Juanita Collins Daycare

Regulation: 3270.107

Description: Refrigerator

Noncompliance Area: The small refrigerator in the front walkway lacked a thermometer and contained a cup of juice for a child enrolled at the facility.

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

Regulation: 3270.123(a)(3)

Description: Services proceeded

Noncompliance Area: The files for child #1 and #2 lacked a current child service report updated within the last 6 months.

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)(2)

Description: Physician name, address, phone

Noncompliance Area: The file for child #4 had an emergency contact form that lacked the telephone number of the child's physician.

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)(6)

Description: Insurance coverage information

Noncompliance Area: The file for child #3 had an emergency contact form that lacked the health insurance policy number.

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: 3270.135(b)

Description: Surfaces cleaned

Noncompliance Area: In the infant room, the changing table was observed with a cloth sheet cover on the diaper changing surface. According to staff statements, the sheet cover was not changed between diaper changes.

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

Regulation: 3270.165

Description: Menus

Noncompliance Area: The menu was not posted at least 1 week in advance or provided to each family for the children that receive meals at the facility.

Correction Required: An operator shall conspicuously post the menu at least 1 week in advance or provide a menu to each family.

Regulation: 3270.171(a)

Description: Pick-up and drop-off points

Noncompliance Area: The operator lacked documentation of notifying local traffic safety authorities in writing within the last year of the location of the facility and the program's use of pedestrian and vehicular routes around the child 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 child care facility.

Regulation: 3270.31(e)

Description: Age and Training

Noncompliance Area: The file for staff person #1 lacked 3 of the 12 required hours of annual child care training.

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

Regulation: 3270.65

Description: Protective Outlet Covers 5 yrs. or less

Noncompliance Area: In the back preschool room, there were an electrical outlet on the back wall and an outlet on the right wall near the back corner that lacked outlet covers and were accessible to children 5 years of age and younger.

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

Regulation: 3270.67(d)

Description: Contaminated trash in closed plastic-lined receptacle

Noncompliance Area: In the 2 year old room, the lidded trash can was observed containing food trash contaminated by human secretions and lacked a plastic liner as required.

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

Regulation: 3270.76

Description: Building Surfaces

Noncompliance Area: In the infant room on the front wall under the television, there was an electrical outlet that lacked a faceplate exposing the wires behind the outlet. In the infant room, there was a leak in a pipe in the ceiling that was observed with water dripping from a ceiling tile/opening in the ceiling to the floor. In all rooms on the main floor in the facility, there were multiple damaged ceiling tiles that were observed.

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: 3270.25(b)

Description: Post the inspection summary

Noncompliance Area: The sanction letter and corresponding inspection summaries were not posted in a conspicuous location used by parents.

Correction Required: The operator shall post a copy of each inspection summary issued by the Department in a conspicuous location used by parents. The inspection summary shall remain posted until an agent of the Department verifies that each regulatory noncompliance item cited on the inspection summary has been corrected.

Regulation: 3270.51

Description: Similar Age Level

Noncompliance Area: Continued Non-Compliance: On 11-7-25 at approximately 12:05 p.m., child #1, a 3 year old, was observed walking from the back preschool room into the middle room to wash their hands with no staff present in the middle room and was in the room alone for approximately 45 seconds. As a result, there was a 0 to 1 staff to child ratio. Staff person #1 and #2, who were in the back preschool room, were unaware that child #1 had entered the middle room. The facility's acceptable plan of correction indicated that the director and owner would attend Existing Provider Training conducted by the Western Regional Office on 1-21-26. The owner and director did not attend a complete session of the training on 1-21-26.

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 director and the owner shall attend Existing Provider training conducted by the Western Regional Office. The next trainings are offered on 3-13-26 and 5-13-26. (The director/owner shall call the Western Regional Office to register.) The correction date for this portion of the plan shall be the date the training is completed. The training must be completed by 7-23-26.

Regulation: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: 2ND CITATION: The file for staff person #1 had an outdated disclosure statement form and lacked the current disclosure statement form. (See LIS CODE SHEET) PREVIOUSLY CITED ON 11-7-25.

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: 3270.113(a)

Description: Supervised at all times

Noncompliance Area: 2nd CITATION: On 11-7-25 at approximately 12:05 p.m., child #1, a 3 year old, was observed walking from the back preschool room into the middle room to wash their hands with no staff present in the middle room and was in the room alone for approximately 45 seconds. Staff person #1 and #2, who were in the back preschool room, were unaware that child #1 had entered the middle room and were unable to see, hear, direct, and assess child #1. PREVIOUSLY CITED ON 8-14-25.

Correction Required: Tiered LIS: 1. 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. This portion of the plan shall have an immediate correction date. 2. Participate in a minimum of 2 onsite technical assistance sessions conducted by ELRC #5 to discuss room layouts and classroom environment. The correction date of this portion of the plan is to be within two months of the acceptance of the plans of correction.

Regulation: 3270.113(a)(1)

Description: Staff assigned to specific children

Noncompliance Area: 2nd CITATION: On 11-7-25 at approximately 12:05 p.m., child #1, a 3 year old, was observed walking from the back preschool room into the middle room to wash their hands with no staff physically present in the middle room and was in the room alone for approximately 45 seconds. Staff person #1 and #2, who were in the back preschool room, were unaware that child #1 had entered the middle room. PREVIOUSLY CITED ON 8-14-25.

Correction Required: Tiered LIS: 1. 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. This portion of the plan shall have an immediate correction date. 2. Participate in a minimum of 2 onsite technical assistance sessions conducted by ELRC #5 to review best practices for supervision. The correction date of this portion of the plan is to be within two months of the acceptance of the plans of correction. 3. The owner and director shall hold mandatory, monthly staff meetings for a period of four months from the acceptance of the plans of correction, which shall include all staff persons, to discuss supervision/ratio violations that have been issued within the past 12 months, including current violations, under this regulation. Documentation including a dated agenda, topics/violations discussed and a signed attendance sheet for each monthly meeting will be kept with facility files and will be made available to OCDEL/Certification representatives upon request. The correction date for this portion of the plan shall be a minimum four months from the date of acceptance of the plans of correction.

Regulation: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: The file for staff person #1 had an outdated disclosure statement form and lacked the current disclosure statement form. (See LIS CODE SHEET)

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: 3270.51

Description: Similar Age Level

Noncompliance Area: 2nd CITATION: On 11-7-25 at approximately 12:05 p.m., child #1, a 3 year old, was observed walking from the back preschool room into the middle room to wash their hands with no staff present in the middle room and was in the room alone for approximately 45 seconds. As a result, there was a 0 to 1 staff to child ratio. Staff person #1 and #2, who were in the back preschool room, were unaware that child #1 had entered the middle room. PREVIOUSLY CITED ON 8-14-25.

Correction Required: Tiered LIS: 1. 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. This portion of the plan shall have an immediate correction date. 2. The director/owner shall post signs at all child care space entrances/exits that remind staff to check ratio prior to leaving a child care space or child care group. The correction date for this portion of the plan is to be within two weeks of acceptance of the plan of correction. 3. The director and the owner shall attend Existing Provider training conducted by the Western Regional Office on January 21, 2026. (The director/owner shall call the Western Regional Office to register.) The correction date for this portion of the plan shall be the date the training is completed.

Regulation: 3270.65

Description: Protective Outlet Covers 5 yrs. or less

Noncompliance Area: In the middle room, there was a power strip that lacked three outlet covers and was accessible to children 5 years of age and younger.

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

Regulation: 3270.76

Description: Building Surfaces

Noncompliance Area: On the outdoor play space, there were empty soda cans and food/chip bags and containers that were on the ground in the play space.

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

Regulation: 3270.77(a)

Description: No peeling paint or plaster

Noncompliance Area: In the toddler room, there were a couple areas of peeling paint on the wall.

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

Regulation: 3270.91(a)

Description: Stairs, exits, etc. unobstructed

Noncompliance Area: According to staff statements and observations, there was a wooden shelf in the room that was blocking the entrance/exit of the toddler room.

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

Regulation: 3270.113(a)

Description: Supervised at all times

Noncompliance Area: On 8-14-25 at approximately 12:07 p.m. in the upstairs room during naptime, there were 4 preschoolers observed alone in the room on rest equipment for approximately 5-10 seconds without a staff person present in the room. Then, staff person #4 walked into the room from the back hallway to supervise the children.

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)(1)

Description: Staff assigned to specific children

Noncompliance Area: On 8-14-25 at approximately 12:07 p.m. in the upstairs room during naptime, there were 4 preschoolers observed alone in the room on rest equipment for approximately 5-10 seconds without a staff person present in the room. Then, staff person #4 walked into the room from the back hallway to supervise the children. On 8-14-25, staff person #6 and #7 were observed on an excursion leaving the nearby high school with 18 school-age and preschool children and were walking back to the facility. Staff person #6 and #7 both stated that they were sharing the group of 18 children, with staff person #6 naming all 18 children, and staff person #7 naming 16 of the 18 children and stated that they did not know 2 of the children's names.

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: 3270.32(a)

Description: Comply with CPSL

Noncompliance Area: Staff person #3 had mandated reporter trainings dated 6-16-20 and 6-25-25 that were over 60 months between trainings.

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

Regulation: 3270.51

Description: Similar Age Level

Noncompliance Area: On 8-14-25 at approximately 12:07 p.m. in the upstairs room during naptime, there were 4 preschoolers observed alone in the room on rest equipment for approximately 5-10 seconds without a staff person present in the room resulting in a 0 to 4, staff to child ratio. Then, staff person #4 walked into the room from the back hallway to supervise 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.

Regulation: 3270.52

Description: Mixed Age Level

Noncompliance Area: On 8-14-25 at approximately 12:05 p.m. with a total of 8 children in the toddler area, staff person #5 named 8 children in their group, including 7 older toddlers and 1 preschooler, resulting in staff person #5 being out of ratio. The 7 older toddlers were on rest equipment for naptime, and the preschooler was sitting in a chair and not on rest equipment, resulting in napping ratios not being applicable due to the preschool child that was not on rest equipment.

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: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: The file for staff person #1 had an NSOR verification certificate dated 8-5-20 and lacked a current NSOR verification certificate updated within the last 60 months. The file for staff person #2 had child abuse clearances dated 6-16-20 and 7-2-25 that were over 60 months between clearances.

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. Staff Person #1 may not work in a child care position at the facility.

Regulation: 3270.77(a)

Description: No peeling paint or plaster

Noncompliance Area: 2nd CITATION: In the upstairs room, there were multiple areas of peeling paint on the back and right walls, and there were multiple areas of peeling paint on the two corners near the boys' bathroom in the hallway leading from the room to the bathroom. In the back room downstairs, there were a couple areas of peeling paint near the door to the room. PREVIOUSLY CITED ON 6-11-25.

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

Regulation: 3270.151(c)(3)

Description: Exam communicable disease

Noncompliance Area: The file for staff person #2 had a health assessment that said "Yes" to having any communicable diseases and lacked an explanation of the results of the examination.

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

Regulation: 3270.21

Description: General Health and Safety

Noncompliance Area: In the upstairs sink/counter area in the kitchen near the bathrooms, there were a sharp knife and a pitchfork utensil that had sharp edges and were 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(e)(4)(i)

Description: Age and Training

Noncompliance Area: The file for staff person #3 had current pediatric first-aid/CPR training with a completion date of 11-23-24 that was after the October 2024 expiration of the prior training.

Correction Required: Competence is the completion of training by a professional in the field of first-aid and cardiopulmonary resuscitation (CPR). All staff persons shall renew their certification in pediatric first aid and pediatric cardiopulmonary resuscitation (CPR) on or before the expiration of the most current certification.

Regulation: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: The file for staff person #1 had an invalid state police clearance that lacked the disseminated date and requires a current state police clearance updated within the last 60 months. The file for staff person #1 had child abuse clearances and NSOR verification certificates that exceeded 60 months between clearances/certificates. The file for staff person #2 had state police clearances, FBI clearances, and NSOR verification certificates that exceeded 60 months between clearances/certificates.

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. Staff Person #1 may not work in a child care position at the facility.

Regulation: 3270.76

Description: Building Surfaces

Noncompliance Area: On the outdoor play space, there were 4 bolts on the inside of the fence near the gate and right corner that were protruding out and were a visible hazard. In the upstairs back stairwell, the windowsill had cobwebs and visible dirt.

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

Regulation: 3270.77(a)

Description: No peeling paint or plaster

Noncompliance Area: There were a couple areas of peeling paint upstairs on the left side of the hallway leading to the bathrooms and a couple areas on the right wall near the baseboard in the girls' bathroom.

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

Regulation: 3270.82(e)

Description: Toilet and sinks proper height

Noncompliance Area: In the infant room with a 1 year old that was walking and able to wash their hands, the sink next to the changing table had a stepstool that was at a height that the child was unable to reach the sink after diapering to wash their hands.

Correction Required: Toilets and sinks shall be at proper heights for children using them or shall be easily approached by means of platforms or steps.

Regulation: 3270.95(a)/3270.95(b)

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

Noncompliance Area: According to the log, the operator did not manually test the interconnected fire detection system in the facility at least once every 30 days between 5-9-25 to 6-9-25.

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

Regulation: 3270.103

Description: Small Toys and Objects

Noncompliance Area: In the toddler room with young and older toddlers present in the room, there were two large fabric blocks that had multiple tears with small pieces coming apart from the blocks with a diameter of less than 1 inch and were accessible to children who are still placing objects in their mouths.

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

Regulation: 3270.123(a)(1)

Description: Amount of fee

Noncompliance Area: The file for child #1 had an agreement that lacked the fee amount.

Correction Required: An agreement shall specify the amount of the fee to be charged per day or per week.

Regulation: 3270.131(a)/3270.182(1)

Description: Health information/Initial and subsequent health reports

Noncompliance Area: The file for child #2 had an initial health assessment that was dated over 60 days after the child's first day of attendance at the facility.

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)/3270.182(1)

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

Noncompliance Area: The file for child #3, a preschooler, had a health assessment that exceeded 12 months between assessments.

Correction Required: The operator shall require the parent to provide an updated health report at least every 12 months for an older toddler or preschool child. A child's record shall contain initial and subsequent health reports.

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

Description: Immunization record/Dismissal policy

Noncompliance Area: The file for child #2, a 2 year old enrolled more than 60 days at the facility, lacked documentation of the 3rd Hepatitis B and 4th DTAP vaccinations being administered in accordance with the schedule recommended by the ACIP and lacked exemption documentation.

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). Child #2 must be dismissed from care by close of business on 6-28-24 and may only return to care when the immunization record is updated or when a parent provides a written, signed exemption letter.

Regulation: 3270.14/3270.21

Description: Pertinent Laws & Regulations/General Health and Safety

Noncompliance Area: Staff person #4 was observed to be caring for children unsupervised. Staff person #4 has not completed the following pre-service training required prior to caring for children unsupervised: Health and Safety Training in the topics of 3270.31(f)(1-9).

Correction Required: A facility shall be operated in conformity with applicable Federal and State laws and regulations. State agencies whose regulations may relate to the operation of a facility include the Department of Environmental Resources, the Department of Labor and Industry, the Department of Health, the Department of Education and the Department of Transportation. Conditions at the facility may not pose a threat to the health or safety of the children. Until such time as the required pre-service trainings are completed, staff person #4 must be supervised, when interacting with children, by an AGS who has completed the required training related to this citation. If there are no staff person(s) available to supervise staff person #4, staff person #4 may not work in a child-care position at the facility.

Regulation: 3270.151(a)/3270.192(3)

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

Noncompliance Area: The file for staff person #1 had a health assessment that was dated after the staff person provided initial service in a child care setting at the facility. The files for staff person #2 and #3 had a health assessment that exceeded 24 months between assessments.

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

Regulation: 3270.151(c)(2)

Description: Mantoux TB

Noncompliance Area: The file for staff person #1 had a tuberculosis screening by the Mantoux method that was dated after their initial employment at the facility.

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.

Regulation: 3270.27(e)

Description: Letter to parents

Noncompliance Area: The operator's letter provided to the parent of each enrolled child explaining the emergency procedures lacked the accommodations for infants, toddlers, and children with disabilities.

Correction Required: The operator shall provide to the parent of each enrolled child a letter explaining the emergency procedures. The operator shall also provide to the parent of each enrolled child a letter explaining any subsequent update to the plan.

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

Description: Fire safety - 1 yr.

Noncompliance Area: The file for staff person #3 had fire safety training that exceeded a year between trainings.

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

Regulation: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: The file for staff person #1 had an invalid state police clearance and requires a current state police clearance. The file for staff person #1 had a disclosure statement that was dated after their start date at the facility. The file for staff person #4 had a disclosure statement that lacked the signature of a witness.

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. Staff Person #1 may not work in a child care position at the facility.

Regulation: 3270.34(a)(6)

Description: Staff evaluations

Noncompliance Area: The file for staff person #3 had a staff evaluation that exceeded 12 months between evaluations.

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

Regulation: 3270.76

Description: Building Surfaces

Noncompliance Area: On the outdoor play space, there were several sharp edges of metal on the right wall of the building that were accessible to 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: 3270.77(a)

Description: No peeling paint or plaster

Noncompliance Area: In the school-age room, there was damaged paint and plaster in one area on the wall.

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

Regulation: 3270.92(a)

Description: No portable space heaters

Noncompliance Area: There was a portable space heater observed in the office area in the front of the building.

Correction Required: Portable space heaters are not permitted.

Regulation: 3270.95(a)/3270.95(b)

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

Noncompliance Area: According to the log, the operator did not manually test the interconnected fire detection system in the facility at least once every 30 days on multiple occasions within the last year.

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.

Regulation: 3270.102(a)

Description: Clean and good repair

Noncompliance Area: There were foam blocks in the Infant area and in the Toddler area that had teeth marks and small chunks that had broken off.

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)(1)

Description: Staff assigned to specific children

Noncompliance Area: During a supervision and ratio check at nap time, Staff person #1 , who was supervising 1 young toddler and 4 older toddlers, could not name 2 of the 5 children.

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 file for Child #3, with an admission date of 9/19/22, more than 6 months ago, does not include a 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: 3270.124(b)(4)/3270.182(3)

Description: Written consent/Consent for emergency medical care required prior to admission

Noncompliance Area: The file for Child #4 does not include written parental permission for the facility to obtain emergency medical care.

Correction Required: Emergency contact information must include the written consent signed by a parent for emergency medical care. A child's record shall contain signed parental consent for emergency medical care for the child. Written consent is required prior to admission.

Regulation: 3270.124(b)(6)

Description: Insurance coverage information

Noncompliance Area: The emergency contact form on file for Child #3 does not include the child's health insurance policy number for the child's health care benefits.

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 emergency contact form on file for Child #1 and #2 does not include a complete address for all listed release persons.

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

Regulation: 3270.131(a)/3270.182(1)

Description: Health information/Initial and subsequent health reports

Noncompliance Area: The file for Child #4, with an enrollment date of 3/6/23, more than 60 days ago, does not include a valid health assessment.

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

Description: Immunization record/Dismissal policy

Noncompliance Area: The most recent influenza vaccination on file for Child #1, who is 3 years old, is dated 2/16/21, more than 1 year ago, and is recommended annually by the ACIP. The immunization record on file for Child #4, who is 3 years old, includes 3 of 4 Pneumococcal vaccines recommended by the ACIP for a child this age, and a most recent influenza vaccination, which is recommended annually, dated 1/8/21, more than 1 year ago. The most recent influenza vaccination on file for Child #5, who is 5 years old, is dated1/25/19, more than 1 year ago, and is recommended annually by the ACIP.

Correction Required: ·Child #1, #4, and #5 must be dismissed from care by close of business on 6/28/23, and may only return to care when the immunization record is updated or when a parent provides a written, signed exemption letter. 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: 3270.135(a)(3)

Description: Disposable diapers

Noncompliance Area: The Infant diapering area does not have a hands-free, lined, lidded can for the disposal of diapers.

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.

Regulation: 3270.14/3270.21

Description: Pertinent Laws & Regulations/General Health and Safety

Noncompliance Area: The Health and Safety professional development training update on file for Staff person #2 is dated 2/27/23, after the deadline of 12/30/22, as per Announcement C-22-06. The Health and Safety professional development training update on file for Staff person #3 is dated 2/22/23, after the deadline of 12/30/22, as per Announcement C-22-06. The Health and Safety professional development training update on file for Staff person #4 is dated 1/12/23, after the deadline of 12/30/22, as per Announcement C-22-06. The file for Staff Person #6 did not contain the Pa. Health and Safety update 2022 which was required to be completed by 12.30.22, as per Announcement C-22-06. The Health and Safety professional development training update on file for Staff person #7 is dated 2/28/23, after the deadline of 12/30/22, as per Announcement C-22-06.

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: 3270.152

Description: Adult Hygiene

Noncompliance Area: During an observed diaper change in the Infant area, a staff person did not wash their hands following the diaper change.

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

Regulation: 3270.182(5)

Description: Consent for administration of minor first-aid required prior to admission

Noncompliance Area: The file for Child #4 does not include written parental permission for the facility to administer minor first aid procedures.

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

Regulation: 3270.192(4)

Description: CPSL information

Noncompliance Area: The file for Staff person #3 did not contain the previously viewed Criminal history clearance, child abuse clearance, and FBI clearance, which were dated 5/11/15, 5/14/15, and 4/30/15, respectively. The file for Staff person #6 did not contain the previously viewed Criminal history clearance, child abuse clearance, which were dated 8/2/17 and 8/4/17, respectively. The file for Staff person #7 did not contain the previously viewed Criminal history clearance, child abuse clearance, and FBI clearance, which were dated 8/29/15, 6/18/15, and 9/25/15, respectively.

Correction Required: A facility person's record shall include a copy of requests for the criminal history record and child abuse registry clearance information, a copy of the disclosure statement and a copy of the completed clearance information required under the CPSL.

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

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

Noncompliance Area: The 2 most recent emergency plan trainings on file for Staff person #7 are dated 5/10/22 and 6/6/23, more than 1 year apart.

Correction Required: The operator shall assure that each facility person receives training regarding the emergency plan at the time of initial employment, on an annual basis and at the time of each plan update. The operator shall document the date of each training and the names of all facility persons who received the training and kept on file at the facility. A facility person's record shall include verification of child care experience, education and training following the outset of service at the facility.

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

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

Noncompliance Area: The 2 most recent fire safety training certificates on file for Staff person #6 are dated 10/16/20 and 10/22/22, more than 1 year apart. The 2 most recent fire safety training certificates on file for Staff person #7 are dated 1/24/22 and 2/28/23, more than 1 year apart.

Correction Required: Staff persons shall participate, at least annually, in firesafety training conducted by a fire protection professional. Staff persons and volunteers shall receive training in maintenance of smoke detectors, the duties of facility persons during a fire drill and during a fire and the use of the facility's fire extinguishers, not including discharge of the fire suppressant agent. A facility person's record shall include verification of child care experience, education and training following the outset of service at the facility.

Regulation: 3270.32(a)

Description: Comply with CPSL

Noncompliance Area: Staff person #3 completed mandated reporter training on 1/9/23, more than 60 months after the previous training, dated 10/28/17.

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

Regulation: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: The Disclosure statement on file for Staff person #1 does not include a witness signature. The file for Staff person #5, who was re-hired, does not include a signed Disclosure statement, signed at the time of re-hire (See LIS code sheet). The criminal history clearance on file for Staff person #5 is incomplete, making it invalid; and the FBI clearance on file includes a RAP sheet with charges that do not have a disposition, making it invalid.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). Facility Person #1, #5 may not work in a child care position at the facility.

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

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

Noncompliance Area: The file for Staff person #1, and #5 classified as an Assistant Group Supervisor, does not include a high school diploma or a general educational development certificate and 30 credits in education or a related human services field; or a high school diploma or a general educational development certificate and 15 credits in education or a related human services field and 1 year of verified child care experience; or a high school diploma or a general educational development certificate with 2 years of verified child care experience.

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

Regulation: 3270.34(a)(6)

Description: Staff evaluations

Noncompliance Area: The file for Staff person #7, who has been employed for more that 1 year, does not include a staff evaluation (See LIS code sheet)

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

Regulation: 3270.76

Description: Building Surfaces

Noncompliance Area: There were area rugs in the Toddler area that were not tacked down and caused a tripping hazard as they were frequently kicked up or bunched up, creating a tripping hazard. There were missing ceiling tiles in the preschool area that had been removed during roof and water damage repairs and had not been replaced.

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: 3270.82(j)

Description: Running water - diapering

Noncompliance Area: There was no running water for handwashing in the infant diapering area.

Correction Required: A source of running water for handwashing shall be present in infant and toddler diapering areas. If the running water does not flow directly into a drain that is connected to a sewage system, a receptacle shall be provided to contain the water used for washing. The receptacle shall be emptied into an approved sewage system at least once a day.

Regulation: 3270.95(a)/3270.95(b)

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

Noncompliance Area: The most recent 30-day fire alarm test on file is dated 4/13/23, more than 30 days ago.

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.

Regulation: 3270.106(a)

Description: Clean, age appropriate

Noncompliance Area: The cribs in the infant room are not labeled for use by a specific child.

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: 3270.107

Description: Refrigerator

Noncompliance Area: During the renewal inspection, the refrigerator in the infant room was observed to not be closed fully, due to a milk jug preventing the refrigerator from closing completely, and the temperature measuring over 60 degrees Fahrenheit; while there was milk in the refrigerator.

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: 3270.131(d)(5)/3270.131(e)(1)

Description: Immunization record/Exemption documentation from parent/guardian

Noncompliance Area: The immunization record on file for Child #1, who is 2 years old, included 3 of 4 pneumococcal vaccines recommended by the ACIP for a child this age. The most recent influenza vaccination on file for Child #2, who is 4 years old, is dated 1/25/19, more than 1 year ago, as is recommended annually by the ACIP. The immunization record on file for Child #3, who is 4 years old, includes 1 of 4 HIB vaccines recommended for a child this age by the ACIP. The immunization record on file for Child #4, who is 2 years old, includes 2 of 4 DTAP vaccines, 0 of 4 HIB vaccines, 2 of 4 Pneumococcal vaccines, 2 of 3 Polio vaccines, and 1 of 2 Hepatitis A vaccines recommended by the ACIP for a child this age.

Correction Required: A health report shall include a review of the child's immunized status according to recommendations of the ACIP.The facility shall require the parent to provide updated written verification from a physician, physician's assistant, CRNP, the Department of Health or a local health department of ongoing vaccines administered to an infant, toddler or preschool child in accordance with the schedule recommended by the ACIP.

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 initial health assessment on file for Staff person #3 does not indicate that a physical examination was conducted by the health care provider (See LIS Code Sheet).

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

Regulation: 3270.192(5)

Description: Two written references

Noncompliance Area: The file for Staff person #4 does not include two written, nonfamily references from individuals attesting to the person's suitability to work in a child care position. The file for Staff person #6 includes just one written, nonfamily references from individuals attesting to the person's suitability to work in a child care position.

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

Regulation: 3270.21

Description: General Health and Safety

Noncompliance Area: There was no gate at the top of the stairs on the 2nd floor, where 4 older toddlers were receiving care.

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

Regulation: 3270.27(a)(6)

Description: Emergency plan

Noncompliance Area: There was no written documentation of an emergency drill being conducted prior to 12/19/21, as per updates to Chapter 3270 regulations, effective 12/19/20.

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

Regulation: 3270.31(e)(1)(iii)/3270.192(2)(iii)

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

Noncompliance Area: The file for Staff person #2 includes 8 of 12 required annual training hours completed between 12/19/20-12/19/21, as per Announcement C-21-09. The file for Staff person #7 includes 9 of 12 required annual training hours completed between 12/19/20-12/19/21, as per Announcement C-21-09.

Correction Required: Training conducted in conferences or workshops is acceptable and may count toward the annual requirement for 12 clock hours of child care training.A facility person's record shall include verification of child care experience, education and training following the outset of service at the facility.

Regulation: 3270.31(f)

Description: Health and Safety Training

Noncompliance Area: Staff person #2 and Staff person #7 worked between 4/29/22-5/12/22 without having completed a PQAS approved Pediatric First Aid/CPR course taught by a PQAS approved instructor. Staff person #4 has not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): Pediatric First Aid/Pediatric CPR and Get Started with Center-based Care: Building Blocks for Quality.

Correction Required: Staff person(s) shall complete professional development in the topics of 3270.31(f)(1 -- 10) within 90 days of hire. Staff person #4 will have until 8/16/22 to complete the required trainings. Until such time as the required training has been completed, staff person #4 must be supervised, when interacting with children, by an (AGS, primary staff person, or family child care home staff person) who has completed the required training related to this citation. If there are no staff available to supervise staff person #4, staff person #4 may not work in a child-care position at the facility.

Regulation: 3270.32(a)

Description: Comply with CPSL

Noncompliance Area: The 2 most recent mandated reporter training certificates on file for Staff person #2 are dated 5/29/15 and 6/16/20, more than 60 months apart. The signed disclosure statement on file for Staff person #3, #5, #6 are not dated, making them invalid. The file for Staff person #4 does not include a signed disclosure statement (See LIS Code Sheet).

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

Regulation: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: The file for staff person #1 was observed not to include a rap sheet with the FBI clearance, which indicated the person has a record (See IS CODE SHEET) required for CPSL compliance. The file for staff person #4 was observed not to contain a valid NSOR certificate within 45 days of hire (See IS CODE SHEET).

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). A facility person's record shall include a copy of requests for the criminal history record and child abuse registry clearance information, a copy of the disclosure statement and a copy of the completed clearance information required under the CPSL. Facility Person #1, #4 may not work in a child care position at the facility.

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

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

Noncompliance Area: The file for Staff person #3, who was classified as a group supervisor, does not have verification of a Bachelor's degree in education or a related human services field; or a Bachelor's degree with 30 credits in education or a related human services field and 1 year of verified child care experience; or an Associate's degree in education or a related human services field and 2 years of verified child care experience; or an Associate's degree with 30 credits in education or a related human services field and 3 years of verified child care experience. The file for Staff person #4 and Staff person #6, both classified as Assistant Group Supervisors do not include a high school diploma or a general educational development certificate and 30 credits in education or a related human services field; or i high school diploma or a general educational development certificate and 15 credits in education or a related human services field and 1 year of verified child care experience; or a high school diploma or a general educational development certificate with 2 years of verified child care experience.

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

Regulation: 3270.52

Description: Mixed Age Level

Noncompliance Area: While assessing supervision and ratio in the school age classroom, a staff person named 13 young and older school age children.

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).

Noncompliance Area: Child #1 had an emergency contact form that lacked the addresses of the individuals designated by the parent to whom the child may be released.

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

Noncompliance Area: Staff person #1 had an initial health assessment on which the date of the health assessment had white out on the form. The date on the form was 9-23-19. The month and the year were written in one color ink and the year was written in a different color ink over top of the white out. It was unclear when the health assessment was administered.

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

Noncompliance Area: It was observed that the smoke alarm in the hallway outside of the upstairs bathroom was making a chirping noise causing the smoke alarm to be in disrepair. It was observed that the smoke alarm in the kitchenette in the upstairs of the facility was making a chirping noise causing the smoke alarm to be in disrepair. There were cords for a fan and a surveillance camera mounted high on the wall hanging down in to the childcare space making the cords accessible to the children and causing a possible hazard that the children could pull the items down.

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

Noncompliance Area: Staff person #1, with a documented start date with children of 9-24-19, had an NSOR verification dated 9-1-20; which was obtained after the required time frame as designated by the CPSL.

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

Noncompliance Area: Staff person #1 lacked an annual written evaluation.

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

Noncompliance Area: There was an electrical box on the floor in the rear room of the facility that had a cracked plate cover causing sharp edges to be accessible to the 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.

Noncompliance Area: There was damaged paint on the blue wall in the upstairs preschool room.

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

Noncompliance Area: A mat in the rear room was observed to have a rip in the vinyl cover, causing foam to be exposed. A shelf on the bookshelf in the upstairs room was detached, causing sharp edges of a screw to protrude outward and be accessible to children. There were cracks on two plastic teeter-totters on the outdoor play area, causing pinch points to be accessible to children. There was a broken push toy on the outside play area, causing sharp plastic edges to be accessible to children. There was a brown climbing structure on the outdoor play area that was not properly assembled, causing the structure to be unstable. There was a plastic shelf on a bookshelf in the front room that was cracked, exposing the children to sharp edges and pinch points.

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

Noncompliance Area: The file for Child #2 contained an immunization record that lacked a current flu vaccination, as recommended by the ACIP.

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

Noncompliance Area: The lid on the hands-free garbage can in the diapering area in the middle room downstairs was broken, causing it to not be hands-free.

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.

Noncompliance Area: There was a plastic bag that contained a package of cigarettes and a disposable lighter on the floor, accessible to children, on the floor in the rear room downstairs.

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