Rhyming Thyme Inc

Regulation: 3270.119

Description: Infant sleep position

Noncompliance Area: Upon arrival in the infant room at approximately 10:15am, a 2-month-old infant was observed sleeping in their crib on their stomach, which is not the sleeping position recommended by the American Academy of Pediatrics.

Correction Required: Infants shall be placed in the sleeping position recommended by the American Academy of Pediatrics unless there is a medical reason an infant should not sleep in this position. The medical reason shall be documented in a statement signed by a physician, physician's assistant or CRNP and placed in the child's record at the facility.

Regulation: 3270.123(a)(2)

Description: Date fee to be paid

Noncompliance Area: The file for Child #1 contained an Agreement form that was lacking that date on which 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)(6)/3270.182(2)

Description: Admission date/Application, admission, withdrawal dates

Noncompliance Area: The file for Child #1 contained an Agreement form that was lacking the child's admission date.

Correction Required: An agreement shall specify the date of the child's admission. A child's record shall contain the dates of application, admission and withdrawal of the child.

Regulation: 3270.131(b)(2)

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

Noncompliance Area: The file for Child #2 contained a child health report that was obtained 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.

Regulation: 3270.131(e)(1)

Description: Exemption documentation from parent/guardian

Noncompliance Area: The file for Child #2 contained an immunization record that was lacking 1 dose of DTAP, 2 doses of HIB, 1 dose of Pneumococcal, 1 dose of MMR, 1 dose of Varicella and 2 doses of Hepatitis A.

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: 3270.27(a)(5)

Description: Emergency plan

Noncompliance Area: The facility's emergency plan was lacking accommodations for infants and toddlers.

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

Regulation: 3270.27(a)(6)

Description: Emergency plan

Noncompliance Area: The facility was lacking a documented emergency drill within the past year.

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

Regulation: 3270.32(a)

Description: Comply with CPSL

Noncompliance Area: The file for Staff #1 contained 2 child abuse clearances that were more than 60 months apart. The file for Staff #3 and #4 both contained 2 state police clearances, 2 child abuse clearances and 2 FBI clearances that were all more than 60 months apart.

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

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

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

Noncompliance Area: The file for Child #3, a young toddler age child, contained a health assessment that was more than 6 months old.

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(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 #1, who is a preschool aged child, contained two health assessments that were more than 12 months apart. The file for Child #2, who is a older toddler aged child, contained two health assessments that were more than 12 months apart.

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: 3270.131(e)(1)

Description: Exemption documentation from parent/guardian

Noncompliance Area: The file for Child #3 contained an immunization record that was lacking one dose of HIB and one dose of Pneumococcal vaccines.

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: 3270.135(a)(3)

Description: Disposable diapers

Noncompliance Area: In the infant room, soiled diapers were observed being placed into plastic bags and placed out on a deck. The hands-free garbage can in the infant room was not operable.

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: 3270.25(a)

Description: Availability of certificate of compliance and applicable regulations

Noncompliance Area: The facility was lacking information to parents on how to access the 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: 3270.32(a)

Description: Comply with CPSL

Noncompliance Area: The file for Staff #1 contained two state police clearances dated 1.6.20 and 1.13.25, two child abuse clearances dated 1.6.20 and 1.13.25, two FBI clearances dated 1.8.20 and 1.14.25 and two NSOR certificates dated 12.6.19 and 12.16.24 all of these were more then the 60 month requirement of the CPSL. The file for Staff #2 contained two child abuse clearances dated 9.2.19 and 10.29.24 which is more than the 60 month requirement of the CPSL.

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

Regulation: 3270.82(h)

Description: Handwashing signs

Noncompliance Area: During observation of two diaper changes in the infant room, the staff member did not wash her hands or the children's hands after each diaper change.

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: 3270.123(a)(6)

Description: Admission date

Noncompliance Area: The financial agreement of child #1 and #2 did not contain the child's admission date.

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

Regulation: 3270.123(b)

Description: Parent receives original

Noncompliance Area: The file of child #3 and #5 contained the original financial agreements.

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

Regulation: 3270.124(b)(2)

Description: Physician name, address, phone

Noncompliance Area: The emergency contact information of child #6 did not include the name, address and telephone number of the child's physician or source of medical care.

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

Regulation: 3270.124(b)(3)

Description: Parent home/work address, phone

Noncompliance Area: The emergency contact information of child #1, #5 and #6 did not include the work address and work telphone number of the enrolling parent.

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

Regulation: 3270.124(b)(5)

Description: Information re: special needs

Noncompliance Area: The emergency contact information of child #1 did not include information on the child's special needs, as specified by the child's parent, physician, physician's assistant or CRNP, which is needed in an emergency situation or documentation this is not applicable to the child.

Correction Required: Emergency contact information must include information on the child's special needs, as specified by the child's parent, physician, physician's assistant or CRNP, which is needed in an emergency situation.

Regulation: 3270.124(b)(7)

Description: Name/address/phone release person

Noncompliance Area: The emergency contact information of child #1 did not include the address of a release person 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)/3270.182(1)

Description: Health information/Initial and subsequent health reports

Noncompliance Area: The file of child #6, who has been enrolled more than 60 days (see coded LIS sheet), did not have an initial health assessment.

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

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

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

Noncompliance Area: The file of child #1, identified as a young toddler (see coded LIS sheet), contained a health assessment dated 5/16/2023 but did not contain an updated health assessment within 6 months. The file of child #2, also identified as a young toddler (see coded LIS sheet), contained a health assessment dated 11/17/2022 and an updated assessment dated 9/21/2023, exceeding 6 months.

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(b)(2)/3270.182(1)

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

Noncompliance Area: The file of child #3, identified as a preschool aged child (see coded LIS sheet), contained health assessment dated 8/10/2022 but did not have documentation of an updated assessment within 12 months. The file of child #4, identified as a preschool aged child (see coded LIS sheet), contained health assessments which were dated more than 12 months apart (1/6/2021 and 1/12/2024). The file of child #5, now identified as an older toddler, contained a health assessment dated 2/11/2022 and did not contain an updated health assessment as a young or older toddler.

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

Description: Immunization record/Dismissal policy

Noncompliance Area: The immunization records of child #2 and #5 were not in accordance with the recommendations of the ACIP and acceptable exemptions were not on file.

Correction Required: A health report shall include a review of the child's immunized status according to recommendations of the ACIP. The facility shall implement dismissal policies in accordance with the Department of Health regulation in 28 Pa. Code § 27.77 (relating to immunization requirements for children in child care group settings).

Regulation: 3270.14/3270.21

Description: Pertinent Laws & Regulations/General Health and Safety

Noncompliance Area: Staff person #1 was observed to be caring for children unsupervised. Staff person #1 has not completed the following pre-service training required prior to caring for children unsupervised: Pediatric first aid and pediatric CPR.

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)

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

Noncompliance Area: The file of facility person #4 contained a health assessment dated 5/15/2021 and a signed health assessment form dated 5/22/2023, however, the health assessment form was incomplete and did not confirm a physical exam was conducted, they appear to be free from communicable disease and are suitable to provide child care.

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: 3270.181(c)

Description: Emergency info/agreement updated 6 mos

Noncompliance Area: Documentation of review and/or update to the emergency contact information and financial agreements exceeded 6 months for child #2 and #3. The file of child #5 contained documentation of the last review and/or update to the emergency contact information and financial agreement being completed on 3/21/2022, lacking a review/update within the past 6 months.

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

Regulation: 3270.181(d)

Description: Dated signature affixed

Noncompliance Area: The financial agreement of child #6 was signed, but not dated by the child's parent.

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

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

Description: Age and Training

Noncompliance Area: The file of staff person #2, #3, #4, #6 and #7 contained documentation of pediatric first aid and pediatric CPR which was updated after the expiration of the prior certification.

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: The file of staff person #2 contained documentation of the 1-hour health and safety update training dated 12/5/2023, more than 90 days from staring at the facility (see coded LIS sheet). The file of staff person #8 contained documentation of training listed in subsections (f)1-9 dated 12/10/2023, which was more than 90 days from their start date at the facility (see coded LIS sheet).

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

Regulation: 3270.32(a)

Description: Comply with CPSL

Noncompliance Area: The file of staff person #1 contained a completed disclosure statement, however, it was not on the current form. The NSOR application (dated 1/8/2024) and NSOR verification certificate (dated 1/10/2024) of staff person #1 were both dated after their start date at the facility (see coded LIS sheet). The file of staff person #3 contained PA state police clearances (9/10/2018 and 1/9/2024) and child abuse clearances (9/18/2018 and 1/9/2024) which are dated more than 60 months apart. The PA state police clearances of staff person #5 were dated more than 60 months apart (6/15/2018 and 7/28/2023).

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

Regulation: 3270.76

Description: Building Surfaces

Noncompliance Area: A portion of the fence in the infant/toddler outdoor play space was damaged by a tree that had fallen. A section of the fence was bent in towards the playground and exposed the children to sharp areas of the fence.

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: 3270.94(a)(1)

Description: Every 60 days

Noncompliance Area: Documentation of fire drills exceeded 60 days on the following dates: 1/3/2023 to 3/3/2023 and 10/26/2023 to 12/26/2023.

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

Regulation: 3270.124(b)(2)

Description: Physician name, address, phone

Noncompliance Area: The emergency contact information of child #1 did not contain the address and telephone number and child #3 did not contain the phone number of the child's physician or source of medical care.

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

Regulation: 3270.124(b)(3)

Description: Parent home/work address, phone

Noncompliance Area: The emergency contact information of child #3 did not contain the work address or telephone number of the enrolling parent.

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

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

Description: Immunization record/Dismissal policy

Noncompliance Area: The immunization record of child #1 (correction #2/added 2/22/2023) did not contain 1 polio, 1 Hep A, and a current influenza vaccination and child #3 did not contain a current influenza vaccination as recommended by the ACIP or an acceptable exemption.

Correction Required: A health report shall include a review of the child's immunized status according to recommendations of the ACIP. The facility shall implement dismissal policies in accordance with the Department of Health regulation in 28 Pa. Code § 27.77 (relating to immunization requirements for children in child care group settings).

Regulation: 3270.14/3270.21

Description: Pertinent Laws & Regulations/General Health and Safety

Noncompliance Area: The emergency plan did not include a plan for continuity of operations which may include backing up or retrieving health and other key records/files and managing financial issues such as paying employees and bills during the aftermath of the disaster, or a contingency plan/contingency fund which can help strategize paying for repairs, paying staff, and continuing to run the business after a disaster or emergency.

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: 3270.14/3270.21

Description: Pertinent Laws & Regulations/General Health and Safety

Noncompliance Area: The requirement of taking an additional one-hour training course titled, "Pennsylvania Health and Safety Update 2022" for facility staff who have taken the "Health and Safety Basics" training or "Get Started with Center- Based Care: Building Blocks for Quality" (taken before 10/4/2022) was completed after 12/30/2022 by facility person #5 (1/5/2023), #6 (1/6/2023), #7 (1/5/2023), #8 (1/5/2023), #9 (1/5/2023) and #10 (1/6/2023).

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: 3270.151(a)

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

Noncompliance Area: Documentation of the updated health assessment (dated 4/20/2022) of facility person #6 exceeded 24 months from the prior health assessment (dated 8/14/2020).

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

Regulation: 3270.166(4)

Description: Bottles labeled

Noncompliance Area: A bottle, which was in the refrigerator of the kitchen, was not labeled with the name of the child for whom it was intended.

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

Regulation: 3270.27(a)(5)

Description: Emergency plan

Noncompliance Area: Accommodations for infants and toddlers in the event of an emergency was not located in the emergency plan.

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

Regulation: 3270.27(a)(6)

Description: Emergency plan

Noncompliance Area: Documentation of emergency drills were not provided at the inspection.

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

Regulation: 3270.31(f)

Description: Health and Safety Training

Noncompliance Area: Documentation of 9/10 health and safety topics listed in subsections (f)1-10 were dated 10/27/2022, which was more than 90 days from the start date of facility person #2 (see coded LIS sheet).

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

Regulation: 3270.32(a)

Description: Comply with CPSL

Noncompliance Area: The file of facility person #1 (see coded LIS sheet) contained a household member child abuse clearance dated 10/21/2021. The file of facility person #2, employed over 45 days (see coded LIS sheet), did not contain a completed NSOR verification certificate and facility person #3 contained an application for the NSOR verification certificate dated 10/27/2022 which was after their start date (see coded LIS sheet) but now has a completed NSOR certificate. The PA state police (dated 2/22/2017) and child abuse (dated 2/22/2017) clearances of facility person #4, who was doing administrative work at the facility, were not current when rehired (see coded LIS date) and their FBI clearance was not renewed prior to its expiration on 7/20/2022. They are now current. The PA state police clearance of facility person #5 was dated 4/20/2022, which was updated more than 60 months from the prior clearance dated 2/14/2017 and their child abuse clearance was dated 2/14/2017 and updated 12/12/2022, which was over 60 months, but was also a child abuse clearance for a household member and not for employment.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). Facility Person # 1, 2 and 5 may not work in a child care position at the facility.

Regulation: 3270.71

Description: Heat Source

Noncompliance Area: A bottle warmer was observed on the shelf below the changing table accessible to children. Based on discussion with facility person #3, the bottle warmer is used on this shelf to warm the bottles. When the warmer was turned on, the heat exceeded 110 degrees F.

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: 3270.75(c)

Description: Has all items

Noncompliance Area: The first-aid kit in the blue room, across from the office, did not contain tape.

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

Regulation: 3270.95(a)/3270.95(b)

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

Noncompliance Area: Documentation of testing the fire detection system exceeded 30 days: 1/3/2022 to 2/4/2022 and 3/4/2022 to 4/6/2022 and 5/6/2022 to 6/8/2022 and 7/8/2022 to 8/10/2022.

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

Regulation: 3270.102(a)

Description: Clean and good repair

Noncompliance Area: Observed two cracked toy bins in the purple/green room.

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

Regulation: 3270.103

Description: Small Toys and Objects

Noncompliance Area: Observed a tear on the blue couch in the young toddler room. This exposed the inner foam which can create a potential choking hazard for children who are still placing objects in their mouths.

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: 3270.124(b)(2)

Description: Physician name, address, phone

Noncompliance Area: The emergency contact form for child #1 did not include the name, address and telephone number of the child's physician or source of medical care.

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

Regulation: 3270.124(b)(3)

Description: Parent home/work address, phone

Noncompliance Area: The emergency contact form for child #2 did not include the work addresses and telephone numbers of the enrolling parent. The emergency contact form for child #3 did not include the home telephone numbers of the enrolling parent.

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

Regulation: 3270.124(c)

Description: Each child care space

Noncompliance Area: The emergency contact binder in the purple/green room did not contain the emergency contact form for child #3 who was receiving care in the room.

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

Regulation: 3270.131(a)/3270.182(1)

Description: Health information/Initial and subsequent health reports

Noncompliance Area: The initial health assessment in the file for child #5 was conducted more than 90 days after the child's first day of attendance in the facility.

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

Regulation: 3270.131(e)(1)/3270.182(1)

Description: Exemption documentation from parent/guardian/Initial and subsequent health reports

Noncompliance Area: The most recent immunization records in the files for child #2, #3, and #4 did not include documentation of a flu shot administered in the past year or a letter of exemption from the parent or physician.

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

Regulation: 3270.31(f)/3270.192(2)(iii)

Description: Health and Safety Training/Exp, educ., training at facility

Noncompliance Area: The files for staff persons #1 and #2 who have been working at the facility for more than 90 days did not include documentation of Health and Safety training.

Correction Required: Staff persons shall complete professional development in the following topics within 90 days of hire:A facility person's record shall include verification of child care experience, education and training following the outset of service at the facility.

Regulation: 3270.76

Description: Building Surfaces

Noncompliance Area: Observed a crack in the electrical plate cover for the cable line in the purple/green room.

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

Regulation: 3270.77(a)

Description: No peeling paint or plaster

Noncompliance Area: Observed cracked plaster above the toilet in the pink bathroom by the infant room.

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

Noncompliance Area: Observed in the Green/Yellow Room: Cracks in the lid of the clear toy bin. This creates sharp edges and possible pinch points for children in care.

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: Observed less than two feet of space between two cribs in the left Infant Room, where Child #3 was napping. Observed less than two feet of space between three cribs in the Right Infant Room, where Child #2, #4 and #5 were napping.

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.

Noncompliance Area: The most recent Child Service Reports in the file for Child #7 exceeded 6 months between reports. December 2018-November 2019. The most recent Child Service Report in the file for Child #7 is current.

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 Binder in the Purple/Green Room did not include an Emergency Contact Form for Child #1 who was receiving care in this area. The Emergency Contact Binder in the Right Infant Room did not include an Emergency Contact Form for Child #2 who was receiving care in this area.

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.

Noncompliance Area: The initial health report in the file for Child #6 was conducted more than 60 days after the child's first day in attendance. This health report is current.

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

Noncompliance Area: The file for Child #3, an infant, did not include an updated health report conducted within the past 6 months.

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.

Noncompliance Area: The most recent immunization records in the files for Child #3, #7 and #8 were not in accordance with the schedule recommended by the ACIP. Child #3: 11 months old: Missing 3rd DTAP and 3rd PCV13. Child #7: No record of flu shot. Child #8: No Flu Shot within past 12 months (October, 2018).

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

Noncompliance Area: The most recent health assessments in the files for Staff Person #3 and #4 exceeded 24 months between assessments. The initial health assessment in the file for Staff Person #7 was conducted after the staff person's first day providing child care. The most recent health assessments in the files for all three staff persons are current.

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. 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: Observed two pairs of adult scissors, which were accessible to children, on the teacher's desk in the first floor School-Age Room.

Correction Required: Conditions at the facility may not pose a threat to the health or safety of the children.

Noncompliance Area: The most recent annual fire safety trainings for the facility were conducted more than 12 months apart: 7/20/18-8/27/19. The most recent fire safety training for the facility is current.

Correction Required: Staff persons shall participate, at least annually, in firesafety training conducted by a fire protection professional. Staff persons and volunteers shall receive training in maintenance of smoke detectors, the duties of facility persons during a fire drill and during a fire and the use of the facility's fire extinguishers, not including discharge of the fire suppressant agent. 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: The most recent State Police and Child Abuse clearances in the file for Staff Person #1 exceeded 60 months between clearances: State Police: 9/13/14-1/6/20. Child Abuse: 9/24/14-1/6/20. The most recent FBI Clearance in the file for Staff Person #1 had not been conducted within the past 60 months: 9/6/14. The FBI Clearance in the file for Staff Person #6, with a start date of 6/11/19, was on the PDE Form.

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. Facility Person # 1 and #6 may not work in a child care position at the facility.

Noncompliance Area: The most recent written evaluations in the file for Staff Person #2 were conducted more than 12 months apart: 6/10/18-7/23/19. The first written evaluation in the file for Staff Person #5 was conducted more than 12 months after the staff person's start date: Start Date: 6/20/18. Evaluation: 7/23/19. The most recent evaluations in the files for both staff persons are current.

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: Observed in the Preschool/School-Age Playground: Splintering wood on the left post, a section separating on the left side, and three protruding nails in the rear section of the wooden fence surrounding the play area. Holes, which creates a potential trip hazard, in the rubberized play surface where poles had been removed. Observed in the left Infant Room: Floor register separating from the wall, which creates a potential pinch point.

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: Observed flaking paint on the wooden door under the patio and under the deck floor ceiling in the Preschool/School-Age Playground. Observed flaking, peeling paint on the purple concrete blocks on each side of the steps leading to the Toddler Play Area.

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

Noncompliance Area: The waste receptacle in the boy's bathroom lacked a lid.

Correction Required: A toilet area, training chair area, diapering area and sink area shall be equipped with a clean, lidded waste receptacle.

Noncompliance Area: Based on interviews, it was determined that on 1/17/19, from 5:04-5:08 PM, Staff Person #1 left her group of children to use the restroom. This left Staff Person #2 responsible for supervising 13 children of mixed age levels, Older and Younger School Age, during this time.

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). 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: The Emergency Contact Form in the file for Child #4 did not include the addresses 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: The files for Child #2 and Child #6, who are school-age children, did not include current health assessments.

Correction Required: The initial health report for a school-age child must be dated in accordance with the requirements for medical examinations for school attendance in 28 Pa. Code 23.2 (relating to medical examinations). A child's record shall contain initial and subsequent health reports.

Noncompliance Area: The most recent parental update for the Emergency Contact Form and Fee Agreement in the file for Child #1 is not current: 1/10/18. The Emergency Contact Form and Fee Agreement in the file for Child #3 have not been updated since enrollment: 3/15/18. The Emergency Contact Form and Fee Agreement in the file for Child #4 has not been updated since enrollment: 6/15/18.

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 files for Child #5 and #7 did not include a copy of the initial fee agreement.

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.

Noncompliance Area: A sharp knife was observed in a drawer that did not contain a child-proof lock in Kitchen 612.

Correction Required: Conditions at the facility may not pose a threat to the health or safety of the children.

Noncompliance Area: A can of Pledge spray was observed in a cabinet under the sink that did not contain a child-proof lock in Kitchen 612.

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

Noncompliance Area: The first aid kit in the Hatch Table Room lacked tweezers. The first aid kit in the Infant Room lacked tape.

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

Noncompliance Area: A metal vent cover with a frayed sharp edge was observed on the building in the outdoor play 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: Teeth marks were observed on the foam pegboards in the Early Head Start Room. This creates a possible choking hazard for children who are still placing objects in their mouths.

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 initial health assessment in the file for Staff Person #1 did not include the results of the tuberculosis screening.

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: The file for Staff Person #2, whose first day working in child care was 5/21/18, did not include a copy of the Child Abuse or State Police clearance. Staff Person #2 was not hired as a provisional 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.

Noncompliance Area: A bottle of rubbing alcohol was observed in an unlocked cabinet in the Head Start Room. A bottle of bleach cleaner was observed in an unlocked cabinet in the Shining Stars Room.

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

Noncompliance Area: The plastic cover was peeling on the sink cabinet in the Preschool Room, which created a possible pinch point. The door frame covering the utility room in the Early Head Start was separating from the wall, which creating a possible pinch point.

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: Peeling paint was observed on the baseboards of the Early Head Start Room. Peeling paint and flaking plaster was observed around the bottom door hinge of the purple exit door 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.

Noncompliance Area: In the Twaddler room, tacks and google eyes were observed in a drawer that was accessible to children who are still placing objects in their mouths.

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 file for child #1 lacked an agreement that specified the child's arrival and departure times.

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

Noncompliance Area: The file for child #1 lacked a health assessment.

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 file for staff person #1 lacked a health assessment that included a physical examination.

Correction Required: An adult health assessment must include a physical examination.

Noncompliance Area: The file for staff person #1 lacked a health assessment that included an examination for communicable diseases and the results of that examination. The health assessment lacked information on medical problems that might threaten the health of the children or prohibit a staff person from providing adequate care to children.

Correction Required: An adult health assessment must include an examination for communicable diseases and the results of that examination. An adult health assessment must include information on medical problems that might threaten the health of the children or prohibit a staff person from providing adequate care to children.

Noncompliance Area: The file for staff person #2, whom was hired as an assistant group supervisor at the facility, lacked an FBI Clearance form. The rap sheet was in the file.

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. Facility Person #2 may not work in a child care position at the facility.

Noncompliance Area: In the kitchen at 612, a power strip by the kitchen table was observed to not have a protective receptacle cover in one of the outlets accessible to children 5 years of age or younger.

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

Noncompliance Area: In the school age room, a disinfectant spray was observed in an unlocked drawer accessible to the 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.

Noncompliance Area: The first-aid kit in the Infant II room at 312, did not contain tape.

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

Noncompliance Area: In the young toddler restroom downstairs at 612 peeling paint was observed on the wall above the toilet.

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

Noncompliance Area: Tears were observed in the small blue couch in the young toddler room and the small black couch in the foyer area. Each of these exposes the inner foam, which creates a potential choking hazard for children who are still placing objects in their mouths.

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 file for Staff Person #1 included only one written, nonfamily reference from an individual 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