TSHC Wonder of LLC

The file for staff #1 contains a TB test that is too old. the TB test on file is dated 2/2023 and is only acceptable for up to 12 months. A new TB test was due upon hire (8/2024).

The file for staff #2 lacks updated first aid training. Staff #2's training expired 10/17/2024. Staff #2 was providing child care services.

The facility's Emergency Plan lacked Continuity of Operations and Volunteer Emergency Preparedness Training.

Two outlet covers were missing in the extension cord next to the television.

Teeth marks were observed in a foam puzzle and a plastic toy fence that were accessible to children who are still placing objects in their mouths.

The file for Child #5 (YT-18 mo) contained an updated health assessment dated 11/16/23, which is more than 6 months after the initial health assessment submitted at enrollment. (SEE LIS CODE SHEET).

The updated Child Health Assessment for Child #4 (OT) was lacking from the Child's file.

The immunization record on file for Child #1 (PSA) contained 3 of 4 doses of HIB and 3 of 4 doses of Pneumococcal with no Letter of Exemption in the file. The immunization record on file for Child #3 (YT-17 mo) contained 2 of 4 doses of HIB, 3 of 4 doses of Pneumococcal, and 0 of 1 dose of MMR and Varicella with no Letter of Exemption on file. The immunization record on file for Child #4 (OT) contained 2 of 3 doses of Hepatitis B with no Letter of Exemption on file. Child #1, Child #3, and Child #4 must be dismissed from care by close of business on 2/20/24 and may only return to care when the immunization record is updated or when a parent provides a written, signed exemption letter.

A Little Remedies Saline Drop medication was observed with an expiration date of 01/2024 in the Infant Room for Child #6.

The Initial Health Assessment on file for Staff #1 is dated 8/28/23, which is after date of hire. (SEE LIS CODE SHEET). The most recent health assessment on file for Staff #2 is dated 11/15/21, more than 24 months ago.

In the Infant Room, a bottle in the refrigerator lacked the child's name labeled for use.

The facility lacked documentation of an annual Emergency Drill.

The facility lacked annual written notification to local traffic safety authorities of location of facilities and vehicular routes around the facility.

Staff #1 had not completed the following required pre-service training within 90 days of their date of hire: Pediatric First-Aid/CPR Training (Dated 12/1/23). (SEE LIS CODE SHEET)

The Financial Agreement for Child #4 lacked persons whom the child can be released to.

The Emergency Contact form for Child #4 lacked written parental permission to administer minor first aid procedures.

The Emergency Contact form for Child #4 lacked written parental consent for "Emergency Medical Care".

The Emergency Contact forms for Child #3 and Child #4 lacked information on the disability or special needs.

The file for Child #2 and Child #5 lacked complete addresses for all listed release persons on the Emergency Contact form.

A written plan identifying the means of transporting a child to emergency care and staffing provisions in the event of an emergency shall be displayed conspicuously in every childcare space and accompany a staff person who leaves on an excursion with children.

The file for Staff #1 lacked two written non-family references attesting to the staff person's suitability to work in child care.

The file for Staff #2 did not contain 12 hours of annual child care training.

The NSOR Certificate in the file for Staff Person #1 was acquired more than 45 days after the staff person's start date (See LIS Code Sheet). The file for Staff Person #1 lacked a DHS FBI Clearance.

Observed adult scissors, which were accessible to children, in the unlocked cabinet drawer next to the refrigerator in the kitchen.

Observed two trash cans, which were not lidded and contained soiled tissues, next to the water fountain.

The white play stove and the tall wooden toy shelf were wobbly, which creates a potential toppling hazard.

The file for Child #1, who has been enrolled for more than 60 days, lacked an immunization record.

The health assessment in the file for Staff Person #1 did not include an examination for communicable diseases and the results of that examination or the physician's or CRNP's assessment of the person's suitability to provide child care.

Observed Staff Person #2 did not wash hands after changing a child's diaper. Discussion revealed that Staff Person #2 does not wash hands after diaper changes because staff person believed that gloves sufficed in lieu of handwashing.

The fire drill/fire system check log, documented two times when fire drills were conducted more than 60 days apart: 9/6/22-12/2/22 and 12/3/22-2/2/23.

The file for Child #1, who has been enrolled for more than 60 days, lacked an initial health assessment.

The health and safety training in the file for Staff Person #1 was conducted more than 90 days after the staff person's first day in child care (See LIS Code Sheet).

The file for Staff Person #1 included only one letter of reference.

On April 6, 2023, at approximately 09:05, CR and CRS observed a child in the kitchen area unsupervised. Staff present in the area were unaware of the child being in the kitchen area.

Staff Person #2 was asked to name her supervision group and successfully named 10 Pre-School children. Staff Person #1 was asked to name the children in her supervision group and named two but actually had three children. CR gave Staff Person #1 a second attempt and was unsuccessful. CR and CRS counted the total number of children and 13 were present. Staff Person #2 was asked to name her group again and again was successful and Staff Person #1 again named two of three children in her supervision group. CR explained there was a total of 13 Pre-School children and one child was left unidentified. After Staff Person #1 and #2 discussed their respective groups, they realized the unidentified child was assigned to Staff Person #1.

The file for Staff Person #3 lacked the following: PA State Police, FBI and Child Abuse clearances, NSOR, and Disclosure Statement.

2nd CITATION: After multiple requests for the documentation, no clearance information was submitted at the time of inspection for Staff #3. PREVIOUSLY CITED 09/27/2022.

Upon arrival at the facility at 09:25, CR and CRS observed Staff Person #2 speaking with a gentleman outside of the facility leaving Staff Person #1 out of ratio with 13 PS Children. Because the maximum ratio for a group with PS Children is 1:10; ratio was exceeded by three children. While performing supervision and ratio in the PS Area at 09:28, Staff Person #2 was observed in the kitchen area with her back to the children leaving Staff Person #1 out of ratio with 13 PS Children. Because the maximum ratio for a group with PS children is 1:10; ratio was exceeded by three children.

While performing supervision and ratio in the PS Area at 09:28, Staff Person #1 was supervising 13 PS Children. Staff Person #1 was asked to identify her supervision group. Staff Person #1 incorrectly identified the number of PS children in her group. She stated she had seven children, but only named six. Staff Person #1 was afforded a second opportunity to identify her supervision group and identified seven children when, in fact, she was supervising nine children. At 09:30, Staff Person #2 returned to the PS Area. She was asked to identify the number of children she was supervising. Staff Person #2 incorrectly identified the number of children in her group. She stated she had five children and only named four. Staff Person #2 was afforded a second opportunity to identify her supervision group and then identified four, but only with assistance from Staff Person #1.

While performing supervision and ratio in the PS Area at 09:28, Staff Person #1 was supervising 13 PS Children. Staff Person #1 was asked to identify her supervision group. Staff Person #1 incorrectly identified the number of PS children in her group. She stated she had seven children, but only named six. Staff Person #1 was afforded a second opportunity to identify her supervision group and identified seven children when, in fact, she was supervising nine children. At 09:30, Staff Person #2 returned to the PS Area. She was asked to identify the number of children she was supervising. Staff Person #2 incorrectly identified the number of children in her group. She stated she had five children and only named four. Staff Person #2 was afforded a second opportunity to identify her supervision group and then identified four, but only with assistance from Staff Person #1.

2nd CITATION: Multiple requests were made to obtain renewal documentation, which is kept offsite in an office not at the facility location. Untimely responses to the requests resulted in a delay to the inspection process and violations for lack of documentation. PREVIOUSLY CITED: 09/27/2022

2nd CITATION: The file for Staff #4 lacked documentation of fire safety training. PREVIOUSLY CITED 09/27/2022.

3rd CITATION: Staff Person #3 has not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): pediatric first aid/CPR training, health and safety training. Staff Person #2 has not completed the following required pre-service training with 90 days of their date of hire (see LIS code sheet): Health and Safety. PREVIOUSLY CITED 07/07/2022 and 09/27/2022.

2nd CITATION: Staff person #3 has not completed the mandated reporter training within 90 days of their date of hire (see LIS code sheet). PREVIOUSLY CITED 09/27/2022.

2nd Citation: After multiple requests for the documentation, no clearance information was submitted at the time of inspection for Staff #3 and #5. PREVIOUSLY CITED 09/27/2022.

2rd CITATION: Multiple requests were made to obtain renewal documentation, which is kept offsite in an office not at the facility location. Untimely responses to the requests resulted in a delay to the inspection process and violations for lack of documentation. PREVIOUSLY CITED 09/27/2022.

2nd CITATION: The file for Staff #4 lacked documentation of fire safety training. PREVIOUSLY CITED 09/27/2022.

3rd Citation: Staff persons #1, #2 and #3 have not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): pediatric first aid/CPR training, health and safety training. Staff person #6 has not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): pediatric first aid/CPR training. PREVIOUSLY CITED 07/07/2022 and 09/27/2022.

2nd Citation: Staff persons #1 and #3 have not completed the mandated reporter training within 90 days of their date of hire (see LIS code sheet). PREVIOUSLY CITED 09/27/2022.

2nd Citation: The file for Child #3 lacked updates to the emergency contact and agreement forms. PREVIOUSLY CITED 09/27/2022.

There was no file provided for Staff #3 at the time of inspection, after multiple requests were made to obtain the information. PREVIOUSLY CITED 09/27/2022.

2nd Citation: The file for Staff #4 lacked two written, nonfamily references. PREVIOUSLY CITED 09/27/2022

Two loose crib sheets were observed on cribs in the Infant Room, causing the risk of suffocation.

*SECOND VIOLATION. Upon assessment of ratio and supervision on 11/9/22 at 9:55 AM, Staff #1, in the Infant Room, was observed sitting in a rocking chair, with her eyes closed, while holding an infant. Three other infants were sleeping in cribs in the room with Staff #1. Previously cited on SIN-00210734 on 7/22/22.

**SECOND VIOLATION. Upon assessment of ratio and supervision on 11/9/22 at 9:55 AM, Staff #1, in the Infant Room, was observed sitting in a rocking chair, with her eyes closed, while holding an infant. Three other infants were sleeping in cribs in the room with Staff #1. Previously cited on SIN-00210734 on 7/22/22.

An infant in the Infant Room was observed sleeping on his belly. When asked how the child was placed in the crib, the staff reported he was placed in the crib on his belly.

SECOND VIOLATION. The files for Staff #1, #3 and #4 lacked documentation of initial emergency plan training. Previously cited on SIN-00210734 on 7/22/22.

SECOND VIOLATION. A crib in the Infant Room was observed to lack 2 feet on 3 sides while an infant was sleeping in the crib. as one side was against a wall, and another side was closer than 2 feet to another crib. Previously cited on SIN-00210734 on 7/22/22.

Continued Non-Compliance: On 7/22/22 a complaint investigation was conducted at the facility. Staff person #3 and #4 had not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): Pediatric first aid and CPR, health and safety training. The facility's acceptable plan of correction indicated the correction would be implemented by 9/30/22. On 11/9/22 an unannounced inspection was conducted. Staff person #3 and #4 still have not completed the following required pre-service training: pediatric first aid and CPR, health and safety training

Staff person #1 was observed to be caring for children unsupervised. Staff person #1 has not completed the following pre-service training required prior to caring for children unsupervised: mandated reporter training, pediatric first-aid/CPR training, health and safety training.

After multiple requests for the documentation, no clearance information was submitted at the time of inspection for Staff #1, #2, #3, #4, and #5.

The observed emergency plan had not been updated in the past 12 months.

The file for Staff #4 lacked documentation of emergency plan training.

The emergency telephone numbers in the Main Room were observed to be posted on the other side of the room from the telephone.

A first-aid kit was not present in the Gym and staff did not bring a first-aid kit with them into the Gym when children were present in that space.

Handwashing signs were not posted at the sink in the kitchen area, the changing station or the sink in the infant area.

The cribs in the Infant area were observed to lack labels. The wall behind the cribs was labeled with a child's name.

The file for Child #4 contained a most recent health report dated more than 12 months in the past.

The files for Child #1, #3 and #5 lacked records of immunization history. The file for Child #4 contained a record of immunization history which lacked a current influenza vaccination.

Unlabeled cough and cold medicine, cough syrup, gym soother, and Orejel were observed in the Main Room.

Two expired cough syrups and an expired Benadryl were observed in the Main Room.

An Auvi-Q labeled for Child #6 was observed to lack written parental consent for administration. An unlabeled Orajel, reported to be intended for Child #7 was observed to lack written parental consent for administration. A Vicks Baby Rub labeled for Child #8 was observed to lack written parental consent for administration. A Zyrtec labeled for Child #9 was observed to lack written parental consent for administration. A Motrin and Acetaminophen labeled for Child #10 was observed to lack written parental consent for administration. A cough syrup labeled for Child #11 was observed to lack written parental consent for administration.

The file for Staff #4 contained an initial health assessment dated after the date of hire.

Documentation of an emergency drill held in the past 12 months was not available at the facility.

The observed fire drill log contained consecutive drills held more than 60 days apart.

An evacuation route was not posted in the facility.

An annual fire test conducted by a fire professional was not available at the time of inspection, nor was a log of the fire detection system being tested every 30 days.

The files for Child #1, #3, and #5 lacked health reports.

A Prevention of Shaken Baby Syndrome, Abusive Head Trauma, and Child Maltreatment policy was not available at the time of the inspection.

Multiple requests were made to obtain renewal documentation, which is kept offsite in an office not at the facility location. Untimely responses to the requests resulted in a delay to the inspection process and violations for lack of documentation.

The file for Staff #4 lacked documentation of fire safety training.

Staff person #1, #2, #3 have not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): pediatric first-aid/CPR training, health and safety training. Staff person #4 had not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): pediatric first-aid/CPR training (dated 10/17/22), health and safety training (dated 10/8/22). Staff person #6 has not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): pediatric first-aid/CPR training.

Staff person #1, #2, #3 and #6 have not completed the mandated reporter training within 90 days of their date of hire (see LIS code sheet). Staff person #4 had not completed the mandated reporter training (dated 1/30/22) within 90 days of their date of hire (see LIS code sheet).

The file for Staff #4 lacked documentation of education and previous child care experience, making it unable to be determined if the individual qualified as a staff person.

The file for Staff #4 lacked a staff evaluation.

According to staff report, infants are not being taken out doors daily.

The files for Child #1 and #3 lacked current child service reports.

The file for Child #2 lacked an emergency contact form.

The file for Child #1 contained an emergency contact form which lacked the address of the child's medical provider.

The file for Child #1 contained an emergency contact form which lacked the work address and telephone number of the enrolling parent.

The file for Child #1 contained an emergency contact form which lacked the addresses and telephone numbers of the release persons.

The files for Child #1, #3, #4 and #5 lacked updates to the emergency contact and agreement forms.

The file for Child #2 lacked an agreement, making it unable to be determined the date of application and admission of the child.

The file for Child #2 lacked an emergency contact form, and therefore lacked signed parental consent for emergency care.

The file for Child #2 lacked an emergency contact form, and therefore lacked singed parental consent for administration of first-aid.

The file for Child #2 lacked an agreement.

There were no files provided for Staff #1, #2, #3 and #5 at the time of inspection, after multiple requests were made to obtain the information.

The file for Staff #4 lacked two written, nonfamily references.

Upon assessment of supervision and ratio in the Gym on 7/22/22, Staff #1 and #2 were present with 15 PS. At 10:45 AM, Staff #2 left the Gym to take a phone call and was gone approximately three minutes, leaving Staff #1 alone with 15 PS children.

Staff #3, in the Infant Room, was observed sitting on a chair in the room, with her back to the cribs. A sleeping infant was in a crib behind Staff #3. Staff #3 was not able to see or properly supervise the sleeping infant from her seated position. Staff #3 was also observed on her cell phone, looking down at the phone while feeding an infant in her lap.

Upon assessment of supervision and ratio in the Main Room on 7/22/22 at 10:40 AM, Staff # 4 and Staff #5 were observed with 9 OT children. Staff #4 named all 9 OT children. Staff #5 could not name one of the children. When asked to attempt to name them for a second time, she could still not do so and Staff #4 told her the name of the child. Upon assessment of supervision and ratio in the Gym on 7/22/22 at 10:45 AM, Staff #1 and Staff #2 were present with 15 PS children. Staff #1 named all of the children. Staff #2 could not name one of the children. When asked to attempt to name them for a second time, she could still not do so.

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

A crib in the Infant Room was observed to lack 2 feet on 3 sides, as one side was against a wall, and a mattress was leaning up against the crib, while an infant was sleeping in the crib.

Staff person #3 and #4 have not completed the following required pre-service training within 90 days of their date of hire (see LIS sheet): pediatric first-aid and CPR, health and safety training.

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

There were no handwashing signs posted near either of the two toilets in the front restroom or back restroom.

A Proof of Purchase was not provided for the fire detection system.

The file for Staff #1 contained First-Aid training on 12.17.19, but it was not Pediatric. The file for Staff #1 did not contain verification of Pediatric CPR.

The file for Child #3 did not contain the address of the physician

The file for Child #1 did not contain the enrolling parent's work address or work phone number. The file for Child #2 did not contain the enrolling parent's work phone number. The file for Child #3 did not contain the enrolling parent's work address or work phone number.

The files for Child #2 and Child #3 did not contain the release person's address.

The file for Staff #2 did not contain proof of qualifications.

The file for Staff #2 did not contain verification of experience or education.

The file for Staff #2 did not contain two written, nonfamily references.

There was no notice provided to parents on how to access the regulations electronically or how to contact the appropriate regional child care office.