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Mobile App Manual Review under COPPA Rule: ‘Central Hospital Stories'

Nov 1, 2023 12:45:00 PM

Welcome to Pixalate’s CTV & Mobile App Manual Reviews According to COPPA, a series containing the detailed factors the Trust & Safety Advisory Board educators used to assess an app’s child-directedness.

The educators manually review thousands of mobile apps available in the Google Play & Apple App Stores as well as connected TV (CTV) apps from the Roku Channel Store and Amazon Fire TV App Store using the COPPA Rule factors shown below & make those results available to the public at ratings.pixalate.com.

This post takes a look at a game which is available from the Google Play & Apple App Stores. Our reviewer discusses how the subjective factors set forth in the COPPA Rule apply to the app and factor into the reviewer's determination as to whether the app is child-directed or general audience (i.e., it is not targeting children).

Manually reviewed in this post


The 10 COPPA Rule factors

The teacher will indicate the factors they relied upon in their assessment using the 10 factors shown below that reflect the 10 child-directed factors in the COPPA Rule.

Reviewed by: Tabitha Walker

Tabitha Walker

Manual Review: Central Hospital Stories

Likely audience after manual review

  • Google Developer: SUBARA
  • Apple Developer: SUBARA SG Ltd.
  • Google Bundle ID: com.playtoddlers.centralhospitalstories.free
  • Apple Bundle ID: 1458894591
  • Privacy Policy
  • Tabitha’s Take: A virtual doll inspired game that allows young children to creatively play inside a hospital.

COPPA factors used to determine audience

Central Hospital Stories allows young children to play doctor and patient in a virtual hospital setting. It is a virtual doll-type game, rather than a simulation. The hospital is like a doll house and the players can interact with any of the various characters and objects they encounter. There are no missions, quests, or other specific tasks that the player needs to accomplish. The app encourages imagination and creativity and users are able to interact with the hospital in whatever way they want.


The animations are very childlike, with characters constructed of very basic shapes- such as circles for hands. The basic outline of all the characters is the same, with small differences in skin color, hairstyles, and clothing to distinguish each character.

The hospital is brightly colored and filled with numerous objects for the players to interact with. All of the characters and most objects can be moved around and interacted with.

Animations accompany many of the interactions with the hospital. For example, dragging an apple to a character triggers a chewing animation, while putting a character on the various scanning machines will trigger flashing lights and beeping.

Other than a few words on signs around the hospital, there is no written or verbal language within the app. Visuals are used to indicate what each wing of the hospital is for, making it easy for toddlers and children who cannot yet read to interact with the game.

There are plenty of sound effects to keep young children interested in clicking around inside the app. Elevators dinging, dogs barking (yes, this hospital has a veterinarian wing), and water flowing into the sink are just a few of the numerous sound effects. Soft, upbeat music also plays in the background.

The iPhone version of the app had no ads but numerous locked rooms that could only be played with a paid upgrade.

The Android version allows access to the entire hospital but displays ads throughout gameplay. Video ads for a variety of general audiences, mixed audiences, and child-directed apps are played each time a player switches rooms. There was even an advertisement for an app that appeared to be identical to this one but with a different name. The home screen also displays a banner ad for additional games by the same developer.


Central Hospital Story's description indicates the app is “designed for kids between 4 and 14 years old, but appropriate to be enjoyed by the whole family.” The Apple App Store rates it as 4+ but indicates that it is for 6-8-year-olds. The Google Play Store has given the app a “teacher approved” tag and rates it as 4+ in the US and PEGI 3 in Europe.

The reviews indicate that children are the primary users of the app. There are numerous reviews from parents and from children themselves. Reviews indicate that children as young as 3 and as old as 13 are playing the game.


According to the privacy policy, which was last updated on April 20, 2022, the app does not collect any personal information from any user. They do utilize a third party to collect analytical information to improve their app.

Screenshots of Central Hospital Stories

About Pixalate’s Trust & Safety Advisory Board

Pixalate’s Trust and Safety Advisory Board was created to bring in individuals with experience using child-directed apps in the classroom to review and assess which apps are child-directed. This manual review process serves to quality check Pixalate’s automated review process. See our full methodology for more information.


This blog post published by Pixalate is available for informational purposes only and is not considered legal advice. By viewing this blog post, the reader understands and agrees that there is no attorney-client relationship between the reader and the blog publisher. The blog should not be used as a substitute for legal advice from a licensed professional attorney in the applicable jurisdiction(s), and readers are urged to consult their own legal counsel on any specific legal questions concerning any specific situation. The content of this blog post reflects Pixalate's opinions with respect to factors that Pixalate believes may be useful to the digital media industry. Pixalate's opinions are just that, opinions, which means that they are neither facts nor guarantees; and this blog post is not intended to impugn the standing or reputation of any entity, person or app, but instead, to report findings pertaining to mobile and Connected TV (CTV) apps.

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