Discovery Kids Daycare Center

Second citation, previously cited on 4-10-25, the file of staff #1 lacked completing health and safety training within 90 days of hire (see LIS code sheet).

The files of staff #4, #8, and #9 lacked the National Sex Offender clearance report (see LIS code sheet). The file of staff #2 lacked the National Sex Offender clearance report and PA Child Abuse clearance report.

Staff #4 identified 5 children in care; 4 young toddlers and 1 infant. Therefore, staff #4 was over ratio.

At the time of the inspection, the first-aid kit in the older toddler room lacked band aides and the first-aid kit in the school-age room lacked tweezers.

At the time of the inspection, there was not a hand washing sign posted at the second toilet from the left upon entering the restroom.

Observed a red and yellow Little Tikes Cozy Coupe with an exposed bolt on the right side near the door.

The file of staff #2 had a late initial health assessment due to the fact it was dated 3-26-25 (see LIS code sheet). The file of staff #5 lacked health assessments every 24 months due to the fact they were dated: 11-8-22 and 3-25-25.

The file of staff #5 had documentation of not renewing CPR training prior to expiration due to the fact they were dated: 11-2024 expiration and 1-8-25 renew date.

The file of staff #7 had not completed the 1-hour health and safety training and only had documentation of completing Health and Safety training; not revised. The files of staff #1 and #9 lacked completing health and safety training within 90 days of hire (see LIS code sheet).

The file of staff #6 lacked a written evaluation.

The files of children #2 and #5 lacked emergency contact forms with the parents' work addresses and telephone numbers of the enrolling parent.

The file of child #5 lacked an emergency contact form with the information on the child's special needs or "NA" if not applicable.

The file of child #4 lacked an emergency contact form with the full, complete address of the individual designated by the parent to whom the child may be released.

At the time of the inspection, there was not emergency contact information in the rooms where the children were observed to be receiving care for the following children: child #1, #2, #3, #4, #5, #6, #7, #8, #9, #10, #11, #12, #13, and #14.

The file of staff #2 lacked two written, nonfamily references from individuals attesting to the person's suitability to serve as a facility person due to the fact there was 1 in the file.

The files of staff #2, #3, and #7 lacked completing professional development in pediatric first aid and pediatric cardiopulmonary resuscitation within 90 days of hire.

The file of staff #5 lacked documentation of completing the annual minimum of 12 clock hours of child care training.

2nd citation. Previously cited on 4/2/24. The file of Staff #1 lacked a dated disclosure statement. The file of Staff #2 lacked a dated disclosure statement. The file of Staff #3 did not contain a witnessed disclosure statement.

2nd citation. Previously cited on 4/2/24. The operator did not provide to the parent of each enrolled child a letter explaining the emergency procedures including lockdown.

2nd citation. Previously cited on 4/2/24. Observed an electrical outlet which lacked a protective receptacle cover to the left of the bookcase in the reading nook area of the Infant Room.

2nd citation. Previously cited on 4/2/24. Observed an exposed bolt on the bottom of the fence under the window in the Outdoor Play Space.

2nd citation. Previously cited on 4/2/24. Observed seven approximately 1/4 inch to 1-inch holes on the wall between the first and second windows in the Preschool Room. Observed 12 approximately 1/4-inch holes in the drywall under the chalkboard in the Preschool Room. Observed 2 approximately 1/4-inch holes to the right of the chalkboard and to the left of the second electrical outlet in the Preschool Room. Observed 1/2-inch and 1/4-inch holes to the left of the toy box in the Older Toddler Room.

2nd citation. Previously cited on 4/2/24. Observed a broken, lidded waste receptacle in the bathroom.

Observed cubbies by the changing table which were not anchored creating a potential tipping hazard in the Infant Room.

2nd citation. Previously cited on 4/2/24. The operator did not 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.

2nd citation. Previously cited on 4/2/24. Children #2 and #3 lacked child service reports completed at least every 6 months. Child #2, with an admission date of 8/28/23, had a child service report in the file, but it was not dated. Child #3, with an admission date of 3/14/23, had a child service report in the file, but it was not dated.

2nd citation. Previously cited on 4/2/24. Emergency contact information for Child #1 did not include the work address of the enrolling parent.

2nd citation. Previously cited on 4/2/24. The emergency contact for Child #1 did not include written consent signed by a parent for emergency medical care.

2nd citation. Previously cited on 4/2/24. The emergency contact and agreement for Child #2 were not reviewed and updated at least once in a 6-month period. Child #2's emergency contact was signed on 8/21/23. Child #2's agreement was signed on 8/28/23. The emergency contact and agreement for Child #3 were not reviewed and updated at least once in a 6-month period. Child #3's emergency contact and agreement were signed on 7/26/23.

2nd citation. Previously cited on 4/2/24. The files of Children #1 and #3 did not contain signed parental consent for administration of minor first-aid procedures by facility staff on the emergency contact form.

Observed 2 cribs with loose sheets in the Infant Room creating a potential suffocation hazard. Observed a flat screen TV in the Preschool Room which was not anchored posing a falling hazard.

The file of Staff #1 lacked a valid FBI Clearance because it did not contain a disposition for all charges. The file of Staff #1, a provisional hire, lacked a National Sex Offender Registry Certificate within 45 days of start (SEE LIS Code Sheet). The file of Staff #1 contained no NSOR, and Staff #1 was not suspended after 45 days. The file of Staff #1 lacked a dated disclosure statement. The file of Staff #2 lacked a dated and witnessed disclosure statement. The file of Staff #4 lacked a dated disclosure statement. The file of Staff #5, a provisional hire, lacked application for the National Sex Offender Registry Certificate prior to or on the date of initial hire (SEE LIS Code Sheet). The file of Staff #5 contained a NSOR request date of 4/1/24. The file of Staff #5 lacked a dated disclosure statement. The file of Staff #6 lacked a completed FBI Clearance prior to providing initial service in child care (SEE LIS Code Sheet). The file of Staff #6 did not contain an FBI Clearance. The file of Staff #6 did not contain a dated disclosure statement. The file of Staff #8 lacked a Child Abuse Clearance prior to or on the date of initial hire (SEE LIS Code Sheet). The file of Staff #8…

The files of Staff #1, #2, #3, and #6 lacked documentation of receiving training regarding the emergency plan at the time of initial employment (SEE LIS Code Sheet). The files of Staff #7, #9, #11, and #12 lacked documentation of receiving training regarding the emergency plan on an annual basis. The file of Staff #7 contained documentation of emergency plan training on 1/2/23 but no documentation for 2024. The file of Staff #9 contained documentation of emergency plan training on 10/13/22 and 1/2/23 but no documentation for 2024. The file of Staff #11 contained documentation of emergency plan training on 1/2/23 but no documentation for 2024. The file of Staff #12 contained documentation of emergency plan training on 2/10/23 but no documentation for 2024.

The operator did not provide to the parent of each enrolled child a letter explaining the emergency procedures including shelter of children during an emergency including lockdown, shelter in place at the facility, and shelter at locations away from the facility premises; evacuation of children from the building and evacuation of children to a location away from the facility premises; a method to contact parents as soon as reasonably possible when an emergency situation arises; a method for facility persons to inform parents that the emergency has ended and to provide instructions as to how parents can safety be reunited with their children; accommodations for infants, toddlers, children with disabilities and children with chronic medical conditions; and emergency drills conducted annually.

Observed an electrical outlet which lacked a protective receptacle cover under the hanging cubby in the diapering area of the Infant Room.

Observed a first-aid kit on the windowsill to the left of the fire extinguisher in the Preschool Room which was accessible to children.

Observed an exposed bolt on the bottom of the fence under the window in the Outdoor Play Space. Observed approximately a 1 inch by 2-inch loose piece of the protective surfacing in the middle of the Outdoor Play Space. Observed a loose doorknob on Preschool Room door.

Observed peeling paint beside the 1st window on the wall opposite from the entrance in the Preschool Room. Observed five 1/2 inch to 1-inch holes in the drywall beside the 1st window on the wall opposite from the entrance in the Preschool Room. Observed nine approximately 1/2-inch holes in the drywall beside the sink and above the mats in the Young Toddler Room. Observed approximately fifteen 1/8-to-1-inch holes in the drywall behind the bookshelf in the Young Toddler Room. Observed ten approximately 1/8-to-1/4-inch holes in the drywall under the office window in the Older Toddler Room. Observed six approximately 1/2-inch holes in the drywall behind the TV in the Preschool Room. Observed three approximately 1-inch holes in the drywall under the 2nd and 3rd windows in the Preschool Room. Observed nine approximately 1/8-to-1/4-inch holes in the drywall to the left of the toy box in the Older Toddler Room.

The counter height sink in the Infant Room did not have platforms or steps, and staff were holding children to wash their hands.

The 1st stall in the bathroom lacked a handwashing sign.

Observed a broken lidded waste receptacle in the bathroom.

Observed approximately a 3-inch crack on the landing of a Little Tyes climber to the right of the refrigerator in the Young Toddler Room. Observed a black and white polka dot block with exposed foam in the Infant Room. Observed a frayed basket containing rattles and blocks in the Infant Room.

Observed a Bumbo seat with an incorrect strap. The strap used with the Bumbo seat stated "Little Tykes" on it.

Observed plastic bags containing clothes under the changing table in the Infant Room which were accessible to children.

Observed rest equipment not labeled for the use of a specific child in the Infant Room.

The file of Staff #10 lacked an initial health assessment conducted within 12 months prior to providing initial service in a child care setting. (SEE LIS Code Sheet). The file of Staff #10 contained a health assessment dated 12/2/23.

The file of Staff #10 lacked an initial health assessment which included tuberculosis screening by Mantoux method at initial employment (SEE LIS Code Sheet). Staff #10 had a Mantoux read date of 12/2/23.

Staff #12 did not immediately wash his/her hands after diapering a child in the Infant Room. After diapering a child, Staff #12 opened and closed a gate and then returned to wash his/her hands. The Infant Room lacked a means to dry hands.

Observed bottles which were not labeled with the child's name in the Infant Room.

The files of Children #2 and #5 lacked a health report no later than 60 days following the first day of attendance at the facility. Child #2 who had an admission date of 8/28/23 had a health report dated 3/8/24. Child #5 who had an admission date of 3/14/23 had a health report dated 2/12/24.

The operator did not 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.

The file of Staff #7 and #9 lacked documentation of participating, at least annually, in fire safety training conducted by a fire protection professional (SEE LIS Code Sheet). The file of Staff #7 contained documentation of fire safety training completed on 2/27/24. The file of Staff #9 contained documentation of fire safety training completed on 11/21/23.

Staff person #10 has not completed the following required pre-service training within 90 days of their date of hire (SEE LIS Code Sheet): pediatric first aid/CPR from a PQAS approved trainer and a PQAS approved curriculum.

The files of Staff #1 and #6 lacked documentation of completing health and safety training within 90 days of hire (SEE LIS Code Sheet). The file of Staff #1 contained documentation of completing health and safety training on 1/4/24. The file of Staff #6 contained documentation of completing health and safety training on 3/27/24.

The files of Staff #7, #9, #11, and #12 lacked a written evaluation on a regular basis, a minimum of one evaluation every 12 months (SEE LIS Code Sheet). The file of Staff #7 did not contain a written evaluation. The file of Staff #9 did not contain a written evaluation. The file of Staff #11 contained a staff evaluation dated 1/23/23. The file of Staff #12 did not contain a written evaluation.

The file of Staff #1, who was designated as an assistant group supervisor, lacked documentation of 2 years experience with children.

Children #2 and #5 lacked child service reports completed at least every 6 months. Child #2, with an admission date of 8/28/23, had a child service report in the file, but it was not dated. Child #5, with an admission date of 3/14/23, had a child service report in the file, but it was not dated.

Emergency contact information for Child #1 did not include the work address of the enrolling parent. Emergency contact information for Child #4 did not include the complete work address of the enrolling parent.

The emergency contact for Child #1 did not include written consent signed by a parent for emergency medical care.

Emergency contact information for Child #4 did not include the complete address of the individual designated by the parent to whom the child may be released.

The emergency contact and agreement for Child #2 were not reviewed and updated at least once in a 6-month period. Child #2's emergency contact was signed on 8/21/23. Child #2's agreement was signed on 8/28/23. The emergency contact and agreement for Child #5 were not reviewed and updated at least once in a 6-month period. Child #5's emergency contact and agreement were signed on 7/26/23.

The files of Children #1 and #5 did not contain signed parental consent for administration of minor first-aid procedures by facility staff on the emergency contact form.

It was observed that an agreement was not on file at the date of enrollment for Children #3 and #5. Child #3's date of admission was 3/4/24 with an agreement dated 3/18/24. Child #5's date of admission was 3/14/23 with an agreement dated 7/26/23.

The file of Staff #1 lacked two written, nonfamily references from individuals attesting to the person's suitability to serve as a facility person.

The files of Staff #7, #11, and #12 lacked documentation of obtaining an annual minimum of 12 clock hours of child care training.

2nd citation. Previously cited on 1/5/24. The files of Volunteers #1 and #2 lacked an FBI Clearance.

Observed 2 cribs with loose sheets in Infant Room 1 creating a potential suffocation hazard.

The files of Volunteers #1 and #2 lacked an FBI Clearance and National Sex Offender Registry Certificate.

The first-aid kit in Infant Room 1 lacked soap and disposable, nonporous gloves.

Observed a protruding screw on an access panel to the left of the bump out in Infant Room 1.

Observed peeling paint to the right of the door leading to the kitchen in Infant Room 1. Observed approximately a 1 by 2-inch hole in the drywall to the right of the door leading to the kitchen in Infant Room 1. Observed three approximately 1/2-inch holes and two approximately 1-inch holes in the drywall on the wall left of the main entrance in Infant Room 1. Observed approximately a 1 by 2-inch piece of missing drywall and approximately a 1 by 5-inch piece of missing drywall on the bump out to the left of the changing table in Infant Room 1.

Observed a bookcase by the changing table which was not anchored creating a potential tipping hazard in Infant Room 1. Observed a bookcase in the reading area which was not anchored creating a potential tipping hazard in Infant Room 1. Observed a bookcase by the entrance to the reading area which was not anchored creating a potential tipping hazard in Infant Room 1.

The files of Volunteers #1 and #2 did not include verification of age.

The Director or designated staff person who is responsible for compliance with this chapter did not ensure that the hypothetical locations of the fire are rotated around the facility for each drill such that the hypothetical location is never the same for consecutive drills.

2nd citation. Previously cited on 8/7/23. The Director or designated staff person who is responsible for compliance with this chapter did not ensure that fire drills were conducted at least once every 60 days. The facility provided documentation of fire drills being conducted on 4/3/23, 6/6/23, 8/9/23, and 10/9/23.

On 8/7/23 the Director or designated staff person who is responsible for compliance with this chapter did not ensure that fire drills were conducted at least once every 60 days. The facility provided documentation of fire drills being conducted on 4/3/23 and 6/6/23.

Observed toys and a tunnel on the ramp which obstructed the exit from the facility.

At approximately 10:56 AM Certification Staff observed a 4-month-old infant strapped in a bouncer seat while staff fed him/her a bottle.

Observed a lidded waste receptacle in front of the gate in the Infant Room which obstructed the means of egress.

Staff did not ensure a child's hands were washed before giving a child a snack in the Infant Room.

Staff did not wash his/her hands before giving a child a snack in the Infant Room.

Observed loose sheets in 3 cribs in the Infant Room creating a potential suffocation hazard. Observed an electrical cord to a sound machine which was not secured creating a potential tripping and/or strangulation hazard in the Infant Room.

The file of Staff #1 lacked a valid PA State Police Clearance. Staff #1's State Police Clearance lacked a disseminated on date. The file of Staff #3 lacked documentation of application for the State Police Clearance prior to or on the date of initial hire (SEE LIS Code Sheet). The file of Staff #3 contained a State Police Clearance dated 2/13/23. The file of Staff #3 did not contain a Child Abuse Clearance and FBI Clearance. The file of Staff #3, a provisional hire, lacked a National Sex Offender Registry Certificate within 45 days of start (SEE LIS Code Sheet). The file of #3 contained a NSOR dated 4/24/23 with no documentation that Staff #3 was suspended after 45 days.

The files of Staff #1 and #3 lacked documentation of receiving training regarding the emergency plan at the time of initial employment (SEE LIS Code Sheet). The file of Staff #1 contained documentation of emergency plan training on 10/13/22. The file of Staff #3 contained no documentation of emergency plan training.

Observed an electrical outlet which lacked a protective receptacle cover to the right of the rocking chair in the Infant Room. Observed an electrical outlet which lacked a protective receptacle cover between the black shelf and bump out in the Toddler/Preschool Classrooms.

Observed Sensi Care, A&D Treat, and Aquaphor which indicated "keep out of the reach of children" under the changing table in the Infant Room which were accessible to children. Observed bleach water and Pure Hand Sanitizer which indicated "keep out of the reach of children" on the white cabinet in the Preschool section of the classroom which were accessible to children.

Observed bleach water stored in a plastic spray bottle which did not specify the content in the Preschool section of the classroom.

Observed rust on the top bars of the fence on either side of the gate beside the building in the outdoor play space. Observed rust on the bottom hinge of the gate beside the building in the outdoor play space. Observed rust on the gate post beside the parking lot in the outdoor play space. Observed rust on the 2nd post from the gate beside the parking lot in the outdoor play space. Observed a loose doorknob on the door leading from the Infant Room to the hall.

Observed peeling paint on the wall to the right of the sink in the Young Toddler section of the classroom. Observed approximately twelve 1 to 3 inch holes in the drywall by the rocking chair in the Infant Room.

The diapering area in the Infant Room lacked a clean, lidded waste receptacle.

Observed the diapering area in the Older Toddler section of the classroom lacked a source of running water for handwashing.

Observed foam peg boards with bite marks in the Preschool section of the classroom.

The file of Child #5, a 15-month-old, lacked Pneumococcal immunizations according to the recommendations of the ACIP. The file of Child #5 contained documentation of 3 Pneumococcal immunizations.

The Director or designated staff person who is responsible for compliance with this chapter did not ensure that fire drills were conducted at least once every 60 days. The facility provided documentation that fire drills were conducted on 8/11/22, 10/6/22, 12/8/22, 2/3/23, 4/3/23, and 6/6/23.

The file of Staff #2, who was designated as a group supervisor, lacked documentation of 30 credit hours in early childhood education, child development, special education, elementary education or the human services field.

The written plan of daily activities was not posted in the Infant Room.

The agreement for Child #5 did not specify the persons designated by a parent to whom the child may be released.

The agreement for Child #1 lacked the date of the child's admission.

Emergency contact information for Child #3 lacked the telephone number of the child's physician or source of medical care.

Emergency contact information for Child #4 lacked the address of the individual designated by the parent to whom the child may be released. Emergency contact information for Child #5 lacked the complete address of the individual designated by the parent to whom the child may be released.

A written plan identifying the means of transporting a child to emergency care and staffing provisions in the event of an emergency was not displayed conspicuously in the Infant Room.

The operator did not establish and maintain an individual record for Child #1. The file of Child #1 also contained information for Child #1's sibling.

**At approximately 12:00 PM Certification Staff observed a child lying on rest equipment behind the refrigerator which did not allow for critical oversight in which the supervisor could see, hear, direct, and assess the activity of the supervisee. At approximately 12:35 PM Certification Staff observed Staff #1 nodding off several times while sitting between 2 children at naptime.

*At approximately 12:00 PM Certification Staff observed a child lying on rest equipment behind the refrigerator which did not allow for critical oversight in which the supervisor could see, hear, direct, and assess the activity of the supervisee. At approximately 12:35 PM Certification Staff observed Staff #1 nodding off several times while sitting between 2 children at naptime.

***At approximately 12:00 PM Certification Staff observed a child lying on rest equipment behind the refrigerator which did not allow for critical oversight in which the supervisor could see, hear, direct, and assess the activity of the supervisee. At approximately 12:35 PM Certification Staff observed Staff #1 nodding off several times while sitting between 2 children at naptime.

**Based on interviews, children who do not listen are placed in highchairs and/or pack 'n plays for up to 10 minutes.

*Based on interviews, children who do not listen are placed in highchairs and/or pack 'n plays for up to 10 minutes.

Observed adult scissors on the teacher's desk in the Older Toddler/Preschool Rooms.

The files of Staff #1 and #2 lacked documentation of completing the Pennsylvania Health and Safety Update 2022 by December 30, 2022. The files of Staff #1 and #2 contained no documentation of completing the health and safety update.

Based on interviews, the operator did not permit an adult individual who provides specialized services to a child with special needs to provide those services on the facility premises as specified in the child's IEP, IFSP, or written behavioral plan.

Staff person #3 has not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): 10 hour health and safety training.

*2nd citation. Previously cited on 12/7/22. At approximately 9:30 AM Staff #1, #2, and #3 were caring for a group 16 mixed-age children which included 5 infants, 5 young toddlers, 4 older toddlers, and 2 preschoolers.

**2nd citation. Previously cited on 12/7/22. At approximately 9:30 AM Staff #1, #2, and #3 were caring for a group 16 mixed-age children which included 5 infants, 5 young toddlers, 4 older toddlers, and 2 preschoolers.

**2nd citation. Previously cited on 12/7/22. At approximately 9:30 AM Certification Staff observed an infant sleeping in a bouncer seat.

*2nd citation. Previously cited on 12/7/22. At approximately 9:30 AM Certification Staff observed an infant sleeping in a bouncer seat.

Based on interviews and documentation, Staff #1, #2, and #3 were caring for a group of 16 mixed-age children which included 5 infants, 2 preschoolers, 5 young toddlers, and 4 older toddlers.

The file of Staff #1, a provisional hire, lacked the results of the PA Child Abuse Clearance and PA State Police Clearance as well as application for the FBI Clearance and the National Sex Offender Registry prior to employment (SEE LIS Code Sheet). The file of Staff #1 did not contain a PA Child Abuse Clearance. The file of Staff #1 contained a PA State Police Clearance with no dissemination date. The file of Staff #1 contained an FBI receipt dated 11/18/22. The file of Staff #1 contained a NSOR dated 11/15/22.

At approximately 9:40 AM Certification Staff observed an infant sleeping in a bouncer seat.

Observed an electrical outlet that lacked a protective receptacle cover by the rocking chair and cubby in the Infant Classroom.

2nd citation. Previously cited on 10/4/22. Observed rest equipment not labeled for the use of a specific child in the Toddler Classroom.

The file of Staff #1 lacked an initial health assessment conducted within12 months prior to providing initial service in a child care setting. The file of Staff #1 did not contain a health assessment.

2nd citation. Previously cited on 10/4/22. The file of Child #1 lacked the work address of the enrolling parent on the emergency contact form.

The file of Staff #2 lacked a signed disclosure statement prior to or on the date of initial service in a child care setting (SEE LIS Code Sheet). Staff #2 had a disclosure statement dated 8/28/22.

The emergency plan did not address continuity of operations.

The file of Staff #3 lacked documentation of training regarding the emergency plan at the time of initial employment (SEE LIS Code Sheet). The file of Staff #3 contained no documentation of emergency plan training.

The operator did not post the emergency plan in the facility at a conspicuous location.

Observed cigarette butts under the side gate in the outdoor play space which were accessible to children. Observed Keep Clean Moisturizing Hand Sanitizer and Bordeaux Butt Paste which both indicated "keep out of the reach of children" in a diaper bag on a low shelf which were accessible to children in the Infant Classroom. Observed Bordeaux Butt Paste which indicated "keep out of the reach of children" on a shelf in the cubby which were accessible to children in the Infant Classroom. Observed Clorox Disinfecting Wipes which indicated "keep out of the reach of children" on the 1/2 wall by the refrigerator which were accessible to children. Observed Clorox Scentiva Disinfecting Wipes which indicated "keep out of the reach of children" on the ledge of the 1st bathroom stall which were accessible to children.

The hot water temperature at the first bathroom sink was 111.7 degrees. The hot water temperature at the 2nd bathroom sink was 112 degrees.

Observed loose protective guards on the retaining wall in the Outdoor Play Space.

Observed approximately five 1 inch holes in the drywall behind the cubby in the Infant Classroom. Observed approximately thirteen 1 to 3 inch holes in the drywall by the refrigerator in the Infant Classroom.

Observed a blue and white cabinet in the School-Age/Preschool Classroom which was not anchored creating a potential tipping hazard. Observed a cracked bin containing wooden blocks in the Toddler Classroom. Observed a purple, blue, and yellow pop up play hut with approximately 2 inch holes on the mesh in 2 places. Observed exposed bolts which are approximately 3 to 4 inches long on the toilet bases.

Observed plastic bags on the window ledge of the bathroom which were accessible to children who are still placing objects in their mouths. Observed foam blocks with bite marks in the Toddler Classroom. Observed plastic bags in the cabinet under the toaster oven in the kitchen area which were accessible to children who are still placing objects in their mouths. Observed plastic bags in a tote under the table at the entrance to the facility which were accessible to children who are still placing objects in their mouths. Observed small stones with a diameter of less than 1 inch in front of the retaining walls in the Outdoor Play Space.

Observed an Ingenuity Booster which lacked a T-shaped safety strap.

Observed rest equipment not labeled for the use of a specific child in the Toddler Classroom.

The file of Child #1 contained a health report which was signed but did not include the individual's professional title.

The file of Child #2, a 2 year old, lacked Hepatitis A immunizations in accordance with the schedule recommended by the ACIP. The file of Child #2 contained documentation of one Hepatitis A immunization. The file of Child #3, a 3 year old, lacked a current influenza immunization in accordance with the schedule recommended by the ACIP.

Staff in the Toddler Classroom did not ensure that children's hands were washed before snack.

Observed the changing table in the Toddler Classroom lacked a plastic-lined, hands-free covered can to discard a soiled diaper immediately.

The file of Staff #1 lacked an adult health assessment which included a physical examination.

The file of Staff #1 lacked an adult health assessment which included a tuberculosis screening by the Mantoux method at initial employment (SEE LIS Code Sheet). Staff #1 had a Mantoux read date of 10/2/20.

The file of Staff #1 lacked an adult health assessment which included an examination for communicable diseases and the results of that examination.

The file of Staff #1 lacked an adult health assessment which included the physician's or CRNP's assessment of the person's suitability to provide child care.

Staff in the Toddler Classroom did not wash their hands before snack.

The operator did not conspicuously post the menu at least 1 week in advance.

Observed bottles which were not labeled with the child's name.

The file of Child #3 lacked the date of the child's admission on the agreement.

The files of Children #1, #3, #4, and #5 contained the original copies of the agreement. The facility did not make a copy for the files and give the original to the parent.

The files of Children #1 and #2 lacked the telephone number of the child's physician or source of medical care on the emergency contact form. The file of Child #4 lacked the complete address of the child's physician or source of medical care on the emergency contact form.

The file of Child #1 lacked the home address, work address, and work telephone number of the enrolling parent on the emergency contact form. The file of Child #2 lacked the complete home and work addresses of the enrolling parent on the emergency contact form. The file of Child #4 lacked the complete work address of the enrolling parent on the emergency contact form.

The files of Children #1 and #4 lacked the health insurance coverage and policy number for a child under a family policy or Medical Assistance benefits, if applicable, on the emergency contact form. The file of Child #2 lacked the health insurance policy number for a child under a family policy or Medical Assistance benefits, if applicable, on the emergency contact form.

The file of Child #2 lacked the address and telephone number of the individual designated by the parent to whom the child may be released on the emergency contact form. The file of Child #4 lacked the address of the individual designated by the parent to whom the child may be released on the emergency contact form.

Emergency contact information for Children #2 and #6 were not present when they were receiving care in the Toddler Classroom.

It was observed that the agreement for Child #2 was not on file at the date of enrollment. Child #2's date of enrollment was 10/4/22. Child #2 did not have an agreement on file.

The operator did not provide the parent of each child enrolled with information on how to access the regulations in this chapter electronically.

At approximately 9:30 AM Staff #1 and #2 were caring for a group of 6 mixed age children which included 3 older toddlers, 2 infants, and 1 young toddler. Staff #1 and #2 indicated they were sharing responsibility of the children. When asked to name the children, Staff #1 was able to name all of them, but Staff #2 was only able to name 5 of them.

Staff persons #1 and #2 were observed to be caring for children unsupervised. Staff persons #1 and #2 have not completed the following pre-service training required prior to caring for children unsupervised: health and safety topics including pediatric first aid/CPR from a PQAS approved trainer and a PQAS approved curriculum and mandated reporter training.