Rainbows End Learning Center INC · Washington

Two electrical outlets in the Pre-K room, accessible to children 5 years of age or younger, lacked protective covers. The outlets were located under the TV and on a power strip near the teacher's desk. The power strip was plugged into the wall outlet at the time of the observation,

An unlabled reusable spray bottle,containing blue cleaning liquid, was observed in the cabinet above the sink in the preschool room.

An active bee's nest was observed in the mulch in the outdoor play space.

Two cigarette butts were observed inside the fence of the mulched play ground, near the raised garden bed.

One ceiling tile was missing in the Pre-K room.

Crumbling plaster/drywall was observed inside the main entry, near the floor. Three areas of peeling paint were observed on the wall with the window in the older toddler room.

Restroom #2 in the Pre-K room lacked a lidded trash can. A lid was present in the restroom, however it was placed beside the trash can on the floor.

Cribs in use by children in the infant room lacked two feet of space on 3 sides. The sides were blocked by bouncy chairs and an adult rocking chair. Nap cots in use by children in the older toddler room lacked two feet of space on 3 sides. The cots were placed too close together.

The hands-free cans at the diapering tables in the YT and OT rooms were not functioning properly. The lids did not close on their own after opening causing staff to use their hand to close the lid.

The facility lacked documentation of completing an emergency drill within the past 12 months. The most recent documentation was dated 3/20/24.

The file for staff #1 contained a reference written by a family member (aunt).

Two electric outlets on a power strip lacked protective covers in the Pre-K room. The power strip was plugged in and was accessible to children 5 years of age or younger.

Two wet-mops with attached cleaning solution bottles were accessible to children in the Pre-K restroom and outside the restroom door.

The first aid kit in the Pre-K room was accessible to children in the emergency backpack sitting on a shelf near the door.

In the PS room, a broken clear plastic bin and a torn puppet exposing the inner foam filling were observed. In a storage area outside the Pre-K room, 2 nap mats were observed with split seems which exposed the inner foam filling.

Antibiotic ointment and bee sting packets which were not labeled for specific children, were observed in the first aid kit in the infant room.

Infant bottles maintained at the facility were not being washed in a commercial dishwasher. Based on statements made by staff, the bottles were handwashed in a bleach solution.

The file for staff #1 contained consecutive fire safety training documentation dated more than 12 months apart; 11/20/23 and 12/13/24.

The pre-k room lacked a posted written plan of daily activities.

On 12/10/24, at approximately 3:40PM, 4 young school agers, children #1-4, were alone and unsupervised in the facility's parking lot for approximately 5 minutes after exiting the school bus.

*On 12/10/24, at approximately 3:40PM, 4 young school agers, children #1-4, were alone and unsupervised in the facility's parking lot for approximately 5 minutes after exiting the school bus.

**On 12/10/24, at approximately 3:40PM, 4 young school agers, children #1-4, were alone and unsupervised in the facility's parking lot for approximately 5 minutes after exiting the school bus.

On 12/10/24, at approximately 3:40PM, 4 young school agers, children #1-4, were alone and unsupervised in the facility's parking lot for approximately 5 minutes after exiting the school bus.

On 12/10/24, at approximately 3:40PM, 4 young school agers, children #1-4, were alone and unsupervised in the facility's parking lot for approximately 5 minutes after exiting the school bus.

An open bag of rock salt, labeled keep out of reach of children, was observed near the entrance door of the facility.

Multiple bumps and waves, which created a tripping hazard, were observed on an area rug in the Pre-K room. Staff in the room stated they were aware of the problem, but it had not yet been corrected by maintenance.

Following an incident on 12/05/24, involving child #5, the incident report was not given to the parent on the same day as the incident. This is evidenced by the report stating the incident occurred on 12/05/24 and the parent's signature indicating receipt being date 12/06/24.

In the play area of the infant room, a large area rug was observed to have significant staining and evidence of dried soiling.

Based on a review of children's files, child #1 and child #2, who were excluded from care due to displaying symptoms of a communicable infection, did not have notification on file from a physician or a CRNP that the child was no longer considered a threat to the health of others prior to returning to care.

On 3/07/24 at approximately 3:50PM 6 young school age children, child #1-#6, were alone in the parking lot for approximately 5 to 10 minutes after exiting the school bus.

On 3/07/24 at approximately 3:50PM 6 young school age children, child #1-#6, were alone in the parking lot for approximately 5-10 minutes after exiting the school bus.

A loose crib sheet was observed in the infant room while the crib was in use by an infant.

The file for staff #6 contained an application for an NSOR clearance dated 1/24/24 which is after their first day in a child care position. The completed clearance is now on file. The file for facility persons #8, #9, and #10, observed having direct contact with children, lacked NSOR clearances and lacked NSOR applications. The files for facility persons #8 and #9 contained incomplete state police clearances. The clearances did not have a dissemination date. The files for facility persons #8, #9, and #10 contained disclosure statements which were not dated and/or signed by a witness.

The files for staff #2 and #3 contained documentation of completing emergency plan training more than 12 months apart. The trainings were dated September 2022 and January 2024.

The letter for parents explaining the emergency procedures did not include details regarding accommodations for infants and toddlers.

A reusable spray bottle observed in the OT room was not labeled with the contents. Based on statements made by staff, the bottle contained Mr. Clean.

The first aid kit in the infant room lacked gloves and tweezers.

A toilet seat in the Pre-K Counts restroom was not fully secured to the toilet.

The following equipment hazards were observed; a broken hard plastic top on a magnetic toy in PS3, a cracked bin which created a pinch point on the OT room, an area of sharp broken plastic on a support beam of a exercise bouncer in the infant room,.

A piece of thin blue plastic, approximately 2 inches by 1 inch, was observed in the seat of a swing in the infant room. The plastic piece appeared to be from a grocery bag.

A crib in use by a child in the infant room lacked 2 feet of space on three sides. One side was blocked by an infant carrier.

Multiple soiled brown sticky areas were observed inside the refrigerator in the infant room.

The file for child #3 contained consecutive health reports dated more than 12 months apart. The most recent health report on file is now current.

Homemade diaper cream, labeled by the parent as a mix of A&D ointment and Lotrimin, was observed in the infant and older toddler rooms.

The first aid kit in the YT room included the following medications which were not labeled for a specific child; Benadryl, Neosporin, burn cream, Tylenol, Neomycin Antibiotic cream and sting relief.

An expired Epi Pen was observed in the OT room. The pen was labeled with an expiration date of Dec 2023.

The following medication observed in the infant room lacked written parental consent for administration; Motrin intended for child #6 and Acetaminophen intended for child #7.

The medication log in the infant room indicated child #6 received medication on 2/09/24, however the log did not include the time of administration, the amount given, or the initials of the staff person who administered the medication.

The medication log in the infant room indicated child #6 received medication on 2/09/24, however the log did not include the time of administration, the amount given, or the initials of the staff person who administered the medication.

The medication log in the infant room indicated child #6 received medication on 2/09/24, however the log did not include the time of administration, the amount given, or the initials of the staff person who administered the medication.

The file for staff #7 contained a health assessment which lacked the results of an examination for communicable diseases and lacked a statement of the physician's or CRNP's assessment of the person's suitability to provide child care.

The operator lacked documentation of submitting the emergency plan to the local and county EMA. Changes were made to the plan in May 2023.

The file for child #4, enrolled for more than 60 days, did not include a health report.

The file for staff #5 contained mandated reporter training completed more than 90 days after their first day working with children. (SEE LIS CODE SHEET)

The file for staff #6, designated as an assistant group supervisor on the staff data sheet, did not contain documentation of the qualifications required for the position. The file for staff #7, who based on statements has performed the duties of an assistant group supervisor, did not contain documentation of the qualifications required for the position.

The files for staff #1, #2, #3, and #4 contained consecutive evaluations dated more than 12 months apart. Current evaluations are now on file.

The agreements for child #1 and #2 were not signed by the operator.

Th agreement for child #1 did not specify the amount of the fee to be charged per day or per week.

The file for child #3 lacked a service report shared with the parent in the past 6 months. The file for child #1 enrolled since 5/30/23 contained an initial service report dated more than 6 months after their enrollment, but is now current.

The agreement for child #1 did not specify the date of the child's admission.

The file for child #5 did not include written consent signed by a parent for emergency medical care.

The emergency contact form for child #4 did not include the address of the individual designated by the parent to whom the child may be released.

Emergency contact information for child #4 was not present in the room where the child was observed receiving care.

The file for child #3 contained an agreement and an emergency contact form that have not been reviewed and signed by a parent in the past 6 months. The file for child #1 contained updates to the emergency contact form and agreement dated more than 6 months apart, but are now current.

The file for child #5 did not contain signed parental consent for administration of minor first-aid procedures by facility staff.

The file for staff #7 lacked written references.

Staff person #1was 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: Pediatric First Aid/Pediatric CPR.

The file for staff person #1 lacked a PA Child Abuse clearance; documentation of application for a PA Criminal History clearance; documentation of application for the NSOR certificate; and lacked a signed Disclosure Statement prior to the date of hire (See IS CODE SHEET) required for provisional hiring under the CPSL. The file for Staff person #2 lacked documentation of application for a PA Criminal History clearance prior to the date of hire (See IS CODE SHEET) required for provisional hiring under the CPSL. The file for Staff person #3 lacked a PA Child Abuse clearance; a complete PA Child Abuse Clearance or complete FBI clearance; proof of applying for a Criminal History clearance or obtaining FBI fingerprints; and lacked documentation of application for the NSOR certificate, (See LIS CODE SHEET), all required for provisional hiring under the CPSL.

During a complaint investigation on 1.31.24, the fire alarm 30-day test log was reviewed and included test dates of 11.3.23-12.11.23 and 12.11.23-1.12.24, more than 30 days apart.

Based on staff interviews, it was determined that Staff Person #1 used physical discipline when they were observed grabbling child #1 by the wrists and "tossing" child #1 into a classroom causing child #1 to lose their balance and land on the floor.

An extension cord outside the front entrance lacked protective covers. An electrical outlet and a power strip in the Pre-K Counts room also lacked protective covers. Both the wall outlet and the power strip were equipped with built in covers, however both were set to the open position during the inspection. All three outlets were accessible to children 5 years of age or younger.

Soiled diapers were observed in the trash can in the infant room. Based on statements made by staff, the infant room has not been in use for at least a week.

Emergency phone numbers were not posted at the phone in the young toddler room.

A protruding screw was observed on one of the support pieces at the base of play ground fence near the storage shed. The support pieces are normally covered by plastic caps. The cap was not in place during the inspection leaving the protruding screw accessible.

The rear emergency exit in the Pre K Counts room does not open freely. The door requires substantial weight to be pushed against it before it will open.

A wooden bench in the outdoor play space has splintering and rotting wood on the left end of the back rest. The bench also has an unsecured support partially attached to the back leaving sharp wood screws exposed and accessible. A wrist scarf with multiple holes and a table with loose legs creating pinch point were observed in the older toddler room. The seat belts of 1 seat in a 6-seat red stroller were cut and no longer functional. A loose hook with one partially attached screw was observed in the dramatic play storage unit. The second screw from the hook was observed in the bottom of the storage unit mixed with the play clothes.

The file for child #1 contained an immunization record which lacked documentation of receiving the influenza vaccine any time after 12/01/21. The file for child #2 contained an immunization record which lacked documentation of receiving the influenza vaccine any time after 11/17/21.The file for child #3 contained an immunization record which lacked documentation of receiving the influenza vaccine any time after 6/30/20. The file for child #4 contained an immunization record which lacked documentation of receiving the influenza vaccine at any time. Written exemptions were not on file for these 4 children. Children #1 and #4 have documentation from a doctor's office of upcoming appointments. Children #2 and #3 must be dismissed from care until the files are compliant.

The following medications were observed in the first ail kit in the young toddler room; Neosporin, Extra Strength Benadryl, and 2 packets of Tylenol. The medications were not labeled for a specific child and written consent was not on file.

Documentation of annual emergency drills was not presented for review at renewal.

The fire drill documented on 2/06/23 did not include a hypothetical location.

Th facility previously completed an attestation in lieu of the proof of purchase for the fire alarm system. This was noted in 2021. This attestation (or proof of original installation/proof of purchase) was not presented for review at the renewal inspection.

The file for child #5 contained an initial health report conducted 81 days after their first day of attendance at the facility. The health report on file is now current.

Staff #2 has not completed the 1-hour Pennsylvania Health and Safety Training update. Completion was required by 12/30/22 as stated in Announcement C-22-06.

The file for staff #1 contained fire safety training certificates dated 7/18/20 and 6/25/22. A certificate for 2021 was not on file during the inspection.

The files for children #1-#4 contained service reports which were not updated by the reinstatement date set forth in Announcement C-21-09. Current service reports are now on file.

The agreement for child #4 did not specify the persons designated by a parent to whom the child may be released.

The emergency contact information and agreements for children #1, #2, #4, and #5 were not updated by the parents within 6 months. Current documents are now on file.

The file for staff #2 contained a disclosure statement which was not dated or signed by a witness. PREVIOUSLY CITED ON SIN-00213289

At approximately 9:30 AM, staff #6 was observed answering the door to the facility for a parent dropping off a child and the certification representative. Staff #1 was observed alone in the Pre-k room with 13 preschool age children.

**At approximately 9:30 AM, staff #6 was observed answering the door to the facility for a parent dropping off a child and the certification representative. Staff #1 was observed alone in the Pre-k room with 13 preschool age children

*At approximately 9:30 AM, staff #6 was observed answering the door to the facility for a parent dropping off a child and the certification representative. Staff #1 was observed alone in the Pre-k room with 13 preschool age children.

The facility's emergency plan did not address continuity of operations as required in Announcement C-22-04. PREVIOUSLY CITED ON SIN-00213289.

A child size basketball hoop in the toddler area of the play ground was not anchored. PREVIOUSLY CITED ON SIN-00213289. A bucket containing approximately 2 inches of rain water mixed with sodium chloride was accessible to children in a cart at the front door of the facility.

Two bags of sodium chloride, 1 of which was open, were accessible to children in a cart at the front door of the facility. A plastic bucket containing a mixture of the sodium chloride and rain water was also accessible. The bags were labeled "Keep out of reach of children". Two Swiffer Jet Mops, with the canisters of cleaning fluid attached, were accessible to childen; one in the young toddler room and one in the older toddler room. The canisters are labeled "Keep out of reach of children". PREVIOUSLY CITED ON SIN-00213289.

Approximately 5 cigarette butts were observed in the cement area of the outdoor play space. PREVIOUSLY CITED ON SIN-00213289.

The files for children #1, 2, 3, and 6 contained health reports which have not been updated on over 12 months. PREVIOUSLY CITED ON SIN-00213289.

The files for children #1, 2, 3, and 5 contained immunization records which did not include verification of receiving the influenza vaccine in accordance with the schedule recommended by the ACIP. Written exemptions were not on file. PREVIOUSLY CITED ON SIN-00213289.

The facility's emergency plan did not address accommodations for infants and toddlers. PREVIOUSLY CITED ON SIN-00213289.

The file for staff #2, designated as an assistant group supervisor on the staff data sheet, did not contain documentation of the qualifications required to perform the position. PREVIOUSLY CITED ON SIN-00213289

The files for child #3 contained agreements which did not specify the date of the child's admission. PREVIOUSLY CITED ON SIN-00213289

The file for child #2 contained emergency contact information which did not include the address of the individuals designated by the parent to whom the child may be released. PREVIOUSLY CITED ON SIN-00213289.

Staff person #8 was observed to be caring for children unsupervised. Staff person #8 has not completed the following pre-service training required prior to caring for children unsupervised: Health and safety topics 1-9 and mandated reporter training.

The file for staff #2 contained a disclosure statement which was not dated or signed by a witness The files for staff #7 and #9 contained disclosure statements which were not dated. The file for staff #5 contained a disclosure statement dated 11/03/22 which is after their first day in a child care position (SEE LIS CODE SHEET).

An infant was observed sleeping on their stomach during the inspection. When asked, staff stated the infant was placed into the crib on their stomach instead of first placing the infant on their back and allowing them to roll over on their own.

The facility's emergency plan did not address continuity of operations.

Stacked storage bins observed in the Pre K room presented a tipping hazard. Eleven boxes were observed in the stack and the stack was leaning over. Two child size basketball hoops in the outdoor play space were not weighted or anchored creating a tipping hazard.

A Swiffer Wet Jet mop with the canister containing cleaning solution attached and accessible was observed in the restroom of the PS 3 room. A tub of sanitizing wipes was accessible to children beside a toilet in the Older Toddler restroom. Windex and bleach were accessible to children in an unlocked cabinet under the sink in the infant room.

Approximately 5 cigarette butts were observed in the cement area of the outdoor play space.

Two areas of damaged crumbling plaster were observed in the Pre K room below the color poster at the base of the wall and on the wall to the right of the mounted TV. A chalkboard tray mounted in the Young Toddler room was not secured to the wall which created pinch points along the tray.

A source of running water was not located in the diapering area of the young toddler room.

A gray plastic toy bin with a cracked edge was observed in the older toddler room.

A split seam, which left the inner foam filling accessible, was observed on a sleeping mat in the older toddler room.

The rest mats in the Young Toddler room were not labeled for use by a specific child.

A crib in use by a child in the infant room lacked 2 feet of space on 3 sides. The sides were blocked by other equipment.

The files for children #4 and #5, both under two years of age, contained health assessments which have not been updated in over 6 months.

The files for children #1, 2, 3, and 6 contained health reports which have not been updated on over 12 months.

The files for children #1, 2, 3, and 5 contained immunization records which did not include verification of receiving the influenza vaccine in accordance with the schedule recommended by the ACIP. Written exemptions were not on file.

A bottle of acetaminophen, labeled for use by 2 children instead of just 1 child. was observed in the infant room.

Tylenol with an expiration date of 9/2022, intended for child #9, was observed in the infant room.

Two hands free trash cans with nonfunctioning lids were observed in the diapering area of the Young Toddler Room.

The file for staff #1 contained consecutive health assessments conducted more than 24 months apart. The most recent health assessment on file is now current.

The facility's emergency plan did not address accommodations for infants and toddlers.

Staff person #8 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 1-9.

Staff person #8 has not completed the mandated reporter training within 90 days of their date of hire (see LIS code sheet).

The file for staff #2, designated as an assistant group supervisor on the staff data sheet, did not contain documentation of the qualifications required to perform the position. Staff #8, designated as an aide on the staff data sheet was observed performing the role of an AGS while escorting a child to a classroom on the day of the inspection, however the file for staff #8 did not contain documentation of the qualification required to perform the position.

The files for staff #1, #3, #4, #6, and #7 contained consecutive evaluations conducted more than 12 months apart. The most recent evaluations on file are now current.

The files for children #1, #2, and #3 contained agreements which did not specify the date of the child's admission.

The file for child #2 contained an agreement which did not include the address of the child's physician or source of medical care.

The files for child #1 and child #2 contained emergency contact information which did not include the address of the individual designated by the parent to whom the child may be released.

Emergency contact information was not present in the Pre K room for child #7. Emergency contact information was not present in the infant room for child #8. Both children were observed in care in the corresponding rooms.

The files for children #1-6 contained emergency contact information and agreements which were not updated at least once in a 6 month period. The documents on file for child 1, 3, 4, 5, and 6 are now current, however the file for child #2 does not contain documents updated within the last 6 months.

The facility's fire drill log did not include the required details for the fire drill conducted in April.

Staff persons #3 and #4 were observed to be caring for children unsupervised. Staff #3 and #4 have not completed the pre-service training required prior to caring for children unsupervised: Health and Safety Training topics 1-9 and mandated reporter training.

Prescription Nystatin, which lacked a medication log, was observed in the infant room. The medication was intended for child #1. Based on statements made by staff, the medication had been administered on more than one occasion.

An expired albuterol inhaler was observed in the school age room. The medication expired April 2022 and was labeled for child #1. Based on statements made by staff, the child was in care until 6/01/22.

Staff #1, #2, #3, and #4 have not completed the following pre-service training within 90 days of their hire date)SEE LIS CODE SHEET): Health and Safety Training topics 1-9.

Staff person #1, #3, and #4 have not completed mandated reporter training within 90 days of hire (SEE LIS CODE SHEET).

Based on statements made by staff, a 4 year old child was left alone in a classroom for approximately 45 seconds to 1 minute during a fire drill that occurred on 4/21/22.

Based on statements made by staff, a 4 year old child was left alone in a classroom for approximately 45 seconds to 1 minute during a fire drill that occurred on 4/21/22.

The files for Staff #1, Staff #3, Staff #5, and Staff #6 did not contain a date on the Disclosure Statement. It could not be determined if the Disclosure Statement was obtained at the time of hire due to the missing date. The file for Staff #1 did not contain a witness signature on the Disclosure Statement.

The files for Staff #1 (DOH 3.8.21), Staff #2 (DOH 7.31.12), Staff #3 (DOH 4.19.21), Staff #4 (DOH 12.3.07), Staff #5 (DOH 9.28.21), Staff #6 (DOH 10.20.21), and Staff #7 (8.5.96), did not contain documentation of Emergency Plan training at the time of initial employment or on an annual basis.

Although a digital plan was available, there was no Emergency Plan posted anywhere in the facility.

No handwashing sign was displayed at the toilet in the restroom near the 3 year-old room.

A Cortisone-10 container, which was located in the child medication bin in the PK room, did not have the name of the child for whom the medication is intended.

A Proof of Purchase was not available for the interconnected fire detection system.

The files for Staff #1 (DOH 3.8.21), Staff #2 (DOH 7.31.12), and Staff #3 (DOH 4.19.21) did not contain verification of PEDIATRIC First-Aid/CPR.

The Mandated Reporter training for Staff #2 was completed on 2.10.15 and 11.4.20, which was beyond the 60-month renewal requirement. The Mandated Reporter training for Staff #7 was completed on 2.11.15 and 10.30.20, which was beyond the 60-month renewal requirement.

The Fee Agreement, for Child #6, did not contain the fee amount.

The Emergency Contact form, for Child #1, did not contain the physician's address.

The Emergency Contact form, for Child #5, did not contain the name of the physician.

The Emergency Contact form, for Child #6, did not contain the enrolling parent's work address or work phone number.

The Emergency Contact form, for Child #5, contained the health insurance policy number, but not the name of the health insurance company.

The Emergency Contact form, for Child #6, did not contain the release person's address.