Wanda T Rosado

Regulation: 3290.123(a)(3)

Description: Services provided

Noncompliance Area: The files of children #1, #2, and #3 did not have evidence of completed child service reports.

Correction Required: An agreement shall specify 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 at § 3290.124(e).

Regulation: 3290.94(a)(1)

Description: Every 60 days

Noncompliance Area: The fire drill log showed evidence that fire drills were not conducted at least once every 60 days. 5/8/25-7/8/25 (61 days) 7/8/25-9/8/25 (62 days) 9/8/25- 11/10/25 (63 days)

Correction Required: Fire drills are conducted at least once every 60 days.

Regulation: 3290.95(a)/3290.95(b)

Description: System in compliance/Operator or designated staff responsibility

Noncompliance Area: The fire detection system testing log showed evidence that the system was not tested at least once every 30 days. 7/25/25- 8/25/25 (31 days) 8/25/25- 9/25/25 (31 days) 1/8/26-2/9/26 (32 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 operator or designated staff person who is responsible for compliance with this chapter shall ensure the requirements in subsection (a) are met.

Regulation: 3290.105(a)

Description: Clean, age appropriate

Noncompliance Area: A pack-n-play was being used by both infants at the facility; Children #1 and #2, and it was not labelled for individual use of a specific child. The nap cots were also not labelled for individual use of a specific child.

Correction Required: Individual, clean, age-appropriate rest equipment shall be provided for preschool, toddler and infant children as agreed between the parent and the operator. The rest equipment must be labeled with the child's name and used only by the named child while enrolled in the program.

Regulation: 3290.105(b)

Description: No bed linens alone

Noncompliance Area: Child #3 was observed sleeping on a blanket on the couch.

Correction Required: Bed linens may not be used alone as age-appropriate rest equipment.

Regulation: 3290.123(a)(3)

Description: Services provided

Noncompliance Area: The file for Child #1 did not include a completed Child Service Report within 6 months of the child's start date.

Correction Required: An agreement shall specify 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 at § 3290.124(e).

Regulation: 3290.124(c)

Description: Excursions

Noncompliance Area: There was no Emergency Contact form for Child #4, in the vehicle used to transport her (corrected on-site).

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: 3290.124(d)

Description: Written emergency plan posted

Noncompliance Area: There was no Emergency 911 Transportation Plan in the vehicle used to transport children (corrected on-site).

Correction Required: A written plan shall be conspicuously posted which identifies the means of transporting a child to emergency care and the facility staffing provisions in the event of an emergency. The plan must accompany a staff person who leaves the facility on an excursion with children.

Regulation: 3290.135(e)

Description: Every 2 hours

Noncompliance Area: Diapers were not checked/changed every 2 hours. The Operator said that the diapers of Children #1 and #2 had been changed shortly before the certification rep arrived at 10:15am. They were not changed again during the inspection, by 1:30pm.

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: 3290.166(1)

Description: Written statement

Noncompliance Area: There was no written statement from the parents of Children #1 and #2, giving the formula and feeding schedule for their infants.

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

Regulation: 3290.166(4)

Description: Bottles labeled

Noncompliance Area: Bottles for Children #1 and #2 were not labeled with the children's names.

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

Regulation: 3290.73(c)/3290.176

Description: Has all items/Transportation First Aid Kit

Noncompliance Area: There was no first aid kit in the vehicle used to transport children.

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. A first-aid kit, including the contents as specified in §3290.73 (relating to first-aid kit) shall be in the vehicle when children are being transported.

Regulation: 3290.95(a)/3290.95(b)

Description: System in compliance/Operator or designated staff responsibility

Noncompliance Area: The 4 smoke alarms were not connected when the system was tested during the inspection (corrected on-site).

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 operator or designated staff person who is responsible for compliance with this chapter shall ensure the requirements in § 3290.95(a) are met.

Regulation: 3290.101(a)

Description: Age appropriate

Noncompliance Area: The children did not have access to a variety of toys and materials during the inspection. The children and all childcare materials and equipment were in one small space that did not provide room to explore a variety of materials. There were no books available to the children.

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

Regulation: 3290.111(a)

Description: Written plan

Noncompliance Area: There was no written, posted schedule/daily activities and routines at the facility. A picture chart schedule was hanging in the childcare space, however the activity cards were all in one pocket, not showing when the activities occur.

Correction Required: A written plan of daily activities and routines, including a time for free play shall be established for each group. The plan shall be flexible to accommodate the needs of individual children and the dynamics of the group.

Regulation: 3290.111(c)

Description: Promote development

Noncompliance Area: The children were not engaged in a variety of activities that encouraged development of skills, social competence and self-esteem. Children cried for long periods of time and were not comforted or guided to another activity. Staff Person #1 raised her voice often. At one point, Staff Person #1 pretended to cry and said to a child "You're not allowing me to do anything. I gotta pass with the state." On another occasion, she said loudly to a child who wasn't listening, "You want me to give you a punch in the nose nose". She laughed after saying that to indicate that she was joking around but the child looked confused.

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: 3290.111(c)

Description: Promote development

Noncompliance Area: The children were not engaged in a variety of activities that encouraged development of skills, social competence and self-esteem. Children cried for long periods of time and were not comforted or guided to another activity. Staff Person #1 raised her voice often. At one point, Staff Person #1 pretended to cry and said to a child "You're not allowing me to do anything. I gotta pass with the state." On another occasion, she said loudly to a child who wasn't listening, "You want me to give you a punch in the nose nose". She laughed after saying that to indicate that she was joking around but the child looked confused.

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. Staff #1 must complete a minimum of 2 TA sessions regarding age-appropriate daily activities. DHS must approve TA prior to completion. Documentation of completed TA must be submitted to DHS and be kept on-file at the facility.

Regulation: 3290.123(a)(3)

Description: Services provided

Noncompliance Area: There were no completed Child Service Reports provided to parents of Children #1, #2, #3 or #4, with information about the children's growth and development.

Correction Required: An agreement shall specify 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 at § 3290.124(e).

Regulation: 3290.131(b)(2)

Description: Updated toddler/preschool health report: every 12 months

Noncompliance Area: There were no updated health reports for Children #2, #3 or #4 dated 12 months or less from the prior health reports. The last documented health report for Child #2 was dated 3/3/23. The last documented health report for Child #3 was dated 3/3/23 and the last documented health report for Child #4 was dated 4/20/22.

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. The Operator must complete in-person Existing Provider Orientation with the Central Regional office of Child Development and Early Learning. Documentation of completed training must be submitted to DHS and kept on file at the facility.

Regulation: 3290.131(b)(2)

Description: Updated toddler/preschool health report: every 12 months

Noncompliance Area: There were no updated health reports for Children #2, #3 or #4 dated 12 months or less from the prior health reports. The last documented health report for Child #2 was dated 3/3/23. The last documented health report for Child #3 was dated 3/3/23 and the last documented health report for Child #4 was dated 4/20/22.

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: 3290.18

Description: General Health and Safety

Noncompliance Area: The facility did not have a written policy to address the recognition of potential signs/symptoms of shaken baby syndrome and abusive head trauma, strategies for coping with a crying, fussing or distraught child, or the prevention and identification of child maltreatment.

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

Regulation: 3290.72

Description: Emergency Numbers Posted

Noncompliance Area: There were no Emergency telephone numbers of the nearest hospital, police dept., fire dept., ambulance and poison control center posted by the facility's telephone (corrected on-site).

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

Regulation: 3290.94(a)(1)

Description: Every 60 days

Noncompliance Area: The fire drill log did not document that fire drills had been conducted every 60 days or less. For example, a fire drill was documented on 1/5/24 and then the next fire drill was not documented until 4/5/24.

Correction Required: The operator 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: 3290.94(a)(4)

Description: Hypothetical locations

Noncompliance Area: There were no hypothetical locations of the fire (such as kitchen, basement, living room) documented on the fire drill log.

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

Regulation: 3290.123(a)(3)

Description: Services provided

Noncompliance Area: The files for Child #2, #3, and #4 did not include completed Child Service Forms within 6 months, to provide information to the family about their child's growth and development in the context of the services being provided.

Correction Required: An agreement shall specify 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 at § 3290.124(e).

Regulation: 3290.124(a)/3290.181(a)

Description: Each child emergency contact person/Each child

Noncompliance Area: There was no file at the facility for Child #2 and there was no completed Emergency Contact form for Child #2, referencing who shall be contacted in an emergency.

Correction Required: Emergency contact information is required for each enrolled child. Emergency contact information must reference who shall be contacted in an emergency. An operator shall establish and maintain an individual record for each child enrolled in the facility.

Regulation: 3290.131(a)

Description: Within 60 days

Noncompliance Area: The file for Child #1 contained an initial health report that was dated beyond the required 60 days following the first day of attendance. The date of the health report was 4/20/22. The file for Child #2 did not contain any completed health reports within the first 60 days of enrollment.

Correction Required: The operator shall require the parent of an enrolled child to provide an initial health report no later than 60 days following the first day of attendance at the facility.

Regulation: 3290.131(b)(2)

Description: Updated toddler/preschool health report: every 12 months

Noncompliance Area: The file for Child # 1 did not contain an updated health report within 12 months from the last one, which is dated 4/20/22.

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: 3290.131(e)

Description: Immunization record

Noncompliance Area: Child #2 was still enrolled at the facility without having received written verification of the child's immunizations in accordance with the ACIP recommended schedule, within 60 days of the child's first day of attendance.

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.

Regulation: 3290.131(e)(1)

Description: Parent written verification from Doctor.

Noncompliance Area: The health report for Child #1 did not include documentation of the influenza vaccine in the past year, in accordance with the ACIP schedule. The last one documented was dated 12/5/19.

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

Regulation: 3290.181(c)

Description: Emergency info/agreement updated 6 mos

Noncompliance Area: The Emergency Contact Form and Financial Agreement for Child #1 were not reviewed and updated by the parent once in a 6-month period. The Emergency Contact Form was last signed on 4/27/22 and the Financial Agreement was last signed on 1/30/22.

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: 3290.182(1)

Description: Initial and subsequent health assessments

Noncompliance Area: There were no completed health reports at the facility for Child #2.

Correction Required: A child's record must contain initial and subsequent health reports.

Regulation: 3290.182(3)/3290.182(5)

Description: Consent for emergency medical care required prior to admission/Consent for administration of minor first-aid required prior to admission

Noncompliance Area: There was no Emergency Contact Form for Child #2, therefore, there was no signed parental consent for emergency medical care or administration of minor first-aid procedures by facility staff. The Emergency Contact Form for Child #5 did not include signed parental consent for emergency medical care or administration of minor first-aid procedures by facility staff.

Correction Required: A child's record must contain signed parental consent for emergency medical care for the child. Written consent is required prior to admission. A child's record must contain signed parental consent for administration of minor first-aid procedures by facility staff. Written consent is required prior to admission.

Regulation: 3290.182(4)/3290.182(6)

Description: Consent for administration of medications or special dietary needs/Signed parental consent for transportation, walking excursions, swimming and wading

Noncompliance Area: There was no Emergency Contact Form on file at the facility for Child #2, therefore, there was no signed parental consent for administration of medications or special dietary needs or for walking excursions, transportation and wading.

Correction Required: A child's record must contain signed parental consent for administration of medications or special dietary needs. A child's record must contain signed parental consent for transportation, walking excursions, swimming and wading.

Regulation: 3290.182(8)

Description: Copy of initial and subsequent agreements. Parent receives original.

Noncompliance Area: There was no copy of an initial financial agreement for Child #2 or for Child #5 on file at the facility.

Correction Required: A child's record must contain a copy of the initial agreement and subsequent written agreements between the parent and the operator. The parent receives the original agreement.

Regulation: 3290.24(a)(1)/3290.24(a)(2)

Description: Emergency plan/Emergency plan

Noncompliance Area: The facility's emergency plan and parent letter about the emergency plan, did not include accommodations for lockdown and shelter in-place and at locations away from the facility premises. Additionally, the plan did not include evacuation procedures.

Correction Required: The facility shall have an emergency plan that provides for accommodations for shelter of children during an emergency including lock-down, shelter in place at the facility and shelter at locations away from the facility premises. The facility shall have an emergency plan that provides for accommodations for evacuation of children from the facility building and evacuation of children to a location away from the facility premises. The evacuation routes and evacuation plans to exit the building may be the same as those required by §  3290.94 (relating to fire drills).

Regulation: 3290.24(a)(3)/3290.24(a)(4)

Description: Contact when arises/Contact when ended

Noncompliance Area: The facility did not have an emergency plan that provides for a method for facility persons to contact parents as soon as reasonably possible when an emergency arises or to inform the parents that the emergency has ended and to provide instruction as to how parents can be safely reunited with their children.

Correction Required: The facility shall have an emergency plan that provides for a method for facility persons to contact parents as soon as reasonably possible when an emergency situation arises. The facility shall have an emergency plan that provides for a method for facility persons to inform parents that the emergency has ended and to provide instruction as to how parents can safely be reunited with their children.

Regulation: 3290.24(a)(5)

Description: Emergency plan

Noncompliance Area: The facility did not have an emergency plan that provides for accommodations of infants and toddlers, children with disabilities, and children with chronic medical conditions. It also did not include a plan for continuity of care.

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

Regulation: 3290.24(d)

Description: Emergency plan

Noncompliance Area: There was no documented Emergency Drill having been conducted within the past 12 months on file at the facility.

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

Regulation: 3290.24(e)

Description: Emergency plan

Noncompliance Area: There was no emergency plan posted in the facility at a conspicuous location.

Correction Required: The emergency plan shall be posted in the facility at a conspicuous location.

Regulation: 3290.77

Description: Glass

Noncompliance Area: The glass entry door did not have a visual strip or other visual identification on the glass at the child's level.

Correction Required: A visual strip or other visual identification shall be placed on glass located in a traffic area, a child care space or a play space.

Regulation: 3290.94(a)(5)

Description: Evacuation routes posted

Noncompliance Area: Evacuation routes were not posted in a conspicuous location on each floor of the facility.

Correction Required: The operator or designated staff person who is responsible for compliance with this chapter shall conduct fire drills and ensure that evacuation routes are posted in a conspicuous location on each floor of the facility.

Regulation: 3290.105(a)

Description: Clean, age appropriate

Noncompliance Area: Two children (siblings) were observed sleeping on one rest cot and the cots were not labeled with children's names and being used only by that child.

Correction Required: (a) Individual, clean, age-appropriate rest equipment shall be provided for preschool, toddler and infant children as agreed between the parent and the operator. The rest equipment must be labeled with the child's name and used only by the named child while enrolled in the program.

Regulation: 3290.124(a)

Description: Each child emergency contact person

Noncompliance Area: The file for Child #1 did not include a completed Emergency Contact Form.

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

Regulation: 3290.124(d)

Description: Written emergency plan posted

Noncompliance Area: There was no written plan posted which identifies the means of transporting a child to emergency care and the facility staffing provisions in the event of an emergency.

Correction Required: A written plan shall be conspicuously posted which identifies the means of transporting a child to emergency care and the facility staffing provisions in the event of an emergency. The plan must accompany a staff person who leaves the facility on an excursion with children.

Regulation: 3290.131(a)/3290.131(e)

Description: Within 60 days/Immunization record

Noncompliance Area: The file for Child #1 did not include an initial health report and immunizations within 60 days of enrollment and the child was still enrolled at the facility.

Correction Required: The operator shall require the parent of an enrolled child to provide an initial health report no later than 60 days following the first day of attendance at the facility. 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.

Regulation: 3290.134(a)

Description: Child's hands washed

Noncompliance Area: Children's hands were not washed before meals or after being diapered.

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

Regulation: 3290.135(a)(3)

Description: Disposable diapers

Noncompliance Area: Soiled Diapers were placed in a plastic bag and thrown outside the entry door where they remained until the end of the day.

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: 3290.135(b)

Description: Surfaces cleaned

Noncompliance Area: Diapers were observed being changed for multiple children on the Operator's lap. Diapers were not changed on a surface that is able to be cleaned and sanitized after 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: 3290.152

Description: Adult Hygiene

Noncompliance Area: The operator did not wash her hands after each diaper change.

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

Regulation: 3290.182(3)/3290.182(5)

Description: Consent for emergency medical care required prior to admission/Consent for administration of minor first-aid required prior to admission

Noncompliance Area: The file for Child #1 did not include a completed Emergency Contact Form that included signed parental consent for emergency medical care or administration of minor first-aid procedures by facility staff, which are required prior to admission.

Correction Required: A child's record must contain signed parental consent for emergency medical care for the child. Written consent is required prior to admission. A child's record must contain signed parental consent for administration of minor first-aid procedures by facility staff. Written consent is required prior to admission.

Regulation: 3290.191

Description: Individual Records

Noncompliance Area: There was no individual record/file for Staff Person #1. Documents needed for a staff file were in various piles that were not filed together.

Correction Required: An individual record is required for each facility person.

Regulation: 3290.192(3)

Description: CPSL information

Noncompliance Area: There were no Disclosure Statements (dated, signed and witness signature) in the files for Household Members #2 or #3. There were no state police clearances in the files for Household Members #2, #3, and #4. There was also no state police clearance documented for the Operator/Staff Person #1, which was corrected during the inspection.

Correction Required: A facility person's record shall include a copy of requests for the criminal history record and child abuse registry clearance information, a copy of the disclosure statement and a copy of the completed clearance information required under the CPSL.

Regulation: 3290.24(a)(1)/3290.24(a)(5)

Description: Emergency plan/Emergency plan

Noncompliance Area: The Emergency Plan had not been updated to include lock-down procedures or accommodations of infants and toddlers and children with disabilities and/or chronic medical conditions.

Correction Required: The facility shall have an emergency plan that provides for accommodations for shelter of children during an emergency including lock-down, shelter in place at the facility and shelter at locations away from the facility premises. The facility shall have an emergency plan that provides for accommodations of infants and toddlers, children with disabilities, and children with chronic medical conditions.

Regulation: 3290.24(d)

Description: Emergency plan

Noncompliance Area: There was no documentation showing that an Emergency Drill (such as tornado, lock-down, intruder) had 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: 3290.24(g)

Description: Emergency plan

Noncompliance Area: There was no documentation showing that emergency plan updates were sent to the local municipality or county emergency management agency.

Correction Required: The operator shall send a copy of the emergency plan and subsequent plan updates to the local municipality and to the county emergency management agency.

Regulation: 3290.72

Description: Emergency Numbers Posted

Noncompliance Area: There were no telephone numbers of the nearest hospital, police department, fire department, ambulance or poison control center posted at the facility.

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

Regulation: 3290.73(c)

Description: Has all items

Noncompliance Area: The first aid kit at the facility did not contain soap or scissors.

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

Regulation: 3290.77

Description: Glass

Noncompliance Area: The glass entry door did not have a visual strip or other visual identification as required in a traffic area of the child care space.

Correction Required: A visual strip or other visual identification shall be placed on glass located in a traffic area, a child care space or a play space.