Nature And Nurture Discovery School

Regulation: 3270.101(a)

Description: Age appropriate

Noncompliance Area: Observed the Fireflies classroom had 4 books in the reading area which was an insufficient amount and variety.

Correction Required: Play equipment and materials appropriate to the developmental needs, individual interests and ages of the children shall be provided in sufficient amount and variety to preclude long waits for use.

Regulation: 3270.102(a)

Description: Clean and good repair

Noncompliance Area: Observed vinyl child size couches in the Monarchs, Ladybugs, Kadydid and Junebug classroom which were peeling on the surface. Observed vinyl soft blocks in the Fireflies classroom which were peeling on the surface.

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)

Description: Signed

Noncompliance Area: The agreement for child #1 was not signed by the parent.

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

Regulation: 3270.123(a)(2)

Description: Date fee to be paid

Noncompliance Area: The agreement for child #8 and #9 did not specify the date the fee is to be paid.

Correction Required: An agreement shall specify the date on which the fee is to be paid.

Regulation: 3270.123(a)(5)

Description: Designated release persons

Noncompliance Area: The agreement for child #8 and #9 did not specify the persons designated by a parent to whom the child may be released.

Correction Required: An agreement shall specify the persons designated by a parent to whom the child may be released.

Regulation: 3270.123(a)(6)

Description: Admission date

Noncompliance Area: The agreement for child #8 and #9 did not specify the date of the child's admission.

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

Regulation: 3270.123(b)/3270.182(8)

Description: Parent receives original/Copy of initial and subsequent agreements. Parent receives original.

Noncompliance Area: The files for child #2, #3, #4, #5, #6 and #7 included the original agreement. The parent was not provided with the original agreement.

Correction Required: A parent shall receive the original agreement. The facility shall retain a copy of the agreement. A child's record shall contain a copy of the initial agreement and subsequent written agreements between the parent and the operator. The parent receives the original agreement.

Regulation: 3270.124(f)/3270.181(c)

Description: Updated every 6 months/Emergency info/agreement updated 6 mos

Noncompliance Area: The emergency contact information and/or financial agreement for child #1, #4, #5 and #7 were not reviewed and updated by a parent at least once every 6-months.

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

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

Noncompliance Area: The file for child #3 and #5 did not include an updated health rpeort at least once every 12 months for an older toddler or preschool child (see LIS code sheet). The most recent heath report on file for child #3 was dated 02/17/2025 with no subsequent health report on file. The most recent health report on file for child #5 was dated 06/13/2024 with no subsequent health report on file.

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

Regulation: 3270.135(a)(3)

Description: Disposable diapers

Noncompliance Area: The diaper changing station in the Ladybugs classroom did not have a plastic liner / trash bag in the hands-free covered can. *Corrected at the time of the inspection.

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: 3270.14/3270.21

Description: Pertinent Laws & Regulations/General Health and Safety

Noncompliance Area: The provider's Shaken Baby, Abusive Head Trauma & Child Maltreatment policy does not address the prevention and identification of child maltreatment.

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

Regulation: 3270.192(2)(ii)

Description: Exp, educ., training prior to facility

Noncompliance Area: The file for staff person #5 did not include verification of 1 year of child care experience prior to service at the facility to qualify as the director. The file for staff person #7 did not include verification of 2 years of experience on file prior to service at the facility to qualify as an assistant group supervisor. Staff person #7 was observed working alone in the Junebugs classroom with a group of 5 toddlers.

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

Regulation: 3270.192(2)(iv)

Description: Transcript, diploma and letters

Noncompliance Area: The file for staff person #7 did not include acceptable verification of education; the HS transcript on file was not signed by a representative of the educational entity.

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: The file for staff person #5 did not include 2 written, nonfamily references from individuals attesting to the person's suitability to serve as a facility person. The file for staff person #7 did not include 2 written, nonfamily references from individuals attesting to the person's suitability to serve as a facility person.

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

Regulation: 3270.25(a)

Description: Availability of certificate of compliance and applicable regulations

Noncompliance Area: The operator does not provide the parent of each child enrolled with information on how to access the regulations in chapter 3270 electronically with instructions for contacting the central regional child care office.

Correction Required: The facility's current certificate of compliance shall be posted in a conspicuous location used by parents. The operator shall provide the parent of each child enrolled with information on how to access the regulations in this chapter electronically and with instructions for contacting the appropriate regional child care office.

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

Description: Fire safety - 1 yr.

Noncompliance Area: The file for staff person #3 included fire safety training dated 05/27/2025 which was not updated at least annually; there was no subsequent fire safety training on file. The file for staff person #1 and #4 included fire safety training dated 06/08/2026 was not updated within 12 months; the previous training which was completed on 05/23/2025.

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: 3270.34(a)(6)

Description: Staff evaluations

Noncompliance Area: The director did not complete a written evaluation for staff person #1, #2, and #3 within 12 months of hire (see LIS code sheet). The evaluation on file for staff person #1, #2 and #3 were completed on 03/25/2026 with no previous evaluation completed. The director did not complete a written evaluation for staff person #4 and #6 within 12 months of the previous evaluation. The evaluation on file for staff person #4 and #6 were completed on 03/25/2026 with the previous evaluation completed on 02/19/2025.

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: 3270.66(b)

Description: Original container

Noncompliance Area: Observed a red bottle in the Honeybees classroom which was not labeled with its contents. Observed a white and green bottle in the Junebug classroom which was not labeled with its contents. Observed a purple and a yellow bottle in the Ladybugs classroom which was not labeled with its contents. Observed cleaning supplies in the Junebug classroom stored in a cabinet under the sink which was unlocked. Observed the door leading into the kitchen and the door leading into the storage room in the kitchen were unlocked allowing access to cleaning products in the storage room including Clorox, Laundry Pods, Lysol Cleaner, Dish washing PODS and Windex. A bottle of dish soap was observed on the floor in the kitchen.

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: 3270.77(a)

Description: No peeling paint or plaster

Noncompliance Area: Observed peeling paint in the Katydids classroom to the left of the sink. Observed peeling paint in the Fireflies under the window behind the climber. Observed chipped paint in the Honeybees classroom under the window behind the climber. Observed peeling paint in the Junebug classroom to the left of the climber and window. Observed peeling pain in the Ladybugs classroom to the right of the climber.

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

Regulation: 3270.82(h)

Description: Handwashing signs

Noncompliance Area: Observed the back toilet stall located in the Katydids classroom did not have a handwashing sign.

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

Regulation: 3270.94(a)(2)/3270.94(a)(3)

Description: Different times of day/Various activity times

Noncompliance Area: Fire drill documentation between January - June show they have been conducted in the early morning hours. On 02/19/2026 the drill was conducted at 7:40 am. On 04/14/2026 the drill was conducted at 7:15 am. The fire drills documented in November and December were conducted during low attendance days immediately before a holiday on 11/26/2025 and 12/24/2025.

Correction Required: The Director or designated staff person who is responsible for compliance with this chapter ensure fire drills are conducted at different times of the day or night, or both, if applicable. The Director or designated staff person who is responsible for compliance with this chapter ensure fire drills are conducted during various program activity times.

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 mandated reporter training within the last 60 months. This is evidenced by the previously documented mandated reporter training on file being dated 04/26/2021. *Corrected on the date of the inspection.

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: 3270.32(a)

Description: Comply with CPSL

Noncompliance Area: Staff person/facility person/volunteer #1 has not completed mandated reporter training within the last 60 months. This is evidenced by the previously documented mandated reporter training on file being dated 04/26/2021. *Corrected on the date of the inspection.

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

Regulation: 3270.52

Description: Mixed Age Level

Noncompliance Area: Staff stated that on 04/24/2026, there was 1 staff person was working alone in a preschool classroom with a mixed group of 11 - 22 preschool & young school age children from approximately 7:45 am - 8:45. Staff stated that during the week of 5/18/2026 at approximately 8:00 am, there was 1 staff person working alone in a toddler classroom with a mixed group of 13 young and 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: 3270.106(f)

Description: 2 feet apart

Noncompliance Area: Observed a crib in the Inchworms (infant) classroom did not have 2 feet on 3 sizes while in use. The crib was located on the far-left corner of the room and was against the corner wall and did not have 2 feet of space between the crib in use and the crib next to it.

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(b)

Description: No physical punishment

Noncompliance Area: On 09/03/2025 at approximately 1:06 pm, video footage shows staff person #1 walk toward child #1's rest mat and sit down on the floor on the left side of the mat. After staff person #1 sat down, child #1 moved back to the center of the mat and while lying on their belly pulls their blanket and scrunches it underneath themself between their chin and chest. Staff person #1 reached over the child's body and grabbed the blanket from the right side and begins to pull the blanket out from underneath the child. Child #1 resists and tries to hold on to the blanket. Staff person #1 continues to pull the blanket which causes the blanket to rub against the child's neck from the force causing an abrasion on the right side of the child's neck.

Correction Required: A facility person may not use any form of physical punishment, including spanking a child.

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: An accident report was not completed for child #1 following an incident which resulted in an injury to the child.

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: 3270.192(4)

Description: CPSL information

Noncompliance Area: The file for staff person #1 did not include a signed disclosure date at the time of initial hire (see LIS code sheet).

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: 3270.95(b)

Description: Director or designated staff person ensure compliance

Noncompliance Area: The director or designated staff person did not ensure a test of the fire detection system was completed at least once every 30 days from July - August. The most recent test was completed on 08/05/2025 with the previous conducted on 07/05/2025.

Correction Required: The Director or designated staff person who is responsible for compliance with this chapter shall ensure the requirements under subsection (a) are met.

Regulation: 3270.113(c)

Description: No ridicule or threaten harm

Noncompliance Area: On 07/21/2025 at approximately 1:30 pm, a verbal altercation occurred between staff person #1 and individual #1 in the lobby at the facility. During the altercation, staff person #1 threatened harm to the child by stating, "I hope your baby gets hit by a car."

Correction Required: A facility person may not single out the child for ridicule, threaten harm to the child or the child's family and may not specifically aim to degrade the child or the child's family.

Regulation: 3270.123(a)

Description: Signed

Noncompliance Area: The agreement for child #6 was not signed by the parent. The agreement for child #7 was not signed by the operator.

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

Regulation: 3270.123(a)(4)

Description: Arrival/departure times

Noncompliance Area: The agreement for child #6 did not specify the child's arrival and departure times.

Correction Required: An agreement shall specify the child's arrival and departure times.

Regulation: 3270.124(b)(3)

Description: Parent home/work address, phone

Noncompliance Area: The emergency contact information for child #6 did not include the enrolling parent's work telephone number.

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

Regulation: 3270.124(b)(7)

Description: Name/address/phone release person

Noncompliance Area: The emergency contact information for child #2 did not include the address of the individuals designated by the parent to whom the child may be released. The emergency contact information for child #5 did not include the complete address of the individuals 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: On 07/11/2025, emergency contact information was not present in the Honeybees classroom for child #6 while receiving care in the space. Emergency contact information was not present in the Katydids classroom for child #2 and #8 while receiving care in the space.

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

Regulation: 3270.131(a)

Description: Health information

Noncompliance Area: The file for child #5 did not have an initial health report within 60 days of attendance (see LIS code sheet); the file did not include any health reports.

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: 3270.131(b)(2)

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

Noncompliance Area: On 07/11/2025, the health report on file for child #3 was not updated within 12 months of the previous health report; the most recent health report on file was dated 06/06/2024 and no subsequent report was on file.

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

Regulation: 3270.131(e)

Description: ACIP recommended immunization record

Noncompliance Area: The file for child #1 (see LIS code sheet) included a record of the child's immunization status which lacked a 3rd dose of DTap and a 3rd dose of PCV13. The file for child #4 (see LIS code sheet) included a record of the child's immunization status which lacked a 2nd dose of HepB, a 1st dose of DTap, a 1st dose of HiB, a 1st dose of Rotavirus, a 1st dose of PCV13, and a 1st dose of Polio immunizations.

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

Regulation: 3270.151(a)

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

Noncompliance Area: The file for staff person #2 did not include a health assessment prior to providing initial service in a child care setting (see LIS code sheet); the file included a health assessment dated 04/09/2025 and a TB test dated 04/11/2025. The file for staff person #4 included a health assessment that was not updated within 24 months for the previous health assessment; the current assessment on file was dated 05/21/2025 with the previous assessment dated 04/03/2023.

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: 3270.166(4)

Description: Bottles labeled

Noncompliance Area: Observed bottles in the refrigerator located in the Inchworms classroom which were not labeled with the child's name.

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

Regulation: 3270.182(5)

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

Noncompliance Area: The file for child #6 did not include signed parental consent for the administration of minor first-aid procedures prior to admission (see LIS code sheet).

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

Regulation: 3270.182(8)

Description: Copy of initial and subsequent agreements. Parent receives original.

Noncompliance Area: The file for child #4 did not include an initial agreement at the time of enrollment.

Correction Required: A child's record shall contain a copy of the initial agreement and subsequent written agreements between the parent and the operator. The parent receives the original agreement.

Regulation: 3270.31(e)

Description: Age and Training

Noncompliance Area: The file for staff person #1 did not have documentation of an annual minimum of 12 clock hours of child care training; there were 9.5 hours of documented training between 12/2023 - 12/2024.

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

Regulation: 3270.31(f)

Description: Health and Safety Training

Noncompliance Area: Staff person #3 did not complete the following required pre- service training within 90 days of their date of hire (see LIS code sheet): Health & Safety (CCDGB) 2025 Part 1 and Part 2 were completed on 05/28/2025.

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

Regulation: 3270.37(c)

Description: Aides supervised all times

Noncompliance Area: On 06/13/2025, observed staff person #5 (an aide) working alone in the Inchworms classroom. Staff person #5 was not supervised by a staff person qualified at a minimum as an assistant group supervisor.

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: 3270.14/3270.21

Description: Pertinent Laws & Regulations/General Health and Safety

Noncompliance Area: Staff person #1 has completed the health and safety course titled ·Get Started with Center-Based Care: Building Blocks for Quality (10 hours) dated 12/09/2019 but did not have documentation on file of completing the required health and safety update course titled Pennsylvania Health and Safety Update 2022 (1 hour) 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. Staff person #1 must complete (PA Required Health and Safety for Centers-Group Child Care Parts 1 and 2.

Regulation: 3270.151(a)

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

Noncompliance Area: The file for staff person #5 did not include a health assessment prior to providing initial service in a child care setting. The file included a TB test result dated 03/05/2025 in lieu of a complete health assessment. The file for staff person #9 did not include an updated health assessment within 24 months of the previous health assessment; the most recent health assessment on file was completed on 11/08/2022.

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)(ii)

Description: Exp, educ., training prior to facility

Noncompliance Area: The file for staff person #2 did not include verification of child care experience or education at the time of initial hire (see LIS code sheet). The file for staff person #4 and #6 did not include verification of education at the time of initial hire (see LIS code sheet).

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

Regulation: 3270.192(5)

Description: Two written references

Noncompliance Area: The file for staff person #1, #2, #6, #8 and #9 did not include two written, nonfamily references from individuals attesting to the person's suitability to serve as a facility person.

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

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

Description: Age and Training

Noncompliance Area: Staff person #3 has not completed Pediatric first aid and CPR training on or before expiration of the most current certification. This is evidenced by the previously documented Pediatric first aid and CPR training on file expiring 04/2025. Documentation of updated Pediatric first aid and CPR training is not on file Staff person #3 was observed to be working in the Inchworms classroom with staff person #1. Staff person #1 did not have a complete file to qualify as a permanent employee to supervise staff person #3.

Correction Required: Competence is the completion of training by a professional in the field of first-aid and cardiopulmonary resuscitation (CPR). All staff persons shall renew their certification in pediatric first aid and pediatric cardiopulmonary resuscitation (CPR) on or before the expiration of the most current certification. Until such time as the required training has been completed, staff person #3 must be supervised, when interacting with children at a minimum by, an AGS who has completed all preservice trainings and has all qualifications to care for children unsupervised. If there are no staff person(s) available to supervise staff person #3, staff person #3 may not work in a child-care position at the facility.

Regulation: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: Observed staff person #1, a provisional hire (see LIS code sheet) working in the Inchworms classroom with staff person #3. Staff person #3 did not have a complete file to qualify as a permanent employee to supervise staff person #1. The file for staff person #1 did not have a current State Police clearance. The file included a State Police Clearance dated 06/14/2016 and documentation of a request dated 03/0/2025 without the final clearance results. The file for staff person #2 did not have the results of the NSOR certificate prior to working in a child care position at the facility (see LIS code sheet); the NSOR clearance was requested on 04/14/2025. The file for staff person #2 did not have a copy of the request or the results of the FBI clearance on file. Staff person #2 was observed caring for children in the Junebug's classroom. The file for staff person #5 included a copy of an FBI clearance dated 07/14/2022 with the name blacked out on the certificate. The file for staff person #7 did not have the results of the NSOR certificate prior to working in a child care position at the facility (see LIS code sheet); the NSOR clearance was requested on 03/07/2025. The file for staff person #7 did not have a copy of the request or the results of the FBI clearance. Staff person #7 was observed caring for children in the Honeybees classroom unsupervised. The disclosure statement for staff person #8 dated 04/09/2025 was not witnessed at the time it was signed. The file for staff person #10 included a child abuse clearance which was not updated within 60 months of the previous clearance. The most recent child abuse clearance on file was dated 03/06/2020.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). LACKING REQUIRED HIRING DOCUMENTS: Facility Person # -- 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.

Regulation: 3270.37(c)

Description: Aides supervised all times

Noncompliance Area: Observed staff person #7, an aide, working unsupervised in the Honeybees classroom. The file for staff person #1 included a HS diploma and 1 year of verified child care experience.

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: 3270.119

Description: Infant sleep position

Noncompliance Area: On 07/25/2024 at approximately 10:00 am, staff at the facility observed staff person #1 place child #1 into their crib on their stomach to sleep. According to the AAP, it is recommended infants be placed on their back for safe sleep.

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: 3270.135(e)

Description: 2 hour diaper check

Noncompliance Area: Staff at the facility observed numerous occasions where infants' diapers were soaking wet and diaper changes were not documented in the morning. On 07/19/2024, child #2 arrived at 9:17 am and the first logged diaper change was documented at 1:38 pm. On 07/19/2024, child #3 arrived at 7:29 am and the first logged diaper change was documented at 1:34 pm. During the week of 07/22 - 07/26/2024, diaper logs for child #1, #2 and #4 showed several times throughout the day when diaper changes were not documented at least every 2 hours. Observed the daily schedule in the Honey Bees classroom lists the following diaper changing times- 9:00 - 9:30, 12:00-12:15, 2:35 - 2:45 and 3:50 - 4:30. The scheduled diaper changes between 9:00 - 12:00 exceeds 2 hours.

Correction Required: A staff person shall check a child's diaper at least every 2 hours and whenever the child indicates discomfort or exhibits behavior that suggests a soiled diaper. A staff person shall change a child's diaper when the diaper is soiled.

Regulation: 3270.166(1)

Description: Written statement

Noncompliance Area: The written feeding schedules for child #1, #2, #3 and #4 were not followed by staff person #1. The feeding schedule for child #1 indicates feeding times as "on demand" every 3 hours (9:00, 11:00 and 1:00 pm). During the week of 07/22 - 07/26/2024, the feeding log for child #1 listed several times when feeding times for child #1 exceeded 3 hours and the first feeding was not documented until after 10:00 am. On 07/19/2024, morning feedings were not documented for child #2 and #3. The first documented feeding for child #2 was listed at 1:57 pm. The first documented feeding for child #3 was listed at 1:47 pm. On 07/23/2023, the first feeding time for child #4 was listed at 10:38 am with the afternoon feeding documented at 3:19 pm. On 07/25/2023, the first feeding time for child #4 was listed at 8:35 am with the afternoon feeding documented at 12:38 pm.

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

Regulation: 3270.124(b)(2)/3270.124(b)(3)

Description: Physician name, address, phone/Parent home/work address, phone

Noncompliance Area: The emergency contact information for child #4 did not include the complete address of the child's physician or source of medical care. The emergency contact information for child #3 did not include the complete telephone number of the child's physician or source of medical care.  The emergency contact information for child #1 and #5 did not include the work telephone number of the enrolling parent.

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

Regulation: 3270.124(f)/3270.181(c)

Description: Updated every 6 months/Emergency info/agreement updated 6 mos

Noncompliance Area: The emergency contact and financial agreement for child #3 was not updated within 6 months of initial enrollment (see LIS code sheet). The most recent review was completed on 04/16/2024.

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. 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: 3270.131(b)(1)

Description: Infant: updated health report every 6 months

Noncompliance Area: The file for child #2 and #3 included a health report which was not updated within 6 months of the previous health report for an infant or young toddler (see LIS code sheet). A current health report on file for child #2 was dated 06/11/2024 with the previous health report dated 06/13/2023 and an initial health report dated 10/21/2022. A subsequent health assessment for 12/2023 was not on file. The current health report on file for child #3, dated 06/06/2024, was not completed within 6 months of the initial health report dated 09/05/2023.

Correction Required: The operator shall require the parent to provide an updated health report at least every 6 months for an infant or young toddler.

Regulation: 3270.131(b)(2)

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

Noncompliance Area: The file for child #1 included a health report which was not updated within 12 months of the previous health report for an older toddler or preschool child (see LIS code sheet). The current health report on file was dated 06/06/2024 with the previous health report dated 08/30/2022.

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

Regulation: 3270.131(d)(4)/3270.131(d)(8)

Description: Acute or chronic health problem/Age appropriate screenings complete

Noncompliance Area: The initial health report dated 03/26/2024 for child #5 was not completed in its entirety. The sections regarding health problems or special needs, including information regarding abnormal results of screening tests for vision, hearing or lead poisoning and a statement that age-appropriate screenings recommended by the American Academy of Pediatrics were conducted were left blank by the MD/CRNP/PA who completed the form.

Correction Required: A health report shall include an assessment of an acute or chronic health problem or special need and recommendations for treatment or services, including information regarding abnormal results of screening tests for vision, hearing or lead poisoning. A health report shall include a statement that age-appropriate screenings recommended by the American Academy of Pediatrics were conducted since the time of the previous health report required by this section.

Regulation: 3270.131(d)(7)

Description: Free from contagious/communicable disease

Noncompliance Area: The initial health report dated 03/26/2024 for child #5 was not completed in its entirety. The section regarding whether the child is able to participate in child care and appears to be free from contagious or communicable disease was. left blank by the MD/CRNP/PA who completed the form.

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: 3270.192(2)(ii)

Description: Exp, educ., training prior to facility

Noncompliance Area: The file for staff person #2 did not include verification of education at the time of initial hire (see LIS code sheet).

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

Regulation: 3270.27(c)

Description: Training regarding plan

Noncompliance Area: The emergency plan training for staff person #3 was not updated within 12 months of the previous training; the most recent training was dated 05/26/2023 with no documentation of subsequent training.

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(f)(10)

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

Noncompliance Area: Staff person #1 has not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): Pediatric First Aid & CPR in a PQAS approved curriculum from a PQAS approved trainer. The file for staff person #1 included American Heart Association Heartsaver for K-12 Schools training dated 01/10/2023.

Correction Required: Staff persons shall complete professional development in pediatric first aid and pediatric cardiopulmonary resuscitation within 90 days of hire. Staff person #1 will have until 07/15/2024 to complete the required training. Until such time as the required training has been completed, staff person #1 must be supervised, when interacting with children, by a AGS who has completed the required training related to this citation. If there are no staff available to supervise staff person #1, staff person #1 may not work in a child-care position at the facility.

Regulation: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: The file for staff person #1, who has resided outside of PA in the previous 5 years, did not include documentation of out of state clearances within 45 days of hire (see LIS code sheet).

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). LACKING REQUIRED HIRING DOCUMENTS: Facility Person #1 may not work in a child care position at the facility. 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: 3270.82(e)

Description: Toilet and sinks proper height

Noncompliance Area: Observed a young toddler being lifted by a staff person to reach the sink to wash their hands; the sink in the Inchworms classroom was not a proper height for use by young toddlers and did not include a platform or steps for the children to easily approach the sink for handwashing.

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: 3270.106(a)

Description: Clean, age appropriate

Noncompliance Area: Observed the crib located in the Honeybees classroom, used by Child #1, was not labeled for the use by the specified child.

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

Regulation: 3270.124(f)/3270.181(c)

Description: Updated every 6 months/Emergency info/agreement updated 6 mos

Noncompliance Area: Observed the emergency contact information for child #2, #3, #4, #6 and #7 were not updated by a parent at least once every 6 months. The emergency contact information for child #3, #4 and #6 was last reviewed in October 2022. The emergency contact information for child #2 was reviewed in June 2023 with the previous review in October 2022. The emergency contact information for child #7 was reviewed April 2022. A subsequent review in September 2022 was not signed by the parent.

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

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

Noncompliance Area: The health report for child #2 and #4 was not updated at least once every 6 months for an infant or young toddler (see LIS code sheet) The most recent health report on file for child #2 was dated 06/21/2022 with no additional health reports on file. The most recent health report on file for child #4 was dated 08/30/2022 with the previous health report on file dated 04/14/2021.

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

Regulation: 3270.131(e)(1)

Description: Exemption documentation from parent/guardian

Noncompliance Area: The file for child #2 (see LIS code sheet) included a record of the child's immunization status which lacked a 4th dose of DTap, a 4th dose of PCV13, an MMR, a Varicella and an influenza immunization. The file for child #4 (see LIS code sheet) included a record of the child's immunization status which lacked a 2nd dose of Hep A and an influenza immunization. The file for child #5 (see LIS code sheet) included a record of the child's immunization status which lacked a current influenza immunization. The file for child #6 (see LIS code sheet) included a record of the child's immunization status which lacked an influenza immunization.

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: 3270.131(e)/3270.182(1)

Description: ACIP recommended immunization record /Initial and subsequent health reports

Noncompliance Area: The file for child #3 (see LIS code sheet) did not include initial and subsequent health reports. The most recent health report on file dated 10/26/2022 did not include a copy of the child's immunization record.

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

Regulation: 3270.133(4)

Description: Locked

Noncompliance Area: Observed diaper creams stored on the bottom shelf of an unlocked cabinet on the changing tables located in the Katydids and Ladybugs classrooms which were accessible to children in care.

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

Regulation: 3270.31(f)

Description: Health and Safety Training

Noncompliance Area: Staff person #2 did not complete the following required pre-service training within 90 days of their date of hire (see LIS code sheet): Get Started with Center Based Care - Revised 2022; the training was completed on 04/30/2023.

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

Regulation: 3270.34(a)(6)

Description: Staff evaluations

Noncompliance Area: The director did not complete a written evaluation for staff person #1 within 12 months of hire (see LIS Code Sheet).

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

Regulation: 3270.66(b)

Description: Original container

Noncompliance Area: Observed hand soap in a hand sanitizer bottle in the Monarch classroom which was not in an original labeled container that specified the content.

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: 3270.111(b)

Description: Posted in group space

Noncompliance Area: On 11/08/2022, a written plan of daily activities was not posted in the "Inchworms" (infants) classroom.

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

Regulation: 3270.131(d)(7)

Description: Free from contagious/communicable disease

Noncompliance Area: On 11/21/2022, the health report for child #3 did not include a statement that the child is able to participate in child care and appears to be free from contagious or communicable disease.

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

Regulation: 3270.161(d)

Description: Potentially hazardous food refrigerated

Noncompliance Area: Potentially hazardous food brought from the child's home are not being refrigerated by the facility. Ice packs are used in lunchboxes for lunches packed by the parents in lieu of being refrigerated.

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

Regulation: 3270.182(1)

Description: Initial and subsequent health reports

Noncompliance Area: On 11/21/2022, the file for child #1 and #2 did not contain an initial health report (see LIS code sheet). The current health report on file for child #1 was dated 09/01/2022, with no prior health report on file. The current health report on file for child #4 was dated 08/05/2022, with no prior health report on file.

Correction Required: A child's record shall contain initial and subsequent health reports.

Regulation: 3270.192(5)

Description: Two written references

Noncompliance Area: On 11/08/2022, the file for staff person #2 had one written, nonfamily reference.

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)

Description: Comply with CPSL

Noncompliance Area: Staff person #1 did not complete mandated reporter training within 60 months of the previous training. The current Mandated Reporter training was completed on 11/07/2022 and the previous documented mandated reporter training on file was dated 03/12/2017. On 11/08/2022, the file for staff person #2 included a volunteer Child Abuse Clearance dated 08/29/2018 in lieu of a child abuse clearance for employment.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). LACKING REQUIRED HIRING DOCUMENTS: Facility Person #2 may not work in a child care position at the facility.

Regulation: 3270.124(b)(7)

Description: Name/address/phone release person

Noncompliance Area: On 01/03/2022, the emergency contact information for child #3 did not include the addresses of the individuals 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: On 01/03/2022, the file for child #1, with an enrollment date of 07/06/2021 did not include an initial health report within 90 days (under the COVID suspended regulations) following the first day of attendance at the facility. The file contained an immunization record dated 07/21/2021 and a Well Child Report dated 11/24/2021. The file for child #3, with an enrollment date of 11/03/2020 did not include an initial health report within 90 days (under the COVID suspended regulations) following the first day of attendance at the facility; the file contained an immunization record dated 10/21/2020 in lieu of a complete health report.

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: 3270.131(d)(7)

Description: Free from contagious/communicable disease

Noncompliance Area: On 01/03/2022, the Well Child Report, dated 11/24/2021, for child #1 did not include a statement that the child is able to participate in child care and appears to be free from contagious or communicable disease.

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

Regulation: 3270.131(e)(1)

Description: Exemption documentation from parent/guardian

Noncompliance Area: On 01/03/2022, the file for child #2, a 17 month old, included a record of the child's immunization status which lacked an influenza immunization. The file for child #3, a 3-year-old, included a record of the child's immunization status which lacked an influenza immunization.

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

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

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

Noncompliance Area: On 01/03/2022, the file for staff person #6 included a health assessment & results of tuberculosis screening completed after providing initial service in a child care setting; the health assessment was dated 06/20/2021 and the TB screening was dated 06/30/2021. The initial start date caring for children for staff person #6 was 06/07/2021.

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: 3270.192(5)

Description: Two written references

Noncompliance Area: On 01/03/2022, the file for staff person #5 and #7 did not include two written, nonfamily references from individuals attesting to the person's suitability to serve as a facility person

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

Regulation: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: On 01/03/2022, the file for staff person #1, start date 10/18/2021, included CPSL provisional hire documentation which was not complete prior to working with children. The file contained requests for the State Police Clearance dated 10/18/2021, a request for the Child Abuse Clearance dated 10/18/2021, FBI fingerprint receipt dated 10/25/2021 and NSOR request dated 11/01/2021. The results of the PA State Police Clearance or FBI Clearance was not on file prior to their start date. The file contains a State Police Clearance dated 12/02/2021, a child abuse clearance dated 12/02/2021, an FBI Clearance dated 10/25/2021 and an NSOR certificate dated 11/01/2021. The file for staff person #3, start date 07/19/2021, included CPSL provisional hire documentation which was not complete prior to working with children. The file contained requests for the State Police Clearance dated 08/09/2021, and a request for the Child Abuse Clearance dated 08/09/2021. The results of the PA State Police Clearance or FBI Clearance was not on file prior to their start date. Documentation of the receipt with the date of FBI fingerprinting and proof of submission for the NOSR clearance was not on file. The file contains a State Police Clearance dated 08/09/2021, a child abuse clearance dated 08/09/2021, an FBI Clearance dated 07/22/2021 and an NSOR certificate dated 07/20/2021. The file for staff person #5, initial start date 11/02/2021 included an NSOR certificate dated 12/06/2021; documentation of the NSOR request was not on file prior to their first day working with children.

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

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

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

Noncompliance Area: On 12/21/2021, observed staff person #7 working alone in the infant classroom as an Assistant Group Supervisor; the file for staff person #7 included documentation of a high school diploma but did not include verification child care experience or credit hours from an accredited college or university to qualify as an AGS.

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

Regulation: 3270.75(b)

Description: Inaccessible to children

Noncompliance Area: On 12/21/2021, observed the bag containing the first-aid kit was accessible to children on the ground next to the table in the pavilion, while the 3 year old class was outside playing on the playground.

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