Metropolitan Preschool and Nursery-Warner Center

Previously cited on 4/4/25. Due to repeated citations under 3270.113(a)(1), provider was required to provide a plan of correction, which included random weekly supervision checks in each room for a period of four months (6/6/25-9/27/25). During an unannounced monitoring conducted on 9/29/25 to verify corrections, it was observed that weekly supervision checks were not conducted/documented during the following weeks: (6/8-6/14, 6/22-6/28, 8/3-8/16, 8/24-9/20).

Staff person #4 was observed to be caring for children unsupervised in Room #2. Staff person #4 has not completed the following pre-service training required prior to caring for children unsupervised: Pediatric First Aid/CPR in an approved curriculum from a certified PQAS instructor.

The most recent Child Abuse Clearances in the file for Staff Person #1 exceeded 60 months between clearances. The State Police, FBI Clearances and NSOR Certificate in the file for Staff Person #3 were acquired more than 45 days after the staff person's first day working in childcare (See LIS Code Sheet).

On 4/24/25 at 1:00 PM, Staff Person #5 was supervising 7 OT/PS children in Room 6 at naptime. Staff Person #5 could not identify three of the children in care by name.

The childproof latches were not functioning properly on four electrical outlets in Room 4, four electrical outlets in the gym, and six electrical outlets in Room 5. These outlets also lacked protective receptacle covers.

Observed damaged and missing ceiling tiles above the toilet in the bathroom for Room 7 and a hole in the ceiling above the toilet in the bathroom outside Room 7. This exposed flaking drywall and drainpipes above. Also observed a rusty drainpipe with a cracked lid next to the toilet in the bathroom for Room 7.

Observed peeling paint on the purple wall in Room 2 entrance to carpeted area.

Observed a clothes shelf separating, which creates a potential pinch hazard, in Room 4. Observed a wobbly shelf, which creates a toppling hazard, in Room 7.

The refrigerator in Room 2 lacked an operating thermometer.

The most recent health reports in the file for Child #3, a preschool child, exceeded 12 months between reports.

The most recent health assessments in the file for Staff Person #2 exceeded 24 months between assessments.

The initial health reports in the files for Child #1 and Child #6 were conducted more than 60 days after the child's first day in attendance.

Observed a loose-fitted sheet in one pack n play in Room #1.

The file for Staff Person #4 contains a foreign degree that has not been translated/evaluated by an approved accreditation agency.

The most recent child service reports in the file for Child #3 exceeded six months between reports.

The emergency contact binder in the gym did not include an emergency contact form for Child #3 who was receiving care in this area.

The most recent parent updates for the emergency contact forms and fee agreements in the files for Child #1, 3, 4, 5 and 6 exceeded six months between updates. The initial parent updates for the emergency contact form and fee agreement in the file for Child #2 were conducted more than six months after the child's first day in care.

Staff Person #1 was observed on video surveillance to forcefully place Child #1 into a highchair for "time out purposes". Staff Person #1 was observed to walk past Child #1 in the highchair and aggressively push the child's leg/foot as they walked past the child. Staff Person #1 was observed to aggressively push Child #1's arm away after the child pulled a bin from the changing area to the floor. Staff Person #1 then forcefully pushed the highchair the child was seated in forward.

Staff Person #1 was observed on video surveillance to place Child #1 in a highchair "for time out purposes" from 9:15am until 11:48am. The child was only removed from the highchair for one diaper change and one diaper check during this time.

Staff Person #1 was observed on video surveillance to aggressively place Child #1 into a highchair for "time out purposes". The child was strapped into the highchair from 9:15am to 11:48am. The child was only removed from the highchair for one diaper change and one diaper check during that time.

At approximately 9:45am Staff Person #1 and #2 were observed to be caring for 11 older toddlers in Classroom #7. Staff each identified being responsible for 5 children. This information was also listed on a dry erase board in the classroom. This left 1 child who had not been assigned to a specific staff person.

Staff Person #1 was observed to change Child #1's diaper and did not ensure that the child's hands were washed following the diapering change.

Based on conversation with staff, it was determined that Staff Person #1 was not actively supervising Child #1 on 9/11/24 at 11:00 AM in Room #3. The staff person's back was turned away when Child #1 fell and bumped his head. Staff Person #1 was unaware the incident occurred until it was brought to Staff Person's attention by Director who reviewed the incident on video.

The file for Staff Person #1 did not include application for or documentation of a State Police Clearance. The status of the State Police Clearance in the file for Staff Person #3 was "Under Review". The file for Staff Person #4 lacked a receipt for fingerprinting and an FBI Clearance.

The file for Staff Person #2, who has been working in child care for more than 90 days (See LIS Code Sheet), did not include documentation of initial training in the facility's emergency plan.

Observed ceiling tiles, discolored from water damage, in the Young Toddler Room.

The initial health assessment in the file for Staff Person #1 did not include an examination for communicable diseases and the results of that examination or the physician's or CRNP's assessment of the person's suitability to provide child care.

Based on conversation with staff, the infants and young toddlers in care and staff responsible for these children did not participate in the fire drills conducted on 7/26/24 and 8/30/24 due to inoperability of evacuation strollers.

Based on conversation with staff, the infants and young toddlers in care and staff responsible for these children did not exit the building during the fire drills conducted on 7/26/24 and 8/30/24 due to inoperability of evacuation strollers.

Based on conversations with staff, the infants and young toddlers had not been taken outdoors from mid-June through the end of September, 2024 due to some of the strollers being stollen and the other strollers not functioning properly.

The file for Staff Person #1, an Aide, included documentation of only 1.5 years child care experience.

The file for Staff Person #1 lacked two reference letters.

2nd CITATION. Previously cited on 4/9/24. On 5/20/24 at 11:00 AM, Staff Person #1 was supervising 8 Preschool Children in Room #8. When asked to identify the children, Staff Person #1 could only name seven of the eight children in care. Staff Person #1 did not know the name of Child #1. Staff Person #1 stated that child had recently started, and he did not have a card for Child #1.

The file of staff #3, a Childcare Careers contracted provider, was not available on the day of the inspection making it unable to determine they had the required CPSL paperwork to care for children.

**At approximately 10:08 am, 20 preschool children were being cared for in Room 4/Preschool. When asked to identify their primary supervisory group, staff #1 identified 7 preschool children. When staff #2 was asked, they stated they were unable to name their group at this moment as they are covering the classroom because a preschool staff called off. Staff #2 had a group size of 13 preschool-age children, exceeding the 1:10 staff to child ratio by 3 children. At approximately 10:38, staff #1 was observed to be taking 7 preschool age children to the indoor play space leaving staff #2 in Room 4/Preschool with 13 children between 3 and 5 years of age, once again exceeding the staff to child ratio of 1:10 by 3 children.

*At approximately 10:08 am, 20 preschool children were being cared for in Room 4/Preschool. When asked to identify their primary supervisory group, staff #1 identified 7 preschool children. When staff #2 was asked, they stated they were unable to name their group at this moment as they are covering the classroom because a preschool staff called off. Staff #2 had a group size of 13 preschool-age children, exceeding the 1:10 staff to child ratio by 3 children. At approximately 10:38, staff #1 was observed to be taking 7 preschool age children to the indoor play space leaving staff #2 in Room 4/Preschool with 13 children between 3 and 5 years of age, once again exceeding the staff to child ratio of 1:10 by 3 children.

At approximately 10:08 am, 20 preschool children were being cared for in Room 4/Preschool. When asked their primary supervisory group, staff #1 identified 7 preschool children. When staff #2 was asked, they stated they were unable to name their group at this moment as they are covering the classroom because a preschool staff called off. Staff #2 was not able to name the 13 preschool age children in the primary supervision group.

The facility did not present a current annual fire detection inspection conducted within the past 12 months at the time of the inspection.

The file of staff #3, a Childcare Careers contracted provider, was not available on the day of the inspection.

In Room #2, observed loose-fitting sheet in the Pac n Play for Child #1. In Room #4 and Room #8, observed dangling TV and CD player cords, which create an entanglement hazard. Observed in ROOM 6: Drawer beside sink was not locked. The drawer contained a stapler, which was accessible to children. Drawer could also be pulled all the way out, which creates a toppling hazard. Also observed a pair of adult scissors on a low cabinet, which were accessible to children.

The parent letter regarding the facility's emergency plan did not include accommodations for infants, toddlers, children with disabilities, and children with chronic medical conditions.

In Room #4, observed thick dust buildup on the mounting behind the TV. In Room #5, observed wobbly toy shelves, which create a toppling hazard. The electrical outlet box in the gym was separating from the wall. The thermostat in Room #8 was not covered.

Observed in Room #4, flaking plaster from a hole where kitchen play set had been nailed to the wall. Observed in Room #5, peeling paint on the cabinet under the sink and next to the diaper changing table.

The sink where toddlers wash their hands in Room #1 was not easily approached by the stepstool they were using.

A handwashing sign was not posted in the first toilet stall in the Preschool/SA Restroom.

Observed a nail protruding from the kitchen play set in Room #4. The playset had separated from the wall where it was mounted.

Observed less than two feet of space on three sides of the cot where Child #2 was sleeping in Room #2

The most recent updated health reports in the files for Child #4 and #5, preschool children, exceeded 12 months between reports. The file for Child #3, a preschool child, did not include an updated health report conducted within the past 12 months.

The most recent health assessments in the file for Staff Person #1 exceeded 24 months between assessments.

The initial health report in the file for Child #1 was conducted more than 60 days after the child's first day in care.

The most recent fire safety trainings in the files for Staff Person #1 and #2 exceeded 12 months between trainings.

The Pediatric CPR/First Aid Certification in the file for Staff Person #4 was conducted more than 90 days after the staff person's first day in child care (See LIS Code Sheet).

The file for Staff Person #3, who has been working for more than 12 months, did not include a written evaluation (See LIS Code Sheet).

The daily activity schedule was not posted in Room #2 (Toddler Room). The Toddler daily activity schedule was posted in Room #1 (Infant Room).

The most recent Child Service Reports in the file for Child #4 exceeded 6 months between reports. The file for Child #5 did not include a Child Service Report conducted within the past 6 months.

Staff person #1 and #2 were observed to be caring for children unsupervised. Staff person #1 and #2 have not completed the following pre-service training required prior to caring for children unsupervised: Pediatric First Aid/CPR.

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.

Previously cited on 4/4/22, SIN-00221877. On 5/31/23, at 8:00 AM, Staff Person #1 and #2 were providing care for a mixed group of ten children: 2 Infants, 5 Younger Toddlers, and 3 Older Toddlers.

Due to one staff call-off and another staff late, the following non-compliance with similar and mixed aged levels was observed on 4/4/23 between 9:00-9:30 AM. When Cert Rep arrived on 4/4/23 at approximately 9:00 AM, Staff Person #1 left the Infant Room for approximately one minute to sign in a preschool child who was being dropped off by a parent. This left Staff Person #2 alone in the Infant Room supervising 5 infants and 4 young toddlers. When Staff Person #1 returned to the Infant Room, the following rooms were over ratio from approximately 9:01 until 9:30: Infant Room: Staff Person #2 was supervising 5 infants. Preschool Room: Staff Person #3 was supervising 11 preschool children. Staff Person #4 was supervising 9 preschool children and three older toddlers. It is unknown how long rooms were over ratio prior to 9:00 AM.

The first aid kit in the toddler room lacked scissors and soap.

Observed dirt and debris under the mat of the diaper changing table in the toddler room.

The cots in the toddler room and preschool room were not labeled.

Observed less than 2 feet of space on three sides of the cots in the preschool room where children were napping.

The file for Child #1, an infant, did not include an updated health report conducted within the past 6 months.

The most recent updated health report in the file for Child #7 did not include a statement that the child is able to participate in child care and appears to be free from contagious or communicable disease.

The most current immunization records in the files for Child #5 and #6 did not include documentation of a flu shot administered within the past year or a letter of exemption from the parent or physician. The most current health report in the file for Child #7 did not include an immunization record.

The initial health assessment in the file for Staff Person #5 was conducted after the staff person's first day working in child care. The health assessment in the file for Staff Person #5 did not include documentation of a TB Screening. The file for Staff Person #6 did not include an updated health assessment conducted within the past 24 months.

The Health and Safety Training in the file for Staff Person #2 was conducted more than 90 days after the staff person's date of hire. (See LIS Code Sheet).

The Mandated Reporter Training in the files for Staff Person #2 and #4 was conducted more than 90 days after the staff persons' date of hire. (See LIS Code Sheet).

The files for Child #2, #5, #6 and #7, who have been enrolled for more than 6 months, did not contain a child service report conducted within the past six months.

The emergency contact forms in the files for Child #1, #3 and #4 did not include the work address and phone number of the enrolling parent.

Based on conversation with the facility director regarding her review of video footage, on the morning of 6/27/22 at approximately 7:45 AM, Child #1 tripped and fell on a toy in the infant classroom. This sustained a scratch and bruise under the left eye. Staff Person #1 and Staff Person #2, who were providing care at the time in this room, were unaware that the child had fallen and sustained the injury.

On the morning of the renewal inspection, Child #1, an infant, was observed sleeping propped up in a carrier. Staff stated that the child had been sleeping in this position approximately one hour.

Observed flaking plaster near the red carpeted area of the Infant Room.

The refrigerator in the Ones Room lacked an operating thermometer.

The file for Child #3, a preschool child, did not contain an updated health report conducted within the past 12 months.

The most recent health report in the file for Child #5 did not include a statement that the child is able to participate in child care and appears to be free from contagious or communicable disease.

The immunization record in the file for Child #3 did not include documentation of a flu shot administered within the past year or a letter of exemption from the parent or physician. The file for Child #5, who has been enrolled for more than 60 days, did not include an immunization record.

The epinephrine and albuterol for Child #6 lacked written parental consent form.

The file for Staff Person #1 did not include an initial health assessment/TB Screening conducted within one year of staff person's start date. The most recent health assessments in the file for Staff Person #5 exceeded 24 months between assessments.

The most recent Pediatric CPR/First Aid Certifications in the file for Staff Person #2 expired between certifications: 1/28/20-3/22/22. The most recent Pediatric CPR/First Aid Certification in the file for Staff Person #5 expired October, 2020.

The most recent fire safety training in the file for Staff Person #2 was conducted on 2/17/21. This is more than 12 months prior to the date of the renewal inspection on 4/11/22. The most recent fire safety trainings in the file for Staff Person #3 exceeded 12 months between trainings: 7/31/20-11/17/21.

The file for Staff Person #5 did not include documentation of Mandated Reporter Training conducted within the past 60 months. The most recent Mandated Reporter Training in the file for Staff Person #5 was conducted on 3/7/16.

The file for Staff Person #4 did not include written evaluations for March, 2021 and March, 2022.

On the day of the renewal inspection, 52 children were receiving care and the Director informed the Certification Rep that 64 children were enrolled. A review of staff files demonstrated that all staff, with the exception of the Director, qualify as Assistant Group Supervisors. At this time, the facility lacks two Group Supervisors based on current attendance/enrollment.

The Emergency Contact Form in the file for Child #4 did not include the work phone for the enrolling parent.

Emergency Contact Forms for 22 children were missing from the binders in the rooms where children were receiving care.

The Emergency Transportation Plan was not posted in Room #5 Preschool Room.