The Childrens Garden Of St Johns Lutheran Churc

Regulation: 3270.104(a)

Description: Clean, good repair, proper size

Noncompliance Area: The play couch in the YT classroom had peeling fabric on the corners of the arms.

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

Regulation: 3270.106(j)

Description: Prohibit items in crib

Noncompliance Area: It was observed in the infant room that a sound machine was hanging on the side of a crib.

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

Regulation: 3270.123(a)(3)

Description: Services proceeded

Noncompliance Area: The files of children #1, #2, #3, #4, #5, #6, #7, #8, #9, and #10 did not contain evidence of child service reports being completed every 6-months.

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: 3270.131(e)/3270.182(1)

Description: ACIP recommended immunization record /Initial and subsequent health reports

Noncompliance Area: The file for child #1 did not contain evidence of an initial health assessment, nor written verification of immunizations within 60 days of enrollment.

Correction Required: The facility may not accept or retain an infant 2 months of age or older, a toddler or a preschool child at the facility for more than 60 days following the first day of attendance at the facility unless the parent provides written verification from a physician, physician's assistant, CRNP, the Department of Health or a local health department of the dates (month, day and year) the child was administered immunizations in accordance with the recommendations of the ACIP. A child's record shall contain initial and subsequent health reports.

Regulation: 3270.14/3270.21

Description: Pertinent Laws & Regulations/General Health and Safety

Noncompliance Area: The emergency plan did not address continuity of operations. (Corrected on site.)

Correction Required: A facility shall be operated in conformity with applicable Federal and State laws and regulations.State agencies whose regulations may relate to the operation of a facility include the Department of Environmental Resources, the Department of Labor and Industry, the Department of Health, the Department of Education and the Department of Transportation. Conditions at the facility may not pose a threat to the health or safety of the children.

Regulation: 3270.14/3270.31(f)

Description: Pertinent Laws & Regulations/Health and Safety Training

Noncompliance Area: The files for staff persons #1#3, #4, #6, and #10 did not contain evidence of completing health and safety training and were outside of their 90- day provisional hire period.

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

Regulation: 3270.151(c)(2)

Description: Mantoux TB

Noncompliance Area: It was observed that the files for staff persons #1 and #6 did not contain evidence of a TB test at initial employment.

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: 3270.181(c)

Description: Emergency info/agreement updated 6 mos

Noncompliance Area: The files of children #1, #2, #3, #4, #5, #6, #7, #8, and #9 did not contain evidence of the agreement forms being reviewed and updated every 6 months.

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

Regulation: 3270.192(2)(iv)

Description: Transcript, diploma and letters

Noncompliance Area: The files for staff persons #1, #8, and #10 did not contain evidence of education at the time of the inspection. The files for staff persons #1, #3, #5, #8 and #10 did not contain evidence of experience at the time of the inspection

Correction Required: 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(3)

Description: Health assessment, TB test

Noncompliance Area: It was observed that the file of staff person #1 did not have evidence of obtaining a health assessment every 24 months. The last one on file was dated 6/16/23. It was observed that the file of staff person #10 did not have evidence of obtaining a health assessment every 24 months. (5/24/2206/15/26)

Correction Required: 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: 3270.192(5)

Description: Two written references

Noncompliance Area: The files of staff persons #1, #2, #9 did not contain evidence of two written, nonfamily references, they had one. The files of staff persons #3and #4 did not contain evidence of 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.

Regulation: 3270.27(c)

Description: Training regarding plan

Noncompliance Area: The files of staff persons #5, #7, and #10 did not contain evidence of annual emergency plan training and are outside of their 90-day provisional hire period.

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

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

Description: Age and Training

Noncompliance Area: The file for staff person #1 did not contain evidence that they renewed their pediatric first aid and CPR training before the expiration of the most current one on file, 1/4/23.

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(e)(4)(ii)

Description: Fire safety - 1 yr.

Noncompliance Area: The file of staff person #7 did not contain evidence of fire safety training.

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: 3270.31(f)(10)

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

Noncompliance Area: It was observed that the file for staff person #9 did not contain evidence of completing their pediatric first aid and CPR certification and were outside of their 90-day provisional hire period.

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

Regulation: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: At the time of the inspection, it was observed that the file of staff person #1 did not contain a complete state police clearance and their child abuse clearance, DHS FBI clearance, and NSOR were obtained after they started working with children. At the time of the inspection, it was observed that the file of staff person #4 did not contain a signed disclosure statement or an NSOR clearance. At the time of the inspection, it was observed that the file of staff person #8 had a receipt for their DHS FBI clearance on file, but the clearance had not been returned, and they were outside of their 45-day provisional hire date. At the time of the inspection, it was observed that staff person #9 obtained their DHS FBI clearance and NSOR certificate after they began working with children.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). Facility Persons #4 and #8 may not work in a childcare position at the facility.

Regulation: 3270.34(a)(6)

Description: Staff evaluations

Noncompliance Area: The files of staff person #1, #5, #6, #7and #10 did not contain evidence of annual written evaluations.

Correction Required: A director is responsible for written evaluation of staff persons on a regular basis, a minimum of one evaluation every 12 months.

Regulation: 3270.76

Description: Building Surfaces

Noncompliance Area: It was observed that in the bathroom across from PK-2 the step stools had an excessive build-up of dirt. There were also stained ceiling tiles near the sinks. It was observed that in the bathroom labeled 'Men' near the entrance of the building the step stools had an excessive build-up of dirt. It was observed that in the bathroom labeled 'Women' near the entrance of the building, the toilet seats in stalls 1, 2, 3, and 4 had stains and were peeling. It was observed that the air vents in PS- 3 had an excessive build-up of dirt. It was observed that the return vents in YT (on the right in infant room), PS-2, and both OT classrooms had an excessive build-up of dirt on them. It was observed that the ceiling lights in YT (on the right in infant room), PS-2, had an excessive build-up of dirt on them.

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: 3270.111(c)

Description: Promote development

Noncompliance Area: It was observed that in the older toddler classroom that the physical environment and daily activities provided by staff persons #1 and #2 do not promote the development of skills, social competence and self-esteem.

Correction Required: Tiered LIS: 1.Daily activities shall promote the development of skills, social competence and self-esteem. Daily experiences shall recognize the child as an individual and give some choice of activities that respect personal privacy, lifestyle and cultural background. This portion of the plan shall have an immediate correction date. 2.The legal entity must arrange for the older toddler classroom staff to receive a minimum of two hours of training and 2 hours of TA regarding classroom environment and programming. The legal entity must receive DHS approval of the training content prior to scheduling the training. The operator shall provide a date of when the training and TA will be completed.

Regulation: 3270.113(a)

Description: Supervised at all times

Noncompliance Area: in the older toddler classroom child #1 was able to push over a bookshelf and bite peers while being supervised by staff persons #1 and #2.

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. TIERED LIS: 1. Children must be supervised at all times. This portion of the plan shall have an immediate correction date. 2. The legal entity must arrange for the older toddler classroom staff to receive a minimum of two hours of training regarding supervision of children. The legal entity must receive DHS approval of the training content prior to scheduling the training. The operator shall provide a date of when the training and TA will be completed.

Regulation: 3270.182(7)

Description: Reports of accidents, injuries and illnesses. Original report - parent same day Copy - facility accident file. Copy - child's file

Noncompliance Area: It was observed that two incidents occurred with child #1 where incident reports were either not written or was not given to the parent.

Correction Required: A child's record shall contain reports of accidents, injuries and illnesses involving a child in care at the facility. The original report shall be given to the parent on the day of the incident. The second copy of the report shall be retained at the facility in an accident file. The third copy of the report shall be retained at the facility in the child's file.

Regulation: 3270.111(c)

Description: Promote development

Noncompliance Area: Staff #1 stated they carried Child #1 to the office while the child flailed, kicked, and would not walk. Staff #1 held the child on their lap and restrained the child's movement for a minimum of 10 minutes. During this timeframe, Staff #1 stated the child was yelling and kicking.

Correction Required: 1. Daily activities shall promote the development of skills, social competence and self-esteem. Daily experiences shall recognize the child as an individual and give some choice of activities that respect personal privacy, lifestyle and cultural background. This portion of the plan should have an immediate correction date. 2. The legal entity must arrange for all facility staff to receive a minimum of two hours of training regarding appropriate daily activities to use with children. Following the training, the legal entity must arrange for at least two technical assistance (TA) sessions in any classroom that requests TA in using appropriate daily activities. The legal entity must receive DHS approval of the training content prior to scheduling the training. The operator shall provide a date of when this training will be completed.

Regulation: 3270.111(c)

Description: Promote development

Noncompliance Area: Self- report investigation revealed that during naptime in the young toddler classroom, staff #1 was observed patting child #1 in an aggressive manner and laying their arm across them to keep child #1 on their cot. Child #1 was also observed to have their head covered by a blanket.

Correction Required: TIRED LIS: 1. A facility person must use daily activities shall promote the development of skills, social competence and self-esteem. Daily experiences shall recognize the child as an individual and give some choice of activities that respect personal privacy, lifestyle and cultural background. This portion of the plan shall have an immediate correction date. 2. The legal entity shall arrange for all facility staff to receive a minimum of two hours of in-person training regarding appropriate naptime practices. The training must include information about safe sleep and appropriate strategies for assisting children who resist nap time. Following the training, the legal entity must arrange for at least two technical assistance (TA) sessions in the young toddler classrooms and any other staff that requests TA in their classrooms. The legal entity must receive DHS approval of the training content and TA prior to scheduling the training. The operator shall provide a date of when this training and TA will be completed. 3. The legal entity must submit documentation in a format approved by DHS proving that the facility is promoting daily appropriate activities during naptime (for example a daily naptime staff observation checklist completed by the director). The legal entity will confirm continuing compliance by sending copies of the documentation to the Regional Office of Child Development and Early Learning on a weekly basis for a period of three months after DHS approves the documentation format. The correction date for this portion of the plan shall be at minimum 3 months from the date the Regional Office approves the checklist.

Regulation: 3270.113(a)(1)

Description: Staff assigned to specific children

Noncompliance Area: Child #1 in PK-1 was left in the bathroom for approximately 2-5 minutes by staff persons #1 and #2 when the class went back to the classroom. Child #1 was discovered by another teacher when their class was in the bathroom. Child #1 was never alone in the bathroom.

Correction Required: 1. 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. This portion of the plan should have an immediate correction date. 2. The legal entity must arrange for all facility staff to receive a minimum of two hours of training regarding supervision of children. The legal entity must receive DHS approval of the training content prior to scheduling the training. The operator shall provide a date of when this training will be completed.

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

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

Noncompliance Area: Staff persons #1, #2, and #3 were observed working with children and did not have a current health assessment on file nor did they have a TB test at initial employment on file.

Correction Required: A facility person providing direct care who comes into contact with the children or who works with food preparation shall have a health assessment conducted within 12 months prior to providing initial service in a child care setting and every 24 months thereafter. A health assessment is valid for 24 months following the date of signature, if the person does not contract a communicable disease or develop a medical problem. An adult health assessment must include tuberculosis screening by the Mantoux method at initial employment. Subsequent tuberculosis screening is not required unless directed by a physician, physician's assistant, CRNP, the Department of Health or a local health department.

Regulation: 3270.95(a)/3270.95(b)

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

Noncompliance Area: Documentation shows that the fire detection system was not tested every 30 days. 12/3/25 and 1/7/26 (35 days)

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: 3270.113(a)

Description: Supervised at all times

Noncompliance Area: An altercation took place between child #1 and child #2 in the PK-2 classroom. Staff persons #1 and #2 were unable to give an amount of time that the altercation took place or the amount of time it took for them to notice the altercation.

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.

Regulation: 3270.113(a)(1)

Description: Staff assigned to specific children

Noncompliance Area: In the PK-2 classroom staff member #1 was unable to name the children in their primary care group.

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.

Regulation: 3270.182(7)

Description: Reports of accidents, injuries and illnesses. Original report - parent same day Copy - facility accident file. Copy - child's file

Noncompliance Area: Child #1 had scratch marks and red marks on their cheek, and an incident report was not written nor given to the parents the day of the incident.

Correction Required: A child's record shall contain reports of accidents, injuries and illnesses involving a child in care at the facility. The original report shall be given to the parent on the day of the incident. The second copy of the report shall be retained at the facility in an accident file. The third copy of the report shall be retained at the facility in the child's file.

Regulation: 3270.113(a)(1)

Description: Staff assigned to specific children

Noncompliance Area: It was observed that in the OT classroom staff persons 1 and 2 named 12 of 17 children. It was observed that in the PK-2 classroom, staff person #3 was unable to name the children in care during nap time. It was observed that in the PS-1 classroom there were 14 children and staff persons 4 and 5 named 13 children. It was observed that in the PK-1 classroom, staff person #6 was working alone during nap time, but only named the children in their care group not all the children in the classroom.

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.

Regulation: 3270.51

Description: Similar Age Level

Noncompliance Area: On 11/18/25, the kindergarten classroom with 22 five-year-olds and the PK-2 classroom with 16 four and five-year-olds were out of ratio for 25 to 30 minutes as one staff person was left supervising the children in each of the aforementioned classrooms.

Correction Required: When children are grouped in similar age levels, the following maximum child group sizes and ratios of staff persons apply: Infants 1:4 with a maximum group size of 8; Young toddlers 1:5 with a maximum group size of 10; Older toddlers 1:6 with a maximum group size of 12; Preschool children 1:10 with a maximum group size of 20; Young school-age children 1:12 with a maximum group size of 24; Older school-age children 1:15 with a maximum group size of 30.

Regulation: 3270.68(a)

Description: No smoking areas

Noncompliance Area: Facility Self- Reported the following incident occurred on 8/15/25: Facility person #1, employed by an outside agency, was observed to have a vape pen in hand and was actively smoking in the childcare facility.

Correction Required: Cigarettes, pipes or cigars may not be smoked in a childcare space, a play space or a food preparation area when children are in care or when food is being prepared.

Regulation: 3270.111(c)

Description: Promote development

Noncompliance Area: Staff persons #1 and #2 were reported to have used loud tones and impatient language with children.

Correction Required: Daily activities shall promote the development of skills, social competence and self-esteem. Daily experiences shall recognize the child as an individual and give some choice of activities that respect personal privacy, lifestyle and cultural background.

Regulation: 3270.123(a)(3)

Description: Services proceeded

Noncompliance Area: On 1/24/25, it was observed that the agreement forms for children 1, 2, 3, 4, 5, 6, 7, 8, and 9 did not include serveices that would be provided to the children.

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: 3270.151(c)(3)

Description: Exam communicable disease

Noncompliance Area: On 1/24/25, it was observed that the health assessment for staff person 1 did not include the results of screening for communicable diseases.

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

Regulation: 3270.27(a)(5)

Description: Emergency plan

Noncompliance Area: On 1/24/25, it was observed that the facility emergency plan did not include a plan for accommodations for infants, toddlers, children with disabilities, and children with chronic medical conditions. CORRECTED ON SITE.

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

Regulation: 3270.66(a)

Description: Locked or inaccessible

Noncompliance Area: On 1/24/25, it was observed that White Out was accessible to children in the PreK 2 and Preschool 2 classrooms. CORRECETED ON SITE.

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: 3270.66(b)

Description: Original container

Noncompliance Area: On 1/24/25, it was observed that magic erasers were stored without their original container and were not labeled in the Preschool 2 and Tot classrooms. CORRECTED ON SITE.

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.

Regulation: 3270.111(c)/3270.113(e)

Description: Promote development/Restraints prohibited

Noncompliance Area: On 8-6-2-23 at approximately 2:23 pm child #1 was strapped into his stroller by staff #1 without any developmentally appropriate stimulation or enrichment activities for a period from 2-5 minutes.

Correction Required: Daily activities shall promote the development of skills, social competence and self-esteem. Daily experiences shall recognize the child as an individual and give some choice of activities that respect personal privacy, lifestyle and cultural background. A facility person may not restrain a child by using bonds, ties or straps to restrict a child's movement or by enclosing the child in a confined space, closet or locked room. The prohibition against restraining a child does not apply to the use of adaptive equipment prescribed for a child with special needs.

Regulation: 3270.95(a)/3270.95(b)

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

Noncompliance Area: Facility self-report on 8-11-23, while performing 30 day testing of the facility's smoke detection system, the lights flashed but the alarm did not sound.

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: 3270.124(d)

Description: Excursions

Noncompliance Area: It was observed at the time of inspection that the emergency contact information specific to child #1 and child #2 on a swimming excursion, did not accompany a staff person on the excursion.

Correction Required: When children leave the facility on walking and riding excursions, emergency contact information specific to each child on the excursion shall accompany a staff person on the excursion.

Regulation: 3270.20(b)

Description: Mail or deliver written report to regional office within 72 hours

Noncompliance Area: A child was injured at the facility on 6-2-2023 at 11:15 am. The incident report was delivered at 4:11 pm on 6-5-2023 more than 72 after emergency room treatment.

Correction Required: The operator shall mail or deliver a written report to the appropriate regional office within 72 hours after hospitalization of a child in care, emergency room treatment of a child in care, death of a child in care, a facility fire requiring the services of a fire department.

Regulation: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: It was observed at the time of inspection staff #1, hired on 3-21-23, did not have a National Sex Offender Registry Clearance in their file. Staff #1 was working beyond the provisional hire period of 45 days without a National Sex Offender Registry Clearance .

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 at the facility.

Regulation: 3270.104(a)

Description: Clean, good repair, proper size

Noncompliance Area: Observed the mats used in the PS3 room to be in disrepair with the foam interior exposed on multiple mats.

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

Regulation: 3270.131(b)(2)

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

Noncompliance Area: Children's files were reviewed. Children #1 and #2 do not have updated health assessments on file. Correct child #1 and child #2 folders by contacting parents and receiving new health assessments.

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: 3270.77(a)

Description: No peeling paint or plaster

Noncompliance Area: Observed damaged paint to be present near the exterior door in the PK1 room.

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

Regulation: 3270.102(a)

Description: Clean and good repair

Noncompliance Area: It was observed at the time of inspection the metal heating vent cover had sharp corners. The plastic mats used for napping in the Pre-School 2 classroom were cracked and the foam was exposed.

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: 3270.106(a)

Description: Clean, age appropriate

Noncompliance Area: It was observed at the time of inspection that child #1's pack and play was not labeled for the specific use of child #1.

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.

Regulation: 3270.76

Description: Building Surfaces

Noncompliance Area: It was observed at the time of inspection the floor under the metal preparation table in the kitchen was dusty and had dried liquid on the floor.

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: Plastic bags were observed in the Young Toddler 2 room on low shelves in multiple locations throughout the room, accessible to children who are still placing objects in their mouths. Pom poms, with a diameter of less than an inch, were also observed in the Young Toddler 2 room, accessible to children. A plastic bag was observed in the Young Toddler 1 room, next to the changing table, accessible to children who are still placing objects in their mouths. ALL CORRECTED ON SITE

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

Noncompliance Area: The file for child #2 (enrollment date 1/2/18) included an initial health assessment dated 5/9/18. The file for child #3 (enrollment date 7/24/18) included an initial health assessment dated 10/25/18. These health assessments were both obtained past the initial 60 days of 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: It was observed that the Loratadine for child #1 was not labeled with child's name. CORRECTED ON SITE

Correction Required: The label of a medication container shall identify the name of the medication and the name of the child for whom the medication is intended. Medication shall be administered to only the child whose name appears on the container.

Noncompliance Area: The file for staff person #1 (start date 9/3/19) included an initial health assessment and TB test dated 10/7/19.

Correction Required: A facility person providing direct care who comes into contact with the children or who works with food preparation shall have a health assessment conducted within 12 months prior to providing initial service in a child care setting and every 24 months thereafter. A health assessment is valid for 24 months following the date of signature, if the person does not contract a communicable disease or develop a medical problem.An adult health assessment must include tuberculosis screening by the Mantoux method at initial employment. Subsequent tuberculosis screening is not required unless directed by a physician, physician's assistant, CRNP, the Department of Health or a local health department.

Noncompliance Area: The file for staff person #2 (hire date 4/8/19) included an FBI clearance dated 4/19/19, a State Police clearance dated 4/18/19 and a Child Abuse clearance dated 6/28/19, all obtained after starting work in a child care position at the facility with provisional hire paperwork dated the same as the clearances. The file for staff person #3 (hire date 7/2/19) included a State Police clearance dated 8/27/19, with no provisional hire paperwork on file. The file of Staff Person #4 hired (11/23/19) did not contain completed child abuse and criminal history information required under the CPSL and does not contain a copy of a request for child abuse history clearance, a copy of a request for criminal history clearances required for provisional hiring under the CPSL. Staff person #4 cannot work in a child care position at the facility.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). LACKING REQUIRED HIRING DOCUMENTS: Facility Person #4 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 #4 may not work in a child care position at the facility.

Noncompliance Area: It was observed that there was a plastic bag with wipes in it accessible to children in the 1&1/2-2 year old room, under the changing table. *CORRECTED ON SITE. Plastic bags holding diapers were also observed under the sink, in the bathroom that is used by 2 year olds. These plastic bags were accessible to children. *CORRECTED ON SITE. Plastic bags were also observed as accessible in the older toddler room (2s and 3s), in the closet that was not locked. *CORRECTED ON SITE

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 fee agreement for child #2 did not contain a departure time.

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

Noncompliance Area: The initial health assessment for child #1 was not completed within 60 days of child's start date at facility. Child's Start date was 8/20/18 and the initial health assessment is dated 11/23/18.

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 medication for child #3 did not have child's name on the medication. *CORRECTED ON SITE

Correction Required: The label of a medication container shall identify the name of the medication and the name of the child for whom the medication is intended. Medication shall be administered to only the child whose name appears on the container.

Noncompliance Area: It was observed that the first aid kit in the Young Toddler room (2s), did not contain tape. *CORRECTED ON SITE

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: It was observed that Staff #1, #2, #3 & #4 did not have updated health assessments conducted within 24 months of the previous health assessments on file. Staff #1, #2 & #3 currently have new assessments on file. Staff #4 is in need of a new 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: It was observed that windows above the ground floor that opened directly to the outdoors and were accessible to children in classroom spaces had not been modified or adapted to limit the opening to 6 or fewer inches.

Correction Required: Windows or doors above the ground floor that open directly to the outdoors and are accessible to children shall be constructed, modified or adapted to limit the opening to 6 or fewer inches.

Noncompliance Area: It was observed, in the young toddler 1 classroom, that the heating vents (along windows) had rust which created a potiental hazard to children.

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.