Tender Care Learning Center/Clairton

Desitin cream and A&D ointment, labeled "keep out of the reach of children," were observed in the bathroom in the Toddler 4 room and accessible to children.

An unlidded trash can, containing a used cup, was observed of the Toddler 4 room.

The first aid kits located in Preschool 2, Toddler 2, and Toddler 3 classrooms were observed hanging from a cubby hook and accessible to children.

A cabinet door was observed to be broken and not in good repair in the Toddler 1 classroom. Wet, soft, and stained ceiling tiles were observed in the hallway outside the Preschool 4 classroom. Standing water in the sandbox cover, cracked playground surfacing, and a rusty, sharp hole on the gate were observed on the lower outdoor play space. Standing water in the sandbox cover and exposed screws on the gate were observed on the upper outdoor play space.

Peeling paint was observed on the wall above the art supplies in the Preschool 3 classroom.

In the Toddler 1 classroom (a room designated for children who are still placing objects in their mouths), the green couch and the soft blocks toybox were observed to contain ripped and peeling vinyl. In the Toddler 2 classroom (a room designated for children who are still placing objects in their mouths), floor mats were observed to contain peeling vinyl and peeling tape. In the Toddler 4 classroom (a room designated for children who are still placing objects in their mouths), a wooden platform at the sink was observed to contain peeling carpet and tape.

Ripped vinyl on rest equipment was observed in the Preschool 1 and Preschool 3 classrooms and not in good repair. Cracked magnet tiles were observed to have sharp corners in the Preschool 4 and Preschool 5 classrooms.

The most recent health report form on file for Child #1 is dated 7/26/24 (a young toddler at that time), more than 6 months prior. The most recent health report on file for Child #5 (a young toddler) is dated 10/30/24, more than 6 months prior.

The two most recent health report forms on file for Child #3 are dated 8/22/23 and 4/21/25, more than 12 months apart.

The health report form on file for Child #4 lacked a statement that the child is able to participate in childcare and is free from communicable disease.

The immunization record on file for Child #5 (18 months) contained 3 out of 4 DTAP vaccines recommended by the ACIP for a child this age; 3 out of 4 pneumococcal vaccines recommended by the ACIP for a child this age; 0 out of 1 MMR vaccines recommended by the ACIP for a child this age; and 0 out of 1 Varicella vaccines recommended by the ACIP for a child this age, without a letter of exemption on file.

The two most recent health assessments on file for Staff #4 are dated 8/4/21 and 7/8/24, more than 24 months apart.

The health assessment on file for Staff #3 does not include the physician's assessment and results for communicable diseases.

The most recent Pediatric First Aid/CPR certificate on file for Staff #6 is dated 5/9/23, exceeding its expiration date.

The two most recent fire safety trainings on file for Staff #1 are dated 7/13/23 and 1/3/25, more than 12 months apart. The two most recent fire safety trainings on file for Staff #5 are dated 7/21/23 and 1/8/25, more than 12 months apart.

Staff #3 had completed a Pediatric first aid and CPR training on 8/20/24, however the trainer had not provided documentation that they are PQAS-certified in that training curriculum.

The two most recent Mandated Reporter trainings on file for Staff #4 are dated 1/9/20 and 1/14/25, more than 60 months apart.

The two most recent assessments for growth and development on file for Child #7 are dated 10/17/24 and 5/9/25, more than 6 months apart.

The emergency contact form for Child #1, Child #4, Child #6, and Child #7 lacked a signature for parental consent for emergency medical care.

The file for Child #1, Child #3, Child #4, Child #5, Child #6, and Child #7 contained an emergency contact form that was not updated within 6 months of the previous update. (SEE LIS CODE SHEET)

The file for Child #1, Child #3, Child #4, Child #5, Child #6, and Child #7 contained a financial agreement form that was not updated within 6 months of the previous update. (SEE LIS CODE SHEET)

The emergency contact form for Child #1, Child #2, Child #4, Child #6, and Child #7 lacked a signature for written parental consent for administration of minor first aid.

The file for Staff #2 lacked two written non-family references.

The first aid kit in the Toddler 2 classroom lacked scissors and soap. The first aid kit in the Preschool 3 classroom lacked tape.

On the lower playground, a wooden kitchen contained a piece of broken/split wood that could cause injury.

On the lower playground, a wooden kitchen contained a loose screw less than 1 inch in diameter and accessible to children who are still placing objects in their mouths.

The file for Child #4, a preschool aged child, lacked an updated health report within the last 12 months. (SEE LIS CODE SHEET)

The fee agreement form for Child #1 and Child #4 lacked the names of the release persons.

The fee agreement form for Child #4 did not contain the date of admission.

The emergency contact form for Child #4 lacked an address and phone number for the physician/medical care provider.

The emergency contact form for Child #2 and Child #4 lacked the enrolling parent's work address.

The emergency contact form for Child #4 lacked indication if the child has any special medical needs.

The emergency contact form for Child #4 lacked the health insurance coverage name and the health insurance policy number.

The emergency contact form for Child #3 and Child #4 lacked an address for the release persons.

The file for Child # 2, Child #4, Child #5, and Child #6 contained an emergency contact form that was not updated within 6 months of the previous update. (SEE LIS CODE SHEET)

The file for Child # 2, Child #4, Child #5, and Child #6 contained a fee agreement form that was not updated within 6 months of the previous update. (SEE LIS CODE SHEET)

The fire alarm 30-day test log includes test dates 9/20/23-10/22/23 and 11/20/23-12/23/23, more than 30 days apart.

On the lower playground, the first aid kit in the Infant 2 bookbag did not include a pair of tweezers.

On the Upper Playground, standing water was observed on the sandbox cover and in a groove of a red climber that a child was drinking. A gap with a lifted surface was observed on the Upper Playground between a concrete sidewalk and playground pad. On the Lower Playground, standing water was observed on the sandbox cover and a deep divot was observed in the grass that could create a tripping hazard for children in care. In the Preschool 4 Room, a broken door stop plate was observed on the bathroom door on the right that was accessible to children. On the Lower Playground, exposed bolts were observed on the perimeter of the inside of the gate, which is accessible to children.

Peeling paint and plaster were present in the doorway of the Preschool 4 room, observed to be caused by water damage. Peeling paint and rust was observed on the Upper Playground on a climber's post caps that was in reach of children.

There were no steps for children who are walking to approach an adult sized sink in the Infant 2 and Toddler 1 rooms.

Cracked and broken magnatiles were observed in the Preschool 3 and Preschool 5 rooms. In the Preschool 3 room, a cracked lego toy bin was observed with pinch points that could cause injury. In Preschool 2 room, foam blocks were observed with teeth marks and missing pieces that were not in good repair. In Preschool 4, a cracked waffle toy was observed with pinch points that could cause injury. On the Upper Playground, a large lizard seesaw was observed to have cracks and pinch points around the neck, which could cause injury. On the Lower Playground, exposed bolts were observed on the perimeter of the inside of the gate, which is accessible to children.

The two most recent health assessments on file for Child #2, who is a Young Toddler, are dated 1/18/22 and 9/11/23, more than 6 months apart. The most recent health assessment on file for Child #8, who is a Young Toddler, is dated 12/6/22, more than 6 months prior.

The most recent health assessment on file for Child #7, who is a preschool age child, is dated 10/27/21, more than 1 year prior.

The most recent influenza vaccination on file for Child #4, who is 4 years old, is dated 12/16/21, is dated more than 1 year ago, and is recommended annually by the ACIP. Child #4 must be dismissed from care by close of business on 9/11/2023, and may only return to care when the immunization record is updated or when a parent provides a written, signed exemption letter.

The file for Staff #1 includes verification of First Aid/CPR training dated 4/12/22, after the expiration date of 1/11/22.

Staff #4 did not complete the required CPR/First Aid pre-service training within 90 days from their date of hire. (SEE LIS CODE SHEET) The training was completed on 2/26/23.

Staff #3, who is classified as an Assistant Group Supervisor, has 1700 out of 2500 hours of child care experience documented on file.

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

The agreement on file for Child #7 does not include the child's departure time.

The emergency contact form on file for Child #4 & Child #5 does not include the complete address for the child's pediatrician/source for medical care.

The emergency contact form for Child #5 does not include a complete work and home address for the enrolling parent. The emergency contact form for Child #7 does not include a complete work phone number for the enrolling parent.

The emergency contact form for Child #2 does not include the child's health insurance coverage name. The emergency contact for Child #4 does not include the child's health insurance policy number.

The emergency contact forms for Child #4 and Child #5 do not include a complete address for all release persons. The emergency contact form for Child #7 does not include a complete phone number for all release persons.

The most recent 6 month review signature for the emergency contact form and financial agreement on file for Child #2 is dated more than 6 months after the previous 6 month review signature. The most recent 6 month review signature for the emergency contact form and financial agreement on file for Child #5 is dated 1/28/23 and Child #8 is dated 1/21/23, which is more than 6 months prior. The file for Child #4 and Child #7 does not include a 6 month review signature from the date of enrollment for the emergency contact form and financial agreement. (SEE LIS CODE SHEET)

The file for Staff #3 lacked documentation of 12 completed hours of annual training between 2/21/22-2/21/23.

Observed teeth marks in the foam pegboards in the Preschool #1 Room. This creates a potential choking hazard for children who are still placing objects in their mouths.

Observed baseboards peeling in various areas of in the Preschool 1 and Preschool 5 Rooms.

Observed adult scissors, which were accessible to children, on a desk in the Preschool 3 Room.

Observed two cans of paint in the hallway, which serves as a fire exit from the facility.

In the hall that serves as a fire exit from the facility, observed a ladder propped against the wall, which creates a potential toppling hazard,

Observed a wheeled trash cart blocking the doorway of the fire exit on the left hallway.

SECOND VIOLATION. An electrical outlet was observed to have a broken front cover, causing a sharp edge. Previously cited on SIN-00214332 on 11/2/22.

Peeling paint was observed on the wall above the book area in the PS 2 Room and on the wall above the chair rail in the Infant 2 Room.

The playhouse in the lower PG was observed to have a shutter broken off, causing a rough edge around the window.

Small rubber bands with a diameter of less than 1 inch were observed in the bathroom of the Toddler 4 Room in an unlocked cabinet, accessible to children who may still be placing objects in their mouths.

Staff Person #1 has been named as a perpetrator in an indicated case of child abuse. Staff Person #1 cannot work at the childcare facility.

Toxic Clorox was observed to be accessible to children in an unlocked cabinet in the Toddler 4 Room.

Two holes large enough for a child's foot were observed around the shed in the lower outdoor play space.

Upon arrival to the facility at 10:15 AM on 10 18.22, Staff # 1 was observed on the lower playground with 7 children - 6 OT and 1 PS.

Upon assessment of supervision and ratio in the Toddler 3 Room at 10:25 AM on 10/18/22, 11 children were observed in care. The Toddler 3 Room has a measured capacity of 10 children.

The water at the sinks used for handwashing, in both the Infant 1 and Toddler 4 Rooms, was measured at 116 degrees F.

The door between the PS 5 and SA Room was observed to be obstructed, with bins in front of the door.

Open Inspection Summaries, SIN-00211310 and SIN-00211324, were not posted in a conspicuous location used by parents at the facility.

Based on an interview with Staff Person #2 and review of written statements from Staff Persons #1 and #2, it was verified that on 9/12/22 at approximately 5:15 PM, Child #2 was found outside the facility lacking staff supervision, thereby resulting in the staff to child ratio being 0 to 1. It is unknown how long Child #2 was unsupervised outside, and it was later confirmed that Child #2 had endured serious bodily injuries.

Based on interviews with Staff Persons #2 and #3, a written statement from Staff Person #3, and a review of documents, on 9/12/22 at approximately 5:00 PM, Staff Person #1 was assigned responsibility for supervising a mixed age group of 5 young toddlers and older toddlers in the Toddler 4 Room. At approximately 5:10 PM, after two of those children had been picked up, Staff Person #1 called the office to inform Staff Person #2 that she did not know the whereabouts of Child #1 and Child #2 who were in her care. It is unknown how long Child #1 and Child #2 were unsupervised. Child #1 was found hiding behind a toy shelf near an open window in the Toddler 4 Room. At approximately 5:15 PM, Child #2 was found outside of the two-story building near the entrance to the first-floor level of the building by an employee of another business located on that level. (The childcare facility is located on the second floor of the building.) As a result of Child #2 not being supervised, he sustained serious bodily injuries.

Based on interviews with Staff Persons #2 and #3, a written statement from Staff Person #3, and a review of documents, on 9/12/22 at approximately 5:00 PM, Staff Person #1 was assigned responsibility for supervising a mixed age group of 5 young toddlers and older toddlers in the Toddler 4 Room. At approximately 5:10 PM, after two of those children had been picked up, Staff Person #1 called the office to inform Staff Person #2 that she did not know the whereabouts of Child #1 and Child #2 who were in her care. It is unknown how long Child #1 and Child #2 were unsupervised. Child #1 was found hiding behind a toy shelf near an open window in the Toddler 4 Room. At approximately 5:15 PM, Child #2 was found outside of the two-story building near the entrance to the first-floor level of the building by an employee of another business located on that level. (The childcare facility is located on the second floor of the building.) As a result of Child #2 not being supervised, he sustained serious bodily injuries.

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: Pediatric First Aid/CPR in an approved curriculum from a PQAS Instructor, Mandated Reporter Training, and Health and Safety Training.

Based on an interview with Staff Person #2 and a written statement from Staff Person #1, it was confirmed that on the afternoon of 9/12/22, the far right window of the Toddler 4 Room was open more than six inches while children were receiving care in the room. The Toddler 4 Room is located on the second floor of the building and the window opened directly to the outdoors. Based on an interview with Staff Person #2, Staff Person #1 had opened the window because she was hot.

On 9/12/22, Child #2 received serious bodily injuries due to lack of supervision. Based on an interview with Staff Person #2, she believed Child #2 sustained his injuries by climbing out an open window located in the Toddler 4 Room on the second floor and falling off the second floor roof onto the ground outside. Staff Person #2 did not call 911 for emergency care nor was Child #2's parent notified of the incident until she arrived approximately ten minutes later at the regular pick-up time.

Staff person #4 has acceptable pediatric first aid/CPR training in an approved curriculum; however, the trainer has not provided documentation that they are PQAS-certified in that training topic.

The file for staff #1 lacks a current health assessment.

Staff files #2, #3, #4, and #6 contain health assessments that were updated late.

The health assessment on file for staff #5 lacks the physician's or CRNP's assessment of the person's suitability to provide child care.

The file for staff #5 contains first aid and CPR training that was conducted late. The training was due on 12/7/21 and was completed on 1/26/22.