Nurturing Arms Daycare

Regulation: 3270.14/3270.21

Description: Pertinent Laws & Regulations/General Health and Safety

Noncompliance Area: During the inspection, staff person #8 was observed to be caring for children unsupervised. Staff person #8 has not completed the following pre- service training required prior to caring for children unsupervised: Pediatric First Aid/CPR training

Correction Required: A facility shall be operated in conformity with applicable Federal and State laws and regulations. State agencies whose regulations may relate to the operation of a facility include the Department of Environmental Resources, the Department of Labor and Industry, the Department of Health, the Department of Education and the Department of Transportation. Conditions at the facility may not pose a threat to the health or safety of the children. Until such time as the required pre- service trainings are completed, staff person #8 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 #8, staff person #8 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: At the time of the inspection, the NSOR certificates on file for staff persons #7 and #8 were dated 6/17/26, which was after their dates of hire, and after they had direct contact and routine interaction with children (see LIS code sheet for date of hire).

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(c)/3270.192(2)(ii)

Description: Supervised volunteer/Exp, educ., training prior to facility

Noncompliance Area: At the time of the inspection, staff person #9 had foreign education on file that was not evaluated and therefore, could not qualify as an AGS, which was the position they were performing.

Correction Required: A volunteer shall be supervised by a staff person who is qualified at minimum as an assistant group supervisor. A facility person's record shall include verification of child care experience, education and training prior to service at the facility.

Regulation: 3270.77(a)

Description: No peeling paint or plaster

Noncompliance Area: At the time of the inspection, the yellow wall in the bathroom in the preschool room had peeling paint.

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

Regulation: 3270.104(a)

Description: Clean, good repair, proper size

Noncompliance Area: At the time of the inspection, the white shelf in the younger preschool room and the black shelf in the school age room were wobbly, not secured to a surface and able to be tipped over posing a hazard to children.

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

Regulation: 3270.131(b)(1)

Description: Infant: updated health report every 6 months

Noncompliance Area: At the time of the inspection, the last documented health assessment on file for child #5 was conducted on 4/10/25, and not every 6 months as required.

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: 3270.151(a)

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

Noncompliance Area: At the time of the inspection, staff persons #2 and #13 did not update their health assessment every 24 months, as required. This is evidenced by the current health assessment date of 9/25/25 and 8/4/25, respectively. The previous health assessments were dated 8/18/23 and 6/19/23, respectively.

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: 3270.163(a)(1)

Description: Dairy

Noncompliance Area: At the time of the inspection, in the older toddler class with staff person #2, the children were not served a dairy product during lunch. Their lunch consisted of corn, penne pasta with marinara meat sauce and water to drink.

Correction Required: A lunch or dinner prepared at the facility for children of toddler age or older shall include at least one dairy product.

Regulation: 3270.171(a)

Description: Pick-up and drop-off points

Noncompliance Area: At the time of the inspection, the last documented date that the facility notified the local traffic safety authorities in writing regarding the location of the facility and the program's use of pedestrian and vehicular routes around the childcare facility was on 1/13/25 and not annually, as required.

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: 3270.31(e)(4)(ii)

Description: Fire safety - 1 yr.

Noncompliance Area: At the time of the inspection, staff person #1 did not complete fire safety training annually as required. This is evidenced by the current fire safety training date of 2/1/26 and the previous fire safety training date of 1/24/25.

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: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: At the time of the inspection, staff person #5 did not update their PA State Police clearance, Child Abuse clearance, FBI clearance and NSOR certificate every 60 months, prior to the current clearance's expiration, as required. This is evidenced by the current clearance on file dated 8/5/25, 1/28/26, 1/27/26, and 8/8/25, respectively. The previous clearance dates were 4/21/20, 4/29/20, 4/24/20, and 5/4/20, respectively. Staff person #5 had routine interaction and direct contact with children. Staff person #8 did not update their NSOR certificate every 60 months, prior to the current certificate's expiration. This is evidenced by the current NSOR date of 1/26/26 and the previous clearance date of 2/25/20. Staff person #8 had routine interaction and direct contact 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. The CPSL was revised to include a requirement that all clearances be updated and on file at least every 60 months.

Regulation: 3270.65

Description: Protective Outlet Covers 5 yrs. or less

Noncompliance Area: At the time of the inspection, protective receptacle covers were missing from the older toddler and younger preschool rooms.

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

Regulation: 3270.75(c)

Description: Has all items

Noncompliance Area: At the time of the inspection, soap was missing from the first aid kit in the infant room.

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

Regulation: 3270.94(a)(5)

Description: Evacuation routes posted

Noncompliance Area: At the time of the inspection, evacuation routes were missing from the school age room, located on the second-floor loft.

Correction Required: The Director or designated staff person who is responsible for compliance with this chapter ensure evacuation routes are posted in a conspicuous location on each floor of the facility.

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 on 2/25/26, the last documented manual monthly monitoring of the fire detection system was conducted on 1/9/26 and not every 30 days, as required.

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)/3270.135(b)

Description: Clean and good repair/Surfaces cleaned

Noncompliance Area: At the time of the inspection, the changing table pad in the middle-left room was torn, and the inside foam was exposed. This prevents the changing pad from being properly cleaned with a sanitizing solution.

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

Regulation: 3270.104(a)

Description: Clean, good repair, proper size

Noncompliance Area: At the time of the inspection, the fold down changing tables located in the infant and toddler rooms had a label reading "suitable for child up to 11kg or 12 months." Child #8, a three-year-old, was observed being changed on one of these tables in the toddler room. These changing tables are not appropriate for the children's age and size who were present in care in these spaces.

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

Regulation: 3270.133(3)/3270.133(5)

Description: Name on bottle/Original label

Noncompliance Area: At the time of the inspection, the Flovent inhaler, which the operator stated was child #7's, was observed inside a plastic bag at the facility. It did not contain a label identifying the name of the child for whom the medication is intended. The medication itself also read to discard after 1/2024.

Correction Required: The label of a medication container shall identify the name of the medication and the name of the child for whom the medication is intended. Medication shall be administered to only the child whose name appears on the container. Medication shall be stored in accordance with the manufacturer's or health professional's instructions on the original label.

Regulation: 3270.135(a)(3)

Description: Disposable diapers

Noncompliance Area: At the time of the inspection, the trash can used for diapering in the infant and toddler rooms contained used diapers and was not plastic-lined.

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

Regulation: 3270.151(a)

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

Noncompliance Area: At the time of the inspection, staff person #8 did not have a health assessment conducted every 24 months, as required, on file. This is evidenced by the health assessment on file dated 11/3/22.

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(1)

Description: Written statement

Noncompliance Area: At the time of the inspection, staff person #2 had acknowledged that written statements giving the formula and feeding schedule for an infant are not obtained from the parent.

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

Regulation: 3270.171(c)/3270.171(d)

Description: Safe routes posted/Pick-up and drop-off at specified areas

Noncompliance Area: At the time of the inspection, written notification of safe routes were not posted in the facility.

Correction Required: Written notification of safe routes shall be posted by the operator at a conspicuous location in the child care facility. Children shall be picked up and discharged only at locations specified by the facility as safe locations.

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

Description: Age and Training

Noncompliance Area: At the time of the inspection, staff person #8 did not renew the Pediatric First Aid/CPR training until 12/7/24. The previous training date was 7/20/22. This reflects a timeframe of when staff person #8 did not have current Pediatric First Aid/CPR training.

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

Regulation: 3270.31(f)

Description: Health and Safety Training

Noncompliance Area: Staff person #14 did not complete the following required pre- service training within 90 days of their date of hire (see LIS code sheet): Pediatric First Aid/CPR training. This is evidenced by the Pediatric First Aid/CPR training on file dated 12/7/24.

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

Regulation: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: At the time of the inspection, staff person #5 did not have a signed disclosure statement at time of hire (see LIS code sheet for date of hire).

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: 3270.61(h)

Description: Exceeding Capacity

Noncompliance Area: During the inspection, there were 4 mixed aged children in the infant room. The maximum capacity for this room is 3 children.

Correction Required: The capacity established for an indoor space may not be exceeded.

Regulation: 3270.66(a)/3270.133(4)

Description: Locked or inaccessible/Locked

Noncompliance Area: At the time of the inspection, in the Preschool classroom, staff person #3's purse was accessible to children. Inside the purse was a bottle of Benadryl and a bottle lavender oil. In the preschool room, in a closet that was only partially closed off by a curtain, there were cans of paint accessible to children.

Correction Required: Cleaning materials and other toxic materials shall be kept in an area or container that is locked or made inaccessible to children. Medication shall be stored in a locked area of the facility or in an area that is out of the reach of children.

Regulation: 3270.71

Description: Heat Source

Noncompliance Area: At the time of the inspection, the baseboard heaters in the middle right room, the Preschool bathroom and the toddler room exceeded 110° F and were accessible to children. The temperatures they measured were 282° F, 142° F and 145° F, respectively.

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: 3270.76

Description: Building Surfaces

Noncompliance Area: At the time of the inspection, in the toddler room, the heat vent cover was broken and exposed the metal guard edges, posing a hazard to children. In the school age room, a shelf was not secured to a surface and posed a tipping hazard.

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

Regulation: 3270.77(a)

Description: No peeling paint or plaster

Noncompliance Area: At the time of the inspection, there was peeling paint behind the toilet in the preschool bathroom. There was peeling paint on the blue wall in the toddler room.

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(j)

Description: Running water - diapering

Noncompliance Area: At the time of the inspection, the 5 gallon receptacles used for water for handwashing in the infant and toddler rooms were filled with water. This is evidence that they are not emptied daily.

Correction Required: A source of running water for handwashing shall be present in infant and toddler diapering areas. If the running water does not flow directly into a drain that is connected to a sewage system, a receptacle shall be provided to contain the water used for washing. The receptacle shall be emptied into an approved sewage system at least once a day.

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 on 2/12/25, the last documented testing of the fire detection system was conducted on 1/10/25 and not every 30 days as required.

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(g)/3270.119

Description: Hazardous toys and equipment/Infant sleep position

Noncompliance Area: At the time of the inspection, Child #1, a 7-month old (see LIS code sheet for date of birth), as reported by staff and confirmed through enrollment paperwork, was observed sleeping unsupervised in a Fisher Price Infant-to-Toddler Rocker inside a crib in the infant room. The child was not placed in the recommended sleeping position, in approved rest equipment, to sleep. In June 2022, the Consumer Product Safety Commission and Fisher-Price issued a warning for consumers about infant deaths in Fisher-Price Infant-to-Toddler and Newborn-to-Toddler Rockers and advised rockers should never be used for sleep, and infants should never be unsupervised.

Correction Required: Children's toys and equipment, including furniture and rest equipment, described as hazardous by the United States Consumer Product Safety Commission may not be used by children at the facility and may not be on the premises at the facility. At the time of inspection, the operator shall submit to the Department written affirmation on a form provided by the Department stating that the facility is in compliance with this requirement. 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. The legal entity must arrange for all facility staff to receive a minimum of two hours of PQAS-approved in-person training, including technical assistance, regarding "Health and Safety: Infant/Toddler Safe Sleep." This training must be completed as a live training or in-person. The legal entity must receive DHS approval of the training content prior to scheduling the training. All staff who are employed by the date of the training must take the training.

Regulation: 3270.102(g)/3270.119

Description: Hazardous toys and equipment/Infant sleep position

Noncompliance Area: At the time of the inspection, Child #1, a 7-month old (see LIS code sheet for date of birth), as reported by staff and confirmed through enrollment paperwork, was observed sleeping unsupervised in a Fisher Price Infant-to-Toddler Rocker inside a crib in the infant room. The child was not placed in the recommended sleeping position, in approved rest equipment, to sleep. In June 2022, the Consumer Product Safety Commission and Fisher-Price issued a warning for consumers about infant deaths in Fisher-Price Infant-to-Toddler and Newborn-to-Toddler Rockers and advised rockers should never be used for sleep, and infants should never be unsupervised.

Correction Required: Children's toys and equipment, including furniture and rest equipment, described as hazardous by the United States Consumer Product Safety Commission may not be used by children at the facility and may not be on the premises at the facility. At the time of inspection, the operator shall submit to the Department written affirmation on a form provided by the Department stating that the facility is in compliance with this requirement. 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: 3270.113(a)/3270.113(a)(1)

Description: Supervised at all times /Staff assigned to specific children

Noncompliance Area: On 11/4/24 at approximately 9:30am, Child #1, a 7-month old, was observed sleeping unsupervised in a Fisher Price Infant-to-Toddler Rocker inside a crib in the infant room. Child #1 was assigned to staff #10, who was observed in the young toddler room at this time, and no other adults were present in the infant room with Child #1.

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

Regulation: 3270.113(a)/3270.113(a)(1)

Description: Supervised at all times /Staff assigned to specific children

Noncompliance Area: On 11/4/24 at approximately 9:30am, Child #1, a 7-month old, was observed sleeping unsupervised in a Fisher Price Infant-to-Toddler Rocker inside a crib in the infant room. Child #1 was assigned to staff #10, who was observed in the young toddler room at this time, and no other adults were present in the infant room with Child #1.

Correction Required: Children on the facility premises and on facility excursions off the premises shall be supervised by a staff person at all times. Outdoor play space used by the facility is considered part of the facility premises. 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. The legal entity must arrange for all facility staff to receive a minimum of three hours of PQAS-approved in-person training, including technical assistance, regarding ratios and supervision of children. This training must be completed as a live training or in-person. The legal entity must receive DHS approval of the training content prior to scheduling the training. All staff who are employed by the date of the training must take the training.

Regulation: 3270.33(a)

Description: Each staff person meets quals

Noncompliance Area: At the time of the inspection, staff person #10 had foreign education on file that was not evaluated and translated and therefore, could not qualify for the position she was performing.

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

Regulation: 3270.52

Description: Mixed Age Level

Noncompliance Area: On 11/4/24 at approximately 9:23am, 12 children (11 older toddlers and 1 young toddler) were present with staff person #8 and staff person #9. This number and age of children requires there to be three staff people present at all times.

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). The legal entity must print and post the required ratios in each measured child care space. The Legal Entity/ Director will establish a supervision and ratio policy. The policy must address how the facility will maintain appropriate supervision and proper staff:child ratios at all times. The policy must also address situations that might affect staff:child ratios, such as staff late or calling off and children being dropped off outside of their agreed upon care hours or days. The policy must address a plan to either turn children away or keep parents at the facility until extra staff arrive. This policy must be sent to the Northeast Regional Office for review and approval. Once approved, all existing staff and new hires must be trained on the approved procedures, and their signatures will indicate their understanding and ability to implement the policy. This documentation must be maintained at the facility.

Regulation: 3270.52

Description: Mixed Age Level

Noncompliance Area: On 11/4/24 at approximately 9:23am, 12 children (11 older toddlers and 1 young toddler) were present with staff person #8 and staff person #9. This number and age of children requires there to be three staff people present at all times.

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). The required staff:child ratios must be maintained at all times.

Regulation: 3270.104(a)/3270.135(b)

Description: Clean, good repair, proper size/Surfaces cleaned

Noncompliance Area: During the inspection on 10/2/24, the changing table pad used for diapering in the toddler room was torn and the inside foam was exposed. This prevents the changing table pad from being properly sanitized after each use.

Correction Required: Furniture must be durable, safe, easily cleaned and appropriate for the child's size, age and special needs. Diaper changing surfaces shall be cleaned after each use by wiping the surface with a sanitizing solution or by changing a pad or other surface covering.

Regulation: 3270.106(f)

Description: 2 feet apart

Noncompliance Area: During the inspection on 10/2/24 at rest time in the preschool room, there was not at least 2 feet of space on three sides of each child's cot.

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: 3270.14/3270.21

Description: Pertinent Laws & Regulations/General Health and Safety

Noncompliance Area: During the inspection on 10/2/24, the operator acknowledged that she did not have a policy and procedure to identify the recognition of potential signs and symptoms of shaken baby syndrome and abusive head trauma; strategies for coping with a crying, fussing, or distraught child; and addressing the prevention and identification of child maltreatment. Infants and toddlers receive care at this facility.

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. OCDEL Announcement C-22-03 addresses child care providers to develop a policy and procedure to identify the prevention of shaken baby syndrome, abusive head trauma, and child maltreatment. The policy must include, but is not limited to: Recognition of potential signs and symptoms of shaken baby syndrome and abusive head trauma; strategies for coping with a crying, fussing, or distraught child; and addressing the prevention and identification of child maltreatment.

Regulation: 3270.14/3270.21

Description: Pertinent Laws & Regulations/General Health and Safety

Noncompliance Area: During the inspection on 10/2/24, 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: PQAS approved Pediatric First Aid/CPR and Health and Safety training requirements.

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

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

Noncompliance Area: During the inspection on 10/2/24, the TB screening on file for staff person #1 was conducted on 5/12/23 and not within 12 months of initial hire at the facility (see LIS code sheet for date of hire). Staff person #8 did not update the health assessment on file every 24 months as required. This is evidenced by the most current health assessment on file dated 7/7/22.

Correction Required: A facility person providing direct care who comes into contact with the children or who works with food preparation shall have a health assessment conducted within 12 months prior to providing initial service in a child care setting and every 24 months thereafter. A health assessment is valid for 24 months following the date of signature, if the person does not contract a communicable disease or develop a medical problem. An adult health assessment must include tuberculosis screening by the Mantoux method at initial employment. Subsequent tuberculosis screening is not required unless directed by a physician, physician's assistant, CRNP, the Department of Health or a local health department.

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

Description: Exam communicable disease/Physician/CRNP assessment

Noncompliance Area: During the inspection on 10/2/24, the health assessment dated 8/18/23 on file for staff person #2 did not include an examination for communicable diseases and the results of that examination or include the physician's or CRNP's assessment of the person's suitability to provide childcare.

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

Regulation: 3270.25(a)

Description: Availability of certificate of compliance and applicable regulations

Noncompliance Area: During the inspection, the operator acknowledged that the parents are not provided Chapter 3270 regulations electronically.

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: 3270.27(a)(6)

Description: Emergency plan

Noncompliance Area: During the inspection on 10/2/24, the operator acknowledged that she has never had documentation on file regarding conducting annual emergency drills.

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

Regulation: 3270.27(c)

Description: Training regarding plan

Noncompliance Area: During the inspection on 10/2/24, the emergency plan was last updated on 2/27/24 with continuity of operations added. Facility and staff persons were not trained at the time of this plan update. This is evidenced by the last date of emergency plan training being conducted on 12/20/23.

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: During the inspection on 10/2/24, staff person #1, a provisional hire, did not have a completed FBI clearance on file and was observed working unsupervised in the infant room. Staff person #4 did not update the Child Abuse and FBI clearance every 60 months as required. This is evidenced by the current clearance dates of 7/12/24 and 7/13/24, respectively. The previous dates of the clearances on file are 3/28/19 and 3/29/19, respectively. Staff person #8 did not update the PA State Police, Child Abuse clearance and FBI clearance every 60 months as required. This is evidenced by the current clearances on file dated 11/30/23, 12/26/23 and 11/30/23, respectively. The previous clearance dates on file are 11/26/18, 11/26/18 and 11/29/18, respectively.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). 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. The CPSL was revised to include that clearances are updated every 60 months.

Regulation: 3270.36(b)(5)/3270.192(2)(ii)

Description: HS/GED + 2 yrs/Exp, educ., training prior to facility

Noncompliance Area: During the inspection on 10/2/24, staff persons #1, #2 and #3 did not have documentation of 2,500 hours of childcare experience on file and therefore, could not qualify as assistant group supervisors.

Correction Required: An assistant group supervisor shall have a high school diploma or a general educational development certificate and 2 years experience with children. A facility person's record shall include verification of child care experience, education and training prior to service at the facility.

Regulation: 3270.65/3270.76

Description: Protective Outlet Covers 5 yrs. or less /Building Surfaces

Noncompliance Area: During the inspection on 10/2/24, a protective receptacle cover was missing from the outlet in the toddler room. There were two holes in the wall above the wooden vent cover in the young toddler room.

Correction Required: Protective receptacle covers shall be placed in electrical outlets accessible to children 5 years of age or younger. 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: 3270.81

Description: Glass

Noncompliance Area: During the inspection on 10/2/24, the two sliding glass doors in the toddler room which lead to the outdoor play space did not have a visual strip or other visual identification on them.

Correction Required: A visual strip or other visual identification shall be placed on glass located in a traffic area, a child care space or a play space.

Regulation: 3270.95(a)/3270.95(b)

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

Noncompliance Area: During the inspection on 10/2/24, the manual monthly monitoring of the fire detection device was last documented as being conducted on 8/14/24 and not every 30 days as required.

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: 3270.103

Description: Small Toys and Objects

Noncompliance Area: A renewal inspection was conducted on 2/27/24. At that time, plastic bags containing diapers and wipes were observed in an unlocked drawer next to the changing table, approximately 18 inches high, where they were 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: 3270.123(a)(5)

Description: Designated release persons

Noncompliance Area: A renewal inspection was conducted on 2/27/24. At that time, the financial agreement for the following children did not include the names of the release persons: Child #1, Child #3, and Child #4,

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

Regulation: 3270.124(b)(3)

Description: Parent home/work address, phone

Noncompliance Area: A renewal inspection was conducted on 2/27/24. At that time, the emergency contact information for the following children did not include the work address and phone number of the parents: Child #1, Child #2, and Child #4,

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

Regulation: 3270.124(c)

Description: Each child care space

Noncompliance Area: A renewal inspection was conducted on 2/27/24. At that time, the emergency contact information was not located in each child care 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: 3270.14

Description: Pertinent Laws & Regulations

Noncompliance Area: A renewal inspection was conducted on 2/27/24. At that time, the facility bus used for field trips was inspected. The bus had not been inspected under Title 75 §4705 that requires all school buses be inspected annually by the PSP Commercial Vehicle Safety Division.

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.

Regulation: 3270.31(f)

Description: Health and Safety Training

Noncompliance Area: A renewal inspection was conducted on 2/27/24. At that time, the staff files were reviewed. The file for Staff Person #1 contained the six hour health and safety training completed 11/30/18, which is outside of the acceptable date range for the six hour training. The file for Staff Person #2 contained the six hour health and safety training completed 7/1/29, which is outside of the acceptable date range for the six hour training.

Correction Required: Staff persons shall complete professional development within 90 days of hire as listed in subsections (f)1-10. Staff person #1 and Staff Person #2 will have until 3/13/24 to complete the required training. Until such time as the required training has been completed, staff person #1 and Staff Person #2 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 #1 and Staff Person #2, then staff person #1 and Staff Person #2 may not work in a child-care position at the facility.

Regulation: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: A renewal inspection was conducted on 2/27/24. At that time, the staff files were reviewed. The file for Staff Person #3 included an FBI clearance request dated 7/6/23, which was after the staff's date of hire. The file did not include a completed FBI Clearance for Staff Person #3.

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. Staff Person #3 may not work in a child care position at the facility until an FBI Clearance is on file at the facility.

Regulation: 3270.36(b)(5)/3270.192(2)(ii)

Description: HS/GED + 2 yrs/Exp, educ., training prior to facility

Noncompliance Area: A renewal inspection was conducted on 2/27/24. At that time, the staff files were reviewed. Staff Person #3, an assistant group supervisor, did not have verification of any experience working with children on file at the facility.

Correction Required: An assistant group supervisor shall have a high school diploma or a general educational development certificate and 2 years experience with children. A facility person's record shall include verification of child care experience, education and training prior to service at the facility.

Regulation: 3270.66(a)

Description: Locked or inaccessible

Noncompliance Area: A renewal inspection was conducted on 2/27/24. At that time, Clorox cleaning spray was observed in an unlocked, floor level cabinet under the sink the overflow bathroom and was accessible to the children using the bathroom. The Clorox spray was labeled "keep out of reach of children."

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

Regulation: 3270.72(b)

Description: Screened

Noncompliance Area: A renewal inspection was conducted on 2/27/24. At that time, three small windows in the upstairs classroom were used for ventilation but were not equipped with screens.

Correction Required: Windows or doors used for ventilation shall be screened when open.

Regulation: 3270.82(j)

Description: Running water - diapering

Noncompliance Area: A renewal inspection was conducted on 2/27/24. At that time, there was no sink or source of running water in the young toddler 2 room or the infant room, where the children's diapers are changed at the changing table.

Correction Required: A source of running water for handwashing shall be present in infant and toddler diapering areas. If the running water does not flow directly into a drain that is connected to a sewage system, a receptacle shall be provided to contain the water used for washing. The receptacle shall be emptied into an approved sewage system at least once a day.

Regulation: 3270.95(a)/3270.95(b)

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

Noncompliance Area: A renewal inspection was conducted on 2/27/24. At that time, the thirty day testing log for the fire detection system was reviewed. The dates of testing were as follows, showing more than 30 days between testing on occasion: 3/15/23, 4/27/23, 5/16/23, 6/28/23, 7/10/23, 8/18/23, 9/26/23, 10/20/23, 11/9/23, 12/12/23, 1/23/24, 2/22/24.

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)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: Staff #1 hired as a provisional staff does not have a record of a PA State Police Clearance and a NSOR clearance.

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

Regulation: 3270.106(a)/3270.119

Description: Clean, age appropriate/Infant sleep position

Noncompliance Area: Per investigation on 9/22/22, staff interviews and observation revealed that on 9/16/22 and as an ongoing practice, child #1 and child #2 had been placed to sleep in infant seats that did not allow them to be in the sleeping position recommended by the American Academy of Pediatrics.

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.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.

Noncompliance Area: The emergency contact form on file for child # 1 did not have the address and phone number of the child's physician. The emergency contact from on file for child # 2 did not have the name and phone number of the child's physician.

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

Noncompliance Area: The emergency contact information on file for child # 1 did not have the address and phone number listed for the release persons.

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

Noncompliance Area: During a renewal inspection on 2/19/20, the certification rep observed snack being served to children in the young preschool room. Prior to snack being served, the children did not wash their hands.

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

Noncompliance Area: The director reported that there are 72 children enrolled at the facility. There is no group supervisor on staff as required for the group of 45 children or for the partial group of 45 children.

Correction Required: In a facility in which more than 45 children are enrolled, a group supervisor is required for the first group of 45 enrolled children and for each group or partial group of 45 additional enrolled children.

Noncompliance Area: The first aid kits in the child care spaces did not have all items; the preschool and infant room first aid kits were missing tweezers, soap, gloves, and scissors, the young toddler first aid kit was missing tweezers, soap, and gloves, the young preschool and school aged first aid kits were missing soap, scissors, tweezers, and gloves.

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.

Noncompliance Area: There is a green play mat in the infant room with torn edges. The oven door on the wooden play stove in the preschool room has a door hanging off the hinge.

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.

Noncompliance Area: Child # 1 started at the facility on 5/14/18 and there is no Child Service Report on file within 6 months.

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

Noncompliance Area: The emergency contact forms and financial agreements on file for children # 1 and # 2 were not updated once every six months. The emergency contact forms and financial agreements for child # 1 were reviewed and updated in May, 2018 and then again in December 2018. The emergency contact forms and financial agreements for child # 2 were reviewed and updated in March, 2018 and then December, 2018.

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.

Noncompliance Area: The health assessment for Child #1 shows that the child, 4 years old, has not received a flu vaccination. The health assessment for Child #2 shows that the child, 5 years old, has not received a flu vaccination. There is no letter of exemption on file for the flu vaccine for either child.

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.

Noncompliance Area: More than 24 months passed between health assessments for staff person # 1. The health assessment on file is dated 8/14/18 and the previous health assessment is dated 4/22/16.

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.

Noncompliance Area: There are no written non family references on file for staff person # 2.

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

Noncompliance Area: There is a crack in the wooden heater cover 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.

Noncompliance Area: On 11/27/18 during a compliant investigation Styrofoam cups were observed in the child care space. The operator admitted to using Styrofoam cups for drinking.

Correction Required: Styrofoam cups and plates may not be used.

Noncompliance Area: On 11/27/18 during a complaint investigation, the cert rep observed staff person # 2 to not be physically present with her group. Staff person # 2 was sitting at a table in the front of the facility working on paperwork and the children in her group were in the back of the facility around a corner where staff could not see, hear, direct, or assess the children in the 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.

Noncompliance Area: On 11/27/18, during a complaint investigation, there was no hands free lidded trash can in the diapering area.

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.

Noncompliance Area: On 11/27/2018, during a complaint investigation the certification rep observed staff # 1 to be out of ratio. Staff Person # 1 had one infant and 4 preschool children in their group.

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).

Noncompliance Area: On 11/27/2018, during a complaint investigation, the cert rep observed 6 school aged children in a room that has a capacity of 5.

Correction Required: Indoor child care space is measured within permanent stationary partitions or walls. The allowable number of children in a space is determined by dividing the total square feet in a space by 40.

Noncompliance Area: THERE IS NO RELEASE PERSON ADDRESS ON THE EMERGENCY CONTACT FORMS FOR CHILDREN # 1, 2, AND 3.

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.

Noncompliance Area: CHILD # 2 IS AN OLDER TODDLER; THE HEALTH REPORTS ON FILE WERE NOT UPDATED EVERY 12 MONTHS. HEALTH REPORTS ARE DATED 5/21/17 AND 1/30/18. CHILD # 3 IS AN OLDER TODDLER; THE HEATLH REPORTS ON FILE WERE NOT UPDATED EVERY 12 MONTHS. HEALTH REPORTS ARE DATED 6/3/15 AND 12/15/17.

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.

Noncompliance Area: THERE WERE TWO UNLABELED BOTTLES IN THE INFANT ROOM.

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

Noncompliance Area: THE CERAMIC SINK IN THE PRESCHOOL ROOM WAS NOT SECURELY ATTACHED TO THE CABINET BELOW. THE SLIDING CLOSET DOORS IN THE SCHOOL AGE ROOM WERE NOT SECURED ON THE TRACKS. THE DOORS WERE HANGING AND COULD EASILY FALL OFF. THE OUTDOOR CARPET IN THE PLAY SPACE WAS LOOSE AND FOLDED UP IN MANY AREAS CAUSING A TRIPPING HAZARD THROUGHOUT THE PLAY SPACE.

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.

Noncompliance Area: THERE ARE EXPOSED BOLTS ON FENCING AROUND OUTDOOR PLAY SPACE.

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.

Noncompliance Area: PACK & PLAYS IN INFANT ROOM ARE NOT LABELED FOR THE USE OF A SPECIFIC 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.

Noncompliance Area: THERE IS NO DAILY SCHEDULE POSTED IN INFANT, 1 YEAR OLD, 2 YEAR OLD, 3 YEAR OLD & SCHOOL AGE ROOMS

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

Noncompliance Area: CHILD #1, CHILD #2, CHILD #3 & CHILD #4 DO NOT HAVE HEALTH INSURANCE COVERAGE INFORMATION OR POLICY NUMBERS LISTED ON THEIR EMERGENCY CONTACT FORMS.

Correction Required: Emergency contact information must include health insurance coverage and policy number for a child under a family policy or Medical Assistance benefits, if applicable.

Noncompliance Area: THERE IS NO PLASTIC-LINED, HANDS-FREE, COVERED TRASH CAN FOR DISPOSABLE DIAPERS NEAR CHANGING TABLE

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.

Noncompliance Area: MENU IS NOT POSTED IN FACILITY

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

Noncompliance Area: BOTTLES IN INFANT ROOM ARE NOT LABELED.

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

Noncompliance Area: THE TWO YEAR OLD ROOM WAS OUT OF RATIO AS IT HAS ONE STAFF MEMBER WITH 6 CHILDREN, ONE OF WHOM IS 1 YEAR OLD.

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

Noncompliance Area: OPEN WINDOW IN 3 YEAR OLD ROOM HAS NO SCREEN

Correction Required: Windows or doors used for ventilation shall be screened when open.

Noncompliance Area: SCREENS IN SCHOOL AGE ROOM ARE RIPPED.

Correction Required: Screens shall be in good repair.