Small Wonders Day Care School

Regulation: 3270.191

Description: Individual Records

Noncompliance Area: During a water activity inspection on 7/21/26, Facility Person #1 acknowledged that they were acting in a lifeguard role and had proof of lifeguard certification. However, Facility Person #1, who is employed as a lifeguard, does not have an individual record at the facility.

Correction Required: An individual record is required for each facility person.

Regulation: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: During a water activity inspection on 7/21/26, Facility Person #1, who is employed as a lifeguard, acknowledged that they were acting in a lifeguard role, having direct contact and routine interaction with children. Facility Person #1 did not have proof of a completed disclosure statement or NSOR Clearance on file, and these were required prior to Facility Person #1 working with children.

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. Facility Person #1 may not work in a childcare position until all required paperwork is on file at the facility.

Regulation: 3270.102(a)

Description: Clean and good repair

Noncompliance Area: A child's desk in the 7th Grade Room, that was near the fish tank, had a cracked outlet plate cover on its side. A multi-colored foam block climber in the Infant Room had peeling plastic. The Jenga toy box lid in the Pre-K Room was cracked, creating a possible pinch or scratch 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.

Regulation: 3270.103

Description: Small Toys and Objects

Noncompliance Area: During lunch time, infants and young toddlers in the Infant Room were observed with thin, disposable plastic bibs around their necks, and one of the young toddlers placed a corner of the plastic bib in their mouth.

Correction Required: Toys and objects with a diameter of less than 1 inch, objects with removable parts that have a diameter of less than 1 inch, plastic bags and styrofoam objects may not be accessible to children who are still placing objects in their mouths.

Regulation: 3270.151(a)

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

Noncompliance Area: Staff #1 (see code sheet for first day with children) had a health assessment on file dated 11/13/25, which was completed after they began working with children.

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: 3270.31(e)

Description: Age and Training

Noncompliance Area: Staff #19 had 11 hours and 30 minutes of annual child care training on file, and not the required 12 clock hours of child care training.

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

Regulation: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: Staff person #4 had a Department of Education FBI clearance on file dated 8/8/2024, which is not suitable for employment in childcare, and not the required DHS FBI Clearance. Also, there was no proof on file showing that the proper FBI clearance was requested prior to Staff person #4 supervising children. During the inspection on 4/13/26, Staff person #4 was observed having routine interaction and direct contact with children in the Infant Room.

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 #4 cannot work in a child care position that involves direct contact or routine interaction with children until all required paperwork is completed and on file at the facility.

Regulation: 3270.75(b)

Description: Inaccessible to children

Noncompliance Area: The first aid kit, which was located in a black and gray bookbag in the Pre-K Room, was observed to be accessible to preschoolers who were being supervised in that room.

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

Regulation: 3270.133(4)/3270.133(5)

Description: Locked/Original label

Noncompliance Area: During a water activity, an EpiPen for Child #2 was observed in an unlocked Wilkes-Barre Academy bookbag that was labeled, "4th Grade First Aid." This EpiPen was accessible to children. Also, Albuterol Sulfate HFA Inhalation Aerosol medication for Child #3 was observed in a black and gray Wilkes-Barre Academy bookbag which was labeled, "1st Grade 1st Aid". This medication had an expiration date of 9/2024. In that same bookbag, there were medications for Child #1 that were expired. Child #1 was observed to have a CVS Health Children's Allergy Loratadine Oral Solution medication, which expired 7/2023 and a Children's Loratadine Oral Solution medication that expired on 3/2025.

Correction Required: Medication shall be stored in a locked area of the facility or in an area that is out of the reach of children. Medication shall be stored in accordance with the manufacturer's or health professional's instructions on the original label.

Regulation: 3270.66(a)

Description: Locked or inaccessible

Noncompliance Area: During a water activity, four packs of Insta Kool Instant Cold Compress, each labeled "keep out of reach of children," were observed in an unlocked "4th Grade First Aid" Wilkes-Barre Academy bookbag. These toxic items were 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.

Regulation: 3270.102(c)

Description: Outdoor equip.- protective surfacing

Noncompliance Area: An anchored plastic gray rock wall climber was observed in the Big Play Area. The climber was mounted over "Safety Turf Poured in Place". The climber had a fall height of 6.46 feet. However, ASTM fall height certification paperwork, which was provided by the facility, showed that the "Safety Turf Poured in Place" only protected children from a fall height of 5 feet, and not the required 6.46 feet.

Correction Required: Outdoor equipment that requires embedded mounting must be mounted over a loose-fill or unitary playground protective surface covering that meets the recommendations of the United States Consumer Product Safety Commission. The equipment must be anchored firmly and be in good repair.

Regulation: 3270.124(b)(3)

Description: Parent home/work address, phone

Noncompliance Area: The emergency contact information on file for Child #2 and Child #5 through Child #10 was observed to be missing a parent's work phone number.

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

Regulation: 3270.124(f)/3270.181(c)

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

Noncompliance Area: The emergency contact and financial agreement information on file for Child #1 through Child #6 and Child #9 were dated 8/2024 and 3/2025. More than 6 months had passed since a parent last reviewed, updated, and signed the emergency contact and financial agreement forms.

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

Regulation: 3270.131(a)/3270.182(1)

Description: Health information/Initial and subsequent health reports

Noncompliance Area: The only health assessment on file for Child #9 (see code sheet for admission date) was dated 2/25/25. This child did not have proof that they completed a health assessment within the 60 days following their first day of attendance at the facility.

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

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

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

Noncompliance Area: The only health assessment on file for Staff #9 (see code sheet for first day with children) was dated 3/14/25. The only health assessment and tuberculosis screening test on file for Staff #10 (see code sheet for first day with children) were dated 11/20/24. These were required to be completed within the 12 months prior to the staff providing initial service in a childcare setting. The health assessments on file for Staff #32 were dated 2/9/23 and 3/2/25. More than 24 months had lapsed between health assessments. The file for Staff #35 did not include any tuberculosis screening tests.

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: 3270.171(a)

Description: Pick-up and drop-off points

Noncompliance Area: There was no proof on file showing that the local traffic safety authorities had been notified in writing of the location of the facility and the program's use of pedestrian and vehicular routes around the childcare facility.

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

Regulation: 3270.27(c)

Description: Training regarding plan

Noncompliance Area: Staff person #10 (see code sheet for date of hire) did not have initial emergency plan training on file. This was required to be completed within 90 days of hire.

Correction Required: The operator shall assure that each facility person receives training regarding the emergency plan at the time of initial employment, on an annual basis and at the time of each plan update. The operator shall document the date of each training and the names of all facility persons who received the training and kept on file at the facility.

Regulation: 3270.31(e)

Description: Age and Training

Noncompliance Area: Staff #5 had 5 hours of annual childcare training on file and Staff #11 had 1 hour of annual childcare training on file. These staff were required to have an annual minimum of 12 clock hours of childcare training.

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

Regulation: 3270.31(f)

Description: Health and Safety Training

Noncompliance Area: Staff person #10 had not completed the following required pre-service trainings within 90 days of their date of hire (see code sheet for date of hire): Pediatric first aid/CPR and Health and Safety trainings.

Correction Required: Staff persons shall complete professional development within 90 days of hire as listed in subsections (f)1-10. Until such time as the required training has been completed, staff person #10 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 #10, staff person #10 may not work in a child-care position at the facility.

Regulation: 3270.32(a)

Description: Comply with CPSL

Noncompliance Area: Staff persons #2, #3, #8, and #32 had not completed mandated reporter training prior to the previous training expiring. This is evidenced by the mandated reporter trainings on file being dated 9/24/19 and 10/9/24 for Staff #2; 1/29/20 and 2/20/25 for Staff #3; 11/20/19 and 4/8/25 for Staff #8, and 11/30/19 and 1/18/25 for Staff #32. Also, Staff #4 and Staff #5 had not completed mandated reporter training within the last 60 months. The most recent mandated reporter trainings on file for Staff #4 was dated 3/5/20 and for Staff #5 was dated 11/23/19.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to Child Protective Services). Until such time as the required training has been completed, staff persons #4 and #5 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 persons #4 and #5, staff persons #4 and #5 may not work in a child-care position at the facility.

Regulation: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: The most recent Child Abuse Clearance on file for Staff #34 was dated 3/1/2020. This staff was required to obtain an updated Child Abuse Clearance by 3/1/25. The file for Staff #34 had State Police Clearances dated 2/13/20 and 2/26/25; DHS FBI Clearances dated 2/20/20 and 2/27/25; and NSOR Clearances dated 2/24/20 and 2/27/25. Also, the file for Staff #4 had State Police Clearances dated 8/16/19 and 8/22/24 and Child Abuse Clearances dated 8/27/19 and 9/5/24. More than 60 months had lapsed between each 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 #34 may not work in a childcare position that involves direct contact with children until all completed paperwork 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: Staff #9 did not have proof of any completed education on file, such as a high school diploma, which was required to qualify the staff as an assistant group supervisor.

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: 3270.76/3270.102(a)

Description: Building Surfaces/Clean and good repair

Noncompliance Area: Two brown stain ceiling tiles were observed near a white cabinet in the Fifth Grade classroom. One cracked ceiling tile was observed outside of the Toddler Room. The Sixth Grade classroom had two water-stained ceiling tiles. One of the tiles was significantly bowed out. The Seventh Grade classroom had four brown stained ceiling tiles and one cracked ceiling tile. Three blue and gray plastic rest mats in the Preschool Room were observed to be torn. The gazebo in the outdoor Toddler Play Area had two exposed nails. The Boys' and Girls' Restroom, located near the Pre-K Room, had one toilet with two exposed bolts near its base. The Girls' Middle School Restroom had one toilet with two exposed bolts near its base. The Boys' Lower School Restroom had two toilets with two exposed bolts near its base. One of these toilets also had a rough, rusted piece of metal on its waterline.

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. 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: 3270.77(a)

Description: No peeling paint or plaster

Noncompliance Area: The gazebo in the Toddler Play Area had chipped paint. Two green poles, that were attached to a wire fence in the Big Play Area, were also observed to have 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: 3270.106(f)

Description: 2 feet apart

Noncompliance Area: A renewal inspection was conducted on 4/10/24. In the Pre-K and Preschool classrooms during nap time it was observed that several children's cots did not have 2 feet space on three sides.

Correction Required: At least 2 feet of space is required on three sides of a bed, cot, crib or other rest equipment while the equipment is in use.

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

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

Noncompliance Area: A renewal inspection was conducted on 4/10/24. During naptime in the infant room, one of the staff persons identified supervising one infant, the second staff person identified supervising four infants. Cert rep observed 9 infants in the classroom, four infants were not identified as being supervised. In the Preschool classroom during naptime, two staff persons were present and each identified seven children they were supervising. Cert rep observed thirty children in the classroom, sixteen children were not identified.

Correction Required: Children on the facility premises and on facility excursions off the premises shall be supervised by a staff person at all times. Indoor 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 will establish a supervision policy. The policy will include how the facility will demonstrate their knowledge and ability to adequately supervise children at all times. The policy must focus on ensuring that each child is seen, heard, assessed and able to be directed at all times. The policy must include how the facility will ensure appropriate supervision during transition times and while in the indoor play area. The policy must also include a plan for each staff to be assigned the responsibility for supervision of specific children, including the requirement that the staff person know the names and whereabouts of the children in their assigned group and be physically present with the children in their group on the facility premises and on facility excursions off the facility premises. The legal entity must submit the policy to regional office for approval. All existing staff and new hires must be trained on the policy and sign an acknowledgment that must be kept on file.

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

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

Noncompliance Area: A renewal inspection was conducted on 4/10/24. During naptime in the infant room, one of the staff persons identified supervising one infant, the second staff person identified supervising four infants. Cert rep observed 9 infants in the classroom, four infants were not identified as being supervised. In the Preschool classroom during naptime, two staff persons were present and each identified seven children they were supervising. Cert rep observed thirty children in the classroom, sixteen children were not identified.

Correction Required: Children on the facility premises and on facility excursions off the premises shall be supervised by a staff person at all times. Indoor 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 their assigned group. The staff person shall be physically present with the children in their group on the facility premises and on facility excursions off the facility premises.

Regulation: 3270.124(b)(7)

Description: Name/address/phone release person

Noncompliance Area: A renewal inspection was conducted on 4/10/24. Child #1's emergency contact form did not list the release person's address.

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

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

Description: Immunization record/Dismissal policy

Noncompliance Area: A renewal inspection was conducted on 4/10/24. Child #2's immunization record indicates the child has 1 Hep A vaccine and no exemption letter is in child's file. This is not in accordance with the ACIP recommended schedule.

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). Child #2 will be removed from care by close of business on 4/10/24 until either the vaccination record is updated according to the ACIP recommended schedule or the parent provides an exemption letter.

Regulation: 3270.151(a)

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

Noncompliance Area: A renewal inspection was conducted on 4/10/24. The following staff did not update their health assessment every 24 months as required by regulation: Staff #1 current assessment dated 4/1/24, previous dated 2/3/22. Staff #2 current assessment dated 4/20/22, previous dated 2/9/20.

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: 3270.161(d)

Description: Potentially hazardous food refrigerated

Noncompliance Area: A renewal inspection was conducted on 4/10/24. Cert rep observed several children's lunchboxes brought from home that contained meat and dairy products. These items were not refrigerated and found in the children's cubbies in the Pre-k classroom.

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

Regulation: 3270.51

Description: Similar Age Level

Noncompliance Area: A renewal inspection was conducted on 4/10/24. In the infant room during naptime, cert rep observed two staff persons supervising 9 infants. It was reported that the third staff person went to the restroom and left two staff persons to supervise all 9 infants. Staff ratio to infant is 1:4.

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. The required staff:child ratios must be maintained at all times, including during naptime. The legal entity must create a policy regarding ratio which must include maintaining proper ratios when staff must leave the childcare space. The legal entity must submit the policy to Northeast regional office for approval. All staff must be trained and sign an acknowledgment that must be kept on file.

Regulation: 3270.51

Description: Similar Age Level

Noncompliance Area: A renewal inspection was conducted on 4/10/24. In the infant room during naptime, cert rep observed two staff persons supervising 9 infants. It was reported that the third staff person went to the restroom and left two staff persons to supervise all 9 infants. Staff ratio to infant is 1:4.

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.

Regulation: 3270.61(h)(2)/3270.61(h)(2)(ii)

Description: Measurement and use of indoor child care space/Designated on facility schedule

Noncompliance Area: A renewal inspection was conducted on 4/10/24. Cert rep observed the Pre-K classroom and Preschool classroom to be over capacity and this was not indicated on the facility's schedule of daily activities for a 30-minute special activity. The Pre-K classroom had 34 children and the capacity of the classroom is 31 children. The Preschool classroom had 31 children and the capacity of the classroom is 29 children. The operator stated that in the morning there is more children in the classrooms and certain children leave daily at noon bringing the classrooms back to capacity. It was indicated that the mornings are over capacity due to extra children only attending in the morning.

Correction Required: The capacity established for indoor space may not be exceeded except when older toddler, preschool or school-age children are participating in a program activity. When the number of older toddler, preschool or school-age children participating in a program activity exceeds the capacity of the child care space each time period shall be designated on the facility's schedule of daily activities.

Regulation: 3270.75(c)

Description: Has all items

Noncompliance Area: A renewal inspection was conducted on 4/10/24. The emergency bag first aid kit in the Preschool classroom did not contain a bottle of water. The operator acknowledged that this is the bag they take in case of an emergency.

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

Regulation: 3270.76

Description: Building Surfaces

Noncompliance Area: A renewal inspection was conducted on 4/10/24. In the boy's bathroom between the Preschool and Pre-K classrooms had a water damaged ceiling tile.

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: 3270.123(a)(3)/3270.181(c)

Description: Services proceeded/Emergency info/agreement updated 6 mos

Noncompliance Area: A renewal inspection occurred at the facility. A review of children's files was conducted. The following child service reports were not completed every 6 months as required by regulation: Child #1 current 1/2023 previous 12/16/21. Child #3 current 1/2023, no previous. Child #4 current 1/2023, previous 1/2022. Child #5 current 2/1/23, previous 2/8/22. Child #6 current 1/2023, previous 2/1/22. Child #7 current 1/2023, previous 2/1/22. Child #9 current 1/2023, previous 12/15/21. Child #10 current 1/2023, previous 1/2022.

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). 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: 3270.151(a)/3270.192(3)

Description: 12 months prior to service and every 24 months thereafter/Health assessment, TB test

Noncompliance Area: A renewal inspection occurred at the facility. A review of staff files was conducted. The following staff did not update their health assessment every 24 months as required by regulation: Staff #3 current assessment dated 2/16/23, previous dated 1/4/23. Staff #12 current assessment dated 3/22/23, previous dated 2/6/21. Staff #15 current assessment dated 3/23/23, previous dated 1/4/23. Staff #17 current assessment dated 3/13/23, previous dated 10/5/20. Staff #18 current assessment dated 3/31/23, previous dated 8/6/19. Staff #24 current assessment 3/10/23, previous dated 2/3/21. The following staff did not have a health assessment conducted within 12 months prior to providing initial service in a child care setting (see the code sheet for the dates of hire): Staff #30 health assessment and tuberculosis screening dated 2/8/23. Staff #33 health assessment and tuberculosis screening dated 12/21/22. Staff #34 tuberculosis screening dated 8/14/20. Staff #36 health assessment and tuberculosis screening dated 3/20/23. Staff #37 health assessment and tuberculosis screening dated 3/19/23.

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

Regulation: 3270.151(c)(2)/3270.192(3)

Description: Mantoux TB/Health assessment, TB test

Noncompliance Area: A renewal inspection occurred at the facility. A review of staff files was conducted. The following staff did not have a tuberculosis screening by the Mantoux method at initial employment. (see the code sheet for the dates of hire): Staff #30 tuberculosis screening dated 2/8/23. Staff #33 tuberculosis screening dated 12/21/22. Staff #34 tuberculosis screening dated 8/14/20. Staff #36 tuberculosis screening dated 3/20/23. Staff #37 tuberculosis screening dated 3/19/23.

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.

Regulation: 3270.161(d)

Description: Potentially hazardous food refrigerated

Noncompliance Area: A renewal inspection occurred at the facility. A physical site review was conducted. Children's lunchboxes brought from home were found and observed to include meat and dairy. These items were not refrigerated but found in the children's cubbies in the pre-k classroom.

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

Regulation: 3270.31(f)

Description: Health and Safety Training

Noncompliance Area: A renewal inspection occurred at the facility. A review of staff files was conducted. Staff persons #1through #19, #21 through #30, #32, and #33 did not complete the required one-hour 2022 update to the health and safety training by 12/30/2022.

Correction Required: Staff person #1 shall complete the required one-hour 2022 update to the health and safety training by 5/10/23.

Regulation: 3270.31(f)

Description: Health and Safety Training

Noncompliance Area: A renewal inspection occurred at the facility. A review of staff files was conducted. Staff persons #31 and #36 have not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): health and safety topics.

Correction Required: Staff person(s) shall complete professional development in the topics of 3270.31(f)(1 -- 9) within 90 days of hire. Staff persons #31 and #36 will have until 5/10/23 to complete the required training. Until such time as the required training has been completed, staff persons #31 and #36 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 persons #31 and #36, staff persons #31 and #36 may not work in a child-care position at the facility.

Noncompliance Area: A renewal inspection occurred at the facility and a review of children's files was conducted. Child file # 2 had a health assessment dated for 3/19/19 and at the time of the inspection had not yet been updated. Child # 2 is 4-years old and requires a health assessment every 12 months.

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.

Noncompliance Area: A review inspection occurred at the facility and a review of children's files was conducted. Child file # 1 had a health assessment dated for 3/2/20 and this health assessment did not include a review of the child's immunizations.

Correction Required: A health report shall include a review of the child's immunized status according to recommendations of the ACIP.

Noncompliance Area: A renewal inspection occurred at the facility and a review of staff files was conducted. Staff # 3 had a health assessment dated for 10/12/17 and not updated until 2/7/20. Staff # 7 had a health assessment dated for 6/27/17 and not updated until 2/14/20. Staff # 9 had a health assessment dated for 6/22/17 and not updated until 1/15/20. Staff # 12 had a health assessment dated for 6/20/17 and not updated until 6/17/20. Staff # 19 had a health assessment dated for 11/3/17 and not updated until 1/29/20. Staff # 21 had a health assessment dated for 5/19/17 and not updated until 8/13/19. Staff # 22 had a health assessment dated for 8/7/17 and not updated until 1/3/20. Staff # 24 had a health assessment dated for 1/24/18 and not updated until 11/13/20. Staff # 26 had a health assessment dated for 5/16/18 and this staff's health assessment has yet to be updated. Staff # 27 had a date of hire of 11/4/14 and this staff did not participate in a health assessment and tuberculosis screening until 2/27/20.

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: A renewal inspection occurred at the facility and a review of staff files was conducted. The Child Protective Services Law(CPSL) was revised to include the requirement for the National Sex Offender Registry(NSOR) clearance effective 9/30/2019. The CPSL also states that anyone hired before 9/30/19 had until 7/1/20 to obtain this clearance. The following staff have been employed at the center before 9/30/19 and at the time of inspection the files did not contain NSOR clearances dated prior to 7/1/20; Staff # 1, # 2, # 3 , # 4, # 5, # 6, # 7, # 8, # 10, # 11, # 12, and # 13. Staff # 2, # 4, # 6, # 7, # 8, # 9, # 10, # 12, # 13, # 14, # 16, # 18, # 19, # 22, # 23, # 24, # 25, # 26, # 27, # 28, # 29, # 30, and # 31. Staff # 32 was hired 12/20/19, Staff # 33 was hired 10/3/19, and Staff # 34 was hired 9/30/19; and the CPSL required these staff to have an NSOR at the time of hire. Staff # 32 did not have an NSOR clearance until 7/8/20, Staff # 33 until 7/9/20 and at the time of the inspection, Staff # 34 did not have an NSOR on file at the facility. The following staff were working with children during this inspection: Staff # 2, # 6, # 8, # 10, # 12, # 19, # 22, # 25, # 30, # 31, # 32, # 33 and # 34. The following staff have been employed at the center before 9/30/19 and at the time of inspection the files did not contain NSOR clearance; Staff # 11, # 15, # 17, # 20, # 21, # 34. Staff # 32 was hired provisionally on 12/20/19 and the file is missing documentation that this staff's NSOR clearance was applied for before working with children. Staff # 27 was hired provisionally on 11/4/19 and the file was missing documentation that his staff's NSOR clearance was applied for before working with children and was not received until 7/9/20, the child abuse clearance was not obtained until 11/8/19 and an FBI clearance was not obtained until 1/10/20. Staff # 33 was hired provisionally on 10/3/19 and the file was missing documentation that his staff's NSOR clearance was applied for before working with children. Staff # 34 was hired provisionally on 9/30/19 and the file was missing documentation that this staff's NSOR clearance was applied for before working with children. Staff # 34 does not have a completed NSOR clearance on file. Staff # 32, # 33 and # 34 was working with the children at the time of this inspection. The amendments to the CPSL also eliminated the ability to hire staff on a provisional hire basis beginning 12/31/19. In order to continue hiring staff provisionally the legal entity was required to apply to the Department for a waiver. The legal entity did not receive the provisional hire waiver approval until 1/7/20. The CPSL requires that mandated reporter training and clearances are updated every 60 months. Staff # 1 had a child abuse clearance dated for 7/2/15 and updated 7/8/20, and an FBI clearance dated for 7/7/15 that at the time of this inspection had not yet been updated. Staff # 2 had a child abuse clearance dated for 7/7/15 and updated 7/10/20, and an FBI clearance dated for 7/7/15 and updated 7/15/20. Staff # 3 had a child abuse clearance dated for 7/7/15 and updated 7/8/20, and an FBI clearance dated for 7/8/15 and updated 7/16/20. Staff # 4 had a child abuse clearance dated for 7/6/15 and updated 7/8/20. Staff # 5 had an FBI clearance dated for 5/29/15 and updated 7/17/20. Staff # 6 had a child abuse clearance dated for 7/6/20 and updated 7/8/20. Staff # 7 had an FBI clearance dated for 7/2/15 and updated 7/15/20. Staff # 8 had a child abuse clearance dated for 7/7/15 and updated 7/8/20 and an FBI clearance dated for 6/5/15 and updated 7/16/20. Staff # 9 had a state police clearance dated for 7/6/15 and updated 7/10/20, a child abuse clearance dated for 7/2/15 and updated 7/14/20, and an FBI clearance dated for 6/4/15 and updated 7/22/20. Staff # 10 had a child abuse clearance dated for 7/6/15 and updated 7/8/20. Staff # 11 has a state police clearance dated for 7/2/15, an FBI clearance dated for 6/2/15 and these clearances have yet to be updated. Staff # 12 had a child abuse clearance dated for 7/6/15 and updated 7/8/20. Staff # 13 had a state police clearance dated for 7/2/15 and updated 7/9/20, and an FBI clearance dated for 6/9/15 and updated 7/23/20. Staff # 14 had a child abuse clearance dated for 7/7/15 and updated 7/8/20. Staff # 15 had a state police clearance dated for 7/2/15 and updated 7/12/20, a child abuse clearance dated for 7/2/15, an FBI clearance dated for 7/7/15 and the child abuse and FBI clearances have yet to be updated. Staff # 16 had a child abuse dated for 7/7/15 and updated 7/8/20, and an FBI clearance dated for 6/5/15 and updated 7/12/20. Staff # 17 had a state police clearance dated for 7/2/15 and updated 7/31/20, a child abuse clearance dated for 7/2/15, an FBI clearance dated for 6/4/15 and the child abuse and FBI clearances have yet to be updated. Staff # 18 had a state police clearance dated for 7/2/15 and updated 7/9/20, a child abuse clearance dated for 7/2/15 and updated 7/14/20, and an FBI clearance dated for 6/5/15 and updated 7/22/20. Staff # 20 had mandated reporter training dated for 3/23/15 and the training has yet to be updated. Staff # 21 had a state police clearance dated for 8/20/14, child abuse clearance dated for 8/29/14 and these clearances have yet to be updated. Staff # 22 had an FBI clearance dated for 6/5/15 and updated 7/17/20. Staff # 25 had a state police clearance dated for 1/20/15 and updated 7/2/20, a child abuse clearance dated for 2/10/15 and updated 7/8/20, an FBI clearance dated for 3/5/15 and updated 7/22/20. Staff # 29 had a state police clearance dated for 7/2/15 and updated 7/9/20, a state police clearance dated for 7/7/15 and updated 7/14/20, and an FBI clearance dated for 6/3/15 and updated 7/22/20. These staff did not update their clearances or mandated reporter training every 60 months as required by CPSL.

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, # 2, # 3, # 4, # 5, # 6, # 7, # 8, # 9, # 10, # 11, # 12, # 13, # 14, # 15, # 16, # 17, # 18, # 19, # 20, # 21, # 22, # 23, # 24, # 25, # 26, # 27, # 29, # 30, # 31, # 32, # 33, # 34 may not work in a child care position at the facility.

Noncompliance Area: On the date of this renewal inspection, a physical site review was conducted. In the large outdoor play area, toys were found that were not in good repair. A ride on car, 2 hand held push cars, a scooter, and a chair were found that had areas that were cracked or with rough edges.

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: On the date of this renewal inspection, a physical site review was conducted. In the infant room, an infant was found sleeping in a crib with a toy attached to the side of the crib.

Correction Required: Toys, bumper pads, or pillows may not be present in a crib while an infant is sleeping in the crib.

Noncompliance Area: On the date of this renewal inspection, a physical site inspection was completed. In the small outdoor play area, a gazebo was found to have several areas of peeling paint.

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

Noncompliance Area: MEDICAL POLICY NUMBER IS MISSING FOR CHILD # 1.

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: STAFF MEMBERS 1,2 & 3 ALL HAD HEALTH ASSESSSMENTS CONDUCTED IN OVER 24 MONTHS FROM TIME OF HIRE.

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.