The Ymca Child Development Center At Halifax

Regulation: 3270.21

Description: General Health and Safety

Noncompliance Area: On 07/06/2026, child #1 was injured on a slide while on an excursion to a local park. Staff person #1 saw the child fall from the middle of the slide and heard a "crack". Staff person #1 had the child hold their arm in a sling position and walked the child over to the table to sit down. Staff person #2 got an ice pack and staff person #1 attempted to call the child's mother. Staff person #1 then called the next person on the emergency contact list when the mother could not be reached. The group stayed at the park until the child was picked up. Staff person #1 sat with the child trying to distract them and keep them awake while fanning the child and giving them sips of water. Staff person #1 and #2 did not call 9-1-1 for emergency medical care for the child to be assessed, when there were concerns about keeping the child "awake" while waiting for someone to pick the child up for medical care.

Correction Required: Conditions at the facility may not pose a threat to the health or safety of the children. The legal entity must arrange for all facility staff to complete the Better Kid Care 911: Responding to Medical Emergencies Self-Learning Module. The legal entity will confirm compliance by sending a copy of the training certificate to the Central Regional Office of Child Development and Early Learning upon completion of the training.

Regulation: 3270.102(c)

Description: Outdoor equip.- protective surfacing

Noncompliance Area: Observed the outdoor embedded equipment did not have a minimum of 9" of mulch surrounding the equipment to meet the recommendations of the US CPSC. The mulch was compacted and displaced in the fall zone areas with the mulch being approximately 3 - 6" or less.

Correction Required: Outdoor equipment that requires embedded mounting must be mounted over a loose-fill or unitary playground protective surface covering that meets the recommendations of the United States Consumer Product Safety Commission. The equipment must be anchored firmly and be in good repair.

Regulation: 3270.103

Description: Small Toys and Objects

Noncompliance Area: Observed a box of latex gloves on the floor in the toddler bathroom which was 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(b)(2)

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

Noncompliance Area: The file for child #1 did not include an updated health report at least once every 12 months for an older toddler or preschool child (see LIS code sheet); the most recent health report on file was dated 03/11/2025 with no subsequent report on file.

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(e)(1)

Description: Exemption documentation from parent/guardian

Noncompliance Area: The file for child #2 (see LIS code sheet) included a record of the child's immunization status which lacked documentation of a 3rd & 4th dose of DTap, a 3rd dose of HiB, a 2nd & 3rd dose of Hep B, and a 3rd dose of Polio 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.

Regulation: 3270.135(a)(3)

Description: Disposable diapers

Noncompliance Area: Observed staff in the infant classroom use their hand to open the lid of the hands-free covered can in lieu of the foot pedal when disposing a soiled disposable diaper.

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: 3270.162(c)

Description: Not withheld as discipline

Noncompliance Area: There was documentation that a child's lunch was threatened to be withheld due to child's behavior.

Correction Required: Food may not be withheld from a child for purposes of discipline.

Regulation: 3270.182(7)

Description: Reports of accidents, injuries and illnesses. Original report - parent same day Copy - facility accident file. Copy - child's file

Noncompliance Area: It was observed that incident report originals were kept by the center, and a copy was given to the parents. There was not a third copy kept in the child's files.

Correction Required: A child's record shall contain reports of accidents, injuries and illnesses involving a child in care at the facility. The original report shall be given to the parent on the day of the incident. The second copy of the report shall be retained at the facility in an accident file. The third copy of the report shall be retained at the facility in the child's file.

Regulation: 3270.95(a)/3270.95(b)

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

Noncompliance Area: Documentation shows that the fire detection system was not tested every 30 days. It was tested 6/28/25 and 7/29/25 (31 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 Director or designated staff person who is responsible for compliance with this chapter shall ensure the requirements under subsection (a) are met.

Regulation: 3270.102(a)

Description: Clean and good repair

Noncompliance Area: Continued non-compliance from SIN-00265337. A bin containing large plastic puzzle pieces was observed to be cracked on the playground outside.

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(j)

Description: Prohibit items in crib

Noncompliance Area: During a correction verification visit, it was observed that an infant was sleeping on a pillow in a crib.

Correction Required: Toys, bumper pads, or pillows may not be present in a crib while an infant is sleeping in the crib.

Regulation: 3270.113(a)(1)

Description: Staff assigned to specific children

Noncompliance Area: During a correction verification visit, it was observed that staff member 2 could not name the children assigned to them in their primary care group.

Correction Required: 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: 3270.151(a)/3270.192(3)

Description: 12 months prior to service and every 24 months thereafter/Health assessment, TB test

Noncompliance Area: Documentation of a health assessment was not on file for staff member 1.

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.

Regulation: 3270.21

Description: General Health and Safety

Noncompliance Area: While completing an unannounced swimming monitoring visit, staff stated that child 1 needed their medication while in the heat. Staff members did not have the required medication with them while swimming.

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

Regulation: 3270.51

Description: Similar Age Level

Noncompliance Area: During a correction verification visit, it was observed that 1staff member was working alone with 15 preschool aged children.

Correction Required: When children are grouped in similar age levels, the following maximum child group sizes and ratios of staff persons apply: Infants 1:4 with a maximum group size of 8; Young toddlers 1:5 with a maximum group size of 10; Older toddlers 1:6 with a maximum group size of 12; Preschool children 1:10 with a maximum group size of 20; Young school-age children 1:12 with a maximum group size of 24; Older school-age children 1:15 with a maximum group size of 30. IF USING TIERED LIS: The required staff:child ratios must be maintained at all times. The legal entity must submit documentation in a format approved by DHS proving that the facility is maintaining the required staff:child ratios at all times. The legal entity will confirm continuing compliance by sending copies of the documentation to the -------- Region Office on a weekly basis for a period of three months after DHS approves the documentation format.

Regulation: 3270.75(b)

Description: Inaccessible to children

Noncompliance Area: During an unannounced swimming monitoring visit, it was observed that the first aid kit was on a picnic table accessible to children. This was corrected during the inspection.

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

Regulation: 3270.102(a)

Description: Clean and good repair

Noncompliance Area: During the time of inspection, it was observed that the plastic container with toys on the older children's playground was cracked/broken.

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)(7)

Description: Name/address/phone release person

Noncompliance Area: Documentation of the emergency contact form on file for child 2, did not include the release person's 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(c)

Description: Each child care space

Noncompliance Area: During the time of inspection, it was observed that an emergency contact form was not in the childcare space for a child in the older toddler classroom. This was corrected during 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: 3270.124(e)

Description: Written emergency plan posted

Noncompliance Area: During the time of inspection, it was observed that the emergency transportation plan was not posted in the older toddler classroom. This was corrected during the inspection.

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.

Regulation: 3270.151(a)/3270.192(3)

Description: 12 months prior to service and every 24 months thereafter/Health assessment, TB test

Noncompliance Area: Documentation of the health assessment on file for staff member 3 was updated more than 24 months of the original health assessment date. The original health assessment was conducted on 3/26/22 and was updated on 5/30/24.

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.

Regulation: 3270.166(4)

Description: Bottles labeled

Noncompliance Area: During the time of inspection, it was observed that a sippy cup in the infant refrigerator was not labeled with the child's name. This was corrected during the inspection.

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

Regulation: 3270.181(c)

Description: Emergency info/agreement updated 6 mos

Noncompliance Area: Documentation of the emergency contact form on file for child 1 was not updated within the last six months.

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: 3270.192(4)

Description: CPSL information

Noncompliance Area: Documentation of the child abuse clearance on file for staff member 2 was updated more than 60 months of the original clearance date. The child abuse clearance expired on 10/12/24 and was updated on 4/7/25.

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: 3270.27(a)(5)

Description: Emergency plan

Noncompliance Area: Documentation of the emergency plan letter that the parents receive at the time of enrollment, did not include accommodations for infants and toddlers.

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: 3270.31(e)(4)(i)

Description: Age and Training

Noncompliance Area: Documentation of the first aid/CPR certification on file for staff member 1 was renewed after the current certification expired. The certification expired on 3/26/24 and was updated 5/30/24.

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: 3270.66(a)

Description: Locked or inaccessible

Noncompliance Area: During the time of inspection, it was observed that cleaning supplies were within reach of children in the school age room. This was corrected during the inspection.

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: 3270.76

Description: Building Surfaces

Noncompliance Area: During the time of inspection, it was observed that a plastic cover over an outlet in the infant classroom was broken/cracked with sharp edges. This was corrected during 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: 3270.78/3270.113(a)

Description: Lighting/Supervised at all times

Noncompliance Area: During the time of inspection, it was observed that it was too dark during nap in the preschool classroom and certification representative wasn't able to see all of the children. In order to properly supervise children, staff must be able to see, hear, direct and assess the activities of the children at all times.

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.

Regulation: 3270.95(b)

Description: Director or designated staff person ensure compliance

Noncompliance Area: Documentation of the fire detection alarm testing on file showed that the alarm was not tested every thirty days. The alarm was tested on 6/28/24 and again on 7/31/24; which is 33 days. 8/30/24 and again on 9/30/24; which is 31 days. 9/30/24 and again on 10/31/24; which is 31 days. 11/29/24 and again on 12/31/24; which is 32 days. 12/31/24 and again on 1/31/25; which is 31 days. 2/28/25 and again on 3/31/25; which is 31 days.

Correction Required: The Director or designated staff person who is responsible for compliance with this chapter shall ensure the requirements under subsection (a) are met. To verify operability, a child care center shall manually test all fire detection devices or systems at least once every thirty days and shall maintain a written record of the testing with the facility's fire drill logs.

Regulation: 3270.106(j)

Description: Prohibit items in crib

Noncompliance Area: It was observed at the time of inspection an infant was sleeping in their crib with a pacifier that had a stuffed toy attached.

Correction Required: Toys, bumper pads, or pillows may not be present in a crib while an infant is sleeping in the crib.

Regulation: 3270.181(c)

Description: Emergency info/agreement updated 6 mos

Noncompliance Area: It was observed at the time of inspection child #1's emergency contact information and financial agreement was updated on 8-15-23/8-22 respectively, and then again on 3-19-24. Child #2's emergency contact information and financial agreement was updated on 9-10-23 and then again on 3-26-24. More than the 6-month requirement.

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: 3270.27(a)(5)/3270.27(e)

Description: Emergency plan/Letter to parents

Noncompliance Area: It was observed at the time of inspection that the facility's emergency plan and letter to parents explaining the emergency procedures did to provide accommodations for infants, toddlers, children with disabilities and chronic medical 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. 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: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: It was observed at the time of inspection that staff #1's FBI criminal history clearance was completed by the Department of Education and not by DHS as required by the CPSL.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services).

Regulation: 3270.111(c)

Description: Promote development

Noncompliance Area: On 12/14/23, at approximately 11 am, staff #1 was observed grabbing child #1 by the arm then forcefully putting child #1 on the floor on her buttocks. Staff #1 has been observed "yelling" at children on multiple occasions.

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: 3270.111(c)

Description: Promote development

Noncompliance Area: On 12/14/23, at approximately 11 am, staff #1 was observed grabbing child #1 by the arm then forcefully putting child #1 on the floor on her buttocks. Staff #1 has been observed "yelling" at children on multiple occasions.

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 #1will complete the on-line Better Kid Care Training: Dealing with Anger -- The Children's and Yours. Documentation of completed training will be submitted to DHS and be kept on file at the facility.

Regulation: 3270.102(a)

Description: Clean and good repair

Noncompliance Area: It was observed at the time of inspection the sink in the kitchen was not working, an infant swing cord was hanging freely posing a strangulation hazard, under the diaper changing pad in the infant room there was dust and debris (corrected at inspection), and a the wood on a wooden slide was splintered in the young toddler classroom.

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: 3270.107

Description: Refrigerator

Noncompliance Area: It was observed at the time of inspection the refrigerator in the kitchen did not have a thermometer.

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

Regulation: 3270.14/3270.21

Description: Pertinent Laws & Regulations/General Health and Safety

Noncompliance Area: It was observed at the time of inspection staff #2 completed the required one hour DHS Health and Safety updated training on 4-18-23 after the 12-20-22 requirement. Staff #3 completed the required one hour DHS Health and Safety training on 4-19-23 after the 12-20-22 requirement. Staff #7 completed the required health and safety training on 4-29-23 after the 12-20-22 requirement. Staff #4, staff #5 and staff #6 had not completed the required one hour DHS Health and safety training.

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: 3270.151(a)

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

Noncompliance Area: It was observed at the time of inspection staff #1's health assessment and TB test was completed after their date of hire and working with children. Staff #5's last health assessment was dated 3-6-20 and then again on 4-11-22.

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: 3270.192(5)

Description: Two written references

Noncompliance Area: It was observed at the time of inspection staff #1's record included one 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.

Regulation: 3270.31(f)(10)

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

Noncompliance Area: It was observed at the time of inspection that staff #1 did not completed professional development in pediatric first-aid and pediatric cardiopulmonary resuscitation within 90 days of hire.

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)

Description: Comply with CPSL

Noncompliance Area: It was observed at the time of inspection staff #1's FBI Criminal History Clearance was completed by the Department of Education, not DHS as required. Staff #5's State Police Clearance was dated 3-18-18 and then updated 4-11-23, Child Abuse Registry Clearance was completed 12-4-17 and then updated on 1-28-23, Mandated Reporter training was completed 11-7-17 and then on 12-19-22. All beyond the 60 month requirement. Staff #7's FBI clearance was completed on 5-8-23 beyond the 45 day provisional hire requirement.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services).

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

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

Noncompliance Area: It was observed at the time of inspection staff #4's experience was documented working with adults and not experience working with children.

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

Regulation: 3270.105

Description: High Chairs

Noncompliance Area: It was observed at the time of inspection the high chair being used in the Young Toddler Classroom did not have a t-shaped safety strap.

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

Regulation: 3270.111(c)

Description: Promote development

Noncompliance Area: It was observed at the time of inspection that the outside temperature was 60 degrees. Child #1 was dressed in a t-shirt, shorts and was not wearing socks or shoes. Child #1 was carried outside and placed on the padded surface in the infant toddler play area. Child #1 was developmentally able to pull himself up, stand and sit on the ground. Child #1 was outside for a period of 45 minutes.

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: 3270.31(e)(4)(i)

Description: Age and Training

Noncompliance Area: It was observed at the time of inspection that all staff's DHS Approved Pediatric First-Aid and CPR Training was not completed by a PQAS Certified Trainer.

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: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: It was observed at the time of inspection staff #1 did not have the required National Sex Offender Registry Clearance completed as required.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). LACKING REQUIRED HIRING DOCUMENTS: Facility Person # 1-- may not work in a child care position at the facility. 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. Facility Person #1--- may not work in a child care position at the facility.

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

Description: HS/GED + 2 yrs/Transcript, diploma and letters

Noncompliance Area: It was observed at the time of inspection that staff #1's record did not contain documentation of her education.

Correction Required: An assistant group supervisor shall have a high school diploma or a general educational development certificate and 2 years experience with children. A facility person's record shall include acceptable verification of experience, education or training is a transcript or a diploma or a letter signed by a representative of the experiential, educational or training entity.

Regulation: 3270.76

Description: Building Surfaces

Noncompliance Area: It was observed at the time of inspection the surface on the heating vent was covered in a layer of dust in the young toddler room. The surface of the heating vent was accessible to children in care.

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 thermometer in the 3/4's room refrigerator read 50 F.

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

Noncompliance Area: Staff person #1 has a health summary on file but it does 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.

Noncompliance Area: Staff person #1 has a health summary on file but it does 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.

Noncompliance Area: The hot water temperature in the upstairs bathrooms was 114 F. Children use these sinks for handwashing. The hot water was turned off during inspection.

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

Noncompliance Area: The first aid kits in the 3/4's and camp rooms were both missing soap. Corrected during inspection.

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.

Noncompliance Area: Child #1 does not have a current health assessment on file. The last health assessment on file is dated 04/08/19.

Correction Required: The operator shall require the parent to provide an updated health report at least every 6 months for an infant or young toddler. A child's record shall contain initial and subsequent health reports.

Noncompliance Area: Child #1, a young toddler, fell down a flight of 17 stairs. He had a red mark/bruise on his cheek and the parent was not given the incident report on the date of incident.

Correction Required: A child's record shall contain reports of accidents, injuries and illnesses involving a child in care at the facility. The original report shall be given to the parent on the day of the incident. The second copy of the report shall be retained at the facility in an accident file. The third copy of the report shall be retained at the facility in the child's file.

Noncompliance Area: On 07/30/19 a group of five school age children exposed their genitals to each other during outside play time. Three staff were at the picnic tables and this group of children was in the tree line about 25 yards up the hill behind the fenced play area. Given the proximity of the staff to the children, the staff was unable to hear, assess and direct the activities of the children.

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. 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. The definition of supervision is to see, hear, assess and direct the activities of the children. Center director must complete Better Kid Care's training titled: Keeping children safe on playgrounds-for center directors

Noncompliance Area: Child #3 does not have documentation that she is vaccinated in accordance with the ACIP schedule. The parents wrote a note that the doctor is vaccinating on an alternate schedule. There is no documentation from the physician regarding the medical reason for the alternate schedule.

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.Exemption from immunization for reasons of medical need must be documented by a written, signed and dated statement from the child's physician, physician's assistant or CRNP. The statement shall be kept in the child's record.

Noncompliance Area: On 06/13/19 DHS representative observed lunch being prepared and served by the facility and the children were not given a protein. On 07/24/19 DHS representative observed the children being served lunch prepared by the facility. The children were not given a grain. They were served hot dogs, milk, applesauce and carrots.

Correction Required: A lunch or dinner prepared at the facility for children of toddler age or older shall include at least one grain. The facility director and any other staff involved in menu planning, meal preparation or food shopping must receive training on nutrition and meeting the required food groups.

Noncompliance Area: Staff person #5, date of hire 04/12/19, has an FBI clearance on file dated 04/19/14, which is more than 60 months old.

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. Facility Person #5 may not work in a child care position at the facility.

Noncompliance Area: A visible layer of dust and surface dirt was observed under the diaper changing pad in the older toddler room. Cleaned during inspection.

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: Mulch and gravel less than one inch in diameter was observed on the toddler playground.

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.

Noncompliance Area: Facility does not have established and written policies regarding supervision or dismissal of children.

Correction Required: The operator shall review with the parent, at the time of application, the facility's general daily schedule, hours for which care is provided, fees, responsibilities for meals, clothing, health policies, supervision policies, night care policies, dismissal policies, transportation and pick-up arrangements.At the time of enrollment, a parent shall receive in writing the facility's general daily schedule, hours for which care is provided, fees, responsibilities for meals, clothing, health policies, supervision policies, night care policies, dismissal policies, transportation and pick-up arrangements.

Noncompliance Area: The agreement for child #1 is not signed by the operator, and the agreement for child #2 is not signed by the parent.

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

Noncompliance Area: The agreement for child #3 does not specify the child's arrival and departure times.

Correction Required: An agreement shall specify the child's arrival and departure times.

Noncompliance Area: The original agreements were on file for children #2,3,4 and 5.

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

Noncompliance Area: The file for child #1 does not include the name, address or telephone number of the child's physician or source of medical care. The physician's phone number is not on file for child #5.

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 #1 does not include the parents work address or phone number.

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

Noncompliance Area: The file for child #1 does not include written consent signed by a parent for emergency medical care.

Correction Required: Emergency contact information must include the written consent signed by a parent for emergency medical care. A child's record shall contain signed parental consent for emergency medical care for the child. Written consent is required prior to admission.

Noncompliance Area: The file for child #1 does not include the health insurance policy number.

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

Noncompliance Area: The file for child #5 does not include complete addresses or phone numbers for release persons.

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

Noncompliance Area: A written plan identifying the means of transporting a child to emergency care and staffing provisions in the event of an emergency was not posted in the older toddler room. Corrected during inspection.

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 emergency contact forms and agreements for children #2,3,4,5 are up to date but were not previously updated within a six month time frame.

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 informationA 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: Children #2,3 do not have documentation that they have been vaccinated in accordance with the schedule recommended by the ACIP. There is no documentation of exemption for religious, personal, or medical reasons for these children.

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 #1, 3 have a current health assessment on file but it was not updated within the 24 month time frame required by regulations. Staff #2,4 began employment at the facility on 10/22/18 and their health assessment is not dated until 10/30/18. Staff person #5 does not have a current health assessment on file and she began employment on 04/12/19.

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: On 06/13/19 DHS representative observed lunch being prepared and served by the facility. The children were not given a protein.

Correction Required: A lunch or dinner prepared at the facility for children of toddler age or older shall include at least one protein.

Noncompliance Area: On 06/13/19 DHS representative observed lunch being prepared and served by the facility. A preschool age child requested a second serving and the request was denied by staff.

Correction Required: Food servings shall be portioned suitably for the size and age of the children in care. Additional food in reasonable amounts shall be made available to children upon the request of the parent or child.

Noncompliance Area: Written feeding statements are not available for the infants in care.

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

Noncompliance Area: Facility hand washes bottles provided by parents and reuses them throughout the day. A commercial dishwasher is not used.

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.

Noncompliance Area: An unlabeled bottle was observed in the infant room. Corrected during inspection.

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

Noncompliance Area: The file for child #1 does not contain signed parental consent for administration of minor first-aid procedures by facility staff.

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

Noncompliance Area: Child #1 does not have signed parental consent for transportation, walking excursions, swimming or wading. Child #1 is a school age children and they walk to the park and swim daily.

Correction Required: A child's record shall contain signed parental consent for transportation, walking excursions, swimming and wading.

Noncompliance Area: Child and staff records were not being stored in a locked cabinet. Corrected during inspection.

Correction Required: Child records are confidential and shall be stored in a locked cabinet. Facility persons' records are confidential and shall be stored in a locked cabinet.

Noncompliance Area: A HACC student volunteer was observed in the three year old room. The student volunteer did not have a file.

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

Noncompliance Area: The file for facility persons #2,4 do not contain two written, nonfamily references attesting to their suitability to work with children.

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's current certificate of compliance was not posted in the parent area. Corrected during inspection.

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: Facility persons were not trained annually on the emergency plan. Staff were not trained between 04/26/18-05/30/19. Documentation of current training is now on file.

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.

Noncompliance Area: Staff persons did not have annual fire safety training. Fire safety training was not conducted between 05/23/18-06/04/19. Documentation of recent training is now on file.

Correction Required: Staff persons shall participate, at least annually, in firesafety training conducted by a fire protection professional. Staff persons and volunteers shall receive training in maintenance of smoke detectors, the duties of facility persons during a fire drill and during a fire and the use of the facility's fire extinguishers, not including discharge of the fire suppressant agent.

Noncompliance Area: Staff person #2, date of hire 10/22/18, has a DOE FBI clearance on file. Staff person #4, date of hire 10/22/18, has a DOE FBI clearance on file. Staff person #5, date of hire 04/12/19, has an FBI clearance on file dated 04/19/14, which is more than 60 months old.

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. Facility Persons #-2,5 and 5 may not work in a child care position at the facility.

Noncompliance Area: Staff person #2, qualified as an AGS, does not have documentation of a high school diploma or GED on file.

Correction Required: An assistant group supervisor shall have a high school diploma or a general educational development certificate and 2 years experience with children.

Noncompliance Area: All emergency telephone numbers were not posted by the telephone in the older toddler room. Corrected during inspection.

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.

Noncompliance Area: Areas of the fencing in the toddler outdoor play space were covered with a visible layer of surface dirt.

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 toilet in the upstairs bathrooms used by the older toddlers had a rim of black scum indicating that it has not been cleaned daily. Corrected during inspection.

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

Noncompliance Area: A portable sink is available for hand washing in the older toddler room but the sink was not in working order. Corrected during inspection.

Correction Required: A source of running water for handwashing shall be present in infant and toddler diapering areas. If the running water does not flow directly into a drain that is connected to a sewage system, a receptacle shall be provided to contain the water used for washing. The receptacle shall be emptied into an approved sewage system at least once a day.

Noncompliance Area: Evacuation routes were not posted in the older toddler room. Corrected during inspection.

Correction Required: Evacuation routes shall be posted.

Noncompliance Area: Persons #2,3 acknowledged that on 09/27/18 they observed staff #1 "snatch up roughly" child #1.

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. A facility person may not use any form of physical punishment, including spanking a child.

Noncompliance Area: On 08/07/18 DHS representative conducted an unannounced visit at the Halifax Community Pool. As the representative entered the pool area staff person #1 could be heard screaming at and loudly reprimanding a group of children.

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

Noncompliance Area: Child #1 does not have signed parental consent for emergency medical care for the child

Correction Required: A child's record shall contain signed parental consent for emergency medical care for the child. Written consent is required prior to admission.