Crystal Underkoffler

Regulation: 3280.131(a)/3280.182(1)

Description: Health Information/Initial and subsequent health assessments

Noncompliance Area: At time of inspection, the record for child #1 (date of admission see LIS code sheet) does not contain an initial health report. The child has been in attendance for more than 60 days.

Correction Required: The operator shall require the parent of an enrolled child, including a child, a foster child and a relative of an operator or a facility person, to provide an initial health report no later than 60 days following the first day of attendance at the facility. A child's record must contain initial and subsequent health reports.

Regulation: 3280.151(a)

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

Noncompliance Area: The health assessment for staff person #1 was not updated in a timely manner. This is evidenced by health assessments dated 11/16/2023 and 4/15/2026, which exceeds 24 months.

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: 3280.192(3)

Description: Health assessment, TB test

Noncompliance Area: The record for staff person #1 only contains the most recent health assessment form dated 4/7/2026 and the results of the initial TB test dated 12/23/2021, not the initial and all subsequent health assessments as required.

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: 3280.26(b)

Description: Emergency plan

Noncompliance Area: Documentation on file at the facility indicates that the emergency plan was last reviewed on 3/11/2025, which exceeds the annual requirement.

Correction Required: The operator shall review the emergency plan at least annually and update the plan as needed. Each review and update of the emergency plan shall be documented in writing and kept on file at the facility.

Regulation: 3280.124(b)(7)

Description: Name/address/phone release person

Noncompliance Area: It was observed that the files of children #1 and #2 did not have the complete addresses of the release persons.

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: 3280.131(b)(2)

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

Noncompliance Area: It was observed that the files for children #2, #3, and #5 did not have updated health assessments within 12 months of their previous health assessment.

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: 3280.192(5)

Description: Two written references

Noncompliance Area: It was observed that the file of staff #1 did not contain two written non-family references.

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: 3280.95(a)/3280.95(b)

Description: FIRE DETECTION/Staff responsibility

Noncompliance Area: Documentation shows that the fire detection system was not tested every 30 days. 5/30/25- 6/30/25 6/30/25- 7/31/25 8/29/25- 9/30/25

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 primary staff person or designated staff person who is responsible for compliance with this chapter shall ensure the requirements in subsection (a) are met

Regulation: 3290.124(b)(5)

Description: Information re: disability

Noncompliance Area: The emergency contact form that the facility uses, does not have a space for the parents to list disabilities or special medical/dietary needs.

Correction Required: Emergency contact information must include information on the child's special needs, as specified by the child's parent, physician, physician's assistant of CRNP, which is needed in an emergency situation.

Regulation: 3290.131(a)/3290.131(e)

Description: Within 60 days/Immunization record

Noncompliance Area: The initial health report submitted for Child #2, dated 5/14/24, did not include all of the administered immunizations in accordance with the ACIP. The child remained enrolled at the facility beyond 60 days following the first day of attendance, even though there was no documentation of the following immunizations (or an acceptable exemption statement): Hep A, Rotavirus, MMR, and Varicella.

Correction Required: The operator shall require the parent of an enrolled child to provide an initial health report no later than 60 days following the first day of attendance at the facility. 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.

Regulation: 3290.131(b)(2)

Description: Updated toddler/preschool health report: every 12 months

Noncompliance Area: There was no documentation of a health report dated 12 months prior to the current one (11/25/24) in the file for Child #3.

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: 3290.133(6)/3290.133(7)

Description: Written consent/Medication log

Noncompliance Area: There was no Medication Log completed by the parent of Child #1, giving instructions on when to administer and permission to administer, the child's inhaler, which was at the facility.

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: 3290.18

Description: General Health and Safety

Noncompliance Area: The emergency plan and parent letter about the emergency plan, did not address continuity of operations.

Correction Required: Conditions at the facility may not pose a threat to the health or safety of the children.

Regulation: 3290.31(f)

Description: Age and training

Noncompliance Area: The file for Staff Person #1 did not include documentation of 12 hours of annual childcare training. There was documentation of 7.5 hours of the required 12 hours of annual training.

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

Regulation: 3290.76(b)/3290.76(c)

Description: Ammunition locked and separate/Notify parents

Noncompliance Area: Firearms and ammunition were stored together, in a locked safe at the facility. The operator had not notified the parents that firearms and ammunition are present at the facility.

Correction Required: If the facility is located in a residence, ammunition shall be contained in a locked area separate from weapons and firearms. If the facility is located in a residence, the operator shall notify the parent when weapons, firearms or ammunition are present at the facility.