Tiny Tots Childcare & Learning Center

Regulation: 3270.124(b)(2)

Description: Physician name, address, phone

Noncompliance Area: Emergency contact information for Child #2 did not include the complete address of the child's physician or source of medical care.

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)(7)

Description: Name/address/phone release person

Noncompliance Area: Emergency contact information for Child #1 did not include the telephone number of the individual 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: 3270.131(d)(5)/3270.131(e)(3)

Description: Immunization record/Dismissal policy

Noncompliance Area: Child #3, a young toddler, lacked HIB and Pneumococcal immunizations according to the recommendations of the ACIP. Child #3 had documentation of 2 HIB immunizations and 2 Pneumococcal immunizations. Child #4, an older toddler, lacked MMR and Varicella immunizations according to the recommendations of the ACIP. Child #4 had no documentation of MMR and Varicella 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 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: 3270.76

Description: Building Surfaces

Noncompliance Area: Observed approximately 2-inch holes on the bottom section of the fence attached to the back of the building in the outdoor play space. Observed approximately 1/2-inch holes on the bottom of the 2nd section of the fence from the building in the outdoor play space. Observed approximately 1/2 to 2-inch holes on the bottom of the 3rd section of the fence from the post opposite the center located at the back of the outdoor play space. Observed approximately 1-inch holes on the bottom of the 6th section of the fence located across from the entrance to the outdoor play space. Observed exposed screws on the deck located at the rear entrance to the outdoor play space. Observed rotted wood along the bottom of the deck located at the rear entrance and to the left of the steps leading to the outdoor play space. Observed splintering wood on the first step of the deck located at the rear entrance leading to the outdoor play space.

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 a broken toilet handle in the bathroom located in the hallway towards the front of the building.

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

Regulation: 3270.94(a)(4)

Description: Hypothetical locations

Noncompliance Area: The Director or designated staff person who is responsible for compliance with this chapter did not ensure the hypothetical locations of the fire were rotated around the facility for each drill such that the hypothetical location was never the same for consecutive drills.

Correction Required: The Director or designated staff person who is responsible for compliance with this chapter ensure 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: 3270.102(a)

Description: Clean and good repair

Noncompliance Area: Observed approximately a 2-foot by 2-foot foam square with loose pieces in the Infant Room. Observed approximately a 3-inch tear at the bottom of the Mickey Mouse children's sofa in the Preschool Front Room.

Correction Required: Toys, play equipment and other indoor and outdoor equipment used by the children shall be clean, in good repair and free from rough edges, sharp corners, pinch and crush points, splinters and exposed bolts.

Regulation: 3270.106(a)

Description: Clean, age appropriate

Noncompliance Area: Observed rest equipment not labeled for the use of a specific child in the Activity Room.

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: 3270.124(b)(7)

Description: Name/address/phone release person

Noncompliance Area: Emergency contact information for Child #1 did not include the address of the individual 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: 3270.131(d)(5)/3270.131(e)(3)

Description: Immunization record/Dismissal policy

Noncompliance Area: The file of Child #2, a 35-month-old, lacked Pneumococcal immunizations according to the recommendations of the ACIP. Child #2 had documentation of 3 Pneumococcal 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 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: 3270.14/3270.21

Description: Pertinent Laws & Regulations/General Health and Safety

Noncompliance Area: The emergency plan did not address continuity of operations.

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

Regulation: 3270.165

Description: Menus

Noncompliance Area: The operator did not conspicuously post the menu at least 1 week in advance.

Correction Required: An operator shall conspicuously post the menu at least 1 week in advance or provide a menu to each family.

Regulation: 3270.21

Description: General Health and Safety

Noncompliance Area: Observed a cord to a white noise machine which was not secured creating a potential tripping and/or strangulation hazard in the Infant Room.

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

Regulation: 3270.27(e)

Description: Letter to parents

Noncompliance Area: The letter provided to the parent explaining emergency procedures did not address accommodations for infants, toddlers, children with disabilities, and children with chronic medical conditions.

Correction Required: The operator shall provide to the parent of each enrolled child a letter explaining the emergency procedures. The operator shall also provide to the parent of each enrolled child a letter explaining any subsequent update to the plan.

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

Description: Age and Training

Noncompliance Area: Staff #1, #2, and #3 lacked renewal of their certification in pediatric first aid and pediatric cardiopulmonary resuscitation on or before the expiration of the most current certification. The most current certification on file for Staff #1, #2, and #3 was dated 10/3/24 with the previous certification dated 9/8/22.

Correction Required: Competence is the completion of training by a professional in the field of first-aid and cardiopulmonary resuscitation (CPR). All staff persons shall renew their certification in pediatric first aid and pediatric cardiopulmonary resuscitation (CPR) on or before the expiration of the most current certification.

Regulation: 3270.34(a)(6)

Description: Staff evaluations

Noncompliance Area: The file of Staff #3 lacked a written evaluation on a regular basis, a minimum of one evaluation every 12 months (SEE LIS Code Sheet). The file of Staff #3 contained a written evaluation dated 9/30/24 with a previous one dated 7/1/23.

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

Regulation: 3270.76

Description: Building Surfaces

Noncompliance Area: Observed an exposed screw in the opposite corner of the door in the Infant Room.

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 several small holes approximately 1/4-inch to 1/2-inch in diameter on the drywall behind the door and on the drywall across from the door in the Playroom. Observed peeling paint to the right of the doll house in the Playroom. Observed approximately a 1-inch by 1/2-inch hole in the drywall to the right of the dollhouse and above the electrical outlet in the Playroom. Observed 2 approximately 1/2-inch holes in the drywall to the right of the door leading to the Playroom. Observed 2 approximately 1/2-inch pieces of drywall missing to the right of the sink in the Infant Room. Observed several small holes in the drywall on the archway to the right of the door leading to the outdoor play space.

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

Regulation: 3270.133(3)

Description: Name on bottle

Noncompliance Area: It was observed samples of sting relief and liquid skin in the first aid kit in the childcare front room that was not labeled for individual use. It was also observed insect repellent in a child's open diaper bag accessible to other children marked "Keep out of reach of Children".

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

Regulation: 3270.135(a)(3)

Description: Disposable diapers

Noncompliance Area: It was observed on the day of inspection, that a staff member put a soiled diaper in a plastic bag and then discarded it in the hands-free covered can.

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: 3270.21

Description: General Health and Safety

Noncompliance Area: A large upright freezer in the child care space, accessible to children was observed not to be locked. A large fax machine with a phone cord hanging off the top cubby in the front room was observed, posing a threat to the safety of children.

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

Regulation: 3270.52/3270.113(a)(1)

Description: Mixed Age Level/Staff assigned to specific children

Noncompliance Area: On the day of inspection, January 24, 2024, it was observed that staff #1 came to the door and left one infant, two young toddlers, two old toddlers and two preschool children with one staff member.

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). 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: 3270.76

Description: Building Surfaces

Noncompliance Area: It was observed that the finial on the railing of the outdoor deck was broken and cracked causing splintering.

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: 3270.95(a)/3270.95(b)

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

Noncompliance Area: The facility fire drill log showed that the facility has not been regularly testing the facility's fire detection system every 30 days. This is evidenced by testing being done; 1/2/23-2/3/23- 3/4/23, and also 7/3/23-8/6/23; 11/3/23-12/12/23.

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: 3270.103

Description: Small Toys and Objects

Noncompliance Area: It was observed located in the play kitchen area; green bubble wrap accessible to children who are still placing objects in their mouths.

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: 3270.131(d)(5)/3270.131(e)(3)

Description: Immunization record/Dismissal policy

Noncompliance Area: The health report on file for Child #1 and Child #2 did not contain documentation of an influenza vaccine being administered with in the last year in accordance with the recommendations of the ACIP.

Correction Required: A health report shall include a review of the child's immunized status according to 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: 3270.133(3)

Description: Name on bottle

Noncompliance Area: There were sample packets of insect sting repellent in the first aid kit not labeled for individual use.

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

Regulation: 3270.21

Description: General Health and Safety

Noncompliance Area: Two large deep freezers in the childcare space, accessible to children were observed not to be locked posing a threat to the safety of children.

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

Regulation: 3270.25(a)

Description: Availability of certificate of compliance and applicable regulations

Noncompliance Area: It was observed the facility did not have posted the most up to date Certificate of Compliance on the back bulletin board. This was evidenced by the certificate being dated 4/6/21 to 4/6/22.

Correction Required: The facility's current certificate of compliance shall be posted in a conspicuous location used by parents. The operator shall provide the parent of each child enrolled with information on how to access the regulations in this chapter electronically and with instructions for contacting the appropriate regional child care office.

Regulation: 3270.76

Description: Building Surfaces

Noncompliance Area: It was observed outside an exposed screw on the deck railing.

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(h)

Description: Handwashing signs

Noncompliance Area: It was observed in the back restroom that a handwashing sign was not posted above the toilet.

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: 3270.102(a)

Description: Clean and good repair

Noncompliance Area: It was observed in the large main play space an ABC block was split and cracked and the back of a yellow dump truck was cracked along the bottom edge, exposing children in care to rough edges and sharp corners.

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: 3270.124(b)(3)

Description: Parent home/work address, phone

Noncompliance Area: The file for Child #1 was observed to not have information on the disability of a child, Health Insurance or release person's address or parents work address.

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

Regulation: 3270.124(b)(5)

Description: Information re: special needs

Noncompliance Area: The file for Child #1 was observed to not have information on the disability of a child, Health Insurance or release person's address or parents work address.

Correction Required: Emergency contact information must include information on the child's special needs, as specified by the child's parent, physician, physician's assistant or CRNP, which is needed in an emergency situation.

Regulation: 3270.124(b)(6)

Description: Insurance coverage information

Noncompliance Area: The file for Child #1 was observed to not have information on the disability of a child, Health Insurance or release person's address or parents work address.

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: The file for Child #1 was observed to not have information on the disability of a child, Health Insurance or release person's address or parents work address.

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(b)(7)

Description: Name/address/phone release person

Noncompliance Area: The file for child #2 was observed not to have release person's address listed on the Emergency Contact Form.

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: 3270.25(a)

Description: Availability of certificate of compliance and applicable regulations

Noncompliance Area: It was observed that the facility did not provide the parent of each child in the facility with information on how to access the regulation electronically.

Correction Required: The facility's current certificate of compliance shall be posted in a conspicuous location used by parents. The operator shall provide the parent of each child enrolled with information on how to access the regulations in this chapter electronically and with instructions for contacting the appropriate regional child care office.

Regulation: 3270.27(a)(5)

Description: Emergency plan

Noncompliance Area: It was observed the facilities emergency plan did not list accommodations of infant and toddlers, children with disabilities and children with chronic medial conditions.

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

Regulation: 3270.69(b)

Description: 110º F or less

Noncompliance Area: The infant room was observed having a hot water temperature of 117° F .

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

Regulation: 3270.76

Description: Building Surfaces

Noncompliance Area: It was observed that the door trim around the outside door exiting to the playground area was missing exposing large gaps and splintering causing children in care to rough edges and sharp areas.

Correction Required: Floors, walls, ceilings and other surfaces, including the facility's outdoor play space surfaces shall be kept clean, in good repair and free from visible hazards.

Noncompliance Area: Observed a black clutch purse in classroom #4 with a broken chain strap.

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.

Noncompliance Area: The files for children #1 and #2 contained the original agreement; the parent did not receive the original.

Correction Required: A parent shall receive the original agreement. The facility shall retain a copy of the agreement.

Noncompliance Area: Emergency contact information for child #5 was not present in the main classroom while receiving care in the space.

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.

Noncompliance Area: The file for child #2 lacked an updated health report at least once every 6 months for a young toddler; the file contains a current health report dated 01/02/2020 with the previous health report dated 06/03/2019.

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

Noncompliance Area: The health report for child #1 lacked a statement that the child is able to participate in child care and appears to be free from contagious or communicable disease.

Correction Required: A health report shall include a statement that the child is able to participate in child care and appears to be free from contagious or communicable disease.

Noncompliance Area: The file for child #3, 2 years and 7 months old, included a record of the child's immunization status which lacked a 4th dose of PCV13, a 3rd Polio and an influenza immunization. The file for child #4, a 4 year old , included a record of the child's immunization status which lacked an influenza immunization. The file for child #5, 2 years and 5 months old, included a record of the child's immunization status which lacked an influenza immunization.

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.

Noncompliance Area: Staff were not checking the children's diapers at least once every 2 hours. Observed the diaper for child #3 was checked at 12:20 pm. According to staff #1, the previous diaper change was at 8:30 am.

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.

Noncompliance Area: Observed the door to the "tub/shower" room was unlocked; the tub had shampoo, conditioner, shave cream and shower gel labeled "Keep out of reach of children" on the ledge which were accessible to children. Observed hand sanitizer on a low shelf in the main classroom labeled "Keep out of reach of children" which was accessible to the toddler and preschool children receiving care.

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

Noncompliance Area: Observed damaged ceiling tiles in classroom #4. Observed a hole in the drywall below the bulletin board next to the entrance of the facility.

Correction Required: Floors, walls, ceilings and other surfaces, including the facility's outdoor play space surfaces shall be kept clean, in good repair and free from visible hazards.

Noncompliance Area: 2nd CITATION: Observed a Pack 'N Play in the classroom which lacked the name of the specific child for whom it is intended. Observed the numbers with the names of the children listed on the chart did not match the numbers on the cots being used. PREVEIOUSLY CITED ON 12/17/2018.

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.

Noncompliance Area: Observed a bottle on the table in the main classroom which lacked a label with the child's name for whom it is intended.

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

Noncompliance Area: Observed a crib sheet in lieu of a Pack 'N Play sheet in the Pack 'N Play, used by an infant in care, which did not fit properly and created excess material.

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

Noncompliance Area: The most recent fire drill documented on the fire drill log was dated 01/15/2019 without documentation of an additional fire drill within the next 60 days.

Correction Required: A fire drill shall be held at least every 60 days. Facility persons and children in attendance shall participate in the fire drill. Facility persons and children shall exit the building, weather permitting.

Noncompliance Area: Observed a ride-on toy bulldozer in the outdoor play space with a cracked plastic handle. Observed the Little Tykes climbing cube leaning against the steps leading to the outdoor play space. Observed a wooden barn in the front classroom located at the main entrance of the facility with the corner of the roof broken off creating splintering edges.

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.

Noncompliance Area: Observed a white shelf in playroom #3 which was not anchored to prevent a tip hazard. Observed a white & lavender wooden doll house approximately 4 1/2 feet in height in playroom #4 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.

Noncompliance Area: Observed cots in the infant/toddler classroom which were not properly labeled for use of a specific child and used only by the specified child. The numbers with the names of the children listed on the chart did not match the numbers on the cots being used.

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.

Noncompliance Area: The infant/toddler classroom and the small playrooms located off of the main child care space lacked a written plan of daily activities in the group space.

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

Noncompliance Area: The file for child #4 lacked the health insurance policy number on the emergency contact form.

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.

Noncompliance Area: The infant/toddler classroom and the small playrooms located off of the main child care space lacked a posting of the emergency transportation plan in a conspicuous location. The excursion back pack, which accompanies a staff person to the outdoor play space, lacked a copy of the emergency transportation plan.

Correction Required: A written plan identifying the means of transporting a child to emergency care and staffing provisions in the event of an emergency shall be displayed conspicuously in every child care space and shall accompany a staff person who leaves on an excursion with children.

Noncompliance Area: The file for child #5 lacked a review of the emergency contact form by a parent at least once every 6 months; the emergency contact form was originally signed on 06/01/2018 with no additional documentation of a review on file.

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.

Noncompliance Area: The file for child #5, with an enrollment date of 06/01/2018, lacked an initial health report within 60 days following the first day of attendance; the file contains a current health report dated 11/07/2018 with no additional health reports 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.

Noncompliance Area: The file for child #3, lacked an updated health report at least once every 6 months for an infant or young toddler; the most recent health report on file is dated 04/11/2018 with no additional health reports on file.

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

Noncompliance Area: The file for child #2 lacked an updated health report at least once every 12 months for a preschool child; the most recent health report on file is dated 12/28/2017 and a previous health report dated 12/21/2016.

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.

Noncompliance Area: The file for staff person #1 lacked an updated health assessment at least once every 24 months; the most recent health report on file is dated 07/15/2016 with no current health assessment on file.

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

Noncompliance Area: Observed 2 Cosco booster seats in the van used for transporting children which lacked a copy of the manufacturer's instructions in the vehicle.

Correction Required: Manufacturers' instructions for use of safety restraints shall be kept in the vehicle at all times.

Noncompliance Area: The file for child #1, with an enrollment date of 04/25/2018, lacked a dated signature at the time of the review of the emergency contact form. The original signature on the emergency contact form was dated 03/07/2018; at the time of the review, the date was crossed off and changed to 09/07/2018.

Correction Required: Following review, a parent shall attest to the accuracy of information in the emergency contact information and the financial agreement at each review by affixing a dated signature to the record.

Noncompliance Area: The file for staff person #1, with an initial hire date of 08/01/2011 lacked an annual minimum of 6 clock hours of child care training between 08/2017 - 08/2018; the file currently has 2 hours of training completed on 08/30/2018; 1 hour completed on 10/24/2018 and 3 hours completed on 10/25/2018. Previous hours obtained were prior to 08/2017.

Correction Required: A staff person shall obtain an annual minimum of 6 clock hours of child care training.

Noncompliance Area: Observed an electrical outlet next to the storage cabinet in the foyer/front play area which lacked a protective receptacle cover.

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

Noncompliance Area: The infant/toddler classroom lacked a first-aid kit while children were in the child care space.

Correction Required: A first-aid kit shall be in a child care space.

Noncompliance Area: Observed an unsecured gate between the entrance foyer and exercise equipment allowing children access to the equipment. Observed loose floor tiles in the open doorway to the right of the door leading to the outdoor play space. Observed cracked and broken vinyl lattice on the bottom of the fencing surrounding the outdoor play space. Observed a hole approximately 6-8 inches in diameter in the screen protecting exposed insulation in the basement wall/foundation under the deck located in the outdoor play space allowing children access to the insulation.

Correction Required: Floors, walls, ceilings and other surfaces, including the facility's outdoor play space surfaces shall be kept clean, in good repair and free from visible hazards.

Noncompliance Area: Observed staff person #2 lift up a toddler to reach the sink to wash the child's hands after diapering; the sink located in the infant/toddler changing area lacked a means of platform or steps to ensure the child is easily able to reach the sink.

Correction Required: Toilets and sinks shall be at proper heights for children using them or shall be easily approached by means of platforms or steps.

Noncompliance Area: Observed foam toy fruits (2 apples) and vegetables (broccoli and a pea pod) in the toy room with torn off pieces and bite marks. Observed a wooden toaster located in the toy room with a crack in the corner creating a pinch hazard. Observed a side panel and a door disconnected from the Little Tykes play set located in the outdoor play space; the disconnected side panel created the play set to be unstable. Observed a crack in a Little Tykes dump truck located in the outdoor play space which created a pinch hazard. Observed a kitchen play set in one of the play rooms with a broken door and a loose top.

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.

Noncompliance Area: The file for child #1 lacked the signature of the operator on the agreement form.

Correction Required: An agreement shall be signed by the operator and the parent.

Noncompliance Area: The file for child #2 lacked a complete address for the individuals designated by the parent to whom the child may be released on the emergency contact form.

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.

Noncompliance Area: The file for staff person #1 lacked an updated health assessment at least once every 24 months; the file contains a current health report dated 09/04/2017 with the previous health assessment dated 03/02/2015.

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

Noncompliance Area: Observed an electrical outlet in the toy room which lacked a protective receptacle cover.

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

Noncompliance Area: Observed laundry detergent, liquid fabric softener and dryer sheets on top of the dryer located in the laundry room, the laundry room door was unlocked and 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.

Noncompliance Area: The hot water from the sink located in the bathroom in the front hallway reached a temperature of 128 F.

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

Noncompliance Area: Observed a loose hinge on the cabinet door located on the vanity/sink located in infant room.

Correction Required: Floors, walls, ceilings and other surfaces, including the facility's outdoor play space surfaces shall be kept clean, in good repair and free from visible hazards.

Noncompliance Area: The files for children #1, #2 and #4 lacked the complete address of the child's physician or source of medical care on the emergency contact form.

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

Noncompliance Area: The file for child #3 lacked the work address of the enrolling parent; the files for children #1 and #4 lacked the complete address of the enrolling parent on the emergency contact form.

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

Noncompliance Area: The files for children #1, #2, #3 and #4 lacked the complete address of the persons to whom the child may be released on the emergency contact form.

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.

Noncompliance Area: The facility lacked a posting of the means of transporting a child to emergency care and staff provisions in the front classroom in a conspicuous location. A copy of the policy does not accompany a staff person who leaves on an excursion with children.

Correction Required: A written plan identifying the means of transporting a child to emergency care and staffing provisions in the event of an emergency shall be displayed conspicuously in every child care space and shall accompany a staff person who leaves on an excursion with children.

Noncompliance Area: The file for child #3 lacked an updated health report at least every 12 months for a preschool child. A current health report on file is dated 12/21/2016 with a previous health report dated 05/13/2015.

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.

Noncompliance Area: The file for staff person #1 lacked a current health report within a 24 month period; the most recent health report on file is dated 08/04/2014.

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.A facility person's record shall include a written report of initial and subsequent health assessments, including the results of initial and subsequent tuberculin skin tests, x-rays or other medical documentation necessary to confirm freedom from communicable tuberculosis.

Noncompliance Area: The files for staff person #2 and #3 lacked verification of child care experience and education to qualify as an aide.

Correction Required: A facility person's record shall include verification of child care experience, education and training prior to service at the facility.

Noncompliance Area: The file for staff person #3 lacked two written, nonfamily references from individuals attesting to the person's suitability to serve as a facility person.

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

Noncompliance Area: The facility lacked a posting with instructions for contacting the appropriate regional day care office in a conspicuous location used by parents.

Correction Required: The facility's current certificate of compliance and a copy of the applicable regulations under which the facility is certified shall be posted in a conspicuous location used by parents, with instructions for contacting the appropriate regional day care office posted at the same location.

Noncompliance Area: Observed styling gel on top of the paper towel holder, in the restroom located next to the office, which was accessible to children. Observed bleach wipes and a bucket with a mixture of dish soap and water on the sink counter located in the infant/toddler space (which is also used by preschool children)which was accessible to children. Observed hand sanitizer in an unlocked cabinet located above the sink in the bathroom (down the hall from the main classroom) which 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.

Noncompliance Area: Observed an unlabeled bucket on the counter located in the infant/toddler room which contained a mixture of dish soap and water.

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.

Noncompliance Area: Observed the first-aid kit located in the main classroom hanging on a hook next to the doorway which was accessible to the children in care.

Correction Required: A first-aid kit must be inaccessible to children.

Noncompliance Area: The first-aid kit located in the mini-van used to transport children lacked tweezers, scissors, soap and water.

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).

Noncompliance Area: Observed a loose backboard and a crack in the water tub of the play sink located in the small playroom creating a pinch hazard. Observed a changing table in the bathroom which was unstable creating a fall hazard. Observed the following in the main classroom: a baseboard heater protective panel which was loose and falling off of the unit creating sharp edges and access to the heating element; a loose faucet on the play kitchen creating a pinch hazard; the cushion on the pink child size love seat seams were splitting allowing access to the foam inside.

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. 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.

Noncompliance Area: Observed peeling paint along the wall located in the infant/toddler space.

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

Noncompliance Area: On 01/24/2017 at approximately 12:45 pm, observed 5 toddlers and preschoolers sleeping in a dark room. Staff person #4 was unable to see, hear, direct and assess the sleeping children and was unable to identify all of the children sleeping in the room. Staff person #4 was sitting in the doorway and was unable to see all of the children in the room and staff person #1 came to assist. Both staff person #1 and #4 stated there were 4 children sleeping in the room. Due to the low lighting in the room both staff members missed identifying the 5th child sleeping in the room.

Correction Required: Rooms, hallways, stairways, outside steps, porches and ramps shall be lighted by artificial or natural light. 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.