KinderCare Learning Center 1278

Staff person #1 was observed to be caring for children unsupervised. Staff person #1 has not completed the following pre- service training required prior to caring for children unsupervised: health and safety training topics, Pediatric First Aid and CPR, and mandated reporter training. Staff person #2 was observed to be caring for children unsupervised. Staff person #2 has not completed the following pre- service training required prior to caring for children unsupervised: health and safety training topics and mandated reporter training. Staff person #4 was observed to be caring for children unsupervised. Staff person #4 has not completed the following pre- service training required prior to caring for children unsupervised: Pediatric First Aid and CPR. Staff person #5 was observed to be caring for children unsupervised. Staff person #5 has not completed the following pre- service training required prior to caring for children unsupervised: health and safety training topics and mandated reporter training.

The file for staff person #2, hire date (see IS code sheet) contains a state police clearance that is missing the dissemination date and is therefore not valid and is lacking a completed NSOR verification. The file for staff person #6, hire date (see IS code sheet) contains a state police clearance that expired 5/28/25 and a child abuse clearance that expired 5/29/25 and is lacking current updated clearances. The file for staff person #10, hire date (see IS code sheet) is lacking an NSOR verification as required under CPSL for employment in a child care facility.

The files for staff persons # 1,5 and 11 contain documentation to serve as an aide. Observed staff persons #1,5 and 11 working with children unsupervised by at minimum an AGS with all requirements to care for children unsupervised.

A lack of sufficient artificial or natural lighting in the multi-aged classroom during naptime prevented the staff from adequately being able to see the children in care to assure their well-being.

Observed 2 preschool aged children to be alone in the Preschool 2 classroom with a speech therapist and no staff were present in the child care space. Staff person #2 who claimed the children in their supervision group was in the adjacent Preschool 1 classroom.

The wooden gate on the preschool playground which exits into the front parking lot bordering a busy street was not latched. The gate was able to open slightly allowing space for a small child to escape however an uneven ground surface prevented the gate from opening fully to allow an adult to exit.

Observed in the DP 2 classroom a plastic trash container that had visible stuck-on food particles and mold on the interior of the container.

On a low shelf in the unlocked Atrium bathroom, observed spray cleaners stating 'Keep out of reach of children' accessible to children. On an accessible shelf in an unlocked cabinet in the Multi--age classroom, observed disinfectant spray and glass cleaner labeled keep out of reach of children. Also observed disinfectant spray on an open classroom shelf. On the outdoor play spaces along the fence observed English Ivy and Virginia Creeper, both identified as toxic to humans. In an unlocked hallway closet by the front stairs observed bug spray and paint, both labeled keep out of reach of children.

Observed a corn plant on a high shelf in the DP1 classroom. Corn plants are identified as toxic to humans. On the outdoor play spaces along the fence observed English Ivy and Virginia Creeper, both identified as toxic to humans.

The water temperature at the sink in the bathroom in the downstairs multi-age classroom measured 120 degrees.

The first aid kit in the Muliti-age classroom contained a roll of gauze that was out of the package and therefore not sterile.

Observed in the Multi-age room a CD player / radio sitting in a high window with the cord hanging low and accessible to children causing a hazard if a child were to pull the cord. Observed the playground turf to be covered with twigs, leaves, acorns and weeds growing in the turf demonstrating that the playground surface is not being maintained for safety. Observed a protruding screw on a bulletin board by the circle time area in the Preschool room.

The waste receptacle by the classroom sink in the Multi-age classroom is lacking a lid.

The outside cellarway of the Preschool 2 emergency exit was used for storing unused or broken toys and equipment causing an obstruction to the exit. The exit ramp of the emergency exit from the Infant room was used to store unused equipment causing an obstruction to the exit. The large wooden gate to exit from the preschool side of the playground into the front parking lot was blocked by uneven ground. The gate would open far enough to allow a small child to escape but not allow a larger child or adult to exit.

Observed the playground climbing equipment on both the toddler and preschool playgrounds to be visibly dirty with debris and cobwebs. Observed a radio flyer trike on the toddler playground to have cracked plastic with a sharp edge. The hallway gate by the Todd B classroom was cracked with a sharp edge. The backside of the changing table in the Todd B room had cracked plastic and a protruding latch.

The Multi-age classroom was lacking a current mat list to identify which rest mat belonged to which specific child. Two infants were observed sleeping on the floor in the infant room.

Observed an infant sleeping in a crib which was beside a chair, shelf and rest mat therefore not allowing the required 2 feet of space on 3 sides of the crib.

The refrigerator in the Multi-age classroom was lacking an operable thermometer. The thermometer in the white refrigerator in the infant room read 55 degrees.

The file for child #1, young toddler, contains an updated health report that was obtained greater than 6 months after the previous health report. The file is now current.

The file for child #4, preschool aged, contains an updated health report that was obtained greater than 12 months after the previous health report. The file is now current.

The file for child #1 is lacking current HIB and Hep A immunizations as required by the ACIP. The file for child #2 is lacking current Hep A. Child #1 and #2 must be removed from care until current immunization status is received.

Alcohol antiseptic pads were present in first-aid bags in the Todd A, Todd B, Multi-age and Preschool rooms and lacked the name of the child for whom they were intended.

Observed staff persons #1, infant room, and #8, Todd A, did not immediately discard a soiled diaper during a diaper change.

Staff #1, infant room, did not clean the changing surface following a diaper change. According to staff in the Multi-age classroom and Preschool 1 classroom, children who wear pull-ups are changed standing up in the preschool bathrooms. The surface is not cleaned after each pull-up change.

Diaper changes in the Todd B room exceeded 2 hours between diaper changes as evidenced by staff person #11 stating that diapers had been changed at 9:00 am and would be changed again after the children ate lunch which was observed to be occurring at 11:30am.

The file for staff person #4 is lacking a staff health assessment and TB test results and was observed working with children in the Multi-age classroom.

Observed staff person #1 in the infant room did not wash their hands after changing a child's diaper.

Observed in the refrigerator in the Preschool 2 classroom open container of 1% milk that smelled spoiled.

The file for child #5 contains an initial health report that was received greater than 60 days after the first day of attendance at the facility. The file is now current.

Staff person #9 has not completed the following required pre- service training within 90 days of their date of hire (see LIS code sheet): Health and Safety training topics.

The files for staff persons #1, #5 and #11, observed serving as assistant group supervisors working unsupervised, are lacking qualifications to serve as assistant group supervisors.

The files for staff persons #6 and #7 are lacking an annual written evaluation completed during the previous 12 month period.

On the day of inspection there are 51 children enrolled and 48 children in attendance. The only staff person with group supervisor qualifications is serving as director. The facility is lacking a group supervisor for the first group of 45 children and is lacking a group supervisor for the additional partial group of 45 children.

According to staff interviews, the children are not taken outdoors daily.

The files for child #3 and #5 are lacking signed parental consent for emergency medical care for the child.

Emergency contact information was not present in the Todd A room for a young toddler receiving care in the child care space. Emergency contact information was not present in the Todd B room for 4 young toddlers receiving care in the child care space.

A written plan identifying the means of transporting a child to emergency care was not posted in the DP 1 classroom.

The files for children #1,2,4 and 5 contain current emergency contact forms and financial agreements that were updated greater than 6 months after the previous update. The files are now current.

The files for child #1,4 and 5 are lacking timely initial or updated health reports. The files are now current.

The files for children #3 and #5 contain emergency contact forms that are lacking signed parental consent for administration of minor first-aid procedures by facility staff.

The files for staff persons #3 and #8 are lacking 2 non-family reference letters.

The file for staff person #6 contains only 9 of the required 12 annual training hours completed during the period 12/2023 to 12/2024.

2ND CITATION: The first-aid kits in the Discovery 1 and Pre-K classrooms were lacking tweezers. PREVIOUSLY CITED ON 1/15/25

2ND CITATION: The toilet in the Discovery 2 bathroom had exposed protruding bolts at the base. PREVIOUSLY CITED ON 1/15/25

2ND CITATION: The file for child #3, preschool aged, is lacking an updated health report in the previous 12-month period. PREVIOUSLY CITED ON 1/15/25

2ND CITATION: The files for staff persons #2,3,5 and 6 are lacking documentation of fire safety training completed during the previous 12-month period. PREVIOUSLY CITED ON 1/15/25

2ND CITATION: Staff persons #2,3,5 and 6 have not received written evaluations during the previous 12-month period. PREVIOUSLY CITED ON 1/15/25

2ND CITATION: On 3/7/2025 at 8:35am observed staff person #1 caring for 7 older toddler children in the Discovery Preschool 1 room. At 8:45am observed staff persons #2 and #3 caring for 25 preschool aged children in the downstairs Multi-age B classroom. PREVIOUSLY CITED 10/30/2024.

Based on staff interviews, there were 30 preschool children receiving care in the downstairs multi-aged classroom which has a capacity of 29.

Based on staff interviews, staff will take a baby into the kitchen or into the office with them when classrooms are over ratio. The office and kitchen are not licensed child care spaces.

Based on staff interviews, staff will sometimes hold a baby while preparing meals in the kitchen which contains an oven and stove top, heat sources over 110° F.

It was self-reported and verified through staff's written statements that staff person #1 restrained a child when staff #1 lay her body across a child preventing the child from moving.

Staff person #1 was observed to be caring for children unsupervised. Staff person #1 has not completed the following pre- service training required prior to caring for children unsupervised: Mandated reporter training.

The file for staff person #1, hire date (see IS code sheet), contains a criminal history clearance dated 2/28/2024 obtained for the purpose of volunteer which is not valid for employment in child care under CPSL.

The files for staff persons #1, hire date (see IS code sheet) and #4, hire date (see IS code sheet) are lacking signed, dated and witnessed disclosure statements as required under CPSL.

Observed the outlet below the small refrigerator in the Pre-K room is lacking a protective cover. Children 5 and under receive care in the pre-K room.

The hot water in the downstairs pre-k bathroom measured 115 degrees.

The first-aid kits in the Discovery 1 and Pre-K classrooms were lacking tweezers.

The toilet in the Discovery 2 bathroom had exposed protruding bolts at the base. The 2 toilets in the downstairs preschool rooms were not operational.

The Pre-k bathroom with the sink was lacking a lidded waste receptacle.

The rest cots used by the children in the preschool room were numbered however there was no list identifying which individual child was to use which rest cot.

Observed in the pre-k room a refrigerator that was unplugged and identified by staff as being non-operable.

The file for child #3, preschool aged, is lacking an updated health report in the previous 12-month period.

The file for child #2, age 6 months, is lacking an immunization report and has been in attendance for greater than 60 days. Child #2 must be removed from care.

The files for staff persons #2 and #3 contain current health assessments that were conducted greater than 24 months after the previous health assessment.

The operator is lacking documentation to verify that an emergency drill has been conducted during the previous 12-month period.

The fire drill log identifies that fire drills were conducted on 9/13/2024 and 11/20/2024, exceeding 60 days between fire drills.

The fire alarm test log identifies alarm tests were conducted on 9/13/24, 11/20/24 and 12/23/24 exceeding 30 days between alarm tests.

The operator has not sent an updated emergency plan to the county emergency management agency and the local municipality.

The file for child #2 is lacking an initial health report within 60 days of the first day of attendance.

The facility is lacking any verification that the local traffic safety authorities had been notified in writing within the previous 12 months of the location of the facility and the program's use of pedestrian and vehicular routes around the child care facility

The files for staff persons #2,3,5 and 6 are lacking documentation of fire safety training completed during the previous 12-month period.

Staff persons #2,3,5 and 6 have not received written evaluations during the previous 12-month period.

The file for child #1 included emergency contact information that was lacking written consent by a parent for emergency medical care.

Emergency contact information was not available in the Discovery 1 room for children #4. 5.6.7 and 8 who were observed being cared for in the Discovery 1 room.

The file for child #1 is lacking signed parental consent for administration of minor first-aid procedures.

The file for staff person #2 contains only 4 of the required 12 hours of child care training between 12/19/23 and 12/31/24. The file for staff person #3 contains only 3 of the required 12 hours of child care training between 12/19/23 and 12/31/24. The file for staff person #5 contains only 1 of the required 12 hours of child care training between 9/6/23 and 9/30/24. The file for staff person #6 contains only 1 hour of child care training between 3/27/23 and 3/31/24.

**On 10/30/24 between 8:15am and 9:30am the following noncompliance with staff: child ratios was observed; At 8:15am staff person #1 was observed supervising 5 infants alone in the infant room. At 8:35am staff person #2 was observed supervising 7 older toddlers alone in the Discovery Preschool 2 room. At 8:45am staff persons #3 and #4 were observed supervising 13 young toddlers in the Toddler A room. Based on staff interviews, staff persons #5 and #6 were supervising 21 preschool children in the Pre-K room for ~5 minutes until staff person #7 arrived at 8:45am. At 9:30am staff persons #3 and #8 were observed supervising 13 young toddlers in the Toddler A room.

On 10/30/24 between 8:15am and 9:30am the following noncompliance with staff: child ratios was observed; At 8:15am staff person #1 was observed supervising 5 infants alone in the infant room. At 8:35am staff person #2 was observed supervising 7 older toddlers alone in the Discovery Preschool 2 room. At 8:45am staff persons #3 and #4 were observed supervising 13 young toddlers in the Toddler A room. Based on multiple staff interviews, staff persons #5 and #6 were supervising 21 preschool children in the Pre-K room for ~5 minutes until staff person #7 arrived at 8:45am. At 9:30am staff persons #3 and #8 were observed supervising 13 young toddlers in the Toddler A room.

*On 10/30/24 between 8:15am and 9:30am the following noncompliance with staff: child ratios was observed; At 8:15am staff person #1 was observed supervising 5 infants alone in the infant room. At 8:35am staff person #2 was observed supervising 7 older toddlers alone in the Discovery Preschool 2 room. At 8:45am staff persons #3 and #4 were observed supervising 13 young toddlers in the Toddler A room. Based on staff interviews, staff persons #5 and #6 were supervising 21 preschool children in the Pre-K room for ~5 minutes until staff person #7 arrived at 8:45am. At 9:30am staff persons #3 and #8 were observed supervising 13 young toddlers in the Toddler A room.

Staff persons #2 was observed to be caring for children unsupervised. Staff persons #2 has not completed the following pre-service training required prior to caring for children unsupervised: PFA/PCPR conducted by a PQAS certified instructor.

The file for staff person #1, hire date (see IS code sheet) is lacking verification that the NSOR was requested prior to start date in a childcare position. The file does contain a completed NSOR verification. The file for staff person #2, hire date (see IS code sheet) is lacking a child abuse clearance and is lacking verification that the NSOR was requested prior to start date in a childcare position. The file does contain a current NSOR verification. Under CPSL Staff #2 may not work in a child care position until a child abuse clearance is obtained.

Staff persons #1 and #2 are lacking documentation of emergency plan training within 90 days of start date. They do have current training regarding the emergency plan.

Observed electrical outlets lacking protective covers in the preschool room on the wall with windows, in the Atrium and in the hallway by the office. These areas are accessible to children age five and under.

Children were observed receiving care in the pre-k room. The kitchen door was left open allowing the preschool children access to the kitchen. Through the kitchen the mechanical door was left open allowing the preschool children access to the mechanical room. Observed a variety of cleaning supplies labeled keep out of reach of children in the mechanical room accessible to children since the kitchen and mechanical doors were left open.

Children were observed receiving care in the pre-k room. The kitchen door was left open allowing the preschool children access to the kitchen where a stove is located and used for preparing meals. Observed in the hallway by the office a parent coffee station located on a low shelf accessible to children. The coffee pot and contents exceeded 110 degrees.

The fire drill log identified that the most current fire drills were conducted on 7/5/2024 and 9/13/2024, exceeding 60 days between fire drills.

Staff person #2 has not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): Pediatrics First Aid Pediatrics CPR with a PQAS certified trainer.

Staff person #1 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.

The file for Staff #2, who has been employed for several years, lacked any Emergency Plan training.

Staff person #1 has not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): (Health and Safety Basics).

Based on conversations with staff, child #1 received emergency room treatment on 5/15/24 and the appropriate regional office was not notified.

The file for staff person #3, hire date (see IS code sheet), is lacking an NSOR verification as required to work in a child care position under CPSL.

Observed in the preschool room on the back wall 2 electrical outlets lacking protective covers and accessible to children ages 5 and under. Also observed in the Pre-K room near the lunch tables 2 electrical outlets lacking protective covers and accessible to children ages 5 and under.

Observed cleaner labeled keep out of reach of children in an unlocked cabinet in the preschool room and accessible to children, Observed in the Pre-k room multi-purpose cleaning spray labeled keep out of reach of children sitting on a low shelf and accessible to children. Also observed hand sanitizer, labeled keep out of reach of children, on a shelf within reach of the children in care.

Observed a vent cover on the wall behind the trash in the Pre-K room to be rusted with peeling paint.

Observed 3 infants sleeping in cribs that did not have 2 feet of space on three sides of the cribs.

The files for child #1 and child #3, both preschool aged, are lacking health reports conducted during the previous 12-month period.

The file for staff person #2 is lacking an initial health report. The file for staff person #4 contains an initial health report that was conducted more than 12 months prior to providing initial care and is therefore not valid.

The file for staff person #4 contains documentation of TB screening conducted greater than 12 months prior to the start date caring for children and is therefore not valid.

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 / Pediatric CPR approved curriculum with a PQAS certified trainer.

The file for staff person #1, serving as an assistant group supervisor, is lacking the required 2 years of child care experience to qualify as an AGS. Staff #1 may serve as an Aide until documentation of experience is obtained.

The file for child #2 was lacking signed parental consent for emergency medical care for the child.

The file for child #2 is lacking signed parental consent for administration of minor first-aid procedures.

**On 9/5/2023 at 8:14am staff persons #1 and #2 were observed to be caring for 11 young toddlers in the Toddler A room. At 8:15 a 12th young toddler also arrived. The staff child ratio was exceeded for approximately 5 additional minutes until staff person #3 arrived and took 4 of the young toddlers into her supervision group and left the room. Observed staff #3 escorting 4 young toddlers from the Toddler A room across the Atrium to the Toddler B room. Staff #3 entered the Toddler B room with 3 children and closed the door leaving 1 young toddler, who was lagging behind, alone in the Atrium. Cert rep waited approximately 10 seconds and then knocked on Toddler B door to inform Staff #3 of the child in the Atrium. Staff #3 was not aware that a child was left behind.

*On 9/5/2023 at 8:14am staff persons #1 and #2 were observed to be caring for 11 young toddlers in the Toddler A room. At 8:15 a 12th young toddler also arrived. The staff child ratio was exceeded for approximately 5 additional minutes until staff person #3 arrived and took 4 of the young toddlers into her supervision group and left the room. Observed staff #3 escorting 4 young toddlers from the Toddler A room across the Atrium to the Toddler B room. Staff #3 entered the Toddler B room with 3 children and closed the door leaving 1 young toddler, who was lagging behind, alone in the Atrium. Cert rep waited approximately 10 seconds and then knocked on Toddler B door to inform Staff #3 of the child in the Atrium. Staff #3 was not aware that a child was left behind.

According to documentation on the facility Child Supervision Report and staff interviews, on 9/5/2023 staff person #1 was over ratio with 5 young toddlers and 1 older toddler until staff #4 arrived at 7:15am. Also, Staff #1 and staff #4 were over ratio with 10 young toddlers and 3 older toddlers until staff #2 arrived at 7:45am.

*Observed staff #1 escorting 4 young toddlers from the Toddler A room across the Atrium to the Toddler B room. Staff #1 entered the Toddler B room with 3 children and closed the door leaving 1 young toddler, who was lagging behind, alone in the Atrium. Cert rep waited approximately 10 seconds and then knocked on Toddler B door to inform Staff #1 of the child in the Atrium. Staff #1 was not aware that a child was left behind.

**Observed staff #1 escorting 4 young toddlers from the Toddler A room across the Atrium to the Toddler B room. Staff #1 entered the Toddler B room with 3 children and closed the door leaving 1 young toddler, who was lagging behind, alone in the Atrium. Cert rep waited approximately 10 seconds and then knocked on Toddler B door to inform Staff #1 of the child in the Atrium. Staff #1 was not aware that a child was left behind.

Observed staff #1 escorting 4 young toddlers from the Toddler A room across the Atrium to the Toddler B room. Staff #1 entered the Toddler B room with 3 children and closed the door leaving 1 young toddler, who was lagging behind, alone in the Atrium. Cert rep waited approximately 10 seconds and then knocked on Toddler B door to inform Staff #1 of the child in the Atrium. Staff #1 was not aware that a child was left behind.

Observed a section of the baseboard in the Transition Kindergarten room to be detached from the wall and observed the exposed area of wall to be crumbling and visible mold.

Observed a section of the baseboard in the Transition Kindergarten room to be detached from the wall and observed the exposed area of wall to be crumbling and visible mold.

Staff person #9 was observed to be caring for children unsupervised. Staff person #9 has not completed the following pre-service training required prior to caring for children unsupervised: Health & Safety training topics #1-#9. (Staff person #9 completed Health & Safety Getting Started with Home Based Care which is not an acceptable training for employment in a child care center.)

The file for staff person #1, provisional hire date (see IS code sheet), is lacking a completed NSOR within 90 days of hire. The clearance is now current. The file for staff person #3, hire date (see IS code sheet), contains a signed disclosure statement that is lacking a date. The file for staff person #4, provisional hire date (see IS code sheet), is lacking verification of FBI fingerprinting prior to start date and is lacking a child abuse clearance prior to start date as required for provisional hire under CPSL. The clearances are now current. The file for staff person #5, hire date (see IS code sheet), who has resided in New York in the past 5 years, is lacking New York State clearances and contains a signed disclosure statement that is not dated. The file for staff person #7, provisional hire date (see IS code sheet), is lacking verification of fingerprinting and NSOR request prior to start date and is lacking a completed child abuse clearance prior to start date as required for provisional hire under CPSL. The file is now current. The file for staff person #9, provisional hire date (see IS code sheet), contains a signed disclosure statement that is not dated and contains an…

The file for staff person #1is lacking verification of emergency plan training within 90 days of hire. The file does contain current emergency plan training. The file for staff person #10 is lacking current emergency plan training.

The letter provided to parents regarding the facility emergency plan is lacking procedures for a lockdown and accommodations for toddlers during an emergency.

Observed cleaning supplies labeled 'keep out of reach of children' stored on a low shelf in the unlocked Atrium bathroom to be accessible to children in care.

Observed a small wooden table in the Discover Preschool 2 room and Toddler A room to have exposed and protruding bolts under the table causing a hazard to children who may be crawling under the table.

The refrigerator in the Toddler B room is lacking a thermometer.

The files for child #10, an infant, is lacking any health reports.

The files for children #2 and 3 contain current health reports that were conducted greater than 12 months following the previous health report. They are now current. The files for children #5 and #8 are lacking a health report.

The files for children #1,2,3,4,5,6 and 9 are lacking verification of a flu vaccine received during the year 2022. The file for child #9 is lacking verification of a Hep A vaccine. The file for child #8 is lacking an immunization report. Children #1,2,3,4,5,6,8 and 9 must be removed from care until documentation of up to date immunizations or an exemption letter is received.

The files for staff persons #4 and #7 are lacking initial health assessments that were conducted prior to start date but do contain current health assessments. The file for staff person #2 contains a current health assessment that was conducted greater than 24 months after the previous health assessment but is now current. The files for staff persons #8 and #13 are lacking health assessments completed during the previous 24 month period. The file for staff person #9 contains a current health assessment with a physician's statement affirming a communicable disease but does not contain an explanation as to the effect of this on the person's employment in child care. The file for staff person #14 is lacking a health assessment.

The files for staff persons #4 and #7 are lacking verification of a TB test prior to start date in a child care position but do contain a current TB test. The file for staff person #14 is lacking verification of a TB test.

The files for children #5,8,9 and 10 are lacking initial health reports conducted within 60 days form the first date of attendance. The file for child #9 does contain a current health report.

Staff person #2 has not completed the Pennsylvania Health & Safety Update 2022 which was required to be completed by 12/30/2022.

The files for staff persons #2,8,10, and 13 are lacking fire safety training completed during the previous 12 month period.

The files for staff persons #4 and #12, both serving as AGS are lacking verification of 2500 hours of child care experience. The file for staff person #14, serving as an AGS, is lacking verification of a high school diploma.

The files for staff persons #2, #8 and #10 contain current staff evaluations that were completed greater than 12 months after the previous evaluation.

The files for children #1, #6 and #8 are lacking admission dates.

The files for children #1, #3, #4 and #8 contain emergency contact information that is lacking signed parental consent for emergency medical care.

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

Emergency contact information was not available for child #11 and child #12 who were observed receiving care on the toddler playground.

The files for children #1,2,4,5,6,7,8,9 and 10 contain current emergency contact information that was updated greater than 6 months after the previous update. The files for children #2,3,4,5,7,8,9 and 10 contain current financial agreement information that was updated greater than 6 months after the previous update. The files are now current.

The files for children #1.3.4.and 8 are lacking signed parental consent for administration of minor first aid procedures.

The file for staff person #5 is lacking 2 written references.

At approximately 11:00am on 2/22/2023 it was observed that staff person #1 was supervising 10 preschool aged children in the downstairs 'Transition Kindergarten' room when a preschool aged child from the 'Preschool' room next door entered the 'TK' room to wash his hands after using the rest room, putting staff person #1 over ratio with 11 preschoolers.

*At approximately 11:00am on 2/22/2023 it was observed that a preschool aged child, after using the 'Preschool' room rest room, left the 'Preschool' room to wash his hands in the sink in the 'Transistional Kindergarten' room. While he was washing his hands, staff persons #2 and #3 who had previously claimed the child in their supervision group, remained in the 'Preschool' room, where they were not physically present with the child and could not see, hear, direct or assess the child.

***At approximately 11:00am on 2/22/2023 it was observed that a preschool aged child, after using the 'Preschool' room rest room, left the 'Preschool' room to wash his hands in the sink in the 'Transistional Kindergarten' room. While he was washing his hands, staff persons #2 and #3 who had previously claimed the child in their supervision group, remained in the 'Preschool' room, where they were not physically present with the child and could not see, hear, direct or assess the child.

**At approximately 11:00am on 2/22/2023 it was observed that a preschool aged child, after using the 'Preschool' room rest room, left the 'Preschool' room to wash his hands in the sink in the 'Transistional Kindergarten' room. While he was washing his hands, staff persons #2 and #3 who had previously claimed the child in their supervision group, remained in the 'Preschool' room, where they were not physically present with the child and could not see, hear, direct or assess the child.

At approximately 11:00am on 2/22/2023 it was observed that a preschool aged child, after using the 'Preschool' room rest room, left the 'Preschool' room to wash his hands in the sink in the 'Transistional Kindergarten' room. While he was washing his hands, staff persons #2 and #3 who had previously claimed the child in their supervision group, remained in the 'Preschool' room, where they were not physically present with the child and could not see, hear, direct or assess the child.

Observed that in the downstairs preschool classroom there is not a sink in or near the toilet area.

The facility fire alarm test log identified that a fire alarm test had not been conducted during the previous 30 days.

Staff person #4 has not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): Pennsylvania Health & Safety Update 2022.

The file for staff person #1, hire date (see IS code sheet) is lacking the required Pennsylvania Health and Safety Update 2022 by the required compliance date of 12/30/2022.

Staff person #1 has not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): Pediatric first aid / pediatric CPR

Staff person #1 has not completed the mandated reporter training within 90 days of their date of hire (see LIS code sheet).

Based on information obtained during staff interviews, staff persons #1 and #2 were unable to see child #1 on the stairway due to staff #1 having left the stairway and entered the classroom while at the front of the group of 22 children and staff #3 still being in the hallway and not yet entering the stairway while at the rear of the group of 22 children. During the time that child #1 was not supervised by staff #2 or #3, child #1 fell down several stairs and broke his/her arm.

Based on information obtained during staff interviews, staff persons #1 and #2 were unable to see child #1 on the stairway due to staff #1 having left the stairway and entered the classroom while at the front of the group of 22 children and staff #3 still being in the hallway and not yet entering the stairway while at the rear of the group of 22 children. During the time that child #1 was not supervised by staff #2 or #3, child #1 fell down several stairs and broke his/her arm.

The file for staff person #4 contains child abuse clearance that expired 10/5/2021, criminal history clearance that expired 10/7/2021 and FBI clearance that expired 10/6/2021 and contains updated clearances child abuse dated 11/15/2021, criminal history dated 11/15/2021 and FBI dated 11/17/2021 all updated more than 60 months after the previous clearances. The file is now current.

The files for staff persons #1and #17 are lacking training regarding the facility emergency plan at the time of initial hire. The files for staff persons #4, #7,#8 and #9 contain current emergency plan training that was conducted more than 12 months after the previous training. The files are now current.

The water at the sink in the school age bathroom exceeded 110 degrees.

Observed in the Toddler A room a torn window screen.

Observed in the Toddler B room a hole in the wall with tape partially covering the hole. Observed in the pre-k and preschool rooms walls are dirty with peeling paint and general poor repair.

Observed in the school age room that the 2 bathrooms and classroom sink were visibly dirty.

Observed in the Pre-K room a blue children's sofa with torn vinyl exposing the interior foam and wooden frame.

Observed in the Toddler B room the rest cots were not labeled with the individual names of the children using them.

The refrigerators in the preschool room and the school age room are lacking thermometers.

Observed in the preschool, pre-k and school age rooms Styrofoam plates and bowls used to serve the children meals.

The file for child #1, a young toddler, is lacking a health report completed during the previous 6 month period.

The files for child #3,4,6 and 10, all preschool age, are lacking updated health reports during the previous 12 month period.

The files for child #2, 7, 8 and 9 are lacking immunization reports and have been enrolled for greater than 60 days.

The files for child #1, young toddler age, and 4,6,and 10, preschool age, are lacking documentation of current immunization status as required by ACIP.

The files for staff persons #4,5,6,7,8,and 9 contain current health assessments that were completed greater than 24 months after the previous health assessments. The files are now current.

The files for child #2,7,8 and 9 are lacking initial health reports and have been enrolled for greater than 60 days.

The files for staff persons #13 and #14 contain expired PFA/PCPR training and updated training that does not meet the acceptable curriculum and PQAS trainer requirements and is therefore not valid. The files for staff persons #4, #15 and #16 contains valid PFA/PCPR training that was completed after the expiration date of the previous training. The training is now current and valid.

The files for staff persons #4, #7, #8 and #9 contain current fire safety training that was conducted more than 12 months after the previous training.

The files for staff persons #2,3,8,9,10.12.13 and 14 contain training in the first 9 of the required health and safety topics completed greater than 90 days following hire.

The file for staff person #2 contains mandated reporter training completed greater than 90 days after hire. The file for staff person #4 contains current mandated reporter training completed greater than 60 months after the previous mandated reporter training. The files are now current.

There was no written plan of daily activities posted in the school age room.

The files for child #1,2,4,5,6,7,8,9 and 10 all contain the original agreement.

Observed in the pre-k and school age rooms that there was no emergency transportation plan posted in the child care spaces.

The files for child #1,2,4,7,8,9 and 10 contain current emergency contact information that was updated more than 6months following the previous update. The files are now current.

The files for staff persons #3,6,7,8,9,13 and 14 are lacking an approved pediatric first aid / pediatric CPR training using an approved curriculum by a PQAS approved trainer and have exceeded 90 days since hire. The file for staff persons #1, #2,#10 and #17 contain PFA/PCPR training conducted greater than 90 days after hire but is now valid.