Ryanns Room South LLC

Staff #1, who was identified and qualifies as an aide, was observed working alone with young toddlers, unsupervised by a qualified staff person throughout the day.

Hanging blind cords on the door and sidelights were observed in the gross motor room. The 3 dangling cords presented a strangulation hazard to young children.

When asked what the shaving cream in a kitchen cabinet was for, staff stated it was used for science projects. The can is labeled "keep out of the reach of children."

In the infant/young toddler classroom, the metal heater cover was not completely secured to the wall creating a gap where a child's fingers could become trapped between the wall and the cover, presenting an immediate pinch and crush hazard. Also, in the infant/young toddler classroom, the large alphabet rug had large wrinkles in the middle creating a tripping hazard.

At approximately 12:40 PM, Staff #3 changed a child's diaper. Upon completion, the staff member used a disposable wipe to clean the toddler's hands and a separate wipe to clean their own, rather than proper handwashing with running water and soap. Changing tables in the infant/young toddler and older toddler/preschool classrooms did not have posted handwashing signs. The toilet in the bathroom off the older toddler/preschool classroom did not have a posted handwashing sign.

In the older toddler/preschool classroom, an adhesive Command-type hook with a metal prong was attached to the side of a child-size play kitchen. The protruding metal hook creates a risk of laceration, puncture or eye injury if a child comes in contact with it. The older toddler/preschool classroom also contained a clear bin that contained cube blocks which was broken exposing children to sharp edges.

In the older toddler/preschool classroom, stickers on a play kitchen were peeling off. The stickers, which could be pulled off by a toddler, would be less than an inch in diameter creating a hazard for children still placing objects in their mouths.

In the older toddler/preschool classroom, a six-foot-tall cabinet was not anchored to the wall posing a tip-over hazard that could injure a child if it falls. In the older toddler/preschool classroom, an unsecured television was on a mobile cart at a height accessible to children and presenting a tip over hazard if the unit is pulled over, pushed or bumped.

A crib in the infant/young toddler classroom was identified by Staff #1 to be used for a specific child, but the crib was not labeled with the name of the child.

The current vaccination record on file for Child #3 did not meet the ACIP recommended schedule for an older toddler (see LIS code sheet) and there is no acceptable exemption on file. The vaccination record contained documentation of 0/3 hepatitis B, 3/4 DTaP completed, 3/4 pneumococcal completed, 0/1 varicella and 0/1 MMR.

The file of Staff #2 contains consecutive health assessments dated 12/13/2023 and 1/7/2026, more than 24 months apart. The file of Staff #3 did not contain documentation of an initial health assessment (see LIS code sheet).

The file of Staff #3 did not contain documentation of a tuberculosis screening.

An infant feeding schedule was not on file for Child #6, identified as an infant under 12 months of age by Staff #2.

A bottle in the refrigerator in the infant/young toddler classroom was not labeled with the name of the child for whom it is intended.

Acceptable documentation sharing information regarding the child's growth and development with families was not on file for Child #2 who has been enrolled for more than 6 months (see LIS code sheet). Additionally, documentation of the last completed Child Service Report for Child #4 was dated 1/2025, more than 6 months prior to the date of the inspection.

The file of Child #1, #2, #3 and #4 contained the original financial agreements.

The emergency contact form of Child #1 did not contain the telephone number of the child's physician.

The emergency contact information for Child #3 did not contain the work address and work telephone number of the enrolling parent.

The emergency contact information for Child #1 and #2 did not include information on the child's special needs as specified by the child's parent, physician, physician's assistant or CRNP, which is needed in an emergency situation or documentation this is not applicable to the child.

The emergency contact information for Child #2 and #4 did not contain the addresses of the persons identified by the parent to whom the child may be released.

Emergency contact information was not present for Child #5 in the older toddler/preschool classroom where they were receiving care.

The emergency contact form for child #3 was not signed and dated by the parent to attest to the accuracy of its information.

The file of Child #2 did not have signed parental consent for emergency medical care for the child.

The file of Child #2 did not have signed parental consent for administration of minor first-aid procedures by facility staff.

2nd CITATION: The CR arrived at the facility on 2.25.26 at 6:32 AM and observed Staff person #1 enter the building and turn on the lights at 6:55 AM. The 1st child was seen entering the facility at 7:45 AM, with the parent leaving at 7:48 AM. The 2nd child was taken into the facility at 7:49 AM and the parent left at 7:51. The 3rd child and the 4th child were taken into the facility at 7:55 AM with the parent of the 3rd child leaving at 7:58 AM and the parent of the 4th child leaving at 7:57 AM. The 2nd staff person entered the building at 7:58 AM, meaning that Staff person #1 was alone with more than 1 child from 7:51 AM until 7:58 AM. The CR observed 5 more children enter the facility between 8:03 AM-8:22 AM. At 8:35 AM Staff person #3 was seen exiting a vehicle that had been in the parking lot since 7:51 AM and entering the building with the 10th child. At 8:40 AM the 11th child entered the facility. The CR entered the facility at 8:45 AM and assessed supervision and ratio. PREVIOUSLY CITED ON 11.21.25

When the CR entered the facility at 8:45 AM, supervision and ratio were assessed. The CR counted 10 children in the main classroom despite observing 11 children enter the building. The 11th child, a preschool child, was then observed sleeping alone on the other side of an L-shaped, solid, vinyl fence. The L-shaped, solid, vinyl fence was approximately 4 feet tall. The preschool child was sleeping between the two sides of the L-shaped, solid, vinyl fence. All three staff in their current locations could not see through the L-shaped, solid, vinyl fence in order to supervise the sleeping preschool child. No staff member was able to see, direct, or assess the sleeping preschool aged child.

2ND CITATION: There was no director present at the facility on 2.25.26. The CR was previously told Staff person #4 and Staff person #5 would be sharing the 30 hours a week requirement. The CR was also previously made aware that Staff #5 was out of town for several weeks including 2.25.26. The CR was informed on this date that Staff #4 was scheduled to be on site but went to a different location to serve as the director this day. PREVIOUSLY CITED ON 11.21.25.

According to staff statements, staff members have been left out of ratio on multiple occasions, including 1 staff having 8 children, 4 of whom were young toddlers.

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: PA Required Health and Safety for Centers-Group Child Care Part 1.

The file for staff person #2 does not contain documentation of a complete NSOR clearance prior to date of hire (See IS CODE SHEET) required for provisional hiring under the CPSL. The file for staff person #5 did not contain documentation of a Sex Offender Registry search from California, where the staff person lived in the 5 years prior to date of hire (See IS CODE SHEET) required for provisional hiring under the CPSL. The file for Staff person #5 also includes an incomplete criminal history clearance that did not include a dissemination date, making it invalid and the FBI clearance on file was illegible and therefore invalid. The file for staff person #7 did not include a rap sheet with the FBI clearance, which indicated the person has a record (See IS CODE SHEET) required for CPSL compliance.

According to staff statements, staff on multiple occasions have been in the facility with more than 1 child in care with no other staff person present in the facility.

There was an unlatched cupboard in the preschool room 2 cans of shaving cream, multi-purpose spray adhesive, and contact lens cleaning solution, all labeled "Keep out of reach of children" making the toxics accessible to children.

There were cans of shaving cream, labeled "Keep out of the reach of children", used for arts and crafts projects, in the preschool classroom.

Peeling paint was observed in the Infant/Young Toddler room on the wall behind the rocking chair.

The preschool room contained 4 cracked Magna-tiles, a cracked bin containing puzzles, and a cracked plastic lid in the kitchen area.

There was a crib in the Infant/Young Toddler room was that missing 2 wheels on one end, making the crib sit at an uneven angle.

The cribs in the Infant/Young Toddler room were not labeled with the names of the children assigned to the crib.

The file for staff person #3 does not include documentation of a health assessment being completed within 12 months prior to date of hire (See LIS CODE SHEET). The file for staff person #4 does not include documentation of a health assessment being completed within 12 months prior to date of hire (See LIS CODE SHEET).

There was no menu posted in a conspicuous location for parents and no verification available that the menu was provided to parents.

The gross motor room included a ladder and wood panels that were leaning against the wall and could potentially injure a child if they fell.

Staff person #3 has not completed mandated reporter training within the last 60 months; the previously documented mandated reporter training on file is dated 2.27.20.

The file for Staff person #2, who was observed working alone in the Infant/Young Toddler room and in the role of 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 #3, #7, 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…

The file for Child #1, #2, #3, and #4 did not have a signed agreement for this location; all 4 children had transferred from another location and only had agreements for that location in the file.

The agreement on file for Child #5 does not include the amount of the fee to be paid by the parent/guardian.

The emergency contact form on file for Child #1 does not include the work address and telephone number for the enrolling parent.

The emergency contact form on file for Child #3 and #4 does not include a complete address for all listed release persons.

The Infant/Young Toddler room did not include any emergency contact forms for any of the children receiving care.

The file cabinet where the child files are stored was not locked at the time of the inspection.

There was no file on site at the time of the inspection for the Staff person #1.

The file for Staff person #2, #3 does not include 2 written non-family references attesting to the staff person's suitability to work in child care.

According to staff interviews, there is not a director in the facility for a minimum of 30 hours/week.

The outlets behind the crib on the far wall Room 1, which were accessible to children under 5 years old, were missing outlet covers.

There were 2 windows in Room 2, which are above ground level, that did not have any mechanism in place to prevent the windows opening more than 6 inches.

In Room 1 there were several loose screws on the baseboard heating covers. There was a piece of missing baseboard in Room 1.

Peeling paint was observed in Room 1 in the area where the heating unit cover was attached to the wall.