Children Of America Warminster Llc

Regulation: 3270.134(a)

Description: Child's hands washed

Noncompliance Area: Observed on 4/14/2026 Continue non-compliance observed on 4/2/2026 staff #1 was completing a diaper change and after completing the diaper change staff #1 did not handwash children's hands after being diapered.

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

Regulation: 3270.134(a)

Description: Child's hands washed

Noncompliance Area: Observed 4/2/2026 Staff #1 was completing a diaper change and after completing the diaper change staff #1 did not handwash children's hands after being diapered.

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

Regulation: 3270.135(b)

Description: Surfaces cleaned

Noncompliance Area: Observed 4/2/2026 Staff #1 did not clean the diaper changing surfaces after diapering by wiping the surface with a sanitizing solution or by changing a pad or other surface coverings.

Correction Required: Diaper changing surfaces shall be cleaned after each use by wiping the surface with a sanitizing solution or by changing a pad or other surface covering.

Regulation: 3270.152

Description: Adult Hygiene

Noncompliance Area: Observed 4/2/2026 Staff #1 was completing a diaper change and after completing the diaper change staff #1 did not wash their hands after being diapering children.

Correction Required: A facility person shall wash his hands before meals and snacks, and after toileting and after diapering a child.

Regulation: 3270.192(5)

Description: Two written references

Noncompliance Area: Observed 4/2/2026 staff #2 file 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: 3270.65

Description: Protective Outlet Covers 5 yrs. or less

Noncompliance Area: Observed 4/2/2026 in School Age classroom there were missing electrical outlet covers in the childcare space where it's 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)/3270.66(b)

Description: Locked or inaccessible/Original container

Noncompliance Area: Observed 4/2/2026 in School Age Classroom there was disinfectant solution mixed in a spray bottle located in the childcare area where children handwash their hands that was not locked or made inaccessible to children. In Pre K B classroom bathrooms, there was baby wipes located in the bathroom not locked or made inaccessible 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. 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: 3270.76

Description: Building Surfaces

Noncompliance Area: Observed 4/2/2026 in Preschool B 2 classroom bathroom the base board heaters did not have a protect covering that prevent direct contact from children placing their hands or other items inside the heaters. In Pre K B classroom bathroom wall boarder was dislodged not in good repair and free from visible hazards.

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: 3270.124(b)(6)

Description: Insurance coverage information

Noncompliance Area: Observed 8/20/2025 child #5 file did not include the health insurance coverage policy number on the emergency contact form.

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(b)(7)

Description: Name/address/phone release person

Noncompliance Area: Observed 8/20/2025 children # 2 & 4 file were missing the names and addresses of the individual designated by the parent to whom the child may be released to on the emergency contact form.

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.

Regulation: 3270.124(f)/3270.181(c)

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

Noncompliance Area: Observed 8/20/2025 Child # 1 file were missing a periodic review of their emergency contact and agreement forms.

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(b)(2)

Description: Toddler/preschool: updated health report every 12 months

Noncompliance Area: Observed 8/20/2025 children files #3 did not contain an updated health report on file. Child # 3 last physical was 6/27/2024.

Correction Required: The operator shall require the parent to provide an updated health report at least every 12 months for an older toddler or preschool child.

Regulation: 3270.133(3)

Description: Name on bottle

Noncompliance Area: Observed 8/20/2025Child #6 Diazepam medication was not labeled with child's name on it to whom the medication is to be administered to.

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

Regulation: 3270.178

Description: Transportation First Aid Kit

Noncompliance Area: Observed 8/20/2025 on vehicle #1 first aid kit did not include Tweezers, scissors or water.

Correction Required: A first-aid kit, including the contents as specified in §3270.75 (relating to first-aid kit) shall be in the vehicle when children are being transported.

Regulation: 3270.66(a)

Description: Locked or inaccessible

Noncompliance Area: Observed 8/20/2025 in School Age classroom there was "shaving cream" labeled keep out the reach of children in a cabinet in the classroom unlocked and made inaccessible 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: 3270.75(c)

Description: Has all items

Noncompliance Area: Observed 8/20/2025 Preschool I & Preschool II (A) classrooms were missing items from first aid kit. Preschool I first aid kit were missing gloves. Preschool II (A) first aid kit were missing tweezers.

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: Observed 8/20/2025 Two's B bathroom the base board heaters do not have a protect covering that prevent direct contact from children placing their hands or other items inside the heaters.

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: 3270.124(b)(6)

Description: Insurance coverage information

Noncompliance Area: Observed 8/16/2023 children #4, 5, and 8 file was missing health insurance coverage policy number from emergency contact form.

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(b)(7)

Description: Name/address/phone release person

Noncompliance Area: Observed 8/16/2023 child file # 1,2,3,5,7 and 8 emergency contact form were missing the addresses of the individual 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.

Regulation: 3270.124(f)/3270.181(c)

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

Noncompliance Area: Observed 8/16/2023 Child # 6 file was missing a periodic review/update on their emergency contact information.

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(b)(2)

Description: Toddler/preschool: updated health report every 12 months

Noncompliance Area: Observed 8/16/2023 children #4, and 6 file were missing an updated health report on file, the current health report on file dated 5/26/2022 (child #4), & 6/15/2022 (child#6). An updated health report is to be provided at least every 12 months for an older toddler or preschool child.

Correction Required: The operator shall require the parent to provide an updated health report at least every 12 months for an older toddler or preschool child.

Regulation: 3270.131(e)/3270.131(e)(2)(i)

Description: ACIP recommended immunization record /Exemption documentation from parent/guardian

Noncompliance Area: Observed On 8/16/2023 observed child #6 file did not contain an exemption letter for the vaccination (influenza) not completed in accordance with the schedule recommended by the ACIP.

Correction Required: The facility may not accept or retain an infant 2 months of age or older, a toddler or a preschool child at the facility for more than 60 days following the first day of attendance at the facility unless the parent provides written verification from a physician, physician's assistant, CRNP, the Department of Health or a local health department of the dates (month, day and year) the child was administered immunizations in accordance with the recommendations of the ACIP. Exemption from immunization for religious belief or strong personal objection equated to a religious belief shall be documented by a written, signed and dated statement from the child's parent or guardian. The statement shall be kept in the child's record.

Regulation: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: Observed 8/16/2023 The file for staff # 1,2 and 3 does not contain a completed DHS required NSOR clearance. The requirement to have the completed DHS required clearances on file was not met. Each staff member has passed their provisional hire date.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). LACKING REQUIRED HIRING DOCUMENTS: Facility Person # 1,2 and 3 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. Facility Person # 1,2 and 3 may not work in a child care position at the facility.

Regulation: 3270.14/3270.21

Description: Pertinent Laws & Regulations/General Health and Safety

Noncompliance Area: At the time of unannounced monitoring inspection, staff person #1 in Toddler A room and staff person #4 in Preschool room were observed to be caring for children unsupervised. Staff person #1 has not completed following pre-service training required prior to caring for children unsupervised: Pediatric First Aid and CPR training as well as CCDBG health and safety professional development.

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 #1 and #4 must be supervised, when interacting with children by an assistant group supervisor, who has completed the required training related to this citation. If there are no staff person's available to supervise, staff person #1 and #4 may not work in a child-care position at the facility.

Regulation: 3270.151(a)/3270.192(3)

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

Noncompliance Area: At the time of unannounced monitoring inspection, file of staff person #1 did not include an initial health assessment with TB results. File of staff person #3 included a health assessment with dated signature from 8/7/20 that was not valid since it was conducted more than 24 month 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: 3270.151(c)(2)/3270.192(3)

Description: Mantoux TB/Health assessment, TB test

Noncompliance Area: At the time of unannounced monitoring inspection, file of staff person #2 did not include the results of initial or subsequent tuberculin skin tests, x-rays or other medical documentation necessary to confirm freedom from communicable tuberculosis.

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: 3270.192(2)(i)

Description: Age

Noncompliance Area: At the time of unannounced monitoring inspection, file of staff person #2 did not include verification of age.

Correction Required: A facility person's record shall include verification of age.

Regulation: 3270.192(2)(ii)

Description: Exp, educ., training prior to facility

Noncompliance Area: At the time of unannounced monitoring inspection, file of staff person #5 did not include verification of child care experience, education and training prior to service at the facility.

Correction Required: A facility person's record shall include verification of child care experience, education and training prior to service at the facility.

Regulation: 3270.192(5)

Description: Two written references

Noncompliance Area: At the time of unannounced monitoring inspection, file of staff person #1, #4 and #5 did not include two written, nonfamily references from individuals attesting to the person's suitability to serve as a facility person. File of staff person #3 included only one written, nonfamily reference 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: 3270.27(c)

Description: Training regarding plan

Noncompliance Area: At the time of unannounced monitoring inspection, files of staff person #1, #2, #4 and #5 did not include verification that staff received training regarding the emergency plan at the time of initial employment.

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: 3270.31(e)(4)(ii)

Description: Fire safety - 1 yr.

Noncompliance Area: At the time of unannounced monitoring inspection, file for staff person #3 did not include verification that staff participated in fire safety training at least annually.

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: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: At the time of unannounced monitoring inspection file of staff person #1 did not include verification of complete DHS required FBI clearance and NSOR certificate while working unsupervised in Toddler A room as well as signed Disclosure Statement. File of staff person #5, who was hired provisionally, did not include verification of complete Child Abuse Clearance and complete PA State police or complete DHS required FBI clearance. File of staff person #5 did not include verification of request for NSOR certificate.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). LACKING REQUIRED HIRING DOCUMENTS: Staff Person #5 may not work in a child care position at the facility. PROVISIONAL HIRE UNSUPERVISED: A provisional employee may not be permitted to work alone with children and must work within the vicinity of a permanent employee. A facility person's record shall include a copy of requests for the criminal history record and child abuse registry clearance information, a copy of the disclosure statement and a copy of the completed clearance information required under the CPSL. Staff Person # 5 must be removed from child care position by close of business. Complete PA state police or DHS required FBI clearance must be obtained before staff person #5 may resume a child care position.

Regulation: 3270.34(a)(6)

Description: Staff evaluations

Noncompliance Area: At the time of unannounced monitoring inspection, file of staff member #3 did not include an annual 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: 3270.34(b)(3)/3270.192(2)(ii)

Description: Associate's + 3 yrs/Exp, educ., training prior to facility

Noncompliance Area: At the time of unannounced monitoring inspection, file of staff person #2 did not include verification of child care experience required for the position of a director.

Correction Required: A director shall have attained an associate's degree from an accredited college or university in early childhood education, child development, special education, elementary education or the human services field and 3 years of experience with children. A facility person's record shall include verification of child care experience, education and training prior to service at the facility.

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

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

Noncompliance Area: At the time of unannounced monitoring inspection, file of staff person #1 did not include verification of prior child care experience required for the position of an assistant group supervisor.

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: 3270.113(b)

Description: No physical punishment

Noncompliance Area: During the complaint investigation it was seen by two staff that staff person #1 was physically handling children in an inappropriate manner causing them to fall on two separate occasions.

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

Regulation: 3270.113(d)

Description: No harsh language

Noncompliance Area: During the time of the complaint investigation two staff overheard staff person #1 using demeaning and harsh language with children such as " I hate you", "You irritate me", "Shut up", "Get away from me".

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

Regulation: 3270.124(a)

Description: Each child emergency contact person

Noncompliance Area: Observed 8/29/2022 child #8 file did not contain an emergency contact information form.

Correction Required: Emergency contact information is required for each enrolled child. Emergency contact information must reference who shall be contacted in an emergency.

Regulation: 3270.131(b)(2)

Description: Toddler/preschool: updated health report every 12 months

Noncompliance Area: Observed 8/29/2022 child #2, 5, and 6 were missing an updated health report on file, the current health report on file dated 8/16/2019 (child #2), 12/1/2020 (child #5) & 6/11/2021(child#6). An updated health report is to be provided at least every 12 months for an older toddler or preschool child.

Correction Required: The operator shall require the parent to provide an updated health report at least every 12 months for an older toddler or preschool child.

Regulation: 3270.131(d)(8)

Description: Age appropriate screenings complete

Noncompliance Area: Observed 8/29/2022 child #5 health report did not contain the age-appropriate screenings recommended by the American Academy of Pediatrics were conducted since the time of the previous health report.

Correction Required: A health report shall include a statement that age-appropriate screenings recommended by the American Academy of Pediatrics were conducted since the time of the previous health report required by this section.

Regulation: 3270.151(a)

Description: 12 months prior to service and every 24 months thereafter

Noncompliance Area: Observed 8/29/2022 staff # 1 and 2 files were missing health assessment. Staff # 3 medical assessment dated for 8/7/2020, the medical assessment exceeded the 24-month of the signature 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.

Regulation: 3270.166(4)

Description: Bottles labeled

Noncompliance Area: Observed 8/29/2022 Toddlers A and Preschool II classroom in refrigerators bottles were not labeled to identify which bottle belong to which child.

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

Regulation: 3270.181(c)

Description: Emergency info/agreement updated 6 mos

Noncompliance Area: Observed 8/29/2022 Child # 2,4,5,6, and 7 files did not contain verification of a periodic 6 month review in emergency contact.

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(3)

Description: Health assessment, TB test

Noncompliance Area: Observed 8/29/2022 staff files #1 and 2 were missing initial TB shot in files when reviewed.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.

Correction Required: 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(4)

Description: CPSL information

Noncompliance Area: Observed 8/29/2022 staff # 2 did not include a copy of National Sex Offender Registry in their file, a copy of the completed clearance information are required under the CPSL. Staff #1 Mandated reporter training was not included in file when reviewed.

Correction Required: A facility person's record shall include a copy of requests for the criminal history record and child abuse registry clearance information, a copy of the disclosure statement and a copy of the completed clearance information required under the CPSL. Facility Person #1 & 2 may not work in a child care position at the facility.

Regulation: 3270.192(5)

Description: Two written references

Noncompliance Area: Observed 8/29/2022 staff #4 file 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(e)

Description: Age and Training

Noncompliance Area: Observed 8/29/2022 staff # 1, 2, 3, and 4 did not contain annual minimum of 12 clock hours of child care training.

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

Regulation: 3270.34(a)(6)

Description: Staff evaluations

Noncompliance Area: Observed 8/29/2022 staff # 1 ,2, 3 and 4 files did not contain an annual written 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: 3270.75(c)

Description: Has all items

Noncompliance Area: Observed 8/29/2022 Preschool I & Preschool II classrooms were missing items from first aid kit. Preschool I first aid kit were missing gloves. Preschool II first aid kit were missing tweezers and scissors.

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: Observed 8/29/2022 Pre K- A bathroom the base board heaters were damaged and it does not protect covering that prevent direct contact from children placing their hands or other items inside the heaters.

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: 3270.81

Description: Glass

Noncompliance Area: Observed 8/29/2022 Toddlers A classroom area near the exit, the glassing of the door was uncovered without a visible strip in the childcare space.

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: 3270.95(a)

Description: Devices must be compliant

Noncompliance Area: Observed 8/29/2022 facility failed to provide proof of purchase of interconnected fire detection system and did not complete an attestation form.

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)).

Regulation: 3270.105

Description: High Chairs

Noncompliance Area: During the renewal inspection on 9/16/21, it was observed that the high chairs in the Toddler A and Infant A classrooms did not have a T-shaped safety strap

Correction Required: High chairs shall have a wide base and a T-shaped safety strap.

Regulation: 3270.67(d)

Description: Contaminated trash in closed plastic-lined receptacle

Noncompliance Area: During the renewal inspection on 9/16/21, it was observed that the trash cans in the Pre-K B room were not closed receptacles

Correction Required: Trash that has been contaminated by human secretions or excrement shall be contained in closed, plastic-lined receptacles.

Regulation: 3270.76

Description: Building Surfaces

Noncompliance Area: During the renewal inspection on 9/16/21, it was observed that the vents in the school age room was dusty and grey in appearance

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: During the renewal inspection on 10/27/20 it was observed that the records of staff person #1 did not include tuberculosis screening by the Mantoux method at initial employment

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.

Noncompliance Area: During the renewal inspection on 10/27/20 it was observed that the records of staff person #1 did not include an examination for communicable diseases and the results of that examination and the physician's or CRNP's assessment of the person's suitability to provide child care.

Correction Required: An adult health assessment must include an examination for communicable diseases and the results of that examination. An adult health assessment must include the physician's or CRNP's assessment of the person's suitability to provide child care.

Noncompliance Area: During the renewal on 10/27/20, it was observed that the records of staff person #1 did not include information on medical problems that might threaten the health of the children or prohibit a staff person from providing adequate care to children.

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

Noncompliance Area: During the renewal inspection on 10/27/20, it was observed that the records of staff person #4 did not include fire safety training conducted by a fire protection professional

Correction Required: Staff persons shall participate, at least annually, in fire safety training conducted by a fire protection professional. Staff persons and volunteers shall receive training in maintenance of smoke detectors, the duties of facility persons during a fire drill and during a fire and the use of the facility's fire extinguishers, not including discharge of the fire suppressant agent.

Noncompliance Area: During the renewal inspection on 10/27/20, it was observed that the records of staff person #2 and staff person #3 did not include an updated written evaluation of staff persons -evaluations presented were dated 10/16/19 and 10/11/19 respectively.

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

Noncompliance Area: During the renewal inspection on 10/27/20 it was observed that there was no hand washing sign indicating that an able child shall wash his hands after toileting and before eating in the Toddler B and Pre-School 1 rooms

Correction Required: A facility person and an able child shall wash his hands after toileting and before eating. A sign on which this requirement is written shall be posted at each toilet, training chair, diapering area and sink in the facility.

Noncompliance Area: During the renewal inspection on 10/27/20, it was observed that there were no evacuation routes posted in TWO's A room and the School Age room

Correction Required: Evacuation routes shall be posted.

Noncompliance Area: During renewal inspection on 10/8/19 certification representative observed a container of milk on a top of a shelf in the Pre-K B room. No meal was being served at the time.

Correction Required: Food that has been previously served to a person or returned from a table shall be discarded.

Noncompliance Area: During renewal inspection on 10/8/19 certification representative observed a first aid kit in Pre-K B room on a shelf that was accessible to children.

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

Noncompliance Area: ON 10/3/18, CERTIFICATION REPRESENTATIVE OBSERVED 14-16 STACKED REST COTS IN THE PRESCHOOL AND OLDER TODDLER ROOMS LOCATED ON THE SECOND FLOOR. STAFF #2, STAFF #3 AND STAFF #4 STATED THAT CHILD #1 (AGE 3) REPEATEDLY CLIMBS TO THE TOP OF THE STACKED REST COTS REQUIRING ASSISTANCE TO GET DOWN.

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

Noncompliance Area: ON 10/2/18, STAFF #1 WAS OBSERVED OUT OF RATIO WITH 8 CHILDREN ON THE OUTDOOR PLAYSPACE. THE YOUNGEST CHILD IN THE GROUP WAS AN OLDER TODDLER.

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

Noncompliance Area: Staff # 1 grabbed a child by the arm and moved him to another seat on the bus.

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

Noncompliance Area: During unannounced inspection on 6/13/17 certification representative reviewed files of new staff. Staff # 2, an assistant group supervisor whose start date was 6/12/17, did not have date of tuberculosis screening application or reading of results on health assessment.

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.

Noncompliance Area: During unannounced inspection on 6/13/17 certification representative reviewed files of new staff. Staff # 2, an assistant group supervisor whose start date was 6/12/17, had one of the 2 required written nonfamily references on file.

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

Noncompliance Area: During unannounced inspection on 6/13/17 certification representative reviewed files of new staff. Staff # 2, an assistant group supervisor possessing a high school diploma, did not have verification of 2500 hours of experience with children in file.

Correction Required: An assistant group supervisor shall have a high school diploma or a general educational development certificate and 2 years experience with children.

Noncompliance Area: During unannounced inspection on 6/13/17 certification representative asked to review the fire drill log. Operator could not find the current log. Older logs were available.

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

Noncompliance Area: A young toddler was bitten by other young toddlers at least 20 times in a period of one month.

Correction Required: Children on the facility premises and on facility excursions off the premises shall be supervised by a staff person at all times. Outdoor play space used by the facility is considered part of the facility premises.

Noncompliance Area: Staff were putting a young toddler in a high chair to prevent him from biting other children.

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.

Noncompliance Area: During allocated unannounced monitoring on 1/17/17 certification representative review several staff files. Staff # 6 did not have verification of Mandated Reporter training. She stated that she had taken it but did not print out the certificate.

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

Noncompliance Area: During allocated unannounced monitoring on 1/17/17 certification representative observed 1 staff person with 19 children in the Pre-K room. The time was 2:35 pm. It was rest time. The other staff person was on a break. The staff person in the room allowed 8 of the children to be up and off their cots.

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.