Jacobs Ladder Clc Inc

Regulation: 3270.107

Description: Refrigerator

Noncompliance Area: During the renewal inspection conducted on 8/20/26 the refrigerator located in Room #2 did not contain an operable 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: 3270.65

Description: Protective Outlet Covers 5 yrs. or less

Noncompliance Area: During the renewal inspection completed on 8/20/26 there was a missing receptacle cover observed in Room #1.

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

Regulation: 3270.151(a)/3270.192(3)

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

Noncompliance Area: During the renewal inspection on 09/22/23 the file for staff person #1 contained expired health assessment. Health assessment dated 06/24/21.

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: 3270.61(h)

Description: Exceeding Capacity

Noncompliance Area: During the complaint investigation on 09/22/23 the owner confirmed that between the dates of July 18-20 the facility exceeded the facility's capacity.

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

Regulation: 3270.75(c)

Description: Has all items

Noncompliance Area: During the renewal inspection on 09/22/23 the first aid kit located in the toddler room was missing soap, gauze, scissors, and 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: During the renewal inspection on 09/22/23 there was a vacuum cleaner at the top of the stairway used by children.

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: 3270.191

Description: Individual Records

Noncompliance Area: One facility person did not have an individual record that was presented at the time of the inspection. (#6)

Correction Required: An individual record is required for each facility person. Obtain and submit a copy of the completed file for the identified facility person. Ensure that each facility person has a completed individual record.

Regulation: 3270.31(e)

Description: Age and Training

Noncompliance Area: Several staff person's record did not contain written verification of annual minimum 12 hours of child care training. Requested information was not submitted. (#1, #2 and #5)

Correction Required: A staff person shall obtain an annual minimum of 12 clock hours of child care training. Obtain and submit written verification of annual minimum 12 hours of child care training for the identified staff person.

Regulation: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: The facility was not in compliance with the CPSL and with Chapter 3490 (relating to protective services): Several staff/facility person's record did not contain the required CPSL hiring documents. (#3- hired 2/27/23- no record of acceptable NSOR-the date read "034403" and mandated training completed more than 45 days after date of hire (#2-hired 3/6/23- STATE POLICE is for a volunteer and not a staff person and mandated training completed more than 45 days after date of hire. (#6- no record of CPSL clearances)

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). LACKING REQUIRED HIRING DOCUMENTS: 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 #3, #4 and #6 may not work in a childcare position at the facility until required CPSL documents have been obtained, completed and submitted as specified. Submit a copy of the required, completed CPSL clearance documents for the identified staff persons. Ensure that all staff persons (new and existing) have the required CPSL clearance documents within the required timeframes in accordance with the CPSL.

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

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

Noncompliance Area: One staff person's record did not contain written verification of education for their assistant group supervisor position. (#3

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. Obtain and submit written verification of education for the identified staff person/s. Ensure that all staff records have written verification of education and experience for their positions.

Regulation: 3270.14/3270.21

Description: Pertinent Laws & Regulations/General Health and Safety

Noncompliance Area: Three staff persons were observed caring for a child and their record did not contain verification of completed required CCDBG training (Pa Update) (#1, #2 and #5).

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. Staff persons cannot work unsupervised with children until the PA Update has been completed. Submit written verification of the required CCDBG training (PA Update).

Regulation: 3270.191

Description: Individual Records

Noncompliance Area: One facility person did not have an individual record that was presented at the time of the inspection. (#6)

Correction Required: An individual record is required for each facility person. Obtain and submit a copy of the completed file for the identified facility person. Ensure that each facility person has a completed individual record.

Regulation: 3270.31(e)

Description: Age and Training

Noncompliance Area: Several staff person's record did not contain written verification of annual minimum 12 hours of child care training. Requested information was not submitted. (#1, #2 and #5)

Correction Required: A staff person shall obtain an annual minimum of 12 clock hours of child care training. Obtain and submit written verification of annual minimum 12 hours of child care training for the identified staff person.

Regulation: 3270.31(f)

Description: Health and Safety Training

Noncompliance Area: Two staff person's records did not contain written verification of required health and safety training. (#3 and #4)

Correction Required: Staff persons shall complete professional development within 90 days of hire as listed in subsections (f)1-10. Obtain and submit written verification of the required health and safety training for the identified staff persons.

Regulation: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: The facility was not in compliance with the CPSL and with Chapter 3490 (relating to protective services): Several staff/facility person's record did not contain the required CPSL hiring documents. (#3- hired 2/27/23- no record of acceptable NSOR-the date read "034403" and mandated training completed more than 45 days after date of hire (#2-hired 3/6/23- STATE POLICE is for a volunteer and not a staff person and mandated training completed more than 45 days after date of hire. (#6- no record of CPSL clearances)

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). LACKING REQUIRED HIRING DOCUMENTS: 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 #3, #4 and #6 may not work in a childcare position at the facility until required CPSL documents have been obtained, completed and submitted as specified. Submit a copy of the required, completed CPSL clearance documents for the identified staff persons. Ensure that all staff persons (new and existing) have the required CPSL clearance documents within the required timeframes in accordance with the CPSL.

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

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

Noncompliance Area: One staff person's record did not contain written verification of education for their assistant group supervisor position. (#3)

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. Obtain and submit written verification of education for the identified staff person/s. Ensure that all staff records have written verification of education and experience for their positions.

Regulation: 3270.51

Description: Similar Age Level

Noncompliance Area: On 5/17/23, at approximately 3:10pm, staff person #6 was observed caring for a group of 5 infants in the infant room. Staff person #6 verified the ages of the children...

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 legal entity must arrange for all facility staff to receive 2 hours of staff/child ratio training (hands-on/in-person) through the PA Key to include maintaining ratios when there are staffing shortages and other times of transition /staffing shortages, operational needs and times of transition Submit written verification of the completed training.

Regulation: 3270.51/3270.52

Description: Similar Age Level/Mixed Age Level

Noncompliance Area: On 4/10/23 at approximately 2:30pm, staff person # 4 was observed caring for a mixed age group of 6 young/older toddler (ages 1-2 years) and 3/older school age (4thgrade-15 years) children in the preschool room. Staff person #6 verified the ages of the children.

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. 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. Ensure that staff/child ratios are maintained at all times.

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

Description: Fire safety - 1 yr.

Noncompliance Area: Several staff person's records did not contain written verification of annual fire safety training. (#1, #2 and #30

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. Obtain and submit written verification of annual fire safety training for the identified staff persons.

Regulation: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: The facility was not in compliance with the CPSL and with Chapter 3490 (relating to protective services): Several facility person's record did not contain the required CPSL hiring documents. (#1, #2 and #3- mandated reporter training more than 60 months old-#1-12/17/15, #2- 9/15/15 and #3- 2/1/16)

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). LACKING REQUIRED HIRING DOCUMENTS: 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. Obtain and submit a copy of the completed/updated mandated reporter training for the identified staff persons. Ensure that the mandated reporter training is updated within 60 months specified in the CPSL. Until the required mandated training has been completed and submitted staff persons must be supervised when interacting with children by a staff person (GS/AGS) who has completed the required training.

Noncompliance Area: One staff person's records did not contain a health assessment completed within 12 months prior to the date of hire in accordance with these regulations. I was missing several components. (#1)

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. Obtain and submit a current up-to-date health assessment for the identified staff persons. Ensure that staff health assessments are completed within the required timeframes as specified in this regulation.

Noncompliance Area: The facility was not in compliance with the CPSL and with Chapter 3490 (relating to protective services): One facility person's record did not contain the required CPSL hiring documents. (#3- hired 7/29/19- no completed NSOR) (#1)

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services): LACKING REQUIRED HIRING DOCUMENTS: 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 cannot work in a childcare position at the facility until the required CPSL documents have been obtained, completed and submitted as specified. Submit a copy of the required , completed CPSL clearance documents for the identified staff person.. Ensure that all staff persons (new and existing) have the required CPSL clearance documents within the required timeframes in accordance with the CPSL

Noncompliance Area: Two staff person's record did not contain written verification of experience for their assistant group supervisor position.(#2 and #3)

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. Obtain and submit written verification of experience for the identified staff person/s. Ensure that all staff records have written verification of education and experience for their positions.

Noncompliance Area: The written plan of daily activities was not posted in each child care space. (young toddler and 2nd floor classroom)

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. The written plan of daily activities shall be posted in the group space. Post the written plan of daily activities in each child care space.

Noncompliance Area: Two staff persons were observed caring for a group of 15 preschool/young school-age children and were not able to name specific children they were responsible for supervising. ( #1 and #2)

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. The legal entity must arrange for all facility staff persons to receive training in proper supervision of children, including procedures for assigning staff the responsibility for supervision of specific children as well as for staff persons knowing the names of the children in their assigned group. Submit written verification of the completed training for all facility staff persons. Submit written documentation of the facility's procedures for assigning supervision responsibility.

Noncompliance Area: One child's record did not contain a health report completed within the past 6 months as required for a child from infant to young toddler age. (#1)

Correction Required: The operator shall require the parent to provide an updated health report at least every 6 months for an infant or young toddler. Obtain and submit a current up-to-date health report for the indicated child. Ensure that all children's records include a current up-to-date health report as specified in this regulation.

Noncompliance Area: The operator lacked verification of the annual written notification to local traffic safety authorities of the location of the facility and the program's use of pedestrian and vehicular routes around the day care facility.

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 day care facility. Provide and submit verification of written notification of the location of the facility and the program's use of pedestrian and vehicular routes around the day care facility to the local safety authorities as specified.

Noncompliance Area: Hand washing signs were not posted at each sink in the facility. (infant /young toddler room)

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

Noncompliance Area: The 2nd floor hallway was obstructed by toys and other items.

Correction Required: Stairways, hallways, exits from rooms, exits from the facility and other means of egress serving as an exit shall be unobstructed. Remove the items and ensure that all stairways, hallways, exits from rooms, exits from the facility and other means of egress serving as an exit remain unobstructed. Notify staff of this requirement and submit written verification of staff notification that includes each staff person's signature.

Noncompliance Area: Two children's emergency contact information did not include health insurance coverage and policy number information. (#1 and #3)

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. Obtain and submit a written copy of the missing health insurance information for the identified child. Ensure that all children's records contain emergency contact information as specified in these regulations.

Noncompliance Area: Children were observed being cared for in two classrooms and their emergency contact information was not present in the classroom.

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. Ensure that emergency contact information is present in all child care spaces in which children are receiving care.

Noncompliance Area: One child has been enrolled for more than 60 days and their record did not contain a current, up-to-date health report. (#2)

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. Obtain and submit a current up-to-date health report for the indicated child. Ensure that all children's records include a current, up-to-date health report within 60 days of enrollment.

Noncompliance Area: A staff person was observed changing a child's diaper and placed the soiled diaper into a plastic tie bag rather than immediately disposing the soiled diaper into a hands-free plastic-lined container.

Correction Required: If disposable diapers are provided by a parent or by a facility, a soiled diaper shall be discarded by immediately placing the diaper into a plastic-lined, hands-free covered can. Train all facility staff in the proper diapering procedures to include the proper disposal of soiled diapers. Submit written verification of the completed training that includes all staff person's signatures.

Noncompliance Area: The facility provides transportation and lacked written verification that the vehicle is insured in accordance with the requirements of 75 Pa.C.S. 1701-1799.7 (relating to the Motor Vehicle Financial Responsibility Law.

Correction Required: A vehicle shall be insured in accordance with the requirements of 75 Pa.C.S. 1701-1799.7 (relating to the Motor Vehicle Financial Responsibility Law). Obtain and submit written verification of insurance coverage for the vehicles used to transport children.

Noncompliance Area: One staff person's record did not contain written verification of annual fire safety training. (#1)

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. Obtain and submit written verification of annual fire safety training for the identified staff person.

Noncompliance Area: The facility was not in compliance with the CPSL and with Chapter 3490 (relating to protective services): One staff person's record did not contain the required CPSL hiring documents (#1- hired 9/2016-outdated, old format signed DISCLOSURE STATEMENT)

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services. LACKING REQUIRED HIRING DOCUMENTS: 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 may not work in a child care position at the facility until compliance with the CPSL is attained. Obtain and submit a copy of the completed new and revised DISCLOSURE STATEMENT for the identified staff person. Ensure that the new DISCLOSURE STATEMENT form is used for all new hires.

Noncompliance Area: One outlet in the preschool classroom lacked a plate cover.

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. Install a plate cover over the outlet.

Noncompliance Area: Handwashing signs posted in the bathrooms did not specify that a facility person and an able child shall wash his hands after toileting and before eating.

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. Revise and post handwashing signs that includes the information as specified in this regulation.

Noncompliance Area: The facility lacked verification of a veterinarian's certificate of current rabies immunization for a cat at the facility.

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

Noncompliance Area: The facility written plan identifying the means of transporting a child to emergency care did not include staffing provisions in the event of an emergency in accordance with this regulation. Documents submitted on 12/13/17 did not include staffing provisions in the event of an emergency in accordance with this regulation.

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. Revise the written plan identifying the means of transporting a child to emergency care to include staffing provisions in the event of an emergency. Submit a copy of the revised plan, post it in each child care space and ensure that it accompanies staff persons who leave on excursions with children.

Noncompliance Area: One staff person's record did not contain a health assessment completed within 12 months prior to the date. (#1) Documents submitted on 12/13/17 contained a falsified health assessment that had not been completed and signed by the doctor whose name was on the physical.

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. Ensure that health assessments are authentic and completed within the required timeframes. Develop and submit a written policy regarding the submission of fraudulent documents. Notify all staff persons of the policy and submit written notification that includes each staff persons signature.

Noncompliance Area: One facility person's health assessment did not include written verification of tuberculosis screening by the Mantoux method within 12 months prior to the date of initial employment in accordance with 3270.151(a). (#1) Documents submitted on 12/13/17 contained a fraudulent health assessment that was not authentic and had not been completed by the doctor whose name was on the physical.

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. Ensure that health assessments are authentic and completed within the required timeframes. Develop and submit a written policy regarding the submission of fraudulent documents. Notify all staff persons of the policy and submit written notification that includes each staff persons signature.

Noncompliance Area: The facility was not in compliance with the CPSL and with Chapter 3490 (relating to protective services): One staff person's record did not contain the required CPSL hiring documents. (#1- hired 9/11/17- no proof of request for CHILD ABUSE prior to working with children-nothing in file. Documents submitted on 12/13/17 did not include written verification of the completed CPSL training for the administrative staff.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services).LACKING REQUIRED HIRING DOCUMENTS: 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 may not work in a child care position at the facility until the required CPSL documents have been obtained and submitted as specified. Submit a copy of the completed CHILD ABUSE clearance for the identified staff person. Revise and submit written policies and procedures regarding the CPSL hiring requirements to ensure that all staff persons (new and existing) have the required CPSL clearances documents in accordance with the CPSL. The facility director and administrative staff must receive DHS approved training in the CSPL hiring requirements. Submit written verification for the completed training.

Noncompliance Area: Toys, play and other equipment used by children were in need of cleaning; specifically the kid's sofa and chair in the infant room and the yellow children's chairs in the preschool room.

Correction Required: Toys, play equipment and other indoor and outdoor equipment used by the children shall be clean, in good repair and free from rough edges, sharp corners, pinch and crush points, splinters and exposed bolts. Clean the toys and equipment in the toddler room/both classrooms. Submit a written cleaning schedule to ensure that all toys, play and other equipment used by children are cleaned on a regular basis. Ensure that all broken toys and equipment are repaired or discarded.

Noncompliance Area: The facility lacked verification of a veterinarian's certificate of current rabies immunization for a cat at the facility.

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

Noncompliance Area: The agreement form used by the facility did not have a provision to include services to be provided to the family and child. (#2, #3, #4 and #5)

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). Amend the facility's agreement form to include services to be provided to the family and child. Submit a copy of the amended agreement that includes this information for the identified children.

Noncompliance Area: The facility written plan identifying the means of transporting a child to emergency care did not include staffing provisions in the event of an emergency in accordance with this regulation.

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. Revise the written plan identifying the means of transporting a child to emergency care to include staffing provisions in the event of an emergency. Submit a copy of the revised plan, post it in each child care space and ensure that it accompanies staff persons who leave on excursions with children.

Noncompliance Area: One child's record contained a health report completed more than 60 days (3 months) following the first day of attendance at the facility. (#1)

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. Revise and submit written policies and procedures to ensure that children's initial health reports are completed and provided as specified in this regulation/ within 30 days of enrollment to ensure ongoing compliance.

Noncompliance Area: One child's ventolin HFA medication was not administered according to the label which read 2 puffs by mouth every 4 hours'. It was administered 4 puffs every 3-4 hours as was written on the medication log signed by the parent. (#6)

Correction Required: A staff person shall administer a prescription medication only if written instructions are provided from the individual who prescribed the medicine. Instructions for administration contained on a prescription label are acceptable. Revise and submit written policies and procedures regarding the administration of medication to ensure proper and safe medication administration in accordance with the instructions on the label. The plan must include provisions to ensure that the medication log is consistent with the medication label as prescribed. Submit written verification of staff notification of the revised medication administration policies and procedures that includes each staff person's signature.

Noncompliance Area: One staff person's record did not contain a health assessment completed within 12 months prior to the date. (#1)

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. Obtain and submit a current up-to-date health assessment for the identified staff person. Ensure that health assessments are completed within the required timeframes.

Noncompliance Area: One facility person's health assessment did not include written verification of tuberculosis screening by the Mantoux method within 12 months prior to the date of initial employment in accordance with 3270.151(a). (#1)

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. Obtain and submit written documentation from the staff person's physician verifying negative Manotux TB testing within12 months prior to date of initial employment.

Noncompliance Area: An infant bottle observed in the infant room was not labeled with the child's name. (#1)

Correction Required: Disposable nursers and bottles shall be labeled with the child's name. Label the bottle with the child's name and ensure that all children's bottles are properly labeled.

Noncompliance Area: The facility lacked written verification of comprehensive general liability insurance to cover the persons who are on the premises.

Correction Required: The legal entity shall have comprehensive general liability insurance to cover the persons who are on the premises. A current copy of the insurance policy shall be on file at the facility. Obtain and submit written verification of the facility's comprehensive general liability insurance. Ensure that a current copy of the insurance policy is on file at the facility.

Noncompliance Area: The facility was not in compliance with the CPSL and with Chapter 3490 (relating to protective services): One staff person's record did not contain the required CPSL hiring documents. (#1- hired 9/11/17- no proof of request for CHILD ABUSE prior to working with children-nothing in file

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). LACKING REQUIRED HIRING DOCUMENTS: 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 may not work in a child care position at the facility until the required CPSL documents have been obtained and submitted as specified. Submit a copy of the completed CHILD ABUSE clearance for the identified staff person. Revise and submit written policies and procedures regarding the CPSL hiring requirements to ensure that all staff persons (new and existing) have the required CPSL clearances documents in accordance with the CPSL. The facility director and administrative staff must receive DHS approved training in the CSPL hiring requirements. Submit written verification for the completed training.

Noncompliance Area: Window in the upper level classroom that opened directly to the outdoors and were accessible to children were able to open more than 6 inches.

Correction Required: Windows or doors above the ground floor that open directly to the outdoors and are accessible to children shall be constructed, modified or adapted to limit the opening to 6 or fewer inches. Modify the window to limit the opening no more than 6 inches.

Noncompliance Area: Surfaces in the facility /and outdoor play space were in need of cleaning and/or repair: the carpet in the infant room was in cleaning or replacement; the carpet I the rear area was in disrepair and in need of repair or replacement, floor surfaces throughout were in need of cleaning, debris in the rear outdoor play area needed to be removed and sand table was in need of cleaning.

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. Complete all cleaning and repairs as specified. Develop and submit a written schedule for ongoing cleaning and maintenance to ensure compliance.

Noncompliance Area: Fire drill records did not include the names of facility persons; it only included the number of staff persons participating.

Correction Required: 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. Revise the fire drill records to include this information. Submit a copy of the revised fire drill record.