Alliance Child Care Center

Staff persons #1 and #2 have not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): #1 - health and safety training and pediatric first aid/cpr; #2 - part 2 of health and safety training. Part #1 was completed late.

The file for staff #1 contained an NSOR certificate dated 3/10/25 which is more than 45 days after their date of hire (SEE LIS CODE SHEET). Staff #1 was not suspended after 45 days. Staff #6 did not update mandated reporter training within 60 months. This is evidenced by the previously documented mandated reporter training on file being dated 5/05/19 and the most recent training being dated 6/03/24. Current mandated reporter training is now on file. The file for staff #5 lacked a disclosure statement.

At approximately 12:30 PM the certification representative heard staff #1 using harsh language which included shouting "Get down", "Stop it", and "You know you aren't allowed up there".

Adult scissors and a claw type staple remover with sharp points were accessible to children on the teacher's desk in the Red Preschool Room.

Based on schedules posted in the classrooms and statements made by staff, the Sanctuary is used by the program every Friday. The Sanctuary has not been measured and is not included on the facility's certificate of compliance.

Children were observed playing in an outdoor area which has not been measured and is not included in the facility's certificate of compliance. Based on statements made by staff, the area has been used regularly for several years. The area is located near the entry between the parking lot and two streets.

The following toxics were observed to be accessible to children: sanitizer spray and wipes in an unlocked floor level cabinet in the Orange Room. The safety lock in place was not functioning as intended. Lysol spray in an unlocked drawer of the restroom connected to the school age loft room and used by preschoolers, and disinfecting wipes in an unlocked cabinet in the girl's restroom on the main floor.

Stained ceiling tiles were observed in the following areas; 2 in the hallway outside the gym and two in the Blue Preschool room.

In the Orange OT Room, the diapering area was approximately 13 feet from the source of running water. The activity/meal table was located on the route children travel from the diapering area to the sink.

A cracked hand rail was observed on a plastic slide in the small outdoor play space. Exposed foam padding was observed on two pink child size folding chairs in the Purple Room.

An empty plastic garbage bag was accessible to children in an unlocked cabinet in the boy's restroom on the main floor. A tear which exposed the inner foam filling was observed on the diapering pad in the Pink Room.

The file for child #2 contained consecutive health reports dated more than 6 months apart; 5/06/24 and 12/31/24. The most recent health report on file is now current.

The file for staff #5 did not include a health assessment. The file for staff #1 contained an initial health assessment dated after their first day in a child care position.

Based on the facility's fire drill log consecutive drills dated 10/15/24 and 1/13/25 were conducted 90 days apart.

Staff #4 did not renew their certification in pediatric CPR and first aid on or before the expiration of the previous certification. The certifications are dated 6/12/22 and 9/17/24. Current training is now on file.

Staff #1completed the health and safety course titled Health and Safety Basics (6 hours), but did not complete the required health and safety update course titled Pennsylvania Health and Safety Update 2022 (1 hour) training within 90 days of hire. Documentation of completing Health and Safety Training Part 1 and Part 2 is now on file.

A written plan of daily activities was not posted in the gym.

The agreement for child #1 and child #3 did not include the services to be provided. The file for child #4 contained consecutive service reports dated more than 6 months apart; 3/11/24 and 2/09/25) A current report is now on file. The file for child #5 did not contain a current service report. The most recent report on file was dated 8/09/24.

The file for staff #2 contained 9 of the 12 required hours of annual training completed between 12/2023 and 12/2024. Three additional hours are needed. The file for staff #4 contained 6 of the 12 required hours of annual training completed between 9/2023 and 9/2024. Six additional hours are needed.

The Child Abuse clearance on file for Staff #3 was dated 4/21/23, after their date of hire (SEE LIS CODE SHEET). The application for the DHS FBI clearance for Staff #3 (4/18/23) and Staff #8 (3/23/23) were dated after their date of hire. Therefore, Staff #3 and Staff #8 were incorrectly provisionally hired. (SEE LIS CODE SHEET). The disclosure statement on file for Staff #8 was dated 5/1/23, after their date of hire (SEE LIS CODE SHEET).

In the Loft, adult scissors were observed were accessible to children.

A power strip in the Loft lacked protective outlet covers, which was accessible to children ages 5 and younger.

Lysol spray cleaner was observed under the sink in an unlocked cabinet and on the top of the toilet in the Nursery, which was accessible to children.

Cleaning toxics were observed uncontained and above loose diapers in the Yellow and Orange rooms, which could be hazardous to children.

A trash receptacle in the Orange Room contained human secretions that were not contained in a closed, plastic-lined receptacle.

The first aid kit in the Nursery lacked an assortment of bandages.

Ripped carpet and splintered wood pieces were observed on a riser in the Loft.

Foam blocks with peeling plastic were observed in the Gym, which could be hazardous to children.

Two cribs in the Nursery were observed to lack 2 feet on 3 sides, while the crib was in use.

An Albuterol labeled for Child #6 with the expiration date of 1/2023 and an Epi-Pen for Child #7 with the expiration date of 1/2024, were observed in the locked medication drawer in the Office.

Based on a discussion with staff in the Orange Room, the staff person uses their hands to open the hands-free can when disposing a diaper.

The two most recent health assessments on file for Staff #2 (1/8/21 & 2/24/23) Staff #6 (11/2/21 & 1/26/24) are dated more than 24 months apart. The file for Staff #7 contained an initial health assessment dated 3/7/24, which is beyond the date of hire (SEE LIS CODE SHEET).

The file for Staff #7 lacked documentation of a Tuberculosis screening. The file for Staff #3 (5/4/23) and Staff #8 (3/21/23) contained documentation of a Tuberculosis screening dated after their date of hire (SEE LIS CODE SHEET).

In the Blue Room, children's lunch boxes contained potentially hazardous food (yogurt, cheese stick, and chicken nuggets) which needed refrigerated.

The fire drill log on file included fire drills conducted 5/15/23-7/15/23 & 7/15/23-9/15/23, more than 60 days apart.

The file for Child #1 did not contain an initial health assessment and written verification of immunizations within 60 days from enrollment (SEE LIS CODE SHEET). The initial health assessment and written verification of immunizations on file for Child #3 are dated 2/5/24, which is more than 60 days from date of enrollment (SEE LIS CODE SHEET). Child #1 must be dismissed from care by close of business on 4/10/24 and may only return to care when the immunization record is update or when the parent provides a written, signed exemption letter.

Staff #5 and Staff #9 were observed working alone and did not complete the appropriate Heath and Safety training. Both Staff #5 and Staff #9 completed the 6 hour Health and Safety Basics training prior to 9/30/16, but needed the 10 hour Get Started with Center-Based Care: Building Blocks for Quality.

Staff person #7 had not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): Get Started with Center-Based Care: Building Blocks for Quality (12/8/23). Staff #7 has acceptable pediatric first aid/CPR training in an approved curriculum; however, the trainer has not provided documentation that they are PQAS-certified in that training topic.

Staff #7 did not complete the Mandated Reporter training within 90 days of their date of hire (SEE LIS CODE SHEET).

The Financial Agreement form on file for Child #5 lacked the Release Person's Name.

The Financial Agreement forms on file for Child #3 and Child #7 were the original copies, which is to be given to the parent.

The Emergency Contact form for Child #2 lacked an address for the child's physician or source of medical care.

The Emergency Contact form for Child #1 lacked a complete home address for the enrolling parent.

The Emergency Contact forms for Child #1, Child #4, and Child #5 lacked addresses for all listed release persons.

The two most recent parent updates of the Financial Agreement form on file for Child #4 (6/30/2023 & 3/1/2024) and Child #5 (8/16/23 & 4/1/2024) are dated, more than 6 months apart.

The files for Staff #1, Staff #2, Staff #4. Staff #5, and Staff #9 contained the Health and Safety Basic Training 6 Hour Course dated prior to 9/30/2016, and therefore lacked the 10 hour Get Started with Center-Based Care: Building Blocks for Quality.

The file for Staff #3 contained State Police Clearances dated 8.8.15 and 8.25.20, and Child Abuse Clearances dated 8.19.15 and 8.21.20, which exceeded the 60-month renewal requirement. The file for Staff #6 contained FBI Clearances dated 3.4.16 and 3.9.21, which exceeded the 60-month renewal requirement. The file for Staff #7 contained State Police Clearances dated 9.25.13 and 4.9.19, Child Abuse Clearances dated 10.1.13 and 4.19.19, and FBI Clearances dated 10.1.13 and 4.11.19, which exceeded the 60-month renewal requirement.

A black cable line, which was strung along the back of the building in the small outdoor, fenced play yard, was loose in one (1) area, hung down low, was accessible to children, and created a choking/strangling hazard for children in care.

A bottle of Purell Professional Surface Disinfectant, 128 oz, was located in a closet with a curtain in the school-age room, which stated, "Keep out of reach of children," and was accessible to children.

A handwashing sign was not posted at two (2) toilets in the school-age room.

The files for Child #1 and Child #2 did not contain documentation of the Influenza vaccination in accordance with the ACIP recommendations.

The two most recent Health Assessments in the file for Staff #1, Staff #5, and Staff #8 exceeded the 24-month renewal requirement. The file for Staff #10 did not contain documentation of a Health Assessment or Mantoux test at initial hire or thereafter.

The file for Staff #2 contained documentation of Pediatric First-Aid/CPR training on 5.7.19 and 5.20.21, which exceeded the expiration date of the previous training.

The file for Staff #3 contained documentation of Mandated Reporter Training on 8.14.15 and 8.26.20, which exceeded the 60-month renewal requirement. The file for Staff #4 contained documentation of Mandated Reporter Training on 5.6.15 and 5.19.20, which exceeded the 60-month renewal requirement. The file for Staff #7 contained documentation of Mandated Reporter Training on 6.23.15 and 3.14.21, which exceeded the 60-month renewal requirement.

The file for Staff #10, did not contain two, written, nonfamily references.

The file for Staff #9 (see IS Code Sheet) contained documentation of Pediatric First-Aid/CPR training on 9.22.22, which exceeded 90 days of hire.

The file for Staff #2 contained application for NSOR clearance and completed NSOR clearance, both dated after the date of hire. The file for Staff #5 contained an NSOR clearance after the date of hire, with no application for NSOR clearance present in file.

During assessment of supervision and ratio in the Red Room 4/20/22 at 11 AM, one PS child was observed to be alone and unsupervised in the bathroom off the hall, outside of the Red Room.

During assessment of supervision and ratio in the Red Room 4/20/22 at 11 AM, one PS child was observed to be alone and unsupervised in the bathroom off the hall, outside of the Red Room.

During assessment of supervision and ratio in the Red Room 4/20/22 at 11 AM, one PS child was observed to be alone and unsupervised in the bathroom off the hall, outside of the Red Room.

The file for Staff #3 contained documentation of current state police, child abuse and FBI clearances, yet lacked documentation of previous clearances. The clearances had been reviewed at a previous inspection.

Toxic paint and primer were observed in a unlocked closet outside the boys bathroom,.

The first-aid kit in the SA Room was observed to be accessible to children on a low shelf.

Splintered wooden fence slats were observed on the left side slats of the small playground. Pieces of glass were observed on the ground near the right upper fence of the large playground. Animal feces were observed on the ground near the top fight of the large playground.

The rest equipment in the gym was observed to lack labels for some of the children using the rest equipment.

The file for Child #2 contained consecutive health reports dated more than 12 months apart.

The files for Child #2 and #4 contained record of immunization history which lacked current influenza vaccinations.

During an observed diaper change in the Nursery, the hands-free mechanism of the lidded can was not operable.

The files for Staff #1, #4, #6 and #7 contained consecutive health assessments dated more than 24 months apart. The file for Staff #3 contained a most recent health assessment conducted more than 24 months ago.

The proof of purchase for the interconnected fire detection system was not available at the time of the inspection.

The files for Staff #2 and #5 contained health and safety basics training completed more than 90 days after hire.

The files for Staff #2 and #5 contained documentation of mandated reporter training completed more than 90 days after hire. The files for Staff #3 and #4 contained current mandated reporter training but lacked documentation of previous mandated reporter training, making in unable to be determined if current training was completed within 60 months of previous training.

The file for Child #4 contained an emergency contact form which lacked the telephone number of the child's medical provider.

The file for Child #1 contained an emergency contact form which lacked the home telephone number of the enrolling parent. The files for Child #3 and #5 contained emergency contact forms which lacked the work address and telephone number of the enrolling parents.

The file for Child #2 contained an emergency contact form which lacked the full address of the release person. The file for Child #4 contained an emergency contact form which lacked the address and telephone number of the release person.

The file for Staff #5 contained certification in pediatric first-aid and CPR obtained more than 90 days after hire.