The Alphabet Tree

Regulation: 3270.102(a)

Description: Clean and good repair

Noncompliance Area: A cracked lid with a potential pinch point was observed in Classroom 4.

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: 3270.105

Description: High Chairs

Noncompliance Area: Two young toddlers were observed in highchairs without the safety straps being engaged in Classroom 1.

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

Regulation: 3270.106(a)

Description: Clean, age appropriate

Noncompliance Area: Several rest mats in Classrooms 2, 3 and 4 were observed to be unlabeled for use of a specific child.

Correction Required: Individual, clean, age-appropriate rest equipment shall be provided for preschool, toddler and infant children as agreed between the 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: 3270.111(b)

Description: Posted in group space

Noncompliance Area: A written plan of daily activities was not posted in Classroom 5. School age children were observed to be receiving care in Classroom 5.

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

Regulation: 3270.123(a)

Description: Signed

Noncompliance Area: The current agreement on file for Child #1 was not signed by the parent. The current agreement on file for Child #6 was not signed by the Operator.

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

Regulation: 3270.123(a)(1)

Description: Amount of fee

Noncompliance Area: The current agreement on file for Child #3 lacked the fee amount.

Correction Required: An agreement shall specify the amount of the fee to be charged per day or per week.

Regulation: 3270.123(a)(3)

Description: Services proceeded

Noncompliance Area: The file for Children #1 and #5 lacked an approved developmental assessment that had been completed within 6 months of starting at the facility. The CSR on file for Child #1 was dated 331 days and the CSR on file for Child #5 was dated 624 days after starting. The files for Children #2, #3 and #4 lacked current developmental assessments that had been completed within the last 6 months.

Correction Required: The services to be provided to the family and the child, including the Department's approved form to provide information to the family about the child's growth and development in the context of the services being provided. The operator shall complete and update the form and provide a copy to the family in accordance with the updates regarding emergency contact information in § 3270.124(f) (relating to emergency contact information).

Regulation: 3270.123(a)(6)

Description: Admission date

Noncompliance Area: The agreement for Child #6 lacked the child's admission date.

Correction Required: An agreement shall specify the date of the child's admission.

Regulation: 3270.124(b)(7)

Description: Name/address/phone release person

Noncompliance Area: The emergency contact form for Child #1 lacked the address for the release persons listed.

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: An emergency contact form was missing for a child receiving care in Classroom 2.

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: The written emergency transportation plan was not posted in Classroom 5.

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: 3270.131(a)

Description: Health information

Noncompliance Area: The file for Child #3 lacked an initial health report within 60 days of starting at the facility. The initial health report was completed 125 days after starting at the facility.

Correction Required: The operator shall require the parent of an enrolled child, including a child, a foster child and a relative of an operator or a facility person, to provide an initial health report no later than 60 days following the first day of attendance at the facility.

Regulation: 3270.131(b)(1)

Description: Infant: updated health report every 6 months

Noncompliance Area: The files for Children #1 and #6, young toddlers, lacked a current health report that had been completed within the last 6 months. The most recent health report was dated 6.27.25 for Child #1 and 11.4.25 for Child #6.

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

Regulation: 3270.131(b)(2)

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

Noncompliance Area: The updated health reports on file for Child #2, a preschool age child, exceeded 12 months between reports dated 12.20.24 and 2.11.26.

Correction Required: The operator shall require the parent to provide an updated health report at least every 12 months for an older toddler or preschool child.

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

Description: Immunization record/Dismissal policy

Noncompliance Area: The file for Child #1 lacked verification that the child had received their recommended Rotavirus, DTAP, HIB, Pneumococcal, Polio, MMR and Varicella vaccinations. The file for Child #5 lacked verification that the child had received their recommended 15-18 month DTAP vaccination. The file for Child #6 lacked verification that they had received their recommended 6 month DTAP, HIB and Pneumococcal vaccinations. Written exemptions were not on file at the time of the inspection.

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). Children #1, #5 and #6 will be dismissed from care at the close of business on 7.7.2026.

Regulation: 3270.14/3270.21

Description: Pertinent Laws & Regulations/General Health and Safety

Noncompliance Area: Staff person #4 was observed to be caring for children unsupervised. Staff person #4 has not completed the following pre-service training required prior to caring for children unsupervised: Pediatric First Aid and CPR training, Health and Safety Training and Mandated Reporter 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. Once Staff Person #4 has returned to the facility with the required NSOR Certificate and until such time as the required pre-service trainings are completed, staff person #4 must be supervised, when interacting with children, by an AGS, GS or Director who has completed the required training related to this citation. If there are no staff person(s) available to supervise staff person #4, staff person #4 may not work in a child-care position at the facility.

Regulation: 3270.165

Description: Menus

Noncompliance Area: A menu, at least 1 week in advance, was not posted at the facility at the time of the inspection.

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

Regulation: 3270.166(4)

Description: Bottles labeled

Noncompliance Area: Two unlabeled bottles, intended for a child in care, were observed in the refrigerator in Classroom 1

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

Regulation: 3270.171(a)

Description: Pick-up and drop-off points

Noncompliance Area: Verification that the facility has submitted annual notification to the local traffic safety authorities was not on file at the time of the inspection. The most recent notification was reported to have occurred on 5.26.25.

Correction Required: An operator shall notify local traffic safety authorities annually in writing of the location of the facility and the program's use of pedestrian and vehicular routes around the child care facility.

Regulation: 3270.18(a)

Description: On file at facility

Noncompliance Area: A copy of the current liability insurance policy was not on file at the time of the inspection.

Correction Required: The legal entity shall have comprehensive general liability insurance to cover the persons who are on the premises. A current copy of the insurance policy shall be on file at the facility.

Regulation: 3270.181(c)

Description: Emergency info/agreement updated 6 mos

Noncompliance Area: The updates to the financial agreements on file for Children #1 and #2 exceeded 6 months between review. This was evidenced by financial agreements dated 6.25.25 and 7.6.26 for Child #1 and 12.14.24 and 7.1.26 for Child #2. The updates to the emergency contact forms and financial agreements on file for Children #3, #4, #5 and #6 exceeded 6 months between review and update. This was evidenced by emergency contact forms being dated 12.1.25 and 7.1.26 and financial agreements dated 9.5.25 and 7.1.26 for Child #3, emergency contact forms and financial agreements dated 12.2025 and 7.2026 for Child #4. emergency contact forms and financial agreements being dated 5.2025 and 7.2026 for Child #5, and emergency contact forms being dated 9.22.25 and 5.26.26 and one agreement on file dated 7.1.26 for Child #6.

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: 3270.182(3)/3270.182(5)

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

Noncompliance Area: The emergency contact forms on file for Children #1 and #3 lacked signed parental consent for obtaining emergency medical care and administration of minor first aid by facility staff.

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. 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.

Regulation: 3270.21

Description: General Health and Safety

Noncompliance Area: Two thorned weeds were observed along the retaining wall in the outdoor play space. The thorned weeds would be accessible to children playing in the play space.

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

Regulation: 3270.31(e)

Description: Age and Training

Noncompliance Area: The files for Staff Persons #1 and #3 lacked 6 of their 12 hours of annual child care training and the file for Staff Person #2 lacked 1.5 of their 12 hours of child care training in their respective training year of December 2024 to December 2025.

Correction Required: A staff person shall obtain an annual minimum of 12 clock hours of child care training.

Regulation: 3270.31(e)(4)(ii)

Description: Fire safety - 1 yr.

Noncompliance Area: The annual fire safety trainings on file for Staff Persons #1, #3 and #5 exceeded 12 months between trainings. This is evidenced by fire safety trainings dated 11.4.24 and 12.30.25 for Staff Person #1, 1.31.24 and 12.30.25 for Staff Person #3, and 1.5.24 and 12.30.25 for Staff Person #5.

Correction Required: Staff persons shall participate, at least annually, in fire safety 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.

Regulation: 3270.32(a)

Description: Comply with CPSL

Noncompliance Area: The file for Staff Person #4 lacked a completed NSOR Certificate prior to starting in a child care taking position. Staff Person #4 was observed to be caring for a group of children unsupervised.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). Facility Person # 4 may not work in a child care position at the facility. A provisional employee may not be permitted to work alone with children and must work within the vicinity of a permanent employee.

Regulation: 3270.65

Description: Protective Outlet Covers 5 yrs. or less

Noncompliance Area: A power strip was observed to have 10 uncovered electrical outlets on the teacher desk in Classroom 3. The power strip was accessible to children receiving care in Classroom 3.

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

Regulation: 3270.66(a)

Description: Locked or inaccessible

Noncompliance Area: A container of disinfecting wipes was observed on a cabinet in Classroom 3 near the exit to the eating and restroom areas. School Age children pass through Classroom 3, and the disinfecting wipes would be accessible to them. A sunscreen spray was observed in a bookbag in a classroom cubby accessible to preschool age children in Classroom 4. A bottle of floor cleaner was also observed in an unlocked cabinet in Classroom 4. Three sunscreen sprays were observed in children's bookbags on the floor in Classroom 5. A container of disinfecting wipes was also observed on a low cabinet in Classroom 5. School age children were receiving care in Classroom 5. All items were labeled Keep Out of Reach of Children.

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

Regulation: 3270.66(b)

Description: Original container

Noncompliance Area: A container of disinfecting wipes was observed on a low cabinet next to cookies and other snacks in Classroom 5.

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

Regulation: 3270.69(b)

Description: 110º F or less

Noncompliance Area: The hot water in the restroom was measured at 116.1° F.

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

Regulation: 3270.74

Description: Emergency Numbers Posted

Noncompliance Area: The telephone number of the nearest hospital, police department, fire department, ambulance and poison control center were not posted at the telephone in Classroom 4.

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

Regulation: 3270.76

Description: Building Surfaces

Noncompliance Area: Splintering wood was observed on the bottom of a door to a storage area in 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: 3270.91(a)

Description: Stairs, exits, etc. unobstructed

Noncompliance Area: An exit leading outside from Classroom 4 was observed to be blocked by a large box filled with classroom items

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

Regulation: 3270.112

Description: Infant/Toddler Stimulation

Noncompliance Area: An infant was observed to be in a swing from 12:20pm to 2:06pm. This is not acceptable to provide appropriate stimulation to the infant.

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

Regulation: 3270.119

Description: Infant sleep position

Noncompliance Area: It was reported that an infant had been permitted to sleep in a swing for 10-20 minutes. The infant was not moved to a crib when they were observed to have fallen asleep. This did not allow for compliance with the sleeping position recommended by the American Academy of Pediatrics.

Correction Required: Infants shall be placed in the sleeping position recommended by the American Academy of Pediatrics unless there is a medical reason an infant should not sleep in this position. The medical reason shall be documented in a statement signed by a physician, physician's assistant or CRNP and placed in the child's record at the facility.

Regulation: 3270.31(f)(10)

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

Noncompliance Area: The file for Staff Person #1 lacked verification that they had completed pediatric first aid and CPR training within 90 days of their date of hire.

Correction Required: Staff persons shall complete professional development in the topic of pediatric first aid and pediatric cardiopulmonary resuscitation within 90 days of hire.

Regulation: 3270.113(a)

Description: Supervised at all times

Noncompliance Area: At approximately 10:40am, Staff Person #2 was observed to exit the door leading from Classroom 3, an infant rest room, with 1 infant. It was reported that this infant had just awakened from a nap. Certification Rep reviewed video surveillance from Classroom 1and observed both Staff Person's #1 and #2 to be present in Classroom 1 at 10:30am. Certification Rep spoke with Staff Person #2 who confirmed that two infants had been sleeping in Classroom 3 at approximately 9am, with one infant waking at 10am and the second waking at approximately 10:40am. Staff Person #2 reported that they "had been going back and forth [between Classroom 1 and Classroom 3] during the time the children were napping." Based on Staff reports and video observation, a Staff Person would not have been present in Classroom 3 during the duration an infant was napping to allow for appropriate supervision of the child. At approximately 1:20pm four infants were observed in cribs in Classroom 3. The Classroom lacked appropriate artificial or natural lighting to allow for Staff to properly see the children for appropriate supervision.

Correction Required: 1. Children on the facility premises and on facility excursions off the premises will be supervised by a staff person at all times. This portion of the plan will have an immediate correction date. 2. All staff, including the director, will participate in an onsite/ in-person training called, "Creating a Safe Environment with Active Supervision" conducted by the ELRC. These hours are permitted to be counted as part of each staff's required 12 annual training hours. The operator will provide an anticipated date for completion of training. 3. Subsequent to the training, all staff, including the director, will participate in technical assistance sessions with the ELRC Quality Coach. Technical assistance will include a minimum of 2 sessions at the facility. These sessions will address classroom set up to ensure barriers are not in place to impact appropriate supervision and appropriate lighting is in place in all classrooms to ensure staff can see all children present in the child care space. The operator will provide an anticipated date of completion of technical assistance. 4. The Director and/ or operator will develop a tool with which to complete daily supervision checks of all classrooms throughout the day to assess sightlines and staff positioning in the room. The tool will include the classroom name, date and time of observation, staff person(s) present, the number of children and their age levels (Infant, YT, OT, PS, YSA, OSA) present. The tool will assess that a staff person is physically present with their group of children under their supervision. The tool will assess that the staff person can see, hear, direct and assess the activity of the children under their supervision. The director/ operator may consult with the ELRC Quality Coaches to develop this tool for submission to the Western Region office prior to first use. The correction date for this portion of the plan will be the day the assessment tool is submitted to Certification, prior to use. 5. Random checks will occur at least 3 times per week for the 4 months subsequent to training and after submission of the tool. Documentation of the checks will be made available to Certification upon request. The correction date for this portion of the plan will be at minimum 4 months from the date the regional office reviews the tool.

Regulation: 3270.113(a)(1)

Description: Staff assigned to specific children

Noncompliance Area: At approximately 10:40am, Staff Person #2 was observed to exit the door leading from Classroom 3, an infant rest room, with 1 infant. It was reported that this infant had just awakened from a nap. Certification Rep reviewed video surveillance from Classroom 1 and observed both Staff Person's #1 and #2 to be present in Classroom 1 at 10:30am. Certification Rep spoke with Staff Person #2 who confirmed that two infants had been sleeping in Classroom 3 at approximately 9am, with one infant waking at 10am and the second waking at approximately 10:40am. Staff Person #2 reported that they "had been going back and forth [between Classroom 1 and Classroom 3] during the time the children were napping." Based on Staff reports and video observation, a Staff Person would not have been physically present in Classroom 3 during the duration an infant was napping to allow for appropriate supervision.

Correction Required: 1. Each staff person will be assigned the responsibility for supervision of specific children. The staff person will know the names and whereabouts of the children in their assigned group. The staff person will be physically present with the children in their group on the facility premises and on facility excursions off the facility premises. This portion of the plan will have an immediate correction date. 2. The Director and/ or operator will develop a tool with which to assess that all children have been assigned to a designated staff person and that staff can correctly identify the children for whom they are responsible. The director/ operator may consult with the ELRC Quality Coaches to develop this tool. The tool will include the classroom name, date and time of observation, staff person(s) present, the number of children and their age levels (Infant, YT, OT, PS, YSA, OSA) present. The tool will assess that each staff person has been assigned responsibility for supervision of specific children, that they know the whereabouts of the children in their assigned group and that they are physically present with these assigned children. The tool shall be submitted to the Western Region office prior to use. The correction date for this portion of the plan will be the day the assessment tool is submitted to Certification, prior to use. 3. Random checks will occur at least 3 times per week for the 4 months after submission of the tool. Documentation of the checks will be made available to Certification upon request by email or onsite monitoring visits. The correction date for this portion of the plan will be at minimum 4 months from the date the regional office reviews the tool.

Regulation: 3270.51

Description: Similar Age Level

Noncompliance Area: At approximately 10:40am, Staff Person #1 was observed to be caring for 5 infants alone in Classroom 1. The staff:child ratio for infants is 1:4. Staff Person #2 was observed to exit the door leading from Classroom 3, an infant resting room, with 1 infant. It was reported that this infant had just awakened. Certification Rep reviewed video surveillance from Classroom 1 and observed both Staff Person's #1 and #2 to be present in Classroom 1 at 10:30am. Certification Rep spoke with Staff Person #2 who confirmed that two infants had been sleeping in Classroom 3 at approximately 9am, with one infant waking at 10am and the second waking at approximately 10:40am. Staff Person #2 reported that they "had been going back and forth [between Classroom 1 and Classroom 3] during the time the children were napping." Based on staff reports and video observation, a staff person would not have been present in Classroom 3 during the duration an infant was napping to meet the required staff:child ratio requirements.

Correction Required: 1. 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. This portion of the plan will have an immediate correction date. . 2. The Director and/ or operator will develop a tool with which to complete daily ratio checks of all classrooms throughout the day. The tool will include the classroom name, date and time of observation, staff person(s) present, and the number of children and their age levels (Infant, YT, OT, PS, YSA, OSA) present. The director/ operator may consult with the ELRC Quality Coaches to develop this tool for submission to the Western Region office prior to first use. The correction date for this portion of the plan will be the day the assessment tool is submitted to Certification, prior to use. 3. Random checks will occur at least 3 times per week for the 4 months after submission of the tool. Documentation of the checks will be made available to Certification upon request by email or onsite monitoring visits. The correction date for this portion of the plan will be at minimum 4 months from the date the regional office reviews the tool.

Regulation: 3270.78

Description: Lighting

Noncompliance Area: At approximately 1:20pm Staff Person #3 was observed to be caring for 4 infants in Classroom 3. An adequate source of artificial or natural light was not present in the classroom. This lack of lightening did not allow for appropriate supervision of children. Certification Rep confirmed with Staff Person #3 that they could not see the children well due to the lack of lighting.

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

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

Description: Age and Training

Noncompliance Area: The file for Staff Person #1 lacked verification that they had updated their Pediatric First Aid and CPR training on or before the expiration of the prior certification. This is evidenced by a training certification having expired in 12.2022 and an updated training certification being completed on 7.15.25. The information for Staff Person #1 has not been included on Staff Worksheets since their 2022 Renewal Inspection despite continued employment at the facility resulting in their file not being properly assessed at the last 3 renewal inspections.

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: 3270.31(e)(4)(ii)

Description: Fire safety - 1 yr.

Noncompliance Area: The file for Staff Person #1 lacked prior fire safety training that had been completed within the 12 months prior to the current training dated 7.15.25.

Correction Required: Staff persons shall participate, at least annually, in fire safety 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.

Regulation: 3270.32(a)

Description: Comply with CPSL

Noncompliance Area: The updates to the FBI clearances on file for Staff Person #1 exceeded 60 months between clearances dated 2.20.20 and 5.30.25.

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

Regulation: 3270.102(a)

Description: Clean and good repair

Noncompliance Area: One cracked lid with a potential pinch point was observed on a bin in Classroom #6.

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: 3270.103

Description: Small Toys and Objects

Noncompliance Area: Small pom poms, with a diameter of less than 1 inch, were observed in the bottom drawer of a drawer unit in the art area in Classroom #5. Older Toddlers were observed to be receiving care in the space.

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: 3270.113(a)(1)

Description: Staff assigned to specific children

Noncompliance Area: At approximately 9:46 Staff Person's #2 and #8 were observed to be caring for a mixed age group that was determined to include 4 young school age children and 17 preschool age children in Classroom #6. Both Staff initially reported there being 20 children present. 21 children were observed in the space. Staff Person #2 identified being responsible for 10 preschool age children but then named 8 children using the face to name tags in place. Staff Person #7 reported Staff Person #2 had given them two of their face to name tags and gave two tags to Staff Person #2 who then identified two additional children. Staff Person #7 then identified being responsible for 4 young school age and 5 preschool children. This left 2 preschool children not identified by either staff person.

Correction Required: 1. Each staff person shall be assigned the responsibility for supervision of specific children. The staff person shall know the names and whereabouts of the children in his assigned group. The staff person shall be physically present with the children in his group on the facility premises and on facility excursions off the facility premises. This portion of the plan will have an immediate correction date. 2. All Staff will complete the following trainings: Supervision: Counting Children and Supervision: Team Work. These trainings may be counted towards the annual 12 hours of child care training. 3. The facility will work with the ELRC on the appropriate use of the face to name tags already in place at the facility. This will include a method for the tags to be given to staff upon the time of the child's arrival, how groupings will be maintained throughout the day and during transitions, and maintenance of tags after the child exits the program for the day.

Regulation: 3270.133(3)

Description: Name on bottle

Noncompliance Area: An unlabeled Zarbee's Cough Syrup was observed in a bin with Sunscreens in Classroom #4.

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: 3270.134(a)

Description: Child's hands washed

Noncompliance Area: The portable sink next to the changing table on the left side of Classroom #5 was in disrepair. Staff reported using hand sanitizer following diapering of Preschool Children. An operable portable sink was in place on the right side however another Staff Person reported using hand sanitizer following the diapering of Older Toddler and Preschool Children. Staff in Classroom #4 reported using hand sanitizer following the diapering of Toddler age Children in the classroom. Certification Rep observed Older Toddler and Preschool Children transitioning from Classroom #5 to the classroom for meals only. The children were seated without first washing their hands. It was confirmed that they had not washed their hands prior to entering the classroom for meals. Classroom #4 was observed to have already been present in the meal classroom eating their lunch. Staff confirmed that these children also had not washed their hands prior to eating lunch.

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

Regulation: 3270.135(a)(3)

Description: Disposable diapers

Noncompliance Area: A used pull up was observed in an unlidded garbage can at the changing table, reported to not be use, on the right side of Classroom #4.

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: 3270.151(a)

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

Noncompliance Area: The most recent health report on file for Staff Person #5 lacked a date to verify that it had been completed within the last 24 months.

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: 3270.166(5)

Description: Six-months-old held

Noncompliance Area: An infant, reported by Staff to be 5-6 months old, was observed to be propped on a boppy pillow on the floor with a neck pillow in front of their neck propping the bottle. The infant was not being held while being bottle fed.

Correction Required: An infant 6 months of age or younger shall be held while being bottle fed.

Regulation: 3270.192(5)

Description: Two written references

Noncompliance Area: The file for Staff Person #6 lacked two written, nonfamily references attesting to their 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: 3270.21

Description: General Health and Safety

Noncompliance Area: A pair of adult scissors were observed in an unlocked drawer in Classroom #5. The scissors were accessible to Preschool age children receiving care in the space. A loose crib sheet was observed on one of the cribs in Classroom #2.

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

Regulation: 3270.27(c)

Description: Training regarding plan

Noncompliance Area: The file for Staff Person #5 lacked verification that they had received annual emergency plan training within the last 12 months. The most recent fire safety training on file was completed on 1.24.24.

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

Regulation: 3270.31(e)

Description: Age and Training

Noncompliance Area: The file for Staff Person #5 lacked 4.5 of their 12 hours of annual child care training.

Correction Required: A staff person shall obtain an annual minimum of 12 clock hours of child care training.

Regulation: 3270.31(e)(4)(ii)

Description: Fire safety - 1 yr.

Noncompliance Area: The file for Staff Person #5 lacked verification that they had completed annual fire safety training within the last 12 months. The most recent fire safety training on file was completed on 1.30.24.

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.

Regulation: 3270.32(a)

Description: Comply with CPSL

Noncompliance Area: The file for Staff Person #1 lacked a current PA Child Abuse Clearance and and NSOR Certificate. The most recent PA Child Abuse Clearance was dated 5.11.20 and the most recent NSOR was dated 6.4.20 for Staff Person #1. The files for Staff Person #2 and #3 lacked a current NSOR Certificate. The most recent NSOR certificates on file for Staff Person #1 and #2 were both dated 5.22.20. The file for Staff Person #4 lacked a disclosure statement that had been completed within 90 days of starting at the facility.

Correction Required: 1. The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). Facility Person #1, #2, #3 and #4 may not work in a child care position at the facility. This portion of the plan will have an immediate correction date. 2. The Operator will develop a tracking system for updating clearances for all Staff at the facility. The system will include an explanation as to how the tracking system will work and who will be responsible for maintaining the tracking system.

Regulation: 3270.34(a)(6)

Description: Staff evaluations

Noncompliance Area: The file for Staff Person #5 lacked a written evaluation that had been completed within the last 12 months. The most recent written evaluation was dated 1.30.24.

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: 3270.51

Description: Similar Age Level

Noncompliance Area: Based on interviews with Staff at the time of an unannounced visit, it was reported that there are times that the facility is noncompliant with the staff:child ratio requirements with similar age children.

Correction Required: 1. 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. This part of the plan will have an immediate correction date. 2. All Staff will complete the following training: Supervision: Staff:Child Ratios. This training may be counted towards their annual 12 hours of child care training.

Regulation: 3270.52

Description: Mixed Age Level

Noncompliance Area: At approximately 9:46am, Staff Person's #1 and #2 were observed to caring for a mixed age group that included 4 young school age and 17 preschool aged children. The mixed age ratio for a group that includes preschool children is 1:10.

Correction Required: 1. 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). This part of the plan will have an immediate correction date. 2. All Staff will complete the following training: Supervision: Staff:Child Ratios. This training may be counted towards their annual 12 hours of child care training.

Regulation: 3270.65

Description: Protective Outlet Covers 5 yrs. or less

Noncompliance Area: Three electrical outlets were observed to be missing protective receptacle covers in Classroom #7.

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

Regulation: 3270.66(a)

Description: Locked or inaccessible

Noncompliance Area: Four bottles of sunscreen and a Lysol Spray was observed on a low cart in Classroom #7. An unlocked closet was also observed to contain a large box with spray paints. The items would be accessible to Preschool and School Children who pass through the space to go to the outdoor play space and the classroom is reported to be used for overflow at times. All items were labeled Keep Out of Reach of Children. Bingo daubers, labeled Keep Out of Reach of Children, were observed in a bin with the children's toys in Classroom #6. The bingo daubers were accessible to Preschool and School Age children receiving care in the space. In Classroom #5, one bottle of hand sanitizer was observed on a teacher desk on the left side of the classroom, another bottle of hand sanitizer and disinfecting wipes were observed on a drawer unit next to the changing table on the left side. A bottle of hand sanitizer was observed on the drawer unit on the right side of the classroom. A bottle of hand sanitizer and air freshener spray was observed in the unlocked staff restroom located off of the eating area used by children in the facility. The items were labeled Keep Out of Reach of Children.

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

Regulation: 3270.72(b)

Description: Screened

Noncompliance Area: The door from Classroom #7, leading to the outdoor play space, was observed to be open. A screen was not in place.

Correction Required: Windows or doors used for ventilation shall be screened when open.

Regulation: 3270.76

Description: Building Surfaces

Noncompliance Area: A soiled ceiling tile, that appeared to have mold around a vent, was observed in Classroom #4.

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(j)

Description: Running water - diapering

Noncompliance Area: A source of running water was not present at the changing area in Classroom #4. The portable sink at the changing table on the left side of Classroom #5 was reported to not be used as the sink was clogged.

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.

Regulation: 3270.106(f)

Description: 2 feet apart

Noncompliance Area: Based on interviews, rest equipment lacks two feet on three sides of a bed, cot, crib, or other rest equipment while the equipment is in use.

Correction Required: At least 2 feet of space is required on three sides of a bed, cot, crib or other rest equipment while the equipment is in use.

Regulation: 3270.113(a)

Description: Supervised at all times

Noncompliance Area: On 4/22/25 at approximately 11:05 while assessing supervision and ratio, Staff #4 was observed plating food in the front eating area and did not have a supervision group. An infant was observed in a high chair in the eating area. The infant was in Staff #3's supervision group and Staff #3 was not in the room at the time. Staff #3 was observed leaving the Infant room and walking into the eating area while carrying a second infant and putting them in a high chair. When Staff #3 left the Infant Room, Staff #3 left five infants alone with no other staff members in the room. When Staff #3 was asked to name their supervision group, Staff #3 named the two infants in the high chair and began mentioning the children in the Infant Room. While discussing supervision groups with Staff #3, Staff #5 walked into the Infant Room. Staff #5 was the only staff member in the Infant Room and named five infants in their supervision group. At that time, Staff #4 walked into the Infant Room, putting the room back in ratio.

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.

Regulation: 3270.113(a)(1)

Description: Staff assigned to specific children

Noncompliance Area: On 4/22/25 at approximately 11:05 while assessing supervision and ratio, Staff #4 was observed plating food in the front eating area and did not have a supervision group. An infant was observed in a high chair in the eating area. The infant was in Staff #3's supervision group and Staff #3 was not in the room at the time. Staff #3 was observed leaving the Infant room and walking into the eating area while carrying a second infant and putting them in a high chair. When Staff #3 left the Infant Room, Staff #3 left five infants alone with no other staff members in the room. When Staff #3 was asked to name their supervision group, Staff #3 named the two infants in the high chair and began mentioning the children in the Infant Room. While discussing supervision groups with Staff #3, Staff #5 walked into the Infant Room. Staff #5 was the only staff member in the Infant Room and named five infants in their supervision group. At that time, Staff #4 walked into the Infant Room, putting the room back in ratio.

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: 3270.32(a)

Description: Comply with CPSL

Noncompliance Area: Staff #2, previously removed from a child care position on 2/24/25 due to lack of required out of state Child Abuse clearance, was observed to be interacting with and serving lunch to a mixed group of young toddler and preschoolers in the eating area of the facility.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). Facility Person #2 may not work in a child care position at the facility.

Regulation: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: The file for Staff #1 lacked requests or completed clearances for an out of state Child Abuse Clearance and a Sex Offender Clearance for states they have resided in within the last 60 months.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). 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: 3270.51

Description: Similar Age Level

Noncompliance Area: On 4/22/25 at approximately 11:05 while assessing supervision and ratio, Staff #2 was observed plating food in the front eating area and did not have a supervision group. An infant was observed in a high chair in the eating area. The infant was in Staff #1's supervision group and Staff #1 was not in the room at the time. Staff #1 was observed leaving the Infant room and walking into the eating area while carrying a second infant and putting them in a high chair. When Staff #1 left the Infant Room, Staff #1 left five infants alone with no other staff members in the room. When Staff #1 was asked to name their supervision group, Staff #1 named the two infants in the high chair and began mentioning the children in the Infant Room. While discussing supervision groups with Staff #1, Staff #3 walked into the Infant Room. Staff #3 was the only staff member in the Infant Room and named five infants in their supervision group. At that time, Staff #2 walked into the Infant Room, putting the room back in ratio.

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.

Regulation: 3270.61(c)

Description: 40 square feet wall-to-wall

Noncompliance Area: At approximately 11:10 AM, a mixed age group of 30 children ranging from young toddler to preschoolers, were observed in Classroom 5 (Older Toddlers and Preschool 1) which has a designated maximum capacity of 28.

Correction Required: Indoor child care space is measured within permanent stationary partitions or walls. The allowable number of children in a space is determined by dividing the total square feet in a space by 40.

Regulation: 3270.95(a)/3270.95(b)

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

Noncompliance Area: The most recent 30-day fire alarm testing on the fire alarm testing log is dated 3/21/25, more than 30 days prior.

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: 3270.106(a)

Description: Clean, age appropriate

Noncompliance Area: In the cubby areas of Classroom 5 (used by Toddler and Preschool age children) 5 unlabeled mats were observed.

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: 3270.123(b)/3270.182(8)

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

Noncompliance Area: The file for Child #2 was observed to contain an original agreement.

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

Regulation: 3270.124(b)(6)

Description: Insurance coverage information

Noncompliance Area: The emergency contact form for Child #2 lacked the health insurance coverage and policy number for the child.

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 emergency contact form for Child #2 lacked the address for one of the release persons listed. The emergency contact form for Child #5 lacked the addresses for all of the release persons listed.

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(e)

Description: Written emergency plan posted

Noncompliance Area: The written emergency transportation plan was not posted in Classroom #2 (the back infant nap room).

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: 3270.124(f)/3270.181(c)

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

Noncompliance Area: The updates to the emergency contact form and financial agreements for Children #1, #2, and #3 have exceeded 6 months since last review in July 2024. The update to the financial agreement for Child #4 has exceeded 6 months since last review in July 2024.

Correction Required: The parent shall update in writing emergency contact information once in a 6-month period or as soon as there is a change in the information. A parent is required to review and update the emergency contact information and the financial agreement at least once in a 6-month period or as soon as there is a change in the information.

Regulation: 3270.131(a)

Description: Health information

Noncompliance Area: The file for Child #3 lacked an initial health assessment within 60 days of starting at the facility. An initial assessment was not on file until 1079 days after starting at the facility.

Correction Required: The operator shall require the parent of an enrolled child, including a child, a foster child and a relative of an operator or a facility person, to provide an initial health report no later than 60 days following the first day of attendance at the facility.

Regulation: 3270.131(b)(1)

Description: Infant: updated health report every 6 months

Noncompliance Area: The file for Child #4, a young toddler, lacked updated health reports every 6 months. The health reports on file were dated 1.26.24 and 1.28.25.

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

Regulation: 3270.131(b)(2)

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

Noncompliance Area: The file for Child #1, a preschool age child, lacked an updated health report that had been completed within the last 12 months. The most recent report on file for Child #1 was dated 1.22.24.

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: 3270.134(a)

Description: Child's hands washed

Noncompliance Area: Staff Person #2 was observed to change a child's diaper in Classroom #5 and place the child down without ensuring the child washed their hands prior to returning to playing with toys in the classroom.

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

Regulation: 3270.151(c)(5)

Description: Physician/CRNP assessment

Noncompliance Area: The current health assessment on file for Staff Person #2 lacked a statement from the physician regarding their suitability to provide child care.

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

Regulation: 3270.192(5)

Description: Two written references

Noncompliance Area: The file for Staff Person #3 lacked one written, nonfamily reference. One of the two references on file was a relative.

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: 3270.21

Description: General Health and Safety

Noncompliance Area: A pair of adult scissors were observed on the desk in the Preschool area of Classroom #5. The scissors were accessible to preschool age children receiving care in the space.

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

Regulation: 3270.27(a)(6)

Description: Emergency plan

Noncompliance Area: The facility lacked documentation that they had completed an annual emergency drill in the last 12 months. The most recent emergency drill on file was dated 4.6.23.

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

Regulation: 3270.31(f)

Description: Health and Safety Training

Noncompliance Area: The file for Staff Person #1 lacked completion of Pediatric First Aid and CPR training within 90 days of starting at the facility. The completed Pediatric First Aid and CPR training was completed 285 days after starting at the facility. The file for Staff Person #2 lacked completion of the required Health and Safety training within 90 days of starting at the facility. The Health and Safety trainings were not completed until 160 days after starting at the facility. The file for Staff Person #3 lacked completion of the required Health and Safety training within 90 days of starting at the facility. The Health and Safety trainings were not completed until 111 days after starting at the facility. The file for Staff Person #4 lacked completion of their Pediatric First Aid and CPR training and their Health and Safety training within 90 days of starting at the facility. The Pediatric First Aid and CPR training was completed 627 days after starting and the health and safety training was completed 160 days after starting.

Correction Required: Staff persons shall complete professional development within 90 days of hire as listed in subsections (f)1-10.

Regulation: 3270.32(a)

Description: Comply with CPSL

Noncompliance Area: The file for Staff Person #1 lacked a current FBI Clearance that had been completed within the last 60 months. The most recent FBI Clearance was dated 8.24.19. The file for Staff Person #2 lacked a current request for a PA State Police Clearance prior to starting at the facility. The request on file was dated 2 years prior to starting. The file for Staff Person #2 lacked a completed PA State Police Clearance as the one on file was listed as "Under Review". Staff Person #2 has exceeded 45 days in a child care taking position. (Refer to LIS Code Sheet). A completed PA State Police Clearance was not on file until 189 days after starting in a child care taking position. The file for Staff Person #4 lacked a completed out of state Child Abuse Clearance for a state they have resided in within the last 60 months.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). Facility Person #1 and #4 may not work in a child care position at the facility.

Regulation: 3270.66(a)

Description: Locked or inaccessible

Noncompliance Area: A bottle of hand sanitizer was observed on the desk in Classroom #7 (the school age classroom). The room is not currently in use, but children do pass through the classroom to enter the outdoor play space.

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: 3270.67(d)

Description: Contaminated trash in closed plastic-lined receptacle

Noncompliance Area: In the Preschool area of Classroom #5 an open front garbage can was observed to contain used tissues and disposable cups used by the children. The open front of the garbage can did not allow containment of the trash contaminated by human secretions.

Correction Required: Trash that has been contaminated by human secretions or excrement shall be contained in closed, plastic-lined receptacles.

Regulation: 3270.75(a)

Description: In child care spaces

Noncompliance Area: A first aid kit was missing from Classroom #2 (the back infant nap room).

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

Regulation: 3270.76

Description: Building Surfaces

Noncompliance Area: In Classroom #7 (the school age classroom) two damaged ceiling tiles were observed in the loft area. One of the damaged tiles allowed a large area of insulation to be visible. In the outdoor play space one of the railroad ties on the retaining wall was observed to be damaged causing splintering wood. Also in the outdoor play space, a yellow door to the left upon entrance to the play space was observed to be disrepair with splintering wood along the bottom.

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 exceeded 30 days between documented smoke alarm testing on 11.1.24 and 12.3.24 and 12.3.24 and 1.8.25. There was no documentation of alarm testing in the last 30 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: There was a cracked clear bin and cracked lid in the eating area room. There was a yellow school bus and a green connector bunny toy broken in the young older room. There was a broken fire truck toy in the Preschool room. There was a broken orange hanging toy on the toy house in the pre-k room. There was a damaged spot exposing splinters on top of the cubbies in the eating area 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: 3270.107

Description: Refrigerator

Noncompliance Area: The young toddler room refrigerator temperature was 50 degrees.

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: 3270.123(a)(3)

Description: Services proceeded

Noncompliance Area: The file for child # 1 lacked a child service report. The file for child # 2 contained a current child service report dated 1/31/24 that was conducted more than 6 months from the prior report dated 1/27/23.

Correction Required: The services to be provided to the family and the child, including the Department's approved form to provide information to the family about the child's growth and development in the context of the services being provided. The operator shall complete and update the form and provide a copy to the family in accordance with the updates regarding emergency contact information in § 3270.124(f) (relating to emergency contact information).

Regulation: 3270.124(b)(5)

Description: Information re: special needs

Noncompliance Area: The files for child # 1 and 2 lacked the 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, on the Emergency contact form.

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: 3270.131(b)(2)

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

Noncompliance Area: The file for child # 3 a preschooler contained an updated health report dated 8/3/23. The previous report was dated 8/1/22.

Correction Required: The operator shall require the parent to provide an updated health report at least every 12 months for an older toddler or preschool child.

Regulation: 3270.133(7)

Description: Medication log

Noncompliance Area: The operator was not maintaining a medication log for a prescription medication, Auvi Q 0.15 mg Epinephrine injection for child # 4.

Correction Required: An operator is responsible to establish and maintain a medication log if prescription or nonprescription medication is administered.