Tiny Smiles Childcare

The file for Staff #4 lacked a PA State Police Clearance, PA Child Abuse Clearance, FBI Clearance, NSOR Certificate, and Disclosure Statement. Staff #4 was observed alone unsupervised caring for children.

In the Main Classroom at approximately 10:15 AM Staff #1 identified 6 Older Toddler Aged children as part of their assigned group. At this time, Staff #2 identified 5 Preschool Aged children as part of their assigned group. Cert Rep observed 14 children receiving care in the classroom therefore leaving Child #1, #2, and #3 not identified as being in an assigned primary group. At approximately 10:25 AM, Staff #4 was observed in the Baby Space with three infants. Staff #4 when asked to identify their group, name the three infants in the Baby Space and also Child #4 who was observed in a pack n play outside the doorway in the Main Room. Therefore Staff #4 was not physically present with Child #4.

A pack n play with an infant inside was observed taking up the whole doorway blocking the only exit from the Baby Space Classroom which had three infants and a staff person in the room.

The file for Staff #4 lacked a Health Assessment.

The file for Staff #4 did not contain the results of a tuberculin skin test, x-ray or other medical documentation necessary to confirm freedom from communicable tuberculosis.

Based on Fire Drill Log documentation, the last fire drill occurred more that 60 days prior to the current documented fire drill 6/9/25-10/2/25 (115 days).

Staff #4 was observed acting as an AGS in the Baby Space. The file for Staff #4, lacked verification of childcare experience, education and training prior to service at the facility, to qualify as an AGS.

There was no file provided for Staff #4 at the time of inspection.

The file for Staff #4 did not include the address and telephone number of the facility person.

The file for Staff #4 did not include verification of age.

The file for Staff #4 lacked proof of qualifications for education in the form of a diploma, transcript, or letter signed by a representative or the experiential, educational or training entity.

The file for Staff #4, lacked two written, nonfamily references from individuals attesting to the suitability to serve as a facility person.

The file for Staff #1 (See LIS Code Sheet) contained an FBI clearance from the Department of Education dated 8/15/24. The file for Staff #5 (See LIS Code Sheet) contained an NSOR certificate dated 6/16/20 which was obtained over 60 months ago.

The file for Staff #1 (See LIS Code Sheet) lacked a disclosure form.

There was an open outlet in the gross motor play area accessible to children 5 years of age or younger.

In the large restroom, on the lower shelf under the changing table, were sunscreen and diaper cream labeled "Keep out of reach of children" accessible to children.

The water temperature in both the small and large restrooms was 123°F.

The emergency exit from the main room was obstructed by a sink/cabinet. The walkway to the emergency exit near the restrooms was partially obstructed by cots laying in the hallway.

The most recent health assessment of file for Staff #2 was dated 11/15/22 which was more than 24 months ago.

The Activity Room, located through the large restroom, was being used as a storage area and not set up to care for children (no required postings; no first aid kit; etc.).

Documentation of the fire alarm system test shows more than 30 days between testing. (3/20/25 and 4/23/25; 5/6/25 and 6/9/25).

Staff person #3 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, and Pediatric First Aid and CPR.

Staff person #3 has not completed mandated reporter training within 90 days of their date of hire (see LIS code sheet).

The file for Staff #4 lacked a copy of their High School Diploma/GED.

The file for Staff #2 lacked two written, nonfamily references from individuals attesting to the person's suitability to serve as a facility person.

The file for Staff Person #1 (See LIS Code Sheet) lacked a PA State Criminal Clearance and a Disclosure statement; The file for Staff Person #4 (See LIS Code Sheet) lacked a PA State Criminal Clearance; The file for Staff Person #6 (See LIS Code Sheet) lacked a PA State Criminal Clearance and a Disclosure statement.

* At approximately 10:30am, Staff person #1 was observed in the unmeasured eating area with 9 children; 1 Infant, 1 Young Toddler, 5 Older Toddlers, 1 Preschool Aged and 1 School Aged. Staff Person #3 was observed in the Gross Motor Room with 12 children; 5 Preschool Aged and 7 School Aged. At approximately 10:40am, there were 9 children in the eating area with no staff present. Staff #1 who was assigned the responsibility for supervising the 9 children, left the eating area to accompany a child to the restroom located outside of the eating area

**At approximately 10:30am, Staff person #1 was observed in the unmeasured eating area with 9 children; 1 Infant, 1 Young Toddler, 5 Older Toddlers, 1 Preschool Aged and 1 School Aged. Staff Person #3 was observed in the Gross Motor Room with 12 children; 5 Preschool Aged and 7 School Aged. At approximately 10:40am, there were 9 children in the eating area with no staff present. Staff #1 who was assigned the responsibility for supervising the 9 children, left the eating area to accompany a child to the restroom located outside of the eating area

At approximately 10:40am, there were 9 children in the eating area with no staff present. Staff #1 who was assigned the responsibility for supervising the 9 children, left the eating area to accompany a child to the restroom located outside of the eating area.

The Emergency Plan did not address Continuity of Operations as required by Announcement C-22-04 which states to maintain full compliance with 45 CFR § 98.41(a)(1)(vii), child care facilities must have requirements for continuity of operations including information regarding how they will pay for repairs, pay staff, and pay bills during the aftermath of the disaster.

The facility's emergency plan did not provide a method for informing parents that the emergency has ended and how they can reunite with their child(ren).

The emergency plan on site was documented as having last been reviewed 9/30/21 which exceeds the annual requirement.

The files for Staff Person #1, #2, #3, #4, and #6 lacked documentation of emergency plan training.

The parent letter explaining the emergency procedures lacked the following: lockdown information; accommodations for infants, toddlers, children with disabilities, and children with chronic medical conditions; method on how to communicate with parents at the beginning and end of an emergency situation, including how to reunite with their children.

From approximately 10:30am till 12:15pm, 10 children were observed being cared for in the unmeasured eating area.

The Gross Motor Room play space has a measured capacity of 3. From approximately 10:30am till 12:00pm, Staff Person #3 was observed in the Gross Motor Room with 12 children; 5 Preschool Aged and 7 School Aged.

In the restroom, Aquaphor, labeled "keep out of reach of children" was accessible to children. In the main room, Glade air freshener, labeled "keep out of reach of children" was in an unlocked cabinet accessible to children.

The first aid kit in the Main Room lacked soap and scissors. The first aid kits in the Gross motor room lacked soap, scissors, and tweezers.

There was wood splintering above the gate entering the toddler area. There were miscellaneous pieces of equipment outside the toddler area presenting a tripping hazard.

The toddler area had peeling paint on the walls and above the outlet. The paint around the windows was cracked and peeling. In the main room, there was peeling paint around several taped outlets.

There was a urinal in the boys' restroom that lacked a handwashing sign.

There was a broken firetruck missing wheels in the toddler area. There was a sharp edge in the play house in the toddler area where the play phone support is broken. The dolls in the main room were stained and not in good condition.

At approximately 1:30pm, in the main room, 22 children were resting on cots and Port-a-cribs for naptime. All of the rest equipment lacked at least 2 feet of space on three sides.

The file for Child #2, a young toddler, lacked an updated health report. The most recent health report on file is dated 4/8/24, more than 6 months ago.

The file for Staff Person #3 (See LIS Code Sheet) contained TB screening results dated 4/15/21 more than 12 months prior to starting in a child care position. The file lacked a current health assessment. The previous health assessment was dated 6/3/22. The file for Staff Person # 4 (See LIS Code Sheet) lacked an initial health report. The file for Staff Person #5 lacked a current health report. The previous health assessment was dated 6/4/21.

The file for Child #1, an infant, lacked a statement giving the formula and feeding schedule obtained from the parent.

The facility's emergency plan lacked accommodations for infants and toddlers.

The facility lacked a current annual emergency drill. The most recent emergency drill was recorded on 10/29/22, more than 12 months ago.

The lower level of the building where the restrooms, gross motor room, and eating area are located lacked a posted evacuation route.

The facility lacked documentation that the emergency plan was submitted to the local and county EMA.

The facility lacked a current annual notification to local traffic safety authorities of the location of the facility and the program's use of pedestrian and vehicular routes around the child care facility.

The facility lacked a policy and procedure to identify the prevention of shaken baby syndrome, abusive head trauma, and child maltreatment as per Announcement C-22-03.

The file for Staff Person #3 (see LIS Code Sheet) contained a current First Aid and CPR certification dated 1/22/25; the prior First Aid and CPR training was dated 5/8/22 which expired in May 2024. The file for Staff Person #4 (see LIS Code Sheet) lacked pediatric First Aid and CPR. The file for Staff Person #5 (see LIS Code Sheet) contained pediatric First Aid and CPR completed on 7/6/22 which expired in July 2024.

The files for Staff Person #1, #2, #3, #4, #5, and #6 (See LIS Code Sheet) lack documentation of annual fire safety training.

Staff Person #4 and Staff Person #6 (See LIS Code Sheet) have not completed the mandated reporter training within 90 days of their date of hire (see LIS code sheet).

The files for Staff Person #1, #2 and #6 lacked documentation of the qualifications for the position they were performing.

The file for Staff Person #4, employed for more than 12 months, lacked a written evaluation.

The agreement form for Child #1 lacked the date on which the fee is to be paid.

The files for Child #2, #3, and #5 lacked documentation on the Department's approved form to provide the family information about the child's growth and development.

The agreement forms for Child #4 and Child #5 lacked the arrival and departure times.

The agreement forms for Child #1, Child #4, and Child #5 lacked the persons designated by the parent to whom the child may be released.

The file for Child #1 lacked the date of admission.

The files for Child #1, Child #2, Child #3, Child #4, and Child #5 contained the original fee agreement forms.

The file for Child #4 lacked written consent signed by the parent for emergency medical care and minor first-aid procedures.

The emergency contact forms for Child #1 and Child #4 lacked the address of the individual designated by the parent to whom the child may be released.

The files for Child #2 and Child #5, each enrolled for more than 6 months, lacked documentation that the parent reviewed or updated the emergency contact information as well as the financial agreement as required.

The file for Staff Person #2 lacked one written nonfamily reference. The file for Staff Person #4 lacked two written nonfamily references.

The facility's current certificate of compliance was not posted in a conspicuous location used by parents.

The file for Staff Person #2 (See LIS Code Sheet) lacked documentation for 2 of the 12 training hours completed between April 2023 and April 2024. The files for Staff Person #3 and Staff Person #4 (See LIS Code Sheet) lacked documentation for 12 of the 12 training hours to be completed between June 2023 and June 2024. The file for Staff Person #5 (See LIS Code Sheet) lacked documentation for 12 of the 12 training hours completed between December 2023 and December 2024. The file for Staff Person #6 lacked documentation of annual training hours.

While Staff #1 wrote an incident report up for Child #1, it was not given to the parent on the day that the incident occurred.

The file for Staff #3 was lacking a signed and dated disclosure statement.

Upon arrival at the facility, Staff Person #1 was in a room with 3 Older Toddlers and 3 Young Toddlers putting Staff Person #1 out of ratio by 1 child. During time to prepare lunch Staff Person #1 and #2 combined their children. Staff Person #2 kept leaving Staff Person #1 alone in the room with one infant, 3 Young Toddlers and 3 Older Toddlers putting Staff Person #1 out of ratio

The file for Staff #3 was lacking emergency plan training within 90 days of their date of hire. (See LIS code sheet)

There were two missing receptacle covers in the gross motor room when you enter the room the wall on the left.

The small room and the art room were both lacking first aid kits.

The file for Child #1, a preschool aged child, contained 2 Health Assessments that were more than 12 months apart.

The facility did not have evacuation routes posted.

Emergency Contact form were not in the main room when the children were in there, they were not in the lunch room or art room when the children were in those spaces.

The file for Staff #1 was lacking proof of TB testing and the results of that test.

The facility was lacking posted evacuation routes.

The file for Staff #1 was lacking proof of her education

The file for Staff #1 was lacking 2 written non-family reference letters.