Little Blessings Early Learning Center

Noncompliance Area: Continued deficiencies: Facility person #1's record does not include acceptable verification of education.

Correction Required: A facility person's record shall include acceptable verification of experience, education or training is a transcript or a diploma or a letter signed by a representative of the experiential, educational or training entity.

Noncompliance Area: It was observed on 9/22/2020 there was evidence of infestation of rodents in the facility as mouse droppings were observed throughout both buildings used for child care (2nd floor back room behind white trash can by sink and in the bottom left hand cupboard at the sink/ 2nd floor hallway in the bottom of a supply cabinet/ 3rd floor, back room in a cupboard underneath the sink and the bottom of a pantry where 2 boxes of tortilla chips were being stored/ 3rd floor, front room in a cupboard underneath the sink and in two drawers/ Landing behind a closed, unlocked door on the 3rd floor leading to the 2nd floor, front room / School-age building in a drawer of the metal desk). Continued deficiencies: On 10/29/2020 evidence of fresh mouse droppings were observed in the utensil drawer and in the cupboard underneath the sink in the 3rd floor, front room.

Correction Required: Evidence of infestation of insects or rodents in the facility is not permitted.

Noncompliance Area: It was observed on 9/22/2020 in the infant room a cord was hanging loosely from a tv mounted to the wall above a Pack 'N Play, two areas of the carpet portion of the floor had sharp, exposed prongs and there was a chipped outlet cover. It was observed on 9/22/2020 in the room in between the lobby and infant room two corners of the carpet area had exposed prongs. It was observed on 9/22/2020 in the second floor, front room the cupboard below the sink was very dirty, including dead insects, the bottom drawer of the sink area was dirty. It was observed on 9/22/2020 in the third floor, back room a portable air conditioner was dirty, drawers at the sink were dirty, there are water stains on the ceiling in the back corner of the room by the camera, and a drawer in the pantry was dirty with food particles. It was observed on 9/22/2020 in the third floor, front room the end of a metal carpet transition strip near the cubbies was sticking up, the cubbies were dirty, the white wall behind the door was dirty and splattered with food, there are water stains on the ceiling in the corner by the window and around the roof access, and the carpet at the floor vent was fraying. It was observed on 9/22/2020 in the school-age building there was hole in the floor where utility sink pipes go down through the floor, an outlet cover was not flush with the wall, sections of baseboard that are loose and pulling away from the wall, and the utility sink and wall behind the sink were dirty. It was observed on 9/22/2020 the wooden fire escape located at the back of the main building had a loose bottom step on the third flight of stairs, there were multiple area of splintering, rotting railings with screws exposed, there were shards of glass on one of the landings and a cigarette lighter laying on one of the landings. It was observed on 9/22/2020 the outdoor play area was littered with chunks of broken concrete and rocks, sharp rebar rods are protruding from the top of a concrete slab, and wooden boards along the bottom of the kitchen and school-age building were rotting and splintering. It was observed on 9/22/2020 in multiple classrooms free standing fire extinguishers were being stored on top of shelving units, creating a fall hazard. Continued deficiencies: It was observed on 10/29/2020 in the 3rd floor, front room there were fresh water stains on the ceiling in the corner by the window. Water was also observed to be dripping from the window casing and puddling on the windowsill. It was observed on 10/29/2020 in the 3rd floor, back room there are water stains on the ceiling in the back corner of the room by the camera.

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

Noncompliance Area: It was observed on 9/22/2020 play equipment and materials appropriate to the developmental needs, individual interests and ages of the children were not provided in sufficient amount and variety to preclude long waits for use in the second floor, front room. Four children ages 3 - 5 years were observed in the room with 9 toys items that are developmentally appropriate for a toddler and two toy kitchens with a small variety of play food and accessories.

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: It was observed on 9/22/2020 in the third floor, back room the white kitchen set was dirty and the plastic knob on the red kitchen set was not in good repair. It was observed on 9/22/2020 in the third floor, front room the changing pad had a dirty, cloth cover over it and a red and yellow toy dump truck's bed was dirty.

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: It was observed on 9/22/2020 in the infant room a plastic bag was on a shelf that was accessible to children who are still placing objects in their mouths. It was observed on 9/22/2020 in the room in between the lobby and infant room multiple plastic bags are being stored in cubbies that are accessible to children who are still placing objects in their mouths.

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

Noncompliance Area: It was observed on 9/22/2020 in the third floor, back room a school-aged child who was participating in virtual learning for school was sitting at a table that was not appropriate for the child's size or age. The child was observed to be hunched over and her knees could not fit underneath the table. It was observed on 9/22/2020 in the second floor, back room a cubbie shelving unit was very unstable.

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

Noncompliance Area: It was observed on 9/22/2020 the rest equipment in the infant room and in the second floor, front room was not labeled for the use of a specific child. Staff person #1 and staff person #3 could not answer if the rest equipment was only being used by the same child each time.

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.

Noncompliance Area: It was observed on 9/22/2020 the thermometer in the infant room refrigerator was not operating properly and read 65 degreed F.

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

Noncompliance Area: It was observed on 10/5/2020 at approximately 1pm staff person #5 sent a school-age child to the lobby area for departure. The child walked from the 3rd floor, back room to the lobby area unsupervised. It was observed on 10/5/2020 at approximately 1:10pm staff person #1 walked out of the infant room and around the corner into the room in between the infant room and lobby area to retrieve a pacifier out of a child's stroller leaving 3 infants unsupervised for less than 1 minute.

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. Children must be supervised at all times.

Noncompliance Area: When interviewed on 9/22/2020 staff person #2 and staff person #3 stated they are not taking the children out doors on a daily basis, weather permitting.

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

Noncompliance Area: The agreement for child #1 and child #2 does not specify the date of the child's admission.

Correction Required: An agreement shall specify the date of the child's admission. A child's record shall contain the dates of application, admission and withdrawal of the child.

Noncompliance Area: Emergency contact information for child # 1 and child #4 does not include the name, address and telephone number of the child's physician or source of medical care. Emergency contact information for child # 3 does not include the address of the child's physician or source of medical care.

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

Noncompliance Area: Emergency contact information for child #4 does not include the home and work addresses and telephone numbers of the enrolling parent. Emergency contact information for child #1 does not include the work address and home and work telephone numbers of the enrolling parent. Emergency contact information for child #2 does not include the home telephone number of the enrolling parent. Emergency contact information for child #3 does not include the work address and telephone number of the enrolling parent.

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

Noncompliance Area: Emergency contact information for child #4 does not include the name, address and telephone number of the individual designated by the parent to whom the child may be released.

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

Noncompliance Area: It was observed on 9/22/2020 emergency contact information was not present the child care space for any of the children receiving care in that space. The infant room, second floor, front room and the third floor, back room were being used for child care services at time of inspection.

Correction Required: When children are in the facility, emergency contact information shall be present in a child care space for children receiving care in the space.

Noncompliance Area: It was observed on 9/22/2020 staff person #2 did not wash her hands or a child's hands after diapering. It was observed on 9/22/2020 staff person #2 did not wash her or a child's hands before bottle feeding.

Correction Required: A staff person shall ensure that a child's hands are washed before meals and snacks, after toileting and after being diapered.A facility person shall wash his hands before meals and snacks, and after toileting and after diapering a child.

Noncompliance Area: It was observed on 9/22/2020 in the second floor, back room an opened bottle of syrup with an expiration date of 7/14/2019 was in the pantry. The syrup had an unpleasant odor. It was observed on 9/22/2020 in the third floor, back room an opened jar of Jif Chunky Peanut Butter with an expiration date of 6/17/2019 was in the pantry. The peanut butter had a strong, rancid odor.

Correction Required: Food stored, prepared or served shall be clean, wholesome, free from spoilage, free from adulteration and safe for human consumption.

Noncompliance Area: It was observed on 9/22/2020 in the second floor, back room an opened jar of applesauce was being stored in the upper left hand cupboard by the sink. The label read that refrigeration was required after opening.

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

Noncompliance Area: A written statement giving the formula and feeding schedule for an infant was not obtained from the parent

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

Noncompliance Area: It was observed on 9/22/2020 bottles were being washed in the facility's sink and being reused. The facility does not have a commercial dishwasher.

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: It was observed on 9/22/2020 none of the bottles in the infant room were labeled with the child's name.

Correction Required: Disposable nursers and bottles shall be labeled with the child's name.

Noncompliance Area: Facility person #1's record does not include acceptable verification of education.

Correction Required: A facility person's record shall include acceptable verification of experience, education or training is a transcript or a diploma or a letter signed by a representative of the experiential, educational or training entity.

Noncompliance Area: Facility person #1's record includes two written references; however, one of the references is from a family member.

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 operator is not in compliance with the CPSL as staff person # 4 who was hired provisionally on 9/1/2020 and does not have the results of the NSOR verification on file was observed to be working unsupervised with the school-age children on 9/22/2020. The name and date of birth on staff person #1 's State Police clearance does not match the name and date of birth on the government issued ID in her file.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). Staff person #4, a provisional employee may not be permitted to work alone with children and must work within the vicinity of a permanent employee.

Noncompliance Area: Staff person #4, who is being utilized as an assistant group supervisor does not have 2 years experience with children documented in her 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.

Noncompliance Area: It was observed on 9/22/2020 the small, back room in the school-age building is being used as storage and is not set up for indoor child care space.

Correction Required: Measurement and use of indoor child care space

Noncompliance Area: It was observed on 9/22/2020 in the lobby area a can of disinfectant spray was on a table and a bucket of cleaning water was left unattended and accessible to children. (CORRECTED ON SITE) It was observed on 9/22/2020 in the infant room 4 bottles of prescription medication for staff person #1 and a spray bottle of perfume were in a plastic bag on a shelf that was accessible to children. (CORRECTED ON SITE) It was observed on 9/22/2020 the utility room door on the second floor of the main building was not locked and left partially ajar making an opened bucket of laundry detergent accessible to children. It was observed on 9/22/2020 in the second floor, front room of the main building a mop bucket which contained cleaning water was sitting on the floor, hand sanitizer was being stored by the sink, disinfectant spray and wipes, multiple containers of cleaners and deodorizing sprays were being stored in a cupboard to the left of the sink, a bag of TomCat Mouse Killer poison was being stored in a bottom cupboard to the left of the sink all of which are accessible to children. It was observed on 9/22/2020 in the third floor, back room of the main building bleach disinfecting wipes/sprays and deodorizing spray were being stored in the top left cupboard by the sink, TomCat Mouse Killer poison was being stored in a cupboard underneath the sink all of which are accessible to children. It was observed on 9/22/2020 in the third floor, front room of the main building a bottle of Clorox bleach was being stored in a cupboard to the right of the sink, cleaning toxins and mouse glue traps with TomCat Mouse Killer poison was in the cupboard underneath the sink which had a childproof lock that wasn't latched making all items accessible to children. It was observed on 9/22/2020 in the school-age building an unlocked utility closet contained cleaning supplies that was accessible to children.

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

Noncompliance Area: It was observed on 9/22/2020 in the infant room a Magic Eraser was not being stored in an original container or in a container that specifies the content. It was observed on 9/22/2020 in the second floor, back room a bottle of hand sanitizer was on the sink counter next to a box of Cheerios and Cheez Its.

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: It was observed on 9/22/2020 there was evidence of infestation of rodents in the facility as mouse droppings were observed throughout both buildings used for child care (2nd floor back room behind white trash can by sink and in the bottom left hand cupboard at the sink/ 2nd floor hallway in the bottom of a supply cabinet/ 3rd floor, back room in a cupboard underneath the sink and the bottom of a pantry where 2 boxes of tortilla chips were being stored/ 3rd floor, front room in a cupboard underneath the sink and in two drawers/ Landing behind a closed, unlocked door on the 3rd floor leading to the 2nd floor, front room / School-age building in a drawer of the metal desk).

Correction Required: Evidence of infestation of insects or rodents in the facility is not permitted.

Noncompliance Area: It was observed on 9/22/2020 a first-aid kit was not in the child care space located in between the lobby area and infant room. (CORRECTED ON SITE)

Correction Required: A first-aid kit shall be in a child care space.

Noncompliance Area: It was observed on 9/22/2020 a first-aid kit was accessible to children in the second floor, front room. It was observed on 9/22/2020 a first-aid kit was accessible to children in the third floor, back room.

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

Noncompliance Area: It was observed on 9/22/2020 the first-aid kit in the infant room did not contain gloves. It was observed on 9/22/2020 the first-aid kit in third floor, back room did not contain soap.

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.

Noncompliance Area: It was observed on 9/22/2020 in the infant room a cord was hanging loosely from a tv mounted to the wall above a Pack 'N Play, two areas of the carpet portion of the floor had sharp, exposed prongs and there was a chipped outlet cover. It was observed on 9/22/2020 in the room in between the lobby and infant room two corners of the carpet area had exposed prongs. It was observed on 9/22/2020 in the second floor, front room the cupboard below the sink was very dirty, including dead insects, the bottom drawer of the sink area was dirty. It was observed on 9/22/2020 in the third floor, back room a portable air conditioner was dirty, drawers at the sink were dirty, there are water stains on the ceiling in the back corner of the room by the camera, and a drawer in the pantry was dirty with food particles. It was observed on 9/22/2020 in the third floor, front room the end of a metal carpet transition strip near the cubbies was sticking up, the cubbies were dirty, the white wall behind the door was dirty and splattered with food, there are water stains on the ceiling in the corner by the window and around the roof access, and the carpet at the floor vent was fraying. It was observed on 9/22/2020 in the school-age building there was hole in the floor where utility sink pipes go down through the floor, an outlet cover was not flush with the wall, sections of baseboard that are loose and pulling away from the wall, and the utility sink and wall behind the sink were dirty. It was observed on 9/22/2020 the wooden fire escape located at the back of the main building had a loose bottom step on the third flight of stairs, there were multiple area of splintering, rotting railings with screws exposed, there were shards of glass on one of the landings and a cigarette lighter laying on one of the landings. It was observed on 9/22/2020 the outdoor play area was littered with chunks of broken concrete and rocks, sharp rebar rods are protruding from the top of a concrete slab, and wooden boards along the bottom of the kitchen and school-age building were rotting and splintering. It was observed on 9/22/2020 in multiple classrooms free standing fire extinguishers were being stored on top of shelving units, creating a fall 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.

Noncompliance Area: It was observed on 9/22/2020 in the room in-between the lobby area and infant room an area of peeling paint in the corner where the cots are stacked. It was observed on 9/22/2020 in the second floor, back room an area of peeling paint and damaged plaster by the white changing table. It was observed on 9/22/2020 in the third floor, front room an area of peeling paint by the science table and book center. It was observed on 9/22/2020 an area of peeling paint on the outside wall that is accessible to children within the outdoor play space.

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

Noncompliance Area: It was observed on 9/22/2020 the stairway leading from the third floor hallway to the second floor, front room was obstructed by toys, stacked doors and a ladder.

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

Noncompliance Area: When staff person #2 was interviewed on 9/22/2020 she did not know the evacuation plan to remove all four children (ages infant to toddler) she was responsible for supervising from the facility in a single trip.

Correction Required: Evacuation plans shall provide for removal of all persons from the facility in a single trip.

Noncompliance Area: It was observed on 9/16/2020 liquid or powdered soap was not available in the bathroom on the right in the school-age building.

Correction Required: Liquid or powdered soap shall be used for handwashing.

Noncompliance Area: It was observed at 2:26 pm on 9/16/2020 a gallon of milk was being stored on the counter in the school-age building and was not refrigerated. When interviewed staff person #3 stated lunch had been served at 11:30 am and the milk has been there since that time.

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

Noncompliance Area: On 9/16/2020 staff members stated that the facility provided pizza, french fries, peaches, and milk for lunch to children of toddler age and older; therefore at least one protein was not included as pizza does not count as a protein.

Correction Required: A lunch or dinner prepared at the facility for children of toddler age or older shall include at least one protein.

Noncompliance Area: It was observed on 9/16/2020 the operator did not conspicuously post a menu at least 1 week in advance nor did the operator provide a menu to each family.

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

Noncompliance Area: It was observed on 9/16/2020 the facility does not have a COVID-19 Health and Safety Plan posted in a conspicuous location for parents and staff members. It was observed on 9/16/2020 staff person # 1, staff person #2 and staff person #3 were not wearing a face covering appropriately as their mouth and/or nose was not covered during portions of the inspection. Upon entrance to the facility on 9/16/2020 certification representative was not screened for COVID-19 symptoms by a facility person nor was a hand hygiene station observed by the entrance.

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

Noncompliance Area: The facility director was not on-site 9/16/2020 and staff member #4 was not sure who was designated as the staff person who was responsible for compliance with chapter 3270 in the Director's absence.

Correction Required: A director is responsible for designating a staff person who is responsible for compliance with this chapter in the Director's absence.

Noncompliance Area: It was observed on 9/16/2020 staff person #3 was spraying rest cots with an aerosol can of disinfectant spray in close proximity to children.

Correction Required: Cleaning materials and other toxic materials shall be used in a way that does not contaminate play surfaces, food, food preparation areas and does not constitute a hazard to the children.

Noncompliance Area: Evidence of rodents in the kitchen were observed on 9/16/2020 as mice droppings were observed on a white table and on the tops of canned goods and spices being stored in a white plastic bin on top of a cabinet.

Correction Required: Evidence of infestation of insects or rodents in the facility is not permitted.

Noncompliance Area: It was observed on 9/16/2020 the window in the preschool room on the second floor of the main building which opens directly to the outdoors and is accessible to children was fully opened (24 inches). (OCRRECTED ON SITE)

Correction Required: Windows or doors above the ground floor that open directly to the outdoors and are accessible to children shall be constructed, modified or adapted to limit the opening to 6 or fewer inches.

Noncompliance Area: It was observed on 9/16/2020 floors in all areas of the facility's two buildings were dirty as food crumbs, pencil shavings, pieces of paper and other debris were observed on carpeted areas and tile floors. It was observed on 9/16/2020 in the school-age building a rectangular patch of a sticky black substance approximately 12 inches by 3 inches was on the floor and accessible to children. Smaller patches of the black substance were observed on the floor surrounding the rectangular patch. It was observed strands of hair, pieces of paper and a lid to a marker were observed to be stuck in the rectangular patch of black substance. When staff person #1 was asked what the black substance was she stated it was the tar like substance that was left behind from a mouse trap that was used prior to the facility re-opening. It was observed on 9/16/2020 the kitchen was dirty. Mice droppings were observed on a white table and on the tops of canned goods and spices that were being stored in a white plastic bin sitting on top of a storage cabinet.

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

Noncompliance Area: It was observed on 9/16/2020 the lights in both bathrooms in the school-age building were not operable. The bathrooms were not lighted by artificial or natural light.

Correction Required: Rooms, hallways, stairways, outside steps, porches and ramps shall be lighted by artificial or natural light.

Noncompliance Area: It was observed the two bathrooms on the second floor of the main building were dirty as the toilets had not been flushed and the sinks had visible grime on them. It was observed the two bathrooms in the school-age building were dirty as the toilets had not been flushed and the seats were soiled.

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

Noncompliance Area: It was observed on 9/16/2020 a hand washing sign was not posted in the bathroom on the right in the school-age building.

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: It was observed on 9/16/2020 the toilet area on the left in the school-age room was not equipped with a clean, lidded waste receptacle. It was observed on 9/16/2020 all four toilet areas in the main building were equipped with a waste receptacle; however, the lids were observed to be placed inside the waste receptacle and used paper towels were discarded on top of the lids.

Correction Required: A toilet area, training chair area, diapering area and sink area shall be equipped with a clean, lidded waste receptacle.

Noncompliance Area: After a Department of Health (DOH) child record audit, twenty (20) children's files were identified as being noncompliant regarding the immunization status according to recommendations of the ACIP. A certification representative verified on 8/26/2019 seventeen (17) children's files remain non-complaint and do not contain proper documentation according to the recommendations of the ACIP. Of the seventeen (17) files reviewed two (2) children have been in attendance for more than 60 days and do not have written verification from a physician, physician's assistant, CRNP, the Department of Health or a local health department of the dates (month, day and year) the child was administered immunizations in accordance with the recommendations of the ACIP.

Correction Required: A health report shall include a review of the child's immunized status according to recommendations of the ACIP. The facility may not accept or retain an infant 2 months of age or older, a toddler or a preschool child at the facility for more than 60 days following the first day of attendance at the facility unless the parent provides written verification from a physician, physician's assistant, CRNP, the Department of Health or a local health department of the dates (month, day and year) the child was administered immunizations in accordance with the recommendations of the ACIP.

Noncompliance Area: It was observed in the infant room a thermometer was not placed in the refrigerator. (CORRECTED ON SITE)

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

Noncompliance Area: It was observed a written plan identifying the means of transporting a child to emergency care and staffing provisions in the event of an emergency was not displayed conspicuously in the infant room. (CORRECTED ON SITE)

Correction Required: A written plan identifying the means of transporting a child to emergency care and staffing provisions in the event of an emergency shall be displayed conspicuously in every child care space and shall accompany a staff person who leaves on an excursion with children.

Noncompliance Area: The operator did not require the parent of child #1 to provide an initial health report no later than 60 days following the first day of attendance at the facility. Child #1's date of admission was 7/13/2016 and the initial health report was dated 10/3/2016, which was 82 days following the 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.

Noncompliance Area: The adult health assessment for staff person # 3 does not include information on medical problems that might threaten the health of the children or prohibit a staff person from providing adequate care to children.

Correction Required: An adult health assessment must include information on medical problems that might threaten the health of the children or prohibit a staff person from providing adequate care to children.

Noncompliance Area: It was observed in the infant room a bottle was not labeled with the child's name. (CORRECTED ON SITE)

Correction Required: Disposable nursers and bottles shall be labeled with the child's name.

Noncompliance Area: Facility person #3's record did not include two (2) written, nonfamily references from individuals attesting to the person's suitability to serve as a facility person and facility person #2's record only included one (1) written, nonfamily reference from individuals attesting to the person's suitability to serve as a facility person.

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: Staff person #1 did not participate,at least annually, in firesafety training conducted by a fire protection professional.

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.

Noncompliance Area: It was observed in the front School-Age Room cleaning materials and other toxic materials such as Clorox and Clorox wipes were accessible to children. (CORRECTED ON SITE)

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

Noncompliance Area: It was observed in the preschool room a spray bottle that contained cleaning materials was not labeled with the contents of the container. (CORRECTED ON SITE)

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: It was observed the first-aid kit in the front and rear school-age rooms did not contain soap. (CORRECTED ON SITE)

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.

Noncompliance Area: It was observed in the vehicle used to transport children to and from school two (2) seats were not in good repair as foam was exposed. (CORRECTED ON SITE)

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

Noncompliance Area: A parent did not receive the original agreement. The facility had the original agreement on file instead of retaining a copy of the agreement.

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

Noncompliance Area: The provider stated there was a recent incident due to staff turnover that emergency contact information for child #1, who was enrolled at the facility could not be located.

Correction Required: Emergency contact information is required for each enrolled child. Emergency contact information must reference who shall be contacted in an emergency.

Noncompliance Area: Emergency contact information was not present in a child care space for child #1 who was receiving care in the space.

Correction Required: When children are in the facility, emergency contact information shall be present in a child care space for children receiving care in the space.

Noncompliance Area: Records for child #1, 2 &3 did not contain signed parental consent for transportation being provided by the facility in vehicles owned and operated by the facility.

Correction Required: Transportation by the facility requires written parental consent, except for transportation of school-age children who are transported to or from a child care facility in vehicles owned or operated by the school district. A child's record shall contain signed parental consent for transportation, walking excursions, swimming and wading.

Noncompliance Area: It was observed child #4 who is 7 years of age (DOB 1/31/2011) was not being transported in accordance with the requirements for parents and guardians as stated in 75 Pa.C.S. 4581 (relating to restraint systems). The child was observed to only being using a seat belt and was not in a booster seat system.

Correction Required: A child 7 years of age or younger shall be transported in accordance with the requirements for parents and guardians as stated in 75 Pa.C.S. 4581 (relating to restraint systems). The legal entity must submit documentation in a format approved by DHS proving that the facility procedure for securing children in the age appropriate restraint system while transporting children in a facility vehicle is followed at all times e.g., a checklist. The legal entity will confirm continuing compliance by sending copies of documentation to the Regional Office of Child Development and Early Learning on a weekly basis for a period of three (3) months after DHS approves the documentation format.

Noncompliance Area: It was observed the facility was transporting children in a 14 passenger van.

Correction Required: In accordance with the requirements of 67 Pa. Code Chapter 171 (relating to school buses and school vehicles), the facility may not transport a child in an 11-15 passenger van.

Noncompliance Area: It was observed staff person #1 was alone in the toddler room during naptime with a group of eight (8) children ranging in age from 7 months to school-age while staff person #2 was on their break. The mixed age grouping included a 7 month old infant and therefore nap time ratios did not apply making the ratio 4:1. (CORRECTED ON SITE once staff person #2 returned to the classroom)

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 ratio while toddlers and preschoolers are napping is one staff person to 10 young toddlers, one staff person to 12 older toddlers, one staff person to 20 preschool children

Noncompliance Area: A written statement giving the formula and feeding schedule for an infant was not obtained from the parent.

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

Noncompliance Area: In the school age building it was observed foam was exposed on the cushion on the bench by the window, the counter top had pieces of the laminate chipped off and rough wood was exposed which could cause splinters and cabinet doors were hanging in a way that created possible pinch and crush points.

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

Noncompliance Area: It was observed in the infant room the refrigerator was sticky and did not have an operating thermometer in it, a thermometer was not in the refrigerator in the young toddler room and the preschool room on the left side of the stairs the thermometer in the refrigerator was not operating properly. It was observed the refrigerator in the preschool room on the right side of stairs was unplugged and had spoiled food/beverages inside it.

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

Noncompliance Area: A written plan of daily activities was not posted in the infant room, the toddler room on the right side of the stairs, and the school-age room (CORRECTED ON SITE)

Correction Required: The written plan of daily activities shall be posted in the group space.

Noncompliance Area: A written plan of identifying the means of transporting a child to emergency care and staffing provisions in the event of an emergency was not displayed conspicuously in any of the child care spaces in the facility.

Correction Required: A written plan identifying the means of transporting a child to emergency care and staffing provisions in the event of an emergency shall be displayed conspicuously in every child care space and shall accompany a staff person who leaves on an excursion with children.

Noncompliance Area: An updated health report was not on file for child #1-4; last health reports are dated child # 1 3/22/2017, child #2 7/12/2016, child # 3 10/18/2016 and child #4 10/7/2016.

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.

Noncompliance Area: Facility person #2 does not have a valid health assessment on file; the last one on file is dated 12/10/2015 which is longer than 24 months ago.

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

Noncompliance Area: It was observed in the young toddler room bottles were not labeled with the child's name. (CORRECTED ON SITE)

Correction Required: Disposable nursers and bottles shall be labeled with the child's name.

Noncompliance Area: Written notification of safe routes was not posted by the operator at a conspicuous location in the child care facility.

Correction Required: Written notification of safe routes shall be posted by the operator at a conspicuous location in the child care facility.

Noncompliance Area: Facility person #4's record did not include verification of education prior to service at the facility. (CORRECTED ON SITE)

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: Facility person's # 1, 3 and 4 record did not include two written, nonfamily references from individuals attesting to the person's suitability to serve as a facility person. (CORRECTED ON SITE)

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: Two vehicles which are used to the transport school-age children to and from the facility were not made accessible to the certification representative the day of inspection and therefore could be not accessed to determine if the vehicles are in compliance with regulations set forth in Chapter 3270. The operator stated that it was recently noticed that the inspection had expired for both vehicles and therefore were taken in to be inspected. Due to fact that both vehicles had expired inspections and were still being used to transport children, a possible threat to the health and safety of the children existed.

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

Noncompliance Area: Documentation in staff person #2's file indicates that they last participated in firesafety training on 5/25/2016, which does not meet the annual requirement.

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.

Noncompliance Area: In the outdoor play space, it was observed a van and Omni bus were being parked inside the play space. The Omni bus has a rusted spot and a sharp piece of rusted metal protruding from the back of the bus. It was also observed in the outdoor play space a broken sign with metal pieces laying on the ground around it, some trash and debris under the van and/or bus, and several pieces of siding on the ground beside a stroller and bye bye buggy that are being stored outside with the intention of being thrown away. It was also observed that the side of the building within the outdoor play space has some peeling paint on the exterior wall and the ground was scattered with small rocks, which would pose a choking hazard to toddler aged children using the space for large muscle activity.

Correction Required: Outdoor or indoor play space shall be safe for large muscle activity.

Noncompliance Area: It was observed in the preschool room on the left side of the stairs Lysol, Disinfecting Wipes and Hand Sanitizer were on the counter top and accessible to children. It was also observed that a disinfectant spray bottle was under the sink cabinet and accessible to children. (ALL CORRECTED ON SITE)

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

Noncompliance Area: It was observed in the preschool room on the left side of the stairs, the door was being used for ventilation and was not screened while open. (CORRECTED ON SITE)

Correction Required: Windows or doors used for ventilation shall be screened when open.

Noncompliance Area: It was observed in the preschool room a first aid kit was accessible to children. (CORRECTED ON SITE)

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

Noncompliance Area: The first aid kit in the young toddler room did not contain scissors, the first aid kit in the preschool room did not contain disposable,nonporous gloves and the first aid kit in the infant room did not contain scissors, disposable, non-porous gloves, tweezers, soap and gauze. (CORRECTED ON SITE)

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.

Noncompliance Area: It was observed in the preschool room the emergency lights had a thick layer of dust and a cobweb spanning from the lights to the wall.

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

Noncompliance Area: It was observed in the preschool room on the left of the stairs the plaster was damaged on the wall in the corner of the room where the cots are being stored; a metal strip was exposed as a result.

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

Noncompliance Area: It was observed all toilet areas in the facility were not equipped with a lidded waste receptacle. (CORRECTED ON SITE)

Correction Required: A toilet area, training chair area, diapering area and sink area shall be equipped with a clean, lidded waste receptacle.

Noncompliance Area: Emergency contact information was not present in the child care space for any of the 8 children who were present and receiving care in the toddler room, only 3 out of the 10 children who were present and receiving care in the preschool room had emergency contact information in the child care space.

Correction Required: When children are in the facility, emergency contact information shall be present in a child care space for children receiving care in the space.

Noncompliance Area: It was observed that the children's hands were not washed before lunch in the toddler room. A staff member used the same baby wipe to clean the hands of 3 children who were sitting at the table; their lunch plate had already been served to them prior to the baby wipe being used.

Correction Required: A staff person shall ensure that a child's hands are washed before meals and snacks, after toileting and after being diapered.

Noncompliance Area: It was observed that liquid or powdered soap was not available in 2 of the bathrooms used by children nor was liquid or powdered soap available by the sink in the toddler room. It was observed that when the children in the toddler room were cleaned up after lunch that only water was used to clean their hands.

Correction Required: Liquid or powdered soap shall be used for handwashing.

Noncompliance Area: It was observed that there was a soft cloth covering on the changing pad in the toddler room. When a staff member was asked how the surface is cleaned after each diaper change, the staff produced an aerosol can of Lysol spray and stated that the changing pad is sprayed with Lysol after each use.

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

Noncompliance Area: It was observed that the staff members in the toddler room did not wash their hands before lunch.

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

Noncompliance Area: It was observed in the preschool room that cleaning materials were accessible to children. (Corrected on site)

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

Noncompliance Area: It was observed in the school age room located on the 3rd floor of the building 2 heat vents located on the floor were broken and not in good repair.

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

Noncompliance Area: It was observed that the light in the stairway going to the third floor of the building was not working. The stairway was dark as there was not a source of artificial or natural light in that immediate area.

Correction Required: Rooms, hallways, stairways, outside steps, porches and ramps shall be lighted by artificial or natural light.

Noncompliance Area: Staff records for Staff members #1, #4, #5, #6 did not contain proof 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.