Lil Sprouts Child Care Center

Regulation: 3270.121(b)

Description: Given parents in writing

Noncompliance Area: A written policy change to transportation was not provide to the parent of child #1. The transportation change was agreed upon between the parent and the facility verbally.

Correction Required: At the time of enrollment, a parent shall receive in writing the facility's general daily schedule, hours for which care is provided, fees, responsibilities for meals, clothing, health policies, supervision policies, night care policies, dismissal policies, transportation and pick-up arrangements.

Regulation: 3270.102(a)

Description: Clean and good repair

Noncompliance Area: Observed children of YT age being cared for in seats with straps that are intended to be used when the children are in the seats. The straps were not used while the children were being cared for in the seats. Observed a sharp plastic tie on the play house in the YT area.

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: 3270.135(a)(3)

Description: Disposable diapers

Noncompliance Area: The diapering area for the YT children lacked a plastic-lined, hands-free covered 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 staff #3, #4 and #5 contain late health assessments. #3 was due 11/2025 and obtained 12/2025; #4 was due 9/8/2025 and obtained 9/30/2025; #5 was due 3/2025 and obtained 5/2025.

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

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

Description: Mantoux TB/Health assessment, TB test

Noncompliance Area: The file for staff #5 lacks a valid TB test. The TB test on file is too old (11/2022). It exceeds 12 months old.

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: 3270.182(5)

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

Noncompliance Area: The file for child #1 lacks signed parental consent for administration of minor first-aid procedures by facility staff.

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

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

Noncompliance Area: The file for staff #5 contains emergency plan training that was obtained late. It was due 6/30/25 and obtained 8/2025.

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

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

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

Noncompliance Area: The files for staff #1 and #2 contain fire safety training that was updated late. #1 was due 9/2024 and obtained 4/2025; #2 was due 4/2025 and obtained 12/2025.

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. A facility person's record shall include verification of child care experience, education and training following the outset of service at the facility.

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

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

Noncompliance Area: The file for staff #2 contains 1 of the 12 annual child care training hours that was obtained late. 12 hours were to be obtained between 2/2025 - 2/2025. 1 hour was obtained 7/2025.

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)

Description: Comply with CPSL

Noncompliance Area: Staff person #5 had not completed the mandated reporter training within 90 days of their date of hire (see LIS code sheet). The training was due 6/30/25 and was obtained 12/2025.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to Child Protective Services).

Regulation: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: The file for staff #5 contains a disclosure statement that was signed late. It was due 3/2025 and signed 8/2025.

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: 3270.66(b)

Description: Original container

Noncompliance Area: Observed croutons on the top of the refrigerator stored next to dish soap and clorox (toxics).

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: 3270.95(a)/3270.95(b)

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

Noncompliance Area: The facility's fire detection system testing exceeded 30 days on 2 occasions in the past 12 months: 12/6/24-2/14/25; 5/30/25-7/3/25.

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

Regulation: 3270.31(f)

Description: Health and Safety Training

Noncompliance Area: Staff person #1 has not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): health and safety training part 1 and part 2.

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 #1 will have until 9/3/2025 to complete the required training. Until such time as the required training has been completed, staff person #1 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 #1, staff person #1 may not work in a child-care position at the facility.

Regulation: 3270.124(f)/3270.181(c)

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

Noncompliance Area: The file for child #1 lacks a parental update in writing on the emergency contact information and the agreement in a 6-month period. The update was due 9/2024.

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(a)(2)/3270.182(1)

Description: Initial health report for young toddler no more than 6 months/Initial and subsequent health reports

Noncompliance Area: The file for child #2 lacks an initial health assessment. Immunizations are on file. The health assessment was due 10/12/24.

Correction Required: The initial health report for a young toddler must be dated no more than 6 months prior to the first day of attendance at the facility. A child's record shall contain initial and subsequent health reports.

Regulation: 3270.131(b)(1)/3270.182(1)

Description: Infant: updated health report every 6 months/Initial and subsequent health reports

Noncompliance Area: The file for child #3 lacks an updated health assessment. The health assessment was due 11/2024.

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

Regulation: 3270.131(b)(2)/3270.182(1)

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

Noncompliance Area: The file for child #3 contains a health assessment that was obtained late. It was due 8/2024 and obtained 11/2024.

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

Regulation: 3270.151(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 #1 contains a health assessment that was updated late. It was due 4/2024 and obtained 5/2024.

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

Regulation: 3270.61(c)

Description: 40 square feet wall-to-wall

Noncompliance Area: Upon arrival, observed children being care for in unlicensed space. The space was measured and added on the date of the inspection.

Correction Required: Indoor child care space is measured within permanent stationary partitions or walls. The allowable number of children in a space is determined by dividing the total square feet in a space by 40.

Regulation: 3270.61(h)

Description: Exceeding Capacity

Noncompliance Area: Observed 5 children in care at 9:45am in the blue room. The capacity of the blue room is 4.

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

Regulation: 3270.76

Description: Building Surfaces

Noncompliance Area: Observed a sharp corner on a countertop in the newly measured space. (new side)

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: Observed peeling paint on various walls and various areas in the outside play space.

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

Regulation: 3270.173(b)

Description: Driver not counted in ratio - I, T, PS

Noncompliance Area: PREVIOUSLY CITED ON 5/28/24: On 7/16/24 at approximately 6:56 AM, Staff #1 was observed as the driver and only staff person in the facility owned vehicle while transporting 4 children (1 Infant, 1 Toddler, 1 Young School-Age, and 1 Older School-Age).

Correction Required: The driver may not be considered part of the staff-child ratio when infant, young or older toddler or preschool children are transported.

Regulation: 3270.52/3270.173(a)

Description: Mixed Age Level/Ratios apply

Noncompliance Area: PREVIOUSLY CITED ON 5/28/24: On 7/16/24 at approximately 6:56 AM, Staff #1 was observed as the driver and the only staff person in the facility owned vehicle while transporting 4 children (1 Infant, 1 Toddler, 1 Young School-Age, and 1 Older School-Age).

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: 3270.106(f)

Description: 2 feet apart

Noncompliance Area: A crib in the Blue Room was observed to lack 2 feet on 3 sides while an infant was sleeping in the crib.

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: 3270.173(b)

Description: Driver not counted in ratio - I, T, PS

Noncompliance Area: Based on staff interviews, 3 Infants, 1 YT, and 1 PSA are transported daily in the morning and on the facility's van with only Staff #2 present, who is also driving the van. The driver is not considered in staff-child ratio when infants, younger or older toddlers, or preschool-aged children are being transported.

Correction Required: The driver may not be considered part of the staff-child ratio when infant, young or older toddler or preschool children are transported.

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

Description: Age and Training

Noncompliance Area: The Pediatric First Aid/CPR on file for Staff #1 is dated 4/14/22, more than 24 months prior.

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: 3270.52/3270.173(a)

Description: Mixed Age Level/Ratios apply

Noncompliance Area: Based on staff interviews, 3 Infants, 1 YT, and 1 PSA are transported daily in the morning and on the facility's van with only Staff #2 present, who is also driving the van. The driver is not considered in staff-child ratio when infants, younger or older toddlers, or preschool-aged children are being transported.

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). The staff-child ratios specified in §§3270.51 and 3270.52 apply when infant, young or older toddler and preschool children are transported.

Regulation: 3270.62(b)(2)

Description: Toddler - 50 sq ft/child

Noncompliance Area: At approximately 11:20 AM, 11 children (3 YT, 4 OT, 5 PSA, and 1 YSA) were observed on the outdoor play space with a max capacity of 10.

Correction Required: The minimum outdoor or indoor play space required per young or older toddler is 50 square feet.

Regulation: 3270.95(a)/3270.95(b)

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

Noncompliance Area: The most recent fire alarm test date on file is 4/24/24, more than 30 days prior.

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 Orange area, foam blocks were observed with teeth marks and were not in good repair.

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: 3270.102(a)/3270.103

Description: Clean and good repair/Small Toys and Objects

Noncompliance Area: A table leg with ripped and torn plastic tape was observed in a room with toddlers, that were less than 1 inch in diameter, located in the Green room.

Correction Required: Toys, play equipment and other indoor and outdoor equipment used by the children shall be clean, in good repair and free from rough edges, sharp corners, pinch and crush points, splinters and exposed bolts. 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: 3270.105

Description: High Chairs

Noncompliance Area: In the Green room, the 8-seat table only contained 5 of the 8 required T-shaped safety straps. Children were observed in the 3 seats that did not have T-shaped safety straps.

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

Regulation: 3270.123(a)

Description: Signed

Noncompliance Area: The file for Child #2 did not contain an financial agreement form.

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

Regulation: 3270.123(a)(1)

Description: Amount of fee

Noncompliance Area: The financial agreement on file for Child #1 is missing the fee amount.

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

Regulation: 3270.124(b)(2)

Description: Physician name, address, phone

Noncompliance Area: The emergency contact forms for Child #2 lacked the address for physician or medical care provider and Child #5 lacked the name, address, and phone number for physician or medical care provider.

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)(4)/3270.182(3)

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

Noncompliance Area: The emergency contact on file for Child #1 does not include written parental permission for the facility to obtain emergency medical care.

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

Regulation: 3270.124(b)(6)

Description: Insurance coverage information

Noncompliance Area: The emergency contact form for Child #2 lacked the Health Insurance/MA Coverage.

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 for Child #2 lacked the phone number of the listed release person.

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 file for Child #2 (4/18/23) and Child #3 (4/21/23) contained an emergency contact form that was not updated within 6 months of the previous update.

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)/3270.182(1)

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

Noncompliance Area: The most recent health assessment on file for Child #2, who is a preschool age child, is dated 12/1/22, more than 12 months prior.

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

Regulation: 3270.131(c)

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

Noncompliance Area: The initial health assessment on file for Child #3 dated 1/6/22 is not signed by the examining health care professional (MD, CRNP, or PA), making it invalid.

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

Description: Immunization record/Dismissal policy

Noncompliance Area: The file for Child #2 (5 yr) contained the most recent influenza vaccination dated 2/3/20, which is dated more than 1 year ago, without a Letter of Exemption in the file. The file for Child #4 (2 yr) contained the most recent influenza vaccination dated 1/10/22, which is dated more than 1 year ago, without a Letter of Exemption in the file. Child #2 and Child #4 must be dismissed from care by close of business on 12/7/2023 and may only return to care when the immunization record is updated or when a parent provides a written, signed exemption letter.

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

Regulation: 3270.135(a)(3)

Description: Disposable diapers

Noncompliance Area: While observing diaper changes in the Infant Room, Staff #3 was observed opening the hands free can for diaper disposal with their hands.

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 two most recent health assessments on file for Staff #1 are dated 9/8/21 and 11/15/23, more than 24 months apart.

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: 3270.171(a)

Description: Pick-up and drop-off points

Noncompliance Area: The facility's letter notifying local traffic safety authorities of the location of the facility and the program's use of pedestrian and vehicular routes around the child care facility lacked a date, which does not verify if the letter was sent annually.

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

Regulation: 3270.21

Description: General Health and Safety

Noncompliance Area: A loose crib sheet was observed on a crib in the Infant Room, causing the risk of suffocation.

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 most recent Emergency Drill at the facility was dated 10/18/22, which is more than 12 months ago.

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

Regulation: 3270.27(e)

Description: Letter to parents

Noncompliance Area: The letter to parents explaining the emergency procedures did not contain lockdown procedures, accommodations for infants, toddlers, children with disabilities, and children with 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: 3270.27(f)

Description: Emergency plan

Noncompliance Area: The facility files lacked evidence of the Emergency Plan and subsequent plan updates were sent to the local municipality and County Emergency Management Services.

Correction Required: The operator shall send a copy of the emergency plan and subsequent plan updates to the local municipality and to the county emergency management agency.

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

Description: Fire safety - 1 yr.

Noncompliance Area: The two most recent fire safety trainings on file for Staff #1 are dated 4/14/22 and 9/9/23, more than 12 months apart.

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

Regulation: 3270.36(b)(5)

Description: HS/GED + 2 yrs

Noncompliance Area: The file for Staff #2, classified as an assistant group supervisor, did not contain acceptable proof of education on file.

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: 3270.75(c)

Description: Has all items

Noncompliance Area: The First Aid kit in the facility was missing tape.

Correction Required: A first-aid kit must contain the following: soap, an assortment of adhesive bandages, sterile gauze pads, tweezers, tape, scissors and disposable, nonporous gloves.

Regulation: 3270.76

Description: Building Surfaces

Noncompliance Area: Cracked and loose floor tiles were observed in the entryway to the bathroom, which could be hazardous to children.

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

Regulation: 3270.77(a)

Description: No peeling paint or plaster

Noncompliance Area: Peeling paint and plaster was observed in the back corner near the floor and next to the the large toilet in the bathroom. Peeling paint was observed on the purple wall near the floor.

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 fire drill log on file included fire drills conducted 8/10/23-10/10/23, more than 60 days apart.

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: 3270.95(a)/3270.95(b)

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

Noncompliance Area: The fire alarm 30-day test log includes test dates 5/2/23-6/2/23, 6/2/23-8/12/23, and 9/8/23-11/9/23, 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: The top of a children's table in the orange room was not in good repair (torn vinyl).

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: 3270.108(c)

Description: No styrofoam

Noncompliance Area: Styrofoam cups and plates were being used by children in care.

Correction Required: Styrofoam cups and plates may not be used.

Regulation: 3270.123(a)

Description: Signed

Noncompliance Area: The initial agreement for child #4 was not signed by the parent.

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

Regulation: 3270.123(a)(3)

Description: Services proceeded

Noncompliance Area: A Child Service Report (the Department's approved form to provide information to the family about the child's growth and development) was not completed for child #1 and #3 who have been in attendance at the child care facility for more than a 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(a)(4)

Description: Arrival/departure times

Noncompliance Area: The agreement for child #4 did not specify the child's departure time.

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

Regulation: 3270.123(b)/3270.182(8)

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

Noncompliance Area: The record for child #3 and #4 contained the original copy of the agreement between the parent and the operator.

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)(6)

Description: Insurance coverage information

Noncompliance Area: The emergency contact information for child #2 did not include health insurance coverage.

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(f)/3270.181(c)

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

Noncompliance Area: The emergency contact information for child #1, #3 and #4 who has been in attendance at the facility for more than a 6-month period has not been reviewed by a parent.

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(a)/3270.182(1)

Description: Health information/Initial and subsequent health reports

Noncompliance Area: The record for child #3 contained an initial health report dated more than 60 days following the child's first day of attendance at the facility.

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

Regulation: 3270.131(b)(1)/3270.182(1)

Description: Infant: updated health report every 6 months/Initial and subsequent health reports

Noncompliance Area: The record for child #1, a young toddler, contained a current health report dated more than 6 months following the date of their previous health report.

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

Regulation: 3270.14/3270.21

Description: Pertinent Laws & Regulations/General Health and Safety

Noncompliance Area: The facility's emergency plan did not include requirements for volunteer emergency preparedness training and continuity of operations plan to maintain compliance with 45 CFR § 98.41(a)(1)(vii)

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: 3270.66(a)

Description: Locked or inaccessible

Noncompliance Area: The following cleaning materials and other toxic materials that were labeled keep out of the reach of children were observed in areas accessible to children in care: White Out and hand sanitizer were observed in an unlocked teacher's desk drawer in the orange room by the entrance to the facility; and Lysol wipes, bleach cleaner and Clorox toilet bowl cleaner were observed in an unlocked utility closet in the bathroom.

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

Regulation: 3270.75(b)

Description: Inaccessible to children

Noncompliance Area: A first-aid kit was observed on the director's desk in the blue room, accessible to children in care.

Correction Required: A first-aid kit must be inaccessible to children.

Regulation: 3270.106(a)

Description: Clean, age appropriate

Noncompliance Area: SECOND VIOLATION The cribs were observed to lack labels for the children they were intended for. Previously cited on SIN-00208800 on 7/22/22.

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

Regulation: 3270.106(f)

Description: 2 feet apart

Noncompliance Area: SECOND VIOLATION An infant was observed sleeping in a crib which lacked two feet of space on three sides. Previously cited on SIN-00208800 on 7/22/22.

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: 3270.123(a)(4)

Description: Arrival/departure times

Noncompliance Area: SECOND VIOLATION The file for Child #3 contained an agreement which lacked the child's times of care. Previously cited on SIN-00208800 on 7/22/22.

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

Regulation: 3270.123(a)(5)

Description: Designated release persons

Noncompliance Area: SECOND VIOLATION The files for Child #1, #2, #3 and #4 contained agreements which lacked release persons for the child. Previously cited on SIN-00208800 on 7/22/22.

Correction Required: An agreement shall specify the persons designated by a parent to whom the child may be released.

Regulation: 3270.123(a)(6)

Description: Admission date

Noncompliance Area: SECOND VIOLATION The files for Child #1, #2, #3 and #4 contained agreements which lacked the children's enrollment dates. Previously cited on SIN-00208800 on 7/22/22.

Correction Required: An agreement shall specify the date of the child's admission.

Regulation: 3270.124(b)(3)

Description: Parent home/work address, phone

Noncompliance Area: SECOND VIOLATION The files for Child #1, and #4 contained emergency contact forms which lacked the work addresses and telephone numbers of the enrolling parents. The file for Child #3 contained an emergency contact form which lacked the work telephone number of the enrolling parent. Previously cited on SIN-00208800 on 7/22/22.

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

Regulation: 3270.124(b)(6)

Description: Insurance coverage information

Noncompliance Area: SECOND VIOLATION The file for Child #3 contained an emergency contact form which lacked the child's health insurance information. Previously cited on SIN-00208800 on 7/22/22.

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: SECOND VIOLATION The file for Child #4 contained an emergency contact form which lacked the full address for release persons. Previously cited on SIN-00208800 on 7/22/22.

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(e)(1)

Description: Exemption documentation from parent/guardian

Noncompliance Area: SECOND VIOLATION The file for Child #3 contained a record of immunization history which lacked a current influenza vaccination. Previously cited on SIN-00208800 on 7/22/22.

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: SECOND VIOLATION The file for Staff #6 lacked documentation of an initial health assessment. Previously cited on SIN-00208800 on 7/22/22.

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(c)(2)

Description: Mantoux TB

Noncompliance Area: The file for Staff #6 lacked documentation of an initial tuberculosis screening by the Mantoux method.

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

Regulation: 3270.151(c)(5)

Description: Physician/CRNP assessment

Noncompliance Area: SECOND VIOLATION The file for Staff #3 contained a health assessment which lacked the medical provider's assessment of the person's suitability to provide child care. Previously cited on SIN-00208800 on 7/22/22.

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: 3270.166(1)

Description: Written statement

Noncompliance Area: SECOND VIOLATION A written statement giving the formula and feeding schedule was not available at the facility at the time of inspection for one of the infants in care. Previously cited on SIN-00208800 on 7/22/22.

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

Regulation: 3270.182(3)

Description: Consent for emergency medical care required prior to admission

Noncompliance Area: SECOND VIOLATION The file for Child #3 contained an emergency contact form which lacked written parental consent for emergency medical care. Previously cited on SIN-00208800 on 7/22/22.

Correction Required: A child's record shall contain signed parental consent for emergency medical care for the child. Written consent is required prior to admission.

Regulation: 3270.182(5)

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

Noncompliance Area: SECOND VIOLATION The files for Child #3 and #4 contained emergency contact forms which lacked written parental consent for the administration of first-aid. Previously cited on SIN-00208800 on 7/22/22.

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 file for Staff #6 lacked documentation of two written, nonfamily references.

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: SECOND VIOLATION A loose crib sheet was observed on a crib in which an infant was sleeping. Previously cited on SIN-00208800 on 7/22/22.

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

Regulation: 3270.25(b)

Description: Post the inspection summary

Noncompliance Area: A copy of the renewal inspection SIN-0020880 was not posted in the facility in a conspicuous location on the day of the inspection.

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

Regulation: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: *SECOND VIOLATION The file for Staff #6 lacked a state police clearance, no receipt for state police clearance and an FBI clearance indicating a record without a RAP sheet. Staff #6 was observed in ratio with children on 9/27/22 Previously cited on SIN-00208800 on 7/22/22.

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 #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: **SECOND VIOLATION The file for Staff #6 lacked a state police clearance, no receipt for state police clearance and an FBI clearance indicating a record without a RAP sheet. Staff #6 was observed in ratio with children on 9/27/22 Previously cited on SIN-00208800 on 7/22/22.

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 #6 may not work at the facility. For a period of three months from the acceptance of the provider's plan of correction, the provider shall provide the certification representative all clearance documents for full or provisional hire for review prior to the employee's start date.

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

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

Noncompliance Area: *SECOND VIOLATION The file for Staff #6 lacked documentation of education and contained documentation of 2424 hours. Previously cited on SIN-00208800 on 7/22/22.

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

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

Noncompliance Area: **SECOND VIOLATION The file for Staff #6 lacked documentation of education and contained documentation of 2424 hours. Previously cited on SIN-00208800 on 7/22/22.

Correction Required: Within three months of the acceptance of plans of correction, the legal entity will coordinate and comply with ELRC 5 to provide technical assistance in the subject of file organization. Technical assistance will provide guidance to staff who are responsible for staff files in the areas of content, timeliness, staff qualifications and clearances.

Regulation: 3270.103

Description: Small Toys and Objects

Noncompliance Area: Small beads were observed to be accessible to small children who may still be placing objects in their mouths in the play kitchen and in the blue bin in the outdoor play space.

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: 3270.106(a)

Description: Clean, age appropriate

Noncompliance Area: The Main Room contained 6 cribs and pack and plays for the 8 infants and toddlers in care in that room. The cribs in the Main Room were observed to lack labels for whom they were intended. The cots in the Blue Room were observed to contain number labels, but no identifying list of child names was available to coordinate with the numbers.

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

Regulation: 3270.106(f)

Description: 2 feet apart

Noncompliance Area: Infants were observed sleeping in cribs which did not have two feet of space on at least three sides.

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: 3270.106(j)

Description: Prohibit items in crib

Noncompliance Area: A toy was observed in a pack and play in which an infant was sleeping.

Correction Required: Toys, bumper pads, or pillows may not be present in a crib while an infant is sleeping in the crib.

Regulation: 3270.123(a)(2)

Description: Date fee to be paid

Noncompliance Area: The file for Child #5 contained an agreement which lacked the due date for payment.

Correction Required: An agreement shall specify the date on which the fee is to be paid.

Regulation: 3270.123(a)(4)

Description: Arrival/departure times

Noncompliance Area: The file for Child #3 contained an agreement which lacked the child's times of care.

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

Regulation: 3270.123(a)(5)

Description: Designated release persons

Noncompliance Area: The files for Child #1, #2, #3, #4 and #5 contained agreements which lacked the release persons.

Correction Required: An agreement shall specify the persons designated by a parent to whom the child may be released.