Galinis Childrens Center

Regulation: 3270.131(a)

Description: Health information

Noncompliance Area: The file for Child #1 was observed not to have documentation of an initial health report no later than 60 days following the first day of attendance at the facility. This is evidenced by the First date of admission 1/7/2025.

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.

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 was observed to have a health assessment conducted more than 24 months. This is evidenced by the health assessment being done 11/27/23 and 2/25/26. The file for Staff #3 was observed to have a health assessment conducted more than 24 months. This is evidenced by the health assessment being done 3/3/2024.

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: 3270.21

Description: General Health and Safety

Noncompliance Area: The basement door at the facility was observed to not be locked and accessible to children.

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

Regulation: 3270.31(f)

Description: Health and Safety Training

Noncompliance Area: The file for Staff #4, DOH 9/25/25 was observed to not have completed Health and Safety training within 90 days of hire. This is evidenced by the health and safety training being done 2/25/26.

Correction Required: Staff persons shall complete professional development within 90 days of hire as listed in subsections (f)1-10.

Regulation: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: The file for staff #1 was observed to have mandated training completed after the 60 month period. The State Police Clearance, Child abuse Clearance, FBI Clearance and NSOR clearance on file for Staff #1 was observed to not have updated in 60 months. This is evidenced by State Police, Child Abuse being dated 9/9/2020 to 10/16/2025. The FBI dated 9/16/2020 to 10/22/2025. The NSOR Certificate dated 7/1/2020 to 10/20/2025. The State Police clearance on file for Staff #4 DOH: 9/25/25 was observed to be obtained on 1/12/26 after date of hire. The State Police clearance on file for Staff #5 was observed not to have been updated in 60 months. This is evidenced by the last State Police clearance being dated 4/16/20.

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: 3270.102(a)

Description: Clean and good repair

Noncompliance Area: In the green added on room, it was observed that there were cracked magnetic blocks.

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: 3270.113(a)(2)

Description: Supervision on and facility premises

Noncompliance Area: On 9/17/25 it was reported that the facility was out of ratio.

Correction Required: The requirement for supervision on and off the facility premises includes compliance with the staff:child ratio requirements in §§ 3270.51--3270.55.

Regulation: 3270.124(d)

Description: Excursions

Noncompliance Area: It was observed that no documentation of emergency contact information was available in the outdoor play space.

Correction Required: When children leave the facility on walking and riding excursions, emergency contact information specific to each child on the excursion shall accompany a staff person on the excursion.

Regulation: 3270.51/3270.113(a)(1)

Description: Similar Age Level/Staff assigned to specific children

Noncompliance Area: It was observed that Staff #1 took one child to the bathroom leaving her group of children. It was observed that Staff #2 had 12 preschool children in her group.

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. IF USING TIERED LIS: The required staff:child ratios must be maintained at all times. The legal entity must submit documentation in a format approved by DHS proving that the facility is maintaining the required staff:child ratios at all times. The legal entity will confirm continuing compliance by sending copies of the documentation to the -------- Region Office on a weekly basis for a period of three months after DHS approves the documentation format. Each staff person shall be assigned the responsibility for supervision of specific children. The staff person shall know the names and whereabouts of the children in his assigned group. The staff person shall be physically present with the children in his group on the facility premises and on facility excursions off the facility premises.

Regulation: 3270.51/3270.52

Description: Similar Age Level/Mixed Age Level

Noncompliance Area: On 9/17/25 it was reported that the facility was out of ratio.

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: 3270.66(a)

Description: Locked or inaccessible

Noncompliance Area: In the bathroom, a bottle of hairspray and saline eye solution labeled keep out of reach of children were observed in the unlocked medicine cabinet.

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(d)

Description: On excursions

Noncompliance Area: A first aid kit was not observed when the children were in the outdoor play space.

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

Regulation: 3270.124(b)(5)

Description: Information re: special needs

Noncompliance Area: The emergency contact form on file for Child #2 was observed not to list information on the child's special needs, as specified by the child's parent, physician, physician's assistant or CRNP, which is needed in an emergency situation.

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

Regulation: 3270.124(b)(7)

Description: Name/address/phone release person

Noncompliance Area: The Emergency Contact form on file for Child #1 was observed to not contain the address 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(c)

Description: Each child care space

Noncompliance Area: It was observed that the Emergency Contact information in the outdoor bag has not been updated for children receiving care in the space.

Correction Required: When children are in the facility, emergency contact information shall be present in a child care space for children receiving care in the space.

Regulation: 3270.131(d)(7)

Description: Free from contagious/communicable disease

Noncompliance Area: The health assessment on file for Child #3 was observed not to have a statement that the child is able to participate in childcare and appears to be free from contagious or communicable disease.

Correction Required: A health report shall include a statement that the child is able to participate in child care and appears to be free from contagious or communicable disease.

Regulation: 3270.134(a)/3270.152

Description: Child's hands washed/Adult Hygiene

Noncompliance Area: It was observed on the day of inspection that a staff member did not wash their hands or the infants' hands after diapering.

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

Regulation: 3270.21

Description: General Health and Safety

Noncompliance Area: The metal heating radiator located on the floor in the preschool room was observed not to have a cover exposing children in care to rough edges, sharp corners and pinch points.

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

Regulation: 3270.66(a)

Description: Locked or inaccessible

Noncompliance Area: In the facility restroom, spray air freshener and cleaning supplies were accessible to the children in the unlocked closet.

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(e)

Description: Arts and crafts non-toxic

Noncompliance Area: Shaving cream used for arts and crafts labeled "keep out of reach of children" was observed in the bathroom closet

Correction Required: Arts and crafts materials shall be nontoxic.

Regulation: 3270.75(d)

Description: On excursions

Noncompliance Area: The outdoor bag was observed not to contain a bottle of water.

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

Regulation: 3270.94(a)(1)

Description: Every 60 days

Noncompliance Area: The facility fire drill log showed that the facility did not conduct fire drills every 60 days. This is evidenced by there being a gap of more than 60 days from 10/1/24 to 12/17/24.

Correction Required: The Director or designated staff person who is responsible for compliance with this chapter shall conduct fire drills and ensure that fire drills are conducted at least once every 60 days.

Regulation: 3270.102(a)

Description: Clean and good repair

Noncompliance Area: The facility's Main room was observed to have a blue vinyl chair with two visible tears.

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: 3270.107

Description: Refrigerator

Noncompliance Area: The facility's Infant room was observed to have a refrigerator that lacked a thermometer.

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: 3270.111(a)

Description: Written plan

Noncompliance Area: The facility's Dining Room was observed to lack a written plan of daily activities and routines, including a time for free play.

Correction Required: A written plan of daily activities and routines, including a time for free play shall be established for each group. The plan shall be flexible to accommodate the needs of individual children and the dynamics of the group.

Regulation: 3270.123(a)

Description: Signed

Noncompliance Area: The file for child #2 was observed to lack an agreement form.

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

Regulation: 3270.123(a)

Description: Signed

Noncompliance Area: The file for child #2 was observed to contain an agreement that lacked signatures of the operator and the parent. The file for child #4 was observed to contain an agreement that lacked a signature of the parent

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

Regulation: 3270.123(a)(3)

Description: Services proceeded

Noncompliance Area: The files for Children #1, #2, #3, #4, & #5 were observed to lack 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 (Child Service Report).

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

Regulation: 3270.123(a)(6)/3270.182(2)

Description: Admission date/Application, admission, withdrawal dates

Noncompliance Area: The file for child #3 was observed to contain an agreement that failed to specify the date of the child's admission.

Correction Required: An agreement shall specify the date of the child's admission. A child's record shall contain the dates of application, admission and withdrawal of the child.

Regulation: 3270.124(b)(1)

Description: Child's name, birth date

Noncompliance Area: The file for Child #1 was observed to contain an emergency contact form that did not include the child's name.

Correction Required: Emergency contact information must include the name and birth date of the child.

Regulation: 3270.124(b)(2)

Description: Physician name, address, phone

Noncompliance Area: The files for children #2 & #4 were observed to contain and emergency contact form that did not include the name, address and telephone 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(b)(3)

Description: Parent home/work address, phone

Noncompliance Area: The files for children #1, #2 and #4 were observed to contain emergency contact forms that failed to include the home and work addresses and telephone numbers of the enrolling parent.

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

Regulation: 3270.124(b)(5)

Description: Information re: special needs

Noncompliance Area: The files for children #1, #2, #4 & #5 were observed to contain emergency contact forms that failed to include information on the child's special needs, as specified by the child's parent, physician, physician's assistant or CRNP, which is needed in an emergency situation.

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

Regulation: 3270.124(b)(6)

Description: Insurance coverage information

Noncompliance Area: The files for Children #1, #2, & #4 were observed to contain emergency contact forms that failed to include health insurance coverage and policy number for a child under a family policy or Medical Assistance benefits, if applicable.

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: The files for children #1, #2, #3, & #4 were observed to contain emergency contact forms that failed to include the name, address and telephone number 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: 3270.131(a)/3270.182(1)

Description: Health information/Initial and subsequent health reports

Noncompliance Area: The file for child #4 was observed to lack an initial health report no later than 60 days following the first day of attendance at the facility as evidenced by the lack of a health report present in the file. A child's record shall contain initial and subsequent health reports.

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

Regulation: 3270.131(b)(2)

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

Noncompliance Area: The files for children #4 & #5 failed to contain documentation that the parent provided updated health reports at least every 12 months for an older toddler or preschool child. This was evidenced by Child #4's file containing only one health report dated 1/4/24 and the file for child #5 contained health reports dated 09/4/2019 and 4/25/23.

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)

Description: ACIP recommended immunization record

Noncompliance Area: The file for child #4 failed to contain documentation that the parent provided immunization record in accordance with the recommendations of the ACIP within 60 days following the first day of attendance at the facility. As evidenced by one immunization record dated 01/04/2024 present in the file.

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.

Regulation: 3270.171(a)

Description: Pick-up and drop-off points

Noncompliance Area: The facility was observed to lack documentation of written notification at least annually to local traffic safety authority of the location of the facility and the program's use of pedestrian and vehicular routes around the child care facility. This is evidenced by the last written notification on file is dated 2021.

Correction Required: An operator shall notify local traffic safety authorities annually in writing of the location of the facility and the program's use of pedestrian and vehicular routes around the child care facility.

Regulation: 3270.192(2)(ii)

Description: Exp, educ., training prior to facility

Noncompliance Area: The files for Staff #1, #2 and #3 were observed to lack 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: 3270.71

Description: Heat Source

Noncompliance Area: The facility's Older Toddler room upstairs was observed to have a broken metal cover over the heating pipes exposing the hot pipes. The heater cover is located on the back wall on the same side as the stairway.

Correction Required: Hot water pipes and other sources of heat exceeding 110° F that are accessible to children shall be equipped with protective guards or shall be insulated to prevent direct contact.

Regulation: 3270.75(c)

Description: Has all items

Noncompliance Area: The facility was observed to have a first-aid kit in the Infant room that 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: 3270.95(a)

Description: Devices must be compliant

Noncompliance Area: The facility was observed to have a Fire detection system testing log that indicated testing on 6/1/23 and again on 07/6/23 a period of more than 30 days.

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: 3270.113(a)(1)

Description: Staff assigned to specific children

Noncompliance Area: 2nd Citation previously cited on 09/18/2023. On 02/29/2024 Staff #1 and Staff #2 were observed caring for 13 napping pre-school aged children in the big room of the facility. Staff #2 named and identified 6 children as being in their group but did not utilize the hands-free method during the identification process. Staff person #1 also named and identified a group of 6 children, staff person #1 utilized the hand's free method. Neither staff person identified the 13th sleeping child as in their supervised group, leaving the child unassigned. This child's hands-free identification card was laying on the table. Staff Person #3 was observed caring for 4 sleeping older toddlers in the room at the top of the stairs. Staff person #3 was able to identify all 4 toddlers, but only had 3 hands free identification cards in her possession.

Correction Required: Each staff person shall be assigned the responsibility for supervision of specific children. The staff person shall know the names and whereabouts of the children in his assigned group. The staff person shall be physically present with the children in his group on the facility premises and on facility excursions off the facility premises.

Regulation: 3270.113(a)

Description: Supervised at all times

Noncompliance Area: *At approximately 9:50 a.m., CR observed in the larger room upstairs, staff #1 sitting in a glider chair, eating a bag of chips and staff #2 leaning against the far wall while child #1 a young toddler sat in a pack and play in the smaller room with the door closed. Child #1 was alone in the smaller room. Therefore, the child in the smaller room was not being properly supervised. From approximately 10:10 to 10:15, 6 of the 11 pre-school aged children located in the pre-school room downstairs were sitting at 2 tables on the far side of a partition wall which was pulled across the width of the room approximately halfway in the depth of the room while staff #3 was located in the front half of the room. Therefore, staff #3 could not properly supervise the children behind the partition.

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

Regulation: 3270.113(a)

Description: Supervised at all times

Noncompliance Area: **At approximately 9:50 a.m., CR observed in the larger room upstairs, staff #1 sitting in a glider chair, eating a bag of chips and staff #2 leaning against the far wall while child #1 a young toddler sat in a pack and play in the smaller room with the door closed. Child #1 was alone in the smaller room. Therefore, the child in the smaller room was not being properly supervised. From approximately 10:10 to 10:15, 6 of the 11 pre-school aged children located in the pre-school room downstairs were sitting at 2 tables on the far side of a partition wall which was pulled across the width of the room approximately halfway in the depth of the room while staff #3 was located in the front half of the room. Therefore, staff #3 could not properly supervise the children behind the partition.

Correction Required: The Legal Entity will arrange for all staff employed by the facility at the time this POC is accepted to attend a minimum of 3 hours in person training on supervision conducted by ELRC Region 6 staff. The training must be approved by the Department prior to staff attending.

Regulation: 3270.113(a)(1)

Description: Staff assigned to specific children

Noncompliance Area: *At approximately 9:50 a.m., CR was in the larger room upstairs. CR observed 10 children in the larger room and 1 child in the smaller room. CR asked staff #1 and staff #2 to identify the children for whom they are responsible. Staff #1 named 5 toddlers: 1 young toddler and 4 older toddlers. Staff #2 named 6 toddlers: 4 young toddlers, 3 of them were in the larger room, but child #1 was alone in the smaller room and 2 older toddlers, both in the larger room. Both staff named child #2 and neither staff named child #3.

Correction Required: Each staff person shall be assigned the responsibility for supervision of specific children. The staff person shall know the names and whereabouts of the children in his assigned group. The staff person shall be physically present with the children in his group on the facility premises and on facility excursions off the facility premises.

Regulation: 3270.113(a)(1)

Description: Staff assigned to specific children

Noncompliance Area: **At approximately 9:50 a.m., CR was in the larger room upstairs. CR observed 10 children in the larger room and 1 child in the smaller room. CR asked staff #1 and staff #2 to identify the children for whom they are responsible. Staff #1 named 5 toddlers: 1 young toddler and 4 older toddlers. Staff #2 named 6 toddlers: 4 young toddlers, 3 of them were in the larger room, but child #1 was alone in the smaller room and 2 older toddlers, both in the larger room. Both staff named child #2 and neither staff named child #3.

Correction Required: The Legal Entity will arrange to have classroom monitoring visits within the facility during a period of 4 months by Start Up TA specialist from ELRC 6. The number of visits will be determined by the ELRC 6 staff after assessing the program and agreed upon by the provider and approved by the department.

Regulation: 3270.113(a)(1)

Description: Staff assigned to specific children

Noncompliance Area: ***At approximately 9:50 a.m., CR was in the larger room upstairs. CR observed 10 children in the larger room and 1 child in the smaller room. CR asked staff #1 and staff #2 to identify the children for whom they are responsible. Staff #1 named 5 toddlers: 1 young toddler and 4 older toddlers. Staff #2 named 6 toddlers: 4 young toddlers, 3 of them were in the larger room, but child #1 was alone in the smaller room and 2 older toddlers, both in the larger room. Both staff named child #2 and neither staff named child #3.

Correction Required: The operator will develop and ensure all staff actively use a hands-free method to identify the children's names and ages assigned in their supervisory group.

Regulation: 3270.135(e)

Description: 2 hour diaper check

Noncompliance Area: Based on conversation with staff, young and old toddlers are left in soaked or soiled diapers for more than 2 hours.

Correction Required: A staff person shall check a child's diaper at least every 2 hours and whenever the child indicates discomfort or exhibits behavior that suggests a soiled diaper. A staff person shall change a child's diaper when the diaper is soiled.

Regulation: 3270.51

Description: Similar Age Level

Noncompliance Area: **At approximately 9:50 a.m., CR observed in the larger room upstairs, staff #1 sitting in a glider chair, eating a bag of chips and staff #2 leaning against the far wall while child #1 a young toddler sat in a pack and play in the smaller room with the door closed. Child #1 was alone in the smaller room. Therefore, the child in the smaller room was not being properly supervised. From approximately 10:10 to 10:15, 6 of the 11 pre-school aged children located in the pre-school room downstairs were sitting at 2 tables on the far side of a partition wall which was pulled across the width of the room approximately halfway in the depth of the room while staff #3 was located in the front half of the room. Therefore, staff #3 could not properly supervise the children behind the partition.

Correction Required: The operator will have the ratios posted in each childcare space and include the regulatory definitions of young and older toddler. A posting stating, "Children may not be left alone in any classroom" shall be posted in each measured childcare space.

Regulation: 3270.51

Description: Similar Age Level

Noncompliance Area: *At approximately 9:50 a.m., CR observed in the larger room upstairs, staff #1 sitting in a glider chair, eating a bag of chips and staff #2 leaning against the far wall while child #1 a young toddler sat in a pack and play in the smaller room with the door closed. Child #1 was alone in the smaller room. Therefore, the child in the smaller room was not being properly supervised. From approximately 10:10 to 10:15, 6 of the 11 pre-school aged children located in the pre-school room downstairs were sitting at 2 tables on the far side of a partition wall which was pulled across the width of the room approximately halfway in the depth of the room while staff #3 was located in the front half of the room. Therefore, staff #3 could not properly supervise the children behind the partition.

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: 3270.52

Description: Mixed Age Level

Noncompliance Area: *During an unannounced visit on 9-18-23, at approximately 9:50 a.m., observed staff #1 and staff #2 out of ratio in the upstairs childcare spaces due to the fact the following groups of children were present: staff #1 with 2 young toddlers and 3 old toddlers; Staff #2 with 4 young toddlers and 2 older toddlers in the larger room.

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).

Regulation: 3270.61(h)

Description: Exceeding Capacity

Noncompliance Area: *During an unannounced visit, cert rep observed 10 toddlers: 5 young toddlers and 5 older toddlers in the larger room located upstairs which has a capacity of 6; observed 5 toddlers: 2 young toddlers and 3 older toddlers in the smaller room located upstairs which has a capacity of 3. Based on conversation with staff, after 3:00 p.m., there are between 22 and 24 pre-school and young/old school aged children in the pre-school room which has a capacity of 14.

Correction Required: The capacity established for an indoor space may not be exceeded.

Regulation: 3270.61(h)

Description: Exceeding Capacity

Noncompliance Area: **During an unannounced visit, cert rep observed 10 toddlers: 5 young toddlers and 5 older toddlers in the larger room located upstairs which has a capacity of 6; observed 5 toddlers: 2 young toddlers and 3 older toddlers in the smaller room located upstairs which has a capacity of 3. Based on conversation with staff, after 3:00 p.m., there are between 22 and 24 pre-school and young/old school aged children in the pre-school room which has a capacity of 14.

Correction Required: Postings of the capacity for each room will be present in all measured childcare spaces.

Regulation: 3270.111(a)

Description: Written plan

Noncompliance Area: The facility's Young Toddler room was observed to lack a written plan of daily activities and routines posted.

Correction Required: A written plan of daily activities and routines, including a time for free play shall be established for each group. The plan shall be flexible to accommodate the needs of individual children and the dynamics of the group.

Regulation: 3270.113(a)(1)

Description: Staff assigned to specific children

Noncompliance Area: On 5/16/23, Staff person #1 was observed in the dining room with two infants providing them with a snack. Staff person #1 identified 4 infants as being in their care; stating that 2 of those infants were present in the dining room with them and 2 of the infants were in a separate room. Therefore, Staff person #1 was not physically present in the same room with all of the children assigned to them. On 5/16/23 Staff persons #1, #7 & #8 were observed supervising 16 older toddlers in the older toddler room. Collectively, Staff persons #1, #7 & #8 only identified 15 children leaving one older toddler not identified as being supervised by a staff person.

Correction Required: Each staff person shall be assigned the responsibility for supervision of specific children. The staff person shall know the names and whereabouts of the children in his assigned group. The staff person shall be physically present with the children in his group on the facility premises and on facility excursions off the facility premises.

Regulation: 3270.123(a)(3)

Description: Services proceeded

Noncompliance Area: The files for children #1, #2, #3, #4 were observed to lack 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.

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

Regulation: 3270.124(b)(3)

Description: Parent home/work address, phone

Noncompliance Area: The file for Child #4 was observed to contain an emergency contact form that lacked work addresses and telephone numbers of the enrolling parent.

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

Regulation: 3270.124(b)(7)

Description: Name/address/phone release person

Noncompliance Area: The file for child #4 was observed to contain an emergency contact form that lacked the address and telephone number 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(c)

Description: Each child care space

Noncompliance Area: The facility's Young toddler room was observed to lack emergency contact information present during the time staff persons were providing child care in the young toddler room.

Correction Required: When children are in the facility, emergency contact information shall be present in a child care space for children receiving care in the space.

Regulation: 3270.124(e)

Description: Written emergency plan posted

Noncompliance Area: The facility's young toddler room was observed to lack a written plan identifying the means of transporting a child to emergency care and staffing provisions in the event of an emergency displayed conspicuously.

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(d)(4)

Description: Acute or chronic health problem

Noncompliance Area: The file for child #1 was observed to contain a health assessment that failed to include an assessment of an acute or chronic health problem or special need and recommendations for treatment or services, including information regarding abnormal results of screening tests for vision, hearing or lead poisoning.

Correction Required: A health report shall include an assessment of an acute or chronic health problem or special need and recommendations for treatment or services, including information regarding abnormal results of screening tests for vision, hearing or lead poisoning.

Regulation: 3270.131(d)(5)/3270.131(e)(3)

Description: Immunization record/Dismissal policy

Noncompliance Area: The immunization record on file for children #1 was observed to not be up to date with the recommended ACIP schedule.

Correction Required: A health report shall include a review of the child's immunized status according to recommendations of the ACIP. The facility shall implement dismissal policies in accordance with the Department of Health regulation in 28 Pa. Code § 27.77 (relating to immunization requirements for children in child care group settings).

Regulation: 3270.131(d)(7)

Description: Free from contagious/communicable disease

Noncompliance Area: The file for child #1 was observed to lack a health report that included a statement that the child is able to participate in child care.

Correction Required: A health report shall include a statement that the child is able to participate in child care and appears to be free from contagious or communicable disease.

Regulation: 3270.131(d)(8)

Description: Age appropriate screenings complete

Noncompliance Area: The file for child #1 was observed to lack a health report that includes 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.

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: 3270.134(a)

Description: Child's hands washed

Noncompliance Area: On 5/16/2023 staff person #2 was observed diapering child #6, and failed to wash the child's hand after the diapering was complete. On 5/31/2023 staff person #1 was observed diapering child #5, and failed to wash the child's hands once the diapering was completed.

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: 3270.14/3270.21

Description: Pertinent Laws & Regulations/General Health and Safety

Noncompliance Area: The facility was observed to have an emergency plan that lacked a statement regarding continuity of operations. The file for staff person #5 was observed to lack verification of completing the Pennsylvania Health and Safety Update 2022 by December 30, 2022.

Correction Required: A facility shall be operated in conformity with applicable Federal and State laws and regulations.State agencies whose regulations may relate to the operation of a facility include the Department of Environmental Resources, the Department of Labor and Industry, the Department of Health, the Department of Education and the Department of Transportation. Conditions at the facility may not pose a threat to the health or safety of the children.

Regulation: 3270.151(a)

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

Noncompliance Area: The files for staff persons #3 and #5 were observed to lack a health assessment conducted within 24 months of the previous assessment. This is evidenced by health assessments present in the file for staff person #3 dated 07/08/2020 and 02/28/2023 a span of 31 months, and health assessments present in the file for staff person #5 dated 06/29/2020 and 05/08/2023 a span of 35 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: 3270.166(4)

Description: Bottles labeled

Noncompliance Area: Four bottles that lacked a label identifying which child the bottle belonged to were observed to be present in the facility's infant room.

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

Regulation: 3270.51

Description: Similar Age Level

Noncompliance Area: On 5/16/2023 Staff person #2 was observed to be caring for 6 infants without another staff person present in the infant room.

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. IF USING TIERED LIS: The required staff:child ratios must be maintained at all times. The legal entity must submit documentation in a format approved by DHS proving that the facility is maintaining the required staff:child ratios at all times. The legal entity will confirm continuing compliance by sending copies of the documentation to the -------- Region Office on a weekly basis for a period of three months after DHS approves the documentation format.

Regulation: 3270.61(h)

Description: Exceeding Capacity

Noncompliance Area: On 5-16-23 and on 5-31-23, the facility's infant room and older toddler rooms were observed to be exceeding the established capacity. On 5-16-23, staff person #2 and staff person #6 were observed providing childcare to 8 infants. On 5-31-23, staff person #1 And staff person #6 Were observed providing care to 7 infants in the infant room which has an established capacity of 6. On 5-16-23, staff person #1, staff person #7, and staff person #8 were observed providing care to 16 older toddlers in the older toddler room. On 5-31-23, Staff person #4 and staff person #7 were observed providing care to 8 older toddlers in the older toddler room which has an established capacity of 6.

Correction Required: The capacity established for an indoor space may not be exceeded.

Regulation: 3270.61(i)

Description: Measurement and use of indoor child care space

Noncompliance Area: On 5/16/2023 The facility was observed to be providing childcare services to 38 children at one time, and the facility's maximum capacity is 36.

Correction Required: The total number of children receiving child care services at the facility at any one time may not exceed the facility's maximum capacity.

Regulation: 3270.63

Description: Unsafe Areas in Outdoor Space

Noncompliance Area: A former clothesline pole that was cut to ground level was observed to be rusty and protruding from the ground in the grassy area, above the swings in the outdoor play yard.

Correction Required: If unsafe areas or conditions are in or near an outdoor play space, fencing or natural barriers are required to restrict children from those unsafe areas or conditions.

Regulation: 3270.66(a)

Description: Locked or inaccessible

Noncompliance Area: Disinfectant wipes labeled keep out of reach of children, were observed to be stored in an unlocked cabinet under the sink in the upstairs bathroom in the older toddler room.

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: 3270.67(d)

Description: Contaminated trash in closed plastic-lined receptacle

Noncompliance Area: The open (no lid) trash receptacle in the young toddler room was observed to contain soiled diapers.

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

Regulation: 3270.75(a)

Description: In child care spaces

Noncompliance Area: The facility's young toddler room was observed to lack a first-aid kit.

Correction Required: A first-aid kit shall be in a child care space.

Regulation: 3270.76

Description: Building Surfaces

Noncompliance Area: The chain link fence in the facility's outdoor play yard was observed to have bolt ends with sharp edges exposed.

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: 3270.113(a)/3270.113(a)(1)

Description: Supervised at all times /Staff assigned to specific children

Noncompliance Area: On 11/9/2022, multiple preschool aged children being cared for in the back-room addition, were observed leaving the classroom to use the restroom without the presence of a staff person. During interviews with staff, it was confirmed that this regularly occurs in this classroom.

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. Children must be supervised at all times.

Regulation: 3270.151(a)

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

Noncompliance Area: The file for staff person #1 was observed not to contain documentation of a health assessment being completed within 12 months of initial employment (See LIS Code Sheet). This is evidenced by the most recent health assessment on file being dated 05/13/2020.

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: 3270.51

Description: Similar Age Level

Noncompliance Area: Based on interviews with staff, it was disclosed that the facility is regularly out of ratio during lunch time and during staff breaks. On multiple occasions during the week of 10/31/2022 the facility was out of ratio due to one staff person being on vacation. Additionally, on 11/9/2022, multiple preschool aged children being cared for in the back-room addition, were observed leaving the classroom to use the restroom without the presence of a staff person. During interviews with staff, it was confirmed that this regularly occurs in this classroom.

Correction Required: When children are grouped in similar age levels, the following maximum child group sizes and ratios of staff persons apply: Infants 1:4 with a maximum group size of 8; Young toddlers 1:5 with a maximum group size of 10; Older toddlers 1:6 with a maximum group size of 12; Preschool children 1:10 with a maximum group size of 20; Young school-age children 1:12 with a maximum group size of 24; Older school-age children 1:15 with a maximum group size of 30. The required staff:child ratios must be maintained at all times.

Regulation: 3270.102(a)

Description: Clean and good repair

Noncompliance Area: Observed in the large room upstairs, a green bin cracked on the side and top. Observed in the small room upstairs, 2 square and 1 triangle shaped broken Magnitiles.

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

Regulation: 3270.106(a)

Description: Clean, age appropriate

Noncompliance Area: Observed in the infant/young toddler room, a Cosco brand safari print pack and play labeled for child #6 with medium size holes on 2 side of the equipment; and a Cosco brand safari print pack and play label as #2 with a small hole on 1 side; and a Graco brand dots print pack and play labeled for child #1 with a small hole on the side. Observed in the small room upstairs, a Cosco brand pack and play with a large hole on the 1 side.

Correction Required: Individual, clean, age-appropriate rest equipment shall be provided for preschool, toddler and infant children as agreed between the child's parent and the operator. The rest equipment shall be labeled for the use of a specific child and used only by the specified child.

Regulation: 3270.124(b)(2)

Description: Physician name, address, phone

Noncompliance Area: The file of child #1 lacked an emergency contact form with the telephone number of the child's physician or source of medical care. The file of child #2 lacked an emergency contact form with the address 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(b)(3)

Description: Parent home/work address, phone

Noncompliance Area: The file of child #2 lacked an emergency contact form with the work address of the enrolling parent.

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

Regulation: 3270.124(b)(6)

Description: Insurance coverage information

Noncompliance Area: The file of child #3 lacked an emergency contact form with the health insurance policy number for a child under a family policy or Medical Assistance benefits, if applicable.

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: The file of child #1 lacked an emergency contact form with the address of the individual designated by the parent to whom the child may be released. The file of child #4 lacked an emergency contact form with the full, complete address 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: 3270.133(5)

Description: Original label

Noncompliance Area: Observed in the infant/young toddler room Desitin diaper cream labeled for child #5 with an expiration date of 4/22.

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

Regulation: 3270.133(6)/3270.133(7)

Description: Written consent/Medication log

Noncompliance Area: Observed Ibuprofen for child #7 but no medication log or written parental consent to administer.

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: 3270.166(1)

Description: Written statement

Noncompliance Area: At the time of the inspection, there was no infant feeding schedule for child #1.

Correction Required: A written statement giving the formula and feeding schedule for an infant shall be obtained from the parent.

Regulation: 3270.27(a)(5)

Description: Emergency plan

Noncompliance Area: The emergency plan lacked accommodations for infants and toddlers.

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(a)(6)

Description: Emergency plan

Noncompliance Area: There was no documentation of completing an emergency drill by 12-19-21. Furthermore, the director informed the cert rep no emergency plan drill has ever been conducted.

Correction Required: Emergency drills shall be conducted annually. Annual emergency drills shall be documented and on file at the facility.

Regulation: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: The file of staff #1 lacked FBI clearances every 60 months due to the fact the FBI clearances on file were dated 7-15-21 and 8-24-15.

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: 3270.76

Description: Building Surfaces

Noncompliance Area: Observed in the preschool room flooring damaged and peel up causing a tripping hazard.

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

Regulation: 3270.95(a)/3270.95(b)

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

Noncompliance Area: There was no documentation to show the smoke detection system has been tested every 30 days.

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: Observed a "U" shaped table with high chairs installed within the table but 3 missing straps.

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

Noncompliance Area: Observed in the upstairs child care space, 2 pack and play rest equipment not labeled for the use of a specific child and used only by the specified child. Observed in the back room located on the main floor, rest equipment not labeled for children; nor a list posted by the rest equipment indicating assigned equipment.

Correction Required: Individual, clean, age-appropriate rest equipment shall be provided for preschool, toddler and infant children as agreed between the child's parent and the operator. The rest equipment shall be labeled for the use of a specific child and used only by the specified child.

Noncompliance Area: The file of child #3 lacked an emergency contact form with the address and telephone 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.

Noncompliance Area: The file of child #3 lacked an emergency contact form with the health insurance policy number for a child under a family policy or Medical Assistance benefits, if applicable.

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.