Tiny Toes Learning Center Llc

Regulation: 3270.106(f)

Description: 2 feet apart

Noncompliance Area: At the time of inspection, in the infant room, 3 children were observed sleeping on cots. The cots were directly next to each other and not spaced at least 2 feet of space on three sides apart.

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

Regulation: 3270.119

Description: Infant sleep position

Noncompliance Area: At the time of the inspection, child #5, an infant, was observed sleeping in an infant bounce chair. Staff person #8 acknowledged that this child was asleep in the bounce chair for approximately an hour.

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

Regulation: 3270.33(a)

Description: Each staff person meets quals

Noncompliance Area: CONTINUED NON-COMPLIANCE: At the time of the inspection on 6/11/26, staff person #1 did not have completed education and experience on file and therefore, could not qualify for the position they were performing. Staff people #4, #5 and #6 also did not have 2 years (2,500 hours) of documented childcare experience on file and therefore, could not qualify for the position they were performing. An acceptable plan of correction was received stating that the corrections would be implemented by 8/5/26. An inspection occurred on 8/7/26. Staff person #5 did not have 2 years (2,500 hours) of documented childcare experience on file and therefore, could not qualify for the position they were performing. Staff person #9 did not have their high school diploma from a foreign country evaluated and translated and therefore, could not qualify for the position they were performing.

Correction Required: A staff person or a substitute staff person shall meet one of the applicable staff qualifications for the position in which the person is performing.

Regulation: 3270.52

Description: Mixed Age Level

Noncompliance Area: During the inspection on 8/7/26, during rest time in the infant room, there were 7 children present with only staff person #8. Three of these children were infants. Staff #8 acknowledged that staff person #4 went on their lunch break. This number and age of children in the classroom requires there to be two 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.) 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 surrounding staff-to-child ratios, including a section that explains that infant ratios do not double during rest time. This policy will address ensuring ratios in all classrooms are met, including staff lunch breaks and call offs. 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 portion of the plan will have a date of correction as to when all of the requirements have been met. 3.) For a period of 3 months, the facility shall have no occurrences of non-compliance related to staff:child ratios. The operator shall demonstrate compliance on at least 2 unannounced visits over the next 3 months. This portion of the plan will have a date of correction for a period of three months from when an acceptable plan of correction is submitted.

Regulation: 3270.151(a)/3270.192(3)

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

Noncompliance Area: During the course of the inspection, two health assessments for staff person #2 were reviewed in the staff person's file. Staff person #2 had three health assessments on file dated 9/29/22, 10/4/24 and 2/16/26. The date on the health assessment appeared to have been altered by changing the original date of 9/29/22 to the new dates of 10/4/24 and 2/16/26. The document appeared to have been photocopied after the date was altered on the original copy as the remaining pieces of the document including the writing was identical. The physician's office confirmed that a physical was not conducted for this staff person on either 10/4/24 or 2/16/26 and that the doctor's name who was on the form was not at that facility since 2023. Staff person #2 later acknowledged that they altered the forms.

Correction Required: A facility person providing direct care who comes into contact with the children or who works with food preparation shall have a health assessment conducted within 12 months prior to providing initial service in a child care setting and every 24 months thereafter. A health assessment is valid for 24 months following the date of signature, if the person does not contract a communicable disease or develop a medical problem. A facility person's record shall include a written report of initial and subsequent health assessments, including the results of initial and subsequent tuberculin skin tests, x-rays or other medical documentation necessary to confirm freedom from communicable tuberculosis.

Regulation: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: At the time of the inspection, staff person #3 did not have a current FBI clearance on file and was observed having direct contact and routine interaction with children. Staff person #4 and #6 did not have a signed disclosure statement on file. Staff person #5 was missing the witness signature from the disclosure statement.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). A facility person's record shall include a copy of requests for the criminal history record and child abuse registry clearance information, a copy of the disclosure statement and a copy of the completed clearance information required under the CPSL. Staff Person #3 may not work in a child care position with direct contact and routine interaction with children.

Regulation: 3270.33(a)

Description: Each staff person meets quals

Noncompliance Area: At the time of the inspection, staff person #1 did not have completed education and experience on file and therefore, could not qualify for the position they were performing. Staff people #4, #5 and #6 also did not have 2 years (2,500 hours) of documented childcare experience on file and therefore, could not qualify for the position they were performing.

Correction Required: A staff person or a substitute staff person shall meet one of the applicable staff qualifications for the position in which the person is performing.

Regulation: 3270.33(b)

Description: No more than 50% aides

Noncompliance Area: At the time of the inspection, there were 6 staff present. Of those 6 staff, 4 only had the proof of education and experience on file to qualify as aides. This number of staff qualifying as aides is more than the allotted amount of 50% in the facility.

Correction Required: At least 50% of the staff persons in a facility shall be individuals qualified and functioning as directors, group supervisors and assistant group supervisors. No more than 50% of the staff persons may be of aide qualification level.

Regulation: 3270.37(c)

Description: Aides supervised all times

Noncompliance Area: At the time of the inspection, staff person #1 and staff person #4, who only had the proof of education and experience on file to qualify as aides, were observed working unsupervised in the caterpillar room.

Correction Required: An aide or a combination of aides shall be supervised at all times by a staff person qualified at minimum as an assistant group supervisor.

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

Description: Age and Training

Noncompliance Area: An unannounced inspection occurred at the facility. A review of staff files was conducted. Staff #1 has not completed the following required pre-service training prior to their current certification expiring on 10/19/25: pediatric first aid and CPR. Staff #1 was working in a child care role at the time of this inspection.

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 pre- service trainings are completed, staff #1 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 #1, staff #1 may not work in a child-care position at the facility.

Regulation: 3270.102(a)

Description: Clean and good repair

Noncompliance Area: A renewal inspection occurred at the facility. A physical site review was conducted. Three metal bikes were found in the outdoor play area that had peeling paint and rust. These bikes were not in good repair.

Correction Required: Toys, play equipment and other indoor and outdoor equipment used by the children shall be clean, in good repair and free from rough edges, sharp corners, pinch and crush points, splinters and exposed bolts.

Regulation: 3270.124(e)

Description: Written emergency plan posted

Noncompliance Area: A renewal inspection occurred at the facility. A physical site review was conducted. An emergency medical plan is required to be posted in child care spaces. At the time of this inspection, the facility's emergency medical plan was not posted in any child care space.

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

Regulation: 3270.124(f)/3270.181(c)

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

Noncompliance Area: A renewal inspection occurred at the facility. A review of child files was conducted. Regulation requires children's emergency contact and agreement forms be reviewed at least every 6-months. The following children's documents were not updated at least every 6-months: Child #2 (emergency contact previous 12/17/24, current 9/29/25), Child #3 (emergency contact and agreement previous 10/2/23, current 9/30/25), Child #4 (emergency contact previous 3/1/24, current 9/30/25 and agreement previous 3/1/24, no current) and Child #5 emergency contact previous 12/17/24, no current and agreement previous 12/17/24, current 9/29/25).

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

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

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

Noncompliance Area: A renewal inspection occurred at the facility. A review of child files was conducted. See the code sheet for the dates of birth. Child #4 is a preschool aged child and did not have their 3-year-old health report with immunizations on file as required by regulation. The last health report on file was dated 3/4/24. Child #5 did not have on file their 1 1/2 -year-old health report with immunizations on file as required by regulation. The last health report on file was dated 12/12/24.

Correction Required: The operator shall require the parent to provide an updated health report at least every 6 months for an infant or young toddler. The operator shall require the parent to provide an updated health report at least every 12 months for an older toddler or preschool child.

Regulation: 3270.133(4)

Description: Locked

Noncompliance Area: A renewal inspection occurred at the facility. A physical site review was conducted. The following medication was found accessible to children in the Caterpillar room: Children's Tylenol. Children were observed receiving care in this room and this medication indicated the need to be kept out of reach of children.

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

Regulation: 3270.151(a)/3270.192(3)

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

Noncompliance Area: A renewal inspection occurred at the facility. A review of staff files was conducted. Regulation requires staff participate in an updated health assessment at least every 24 months. The following staff did not update their health assessments at least every 24 months: Staff #2 (previous 11/18/22, current 9/30/25 and Staff #5 (previous 6/15/23, no current).

Correction Required: A facility person providing direct care who comes into contact with the children or who works with food preparation shall have a health assessment conducted within 12 months prior to providing initial service in a child care setting and every 24 months thereafter. A health assessment is valid for 24 months following the date of signature, if the person does not contract a communicable disease or develop a medical problem. A facility person's record shall include a written report of initial and subsequent health assessments, including the results of initial and subsequent tuberculin skin tests, x-rays or other medical documentation necessary to confirm freedom from communicable tuberculosis.

Regulation: 3270.182(5)

Description: Consent for administration of minor first-aid required prior to admission

Noncompliance Area: A renewal inspection occurred at the facility. A review of child files was conducted. The following child's file was missing consent for administration of minor first-aid procedures by staff as required by regulation: Child #5.

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

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

Description: Age and Training

Noncompliance Area: A renewal inspection occurred at the facility. A review of staff files was conducted. Regulation requires staff to participate in updated training for pediatric first aid and CPR prior to the current certification expiring. The following staff did not participate in this training prior to the current certification expiring: Staff #2 (previous 3/25/23, no current).

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 pre- service trainings are 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: 3270.31(e)(4)(ii)

Description: Fire safety - 1 yr.

Noncompliance Area: A renewal inspection occurred at the facility. A review of staff files was conducted. Regulation requires staff to participate in annual fire safety training. The following staff did not participate in annual fire safety training: Staff #2 (current 10/1/25) and Staff #6 (previous 4/8/24, current 6/16/25).

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

Regulation: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: A renewal inspection occurred at the facility. A review of staff files was conducted. See the code sheet for the date of hire. Staff #3 was observed working in a child care role at the facility at the time of this inspection. Staff #3 did not apply for the FBI clearance prior to working in child care as required by the CPSL. Staff #4 was observed working in a child care role at the facility at the time of this inspection. Staff #4 did not receive their NSOR clearance prior to working in child care as required by the CPSL.

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 #3 and #4 may not work in a child care position with direct contact with children at the facility.

Regulation: 3270.34(a)(6)

Description: Staff evaluations

Noncompliance Area: A renewal inspection occurred at the facility. A review of staff files was conducted. Regulation requires a written evaluation of staff to be conducted by the director at least every 12 months. The following staff did not have an evaluation conducted on them at least every 12 months: Staff #1 (previous 10/9/23, current 9/30/25).

Correction Required: A director is responsible for written evaluation of staff persons on a regular basis, a minimum of one evaluation every 12 months.

Regulation: 3270.65

Description: Protective Outlet Covers 5 yrs. or less

Noncompliance Area: A renewal inspection occurred at the facility. A physical site review was conducted. Outlet covers were missing in the following room outlets: Grasshopper, Butterfly, girl's bathroom and boy's bathroom. These outlets were discussed with staff that needed the covers during the inspection.

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

Regulation: 3270.66(a)

Description: Locked or inaccessible

Noncompliance Area: A renewal inspection occurred at the facility. A physical site review was conducted. In the Busy Bee room, the following items were observed accessible to children: ointment, diaper rash cream, sunscreen and Desitin. These items indicated the need to be kept out of reach of children and children were observed receiving care in this room. In the Butterfly room, the following items were observed accessible to children: 2 sunscreens. These items indicated the need to be kept out of reach of children and children were observed receiving care in this room. In the Caterpillar room, the following items were observed accessible to children: Desitin and diaper cream. These items indicated the need to be kept out of reach of children and children were observed receiving care in this room. In the boy's bathroom was an unlocked storage cabinet. This cabinet contained items that indicated the need to keep out of reach of children, and they were as follows: bottles of cleaning chemicals and bottles of bleach.

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

Regulation: 3270.76

Description: Building Surfaces

Noncompliance Area: A renewal inspection occurred at the facility. A physical site review was conducted. In the Busy Bees room and in the boy's bathroom a metal garbage can was found that contained rust. The garbage can in the bathroom also contained a broken metal wire standing up on the top of the garbage can.

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

Regulation: 3270.95(a)/3270.95(b)

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

Noncompliance Area: An unannounced inspection occurred at the facility. A review of the facility's fire safety system testing log was condcuted. Regulation requires the facility to test the fire safety system at least every 30 days. The following tests lapsed occurring at least every 30 days: 3/14/25, 4/14/25, 5/15/25 and 6/16/25.

Correction Required: Fire detection devices or systems must be in compliance with standards established under section 1016(c) of the act (62 P.S. §  1016(c)). The Director or designated staff person who is responsible for compliance with this chapter shall ensure the requirements under subsection (a) are met.

Regulation: 3270.102(c)

Description: Outdoor equip.- protective surfacing

Noncompliance Area: A renewal inspection occurred at the facility. A physical site review as conducted. In the outdoor play area, a swing set was observed mounted to a wooden deck. The swing set was not mounted over protective surface covering as required by the United States Consumer Product Safety Commission.

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: 3270.113(a)(1)

Description: Staff assigned to specific children

Noncompliance Area: A renewal inspection occurred at the facility. A physical site review was conducted on 9/30/24. The Butterfly room contained Staff #2, #9 and #11. These staff were unable to appropriately identify the children in their supervision groups. The staff needed assistance from other staff to ensure all children were accounted for and assigned for proper supervision groups.

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

Regulation: 3270.123(a)(1)

Description: Amount of fee

Noncompliance Area: A renewal inspection occurred at the facility. A review of children's files was conducted. The following children's files were missing the amount of the fee to be charged for attendance: Child #3, Child #5 and Child #6.

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

Regulation: 3270.123(a)(2)

Description: Date fee to be paid

Noncompliance Area: A renewal inspection occurred at the facility. A review of children's files was conducted. The following children's files were missing on the agreement form the date on which the fee is to be paid: Child #3, #4, #5 and #6.

Correction Required: An agreement shall specify the date on which the fee is to be paid.

Regulation: 3270.123(a)(4)

Description: Arrival/departure times

Noncompliance Area: A renewal inspection occurred at the facility. A review of children's files was conducted. The following child's agreement from was missing their arrival and departure times: child #3.

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

Regulation: 3270.124(b)(6)

Description: Insurance coverage information

Noncompliance Area: A renewal inspection occurred at the facility. A review of children's files was conducted. The following child's file was missing complete health insurance information: Child #4.

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

Regulation: 3270.134(a)/3270.152

Description: Child's hands washed/Adult Hygiene

Noncompliance Area: A renewal inspection occurred at the facility. A physical site review was conducted. On 9/30/24, a diaper change was observed in the Caterpillar Room. After the diaper change, the staff did not wash, with soap and water, their hands or the child's hands.

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.

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

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

Noncompliance Area: A renewal inspection occurred at the facility. A review of staff files was conducted. See the code sheet for the staff dates of hire. Regulation requires staff to participate in a health assessment every 24 months. The following staff did not participate in a health assessment every 24 months: Staff #3 (previous 9/29/22, current 10/4/24). Regulation requires staff to have a health assessment and tuberculosis screening prior to working in child care at initial hire. The following staff did not have a health assessment and tuberculosis screening on file prior to working in a child care role at the facility: Staff #2 (health assessment and TB 10/4/24), Staff #5 (no health assessment or TB), Staff #6 (health assessment and TB 9/26/24), Staff #7 (TB dated 3/9/23, not within 12 months of the staff's hire date and not valid) and Staff #8 (TB 10/3/24).

Correction Required: A facility person providing direct care who comes into contact with the children or who works with food preparation shall have a health assessment conducted within 12 months prior to providing initial service in a child care setting and every 24 months thereafter. A health assessment is valid for 24 months following the date of signature, if the person does not contract a communicable disease or develop a medical problem. 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: 3270.161(a)

Description: Wholesome

Noncompliance Area: A renewal inspection occurred at the facility. A physical site review as conducted. In the Grasshoppers class on 9/30/24, a lunchbox was found and contained yogurt. Regulation requires dairy products to be safely stored in a refrigerator.

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

Regulation: 3270.166(1)

Description: Written statement

Noncompliance Area: A renewal inspection occurred at the facility. A physical site review was conducted. On 9/30/24, staff were asked to provide for review, copies of the infant's formula and feeding schedules. Staff did not provide for review at the time of the inspection, the formula and feeding schedules for the infants.

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

Regulation: 3270.166(3)

Description: Disposable nursers or parents

Noncompliance Area: A renewal inspection occurred at the facility. A physical site review was conducted. Staff in the Caterpillar room on 9/30/24, indicated that infant's bottles are handwash and reused at the facility. Regulation requires infant bottles to be washed only in a commercial dishwasher for reuse.

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.

Regulation: 3270.166(7)

Description: Meals for infants

Noncompliance Area: A renewal inspection occurred at the facility. A physical site review was conducted on 10/28/24. During this review, the Caterpillar room staff were observed warming an infant formula bottle in the microwave. Regulation does not allow for infant formula bottles to be warmed in a microwave.

Correction Required: Neither bottled formula nor human milk may be heated in a microwave.

Regulation: 3270.171(a)

Description: Pick-up and drop-off points

Noncompliance Area: A renewal inspection occurred at the facility. A review of the facility's traffic safety letter was reviewed. At the time of the inspection in 10/28/24, the facility was unable to provide documentation that the facility had provided this letter to the local traffic safety authority on an annual basis.

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

Regulation: 3270.171(c)

Description: Safe routes posted

Noncompliance Area: A renewal inspection occurred at the facility. A physical site review was conducted. During the physical site review on 9/30/24, the facility did not have posted in a conspicuous location a copy of the facilities safe routes letter posted.

Correction Required: Written notification of safe routes shall be posted by the operator at a conspicuous location in the child care facility.

Regulation: 3270.182(5)

Description: Consent for administration of minor first-aid required prior to admission

Noncompliance Area: A renewal inspection occurred at the facility. A review of children's files was conducted. The following children's files were missing consent for first-aid: Child #2 and #4.

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

Regulation: 3270.191

Description: Individual Records

Noncompliance Area: A renewal inspection occurred at the facility. A review of staff files was conducted. The file of Staff #10 was requested for review on 9/30/24 but not provided. Staff #10 was observed caring for children during this inspection.

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

Regulation: 3270.21/3270.82(d)

Description: General Health and Safety/Training chair - sanitized

Noncompliance Area: A renewal inspection occurred at the facility. A physical site review was conducted. In the Busy Bees classroom on 9/30/24, two training chair toilets were observed. They both contained urine and were accessible to children in the child care space. Children were observed receiving care in this space.

Correction Required: Conditions at the facility may not pose a threat to the health or safety of the children. A training chair is not a flushing toilet. A training chair shall be emptied and sanitized after each use. An acceptable sanitizing solution is 1/4 cup of bleach combined with 1 gallon of water. A sanitizing solution shall be treated as a toxic.

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

Description: Age and Training

Noncompliance Area: A renewal inspection occurred at the facility. A review of staff files was conducted. Regulation requires staff to update their pediatric first aid/CPR training prior to the current training expiring. The following staff did not update their pediatric first aid/CPR training prior to their current expiring: Staff #1 (previous 7/15/22, current 9/17/24) and Staff #3 (previous 9/16/22, no update).

Correction Required: Competence is the completion of training by a professional in the field of first-aid and cardiopulmonary resuscitation (CPR). All staff persons shall renew their certification in pediatric first aid and pediatric cardiopulmonary resuscitation (CPR) on or before the expiration of the most current certification.

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

Description: Fire safety - 1 yr.

Noncompliance Area: A renewal inspection occurred at the facility. A review of staff files was conducted. See the code sheet for the staff's date of hire. Regulation requires staff to participate in annual fire safety training. The following staff did not participate in annual fire safety training: Staff # 1 (previous 10/16/21, current 10/31/23), Staff #3 (previous 4/4/23, no current), Staff #4 (see date of hire, current 10/28/24) and Staff #9 (see date of hire, current 10/24/24).

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

Regulation: 3270.32(a)

Description: Comply with CPSL

Noncompliance Area: A renewal inspection occurred at the facility. A review of staff files was conducted. Regulation and the CPSL require staff to participate in mandated reporter training every 60 months. The following staff did not update their mandated reporter training every 60 months: Staff #1 (previous 2/20/15, current 8/2/22).

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

Regulation: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: A renewal inspection occurred at the facility. A review of staff files was conducted. See the code sheet for the date of hire. Regulation and the CPSL require clearances to be updated every 60 months. The following staff did not update their clearances every 60 months: Staff #1 state police (previous 12/27/17, current 10/21/24). Regulation and the CPSL require staff hired provisionally to have obtained a child abuse clearance and applied for any out of state clearances. Staff #5 was hired provisionally and was observed working during the inspection on 9/30/24. Staff #5 did not have a child abuse clearance on file and did not apply for their California clearances.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). A facility person's record shall include a copy of requests for the criminal history record and child abuse registry clearance information, a copy of the disclosure statement and a copy of the completed clearance information required under the CPSL. Facility Person #5 may not work in a child care position at the facility.

Regulation: 3270.52/3270.113(a)(2)

Description: Mixed Age Level/Supervision on and facility premises

Noncompliance Area: A renewal inspection occurred at the facility. A physical site review as conducted. On 9/30/24, the Caterpillar room was observed to contain 2 staff members and 9 infants and toddlers. The amount and ages of the children in this classroom would have required at least 3 staff members to be incompliance with staff:child ratios.

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). The requirement for supervision on and off the facility premises includes compliance with the staff:child ratio requirements in §§ 3270.51--3270.55. The required staff:child ratios must be maintained at all times.

Regulation: 3270.52/3270.113(a)(2)

Description: Mixed Age Level/Supervision on and facility premises

Noncompliance Area: A renewal inspection occurred at the facility. A physical site review as conducted. On 9/30/24, the Caterpillar room was observed to contain 2 staff members and 9 infants and toddlers. The amount and ages of the children in this classroom would have required at least 3 staff members to be incompliance with staff:child ratios.

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). The requirement for supervision on and off the facility premises includes compliance with the staff:child ratio requirements in §§ 3270.51--3270.55. All staff hired as of the date of the inspection must attend at least a 3-hour, in-person, PQAS approved training regarding supervision and ratio of children. The training must be submitted and approved by the Northeast Regional Office prior to scheduling and attending the training. After the training, a copy of the sign-in sheet will be submitted to the Northeast Regional Office as documentation of attending the training.

Regulation: 3270.61(c)

Description: 40 square feet wall-to-wall

Noncompliance Area: A renewal inspection occurred at the facility. A physical site review was conducted. On 9/30/24, in the Butterfly Room, 18 children were observed receiving care. The Butterfly Room has a measured capacity of 12 children. The Butterfly Room on 9/30/24 was over measured capacity by 6 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.

Regulation: 3270.65

Description: Protective Outlet Covers 5 yrs. or less

Noncompliance Area: A renewal inspection occurred at the facility. A physical site review was conducted. During the physical site review on 9/30/24 and 10/28/24 several outlets were observed not covered. These outlets were identified and discussed with the Director at the time of the inspections. These outlets were accessible to children.

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

Regulation: 3270.95(a)/3270.95(b)

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

Noncompliance Area: A renewal inspection occurred at the facility. A review of the facility's fire system testing log was viewed on 9/30/24. Regulation requires the fire safety system to be tested at least every 30 days. The following tests lapsed occurring once at least every 30 days: 12/15/23-1/16/24 2/6/24-3/8/24 3/8/24-6/20/24 6/20/24-7/26/24 8/13/24-9/13/24

Correction Required: Fire detection devices or systems must be in compliance with standards established under section 1016(c) of the act (62 P.S. §  1016(c)). The Director or designated staff person who is responsible for compliance with this chapter shall ensure the requirements under subsection (a) are met.

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

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

Noncompliance Area: Through staff interviews, it was determined that on 5/21/24, a lack of supervision occurred at the facility during the following incident: Staff #1 was transitioning their group from the cafe to the classroom. After entering the classroom, Staff #1 conducted a headcount, and this is when they realized Child #1 was missing. It was determined that Child #1 had hid behind a serving cart when the group left, ran to a closet and this is where the child was found by staff.

Correction Required: Children on the facility premises and on facility excursions off the premises shall be supervised by a staff person at all times. Outdoor play space used by the facility is considered part of the facility premises. Each staff person shall be assigned the responsibility for supervision of specific children. The staff person shall know the names and whereabouts of the children in his assigned group. The staff person shall be physically present with the children in his group on the facility premises and on facility excursions off the facility premises. The Legal Entity / Director will establish or update a supervision policy. The policy will include how the facility will demonstrate their knowledge and ability to adequately supervise children while maintaining appropriate ratio at all times. The policy must focus on ensuring that each child is seen, heard, assessed and able to be directed at all times. The policy must include how the facility will ensure appropriate supervision and ratios during transition times and when staff call off or are running late. 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 their assigned group and be physically present with the children in their group on the facility premises and on facility excursions off the facility premises.

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

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

Noncompliance Area: Through staff interviews, it was determined that on 5/21/24, a lack of supervision occurred at the facility during the following incident: Staff #1 was transitioning their group from the cafe to the classroom. After entering the classroom, Staff #1 conducted a headcount, and this is when they realized Child #1 was missing. It was determined that Child #1 had hid behind a serving cart when the group left, ran to a closet and this is where the child was found by staff.

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. Children must be supervised at all times.

Regulation: 3270.94(a)(1)

Description: Every 60 days

Noncompliance Area: An unannounced inspection occurred at the facility occurred at the facility. A review of the facility's fire drill log was conducted. Regulation requires staff to conduct fire drills at least every 60 days. The following drills did not occur at least every 60 days: 3/8/24-6/20/24.

Correction Required: The Director or designated staff person who is responsible for compliance with this chapter shall conduct fire drills and ensure that fire drills are conducted at least once every 60 days.

Regulation: 3270.113(a)(1)

Description: Staff assigned to specific children

Noncompliance Area: During an inspection on 12/1/23, Staff #1 and #2 were observed working in the Grasshoppers room with 12 children. Staff were unable to identify the specific children in their assigned supervision groups, which would split the children into smaller groups to meet the staff:child ratios. During the same inspection on 12/1/23, a mixed group of 5 infants and young toddlers were assigned to Staff #3. Staff #3 should only have 4 children assigned, since at least one of the children assigned to the staff was an infant, requiring a 1:4 ratio. An acceptable plan of correction was received on 12/21/2023 indicating that the violation was directed as of 12/21/2023. On 1/12/24 at 9:30 a.m., during a supervision and ratio check in the Grasshoppers Room, staff #4 was unable to identify all of the children in the assigned group. This staff person was only able to identify four of the six children in the group.

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

Regulation: 3270.113(a)(1)

Description: Staff assigned to specific children

Noncompliance Area: During an inspection on 12/1/23, Staff #1 and #2 were observed working in the Grasshoppers room with 12 children. Staff were unable to identify the specific children in their assigned supervision groups, which would split the children into smaller groups to meet the staff:child ratios. During the same inspection on 12/1/23, a mixed group of 5 infants and young toddlers were assigned to Staff #3. Staff #3 should only have 4 children assigned, since at least one of the children assigned to the staff was an infant, requiring a 1:4 ratio. An acceptable plan of correction was received on 12/21/2023 indicating that the violation was directed as of 12/21/2023. On 1/12/24 at 9:30 a.m., during a supervision and ratio check in the Grasshoppers Room, staff #4 was unable to identify all of the children in the assigned group. This staff person was only able to identify four of the six children in the 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. The legal entity must develop or update their written supervision and ratio policies to be implemented in the facility. The written policies must specifically address situations in which substitute staff are covering classrooms, and situations typical staff are not present in the classroom. A procedure for substitute staff to identify by name all children in their assigned group should be developed. 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 policies and procedures, and it must be documented in their files.

Regulation: 3270.113(a)(1)/3270.113(a)(2)

Description: Staff assigned to specific children/Supervision on and facility premises

Noncompliance Area: During an inspection on 12/1/23, Staff #1 and #2 were observed working in the Grasshoppers room with 12 children. Staff were unable to identify the specific children in their assigned supervision groups, which would split the children into smaller groups to meet the staff:child ratios. During the same inspection on 12/1/23, a mixed group of 5 infants and young toddlers were assigned to Staff #3. Staff #3 should only have 4 children assigned, since at least one of the children assigned to the staff was an infant, requiring a 1:4 ratio.

Correction Required: Each staff person shall be assigned the responsibility for supervision of specific children. The staff person shall know the names and whereabouts of the children in his assigned group. The staff person shall be physically present with the children in his group on the facility premises and on facility excursions off the facility premises. The requirement for supervision on and off the facility premises includes compliance with the staff:child ratio requirements in §§ 3270.51--3270.55.

Regulation: 3270.14/3270.21

Description: Pertinent Laws & Regulations/General Health and Safety

Noncompliance Area: Staff persons #5 and #7 (see code sheet for date of hire) did not have documentation that they completed the following required pre-service training within 90-days of hire: Health and Safety Update, which should have been completed by 12/30/22 for existing staff.

Correction Required: A facility shall be operated in conformity with applicable Federal and State laws and regulations. State agencies whose regulations may relate to the operation of a facility include the Department of Environmental Resources, the Department of Labor and Industry, the Department of Health, the Department of Education and the Department of Transportation. Conditions at the facility may not pose a threat to the health or safety of the children.

Regulation: 3270.31(f)

Description: Health and Safety Training

Noncompliance Area: Staff person #6 (see code sheet for date of hire) did not have documentation that they completed the following required pre-service trainings within 90-days of hire: pediatric first aid and CPR, and Health and Safety training. Staff person #6 completed their pediatric first aid and CPR on 3/25/23, and their Health and Safety training was completed on 3/9/2023.

Correction Required: Staff persons shall complete professional development within 90 days of hire as listed in subsections (f)1-10. Staff person #6 has now completed the required training. Going forward, until such time as the required training has been completed, a staff person must be supervised, when interacting with children, by an AGS who has completed the required training related to this citation. If there are no staff available to supervise staff persons, a staff person may not work in a child-care position at the facility.

Regulation: 3270.33(a)/3270.192(2)(ii)

Description: Each staff person meets quals/Exp, educ., training prior to facility

Noncompliance Area: Staff person #3 did not have any documentation on file which indicated that they had a high school diploma or general educational development certificate which would qualify them as an assistant group supervisor with their experience. Staff person #3 only had college transcripts on file for a degree that is still in progress.

Correction Required: A staff person or a substitute staff person shall meet one of the applicable staff qualifications for the position in which the person is performing. A facility person's record shall include verification of child care experience, education and training prior to service at the facility.

Regulation: 3270.94(a)(1)

Description: Every 60 days

Noncompliance Area: Fire drill log documentation showed that the last fire drill conducted was on 9/29/2023. The next inspection should have occurred by 11/28/2023.

Correction Required: The Director or designated staff person who is responsible for compliance with this chapter shall conduct fire drills and ensure that fire drills are conducted at least once every 60 days.

Regulation: 3270.95(a)/3270.95(b)

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

Noncompliance Area: During an inspection on 12/1/23, the facility was unable to provide an annual testing report dated within 1 year of the day of the inspection showing that the fire detection system was tested and in operable condition.

Correction Required: Fire detection devices or systems must be in compliance with standards established under section 1016(c) of the act (62 P.S. §  1016(c)). The Director or designated staff person who is responsible for compliance with this chapter shall ensure the requirements under subsection (a) are met.

Regulation: 3270.124(b)(2)

Description: Physician name, address, phone

Noncompliance Area: As of the renewal inspection on 9/28/23, the emergency contact information for child #2 did not include the name, address and telephone number of the child's physician or source of medical care.

Correction Required: Emergency contact information must include the name, address and telephone number of the child's physician or source of medical care.

Regulation: 3270.131(a)

Description: Health information

Noncompliance Area: As of the renewal inspection on 9/28/23, there was no health assessment on file for child #3 (see code sheet for start date).

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

Regulation: 3270.131(b)(2)

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

Noncompliance Area: As of the renewal inspection on 9/28/23, the most recent health assessment on file for child #1 was dated 7/5/22.

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

Regulation: 3270.131(e)

Description: ACIP recommended immunization record

Noncompliance Area: As of the renewal inspection on 9/28/23, there was no documentation of influenza vaccine or an exemption letter on file for child #1. Child #1 must be removed from care until proper documentation is on file.

Correction Required: The facility may not accept or retain an infant 2 months of age or older, a toddler or a preschool child at the facility for more than 60 days following the first day of attendance at the facility unless the parent provides written verification from a physician, physician's assistant, CRNP, the Department of Health or a local health department of the dates (month, day and year) the child was administered immunizations in accordance with the recommendations of the ACIP.

Regulation: 3270.14/3270.21

Description: Pertinent Laws & Regulations/General Health and Safety

Noncompliance Area: As of the renewal inspection on 9/28/23, there was no continuity of operations plan as required by 45 CFR 98.41(a)(1)(vii).

Correction Required: A facility shall be operated in conformity with applicable Federal and State laws and regulations.State agencies whose regulations may relate to the operation of a facility include the Department of Environmental Resources, the Department of Labor and Industry, the Department of Health, the Department of Education and the Department of Transportation. Conditions at the facility may not pose a threat to the health or safety of the children.

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

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

Noncompliance Area: As of the renewal inspection on 9/28/23, there was no initial health assessment or TB screening for staff #5

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: 3270.181(d)

Description: Dated signature affixed

Noncompliance Area: As of the renewal inspection on 9/28/23, the emergency contact information for child #1 was not dated or signed.

Correction Required: Following review, a parent shall attest to the accuracy of information in the emergency contact information and the financial agreement at each review by affixing a dated signature to the record.

Regulation: 3270.192(5)

Description: Two written references

Noncompliance Area: As of the renewal inspection on 9/28/23, there was only one nonfamily references from individuals attesting to the suitability of staff #2 to serve as a facility person.

Correction Required: A facility person's record shall include two written, nonfamily references from individuals attesting to the person's suitability to serve as a facility person.

Regulation: 3270.27(a)(6)

Description: Emergency plan

Noncompliance Area: As of the renewal inspection on 9/28/23, there was no documentation of an emergency drill conducted in the previous year.

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

Regulation: 3270.27(c)

Description: Training regarding plan

Noncompliance Area: As of the renewal inspection on 9/28/23, there was no documentation that staff #2 had received training in 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.

Regulation: 3270.31(e)

Description: Age and Training

Noncompliance Area: As of the renewal inspection on 9/28/23, there was no documentation on file that staff #1 and staff #6 had completed 12 clock hours of child care training.

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

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

Description: Fire safety - 1 yr.

Noncompliance Area: As of the renewal inspection on 9/28/23, there was no documentation that staff #6 had completed fire safety training in the previous year.

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

Regulation: 3270.31(f)

Description: Health and Safety Training

Noncompliance Area: As of the renewal inspection on 9/28/23, staff person #6 did not have documentation of completion of the following required pre-service training within 90 days of their date of hire: Health and Safety training.

Correction Required: Staff person shall complete professional development in the topics of 3270.31(f)(1 -- 10) within 90 days of hire. Staff person #6 will have until 10/28/23 to complete the required training. Until such time as the required training has been completed, staff person #6 must be supervised, when interacting with children, by an AGS or above who has completed the required training related to this citation. If there are no staff available to supervise staff person #6, staff person #6 may not work in a child-care position at the facility.

Regulation: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: As of the renewal inspection on 9/28/23, there was no signed disclosure statement for staff #2; there were no clearances from Florida where staff #3 had lived in the previous five years; there was no documentation of mandated reporter training for staff #4; and the most recent state police clearance on file for staff #6 was dated 12/27/17. Staff #3 and #6 must be removed from care until all required clearances are on file at the facility.

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 #3 and #6 may not work in a child care position at the facility.

Regulation: 3270.34(a)(6)

Description: Staff evaluations

Noncompliance Area: As of the renewal inspection on 9/28/23, there was no written evaluation in the previous year for staff #1.

Correction Required: A director is responsible for written evaluation of staff persons on a regular basis, a minimum of one evaluation every 12 months.

Regulation: 3270.37(b)(1)

Description: HS/GED

Noncompliance Area: As of the renewal inspection on 9/28/23, there was no documentation of qualifications for staff #4 and #5.

Correction Required: An aide shall have a high school diploma or a general educational development certificate.

Regulation: 3270.51

Description: Similar Age Level

Noncompliance Area: On 9/28/23 during the renewal inspection, staff #3 and #4 were in the classroom with 13 older toddlers. This amount of older toddlers would require 3 staff.

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

Regulation: 3270.14/3270.21

Description: Pertinent Laws & Regulations/General Health and Safety

Noncompliance Area: During a complaint investigation visit conducted on 6/27/23, 8 preschool aged and 17 school aged children were observed with four childcare staff members on an excursion at a building located at 1110 Carriage Lane, Tobyhanna, Pa 18466. On 7/10/23, the Coolbaugh Township Director of Zoning & Code Enforcement confirmed that there is no occupancy permit for the property and that no permission was given for the building or property to be used as the safety is unknown.

Correction Required: A facility shall be operated in conformity with applicable Federal and State laws and regulations.State agencies whose regulations may relate to the operation of a facility include the Department of Environmental Resources, the Department of Labor and Industry, the Department of Health, the Department of Education and the Department of Transportation. Conditions at the facility may not pose a threat to the health or safety of the children.

Regulation: 3270.14/3270.21

Description: Pertinent Laws & Regulations/General Health and Safety

Noncompliance Area: Staff person #-1- was observed to be caring for children unsupervised. Staff person #-1- has not completed pre-service training required prior to caring for children unsupervised including mandated reporter training.

Correction Required: A facility shall be operated in conformity with applicable Federal and State laws and regulations. State agencies whose regulations may relate to the operation of a facility include the Department of Environmental Resources, the Department of Labor and Industry, the Department of Health, the Department of Education and the Department of Transportation. Conditions at the facility may not pose a threat to the health or safety of the children. Until such time as the required pre-service trainings are completed, staff person #-1- must be supervised, when interacting with children, by an AGS person) who has completed the required training related to this citation. If there are no staff person(s) available to supervise staff person #-1-, staff person #-1- may not work in a child-care position at the facility

Regulation: 3270.32(a)

Description: Comply with CPSL

Noncompliance Area: Per inspection on 3/2/24 verified that staff number 1 a provisional staff who did not have a state police and NSOR clearance on file and did not have a State Police request on file, was working alone unsupervised with a group of 11 school-age children on 2/24/23

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). Facility Administrator, Facility Director and any other staff responsible for creating or maintaining staff files shall complete the existing provider training scheduled for 5/4/23.

Regulation: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: Per inspection on 3/2/24 verified that staff number 1 a provisional staff who did not have a state police and NSOR clearance on file and did not have a State Police request on file, was working alone unsupervised with a group of 11 school-age children on 2/24/23. Per inspection on 5/18/23 verified that staff number 2 hired as a provisional staff was working past the CPSL timeline without a record of FBI clearance.

Correction Required: PROVISIONAL HIRE UNSUPERVISED: A provisional employee may not be permitted to work alone with children and must work within the vicinity of a permanent employee. Lacking required documents. Staff Person # -1-2 may not work in a childcare position at the facility.

Regulation: 3270.181(b)/3270.181(c)

Description: Current/Emergency info/agreement updated 6 mos

Noncompliance Area: Inspection on 12/7/22 revealed that Children # 1-2-3-4 have not had emergency contact and fee agreement updated within the past 6 months.

Correction Required: Information in a child's record shall be kept current by the operator. A parent is required to review and update the emergency contact information and the financial agreement at least once in a 6-month period or as soon as there is a change in the information.

Regulation: 3270.185

Description: Record Retention for One Year

Noncompliance Area: Per inspection at the facility on 12/7/2022 it was revealed that children # 5-6 discharged from the facility 6/2022 do not currently have a file retained at the facility.

Correction Required: A copy of the child's record shall be retained at the facility for at least 1 year after termination of service, unless the entire record is transferred by the operator to the parent or guardian or to another agency at the request of the parent or guardian.

Regulation: 3270.131(e)(4)

Description: Annual immunization reporting to DOH

Noncompliance Area: Inspection revealed that Child number 1 does not have a record of immunization.

Correction Required: The facility shall comply with the annual immunization reporting requirements in accordance with the Department of Health regulation in 28 Pa. Code §27.77.

Regulation: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: Inspection revealed that staff # 1 does not have the required clearances per the CPSL.

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: 3270.191

Description: Individual Records

Noncompliance Area: During a complaint investigation conducted on 2/2/22, Staff Person #1 admitted that Staff Person #2, who started at the facility on 1/28/22, does not have a staff file

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

Regulation: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: During a complaint investigation conducted on 2/2/22, it was discovered that Staff Person #1, who started at the facility on 1/28/22 has no child abuse, criminal, FBI or NSOR clearances. There is no verification on file that Staff Person #1 applied for the child abuse, criminal, FBI or NSOR clearances prior to starting at the facility.

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 Child Protective Services Law (CPSL) was revised to include the requirement for the National Sex Offender Registry (NSOR) clearance effective 9/30/2019. The CPSL also states that anyone hired before 9/30/19 had until 7/1/20 to obtain this clearance. Staff Person # 1 may not work in a child care position at the facility

Regulation: 3270.94(a)(1)

Description: Every 60 days

Noncompliance Area: During an unannounced investigation conducted on 2/2/22, the fire drill log showed that it had been over 60 days since the last fire drill was conducted. The most recent fire drill was conducted on 8/3/21

Correction Required: The Director or designated staff person who is responsible for compliance with this chapter shall conduct fire drills and ensure that fire drills are conducted at least once every 60 days.

Regulation: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: Staff #1 start date 5/17/21 does not have a record of NSOR clearance.

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 Child Protective Services Law (CPSL) was revised to include the requirement for the National Sex Offender Registry (NSOR) clearance effective 9/30/2019. . Staff # 1, may not work in a child care position at the facility.

Regulation: 3270.61(c)/3270.61(e)

Description: 40 square feet wall-to-wall/Halls, etc. not included

Noncompliance Area: During inspection on 9/21/21 observed a childcare space that included within this permanent walled space a kitchen area including a stove.

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. Measured indoor space excludes space occupied by halls, bathrooms, offices, kitchens and locker rooms.

Noncompliance Area: During a complaint investigation on 2/24/20, staff person # 1 admitted that on 2/19/19 they restrained child # 1 while the child was having a tantrum. Staff # 1 admitted to holding the child and bringing the child to another area of the facility.

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. Staff person # 1 shall attend a minimum of 2 hours of approved training; the topic shall be learning to deal with difficult behaviors.

Noncompliance Area: There is no date of admission on the fee agreement on file for child # 3.

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

Noncompliance Area: The emergency contact form on file for child # 4 does not include the name, address, and phone number of the child's physician. The emergency contact form on file for child # 3 does not include the child's health insurance name or 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: There is no release persons address provide on the emergency contact form for child # 5.

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

Noncompliance Area: Staff persons # 2, 3, and 4 did not have a health assessment conducted within 12 months prior to providing initial service. Staff person # 2 started on 8/21/2019 and has not yet received a health assessment or TB screening. Staff person # 3 started on 8/26/19; their health assessment is dated 9/24/19. Staff person # 4 started on 9/16/19; there is no health assessment or TB screening on file.

Correction Required: A facility person providing direct care who comes into contact with the children or who works with food preparation shall have a health assessment conducted within 12 months prior to providing initial service in a child care setting and every 24 months thereafter. A health assessment is valid for 24 months following the date of signature, if the person does not contract a communicable disease or develop a medical problem. A facility person's record shall include a written report of initial and subsequent health assessments, including the results of initial and subsequent tuberculin skin tests, x-rays or other medical documentation necessary to confirm freedom from communicable tuberculosis.

Noncompliance Area: The emergency contact forms and agreements were not reviewed and updated by the parents at least once in a 6 month period. There is no date on the emergency contact from for child # 2 and the agreement is last dated 11/2018. The emergency contact and agreement forms on file for child # 3 are dated 8/27/2018. The most recent agreement on file for child # 4 is dated 1/12/19. There is no date on the emergency contact form for child # 6 and the agreement is dated 11/28/18.

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: The emergency contact form on file for children # 3 and 5 do not have written consent for emergency medical care or the administration of minor first aid procedures.

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

Noncompliance Area: The emergency contact forms on filed for children # 3 and 5 do not have written consent for transportation and walking excursions.

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