The Alphabet Tree

The updates to the FBI clearances on file for Staff Person #1 exceeded 60 months between clearances dated 2.20.20 and 5.30.25.

The file for Staff Person #1 lacked verification that they had updated their Pediatric First Aid and CPR training on or before the expiration of the prior certification. This is evidenced by a training certification having expired in 12.2022 and an updated training certification being completed on 7.15.25. The information for Staff Person #1 has not been included on Staff Worksheets since their 2022 Renewal Inspection despite continued employment at the facility resulting in their file not being properly assessed at the last 3 renewal inspections.

The file for Staff Person #1 lacked prior fire safety training that had been completed within the 12 months prior to the current training dated 7.15.25.

Based on interviews with Staff at the time of an unannounced visit, it was reported that there are times that the facility is noncompliant with the staff:child ratio requirements with similar age children.

At approximately 9:46am, Staff Person's #1 and #2 were observed to caring for a mixed age group that included 4 young school age and 17 preschool aged children. The mixed age ratio for a group that includes preschool children is 1:10.

A pair of adult scissors were observed in an unlocked drawer in Classroom #5. The scissors were accessible to Preschool age children receiving care in the space. A loose crib sheet was observed on one of the cribs in Classroom #2.

The file for Staff Person #1 lacked a current PA Child Abuse Clearance and and NSOR Certificate. The most recent PA Child Abuse Clearance was dated 5.11.20 and the most recent NSOR was dated 6.4.20 for Staff Person #1. The files for Staff Person #2 and #3 lacked a current NSOR Certificate. The most recent NSOR certificates on file for Staff Person #1 and #2 were both dated 5.22.20. The file for Staff Person #4 lacked a disclosure statement that had been completed within 90 days of starting at the facility.

At approximately 9:46 Staff Person's #2 and #8 were observed to be caring for a mixed age group that was determined to include 4 young school age children and 17 preschool age children in Classroom #6. Both Staff initially reported there being 20 children present. 21 children were observed in the space. Staff Person #2 identified being responsible for 10 preschool age children but then named 8 children using the face to name tags in place. Staff Person #7 reported Staff Person #2 had given them two of their face to name tags and gave two tags to Staff Person #2 who then identified two additional children. Staff Person #7 then identified being responsible for 4 young school age and 5 preschool children. This left 2 preschool children not identified by either staff person.

A soiled ceiling tile, that appeared to have mold around a vent, was observed in Classroom #4.

The file for Staff Person #5 lacked verification that they had received annual emergency plan training within the last 12 months. The most recent fire safety training on file was completed on 1.24.24.

Three electrical outlets were observed to be missing protective receptacle covers in Classroom #7.

Four bottles of sunscreen and a Lysol Spray was observed on a low cart in Classroom #7. An unlocked closet was also observed to contain a large box with spray paints. The items would be accessible to Preschool and School Children who pass through the space to go to the outdoor play space and the classroom is reported to be used for overflow at times. All items were labeled Keep Out of Reach of Children. Bingo daubers, labeled Keep Out of Reach of Children, were observed in a bin with the children's toys in Classroom #6. The bingo daubers were accessible to Preschool and School Age children receiving care in the space. In Classroom #5, one bottle of hand sanitizer was observed on a teacher desk on the left side of the classroom, another bottle of hand sanitizer and disinfecting wipes were observed on a drawer unit next to the changing table on the left side. A bottle of hand sanitizer was observed on the drawer unit on the right side of the classroom. A bottle of hand sanitizer and air freshener spray was observed in the unlocked staff restroom located off of the eating area used by children in the facility. The items were labeled Keep Out of Reach of Children.

The door from Classroom #7, leading to the outdoor play space, was observed to be open. A screen was not in place.

A source of running water was not present at the changing area in Classroom #4. The portable sink at the changing table on the left side of Classroom #5 was reported to not be used as the sink was clogged.

One cracked lid with a potential pinch point was observed on a bin in Classroom #6.

Small pom poms, with a diameter of less than 1 inch, were observed in the bottom drawer of a drawer unit in the art area in Classroom #5. Older Toddlers were observed to be receiving care in the space.

An unlabeled Zarbee's Cough Syrup was observed in a bin with Sunscreens in Classroom #4.

The portable sink next to the changing table on the left side of Classroom #5 was in disrepair. Staff reported using hand sanitizer following diapering of Preschool Children. An operable portable sink was in place on the right side however another Staff Person reported using hand sanitizer following the diapering of Older Toddler and Preschool Children. Staff in Classroom #4 reported using hand sanitizer following the diapering of Toddler age Children in the classroom. Certification Rep observed Older Toddler and Preschool Children transitioning from Classroom #5 to the classroom for meals only. The children were seated without first washing their hands. It was confirmed that they had not washed their hands prior to entering the classroom for meals. Classroom #4 was observed to have already been present in the meal classroom eating their lunch. Staff confirmed that these children also had not washed their hands prior to eating lunch.

A used pull up was observed in an unlidded garbage can at the changing table, reported to not be use, on the right side of Classroom #4.

The most recent health report on file for Staff Person #5 lacked a date to verify that it had been completed within the last 24 months.

An infant, reported by Staff to be 5-6 months old, was observed to be propped on a boppy pillow on the floor with a neck pillow in front of their neck propping the bottle. The infant was not being held while being bottle fed.

The file for Staff Person #5 lacked verification that they had completed annual fire safety training within the last 12 months. The most recent fire safety training on file was completed on 1.30.24.

The file for Staff Person #5 lacked a written evaluation that had been completed within the last 12 months. The most recent written evaluation was dated 1.30.24.

The file for Staff Person #6 lacked two written, nonfamily references attesting to their suitability to serve as a facility person.

The file for Staff Person #5 lacked 4.5 of their 12 hours of annual child care training.

On 4/22/25 at approximately 11:05 while assessing supervision and ratio, Staff #2 was observed plating food in the front eating area and did not have a supervision group. An infant was observed in a high chair in the eating area. The infant was in Staff #1's supervision group and Staff #1 was not in the room at the time. Staff #1 was observed leaving the Infant room and walking into the eating area while carrying a second infant and putting them in a high chair. When Staff #1 left the Infant Room, Staff #1 left five infants alone with no other staff members in the room. When Staff #1 was asked to name their supervision group, Staff #1 named the two infants in the high chair and began mentioning the children in the Infant Room. While discussing supervision groups with Staff #1, Staff #3 walked into the Infant Room. Staff #3 was the only staff member in the Infant Room and named five infants in their supervision group. At that time, Staff #2 walked into the Infant Room, putting the room back in ratio.

The file for Staff #1 lacked requests or completed clearances for an out of state Child Abuse Clearance and a Sex Offender Clearance for states they have resided in within the last 60 months.

Staff #2, previously removed from a child care position on 2/24/25 due to lack of required out of state Child Abuse clearance, was observed to be interacting with and serving lunch to a mixed group of young toddler and preschoolers in the eating area of the facility.

On 4/22/25 at approximately 11:05 while assessing supervision and ratio, Staff #4 was observed plating food in the front eating area and did not have a supervision group. An infant was observed in a high chair in the eating area. The infant was in Staff #3's supervision group and Staff #3 was not in the room at the time. Staff #3 was observed leaving the Infant room and walking into the eating area while carrying a second infant and putting them in a high chair. When Staff #3 left the Infant Room, Staff #3 left five infants alone with no other staff members in the room. When Staff #3 was asked to name their supervision group, Staff #3 named the two infants in the high chair and began mentioning the children in the Infant Room. While discussing supervision groups with Staff #3, Staff #5 walked into the Infant Room. Staff #5 was the only staff member in the Infant Room and named five infants in their supervision group. At that time, Staff #4 walked into the Infant Room, putting the room back in ratio.

On 4/22/25 at approximately 11:05 while assessing supervision and ratio, Staff #4 was observed plating food in the front eating area and did not have a supervision group. An infant was observed in a high chair in the eating area. The infant was in Staff #3's supervision group and Staff #3 was not in the room at the time. Staff #3 was observed leaving the Infant room and walking into the eating area while carrying a second infant and putting them in a high chair. When Staff #3 left the Infant Room, Staff #3 left five infants alone with no other staff members in the room. When Staff #3 was asked to name their supervision group, Staff #3 named the two infants in the high chair and began mentioning the children in the Infant Room. While discussing supervision groups with Staff #3, Staff #5 walked into the Infant Room. Staff #5 was the only staff member in the Infant Room and named five infants in their supervision group. At that time, Staff #4 walked into the Infant Room, putting the room back in ratio.

At approximately 11:10 AM, a mixed age group of 30 children ranging from young toddler to preschoolers, were observed in Classroom 5 (Older Toddlers and Preschool 1) which has a designated maximum capacity of 28.

Based on interviews, rest equipment lacks two feet on three sides of a bed, cot, crib, or other rest equipment while the equipment is in use.

The most recent 30-day fire alarm testing on the fire alarm testing log is dated 3/21/25, more than 30 days prior.

The file for Staff Person #1 lacked a current FBI Clearance that had been completed within the last 60 months. The most recent FBI Clearance was dated 8.24.19. The file for Staff Person #2 lacked a current request for a PA State Police Clearance prior to starting at the facility. The request on file was dated 2 years prior to starting. The file for Staff Person #2 lacked a completed PA State Police Clearance as the one on file was listed as "Under Review". Staff Person #2 has exceeded 45 days in a child care taking position. (Refer to LIS Code Sheet). A completed PA State Police Clearance was not on file until 189 days after starting in a child care taking position. The file for Staff Person #4 lacked a completed out of state Child Abuse Clearance for a state they have resided in within the last 60 months.

A pair of adult scissors were observed on the desk in the Preschool area of Classroom #5. The scissors were accessible to preschool age children receiving care in the space.

A bottle of hand sanitizer was observed on the desk in Classroom #7 (the school age classroom). The room is not currently in use, but children do pass through the classroom to enter the outdoor play space.

In the Preschool area of Classroom #5 an open front garbage can was observed to contain used tissues and disposable cups used by the children. The open front of the garbage can did not allow containment of the trash contaminated by human secretions.

A first aid kit was missing from Classroom #2 (the back infant nap room).

In Classroom #7 (the school age classroom) two damaged ceiling tiles were observed in the loft area. One of the damaged tiles allowed a large area of insulation to be visible. In the outdoor play space one of the railroad ties on the retaining wall was observed to be damaged causing splintering wood. Also in the outdoor play space, a yellow door to the left upon entrance to the play space was observed to be disrepair with splintering wood along the bottom.

In the cubby areas of Classroom 5 (used by Toddler and Preschool age children) 5 unlabeled mats were observed.

The file for Child #4, a young toddler, lacked updated health reports every 6 months. The health reports on file were dated 1.26.24 and 1.28.25.

The file for Child #1, a preschool age child, lacked an updated health report that had been completed within the last 12 months. The most recent report on file for Child #1 was dated 1.22.24.

Staff Person #2 was observed to change a child's diaper in Classroom #5 and place the child down without ensuring the child washed their hands prior to returning to playing with toys in the classroom.

The current health assessment on file for Staff Person #2 lacked a statement from the physician regarding their suitability to provide child care.

The facility lacked documentation that they had completed an annual emergency drill in the last 12 months. The most recent emergency drill on file was dated 4.6.23.

The facility exceeded 30 days between documented smoke alarm testing on 11.1.24 and 12.3.24 and 12.3.24 and 1.8.25. There was no documentation of alarm testing in the last 30 days.

The file for Child #3 lacked an initial health assessment within 60 days of starting at the facility. An initial assessment was not on file until 1079 days after starting at the facility.

The file for Staff Person #1 lacked completion of Pediatric First Aid and CPR training within 90 days of starting at the facility. The completed Pediatric First Aid and CPR training was completed 285 days after starting at the facility. The file for Staff Person #2 lacked completion of the required Health and Safety training within 90 days of starting at the facility. The Health and Safety trainings were not completed until 160 days after starting at the facility. The file for Staff Person #3 lacked completion of the required Health and Safety training within 90 days of starting at the facility. The Health and Safety trainings were not completed until 111 days after starting at the facility. The file for Staff Person #4 lacked completion of their Pediatric First Aid and CPR training and their Health and Safety training within 90 days of starting at the facility. The Pediatric First Aid and CPR training was completed 627 days after starting and the health and safety training was completed 160 days after starting.

The file for Child #2 was observed to contain an original agreement.

The emergency contact form for Child #2 lacked the health insurance coverage and policy number for the child.

The emergency contact form for Child #2 lacked the address for one of the release persons listed. The emergency contact form for Child #5 lacked the addresses for all of the release persons listed.

The written emergency transportation plan was not posted in Classroom #2 (the back infant nap room).

The updates to the emergency contact form and financial agreements for Children #1, #2, and #3 have exceeded 6 months since last review in July 2024. The update to the financial agreement for Child #4 has exceeded 6 months since last review in July 2024.

The file for Staff Person #3 lacked one written, nonfamily reference. One of the two references on file was a relative.

The file for staff # 4 contained a current State Police clearance dated 1/4/24, that was not renewed within 60 months of the prior State Police clearance dated 1/3/19.

There was a backpack in the YT room that contained fever and pain medication label " keep out of reach of children." Accessible to children.

There were 2 damaged ceiling tiles in the infant room. There was a damaged ceiling grid in the bathroom. There was a damaged ceiling tile grid in the eating area room. There were two broken floor boards that created a tripping hazard in the OT room.

There was peeling paint on the right-side wall in the YT room. There was peeling paint on the back wall in the OT room.

There was a cracked clear bin and cracked lid in the eating area room. There was a yellow school bus and a green connector bunny toy broken in the young older room. There was a broken fire truck toy in the Preschool room. There was a broken orange hanging toy on the toy house in the pre-k room. There was a damaged spot exposing splinters on top of the cubbies in the eating area room.

The young toddler room refrigerator temperature was 50 degrees.

The file for child # 3 a preschooler contained an updated health report dated 8/3/23. The previous report was dated 8/1/22.

The operator was not maintaining a medication log for a prescription medication, Auvi Q 0.15 mg Epinephrine injection for child # 4.

Staff # 8 kept a soiled diaper on the changing table until she was done with the diaper change, instead of discarding it immediately into a plastic-lined, hands-free covered can.

The file for staff # 1 contained a current fire safety training certificate dated 1/5/24. The training was obtained greater than one year past the prior training, obtained 12/14/22. The file for staff # 2 contained a current fire safety training certificate dated 1/5/24. The training was obtained greater than one year past the prior training, obtained 12/14/22. The file for staff # 3 contained a current fire safety training certificate dated 1/5/24. The training was obtained greater than one year past the prior training, obtained 12/14/22. The file for staff # 4 contained a current fire safety training certificate dated 1/30/24. The training was obtained greater than one year past the prior training, obtained 12/14/22. The file for staff # 5 contained a current fire safety training certificate dated 1/16/24. The training was obtained greater than one year past the prior training, obtained 12/14/22. The file for staff # 6 contained a current fire safety training certificate dated 1//24. The training was obtained greater than one year past the prior training, obtained 12/14/22. The file for staff # 7 contained a current fire safety training certificate dated 1/5/24. The training was…

The files for staff # 5 and 6 lacked written evaluation every 12 months. The last evaluation on file is dated 1/24/23.

The file for child # 1 lacked a child service report. The file for child # 2 contained a current child service report dated 1/31/24 that was conducted more than 6 months from the prior report dated 1/27/23.

The files for child # 1 and 2 lacked the 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, on the Emergency contact form.

Staff person #1 has not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): First-aid/CPR and Health and safety training.

There was a can of Lysol Disinfectant spray on the diaper table in the Preschool 2 room.

There was one handwashing sign for both sinks in the children's bathroom off the lunch room. There was one handwashing sign for both the diaper table and the camping sink in the front of the Toddler/Preschool room.

The last two health reports in the file for child #1, a young toddler, were dated 10/5/21 and 5/2/22 and the last health report is dated more than 6 months ago.

The last two health reports in the file for child #4, a preschooler, were dated 6/25/21 and 8/1/22. The last two health reports in the file for child #5, a preschooler, were dated 9/10/21 and 1/16/23.

The last two health assessments in the file for staff person #3 were dated 11/27/20 and 1/18/23. The last two health assessments in the file for staff person #4 were dated 12/7/20 and 1/26/23.

There was one time in the previous 12 months that the fire detection system was tested 31 days apart: 10/7/22 and 11/7/22.

The large screen television in the older toddler/preschool 1 room was not anchored, creating a possible tipping hazard. The facility's shaken baby policy did not include information regarding the identification and prevention of child maltreatment/abuse.

The 1 hour health and safety in the file for staff person #4 was dated 12/31/22.

The last two mandated reporter trainings in the file for staff person #4 were dated 11/27/17 and 12/30/22. The last two mandated reporter training in the file fir staff person #9 were dated 10/10/17 and 11/23/22.

The last two evaluations in the files for staff person #1 through #9 were dated 1/14/22 and 1/24/23.

The last two child assessments in the file for child #1 were dated 12/29/21 and 1/19/23. The last two child assessments in the file for child #2 were dated 1/28/21 and 1/17/23. The last two child assessments in the file for child #3 were dated 12/29/21 and 1/27/23. The last two child assessments in the file for child #4 were dated 12/29/21 and 1/17/23.

The file for staff person #10 did not include two letters of reference.

Facility Person #4 began employment in a child care position on 6/23/21 with a signed disclosure statement and proof of application for an NSOR clearance both dated 6/21/21. The NSOR clearance on file for Facility Person #4 was dated 12/21/21.

The facility's plan for a lockdown was not included in the letter to the parents explaining the emergency plan.

There were areas of of peeling paint/damaged plaster in the infant room on the wall behind a chair and where the gate attaches at the doorway to the kitchen area. There was an area of peeling paint on the wall in the 3's room next to the door to the 4's room, behind a trash can and near the block area.

There was no documentation of a current flu vaccine on file (recommended annually by the ACIP) on file for child #1.

The written safe routes for pick-up and drop-off was not posted at the facility.

There was no documentation of an emergency drill.

Documentation of testing of the facility's smoke detectors indicates that more than 30 days passed between testing on the following dates: 7/16/21-8/16/21; 12/10/21-1/10/22.

Current firesafety training was completed by Facility Persons #1 and #2 more than 12 months after the prior firesafety training, according to documentation on file.

There were no emergency contact forms in the front lunch room for the children having lunch in that space.

The current emergency contact forms and agreements on file for children #1, #3 and #4 were reviewed and updated by a parent in writing more than 6 months after the previous review. The most recent emergency contact and agreement form on file for child #2 were not reviewed and updated by a parent in writing in the previous 6 months.

It was observed that the operator had added interior walls to the facility, which, according to the municipality's building inspector, would require an inspection and updated occupancy permit. The operator had failed to apply for and obtain a revised occupancy permit as required.

Facility Persons #3 and #4 each completed pediatric first aid and CPR more than 90 days after their hire dates.