Description: Refrigerator

Noncompliance Area: A thermometer was not located in the refrigerator in the Staff Lounge, child care space.

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: 3270.123(a)(4)

Description: Arrival/departure times

Noncompliance Area: The Agreement, in the file for Child #1, did not contain the arrival and departure times.

Correction Required: An agreement shall specify the child's arrival and departure times.

Regulation: 3270.151(a)/3270.192(3)

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

Noncompliance Area: The file for Staff #2 (see IS Code Sheet) contained a Health Assessment dated 9.12.22 and a Mantoux test reading on 9.9.22, which was beyond initial service. The file for Staff #3 contained Health Assessments dated 7.30.20 and 8.17.22, which exceeded the 24-month renewal requirement. The file for Staff #5 (see IS Code Sheet) contained a Health Assessment dated 8.7.22 and a Mantoux test reading on 9.4.22, which was beyond initial service. The file for Staff #7 contained Health Assessments dated 5.11.20 and 8.24.22, which exceeded the 24-month renewal requirement. The file for Staff #8 contained Health Assessments dated 7.9.20 and 9.12.22, which exceeded the 24-month renewal requirement. The file for Staff #10 contained Health Assessments dated 2.16.21 and 9.29.23, which exceeded the 24-month renewal requirement. The file for Staff #12 contained Health Assessments dated 6.3.21 and 7.31.23, which exceeded the 24-month renewal requirement. The file for Staff #19 contained Health Assessments dated 8.26.21 and 8.30.23, which exceeded the 24-month renewal requirement. The file for Staff #20 (see IS Code Sheet) contained a Health Assessment dated 9.19.22, and a Mantoux test reading dated 9.15.22, which was beyond initial service. The file for Staff #21 (see IS Code Sheet) contained a Health Assessment dated 8.30.22, and a Mantoux test reading on 8.30.22, which was beyond initial service. The file for Staff #22 contained Health Assessments dated 12.9.20 and 8.24.23, which exceeded the 24-month renewal requirement. The file for Staff #23 contained Health Assessments dated 6.11.20 and 9.13.22, which exceeded the 24-month renewal requirement. The file for Staff #26 contained Health Assessments dated 12.9.20 and 4.20.23, which exceeded the 24-month renewal requirement. The file for Staff #28 contained Health Assessments dated 2.23.21 and 7.20.23, which exceeded the 24-month renewal requirement. The file for Staff #29 (see IS Code Sheet) contained a Health Assessment and Mantoux test reading dated 8.29.22, which was beyond initial service. The file for Staff #31 (see IS Code Sheet) contained a Mantoux test reading dated 11.23.22, which was beyond initial service. The file for Staff #32 (see IS Code Sheet) contained a Health Assessment dated 11.21.22, which was beyond initial service. The file for Staff #33 (see IS Code Sheet) contained a Health Assessment dated 12.14.22 and a Mantoux test reading dated 12.21.22, which was beyond initial service.

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: 3270.27(c)/3270.192(2)(iii)

Description: Training regarding plan/Exp, educ., training at facility

Noncompliance Area: The most recent Emergency Plan trainings in the files for Staff #1, Staff #2, Staff #4, Staff #8, Staff #9, Staff #10, Staff #11, Staff #16, Staff #19, Staff #21, Staff #24, Staff #28, and Staff #34 were dated 8.23.23, while the previous Emergency Plan trainings were dated more than a year prior to that date. The most recent Emergency Plan trainings in the files for Staff #3, Staff #5, Staff #6, Staff #7, Staff #12, Staff #13, Staff #14, Staff #17, Staff #18, Staff #20, Staff #25, Staff #26, and Staff #27 were dated 8.21.23, while the previous Emergency Plan trainings were dated more than a year prior to that date. The most recent Emergency Plan training in the file for Staff #15 was dated 8.18.23, while the previous Emergency Plan training was dated more than a year prior to that date. The most recent Emergency Plan training in the files for Staff #22 and Staff #29 were dated 8.28.23, while the previous Emergency Plan trainings were dated more than a year prior to that date. The most recent Emergency Plan training in the file for Staff #23 was dated 8.24.23, while the previous Emergency Plan training was dated more than a year prior to that date.

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. A facility person's record shall include verification of child care experience, education and training following the outset of service at the facility.

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

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

Noncompliance Area: The file for Staff #33 contained documentation of Pediatric First-Aid/CPR training dated 4.2.21 and 9.1.23, which exceeded the renewal requirement.

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

Regulation: 3270.31(f)(10)

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

Noncompliance Area: The files for Staff #5, Staff #6, Staff #20, and Staff #29 (see IS Code Sheet), contained documentation of Pediatric First-Aid/CPR training on 9.2.22, which exceeded 90 days of hire. The files for Staff #30 and Staff #31 (see IS Code Sheet), contained documentation of Pediatric First-id/CPR training on 9.1.22, which exceeded 90 days of hire.

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

Regulation: 3270.32(a)

Description: Comply with CPSL

Noncompliance Area: The file for Staff #2 (see IS Code Sheet) contained an NSOR Certificate dated 7.1.22, and an Application dated 6.24.22, which exceeded initial service. The file for Staff #5 (see IS Code Sheet) contained an NSOR Certificate dated 7.18.22 and an Application for the NSOR dated 6.9.22, and the Mandated Reporter training was dated 9.3.22 (see IS Code Sheet), which exceeded the requirements. The file for Staff #21 (see IS Code sheet) contained an FBI Clearance dated 11.10.17, which expired on 11.10.22, and was not renewed until 7.20.23, which exceeded the 60-month renewal requirement. The file for Staff #22 (see IS Code Sheet) contained an NSOR Certificate dated 11.21.19 and an NSOR Application dated 9.23.19, which exceeded initial service. The file for Staff #29 (see IS Code Sheet) contained an NSOR Certificate dated 6.21.22 and an NSOR Application dated 6.9.22, which exceeded initial service. The file for Staff #30 (see IS Code Sheet) contained a Child Abuse Clearance dated 11.15.22, which exceeded initial service. The file for Staff #33 (see IS Code Sheet) contained a Child Abuse Clearance dated 6.20.18, which expired on 6.20.23, and was not renewed until 7.25.23, which exceeded the 60-month renewal requirement. The FBI Clearance was dated 6.19.18, which expired on 6.19.23, and was not renewed until 7.20.23, which exceeded the 60-month renewal requirement.

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

Regulation: 3270.34(a)(6)

Description: Staff evaluations

Noncompliance Area: The files for Staff #2, Staff #3, Staff #4, Staff #5, Staff #6, Staff #9, Staff #10, Staff #11, Staff #13, Staff #15, Staff #16, Staff #18, Staff #19, Staff #20, Staff #22, Staff #23, Staff #24, Staff #25, Staff #26, Staff #27, Staff #28, and Staff #29, (see IS Code Sheet) contained documentation of Staff Evaluations dated 8/2023, which exceeded the 12-month requirement, since the previous written evaluations were dated more than a year prior to the current written evaluations.

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: 3270.75(c)

Description: Has all items

Noncompliance Area: Scissors were not located in the first-aid kit in Room 2/Annex.

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: 3270.82(h)

Description: Handwashing signs

Noncompliance Area: In Room 3/Butterflies, a handwashing sign was not posted at the toilet.

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: 3270.18(b)

Description: Report claims to DHS

Noncompliance Area: In January 2022, when the Legal Entity became aware of an insurance claim, the LE did not report the information to DHS.

Correction Required: The operator shall report to the Department liability insurance claims brought against the operator or a facility person.

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

Description: Exemption documentation from parent/guardian/Initial and subsequent health reports

Noncompliance Area: The Immunization Record, in the files for Child #1 and Child #2, did not contain documentation of the Influenza Vaccine, according to the ACIP recommendations.

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

Regulation: 3270.151(a)/3270.192(3)

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

Noncompliance Area: The file for Staff #9 (see IS Code Sheet) contained a Health Assessment dated 8.29.22, which exceeded the "start" date.

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: 3270.25(a)

Description: Availability of certificate of compliance and applicable regulations

Noncompliance Area: No information was provided to parents, of enrolled children, with information on how to access the regulations in this chapter electronically.

Correction Required: The facility's current certificate of compliance shall be posted in a conspicuous location used by parents. The operator shall provide the parent of each child enrolled with information on how to access the regulations in this chapter electronically and with instructions for contacting the appropriate regional child care office.

Regulation: 3270.31(f)(10)

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

Noncompliance Area: Staff #2 (see IS Code Sheet) has not completed the following required pre-service training within 90 days of their date of hire: Pediatric First-Aid/CPR.

Correction Required: Staff persons shall complete professional development in pediatric first aid and pediatric cardiopulmonary resuscitation within 90 days of hire. Staff #2 will have until 11.11.22 to complete the required training. Until such time as the required training has been completed, Staff #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 #2, Staff #2 may not work in a childcare position at the facility.

Regulation: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: The file for Staff #3 (see IS Code Sheet), contained a Child Abuse Clearance dated 5.4.22, which was after date of hire.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). A facility person's record shall include a copy of requests for the criminal history record and child abuse registry clearance information, a copy of the disclosure statement and a copy of the completed clearance information required under the CPSL.

Regulation: 3270.34(a)(6)

Description: Staff evaluations

Noncompliance Area: The file for Staff #1 contained a written evaluation dated 8.16.21, and none thereafter, which has exceeded the 12-month requirement. The files for Staff #4, Staff #5, Staff #6, and Staff #7 contained written evaluations dated 8.20.21, and none thereafter which has exceeded the 12-month requirement. The file for Staff #9 contained a written evaluation dated 9.1.21, and none thereafter, which has exceeded the 12-month requirement.

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: 3270.76

Description: Building Surfaces

Noncompliance Area: The asphalt surface on the playground, under the movable picnic table, was raised and crumbled, approximately five (5) feet, which created a tripping/falling hazard for children in care. The asphalt/cement surface on the playground, under and around the sand table structure, was uneven, which created a tripping/falling hazard for children in care. Along the playground fence, broken asphalt and cement were observed, along with multiple holes, which created a tripping/falling hazard for children in care. The playground surface, surrounding the sewer caps, was uneven/cracked, which created a tripping/falling hazard for children in care.

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: 3270.106(f)

Description: 2 feet apart

Noncompliance Area: Observed in the Infant Porch Room: Infant rocker and infant pop-up play mat, which obstructed two sides of a crib where an infant was napping.

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: 3270.111(b)

Description: Posted in group space

Noncompliance Area: The daily activity schedule was not posted in the Infant Nap Room or Infant Porch Room.

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

Regulation: 3270.124(b)(6)

Description: Insurance coverage information

Noncompliance Area: The emergency contact form in the file for Child #1 did not include the policy number for the child's health insurance coverage.

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.

Regulation: 3270.124(e)

Description: Written emergency plan posted

Noncompliance Area: The Emergency Transportation Plan was not posted in the Infant Nap Room.

Correction Required: A written plan identifying the means of transporting a child to emergency care and staffing provisions in the event of an emergency shall be displayed conspicuously in every child care space and shall accompany a staff person who leaves on an excursion with children.

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

Description: Exemption documentation from parent/guardian/Initial and subsequent health reports

Noncompliance Area: The most recent immunization record in the file for Child #2 did not include documentation of a flu shot administered within the past 12 months or a letter of exemption from the parent or physician.

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

Regulation: 3270.151(a)/3270.192(3)

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

Noncompliance Area: The most recent health assessments in the file for Staff Person #2 exceeded 24 months between assessments.

Correction Required: A facility person providing direct care who comes into contact with the children or who works with food preparation shall have a health assessment conducted within 12 months prior to providing initial service in a child care setting and every 24 months thereafter. A health assessment is valid for 24 months following the date of signature, if the person does not contract a communicable disease or develop a medical problem. A facility person's record shall include a written report of initial and subsequent health assessments, including the results of initial and subsequent tuberculin skin tests, x-rays or other medical documentation necessary to confirm freedom from communicable tuberculosis.

Regulation: 3270.192(5)

Description: Two written references

Noncompliance Area: The file for Staff Person #4 contained only one letter of reference. The file for Staff Person #7 lacked two letters of 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

Regulation: 3270.27(a)(5)

Description: Emergency plan

Noncompliance Area: The facility's Emergency Plan did not include 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.

Regulation: 3270.27(c)/3270.192(2)(iii)

Description: Training regarding plan/Exp, educ., training at facility

Noncompliance Area: The annual Emergency Plan Training for the facility exceeded 12 months between trainings: June 2020-July 2021. The initial Emergency Plan Training in the file for Staff Person #6 (July, 2021) was conducted more than one week after the Staff Person's first day working in child care(5/17/21).

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. A facility person's record shall include verification of child care experience, education and training following the outset of service at the facility.

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

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

Noncompliance Area: The Pediatric First Aid/CPR Certification for staff hired prior to 12/19/20 expired on 8/30/21. New certification date for these staff was 9/3/21.

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

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

Description: Fire safety - 1 yr./Exp, educ., training at facility

Noncompliance Area: Annual Fire Safety Training was conducted at the facility was conducted on 9/3/21. This exceeded 12 months for 13 of the staff who had completed the approved online training during the pandemic in 2020.

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. A facility person's record shall include verification of child care experience, education and training following the outset of service at the facility.

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

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

Noncompliance Area: The initial Pediatric First Aid/CPR Training in the file for Staff Person #3 was conducted after the 6/30/21 deadline for staff hire prior to 12/19/21 (9/3/21). The initial Pediatric First Aid/CPR Training in the file for Staff Person #6 (9/3/21) was conducted more than 90 days after the staff person's start date (5/17/21). The files for Staff Person #3 and #6, who have been working for more than 90 days, did not include documentation of Health and Safety Training.

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

Regulation: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: The file for Staff Person #4, who was hired as a Group Supervisor, contained a Volunteer Child Abuse clearance. The NSOR Certificate in the file for Staff Person #5 was dated 7/30/21, which was after the 45-day provisional hire end date (7/15/21). The file for Staff Person #6, whose provisional hire end date was 7/1/21, lacked an NSOR Certificate. The application for NSOR (8/27/21) in the file for Staff Person #7 was after the Staff Person's start date (8/19/21). For this reason, Staff Person #7 cannot be considered a provisional hire. The file for Staff Person #7 did not include a Child Abuse Clearance.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). A facility person's record shall include a copy of requests for the criminal history record and child abuse registry clearance information, a copy of the disclosure statement and a copy of the completed clearance information required under the CPSL. Facility Person #4, 6 and 7 may not work in a child care position at the facility.

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

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

Noncompliance Area: The file for Staff Person #7 did not include documentation of education and experience.

Correction Required: A staff person or a substitute staff person shall meet one of the applicable staff qualifications for the position in which the person is performing.A facility person's record shall include verification of child care experience, education and training prior to service at the facility.

Regulation: 3270.34(a)(6)

Description: Staff evaluations

Noncompliance Area: The first written evaluation in the file for Staff Person #1 was conducted 8/16/21, more than 12 months after the staff person's first day working in child care (6/22/20).

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: 3270.75(c)

Description: Has all items

Noncompliance Area: The first aid kit in the Brown Bears B playground bag lacked gloves. The first aid kit for Room 5 lacked 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: The baseboard in the Infant Porch Room was peeling. Observed ladders and maintenance equipment in the Indoor Gym.

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: Observed peeling, flaking paint on the outer door frame in the Brown Bears A Room.

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

Regulation: 3270.95(a)/3270.95(b)

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

Noncompliance Area: The facility has not documented monthly fire system checks for the interconnected smoke detection systems at the facility. The facility did not have a receipt on file for the interconnected smoke detector system in the Infant House.

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

Noncompliance Area: Child #1, child #2 and child #3 had agreements that did not specify the date on which the fee is to be paid.

Correction Required: An agreement shall specify the date on which the fee is to be paid.

Noncompliance Area: Child #1, child #2 and child #3 had agreements that lacked the services to be provided to the family and the child.

Correction Required: The services to be provided to the family and the child, including the Department's approved form to provide information to the family about the child's growth and development in the context of the services being provided. The operator shall complete and update the form and provide a copy to the family in accordance with the updates regarding emergency contact information in 3270.124(f) (relating to emergency contact information).

Noncompliance Area: Child #1, child #2, and child #3 had agreements that did not specify the child's arrival and departure times.

Correction Required: An agreement shall specify the child's arrival and departure times.

Noncompliance Area: Child #1, child #2, and child #3 had agreements that did not specify the persons designated by a parent to whom the child may be released.

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

Noncompliance Area: Child #4 had an emergency contact form that lacked the addresses of the individuals designated by the parent to whom the child may be released.

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

Noncompliance Area: There was no written parental consent for the staff to administer a child's epi-pen medication found in Room 3.

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

Noncompliance Area: Staff person #4 had a health assessment that was not signed by a physician, physician's assistant or CRNP.

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.

Noncompliance Area: Staff person #4 had a health assessment that did not include an examination for communicable diseases and the results of that examination.

Correction Required: An adult health assessment must include an examination for communicable diseases and the results of that examination.

Noncompliance Area: Staff person #4 had a health assessment that did not include the physician's or CRNP's assessment of the person's suitability to provide child care.

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

Noncompliance Area: Child #1, child #2, and child #3 had a record that did not contain signed parental consent for administration of minor first-aid procedures by facility staff.

Correction Required: A child's record shall contain signed parental consent for administration of minor first-aid procedures by facility staff. Written consent is required prior to admission.

Noncompliance Area: Staff person #3, with a documented start date with children of 10-3-19, had a mandated reporter training that was dated 8-31-20. The training was obtained after the required time frame as designated by the CPSL.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services).A facility person's record shall include verification of child care experience, education and training following the outset of service at the facility.

Noncompliance Area: Staff person #1, with a documented start date with children of 5-6-19, had an NSOR verification dated 8-18-20 which was obtained after the required time frame as designated by the CPSL. Staff person #2 and Staff person #4 lacked the required out of state clearances.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). Facility Person # 2 and #4 may not work in a child care position at the facility.A facility person's record shall include a copy of requests for the criminal history record and child abuse registry clearance information, a copy of the disclosure statement and a copy of the completed clearance information required under the CPSL.

Noncompliance Area: Staff person #4, classified as an Assistant Group Supervisor, lacked proof of childcare experience.

Correction Required: A staff person or a substitute staff person shall meet one of the applicable staff qualifications for the position in which the person is performing.A facility person's record shall include verification of child care experience, education and training prior to service at the facility.

Noncompliance Area: There was an uncovered outlet on the wall behind a high chair in Room 1.

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

Noncompliance Area: The first aid kit in room 1A lacked soap.

Correction Required: A first-aid kit must contain the following: soap, an assortment of adhesive bandages, sterile gauze pads, tweezers, tape, scissors and disposable, nonporous gloves.

Noncompliance Area: The wooden trim on the door frame in the Brown Bear B room was detached in several places causing sharp nails to be accessible to children. The gym area outside of Room 3 was under construction causing the following hazards to be accessible to children: splintered wood on the floor, loose cords stretched across the floor, and an electrical conduit stretched across the floor.

Correction Required: Floors, walls, ceilings and other surfaces, including the facility's outdoor play space surfaces shall be kept clean, in good repair and free from visible hazards.

Noncompliance Area: There was chipping and damaged paint on the wall in several areas under the mirror near the baseboard in Room 5.

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

Noncompliance Area: There was no visual strip or other visual identification on the glass doors that lead from the gym to the outdoor play area.

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.

Noncompliance Area: An exit door leading from Room 3 into the adjacent room was obstructed by a stack of cots, a child sized chair, and a child resting on a cot.

Correction Required: Stairways, hallways, exits from rooms, exits from the facility and other means of egress serving as an exit shall be unobstructed.

Noncompliance Area: There was splintered wood on the handles to the wooden step stool at the handwashing sinks in Room 1B and Room 1A. There was a crack on the mirror in Room 1 causing the mirror to be in disrepair. There was a plastic bench on the infant outdoor play area on which there was a piece of broken plastic on the leg causing sharp edges to be accessible to the children.

Correction Required: Toys, play equipment and other indoor and outdoor equipment used by the children shall be clean, in good repair and free from rough edges, sharp corners, pinch and crush points, splinters and exposed bolts.

Noncompliance Area: There was a foam block with teeth marks and small chunks missing from it accessible to children who are still placing objects in their mouths in Room 1B.

Correction Required: Toys and objects with a diameter of less than 1 inch, objects with removable parts that have a diameter of less than 1 inch, plastic bags and styrofoam objects may not be accessible to children who are still placing objects in their mouths.

Noncompliance Area: There was a stuffed animal attached to a pacifier that an infant was using while sleeping in a crib in the upstairs infant room.

Correction Required: Toys, bumper pads, or pillows may not be present in a crib while an infant is sleeping in the crib.

Noncompliance Area: There was a dried sticky substance and food debris on the lower shelf of the refrigerator in Room 1A. There was food debris on the shelves of the refrigerator in Room 3.

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

Noncompliance Area: There were no written instructions from the medical provider for a child's epi-pen. A large portion of the prescription label on the epi-pen was ripped off causing the label to not be legible.

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

Noncompliance Area: Staff person #2 had a previous health assessment dated 9-14-17 and a current health assessment dated 9-16-19.

Correction Required: A facility person providing direct care who comes into contact with the children or who works with food preparation shall have a health assessment conducted within 12 months prior to providing initial service in a child care setting and every 24 months thereafter. A health assessment is valid for 24 months following the date of signature, if the person does not contract a communicable disease or develop a medical problem.

Noncompliance Area: Staff person #2 had a health assessment that documented that the staff person had a communicable disease.

Correction Required: An adult health assessment must include an examination for communicable diseases and the results of that examination.