Keystone Kidz LLC

Based on video footage and other documentation obtained from other investigating agencies, Staff person #1 used physical discipline when attempting to remove cookies from Child #1's mouth that the child took without permission.

RECITED FROM SIN-00267752: The file for Staff person #1 (See LIS Code Sheet) includes an incomplete criminal history clearance, stating it was "under review" and it did not include a dissemination date, making it invalid. The two most recent State Police Criminal History clearances on file for Staff person #2 are dated 4.7.20 and 6.10.25, more than 60 months apart. The most recent Child Abuse clearance on file for Staff person #2 is dated 4.22.20 and the most recent FBI clearance on file for Staff person #2 is dated 6.8.20, both more than 60 months ago. Staff person #1 was observed in ratio at an unannounced inspection on 9.12.25 and Staff person #2 is still a facility person.

While assessing ratio in the preschool room during an unannounced monitoring inspection on 9.12.25, Staff person #3 and #4 were present with 14 children. Staff person #4 identified her assigned group, consisting of 1 older toddler and 6 preschool children. Staff person #3 identified her assigned group consisting of 7 preschool children.

RECITED FROM SIN-00267752: On 9.12.25 the Nap Room was observed to be too dark for the staff person to be able to see all of the children. While observing implementation of corrections on 9.12.25 from the previous inspection dated 6.10.25, the CR observed Staff person #5 enter a curtained off area where 5 young toddlers were napping. At this time, it was not possible to see what was inside the curtained area. When the CR entered the area, Staff person #5 was asked if another staff person had been present with the children prior to them entering the curtained area; Staff person #5 stated no and indicated they had stepped out briefly, leaving the 5 young toddlers unsupervised by a staff person who could see, hear, direct, and assess the children.

While observing implementation of corrections on 9.12.25 the CR observed Staff person #5 enter a curtained off area where 5 young toddlers were napping. When the CR entered the area, Staff person #5 was asked if another staff person had been present with the children prior to them entering the room; Staff person #5 stated no and indicated they had stepped out briefly, meaning Staff person #5 was not present with the 5 young toddlers for several minutes.

RECITED FROM SIN-00267752: Staff person #2 has completed the health and safety course titled Get Started with Center-Based Care: Building Blocks for Quality but has not completed the required health and safety update course titled Pennsylvania Health and Safety Update 2022 (1 hour) training.

RECITED FROM SIN-00267752: Staff person #2 has not completed mandated reporter training within the last 60 months; the previously documented mandated reporter training on file is dated 4.7.20.

RECITED FROM SIN-00267752: The agreement on file for Child #4 does not include the child's date of admission.

RECITED FROM SIN-00267752: The most recent 6-month review signature for the emergency contact form on file for Child #3 is dated more than 6 months ago. The most recent 6-month review signature for the agreement on file for Child #1, #2, #3, #4 is dated more than 6 months ago.

The file for Staff person #1 (See LIS Code Sheet) includes an incomplete criminal history clearance, stating it was "under review" and it did not include a dissemination date, making it invalid. The two most recent State Police Criminal History clearances on file for Staff person #2 are dated 4.7.20 and 6.10.25, more than 60 months apart. The most recent Child Abuse clearance on file for Staff person #2 is dated 4.22.20 and the most recent FBI clearance on file for Staff person #2 is dated 6.8.20, both more than 60 months ago. The Disclosure Statement on file for Staff person #3 is dated 6.4.25, after the hire date (See LIS Code Sheet).

A school-age child was observed exiting the gross motor room, walking through the school-age room and into the bathroom, without a staff person being present, making the classroom out of ratio.

At 2:00 PM, the Nap Room was observed to be too dark for the staff person to be able to see all of the children. A school-age child was observed exiting the gross motor room, walking through the school-age room and into the bathroom, unsupervised and without the staff being able to see, hear, direct, and assess the child.

A school-age child was observed exiting the gross motor room, walking through the school-age room and into the bathroom, unsupervised by the staff person assigned to be responsible for the child.

A staff person was observed laying an infant under 12 months of age in their crib on their stomach.

There was an outlet by the sound machine in the nap room that was missing an outlet cover and was accessible to children.

There was no first aid kit in the Playhouse childcare space.

There were several posts in the Main childcare room with missing baseboard around the bottom of the posts.

There was peeling paint and damaged plaster in the eating area of the Main classroom. There was peeling paint in the Gross Motor room under the "2", behind the climber.

There was a cracked plastic bin holding music toys in the Young Toddler area in the Main classroom.

There was a small piece of wood on the floor at the base of a post in the Main classroom where children who are placing things in their mouths receive care, that was smaller than 1 inch diameter, creating a choking hazard.

The two most recent health assessments on file for Child #1, who was a Young Toddler, are dated 10.24.23 and 10.23.24 more than 6 months apart. The most recent health assessments on file for Child #2, who was a Young Toddler, are dated 10.25.23 and 10.9.24, more than 6 months apart.

While observing a diaper change in the Main classroom, it was observed that the trashcan used for the disposal of the soiled diaper has a drop-lid, which is not approved as a hands-free can, as the soiled diaper comes in contact with the lid, cross-contaminating the lid.

The most recent health assessment on file for Staff person #2 is dated 10.13.22, more than 24 months ago.

There were 2 infant feeding bottles in the infant room that was not labeled with the name for whom the bottle was intended.

The most recent documentation of an emergency drill on file at the facility is dated 6.2.25, more than 1 year following the previous emergency drill, dated 4.12.24.

The fire alarm 30-day test log includes test dates 6.3.24-7.8.24, 9.6.24-10.7.24, 1.2.25-2.3.25, 4.3.25-5.8.25, more than 30 days apart

Staff person #2 has completed the health and safety course titled Get Started with Center-Based Care: Building Blocks for Quality but has not completed the required health and safety update course titled Pennsylvania Health and Safety Update 2022 (1 hour) training.

The two most recent fire safety trainings on file for Staff person #2 are dated 5.6.22 and 6.28.25, more than 12 months apart. The two most recent fire safety trainings on file for Staff person #5 are dated 4.17.24 and 5.27.25, more than 12 months apart.

Staff person #3 has not completed the following required pre- service training within 90 days of their date of hire (see LIS code sheet): Pediatric First Aid and CPR. Staff person #4 has 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.

Staff person #2 has not completed mandated reporter training within the last 60 months; the previously documented mandated reporter training on file is dated 4.7.20.

There was no written daily activity schedule in the Infant room, the Playhouse, and the Nap room (Gym).

The agreement on file for Child #4 does not include the child's date of admission.

There were no Emergency contact forms in the Playhouse childcare space. Three children were observed receiving care in the Preschool/School-age room without their emergency contact forms being in the classroom.

There was no emergency transportation plan posted in a conspicuous location in the Playhouse.

The most recent 6-month review signature for the emergency contact form on file for Child #1, #2 is dated more than 6 months after the previous 6-month review signature; The most recent 6-month review signature for the emergency contact form on file for Child #3 is dated more than 6 months ago. The most recent 6-month review signature for the agreement on file for Child #1, #2, #3, #4 is dated more than 6 months ago.

The file for Staff person #2, includes verification of 4.5 of the required 12 hours of annual training between 12.2023-12.2024; an additional 8 hours of training from 2.20.23 and 2.23.25 are borrowed to meet the requirement.

The emergency plan on site does not include provisions regarding volunteer emergency preparedness training, and continuity of operations, required as of 7/1/22, as per Announcement C-22-04.

The last stall in the main room bathroom had a hole in the wall with exposed plaster and an exposed toilet bolt. There were multiple holes on the wall on the stairwell that leads to the school-age room.

There was no thermometer in the refrigerator in the main room where children's milk and lunches are stored. The thermometer in the refrigerator in the school-age room read over 48 degrees.

The most recent health assessments on file for Child #4, who was a Young Toddler, is dated 10/25/23 and was due to be updated by 4/30/24.

The most recent health assessment on file for Child #6, who is a preschool age child, is dated 4/17/23, more than 12 months ago.

The immunization record on file for Child #1, who is 3 years old, included 2 of 4 pneumococcal vaccines recommended by the ACIP for a child this age. The immunization exemption on file for Child #5 is invalid as it is not written by the parent but is on a pre-made form.

There were gas drops labeled for use by a specific child in the young toddler room that had expired 5/2024 and was therefore not in accordance with the manufacturer's original label. There was an Albuterol inhaler labeled for use by a specific child in the school-age room that had expired 3/23/2024 and was therefore not in accordance with the manufacturer's original label.

There was an Albuterol inhaler n the school-age room that did not have written parental permission to administer.

The emergency plan on site at the facility does not include accommodations for infants and toddlers, children with disabilities, and children with chronic medical conditions, required as of 7/1/22, as per Announcement C-22-04

The fire alarm 30-day test log includes test dates 6/4/23-7/10/23; 7/10/23-8/21/23; 10/10/23-11/29/23; 2/7/24-3/11/24, and 3/11/24-4/22/24, all more than 30 days apart.

The facility does not have documentation verifying that the most recent emergency plan was submitted to the local municipality and to the county emergency management agency.

The facility does not have verificastion of an annual traffice safety letter notifying local traffic authorities of the facility location and vehicular and pedestrian routes around the facility.

The two most recent fire safety trainings on file for Staff person #3 are dated 5.6.22 and 6.6.23, more than 1 year apart.

Staff person #5 did not complete the following required pre-service training within 90 days of their date of hire (see LIS code sheet): Pediatric First Aid/Pediatric CPR; the training was completed on 12.1.23.

The file for Staff person #4, #6, classified as an assistant group supervisor, does not include a high school diploma or a general educational development certificate and 30 credit hours in education or a related human services field; or a high school diploma or a general educational development certificate with 15 credits in education or a related human services field and 1 year of experience with children; or a high school diploma or a general educational development certificate and 2 years experience with children. The file for Staff person #5, who was classified as a group supervisor, does not have verification of a Bachelor's degree in education or a related human services field; or a Bachelor's degree with 30 credits in education or a related human services field and 1 year of verified child care experience; or an Associate's degree in education or a related human services field and 2 years of verified child care experience; or an Associate's degree with 30 credits in education or a related human services field and 3 years of verified child care experience.

The file for Staff person #2, #3, who has been employed for more than 1 year (See LIS Code Sheet), does not include a staff evaluation.

The file for Child #1, with an enrollment date of 2/15/22, more than 6 months ago, does not include a child service report. The file for Child #2, with an enrollment date of 6/13/22, more than 6 months ago, does not include a child service report. The file for Child #6, with an enrollment date of 2/22/21, more than 6 months ago, does not include a child service report.

The file foe Child #3 did not include an emergency contact form at the time of the inspection.

The emergency contact form on file for Child #2 does not include the address or telephone number for the child's pediatrician/source for medical care.

The emergency contact form on file for Child #4 and #5 does not include the work address and/or telephone number for the enrolling parent.

The file for Child #1 and #3 does not include written parental permission for the facility to obtain emergency medical care.

The current emergency contact form on file for Child #1 and #5 does not indicate if the child has any special medical needs, which is needed in an emergency situation.

The file for Child #1, #2, #3, #5, and #6 do not include a review signature for the emergency contact form and agreement dated within the last 6 months.

The file for Child #1 and #3 does not include written parental permission for the facility to administer minor first aid procedures.

The Certificate of Compliance posted at the facility had an expiration date of 9/12/23. The facility did not have verification of providing the parent of each child enrolled with information on how to access the regulations in this chapter electronically and with instructions for contacting the appropriate regional childcare office.

The files for facility persons #7, #8, and #9 are all lacking signed disclosure statements as required under CPSL to serve in a childcare facility.

The facility emergency plan is lacking a plan for Continuity of Operations following an emergency. The facility emergency plan is lacking information regarding the role of volunteers during an emergency.

The files for staff persons # 3 and #5 are lacking emergency plan training and have been employed for more than 90 days. The file for staff person #4 contains initial emergency plan training that was completed greater than 90 days after hire.

The facility's letter to parents regarding the emergency plan is lacking information on accommodations for infants, toddlers, children with disabilities and children with chronic medical conditions.

According to classroom staff in the School Age Room, a first aid kit is not taken with the group when they go on excursions away from the facility.

The refrigerators in the Infant child care space, lunch room and school age room do not contain thermometers.

Observed in the first aid kit in the downstairs Play Space a container of Opthalmic Solution Eyewash not labeled with the name of the person for whom it was intended. Observed in the School Age room bee sting pads not labeled with the name of the person for whom they were intended.

The facility is lacking a policy on Prevention of Shaken Baby Syndrome, Abusive Head Trauma and Child Maltreatment required by 4/29/2022 from Announcement C- 22-03.

The files for staff persons #1, #2, #3, #4 and #5 all contain the PA Health & Safety Update 2022 completed after the required date of 12/30/2022. The file for staff person #6 is lacking the PA Health & Safety Update 2022 which was required to be completed by 12/30/2022.

The file for staff person #4 contains current fire safety training that was conducted greater than one year after the previous training.

The file for child #1 contains emergency contact information that is lacking health insurance coverage and policy number.

The water temp in the bathroom sinks and the infant diapering area sink exceeded 110° F.

Observed in the indoor play space peeling and chipping paint on the wall near the rest cots.

Observed exposed protruding bolts at the base of 2 of the toilets in the child restroom.

The file for child #1, older toddler, contains a current health report that was conducted greater than 12 months after the previous health report.

The file for child #1, older toddler, is lacking verification of a flu vaccine received during the year 2021.

Observed in the first aid kit in the play space packets of alcohol pads and antiseptic wipes that were not labeled with the name of the child for whom they were intended.

The file for staff person #3 contains an initial health assessment and TB test result that was conducted greater than 12 months prior to the start of employment in child care at the facility.

The file for child #2, preschool aged, contains an initial health report conducted greater than 60 days after the first day of attendance at the facility.

The file for staff person #2 does not contain an annual evaluation during the previous 12 month period.

There was not a written medical emergency transportation plan posted in the main child care space, or the play space or accompanying children who left on a walking excursion.

The file for staff person #3 contains only one of the required two written references.

The file for staff person #1 contains only 9 of the required 12 hours of child care training during the 12/19/2020 to 12/19/2021 time period.

2nd CITATION: The staff file for Staff person #3 contained a current health assessment dated 4/22/21 that lacked mention of an examination for communicable disease, the results of that examination, as well as lacked an assessment that the person is suitable to provide child care. PREVIOUSLY CITED ON 1/24/22

2ND CITATION: The staff file for Staff person #3, and Staff person #6, all lacked pediatric first-aid/CPR which is required to be completed within 90 days of hire. PREVIOUSLY CITED 1/24/22.

***At approximately 10:55am Staff person #5 was observed in the large motor skills room by herself with 11 children of mixed ages (1 young toddler, 6, older toddlers, and 4 preschool aged child).

*At approximately 10:55am Staff person #1 was observed in the large motor skills room by herself with 11 children of mixed ages (1 young toddler, 6, older toddlers, and 4 preschool aged child).

**At approximately 10:55am Staff person #5 was observed in the large motor skills room by herself with 11 children of mixed ages (1 young toddler, 6, older toddlers, and 4 preschool aged child).

At approximately 10:50am upon arrival at the facility Staff person #2 answered the door, walked to the large gross motor skill room where all the children were located. At that time Staff person #2 indicated that she was responsible for 2 older toddlers and 4 preschool aged children which meant Staff person #4 was not physically present with the children in their group when she was observed in the main child care room.

2nd CITATION: The wooden fence in the quiet area of the main child care room was observed to be splintering on the base nearest where the fence connects to the wall. Also on another part of the wooden fence, near the bottom, two screws used to hold the fencing together were protruding out causing a visible hazard. PREVIOUSLY CITED ON 1/31/22.

The staff file for Staff person #2, lacked a State Police clearance on file prior to working with children; a State Police clearance is on file dated 7/28/21 and there was no application of having applied prior working with children on file as required by the Child Protective Service Law (CPSL). The staff file for Staff person #2 also lacked a signed disclosure statement. The staff file for Staff person #3, contained a National Sex Offender Registry (NSOR) Certificate on file dated 7/27/21 which was not obtained within 45 days of hire. The staff file for Staff person #4, lacked a Child Abuse clearance and NSOR certificate on file prior to working with children; a Child Abuse clearance dated 8/31/21 and a NSOR certificate dated 7/27/21 are on file and there were no applications provided of having applied prior to working with children as required by the CPSL. The staff file for Staff person #5, lacked a Child Abuse clearance on file prior to working with children; a Child Abuse clearance dated 1/11/22 is on file and there was no documentation of having applied prior to working with children as required by the CPSL

At approximately 11:00am two Staff and nine young and older toddlers were observed in the lunch area. Staff person #1 was observed going into the kitchen, which is off of the lunch area, to prepare the children's lunches leaving Staff person #2 with nine young and older toddlers thus causing them not to be in compliance with staff:child ratos.

In the children's restroom a spray canister of ZEP Freshen Disinfectant labeled 'Keep Out of Reach of Children' was observed on the counter, to the right of the sink where children wash their hands, thus making it accessible to the children in care who use that restroom.

The gross motor room lacked a first-aid kit.

The wooden fence in the quiet area of the main child care room was observed to be splintering on the base nearest where the fence connects to the wall. Also on another part of the wooden fence, near the bottom, two screws used to hold the fencing together were protruding out causing a visible hazard.

The staff file for Staff person #5 lacked a valid health assessment; the DHS health form dated 9/15/21 on file was incomplete thus making it difficult to determine if a physical was conducted, if the individual is free of communicable disease, and able to provide child care. The staff file for Staff person #6, lacked a valid health assessment; the health assessment on file is dated 5/22/20 which was conducted more than 12 months prior to providing initial service in a child care setting. The facility file for Facility person #7, who has direct contact with children, lacked a health assessment.

The staff file for Staff person #6, contained a tuberculosis screening dated 5/22/20 which was conducted more than 12 months prior to providing initial service in a child care setting.

The staff file for Staff person #3 contained a current health assessment dated 4/22/21 that lacked mention of an examination for communicable disease, the results of that examination, as well as lacked an assessment that the person is suitable to provide child care.

Facility person #7 self reported that an emergency drill was conducted however the drill was not documented and on file at the facility.

The staff file for Staff person #1, lacked training in health and safety topics numbers 1-9 as listed in the regulation 3270.31(f) which was required to be completed by 6/17/21. The staff file for Staff person #3, Staff person #4, and Staff person #5, all lacked training in health and safety topics numbers 1-9 as listed in the regulation 3270.31(f) which was required to be completed within 90 days of hire.

The child file for Child #2 contained a financial agreement form that lacked the arrival and departure times.

The child file for Child #1 and Child #2 contained a financial agreement form that lacked the name(s) of the person(s) designated by a parent to whom the child may be released.

The child file for Child #1 contained an emergency contact information form that lacked the address of one of the individuals designated by the parent to whom the child may be released.

In the gross motor room, 9 children of mixed ages (4 young toddlers and 5 older toddlers) were observed to be receiving care in the space and their emergency contact information was not present in that child care space.

The staff file for Staff person #2, Staff person #3, Staff person #4, Staff person #5, and Staff person #6, all lacked pediatric first-aid/CPR which is required to be completed within 90 days of hire.