Fresh Start Childcare Llc

Noncompliance Area: Twelve children were observed with a single staff person. The youngest child in the group was a preschooler, making the required staff:child ratio 1:10. Two preschoolers and ten school-aged children were in the group.

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. 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).

Noncompliance Area: A container of hand-sanitizer was observed on a counter in an area accessible to children in the preschool/school-age room.

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: At the time of inspection, facility person 1 stated that she "bear hugged" child 1 (young school age) to stop her behavior while the child was exhibiting some difficult behaviors (flipping tables, throwing chairs, etc.).

Correction Required: A facility person may not restrain a child by using bonds, ties or straps to restrict a child's movement or by enclosing the child in a confined space, closet or locked room. The prohibition against restraining a child does not apply to the use of adaptive equipment prescribed for a child with special needs.

Noncompliance Area: Plastic bags (used for sensory play) were observed in an area accessible to toddlers. (CORRECTED ON SITE) Plastic trash bags were being used to cover the urinals in the boys bathroom. The plastic bags had large rips in them and were in an area accessible to toddlers that use the restroom.

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 crib was not labeled for the use by a specific child (CORRECTED ON SITE).

Correction Required: Individual, clean, age-appropriate rest equipment shall be provided for preschool, toddler and infant children as agreed between the child's parent and the operator. The rest equipment shall be labeled for the use of a specific child and used only by the specified child.

Noncompliance Area: The refrigerator in both the infant room and the kitchen had food debris at the bottom. (CORRECTED ON SITE)

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

Noncompliance Area: Staff person 1 was observed (from the hallway) for approximately 10 minutes. Her language and interactions with the children were harsh and there were very little positive interactions to develop skills, social competence and self-esteem. She was observed yelling (using a harsh tone) the following: "Excuse me! No thank you!" "Stop!" (repeatedly) "Hey! No! I told you" "Ya'll need to stop. You need to listen." "Sit!" "Get back here. Let's go." "Knock it off." "Uh-uh-uh no" "Get in line." "Please clean up or we aren't going to be able to play again."

Correction Required: A facility person may not use harsh, demeaning or abusive language in the presence of children. Daily activities shall promote the development of skills, social competence and self-esteem. Daily experiences shall recognize the child as an individual and give some choice of activities that respect personal privacy, lifestyle and cultural background.

Noncompliance Area: Staff person 1 was the sole staff person responsible for the 9 preschool aged children in her group. Upon entering the hallway for inspection of the second floor, preschool aged children were observed unsupervised in the hallway. Staff person 1 was in the boys bathroom. During this time, there were also preschool aged girls unattended in the girls bathroom. A few minutes later, staff person 1 was observed walking out of the preschool classroom to put something in a cubby in the hallway, leaving the children in the room unsupervised.

Correction Required: Children on the facility premises and on facility excursions off the premises shall be supervised by a staff person at all times. Outdoor play space used by the facility is considered part of the facility premises.Each staff person shall be assigned the responsibility for supervision of specific children. The staff person shall know the names and whereabouts of the children in his assigned group. The staff person shall be physically present with the children in his group on the facility premises and on facility excursions off the facility premises.

Noncompliance Area: The children and staff in the preschool room did not wash their hands prior to eating lunch. They went from playing/cleaning immediately to the table for 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.A facility person shall wash his hands before meals and snacks, and after toileting and after diapering a child.

Noncompliance Area: A bottle was not labeled with the child's name. (CORRECTED ON SITE)

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

Noncompliance Area: An electrical outlet was not covered in the preschool room, (CORRECTED ON SITE)

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

Noncompliance Area: A container of Lysol air freshener was stored underneath the sink in an unlocked cabinet in the school-age bathroom. A bottle labeled "disinfectant" was observed in an area accessible to the children. (CORRECTED ON SITE)

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: Mulitple ceiling tiles in the basement child care space were in poor repair. There was evidence of water damage and the tiles were not properly secured into the ceiling.

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: Children were observed resting on cots that had less than 2 feet of space on 3 sides in the preschool nap room.

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.

Noncompliance Area: At the time of inspection, a refrigerator located in the kitchen was dirty (sticky, food residue) and did not contain a working thermometer. (CORRECTED ON SITE)

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

Noncompliance Area: The vaccination records on file for children 1 and 2 were not up to date at the time of inspection. Child 1 was 7 months old at the time of inspection. Her record did not include documentation regarding her 6 month vaccinations (DTAP, PCV, IPV). Child 2 was 16 months old at the time of inspection. Her record did not include documentation regarding her 3rd HIB vaccination that she should have received by 15 months (Per the ACIP guidelines).

Correction Required: The facility shall require the parent to provide updated written verification from a physician, physician's assistant, CRNP, the Department of Health or a local health department of ongoing vaccines administered to an infant, toddler or preschool child in accordance with the schedule recommended by the ACIP.

Noncompliance Area: Facility person #2 is a volunteer at the facility. She began volunteering on 7/29/2019. Her initial health assessment was not dated in the 12 months prior to initial service at the facility. She has since obtained a health assessment, dated 10-3-2019. Staff person #3 began employment on 3-8-2019. Her health assessment and TB test were more than 12 months old prior to her start date and are no longer valid.

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.

Noncompliance Area: Some of the emergency contact forms located in the two year old classroom had not been updated during the 6 months prior to inspection. They had been updated in the master file.

Correction Required: If emergency information is updated in a master file, it shall be updated accordingly in other facility records.

Noncompliance Area: At the time of inspection, the record for staff person 3 did not include documentation of having received emergency plan training at hire. She has since been trained on the emergency plan.

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

Noncompliance Area: Facility person #2 is a volunteer at the facility. She began volunteering on 7-29-2019. Her record did not include a Pennsylvania State Police clearance until 10-2-2019, and did not include documentation of submitting the request prior to serving as a volunteer.

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

Noncompliance Area: Staff person 1 was serving as an assistant group supervisor at the facility. She had a high school diploma on file. Her file included only 1, 603 hours of child care experience.

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

Noncompliance Area: At the time of inspection, the following was observed: -The carpets in the preschool classrooms were dirty. -The foot pedal of the trash can in the younger toddler room was broken. (CORRECTED ON SITE)

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: At the time of inspection, an area of peeling paint was observed in an upstairs bathroom.

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

Noncompliance Area: The emergency contact information on file at the time of inspection for child 1 did not include the child's physician's address, or the child's policy number.

Correction Required: Emergency contact information must include the name, address and telephone number of the child's physician or source of medical care.Emergency contact information must include health insurance coverage and policy number for a child under a family policy or Medical Assistance benefits, if applicable.

Noncompliance Area: According to documentation on file at the time of inspection, child 2's start date at the facility was 12-27-2017. His initial health assessment was dated more than 60 days later, on 6-14-2018

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: At the time of inspection, it was observed that the infant in care only had 1 bottle at the facility. The facility staff reported that they do not use a commercial dishwasher to clean the bottles in between uses.

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

Noncompliance Area: At the time of inspection, an outlet was uncovered in the upstairs girl's bathroom. (CORRECTED ON SITE)

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

Noncompliance Area: At the time of inspection, the portable sink near the diapering area in the opening classroom space was not working properly and water would not flow. (CORRECTED ON SITE)

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

Noncompliance Area: At the time of inspection on 9/6/18, staff person 2 was overheard scolding a 2 year old while they were in the bathroom. The children were being asked to sit still with nothing to do for a period of time and they were not responding to her requests. She told a child, "Stop! This is ridiculous! I don't care, you can sit until lunch!" It was approximately 10:30. The staff person was loud enough that I could hear her on the other side of the building (same floor).

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

Noncompliance Area: At the time of inspection on 8/29/2018, 13 children were observed to be napping in the basement child care space. Three of the children were two year olds, and the remaining ten children were preschoolers. Staff person 2 left the room and went up the the main floor of the building leaving staff person 1 alone and out of ratio with 13 children (as the youngest child in the group determines the maximum naptime ratio to be 1:12).

Correction Required: The staff:child ratio while toddlers and preschoolers are napping is one staff person to 10 young toddlers, one staff person to 12 older toddlers, one staff person to 20 preschool children

Noncompliance Area: At the time of inspection, two of the climbers on the playground were observed to be in poor repair. Both of them have developed large cracks in the plastic.

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: At the time of inspection, three two year old were observed in a preschool classroom space. There were toys in the classroom with a diameter of less than 1 inch (ex. toy bear counters).

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: At the time of inspection, staff person 1 was unable to state the names of the 6 children in her primary care group.

Correction Required: Each staff person shall be assigned the responsibility for supervision of specific children. The staff person shall know the names and whereabouts of the children in his assigned group. The staff person shall be physically present with the children in his group on the facility premises and on facility excursions off the facility premises.

Noncompliance Area: At the time of inspection, 14 children were observed in a classroom space that is measured for 13 children.

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.

Noncompliance Area: At the time of inspection, uncovered outlets were observed in the following spaces: The lobby, the one year old classroom, the 2 year old classroom, the preschool classroom, the boys bathroom upstairs, the infant classroom, and the basement childcare space.

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

Noncompliance Area: At the time of inspection, the following toxic materials were observed in areas accessible to children. Paint, paint remover, clog remover, primers, and paints were located in an unlocked storage closet off of the basement childcare space. Bleach and other cleaners were observed in the laundry room right off of the children's bathroom in the basement.

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: At the time of inspection, the following items were observed. The floor in the 2 year old classroom was dirty, and various items were stacked throughout the room creating a hazard for the children. Two cords were dangling loosely in the child care space across from the upstairs boys bathroom. A bucket with standing water was observed in a storage closet off of the childcare space in the basement. An outlet plate was cracked in the basement classroom space. The trashcan in the basement bathroom was overflowing and there were paper towels all over the floor.

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: At the time of inspection, peeling paint was observed in the one year old classroom, and in the basement child care space.

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

Noncompliance Area: At the time of inspection, the sinks located in the upstairs bathrooms were not functioning properly. One sink in each the girls and boys bathrooms did not have any running water at all, and the the water flow was so light in the 2nd sinks that the flow would be insufficient for hand washing. The bathrooms are being used by the children enrolled on the classrooms on the second floor.

Correction Required: Toilet areas and fixtures shall be cleaned daily and be in good repair. A staff person shall ensure that a child's hands are washed before meals and snacks, after toileting and after being diapered.

Noncompliance Area: At the time of inspection, the trashcan located in the upstairs boys bathroom was not lined. The trashcan contained used paper towels.

Correction Required: A toilet area, training chair area, diapering area and sink area shall be equipped with a clean, lidded waste receptacle.

Noncompliance Area: At the time of inspection, the changing mat in the young toddler classroom was observed to be torn. Two carpet squares found in the preschool space were observed to be in poor repair. (CORRECTED ON SITE)

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: At the time of inspection, the fabric on a bouncy seat in the infant classroom was observed to be torn. (CORRECTED ON SITE)

Correction Required: Furniture must be durable, safe, easily cleaned and appropriate for the child`s size, age and special needs.

Noncompliance Area: At the time of inspection, the nap mats in the young toddler classroom were labeled with numbers. The staff person in the classroom was unable to identify which cots were used by which children in the room. (CORRECTED ON SITE)

Correction Required: Individual, clean, age-appropriate rest equipment shall be provided for preschool, toddler and infant children as agreed between the child`s parent and the operator. The rest equipment shall be labeled for the use of a specific child and used only by the specified child.

Noncompliance Area: At the time of inspection, the refrigerators in the basement were dirty. (CORRECTED ON SITE)

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

Noncompliance Area: At the time of inspection, the written plan of daily activities was not posted in the preschool/school age child care space. (CORRECTED ON SITE)

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

Noncompliance Area: The health assessment on file for staff person 1 at the time of inspection did not include results of an examination for communicable diseases, or a physician`s or CRNP`s assessment of the person`s suitability to provide child care.

Correction Required: An adult health assessment must include an examination for communicable diseases and the results of that examination. An adult health assessment must include the physician`s or CRNP`s assessment of the person`s suitability to provide child care.

Noncompliance Area: At the time of inspection, multiple jugs of spoiled milk were observed in the basement refrigerator (use by dates ranged from 9/2017-early 10/2017). A container of baby food had mold was observed to be moldy. (CORRECTED ON SITE)

Correction Required: Food stored, prepared or served shall be clean, wholesome, free from spoilage, free from adulteration and safe for human consumption.

Noncompliance Area: The most recent parent signature on child 3's emergency contact and financial agreements were dated 3/30/17.

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: At the time of inspection, the following items were observed: Floor tiles in the basement classroom were observed to be peeling up, an electrical cord was dangling in an area accessible to young toddlers. (CORRECTED ON SITE) A ceiling tile was falling loose and signs of water damage were observed in the stairwell to the right of the pantry.

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: At the time of inspection, chipping paint was observed on the floor of the doorway in between the toddler classrooms. (CORRECTED ON SITE)

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

Noncompliance Area: The fire drill log that was presented at the time of inspection did not list the hypothetical location of the fire.

Correction Required: A written record shall be kept of the date, the time of day, the hypothetical location of the fire, the evacuation time, the names of facility persons and the number of children participating in the fire drill.

Noncompliance Area: It was observed on camera that staff person #1 carried child #1 across the room by hanging her by her arms. It was also reported by multiple staff persons that they have observed staff person #1 using physical discipline with children #1 and #2.

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

Noncompliance Area: It was observed on the video feed that staff person #1 did not intervene in a timely fashion when child #1 was striking child #2.

Correction Required: A facility person may not use any form of physical punishment, including spanking a child. Daily activities shall promote the development of skills, social competence and self-esteem. Daily experiences shall recognize the child as an individual and give some choice of activities that respect personal privacy, lifestyle and cultural background.

Noncompliance Area: It was verfied by multiple school age children that staff threaten to withhold food as means of discipline.

Correction Required: A facility person may not use harsh, demeaning or abusive language in the presence of children.Food may not be withheld from a child for purposes of discipline.

Noncompliance Area: There was no soap available for handwashing in the basement bathroom.

Correction Required: Liquid or powdered soap shall be used for handwashing.

Noncompliance Area: At the time of inspection, an outlet in a toddler classroom was not covered. CORRECTED ON SITE. Multiple outlets in the basement classroom were not covered.

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

Noncompliance Area: At the time of inspection, bottles of bleach solution were observed to be stored in areas accessible to children. (CORRECTED ON SITE)

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: At the time of inspection, the dirty water from the portable sink in the toddler room had leaked onto the carpeting on the floor. (CORRECTED ON SITE). A wooden strip on the wall was loose/broken and nails were exposed. CORRECTED ON SITE.

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

Noncompliance Area: The children's bathroom in the basement was dirty.

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

Noncompliance Area: Staff person in a classroom with a broken sink reported using hand sanitizer on the children's hands instead of hand washing before meals/after diapering. An infant's hands were not washed after a diaper change.

Correction Required: A facility person and an able child shall wash his hands after toileting and before eating.

Noncompliance Area: At the time of inspection, a trash can in a third floor bathroom was un-lined. (CORRECTED ON SITE)

Correction Required: A toilet area, training chair area, diapering area and sink area shall be equipped with a clean, lidded waste receptacle.

Noncompliance Area: At the time of inspection the portable sink in the toddler rooms were not working. One of them was broken and the other one did not have water in it.

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.