My First Steps Child Care Center Ii

Regulation: 3270.121(b)

Description: Given parents in writing

Noncompliance Area: During a renewal inspection 2/11/26-3/10/26 it was noted that the facility was not providing parents information in writing regarding their night care policies. The facility reported via their provider survey that evening care is provided.

Correction Required: 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.

Regulation: 3270.124(b)(3)

Description: Parent home/work address, phone

Noncompliance Area: During a renewal inspection on 2/11/26-3/10/26 emergency contact information for Children 1-9 did not include parent's home address and phone number (Children 7 and 9), Parent's work address (Children 1-8), Parent's work phone number (Children 5 &7).

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

Regulation: 3270.124(e)

Description: Written emergency plan posted

Noncompliance Area: During a renewal inspection on 2/11/26 Cert rep observed that the emergency medical transportation plan was not present in the vehicles for transportation, or the binders taken with staff during transportation. It was reported that the emergency medical transportation was not taken with staff during transportation of children to and from the facility.

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: 3270.133(5)

Description: Original label

Noncompliance Area: During a renewal inspection on 2/11/26 Cert rep observed a child's Diaper rash cream with expiration date 9/2024 in Room 6(The Rainbow room).

Correction Required: Medication shall be stored in accordance with the manufacturer's or health professional's instructions on the original label.

Regulation: 3270.135(a)(3)

Description: Disposable diapers

Noncompliance Area: During a renewal inspection on 2/11/26 Cert rep observed Staff 5 using their hand to lift the lid of the trash can during a diaper change.

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: 3270.14/3270.21

Description: Pertinent Laws & Regulations/General Health and Safety

Noncompliance Area: During a renewal inspection 2/11/26-3/10/26 the facility did not have a written policy which addressed the prevention and identification of child maltreatment.

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. Announcement C-22-03: Updates to Prevention of Shaken Baby Syndrome, Abusive Head Trauma, and Child Maltreatment Requirements states To maintain compliance with 45 CFR 98.41(a)(1)(vi), in addition to the training requirements, child care providers must have a policy and procedure to identify the prevention of shaken baby syndrome, abusive head trauma, and child maltreatment. The policy must include, but is not limited to: Recognition of potential signs and symptoms of shaken baby syndrome and abusive head trauma; Strategies for coping with a crying, fussing, or distraught child; and Address the prevention and identification of child maltreatment.

Regulation: 3270.151(a)/3270.151(b)

Description: 12 months prior to service and every 24 months thereafter/Conducted by physician, PA or CRNP

Noncompliance Area: During a renewal inspection on 2/11/26-3/10/26, Cert Rep observed health assessments on file for Facility Persons 1-10 dated 9/18/24, 11/1/24, 6/14/25, 9/22/25, 6/13/25, 6/13/25, 9/18/24, 1/31/25, 1/5/26, and 6/7/24 respectively. The physician's signature and date appeared to be altered. Cert Rep spoke with the physician's office and the office confirmed that Facility Persons 1-9 are not patients, and Facility Person 10 has not been seen as a patient since 2018. The health assessments for Facility Persons 1-10 are fraudulent and not valid. Facility Persons 1-10 did not have another current valid health assessment on file.

Correction Required: A facility person providing direct care who comes into contact with the children or who works with food preparation shall have a health assessment conducted within 12 months prior to providing initial service in a child care setting and every 24 months thereafter. A health assessment is valid for 24 months following the date of signature, if the person does not contract a communicable disease or develop a medical problem. A health assessment shall be conducted and a report shall be written and signed by a physician, physician's assistant or CRNP. The signature must include the individual's professional title. TIERED LIS: 1. 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 shall be conducted and a report shall be written and signed by a physician, physician's assistant or CRNP. The signature must include the individual's professional title. Facility Persons 1-10 must obtain a valid and current Health Assessment. The operator shall provide a correction date for when this portion of the plan will be corrected. 2. The legal entity will submit initial Health Assessments of any newly hired facility persons and staff, and any newly updated Health Assessments for all existing facility person and staff who were hired before the date of this inspection for a period of 3 months to the NE Regional Office. During that time any initial and updated health assessment is not considered acceptable until their health assessment has been approved by the NE Regional Office. Submitted health assessments will be reviewed by the NE regional office within 1 week of submission. The operator shall provide a correction date that is a minimum of 3 months from the date an acceptable plan is received.

Regulation: 3270.176(f)

Description: Prohibition using an 11-15 passenger vans

Noncompliance Area: During a renewal inspection on 2/11/26 Cert rep observed that the GMC Savanna G3500 van with VIN ending in 6863 did not have the manufacturer's sticker showing the capacity. Compliance is unable to be verified, as the capacity sticker is missing.

Correction Required: In accordance with the requirements of 67 Pa. Code Chapter 171 (relating to school buses and school vehicles), the facility may not transport a child in an 11-15 passenger van. Effective 2/11/26 the GMC Savanna G3500 van with VIN ending in 6863 can not be used for transporting children, until such time as the van is verified to meet the requirements of 67 Pa. Code Chapter 171 and is verified through the manufacturer's sticker to not be an 11-15 passenger van.

Regulation: 3270.27(e)

Description: Letter to parents

Noncompliance Area: During a renewal inspection 2/11/26-3/10/26 the facility did not have a letter for the parents which explained the emergency procedures.

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

Regulation: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: During a renewal inspection on 2/11/26 Staff Person 5 and Facility Person 6 did not have all required clearances on file before their first day working with or interacting with children. (See LIS code sheet for first day with children). Staff Person 5 and Facility Person 6 reported they had resided in Florida in the past 60 months, however Staff Person 5 and Facility Person 6 did not have Florida Criminal record check and Florida Child Abuse clearances on file. Staff Person 5 was observed providing care to children on 2/11/26 and Facility Person 6 was observed interacting with children. Additionally Facility Person 6 had a PSP clearance request dated 2/26/25, however they did not have a PSP clearance on file. Facility Person 6 is beyond their 45 day provisional hire time period.

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. Staff Person 5 and Facility Person 6 may not work in a child care position or have any interaction with children at the facility until such time as the required PA and out of state clearances are on file for Staff Person 5 and Facility Person 6.

Regulation: 3270.35(b)(2)/3270.192(2)(iv)

Description: Bachelor's, 30 credits + 1 yrs/Transcript, diploma and letters

Noncompliance Area: During a renewal inspection 2/11/26-3/10/26 Staff Person 11 had a foreign degree that was evaluated to be equivalent to a bachelor's degree from an accredited college or university in the United States. Staff Person 11 did not have transcripts or other acceptable forms of documentation available to review to determine if they had at least 30 credit hours in early childhood education, child development, special education, elementary education or the human services field. Staff Person 11 did not have an experience working with children verified in the file.

Correction Required: A group supervisor shall have a bachelor's degree from an accredited college or university, including 30 credit hours in early childhood education, child development, special education, elementary education or the human services field and 1 year of 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: 3270.66(a)

Description: Locked or inaccessible

Noncompliance Area: During a renewal inspection on 2/11/26 Cert rep observed Lysol in an unlocked and accessible staff locker in the Light Green Room(Room 1). The Lysol was 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: 3270.71

Description: Heat Source

Noncompliance Area: During a renewal inspection on 2/11/26 Cert rep observed the door between Room 5(Orange) and the kitchen which had a working stove was open and unlocked. The stove did not have any protective mechanism to prevent direct contact with the stove, or the knobs to turn the stove on.

Correction Required: Hot water pipes and other sources of heat exceeding 110° F that are accessible to children shall be equipped with protective guards or shall be insulated to prevent direct contact.

Regulation: 3270.75(b)

Description: Inaccessible to children

Noncompliance Area: During a renewal inspection on 2/11/26 Cert rep observed the first aid kits in the following rooms were on shelves that would be accessible to the school age children who use these rooms: Room 1 (Light Green), Room 2(Blue), Room 3(Purple), and Room 5(Orange).

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

Regulation: 3270.76/3270.102(a)

Description: Building Surfaces/Clean and good repair

Noncompliance Area: During a renewal inspection on 2/11/26 Cert rep observed tears in the beige chair in Room 3(Purple Room), tears in the foam play pit in Room 6 (Rainbow Room), a rough edge from a broken piece of trim on the back wall of the right side of Room 6 (Rainbow Room), Frayed carpet on right side of Room 6 (Rainbow Room), tears in the changing mat in the men's bathroom used by room 8(Sky Blue Room) and room 9(Green Room), and holes which exposed the internal foam in the door frame cushion for the door to Room 9(Green Room). On 2/27/26 Cert rep observed splintering wood which created a rough edge on the wood trim around the raise section of the Side playground, a crack which caused a rough edge on the plastic bench in the front playground, and a crack which caused a rough edge on the yellow plastic bridge equipment on the front playground.

Correction Required: Floors, walls, ceilings and other surfaces, including the facility's outdoor play space surfaces shall be kept clean, in good repair and free from visible hazards. Toys, play equipment and other indoor and outdoor equipment used by the children shall be clean, in good repair and free from rough edges, sharp corners, pinch and crush points, splinters and exposed bolts.

Regulation: 3270.77(a)

Description: No peeling paint or plaster

Noncompliance Area: During a renewal inspection on 2/11/26 Cert rep observed peeling paint on the door frame of the door to Room 9(Green Room). On 2/27/26 Cert rep also observed peeling paint on the green metal toy car in the front playground.

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

Regulation: 3270.103

Description: Small Toys and Objects

Noncompliance Area: During a renewal inspection on 2/20/25 cert rep observed a plastic bag in an accessible children's cubie in the green apple room. This room had older toddlers who may still be 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: 3270.123(a)(3)

Description: Services proceeded

Noncompliance Area: During a renewal inspection on 2/21/25 Cert rep noted Child 4's most recent child service report was dated 7/10/24. This is more than 6 months since the previous child service report. Staff reported that the facility was only completing child service reports once a year for enrolled children.

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(e)

Description: Written emergency plan posted

Noncompliance Area: During a renewal inspection on 2/20/25 Cert rep observed that the emergency medical transportation plan was not located in the vehicles or in the emergency contact binders for transportation. Staff reported the facility was not taking the emergency medical transportation plan when staff left the facility with children.

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

Regulation: 3270.131(b)(2)

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

Noncompliance Area: During a renewal inspection on 2/21/25 cert rep noted Child 3's most recent acceptable health assignment was dated 9/12/23. This is more than 12 months old.

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(c)

Description: Completed or signed by physician, PA, or CRNP

Noncompliance Area: During a renewal inspection on 2/21/25 Cert rep observed Child 1 had an appointment summary on file as a health assessment. Cert rep observed Child 1's Health assessment was not signed by a physician, physician's assistant or a CRNP.

Correction Required: A health report must be written and signed by a physician, physician's assistant or a CRNP. The signature must include the individual's professional title.

Regulation: 3270.131(d)(7)/3270.131(d)(8)

Description: Free from contagious/communicable disease/Age appropriate screenings complete

Noncompliance Area: During a renewal inspection on 2/21/25 Children 1, and 2 did not have an acceptable health assessment which provided answers to the following: a statement that the child is able to participate in child care and appears to be free from contagious or communicable disease and a statement that the child had age-appropriate screenings recommended by the American Academy of Pediatrics were conducted. Child 1 had an appointment summary on file as a health assessment. Child 2 had a PA school physical on file as a Child health assessment and is not a school age child(see DOB in code). Children 1 and 2 have been enrolled for more than 60 days.

Correction Required: A health report shall include a statement that the child is able to participate in child care and appears to be free from contagious or communicable disease. A health report shall include a statement that age-appropriate screenings recommended by the American Academy of Pediatrics were conducted since the time of the previous health report required by this section.

Regulation: 3270.131(e)

Description: ACIP recommended immunization record

Noncompliance Area: During a renewal inspection on 2/21/25 Cert rep noted that Child 1 did not have written verification of the child's immunization record on file. Child 1 did not have an immunization exemption on file. Child 1 in still in care at the facility. Child 1 has been enrolled for more than 60 days.

Correction Required: The facility may not accept or retain an infant 2 months of age or older, a toddler or a preschool child at the facility for more than 60 days following the first day of attendance at the facility unless the parent provides written verification from a physician, physician's assistant, CRNP, the Department of Health or a local health department of the dates (month, day and year) the child was administered immunizations in accordance with the recommendations of the ACIP. Directed plan: Child 1 must be dismissed from care after 2/21/25 until Child 1's immunization record which is in compliance with the ACIP immunization schedule or an immunization exemption letter is on file at the facility.

Regulation: 3270.135(a)(3)

Description: Disposable diapers

Noncompliance Area: During a renewal inspection on 2/20/25 Cert rep observed that when diapers were changed in the Sky blue room a non-hands free trash can was being used to disposed of soiled disposable diapers.

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: 3270.14/3270.21

Description: Pertinent Laws & Regulations/General Health and Safety

Noncompliance Area: During a renewal inspection on 2/20/25 Cert rep observed the facility did not have a written policy that addresses: Strategies for coping with a crying, fussing, or distraught child.

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. The operator shall have a Written policy to address the following: 1) Recognition of potential signs/symptoms of shaken baby syndrome and abusive head trauma, 2) Strategies for coping with a crying, fussing, or distraught child and 3) The prevention and identification of child maltreatment

Regulation: 3270.151(a)/3270.151(c)(2)

Description: 12 months prior to service and every 24 months thereafter/Mantoux TB

Noncompliance Area: During a renewal inspection on 2/20/25 and 2/21/25 Cert rep noted Staff 5 had a health assessment and TB test dated 9/15/23. This is not within 12 months of Staff 5's start date (See LIS code sheet for DOH).

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. An adult health assessment must include tuberculosis screening by the Mantoux method at initial employment. Subsequent tuberculosis screening is not required unless directed by a physician, physician's assistant, CRNP, the Department of Health or a local health department.

Regulation: 3270.178

Description: Transportation First Aid Kit

Noncompliance Area: During a renewal inspection on 2/20/25 Cert rep observed the first aid kits in the Chevy Express and the GMC Nico did not contain water bottles.

Correction Required: A first-aid kit, including the contents as specified in §3270.75 (relating to first-aid kit) shall be in the vehicle when children are being transported.

Regulation: 3270.27(d)/3270.27(e)

Description: Plan posted/Letter to parents

Noncompliance Area: During a renewal inspection on 2/20/25 Staff reported that parents were not being provided a letter explaining the emergency procedures. Cert rep observed that the emergency plan was not posted in a conspicuous location for parents.

Correction Required: The operator shall post the emergency plan in the facility at a conspicuous location. 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: 3270.27(f)

Description: Emergency plan

Noncompliance Area: During a renewal inspection Cert rep noted there was not documentation available for review that supported the emergency plan was sent to the local municipality.

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

Regulation: 3270.31(e)

Description: Age and Training

Noncompliance Area: During a renewal inspection on 2/20/25 and 2/21/25 the following staff did not have 12 training hours during their training year: Staff 2 (6.5 hours recorded during training year 12/2023-12/2024) Staff 3 (6 hours recorded during training year 110/2023-10/2024) Staff 4 (6.5 hours recorded during training year 12/2023-12/2024)

Correction Required: A staff person shall obtain an annual minimum of 12 clock hours of child care training. Directed Plan: Staff 2 must take 5.5 hours of professional development to fulfill requirement for training year 12/2023-12/2024. Hours used to fulfill training year 12/2023-12/2024 may not be used to fulfill current training year. Staff 3 must take 6 hours of professional development to fulfill requirement for training year 10/2023-10/2024. Hours used to fulfill training year 10/2023-10/2024 may not be used to fulfill current training year. Staff 4 must take 5.5 hours of professional development to fulfill requirement for training year 12/2023-12/2024. Hours used to fulfill training year 12/2023-12/2024 may not be used to fulfill current training year.

Regulation: 3270.35(e)

Description: 46 or more children- additional group sups

Noncompliance Area: During a renewal inspection on 2/20/25 Staff reported the maximum number of children at the facility at one time is 80 which would require 2 group supervisors. The facility had 1 Staff Person working as a group supervisor.

Correction Required: In a facility in which more than 45 children are enrolled, a group supervisor is required for the first group of 45 enrolled children and for each group or partial group of 45 additional enrolled children.

Regulation: 3270.36(b)(5)

Description: HS/GED + 2 yrs

Noncompliance Area: During a renewal inspection on 2/21/25 Staff 1 did not have a high school diploma or a general educational development certificate on file. Staff 1 has been working has an assistant group supervisor.

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

Regulation: 3270.65

Description: Protective Outlet Covers 5 yrs. or less

Noncompliance Area: During a renewal inspection on 2/20/25 Cert rep observed an outlet without a protective cover in the yellow room on the wall to the right of the door with the moths of the year sign. This room could be accessible to children 5 years old or younger.

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

Regulation: 3270.76/3270.102(a)

Description: Building Surfaces/Clean and good repair

Noncompliance Area: During a renewal inspection on 2/20/25 Cert rep observed the free standing sink was not securely attached to the wall. Children would be able to climb or hang on the sink which creates a hazard as it could fall on children if it detached fully from the wall. Cert rep also observed a pinch point between the sink and the wall as a result of it not be securely attached to the wall. This sink was located in the boys bathroom used by the Sky blue room and the green apple room. Cert rep observed a curl in the outdoor matting in the toddler playspace which created a tripping hazard. Cert Rep observed the cement in the raised section of the all ages playspace had loose chipped pieces with sharp edges.

Correction Required: Floors, walls, ceilings and other surfaces, including the facility's outdoor play space surfaces shall be kept clean, in good repair and free from visible hazards. Toys, play equipment and other indoor and outdoor equipment used by the children shall be clean, in good repair and free from rough edges, sharp corners, pinch and crush points, splinters and exposed bolts.

Regulation: 3270.113(a)(1)

Description: Staff assigned to specific children

Noncompliance Area: During an unannounced inspection on 12/19/24 Cert rep observed the school age children leaving the school aged classroom to go down the hall to their cubbies. Staff 1 and 2 who were assigned supervision of these children was not physically present with these children.

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. Operator will revise supervision policy to include information regarding the supervision of school aged children and children in the hallways. Operator will review this policy with all staff. Staff will sign acknowledgement of this policy which will remain in their Staff files.

Regulation: 3270.113(a)(1)

Description: Staff assigned to specific children

Noncompliance Area: During an unannounced inspection on 12/19/24 Cert rep observed the school age children leaving the school aged classroom to go down the hall to their cubbies. Staff who was assigned supervision of these children was not physically present with these children.

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: 3270.134(a)

Description: Child's hands washed

Noncompliance Area: During a renewal inspection on 12/19/24 cert rep observed school aged children having snack without washing their hands beforehand.

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: 3270.31(f)

Description: Health and Safety Training

Noncompliance Area: During an announced inspection on 12/19/24 it was noted Staff person 1 does not have a valid Pediatric First Aid and CPR on file. This is evidenced by the previously documented Pediatric First aid and CPR training on 10/15/2022 which expired 10/31/2024.

Correction Required: Staff person(s) shall complete professional development in the topics of 3270.31(f)(1 -- 10), within 90 days of hire. Until such time as the required training has been completed, staff person 1 must be supervised, when interacting with children, by an AGS, group supervisor or director who has completed the required training related to this citation. If there are no staff available to supervise staff person 1, staff person 1 may not work in a child-care position at the facility.

Regulation: 3270.175(a)

Description: Age appropriate restraints

Noncompliance Area: During an unannounced inspection on 10/2/24 cert rep observed two school aged children (ages 5 years and 6 years old) being transported in the facility van without appropriate safety restraints, booster seats.

Correction Required: A child 7 years of age or younger shall be transported in accordance with the requirements for parents and guardians as stated in 75 Pa.C.S. §4581 (relating to restraint systems).

Regulation: 3270.175(c)

Description: Manufacturer's instructions used

Noncompliance Area: During an unannounced inspection on 10/2/2024 cert rep observed safety restraints-booster seats in the silver Odyssey van that did not have the booster seat's manufactures' instructions in the vehicle.

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

Regulation: 3270.135(a)(3)

Description: Disposable diapers

Noncompliance Area: During The Renewal Inspection on 2/25/2024, the lid for hands-free covered can used for diapering in the older toddler classroom was not going all the way up; thus, it was not working as hands-free.

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: 3270.181(c)

Description: Emergency info/agreement updated 6 mos

Noncompliance Area: During The Renewal Inspection on 2/25/2024, The financial agreement for Child #1 and Child #2 had not been updated by the parent since March of 2023.

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: 3270.119

Description: Infant sleep position

Noncompliance Area: During the Renewal Inspection on 2/9/2023, Child #1, an infant (Date of Birth-12/1/2022) was observed sleeping in a bounce seat from 10:45 AM until 10:56 AM. There is not any medical reason on file to document that Child #1 should not sleep in 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: 3270.151(a)/3270.151(c)(2)

Description: 12 months prior to service and every 24 months thereafter/Mantoux TB

Noncompliance Area: On 2/9/2023, Staff #3 had a completed health assessment on file that was dated 1/20/2022. See LIS code sheet.

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. An adult health assessment must include tuberculosis screening by the Mantoux method at initial employment. Subsequent tuberculosis screening is not required unless directed by a physician, physician's assistant, CRNP, the Department of Health or a local health department.

Regulation: 3270.27(a)(6)

Description: Emergency plan

Noncompliance Area: On 2/9/2023, the facility did not have documented that an annual emergency drill has been conducted during the previous 12 months.

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

Regulation: 3270.32(a)

Description: Comply with CPSL

Noncompliance Area: Staff persons #1 and #2 have not completed mandated reporter training within the last 60 months. This is evidenced by the previously documented verified mandated reporter trainings on file being dated 3/28/2016 for Staff #1 and 12/8/2015 for Staff #2.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). Staff persons #1 and #2 will have until 2/28/2023 to complete the mandated reporter training. Until such time as the required training has been completed, staff persons #1 and #2 must be supervised, when interacting with children, by an AGS who has completed the required training related to this citation. If there are no staff person available to supervise staff persons #1 and #2, staff persons #1 and #2 may not work in a child-care position at the facility.

Regulation: 3270.76/3270.77(a)

Description: Building Surfaces/No peeling paint or plaster

Noncompliance Area: During the Renewal Inspection on 2/9/2023, the soap dispenser in the bathroom for the Blue Room was observed to be cracked with sharp edges exposed. The red wooden fence in the outdoor play area was observed to be peeling in several areas of the fence.

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

Regulation: 3270.102(a)

Description: Clean and good repair

Noncompliance Area: During the Renewal Inspection on 2/3/2022, a playhouse with several cracks that left sharp edges exposed was observed in the outdoor play area.

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: 3270.131(b)(1)/3270.131(b)(2)

Description: Infant: updated health report every 6 months/Toddler/preschool: updated health report every 12 months

Noncompliance Area: During the child file review on 2/3/2022, the most recent health report on file for Child #2, a young toddler was dated 7/26/2021. The most recent health report on file for Child #3, an older toddler was dated 1/7/2021.

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. 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: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: During the staff file review on 2/3/2022, each staff for all files that were reviewed had updated clearances and an updated mandated training on file. However, the following was observed: The mandated reporter training for Staff #2 was completed on 1/30/2021, but the previous mandated reporter training on file for Staff #2 was completed on 9/20/2015. The state police clearance for Staff #3 was updated on 8/4/2021, but the previous state police clearance on file was dated 6/7/2016, the FBI clearance for Staff #3 was updated on 8/6/2021, but the previous FBI clearance on file was dated 2/22/2016 and the mandated reporter training for Staff #3 was updated on 12/22/2021, but the previous mandated reporter training on file was completed 10/14/2016. The state police clearance for Staff #4 was updated on 5/28/2021, but the previous state police clearance on file was dated 3/11/2016, the child abuse clearance for Staff #4 was updated on 6/1/2021, but the previous child abuse clearance on file was dated 3/15/2016 and the FBI clearance for Staff #4 was updated on 5/30/2021, but the previous FBI clearance on file for Staff #4 was dated 3/30/2016. The state police and child abuse clearances for Staff #5 were updated on 5/28/2021 and the FBI clearance was updated on 6/12/2021, but all three of these previous clearances were dated 2/5/2016. The mandated reporter training for Staff #5 was updated on 8/10/2021, but the previous mandated reporter training on file was completed on 2/8/2016.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). Each clearance for all staff must be renewed at least once every 60 months. All staff must also complete an approved mandated reporter training at least once every 60 months. 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: 3270.51/3270.52

Description: Similar Age Level/Mixed Age Level

Noncompliance Area: During the Renewal Inspection on 2/3/2022, Staff #1 and Staff #2 were working in the Green Apple classroom with a group of 12 children that were each identified as Older Toddlers. A review of the file for Child #1 showed that this child will not be age 2 until 3/28/2022.

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. The required staff:child ratios must be maintained at all times. 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). The required staff:child ratios must be maintained at all times.

Regulation: 3270.76/3270.77(a)

Description: Building Surfaces/No peeling paint or plaster

Noncompliance Area: During the Renewal Inspection on 2/3/2022, the red wooden fence in the outdoor play area to have to broken fence posts that exposed sharp edges and splinters. The red wooden fence also had several areas where paint was peeling.

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

Noncompliance Area: A renewal inspection was conducted on 2/14/2020. At that time, a broken tricycle was observed on the playground.

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: A renewal inspection was conducted on 2/14/2020. At that time, the toddlers in the Sky Blue Room were observed playing with matchbox cars, which have small, easily removable parts.

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: A renewal inspection was conducted on 2/14/2020. At that time, the files for Child #1 and Child #2, children whose parents chose to exempt them from the flu vaccine, did not contain documentation of a written signed and dated exemption statement from the children's parents.

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 religious belief or strong personal objection equated to a religious belief shall be documented by a written, signed and dated statement from the child's parent or guardian. The statement shall be kept in the child's record.

Noncompliance Area: A renewal inspection was conducted on 2/14/2020. At that time, the evenflo booster seat observed on the bus did not have the accompanying manufacturers' instructions with it.

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

Noncompliance Area: A renewal inspection was conducted on 2/14/2020. At that time, the first aid kit in the Green Room did not contain soap.

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: An unannounced inspection was conducted on 8/19/19. At that time, two ripped seats were observed on the school bus. A cracked playhouse was observed on the young playground. Cracked play equipment was observed on the older playground.

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: An unannounced inspection was conducted on 8/19/19. At that time, diaper cream was found in a low cubby in the toddler room (Green Apple Room). Diaper cream was found in a diaper bag in a child's cubby in the older toddler room (Sky Blue Room). The diaper creams were labeled "keep out of reach of children" and were accessible to the children in care.

Correction Required: Medication shall be stored in a locked area of the facility or in an area that is out of the reach of children.

Noncompliance Area: An unannounced inspection was conducted on 8/19/19. At that time, the diaper changing pad in the toddler room (Green Apple Room) was observed to be ripped and could not be properly sanitized after each use.

Correction Required: Diaper changing surfaces shall be cleaned after each use by wiping the surface with a sanitizing solution or by changing a pad or other surface covering.

Noncompliance Area: An unannounced inspection was conducted on 8/19/19. At that time, the manufacturer instructions for the child booster seats were not in the school bus.

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

Noncompliance Area: An unannounced inspection was conducted on 8/19/19. At that time, the file for Staff Person #1, a volunteer, did not contain a health assessment or TB test results. Staff Person #1 began volunteering at the facility on 8/19/19.

Correction Required: 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: An unannounced inspection was conducted on 8/19/19. At that time, the file for Staff Person #1, a volunteer, did not contain a two written, nonfamily references.

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: An unannounced inspection was conducted on 8/19/19. At that time, the file for Staff Person #1 did not contain a signed disclosure statement.

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.

Noncompliance Area: An unannounced inspection was conducted on 8/19/19. At that time, a cabinet in the preschool classroom (Green Room) was unlocked. Clorox disinfectant wipes labeled, "Keep out of reach of children" were inside the cabinet and accessible to the children in care.

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

Noncompliance Area: An unannounced inspection was conducted on 8/19/19. At that time, a broken gate was observed leading to the older playground. A radiator in the Purple Room is missing an end cover and is very sharp. A hole in the wall was observed under the white board in the Green Room.

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

Noncompliance Area: On the date of this renewal inspection, a review of staff files was conducted. Staff file # 2 had a date of hire of 11/5/18 and was working with children at the time of this inspection but the staff's health assessment did not include documentation that the staff was free from communicable diseases.

Correction Required: An adult health assessment must include an examination for communicable diseases and the results of that examination. 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 the date of this renewal inspection, a review of staff files was conducted. Staff file # 2 had a date of hire of 11/5/18 and was working with children at the time of this inspection but the staff's health assessment did not include documentation that the staff suitable 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: On the date of this renewal inspection, a review of staff files was conducted. Staff file # 1 was viewed which contained an FBI clearance dated 1/12/14. The file did not contain documentation that the FBI clearance had been updated every 60 months and was expired at the time of this inspection. Staff # 1 was working with children during this inspection.

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 # 1 may not work in a child care position at the facility.

Noncompliance Area: A RENEWAL INSPECTION WAS CONDUCTED ON 2/26/18. AT THAT TIME, EXPOSED BOLTS WERE OBSERVED ON THE FENCING OF THE PLAYGROUND. A CRACKED CHAIR CREATING PINCH POINTS WAS OBSERVED IN THE RAINBOW ROOM. RIPPED SEATS WERE OBSERVED ON THE SCHOOL BUS.

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: A RENEWAL INSPECTION WAS CONDUCTED ON 2/26/18. AT THAT TIME, A STAPLER WITH STAPLES IN IT AND SMALL PENCIL SHARPENERS LESS THAN 1 INCH IN DIAMETER WERE OBSERVED IN AN UNLOCKED DRAWER THAT WAS ACCESSIBLE TO THE MOBILE INFANTS IN THE RAINBOW ROOM. PLASTIC BAGS WERE OBSERVED IN LOW CUBBIES THAT WERE ACCESSIBLE TO THE YOUNG TODDLERS IN THE GREEN APPLE ROOM. PLASTIC GLOVES WERE OBSERVED IN AN UNLOCKED DRAWER IN THE SKY BLUE ROOM AND WERE ACCESSIBLE TO THE CHILDREN.

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: A RENEWAL INSPECTION WAS CONDUCTED ON 2/26/18. AT THAT TIME, A&D OINTMENT WAS OBSERVED IN LOW CUBBIES IN THE GREEN APPLE ROOM AND WERE ACCESSIBLE TO THE CHILDREN. A&D OINTMENT IS LABELED ''KEEP OUT OF REACH OF CHILDREN.''

Correction Required: Medication shall be stored in a locked area of the facility or in an area that is out of the reach of children.

Noncompliance Area: A RENEWAL INSPECTION WAS CONDUCTED ON 2/26/18. AT THAT TIME, CHILDREN USED HAND SANITIZER TO WASH HANDS BEFORE EATING MORNING SNACK IN THE BLUE ROOM. FACILITY DID NOT HAVE WRITTEN PERMISSION FROM PARENTS TO USE HAND SANITIZER. HAND SANITIZER CANNOT BE USED IN PLACE OF SOAP AND WATER FOR HAND WASHING.

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

Noncompliance Area: A RENEWAL INSPECTION WAS CONDUCTED ON 2/26/18. AT THAT TIME, A BOTTLE WAS OBSERVED IN THE RAINBOW ROOM THAT WAS NOT LABELED FOR USE BY THE INDIVIDUAL CHILD.

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

Noncompliance Area: A RENEWAL INSPECTION WAS CONDUCTED ON 2/26/18. AT THAT TIME, STAFF #1 DID NOT HAVE VERIFICATION OF EDUCATION ON FILE AT THE FACILITY.

Correction Required: An aide shall have a minimum of an 8th grade education and 2 years of experience with children. A facility person's record shall include verification of child care experience, education and training prior to service at the facility.

Noncompliance Area: A RENEWAL INSPECTION WAS CONDUCTED ON 2/26/18. AT THAT TIME, HAND SANITIZER WAS OBSERVED ON A LOW SHELF THAT WAS ACCESSIBLE TO THE CHILDREN IN THE BLUE ROOM. THE HAND SANITIZER IS 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.

Noncompliance Area: A RENEWAL INSPECTION WAS CONDUCTED ON 2/26/18. AT THAT TIME, THERE WERE NO TWEEZERS IN THE FIRST AID KIT IN THE GREEN APPLE ROOM. THE FIRST AID KIT ON THE SCHOOL BUS DID NOT CONTAIN WATER.

Correction Required: A first-aid kit must contain the following: soap, an assortment of adhesive bandages, sterile gauze pads, tweezers, tape, scissors and disposable, nonporous gloves.One first-aid kit per child care group must accompany children and facility persons on excursions from the facility. Each first aid kit taken on an excursion must contain a bottle of water in addition to the items specified at 3270.75(c).

Noncompliance Area: A RENEWAL INSPECTION WAS CONDUCTED ON 2/26/18. AT THAT TIME, THE CORD TO A DVD PLAYER ON A HIGH SHELF WAS HANGING LOW WHERE CHILDREN COULD PULL THE DVD PLAYER DOWN ON THEMSELVES. WATER DAMAGED CEILING TILES WERE OBSERVED IN THE GREEN ROOM.

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

Noncompliance Area: A RENEWAL INSPECTION WAS CONDUCTED ON 2/26/18. AT THAT TIME, PEELING PAINT WAS OBSERVED IN THE BLUE ROOM, RAINBOW ROOM, AND ON THE GREEN CAR ON THE PLAYGROUND.

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

Noncompliance Area: A COMPLAINT INSPECTION WAS CONDUCTED ON 1/29/18 AND 1/31/18. AT THAT TIME, STAFF #1 DID NOT HAVE CURRENT CLEARANCES ON FILE AT THE FACILITY. (FBI CLEARANCE 1/22/13, STATE POLICE 2/6/13, CHILD ABUSE 2/12/13)

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. AS PER THE CHILD PROTECTIVE SERVICES LAW(CPSL), ALL THREE CLEARANCES MUST BE UPDATED EVERY 60 MONTHS. ALL THREE CLEARANCES SHALL BE UPDATED BY THE OLDEST DATE ON THE CLEARANCES. IN THE CASE OF STAFF #1 ALL THREE CLEARANCES SHOULD HAVE BEEN UPDATED BY 1/22/2018 SINCE HER FBI CLEARANCE WAS DATED 1/22/2013. FACILITY PERSON #1 MAY NOT WORK IN A CHILD CARE POSITION AT THE FACILITY UNTIL NEW CLEARANCES HAVE BEEN OBTAINED AND REVIEWED BY THE DEPARTMENT.

Noncompliance Area: A COMPLAINT INSPECTION WAS CONDUCTED ON 1/29/18. AT THAT TIME, 26 CHILDREN WERE OBSERVED EXITING THE 30 CAPACITY SCHOOL BUS AT MUHLENBERG ELEMENTARY SCHOOL. TWENTY OF THE CHILDREN WERE YOUNG SCHOOL AGE CHILDREN. SIX CHILDREN WERE OLDER SCHOOL AGE CHILDREN. THERE WERE ONLY TWO STAFF PRESENT ON THE BUS, FACILITY PERSON #1 AND #2. IN ORDER TO MEET APPROPRIATE STAFF:CHILD RATIO, THREE STAFF WOULD BE NEEDED.

Correction Required: When children are grouped in mixed age levels, the age of the youngest child in the group determines the staff:child ratio and maximum group size in accordance with the requirements in 3270.51 (relating to similar age level). When school-age children are transported, the driver may be considered part of the staff-child ratio required in 3270.51.

Noncompliance Area: During an unannounced inspection on 6/12/17, the facility had purchased 2 new vans that were parked on the premises that were 11-15 passenger vans. According to staff, these vans have not yet been used to transport children.

Correction Required: In accordance with the requirements of 67 Pa. Code Chapter 171 (relating to school buses and school vehicles), the facility may not transport a child in an 11-15 passenger van.

Noncompliance Area: CHILD #1 FELL AT THE FACILITY AND SUSTAINED AN INJURY, BUT THE PARENT WAS NOT IMMEDIATELY NOTIFIED AFTER THE INCIDENT, AND THE CHILD HAD A GOOSE EGG.

Correction Required: If emergency medical care is needed for a child, the parent shall be contacted as soon as practical in the best interest of the child. If the parent cannot be reached, the operator shall record in writing the reason emergency care was required and the attempts made to inform the parent.

Noncompliance Area: MULTIPLE COTS IN THE PRESCHOOL ROOM NEAR THE TODDLERS AND COTS IN THE SCHOOL AGE ROOM WERE OBSERVED TO BE TORN. A SMALL KITCHEN PLAYSET ON THE PLAYGROUND WAS OBSERVED TO HAVE CRACKED SHARP PLASTIC EDGES. MULTIPLE BUS SEATS WERE OBSERVED TO BE TORN ON BUSES WITH THE FOLLOWING LICENSE PLATES: JZC7658, OB75517, AND JNT4533.

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: PLASTIC BAGS WERE OBSERVED ACCESSIBLE TO CHILDREN IN THE INFANT CLASSROOM.

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: FEE AGREEMENT FOR CHILD #2 AND #4 ARE MISSING THE AMOUNT OF THE FEE TO BE CHARGED. THE AGREEMENT FOR CHILD #4 IS ALSO MISSING ARRIVAL AND DEPARTURE TIMES.

Correction Required: An agreement shall specify the amount of the fee to be charged per day or per week. An agreement shall specify the child`s arrival and departure times.

Noncompliance Area: FEE AGREEMENT FOR CHILD #1 IS MISSING SERVICES TO BE PROVIDED AT THE FACILITY. A REVIEW OF ALL CHILDREN'S FILES SHOWED THAT CHILD SERVICE REPORTS OF GROWTH AND DEVELOPMENT ARE BEING COMPLETED YEARLY, INSTEAD OF EVERY 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).

Noncompliance Area: FILE FOR CHILD #3 IS MISSING PROOF OF INITIAL AND REQUIRED UPDATED HEALTH ASSESSMENTS, AND HAS BEEN ENROLLED AT THE FACILITY SINCE 12/30/2015.

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

Noncompliance Area: A STAFF BAG IN THE PRESCHOOL CLASSROOM BY THE KITCHEN AS WELL AS TWO DIAPER BAGS IN THE INFANT ROOM WERE OBSERVED TO CONTAIN MEDICATION AND LEFT IN REACH OF CHILDREN. AN EXPIRED DIAPER CREAM (EXP: 09/2016) WAS OBSERVED IN THE 2 YEAR OLD TODDLER GROUP.

Correction Required: Medication shall be stored in a locked area of the facility or in an area that is out of the reach of children. Medication shall be stored in accordance with the manufacturer`s or health professional`s instructions on the original label.

Noncompliance Area: BOOSTER SEATS IN THE TRANSPORTATION VEHICLES WERE MISSING MANUFACTURER'S INSTRUCTIONS FOR USE. A BOOSTER SEAT WAS ALSO OBSERVED TO BE EXPIRED AS OF 2015.

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

Noncompliance Area: A REVIEW OF CHILDREN'S FILES SHOWED THAT THE FACILITY HAS BEEN UPDATING ALL CHILDREN'S FEE AGREEMENTS YEARLY, INSTEAD OF EVERY 6 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.

Noncompliance Area: FILE FOR STAFF #3 IS MISSING TWO WRITTEN REFERENCES. FILE FOR STAFF #1 IS MISSING ONE WRITTEN REFERENCE.

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: STAFF #4, #5, AND #6 DO NOT HAVE PROOF OF MANDATED REPORTER TRAINING ON FILE, HAVE WORKED BEYOND THE 90-DAY PROVISIONAL PERIOD, AND HAVE DIRECT CONTACT WITH CHILDREN.

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

Noncompliance Area: Two ceiling tiles in the preschool room by the kitchen and two ceiling tiles in the infant classroom were observed to be stained. In the 2 year old classroom, a spot of crumbling plaster was observed on the wall between both exit doors. In the other preschool group by the toddlers, molding was missing around the back door frame, allowing crumbling plaster to be accessible to children. In the School Age classroom, The large red rug in the School Age classroom was observed to have fraying edges. The red fence on the playground was observed to have chipping paint, a board missing, and a nail protruding. The black surfacing on the playground was observed to have a buckle, posing a tripping hazard. The green turf grass on the playground was observed to have multiple fraying spots.

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