Teddy Bear Day Care Center

Regulation: 3270.52

Description: Mixed Age Level

Noncompliance Area: On 7/1/26, staff person #1 was observed standing at the back door of the infant/young toddler classroom. Staff person #1 then left the room and walked over to the kitchen where staff person #2 was. As the certification representative entered the infant/toddler classroom, staff person #1 and staff person #2 followed behind. Staff person #3 was observed to have 13 children in their care, 4 of those children were infants. This age and number of children require there to be three staff people present at all times.

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). Tiered LIS: 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 The required staff:child ratios must be maintained at all times. This portion of the plan requires an immediate date of correction. 2.) The Legal Entity shall create or update policies regarding maintenance of staff-to-child ratios. The policies must include how staff will maintain the proper staff to child ratios at all times. They must also include methods or procedures for staff to maintain ratios during transitions, covering staff breaks, and situations that might require a staff to leave the room (i.e. bathroom breaks, gathering supplies or answering the door). The policies must include a statement that staff should not leave the classroom if the proper ratios cannot be maintained. This policy must be submitted to the Northeast Regional Office for approval. Once approved, all existing staff and any new hires must be trained on the approved policy and documentation must be kept on file at the facility. This date of correction will be when all requirements have been met.

Regulation: 3270.102(a)

Description: Clean and good repair

Noncompliance Area: At the time of the inspection, on the upper playground, the window of the plastic playhouse was cracked and posed a pinch point for children playing in the house.

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: 3270.102(c)

Description: Outdoor equip.- protective surfacing

Noncompliance Area: At the time of the inspection, on the lower playground, the embedded climber equipment with a fall height of 43 inches only had 3 inches of loose-fill mulch not the required 9 inches of loose-fill material.

Correction Required: Outdoor equipment that requires embedded mounting must be mounted over a loose-fill or unitary playground protective surface covering that meets the recommendations of the United States Consumer Product Safety Commission. The equipment must be anchored firmly and be in good repair. Tiered LIS: 1. The embedded climber in the play yard shall be made inaccessible and will not be used by the children until such time as the loose-fill impact-absorbing material meets the recommendations of the United States Consumer Product Safety Commission. For this piece of equipment, there needs to be at least 9 inches of loose-fill impact-absorbing material under the equipment. This portion of the plain requires an immediate correction. 2. The operator shall obtain more loose-fill impact absorbing material to bring the depth into compliance with the recommendations of the United States Consumer Product Safety Commission. This portion of the plan requires a date by which this will be complete.

Regulation: 3270.124(b)(7)

Description: Name/address/phone release person

Noncompliance Area: At the time of the inspection, the emergency contact form for child #3 did not include the address of the individual designated by the parent to whom the child may be released.

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

Regulation: 3270.131(a)

Description: Health information

Noncompliance Area: At the time of the inspection, there was no initial health assessment on file for child #3. Child #3 has been enrolled at the facility for more than 60 days (see LIS code sheet for date of admission).

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: 3270.151(c)(2)

Description: Mantoux TB

Noncompliance Area: At the time of the inspection, the health assessment for staff person #1 did not contain a date as to when the tuberculosis screening by the Mantoux method was conducted.

Correction Required: 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: 3270.31(e)

Description: Age and Training

Noncompliance Area: At the time of the inspection, staff person #2 only took 8.5 hours of childcare training during the 4/2025-4/2026 training period.

Correction Required: A staff person shall obtain an annual minimum of 12 clock hours of child care training. Staff person #2 must take 3.5 hours of professional development to fulfill requirement for training year 4/2025-4/2026. Hours used to fulfill training year 4/2025-4/2026 may not be used to fulfill current training year.

Regulation: 3270.32(a)

Description: Comply with CPSL

Noncompliance Area: At the time of the inspection, staff person #12, who initially started as a volunteer prior to becoming a staff person, has not completed mandated reporter training within 90 days of their date of volunteering (see LIS code sheet).

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to Child Protective Services). Until such time as the required training has been completed, staff person #12 must be supervised, when interacting with children at a minimum by, an AGS who has completed all preservice trainings and has all qualifications to care for children unsupervised. If there are no staff person(s) available to supervise staff person #12, staff person #12 may not work in a child-care position at the facility

Regulation: 3270.113(a)/3270.113(a)(1)

Description: Supervised at all times /Staff assigned to specific children

Noncompliance Area: On 1/14/26, the parent of Child #1 came to pick up child at 4:30pm in the Pre-K room. Child #1 could not be located by Staff Person #1. The parent was directed to different levels of the building, but the child was not located by the parent. Upon returning to Child #1's regular classroom, Child #1 was observed being walked across the hallway by Staff Person #1, from a classroom that was not being utilized. Staff Person #1 claimed that Child #1 must have followed Facility Person #2 out of the room around 4:15pm when they went to another room to retrieve a diaper for another child. Through interviews, it was determined that Child #1 was unsupervised for approximately 15 minutes.

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. TIERED LIS: 1.) Children must be supervised at all times. 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 shall have an immediate correction date. 2.) The legal entity shall install a device on each door of each classroom that will notify staff each time the door is opened and will assist in the prevention of children eloping from the classroom. This date of correction is when the device will be installed. 3.) The legal entity will develop a policy and a procedure for the closing of classrooms at the end of the day and ensuring that no child is left in a classroom after the room has been closed. The policy will include procedures that staff or volunteers are to follow if entering a classroom that is already closed to obtain supplies for another classroom to ensure supervision of children is in compliance. The legal entity will submit their policies and procedures to the Northeast Regional Office for approval. Once approved, all existing staff and any new hires must be trained on the approved policy and procedure, and it must be documented in their files. This date of correction will be when all requirements have been met. 4.) The legal entity must arrange for all facility staff to receive a minimum of 3 three hours of live training regarding Supervision and Ratios. The legal entity must receive DHS approval of the training content prior to scheduling the training. All staff hired as of the date of the training must take the training. This date of correction will be when the training is completed for all staff. 5.) The legal entity must submit documentation in a format approved by DHS proving that the facility procedure for counting children is followed at all times e.g., a checklist. The legal entity will confirm continuing compliance by sending copies of the documentation to the Regional Office of Child Development and Early Learning on a weekly basis for a period of three months after DHS approves the documentation format. The documentation must be received by close of business on Monday for the week prior. This date of correction must extend out to a period of 3 months after an acceptable counting checklist has been submitted.

Regulation: 3270.135(e)

Description: 2 hour diaper check

Noncompliance Area: On 1/14/26, the parent of Child #1 came to pick up child at 4:30pm in the Pre-K room. Upon locating child #1, the diaper of child #1 was observed to be soiled and needed to be changed. It is unknown for how long the child had been soiled, as the child was unsupervised for approximately 15 minutes.

Correction Required: A staff person shall check a child's diaper at least every 2 hours and whenever the child indicates discomfort or exhibits behavior that suggests a soiled diaper. A staff person shall change a child's diaper when the diaper is soiled.

Regulation: 3270.31(a)/3270.33(c)

Description: Age and Training/Supervised volunteer

Noncompliance Area: Staff Person #1 confirmed that on 1/14/26 they left six children in the Pre-K room with Facility Person #2, a volunteer, while they went across the hallway to another room to locate Child #1 during a supervision incident. There were no other staff present in the classroom to supervise Facility Person #2 at this time.

Correction Required: A volunteer shall be 16 years of age or older and shall be directly supervised at all times by a staff person. A volunteer shall be supervised by a staff person who is qualified at minimum as an assistant group supervisor.

Regulation: 3270.31(f)

Description: Health and Safety Training

Noncompliance Area: At the time of the inspection, staff person #3 did not complete the following required preservice training within 90 days of hire: Pediatric First Aid/CPR training. The training was not completed until 1/6/26 (See LIS code sheet for date of hire).

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

Regulation: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: At the time of the inspection, the NSOR on file for Facility Person #2 was not received until 11/18/25 and not at or before the time of initial service in the facility. Facility Person #2 has had direct contact and routine interaction with children (see LIS code sheet for start date of volunteering).

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. A volunteer may not have routine interaction or direct contact with children until all completed clearances are on file. TIERED LIS: 1.) The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). This portion of the plan shall have an immediate correction date. 2.) The Legal Entity, Director and any facility persons responsible for hiring and maintaining staff files must register for and attend the Existing Provider Orientation training at a Regional Office. This date of correction will be when the Legal Entity, Director and any facility persons responsible for hiring attends the Existing Provider Orientation and provides a certificate of attendance for attending.

Regulation: 3270.111(c)

Description: Promote development

Noncompliance Area: Staff person #2 and staff person #3 acknowledged that on 10/17/25, child #2 was not taken to the bathroom, resulting in child #2 having an accident. According to staff person #1, #2 and #3, there were enough staff present to where the child could have been taken to the bathroom when the child asked to go. Staff #2 had stated "we could have taken the child, we just didn't."

Correction Required: Daily activities shall promote the development of skills, social competence and self-esteem. Daily experiences shall recognize the child as an individual and give some choice of activities that respect personal privacy, lifestyle and cultural background.

Regulation: 3270.113(a)/3270.113(a)(1)

Description: Supervised at all times /Staff assigned to specific children

Noncompliance Area: At the time of the inspection on 11/5/25, child #1 was observed in the hallway with a member of an outside agency. No staff of the facility were observed with child #1. The director acknowledged that there was no written parent consent for the children to be removed from the classroom.

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. TIERED LIS: 1.) Children must be supervised by a staff person at all times. This portion of the plan requires an immediate correction date. 2.) The legal entity shall update supervision procedures to include the following: a.) The requirement for a permission slip that is signed by the parent allowing for children to be removed from the classroom to receive outside services. b.) The signed permission slip will be placed in the child's file as well as a copy to accompany the emergency contact form in the child's classroom. c.) A roster will be created listing the names of the children who receive outside services who have signed parental consent to leave the classroom. The roster will be provided to each classroom and children who do not have parental consent will not be permitted to leave with the outside agency. This roster will be reviewed weekly. This date of correction will be when all requirements have been met.

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

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

Noncompliance Area: At the time of the inspection, there was no health assessment or TB screening on file for volunteer #10.

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: 3270.192(5)

Description: Two written references

Noncompliance Area: At the time of the inspection, volunteer #10 did not have two written, nonfamily references from individuals attesting to the person's suitability to serve as a facility person on file.

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: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: At the time of the inspection, volunteer #10 did not have any clearances on file. The disclosure statement was not dated for volunteer #10. Staff person #1 acknowledged that volunteer #10 comes into the facility 3-4 times per week for an hour at a time and volunteers in the classroom where children are present (see LIS code sheet for volunteering start date). Staff person #11 did not have a completed NSOR on file at time of hire (see LIS code sheet for date of hire). Volunteer #10 and staff person #11 have had routine interaction and direct contact with children.

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. Volunteer #10 and staff person #11 may not have routine interaction or direct contact with children until all completed clearances are on file.

Regulation: 3270.76

Description: Building Surfaces

Noncompliance Area: CONTINUED NON-COMPLIANCE: At the time of the inspection on 9/17/25, the carpets throughout the facility were dirty and contained brown stains. An acceptable plan of correction was received stating the correction would be implemented by 10/20/25. An inspection occurred on 10/31/25. The carpets on the first and second floors of the facility were still dirty and contained brown stains. Staff acknowledged that the carpet cleaner broke down and the carpets on these floors were not cleaned.

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: 3270.102(c)

Description: Outdoor equip.- protective surfacing

Noncompliance Area: At the time of the inspection, there was only 2.5 inches of wooden mulch under the slide which had a fall height of 39". There was only 5.5 inches of wooden mulch under the slide that had a fall height of 48". There was only 1.5 inches of wooden mulch under the blue swings that had a fall height of 72". These areas require there to be at least 9 inches of wooden mulch under and around the equipment.

Correction Required: Outdoor equipment that requires embedded mounting must be mounted over a loose-fill or unitary playground protective surface covering that meets the recommendations of the United States Consumer Product Safety Commission. The equipment must be anchored firmly and be in good repair. Tiered LIS: 1.) Outdoor equipment that requires embedded mounting must be mounted over a loose-fill or unitary playground protective surface covering that meets the recommendations of the United States Consumer Product Safety Commission. The equipment must be anchored firmly and be in good repair. The slides and swings in the play yard shall be made inaccessible and will not be used by the children until such time as the loose-fill impact-absorbing material meets the recommendations of the United States Consumer Product Safety Commission. For this piece of equipment, there needs to be at least 9 inches of loose-fill impact-absorbing material under the equipment. This portion of the plan requires an immediate correction date. 2.) Outdoor equipment that requires embedded mounting must be mounted over a loose-fill or unitary playground protective surface covering that meets the recommendations of the United States Consumer Product Safety Commission. The equipment must be anchored firmly and be in good repair. The operator shall obtain more loose-fill impact absorbing material to bring the depth into compliance with the recommendations of the United States Consumer Product Safety Commission. This correction date will be when more mulch is added to the slides and swings to meet compliance with the recommendations of the United States Consumer Product Safety Commission.

Regulation: 3270.104(a)

Description: Clean, good repair, proper size

Noncompliance Area: At the time of the inspection, the television on the shelf in the toddler room was wobbly and not secured to a surface.

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

Regulation: 3270.107

Description: Refrigerator

Noncompliance Area: At the time of the inspection, there was no thermometer in the refrigerator of the school age classroom.

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: 3270.113(a)/3270.113(a)(1)

Description: Supervised at all times /Staff assigned to specific children

Noncompliance Area: At the time of the inspection on 9/17/25 at 9:40am, two children were observed in the hallway with a member of an outside agency. The director acknowledged that there was no written parent consent for the children to be removed from the classroom.

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. TIERED LIS: 1.) Children must be supervised at all times. This portion of the plan requires an immediate correction date. 2.) The legal entity must develop or update their written supervision policies and procedures to be implemented in the facility. The written policy must ensure that each child is seen, heard, assessed and able to be directed at all times. The policy must also include a plan for each staff to be assigned the responsibility for supervision of specific children, including the requirement that the staff person know the names and whereabouts of the children in his/her assigned group and be physically present with the children in his/her group on the facility premises and on facility excursions off the facility premises. The policy must also address how these groups will be transitioned from one staff person to another during staffing changes. The written policy will address the procedure for not leaving children under the supervision of anybody who is not a staff person of the facility. The updated policies must also reflect the need for parental consent for any child to leave the classroom to receive outside services. It will be sent to DHS for review prior to training any staff. Both the updated supervision policies and new supervision procedures must be submitted to the Northeast Regional Office for approval prior to implementation. Once approved by the Department, the director will ensure that all current employees and any new hires are trained on the policies and procedures, and it must be documented in their files. This date of correction will be when the policies and procedures have been approved, and all staff will be trained.

Regulation: 3270.118(c)

Description: Vet's certificate required

Noncompliance Area: During the inspection, the director acknowledged that a kitten was previously brought into a facility for a day in the summer by a previous staff person. There was no rabies vaccination on file for the kitten.

Correction Required: A veterinarian's certificate of current rabies immunization is required for a cat or dog at the facility. The certificate shall be on file when the cat or dog is present.

Regulation: 3270.123(a)(3)

Description: Services proceeded

Noncompliance Area: At the time of the inspection, the child service report on file for child #4 was not conducted until 5/13/25, which is not every 6 months, as required (see LIS code sheet for date of admission).

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: 3270.161(d)

Description: Potentially hazardous food refrigerated

Noncompliance Area: At the time of the inspection, in the pre-K room, there were lunch boxes in cubbies. Inside the lunch boxes, there were lunch meat and cheese products. These are required to be refrigerated.

Correction Required: Potentially hazardous food brought from the child's home or provided by the facility shall be refrigerated.

Regulation: 3270.27(c)

Description: Training regarding plan

Noncompliance Area: At the time of the inspection, staff person #4 did not have any documentation of emergency plan training on file and has been employed for more than 90 days (see LIS code sheet for date of hire).

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: 3270.27(e)

Description: Letter to parents

Noncompliance Area: At the time of the inspection, the operator did not provide the parents a letter explaining all of the center's 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: 3270.31(e)

Description: Age and Training

Noncompliance Area: At the time of the inspection, staff person #3 only had 3.5 hours of childcare training on file during the 3/24-3/25 training period.

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

Regulation: 3270.36(b)(5)

Description: HS/GED + 2 yrs

Noncompliance Area: At the time of the inspection, staff person #4 did not have documentation of 2,500 hours of prior childcare experience on file and therefore, could not qualify as 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: 3270.67(d)

Description: Contaminated trash in closed plastic-lined receptacle

Noncompliance Area: At the time of the inspection, the trash cans in both the Pre-K and the School Age rooms did not have lids. Inside the trash cans were tissues contaminated by human secretions or excrement.

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

Regulation: 3270.76

Description: Building Surfaces

Noncompliance Area: At the time of the inspection, the carpets throughout the facility were dirty and contained brown stains.

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: 3270.111(a)/3270.111(b)

Description: Written plan/Posted in group space

Noncompliance Area: At the time of the inspection, there was no written daily schedule posted in the school age room.

Correction Required: A written plan of daily activities and routines, including a time for free play shall be established for each group. The plan shall be flexible to accommodate the needs of individual children and the dynamics of the group. The written plan of daily activities shall be posted in the group space.

Regulation: 3270.113(a)/3270.113(a)(1)

Description: Supervised at all times /Staff assigned to specific children

Noncompliance Area: At the time of the inspection on 7/1/25, the certification representative observed staff person #3 sitting at a desk on their phone and not supervising school-age children. Children were arguing over activities in the classroom, running through the room and it appeared to be unstructured. During this same inspection on 7/1/25, Child #2, a school-age child was observed alone in the hallway taking things out of their bookbag. Child #2 was not supervised by any staff person while in the hallway. Numerous staff, including the Director, and school-age children acknowledged that the school-age children are permitted to leave the classroom, go down the hall and through the hallway door to the bathroom without a staff person present.

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. Tiered LIS: 1.) Children must be supervised at all times. This portion of the plan requires an immediate correction. 2.) The Legal Entity/Director must update existing supervision policies/procedures. The policies and procedures must include the requirement for staff to be able to see, hear, direct and assess children at all times. The procedures and policies must include requirement that staff know the names and whereabouts of children in their assigned group, and be physically present with the children in the assigned group at all times. The updates must also include policies for supervising school-age children at all times, specifically when in the hallway and using the restroom areas. The policies must also include the prohibition of staff using their cell phones use while supervising children. The Legal Entity/Director will submit the updated policies to the Northeast Regional Office for approval. Once approved, all existing staff and new hires must be trained on the approved policies and procedures, and it must be documented in their files. This portion of the plan requires a date of correction for when acceptable policies and procedures will be submitted to the Northeast Regional office for review and reviewed with all staff.

Regulation: 3270.113(c)

Description: No ridicule or threaten harm

Noncompliance Area: At the time of the inspection on, staff acknowledged that staff person #2 had stated to other children 'I told you to stay away from him, he is a bad kid" when referencing other child interactions with child #1. The director acknowledged that staff person #2 stated something to this extent regarding child #1.

Correction Required: A facility person may not single out the child for ridicule, threaten harm to the child or the child's family and may not specifically aim to degrade the child or the child's family. Tiered LIS: 1.) A facility person may not single out the child for ridicule, threaten harm to the child or the child's family and may not specifically aim to degrade the child or the child's family. This portion of the plan requires an immediate correction date. 2.) The legal entity must develop a written supervision policy and procedure to be implemented in the facility. The written policy must address all subsections of 3270.113. The written policy must address the disciplinary actions of any staff person violating any subsections of 3270.113. The legal entity will submit policy/procedure to the Northeast Regional Office for approval. Once approved, all existing staff and new hires must be trained on the approved policies and procedures and it must be documented at the facility. This portion of the plan requires a date of correction for when acceptable policies and procedures will be submitted to the Northeast Regional office for review and reviewed with all staff. 3.) The legal entity must arrange for staff person #2 to take the 2-hour training titled "Interactions Matter: Positive Teacher-Child Interaction Strategies" which is available on Better Kid Care. This portion of the plan requires a date of correction for when the training will be completed.

Regulation: 3270.134(a)

Description: Child's hands washed

Noncompliance Area: At the time of the inspection, the certification representative observed school age children not washing their hands before morning snack. The school age children also acknowledged that they do not wash their hands before eating.

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: 3270.182(7)

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

Noncompliance Area: At the time of the inspection, staff person #1 acknowledged that an incident report was not completed or provided to the parent during a previous incident that occurred on 6/20/25 for child #1.

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

Regulation: 3270.76

Description: Building Surfaces

Noncompliance Area: At the time of the inspection, in the school age room, there were numerous holes in the wall causing the drywall to crumble and lay on the floor. Staff acknowledged the holes were put in the wall by the school age children.

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: 3270.113(b)

Description: No physical punishment

Noncompliance Area: Staff person #8 acknowledged that on 4/9/25, child #1 was screaming in her face and climbing on the table and chairs in the toddler room. Staff person #8 then pulled the child down from the table, put the child in her lap and proceeded to cover the child's mouth with her hand for a period of ten seconds while the child was crying.

Correction Required: A facility person may not use any form of physical punishment, including spanking a child. Tiered LIS: 1.) A facility person may not use any form of physical punishment, including spanking a child. This plan of correction requires an immediate correction date. 2.) The legal entity must arrange for all facility staff hired as of the date of the training to receive a minimum of 2 hours of PQAS-approved training regarding Behavior Management. The legal entity must receive DHS approval of the training content prior to scheduling the training. The operator shall provide a date for when the training will be completed.

Regulation: 3270.151(a)

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

Noncompliance Area: Staff person #4 has not updated the health assessment every 24 months as required. This is evidenced by the health assessment on file dated 10/27/22.

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

Regulation: 3270.151(c)(3)

Description: Exam communicable disease

Noncompliance Area: Staff person #2 and staff person #7's health assessment read "yes" to communicable diseases with no additional documentation describing the conditions and the risk it might pose to others exposed to this individual, as required on the staff health assessment.

Correction Required: An adult health assessment must include an examination for communicable diseases and the results of that examination.

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

Description: Age and Training

Noncompliance Area: Staff person #2 has not completed Pediatric first aid and CPR training on or before expiration of the most current certification. This is evidenced by the previously documented Pediatric first aid and CPR training on file expiring 2/25/25. Documentation of updated Pediatric first aid and CPR training is not on file.

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. Until such time as the required training has been completed, staff person #2 must be supervised, when interacting with children at a minimum by, an AGS who has completed all preservice trainings and has all qualifications to care for children unsupervised. If there are no staff person(s) available to supervise staff person #2, staff person #2 may not work in a child-care position at the facility

Regulation: 3270.102(c)

Description: Outdoor equip.- protective surfacing

Noncompliance Area: During the inspection, the embedded swing-set with a fall height of 83" did not have any loose fill protective surfacing under the swings and the underlayment compacted sand was exposed. There were numerous areas surrounding the embedded climber which had a fall height of 5' that did not have loose-fill protective surfacing and a green underlayment tarp was exposed. At minimum, embedded equipment requires there to be 9 inches of loose fill mulch around the equipment.

Correction Required: Outdoor equipment that requires embedded mounting must be mounted over a loose-fill or unitary playground protective surface covering that meets the recommendations of the United States Consumer Product Safety Commission. The equipment must be anchored firmly and be in good repair. The operator shall add more loose-fill impact absorbing material to bring the depth into compliance with the recommendations of the United States Consumer Product Safety Commission.

Regulation: 3270.102(c)

Description: Outdoor equip.- protective surfacing

Noncompliance Area: During the inspection, the embedded swing-set with a fall height of 83" did not have any loose fill protective surfacing under the swings and the underlayment compacted sand was exposed. There were numerous areas surrounding the embedded climber which had a fall height of 5' that did not have loose-fill protective surfacing and a green underlayment tarp was exposed. At minimum, embedded equipment requires there to be 9 inches of loose fill mulch around the equipment.

Correction Required: Outdoor equipment that requires embedded mounting must be mounted over a loose-fill or unitary playground protective surface covering that meets the recommendations of the United States Consumer Product Safety Commission. The equipment must be anchored firmly and be in good repair. The large, embedded climber and swing set in the play yard shall be made inaccessible and will not be used by the children until such time as the loose impact absorbing material meets the recommendations of the United States Consumer Product Safety Commission. For this piece of equipment there needs to be nine inches of loose-fill impact absorbing material under the climber.

Regulation: 3270.102(g)

Description: Hazardous toys and equipment

Noncompliance Area: Two Fisher Price Infant to Toddler Rocker was observed in the Infant room. The United States Consumer Product Safety Commission deemed this hazardous in June 2022 and may not be used by children at the facility and may not be on the premises at the facility.

Correction Required: Children's toys and equipment, including furniture and rest equipment, described as hazardous by the United States Consumer Product Safety Commission may not be used by children at the facility and may not be on the premises at the facility. At the time of inspection, the operator shall submit to the Department written affirmation on a form provided by the Department stating that the facility is in compliance with this requirement.

Regulation: 3270.121(b)

Description: Given parents in writing

Noncompliance Area: During the inspection, the operator acknowledged that she does not provide written supervision policies to parents at the time of enrollment

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: 3270.131(d)(7)

Description: Free from contagious/communicable disease

Noncompliance Area: The health report for child #1 did not include a statement that the child is able to participate in child care and appears to be free from contagious or communicable disease.

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

Regulation: 3270.14/3270.21

Description: Pertinent Laws & Regulations/General Health and Safety

Noncompliance Area: Staff person #6 did not complete the Pennsylvania Health and Safety Update 2022 by 12/30/22 as required. This is evidenced by the Pennsylvania Health and Safety Update 2022 training on file dated 1/3/23.

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 OCDEL ANNOUNCEMENT C-22-06 states that all staff hired prior to October 4, 2022 had until December 30, 2022 to complete the Pennsylvania Health and Safety Update 2022.

Regulation: 3270.151(a)

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

Noncompliance Area: Staff person #6, #8 and staff person #9 did not obtain a health assessment every 24 months as required. This is evidenced by the current health assessment on file dated 4/14/23, 7/6/23 and 10/19/22, respectively. The previous health assessments were dated 12/3/20, 3/24/21 and 9/2/20, respectively. Staff #10 has not had a valid health assessment conducted within the last 24 months. Staff #10 acknowledged that the health assessments on file, dated 11/15/21 and 11/13/23, were forged by the staff person. Director/Owner denied knowledge of this, and the staff acknowledged that she never informed the Director/Owner that the health assessment was fraudulent.

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: 3270.27(c)

Description: Training regarding plan

Noncompliance Area: During the inspection, the operator did not have any documentation of any staff person receiving emergency plan training in the past 12 months. The last documented date of emergency plan training on file was 9/14/21.

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: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: During the inspection, staff person #5 had a PA State Police clearance dated 8/22/24, a Child Abuse clearance dated 8/31/24 and mandated reporter training dated 8/27/24. The previous date of PA State Police was 1/2/19, Child Abuse was 1/23/19 and mandated reporter training dated 6/27/19. This reflects a period of time where the PA State Police, Child Abuse clearance and mandated reporter training were not current.

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. The CPSL was revised to include that clearances and mandated reporter training are updated every 60 months.

Regulation: 3270.75(c)/3270.178

Description: Has all items/Transportation First Aid Kit

Noncompliance Area: During the inspection, gloves were missing from the first aid kit in both the 3-year-old and Pre-K room. Tape was missing from the first aid kit in the Infant room. Scissors were missing from the first aid kit in the van used for transportation.

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. 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: 3270.82(j)

Description: Running water - diapering

Noncompliance Area: In the toddler room, there was not a source of running water for handwashing in the diapering area.

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: 3270.131(a)

Description: Health information

Noncompliance Area: CHILD #1 (see code sheet) has been enrolled more than 60 days and does not have a health assessment in file.

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

Regulation: 3270.131(d)(5)/3270.131(e)(2)(i)

Description: Immunization record/Exemption documentation from parent/guardian

Noncompliance Area: CHILD #2 (see code sheet) is more than 6 months old and does not have ACIP recommended influenza immunization or an exemption statement in file.

Correction Required: A health report shall include a review of the child's immunized status according to recommendations of 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.

Regulation: 3270.31(f)

Description: Health and Safety Training

Noncompliance Area: STAFF #1 and STAFF #2 (see code sheet) have not completed the following required pre-service training within 90 days of their date of hire: Pediatric first aid & CPR from a PQAS-approved trainer and a PQAS-approved curriculum.

Correction Required: Staff persons shall complete professional development within 90 days of hire as listed in subsections (f)1-10. STAFF #1 and 2 will have until 10/4/23 to complete the required training. Until such time as the required training has been completed, STAFF # 1 & 2 must be supervised, when interacting with children, by a GS or AGS who has completed the required training related to this citation. If there are no staff available to supervise STAFF #1 & 2, STAFF #1 & 2 may not work in a childcare position at the facility.

Regulation: 3270.102(a)

Description: Clean and good repair

Noncompliance Area: During the renewal inspection, Rep observed exposed bolts in the corner of the fence in front of the building in the corner near the exit driveway and on the gate behind the building that opens to the parking lot. Rep also observe a cracked area on top of the ship toy in the rear of the building. The cracked plastic has a sharp edge that is accessible to children.

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: 3270.102(c)

Description: Outdoor equip.- protective surfacing

Noncompliance Area: During the renewal inspection, Rep measured mulch in the area right behind the building. Areas near the blue double slide the mulch was a mixture of wood and rubber and measured from 2"- 7" deep. areas near the blue single slide measured 6" deep and were all wood mulch. Areas near the yellow ladder measure 4" deep and were only rubber mulch. CPSC recommendations are 6" of recycled rubber and 9" of wood mulch for fall heights up to 10' and 7' respectively. In the far rear play area, the metal slide in mounted over grass and dirt only and is embedded into the ground. Areas of wood mulch measured around the bar and rings swings measured 2'-3' deep. The wood mulch around the strap seat swings and the merry-go round measured 0'-3" deep. Areas of wood mulch around the monkey bars also measured no more than 6" deep. All of the listed equipment is embedded in the ground.

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

Regulation: 3270.106(b)

Description: No bed linens alone

Noncompliance Area: During the renewal inspection, Rep observed a child in the toddler room napping on the floor with 2 blankets only. The toddler staff reports that they do not use mats or cots. Rep also observed 2 children resting in the preschool room who were using blankets on the floor only without a sleeping bag, mat, or cot. In both rooms, other children were using sleeping bags.

Correction Required: Bed linens may not be used alone as age-appropriate rest equipment.

Regulation: 3270.121(b)

Description: Given parents in writing

Noncompliance Area: During the renewal inspection, Rep reviewed the information/handbook given to parents at enrollment. It does not contain information about supervision and dismissal policies, a general daily schedule, and transportation & pick up arrangements. Operator acknowledges that this is reviewed verbally but not given in writing.

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: 3270.123(a)(3)

Description: Services proceeded

Noncompliance Area: During the renewal inspection, child #4 has a child service report on file that is not an assessment form that is approved for use by DHS.

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)(5)

Description: Designated release persons

Noncompliance Area: During the renewal inspection, fee agreements for children #1- #7 do not contain the names of designated release persons.

Correction Required: An agreement shall specify the persons designated by a parent to whom the child may be released.

Regulation: 3270.124(e)

Description: Written emergency plan posted

Noncompliance Area: During the renewal inspection, a written plan for emergency transportation for medical care and staff provisions is not posted in all of the child care spaces and is not in the van when transporting children off premises.

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(e)(1)

Description: Exemption documentation from parent/guardian

Noncompliance Area: During the renewal inspection, child #1 is 7 months of age and has only 2 DTAP, 1 HIB, 1 Pneumococcal and 1 polio vaccines documented in the immunization record. This is not in accord with the recommendations of the ACIP for a 7 month old child. No exemptions are on file.

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

Regulation: 3270.133(3)

Description: Name on bottle

Noncompliance Area: During the renewal inspection, Rep observed a green & white tube of diaper rash cream in the toddler room that is not labeled with a child's name.

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: 3270.171(b)/3270.171(c)

Description: Safe pick-up and drop-off in writing/Safe routes posted

Noncompliance Area: During the renewal inspection, safe pick up & drop off points and pedestrian & bike routes are not posted in the a conspicuous location in the facility. Operator acknowledges that these are also not provided to the parents writing.

Correction Required: Safe pedestrian crossways, pick-up and drop-off points and bike routes shall be appropriately determined in the vicinity of the facility and communicated to the children and parents in writing. Written notification of safe routes shall be posted by the operator at a conspicuous location in the child care facility.

Regulation: 3270.27(f)

Description: Emergency plan

Noncompliance Area: During the renewal inspection, the operator does not have proof that the facility emergency plan was sent to the local municipality. Operator reports that the Township has not returned the receipt.

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: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: During the renewal inspection, facility person #1 began working in care on 6/30/21 and does not have a disclosure statement in her file and has clearances as follows: PSP 6/29/21, child abuse 6/11/21, NSOR 6/17/21 and an FBI request 6/30/21. Facility person #1 was hired provisionally and the 45 day provisional period has expired. Facility person #1 may not work until an FBI clearance is on file.

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.

Regulation: 3270.36(b)(5)

Description: HS/GED + 2 yrs

Noncompliance Area: During the renewal inspection, Facility person #2 is employed as an AGS but does not have 2500 hours of experience documented in her file. Reference letters indicate that she has experience but the number of hours is not supplied.

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: 3270.63

Description: Unsafe Areas in Outdoor Space

Noncompliance Area: During the renewal inspection, Rep observed a dilapidated shed adjacent to the rear outdoor play area. There are no doors on the shed and the fence does not separate the doorway from the play area. The inside of the shed is accessible to children.

Correction Required: If unsafe areas or conditions are in or near an outdoor play space, fencing or natural barriers are required to restrict children from those unsafe areas or conditions.

Regulation: 3270.66(a)

Description: Locked or inaccessible

Noncompliance Area: During the renewal inspection, sunscreen and cleaning erasers are accessible on a low ledge behind the desk in the school age room. Both items are labeled "keep out of reach of children" and are accessible to school age children. In the preschool room, lotion that is labeled "keep out of reach of children" is on the staff desk and is accessible to children.

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

Regulation: 3270.75(b)

Description: Inaccessible to children

Noncompliance Area: During the renewal inspection, Rep observed the first aid kit in the Pre K room in an open bag near the door. It is accessible to children.

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

Regulation: 3270.75(c)/3270.178

Description: Has all items/Transportation First Aid Kit

Noncompliance Area: During the renewal inspection, the first aid kit in the school age room did not contain soap, scissors or tweezers. The first aid kit kept in the van during transportation was missing soap and water.

Correction Required: A first-aid kit must contain the following: soap, an assortment of adhesive bandages, sterile gauze pads, tweezers, tape, scissors and disposable, nonporous gloves. 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: 3270.77(a)

Description: No peeling paint or plaster

Noncompliance Area: During the renewal inspection, Rep observed peeling paint on the fire doors at the far end of the first floor hall.

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

Regulation: 3270.95(a)/3270.95(b)

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

Noncompliance Area: The operator reports that she does not have proof of purchase for the fire detection system currently in use. Operator reports that the system was present when she opened.

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.

Noncompliance Area: On 9/25/2019, Staff #1, the operator admitted that the facility used a 12 passenger van to transport children to and from ice cream outings during this past summer.

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: On 9/25/2019, a complaint inspection was conducted involving Staff #2. Staff #1, the operator reported that she did not have a file for Staff #2 because Staff #2 only helped out with school transportation for one week.

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

Noncompliance Area: During the Renewal Inspection on 9/25/2019, it was discovered that the state police clearances and child abuse clearances on file for Staff #1 and Staff #2 were both volunteer clearances. Staff #3 had up to date clearances on file, but the state police clearance was more than 5 years old when it was renewed on 9/5/2019.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). All clearances must be employment clearances. All clearances must be updated at least every 5 years. 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 and #2 may not work in a child care position at the facility until the child abuse and state police clearances employment clearances are requested and received.

Noncompliance Area: During the Renewal Inspection on 9/25/2019, a fence pole with sharp areas exposed was observed hanging down from the fence in the outdoor play area in front of the building.

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: During the Renewal Inspection on 9/25/2019, a ditch, which posed a tripping hazard was observed near the swings on the school age playground. The large train outside had peeling paint on it, and also had rotting wood with a risk of splinters on some of the wheels.

Correction Required: Peeled or damaged paint or damaged plaster is not permitted on indoor or outdoor surfaces in the child care facility. 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: Staff #1 was employed at the facility during this past summer 2018. Staff #1 had a current health assessment on file on 9/18/2018, but this health assessment did not include a tuberculosis screening by the Mantoux method at initial employment.

Correction Required: 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: On 9/18/2018, a small hole in the wall was seen in the preschool classroom. Rust was also seen on the bottom of the stalls in the bathrooms.

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: During a follow-up visit to the facility on 1/3/2018, it was discovered that Staff #1 does not have a health assessment and tuberculosis screening by the Mantoux method on file. Staff #1 began working at the facility on 12/18/2017.

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: A ripped chair with exposed foam was observed in the infant classroom and in the toddler classroom. A chair in the preschool classroom also had a rip on the side leaving foam exposed.

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

Noncompliance Area: The most recent child service report on file for Child #1 at the time of inspection is dated 11/21/2016.

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: The following was observed in the facility: Loose cove on the wall in the toddler classroom, a missing door knob on a closet door, leaving sharp edges exposed in the school age classroom, and small areas of peeling paint in the pre-k and school age classrooms.

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.