Tender Care Learning CTR/Lower Burrell

The file for Staff Person #2 (See LIS Code Sheet) contained an NSOR Certificate dated 5/16/23 which was more than 90 days from date of hire. The file for Staff Person #3 (See LIS Code Sheet) contained and NSOR Certificate dated 4/17/25 which was obtained more than 60 months from the previous certificate dated 4/16/20. The file for Staff Person #7 (See LIS Code Sheet) contained a PA Child Abuse clearance dated 10/23/24 which was obtained more than 60 months from the previous clearance dated 9/25/19. The file for Staff Person #8 (See LIS Code Sheet) contained and NSOR certificated dated 7/10/24 which was obtained after the staff person started working in a child care position; the file for Staff Person #8 did not contain the application for the NSOR clearance. The file for Staff Person #9 (See LIS Code Sheet) contained a volunteer PA State Police clearance dated 2/27/25 and a volunteer PA Child Abuse clearance dated 4/4/25. The file for Staff Person #10 contained an NSOR certificate dated 4/29/25 which was obtained more than 60 months form the previous certificate dated 4/13/20.

The facility's emergency plan lacked a method to contact parents when an emergency situation arises and a method to contact parents with information on how to safely reunite with their child(ren)

In the PreK classroom, there was a power strip with 2 open outlets; in the older toddler room there was a multiplug with an open outlet next to the fish aquarium; in the infant room there was an open outlet on the wall next to the door from the preschool area. The open outlets were accessible to children 5 years of age or younger.

The first aid kit in the infant room lacked tweezers. The first aid kit in the preschool readiness room lacked gauze. The first aid kit in the outdoor play area on the left lacked tweezers.

During naptime in the PreK, 3 children were sleeping on mats that had less than 2 feet of space on three sides; and in the Preschool 1 room, 2 children were observed sleeping on mats that had less than 2 feet of space on three sides.

The health report on file for Child #2, a toddler at the time (See LIS Code Sheet), was dated 7/24/24 more than 6 months after the previous health report dated 6/9/23. The health report for Child #3, a toddler at the time (See LIS Code Sheet) was dated 2/28/25 more than 6 months after the previous health report dated 5/4/23.

The most recent health assessment on file for Staff Person #1 was dated 5/7/25 more than 24 months from the previous health assessment dated 7/31/19. The most recent health assessment on file for Staff Person #7 was dated 6/13/24 more than 24 months from the previous health assessment dated 2/1/22.

The file for Staff Person #6 (See LIS Code Sheet) contained fire safety training dated April 2025, more than 12 months from the previous fire safety training dated February 2024. The file for Staff Person #7 (See LIS Code Sheet) contained fire safety training dated 4/23/25, more than 12 months from the previous fire safety training dated 2/29/24.

The emergency contact form for Child #1 lacked the health insurance policy number.

The Emergency Transportation Plan was not posted in the Preschool 1 classroom.

The file for Staff Person #5 (See LIS Code Sheet) lacked pediatric first aid and CPR training within 90 days of hire date.

The file for staff #2 contained an expired state police clearance dated 1/16/19. The file for staff #3 contained applications for the FBI and NSOR clearances dated 12/29/23, however the file did not contain the completed results. The file for staff #4 contained an NSOR application dated 9/18/23 and results dated 1/31/24. The file did not contain documentation of suspension at the end of the 45-day provisional hire period. The file for staff #5 contained a disclosure statement which was not dated or signed by a witness.

The letter to parents explaining the facility's emergency procedures did not include details regarding accommodations for infants, toddlers, and children with disabilities or chronic medical conditions.

Two pothos plants were observed in child care space; in Pre-K and PS 1. Pothos is designated as a poisonous plant by Caring for Our Children: National Health and Safety Performance Standards.

A first aid kit on the playground was accessible to children. The bag was observed hanging on the fence behind the chalkboard.

The school age first aid kit did not include gloves.

Two areas of broken window trim, with splintering wood, were observed in the PSR room. A protruding nail was observed in the wall trim of the OT room under the numbered balloons. Metal anchors, intended to hold down a small shade tent, were not secured in place causing the ends to protrude upward creating a risk for tripping or injury.

A loose toilet seat was observed in the restroom adjacent to Preschool 1.

The waste receptacle near the sink in the school age area was not lidded.

One of two exits from the PSR room was observed to be blocked with a food service cart at approximately 9:35 AM.

Two pairs of Colorations brand blue, blunt tip, scissors were observed in the Pre-K room. According to the manufacturer's website, the scissors are intended for ages 5+ and grades K+.

Cracked Magna Blocks were observed in the preschool room. A loose handle creating a pinch point was observed on a storage cabinet near the door to the outdoor play space. Loose legs, creating pinch points, were observed on a wooden table on the playground.

A bin of plastic connecting cubes, with a diameter of less than 1 inch, were accessible to toddlers near the door used by children to access the outdoor play space.

A crib in use in the infant room lacked 2 feet of space on 3 sides. One side was obstructed by an empty crib.

An accessible metal storage box, containing medication, was observed mounted on the wall behind the sink in the school age area. The lock on the box was no longer functional due to a key broken off in the lock. A child proof plastic strap type appliance lock was in place during the inspection, however, this lock was not sufficient for the school age children observed in the space. The box is mounted directly behind the sink faucet and knobs.

The file for staff #6 contained a health assessment that lacked confirmation that a physical examination was done. The related question on the form was marked NO by the individual who completed the form.

The facility lacked documentation of submitting the emergency plan to the county emergency management agency. Changes were made to the plan in 2023.

The files for staff #3 and #5, designated on the staff data sheet as group supervisors, did not contain documentation of the qualifications required for the position.

The file for child #6 contained a child service report which was signed but not dated by the parent, therefore compliance could not be determined. The file for child #8 contained a child service report dated more than 6 months after their first day of attendance, but is now current.

The files for children #1, and #3-8 contained the original agreements.

The emergency contact form for child #4 did not include the child's birth date.

The emergency contact forms for child #5 and child #8 did not include the enrolling parent's work phone number.

The files for children #2, #3, #4, #5, and #7 contained emergency contact information and agreements which were not reviewed and signed by the parent at least once in a 6-month period. All files cited now contain current emergency contact information and agreements.

The file for staff #6 contained only 1 written reference.

The file for staff #1 contained documentation of 5.5 hours of training completed on time between 12/2022 and 12/2023 and contained 6.5 hours of training completed late, The file is now current.

Based on staff statements and video observation, on 9/26/23 child # 1 and #2 arrived late. The children were taken out to the play space to join their class. When staff # 1 saw the children, she pushed them by the arm into a line by the play space fence and loudly stated that the children should just get in line because they already missed half the day, and they were headed inside for lunch. There were no other children in line at the time.

Based on staff statements and video observation, on 9/26/23 child # 1 and #2 arrived late. The children were taken out to the play space to join their class. When staff # 1 saw the children, she pushed them by the arm into a line by the play space fence and loudly stated that the children should just get in line because they already missed half the day, and they were headed inside for lunch. There were no other children in line at the time.

The Facility's emergency plan lacked a method for facility persons to contact parents as soon as reasonably possible when an emergency situation arises.

The facility lacked a method for facility persons to inform parents that the emergency has ended and to provide instruction as to how parents can safely be reunited with their children.

There was hand sanitizer label "Keep out of reach of children " on top of the school age room counter accessible to children. There was healing ointment skin protector label " keep out of reach of children " in a child's backpack in the preschool room.

There was chipped plaster on the wall by the window in the school age room.

The shed in the playground has a wall panel pulling off. There was a highchair with missing straps in the YT room.

The thermometer in the refrigerator in the PSR room was 47 degrees.

The file for child # 1 is missing a dose of the DTAP, HIB, HB, Pneumococcal and Polio vaccines. The files for child # 3 and 5 lacked influenza vaccine.

The operator was not maintaining a medication log for a prescription medication, Albuterol Sulfate Inhalation Aerosol for child #6.

There was chicken nuggets, cheese and lunch meat in three different lunch boxes in the pre k room.

The file for child # 2 contained a current health report that was provided after 60. The child was in care longer that 60 days without initial health report. The file for child # 3 contained a current health report that was provided after 60. The child was in care longer that 60 days without initial health report. The file for child # 4 contained a current health report that was provided after 60. The child was in care longer that 60 days without initial health report.

The staff files were stored in the office in an unlocked cabinet.

The file for staff #1 lacked the date on the disclosure statement.

There was a sanitizer bottle on top of a shelf in the preschool room accessible to children.

There was a glass multi surface cleaner on top of the white refrigerator by 2 boxes of Kool-Aid freeze pops. There was a Hospital Disinfectant can in the PSR room cabinet by a cereal box and crackers on the bottom shelf.

There was 3 holes on the screens on the left side of the window on the back of the preschool room.

There was 2 holes with rough edges on the beige wall under the toothbrushes bulletin board. The counter top of the sink in the preschool bathroom is pulling off the wall.

The first toilet stall on the right in the preschool room was soiled with urine and toilet paper. In the Pre-k room bathroom both toilet stalls were soiled with urine.

There were 3 plastics bins cracked in the preschool room. There was a cracked plastic bin. There was a white board with exposed sharp edges in the pre-k room.

There was a blue chair with a missing screw creating a pinching hazard in the PSR room.

There were 5 rest mats that had less than 2 feet of space on three sides, in the preschool room. There were 4 cribs that had less than 2 feet of space between them, in the infant room.

The file for child # 4 lacked an initial health report, the child start date was 11/8/21.The current health report is dated 4/4/22.

The file for child #5, a young toddler, lacked a health report within 6 months of the previous report.

Staff # 4 didn't wash the child's hands after being diapered.

staff # 4 was observed placing a soiled diaper on the changing table during a diaper change, rather than immediately discarding it into a plastic-lined, hands-free covered can.

Staff # 4 did not disinfecting the changing table surfaces after diapering.

Observed staff # 4 diaper a child. The staff did not wash their hands after diapering the child.

There was a gallon of 1% milk not refrigerated left on the counter top in the kitchen.

There was a bowl with oranges on top of the counter top. There was a bag of oranges not refrigerated, they were on the counter top in the kitchen.

Staff person(s) shall complete professional development in the topics of 3270.31(f)(1 -- 10), 3280.31(f)(1-10), or 3290.31(g)(1-10) within 90 days of hire. Staff person #3 will have until 8/23/22 to complete the required training with a PQAS approved trainer. Until such time as the required training has been completed, staff person #3 must be supervised, when interacting with children, by an AGS who has completed the required training related to this citation. If there are no staff available to supervise staff person #3, staff person #3 may not work in a child-care position at the facility.

The file for child # 1 lacked the information on the child's special needs, on the emergency contact form.

The information on how to access the regulations electronically was not provided to the parents of each enrolled child.

On October 1, 2021 staff #1 was alone in the Older Toddler Room with a group of 6 older toddler and preschool aged children, the youngest being 2 years old. While caring for 6 children, staff #1 took one child into a separate room (restroom) to perform a diaper change. During the diaper change, the remaining 5 children were left alone (no staff person was physically present to maintain ratio) and unsupervised in the classroom. During this time, child #1 received an injury when his fingers were closed in the bathroom door by another child in the unsupervised classroom.

On October 1, 2021 staff #1 was alone in the Older Toddler Room with a group of 6 older toddler and preschool aged children, the youngest being 2 years old. While caring for 6 children, staff #1 took one child into a separate room (restroom) to perform a diaper change. During the diaper change, the remaining 5 children were left alone (no staff person was physically present to maintain ratio) and unsupervised in the classroom. During this time, child #1 received an injury when his fingers were closed in the bathroom door by another child in the unsupervised classroom.

On October 1, 2021 staff #1 was alone in the Older Toddler Room with a group of 6 older toddler and preschool aged children, the youngest being 2 years old. While caring for 6 children, staff #1 took one child into a separate room (restroom) to perform a diaper change. During the diaper change, the remaining 5 children were left alone (no staff person to maintain ratio) and unsupervised in the classroom. During this time, child #1 received an injury when his fingers were closed in the bathroom door by another child in the unsupervised classroom.