Sunshine Kids Inc

Regulation: 3270.14/3270.27(c)

Description: Pertinent Laws & Regulations/Training regarding plan

Noncompliance Area: The emergency plan training for staff person #2 is dated 6/2/25, which is after their date of hire (see LIS code sheet).The emergency plan training for staff person #2 is dated 6/2/25, which is after their date of hire (see LIS code sheet).

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. 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: 3270.151(a)

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

Noncompliance Area: The current health assessment for staff person #1 is dated 5/22/25, which is more than 24 months after the previous health assessment that is dated 4/28/23. The current health assessment for staff person #2 is dated 11/8/24, which is after their date of hire (see LIS code sheet).

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: 3270.151(c)(2)

Description: Mantoux TB

Noncompliance Area: The tuberculosis test for staff person #2 is dated 11/11/24, which is after their date of hire (see LIS code sheet).

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.

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

Description: Age and Training

Noncompliance Area: The current pediatric first aid and CPR training for staff person #1 is dated 6/18/25, which is more than 24 months after the previous training that is dated 4/28/23.

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

Regulation: 3270.31(f)

Description: Health and Safety Training

Noncompliance Area: Staff person #2 has health and safety training (Part 1: 4/1/25, Part 2: 4/2/25) dated more than 90 days after the date of hire (see LIS code 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: Staff person #2 has PA State Police clearance dated 10/31/24, Child Abuse Clearance dated 10/31/24, DHS FBI clearance dated 4/12/25, and NSOR certificate dated 11/18/24. All clearance dates are after the date of hire (see LIS code sheet). Staff persons #3 and #4 have current NSOR certificates dated 1/10/25, which is more than 60 months after the previous NSOR certificates that are dated 12/13/19. The current mandated reporter training for staff person #3 is dated 5/4/22, which is more than 60 months after the previous mandated reporter training that is dated 2/20/27.

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

Regulation: 3270.131(b)(2)

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

Noncompliance Area: The updated health assessment for Child #1, an older toddler, was dated more than 12 months past the initial health assessment. Initial health assessment was dated 3/6/23 and updated health assessment was dated 4/15/24.

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: 3270.151(a)

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

Noncompliance Area: Staff persons #2 and #4 have current health assessments that are dated more than 24 months past their previous health assessments. The dates for health assessments for staff person #2 are 8/13/21 and 11/21/23. The dates for health assessments for staff person #4 are 1/5/22 and 2/14/24.

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)(4)(i)

Description: Age and Training

Noncompliance Area: Staff persons #1, #3, and #4 renewed certification in pediatric first aid and pediatric CPR 11 days after the previous certification expired. Previous certification expired on 5/4/24 and current certification was granted on 5/15/24.

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: 3270.65

Description: Protective Outlet Covers 5 yrs. or less

Noncompliance Area: A surge-protector power strip on a shelf accessible to children in the younger toddler room (Room 7 on 2nd floor) did not contain protective receptacle covers.

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

Regulation: 3270.76

Description: Building Surfaces

Noncompliance Area: In the outdoor pre-school play space, there were exposed bolts on the inside of the fence section that faces the main road, presenting a hazard to children utilizing the play space.

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

Regulation: 3270.102(a)

Description: Clean and good repair

Noncompliance Area: A tear was observed on a vinyl ottoman used by children in room #3.

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: 3270.111(b)

Description: Posted in group space

Noncompliance Area: A written plan of daily activities was not posted in room #6.

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

Regulation: 3270.124(b)(4)/3270.182(3)

Description: Written consent/Consent for emergency medical care required prior to admission

Noncompliance Area: The record for child #1 did not contain signed parental consent for emergency medical care for the child.

Correction Required: Emergency contact information must include the written consent signed by a parent for emergency medical care. A child's record shall contain signed parental consent for emergency medical care for the child. Written consent is required prior to admission.

Regulation: 3270.124(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 was not displayed in room #6.

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

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

Noncompliance Area: The record for child #1, a young toddler, did not contain a current health report.

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: 3270.133(4)

Description: Locked

Noncompliance Area: Infant Tylenol and Infant Mylicon was observed in a child's cubby outside of the bathroom on the 2nd floor accessible to children in care.

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.

Regulation: 3270.14/3270.21

Description: Pertinent Laws & Regulations/General Health and Safety

Noncompliance Area: Staff #1, #2, #3 and #4 did not complete the Pennsylvania Health and Safety Update 2022 by December 30, 2022, which was the prescribed timeframe required by OCDEL to complete the training, as per Announcement C-22-06. Staff #1 completed the Pennsylvania Health and Safety Update 2022 on 1/27/2023; staff #2 and staff #3 completed the Pennsylvania Health and Safety Update 2022 on 1/26/2023; and staff #4 completed the Pennsylvania Health and Safety Update 2022 on 6/13/2023.

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: 3270.182(5)

Description: Consent for administration of minor first-aid required prior to admission

Noncompliance Area: The record for child #1 did not contain signed parental consent for administration of minor first-aid procedures by facility staff.

Correction Required: 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.

Regulation: 3270.27(b)

Description: Plan reviewed/updated annually

Noncompliance Area: The operator did not review the emergency plan and document the review in writing at least annually during the period between 5/18/2022 and 6/5/2023.

Correction Required: The operator shall review the emergency plan at least annually and update the plan as needed. The operator shall document in writing each review and update of the emergency plan and kept on file at the facility.

Regulation: 3270.31(f)(10)

Description: Health and Safety Training - Pediatric First Aid and CPR

Noncompliance Area: Staff #1 completed professional development in pediatric first aid and pediatric cardiopulmonary resuscitation on 5/4/2022 and staff #4 completed professional development in pediatric first aid and pediatric cardiopulmonary resuscitation on 6/16/2023 which was more than 90 days following date of hire - see staff individual codes.

Correction Required: Staff persons shall complete professional development in pediatric first aid and pediatric cardiopulmonary resuscitation within 90 days of hire.

Regulation: 3270.65

Description: Protective Outlet Covers 5 yrs. or less

Noncompliance Area: Protective receptacle covers were not placed in electrical outlets accessible to children 5 years of age or younger in the following areas: (2) electrical outlets on the outside of the building by the entrance to the facility; (2) electrical outlets on the wall in room #3; and (2) electrical outlets on the wall in room #6.

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

Regulation: 3270.71

Description: Heat Source

Noncompliance Area: A door in room #3 that leads to the kitchen was unlocked, making the stove, which is a source of heat exceeding 110° accessible to children.

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: 3270.82(h)

Description: Handwashing signs

Noncompliance Area: A handwashing sign was not posted at the diapering area in room #6.

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: 3270.91(a)

Description: Stairs, exits, etc. unobstructed

Noncompliance Area: The door from room #8 into the upstairs hallway was obstructed by cubbies; the exit from the upstairs to the outside of the building was obstructed by a drying rack and children's chairs; and the doorway between room #5 and room #7 was obstructed by a changing table and a stack of rest mats.

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

Regulation: 3270.107

Description: Refrigerator

Noncompliance Area: An operating thermometer was not placed in the refrigerator located in the garage that is used to store milk for the children in care.

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: 3270.111(b)

Description: Posted in group space

Noncompliance Area: The written plan of daily activities was not posted in room #4.

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

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

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

Noncompliance Area: The record for child #2, a young toddler, contained a current health report dated more than 6 months following the date of their previous health report.

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 record for child #1, a preschool child, contained a current health report dated more than 12 months following the date of their previous health report.

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: 3270.151(a)/3270.192(3)

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

Noncompliance Area: The record for staff #5 included a current health assessment dated more than 24 months following the date of their previous 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.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: 3270.27(a)(6)

Description: Emergency plan

Noncompliance Area: An emergency drill was not conducted annually between 12/19/2020 and 1/3/2022.

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

Regulation: 3270.31(e)(4)(ii)

Description: Fire safety - 1 yr.

Noncompliance Area: Staff persons #2 and #6 did not participate, at least annually, in fire safety training between 9/9/2020 and 4/12/2022; staff persons #1 and #5 did not participate, at least annually, in fire safety training between 9/9/2020 and 4/13/2022; staff person #3 did not participate, at least annually, in fire safety training between 7/16/2020 and 4/12/2022; and staff person #7 did not participate, at least annually, in fire safety training between 12/30/2020 and 4/14/2022.

Correction Required: Staff persons shall participate, at least annually, in fire safety training conducted by a fire protection professional. Staff persons and volunteers shall receive training in maintenance of smoke detectors, the duties of facility persons during a fire drill and during a fire and the use of the facility's fire extinguishers, not including discharge of the fire suppressant agent.

Regulation: 3270.32(a)

Description: Comply with CPSL

Noncompliance Area: The record for staff #1 and staff #3 included a current certificate of completion for mandated reporter training completed more than 60 months following the completion of their previous training.

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

Regulation: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: The record for staff #1 included a current state police, child abuse and FBI clearance dated more than 60 months following the dates of their previous clearances. The record for staff #5 included a current state police clearance dated more than 60 months following the date of their previous clearance. The record for staff #4 who was hired on a provisional basis included a copy of their request for the NSOR verification certificate and a current NSOR verification certificate dated more than 45 days following their date of hire.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). A facility person's record shall include a copy of requests for the criminal history record and child abuse registry clearance information, a copy of the disclosure statement and a copy of the completed clearance information required under the CPSL.

Regulation: 3270.67(d)

Description: Contaminated trash in closed plastic-lined receptacle

Noncompliance Area: A closed receptacle that was not in a plastic-lined was observed being used to contain trash that was possibly contaminated by human secretions (nasal tissues) in room #5.

Correction Required: Trash that has been contaminated by human secretions or excrement shall be contained in closed, plastic-lined receptacles.

Regulation: 3270.71

Description: Heat Source

Noncompliance Area: There was no door or barrier to prevent children from entering the kitchen from the hallway which made the stove (a source of heat exceeding 110° F) accessible to children.

Correction Required: Hot water pipes and other sources of heat exceeding 110° F that are accessible to children shall be equipped with protective guards or shall be insulated to prevent direct contact.

Regulation: 3270.76

Description: Building Surfaces

Noncompliance Area: The following hazards were observed on outdoor play surfaces and accessible to children in care: pieces of siding were broken off with sharp edges near the bottom of the facility and the garage; and there were sharp pieces of wood protruding from the railroad ties along the fence in the outdoor play space for preschool children and along the walkway to the entrance of the facility.

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: Peeling/damaged paint was observed on the bottom of the trim around the outside of the door used by children to enter the facility.

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

Noncompliance Area: Child file #2, DOE 7/22/19 contained copy of immunization record dated 7/10/19, but lacked an initial health report obtained within 60 days of enrollment 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.

Noncompliance Area: Child file #1, DOE 4/9/18, lacked updated health reports every 12 months as required for a preschool child.

Correction Required: The operator shall require the parent to provide an updated health report at least every 12 months for an older toddler or preschool child.

Noncompliance Area: Child file #3, a toddler, and child file #4 a preschool child lacked documentation of Influenza vaccination in accordance with the schedule recommended by the ACIP.

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

Noncompliance Area: The facility contained Sorbee cough syrup for use with a child that was expired.

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

Noncompliance Area: Staff file #3, DOH 1/19/18, contained health assessments dated 8/24/17 and 9/22/19 which exceeded the 24 months as required for health assessments being conducted.

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: Staff file #4, DOH 1/13/20, contained Mandated Reporter Training dated 6/4/20 which was not completed within 90 days of hire.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). A facility person's record shall include verification of child care experience, education and training following the outset of service at the facility.

Noncompliance Area: Staff file #1, DOH 9/1/17, contained the receipt dated 2/3/17 for the PA State Criminal Clearance, not the valid clearance. Staff file #2, DOH 5/19/20, lacked a request for PA State Criminal Clearance prior to hire, the valid PA State Criminal Clearance dated 6/19/20 was in the file. Staff file #5, DOH 11/5/19, contained an NSOR request dated 11/11/19, which was not prior to 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: The downstairs Preschool room had an outlet near the office door that lacked a protective outlet cover and was accessible to children under 5 years of age.

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

Noncompliance Area: The emergency exit steps from the upstairs of the facility were obstructed with buckets and various items being stored on the landing and boxes at the bottom of the stairs by the exit door.

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: Staff #1 who was supervising a group of 10 younger school-age children in the dining/crafts area was asked to identify the children in their assigned group and they were unable to name any of the children.

Correction Required: Each staff person shall be assigned the responsibility for supervision of specific children. The staff person shall know the names and whereabouts of the children in his assigned group. The staff person shall be physically present with the children in his group on the facility premises and on facility excursions off the facility premises.

Noncompliance Area: There was a loose sheet observed in a crib that staff said was designated for use by an infant in care, posing a potential suffocation risk.

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

Noncompliance Area: The wooden play refrigerator in the young toddler room had a child proof lock on it, keeping the children from opening the door, this posed a hazard of the refrigerator falling on the child as they pulled at the door to open it.

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

Noncompliance Area: The infant and young toddler room lacked enough light in the room for staff to see the children while the children were napping. The staff in the EHS room could not see the infants because of the shelves obstructed their view of the infants while they were sleeping in their cribs.

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. Children must be supervised at all times.

Noncompliance Area: The young toddler room lacked copies of the emergency contacts forms for a random selection of children in care during the inspection.

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: Child file #1 lacked an updated health report every 6 months for an infant in care.

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: Child file #2, a preschool age child lacked an updated influenza vaccination in accordance with ACIP schedule. Child file #3, a preschool age child lacked documentation of updated vaccinations in accordance with ACIP schedule.

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

Noncompliance Area: The facility lacked written consent from the parent for administration of medication that was to be administered at the facility.

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

Noncompliance Area: Staff in the infant room did not wash a young toddler child's hands after diapering the child.

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

Noncompliance Area: Staff in the infant room did not use the hands-free covered can to immediately dispose of a soiled diaper after removing it from the young toddler. Staff did not sanitize the diaper changing surface after the diaper change.

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

Noncompliance Area: Staff file #3, DOH 3/3/17, contained a health assessment dated 4/3/19 which exceeded 24 months after their previous health assessment dated 9/19/16.

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

Noncompliance Area: Staff file #2, DOH 8/21/18 contained a health assessment dated 8/13/18 which did stated "yes" to the communicable diseases question but lacked the results of that examination. Staff file #4, DOH 4/20/19 contained a health assessment dated 2/27/19 which did stated "yes" to the communicable diseases question but lacked the results of that examination.

Correction Required: An adult health assessment must include an examination for communicable diseases and the results of that examination.

Noncompliance Area: Staff in the infant room did not wash their hands after diapering a young toddler child.

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

Noncompliance Area: The infants in care lacked written statements giving the formula and feeding schedule for the infant in care obtained from the parents.

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

Noncompliance Area: The infant bottles lacked label identifying the child's name for whom the bottle belongs.

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

Noncompliance Area: The emergency plan lacked shelter in the facility for children during an emergency.

Correction Required: The facility shall have an emergency plan that provides for shelter of children during an emergency including shelter in place at the facility and shelter at locations away from the facility premises.

Noncompliance Area: The emergency plan lacked documentation of updates when information had changed and copy of the updated plan sent to emergency management agency.

Correction Required: The operator shall review the emergency plan at least annually and update the plan as needed. The operator shall document in writing each review and update of the emergency plan and kept on file at the facility.The operator shall send a copy of the emergency plan and subsequent plan updates to the county emergency management agency.

Noncompliance Area: Staff file #4, DOH 4/20/19, lacked documentation of emergency plan training at 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: Staff file #1, DOH 1/3/13, contained copies of PA State Police Clearance dated 11/20/12 and updated 7/11/18; Child Abuse Clearance dated 11/27/12 and updated 7/19/18; and DHS FBI Clearance dated 1/3/13 and request for updated DHS FBI Clearance dated 6/19/19. Staff #1 continued working with children with clearances that expired on 11/20/17 until 7/16/19. Staff file #1 did not contain a valid DHS FBI clearance and was removed from child care on 7/17/19.

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

Noncompliance Area: The outdoor storage shed containing items including but not limited to toxics, gasoline, and lawn care equipment was unlocked and accessible to the children in care while playing in the outdoor play space.

Correction Required: If unsafe areas or conditions are in or near an outdoor play space, fencing or natural barriers are required to restrict children from those unsafe areas or conditions.

Noncompliance Area: The cabinet in the downstairs preschool room, where toxics were stored, was broken preventing the cabinet to be locked and making the toxics accessible to the children in care.

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 kits in the EHS room, the young toddler room and the upstairs preschool room all lacked nonporous gloves. The first aid kit in the upstairs preschool room was accessible to the children in care.

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

Noncompliance Area: The floor mats at both the entrance to the facility and at the backdoor were children entered and exited to the outdoor play ground were rolled on the edges and posed a tripping hazard to children as they entered and exited the facility.

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 infant room and young toddler lacked enough light during naptime to see the children in care.

Correction Required: Rooms, hallways, stairways, outside steps, porches and ramps shall be lighted by artificial or natural light.

Noncompliance Area: The play stove located in the upstairs preschool room was broken, the oven door lacked a hinge causing the door to not close properly and posing a hazard for pinch points.

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: The outdoor play space contained a Bimbo seat that was on the US CPSC list of recalled items.

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

Noncompliance Area: The infant room lacked copies of the emergency contact forms for all infants present and receiving care in the infant 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.

Noncompliance Area: Child file #1 and #2 lacked copies of initial health reports for school age children submitted within 60 days of admission to the facility. The child files did contain copies of immunization records at the time of admission.

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).

Noncompliance Area: Child file #3 lacked an initial health report submitted within 60 days of admission into the facility. Child file #4 contained an immunization record but not an initial health report submitted within 60 days of admission into the facility and lacked updated health reports submitted every 12 months as required for a preschool child.

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.The operator shall require the parent to provide an updated health report at least every 12 months for an older toddler or preschool child.

Noncompliance Area: The infant room and the young toddler room lacked hands free covered cans for disposable of soiled diapers located by the diaper changing tables.

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: Staff file #1, DOH 8/24/17, lacked documentation of results of a TB screening at initial employment at the facility.

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: Staff file #2, DOH 6/18/18 contained a Volunteer PA State Criminal Certificate dated 4/5/18 in the file. Staff #2 was removed from child care position on 7/20/18. Staff file #3, DOH 7/2/18 contained a request for FBI clearance in the file dated 7/3/18 for Retail Services, not Child care employment and was working alone with children in the older toddler room. Staff #3 was removed from child care position on 7/20/18.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). LACKING REQUIRED HIRING DOCUMENTS: Facility Person # 3 may not work in a child care position at the facility. PROVISIONAL HIRE UNSUPERVISED: A provisional employee may not be permitted to work alone with children and must work within the vicinity of a permanent employee. A facility person's record shall include a copy of requests for the criminal history record and child abuse registry clearance information, a copy of the disclosure statement and a copy of the completed clearance information required under the CPSL. Facility Person #2 and #3 may not work in a child care position at the facility.

Noncompliance Area: There were air freshener canisters that stated "keep out of reach of children" located in the girls bathroom on the first floor that were accessible to the children in care.

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 located in the infant room lacked sterile gauze pads.

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: Mats located in the upstairs PS room were torn and had exposed foam on the corners.

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: Both the EHS and downstairs toddler rooms contained foam blocks with bite marks indicating the children are still placing objects in their mouths and posing a hazard if parts are separated.

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 rest equipment for use with preschool children in the downstairs PS room were not labeled for a specific child's use.

Correction Required: Individual, clean, age-appropriate rest equipment shall be provided for preschool, toddler and infant children as agreed between the child`s parent and the operator. The rest equipment shall be labeled for the use of a specific child and used only by the specified child.

Noncompliance Area: Child file #3 lacked health report within 60 days of first day in 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.

Noncompliance Area: Child file #4 lacked an updated health report every 12 months for a preschool child.

Correction Required: The operator shall require the parent to provide an updated health report at least every 12 months for an older toddler or preschool child.

Noncompliance Area: Child files #1, #2, #5, #6 and #7 lacked a health report that was written and signed by a physician, physician's assistant or a CRNP and their professional title.

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

Noncompliance Area: There was expired diaper cream located in the Infant room.

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

Noncompliance Area: The Infant room hands free covered can in the diapering area 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.

Noncompliance Area: Staff file #2 lacked a health assessment every 24 months. Staff file #5 lacked a health assessment prior to initial DOH of 9/7/16.

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

Noncompliance Area: The facility lacked the manufacturer's instructions for the use of safety restraints in the Dodge Caravan.

Correction Required: Manufacturers` instructions for use of safety restraints shall be kept in the vehicle at all times.

Noncompliance Area: Child files #1, #2, #3, #5 lacked updated on the emergency contact forms every 6 months or as information changes.

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: Staff file #6 lacked copies of two written, nonfamily references from individuals 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

Noncompliance Area: Staff file #3 lacked copy of valid Child Abuse Clearance or completion of Mandated Reporter training within 90 days of DOH 2/21/17. A valid Child Abuse Clearance and mandated reporter training are on file. Staff file #4 lacked copy of completion of Mandated Reporter training within 90 days of DOH 1/31/17. Staff files #5 and #6 lacked signed disclosure statement in their files.

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

Noncompliance Area: The first aid kit used to when outside at the play space lacked soap.

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

Noncompliance Area: The preschool room located on second floor had peeling paint on the dark purple wall near the mats.

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