3270.113(b) · A facility person may not use any form of physical punishment, including spanking a child.

On September 6, 2024 a witness observed Staff Person #1 repeatedly pulling Child #1 up by his hands while they were over his head. This occurred before lunch while Staff Person #1 was helping children wash their hands. Child #1 was already upset because he's new to the school so he was crying because of the transition to washing hands. At some point the stool slipped out from under child and Staff Person #1 was still holding onto his hands while she was fixing the stool. Child #1 dropped his weight and didn't want to put his feet down. Staff person #1's response was to repeatedly pull child #1 up by his hands which were over his head to try to get him up on the stool. He was crying through all of this.

Corrected Corrected by Nov 30, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.113(b) · A facility person may not use any form of physical punishment, including spanking a child. The legal entity must arrange for all staff to receive a minimum of 2 hours of PQAS approved, live training on safe lifting techniques of children and staff working together to prevent injuries to children. It does not matter if the PQAS approved, live training is done through the ELRC. The legal entity must receive DHS approval of training content prior to scheduling the training. The training may not be conducted while children are in care.

On September 6, 2024 a witness observed Staff Person #1 repeatedly pulling Child #1 up by his hands while they were over his head. This occurred before lunch while Staff Person #1 was helping children wash their hands. Child #1 was already upset because he's new to the school so he was crying because of the transition to washing hands. At some point the stool slipped out from under child and Staff Person #1 was still holding onto his hands while she was fixing the stool. Child #1 dropped his weight and didn't want to put his feet down. Staff person #1's response was to repeatedly pull child #1 up by his hands which were over his head to try to get him up on the stool. He was crying through all of this.

Corrected Corrected by Nov 30, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.32(a) · The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). Facility Person #1 may not work in a child care position at the facility.

Staff Person #1 has a volunteer PA Child Abuse History clearance on file, which is not acceptable for employment.

Corrected Corrected by Jul 1, 2024

Category: background checks. Marked corrected in the state record.

3270.76/3270.77(a) · 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. Peeled or damaged paint or damaged plaster is not permitted on indoor or outdoor surfaces in the child care facility.

In the walker room there were 2 small holes in the wall where some of the plaster was loose. In the preschool room there was an area on the wall where the plaster was damaged. In the entrance to the Preschool/ Pre-K room there was a piece of the molding that was peeling away from the wall.

Corrected Corrected by Jun 21, 2024

Category: physical safety. Marked corrected in the state record.

3270.124(b)(4)/3270.182(3) · Emergency contact information must include the written consent signed by a parent for emergency medical care. A child's record shall contain signed parental consent for emergency medical care for the child. Written consent is required prior to admission.

Child #1 did not have signed parental consent for emergency medical care.

Corrected Corrected by Jun 17, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.182(5) · 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.

Child #1 did not have signed parental consent for administration of minor first-aid procedures by facility staff.

Corrected Corrected by Jun 17, 2024

Category: ratio. Marked corrected in the state record.

3270.113(a)/3270.113(a)(1) · 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. 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.

On 9/28/2023 Rep conducted an investigation regarding supervision. Staff #1, #2, #3 were interviewed and admitted to a child being left unattended for approximately 60 seconds on 9/22/2023. It was also observed in the infant room that infants sleeping on cots were not visible due to cribs obstructing the view.

Corrected Corrected by Sep 22, 2023

Category: supervision. Marked corrected in the state record.

3270.113(a)/3270.113(a)(1) · 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. 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. Provider will create a policy for children transitioning from one place to another. All staff will be trained on the policy. Staff will sign off that they have read and understand the policy.

On 9/28/2023 Rep conducted an investigation regarding supervision. Staff #1, #2, #3 were interviewed and admitted to a child being left unattended for approximately 60 seconds on 9/22/2023. It was also observed in the infant room that infants sleeping on cots were not visible due to cribs obstructing the view.

Corrected Corrected by Oct 6, 2023

Category: supervision. Marked corrected in the state record.

3270.31(f) · Staff persons shall complete professional development within 90 days of hire as listed in subsections (f)1-10. Staff #1 and #2 will have until 10/20/2023 to complete the required training. . Until such time as the required training has been completed, staff person #1 & 2 must be supervised, when interacting with children, by an AGS who has completed the required training related to this citation. If there are no staff available to supervise staff person #1 and staff person #2 may not work in a child-care position at the facility.

On 9/28/23 staff files were reviewed. Staff #1 & #2 have not completed the following required pre-service training within 90 days of their date of hire - PQAS approved Pediatric 1st aid/CPR. See code sheet for date of hire.

Corrected Corrected by Oct 10, 2023

Category: supervision. Marked corrected in the state record.

3270.51 · When children are grouped in similar age levels, the following maximum child group sizes and ratios of staff persons apply: Preschool children 1:10 with a maximum group size of 20;

On 9/28/2023, upon arrival to the facility, it was observed that there were 20 pre-k children on the playground with one staff.

Corrected Corrected by Oct 6, 2023

Category: ratio. Marked corrected in the state record.

3270.66(a)/3270.66(b) · Cleaning materials and other toxic materials shall be kept in an area or container that is locked or made inaccessible to children. Cleaning materials and other toxic materials shall be stored in an original labeled container or in a container that specifies the content. Toxics shall be stored away from food, food preparation areas and child care spaces.

On 9/28/23 Rep observed toxic cleaning products within reach of a diaper changing station. Cleaning products were assessable to children and not locked away. Staff confirmed that bottles on the changing station were toxics.

Corrected Corrected by Oct 6, 2023

Category: ratio. Marked corrected in the state record.

3270.106(a)/3270.106(f) · Individual, clean, age-appropriate rest equipment shall be provided for preschool, toddler and infant children as agreed between the child's parent and the operator. The rest equipment shall be labeled for the use of a specific child and used only by the specified child. At least 2 feet of space is required on three sides of a bed, cot, crib or other rest equipment while the equipment is in use.

On 9/28/23 it was observed that infants were not sleeping on age appropriate rest equipment. Infants were sleeping on cots, not approved for children under 12 months. It was also observed that there were not 2 feet of space on three sides of the cots.

Corrected Corrected by Oct 6, 2023

Category: physical safety. Marked corrected in the state record.

3270.119 · Infants shall be placed in the sleeping position recommended by the American Academy of Pediatrics unless there is a medical reason an infant should not sleep in this position. The medical reason shall be documented in a statement signed by a physician, physician's assistant or CRNP and placed in the child's record at the facility.

On 9/28/23 it was observed that infants were sleeping on their stomachs. Staff #3 was asked how the children are laid down for nap time. Staff 3 stated that it depended on how the child liked to be laid down, either stomach or back.

Corrected Corrected by Oct 6, 2023

Category: health medication. Marked corrected in the state record.

3270.106(f) · At least 2 feet of space is required on three sides of a bed, cot, crib or other rest equipment while the equipment is in use.

During the renewal inspection on 6/14/23, child #1 was asleep on a cot that was placed between two cribs, and did not have two feet of space on three sides, as required.

Corrected Corrected by Jun 14, 2023

Category: physical safety. Marked corrected in the state record.

3270.14/3270.21 · 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.

As of the renewal inspection on 6/14/23, there was no continuity plan as required by 45 CFR 98.41(a)(1)(vii).

Corrected Corrected by Jul 3, 2023

Category: ratio. Marked corrected in the state record.

3270.27(e) · 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.

As of the renewal inspection on 6/14/23, the letter sent to parents regarding the emergency procedures did not include information on lockdown or accommodations for infants/toddlers, children with special needs, and children with chronic medical conditions.

Corrected Corrected by Jul 1, 2023

Category: physical safety. Marked corrected in the state record.

3270.124(e) · 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 child care space and shall accompany a staff person who leaves on an excursion with children.

On 6/14/23 during the renewal inspection, a written plan identifying the means of transporting a child to emergency care and staffing provisions in the event of an emergency was not displayed conspicuously in the Nursery room.

Corrected Corrected by Jun 15, 2023

Category: transportation. Marked corrected in the state record.

3270.31(f) · Staff person(s) shall complete the appropriate professional development in the topics of 3270.31(f)(1 -- 9) within the approved time frames. Staff person #1 will have until 7/1/23 to complete the required training. Until such time as the required training has been completed, staff person #1 must be supervised, when interacting with children, by an AGS or above who has completed the required training related to this citation. If there are no staff available to supervise staff person #1, staff person #1 may not work in a child-care position at the facility.

Staff person #1 completed the six hour Health and Safety pre-service training on 8/30/16, prior to the acceptable date of 9/30/16.

Corrected Corrected by Jul 1, 2023

Category: supervision. Marked corrected in the state record.

3270.35(b)(3) · A group supervisor shall have an associate's degree from an accredited college or university in early childhood education, child development, special education, elementary education or the human services field and 2 years of experience with children.

As of the renewal inspection on 6/14/23, there was insufficient documentation to qualify staff #2 for the identified Group Supervisor position.

Corrected Corrected by Jun 14, 2023

Category: supervision. Marked corrected in the state record.

3270.36(b)(5) · An assistant group supervisor shall have a high school diploma or a general educational development certificate and 2 years experience with children.

As of the renewal inspection on 6/14/23, there was insufficient documentation to qualify staff #3 for the identified Assistant Group Supervisor position.

Corrected Corrected by Jun 20, 2023

Category: supervision. Marked corrected in the state record.

3270.37(b)(1) · An aide shall have a high school diploma or a general educational development certificate.

As of the renewal inspection on 6/14/23, there was insufficient documentation to qualify staff #4 for the identified Aide position.

Corrected Corrected by Jul 1, 2023

Marked corrected in the state record.

3270.55(a) · The staff:child ratio while toddlers and preschoolers are napping is one staff person to 10 young toddlers, one staff person to 12 older toddlers, one staff person to 20 preschool children.

On 6/14/23 during the renewal inspection, staff #6 was alone with 18 older toddlers during nap time. This amount of older toddlers would require 2 staff to satisfy the nap time ratios.

Corrected Corrected by Jun 14, 2023

Category: ratio. Marked corrected in the state record.

3270.76 · 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.

On 6/14/23 during the renewal inspection, there was damage to the wall outside of the preschool room from the cots.

Corrected Corrected by Jul 1, 2023

Category: physical safety. Marked corrected in the state record.

3270.124(f)/3270.181(c) · 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.

As of the renewal inspection on 6/14/23, the most recent update to the emergency contact information for child #2 was dated 3/3/22. Child was in attendance at the facility on this date.

Corrected Corrected by Jun 23, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.131(b)(2)/3270.182(1) · 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.

As of the renewal inspection on 6/14/23, the most recent health assessment on file for child #5 was dated 10/21/21.

Corrected Corrected by Jun 20, 2023

Category: health medication. Marked corrected in the state record.

3270.131(e) · The facility may not accept or retain an infant 2 months of age or older, a toddler or a preschool child at the facility for more than 60 days following the first day of attendance at the facility unless the parent provides written verification from a physician, physician's assistant, CRNP, the Department of Health or a local health department of the dates (month, day and year) the child was administered immunizations in accordance with the recommendations of the ACIP.

As of the renewal inspection on 6/14/23, the most recent influenza vaccine for child #4 was dated 10/5/21. The most recent influenza vaccine on file for child #6 was dated 3/24/21. The most recent influenza vaccine on file for child #7 was dated 10/28/21. There was no influenza vaccine documented for child #5 and child #8. There was no documentation of Hepatitis A vaccine for child #3 and child #8. There were no exemption letters on file for any child. Child #3, #4, #5, #6, #7, and #8 must be removed from care until documentation of all vaccines or exemption letters are on file.

Corrected Corrected by Jun 23, 2023

Category: health medication. Marked corrected in the state record.

3270.192(5) · 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.

As of the renewal inspection on 6/14/23, there weren't any references on file for staff #5

Corrected Corrected by Jun 23, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.94(a)(1) · 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 least once every 60 days.

As of the renewal inspection on 6/14/23, the fire drill log had fire drills recorded on 12/3/22, 3/3/23 and then on 6/2/23. The gaps between these fire drills is greater than 60 days.

Corrected Corrected by Jun 20, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.131(a)/3270.182(1) · 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.

As of the renewal inspection on 6/14/23, there was no health assessment on file for child #7 (see code sheet for start date).

Corrected Corrected by Jun 15, 2023

Category: health medication. Marked corrected in the state record.

3270.76/3270.102(a) · 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. 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.

On 2/21/23, the facility reported that a parent closed the door to the classroom and the fingers of child # 1 were pinched in the hinge side of the door.

Corrected Corrected by Feb 22, 2023

Category: physical safety. Marked corrected in the state record.

3270.113(e) · 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. Staff person # 1 will attend a minimum of 3 hours of training to learn to manage toddler behavior. This will not be counted towards the required 12 hours of annual child care training.

During a complaint investigation on 2/15/23, staff person # 1 admitted that on 2/10/23, they held the arms of child # 1 between their elbows and shoulders while the child stood on the chair and squatted up and down. While holding the child's arms, staff person # 1 had their legs over the arms of the chair.

Corrected Corrected by Mar 14, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.113(e) · 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.

During a complaint investigation on 2/15/23, staff person # 1 admitted that on 2/10/23, they held the arms of child # 1 between their elbows and shoulders while the child stood on the chair and squatted up and down. While holding the child's arms, staff person # 1 had their legs over the arms of the chair.

Corrected Corrected by Mar 14, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.31(f) · Staff persons shall complete professional development in the following topics within 90 days of hire: health & safety topics 3270.31(f)(1-10)

During renewal inspection on 6/29/22 cert rep reviewed all staff files. STAFF # 1 completed the health & safety training on 9/2/16. STAFF # 2 completed the health & safety training on 9/13/16. STAFF # 3 completed the health & safety training on 9/14/16. STAFF # 4 completed the health & safety training on 9/8/16. STAFF # 5 completed the health & safety training on 9/238/16. This training is not acceptable for meeting the requirement of completing health & safety training because it was prior to 9/30/16. STAFF # 1, 2, 3, 4, 5 have completed 3270.31(f)(10) and have current & valid dates of completion.

Corrected Corrected by Jul 15, 2022

Category: health medication. Marked corrected in the state record.

3270.102(a) · 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.

During renewal inspection on 6/23/22 cert rep observed loose/torn rug binding on the alphabet rug by letters WXY and on the vehicle rug on 2 of the corners. Both rugs were in the Walkers/YT room and could be a potential tripping hazard.

Corrected Corrected by Jun 24, 2022

Category: transportation. Marked corrected in the state record.

3270.111(a)/3270.111(b) · A written plan of daily activities and routines, including a time for free play shall be established for each group. The plan shall be flexible to accommodate the needs of individual children and the dynamics of the group. The written plan of daily activities shall be posted in the group space.

During renewal inspection on 6/23/22 there was no written plan of daily activities in the Older SA room.

Corrected Corrected by Jun 24, 2022

Category: physical safety. Marked corrected in the state record.

3270.181(c) · 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.

During review of several children's files on 6/23/22, CHILD # 1 last financial review update was 12/17/21; CHILD # 2 was 12/16/21; CHILD # 3 was 8/9/21; CHILD # 4 was 12/16/21; CHILD # 5 was 9/8/21; CHILD # 6 was 11/11/21. All of these dates were more than 6 months old.

Corrected Corrected by Jun 30, 2022

Category: recordkeeping. Marked corrected in the state record.

3270.27(c) · The operator shall assure that each facility person receives training regarding the emergency plan at the time of initial employment, on an annual basis and at the time of each plan update. The operator shall document the date of each training and the names of all facility persons who received the training and kept on file at the facility.

Staff 1 - DOH - 4.21.21, staff 5 - DOH - 10.20.2 did not receive emergency plan training at initial hire. Staff 1 has documented emergency plan training dated 5.7.21, staff 5 has documented emergency plan training dated 11.13.21

Corrected Corrected by Aug 10, 2021

Category: recordkeeping. Marked corrected in the state record.

3270.35(b)(3)/3270.192(2)(ii) · A group supervisor shall have an associate's degree from an accredited college or university in early childhood education, child development, special education, elementary education or the human services field and 2 years of experience with children.A facility person's record shall include verification of child care experience, education and training prior to service at the facility.

Staff 4 and 5 are listed as group supervisors on the staff data sheet and they both have AAS degrees in early childhood education. Staff 4 and 5 do not have 2 years (2500 hours) of experience in child care on file. Staff 8 is listed as a group supervisor on the staff data sheet however, staff 8 does not have the education and experience on file that is required for a group supervisor. Staff 8 has a high school diploma on file.

Corrected Corrected by Aug 10, 2021

Category: supervision. Marked corrected in the state record.

3270.36(b)(5)/3270.192(2)(ii) · 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.

Staff 8 and 9 is listed as an assistant group supervisor and has a high school diploma on file. Staff 8 and 9's file does not include proof of 2 years (2500 hours) of child care experience on file.

Corrected Corrected by Aug 10, 2021

Category: supervision. Marked corrected in the state record.

3270.75(c) · A first-aid kit must contain the following: soap, an assortment of adhesive bandages, sterile gauze pads, tweezers, tape, scissors and disposable, nonporous gloves.

All of the first-aid kits in the preschool room are missing tweezers at time of inspection.

Corrected Corrected by Jul 21, 2021

Marked corrected in the state record.

3270.76/3270.77(a) · 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.Peeled or damaged paint or damaged plaster is not permitted on indoor or outdoor surfaces in the child care facility.

At time of inspection, in the toddler room, inspector observed 2 holes in the wall where the room is being divided by shelves. Inspector also observed peeling paint in same area.

Corrected Corrected by Aug 10, 2021

Category: physical safety. Marked corrected in the state record.

3270.106(a) · Individual, clean, age-appropriate rest equipment shall be provided for preschool, toddler and infant children as agreed between the child's parent and the operator. The rest equipment shall be labeled for the use of a specific child and used only by the specified child.

At time of inspection, the cribs in the infant room were not labeled for the use of a specific child and used only by the specified child. In the toddler room, the rest equipment was not labeled for the use of a specific child and used only by the specified child. The both rooms had a diagram displayed where the children would be placed in the room however, the cots and cribs were not labeled for the use of a specific child and used only by the specified child.

Corrected Corrected by Aug 10, 2021

Category: physical safety. Marked corrected in the state record.

3270.123(a)(5) · Parents added the release person to the fee agreement and provider will send proof to inspector. .An agreement shall specify the persons designated by a parent to whom the child may be released.

After reviewing child 3's file, inspector observed child 3's agreement does not specify the persons designated by a parent to whom the child may be released.

Corrected Corrected by Aug 10, 2021

Category: recordkeeping. Marked corrected in the state record.

3270.124(b)(2) · Emergency contact information must include the name, address and telephone number of the child's physician or source of medical care.

After reviewing child 1's file, inspector observed child 1's emergency contact information did not include the address and telephone number of the child's physician or source of medical care.

Corrected Corrected by Aug 10, 2021

Category: health medication. Marked corrected in the state record.

3270.124(b)(3) · Emergency contact information must include the home and work addresses and telephone numbers of the enrolling parent.

After reviewing child 1 and child 2's file, inspector observed child 1 emergency contact information did not include the work addresses and telephone numbers of the enrolling parent and child 2's emergency contact information did not include the work address of the enrolling parent

Corrected Corrected by Aug 10, 2021

Category: recordkeeping. Marked corrected in the state record.

3270.124(e) · 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 child care space and shall accompany a staff person who leaves on an excursion with children.

At time of inspection, inspector did not see a written plan identifying the means of transporting a child to emergency care and staffing provisions in the event of an emergency displayed conspicuously in every child care space.

Corrected Corrected by Jul 22, 2021

Category: transportation. Marked corrected in the state record.

3270.95(a)/3270.95(b) · 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.

At the time of the renewal inspection, the facility was unable to provide proof of date of purchase and installation of fire detection system as required by section 1016(c) of the act (62 P.S. §1016(c)).

Corrected Corrected by Aug 10, 2021

Category: recordkeeping. Marked corrected in the state record.