CRAYON CLUBHOUSE III

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

The staff file for Staff person #1, contained a current health assessment dated 12/4/25 which was conducted more than 24 months from the previously dated 10/6/23 health assessment on file. 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: Provider acknowledges that Staff Persons #1 health assessment exceeded the required 24-month timeframe. Upon discovery, the staff member was immediately scheduled for and completed an updated health assessment on 12/4/2025. Inspection: Renewal. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

Admission date (3270.123(a)(6))

The child file for Child #1 was observed to contain a current financial agreement form that lacked the child's date of admission. Requirement: An agreement shall specify the date of the child's admission. Correction: Provider added the child's date of admission to the Childcare agreement. The original copy was provided to the parent, and a copy was added to the child file. Inspection: Renewal. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

Services proceeded (3270.123(a)(3))

The child file for Child #2 contained a current child service report dated 11/20/25 that was not completed every 6 months from the previous report dated 1/1/25 on file. 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: Provider will monitor Child service reports to ensure that they are complete within six months of from the previous one. All children are to have a Child Service Report completed within their first 45 day and we complete them ever January and July. Inspection: Renewal. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

Letter to parents (3270.27(e))

The letter to the parents explaining the emergency procedures does not address annual emergency drills. Requirement: The operator shall provide to the parent of each enrolled child a letter explaining the emergency procedures. The operator shall also provide to the parent of each enrolled child a letter explaining any subsequent update to the plan. Correction: Provider added the sentence, " We are required to complete annual emergency drills." to the letter to parents. Provider also made note of the change in the emergency plan adorned by the date of the addition and signature. Inspection: Renewal. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

Devices must be compliant/Director or designated staff person ensure compliance (3270.95(a)/3270.95(b))

Upon review of the facility's 30-day fire testing documentation, more than 30 days has passed since the last test which was conducted on 8/4/25. Requirement: Fire detection devices or systems must be in compliance with standards established under section 1016(c) of the act (62 P.S. § 1016(c)). The Director or designated staff person who is responsible for compliance with this chapter shall ensure the requirements under subsection (a) are met. Correction: The facility acknowledges that more than 30 days passed between required fire system tests. The fire system test was completed on 8/4/2025, and documentation has been updated and filed as required. All current fire safety logs have been reviewed for accuracy and completeness. Inspection: Allocated Unannounced Monitoring. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

Restraints prohibited (3270.113(e))

During an investigation, Staff #2 stated that a staff member admitted to using a "bear hug" to stop the child from kicking/ biting the staff member. In this position, staff sat with the child with staff's arms restraining the child's arms. Requirement: A facility person may not restrain a child by using bonds, ties or straps to restrict a child's movement or by enclosing the child in a confined space, closet or locked room. The prohibition against restraining a child does not apply to the use of adaptive equipment prescribed for a child with special needs. Correction: The child was immediately removed from staff. Staff was immediately terminated, state police were called, CYS was notified and DHS licensing Representative was notified with in 15 minutes of the incident taking place. Staff was trespassed. Despite staff having all clearances, trainings, and supervision in facility. Staff member worked independently and made the decision without seeking assistance in the classroom. Staff made the decision despite all of the trainings and policies including the safe handling policy. Inspection: Allocated Unannounced Monitoring. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

No peeling paint or plaster (3270.77(a))

In the Infant Room peeling paint and damaged plaster was observed where the rocking chair makes contact with the wall. On the far side of the Preschool Room peeling paint and damaged plaster was observed on the wall to the left of the bathroom entryway. Requirement: Peeled or damaged paint or damaged plaster is not permitted on indoor or outdoor surfaces in the child care facility. Correction: Provider immediately covered the paint chips in the classrooms. Once children were out of the facility, provider painted the area. The rocking chair in the nursery was removed from the area to prevent the chipping of paint in the future. Inspection: Allocated Unannounced Monitoring. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

No physical punishment (3270.113(b))

During a complaint investigation, during staff interviews, it was determined that on 9/11/25 at approximately 4:20pm Staff person #1 was observed sitting on the floor holding Child #1 in their lap and Staff person #1's one arm was observed completely around Child #1's neck and Child #1 could be heard saying, "Ow, ow, ow,". Requirement: A facility person may not use any form of physical punishment, including spanking a child. Correction: The child was immediately removed from staff. Staff was then immediately terminated, state police was called, CYS was notified and DHS Licensing was notified immediately of the incident taking place. Staff was trespassed. Despite staff having all clearances, trainings, and supervision in facility. Staff member worked independently and made the decision without seeking assistance in the classroom. Staff made the decision despite all of the trainings and policies including safe handling policy. Inspection: Complaints- Legal Location. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

12 months prior to service and every 24 months thereafter (3270.151(a))

The staff file for staff person #1 contained a health assessment dated 12/18/24 that was deemed unacceptable due to the date, physician's signature/title, printed name, and the Mantoux test date appear to have been altered using white-out. 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. Correction: Provider will have staff #1 get a new physical and TB test to ensure compliance is met. Staff #1 obtained a new health physical and TB test on 3/17/2025. Inspection: Renewal. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

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

The child file for Child #2, who is a preschool age child, lacked an updated health report; the last health report on file is dated 2/23/24 which is more than 12 months old. The child file for Child #3, who is a preschool age child, was observed to contain an updated health report dated 1/9/25 which was conducted more than 12 months from the previously dated 12/7/23 health report on file. 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: Gave parent of Child #2 a health report and told them we needed it back. Provider has a current updated health report on child #3 no correction was needed. Provider will ensure that the health reports stay up to date and are obtained yearly for child #3 Inspection: Renewal. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

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

The child file for Child #1, who was a young toddler at the time, was observed to contain an updated health report dated 2/21/25 which was conducted more than 6 months from the previously dated 2/20/24 health report on file. 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: Provider had a current health report on file for child #1 but will ensure to maintain every 6 months when an infant or young toddler Inspection: Renewal. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

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

The child file for Child #4 contained a current emergency contact information form that lacked the addresses for two of the designated release persons listed. 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: Provider obtained and listed the addresses that were missing from the emergency contact form. Provider had child's parent fill the addresses in that were missing. Inspection: Renewal. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

Admission date (3270.123(a)(6))

The child file for Child #3 contained a current financial agreement form that lacked the child's admission date. Requirement: An agreement shall specify the date of the child's admission. Correction: Provider put the child's admission date on the current service agreement while the State Licensing Rep was present. Provider corrected this on site during inspection Inspection: Renewal. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

Services proceeded (3270.123(a)(3))

The child file for Child #2 contained a current child service report dated 1/13/25 that was not completed every 6 months from the previous report dated 3/28/24. 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: Provider will monitor child service report completion and ensure they are completed within 45 days of enrollment and every 6 months. Inspection: Renewal. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

Toilet and sinks proper height (3270.82(e))

At approximately 11:00am, in Rm 2 after a diaper change, a staff person was observed holding an older toddler up to the portable camping sink to wash their hands due to lacking a platform or steps for the child to use. In Rm 3, which cares for young toddlers, the sink used to wash children's hands after diapering was observed to lack a platform or steps for the child to use. 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: Provider will purchase 2 stools to be placed in Room 2 and Room 3, at the sink, so children are able to wash their hands. Inspection: Renewal. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

Building Surfaces (3270.76)

The staff bathroom located on the far left, just down from Rm 4, has two ceiling tiles that were observed to not be kept clean as evidence by having water spots from a previous leak that has since been repaired. Requirement: Floors, walls, ceilings and other surfaces, including the facility's outdoor play space surfaces shall be kept clean, in good repair and free from visible hazards. Correction: Provider will remove ceiling tile to ensure there is no mold on the back side of the tile. Provider will clean and apply paint to the watermarks on the ceiling tile. Inspection: Renewal. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

Protective Outlet Covers 5 yrs. or less (3270.65)

In the Preschool Room, the bathroom located off the kitchen play area, had an electrical outlet to the right of the sink that was observed to be missing one protective cover and accessible to children 5 years of age or younger. Requirement: Protective receptacle covers shall be placed in electrical outlets accessible to children 5 years of age or younger. Correction: The Provider corrected this immediately by inserting an outlet cover into outlet. This was done while the State Licensing Rep was present. Inspection: Renewal. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

Group sup qualifications/Exp, educ., training prior to facility (3270.35(b)/3270.192(2)(ii))

The staff file for Staff person #1 who is functioning as a Group Supervisor, lacked a bachelors degree. Requirement: A group supervisor shall have attained one of the qualification levels specified at §3270.35(b)(1)-(4). 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 will now be listed as a AGS, not a Group Supervisor, as Staff # 1 is not qualified to be a group supervisor. Inspection: Renewal. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

Copy of initial and subsequent agreements. Parent receives original. (3270.182(8))

The child file for Child #4 lacked a financial agreement form. Requirement: A child's record shall contain a copy of the initial agreement and subsequent written agreements between the parent and the operator. The parent receives the original agreement. Correction: Provider will obtain a current service agreement in child #4's file, with child's parents. Provider will ensure that the file contains a current agreement at all times. Inspection: Renewal. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

Letter to parents (3270.27(e))

The letter to the parents explaining the emergency procedure does not address annual emergency drills, lockdown, and accommodations for infants, toddlers, children with disabilities and children with chronic medical conditions. Requirement: The operator shall provide to the parent of each enrolled child a letter explaining the emergency procedures. The operator shall also provide to the parent of each enrolled child a letter explaining any subsequent update to the plan. Correction: Will add mention of annual emergency drills, lockdown, and accommodations for infants, toddlers, children with disabilities and children with chronic medical conditions to our parent letter. Inspection: Allocated Unannounced Monitoring. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

Two written references (3270.192(5))

The staff file for staff person #1 was observed to lack one nonfamily reference. Requirement: A facility person's record shall include two written, nonfamily references from individuals attesting to the person's suitability to serve as a facility person. Correction: Will ask Staff person #1 to provide a handwritten reference by a nonfamily member. Inspection: Allocated Unannounced Monitoring. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

Emergency plan (3270.27(a)(6))

The facility has not conducted an emergency drill on an annual basis as evidence by the most recent emergency drill documented at the facility was dated 9/20/23. Requirement: Emergency drills shall be conducted annually. Annual emergency drills shall be documented and on file at the facility. Correction: We will conduct an emergency drill with the children and staff and document the drill. Inspection: Allocated Unannounced Monitoring. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

Different times of day (3270.94(a)(2))

Upon review of the facility's fire drill log the fire drill conducted on 7/10/24 lacked the time of day it was conducted. Requirement: The Director or designated staff person who is responsible for compliance with this chapter shall conduct fire drills and ensure that fire drills are conducted at different times of the day or night, or both, if applicable. Correction: Times have been documented for all of the fire drills conducted since 7/10/24 Inspection: Allocated Unannounced Monitoring. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

Mixed Age Level (3270.52)

In Rm 1, at approximately 10:50am, 2 staff and 7 children of mixed ages (older toddler and preschool age) were observed. During the onset of supervision and ratio, Staff person #1 identified and named all 7 children. When Staff person #2 was asked to identify and name the children they were responsible for Staff person #2 said they were just a floater and did not claim responsibility for any children. Staff #1's group exceeded ratio because of their group size. 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 #2 claimed responsibility for one child. Inspection: Change in Location Capacity. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).