The Lightbridge Academy Of Wyomissing Pa

Regulation: 3270.101(a)

Description: Age appropriate

Noncompliance Area: During a renewal inspection on 6/8/26 Cert rep observed "Picasso tiles," which are per the manufacturer recommended for ages 3 years and up, in the Purple Cats room. The children observed to be present in the Purple cats room were young toddlers.

Correction Required: Play equipment and materials appropriate to the developmental needs, individual interests and ages of the children shall be provided in sufficient amount and variety to preclude long waits for use.

Regulation: 3270.107

Description: Refrigerator

Noncompliance Area: During a renewal inspection on 6/8/26 Cert rep observed there was no thermometer in the refrigerator in the Non-Mobile Infants room.

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: 3270.123(a)(3)

Description: Services proceeded

Noncompliance Area: During a renewal inspection 5/28/26-6/8/26 Children 3 and 4 did not have a child service report that was provided the the parents of these children. Children 3 and 4 have been enrolled for more than 6 months. See LIS code sheet for date of admission. Child 2's most recent Child Service report that was completed and provided to the parents was dated 5/30/25 which is more than 6 months ago.

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).

Regulation: 3270.123(a)(4)/3270.124(b)(3)

Description: Arrival/departure times/Parent home/work address, phone

Noncompliance Area: During a renewal inspection 5/28/26-6/8/26 Child 1's fee agreement did not note the child's arrival and departure times. Children 2 and 5's emergency contact forms did not include the parents' work phone numbers. Child 5's emergency contact form also did not include the parents' work addresses.

Correction Required: An agreement shall specify the child's arrival and departure times. Emergency contact information must include the home and work addresses and telephone numbers of the enrolling parent.

Regulation: 3270.131(a)

Description: Health information

Noncompliance Area: During a renewal inspection 5/28/26-6/8/26 a review of children's files determined that Children 3 & 4 did not have an initial health report provided within 60 days of their date of admission. See LIS code sheet for dates of admission. Child 3's initial health assessment was dated 3/12/26, and Child 4's initial health assessment dated 10/24/25. It was reported that both Children 3 and 4 attended between their 60th day and the receipt of their initial health report.

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.

Regulation: 3270.131(b)(1)

Description: Infant: updated health report every 6 months

Noncompliance Area: During a renewal inspection on 5/28/26-6/8/26 young toddler Child 2's most recent health report was dated 4/28/25, which is more than 6 months ago. See LIS code sheet for date of birth. Cert rep observed Child 2 to be present and receiving care on 5/28/26.

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.

Regulation: 3270.133(5)

Description: Original label

Noncompliance Area: During a renewal inspection on 6/8/26 Cert rep observed a child's Epi Pen with expiration date of 12/2025, to be present in the medication storage box in the Orange Giraffe Room.

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

Regulation: 3270.27(c)

Description: Training regarding plan

Noncompliance Area: During a renewal inspection 5/28/26-6/8/26 Facility Person # 4, # 5, & # 6 had initial emergency plan training on 4/9/26, which is after 90 days from their respective dates of hire. See LIS code sheet for dates of hire. There was no documentation available for review that showed Facility Person # 4, # 5, & # 6 received emergency plan training within 90 days of their date 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: 3270.27(d)/3270.27(e)

Description: Plan posted/Letter to parents

Noncompliance Area: During a renewal inspection 5/28/26-6/8/26 Cert rep observed on 5/28/26 the emergency plan was not posted in a conspicuous location accessible to the parents. Review of the emergency procedures letter to the parents determined that this letter did not include the information regarding the facility's accommodations for infants, toddlers, children with disabilities, and children with chronic medical conditions during an emergency.

Correction Required: The operator shall post the emergency plan in the facility at a conspicuous location. The operator shall provide to the parent of each enrolled child a letter explaining the emergency procedures. The operator shall also provide to the parent of each enrolled child a letter explaining any subsequent update to the plan.

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

Description: Age and Training

Noncompliance Area: During a renewal inspection on 5/28/26-6/8/26 Staff person # 1 did not completed Pediatric first aid and CPR training on or before expiration of the most current certification. This is evidenced by the previously documented Pediatric first aid and CPR training on file expiring 3/31/26 and updated Pediatric first aid and CPR training dated 4/29/26. Staff Person # 1 worked as staff between 4/1/26-4/29/26.

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: During a renewal inspection 5/28/26-6/8/26 Staff person #6 did not completed the following required pre- service training within 90 days of their date of hire (see LIS code sheet): Pediatric First Aid and CPR. This is evidenced by the Pediatric first aid and CPR training certificate on file dated 4/29/26. It was reported that Staff Person #6 worked as staff between their 90th day and 4/29/26.

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

Regulation: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: During a renewal inspection on 5/28/26-6/8/26 the following violations of the CPSL were noted: Facility Person # 2 has a NSOR clearance dated 5/27/26, which is after their first day with children. See LIS code sheet for first days with children. Facility Person # 5 did not have a Texas criminal records check or Texas child abuse clearance on file. Facility Person #5 was observed working as staff and providing care to children on 6/8/26, and reported having resided in Texas in the past 60 months.

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. TIERED LIS: 1. The operator shall comply with the CPSL and with Chapter 3490 (related to protective Services. Facility Person #5 may not work in a child care position or have direct contact with children at the facility until such time as all of the required out of state clearances for Facility Person #5 are on file at the facility. This portion of the plan shall have an immediate correction date. 2. The legal entity must create a checklist for staff and facility persons files that addresses all necessary staff and facility persons file paperwork and time frames for renewals of paperwork as appropriate. The staff and facility persons file paperwork that must be addressed in this checklist includes but is not limited to PA clearances, Out of State clearances and trainings as required by the CPSL and all documents required for staff and facility persons to be hired. The checklist must be submitted to the Regional Office for approval. Once approved this checklist shall be used by the person responsible for hiring and maintaining facility persons records. The provider shall provide a date for when this portion of the plan shall be completed.

Regulation: 3270.36(b)(3)/3270.36(b)(5)

Description: HS/GED, 15 credits + 1 yr/HS/GED + 2 yrs

Noncompliance Area: During a renewal inspection 5/28/26-6/8/26 Staff 3, 6, 7, 8, & 9 were reported to be working as AGS, however they did not have verification they meet the qualifications of a AGS in their respective files. Staff 3 had a high school diploma and 2010 hours of verified child care experience in their file. Staff 6 had a high school diploma and 816 hours of verified child care experience in their file. Staff 7 had an associates degree which included 15 credits in human services field and 0 hours of verified child care experience in their file. Staff 8 had a high school diploma and 0 hours of verified child care experience in their file. Staff 9 had a high school diploma and 0 hours of verified child care experience in their file.

Correction Required: An assistant group supervisor shall have a high school diploma or a general educational development certificate, 15 credit hours from an accredited college or university in early childhood education, child development, special education, elementary education or the human services field and 1 year of experience with children. An assistant group supervisor shall have a high school diploma or a general educational development certificate and 2 years experience with children.

Regulation: 3270.66(a)

Description: Locked or inaccessible

Noncompliance Area: During a renewal inspection on 6/8/26 Cert rep observed baking soda and shaving cream on an accesible counter in the Yellow Ducks room. Both of these items are 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.

Regulation: 3270.76/3270.103

Description: Building Surfaces/Small Toys and Objects

Noncompliance Area: During a renewal inspection on 6/8/26 Cert rep observed lose cords from wall mounted TVs (pulling hazards) in the Multipurpose Room and Brown Bears. Cert rep also observed on 6/8/26 a long table (measured over 5 foot long) in the Multipurpose room bathroom set up on the short side, which created a tipping hazard.Cert rep observed toy animals, toy bugs, counting bears, and blocks which all measured less than one inch in diameter in the Blue horses room. Staff reported that a child present in that room on 6/8/26 was know to still be putting objects in their mouth.

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 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: 3270.113(b)

Description: No physical punishment

Noncompliance Area: During a Complaint investigation on 2/19/26 it was verified that on 2/9/26 Staff Person 1 grabbed Child 1 and forcefully sat them down because Child 1 was not listening. It was reported the force was hard enough there was concerns the child could have been injured by the action. Complaint investigation on 2/19/26 also verified that Staff Person 1 grabbed Child 2 by the arm, lifted them off the ground and walked them to the other side of the room, because Child 2 was taking their shoes off.

Correction Required: A facility person may not use any form of physical punishment, including spanking a child. TIERED LIS: 1. A facility person may not use any form of physical punishment, including spanking a child. This portion of the plan shall have an immediate correction date. 2. The legal entity must create a written discipline policy to be implemented in the facility. This policy must included information about acceptable discipline and positive guidance to be used by facility persons at the facility. The written policy must include the information found in 3270.113(b)-3270.113(e). The written policy must address the steps a facility person shall take regarding reporting concerns when a facility person have witnessed or otherwise become aware of a facility person using any unacceptable forms of discipline or punishment against a child. The written policy must address the timeframe for reporting these concerns and to whom these concerns are to be reported to, including but not limited to when the facility person who has used the unacceptable form of punishment is the supervisor of the facility person with concerns. The legal entity will submit policy to the Northeast Regional Office for approval. Once approved, all existing staff and new hires must be trained on the approved policies and procedures, and it must be documented at the facility. The provider will provide a date for when this portion of the plan will be completed.

Regulation: 3270.95(a)/3270.95(b)

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

Noncompliance Area: During an unannounced inspection on 2/19/26 it was noted there was more than 30 days between fire detection testing on two occasions: 12/1/25-1/2/26, & 1/2/26-2/2/26.

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

Regulation: 3270.106(f)

Description: 2 feet apart

Noncompliance Area: During an unannounced inspection on 2/6/26 Cert rep observed that while infant Child 1 was resting in the crib, both of the short sides of Child 1's crib were up against a wall and another crib respectively, which resulted in 0 feet of space on two of the four sides of the crib while it was in use.

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: During a complaint investigation on 11/14/25-12/17/25, Cert rep verified that on 11/13/25 Child 1 was left unsupervised in the classroom bathroom for approximately 40-45 minutes while the staff took the rest of the class outside.

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. 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. TIERED LIS: 1. Children must be supervised at all times. 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 correction date for this portion of the plan must be immediate. 2.The legal entity must update their written supervision policies and procedures to be implemented in the facility. The written policy must ensure 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 outdoor 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 his/her assigned group and be physically present with the children in his/her group on the facility premises and on facility excursions off the facility premises. The policy must also address how these groups will be transitioned from one staff person to another during staffing changes. The facility must create and implement specific procedures using a tangible supervision system, e.g. supervision cards, supervision lists, or another approved method, to ensure appropriate supervision at all times including but not limited to when there is no access to electronic systems. Both the updated supervision policies and new supervision procedures must be submitted to the Northeast Regional Office for approval prior to implementation. Once approved by the Department, the director will ensure that all current employees and any new hires are trained on the policies and procedures and it must be documented in their files. The operator shall provide a correction date for when this portion of the plan will be completed.

Regulation: 3270.14/3270.21

Description: Pertinent Laws & Regulations/General Health and Safety

Noncompliance Area: During an unannounced inspection on 10/6/25 Staff person #4 was observed to be caring for children unsupervised. Staff person #4 has not completed the following pre-service training required prior to caring for children unsupervised: Pediatric first-aid/CPR training.

Correction Required: A facility shall be operated in conformity with applicable Federal and State laws and regulations. State agencies whose regulations may relate to the operation of a facility include the Department of Environmental Resources, the Department of Labor and Industry, the Department of Health, the Department of Education and the Department of Transportation. Conditions at the facility may not pose a threat to the health or safety of the children. Until such time as the required pre- service trainings are completed staff person #4 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 #4, staff person #4 may not work in a child-care position at the facility. Once all preservice trainings are completed, Staff #4 may only care for children unsupervised if they have all qualifications on file to qualify as an AGS or higher.

Regulation: 3270.192(5)

Description: Two written references

Noncompliance Area: During an unannounced inspection 9/22/25 Staff 3 had 1 reference in their staff file.

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.

Regulation: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: During an unannounced inspection on 10/6/25 Staff 4 did not have a California Child Abuse clearance or California Criminal record clearance. Staff 4 reported having resided outside of PA during the previous 60 months. See LIS code sheet for Staff 4's first day with children.

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. Staff 4 may not work in a child care position or have direct contact with children at the facility until such time as the California Child Abuse clearance and California Criminal Record clearance are on file.

Regulation: 3270.36(b)(1)/3270.192(2)(iv)

Description: HS/GED + 30 credits/Transcript, diploma and letters

Noncompliance Area: During an unannounced inspection on 9/22/25 Staff 2 and 3 did not have acceptable documentation which verified they had earned a high school diploma or GED equivalent. Staff 2 and 3 each had college transcripts which showed 30 credits in human services or education, however these transcripts did not indicate if a college degree was awarded Staff 2 and 3 reported they did graduate from high school. Staff 2 and 3 have been working as AGS.

Correction Required: An assistant group supervisor shall have a high school diploma or a general educational development certificate and 30 credit hours from an accredited college or university in early childhood education, child development, special education, elementary education or the human services field. A facility person's record shall include acceptable verification of experience, education or training is a transcript or a diploma or a letter signed by a representative of the experiential, educational or training entity.

Regulation: 3270.36(b)(5)

Description: HS/GED + 2 yrs

Noncompliance Area: During an unannounced inspection on 10/6/25 Staff 5 had 0 years of child care experience verified on file, and a high school diploma. Staff 5 has been working as AGS.

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

Regulation: 3270.37(c)

Description: Aides supervised all times

Noncompliance Area: During an unannounced inspection on 10/6/25 Staff 4 was observed to be caring for children unsupervised in the Goldfish room. Staff 4 is an aide.

Correction Required: An aide or a combination of aides shall be supervised at all times by a staff person qualified at minimum as an assistant group supervisor.

Regulation: 3270.113(b)

Description: No physical punishment

Noncompliance Area: Complaint investigation 9/12/25-11/10/25 verified that on 9/3/25, Staff 1 grabbed Child 1's arm in a way that resulted in pain to the child. It was verified this action was done as a way of correcting the child's behavior.

Correction Required: A facility person may not use any form of physical punishment, including spanking a child. TIERED LIS: 1. A facility person may not use any form of physical punishment, including spanking a child. This portion of the plan shall have an immediate correction date. 2. Staff Person 1 shall take "Big Emotions and Self-Regulation for Adults and Children" available on Better Kid Care or a similar PQAS approved training. The training used to fulfill this portion of the plan must be approved by the NE Regional Office before completion. The certificate from completion of this training shall be maintained in the staff's file. The provider shall provide a date when this portion of the plan will be completed.

Regulation: 3270.106(f)

Description: 2 feet apart

Noncompliance Area: During a renewal inspection on 6/25/25-6/30/25 Cert rep observed nap mats in the purple cats and khaki kangaroos rooms did not have at least two feet of space on 3 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: 3270.111(b)

Description: Posted in group space

Noncompliance Area: During a renewal inspection on 6/25/25 Cert rep observed the daily schedule was not posted in the non-mobile infants room.

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

Regulation: 3270.113(a)(2)

Description: Supervision on and facility premises

Noncompliance Area: During a renewal inspection on 6/25/25 Cert rep observed the following. Staff 2 and 3 were present with 5 infant children. Both staff named and reported all 5 infant children were in their assigned group. This exceeds the 1:4 group size ratio for infants.

Correction Required: The requirement for supervision on and off the facility premises includes compliance with the staff:child ratio requirements in §§ 3270.51--3270.55. TIERED LIS 1. The requirement for supervision on and off the facility premises includes compliance with the staff:child ratio requirements in §§ 3270.51--3270.55. This portion of the plan shall have an immediate correction date. 2.The legal entity must create or update their existing supervision policy in order to maintain proper supervision and compliance with 3270.51-3270.55 with regards to ratios. This policy will ensure that all children are properly assigned to a specific staff person and supervised at all times. This policy must address supervision group sizes, and assignment to ensure no individual staff exceeds ratios for the children they are assigned. The legal entity must receive approval of the policy from the Regional Office. Once approved by the Regional Office, the legal entity must review policy with all staff and have staff sign off that the understand and will follow the supervision policy. The operator shall provide a correction date for when this portion of the plan will be completed.

Regulation: 3270.123(a)(6)

Description: Admission date

Noncompliance Area: During a renewal inspection on 6/25/25-6/30/25 Children 2 and 3's fee agreements did not list their dates of admission.

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

Regulation: 3270.124(b)(3)

Description: Parent home/work address, phone

Noncompliance Area: During a renewal inspection 6/25/25-6/30/25 Child 2's emergency contact did not list the parents' work addresses and phone numbers.

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

Regulation: 3270.133(5)

Description: Original label

Noncompliance Area: During a renewal inspection on 6/25/25 Cert rep observed Destin(exp 7/2024 and 12/2024), and A&D(exp 5/2025) in the non mobile infants room and Aquaphor (exp 1/2025) in the purple cats room.

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

Regulation: 3270.133(7)

Description: Medication log

Noncompliance Area: During a renewal inspection on 6/25/25-6/30/25 the facility did not have a medication log for the administration of Child 3's Tylenol. It was reported the medication had been administered to the child while the child was in care.

Correction Required: An operator is responsible to establish and maintain a medication log if prescription or nonprescription medication is administered.

Regulation: 3270.134(a)

Description: Child's hands washed

Noncompliance Area: During a renewal inspection on 6/30/25 Cert observed Staff 7 did not wash a child's hands after changing the child's diaper.

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

Regulation: 3270.135(a)(3)

Description: Disposable diapers

Noncompliance Area: During a renewal inspection on 6/25/25 Cert rep observed the trash cans used for diapers in the purple cats, khaki kangaroos, and giraffe rooms were not hands free.

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

Regulation: 3270.151(c)(2)

Description: Mantoux TB

Noncompliance Area: During a renewal inspection 6/25/25-6/30/25 it was reported that documentation of Staff 10's TB was not obtained and placed in the staff's file until 6/27/25. This is after Staff 10's first day with children(See LIS code sheet for first day with children.

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: 3270.171(c)

Description: Safe routes posted

Noncompliance Area: During a renewal inspection on 6/25/25-6/30/25 Cert rep observed the facility did not have written notification of safe routes posted in a conspicuous location in the child care facility.

Correction Required: Written notification of safe routes shall be posted by the operator at a conspicuous location in the child care facility.

Regulation: 3270.182(5)

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

Noncompliance Area: During a renewal inspection on 6/25/25-6/30/25 Child 1's file did not have 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: 3270.192(2)(ii)/3270.192(2)(iv)

Description: Exp, educ., training prior to facility/Transcript, diploma and letters

Noncompliance Area: During a renewal inspection 6/25/25-6/30/25 Cert rep observed that Staff 1 did not have acceptable verification of child care experience documented in the staff file. It was reported that a legal entity representative had contacted a previous employer a verified over the phone that Staff 1 had over 5 years of child care experience however documentation to support this verification was not able to be reviewed by the certification rep. Staff 5 did not have acceptable verification of education in the staff file. Staff 5's file noted that Staff 5 graduated from high school however there was no diploma, transcripts or letter signed by the educational institution's representative that supported Staff 5 had attained this level of education.

Correction Required: A facility person's record shall include verification of child care experience, education and training prior to service at the facility. A facility person's record shall include acceptable verification of experience, education or training is a transcript or a diploma or a letter signed by a representative of the experiential, educational or training entity.

Regulation: 3270.192(4)

Description: CPSL information

Noncompliance Area: During a renewal inspection on 6/25/25-6/30/25 it was noted that the disclosure statements for the following staff were signed, dated and witnessed after their first day with children: Staff 1(dated 5/7/25), Staff 4(dated 6/26/25), Staff 6(dated 6/11/25), Staff 7(dated 6/10/25), and Staff 8(dated 5/29/25). See LIS code sheet for first day with children. These staff were not hired provisionally.

Correction Required: 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: 3270.192(5)

Description: Two written references

Noncompliance Area: During a renewal inspection on 6/25/25-6/30/25 Staff 5 and 11 had 0 references on file.

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.

Regulation: 3270.27(c)

Description: Training regarding plan

Noncompliance Area: During a renewal inspection on 6/25/25-6/30/25 there was no documentation available to review that the following staff received emergency plan training within 90 days of their date of hire: Staff 1, 2, 3, 4, 8, and 9. Documentation was available to review that these staff received emergency plan training on 6/26/25, which was after their 90th day. See LIS code sheet for dates 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(f)

Description: Health and Safety Training

Noncompliance Area: During a renewal inspection on 6/30/25 Staff 4 and Staff 8 did not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): Pediatric First Aid and CPR. Staff 4 completed the an acceptable training on 6/26/25, which is beyond their 90 days. Staff 8 had a First aid and CPR training dated 9/13/23 that was not a PQAs approved curriculum.

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 8 must be supervised, when interacting with children, by an AGS or higher who has completed the required training related to this citation. If there are no staff available to supervise Staff 8, Staff 8 may not work in a child-care position or have direct contact with children at the facility.

Regulation: 3270.32(a)

Description: Comply with CPSL

Noncompliance Area: During a renewal inspection 6/25/25-6/30/25 it was noted that Staff 3 has not completed an approved mandated reporter training within 90 days of their date of hire (see LIS code sheet). Staff 3 completed a two part mandated reporter training dated 11/13/23 for teachers which is not approved for use as a child care staff.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). Until such time as the required training has been completed, Staff 3 must be supervised, when interacting with children, by an AGS or higher who has completed the required training related to this citation. If there are no staff person(s) available to supervise Staff 3, Staff 3 may not work in a child-care position or have direct contact with children at the facility.

Regulation: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: During a renewal inspection on 6/25/25-6/30/25 Cert rep noted the following violations of the CPSL: Staff 5 did not have the NSOR clearance certificate on file. Staff 11 did not have the State police clearance or request for the State police clearance on file. Staff 5's disclosure statements was signed, dated and witnessed on 6/11/25 which is after their date of hire. Staff 11 did not have a disclosure statement on file. Staff 5 and 11 were hired provisionally and have begun working with children. See LIS code sheet for first day with children.

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. Staff 5 and 11 may not work in a child care position or have direct contact with children at the facility until such time as the clearances and disclosure statements related to this violation are obtained.

Regulation: 3270.35(b)

Description: Group sup qualifications

Noncompliance Area: During a renewal inspection 6/25/25-6/30/25 it was noted that Staff 7 had a high school diploma, and 30 human services credits, and 5 years of child care experience. Staff 7 reported not earning an associate's degree or bachelor's degree. Staff 7 has been working as a group supervisor and does not meet one of the qualifications required for a group supervisor.

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

Regulation: 3270.66(a)/3270.133(4)

Description: Locked or inaccessible/Locked

Noncompliance Area: During a renewal inspection on 6/25/25 Cert rep observed Aquaphor and insect repellent in a child's cubie in the blue horses room. This cubie was accessible to the children present in this room and both items are 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. Medication shall be stored in a locked area of the facility or in an area that is out of the reach of children.

Regulation: 3270.74

Description: Emergency Numbers Posted

Noncompliance Area: During a renewal inspection on 6/25/25 Cert rep observed the local hospital phone number was not posted by the phones in the Non-mobile infants, mobile infants, and yellow ducks rooms.

Correction Required: The telephone number of the nearest hospital, police department, fire department, ambulance and poison control center shall be posted by each telephone in the facility.

Regulation: 3270.75(c)

Description: Has all items

Noncompliance Area: During a renewal inspection on 6/25/25 Cert rep observed there was no soap in the first aid kit in the Brown bears room.

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: 3270.94(a)(4)

Description: Hypothetical locations

Noncompliance Area: During a renewal inspection on 6/25/25-6/30/25 it was noted that hypothetical location of the fire was the same location(Main door) for two consecutive drills: 4/30/25 & 5/9/25

Correction Required: The Director or designated staff person who is responsible for compliance with this chapter shall conduct fire drills and ensure that the hypothetical locations of the fire are rotated around the facility for each drill such that the hypothetical location is never the same for consecutive drills.

Regulation: 3270.95(a)/3270.95(b)

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

Noncompliance Area: During a renewal inspection on 6/25/25-6/30/25 it was noted there was one incident of more than 30 days between fire detection system testing: 5/9/25-6/11/25

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