Stepping Stones Daycare and Learning Center

Regulation: 3280.106

Description: Refrigerator

Noncompliance Area: The refrigerator, in the toddler room, used for childcare was lacking an operating thermometer.

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

Regulation: 3280.124(c)

Description: Each child care space

Noncompliance Area: All rooms lacked the required emergency contact information for the children receiving care in the space.

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

Regulation: 3280.124(e)

Description: Written emergency plan posted

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

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

Regulation: 3280.166(1)

Description: Written statement

Noncompliance Area: There were no written feeding plan(s) given by the parent(s) for any of the infant(s) under 1 year old who were receiving care.

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

Regulation: 3280.182(2)/3280.182(8)

Description: Application, admission, withdrawal dates/Copy of initial and subsequent agreements. Parent receives original.

Noncompliance Area: The file for child #1, #2, #3 and #4 lacked a fee agreement form. (SEE LIS CODE SHEET)

Correction Required: A child's record must contain the dates of application, admission and withdrawal of the child. A child's record must contain a copy of the initial agreement and subsequent written agreements between the parent and the operator. The parent receives the original agreement.

Regulation: 3280.76

Description: Building Surfaces

Noncompliance Area: In the main room, the vinyl floor plank tile was secured by peeling, black duct tape and the tile was lifting posing a tripping hazard.

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

Regulation: 3280.77(a)

Description: No peeling paint or plaster

Noncompliance Area: The archway leading into the kitchen and toddler room had peeling paint. Next to the bay windows in the toddler room and sand table was 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: 3280.102(a)

Description: Clean and good repair

Noncompliance Area: In Room #3, to the right of the entrance door and to the right of the window, there was a three-tiered bookshelf with a broken top shelf, which posed a cutting hazard. Additionally, a missing screw caused the bookshelf to be unstable, creating a tipping 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: 3280.26(d)

Description: Plan posted

Noncompliance Area: A copy of the facility's current Emergency Plan was not posted in a conspicuous place.

Correction Required: The operator shall post the emergency plan in the facility at a conspicuous location.

Regulation: 3280.32(a)/3280.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: The file(s) for Staff #1 lacked the Child Abuse Clearance and the NSOR Certificate. (SEE LIS CODE SHEET)

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

Regulation: 3280.75(c)

Description: Has all items

Noncompliance Area: The First Aid Kits in Rooms #1, #2, #3 and #4 were lacking Soap and Scissors.

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: 3280.76

Description: Building Surfaces

Noncompliance Area: In Room #3, on the wall across from the room's entrance, there was a service disconnect panel. The electrical panel door was not locked, making two fuses accessible to children. Additionally, the main lever (throw switch) was not secured in the "ON" position. These conditions posed a potential electrocution hazard. At the back of the facility, on the deck, there was a cracked window with exposed sharp edges, which posed a cutting hazard. In the main hallway on the first floor, across from the children's restroom, there was an unlocked door leading to the basement stairs which posed a falling hazard.

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

Noncompliance Area: The file for Child #1, a young toddler, lacked a current health assessment that had been completed within the last 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

Noncompliance Area: The file for Child #1 lacked verification that they have received their 12-15 month Pneumococcal, their 12 month MMR, Varicella and Hepatitis , and their 15-18 DTAP and HIB vaccinations. The file for Child #2 lacked verification that they had received a current flu vaccination. Written exemptions were not on file for the children.

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

Noncompliance Area: In the Infant Medication bin one expired Albuteral Inhaler was observed.

Correction Required: Medication shall be stored in accordance with the manufacturer's or health professional's instructions on the original label.

Noncompliance Area: The first aid kit in the Toddler Classroom was missing gauze.

Correction Required: A first-aid kit shall be in a child care space.

Noncompliance Area: At the time of an unannounced inspection original Agreements were observed in selected children's files.

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

Noncompliance Area: Updates to the Emergency Contact Form were not updated in the last six month for three of five selected Children's files.

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

Noncompliance Area: The file for Children #3 and #4 lacked a Child Service Report.

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 agreements on file for Children #1, #3, #4 and #5 lacked designated release persons to whom the child may be released.

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

Noncompliance Area: Original agreements were observed in the children's files.

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

Noncompliance Area: The emergency contact form for Children #1 and #4 lacked the physician information for the children. The emergency contact form for Child #3 lacked the telephone number for the physician.

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

Noncompliance Area: The Emergency Contact Form for Children #1 and #4 lacked the health insurance coverage and policy number for the child. The Emergency Contact form for Child #3 lacked the policy number for the health insurance.

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

Noncompliance Area: The Emergency Contact Form for Children #1, #4 and #5 lacked the addresses for the designated 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 file for Child #3 lacked an initial health assessment within 60 days following the child's first day of attendance in care.

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 immunization records on file for Children #1, #3 and #4 lacked documentation that the children had received annual flu vaccinations as recommended by the ACIP.

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

Noncompliance Area: A bottle of Infants Acetaminophen was observed in an open cubby in the hallway that children pass through to use the first floor restroom allowing it to be accessible.

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.

Noncompliance Area: A medication log was missing for a Desonide ointment for Child #4.

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

Noncompliance Area: The file for Staff Person #1 lacked an initial health assessment.

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

Noncompliance Area: The file's for Staff Person's #1 and #2 lacked verification that they had received a tuberculosis screening within 12 months prior to starting in a child care taking position.

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.

Noncompliance Area: The updates to the emergency contact form and financial agreement for Child #2 and #3 has exceeded 6 months at this time.

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 Emergency Contact Forms for Children #1, #3 and #4 lacked signed parental consent for obtaining emergency medical care and administration of minor first aid by facility staff.

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

Noncompliance Area: The regulation book and the telephone number for the Regional OCDEL office were not posted in a conspicuous location used by the parents. The emergency plan was also not posted in a conspicuous location used by parents.

Correction Required: The facility's current certificate of compliance and a copy of the applicable regulations under which the facility is certified shall be posted in a conspicuous location used by parents, with instructions for contacting the appropriate regional day care office posted at the same location.The operator shall post the emergency plan in the facility at a conspicuous location.

Noncompliance Area: In Classroom #2 a bottle of disinfectant spray was observed on the window ledge behind the changing table and could be accessible to the children. Also in Classroom #2 a container of vaseline was observed in the unlocked drawers next to the changing table. The items were labeled Keep Out of Reach of Children.

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

Noncompliance Area: The first aid kit in Classroom #4 lacked tweezers and 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: At approximately 1:30pm a mixed age group that included 3 young toddlers, 6 older toddlers and 4 preschool age children were observed to be sleeping on rest equipment without 2 feet of space on three sides of the equipment.

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: On 4/5/19 Operator self reported that in December 2018, former Staff Person #3, had left an infant alone in the Infant Classroom and left the facility.

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

Noncompliance Area: The file for Staff Person #3 lacked a completed State Police Clearance and a request was not on file prior to starting in a child care taking position.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). Facility Person #3 may not work in a child care position at the facility.

Noncompliance Area: On 4/5/19 Staff Person's #1 and #2 were observed to be caring for a mixed age group that included 3 young toddlers and 8 older toddlers. Staff Person #1 claimed responsibility for 3 young toddlers. Staff Person #2 claimed responsibility for 8 older toddlers. This grouping placed Staff Person #2 out of ratio.

Correction Required: When children are grouped in mixed age levels, the age of the youngest child in the group determines the staff:child ratio and maximum group size in accordance with the requirements in 3270.51 (relating to similar age level).

Noncompliance Area: On 3/29/19 at approximately 1:30pm Staff Person's #1 and #2 were observed to be caring for a mixed age group that included 1 infant, 3 young toddlers, 6 older toddlers and 4 preschool age children. No other staff were in the building at the time of Certification Rep's arrival.

Correction Required: Staff persons who are on duty but are not providing child care during naptime shall remain in the child care portion of the facility premises.

Noncompliance Area: The high chairs in Room 2 were missing the safety straps.

Correction Required: High chairs shall have a wide base and a T-shaped safety strap.

Noncompliance Area: The emergency contact forms were not present in the child care space where the children were receiving care.

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 file for Staff Person #2 and #3 lacked completed health assessments.

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

Noncompliance Area: The files for Staff Person's #1, #2 and #3 lacked tuberculosis screenings completed within 12 months of starting in a child care taking position.

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.

Noncompliance Area: In Room 2 an unlabeled bottle that was reported to be for a child receiving care in the space was observed.

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

Noncompliance Area: The files for Staff Person's #2 and #4 lacked verification of experience. The file for Staff Person #3 lacked verification of education and experience.

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

Noncompliance Area: The files for Staff Person's #1, #2, #3 and #4 lacked two written, nonfamily references.

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

Noncompliance Area: The files for Staff Person's #2 and #4 lacked verification that they have received emergency plan training at the time of initial 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.

Noncompliance Area: The file for Staff Person #1 lacked a State Police Clearance. The file's for Staff Person #2 and #3 lacked a State Police and an FBI Clearance. Staff Person #1 was observed to be working alone with a group of Preschool Children. Staff Person's #2 and #3 were observed to be working together with a group of toddlers. The file for Staff Person #4 lacked completion of their mandated reporter training.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). Facility Person #1, #2 and #3 may not work in a child care position at the facility. A provisional employee may not be permitted to work alone with children and must work within the vicinity of a permanent employee.

Noncompliance Area: In Room 1 one uncovered outlet was observed. In the hallway outside Room 2, next to the cubbies, two uncovered outlets were observed.

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

Noncompliance Area: In the restroom in Room 4 cleaning products were observed in an unlocked cabinet under the sink. In the upstairs restroom a container of Clorox wipes were observed in an unlocked cabinet and a bottle of hand sanitizer was observed on the sink. In Room 3 a small container of vaseline was observed in a low open bin at the desk. In Room 2 a container of Clorox wipes were observed on the window seat. In the downstairs restroom a spray bottle containing bleach water was observed on the sink.

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: Unlabeled spray bottles containing bleach water were observed in the downstairs restroom, the restroom in Room 4 and in Room 2.

Correction Required: Cleaning materials and other toxic materials shall be stored in an original labeled container or in a container that specifies the content. Toxics shall be stored away from food, food preparation areas and child care spaces.

Noncompliance Area: A ladder was observed in front of the back door leading from the kitchen to the outside.

Correction Required: Stairways, hallways, exits from rooms, exits from the facility and other means of egress serving as an exit shall be unobstructed.

Noncompliance Area: The garbage cans in place at the changing tables in Room #4 and the first floor restroom in Building 1 were not hands free to allow for appropriate diaper disposal.

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

Noncompliance Area: The hot water in the first floor restroom in Building 1 was measured at 131.1 F.

Correction Required: Hot water temperature, in areas accessible to children, may not exceed 110 F.

Noncompliance Area: The refrigerator in the Kitchen was missing an operating thermometer.

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

Noncompliance Area: In the upstairs restroom a tube of wallpaper peeler labeled Keep Out of Reach of Children was observed in an unlocked drawer. Also in the upstairs restroom the locks that had been installed on the cabinet under the sink were too far over and allowed for access to the toxics inside.

Correction Required: Cleaning materials and other toxic materials shall be stored in an original labeled container or in a container that specifies the content. Toxics shall be kept in a locked area or in an area inaccessible to children, and shall be stored away from food, food preparation areas and child care spaces.

Noncompliance Area: The hot water in Building 1's upstairs hall restroom was measured at 133.7 F. The hot water in the restroom in Room 4 was measured at 133.7 F and the hot water at the Classroom sink in Room 4 was 130.7 F. The hot water in the first floor restroom in Building 1 was measured a 140.2 F. The hot water in the downstairs restoom in Building 2 was measured at 128.6 F.

Correction Required: Hot water temperature, in areas accessible to children, may not exceed 110 F.