Raney Day Learning Center

Noncompliance Area: In the outdoor play space, many of the large "Little Tikes"- style play items, such as benches & ride-atop toys were covered with a green algae-like material and dirt.

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: In the front toddler room, where young toddlers were receiving care, a bin of small foam letter pieces were observed to be accessible to all of the children in the room.

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.

Noncompliance Area: The refrigerator lacked a working thermometer. It was discovered that the thermometer had been placed inside of the freezer instead.

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

Noncompliance Area: The Daily Activity Schedule posted in a room occupied by all PREK children was labeled as a Daily Activity Schedule intended for Older Toddlers.

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.

Noncompliance Area: It is unable to be determined what type of medical provider conducted & signed the health assessment for Child #4, as no initials, medical provider # or title are included.

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

Noncompliance Area: The immunization records for the following children are missing vaccines: Child #1- one dose of DTAP and influenza (none); Child #2- influenza (none); Child #3- 2 doses of pneumococcal pneumonia.

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.

Noncompliance Area: The most current health assessment for Staff #2 is dated more than 24 months ago.

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: A gallon of milk stored in the refrigerator appeared discolored and chunky. Upon closer inspection, the "by" date marked on the milk jug was March. It was determined that the milk was spoiled.

Correction Required: Food stored, prepared or served shall be clean, wholesome, free from spoilage, free from adulteration and safe for human consumption.

Noncompliance Area: Five bottles in the Infant room lacked labels with name of the child to whom it belongs.

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

Noncompliance Area: In the front toddler room, a can of disinfecting/ scent spray with hazard warnings and "Keep Out of Reach" labels and with the dispensers lacking caps, was observed to be stored in the same container and among diapering ointments.

Correction Required: Cleaning materials and other toxic materials shall be used in a way that does not contaminate play surfaces, food, food preparation areas and does not constitute a hazard to the children.

Noncompliance Area: The first-aid kit in the back PREK room lacked 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: Several patches of untreated plaster in the front toddler room and the hallway were observed to be flaking.

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

Noncompliance Area: The sink in the food preparation/ cooking area lacked 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.

Noncompliance Area: *2nd CITATION: During an unannounced corrections visit, in the PREK room, pieces of a broken drop-ceiling tile and other debris were still observed on the floor and now multiple ceiling tiles are observed to be missing, exposing insulation. Through this hole, the roof was visible. Buckets and now a plastic dish pan were observed on the floor to catch water leaks. The water in the dish pan is black. Several other tiles had water stains and now some of the plastic light cover tiles are warping. It is observed that no repair has been made and the correction date is past due and now a strong odor was brought to CR attention by the co-director. She also states that the vents in the room serve another child care space. PREVIOUSLY CITED ON 9/6/19.

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. All items harboring an odor or evidence of mold or mildew will be removed from the room.

Noncompliance Area: During an unannounced corrections visit, a PREKROOM CLOSED sign was observed on the door of a child care space. Upon entry into the room, pieces of a broken drop-ceiling tile and other debris were observed on the floor and a tile was missing from the ceiling, exposing insulation. Through this hole, the roof was visible. Buckets were observed on the floor to catch water leaks. Several other tiles had water stains. It was stated that over the holiday weekend, the operator came to the facility to drop off supplies and saw the damage. It was stated that the damage was caused by a leaky roof that finally broke through due to severe storms. It was stated that the room has been closed when care hours resumed.

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: In the outdoor play space, a layer of green algae is observed atop many of the hard-plastic Little Tikes-style toys, creating a slipping hazard.

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: Eighteen children were receiving care in the back room measured for 17 children.

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

Noncompliance Area: In the room adjacent to the front door (where the office is located), peeled-off paint was observed on the carpet near the corner by the closet.

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

Noncompliance Area: One purple chair in the PREK room was observed to shake and wobble, causing a tipping/ falling hazard. In the back Toddler space, the exposed metal hardware that remained from taking apart the expandable wooden bookcase/toy cases created a protrusion hazard.

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

Noncompliance Area: One preschool child was observed to use only a blanket as rest equipment. Staff stated that the parent forgot to send in the child's sleeping bag.

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: The thermometer in the refrigerator in the PREK room showed a temperature of 20 degrees; however, none of the food was frozen. When the Cert. Rep. took the temperature with the OCDEL-issued thermometer, the temperature read 45 degrees. Therefore, it was determined that the thermometer in the refrigerator was inoperable.

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

Noncompliance Area: The Agreement for Child #3 lacks a parental signature.

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

Noncompliance Area: The only Child Service Report in the file for Child #4, enrolled since 1/18, is dated approximately a year after initial enrollment.

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 Agreement for Child #3 lacks the child's arrival and departure times.

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

Noncompliance Area: The Agreement for Child #3 lacks parental designation of release individuals.

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

Noncompliance Area: The Agreement for Child #3 lacks the child's enrollment date.

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

Noncompliance Area: The Emergency Contact form for Child #3 lacks the name of the health insurer and the policy number, or an indication that the child does not have health insurance.

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: The Emergency Contact Form for Child #3 lacks the address of one 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.

Noncompliance Area: Health assessments show that the following children remain in care and are under-immunized as follows: Child #1, infant older than six months, lacks an influenza vaccine and 2 doses of each DTAP & Rotovirus; Child #2, an older toddler, lacks influenza vaccines since 2017 as well as one dose of DTAP; Child #4 lacks scheduled dose of the DTAP vaccine. No exemption letters are found in the file for these children.

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: The two most current health assessments for Staff #1 are dated more than 24 months apart.

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: The last two written reviews/ updates on the Agreement and Emergency Contact Form for Child #2 were dated more than six months apart.

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

Noncompliance Area: The file for Staff #2 lacked verification of Emergency Plan training.

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

Noncompliance Area: Staff #2, listed & performing duties of a Group Supervisor, lacks attainment of an Associate's degree or higher.

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

Noncompliance Area: Twenty preschoolers were observed receiving care in a child care space with a measured capacity for nineteen children. The Daily Activity Schedule lacked any indication of times when capacity is exceeded.

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

Noncompliance Area: In the PreK room down the hall to the left of the entrance, the temperature in the refrigerator measured 50 degrees.

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

Noncompliance Area: During the AM supervision/ ratio check, one infant appeared to be asleep in a bouncer. Staff #2 stated that the infant had just fallen asleep. During a check of rooms during lunch time, two infants appeared to be asleep in bouncers while Staff #2 was on the floor completing paperwork. When asked, Staff #2 stated that the infants had just fallen asleep. The Cert. Rep. left the room and conducted checks of two other rooms. Upon returning to the Infant room, the two infants were still sleeping in bouncers while Staff #2 continued to complete paperwork.

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.

Noncompliance Area: The Agreement for Child #4 lacked the names of release people.

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

Noncompliance Area: In the back PreK room, the bag stated to be used for excursions lacked an Emergency Transportation Plan.

Correction Required: A written plan identifying the means of transporting a child to emergency care and staffing provisions in the event of an emergency shall be displayed conspicuously in every child care space and shall accompany a staff person who leaves on an excursion with children.

Noncompliance Area: Health assessments for both Child #1 & 2 were dated after the 60th day of each child's first day of attendance.

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

Noncompliance Area: The two health assessments for Child #3 dated from when the child was a young toddler, are dated more than six months apart. It was explained that care for the young toddler had been temporarily discontinued since the health assessment was not received by the six-month mark.

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

Noncompliance Area: Medication logs for medications that had been documented to have been administered to Child #5 & 6 lack written parental consent.

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

Noncompliance Area: The last two evaluations for Staff #1 were completed more than twelve months apart

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

Noncompliance Area: The first-aid kit in the back PreK room lacked tweezers.

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

Noncompliance Area: The ceiling in the PreK room adjacent to the front door had started leaking and is currently under repair, rendering the space not usable for child care.

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: In the back PreK room, peeled paint chips were visible on the carpet on the long, windowed wall.

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

Noncompliance Area: During a ratio/ supervision check conducted at the outset of an unannounced complaint visit, Staff #1 was observed to be supervising six children in the toddler room next to the office. When asked the age of a child who appeared to be young, it was stated that the child was 18 months. Therefore, ratio was 1:6 with a group including a young toddler.

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: Temperatures in the Infant/ Young Toddler area measured 59 degrees with the Western Region issued thermometer. Staff stated that temperatures in the two preschool areas were unable to be maintained at 65 degrees.

Correction Required: The indoor temperature shall be at least 65 F.

Noncompliance Area: Portable space heaters were observed to be operating in both preschool rooms. One non-working space heater was observed in the office.

Correction Required: Portable space heaters are not permitted.

Noncompliance Area: In the right side PREK room, one wooden block was observed to be splintered, creating a splintering hazard. In the left side of the PREK room, one plastic toy bread piece was cracked at the seams, creating a pinching hazard. In the front OT room, one plastic toy bin was observed to be broken. In the outdoor play space, one wooden bench was observed to be splintered and rotted in places and one pink and white plastic toy box contained many pine needles and soiled paper towels.

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: In the Infant room, foam circles on the legs of one crib were observed to be uncovered and were missing chunks.

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.

Noncompliance Area: In the back PREK room, one sleeping bag lacked a label identifying to which child it belonged.

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: During facility nap time, one child each in the Infant/ YT room, the OT room and the side PreK room, was observed to have heads covered with their sleeping bags/ blankets.

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.

Noncompliance Area: The previous and current health assessments for Child #2, a Preschooler, were updated more than 12 months apart. The health assessment for Child #1, an Older Toddler, is dated more than 12 months ago.

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: In the Older Toddler room (office), Cert. Rep asked staff which hands-free garbage can was the diapering can. Staff indicated that the white can was the diapering can. When the can was checked, the pedal failed to open the lid, so it did not operate in a hands-free manner. In addition, soiled diapers were observed to be in both cans. Also, the hands-free can used for diapering in the restroom used for diapering in the restroom lacked a plastic liner.

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: In the Older Toddler Room (office), a spoon and a cup were observed to be sitting on the diapering sink. In the Infant side of the Infant/ YT room, a bin with cups and bottles were observed in the basin of the diapering sink.

Correction Required: The diapering area may not be used for food preparation or food service.

Noncompliance Area: The menu posted at the facility lacked the next week's menu.

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

Noncompliance Area: In the PREK room (side), peeling paint was observed on the carpet that was determined to be coming from the wall where two chairs sat against the wall.

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

Noncompliance Area: One plastic storage bin in the back Older Toddler room and one black plastic container in the left side of the front Pre-K room each was observed to be cracked, creating pinching/ cutting hazards. The diaper pad cover in the back Older Toddler room was observed to have several rips that exposed foam. In the Infant room, a high chair cushion was observed to have several pieces of ripping plastic on the back.

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. 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.

Noncompliance Area: The health assessment for Child #1 lacks a statement assessing the child's ability to participate in child care and the status of contagious or communicable diseases.

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.

Noncompliance Area: The health assessment for Staff #4, listed as a volunteer, lacked a TB test. A health assessment dated more than one year ago shows that the staff previously tested positive for TB. No updated chest x-ray was included in the file or on the current health assessment.

Correction Required: An adult health assessment must include tuberculosis screening by the Mantoux method at initial employment. Subsequent tuberculosis screening is not required unless directed by a physician, physician's assistant, CRNP, the Department of Health or a local health department. A facility person`s record shall include a written report of initial and subsequent health assessments, including the results of initial and subsequent tuberculin skin tests, x-rays or other medical documentation necessary to confirm freedom from communicable tuberculosis.

Noncompliance Area: Staff #5 was observed to have diapered a child and handing the child and a toy prior to the staff washing her own hands.

Correction Required: A facility person shall wash his hands before meals and snacks, and after toileting and after diapering a child.

Noncompliance Area: The PA Child Abuse clearance for Staff #1, listed as a Group Supervisor, was a "Volunteer" clearance, which is invalid for employment purposes. The "Child Abuse Prevention training" submitted to fulfill the Mandated Reporter training requirement for Staff #2 was provided by an entity not approved by DHS.

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.

Noncompliance Area: The file for Staff #3, listed as and completing duties of an Assistant Group Supervisor, lacks evidence of the required 2 years experience with children.

Correction Required: An assistant group supervisor shall have a high school diploma or a general educational development certificate and 2 years experience with children.