Growing Better Child Care Llc

Regulation: 3270.151(c)(3)/3270.151(c)(4)

Description: Exam communicable disease/Information re: medical problems

Noncompliance Area: During an unannounced visit on 5/18/26 Staff 1's health assessment dated 12/6/24 did not have information that an examination for communicable disease was completed, the results of that exam, or information in regards to if the staff was able to provide care. Staff 1 did not have any other health assessments on file that were current.

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 information on medical problems that might threaten the health of the children or prohibit a staff person from providing adequate care to children.

Regulation: 3270.66(a)

Description: Locked or inaccessible

Noncompliance Area: During a complaint investigation on 5/18/26 Cert rep observed the following items which were labeled "keep out of reach of children" in a staff bag that was kept on an accessible shelf in the bathroom of Room 3: Excedrin Migraine, Advil pain reliever creme, and various lotions. The door to the bathroom was open allowing access to the bathroom. The children in Room 3 are mobile.

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: 3270.113(e)

Description: Restraints prohibited

Noncompliance Area: During a complaint investigation on 12/17/25 Cert rep observed Child 2 in a highchair for at least 3 minutes. Staff 2 reported Child 2 was placed in the high chair to prevent the child from running around. Staff 1, 2, 3 & 4 also acknowledged that Child 1 has been placed in a highchair when they are running around, throwing objects, and attempting to harm staff, other children and themselves so Child 1 can calm down.

Correction Required: 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. TIERED LIS: 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. This portion of the plan shall have an immediate correction date. 2. The legal entity must arrange for all facility staff to take both "Infant-Toddler Care: Guiding Behavior" and "Autism Spectrum Disorder and the ECE Professional" available on Better Kid Care or a similar PQAS approved trainings. The trainings used to fulfill this portion of the plan must be approved by the NE Regional Office before completion. The legal entity shall maintain documentation of the training certificates in the staff files. The provider shall provide a date when this portion of the plan will be completed.

Regulation: 3270.94(a)(1)

Description: Every 60 days

Noncompliance Area: During and unannounced inspection on 12/17/25 the most recent fire drill was 10/14/25. This is more than 60 days between fire drills.

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

Regulation: 3270.106(f)

Description: 2 feet apart

Noncompliance Area: During a renewal inspection on 12/3/25 Cert rep observed that of the pack in plays(rest equipment) that were in use in Room 3(Infants) did not have at least 2 feet of space on 3 sides.

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

Regulation: 3270.124(b)(3)

Description: Parent home/work address, phone

Noncompliance Area: During a renewal inspection on 12/3/25 Children 1, 2, and 3's emergency contact forms did not list a work phone number for their respective parents.

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

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

Description: Immunization record/Dismissal policy

Noncompliance Area: During a renewal inspection on 12/3/25 Child 2's immunization record was missing the following immunizations: the 2nd dose of Hepatitis B, the 2nd dose of DTap, the 2nd dose of HIB, the 2nd dose of Pneumococcal and the 2nd dose of Polio vaccines. This is not in accordance with the ACIP schedule(See LIS code sheets for DOB). Child 2 did not have an exemption letter in their files related to these vaccines.

Correction Required: A health report shall include a review of the child's immunized status according to recommendations of the ACIP. The facility shall implement dismissal policies in accordance with the Department of Health regulation in 28 Pa. Code § 27.77 (relating to immunization requirements for children in child care group settings). Child 2 must be dismissed from care by close of business 12/3/25 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)/3270.133(5)

Description: Name on bottle/Original label

Noncompliance Area: During renewal inspection on 12/3/25 Cert rep observed Aquaphor(exp 1/2025) in Room 2(Young Toddler), and Diaper Rash Paste (exp 9/2025) in the Room 3(Infants). Cert rep also observed Destin(exp 2/2025) in Room 2(Young Toddler) which was for a child, however the child's name was not present on the bottle.

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

Regulation: 3270.151(a)

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

Noncompliance Area: During a renewal inspection on 12/3/25-12/4/25 Staff 5 had an initial health assessment dated 1/8/24, which is more than 12 months before their first day with children. (See LIS code sheet for 1st day 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: 3270.192(2)(iv)

Description: Transcript, diploma and letters

Noncompliance Area: During a renewal inspection on 12/3/25-12/4/25 Staff 5's file had a high school diploma and a letter which noted Staff 5 had over 2 years experience working with children. This reference letter is not acceptable verification of experience working with children as it was not written or signed by the a representative of the entity where the experience was obtained. Staff 5 has been working as an assistant group supervisor.

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

Regulation: 3270.192(5)

Description: Two written references

Noncompliance Area: During a renewal inspection on 12/3/25-12/4/25 Staff 2 and 3 each had one reference in their file and Facility Person 4 had 0 references in their files.

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(e)(4)(ii)

Description: Fire safety - 1 yr.

Noncompliance Area: During a renewal inspection on 12/3/25-12/4/25 Staff 3 completed fire safety training on 1/27/24, and 4/8/25, Staff 7 completed fire safety training on 4/27/24, and 5/9/25 and Staff 8 completed fire safety training on 4/27/24, and 6/17/25 which is more than 12 months between fire safety trainings.

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

Regulation: 3270.35(b)

Description: Group sup qualifications

Noncompliance Area: During a renewal inspection on 12/3/25-12/4/25 Staff 6 has been working as a group supervisor but does not meet at least one of qualification levels specified for a group supervisor. Staff 6's file had a high school diploma, two separate CDA certificates, and 10 years of experience working with children. It was reported that Staff 6 did not obtain an associate's degree or bachelor's degree.

Correction Required: A group supervisor shall have attained one of the qualification levels specified at §3270.35(b)(1)-(4).

Regulation: 3270.75(c)

Description: Has all items

Noncompliance Area: During a renewal inspection on 12/3/25-12/4/25 the first kit in the 2019 Ford Transit did not have scissors. The first aid kit on Older Toddler side of Room 1 did not have tweezers, and the First aid kit on the Preschool side of Room 1 did not have tape.

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

Regulation: 3270.77(a)

Description: No peeling paint or plaster

Noncompliance Area: During a renewal inspection on 12/3/25 Cert rep observed peeling paint on the wall by the Circle time chart on the Older Toddler side of Room 1.

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

Regulation: 3270.95(a)/3270.95(b)

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

Noncompliance Area: During a renewal inspection on 12/3/25-12/4/25 there was one incident of more than 30 days between fire detection testing: 8/15/25-9/15/25.

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

Regulation: 3270.102(a)

Description: Clean and good repair

Noncompliance Area: During a renewal inspection on 12/19/24 cert rep observed the following concern regarding equipment and toys at the facility: 1) tear in the black chair in the toddler classroom 2) crack in the microwave door of the teal toy kitchen in the large room 3) tear in the gray high chair seat in the large 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: 3270.103

Description: Small Toys and Objects

Noncompliance Area: During a renewal inspection on 12/19/24 plastic bags and gloves were found in on the bottom shelf of the changing table in the diapering area of the toddler room. The children in this room may still be placing objects in their mouths. This shelf was accessible to children.

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)(1)/3270.123(a)(2)

Description: Amount of fee/Date fee to be paid

Noncompliance Area: During a renewal inspection on 12/19/24 Child 3's and 4's fee agreements did not have the fee amount or date the fee was to be paid.

Correction Required: An agreement shall specify the amount of the fee to be charged per day or per week. An agreement shall specify the date on which the fee is to be paid.

Regulation: 3270.123(a)(3)/3270.123(a)(4)

Description: Services proceeded/Arrival/departure times

Noncompliance Area: During a renewal inspection on 12/19/24 Child 2 and Child 4 did not have the services to be provided listed on the fee agreement. Child 2 did not have the Child's arrival time or departure time listed on fee agreement.

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). An agreement shall specify the child's arrival and departure times.

Regulation: 3270.124(b)(3)

Description: Parent home/work address, phone

Noncompliance Area: During a renewal inspection on 12/19/24 Child 1's emergency contact form did not have a home address for the child's mother, a work address and phone number for the child's father or home phone numbers for either parent. Child 3 and Child 4 did not have their mother's work phone number listed on the emergency contact.

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: During a renewal inspection on 12/19/24 cert rep observed the infant classroom did not have emergency contact forms present for the children receiving care in the infant classroom.

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: 3270.166(3)

Description: Disposable nursers or parents

Noncompliance Area: During a renewal inspection on 12/19/24 Staff reported that infant bottles were being washed a reused at the facility. The facility does not have a commercial dishwasher to wash infant bottles.

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

Regulation: 3270.181(c)

Description: Emergency info/agreement updated 6 mos

Noncompliance Area: During a renewal inspection on 12/19/24 cert rep noted Child 2's fee agreement was most recently reviewed by the parent on 5/1/24. This is more than 6 months since the previous parental review of the Child's fee agreement.

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(7)

Description: Reports of accidents, injuries and illnesses. Original report - parent same day Copy - facility accident file. Copy - child's file

Noncompliance Area: During a renewal inspection on 12/19/24 Staff reported that when accident, illness and injuries occur the parent receives the original report, and a copy of the report is placed in the facility's accident file. Staff reported that a copy of this report is not placed in the child's file.

Correction Required: A child's record shall contain reports of accidents, injuries and illnesses involving a child in care at the facility. The original report shall be given to the parent on the day of the incident. The second copy of the report shall be retained at the facility in an accident file. The third copy of the report shall be retained at the facility in the child's file.

Regulation: 3270.27(a)(6)

Description: Emergency plan

Noncompliance Area: During a renewal inspection on 12/19/24 the facility did not have the emergency drill documentation from 2024 available for review.

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

Regulation: 3270.27(c)

Description: Training regarding plan

Noncompliance Area: During a renewal inspection on 12/19/24 Cert rep noted Staff 3 received emergency plan training 1/11/2022 and 1/12/24. This is more than 12 months between emergency plan training. Staff 7 received emergency plan training on 4/2/24 which is more than 90 days after her date of hire. See code sheet for date of hire.

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

Regulation: 3270.27(f)

Description: Emergency plan

Noncompliance Area: During a renewal inspection on 12/19/24 documentation that the emergency plan was sent to the local municipality was not available for cert rep review.

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

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

Description: Fire safety - 1 yr.

Noncompliance Area: During a renewal inspection on 12/19/24 Cert rep noted Staff 2 completed fire safety training on 2/19/23 and 4/27/24. This is more than 12 months between fire safety 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: During a renewal inspection on 12/19/24 Staff person 8 has not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): PA Health and Safety Requirement. Staff person 8 has completed Pennsylvania Health and Safety Update 2022 (1 hour) on 12/6/23, but there is no proof of completing a 6 or 10 hour health and safety course.

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 8 will complete "PA Required Health and Safety for Centers-Group Child Care Part 1 (Requisitos de Salud y Seguridad para Centros-Grupos de Cuidado Infantil en PA Parte 1)" (3 hours) and "PA Required Health and Safety for Centers-Group Child Care Part 2 (Requisitos de Salud y Seguridad para Centros-Grupos de Cuidado Infantil en PA Parte 2) (3 hours)." Until such time as Part 1 has been completed, staff person 8 must be supervised, when interacting with children, by an AGS, group supervisor or director who has completed the required training related to this citation. If there are no staff available to supervise staff person 8, staff person 8 may not work in a child-care position at the facility.

Regulation: 3270.34(a)(6)

Description: Staff evaluations

Noncompliance Area: During a renewal inspection on 12/19/24 Cert rep noted Staff 1 had no staff evaluations available for review in her Staff file. Staff 1 has been employed for more than one year.

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: 3270.36(b)(5)

Description: HS/GED + 2 yrs

Noncompliance Area: During a renewal inspection on 12/19/24 Cert rep noted that Staff 5, and 6 do not have verification of experience with children documented in their staff file. Staff 4 had 2251 hours of experience with children documented on file. This is less than two years (or 2500 hours). Staff 4, 5, and 6 all have high school diplomas on file and have been working as assistant group supervisors.

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: During a renewal inspection on 12/19/24 Destin was found in on the bottom shelf of the changing table in the diapering area of the toddler room. The Destin is labeled "keep out of reach of children. This shelf was accessible to children.

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

Regulation: 3270.76/3270.103

Description: Building Surfaces/Small Toys and Objects

Noncompliance Area: During a renewal inspection on 12/19/24 cert rep observed sharp screws (with less than one inch length) exposed on the latis on the wall of the outdoor PlaySpace. This PlaySpace is used by children of all ages including those who may still be placing objects in their mouths.

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. 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: 3270.77(a)

Description: No peeling paint or plaster

Noncompliance Area: During a renewal inspection on 12/19/24 Cert rep observed peeling paint on the wall above the colored bones and around the phone outlet of that same wall.

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

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

Description: Immunization record/Dismissal policy

Noncompliance Area: On 12/5/2023, the updated health report for Child #1 did not have did not have documentation of the following up-to-date immunization as recommended by the ACIP: The annual influenza immunization. The file for Child #1 did not include an exemption from immunization for religious belief or strong personal objection equated to a religious belief written, signed and dated statement by the child's parent.

Correction Required: A health report shall include a review of the child's immunized status according to recommendations of the ACIP. The facility shall implement dismissal policies in accordance with the Department of Health regulation in 28 Pa. Code § 27.77 (relating to immunization requirements for children in childcare group settings). Child #1 must be dismissed from care by close of business 12/5/2023 and may only return to care when the immunization record is updated or when a parent provides a written, signed exemption letter.

Regulation: 3270.14/3270.21

Description: Pertinent Laws & Regulations/General Health and Safety

Noncompliance Area: During the Renewal Inspection on 12/5/2023, staff person #1 was observed to be caring for children unsupervised. Staff person #1 has not completed the following pre-service training required prior to caring for children unsupervised: The required pre-service health and safety training.

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 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 person(s) available to supervise staff person #1, staff person #1 may not work in a child-care position at the facility.

Regulation: 3270.32(a)

Description: Comply with CPSL

Noncompliance Area: Staff person #3 did not complete mandated reporter training within 60 months. This is evidenced by the updated mandated reporter training on file being dated 9/14/2023 and the previously documented mandated reporter training on file being dated 1/30/2018.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). Staff persons shall complete mandated reporter training at least every 60 months.

Regulation: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: During the Renewal Inspection on 12/5/2023, staff person #2 had a volunteer state police clearance on file. See LIS code sheet.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). Volunteer clearances are not permitted for childcare staff. A provisional employee may not be permitted to work alone with children and must work within the vicinity of a permanent employee. 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. Staff person #2 may not work in a childcare position at the facility until the state police clearance that is required for employment is on file.

Regulation: 3270.102(a)

Description: Clean and good repair

Noncompliance Area: On 12/8/2022, the top part of a plastic toy grill outside on the playground had a crack with sharp edges exposed.

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

Regulation: 3270.124(e)

Description: Written emergency plan posted

Noncompliance Area: On 12/8/2022, during the renewal inspection, the childcare spaces did not have a written plan displayed identifying the means of transporting a child to emergency care and staffing provisions in the event of an emergency.

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 childcare space and shall accompany a staff person who leaves on an excursion with children.

Regulation: 3270.124(f)/3270.181(e)

Description: Updated every 6 months/Emergency master file updated

Noncompliance Area: During the Renewal Inspection on 12/8/2022, the emergency contact forms in each of the 4 classrooms had not been updated in the previous 6 months as required.

Correction Required: The parent shall update in writing emergency contact information once in a 6-month period or as soon as there is a change in the information. If emergency information is updated in a master file, it shall be updated accordingly in other facility records.

Regulation: 3270.131(d)(5)/3270.131(e)(2)(i)

Description: Immunization record/Exemption documentation from parent/guardian

Noncompliance Area: During the child file review on 12/13/2022, the immunizations attached to the updated health reports for Child #1 and Child #2 did not include immunizations as recommended by the ACIP. Child #1, a young toddler was missing verification of the MMR, Varicella and Hepatitis A immunizations that are recommended by the ACIP between the ages of 12 and 15 months. Child #2, an older toddler did not have the up-to-date influenza immunization as recommended by the ACIP. The files for Child #1 and Child #2 did not include an exemption from immunization for religious belief or strong personal objection equated to a religious belief written, signed and dated by the child's parent. See LIS code sheet.

Correction Required: A health report shall include a review of the child's immunized status according to recommendations of 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: on 12/8/2022, it was observed that the diapering can used for the toddler classroom was not hands-free.

Correction Required: If disposable diapers are provided by a parent or by a facility, a soiled diaper shall be discarded by immediately placing the diaper into a plastic-lined, hands-free covered can.

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

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

Noncompliance Area: During the staff file review on 12/8/2022, the following was observed: Staff #1 did not have an initial health assessment or tuberculosis screening by the Mantoux method required at initial employment on file. Staff #2 had a current initial health assessment and tuberculosis screening on file on 12/8/2022, but not at the time of hire. Staff #3 did not have the initial assessment and tuberculosis screening on file at the time upon hire. Staff #4 did not have the tuberculosis screening conducted prior to employment. Staff #5 did not have an initial health assessment on file. The tuberculosis screening on file for Staff #5 was not conducted prior to employment. See LIS code sheet.

Correction Required: A facility person providing direct care who comes into contact with the children or who works with food preparation shall have a health assessment conducted within 12 months prior to providing initial service in a child care setting and every 24 months thereafter. A health assessment is valid for 24 months following the date of signature, if the person does not contract a communicable disease or develop a medical problem. 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: 3270.171(a)

Description: Pick-up and drop-off points

Noncompliance Area: The operator has not notified the local traffic safety authorities annually in writing of the location of the facility and the program's use of pedestrian and vehicular routes around the childcare facility.

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

Regulation: 3270.192(5)

Description: Two written references

Noncompliance Area: During the file review on 12/8/2022, Staff #1 only had one written nonfamily reference on file. Facility person #6, a volunteer did not have any written references on file. See LIS code sheet.

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(a)(6)/3270.27(b)

Description: Emergency plan/Plan reviewed/updated annually

Noncompliance Area: On 12/8/2022, the facility had not conducted an emergency drill during the previous 12 months of operation. The emergency plan also had not been reviewed and documented in writing during the previous 12 months.

Correction Required: Emergency drills shall be conducted annually. Annual emergency drills shall be documented and on file at the facility. 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: 3270.31(f)

Description: Health and Safety Training

Noncompliance Area: Staff person #4 has not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): The required pre-service health and safety training.

Correction Required: Staff persons shall complete professional development within 90 days of hire as listed in subsections (f)1-9. Staff person #4 will have until 12/28/2022 to complete the required training. Until such time as the required training has been completed, staff person #4 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 #4, staff person #4 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: During the review of staff files on 12/8/2022, the following was observed: Staff #1 had an expired FBI clearance on file that was dated 10/18/2017. Staff #2 had an updated child abuse clearance on file dated 12/2/2022, but the previous child abuse clearance for Staff #2 was dated 10/16/2017. Staff #2 verified that she resided in New Jersey two years ago. Staff #2 did not have the required child abuse clearance from New Jersey on file on 12/8/2022. Staff #5 had proof of all clearance requests on file on 12/8/2022. However, Staff #5 did not have the completed DHS FBI clearance on file. See LIS code sheet.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). Staff #1, Staff #2 and Staff #5 may not work in a childcare position at the facility. A provisional employee may not be permitted to work alone with children and must work within the vicinity of a permanent employee. 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. Staff # 1, Staff #2 and Staff #5 may not work in a childcare position at the facility until they have all required clearances on file.

Regulation: 3270.37(c)

Description: Aides supervised all times

Noncompliance Area: Staff #3 was observed to be working alone with a group of children on 12/8/2022 and 12/13/2022. Staff #3 does not have any documented childcare experience on file as of 12/13/2022.

Correction Required: An aide or a combination of aides shall be supervised at all times by a staff person qualified at minimum as an assistant group supervisor.

Regulation: 3270.77(a)

Description: No peeling paint or plaster

Noncompliance Area: On 12/8/2022, peeling paint was seen on the changing table in the bathroom that is used for the infants.

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: On 12/8/2022, during the renewal inspection, the classrooms were observed to have half-doors separating the areas, which had slide locks installed. The slide locks were observed to be locked, obstructing the emergency means of egress for each of the classroom groups. Both the toddler classroom and the front classroom with the door facing Kutztown Road were observed to have a locked emergency exit, with both a large slide lock and a chain lock engaged on each door.

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

Regulation: 3270.66(a)

Description: Locked or inaccessible

Noncompliance Area: During an unannounced inspection on 8/5/2022, a group of children were observed lined up at the sink in the classroom to wash their hands. Lysol disinfectant spray and OdoBan disinfectant was observed next to the sink accessible to children while they were washing their hands. Both items were labeled keep out of 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: 3270.131(c)

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

Noncompliance Area: During the review of child files on 2/16/2022, the health report on file for Child #1 did not have a signature from physician, physician's assistant or a CRNP with the individual's professional title. Child #1 began attending on 12/8/2021.

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

Regulation: 3270.131(d)(5)/3270.131(e)(2)(i)

Description: Immunization record/Exemption documentation from parent/guardian

Noncompliance Area: On 2/16/2022, the health report for Child #1 did not show any documentation of an influenza vaccine for the child. There was not an exemption letter on file from the parent to explain that the child did not have the influenza vaccine due to a religious belief or strong personal objection equated to a religious belief.

Correction Required: A health report shall include a review of the child's immunized status according to recommendations of 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: 3270.166(1)

Description: Written statement

Noncompliance Area: During the Renewal Inspection on 2/16/2022, the facility did not have a written statement on file from the parent showing the formula and feeding schedule for the infants that are currently enrolled at the facility.

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

Regulation: 3270.192(5)

Description: Two written references

Noncompliance Area: During the Renewal Inspection on 2/16/2022, Staff #3 did not have any written, nonfamily references on file.

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: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: During the Renewal Inspection on 2/16/2022, Staff #1 did not have a completed National Sex Offender Registry (NSOR) clearance on file. The staff data sheet indicated that Staff #1 started working with children at the facility on 12/13/2020. The NSOR clearance was not requested until 1/21/2022. Staff #1 had a completed state police clearance on file, but this clearance was not requested until 1/21/2022. Staff #2 and Staff #3 had each of the required clearances on file on 2/16/2022. However, the staff data sheet indicated that Staff #2 began working with children at the facility on 1/12/2022. The clearances for Staff #2 were requested as follows: NSOR on 1/18/2022 and the state police, child abuse, and proof of being fingerprinted for the DHS FBI clearance on 1/20/2022, Staff #3 began working on 1/10/2022, but was not fingerprinted for the DHS FBI clearance until 1/22/2022.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). Facility Person # 1 may not work in a child care position at the facility. A provisional employee may not be permitted to work alone with children and must work within the vicinity of a permanent employee. 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: 3270.76

Description: Building Surfaces

Noncompliance Area: During the Renewal Inspection on 2/16/2022, a piece of wood with sharp edges exposed was seen on a fence post to the right near the gate entering the outdoor playground.

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: 3270.135(b)

Description: Surfaces cleaned

Noncompliance Area: During the opening inspection on 10/20/2021, the diaper changing pad in the infant room had a rip that left foam exposed: thus the diaper changing pad could not be properly sanitized.

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

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

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

Noncompliance Area: During the opening inspection on 10/20/2021, the health assessment and tuberculosis screening for Staff #1 was dated 1/31/2020.

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: 3270.27(a)(5)

Description: Emergency plan

Noncompliance Area: During the opening inspection on 10/20/2021, the emergency plan for the facility did not provide for accommodations for infants and toddlers.

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

Regulation: 3270.75(c)

Description: Has all items

Noncompliance Area: During the opening inspection on 10/20/2021, the first-aid kit in the classrooms did not contain soap.

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

Regulation: 3270.76

Description: Building Surfaces

Noncompliance Area: During the opening inspection on 10/20/2021, the wooden fence on the outdoor playground had a cracked fence post leaving sharp edges exposed and a risk of splinters. Nails were also protruding from the bottom of the fence and screws were protruding from the plastic lattice attached to the building.

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.