NURSERY RHYMES CHILD CARE CENTER

2025

1. Medium risk8/11/2025

   Written statement (3270.166(1))

   2nd citation. Previously cited on 7/9/25. Observed that a written statement giving the formula and feeding schedule for an infant was not obtained from the parents of some infants in the Infant/Young Toddler Room. Requirement: A written statement giving the formula and feeding schedule for an infant shall be obtained from the parent. Correction: All infants have feeding schedules. All future enrollments of infants will include an area on the agreement to add the feeding schedule, which will be a required area of completion on the form. Will continue to utilize brightwheel for daily feeding documentation from parents and staff. Inspection: Unannounced Monitoring. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

   Corrected 8/12/2025
2. Medium risk8/11/2025

   Free from contagious/communicable disease (3270.131(d)(7))

   The health report for Child #1 did not include a statement that the child is able to participate in child care and appears to be free from contagious or communicable disease. Requirement: A health report shall include a statement that the child is able to participate in child care and appears to be free from contagious or communicable disease. Correction: The doctor's office checked and initialed beside the box. Inspection: Unannounced Monitoring. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

   Corrected 8/13/2025
3. Medium-High risk7/9/2025

   Immunization record/Dismissal policy (3270.131(d)(5)/3270.131(e)(3))

   The file of Child #3, a 13-month-old, lacked DTAP/DTP/TD and Pneumococcal immunizations according to the recommendations of the ACIP. Child #3 had documentation of 2 DTAP/DTP/TD immunizations and 2 Pneumococcal immunizations. Requirement: A health report shall include a review of the child's immunized status according to recommendations of the ACIP. The facility shall implement dismissal policies in accordance with the Department of Health regulation in 28 Pa. Code § 27.77 (relating to immunization requirements for children in child care group settings). Correction: Child #3 has updated immunizations. Child had a checkup 12/2/2024, however parents did not provide form and updated immunizations are that time. Owner/director sent a reminder to parents of requirements for health reports. Inspection: Renewal. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

   Corrected 7/15/2025
4. Medium risk7/9/2025

   HS/GED + 2 yrs/Exp, educ., training prior to facility (3270.36(b)(5)/3270.192(2)(ii))

   The file of Staff #2, who was designated as an assistant group supervisor, lacked documentation of 2 years' experience with children. Requirement: An assistant group supervisor shall have a high school diploma or a general educational development certificate and 2 years experience with children. A facility person's record shall include verification of child care experience, education and training prior to service at the facility. Correction: Staff member was not alone during probationary period. Documentation of experience obtained as of 07/21/2025. See attached. Inspection: Renewal. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

   Corrected 7/21/2025
5. Medium-High risk7/9/2025

   Locked or inaccessible (3270.66(a))

   Observed Top Care Advanced Hand Sanitizer which indicated "keep out of the reach of children" on the sink by the changing tables in the Infant/Young Toddler Room which was accessible to children. Requirement: Cleaning materials and other toxic materials shall be kept in an area or container that is locked or made inaccessible to children. Correction: Hand sanitizer was removed from the sink and placed on a shelf, out of the reach of children. Staff members educated on the dangers of having the sanitizer within reach of the children. Inspection: Renewal. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

   Corrected 7/9/2025
6. High risk7/9/2025

   Emergency Numbers Posted (3270.74)

   The telephone number of the nearest hospital was not posted by each telephone in the facility. Requirement: The telephone number of the nearest hospital, police department, fire department, ambulance and poison control center shall be posted by each telephone in the facility. Correction: Owner made a new document with all emergency numbers, adding the number for the local hospital. Previous postings were removed and replaced with updated posting that include the hospital phone number. These postings are by each telephone in the facility. Inspection: Renewal. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

   Corrected 7/22/2025
7. Medium-High risk7/9/2025

   Services proceeded (3270.123(a)(3))

   Child #2 lacked child service reports completed at least every 6 months. Child #2 had service reports completed on 2/26/24, 9/1/24, and 2/12/25. Requirement: The services to be provided to the family and the child, including the Department's approved form to provide information to the family about the child's growth and development in the context of the services being provided. The operator shall complete and update the form and provide a copy to the family in accordance with the updates regarding emergency contact information in § 3270.124(f) (relating to emergency contact information). Correction: Child #2 has current child service report. Owner/director will complete child service reports and maintain the form in the child's chart and least every 6 months. Inspection: Renewal. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

   Corrected 7/21/2025
8. Medium-High risk7/9/2025

   Updated every 6 months/Emergency info/agreement updated 6 mos (3270.124(f)/3270.181(c))

   The emergency contact for Child #3 was not reviewed and updated at least once in a 6-month period. Child #3's emergency contact was signed on 8/13/24 and reviewed on 12/3/24. Requirement: The parent shall update in writing emergency contact information once in a 6-month period or as soon as there is a change in the information. A parent is required to review and update the emergency contact information and the financial agreement at least once in a 6-month period or as soon as there is a change in the information. Correction: Child #3 has a current review of the emergency contact form. Owner/director will work with families to review/update emergency contact forms at least once in a 6-month period. Inspection: Renewal. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

   Corrected 7/21/2025
9. Medium-High risk7/9/2025

   Infant: updated health report every 6 months (3270.131(b)(1))

   The file of Child #3 lacked an updated health report at least every 6 months for an infant or young toddler. The file of Child #3 contained health reports dated 7/19/24 and 10/24/24. Requirement: The operator shall require the parent to provide an updated health report at least every 6 months for an infant or young toddler. Correction: Child #3 has an updated health report. Child had a checkup 12/2/2024, however parents did not provide form and updated immunizations are that time. Owner/director sent a reminder to parents of requirements for health reports. Inspection: Renewal. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

   Corrected 7/15/2025
10. Medium risk7/9/2025

    Toddler/preschool: updated health report every 12 months (3270.131(b)(2))

    The file of Child #1 lacked an updated health report at least every 12 months for an older toddler or preschool child. The file of Child #1 contained health reports dated 9/22/23 and 10/4/24. Requirement: The operator shall require the parent to provide an updated health report at least every 12 months for an older toddler or preschool child. Correction: Child #1 has a current health report. Owner/director sent a reminder to parents of requirements for health reports. Inspection: Renewal. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

    Corrected 7/21/2025
11. Medium-Low risk7/9/2025

    Completed or signed by physician, PA, or CRNP (3270.131(c))

    The file of Child #3 contained a health report dated 10/24/24 which was not signed by a physician, physician's assistant or CRNP. Requirement: A health report must be written and signed by a physician, physician's assistant or a CRNP. The signature must include the individual's professional title. Correction: Child #3 has an updated health report. Owner/director sent message reminding parents of health assessment requirements, including the importance of signatures. Inspection: Renewal. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

    Corrected 7/21/2025
12. Medium risk7/9/2025

    Child's hands washed (3270.134(a))

    Staff did not ensure that a child's hands were washed after being diapered in the Infant/Young Toddler Room. After diapering the child, staff applied hand sanitizer to the child's hands. Requirement: A staff person shall ensure that a child's hands are washed before meals and snacks, after toileting and after being diapered. Correction: Owner/director re-educated staff members on hand washing requirements, before meals and snacks, after toileting and after being diapered. Inspection: Renewal. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

    Corrected 7/10/2025
13. Medium risk7/9/2025

    Adult Hygiene (3270.152)

    Staff did not wash his hands after diapering a child in the Infant/Young Toddler Room. After diapering the child, staff used hand sanitizer. Requirement: A facility person shall wash his hands before meals and snacks, and after toileting and after diapering a child. Correction: Owner/director re-educated staff members on hand washing requirements, before meals and snacks, after toileting and after diapering. Inspection: Renewal. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

    Corrected 7/10/2025
14. Medium risk7/9/2025

    Written statement (3270.166(1))

    Observed that a written statement giving the formula and feeding schedule for an infant was not obtained from the parents of some infants in the Infant/Young Toddler Room. Requirement: A written statement giving the formula and feeding schedule for an infant shall be obtained from the parent. Correction: All infants have feeding schedules. All future enrollments of infants will include an area on the agreement to add the feeding schedule, which will be a required area of completion on the form. Will continue to utilize brightwheel for daily feeding documentation from parents and staff. Inspection: Renewal. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

    Corrected 7/10/2025
15. Medium-High risk7/9/2025

    Hypothetical locations (3270.94(a)(4))

    The Director or designated staff person who is responsible for compliance with this chapter did not ensure that the hypothetical locations of the fire were rotated around the facility for each drill such that the hypothetical location was never the same for consecutive drills. Requirement: The Director or designated staff person who is responsible for compliance with this chapter shall conduct fire drills and ensure that the hypothetical locations of the fire are rotated around the facility for each drill such that the hypothetical location is never the same for consecutive drills. Correction: New document created for documentation of real fire alarm evacuations that are not set up as hypothetical, in order to separate real alarms and hypothetical situations to ensure that locations do not occur in consecutive locations. Inspection: Renewal. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

    Corrected 7/21/2025
16. Medium-Low risk7/9/2025

    Pick-up and drop-off points (3270.171(a))

    The operator did not notify local traffic safety authorities annually in writing of the location of the facility and the program's use of pedestrian and vehicular routes around the child care facility. The operator provided documentation that local traffic safety authorities were notified on 5/1/24 and 6/2/25. Requirement: An operator shall notify local traffic safety authorities annually in writing of the location of the facility and the program's use of pedestrian and vehicular routes around the child care facility. Correction: Owner will be diligent in updates being sent to local authorities annually, no more than 12 calendar months apart. Inspection: Renewal. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

    Corrected 7/10/2025
17. Medium risk7/9/2025

    Staff evaluations (3270.34(a)(6))

    The file of Staff #1 lacked a written evaluation on a regular basis, a minimum of one evaluation every 12 months (SEE LIS Code Sheet). The file of Staff #1 contained a written evaluation dated 7/30/24 but did not contain one for 2023. Requirement: A director is responsible for written evaluation of staff persons on a regular basis, a minimum of one evaluation every 12 months. Correction: Staff has a current staff evaluation. Owner and staff member completed the review in 2023, however neither retained their original/copy of the review. Owner will be diligent while filing to ensure that misplacement of future reviews does not occur. Inspection: Renewal. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

    Corrected 7/21/2025