Tiny Hands Tiny Toes Learning Center Llc

Regulation: 3270.106(a)

Description: Clean, age appropriate

Noncompliance Area: An unannounced inspection was conducted 4/7/26. At that time, Child #2 was observed sleeping directly on the floor of Room #3.

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: 3270.106(f)

Description: 2 feet apart

Noncompliance Area: An unannounced inspection was conducted 4/7/26. At that time, a child was observed sleeping on a cot. On one side, Child #2 was observed sleeping on the floor up against the cot. On a second side, another child was observed sleeping on a cot up against the cot. There was not two feet of space on three sides of the middle child's cot.

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(d)

Description: No harsh language

Noncompliance Area: A complaint inspection was conducted 4/7/26. It was determined through interviews that Staff Person #1 and Staff Person #3 have yelled harshly at the children, including Staff Person #3 yelling " Lay down! You don't have a choice! Staff Person #3's gonna make you nap!"

Correction Required: A facility person may not use harsh, demeaning or abusive language in the presence of children. TIERED LIS: 1. A facility person may not use harsh, demeaning or abusive language in the presence of children. This portion of the plan shall have an immediate correction date. 2. The legal entity must create a discipline policy. This policy must specifically include positives strategies for guiding children's behavior. The discipline policy must address compliance with 3270.113b, 3270.113c, 3270.113d, and 3270.113e. The discipline policy must include what to do if a staff person observes another staff person not following the discipline policy. 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 current staff and have staff sign off that they understand and will follow the discipline policy. All new staff hired must review the discipline policy with the director at their time of hire and must sign off that they understand and will follow the discipline policy. The operator shall provide a correction date for when the policy will be reviewed with all staff.

Regulation: 3270.63

Description: Unsafe Areas in Outdoor Space

Noncompliance Area: An unannounced inspection was conducted 4/7/26. At that time, Staff Person #1 stated that the children are playing in the facility's parking lot and use cones to block off a section of the parking lot. There is no barrier restricting the children from traveling to other areas of the parking lot.

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.

Regulation: 3270.101(a)/3270.103

Description: Age appropriate/Small Toys and Objects

Noncompliance Area: An unannounced inspection was conducted on 3/18/26. At that time, magnetic tiles were observed on the floor in Room 2, where older toddlers were receiving care. The magnetic tiles are recommended for ages three and up on the manufacturer's instructions.

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. 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(a)/3270.113(a)(1)

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

Noncompliance Area: A complaint inspection was conducted 3/18/26. At that time, staff stated that they sit in the hall area to supervise Room 3 and Room 4 during naptime while the children sleep so that the other staff can leave for a lunch break.

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. 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 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. 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 shall have an immediate correction date. 2. The legal entity must create a policy in order to maintain proper supervision. This policy will ensure that all children are properly assigned to a staff person and supervised at all times. This policy must address supervision during transition times, such as visiting the bathroom and supervision on the playground. The policy must address supervision during naptime. The policy must address naptime ratios and what to do if a child is off their nap mat for a quiet activity. The policy should address naptime ratios when infants are in care. The policy should include the procedures to follow if the children wake and leave their nap mats while naptime ratios are being followed. The legal entity must receive approval of the policy from the Regional Office. Once approved by the Regional Office, the legal entity must review the 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 the policy will be reviewed with all staff.

Regulation: 3270.113(d)

Description: No harsh language

Noncompliance Area: A complaint investigation was conducted on 3/18/26 and 3/23/26. On 3/23/26, staff disclosed that Staff Person #2 had screamed at the children loud enough to be heard in other rooms and outside. Staff Person #2 has yelled "Sit down," "Stop it," and "These kids are pissing me off." Staff Person #2 has also screamed in staff's faces in front of the children. Staff Person #2 was terminated from employment on 3/2/26.

Correction Required: A facility person may not use harsh, demeaning or abusive language in the presence of children.

Regulation: 3270.66(a)/3270.133(4)

Description: Locked or inaccessible/Locked

Noncompliance Area: A complaint inspection was conducted 3/18/26. At that time, a Febreeze plug in was observed plugged into a wall outlet approximately 8 inches high on the wall in Room 4, where it was accessible to the toddlers in the room. During the inspection, Staff Person #1 stated that they had taken their medication at the facility sometime in January 2026. Staff Person #1 stated that they thought they had taken all of their medication, but Child #1 was found with a pill in their mouth. The child did not swallow the pill.

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. TIERED LIS 1. 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. This portion of the plan shall have an immediate correction date. 2.The legal entity must arrange for at least 4 hours of in-person Technical Assistance for Healthy Environments approved by the Northeast Regional Office. The director, assistant director, and staff should be present during the Technical Assistance. The operator shall provide a correction date for when the Technical Assistance will be completed. 3. The facility will maintain compliance with 3270.66a and 3270.133(4) for a period of three months. There may be no instances of noncompliance during this time period during unannounced inspections. The operator shall provide a correction date for when the three months of noncompliance will be completed.

Regulation: 3270.76

Description: Building Surfaces

Noncompliance Area: A complaint inspection was conducted 3/18/26. At that time, a television was observed on a high shelf with the wire pulled tightly to the electrical outlet located approximately eight inches from the floor in Room 3. A television was observed leaned against a wall on a shelf in Room 4 and was not stabilized in any way by a stand or wall mounting. The televisions pose a crushing hazard. The toilet handle in the bathroom across from Room 3 and Room 4 is not working and the toilet is not able to be flushed. The door past the back bathroom was observed to be falling off it's hinges. The door between Room 2 and the kitchen area was observed to have the door handle installed backwards, making it difficult to open and close. Staff stated that the door handle to the bathroom is loose and has to be tightened often because the children pull on it when they visit the bathroom. The doorknob of Room #1 does not latch properly.

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: 3270.91(a)

Description: Stairs, exits, etc. unobstructed

Noncompliance Area: An unannounced inspection was conducted on 3/18/26 and 3/23/26. On 3/23/26, the door in Room 1 leading to the back rooms was blocked by a baby bouncer. The opposite side of the door was blocked by an arched climber. This door is marked as an emergency exit. The staff stated that the door is blocked because it does not latch and the young toddlers push it open and leave the room.

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

Regulation: 3270.95(a)/3270.95(b)

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

Noncompliance Area: An unannounced inspection was conducted on 3/18/26. At that time, the smoke detector in the Room 4 was chirping. The thirty-day testing log of the smoke detectors was reviewed. The thirty day testing log showed that the smoke detectors had not been tested every thirty days. This is evidenced by the testing dates on the log: 12/1/25, 1/9/26, 2/10/26, and 3/13/26.

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: 3270.101(a)/3270.111(c)

Description: Age appropriate/Promote development

Noncompliance Area: A renewal inspection was conducted 8/22/25. At that time, school age children were observed playing the video game "The Last of Us" which is rated mature (ages 17 and up). An older toddler and two other school age children were watching a school age child play the video game. Five other school age children were present in the room. Magnatiles were observed on the floor of Classroom 1, where infants and toddlers were in care. Magnatiles are recommended for ages three and up.

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. 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: 3270.103

Description: Small Toys and Objects

Noncompliance Area: A renewal inspection was conducted 8/22/25. At that time, disposable gloves were observed on the back of the toilet where they were accessible to the toddlers being diapered in the bathroom.

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

Regulation: 3270.105

Description: High Chairs

Noncompliance Area: A renewal inspection was conducted 8/22/25. At that time, one of the high chairs in Classroom 1 did not include a t-shaped safety strap. Staff in the room said that the high chair is used to feed infants.

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

Regulation: 3270.106(a)

Description: Clean, age appropriate

Noncompliance Area: A renewal inspection was conducted 8/22/25. At that time, two pack-n-plays were observed in Classroom 1. The pack-n-plays were not labeled for use by an individual child. Staff said that infants sleep in the pack-n-plays.

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: 3270.107

Description: Refrigerator

Noncompliance Area: A renewal inspection was conducted 8/22/25. At that time, the refrigerator in the kitchen was dirty and did not contain a thermometer.

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

Regulation: 3270.111(b)

Description: Posted in group space

Noncompliance Area: A renewal inspection was conducted 8/22/25. At that time, the daily schedule could not be located in Classroom 3 or Classroom 4.

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

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

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

Noncompliance Area: A renewal inspection was conducted 8/22/25. At that time, Child #6, a preschool child, was observed walking out of Classroom 1 unsupervised and shutting the door at 10:32am. Child #6 walked through the kitchen area, entering the bathroom across from the Playroom. Child #6 returned to the room at 10:34am. Child #7 was observed walking out of Classroom 2 unsupervised and closing the door at 10:24am to go to the bathroom in the hallway. Child #7 returned to Classroom 2 at 10:26am.

Correction Required: Children on the facility premises and on facility excursions off the premises shall be supervised by a staff person at all times. Children must be supervised 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. This portion of the plan shall have an immediate correction date. 2. The legal entity must arrange for all facility staff hired as of the date of the training to receive a minimum of 3 hours of PQAS-approved training regarding Supervision & Ratios. The legal entity must receive DHS approval of the training content prior to scheduling the training. The operator shall provide a correction date for when the training will be completed.

Regulation: 3270.124(b)(2)

Description: Physician name, address, phone

Noncompliance Area: A renewal inspection was conducted 8/22/25. At that time, the child files were reviewed. The emergency contact form for Child #2 did not include the address of the child's doctor.

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

Regulation: 3270.124(b)(3)

Description: Parent home/work address, phone

Noncompliance Area: A renewal inspection was conducted 8/22/25. At that time, the child files were reviewed. The emergency contact form for Child #3 did not include the work information for the child's mother or the work address of the child's father.

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

Regulation: 3270.124(b)(7)

Description: Name/address/phone release person

Noncompliance Area: A renewal inspection was conducted 8/22/25. At that time, the child files were reviewed. The emergency contact form for Child #2 did not include the address of the release person.

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

Regulation: 3270.124(c)

Description: Each child care space

Noncompliance Area: A renewal inspection was conducted 8/22/25. At that time, the emergency contact forms for the children in the classrooms were not present in Classroom 1, Classroom 2, or Classroom 3.

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

Regulation: 3270.124(f)/3270.181(c)

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

Noncompliance Area: A renewal inspection was conducted 8/22/25. At that time, the child files were reviewed. The emergency contact form for Child #4 had not been updated since 7/10/24. The fee agreement for Child #4 had not been updated in a 6 month period. This was evidenced by the dates of the updates on the fee agreement for Child #4 being 7/9/24 and 6/11/25. The emergency contact form for Child #5 had not been updated since 6/9/24. The fee agreement for Child #5 had not been updated in a 6 month period. This was evidenced by the dates of the updates on the fee agreement for Child #4 being 9/6/24 and 6/11/25.

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

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

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

Noncompliance Area: A renewal inspection was conducted 8/22/25. At that time, the child files were reviewed. The most recent health assessment on file for Child #5, a young toddler, was dated 12/18/24.

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: A renewal inspection was conducted 8/22/25. At that time, the child files were reviewed. The most recent health assessment on file for Child #4, an older toddler, was dated 7/10/24.

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. A child's record shall contain initial and subsequent health reports.

Regulation: 3270.131(d)(5)/3270.131(e)(1)

Description: Immunization record/Exemption documentation from parent/guardian

Noncompliance Area: A renewal inspection was conducted 8/22/25. At that time, the child files were reviewed. The immunization record for Child #1 did not include administration of the rotavirus vaccine, the DTAP vaccine, the HIB vaccine, the pneumococcal vaccine, the polio vaccine, or the second dose of the hepatitis B vaccine. The child's file did not include a letter of exemption from the immunizations.

Correction Required: A health report shall include a review of the child's immunized status according to recommendations of the ACIP. 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. Child #1 must be dismissed from care by close of business 8/22/25 and may only return to care when the immunization record is updated or when a parent provides a written, signed exemption letter.

Regulation: 3270.135(b)

Description: Surfaces cleaned

Noncompliance Area: A renewal inspection was conducted 8/22/25. At that time, the diaper changing pad in the child's bathroom was equipped with a fabric liner and was not able to be properly sanitized between each use.

Correction Required: 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.

Regulation: 3270.151(c)(2)

Description: Mantoux TB

Noncompliance Area: A renewal inspection was conducted 8/22/25. At that time, the staff files were reviewed. The file for Staff Person #5 did not include the date of the staff's TB test results.

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: 3270.161(d)

Description: Potentially hazardous food refrigerated

Noncompliance Area: A renewal inspection was conducted 8/22/25. At that time, a lunch box was observed in a floor level cubby in the infant room. The lunch box contained mashed potatoes and gravy, macaroni and cheese, applesauce, and watermelon.

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

Regulation: 3270.166(1)

Description: Written statement

Noncompliance Area: A renewal inspection was conducted 8/22/25. At that time, a feeding schedule had not yet been provided by the parent of one of the infants in care.

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

Regulation: 3270.166(4)

Description: Bottles labeled

Noncompliance Area: A renewal inspection was conducted 8/22/25. At that time, an unlabeled bottle was observed in the kitchen refrigerator. Three more unlabeled bottles were observed on a shelf in Classroom 1, the infant room.

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

Regulation: 3270.171(a)

Description: Pick-up and drop-off points

Noncompliance Area: A renewal inspection was conducted 8/22/25. At that time, the operator stated that the traffic letter had not been sent to the local traffic authorities in the past year.

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

Regulation: 3270.171(c)

Description: Safe routes posted

Noncompliance Area: A renewal inspection was conducted 8/22/25. At that time, written notification of safe routes was not posted by the operator at 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: 3270.18(a)

Description: On file at facility

Noncompliance Area: A renewal inspection was conducted 8/22/25. At that time, the liability insurance could not be located at the facility.

Correction Required: The legal entity shall have comprehensive general liability insurance to cover the persons who are on the premises. A current copy of the insurance policy shall be on file at the facility.

Regulation: 3270.27(a)(6)

Description: Emergency plan

Noncompliance Area: A renewal inspection was conducted 8/22/25. At that time, the operator stated that an emergency drill had not been conducted within the past year.

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

Regulation: 3270.27(c)

Description: Training regarding plan

Noncompliance Area: A renewal inspection was conducted 8/22/25. At that time, the staff files were reviewed. The documentation of emergency plan training that is kept with the emergency plan was reviewed. The documentation stated that training occurred for the following staff on 9/18/24: Staff Person #2, Staff Person #3, Staff Person #4, Staff Person #5, and Staff Person #6. Staff Person #2, Staff Person #3, Staff Person #4, Staff Person #5, and Staff Person #6 were not employed at the facility until after that date.

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

Regulation: 3270.31(e)

Description: Age and Training

Noncompliance Area: A renewal inspection was conducted 8/22/25. At that time, the staff files were reviewed. The file for Staff Person #1 did not include documentation of any child care training hours within the staff's last year of training: 7/8/24-7/8/25.

Correction Required: A staff person shall obtain an annual minimum of 12 clock hours of child care training. Staff person #1 must take 12 hours of professional development to fulfill requirement for training year 7/8/24-7/8/25. Hours used to fulfill training year 7/8/24-7/8/25 may not be used to fulfill current training year.

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

Description: Age and Training

Noncompliance Area: A renewal inspection was conducted 8/22/25. At that time, the staff files were reviewed. Staff person #1 has not completed approved 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 6/2025. Documentation of updated Pediatric first aid and CPR training is not on file.

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. Until such time as the required pediatric first aid and cpr training has been completed, staff person #1 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 #1, then staff person #1 may not work in a child-care position at the facility.

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

Description: Fire safety - 1 yr.

Noncompliance Area: A renewal inspection was conducted 8/22/25. At that time, the staff files were reviewed. The file for Staff Person #1 did not include any fire safety training.

Correction Required: Staff persons shall participate, at least annually, in firesafety 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: 3270.34(b)(2)/3270.192(2)(ii)

Description: Bachelor's, 30 credits + 2 yrs/Exp, educ., training prior to facility

Noncompliance Area: A renewal inspection was conducted 8/22/25. At that time, the staff files were reviewed. The file for Staff Person #2, the director, was reviewed. The file contained a Bachelor of Technology degree from NYC College of Technology and verification of two years working with children. The file did not contain the college transcripts or any other documentation of at least 30 credits in the human services field.

Correction Required: A director shall have attained a bachelor's degree from an accredited college or university, including 30 credit hours in early childhood education, child development, special education, elementary education or the human services field and 2 years of experience with children. A facility person's record shall include verification of child care experience, education and training prior to service at the facility.

Regulation: 3270.36(b)(5)/3270.192(2)(ii)

Description: HS/GED + 2 yrs/Exp, educ., training prior to facility

Noncompliance Area: A renewal inspection was conducted 8/22/25. At that time, the staff files were reviewed. The file for Staff Person #6, an assistant group supervisor, did not contain verification of high school education. The file did contain verification of two years' experience working with children.

Correction Required: An assistant group supervisor shall have a high school diploma or a general educational development certificate and 2 years experience with children. A facility person's record shall include verification of child care experience, education and training prior to service at the facility.

Regulation: 3270.52

Description: Mixed Age Level

Noncompliance Area: A renewal inspection was conducted 8/22/25. At that time, Staff Person #6 was observed caring for a group of eight young and older school age children and Child # 3, an older toddler. Staff Person #6 said that Child #3 was sent to the room because Child #3 had been hitting other children in the older toddler room.

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

Regulation: 3270.61(h)/3270.62(b)

Description: Exceeding Capacity/Play space - 65 square feet/child

Noncompliance Area: A renewal inspection was conducted 8/22/25. At that time, Staff Person #4 was observed in the Playroom with a group of six children consisting of 4 older toddlers and 2 preschool children. The Playroom is play space measured for a capacity of one child.

Correction Required: The capacity established for an indoor space may not be exceeded. Outdoor or indoor play space shall be measured at 65 square feet per child.

Regulation: 3270.66(a)/3270.133(4)

Description: Locked or inaccessible/Locked

Noncompliance Area: A renewal inspection was conducted 8/22/25. At that time, Kidgets vitamin A&D ointment was observed on a shelf approximately 12 inches high in the bathroom where it was accessible to children. Aquaphor and gentle steps diaper rash cream were on a shelf approximately 18 inches high in Classroom 1, the infant room, where they were accessible to the mobile infants and toddlers. Child #1, an infant, was observed playing with Butt Paste diaper cream in the infant room. Children's tylenol and children's motrin were observed in a diaper bag in a floor level cubby where they were accessible to children. Antibacterial wipes were observed in a diaper bag on the floor of Classroom 1, where they were accessible to the children. Gentle Steps Vitamin A&D ointment was observed in a floor level cubby in Classroom 2, where it was accessible to children. Hand sanitizer was observed on the sink ledge of the children's bathroom across from the Playroom and was accessible to the toddlers and preschool children who were using the bathroom. All items were labeled "keep out of reach of children."

Correction Required: Cleaning materials and other toxic materials shall be kept in an area or container that is locked or made inaccessible to children. Medication shall be stored in a locked area of the facility or in an area that is out of the reach of children. TIERED LIS 1. 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. This portion of the plan shall have an immediate correction date. 2. The legal entity must arrange for all facility staff hired as of the date of the training to receive a minimum of 2 hours of PQAS-approved training regarding Health & Safety -- Healthy Environment. The legal entity must receive DHS approval of the training content prior to scheduling the training. The operator shall provide a correction date for when the training will be completed.

Regulation: 3270.67(d)

Description: Contaminated trash in closed plastic-lined receptacle

Noncompliance Area: A renewal inspection was conducted 8/22/25. At that time, an unlidded trash can in the hallway next to Classroom 4 was observed. The trash can contained a discarded cereal bowl with milk and cheerios. A trash can that was not plastic lined or equipped with a lid was observed on the floor in the children's bathroom across from the playroom. The trash can contained discarded tissues and paper towels.

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

Regulation: 3270.69(b)

Description: 110º F or less

Noncompliance Area: A renewal inspection was conducted 8/22/25. At that time, the hot water in the sink in the children's bathroom across from the Playroom reached a temperature of 121° F.

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

Regulation: 3270.71

Description: Heat Source

Noncompliance Area: A renewal inspection was conducted 8/22/25. At that time, the children were observed walking to and from the bathroom and playroom through the kitchen area. A toaster oven was observed on the counter approximately three feet high next to the entryway to the hall with the Playroom and bathroom. The director stated that the toaster oven is used to heat breakfast and lunches, including chicken nuggets, and is unplugged after use but is not moved to an area where it is inaccessible to the children while it is cooling down after use.

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: 3270.75(c)/3270.75(d)

Description: Has all items/On excursions

Noncompliance Area: A renewal inspection was conducted 8/22/25. At that time, the first aid kit in Classroom 2 did not contain gloves. The first aid kit in the emergency backpack that is brought to and from excursions did not include soap, tweezers, scissors, or gloves.

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. One first-aid kit per child care group must accompany children and facility persons on excursions from the facility. Each first aid kit taken on an excursion must contain a bottle of water in addition to the items specified at §3270.75(c).

Regulation: 3270.76

Description: Building Surfaces

Noncompliance Area: A renewal inspection was conducted 8/22/25. At that time, an overflowing trash can was observed in the kitchen area of the facility. Two carpets were bunched up on the floor of Classroom 4 posing a tripping hazard. A diaper bag was observed set on top of a high chair with a strap hanging down. An infant was observed pulling on the strap during the inspection, posing a hazard. The wall next to the door connected Classroom 1 and Classroom 2 was visibly dirty.

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: A renewal inspection was conducted 8/22/25. At that time, damaged plaster was observed in the hallway next to the Playroom. Peeling paint was observed along the wall in Classroom 1, Classroom 2, Classroom 3, and Classroom 4. Damaged plaster was observed in the front corner of Classroom 1 opposite the door and next to the door leading into the hallway to Classroom 3.

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

Regulation: 3270.95(a)/3270.95(b)

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

Noncompliance Area: A renewal inspection was conducted 8/22/25. At that time, the thirty day testing log of the fire detection system was reviewed. The log showed that testing had not occurred every thirty days. This was evidenced by the fire detection testing log testing dates of 5/1/25, 6/2/25, 7/2/25. The log did not include documentation of any testing in 8/2025.

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

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

Noncompliance Area: An unannounced inspection was conducted 2/7/25. At that time, the staff files were reviewed. The file for Staff Person #1 did not include a health assessment. The file for Staff Person #2 did not include a health assessment. The file for Staff Person #3 did not include a health assessment or TB test results. The file for Staff Person #4 did not include a health assessment or TB test results.

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: 3270.192(5)

Description: Two written references

Noncompliance Area: An unannounced inspection was conducted 2/7/25. At that time, the staff files were reviewed. The file for Staff Person #3 did not include any letters of reference.

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: An unannounced inspection was conducted 2/7/25. At that time, the staff files were reviewed. The file for Staff Person #1 did not include an NSOR or the request for the clearance.. The file for Staff Person #2 did not include a PA State Police Clearance, an FBI Clearance, or the requests for the clearances. Staff Person #1 and Staff Person #2 were observed working together, unsupervised by another staff, during the inspection. The file for Staff Person #3 included an NSOR dated 1/14/25, after their date of hire. The file did not include the request for the NSOR. The file for Staff Person #4 included a PA State Police Clearance requested and dated 1/106/25, after their date of hire. The PA Child Abuse Clearance on file for Staff Person #4 was dated 1/16/25, after 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. Staff Person #1 may not work in a child care position at the facility until an NSOR certificate is on file. Staff Person #2 may not work in a child care position at the facility until a PA State Police Clearance and DHS FBI Clearance are on file. The legal entity must create a hiring checklist. The checklist should include an outline of what needs to be in a staff file and by when. The hiring checklist must be submitted to Northeast Regional Office for approval. Once approved, the child care center will use the hiring checklist whenever a new staff is hired.

Regulation: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: An unannounced inspection was conducted 2/7/25. At that time, the staff files were reviewed. The file for Staff Person #1 did not include an NSOR or the request for the clearance.. The file for Staff Person #2 did not include a PA State Police Clearance, an FBI Clearance, or the requests for the clearances. Staff Person #1 and Staff Person #2 were observed working together, unsupervised by another staff, during the inspection. The file for Staff Person #3 included an NSOR dated 1/14/25, after their date of hire. The file did not include the request for the NSOR. The file for Staff Person #4 included a PA State Police Clearance requested and dated 1/106/25, after their date of hire. The PA Child Abuse Clearance on file for Staff Person #4 was dated 1/16/25, after 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. Staff Person #1 may not work in a child care position at the facility until an NSOR certificate is on file. Staff Person #2 may not work in a child care position at the facility until a PA State Police Clearance and DHS FBI Clearance are on file.

Regulation: 3270.36(b)(5)/3270.192(2)(ii)

Description: HS/GED + 2 yrs/Exp, educ., training prior to facility

Noncompliance Area: An unannounced inspection was conducted 2/7/25. At that time, the staff files were reviewed. The file for Staff Person #1 included verification of 2 years' experience working with children. The file also included education from the Dominican Republic that had not been evaluated by a service that is a member of the National Association of Credential Evaluation Services (NACES) or the Association of International Credential Evaluators (AICE). The file for Staff Person #3 included verification of 2 years' experience working with children, but did not include verification of education. The file for Staff Person #4 included verification of 2 years' experience working with children, but did not include verification of education.

Correction Required: An assistant group supervisor shall have a high school diploma or a general educational development certificate and 2 years experience with children. A facility person's record shall include verification of child care experience, education and training prior to service at the facility.

Regulation: 3270.65

Description: Protective Outlet Covers 5 yrs. or less

Noncompliance Area: An unannounced inspection was conducted 2/7/25. At that time, an uncovered electrical outlet was observed outside the bathroom in the hallway. An uncovered electrical outlet was observed in the gross motor room. Both uncovered electrical outlets were located in areas where they were accessible to the children.

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

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: A complaint inspection was conducted on 12/10/24. At that time, it was found that a parent did not receive an incident report for an injury their child received on 11/27/24. The director stated that the parent had been notified by message on the Bright Wheel app, but the message could not be found. The director also stated that the facility does not have a master file of incident reports.

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: 3270.103

Description: Small Toys and Objects

Noncompliance Area: A renewal inspection was conducted 9/13/24. At that time, plastic bags were observed on the bottom shelf of the changing table in the bathroom, where they were accessible to the toddlers. Plastic bags were observed hanging from hooks in Room 1, where they were accessible to the toddlers in the room. An acceptable plan of correction was submitted with a correction date of 9/13/24. On 10/8/24, an unannounced inspection was conducted. At that time, plastic bags were observed on the bottom shelf of the changing table in the bathroom, where they were accessible to the toddlers.

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

Regulation: 3270.135(a)(3)

Description: Disposable diapers

Noncompliance Area: A renewal inspection was conducted 9/13/24. At that time, the trash can used for diapering in the bathroom was not hands-free. An acceptable plan of correction was submitted with a correction date of 9/13/24. On 10/8/24, an unannounced inspection was conducted. At that time, dirty diapers were observed in an unlidded trash can that was not plastic-lined in the bathroom.

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: 3270.52

Description: Mixed Age Level

Noncompliance Area: On 10/8/24, an unannounced inspection was conducted. At that time, Staff Person #1 was observed working unsupervised with two older toddlers, four young toddlers, and one infant.

Correction Required: When children are grouped in mixed age levels, the age of the youngest child in the group determines the staff:child ratio and maximum group size in accordance with the requirements in § 3270.51 (relating to similar age level). The required staff:child ratios must be maintained at all times. The legal entity must post ratio requirements in all child care spaces.

Regulation: 3270.52

Description: Mixed Age Level

Noncompliance Area: On 10/8/24, an unannounced inspection was conducted. At that time, Staff Person #1 was observed working unsupervised with two older toddlers, four young toddlers, and one infant.

Correction Required: When children are grouped in mixed age levels, the age of the youngest child in the group determines the staff:child ratio and maximum group size in accordance with the requirements in § 3270.51 (relating to similar age level). The required staff:child ratios must be maintained at all times.

Regulation: 3270.103

Description: Small Toys and Objects

Noncompliance Area: A renewal inspection was conducted 9/13/24. At that time, plastic bags were observed on the bottom shelf of the changing table in the bathroom, where they were accessible to the toddlers. Plastic bags were observed hanging from hooks in Room 1, where they were accessible to the toddlers in the room.

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

Regulation: 3270.123(a)(5)

Description: Designated release persons

Noncompliance Area: A renewal inspection was conducted 9/13/24. At that time, the fee agreement for Child #3 did not include the designated release persons.

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

Regulation: 3270.123(a)/3270.123(b)

Description: Signed /Parent receives original

Noncompliance Area: A renewal inspection was conducted 9/13/24. At that time, there was no fee agreement on file for Child #2 or Child #4.

Correction Required: An agreement shall be signed by the operator and the parent. A parent shall receive the original agreement. The facility shall retain a copy of the agreement.

Regulation: 3270.124(a)

Description: Each child emergency contact person

Noncompliance Area: A renewal inspection was conducted 9/13/24. At that time, there was no emergency contact form on file for Child #2 or Child #3.

Correction Required: Emergency contact information is required for each enrolled child. Emergency contact information must reference who shall be contacted in an emergency.

Regulation: 3270.124(b)(3)

Description: Parent home/work address, phone

Noncompliance Area: A renewal inspection was conducted 9/13/24. At that time, the emergency contact form for Child #1 did not include the business name, address, and phone number of the parents.

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

Regulation: 3270.124(b)(4)

Description: Written consent

Noncompliance Area: A renewal inspection was conducted 9/13/24. At that time, the emergency contact forms for Child #1, Child #4, and Child #5 did not include signed consent by a parent for emergency medical care.

Correction Required: Emergency contact information must include the written consent signed by a parent for emergency medical care.

Regulation: 3270.124(b)(6)

Description: Insurance coverage information

Noncompliance Area: A renewal inspection was conducted on 9/13/24. At that time, the child files were reviewed. The emergency contact forms for Child #1 did not include the health insurance policy number.

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

Regulation: 3270.124(b)(7)

Description: Name/address/phone release person

Noncompliance Area: A renewal inspection was conducted on 9/13/24. At that time, the child files were reviewed. The emergency contact forms for Child #1 did not include the address and phone number of the release persons. The emergency contact forms for Child #4 did not include the address of the release persons.

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

Regulation: 3270.124(c)

Description: Each child care space

Noncompliance Area: A renewal inspection was conducted on 9/13/24. At that time, the emergency contact forms were not present in any classroom of the child care center.

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

Regulation: 3270.131(a)

Description: Health information

Noncompliance Area: A renewal inspection was conducted on 9/13/24. At that time, Child #1, who has been enrolled longer than 60 days at the facility, did not have a health report on file.

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: 3270.133(4)

Description: Locked

Noncompliance Area: A renewal inspection was conducted on 9/13/24. At that time, Boudreaux butt paste was observed on a shelf under the changing table in the bathroom where it was accessible to the 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: 3270.135(a)(3)

Description: Disposable diapers

Noncompliance Area: A renewal inspection was conducted 9/13/24. At that time, the trash can used for diapering in the bathroom was 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: 3270.182(5)

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

Noncompliance Area: A renewal inspection was conducted 9/13/24. At that time, the emergency contact forms for Child #1, Child #4, and Child #5 did not include 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: 3270.69(b)

Description: 110º F or less

Noncompliance Area: A renewal inspection was conducted 9/13/24. At that time, the hot water in the bathrooms reached a temperature of 119° F.

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