Tiny Fingers Tiny Toes Early Childcare Center

Regulation: 3270.104(a)

Description: Clean, good repair, proper size

Noncompliance Area: Observed a wooden laminate display bookshelf in the older toddler classroom with splintering wood at the lower left hand corner of the base. *Corrected at the time of the inspection.

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

Regulation: 3270.65

Description: Protective Outlet Covers 5 yrs. or less

Noncompliance Area: Observed an electrical outlet in the preschool classroom which did not have a protective receptacle cover and was accessible to children 5 years of age and younger. *Corrected at the time of the inspection.

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

Regulation: 3270.76

Description: Building Surfaces

Noncompliance Area: Observed an accumulation of dust on the window frames located in the preschool classroom.

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: Observed damaged plaster in the wall in the left bathroom stall located in the children's bathroom in the back hallway next to the kitchen. *Corrected at the time of the inspection. Observed peeling paint on the window frames located in the preschool classroom.

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

Regulation: 3270.82(g)

Description: Clean and good repair

Noncompliance Area: Observed a toilet paper roll holder was broken off the children's bathroom stall wall on the right in the upstairs bathroom. *Corrected at the time of the inspection.

Correction Required: Toilet areas and fixtures shall be cleaned daily and be in good repair.

Regulation: 3270.91(a)

Description: Stairs, exits, etc. unobstructed

Noncompliance Area: Observed the back stairwell marked as an emergency exit from the younger toddler room was blocked with a cot, totes, toys, and a chair. Observed the second door in the upstairs preschool classroom was blocked with a toy cubby and a display bookshelf. *Corrected at the time of the inspection.

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

Regulation: 3270.123(a)(3)

Description: Services proceeded

Noncompliance Area: The file for child #2 did not have documentation of a completed child service report with information to the family about the child's growth and development at least once every 6 months; the most recent report was dated 04/24/2024, with no subsequent reports on file.

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: 3270.124(f)/3270.181(c)

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

Noncompliance Area: The file for child #2 did not include documentation of a review of the emergency contact information and financial agreement at least once every 6 months; the most recent review was dated 01/12/2024 with no documentation of subsequent reviews.

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)(2)

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

Noncompliance Area: The health report for child #1 was not updated within 12 months of the previous health report; the current health report was completed on 05/16/2025 with the previous report dated 02/14/2024.

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: 3270.135(e)

Description: 2 hour diaper check

Noncompliance Area: The diaper for child #3 was not checked at least once every 2 hours; diaper changes were documented at 11:39 am and 2:37 pm.

Correction Required: A staff person shall check a child's diaper at least every 2 hours and whenever the child indicates discomfort or exhibits behavior that suggests a soiled diaper. A staff person shall change a child's diaper when the diaper is soiled.

Regulation: 3270.76

Description: Building Surfaces

Noncompliance Area: Observed food remnants on the tile floor in the young toddler room and the floor was sticky when walked on; the floor was not cleaned after a previous meal. Observed a power cord and long extension cord in the Preschool 2 classroom which was not secured creating a visible hazard. Observed visible dirt on the baseboards, windowsills and the wall next to the sink. *Corrected at the time of the inspection.

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: 3270.82(g)

Description: Clean and good repair

Noncompliance Area: Observed the toilet on the left in the upstairs bathroom was not flushed and there were brown stains on the sides of the toilet bowl. *Corrected at the time of the inspection.

Correction Required: Toilet areas and fixtures shall be cleaned daily and be in good repair.

Regulation: 3270.102(a)

Description: Clean and good repair

Noncompliance Area: Observed a light blue plastic slide on the playground with a crack in the platform and a crack on the step. Observed a Little Tykes playhouse (with the teal roof) with a crack in the plastic swinging counter. Observed a Little Tykes playhouse (with the faded light blue roof) with a cracked windowsill. Observed a Little Tykes playhouse (with the faded teal roof) with a cracked doorbell. *Corrected at the time of the inspection. Observed a Log Cabin playhouse with a sign that broke off, the plastic still attached to the screw created sharp edges. Observed a hole in the plastic where the sign was previously attached, and wasps were observed entering & exiting the hole.

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: 3270.133(2)/3270.133(3)

Description: Written instructions/Name on bottle

Noncompliance Area: Observed prescription medication for child #1 which did not identify the name of the child for whom the medication is intended or the written instructions from the individual who prescribed the medicine. The prescription label was not present at the facility with the medication when the medication was administered to the child on 05/08/2024 at 11:02 am.

Correction Required: A staff person shall administer a prescription medication only if written instructions are provided from the individual who prescribed the medicine. Instructions for administration contained on a prescription label are acceptable. 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.

Regulation: 3270.133(7)(i)

Description: Name of medication

Noncompliance Area: The medication log for child #1 did not include the name of the medication to be administered. The medication log listed the devices to be used to administer the medication in lieu of the name of the medication.

Correction Required: A medication log shall include the name of the medication.

Regulation: 3270.151(a)

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

Noncompliance Area: The file for staff person #1 included a health assessment that was not updated within 24 months of the previous health assessment. The current health assessment on file was dated 10/13/2023 with the previous assessment dated 06/29/2021.

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

Regulation: 3270.66(b)

Description: Original container

Noncompliance Area: Observed cleaning products being stored on a shelf directly above the counter where food was being plated to be served to the children. *Corrected at the time of the inspection.

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

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

Noncompliance Area: On 01/03/2024 at approximately 3:10 -- 3:15 pm, staff person #1 brought a group of older toddlers into the bathroom. The bathroom is located diagonally across the hall from the classroom entrance. Staff person #1 returned to the classroom at approximately 3:20 pm with a group of children leaving child #1 unsupervised in the bathroom. Staff person #1 and #2 did not notice that Child #1 did not return with the group. Child #1 was alone in the bathroom for an undetermined amount of time until found in the bathroom by the child's parent at pick-up.

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

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

Noncompliance Area: ***On 01/03/2024 at approximately 3:10 -- 3:15 pm, staff person #1 brought a group of older toddlers into the bathroom. The bathroom is located diagonally across the hall from the classroom entrance. Staff person #1 returned to the classroom at approximately 3:20 pm with a group of children leaving child #1 unsupervised in the bathroom. Staff person #1 and #2 did not notice that Child #1 did not return with the group. Child #1 was alone in the bathroom for an undetermined amount of time until found in the bathroom by the child's parent at pick-up.

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. The legal entity must develop a plan to prevent children from being left unsupervised, the plan should include specific strategies for managing transitions throughout the day, such as when children arrive, leave, or move from one location to another within a center. The legal entity must submit documentation in a format approved by DHS proving that the facility procedure for transitioning children from one location to another is followed at all times e.g., a transition checklist. 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. 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: 3270.113(a)/3270.113(a)(1)

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

Noncompliance Area: **On 01/03/2024 at approximately 3:10 -- 3:15 pm, staff person #1 brought a group of older toddlers into the bathroom. The bathroom is located diagonally across the hall from the classroom entrance. Staff person #1 returned to the classroom at approximately 3:20 pm with a group of children leaving child #1 unsupervised in the bathroom. Staff person #1 and #2 did not notice that Child #1 did not return with the group. Child #1 was alone in the bathroom for an undetermined amount of time until found in the bathroom by the child's parent at pick-up.

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. 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. 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: 3270.66(a)

Description: Locked or inaccessible

Noncompliance Area: Observed an aerosol spray can of Lysol Disinfectant labeled "Keep out of reach of children" on a small ledge in the upstairs hallway next to the door leading into the bathroom used by preschool age children that was accessible to children.

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

Regulation: 3270.104(a)

Description: Clean, good repair, proper size

Noncompliance Area: Observed a vinyl couch in the preschool classroom with a torn seat. Observed the table in the younger preschool classroom with the plastic edge torn off the side leaving rough edges along the perimeter of the table.

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

Regulation: 3270.123(a)(3)

Description: Services proceeded

Noncompliance Area: The child service report (CSR) for child #1, #2 and #3 with information provided to the family about the child's growth and development was not completed at least once every 6 months. The most recent CSR for child #1 was completed on 10/21/2022. The most recent CSR #2 was completed on 10/14/2022. The most recent CSR for child #3 was completed on 10/27/2022.

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(b)(1)

Description: Infant: updated health report every 6 months

Noncompliance Area: The health report on file for child #1 was not updated at least every 6 months for an infant or young toddler (see LIS code sheet), the most recent health report on file was dated 08/08/2022.

Correction Required: The operator shall require the parent to provide an updated health report at least every 6 months for an infant or young toddler.

Regulation: 3270.131(b)(2)

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

Noncompliance Area: The health report on file for child #3 was not updated at least every 12 months for an older toddler or preschool child (see LIS code sheet), the current health report on file was dated 04/24/2023 with the previous health report dated 02/10/2022.

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

Description: Immunization record/Exemption documentation from parent/guardian

Noncompliance Area: The file for child #1 (see LIS code sheet) included a record of the child's immunization status which lacked a 4th dose of DTap immunization,

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.

Regulation: 3270.104(a)

Description: Clean, good repair, proper size

Noncompliance Area: Observed a shelf in the In the young toddler classroom which was not anchored to prevent a tip hazard.

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

Regulation: 3270.124(c)

Description: Each child care space

Noncompliance Area: Emergency contact information was not present in the young toddler classroom for all of the children receiving care in the space. *Corrected at the time of the inspection.

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

Regulation: 3270.151(c)(3)

Description: Exam communicable disease

Noncompliance Area: The health assessment on file for staff person #1 was an "After Visit Summary" which did not include an examination for communicable diseases and the results of that examination.

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

Regulation: 3270.151(c)(5)

Description: Physician/CRNP assessment

Noncompliance Area: The health assessment on file for staff person #1 was an "After Visit Summary" which did not include the physician's or CRNP's assessment of the person's suitability to provide child care.

Correction Required: An adult health assessment must include the physician's or CRNP's assessment of the person's suitability to provide child care.

Regulation: 3270.21

Description: General Health and Safety

Noncompliance Area: Observed an infant sleeping with a pacifier in their mouth while attached to their clothing with a pacifier clip. The sheets in the Compact Cribs in the infant room were regular size crib sheets which created excess material.

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

Regulation: 3270.27(c)

Description: Training regarding plan

Noncompliance Area: Emergency plan training was not completed on an annual basis for staff person #1, the most recent emergency plan training was completed 02/09/2022, with the previous training completed ion 01/11/2021. Emergency plan training was not completed on an annual basis for staff person #2, the most recent emergency plan training was completed 02/15/2022, with the previous training completed ion 01/07/2021. Emergency plan training was not completed on an annual basis for staff person #3, the most recent emergency plan training was completed 02/15/2022, with the previous training completed ion 01/17/2021. Emergency plan training was not completed on an annual basis for staff person #4, the most recent emergency plan training was completed 02/10/2022, with the previous training completed ion 01/07/2021. Emergency plan training was not completed on an annual basis for staff person #5, the most recent emergency plan training was completed 02/09/2022, with the previous training completed ion01/07/2021.

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

Regulation: 3270.31(f)

Description: Health and Safety Training

Noncompliance Area: The file for staff person #6 did not include professional development in the Health & Safety topics as required in 3270.31(f)(1) - (9) within 90 days of initial hire (see LIS code sheet); the training was completed on 02/17/2022..

Correction Required: Staff persons shall complete professional development in the following topics within 90 days of hire:

Regulation: 3270.31(f)(10)

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

Noncompliance Area: Pediatric first aid & CPR was not completed by staff person #7 within 90 days of hire (see LIS code sheet); training was completed on 02/01/2022.

Correction Required: Staff persons shall complete professional development in 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: The clearances for staff person #2 were not updated within 60 months of the previous clearance; the current state police clearance on file was dated 01/26/2022 with the previous clearance dated 01/10/2017, the current child abuse clearance on file was dated 04/01/2022 with the previous clearance dated 03/29/2017, the current FBI clearance on file was dated 02/01/2022 with the previous clearance dated 01/26/2017. The NSOR clearance for staff person #6 was not on file within 45 days of initial hire, the NSOR clearance on file was dated 02/07/2022.

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

Regulation: 3270.82(h)

Description: Handwashing signs

Noncompliance Area: Observed the staff bathroom on the second floor of the facility did not have hand washing signs Observed the sink located in the Preschool classroom did not have a hand washing sign. *Corrected at the time of the inspection.

Correction Required: A facility person and an able child shall wash his hands after toileting and before eating. A sign on which this requirement is written shall be posted at each toilet, training chair, diapering area and sink in the facility.

Regulation: 3270.135(e)

Description: 2 hour diaper check

Noncompliance Area: Daily diaper changes logged in "My Kidz Day" App for Child #1, #2 and #3 document diapers were not being checked at least every 2 hours. A random sample of the diaper log has the following documented diaper changes: Child #1- 01/05/2022: 10:30 am - 12:30 pm - 3:18 pm & 01/06/2022: 09:30 am - 10:30 am - 2:40 pm. Child #2- 01/05/2022: 10:30 am - 12:30 pm - 3:14 pm & 01/06/2022: 9:30 am - 10:30 am - 2:40 pm. Child #3- 01/11/2022: 8:55 am - 11:00 am - 1:34 pm. No additional diaper changes were logged in the afternoons on the dated listed.

Correction Required: A staff person shall check a child's diaper at least every 2 hours and whenever the child indicates discomfort or exhibits behavior that suggests a soiled diaper. A staff person shall change a child's diaper when the diaper is soiled.

Regulation: 3270.166(1)

Description: Written statement

Noncompliance Area: A written statement giving the formula and feeding schedule was not obtained from the parents for the infants receiving care.

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

Regulation: 3270.91(a)

Description: Stairs, exits, etc. unobstructed

Noncompliance Area: Observed in the stairwell next to the office: 2 folded (multi-seat) strollers, a ramp and other miscellaneous items blocking the bottom of the stairs which also leads to a outside exit. Observed an easel and high chair in front of the double doors which lead to the same stairwell next to the office.

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

Regulation: 3270.94(a)(1)

Description: Every 60 days

Noncompliance Area: Observed the most recent fire drill documented on the fire drill log was completed on 10/21/2021.

Correction Required: The Director or designated staff person who is responsible for compliance with this chapter shall conduct fire drills and ensure that fire drills are conducted at least once every 60 days.

Regulation: 3270.95(a)/3270.95(b)

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

Noncompliance Area: Observed the most recent manual test of the fire detection system documented on the fire drill log was completed on 10/21/2021.

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.