METROPOLITAN PRESCHOOL AND NURSERY-WARNER CENTER

Supervised at all times (3270.113(a))

Based on interviews with multiple staff, Staff Person #1 was observed to be sleeping on five occasions during October 2025 while responsible for an assigned group of children. Staff interviewed stated they were in the rooms when Staff Person #1 fell asleep. Staff Person #1 was observed sleeping one time in (Room 7 Older Toddler Room) one time in (Room 2 Young Toddler Room), and three times in (Room 4 Preschool Room) including once shortly after breakfast and once during nap. While asleep, Staff Person #1 was unable to actively supervise the children in their assigned group. Requirement: Children on the facility premises and on facility excursions off the premises shall be supervised by a staff person at all times. Outdoor play space used by the facility is considered part of the facility premises. Correction: Staff person #1 was not sleeping on the ONE occasion that it WAS brought to the center Director's attention. Staff person #1 and all staff were reminded of the supervision regulations and company supervision policy. All staff shall remain awake and be able to actively supervise children in their care. Inspection: Complaints- Legal Location. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

Staff assigned to specific children (3270.113(a)(1))

Based on interviews with multiple staff, Staff Person #1 was observed sleeping on five occasions during October 2025 while responsible for an assigned group of children. Staff interviewed stated they were in the rooms when Staff Person #1 fell asleep. Staff Person #1 was observed sleeping one time in (Room 7 Older Toddler Room), one time in (Room 2 Young Toddler Room), and three times in (Room 4 Preschool Room) including once shortly after breakfast and once during naptime. While asleep, Staff Person #1 was unable to actively supervise or know the whereabouts of the children in their assigned group. Requirement: Each staff person shall be assigned the responsibility for supervision of specific children. The staff person shall know the names and whereabouts of the children in his assigned group. The staff person shall be physically present with the children in his group on the facility premises and on facility excursions off the facility premises. Correction: Staff person #1 was not sleeping on the ONE occasion that it WAS brought to the center Director's attention. Staff person #1 and all staff were reminded of the supervision regulations and company supervision policy. All staff shall remain awake and be able to actively supervise and know the whereabouts of the children in their care and be physically present with them on or off the facility premises. Inspection: Complaints- Legal Location. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

Inpatient hospitalization or ER treatment of child (3270.20(a)(1))

Based on interviews, in August 2025 staff reported on two separate occasions that Child #1's eyes were rolling back in his head. Staff Person #1 assessed the child and observed no concerns but directed parent to take Child #1 to the hospital as a precaution. The parent transported Child #1 to the ER. However, the operator did not notify the regional office within 24 hours of the ER visit. Requirement: The operator shall immediately notify a child's parent and shall telephone notice to the appropriate regional office within 24 hours if a child in care at the facility is hospitalized or receives emergency room treatment. Correction: Staff person #1 now has a complete understanding of regulation 3270.20 (a) (1) and moving forward in a situation such as this, will adhere to it. Inspection: Unannounced Monitoring. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

Mail or deliver written report to regional office within 72 hours (3270.20(b))

Based on interviews, in August 2025 staff reported on two separate occasions that Child #1's eyes were rolling back in his head. Staff Person #1 assessed the child and observed no concerns but directed the parent to take the child to the hospital as a precaution. The parent transported Child #1 to the ER. However, the operator did not mail or deliver a written report within 72 hours of the ER visit. Requirement: The operator shall mail or deliver a written report to the appropriate regional office within 72 hours after hospitalization of a child in care, emergency room treatment of a child in care, death of a child in care, a facility fire requiring the services of a fire department. Correction: Staff person #1 now has a complete understanding of the importance of delivering a report to the regional office withing the allotted time frame of 72 hours after a child has received care or treatment at an Emergency room , and will do so in the future. Inspection: Unannounced Monitoring. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

Each staff person meets quals (3270.33(a))

The file for Staff Person #3 contained a high school diploma from a foreign country which had not been evaluated by a service that is a member of the National Association of Credential Evaluation Services (NACES) or the Association of International Credential Evaluators (AICE). Requirement: A staff person or a substitute staff person shall meet one of the applicable staff qualifications for the position in which the person is performing. Correction: Staff person # 3 will be terminated as of today until she can get the proper paper work for her foreign high school diploma. Inspection: Renewal. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

Similar Age Level (3270.51)

On 10/17/25 at 12:20 PM, Staff Person #8 was observed supervising 15 Preschool Children in Room #4. This was during naptime, however, two of the children were still eating lunch at the table. Requirement: When children are grouped in similar age levels, the following maximum child group sizes and ratios of staff persons apply: Infants 1:4 with a maximum group size of 8; Young toddlers 1:5 with a maximum group size of 10; Older toddlers 1:6 with a maximum group size of 12; Preschool children 1:10 with a maximum group size of 20; Young school-age children 1:12 with a maximum group size of 24; Older school-age children 1:15 with a maximum group size of 30. Correction: A second staff person was brought into the room to bring it back into compliance until all of the children were on their cots. Inspection: Renewal. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

Mixed Age Level (3270.52)

On 10/17/25 at 12:15 PM, Staff Person #7 was observed supervising a mixed group of 6 Older Toddler and 4 Preschool Children in Room 6. This was during naptime, however, two of the children had not yet been placed on their cots. Requirement: When children are grouped in mixed age levels, the age of the youngest child in the group determines the staff:child ratio and maximum group size in accordance with the requirements in § 3270.51 (relating to similar age level). Correction: Staff person #7 states that they were in fact moving two of the children and their cots to better visually supervise them during nap time and that both kids had previously been on their cots Inspection: Renewal. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

No peeling paint or plaster (3270.77(a))

Observed flaking plaster along the wall partition near the entrance to Room #4 where a corner molding strip had been removed. Requirement: Peeled or damaged paint or damaged plaster is not permitted on indoor or outdoor surfaces in the child care facility. Correction: The damaged area was temporarily covered until a more permeant fix can be completed by maintenance. the director will monitor and maintain compliance by completed visual inspections daily. Inspection: Renewal. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

Toilet and sinks proper height (3270.82(e))

On 10/17/25 at approximately 10:00 AM in Room 2, observed Staff Person #4 holding Child #2 (young toddler) over the sink to wash child's hands after diaper change. The stool located in Room 2 is not an adequate height for children to reach the sink in the room. Requirement: Toilets and sinks shall be at proper heights for children using them or shall be easily approached by means of platforms or steps. Correction: The center has obtained the additional parts required to address a recall on the step stool that are an adequate height to allow the children to reach the sink . Inspection: Renewal. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

Clean and good repair (3270.102(a))

Observed protruding bolts, which lacked covers, on the legs of the rocking chair in Room 1. Requirement: Toys, play equipment and other indoor and outdoor equipment used by the children shall be clean, in good repair and free from rough edges, sharp corners, pinch and crush points, splinters and exposed bolts. Correction: Bolts will be covered with gauze and duct tape. Inspection: Renewal. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

Services proceeded (3270.123(a)(3))

The first child service report in the file for Child #3 was dated more than six months after the child's first day in care. The files for Child #5 and #6 did not contain a child service report conducted within the past six months. 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: The files for children #3, 5 and 6 now all contain child service reports which will not go over 6 months before the next reports are done and the information is shared and signed off on by a parent or guardian. The reports are available for review in each child's file. Inspection: Renewal. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

Parent home/work address, phone (3270.124(b)(3))

The emergency contact forms in the files for Child #1, 2, 4 and 5 did not include the work addresses and telephone numbers of the enrolling parent. Requirement: Emergency contact information must include the home and work addresses and telephone numbers of the enrolling parent. Correction: The emergency contact for children # 1,2 and 4 all now contained the required work addresses and work phone numbers of the enrolling parent. Inspection: Renewal. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

Name/address/phone release person (3270.124(b)(7))

The emergency contact forms in the files for Child #1 and #2 did not include the release person's addresses. The emergency contact form in the file for Child #4 did not include the release person's phone number and only a partial address. Requirement: Emergency contact information must include the name, address and telephone number of the individual designated by the parent to whom the child may be released. Correction: The emergency contacts for children #1 and 2 now contain release person address information. The emergency contact form for child #4 was completed by the parent or guardian and now has the full address and telephone number of a release person. Inspection: Renewal. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

Each child care space (3270.124(c))

The emergency contact binder in Room 5 did not contain an emergency contact form for Child #4 who was receiving care in that room. Requirement: When children are in the facility, emergency contact information shall be present in a child care space for children receiving care in the space. Correction: The emergency contact binder for child #4 was placed in the classroom binder in room 5 . Inspection: Renewal. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

Infant: updated health report every 6 months/Initial and subsequent health reports (3270.131(b)(1)/3270.182(1))

The file for Child #1, a young toddler, does not include an updated health report conducted within the past 6 months. Requirement: The operator shall require the parent to provide an updated health report at least every 6 months for an infant or young toddler. A child's record shall contain initial and subsequent health reports. Correction: The file for child #1 now contains and updated health record that was completed within the last 6 months. Inspection: Renewal. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

Toddler/preschool: updated health report every 12 months/Initial and subsequent health reports (3270.131(b)(2)/3270.182(1))

The most recent health reports in the files for Child #3, an older toddler, and Child #5 and 6, preschool children, exceeded 12 months between reports. 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. A child's record shall contain initial and subsequent health reports. Correction: The files for children #3,5 and 6 now contain update health reports that are available for review in each child's file. Inspection: Renewal. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

12 months prior to service and every 24 months thereafter/Health assessment, TB test (3270.151(a)/3270.192(3))

The most recent health assessments in the file for Staff Person #5 exceeded 24 months between assessments. Requirement: A facility person providing direct care who comes into contact with the children or who works with food preparation shall have a health assessment conducted within 12 months prior to providing initial service in a child care setting and every 24 months thereafter. A health assessment is valid for 24 months following the date of signature, if the person does not contract a communicable disease or develop a medical problem. A facility person's record shall include a written report of initial and subsequent health assessments, including the results of initial and subsequent tuberculin skin tests, x-rays or other medical documentation necessary to confirm freedom from communicable tuberculosis. Correction: Staff person #5 will be required to receive their next staff physical within 24 months of the current staff physical that is on file. Inspection: Renewal. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

Mantoux TB (3270.151(c)(2))

The initial health assessment in the file for Staff Person #2 does not include a TB screening. Requirement: An adult health assessment must include tuberculosis screening by the Mantoux method at initial employment. Subsequent tuberculosis screening is not required unless directed by a physician, physician's assistant, CRNP, the Department of Health or a local health department. Correction: The file for staff person #2 contains proof of current negative TB testing results which are in their file an available for review. Inspection: Renewal. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

Emergency info/agreement updated 6 mos (3270.181(c))

The emergency contact forms in the files for Child #1, 2, 5 and 7 have not been updated by the parents in the past six months. The most recent parent updates for the fee agreements in the files for Child #3 and 5 exceeded six months between updates. The fee agreements in the files for Child #2 and 7 have not been updated by the parents in the past six months. Requirement: 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: The Emergency contacts for child files #1,2,5 and 7 have all been updated and are available for review in the child files. The fee agreements for children #3, 5, 2 and 7 have also been updated with parent or guardian signatures and the most current fee amounts and are also available for review in each child's file. Inspection: Renewal. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

Consent for administration of minor first-aid required prior to admission (3270.182(5))

The emergency contact form in the file for Child #7 did not contain signed parental consent for administration of minor first-aid procedures by facility staff. Requirement: A child's record shall contain signed parental consent for administration of minor first-aid procedures by facility staff. Written consent is required prior to admission. Correction: The Emergency contact form for child #7 now contains a parent signature giving consent for administration of minor first aid procedures by facility staff. The form is available for review in the child's file. Inspection: Renewal. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

Exp, educ., training prior to facility (3270.192(2)(ii))

The file for Staff Person #1 did not include verification of two years child care experience. Requirement: A facility person's record shall include verification of child care experience, education and training prior to service at the facility. Correction: Staff person #1 had verifiable hours documented on a reference letter. Those hours were totaled up and are available for review in the staff file. Inspection: Renewal. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

Age and Training (3270.31(e))

The files for Staff Person #4 and #6 did not contain documentation of annual 12 hours of child care training for the most recent full year of service. Staff Person #4: 11.5 hours. Staff Person #6: 5.5 hours. Requirement: A staff person shall obtain an annual minimum of 12 clock hours of child care training. Correction: Staff persons #4 and #6 do have more than the required 12 hours of training. The training hours were not available for review on the date of the inspection Inspection: Renewal. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

Health information/Initial and subsequent health reports (3270.131(a)/3270.182(1))

The initial health report in the file for Child #2 was conducted more than 60 days after the child's first day of attendance at the facility. Requirement: The operator shall require the parent of an enrolled child, including a child, a foster child and a relative of an operator or a facility person, to provide an initial health report no later than 60 days following the first day of attendance at the facility. A child's record shall contain initial and subsequent health reports. Correction: The health assessment that is in child #2's file will be updated on or before the next health assessment is due. Inspection: Renewal. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

Staff assigned to specific children (3270.113(a)(1))

Previously cited on 4/4/25. Due to repeated citations under 3270.113(a)(1), provider was required to provide a plan of correction, which included random weekly supervision checks in each room for a period of four months (6/6/25-9/27/25). During an unannounced monitoring conducted on 9/29/25 to verify corrections, it was observed that weekly supervision checks were not conducted/documented during the following weeks: (6/8-6/14, 6/22-6/28, 8/3-8/16, 8/24-9/20). Requirement: 1. Each staff person shall be assigned the responsibility for supervision of specific children. The staff person shall know the names and whereabouts of the children in his assigned group. The staff person shall be physically present with the children in his group on the facility premises and on facility excursions off the facility premises. 2. After a system is established, the director and/or other leadership team members will conduct random checks of all child care spaces to ensure that staff are using the primary group supervision system correctly. Documentation of checks shall indicate the name of staff conducting the checks, the name of the room, the names of staff in the rooms and whether or not staff named their primary supervision group correctly. Weekly checks will be conducted three times per week for a period of 5 weeks (9/29/25 through 10/31/25). Correction Date 10/31/25. Correction: Daily supervision checks were conducted on 6/8-6/14, 6/22-6/28, 8/3-8/16, 8/24-9/20 but were not documented. Moving forward daily supervision checks will be documented and signed by the person conducting the supervision check. Daily supervision checks will be conducted a minimal of 3 times a week. Director will monitor and maintain Inspection: Unannounced Monitoring. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

Pertinent Laws & Regulations/General Health and Safety (3270.14/3270.21)

Staff person #4 was observed to be caring for children unsupervised in Room #2. Staff person #4 has not completed the following pre-service training required prior to caring for children unsupervised: Pediatric First Aid/CPR in an approved curriculum from a certified PQAS instructor. Requirement: A facility shall be operated in conformity with applicable Federal and State laws and regulations. State agencies whose regulations may relate to the operation of a facility include the Department of Environmental Resources, the Department of Labor and Industry, the Department of Health, the Department of Education and the Department of Transportation. Conditions at the facility may not pose a threat to the health or safety of the children. Until such time as the required pre-service trainings are completed, staff person #4 must be supervised, when interacting with children, by an AGS or higher who has completed the required training related to this citation. If there are no staff person(s) available to supervise staff person #-4, staff person #4 may not work in a child-care position at the facility. Correction: Staff person #4 was able to provide proof of valid First aid and CPR. The documentation is available for review at the center or can be emailed to our licensing Representative. Inspection: Renewal. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).