Nanas Nest Daycare

Regulation: 3270.106(f)

Description: 2 feet apart

Noncompliance Area: Observed two pack n plays in the toddler room which did not have 2 feet of space on three sides while infants were sleeping.

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: 3270.113(a)(1)

Description: Staff assigned to specific children

Noncompliance Area: Observed staff #1, who was filling in for a lunch break and was responsible and supervising 8 young school age children, could not name all of the children in the 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: 3270.32(a)

Description: Comply with CPSL

Noncompliance Area: Observed the file for staff #1, who was working in a childcare position, did not contain a valid NSOR verification letter and did not contain a signed disclosure statement which had the signature of a witness.

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 childcare position at the facility until a valid NSOR verification letter is obtained.

Regulation: 3270.66(a)

Description: Locked or inaccessible

Noncompliance Area: Observed hand sanitizer, labeled keep out of the reach of children, accessible to children on a low counter in the main room.

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: 3270.124(b)(2)

Description: Physician name, address, phone

Noncompliance Area: The file of child #3 lacked the complete address of the child's physician or source of medical care.

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

Regulation: 3270.124(b)(3)

Description: Parent home/work address, phone

Noncompliance Area: The files of children #2 and #3 lacked emergency contact forms with the work address of the enrolling parent. The files of children #1 lacked emergency contact forms with 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 files of children #1 and #2 lacked emergency contact forms with the complete addresses of the individual designated by the parent to whom the child may be released.

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

Regulation: 3270.102(a)

Description: Clean and good repair

Noncompliance Area: Observed in the front room a cracked plastic bin housing dinosaurs and a cracked plastic bin housing My Little Ponies.

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: Observed in infant and young toddler room, where children are mobile a plastic bag of clothing in a car seat on the floor, making the plastic bag 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: 3270.111(a)

Description: Written plan

Noncompliance Area: At the time of the inspection, there was not a daily schedule posted in the front room.

Correction Required: A written plan of daily activities and routines, including a time for free play shall be established for each group. The plan shall be flexible to accommodate the needs of individual children and the dynamics of the group.

Regulation: 3270.119

Description: Infant sleep position

Noncompliance Area: At approximately 11:00 observed child #5, an infant sleeping in a bouncer rather than the supine position on a flat, firm surface.

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: 3270.123(a)(3)

Description: Services proceeded

Noncompliance Area: The file of child #4 lacked a child service report every 6 months due to the fact the one in the file was dated: May 2024.

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)(2)

Description: Physician name, address, phone

Noncompliance Area: The file of child #3 lacked the name of the child's physician or source of medical care. the files of children #1, #2, and #4 lacked the complete address of the child's physician or source of medical care.

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

Regulation: 3270.124(b)(3)

Description: Parent home/work address, phone

Noncompliance Area: The files of children #2 and #4 lacked emergency contact forms with the work address of the enrolling parent. The files of children #1 and #3 lacked emergency contact forms with 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 files of children #1 and #2 lacked emergency contact forms with the complete addresses of the individual designated by the parent to whom the child may be released.

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

Regulation: 3270.124(c)

Description: Each child care space

Noncompliance Area: There were not copies of emergency contact forms for the infants and toddlers observed receiving care in the front 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(b)(2)/3270.181(c)

Description: Toddler/preschool: updated health report every 12 months/Emergency info/agreement updated 6 mos

Noncompliance Area: The file of child #4 had health assessments more than 12 months apart due to the fact they were dated: 3-11-26 and 4-18-24. The file of child #3 lacked an updated health assessment due to the fact the one on file was dated: 5-2-24.

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 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: 3270.133(6)

Description: Written consent

Noncompliance Area: Observed a medication log that lacked a parent's signature for written consent to administer the over the counter medication observed for child #3.

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

Regulation: 3270.151(a)

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

Noncompliance Area: The file of staff #2 had health assessments more than 24 months apart due to the fact they were dated: 1-2-26 and 11-28-23.

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: 3270.165

Description: Menus

Noncompliance Area: Observed on 4-8-26, the menu posted in the parent space was for the week of 3-9-26.

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

Regulation: 3270.171(a)

Description: Pick-up and drop-off points

Noncompliance Area: At the time of the inspection, there was not documentation the operator sent notification to local traffic safety authorities annually in writing of the location of the facility and the program's use of pedestrian and vehicular routes around the child care facility.

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

Regulation: 3270.27(c)

Description: Training regarding plan

Noncompliance Area: The file of staff #1, observed in care with children lacked documentation of completing emergency plan training upon initial hire (see LIS code sheet).

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 of staff #1 lacked the PA Child Abuse clearance, the National Sex Offender Registry clearance, and the Disclosure statement lacked a witness. Staff #1 was observed caring for children.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). SAFETY PLAN: The operator is required to submit to the Children and Youth Agency a plan of supervision or alternate arrangement as required by the Child Protective Services Law. LACKING REQUIRED HIRING DOCUMENTS: Facility Person #1 may not work in a child care position at the facility. PROVISIONAL HIRE UNSUPERVISED: 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. Facility Person #1 may not work in a child care position at the facility.

Regulation: 3270.34(a)(6)

Description: Staff evaluations

Noncompliance Area: The file of staff #3 lacked a written evaluation of staff persons on a regular basis, a minimum of one evaluation every 12 months due to the fact none was in the file.

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: 3270.75(b)

Description: Inaccessible to children

Noncompliance Area: Observed a first aid kit located in the bottom drawer of an unlocked cabinet located in the space where the children take off their shoes and hang their coats.

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

Regulation: 3270.94(a)(1)

Description: Every 60 days

Noncompliance Area: Based on the fire drill log drills were held more than 60 days apart due to the fact the dates were: 12-23-25 and 10-3-25 which is 81 days.

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: 3270.95(a)/3270.95(b)

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

Noncompliance Area: At the time of the inspection, observed the fire extinguisher located near the front door. The needle on the gauge of the fire extinguisher indicated "recharge."

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: 3270.94(a)(1)

Description: Every 60 days

Noncompliance Area: Based on the fire drill log, a drill was not held within the last 60 days due to the fact the last date was 6-13-25.

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: 3270.95(a)/3270.95(b)

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

Noncompliance Area: Based on the smoke detection system testing log, the smoke detectors were not tested every 30 days due to the fact the last date documented was 6-13-25.

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: 3270.32(a)

Description: Comply with CPSL

Noncompliance Area: Observed the file of staff person #1, who was in a childcare position on the day of the inspection, did not contain a signed disclosure statement and did not contain a valid child abuse clearance which are required to be in the staff file prior to working in a childcare position.

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 childcare position at the facility until a valid child abuse clearance is obtained.

Regulation: 3270.102(a)

Description: Clean and good repair

Noncompliance Area: Observed a torn diaper changing pad in the toddler room. Observed rest mats with peeling covers and exposed foam in the toddler storage room. Observed standing water in an upside-down turtle sand box.

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(b)(7)

Description: Name/address/phone release person

Noncompliance Area: Observed the emergency contact information for child file #4 did not contain the complete address of the individual designated by the parent to whom the child may be released.

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

Regulation: 3270.131(a)

Description: Health information

Noncompliance Area: Observed the initial health assessment for child file #1 was dated more than 60 days following the first day of attendance at the facility.

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

Regulation: 3270.133(7)

Description: Medication log

Noncompliance Area: Observed the facility did not establish a medication log for a bottle of children's Tylenol kept and used at the facility.

Correction Required: An operator is responsible to establish and maintain a medication log if prescription or nonprescription medication is administered.

Regulation: 3270.14/3270.21

Description: Pertinent Laws & Regulations/General Health and Safety

Noncompliance Area: Observed the operator of the facility could not provide a complete shaken baby, abusive head trauma, and child maltreatment policy. The policy is required to contain recognizing the potential signs/symptoms of shaken baby and abusive head trauma. Strategies for coping with a crying, fussing, or distraught child. The prevention and identification of child maltreatment.

Correction Required: A facility shall be operated in conformity with applicable Federal and State laws and regulations.State agencies whose regulations may relate to the operation of a facility include the Department of Environmental Resources, the Department of Labor and Industry, the Department of Health, the Department of Education and the Department of Transportation. Conditions at the facility may not pose a threat to the health or safety of the children.

Regulation: 3270.166(4)

Description: Bottles labeled

Noncompliance Area: Observed a bottle in the toddler room which was not labeled with the child's name.

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

Regulation: 3270.181(c)/3270.181(d)

Description: Emergency info/agreement updated 6 mos/Dated signature affixed

Noncompliance Area: Observed child file #1 did not contain documentation of parental review of the emergency contact form within the previous 6 months. Observed the documentation of parental review of the financial agreement was obtained more than 6 months after the previous parental review.

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. Following review, a parent shall attest to the accuracy of information in the emergency contact information and the financial agreement at each review by affixing a dated signature to the record.

Regulation: 3270.32(a)

Description: Comply with CPSL

Noncompliance Area: Observed staff file #1 contained a signed disclosure which was an earlier version of a disclosure statement which was not to be used after 2/1/25. Observed staff file #1 applied for the criminal background check after staff #1 first day working with children.

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 childcare position at the facility until the required disclosure statement is signed and witnessed.

Regulation: 3270.65

Description: Protective Outlet Covers 5 yrs. or less

Noncompliance Area: Observed an electrical outlet without a protective receptacle cover on a power strip below the television.

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

Regulation: 3270.95(a)/3270.95(b)

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

Noncompliance Area: Observed the fire alarm testing log revealed that one time (12/20/24-1/20/25) the fire alarm testing was conducted more than 30 days apart.

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

Regulation: 3270.102(a)

Description: Clean and good repair

Noncompliance Area: Observed chairs and rest mats in the preschool/school age main room which had peeling covers and exposed foam. Observed peeling tape on the edges of the school age table.

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: Observed in the toddler room, several small pieces of peeling contact paper accessible to the toddlers in care.

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: 3270.151(a)

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

Noncompliance Area: Observed staff file #1 contained an initial health assessment which was dated 15 months prior to providing initial service in the childcare setting.

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: 3270.32(a)

Description: Comply with CPSL

Noncompliance Area: Observed staff file #1 contained a criminal background clearance which was dated 61 months ago making it not valid. On 10/17/24 observed a child abuse clearance which had expired on 10/16/24 and a new updated child abuse clearance was not in staff #1 file.

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 childcare position at the facility until all valid clearances are obtained.

Regulation: 3270.52

Description: Mixed Age Level

Noncompliance Area: Observed staff #2 caring for a mixed group of children in which there were 6 preschool children and 1 older toddler, while the other staff from the front room was in the back toddler room.

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: 3270.66(b)

Description: Original container

Noncompliance Area: Observed a spray bottle on a high shelf in the toddler room, which was not labeled with the specific contents.

Correction Required: Cleaning materials and other toxic materials shall be stored in an original labeled container or in a container that specifies the content. Toxics shall be stored away from food, food preparation areas and child care spaces.

Regulation: 3270.66(d)

Description: Toxic plants not permitted

Noncompliance Area: Observed pokeweed, a toxic plant, growing in the preschool outdoor play area.

Correction Required: Toxic plants are not permitted in a child care space.

Regulation: 3270.77(a)

Description: No peeling paint or plaster

Noncompliance Area: Observed peeling paint in the toddler room by the diaper changing table and by the reclining chair.

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

Regulation: 3270.102(a)

Description: Clean and good repair

Noncompliance Area: Observed a damaged rear basket with rough edges on the red tricycle in the outdoor play area. Observed a toddler rest mats which had a peeling cover and exposed foam.

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: Observed the most recent child service report for children #3, #4, and #5 were completed more than 6 months after the previously completed child service report.

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

Regulation: 3270.123(a)(6)

Description: Admission date

Noncompliance Area: Observed the agreement for child #2 did not contain the date of the child's admission.

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

Regulation: 3270.124(b)(7)

Description: Name/address/phone release person

Noncompliance Area: Observed the emergency contact information for children #1, #3, and #5 did not contain the complete address of the individual designated by the parent to whom the child may be released.

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

Regulation: 3270.131(d)(7)

Description: Free from contagious/communicable disease

Noncompliance Area: Observed the current health assessment for child #5 did not include a statement that the child is able to participate in childcare 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: Observed child file #1 contained a valid health assessment but did not contain updated written verification of ongoing vaccines administered to an infant, toddler or preschool child in accordance with the schedule recommended by the ACIP.

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: 3270.181(c)/3270.181(d)

Description: Emergency info/agreement updated 6 mos/Dated signature affixed

Noncompliance Area: Observed child files #3, #4, and #5 contained documentation of review and update the emergency contact information and the financial agreement which were completed more than 7 months after the previous parental review.

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. Following review, a parent shall attest to the accuracy of information in the emergency contact information and the financial agreement at each review by affixing a dated signature to the record.

Regulation: 3270.27(b)

Description: Plan reviewed/updated annually

Noncompliance Area: Observed the most recent documented review of the emergency plan was conducted more than 12 months ago.

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

Regulation: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: Observed staff file #1, a provisional hire, did not contain a copy of the FBI fingerprinting receipt dated prior to the first day working in a child care position. Staff #1 has a current valid FBI clearance at this time.

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

Regulation: 3270.66(a)

Description: Locked or inaccessible

Noncompliance Area: Observed in the cubby area, diaper cream which is labeled "keep out of the reach of children", accessible to children in a low cubby.

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

Regulation: 3270.67(d)

Description: Contaminated trash in closed plastic-lined receptacle

Noncompliance Area: Observed children in the preschool room placing soiled tissues into a trash can which did not have a lid.

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

Regulation: 3270.76

Description: Building Surfaces

Noncompliance Area: Observed damaged plastic on a support cable in the outdoor play area. Observed sharp edges on the edge of the fence in the outdoor play area. Observed a pedestal fan on the counter in the toddler room which could be pulled over by a child.

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: 3270.14/3270.21

Description: Pertinent Laws & Regulations/General Health and Safety

Noncompliance Area: 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: 3270.31(f)(1-10).

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: 3270.192(4)

Description: CPSL information

Noncompliance Area: Observed staff file #1, a provisional hire, contained a disclosure statement, criminal background clearance, a child abuse clearance, and NSOR verification letter which were all applied for after staff #1 first day working with children (see LIS code sheet). Staff file #1 did not contain copies of the requests for the criminal background clearance or the child abuse clearance.

Correction Required: 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: 3270.32(a)

Description: Comply with CPSL

Noncompliance Area: Observed staff file #1, a provisional hire, contained a disclosure statement, a criminal background clearance, a child abuse clearance, and NSOR verification letter which were all applied for or signed after staff #1 first day working with children (see LIS code sheet).

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

Regulation: 3270.102(a)

Description: Clean and good repair

Noncompliance Area: Observed in the preschool room, a toy stove with a broken support chain on the oven door. Observed exposed foam on a rocking chair in the toddler room. Observed in the back room, a diaper changing table which had loose supports on the top of the table.

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: Observed child file #1 and #2 contained child service reports which were completed more than 6 months after the previously completed child service 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: 3270.133(2)

Description: Written instructions

Noncompliance Area: Observed prescription nystatin cream which did not have written instructions provided from the individual who prescribed the medicine.

Correction Required: A staff person shall administer a prescription medication only if written instructions are provided from the individual who prescribed the medicine. Instructions for administration contained on a prescription label are acceptable.

Regulation: 3270.14/3270.21

Description: Pertinent Laws & Regulations/General Health and Safety

Noncompliance Area: Observed staff file #1, 2, 3, and 4 contained documentation of the completed health and safety professional development training update which was completed after the due date of 12/30/22.

Correction Required: A facility shall be operated in conformity with applicable Federal and State laws and regulations.State agencies whose regulations may relate to the operation of a facility include the Department of Environmental Resources, the Department of Labor and Industry, the Department of Health, the Department of Education and the Department of Transportation. Conditions at the facility may not pose a threat to the health or safety of the children.

Regulation: 3270.166(4)

Description: Bottles labeled

Noncompliance Area: Observed a bottle in the toddler room refrigerator which was not labeled with the child's name.

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

Regulation: 3270.181(c)/3270.181(d)

Description: Emergency info/agreement updated 6 mos/Dated signature affixed

Noncompliance Area: Observed child file #1 contained documentation of parental update which was completed more than 11 months after the previous documented parental review. Observed child file #2 did not contain documentation of parental review of the emergency contact information and the financial agreement within the previous 6 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. Following review, a parent shall attest to the accuracy of information in the emergency contact information and the financial agreement at each review by affixing a dated signature to the record.

Regulation: 3270.27(a)(6)

Description: Emergency plan

Noncompliance Area: Observed the facility did not have the required information documented for the annual emergency drill conducted.

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: Observed staff file #5 did not contain documentation of training in the emergency plan at the time of initial employment.

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: 3270.31(e)(4)(ii)

Description: Fire safety - 1 yr.

Noncompliance Area: Observed staff file #2, 3, and 4 did not contain documentation of fire safety training completed within the previous 12 months.

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: Staff person #-5- has not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): 3270.31.(f)(10).

Correction Required: Staff person shall complete professional development in the topics of 3270.31(f)(1-10) within 90 days of hire. Staff person #-5- will have until 5/4/23 to complete the required training. Until such time as the required training has been completed, staff person #5 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 #5, staff person #5 may not work in a child-care position at the facility.

Regulation: 3270.32(a)

Description: Comply with CPSL

Noncompliance Area: Observed staff file #5, contained a Department of Education FBI fingerprint clearance which is not acceptable for childcare employment.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). Facility Person # -5- may not work in a childcare position at the facility until a valid DHS fingerprint clearance is obtained.

Regulation: 3270.75(c)

Description: Has all items

Noncompliance Area: Observed the first aid kit in the preschool room did not contain tweezers.

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: Observed rough metal edges in a drain in the toddler play area. Observed a detached ceiling support in the 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: 3270.77(a)

Description: No peeling paint or plaster

Noncompliance Area: Observed peeling paint below the door in the toddler play area.

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

Regulation: 3270.94(a)(1)

Description: Every 60 days

Noncompliance Area: Observed there was no documentation of fire drills being conducted between 8/8/22-3/6/23.

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

Regulation: 3270.102(a)

Description: Clean and good repair

Noncompliance Area: Observed a torn diaper changing pad and a blue gray rest mat with a torn cover 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: 3270.104(a)

Description: Clean, good repair, proper size

Noncompliance Area: Observed 2 wooden shelves in the preschool/school age room which were not securely anchored to the wall. Observed a wooden shelf by the bathroom used by children which was not securely anchored to the wall.

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

Regulation: 3270.113(a)(1)

Description: Staff assigned to specific children

Noncompliance Area: Observed staff #2, a new employee who was working in the toddler room, was not able to name the children who they were specifically assigned the responsibility for supervising.

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(b)

Description: Parent receives original

Noncompliance Area: Observed child file #1, 2, 3, 4, and 5 contained original agreements.

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

Regulation: 3270.131(e)(1)

Description: Exemption documentation from parent/guardian

Noncompliance Area: Observed child file #2 did not contain written verification of ongoing flu vaccines administered in accordance with the schedule recommended by the ACIP.

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: 3270.133(2)

Description: Written instructions

Noncompliance Area: Observed in the toddler room, a tube of prescription diaper cream, which did not have written instructions provided from the individual who prescribed the medicine.

Correction Required: A staff person shall administer a prescription medication only if written instructions are provided from the individual who prescribed the medicine. Instructions for administration contained on a prescription label are acceptable.

Regulation: 3270.134(a)

Description: Child's hands washed

Noncompliance Area: Observed the group of children in the toddler room did not wash their hands prior to eating lunch.

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

Regulation: 3270.151(a)

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

Noncompliance Area: Observed staff file #1 contained an incomplete initial health assessment which was dated after staff #1 began providing initial service in a child care setting.

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: 3270.27(c)

Description: Training regarding plan

Noncompliance Area: Observed staff file #1, 2, 3, 4, and 5 did not contain documentation of training in the emergency plan at the time of initial employment at this new location.

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: 3270.36(b)(5)

Description: HS/GED + 2 yrs

Noncompliance Area: Observed staff file #1 did not contain documentation of 2 years (2500 hours) of experience with children.

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: 3270.52

Description: Mixed Age Level

Noncompliance Area: Observed staff #1 and #2 working in the toddler room with a mixed age group of toddlers. The mixed age group of toddlers consisted of 9 young toddlers and 2 older toddlers.

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: 3270.65

Description: Protective Outlet Covers 5 yrs. or less

Noncompliance Area: Observed electrical outlets on an extension cord in the preschool area which did not have protective receptacle covers.

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

Regulation: 3270.66(a)

Description: Locked or inaccessible

Noncompliance Area: Observed hand sanitizer, labeled keep out of the reach of children, accessible to children, on a counter top in the preschool/school age area.

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: 3270.74

Description: Emergency Numbers Posted

Noncompliance Area: Observed the emergency telephone numbers were not posted by the phone, in its charging base, on the counter in the preschool/school age area.

Correction Required: The telephone number of the nearest hospital, police department, fire department, ambulance and poison control center shall be posted by each telephone in the facility.

Regulation: 3270.76

Description: Building Surfaces

Noncompliance Area: Observed a spot of damaged drywall on the pillar in the preschool area. Observed hanging cords which were a visible hazard by the television in the preschool area.

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: 3270.82(e)

Description: Toilet and sinks proper height

Noncompliance Area: Observed in the toddler room, there was not a platform or steps for the able toddlers to reach the sink to wash their hands.

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: 3270.61(e)

Description: Halls, etc. not included

Noncompliance Area: At the time of the initial inspection, observed a stove located in the infant and toddler room.

Correction Required: Measured indoor space excludes space occupied by halls, bathrooms, offices, kitchens and locker rooms.

Regulation: 3270.63

Description: Unsafe Areas in Outdoor Space

Noncompliance Area: At the time of the initial inspection, the outdoor play space for infants and toddlers lacked fencing to restrict children from those unsafe areas or conditions.

Correction Required: If unsafe areas or conditions are in or near an outdoor play space, fencing or natural barriers are required to restrict children from those unsafe areas or conditions.

Regulation: 3270.69(b)

Description: 110º F or less

Noncompliance Area: The water at the sink in the infant/toddler space measured 117 degrees.

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

Regulation: 3270.71

Description: Heat Source

Noncompliance Area: The baseboard heat register located in the preschool room to the right of the front entrance measured 114 degrees Fahrenheit. The baseboard heat register located in the preschool room in the far right corner of the room from the front entrance measured 115 degrees Fahrenheit. The baseboard heat register located in the infant and toddler room measured 112 degrees Fahrenheit.

Correction Required: Hot water pipes and other sources of heat exceeding 110° F that are accessible to children shall be equipped with protective guards or shall be insulated to prevent direct contact.

Regulation: 3270.82(c)

Description: Sink in toilet area

Noncompliance Area: At the time of the initial inspection, the diaper changing table that was designated to be used by infants and toddlers lacked a sink near the location of the diaper changing table.

Correction Required: A sink shall be located in or near a toilet area.