Learning Tree Schools/monroeville

Regulation: 3270.103

Description: Small Toys and Objects

Noncompliance Area: The play kitchen on the right wall of the Toddler Room had a broken gray plastic burner that was pushed in, leaving sharp edges exposed and creating a cutting hazard.

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: 3270.131(a)

Description: Health information

Noncompliance Area: The Updated Child Health Assessment for Child #1 was dated more than 12 months apart. (SEE LIS CODE SHEET)

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

Regulation: 3270.151(a)

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

Noncompliance Area: The two most recent health assessments for Staff #6 were dated more than 24 months apart. (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.

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(s) for Staff Person(s) #1 lacked an updated Health Assessment. The last Health Assessment on file for Staff Person(s) #1 is dated: 10.17.2023. (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: 3270.31(e)(4)(i)

Description: Age and Training

Noncompliance Area: The two most recent Pediatric First Aid and Pediatric CPR Trainings for staff #2 were dated more than 24-months apart. (SEE LIS CODE SHEET)

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)(4)(ii)

Description: Fire safety - 1 yr.

Noncompliance Area: The last two fire safety trainings in the file for Staff #4 are dated more than one year apart. (SEE LIS CODE SHEET)

Correction Required: Staff persons shall participate, at least annually, in fire safety 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(2)(iii)

Description: Comply with CPSL/Exp, educ., training at facility

Noncompliance Area: Mandated Reporter Training for staff #2 was dated more than 60 months ago. (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 verification of childcare 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 file(s) for Staff Person(s) #1, #3 and #6 had NSOR Certificates dated more than 60 months apart. (SEE LIS CODE SHEET) The two most recent State Police and DHS FBI Clearances and the NSOR Certificates for Staff #5 were dated more than 60 months apart. (SEE LIS CODE SHEET) The two most recent State Police and DHS FBI Clearances and NSOR Certificates for Staff #7 were dated more than 60 months apart. (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: 3270.34(a)(6)

Description: Staff evaluations

Noncompliance Area: The two most recent staff evaluations for Staff #7 were completed more than one year apart. (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: 3270.75(d)

Description: On excursions

Noncompliance Area: The Main Room's excursion first-aid kit lacked a bottle of water.

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

Regulation: 3270.76

Description: Building Surfaces

Noncompliance Area: In the Toddler Room, next to the refrigerator and behind the garbage can, there is what appears to be dried food stains, dried liquid drips, and food crumbs present on the floor.

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: On the upper right-hand corner of the archway leading into the Toddler Room, the paint was peeling.

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

Regulation: 3270.94(a)(1)

Description: Every 60 days

Noncompliance Area: The observed fire drill log contained consecutive drills held more than 60 days apart. [10.01.2024 -- 12.02.2024 (61 Days)] and [12.03.2024 -- 02.03.2025 (62 Days)]

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

Regulation: 3270.95(a)/3270.95(b)

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

Noncompliance Area: The facility's fire alarm test report documented testing of the fire alarm system between [12.03.2024 -- 01.03.2025 (31 Days)]. The test was conducted more than 30 days apart.

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: In the Infant Room across from the refrigerator on the shelf was a purple bin which had a cracked corner posing a cutting hazard. In the Main Room on the shelf next to the staff desk was a clear bin with little, plastic figurines was cracked posing a cutting 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: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: The two most recent NSOR's for Staff #1 were dated more than 60 months apart. (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: 3270.33(a)/3270.192(2)(ii)

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

Noncompliance Area: The file for Staff #1 did not include hours/years of experience in childcare making it unable to be determined if the individual qualified as an AGS.

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: 3270.103

Description: Small Toys and Objects

Noncompliance Area: A bag of pom poms that were less than an inch in diameter in the young toddlers cabinet. Based on conversation with staff, they are used for arts and crafts with the toddlers.

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: 3270.113(a)

Description: Supervised at all times

Noncompliance Area: At approximately 9:25 am on 11/16/23, staff person #1 was at the sink in the front of the preschool room adjacent to the infant room, when staff person #4 went to answer the door. Because the 12 children in the room were on the other side of a half wall and the positioning of staff, neither staff person #1 or staff person #4 could see, hear, direct or assess any of 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: 3270.123(a)(3)

Description: Services proceeded

Noncompliance Area: The last child service report that was dated in the file for child #1 was 12/27/22. There was a second report in the file that was not dated, so timeliness could not be assessed. The last child service report in the file for child #3 was dated 5/28/23.

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

Regulation: 3270.123(a)(4)

Description: Arrival/departure times

Noncompliance Area: The agreement in the file for child #1 did not specify the child's arrival and departure time.

Correction Required: An agreement shall specify the child's arrival and departure times.

Regulation: 3270.124(b)(7)

Description: Name/address/phone release person

Noncompliance Area: The emergency contact form in the file for child #1 did not include addresses for the 4 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: 3270.124(f)/3270.181(c)

Description: Updated every 6 months/Emergency info/agreement updated 6 mos

Noncompliance Area: The last written review by a parent on the emergency contact information in the file for child #3 was dated 1/6/23.

Correction Required: The parent shall update in writing emergency contact information once in a 6-month period or as soon as there is a change in the information. A parent is required to review and update the emergency contact information and the financial agreement at least once in a 6-month period or as soon as there is a change in the information.

Regulation: 3270.131(b)(2)

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

Noncompliance Area: The last two health reports in the file for child #2, a preschooler, were dated 10/4/22 and 11/7/23.

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

Regulation: 3270.133(5)

Description: Original label

Noncompliance Area: There was a bottle of Tylenol in the infant room that had expired in May 2023.

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

Regulation: 3270.27(b)

Description: Plan reviewed/updated annually

Noncompliance Area: The last two documented reviews of the facility's emergency plan were dated 4/27/22 and 8/22/23.

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

Regulation: 3270.27(c)

Description: Training regarding plan

Noncompliance Area: The last two emergency plan trainings in the file for staff person #1 through #4 and #6 thrpough #8 were dated 4/27/22 and 8/22/23.

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: 3270.27(e)

Description: Letter to parents

Noncompliance Area: The parent letter explaining the emergency procedures did not include information regarding the lockdown or accommodations for infants, toddlers, children with diabilities or chronic medical conditions.

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: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: The NSOR clearance in the file for staff person #5, hired on (SEE LIS CODE SHEET), was dated 12/15/22. There was a request for the clearance in the file, but it was not dated so timeliness could not be assessed.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). The 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: Upon arriving at the facility at approximately 9:00 am on 11/16/23, staff person #3 answered the door, leaving staff person #7 briefly alone with 6 infants before returning to the room..

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

Regulation: 3270.52

Description: Mixed Age Level

Noncompliance Area: Upon arriving at the facility at approximately 9:00 am on 11/16/23, staff person #1 and #4 were present in the preschool room with 14 children, a combined group of 2 older toddlers and 12 preschoolers. At the same time, a preschooler arrived, for a total of 15 children. Both staff identified all 15 children, placing them out of ratio.

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(e)

Description: Arts and crafts non-toxic

Noncompliance Area: There were two cans of shaving cream observed in the older toddler cabinet which included instructions to keep out of the reach of children. Based on conversation with staff, the shaving cream was used for arts and crafts with the children.

Correction Required: Arts and crafts materials shall be nontoxic.

Regulation: 3270.82(h)

Description: Handwashing signs

Noncompliance Area: There was not a handwashing sign by the sink basin in the infant room.

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

Regulation: 3270.94(a)(1)

Description: Every 60 days

Noncompliance Area: Based on review of the fire drill log, there was one time when the drills were conducted more than 60 days apart: 6/19/23 and 8/21/23.

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

Regulation: 3270.31(f)

Description: Health and Safety Training

Noncompliance Area: 2nd citation: Staff person #6 has not completed the following required pre-service training within 90 days of their date of hire: First-aid/CPR training. Previously cited 11/22/22.

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

Regulation: 3270.124(b)(7)

Description: Name/address/phone release person

Noncompliance Area: The emergency contact information in the file for child #2 did not include complete address for the 3 release persons. Only the city was listed.

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(b)(2)

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

Noncompliance Area: The last health report in the file for child #3, a preschooler was dated 10/26/21. The last two health reports in the file for child #2 were dated 6/30/21 and 8/10/22.

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

Regulation: 3270.131(c)

Description: Completed or signed by physician, PA, or CRNP

Noncompliance Area: The most recent health report in the file for child #1 did not include the individual's professional title. The most recent health report in the file for child #2 did not include the individual's signature or title.

Correction Required: A health report must be written and signed by a physician, physician's assistant or a CRNP. The signature must include the individual's professional title.

Regulation: 3270.131(e)(1)

Description: Exemption documentation from parent/guardian

Noncompliance Area: The last flu shot in the file for child #2, a 4-year old, was dated 2019 and there was not a written statement of exemption by a parent on file.

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.

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 last two health assessments in the file for staff person #1 were dated 6/1/20 and 6/4/22. The last two health assessments in the file for staff person #2 were dated 12/4/19 and 12/9/21. The last two health assessments in the file for staff person #3 were dated 1/27/20 and 10/13/22.

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(b)

Description: Conducted by physician, PA or CRNP

Noncompliance Area: The health assessment in the file for staff person #5 did not include the individual's signature or professional title.

Correction Required: A health assessment shall be conducted and a report shall be written and signed by a physician, physician's assistant or CRNP. The signature must include the individual's professional title.

Regulation: 3270.151(c)(3)

Description: Exam communicable disease

Noncompliance Area: The health assessment in the file for staff person #5 did not include an examination for communicable disease and the results of that examination.

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

Regulation: 3270.151(c)(5)

Description: Physician/CRNP assessment

Noncompliance Area: The health assessment in the file for staff person #5 did not include the physician's or CRNP's assessment of the person's suitability to provide child care.

Correction Required: 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: The facility did not have it's own shaken baby syndrome policy. It did have information printed from websites regarding shaken baby and soothing a crying/fussing child.

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: The emergency drill that was documented did not include the number of children participating in the drill.

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

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

Description: Fire safety - 1 yr.

Noncompliance Area: The last two fire safety trainings in the file for staff person #9 were dated 10/5/21 and 10/19/22.

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: 3270.31(f)

Description: Health and Safety Training

Noncompliance Area: The first-aid/CPR training in the file for staff person #4 was dated 5/23/22, which is beyond the first 90 days the individual worked with children.

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 #6 has not completed the following required pre-service training within 90 days of their date of hire: First-aid/CPR training.

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 #6 will have until 2/22/23 to complete the required training. Until such time as the required training has been completed, staff person #6 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 available to supervise staff person #6, staff person #6 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 NSOR certificate in the file for staff person #4 was dated 10 months after the individual began working with children.

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: 3270.34(a)(6)

Description: Staff evaluations

Noncompliance Area: The last two evaluations in the file for staff person #1, #2, #3, #6, #8 and #9 were dated 10/25/21 and 10/26/22.

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: 3270.35(b)(2)

Description: Bachelor's, 30 credits + 1 yrs

Noncompliance Area: The file for staff person #2, holding the title of group supervisor, included a bachelors degree in biology and more than a year of experience, but did not include 30 credit hours in a human services field, making them an assistant group supervisor.

Correction Required: A group supervisor shall have a bachelor's degree from an accredited college or university, including 30 credit hours in early childhood education, child development, special education, elementary education or the human services field and 1 year of experience with children.

Regulation: 3270.36(b)(5)

Description: HS/GED + 2 yrs

Noncompliance Area: The file for staff person #4 and #7, both holding the title of assistant group supervisor, included proof of high school but did not include at least 2500 hours of child care experience, qualifying them as an aide.

Correction Required: An assistant group supervisor shall have a high school diploma or a general educational development certificate and 2 years experience with children.

Regulation: 3270.37(c)

Description: Aides supervised all times

Noncompliance Area: Staff person #4 and #7, both qualifying as aides at the time of the inspection, were observed together in the nursery room.

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: 3270.76

Description: Building Surfaces

Noncompliance Area: In the center preschool room, there was a large television that was not anchored, creating a possible tipping 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: There was not a handwashing sign at the adult sink in the main room.

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

Regulation: 3270.95(a)/3270.95(b)

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

Noncompliance Area: There were 4 times since November 2021 when the single unit smoke detector was tested between 31 and 36 days.

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

Regulation: 3270.119

Description: Infant sleep position

Noncompliance Area: At 9:37am an infant was observed to be sleeping in a swing in the Infant Classroom. When asked how long the infant had been sleeping Staff referred to the board posted in the classroom and reported 9:15am. The swing did not allow the child to be placed in the sleeping position recommended by the American Academy of Pediatrics.

Correction Required: Infants shall be placed in the sleeping position recommended by the American Academy of Pediatrics unless there is a medical reason an infant should not sleep in this position. The medical reason shall be documented in a statement signed by a physician, physician's assistant or CRNP and placed in the child's record at the facility.

Regulation: 3270.123(a)(4)

Description: Arrival/departure times

Noncompliance Area: The agreement form for Child #3 lacked the arrival and departure times.

Correction Required: An agreement shall specify the child's arrival and departure times.

Regulation: 3270.123(b)

Description: Parent receives original

Noncompliance Area: The original agreements were observed on file for Children #2 and #4.

Correction Required: A parent shall receive the original agreement. The facility shall retain a copy of the agreement.

Regulation: 3270.124(b)(6)

Description: Insurance coverage information

Noncompliance Area: The emergency contact form for Child #1 lacked the health insurance coverage and policy number for the child.

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: 3270.151(a)

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

Noncompliance Area: The health assessments on file for Facility Person #3 exceeded 24 months between examinations.

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

Regulation: 3270.151(c)(3)/3270.151(c)(5)

Description: Exam communicable disease/Physician/CRNP assessment

Noncompliance Area: The health assessment on file for Facility Person #2 lacked a statement that they had been examined for communicable diseases and the results of that examination and the physicians assessment of their suitability to provide 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: 3270.27(a)(5)

Description: Emergency plan

Noncompliance Area: The emergency plan lacked accommodations for infants, toddlers, children with disabilities and children with chronic medical conditions.

Correction Required: The facility shall have an emergency plan that provides for accommodations for infants, toddlers, children with disabilities, and children with chronic medical conditions.

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

Description: Age and Training

Noncompliance Area: The First Aid and CPR training on file for Facility Person's #2 and #4 lacked verification that it included Pediatric certification.

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)

Description: Comply with CPSL

Noncompliance Area: The file for Facility Person #1 lacked verification that the had requested their State Police Clearance prior to starting in a child care taking position. The Child Abuse Clearance on file for Facility Person #2 exceeded 60 months between update.

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

Regulation: 3270.82(h)

Description: Handwashing signs

Noncompliance Area: A hand washing sign was missing from one of the sinks in the preschool area girls restroom.

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.

Noncompliance Area: In the outdoor play space a cracked area was observed on a plastic basketball hoop. The cracked area cause sharp edges.

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: An infant was observed to be sleeping in a crib without 2 feet of space on three 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.

Noncompliance Area: The emergency contact form for Child #1 lacked the address and telephone number for one of the release persons listed. The emergency contact form for Child #2 lacked the complete address for the release persons listed.

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: A breastfed infant receiving care at the facility was observed to have one bottle, that was to be filled with expressed milk, to be used throughout the day. The bottle was cleaned between uses however it was not being washed in a dishwasher as required.

Correction Required: Disposable nursers shall be used for infants unless bottles are provided by the parent or unless a commercial dishwasher is used by the facility.

Noncompliance Area: The file for Staff Person #1 lacked verification that they had requested their NSOR certificate prior to starting in a child care taking position. Based on their start date it also appears that they worked in excess of 45 days without a completed NSOR certificate on file.

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: In the Older Toddler area of the Toddler Classroom a set of small bubbles labeled for ages 3+ were observed in a bin within the children's toy shelves. Older toddlers were observed to be receiving care in the space at the time of the inspection.

Correction Required: Play equipment and materials appropriate to the developmental needs, individual interests and ages of the children shall be provided in sufficient amount and variety to preclude long waits for use.

Noncompliance Area: The original agreement was observed on file for Child #3.

Correction Required: A parent shall receive the original agreement. The facility shall retain a copy of the agreement.

Noncompliance Area: The emergency contact form for Child #3 lacked the address 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.

Noncompliance Area: The emergency contact form for Child #2 lacked the policy number for the child's health insurance.

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.

Noncompliance Area: The emergency contact form for Child #2 lacked the address for one and the emergency contact form for Child #3 lacked the address for two of the release persons listed 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: The file for Child #1, a young toddler, lacked updated health assessment every 6 months. The initial health assessment was dated 3/9/18 and then the next and last was dated 4/4/19. At this time the child is in need of an updated health assessment. The child is also in need of documentation that they have received their 15-18 month DTAP vaccination.

Correction Required: The operator shall require the parent to provide an updated health report at least every 6 months for an infant or young toddler. 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 file for Staff Person #1 lacked verification of education.

Correction Required: A facility person's record shall include verification of child care experience, education and training prior to service at the facility.

Noncompliance Area: In the Infant Classroom two of the cribs were observed to have loose crib sheets that caused a threat as children could become entangled in them.

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

Noncompliance Area: The file for Staff Person's #2 lacked three and the file for Staff Person #3 lacked six of their six hours of annual child care training in their respective hire year.

Correction Required: A staff person shall obtain an annual minimum of 6 clock hours of child care training.

Noncompliance Area: The facility was unable to demonstrate that they had an operable fire detection system at the time of an unannounced inspection visit.

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

Noncompliance Area: The file for Child #1 lacked an initial health assessment and the child has exceeded 60 days in care at this time.

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.

Noncompliance Area: The file for Child #2, a young toddler, lacked an updated health report that had been completed in the last 6 month.

Correction Required: The operator shall require the parent to provide an updated health report at least every 6 months for an infant or young toddler

Noncompliance Area: In the Preschool Classroom one expired Ventolin Inhaler was observed. In the Young Toddler Classroom one expired Bourdeaux's butt paste was observed.

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

Noncompliance Area: Written parental consent was missing for a Children's Allergey Relief medication and Zoditor antihistamine eye drops for Child #3. Written parental consent was missing for a Children's Tylenol for Child #4.

Correction Required: A parent shall provide written consent for administration of medication or a special diet.

Noncompliance Area: The health assessment on file for Staff Person #4 lacked a date of tuberculosis testing to verify that it had been completed within the 12 months prior to starting in a child care taking position.

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.

Noncompliance Area: The current health assessment on file for Staff Person #1 lacked that they had been examined for communicable diseases and the results of that examination and the physician's assessment of their suitability to provide 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.

Noncompliance Area: The file for Staff Person #3 lacked one of their two written nonfamily references. One of the two references on file was completed by a relative.

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

Noncompliance Area: The file for Staff Person #2 lacked a date of request for their State Police and proof of fingerprinting for their FBI clearance prior to starting in a child care taking position. The file for Staff Person #4 lacked a State Police clearance that had been completed through EPATCH, a request for their Child Abuse Clearance and proof that they had been fingerprinted prior to starting in a child care taking position.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). Staff Person #4 may not work in a child care taking position.

Noncompliance Area: A spray bottle containing a sanitizing solution was observed on top of the first aid cabinet in the Preschool Classroom. The bottle did not specify the type of sanitizing solution present in the bottle.

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.

Noncompliance Area: One cracked bin with a sharp edge was observed in the Preschool classroom. A chair pad in the young toddler room was observed to be torn causing foam to be exposed.

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 emergency contact form for children #1 and #2 lacked all of the addresses and the emergency contact form for child #3 lacked one of the addresses of the release persons listed.

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: The current health assessment on file for child #4 indicated no to the question of whether the child is able to participate in child care and appears to be free from contagious or communicable diseases. No explanation was provided to why no was checked.

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

Noncompliance Area: The most recent health assessment on file for Staff Person #1 has exceeded 24 months since the examination.

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: The tuberculosis screening for Staff Person #2 lacked the date of testing to verify that it had been completed within 12 months prior to starting in a child care taking position.

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.

Noncompliance Area: A copy of the current insurance policy for the facility was not on file at the time of the Renewal Inspection.

Correction Required: The legal entity shall have comprehensive general liability insurance to cover the persons who are on the premises. A current copy of the insurance policy shall be on file at the facility.

Noncompliance Area: One cracked bin with a sharp edge was observed in the PreK 4 classroom.

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: In the Older Toddler medication cabinet a prescription tube of Hydrocortisone Ointment was observed to be missing the physician's instructions.

Correction Required: A staff person shall administer a prescription medication only if written instructions are provided from the individual who prescribed the medicine. Instructions for administration contained on a prescription label are acceptable.

Noncompliance Area: In the Older Todder medication cabinet one unlabeled diaper cream was observed.

Correction Required: The label of a medication container shall identify the name of the medication and the name of the child for whom the medication is intended. Medication shall be administered to only the child whose name appears on the container.