Key Moments Childcare Center

Regulation: 3270.113(a)

Description: Supervised at all times

Noncompliance Area: According to staff statements, children have been observed on multiple occasions using the restrooms while the staff responsible for them remain in the gym or a classroom down or across the hallway.

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: According to staff statements, children have been observed on multiple occasions using the restrooms while the staff responsible for them remain in the gym or a classroom down or across the hall.

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: 3270.193(a)

Description: Confidential; stored in locked cabinet

Noncompliance Area: Staff files were stored in a cabinet that was not locked and in the office on desks and shelves.

Correction Required: Facility persons' records are confidential and shall be stored in a locked cabinet.

Regulation: 3270.31(f)

Description: Health and Safety Training

Noncompliance Area: There was no documentation of completion of any required preservice trainings on file for Facility Person #2, employed more than 90 days. The approved pediatric first aid/CPR training (5/6/26) completed and on file for Facility Person #3 was completed more than 90 days after their start date.

Correction Required: Staff persons shall complete professional development within 90 days of hire as listed in subsections (f)1-10.Until such time as the required training has been completed, staff person #2 must be supervised, when interacting with children at a minimum by, an AGS who has completed all preservice trainings and has all qualifications to care for children unsupervised. If there are no staff person(s) available to supervise staff person #2, staff person #2 may not work in a child-care position at the facility.

Regulation: 3270.32(a)

Description: Comply with CPSL

Noncompliance Area: The only mandated reporter training on file for Facility Person #1 was expired (completed more than 60 months prior.)

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to Child Protective Services). Until such time as the required training has been completed, staff person/facility person #1 must be supervised, when interacting with children at a minimum by, an AGS who has completed all preservice trainings and has all qualifications to care for children unsupervised. If there are no staff person(s) available to supervise staff person #1-, staff person #1 may not work in a child-care position at the facility

Regulation: 3270.51

Description: Similar Age Level

Noncompliance Area: According to staff statements, on 5/20/26 at approximately 8:30-9:00 AM, Facility Person #2 was caring for 21 preschoolers in the gym for about 20 minutes with no other staff present in the gym. According to statements of staff, multiple groups throughout the facility are out of ratio regularly.

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: Facility Person #1 was observed supervising 1 young toddler and 5 older toddlers in the gym at 8:00 AM.

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: 3270.66(a)

Description: Locked or inaccessible

Noncompliance Area: Observed the door to the utility closet located in the front hallway near the employee restroom was wide open, giving children access to Clorox bleach, paint and other cleaning supplies all labeled Keep out of Reach of Children.

Correction Required: Cleaning materials and other toxic materials shall be kept in an area or container that is locked or made inaccessible to children. Tiered LIS: 1) Cleaning materials and other toxic materials shall be kept in an area or container that is locked or made inaccessible to children. (This plan of correction will have an immediate correction date.) 2) Provider will place a sign on the utility closet door reminding facility persons to keep the utility closet door closed at all times. (Operator will provide a correction date within 10 days)

Regulation: 3270.102(a)

Description: Clean and good repair

Noncompliance Area: Observed on the outdoor play space a Little Tykes plastic ship and yellow scooter to be cracked with sharp edges, a Little Tykes basketball hoop that was not anchored and therefore not stable, and the brown climber to be falling apart with exposed screws and a cracked 'sun light' with sharp edges. Observed in the Preschool 1 Room Magna Blocks with cracked edges and a cracked Lego bin.

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: 3270.104(a)

Description: Clean, good repair, proper size

Noncompliance Area: Observed in the Preschool 1 and Preschool 2 rooms wobbly children's wooden chairs with loose screws and pinch points between the seat and chairback.

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

Regulation: 3270.106(f)

Description: 2 feet apart

Noncompliance Area: In the infant room observed a child sleeping on a rest mat positioned inside of a netted play yard which did not allow for the required 2 feet of open space on 3 sides of the rest equipment.

Correction Required: At least 2 feet of space is required on three sides of a bed, cot, crib or other rest equipment while the equipment is in use.

Regulation: 3270.107

Description: Refrigerator

Noncompliance Area: The refrigerator in the Toddler A room is lacking a thermometer.

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

Regulation: 3270.114

Description: Outdoor Activity

Noncompliance Area: According to staff, the outdoor play space is not being used, and children are not taken outdoors daily.

Correction Required: Weather permitting, children shall be taken out doors daily.

Regulation: 3270.123(a)(3)

Description: Services proceeded

Noncompliance Area: The files for child #4 and #5 do not contain child service reports completed during the previous 6-month period.

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

Regulation: 3270.123(b)/3270.182(8)

Description: Parent receives original/Copy of initial and subsequent agreements. Parent receives original.

Noncompliance Area: The files for child #1 and #2 contain the original agreement instead of the copy.

Correction Required: A parent shall receive the original agreement. The facility shall retain a copy of the agreement. A child's record shall contain a copy of the initial agreement and subsequent written agreements between the parent and the operator. The parent receives the original agreement.

Regulation: 3270.124(b)(2)

Description: Physician name, address, phone

Noncompliance Area: The file for child #6 contains an emergency contact form that is lacking address and telephone number of the child's physician or source of medical care.

Correction Required: Emergency contact information must include the name, address and telephone number of the child's physician or source of medical care.

Regulation: 3270.124(b)(7)

Description: Name/address/phone release person

Noncompliance Area: The files for child #3 and child #4 do not include the name, address and telephone number of the individual designated by the parent to whom the child may be released.

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

Regulation: 3270.133(5)

Description: Original label

Noncompliance Area: In the Toddler B classroom there was expired Topcare pain reliever and 2 bottles of expired Children's Tylenol.

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

Regulation: 3270.135(a)(3)

Description: Disposable diapers

Noncompliance Area: In the child's bathroom at the end of the hallway the trash can where diapers were disposed has a broken foot pedal and was therefore not able to function as a hands-free trash can.

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: 3270.151(a)/3270.192(3)

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

Noncompliance Area: The files for facility persons #6,7,8 and 9, serving as volunteers who have direct contact with children, are lacking health assessments. The file for staff person #10, hire date (see IS code sheet) contains an initial health assessment with TB test that was conducted after their start date caring for children evidenced by the only health assessment in the file dated 8/11/2025. The file for staff person #16, hire date (see IS code sheet) contains an initial health assessment with TB test that was conducted after their start date caring for children evidenced by the only health assessment in the file dated 4/25/25.

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 files for staff person's #15 and 18 are lacking 2 refernce letters. The file for staff person #10 contains only 1 of the required 2 refernce letters. The files for facility persons #3,#4,#5,#6,#7,#8 and #9 are lacking 2 reference letters.

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: Observed in the infant room 8 crib sheets that fit the crib mattress either too large or too small causing a possible suffocation hazard.

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

Regulation: 3270.27(c)

Description: Training regarding plan

Noncompliance Area: The files for staff persons #2, #11 and #14 are lacking documentation of annual emergency plan training during the previous 12 month period.

Correction Required: The operator shall assure that each facility person receives training regarding the emergency plan at the time of initial employment, on an annual basis and at the time of each plan update. The operator shall document the date of each training and the names of all facility persons who received the training and kept on file at the facility.

Regulation: 3270.31(e)(4)(i)

Description: Age and Training

Noncompliance Area: The files for staff persons #11, #12, #13, #14, #17 and #20 contain current pediatric first aid and CPR training that was received after the previous training expired. The training is now current.

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

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

Noncompliance Area: The file for staff person #14 contains only 11 of the required 12 hours of child care training completed during the previous 12 month from 10/2024 to 10/2025..

Correction Required: A staff person shall obtain an annual minimum of 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: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: The files for facility persons #1, #3, #4, #5, # 6, # 7, # 8, #9 and #10, hire dates (see IS code sheet) are all lacking signed disclosure statements prior to service in a child care facility. The file for staff person #15 contains a disclosure statement that was obtained after initial hire but is now valid. The file for staff person #18 contains a disclosure statement that is not dated and is therefore not valid. The file for staff person #1, hire date (see IS code sheet) is lacking an NSOR prior to working with children. The file does now contain a valid NSOR verification. The file for facility person #6, hire date (see IS code sheet) contains an FBI clearance that was obtained through the Department of Education and is not valid for service in a child care facility. The file for staff person #11, hire date (see IS code sheet) contains a current FBI fingerprint clearance that was obtained after the previous FBI clearance expired as evidenced by clearances dated 1/3/2020 and 10/21/2025. and contains a current child abuse clearance that was obtained after the previous child abuse clearance expired as evidenced by child abuse clearances dated 1/24/2020 and 10/25/2025. The file is now current. The file for staff person #14 contains a current NSOR verification that was obtained after the previous NSOR expired, as evidenced by NSOR verifications dated 8/6/2018 and 9/5/2025. The file is now current. The files for staff persons #15, #16 and #18, hire dates (see IS code sheet) are lacking NSOR verifications obtained prior to start date in a child care position. The verifications are now current.

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 #1,3,4,5,6,7,8,9,10 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 #15, serving as an assistant group supervisor, is lacking verification of a high school diploma or GED to qualify for the position in which she is serving.

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: 3270.66(a)

Description: Locked or inaccessible

Noncompliance Area: Observed the door to the utility closet located in the front hallway near the employee restroom was slightly ajar, giving children access to bleach, latex paint, and stain remover all labeled Keep out of Reach of Children. Observed a blue substance determined to be toilet bowl cleaner on the toilet seat in the rest room at the end of the hall used by children in care. Observed a bottle of Bar Keeper's Friend Foam cleaner, labeled Keep out of Reach of Children, stored in an unlocked low plastic drawer unit in the children's bathroom at the end of the hallway. Observed fungi's / mushrooms and Boston Ivy growing on the outdoor play space accessible to children utilizing the play space. The plants are listed on the Toxic Plants list. In the Preschool 1 classroom observed body lotion and hand sanitizer, both labeled Keep Out of Reach of Children, on a desk accessible to children. Also observed a purse belonging to a staff person on the bottom of an open closet accessible to children.

Correction Required: Cleaning materials and other toxic materials shall be kept in an area or container that is locked or made inaccessible to children.

Regulation: 3270.66(b)

Description: Original container

Noncompliance Area: Observed a bottle of Bar Keeper's Friend Foam cleaner, labeled Keep out of Reach of Children, stored in an unlocked low plastic drawer unit in the children's bathroom at the end of the hallway. Also stored in the drawer was a child's pull-up. Observed in the Preschool 1 classroom an unlabeled spray bottle identified by staff as sanitizer. Observed in the Preschool 1 classroom Floor Mopping Cloths stored on a shelf above food.

Correction Required: Cleaning materials and other toxic materials shall be stored in an original labeled container or in a container that specifies the content. Toxics shall be stored away from food, food preparation areas and child care spaces.

Regulation: 3270.66(d)

Description: Toxic plants not permitted

Noncompliance Area: Observed fungi's / mushrooms and Boston Ivy growing on the outdoor play space accessible to children utilizing the play space. The plants are listed on the Toxic Plants list. Observed in the window in the Toddler B classroom a Wandering Dude plant which is on the list of toxic plants.

Correction Required: Toxic plants are not permitted in a child care space.

Regulation: 3270.67(a)

Description: Trash removed once a day

Noncompliance Area: Observed at ~10:00am the trashcan in the children's bathroom at the end of the hall was overflowing evident that it had not been emptied the previous day.

Correction Required: Trash shall be removed from the facility at least once per day.

Regulation: 3270.67(d)

Description: Contaminated trash in closed plastic-lined receptacle

Noncompliance Area: Observed in the children's bathroom at the end of the hallway, the trash container which contained soiled diapers / pull-ups did not have a plastic lining /bag.

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

Regulation: 3270.75(c)

Description: Has all items

Noncompliance Area: In the Toddler A classroom, the first aid kit was lacking 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: In the children's bathroom at the end of the hallway observed the following: several strips of toilet paper laying on the floor in the stalls., a blue substance on the toilet seat, clothing laying on the floor and paper towels from an overflowing trash can laying on the floor. In the indoor play space observed the following hazards: ceiling is peeling and crumbling due to water damage, wet mopheads covering the floor behind the furnish unit, corrosion on the metal frame at the bottom of the exit door, cracked window blinds with sharp edges, foam protective coverings torn and / or missing from the window ledges, a metal clamp protruding from the wall near the back exit door. On the outdoor play space observed the following hazards: two 6 to 9 inch holes in the ground near the old tree stump, large bolts protruding from posts of the wooden gate, the wooden gate not able to open and close,

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(g)

Description: Clean and good repair

Noncompliance Area: In the children's bathroom at the end of the hallway observed the following: several strips of toilet paper laying on the floor in the stalls., a blue substance on the toilet seat, clothing laying on the floor and paper towels from an overflowing trash can laying on the floor.

Correction Required: Toilet areas and fixtures shall be cleaned daily and be in good repair.

Regulation: 3270.82(h)/3270.152

Description: Handwashing signs/Adult Hygiene

Noncompliance Area: Observed in the Infant room staff did not wash hands after diapering a child. Observed in the Preschool 1 room staff did not wash hands before serving lunch to the children. Also in the Preschool 1 room observed children did not wash hands before eating lunch. Observed in the Toddler A room the diaper changing area lacks a handwashing sign.

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

Regulation: 3270.91(a)

Description: Stairs, exits, etc. unobstructed

Noncompliance Area: In the infant room the front exit door was blocked by a bouncy seat and staff person sitting Infront of the door leaning against it.

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

Regulation: 3270.151(c)(2)/3270.192(3)

Description: Mantoux TB/Health assessment, TB test

Noncompliance Area: The file for staff person #2 is lacking documentation of TB tests results at the time of initial employment.

Correction Required: An adult health assessment must include tuberculosis screening by the Mantoux method at initial employment. Subsequent tuberculosis screening is not required unless directed by a physician, physician's assistant, CRNP, the Department of Health or a local health department. 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)(3)/3270.151(c)(5)

Description: Exam communicable disease/Physician/CRNP assessment

Noncompliance Area: The file for staff person #1 contains an initial health assessment that is lacking a physician's statements regarding communicable disease and suitability to provider child care.

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

Regulation: 3270.21

Description: General Health and Safety

Noncompliance Area: Observed the office door to be open giving children access to the paper cutter that was on the countertop.

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: Staff person #3 has not completed Pediatric first aid and CPR training on or before expiration of the most current certification. This is evidenced by the previously documented Pediatric first aid and CPR training on file expiring 8/2024. Documentation of updated Pediatric first aid and CPR training is not on file.

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. Until such time as the required training has been completed, staff person #3 must be supervised, when interacting with children at a minimum by an AGS who has completed all preservice trainings and has all qualifications to care for children unsupervised. If there are no staff person(s) available to supervise staff person #3, staff person #3 may not work in a child-care position at the facility.

Regulation: 3270.31(f)

Description: Health and Safety Training

Noncompliance Area: Staff person #3 has not completed the following required pre- service training within 90 days of their date of hire (see LIS code sheet): Health & Safety Training

Correction Required: Staff persons shall complete professional development within 90 days of hire as listed in subsections (f)1-10 or (g)1-10. Until such time as the required training has been completed, staff person #3 must be supervised, when interacting with children at a minimum by an AGS who has completed all preservice trainings and has all qualifications to care for children unsupervised. If there are no staff person(s) available to supervise staff person #3, staff person #3 may not work in a child-care position at the facility.

Regulation: 3270.66(a)

Description: Locked or inaccessible

Noncompliance Area: Observed the door to the maintenance closet, located in the front hallway, was open giving children access to Clorox bleach, Floor-zyme cleaner, sunscreen spray and stain remover, all labeled 'keep out of reach of children'.

Correction Required: Cleaning materials and other toxic materials shall be kept in an area or container that is locked or made inaccessible to children.

Regulation: 3270.102(a)

Description: Clean and good repair

Noncompliance Area: Observed in the young preschool classroom a plastic tote bin of wooden blocks to be cracked with a sharp edge/ pinch point.

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

Regulation: 3270.107

Description: Refrigerator

Noncompliance Area: The refrigerator in the Older Toddler room contained a thermometer that was not operating.

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(a)

Description: Health information

Noncompliance Area: The file for child #2, preschool aged, lacks a health report completed within 60 days of their first day of attendance. The file does contain a current health report.

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

Regulation: 3270.131(b)(2)

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

Noncompliance Area: The file for child #1, preschool aged, is lacking a health report conducted during the previous 12-month period.

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

Regulation: 3270.135(c)

Description: Diapering area not used for food prep

Noncompliance Area: Observed in the Older Toddler room, children's lunch boxes were placed on the diaper changing table.

Correction Required: The diapering area may not be used for food preparation or food service.

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 #2 contains an initial health assessment that was conducted after their initial start date in a child care position.

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: 3270.161(d)

Description: Potentially hazardous food refrigerated

Noncompliance Area: Lunch boxes in the older preschool and younger preschool rooms were not refrigerated. Observed an unrefrigerated lunch box in the younger preschool room to contain yogurt and 2 unrefrigerated lunch boxes in the older preschool room to contain meat and cheese Lunchables.

Correction Required: Potentially hazardous food brought from the child's home or provided by the facility shall be refrigerated.

Regulation: 3270.182(1)

Description: Initial and subsequent health reports

Noncompliance Area: The file for child #1 is lacking a current health report. The file for child #2 is lacking an initial health report within 60 days of their start date.

Correction Required: A child's record shall contain initial and subsequent health reports.

Regulation: 3270.182(5)

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

Noncompliance Area: The file for child #3 contains emergency contact information that is lacking the parents' permission for administration of minor first aid.

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(5)

Description: Two written references

Noncompliance Area: The files for staff #4 and #8 contain only one of the required 2 reference letters. The file for staff #6 is lacking any reference letters.

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

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

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

Noncompliance Area: The file for staff person #5 contains only 10 of the required 12 hours of professional development during the period of 10/2/23-10/2/24. The file for staff person #7 contains only 6 of the required 12 hours of professional development during the period of 10/2/23-10/2/24.

Correction Required: A staff person shall obtain an annual minimum of 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: The file for staff person #3, hire date (see IS code sheet) contains PFA/PCPR that was completed greater than 90 days after the start date. The file for staff person #6, hire date (see IS code sheet) contains Health and Safety training that was completed greater than 90 days after the start date.

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

Regulation: 3270.31(f)

Description: Health and Safety Training

Noncompliance Area: Staff person #3 has not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): PA Health and Safety Topics 1-9.

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 #3 will have until 12/6/2024 to complete the required training. Until such time as the required training has been completed, staff person #3 must be supervised, when interacting with children, by a director, GS or AGS who has completed the required training related to this citation. If there are no staff available to supervise staff person #3, staff person #3 may not work in a child-care position at the facility.

Regulation: 3270.32(a)

Description: Comply with CPSL

Noncompliance Area: The file for staff person #1 contains current mandated reporter training that was completed greater than 60 months after the previous training was completed. The file for staff person #6 contains current mandated reporter training that was completed greater than 90 days after the start date.

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

Regulation: 3270.112

Description: Infant/Toddler Stimulation

Noncompliance Area: Based on multiple staff statements, an infant child was heard and was observed crying in the Infant room for at least 10 minutes and staff were not allowed to comfort or console the crying child.

Correction Required: Infants and toddlers shall be provided stimulation by being held, rocked, talked to, played with and carried.

Regulation: 3270.113(a)

Description: Supervised at all times

Noncompliance Area: On 2/12/24 at approximately 12:15pm, staff person #2 and 8 preschool aged children were observed in the Preschool room during nap time. Staff person #2 was unable to properly supervise children on their resting mats due to their position on the opposite side of a children's toy shelf. Staff person #2 was sitting on the floor and unable to see, hear, and assess the children on the opposite side of the shelf that was blocking site of the children. On 2/12/24 at approximately 12:25pm, staff person #3 and 4 preschool aged children were observed in the gym room and 1 preschool aged child was in the restroom. Staff person #3 was unable to properly supervise the child in the restroom. To access this bathroom, one must walk out of the gym through a door and into an office area, walk approximately seven feet to enter the restroom. Staff person #3 was observed located on the opposite side of the gym room with 4 preschool age 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(e)

Description: Restraints prohibited

Noncompliance Area: Based on staff statements, staff person #1 restricts children's movement in the Infant room by placing children in their cribs as discipline, and staff person #1 restricts children's movement during nap time by placing their hand on children's backs to restrict the children from standing up in their cribs.

Correction Required: A facility person may not restrain a child by using bonds, ties or straps to restrict a child's movement or by enclosing the child in a confined space, closet or locked room. The prohibition against restraining a child does not apply to the use of adaptive equipment prescribed for a child with special needs.

Regulation: 3270.162(d)

Description: Not forced to eat

Noncompliance Area: According to staff statements, staff person #1 forces children in the Infant room to eat food by shoving food into the children's mouths and also by placing one hand on a child's forehead to tilt back and then scoops food into the children's mouth.

Correction Required: A child may not be forced to eat food.

Regulation: 3270.166(2)

Description: New foods - parent's consent

Noncompliance Area: According to staff statements, on 1/31/24 in the infant room staff person #1 fed child #1 another child's pureed food pouch without informing the child's parents as the child has not eaten it before.

Correction Required: New foods shall be introduced to an infant only after consultation with the child's parent.

Regulation: 3270.32(a)

Description: Comply with CPSL

Noncompliance Area: Staff person #4 has not completed mandated reporter training within the last 60 months. This is evidenced by the previously documented mandated reporter training on file being dated 12/21/18.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to Child Protective Services). Staff person #4 will have until 3/5/24 to complete the mandated reporter training. Until such time as the required training has been 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: 3270.37(c)

Description: Aides supervised all times

Noncompliance Area: Staff person #2, who qualifies as an aide, was observed to be supervising 8 preschool aged children in the Preschool Room alone and unsupervised. Staff person #3, who qualifies as an aide, was observed to be supervising 5 preschool aged children in the gym alone and unsupervised.

Correction Required: An aide or a combination of aides shall be supervised at all times by a staff person qualified at minimum as an assistant group supervisor.

Regulation: 3270.102(a)

Description: Clean and good repair

Noncompliance Area: The surface of a train table in the preschool room was not properly attached to the table, leaving gaps, which create a pinch hazard.

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

Regulation: 3270.107

Description: Refrigerator

Noncompliance Area: The refrigerator in the toddler room, where children's lunches are stored, measured, over 45 degrees.

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(b)/3270.182(8)

Description: Parent receives original/Copy of initial and subsequent agreements. Parent receives original.

Noncompliance Area: The agreement on file for Child #1, #2, #3, #4, and #5 is the original agreement, not a copy; the parent is to receive the original agreement.

Correction Required: A parent shall receive the original agreement. The facility shall retain a copy of the agreement. A child's record shall contain a copy of the initial agreement and subsequent written agreements between the parent and the operator. The parent receives the original agreement.

Regulation: 3270.124(b)(2)

Description: Physician name, address, phone

Noncompliance Area: The emergency contact form on file for Child #3 does not include a complete address for the child's pediatrician/source for medical care. The emergency contact form on file for Child #4 does not include the address for the child's pediatrician/source for medical care.

Correction Required: Emergency contact information must include the name, address and telephone number of the child's physician or source of medical care.

Regulation: 3270.124(b)(3)

Description: Parent home/work address, phone

Noncompliance Area: The emergency contact form on file for Child #5 does not include the complete home address and employment address for the enrolling parent.

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

Regulation: 3270.124(b)(5)

Description: Information re: special needs

Noncompliance Area: The current emergency contact form on file for Child #4 does not indicate if the child has any special medical needs, which is needed in an emergency situation.

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

Regulation: 3270.124(b)(6)

Description: Insurance coverage information

Noncompliance Area: The emergency contact form on file for Child #2 does not include the health insurance policy number for the medical insurance policy.

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 #4 and #5 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: 3270.135(a)(3)

Description: Disposable diapers

Noncompliance Area: The infant room did not include a hands-free lidded trash can for the disposal of soiled disposable 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: 3270.151(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 includes an initial health assessment and TB test which is dated after hire (See LIS CODE SHEET). The health assessment for Staff person #1 is dated 10/30/23 and the TB test is dated 11/1/23. The file for Staff person #4 includes an initial health assessment and TB test which is dated after hire (See LIS CODE SHEET). The health assessment for Staff person #4 is dated 11/3/23 and the TB test is dated 11/6/23. The file for staff person #6 does not include documentation of an initial health assessment or TB test being completed within 12 months prior to date of hire (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 #3, #5 includes only 1 written nonfamily reference. The file for Staff person #4 does not include 2 written non-family references attesting to the staff person's suitability to work in child care.

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: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: The file for Staff person #4 includes an incomplete criminal history clearance that did not include a dissemination date, (See LIS Code Sheet), making it invalid.

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 #4 may not work in a child care position at the facility.

Regulation: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: The file for staff person #2 does not include documentation of application of a PA Criminal History clearance prior to date of hire (See IS CODE SHEET) required for provisional hiring under the CPSL; the clearance is dated 10/5/23.

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

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

Noncompliance Area: The file for Staff person #4, classified as an Aide, does not include verification of a high school diploma or general educational development certificate; or a minimum of an 8th grade education and 2 years of child care experience. The file for Staff person #6, classified as an assistant group supervisor, does not include a high school diploma or a general educational development certificate to be combined with the and 2 years of verified experience with children in the file.

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: 3270.102(a)

Description: Clean and good repair

Noncompliance Area: In the indoor play space observed on the vinyl covered soft climbing equipment the edges and corners to be worn exposing the interior foam.

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: 3270.14/3270.21

Description: Pertinent Laws & Regulations/General Health and Safety

Noncompliance Area: The file for staff person #1 is lacking the required Pennsylvania Health & Safety Update 2022 training.

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: 3270.71

Description: Heat Source

Noncompliance Area: Observed off of the main hallway in the facility a kitchen without a door or gate to serve as a barrier to the children. Within the kitchen is a stove / oven which could exceed 110 degrees.

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

Regulation: 3270.76

Description: Building Surfaces

Noncompliance Area: Observed in the play space a heating unit with exposed sharp edges causing a possible hazard.

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

Regulation: 3270.82(h)

Description: Handwashing signs

Noncompliance Area: The restroom at the far end of the hallway is lacking handwashing signs at the 3 sinks.

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.