Metropolitan Preschool And Nursery-warner Center

Regulation: 3270.113(a)

Description: Supervised at all times

Noncompliance Area: Based on interviews with multiple staff, Staff Person #1 was observed to be sleeping on five occasions during October 2025 while responsible for an assigned group of children. Staff interviewed stated they were in the rooms when Staff Person #1 fell asleep. Staff Person #1 was observed sleeping one time in (Room 7 Older Toddler Room) one time in (Room 2 Young Toddler Room), and three times in (Room 4 Preschool Room) including once shortly after breakfast and once during nap. While asleep, Staff Person #1 was unable to actively supervise the children in their assigned group.

Correction Required: Children on the facility premises and on facility excursions off the premises shall be supervised by a staff person at all times. Outdoor play space used by the facility is considered part of the facility premises.

Regulation: 3270.113(a)(1)

Description: Staff assigned to specific children

Noncompliance Area: Based on interviews with multiple staff, Staff Person #1 was observed sleeping on five occasions during October 2025 while responsible for an assigned group of children. Staff interviewed stated they were in the rooms when Staff Person #1 fell asleep. Staff Person #1 was observed sleeping one time in (Room 7 Older Toddler Room), one time in (Room 2 Young Toddler Room), and three times in (Room 4 Preschool Room) including once shortly after breakfast and once during naptime. While asleep, Staff Person #1 was unable to actively supervise or know the whereabouts of the children in their assigned 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.

Regulation: 3270.20(a)(1)

Description: Inpatient hospitalization or ER treatment of child

Noncompliance Area: Based on interviews, in August 2025 staff reported on two separate occasions that Child #1's eyes were rolling back in his head. Staff Person #1 assessed the child and observed no concerns but directed parent to take Child #1 to the hospital as a precaution. The parent transported Child #1 to the ER. However, the operator did not notify the regional office within 24 hours of the ER visit.

Correction Required: The operator shall immediately notify a child's parent and shall telephone notice to the appropriate regional office within 24 hours if a child in care at the facility is hospitalized or receives emergency room treatment.

Regulation: 3270.20(b)

Description: Mail or deliver written report to regional office within 72 hours

Noncompliance Area: Based on interviews, in August 2025 staff reported on two separate occasions that Child #1's eyes were rolling back in his head. Staff Person #1 assessed the child and observed no concerns but directed the parent to take the child to the hospital as a precaution. The parent transported Child #1 to the ER. However, the operator did not mail or deliver a written report within 72 hours of the ER visit.

Correction Required: The operator shall mail or deliver a written report to the appropriate regional office within 72 hours after hospitalization of a child in care, emergency room treatment of a child in care, death of a child in care, a facility fire requiring the services of a fire department.

Regulation: 3270.102(a)

Description: Clean and good repair

Noncompliance Area: Observed protruding bolts, which lacked covers, on the legs of the rocking chair in Room 1.

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: 3270.123(a)(3)

Description: Services proceeded

Noncompliance Area: The first child service report in the file for Child #3 was dated more than six months after the child's first day in care. The files for Child #5 and #6 did not contain a child service report conducted within the past six months.

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

Regulation: 3270.124(b)(3)

Description: Parent home/work address, phone

Noncompliance Area: The emergency contact forms in the files for Child #1, 2, 4 and 5 did not include the work addresses and telephone numbers of 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 forms in the files for Child #1 and #2 did not include the release person's addresses. The emergency contact form in the file for Child #4 did not include the release person's phone number and only a partial address.

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(c)

Description: Each child care space

Noncompliance Area: The emergency contact binder in Room 5 did not contain an emergency contact form for Child #4 who was receiving care in that room.

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.

Regulation: 3270.131(a)/3270.182(1)

Description: Health information/Initial and subsequent health reports

Noncompliance Area: The initial health report in the file for Child #2 was conducted more than 60 days after the child's first day of attendance at the facility.

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

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

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

Noncompliance Area: The file for Child #1, a young toddler, does not include an updated health report conducted within the past 6 months.

Correction Required: The operator shall require the parent to provide an updated health report at least every 6 months for an infant or young toddler. A child's record shall contain initial and subsequent health reports.

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

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

Noncompliance Area: The most recent health reports in the files for Child #3, an older toddler, and Child #5 and 6, preschool children, exceeded 12 months between reports.

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

Regulation: 3270.151(a)/3270.192(3)

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

Noncompliance Area: The most recent health assessments in the file for Staff Person #5 exceeded 24 months between assessments.

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

Regulation: 3270.151(c)(2)

Description: Mantoux TB

Noncompliance Area: The initial health assessment in the file for Staff Person #2 does not include a TB screening.

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: 3270.181(c)

Description: Emergency info/agreement updated 6 mos

Noncompliance Area: The emergency contact forms in the files for Child #1, 2, 5 and 7 have not been updated by the parents in the past six months. The most recent parent updates for the fee agreements in the files for Child #3 and 5 exceeded six months between updates. The fee agreements in the files for Child #2 and 7 have not been updated by the parents in the past six months.

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

Regulation: 3270.182(5)

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

Noncompliance Area: The emergency contact form in the file for Child #7 did not contain signed parental consent for administration of minor first-aid procedures by facility staff.

Correction Required: A child's record shall contain signed parental consent for administration of minor first-aid procedures by facility staff. Written consent is required prior to admission.

Regulation: 3270.192(2)(ii)

Description: Exp, educ., training prior to facility

Noncompliance Area: The file for Staff Person #1 did not include verification of two years child care experience.

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

Regulation: 3270.31(e)

Description: Age and Training

Noncompliance Area: The files for Staff Person #4 and #6 did not contain documentation of annual 12 hours of child care training for the most recent full year of service. Staff Person #4: 11.5 hours. Staff Person #6: 5.5 hours.

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

Regulation: 3270.33(a)

Description: Each staff person meets quals

Noncompliance Area: The file for Staff Person #3 contained a high school diploma from a foreign country which had not been evaluated by a service that is a member of the National Association of Credential Evaluation Services (NACES) or the Association of International Credential Evaluators (AICE).

Correction Required: A staff person or a substitute staff person shall meet one of the applicable staff qualifications for the position in which the person is performing.

Regulation: 3270.51

Description: Similar Age Level

Noncompliance Area: On 10/17/25 at 12:20 PM, Staff Person #8 was observed supervising 15 Preschool Children in Room #4. This was during naptime, however, two of the children were still eating lunch at the table.

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

Regulation: 3270.52

Description: Mixed Age Level

Noncompliance Area: On 10/17/25 at 12:15 PM, Staff Person #7 was observed supervising a mixed group of 6 Older Toddler and 4 Preschool Children in Room 6. This was during naptime, however, two of the children had not yet been placed on their cots.

Correction Required: When children are grouped in mixed age levels, the age of the youngest child in the group determines the staff:child ratio and maximum group size in accordance with the requirements in § 3270.51 (relating to similar age level).

Regulation: 3270.77(a)

Description: No peeling paint or plaster

Noncompliance Area: Observed flaking plaster along the wall partition near the entrance to Room #4 where a corner molding strip had been removed.

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

Regulation: 3270.82(e)

Description: Toilet and sinks proper height

Noncompliance Area: On 10/17/25 at approximately 10:00 AM in Room 2, observed Staff Person #4 holding Child #2 (young toddler) over the sink to wash child's hands after diaper change. The stool located in Room 2 is not an adequate height for children to reach the sink in the room.

Correction Required: Toilets and sinks shall be at proper heights for children using them or shall be easily approached by means of platforms or steps.

Regulation: 3270.113(a)(1)

Description: Staff assigned to specific children

Noncompliance Area: Previously cited on 4/4/25. Due to repeated citations under 3270.113(a)(1), provider was required to provide a plan of correction, which included random weekly supervision checks in each room for a period of four months (6/6/25-9/27/25). During an unannounced monitoring conducted on 9/29/25 to verify corrections, it was observed that weekly supervision checks were not conducted/documented during the following weeks: (6/8-6/14, 6/22-6/28, 8/3-8/16, 8/24-9/20).

Correction Required: 1. 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. 2. After a system is established, the director and/or other leadership team members will conduct random checks of all child care spaces to ensure that staff are using the primary group supervision system correctly. Documentation of checks shall indicate the name of staff conducting the checks, the name of the room, the names of staff in the rooms and whether or not staff named their primary supervision group correctly. Weekly checks will be conducted three times per week for a period of 5 weeks (9/29/25 through 10/31/25). Correction Date 10/31/25.

Regulation: 3270.102(a)

Description: Clean and good repair

Noncompliance Area: Observed a clothes shelf separating, which creates a potential pinch hazard, in Room 4. Observed a wobbly shelf, which creates a toppling hazard, in Room 7.

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

Regulation: 3270.107

Description: Refrigerator

Noncompliance Area: The refrigerator in Room 2 lacked an operating thermometer.

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

Regulation: 3270.113(a)(1)

Description: Staff assigned to specific children

Noncompliance Area: On 4/24/25 at 1:00 PM, Staff Person #5 was supervising 7 OT/PS children in Room 6 at naptime. Staff Person #5 could not identify three of the children in care by name.

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

Regulation: 3270.123(a)(3)

Description: Services proceeded

Noncompliance Area: The most recent child service reports in the file for Child #3 exceeded six months between reports.

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

Regulation: 3270.124(c)

Description: Each child care space

Noncompliance Area: The emergency contact binder in the gym did not include an emergency contact form for Child #3 who was receiving care in this area.

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.

Regulation: 3270.131(a)/3270.182(1)

Description: Health information/Initial and subsequent health reports

Noncompliance Area: The initial health reports in the files for Child #1 and Child #6 were conducted more than 60 days after the child's first day in attendance.

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

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

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

Noncompliance Area: The most recent health reports in the file for Child #3, a preschool child, exceeded 12 months between reports.

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: 3270.14/3270.21

Description: Pertinent Laws & Regulations/General Health and Safety

Noncompliance Area: Staff person #4 was observed to be caring for children unsupervised in Room #2. Staff person #4 has not completed the following pre-service training required prior to caring for children unsupervised: Pediatric First Aid/CPR in an approved curriculum from a certified PQAS instructor.

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. Until such time as the required pre-service trainings are completed, staff person #4 must be supervised, when interacting with children, by an AGS or higher who has completed the required training related to this citation. If there are no staff person(s) available to supervise staff person #-4, staff person #4 may not work in a child-care position at the facility.

Regulation: 3270.151(a)/3270.192(3)

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

Noncompliance Area: The most recent health assessments in the file for Staff Person #2 exceeded 24 months between assessments.

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

Regulation: 3270.181(c)

Description: Emergency info/agreement updated 6 mos

Noncompliance Area: The most recent parent updates for the emergency contact forms and fee agreements in the files for Child #1, 3, 4, 5 and 6 exceeded six months between updates. The initial parent updates for the emergency contact form and fee agreement in the file for Child #2 were conducted more than six months after the child's first day in care.

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

Regulation: 3270.21

Description: General Health and Safety

Noncompliance Area: Observed a loose-fitted sheet in one pack n play in Room #1.

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

Regulation: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: The most recent Child Abuse Clearances in the file for Staff Person #1 exceeded 60 months between clearances. The State Police, FBI Clearances and NSOR Certificate in the file for Staff Person #3 were acquired more than 45 days after the staff person's first day working in childcare (See LIS Code Sheet).

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

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

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

Noncompliance Area: The file for Staff Person #4 contains a foreign degree that has not been translated/evaluated by an approved accreditation agency.

Correction Required: A staff person or a substitute staff person shall meet one of the applicable staff qualifications for the position in which the person is performing. A facility person's record shall include verification of child care experience, education and training prior to service at the facility.

Regulation: 3270.65

Description: Protective Outlet Covers 5 yrs. or less

Noncompliance Area: The childproof latches were not functioning properly on four electrical outlets in Room 4, four electrical outlets in the gym, and six electrical outlets in Room 5. These outlets also lacked protective receptacle covers.

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

Regulation: 3270.76

Description: Building Surfaces

Noncompliance Area: Observed damaged and missing ceiling tiles above the toilet in the bathroom for Room 7 and a hole in the ceiling above the toilet in the bathroom outside Room 7. This exposed flaking drywall and drainpipes above. Also observed a rusty drainpipe with a cracked lid next to the toilet in the bathroom for Room 7.

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

Regulation: 3270.77(a)

Description: No peeling paint or plaster

Noncompliance Area: Observed peeling paint on the purple wall in Room 2 entrance to carpeted area.

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

Regulation: 3270.113(a)(1)

Description: Staff assigned to specific children

Noncompliance Area: At approximately 9:45am Staff Person #1 and #2 were observed to be caring for 11 older toddlers in Classroom #7. Staff each identified being responsible for 5 children. This information was also listed on a dry erase board in the classroom. This left 1 child who had not been assigned to a specific staff person.

Correction Required: 1. 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. 2. All staff will participate in technical assistance sessions with an ELRC Quality Coach to create, implement, and maintain a primary group supervision system. The facility will schedule the first session within 2 weeks of acceptance of this plan of correction. Additional sessions will be conducted as recommended by the ELRC Quality Coach. 3.After a system is established, the director and/or other leadership team members will conduct random weekly checks of all child care spaces to ensure that staff are using the primary group supervision system correctly. Documentation of checks shall indicate the name of staff conducting the checks, the name of the room, the names of staff in the rooms and whether or not staff named their primary supervision group correctly. Weekly checks will be conducted for a period of 4 months.

Regulation: 3270.113(b)

Description: No physical punishment

Noncompliance Area: Staff Person #1 was observed on video surveillance to forcefully place Child #1 into a highchair for "time out purposes". Staff Person #1 was observed to walk past Child #1 in the highchair and aggressively push the child's leg/foot as they walked past the child. Staff Person #1 was observed to aggressively push Child #1's arm away after the child pulled a bin from the changing area to the floor. Staff Person #1 then forcefully pushed the highchair the child was seated in forward.

Correction Required: 1. A facility person may not use any form of physical punishment, including spanking a child. 2. All staff, including the director, will complete a 2 hour, in-person "Creating a Safe Environment Through Active Supervision" training to be conducted by a representative from the ELRC #5 within one month of acceptance of the plan of correction. The facility will arrange the training with the Quality Coach. Training hours can be counted towards the 12 hour annual training requirement. 3. After staff attend the required training, the facility will develop a Supervision Policy that will include an area that addresses the prohibition of physical discipline.

Regulation: 3270.113(c)

Description: No ridicule or threaten harm

Noncompliance Area: Staff Person #1 was observed on video surveillance to place Child #1 in a highchair "for time out purposes" from 9:15am until 11:48am. The child was only removed from the highchair for one diaper change and one diaper check during this time.

Correction Required: 1. A facility person may not single out the child for ridicule, threaten harm to the child or the child's family and may not specifically aim to degrade the child or the child's family. 2. After staff attend the required training, the facility will develop a Supervision Policy that will include an area that addresses that a staff person may not single out a child for ridicule, threaten harm to the child or the child's family and may not specifically aim to degrade the child or the child's family.

Regulation: 3270.113(e)

Description: Restraints prohibited

Noncompliance Area: Staff Person #1 was observed on video surveillance to aggressively place Child #1 into a highchair for "time out purposes". The child was strapped into the highchair from 9:15am to 11:48am. The child was only removed from the highchair for one diaper change and one diaper check during that time.

Correction Required: 1. A facility person may not restrain a child by using bonds, ties or straps to restrict a child's movement or by enclosing the child in a confined space, closet or locked room. The prohibition against restraining a child does not apply to the use of adaptive equipment prescribed for a child with special needs. 2. After staff attend the required training, the facility will develop a Supervision Policy that will include an area that addresses restraining children and the appropriate use of highchairs as equipment for feeding purposes only.

Regulation: 3270.82(h)/3270.134(a)

Description: Handwashing signs/Child's hands washed

Noncompliance Area: Staff Person #1 was observed to change Child #1's diaper and did not ensure that the child's hands were washed following the diapering change.

Correction Required: A facility person and an able child shall wash his hands after toileting and before eating. A sign on which this requirement is written shall be posted at each toilet, training chair, diapering area and sink in the facility. A staff person shall ensure that a child's hands are washed before meals and snacks, after toileting and after being diapered.

Regulation: 3270.113(a)

Description: Supervised at all times

Noncompliance Area: Based on conversation with staff, it was determined that Staff Person #1 was not actively supervising Child #1 on 9/11/24 at 11:00 AM in Room #3. The staff person's back was turned away when Child #1 fell and bumped his head. Staff Person #1 was unaware the incident occurred until it was brought to Staff Person's attention by Director who reviewed the incident on video.

Correction Required: Children on the facility premises and on facility excursions off the premises shall be supervised by a staff person at all times. Outdoor play space used by the facility is considered part of the facility premises.

Regulation: 3270.114

Description: Outdoor Activity

Noncompliance Area: Based on conversations with staff, the infants and young toddlers had not been taken outdoors from mid-June through the end of September, 2024 due to some of the strollers being stollen and the other strollers not functioning properly.

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

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

Description: Exam communicable disease/Physician/CRNP assessment

Noncompliance Area: The initial health assessment in the file for Staff Person #1 did not include an examination for communicable diseases and the results of that examination or 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: 3270.192(5)

Description: Two written references

Noncompliance Area: The file for Staff Person #1 lacked two reference letters.

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

Regulation: 3270.27(c)

Description: Training regarding plan

Noncompliance Area: The file for Staff Person #2, who has been working in child care for more than 90 days (See LIS Code Sheet), did not include documentation of initial training in the facility's emergency plan.

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

Regulation: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: The file for Staff Person #1 did not include application for or documentation of a State Police Clearance. The status of the State Police Clearance in the file for Staff Person #3 was "Under Review". The file for Staff Person #4 lacked a receipt for fingerprinting and an FBI Clearance.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). A facility person's record shall include a copy of requests for the criminal history record and child abuse registry clearance information, a copy of the disclosure statement and a copy of the completed clearance information required under the CPSL. Facility Person #1, 3 and 4 may not work in a child care position at the facility.

Regulation: 3270.37(b)(3)/3270.192(2)(ii)

Description: 8th grade + 2 yrs/Exp, educ., training prior to facility

Noncompliance Area: The file for Staff Person #1, an Aide, included documentation of only 1.5 years child care experience.

Correction Required: An aide shall have a minimum of an 8th grade education and 2 years 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: 3270.76

Description: Building Surfaces

Noncompliance Area: Observed ceiling tiles, discolored from water damage, in the Young Toddler Room.

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: 3270.94(a)(7)

Description: Participation

Noncompliance Area: Based on conversation with staff, the infants and young toddlers in care and staff responsible for these children did not participate in the fire drills conducted on 7/26/24 and 8/30/24 due to inoperability of evacuation strollers.

Correction Required: The Director or designated staff person who is responsible for compliance with this chapter shall conduct fire drills and ensure that facility persons and children in attendance participate in the fire drill.

Regulation: 3270.94(a)(8)

Description: Exit building

Noncompliance Area: Based on conversation with staff, the infants and young toddlers in care and staff responsible for these children did not exit the building during the fire drills conducted on 7/26/24 and 8/30/24 due to inoperability of evacuation strollers.

Correction Required: The Director or designated staff person who is responsible for compliance with this chapter shall conduct fire drills and ensure that facility persons and children exit the building, weather permitting.

Regulation: 3270.113(a)(1)

Description: Staff assigned to specific children

Noncompliance Area: 2nd CITATION. Previously cited on 4/9/24. On 5/20/24 at 11:00 AM, Staff Person #1 was supervising 8 Preschool Children in Room #8. When asked to identify the children, Staff Person #1 could only name seven of the eight children in care. Staff Person #1 did not know the name of Child #1. Staff Person #1 stated that child had recently started, and he did not have a card for Child #1.

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

Regulation: 3270.113(a)(1)

Description: Staff assigned to specific children

Noncompliance Area: At approximately 10:08 am, 20 preschool children were being cared for in Room 4/Preschool. When asked their primary supervisory group, staff #1 identified 7 preschool children. When staff #2 was asked, they stated they were unable to name their group at this moment as they are covering the classroom because a preschool staff called off. Staff #2 was not able to name the 13 preschool age children in the primary supervision 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.

Regulation: 3270.191

Description: Individual Records

Noncompliance Area: The file of staff #3, a Childcare Careers contracted provider, was not available on the day of the inspection.

Correction Required: An individual record is required for each facility person.

Regulation: 3270.32(a)

Description: Comply with CPSL

Noncompliance Area: The file of staff #3, a Childcare Careers contracted provider, was not available on the day of the inspection making it unable to determine they had the required CPSL paperwork to care for children.

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

Regulation: 3270.51

Description: Similar Age Level

Noncompliance Area: **At approximately 10:08 am, 20 preschool children were being cared for in Room 4/Preschool. When asked to identify their primary supervisory group, staff #1 identified 7 preschool children. When staff #2 was asked, they stated they were unable to name their group at this moment as they are covering the classroom because a preschool staff called off. Staff #2 had a group size of 13 preschool-age children, exceeding the 1:10 staff to child ratio by 3 children. At approximately 10:38, staff #1 was observed to be taking 7 preschool age children to the indoor play space leaving staff #2 in Room 4/Preschool with 13 children between 3 and 5 years of age, once again exceeding the staff to child ratio of 1:10 by 3 children.

Correction Required: The required staff:child ratios must be maintained at all times. The legal entity will arrange for all staff to attend a minimum of 3 hours of training on supervision/ratio. The training will be submitted to the regional office for approval prior to attendance. Proof of training will be submitted upon completion.

Regulation: 3270.51

Description: Similar Age Level

Noncompliance Area: *At approximately 10:08 am, 20 preschool children were being cared for in Room 4/Preschool. When asked to identify their primary supervisory group, staff #1 identified 7 preschool children. When staff #2 was asked, they stated they were unable to name their group at this moment as they are covering the classroom because a preschool staff called off. Staff #2 had a group size of 13 preschool-age children, exceeding the 1:10 staff to child ratio by 3 children. At approximately 10:38, staff #1 was observed to be taking 7 preschool age children to the indoor play space leaving staff #2 in Room 4/Preschool with 13 children between 3 and 5 years of age, once again exceeding the staff to child ratio of 1:10 by 3 children.

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

Regulation: 3270.95(a)/3270.95(b)

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

Noncompliance Area: The facility did not present a current annual fire detection inspection conducted within the past 12 months at the time of the inspection.

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

Regulation: 3270.102(a)

Description: Clean and good repair

Noncompliance Area: Observed a nail protruding from the kitchen play set in Room #4. The playset had separated from the wall where it was mounted.

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: 3270.106(f)

Description: 2 feet apart

Noncompliance Area: Observed less than two feet of space on three sides of the cot where Child #2 was sleeping in Room #2

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

Regulation: 3270.111(b)

Description: Posted in group space

Noncompliance Area: The daily activity schedule was not posted in Room #2 (Toddler Room). The Toddler daily activity schedule was posted in Room #1 (Infant Room).

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

Regulation: 3270.123(a)(3)

Description: Services proceeded

Noncompliance Area: The most recent Child Service Reports in the file for Child #4 exceeded 6 months between reports. The file for Child #5 did not include a Child Service Report conducted within the past 6 months.

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

Regulation: 3270.131(a)/3270.182(1)

Description: Health information/Initial and subsequent health reports

Noncompliance Area: The initial health report in the file for Child #1 was conducted more than 60 days after the child's first day in care.

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

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

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

Noncompliance Area: The most recent updated health reports in the files for Child #4 and #5, preschool children, exceeded 12 months between reports. The file for Child #3, a preschool child, did not include an updated health report conducted within the past 12 months.

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

Regulation: 3270.151(a)/3270.192(3)

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

Noncompliance Area: The most recent health assessments in the file for Staff Person #1 exceeded 24 months between assessments.

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

Regulation: 3270.21

Description: General Health and Safety

Noncompliance Area: In Room #2, observed loose-fitting sheet in the Pac n Play for Child #1. In Room #4 and Room #8, observed dangling TV and CD player cords, which create an entanglement hazard. Observed in ROOM 6: Drawer beside sink was not locked. The drawer contained a stapler, which was accessible to children. Drawer could also be pulled all the way out, which creates a toppling hazard. Also observed a pair of adult scissors on a low cabinet, which were accessible to children.

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

Regulation: 3270.27(e)

Description: Letter to parents

Noncompliance Area: The parent letter regarding the facility's emergency plan did not include accommodations for infants, toddlers, children with disabilities, and children with chronic medical conditions.

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

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

Description: Fire safety - 1 yr.

Noncompliance Area: The most recent fire safety trainings in the files for Staff Person #1 and #2 exceeded 12 months between trainings.

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

Regulation: 3270.31(f)

Description: Health and Safety Training

Noncompliance Area: The Pediatric CPR/First Aid Certification in the file for Staff Person #4 was conducted more than 90 days after the staff person's first day in child care (See LIS Code Sheet).

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

Regulation: 3270.34(a)(6)

Description: Staff evaluations

Noncompliance Area: The file for Staff Person #3, who has been working for more than 12 months, did not include a written evaluation (See LIS Code Sheet).

Correction Required: A director is responsible for written evaluation of staff persons on a regular basis, a minimum of one evaluation every 12 months.

Regulation: 3270.76

Description: Building Surfaces

Noncompliance Area: In Room #4, observed thick dust buildup on the mounting behind the TV. In Room #5, observed wobbly toy shelves, which create a toppling hazard. The electrical outlet box in the gym was separating from the wall. The thermostat in Room #8 was not covered.

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

Regulation: 3270.77(a)

Description: No peeling paint or plaster

Noncompliance Area: Observed in Room #4, flaking plaster from a hole where kitchen play set had been nailed to the wall. Observed in Room #5, peeling paint on the cabinet under the sink and next to the diaper changing table.

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

Regulation: 3270.82(e)

Description: Toilet and sinks proper height

Noncompliance Area: The sink where toddlers wash their hands in Room #1 was not easily approached by the stepstool they were using.

Correction Required: Toilets and sinks shall be at proper heights for children using them or shall be easily approached by means of platforms or steps.

Regulation: 3270.82(h)

Description: Handwashing signs

Noncompliance Area: A handwashing sign was not posted in the first toilet stall in the Preschool/SA Restroom.

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

Regulation: 3270.14/3270.21

Description: Pertinent Laws & Regulations/General Health and Safety

Noncompliance Area: Staff person #1 and #2 were observed to be caring for children unsupervised. Staff person #1 and #2 have not completed the following pre-service training required prior to caring for children unsupervised: Pediatric First Aid/CPR.

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. Until such time as the required pre-service trainings are completed, staff person #1 and #2 must be supervised, when interacting with children, by an AGS or higher who has completed the required training related to this citation. If there are no staff person(s) available to supervise staff person #1 and #2, staff person #1 and #2 may not work in a child-care position at the facility.

Regulation: 3270.31(f)

Description: Health and Safety Training

Noncompliance Area: Staff person #1 has not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): Pediatric First Aid/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 #1 will have until 4/2/24 to complete the required training. Until such time as the required training has been completed, staff person #1 must be supervised, when interacting with children, by an AGS or higher who has completed the required training related to this citation. If there are no staff available to supervise staff person #1, staff person #1 may not work in a child-care position at the facility.

Regulation: 3270.51/3270.52

Description: Similar Age Level/Mixed Age Level

Noncompliance Area: Previously cited on 4/4/22, SIN-00221877. On 5/31/23, at 8:00 AM, Staff Person #1 and #2 were providing care for a mixed group of ten children: 2 Infants, 5 Younger Toddlers, and 3 Older Toddlers.

Correction Required: When children are grouped in similar age levels, the following maximum child group sizes and ratios of staff persons apply: Infants 1:4 with a maximum group size of 8; Young toddlers 1:5 with a maximum group size of 10; Older toddlers 1:6 with a maximum group size of 12; Preschool children 1:10 with a maximum group size of 20; Young school-age children 1:12 with a maximum group size of 24; Older school-age children 1:15 with a maximum group size of 30. When children are grouped in mixed age levels, the age of the youngest child in the group determines the staff:child ratio and maximum group size in accordance with the requirements in § 3270.51 (relating to similar age level).

Regulation: 3270.102(a)

Description: Clean and good repair

Noncompliance Area: Observed dirt and debris under the mat of the diaper changing table in the toddler room.

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

Regulation: 3270.106(a)

Description: Clean, age appropriate

Noncompliance Area: The cots in the toddler room and preschool room were not labeled.

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

Regulation: 3270.106(f)

Description: 2 feet apart

Noncompliance Area: Observed less than 2 feet of space on three sides of the cots in the preschool room where children were napping.

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

Regulation: 3270.123(a)(3)

Description: Services proceeded

Noncompliance Area: The files for Child #2, #5, #6 and #7, who have been enrolled for more than 6 months, did not contain a child service report conducted within the past six months.

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

Regulation: 3270.124(b)(3)

Description: Parent home/work address, phone

Noncompliance Area: The emergency contact forms in the files for Child #1, #3 and #4 did not include the work address and phone number of the enrolling parent.

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

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

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

Noncompliance Area: The file for Child #1, an infant, did not include an updated health report conducted within the past 6 months.

Correction Required: The operator shall require the parent to provide an updated health report at least every 6 months for an infant or young toddler. A child's record shall contain initial and subsequent health reports.

Regulation: 3270.131(d)(7)

Description: Free from contagious/communicable disease

Noncompliance Area: The most recent updated health report in the file for Child #7 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: 3270.131(e)(1)

Description: Exemption documentation from parent/guardian

Noncompliance Area: The most current immunization records in the files for Child #5 and #6 did not include documentation of a flu shot administered within the past year or a letter of exemption from the parent or physician. The most current health report in the file for Child #7 did not include an immunization record.

Correction Required: The facility shall require the parent to provide updated written verification from a physician, physician's assistant, CRNP, the Department of Health or a local health department of ongoing vaccines administered to an infant, toddler or preschool child in accordance with the schedule recommended by the ACIP.

Regulation: 3270.151(a)/3270.192(3)

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

Noncompliance Area: The initial health assessment in the file for Staff Person #5 was conducted after the staff person's first day working in child care. The health assessment in the file for Staff Person #5 did not include documentation of a TB Screening. The file for Staff Person #6 did not include an updated health assessment conducted within the past 24 months.

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

Regulation: 3270.31(f)

Description: Health and Safety Training

Noncompliance Area: The Health and Safety Training in the file for Staff Person #2 was conducted more than 90 days after the staff person's date of hire. (See LIS Code Sheet).

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

Regulation: 3270.32(a)

Description: Comply with CPSL

Noncompliance Area: The Mandated Reporter Training in the files for Staff Person #2 and #4 was conducted more than 90 days after the staff persons' date of hire. (See LIS Code Sheet).

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

Regulation: 3270.51/3270.52

Description: Similar Age Level/Mixed Age Level

Noncompliance Area: Due to one staff call-off and another staff late, the following non-compliance with similar and mixed aged levels was observed on 4/4/23 between 9:00-9:30 AM. When Cert Rep arrived on 4/4/23 at approximately 9:00 AM, Staff Person #1 left the Infant Room for approximately one minute to sign in a preschool child who was being dropped off by a parent. This left Staff Person #2 alone in the Infant Room supervising 5 infants and 4 young toddlers. When Staff Person #1 returned to the Infant Room, the following rooms were over ratio from approximately 9:01 until 9:30: Infant Room: Staff Person #2 was supervising 5 infants. Preschool Room: Staff Person #3 was supervising 11 preschool children. Staff Person #4 was supervising 9 preschool children and three older toddlers. It is unknown how long rooms were over ratio prior to 9:00 AM.

Correction Required: When children are grouped in similar age levels, the following maximum child group sizes and ratios of staff persons apply: Infants 1:4 with a maximum group size of 8; Young toddlers 1:5 with a maximum group size of 10; Older toddlers 1:6 with a maximum group size of 12; Preschool children 1:10 with a maximum group size of 20; Young school-age children 1:12 with a maximum group size of 24; Older school-age children 1:15 with a maximum group size of 30. When children are grouped in mixed age levels, the age of the youngest child in the group determines the staff:child ratio and maximum group size in accordance with the requirements in § 3270.51 (relating to similar age level).

Regulation: 3270.75(c)

Description: Has all items

Noncompliance Area: The first aid kit in the toddler room lacked scissors and 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.

Regulation: 3270.113(a)

Description: Supervised at all times

Noncompliance Area: Based on conversation with the facility director regarding her review of video footage, on the morning of 6/27/22 at approximately 7:45 AM, Child #1 tripped and fell on a toy in the infant classroom. This sustained a scratch and bruise under the left eye. Staff Person #1 and Staff Person #2, who were providing care at the time in this room, were unaware that the child had fallen and sustained the injury.

Correction Required: Children on the facility premises and on facility excursions off the premises shall be supervised by a staff person at all times. Outdoor play space used by the facility is considered part of the facility premises.

Regulation: 3270.107

Description: Refrigerator

Noncompliance Area: The refrigerator in the Ones Room lacked an operating thermometer.

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

Regulation: 3270.119

Description: Infant sleep position

Noncompliance Area: On the morning of the renewal inspection, Child #1, an infant, was observed sleeping propped up in a carrier. Staff stated that the child had been sleeping in this position approximately one hour.

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

Regulation: 3270.124(b)(3)

Description: Parent home/work address, phone

Noncompliance Area: The Emergency Contact Form in the file for Child #4 did not include the work phone 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(c)

Description: Each child care space

Noncompliance Area: Emergency Contact Forms for 22 children were missing from the binders in the rooms where children were receiving care.

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.