Yakilsi Guzman

Regulation: 3280.123(a)(3)

Description: Services proceeded

Noncompliance Area: Child Service Reports had not been completed and shared with the parents of Children #1 and #3 within 6 months of enrollment.

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 § 3280.124(f).

Regulation: 3280.131(a)

Description: Health Information

Noncompliance Area: The parents of Children #2 and #3 did not provide an initial health report and immunizations within 60 days of the children's first day of attendance.

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: 3280.131(b)(1)/3280.182(1)

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

Noncompliance Area: The file for Child #4 did not include an updated health report within 6 months of the last one on file dated 7/24/25, as required for infant and young toddlers under the age of 24 months.

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 must contain initial and subsequent health reports.

Regulation: 3280.131(e)/3280.131(e)(3)

Description: ACIP recommended immunization record /Dismissal policy

Noncompliance Area: Child #2 did not have an initial health report and immunizations on file within 60 days of enrollment. It was due by 9/9/25 and was not received until 2/6/26 and the child was still attending. Child #3 did not have an initial health report and immunizations on file within 60 days of enrollment. It was due by 9/6/25 and was not received until 1/16/26 and the child had still been attending.

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. The facility shall implement dismissal policies in accordance with the Department of Health regulation in 28 Pa. Code § 27.77 (relating to immunization requirements for children in child care group settings).

Regulation: 3280.66(a)

Description: Locked or inaccessible - in original container

Noncompliance Area: Two bags of Ice Melt were located outside at the entryway, accessible to children (corrected on-site).

Correction Required: Cleaning materials and other toxic materials shall be stored in an original labeled container or in a container that specifies the content. Toxics shall be kept in a locked area or in an area inaccessible to children, and shall be stored away from food, food preparation areas and child care spaces.

Regulation: 3280.111(c)/3280.112

Description: Promote development/Infant/Toddler Stimulation

Noncompliance Area: Continued non-compliance from 9/25/25: On 12/19/25, Child #5 was observed to be awake and in an infant swing with no activities provided, from 9:50am - 10:40am when certification staff directed the provider to take the child out of the swing.

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. Infants and toddlers shall be provided stimulation by being held, rocked, talked to, played with and carried.

Regulation: 3280.131(a)/3280.131(d)(5)

Description: Health Information/Immunization record

Noncompliance Area: Continued non-compliance from 9/25/25: On 12/19/25, Child #3's file still did not have a completed initial health report. While the child's immunizations were on file, the list of administered immunizations was incomplete as there was no documentation of the 2nd dose of the Hep-A vaccine according to the recommendations by age, of the ACIP.

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. A health report shall include a review of the child's immunized status according to recommendations of the ACIP.

Regulation: 3280.131(e)/3280.131(e)(3)

Description: ACIP recommended immunization record /Dismissal policy

Noncompliance Area: Continued non-compliance from 9/25/25: On 12/19/25, Child #3's file still did not have documentation of complete, current immunizations having been administered according to the recommendations of the ACIP. There was no documentation of the 2nd dose of the Hep-A vaccine having been administered and Child #3 was still attending at the facility. The facility did not dismiss Child #3 until a record of current immunizations according to the recommendations of the ACIP was received.

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. The facility shall implement dismissal policies in accordance with the Department of Health regulation in 28 Pa. Code § 27.77 (relating to immunization requirements for children in child care group settings).

Regulation: 3280.111(c)/3280.112

Description: Promote development/Infant/Toddler Stimulation

Noncompliance Area: The TV was on for the length of the inspection (2 hours 45 minutes) and no other developmentally appropriate activities were observed. Child #1 was observed sitting in a pack-n-play for about 15 minutes and was then taken out, and placed in a highchair, where the child remained for several minutes without any activities.

Correction Required: 1. Daily activities shall promote the development of skills, social competence and self-esteem. Daily experiences shall recognize the child as an individual and give some choice of activities that respect personal privacy, lifestyle and cultural background. Infants and toddlers shall be provided stimulation by being held, rocked, talked to, played with and carried. This portion of the plan shall have an immediate correction date. 2. The legal entity must arrange for all staff to receive a minimum of two hours of in-person training and TA (Technical Assistance) regarding developmentally appropriate daily activities and infant/toddler stimulation. The legal entity must receive HS approval of the training content prior to scheduling the training. The operator shall provide a date of when this training will be completed by.

Regulation: 3280.113(a)/3280.113(a)(1)

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

Noncompliance Area: During the inspection, Staff Persons #1 and #2 were present with 8 children (including 1 Infant, 2 Young Toddlers, 2 Older Toddlers and 3 Preschoolers). Both staff were present with all the children in the childcare space, however they did not identify primary care groups.

Correction Required: 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. 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 arrange for all facility staff to complete the following on-demand trainings on Better Kid Care Website (available in Spanish): (1) Supervision: What Does it Take?, (2) Supervision: Counting Children, and (3) Supervision: Staff to Child Ratios. The operator shall provide a date for when this training will be completed by both staff.

Regulation: 3280.124(a)

Description: Each child emergency contact person

Noncompliance Area: There were no completed Emergency Contact Forms at the facility for Children #3 and #4.

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

Regulation: 3280.124(b)(3)

Description: Parent home/work address, phone

Noncompliance Area: Child #4 and Child #3 did not have an emergency contact form, therefore the home and work addresses and phone numbers of the enrolling parents, was not provided. The emergency contact form for Child #2 did not include the enrolling parent's home address or work address and phone number. The emergency contact form for Child #1 did not include the enrolling parent's work address and phone number.

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

Regulation: 3280.124(b)(7)

Description: Name/address/phone release person

Noncompliance Area: Child #4 and Child #3 did not have an emergency contact form, therefore there was no information (names, addresses and phone numbers) on the individuals designated by the parent to whom the child may be released. The emergency contact forms for Child #1 and Child #2 did not include the addresses of the individuals designated by the parent to whom the child may be released.

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: 3280.131(a)/3280.131(e)

Description: Health Information/ACIP recommended immunization record

Noncompliance Area: Child #3 did not have an initial health report or verification of immunizations in accordance with the recommendations of the ACIP within 60 days following the child's first day of attendance and Child #3 was still attending the facility.

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. 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: 3280.166(3)

Description: Disposable nursers or parents

Noncompliance Area: The provider said that they re-use baby bottles after handwashing them.

Correction Required: Disposable nursers shall be used for infants unless bottles are provided by the parent or unless a commercial dishwasher is used by the facility.