Little House Learning Ctr

Regulation: 3270.123(b)

Description: Parent receives original

Noncompliance Area: The agreements on file in the ten children's files reviewed were the originals.

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

Regulation: 3270.131(b)(2)

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

Noncompliance Area: The current health assessments on file for children #1 and #2, both preschoolers, were completed more than 12 months after their previous health assessments on file.

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

Regulation: 3270.131(d)(7)

Description: Free from contagious/communicable disease

Noncompliance Area: The health assessment on file for child #1 did not include a statement that the child is able to participate in child care and appears to be free from contagious or communicable disease.

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

Regulation: 3270.151(a)

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

Noncompliance Area: The health assessment/ TB test results on file for Facility Person #4 was completed after their start date working with children.

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

Regulation: 3270.161(d)

Description: Potentially hazardous food refrigerated

Noncompliance Area: There were lunches containing potentially hazardous food (chicken nuggets, yogurt, cheese, pepperoni, etc.) on carts in the classrooms, not refrigerated in the Toddler, Preschool and Pre-K rooms.

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

Regulation: 3270.27(d)

Description: Plan posted

Noncompliance Area: The facility's emergency plan was not posted in a conspicuous location.

Correction Required: The operator shall post the emergency plan in the facility at a conspicuous location.

Regulation: 3270.31(f)(10)

Description: Health and Safety Training - Pediatric First Aid and CPR

Noncompliance Area: The approved pediatric first aid & CPR training documented on file for Facility Person #2 was completed more than 90 days after their start date.

Correction Required: Staff persons shall complete professional development in the topic of pediatric first aid and pediatric cardiopulmonary resuscitation within 90 days of hire.

Regulation: 3270.32(a)/3270.192(2)(iii)

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

Noncompliance Area: The current mandated reporter training documented and on file for Facility Person #1 was completed more than 60 months after the previous mandated reporter training on file.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). A facility person's record shall include verification of child care experience, education and training following the outset of service at the facility.

Regulation: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: The criminal history clearances on file for Facility Persons #3 and #7 were incomplete. The only FBI clearance on file for Facility Person #5 was more than 60 months old.

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

Regulation: 3270.36(b)/3270.192(2)(ii)

Description: Assistant Group Supervisor qualifications/Exp, educ., training prior to facility

Noncompliance Area: Facility Persons #3 and #6 were classified as assistant group supervisors without documentation of the required education and/or child care experience for the classification on file.

Correction Required: An assistant group supervisor shall have attained one of the qualification levels specified at § 3270.36(b)(1-5). A facility person's record shall include verification of child care experience, education and training prior to service at the facility.

Regulation: 3270.66(a)

Description: Locked or inaccessible

Noncompliance Area: There was a bottle of Clorox disinfectant spray on a counter in the Preschool room, in reach of children.

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

Regulation: 3270.67(d)

Description: Contaminated trash in closed plastic-lined receptacle

Noncompliance Area: There were trash cans in the classrooms that contained tissues, cups used for drinking, etc. (items that are contaminated by human secretions) that were not lidded.

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

Regulation: 3270.76

Description: Building Surfaces

Noncompliance Area: There was a rug on the floor in the Transition room that was wrinkled, causing a tripping hazard.

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

Regulation: 3270.77(a)

Description: No peeling paint or plaster

Noncompliance Area: There was peeling paint and damaged plaster on a wall in the Pre-Toddler room behind a stack of cots.

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

Regulation: 3270.91(a)

Description: Stairs, exits, etc. unobstructed

Noncompliance Area: There was equipment (a ball pit and soft cushions and blocks) in front of a door in the transition room leading to the Pre-Toddler room.

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

Regulation: 3270.92(a)

Description: No portable space heaters

Noncompliance Area: There were pieces of furniture in the lobby and office that each contained a heating device.

Correction Required: Portable space heaters are not permitted.

Regulation: 3270.103

Description: Small Toys and Objects

Noncompliance Area: There was a foam barrier on the edge of a window ledge, with pieces missing, in the Toddler room.

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

Regulation: 3270.123(a)

Description: Signed

Noncompliance Area: The agreement on file for child #2 was not signed by the parent.

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

Regulation: 3270.123(a)(6)

Description: Admission date

Noncompliance Area: The agreement on file for child #2 did not specify the date of the child's admission.

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

Regulation: 3270.124(b)(7)

Description: Name/address/phone release person

Noncompliance Area: The emergency contact form on file for child #3 did not include the addresses of all release persons listed.

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

Regulation: 3270.124(e)

Description: Written emergency plan posted

Noncompliance Area: The medical emergency transportation plans were not posted conspicuously as follows: in the Preschool room, where it was posted on a wall obstructed by a stack of cots, or the Toddler room, where it was posted on a wall, but covered by a curtain.

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.

Regulation: 3270.131(b)(2)

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

Noncompliance Area: The most recent health assessments on file for child #2, a preschooler, were dated 12/28/23 and 1/8/25, more than 12 months apart.

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

Regulation: 3270.133(3)

Description: Name on bottle

Noncompliance Area: There was triple antibiotic ointment in the first aid kit in the Preschool room, not labeled with a child's name to be used by that child.

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

Regulation: 3270.14/3270.21

Description: Pertinent Laws & Regulations/General Health and Safety

Noncompliance Area: The policy regarding shaken baby syndrome did not include strategies for coping with a crying, fussing, or distraught child; and did not address the prevention and identification of child maltreatment.

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.he operator must have a written policy must include, but is not limited to: Recognition of potential signs and symptoms of shaken baby syndrome and abusive head trauma; strategies for coping with a crying, fussing, or distraught child; and address the prevention and identification of child maltreatment

Regulation: 3270.151(a)/3270.151(c)(2)

Description: 12 months prior to service and every 24 months thereafter/Mantoux TB

Noncompliance Area: The most recent completed health assessment on file for Facility Person #1 was completed more than 24 months after the previous completed health assessment. The TB test on file for Facility Person #5 was documented as read after their start date.

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. 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)(3)

Description: Exam communicable disease

Noncompliance Area: The health assessment on file for Facility Person #3 did not include information regarding an exam for communicable disease and the results of that examination.

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

Regulation: 3270.182(5)

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

Noncompliance Area: There was no signed parental consent for minor first aid administration by staff on file for child #1.

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(b)

Description: Plan reviewed/updated annually

Noncompliance Area: There was no documentation of a date the emergency plan had been reviewed by the operator within the previous 12 months.

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

Regulation: 3270.27(e)

Description: Letter to parents

Noncompliance Area: The explanation of the facility's emergency plan in the handbook was not in letter format and it did not include all emergency procedures required under subsection (a).

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

Regulation: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: The current child abuse clearance on file for Facility Person #2 was completed more than 60 months after the previous child abuse clearance on file. The current criminal history and child abuse clearances on file for Facility Person #4 were completed more than 60 months after the previous respective clearances on file. The FBI clearance on file for Facility Person #6 was completed after their start date. There was no proof of application for an FBI clearance on file for Facility Person #6. Facility Person #7 resided in another state in the previous 5 years and began employment at the facility prior to 2/1/25. There was no criminal history clearance on file for Facility Person #7 from this state. The child abuse clearance from this state, and the proof of application for this clearance were completed after their start date.

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 #7 may not work in a child care position at the facility without all completed required clearances on file..

Regulation: 3270.35(b)(1)/3270.192(2)(iii)

Description: Bachelor's/Exp, educ., training at facility

Noncompliance Area: The degree on file for Facility Person #8, required for the classification, was an international degree and was not accompanied by an evaluation for U.S. equivalency by an accredited agency.

Correction Required: A group supervisor shall have a bachelor's degree from an accredited college or university in early childhood education, child development, special education, elementary education or the human services field. A facility person's record shall include verification of child care experience, education and training following the outset of service at the facility.

Regulation: 3270.65

Description: Protective Outlet Covers 5 yrs. or less

Noncompliance Area: There was an uncovered outlet in the schoolage room on a wall below a computer desk.

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

Regulation: 3270.75(c)

Description: Has all items

Noncompliance Area: There were no gloves or tweezers in a first aid kit in the preschool room.

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: 3270.133(4)

Description: Locked

Noncompliance Area: There was a backpack in reach of children in the schoolage room containing medication (Epipen, Albuterol inhaler).

Correction Required: Medication shall be stored in a locked area of the facility or in an area that is out of the reach of children.

Regulation: 3270.133(6)

Description: Written consent

Noncompliance Area: There was no written parental consent for an Epipen and an Albuterol inhaler in the schoolage room.

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

Regulation: 3270.151(c)(3)

Description: Exam communicable disease

Noncompliance Area: The health assessment on file for Facility Person #4 did not include an examination for communicable diseases and the results of that examination.

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

Regulation: 3270.151(c)(5)

Description: Physician/CRNP assessment

Noncompliance Area: The health assessments on file for Facility Persons #3 and #4 did not include the physician's or CRNP's assessment of the person's suitability to provide child care.

Correction Required: An adult health assessment must include the physician's or CRNP's assessment of the person's suitability to provide child care.

Regulation: 3270.192(5)

Description: Two written references

Noncompliance Area: There were no written, nonfamily references on file for Facility Persons #5, #6, #7, and #8.

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

Regulation: 3270.31(c)(4)

Description: Institution rep written certification

Noncompliance Area: Facility Persons #1, #2, #3, and #4 were high school students ages 16-17 classified as aides. The operator stated that Facility Persons #2, #3, and #4 were enrolled in an approved high school curriculum an have completed the required classroom training, but there was no documentation on file from the training institution to verify this.

Correction Required: An individual 16 years of age or older who is enrolled in an approved training curriculum may be used as a staff person if a representative of the training institution certifies in writing that the individual has completed the required classroom training and is currently enrolled in the curriculum.

Regulation: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: There was no NSOR on file for Facility Person #1. There was no FBI clearance on file for Facility Person #2. The child abuse clearance on file for Facility Person #3 was a volunteer clearance. Facility Persons #1, #2, and #3 were each employed at the facility more than 45 days.

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 Persons #1, #2, and #3 may not work in a child care position at the facility without all completed clearances on file.

Regulation: 3270.36(b)(3)/3270.192(2)(ii)

Description: HS/GED, 15 credits + 1 yr/Exp, educ., training prior to facility

Noncompliance Area: Facility Person # 8 was classified as an assistant group supervisor with documentation of 15 credits in human services on file. There was no documentation of the required child care experience on file for the classification.

Correction Required: An assistant group supervisor shall have a high school diploma or a general educational development certificate, 15 credit hours from an accredited college or university in early childhood education, child development, special education, elementary education or the human services field and 1 year of experience with children. A facility person's record shall include verification of child care experience, education and training prior to service at the facility.

Regulation: 3270.94(a)(4)

Description: Hypothetical locations

Noncompliance Area: Consecutive fire drills documented as occurring on 5/23/24 and 6/22/24 listed the same hypothetical location of the fire (the office).

Correction Required: The Director or designated staff person who is responsible for compliance with this chapter shall conduct fire drills and ensure that the hypothetical locations of the fire are rotated around the facility for each drill such that the hypothetical location is never the same for consecutive drills.

Regulation: 3270.102(a)

Description: Clean and good repair

Noncompliance Area: There were three Magna Tiles that were cracked in the School-Age Classroom.

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

Regulation: 3270.103

Description: Small Toys and Objects

Noncompliance Area: There were loose marker lids in a bin that was on a shelf accessible to children still placing objects in their mouths in the Pre-Toddler Classroom. There were wooden blocks on a shelf accessible to children still placing objects in their mouths in the Toddler Classroom.

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

Regulation: 3270.123(a)

Description: Signed

Noncompliance Area: The agreement on file for Child #1 and #4 is not signed by the operator.

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

Regulation: 3270.123(a)(6)/3270.182(2)

Description: Admission date/Application, admission, withdrawal dates

Noncompliance Area: The agreement on file for Child #1, #3, and #4 does not include the child's date of 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.

Regulation: 3270.124(b)(3)

Description: Parent home/work address, phone

Noncompliance Area: The emergency contact form on file for Child #2 does not include the address and telephone number for the enrolling parent's employment.

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

Regulation: 3270.124(e)

Description: Written emergency plan posted

Noncompliance Area: A written emergency transportation plan detailing transportation procedures for a medical emergency was not posted in the Preschool Classroom.

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.

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 two most recent health assessments on file for Child #1, who is a preschool age child, are dated 8/2/22 and 10/5/23, more than 12 months apart.

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

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

Description: Immunization record/Dismissal policy

Noncompliance Area: The immunization record on file for Child #4, who is 5 months old, includes 1 of 2 Hepatitis B vaccines recommended by the ACIP for a child this age; 1 of 2 Rotavirus vaccines recommended by the ACIP for a child this age; 1 of 2 DTAP vaccines recommended by the ACIP for a child this age; 1 of 2 HIB vaccines recommended by the ACIP for a child this age; and 1 of 2 Pneumococcal vaccines recommended by the ACIP for a child this age.

Correction Required: ·Child #4 must be dismissed from care by close of business on 2/8/24 and may only return to care when the immunization record is updated or when a parent provides a written, signed exemption letter.

Regulation: 3270.133(3)

Description: Name on bottle

Noncompliance Area: There was a bottle of Zyrtek in the medication bin in the School-Age Classroom that was not labeled for the use of a specific child.

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

Regulation: 3270.31(f)

Description: Health and Safety Training

Noncompliance Area: Staff person #1 did not complete the following required pre-service training within 90 days of their date of hire (see LIS code sheet): Pediatric First Aid/Pediatric CPR; the pre-service training on file for staff person #1 was dated 1/4/24. Staff person #5 did not complete the following required pre-service training within 90 days of their date of hire (see LIS code sheet): Get Started with Center-Based Care: Building Blocks for Quality; the pre-service training on file for staff person #5 was dated 11/6/23.

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

Regulation: 3270.31(f)

Description: Health and Safety Training

Noncompliance Area: Staff person #3 has not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): Pediatric First Aid/Pediatric CPR.

Correction Required: Staff person(s) shall complete professional development in the topics of 3270.31(f)(1 -- 10) within 90 days of hire. Staff person #3 will have until 3/16/24 to complete the required training. Until such time as the required training has been completed, staff person #3 must be supervised, when interacting with children, by an AGS who has completed the required training related to this citation. If there are no staff available to supervise staff person #3, staff person #3 may not work in a child-care position at the facility.

Regulation: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: The file for Staff person #2 includes an incomplete criminal history clearance that did not include a dissemination date, (See LIS Code Sheet), making it invalid.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). A facility person's record shall include a copy of requests for the criminal history record and child abuse registry clearance information, a copy of the disclosure statement and a copy of the completed clearance information required under the CPSL. Facility Person #2 may not work in a child care position at the facility.

Regulation: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: The file for staff person #4 did not to contain documentation of a complete PA Child Abuse clearance prior to date of hire (See IS CODE SHEET) required for provisional hiring under the CPSL; the clearance is dated 9/2/23). The file for Staff person #4 did not include proof of application for a criminal history, child abuse, and sex offender clearances from Florida, where the staff person lived within the previous 5 years (See IS CODE SHEET) required for provisional hiring under the CPSL; the FL criminal history and FL child abuse clearances are both dated 2/5/24.

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(e)

Description: Arts and crafts non-toxic

Noncompliance Area: There were cans of shaving cream, labeled "Keep out of the reach of children", reportedly used for arts and crafts projects, in the Pre-K classroom.

Correction Required: Arts and crafts materials shall be nontoxic.

Regulation: 3270.76

Description: Building Surfaces

Noncompliance Area: There were 4 holes in the wall with exposed plaster/drywall in the Preschool Classroom by the outside exit door.

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: 3270.124(b)(3)

Description: Parent home/work address, phone

Noncompliance Area: The emergency contact form on file for Child #2, #3, #6, and #7 does not include the work address and/or telephone number for the enrolling parent.

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

Regulation: 3270.124(b)(7)

Description: Name/address/phone release person

Noncompliance Area: The emergency contact form on file for Child #7 does not include a complete address for all listed release persons.

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

Regulation: 3270.131(b)(1)

Description: Infant: updated health report every 6 months

Noncompliance Area: The two most recent health assessments on file for Child #7, who was a young toddler, are dated 9/27/21 and 9/2/22, more than 6 months apart.

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.

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

Description: Immunization record/Dismissal policy

Noncompliance Area: The most recent influenza vaccination on file for Child #1, who is 4 years old, is dated 11/20/19, more than 1 year ago, as is recommended annually by the ACIP. The most recent influenza vaccination on file for Child #2, who is 4 years old, is dated 11/16/20, more than 1 year ago, as is recommended annually by the ACIP. The most recent influenza vaccination on file for Child #3, who is 3 years old, is dated 10/20/21, more than 1 year ago, as is recommended annually by the ACIP. The most recent influenza vaccination on file for Child #5, who is 2 years old, is dated 11/29/21, more than 1 year ago, as is recommended annually by the ACIP. The immunization record on file for Child #7, who is 2 years old, includes 3 of 4 DATP vaccinations recommended for a child this age; and the most recent influenza vaccination is dated 12/13/21, more than 1 year ago, as is recommended annually by the ACIP. The most recent influenza vaccination on file for Child #8, who is 4 years old, is dated 10/2/21, more than 1 year ago, as is recommended annually by the ACIP.

Correction Required: ·Child #1, #2, #3, #5, #7, and #8 must be dismissed from care by close of business on 4/4/23, and may only return to care when the immunization record is updated or when a parent provides a written, signed exemption letter.

Regulation: 3270.131(d)(8)

Description: Age appropriate screenings complete

Noncompliance Area: The current health assessment on file for Child #4 does not indicate if the child has had all age-appropriate screenings.

Correction Required: A health report shall include a statement that age-appropriate screenings recommended by the American Academy of Pediatrics were conducted since the time of the previous health report required by this section.

Regulation: 3270.133(3)

Description: Name on bottle

Noncompliance Area: There was medication, Simethicone gas drops, in the Infant room, with the names of 2 children, siblings, to share.

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

Regulation: 3270.133(5)

Description: Original label

Noncompliance Area: There was an expired EpiPen in the School-age room, which had an expiration date of 12/2022. There was an expired AuviQ pen in the Transition room.

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

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

Description: Fire safety - 1 yr.

Noncompliance Area: The Fire Safety training that the facility has been utilizing since 2021 through 2023 is in the form of a video recording and is not facilitated by a fire safety professional. Therefore, the previous and current fire safety training on file is not valid for all staff person currently employed.

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. All Staff have until 4/27/23 to complete a DHS approved on-line fire safety training available on the PD Registry, or participate in an in-person fire safety training conducted by a fire safety professional.

Regulation: 3270.31(f)

Description: Health and Safety Training

Noncompliance Area: Staff person #3, #6 has not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): Get Started with Center-Based Care; Building Blocks for Quality. Staff person #5 has not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): Pediatric First Aid/Pediatric CPR

Correction Required: Staff person(s) shall complete professional development in the topics of 3270.31(f) within 90 days of hire. Staff person #3, #5, #6 will have until 4/25/23 to complete the required training. Until such time as the required training has been completed, staff person #3, #5, #6 must be supervised, when interacting with children, by an AGS who has completed the required training related to this citation. If there are no staff available to supervise staff person #3, #5, #6, staff person #3, #5, #6 may not work in a child-care position at the facility.

Regulation: 3270.31(f)

Description: Health and Safety Training

Noncompliance Area: The file for Staff person #4 includes current First Aid/CPR training dated 1/15/23, after the expiration of the previous training, 12/5/22.

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

Regulation: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: The Child Abuse clearance on file for staff person #1 is dated after the date of hire (See IS CODE SHEET) but is required prior to hire for provisional hiring under the CPSL. The Child Abuse clearance on file for staff person #2 is dated after the date of hire (See IS CODE SHEET) but is required prior to hire for provisional hiring under the CPSL. The signed Disclosure statement on file for Staff person #7 is not dated at hire (See LIS Code Sheet); the disclosure statement is dated 2/23/23.

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

Regulation: 3270.69(b)

Description: 110º F or less

Noncompliance Area: The water temperature in the sink in the Pre-K room measured 113 degrees Fahrenheit.

Correction Required: Hot water temperature, in areas accessible to children, may not exceed 110° F.

Regulation: 3270.82(h)

Description: Handwashing signs

Noncompliance Area: There was no handwashing sign at the handicap toilet in the Pre-K room.

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

Regulation: 3270.104(a)

Description: Clean, good repair, proper size

Noncompliance Area: In the school-age room, there was an unanchored cabinet on the back wall that was unstable and a potential hazard.

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

Regulation: 3270.131(e)(1)/3270.131(e)(2)(i)

Description: Exemption documentation from parent/guardian/Exemption documentation from parent/guardian

Noncompliance Area: The file for child #1, a 2 year old, child #2, a 5 year old, and child #3, a 4 year old, had an immunization record that lacked verification of the Influenza vaccination being administered within the last calendar year in accordance with the schedule recommended by the ACIP and lacked exemption documentation.

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. Exemption from immunization for religious belief or strong personal objection equated to a religious belief shall be documented by a written, signed and dated statement from the child's parent or guardian. The statement shall be kept in the child's record.

Regulation: 3270.135(a)(3)

Description: Disposable diapers

Noncompliance Area: The bathroom between the toddler and pre-toddler rooms had soiled diapers thrown away in a trash can that had a flip lid and not in a hands-free diapering 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)

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

Noncompliance Area: The file for staff person #3 had a health assessment that was dated after their start date.

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

Regulation: 3270.151(c)(2)

Description: Mantoux TB

Noncompliance Area: The files for staff person #3 and #6 had a tuberculosis screening by the Mantoux method that was dated after initial employment.

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

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

Description: Exam communicable disease/Physician/CRNP assessment

Noncompliance Area: The file for staff person #7 had a health assessment that lacked an examination for communicable diseases and the results of that examination and the physician's or CRNP's assessment of the person's suitability to provide child care.

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

Regulation: 3270.161(d)

Description: Potentially hazardous food refrigerated

Noncompliance Area: In the facility, there were multiple lunch boxes in each child care room that had potentially hazardous food brought from the child's home that were not refrigerated.

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

Regulation: 3270.31(e)

Description: Age and Training

Noncompliance Area: The file for staff person #1, with a start date prior to 12-20-20, lacked 12 annual hours of child care training between 12-19-20 and 12-18-21 as required by regulations for staff persons with a start date prior to 12-20-20. The files for staff person #2, with 4 hours of training, and staff person #5, with 3 hours of training, had a start date prior to 12-20-20, and lacked 12 annual hours of child care training between 12-19-20 and 12-18-21 as required by regulations for staff persons with a start date prior to 12-20-20.

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

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

Description: Age and Training/Health and Safety Training

Noncompliance Area: The files for staff person #9 had pediatric first-aid and CPR training that expired in October 2021 and lacked current training. The file for staff person #1 had current pediatric first-aid and CPR training with a completion date of 5-24-21 that was after the January 2021 expiration of the prior training.

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

Regulation: 3270.31(f)(10)/3270.31(h)

Description: Health and Safety Training - Pediatric First Aid and CPR/Health and Safety Training

Noncompliance Area: The files for staff person #4, with a start date of 8-16-21, and staff person #7, with a start date of 10-20-21, lacked pediatric first-aid and CPR training within 90 days of their start date and require current training.

Correction Required: Staff persons shall complete professional development in pediatric first aid and pediatric cardiopulmonary resuscitation within 90 days of hire. All staff persons shall complete the professional development under subsection (f).

Regulation: 3270.32(a)/3270.192(2)(iii)

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

Noncompliance Area: Staff person #8, with a start date of 8-13-21, had mandated reporter training dated 2-19-22 that was over 90 days after their start date. Staff person #5 had trainings dated 12-7-15 and 12-22-20 that were over 5 years between trainings.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). A facility person's record shall include verification of child care experience, education and training following the outset of service at the facility.

Regulation: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: The file for staff person #4, with a start date of 8-16-21, had a disclosure statement that lacked the date. The file for staff person #2 had child abuse clearances dated 3-19-14 and 3-21-19 that were over 60 months between clearances.

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

Regulation: 3270.36(b)(5)

Description: HS/GED + 2 yrs

Noncompliance Area: The file for staff person #8, functioning as an assistant group supervisor, lacked verification of education to qualify as an assistant group supervisor.

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: 3270.66(a)

Description: Locked or inaccessible

Noncompliance Area: In the school-age room, there were 2 cans of shaving foam labeled "Keep out of reach of children" that a staff person stated had been used for an art activity with the children and were accessible to children.

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

Regulation: 3270.82(h)

Description: Handwashing signs

Noncompliance Area: In the pre-k room, the toilet in the large stall lacked a handwashing sign.

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

Regulation: 3270.94(a)(1)

Description: Every 60 days

Noncompliance Area: According to the fire drill log, a fire drill was not conducted every 60 days between 7-22-21 to 9-23-21.

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: 3270.113(a)(1)

Description: Staff assigned to specific children

Noncompliance Area: At approximately 12:48 p.m. in the school-age room with a total of 20 children, staff person #1 named 10 preschoolers in their group and staff person #2 named 8 young school-age children in their group, resulting in 2 children not being named in a group.

Correction Required: Each staff person shall be assigned the responsibility for supervision of specific children. The staff person shall know the names and whereabouts of the children in his assigned group. The staff person shall be physically present with the children in his group on the facility premises and on facility excursions off the facility premises.