3290.95(a)/3290.95(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 operator or designated staff person who is responsible for compliance with this chapter shall ensure the requirements in § 3290.95(a) are met. Provider will facetime with certification representative to verify that an operable smoke detector is in place prior to resuming childcare.

During the renewal inspection on 9/23/2024, it was observed that the facility did not have an operable interconnected smoke detector on the first floor of the facility. On 9/24/2024, certification representative contacted staff 1. Staff 1 stated that she did not have a new smoke detector installed yet. Certification representative asked her if she had children in care today. Staff 1 did admit to having children in care.

Corrected Corrected by Sep 24, 2024

Category: recordkeeping. Marked corrected in the state record.

3290.173(a) · A child 7 years of age or younger shall be transported in accordance with the requirements for parents and guardians as stated in 75 Pa.C.S. §4581 (relating to restraint systems).

The facility was using an expired toddler car seat. The car seat expired June of 2020.

Corrected Corrected by Sep 23, 2024

Category: transportation. Marked corrected in the state record.

3290.18/3290.102(a) · Conditions at the facility may not pose a threat to the health or safety of the children. 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.

It was observed that there were two big kitchen knives accessible to children in the kitchen.

Corrected Corrected by Sep 23, 2024

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

3290.64(a)/3290.103 · 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 kept in a locked area or in an area inaccessible to children, and shall be stored away from food, food preparation areas and child care spaces. Toys and objects with a diameter of less than 1 inch, objects with removable parts that have a diameter of less than 1 inch, plastic bags and styrofoam objects may not be accessible to children who are still placing objects in their mouths.

Leading to the downstairs bathroom, there was laundry detergent accessible to the children, near the washer and dryer. In the downstairs bathroom, there were plastic bags accessible to the children, under the sink in an unlocked cabinet.

Corrected Corrected by Sep 23, 2024

Category: ratio. Marked corrected in the state record.

3290.105(a)/3290.166(4) · Individual, clean, age-appropriate rest equipment shall be provided for preschool, toddler and infant children as agreed between the parent and the operator. The rest equipment must be labeled with the child's name and used only by the named child while enrolled in the program. Disposable nursers and bottles shall be labeled with the child's name.

It was observed that the pack and plays and infant bottles were not labeled.

Corrected Corrected by Sep 23, 2024

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

3290.131(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.

Child 1 did not have updated immunizations on file and she was enrolled at the facility for more than 60 days.

Corrected Corrected by Sep 30, 2024

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

3290.182(6) · A child's record must contain signed parental consent for transportation, walking excursions, swimming and wading.

As per provider, when transporting the children, she uses the local school playground as she is picking up the children from school. She stated that this is for children 2-4. Upon a record review, it was found that children 2-4 do not have permission for walks and trips.

Corrected Corrected by Sep 24, 2024

Category: transportation. Marked corrected in the state record.

3290.95(a)/3290.95(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 operator or designated staff person who is responsible for compliance with this chapter shall ensure the requirements in § 3290.95(a) are met. Provider will facetime with certification representative to verify that an operable smoke detector is in place prior to resuming childcare.

During the renewal inspection on 9/23/2024, it was observed that the facility did not have an operable interconnected smoke detector on the first floor of the facility.

Corrected Corrected by Sep 23, 2024

Category: recordkeeping. Marked corrected in the state record.

3290.18 · Conditions at the facility may not pose a threat to the health or safety of the children. The operator shall update the section of their emergency plan that must address continuity of operations.

During renewal inspection conducted 9/27/2023, facility's emergency plan did not include continuity of operations.

Corrected Corrected by Sep 29, 2023

Category: ratio. Marked corrected in the state record.

3290.65(c) · Evidence of infestation of insects or rodents in the facility is not permitted.

During renewal inspection conducted 9/27/2023, two (2) cockroaches were observed to be crawling on the walls.

Corrected Corrected by Oct 3, 2023

Marked corrected in the state record.

3290.69 · Hot water pipes and other sources of heat exceeding 110° F that are accessible to children shall be equipped with protective guards or shall be insulated to prevent direct contact.

During renewal inspection conducted 9/27/2023, facility's stove was not equipped protective guards or knob covers and was accessible to children.

Corrected Corrected by Oct 2, 2023

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

3290.73(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.

During renewal inspection conducted 9/27/2023, facility's first-aid kit in the facility did not have gloves. Facility's first-aid kit for transportation did not have soap.

Corrected Corrected by Sep 29, 2023

Category: transportation. Marked corrected in the state record.

3290.123(a)(3) · An agreement shall specify 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 at § 3290.124(e).

During renewal inspection conducted 9/27/2023, last child service report (CSR) on file for child #1 is dated 7/14/2022.

Corrected Corrected by Oct 2, 2023

Category: recordkeeping. Marked corrected in the state record.

3290.131(b)(2) · The operator shall require the parent to provide an updated health report at least every 12 months for an older toddler or preschool child.

During renewal inspection conducted 9/27/2023, last health assessment on file for child #2 is dated 5/4/2022.

Corrected Corrected by Oct 2, 2023

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

3290.131(d)(5)/3290.131(e)(3) · 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). Child #1 will be dismissed from care by close of business September 27, 2023 until either the immunization record is updated, or a parent provides a written, signed exemption letter.

During renewal inspection conducted 9/27/2023, there was no record of influenza vaccine in child #1's file. There is no exemption on file.

Corrected Corrected by Sep 29, 2023

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

3290.21(f)/3290.172 · A valid photo identification of the operator or designated staff person who is responsible for compliance with this chapter shall be provided to the agent of the Department at the time of inspection. The operator of the vehicle shall be 18 years of age or older and shall have a valid operator's license.

During renewal inspection conducted 9/27/2023, facility person #1's photo ID expired on 9/5/2023. Facility person #1 also provides transportation and admits to providing transportation up to today.

Corrected Corrected by Sep 28, 2023

Category: transportation. Marked corrected in the state record.

3290.94(a)(4)/3290.94(a)(7) · The operator 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. The operator or designated staff person who is responsible for compliance with this chapter shall conduct fire drills and ensure that facility persons and children in attendance participate in the fire drill.

During renewal inspection conducted 9/27/2023, hypothetical location on fire drill log was listed as "home" and participating facility person(s) were not listed.

Corrected Corrected by Sep 29, 2023

Category: recordkeeping. Marked corrected in the state record.

3290.31(f) · A staff person shall obtain an annual minimum of 12 clock hours of child care training.

During renewal inspection conducted 9/27/2023, facility person #1 completed 10 hours of child care training for the training year 12/19/2021-12/19/2022.

Corrected Corrected by Sep 27, 2023

Category: recordkeeping. Marked corrected in the state record.

3290.31(g) · Staff persons shall complete professional development within 90 days of hire as listed in subsections (g)1-10.

During renewal inspection conducted 9/27/2023, facility person #1 did not complete the required one-hour 2022 update to the health and safety training by 12/30/2022. Facility person #1 completed the required training on 7/27/2023.

Corrected Corrected by Jul 27, 2023

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

3290.18 · Conditions at the facility may not pose a threat to the health or safety of the children. Beginning April 29, 2022, all child care facilities must have a policy to identify the prevention of shaken baby syndrome, abusive head trauma, and child maltreatment. The policy must include, but is not limited to: · Recognition of potential signs and symptoms of shaken baby syndrome and abusive head trauma; · Strategies for coping with a crying, fussing, or distraught child; and · Address the prevention and identification of child maltreatment.

During renewal inspection conducted 9/15/2022, facility did not develop a policy and procedure for Shaken Baby, Abusive Head Trauma, and Child Maltreatment.

Corrected Corrected by Sep 23, 2022

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

3290.32(a)/3290.192(3) · The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services).A facility person's record shall include a copy of requests for the criminal history record and child abuse registry clearance information, a copy of the disclosure statement and a copy of the completed clearance information required under the CPSL. Facility Person #1 and #2 may not work in a child care position at the facility until appropriate information is on file.

During renewal inspection conducted 9/15/2022, a disclosure statement was not on file for Facility person #1 or facility person #2.

Corrected Corrected by Sep 15, 2022

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

3290.65(d) · Trash that has been contaminated by human secretions or excrement shall be contained in closed, plastic-lined receptacles.

During renewal inspection conducted 9/15/2022, trashcan located in the bathroom used by children did not have a lid. Trash was observed to have used tissues in it.

Corrected Corrected by Sep 23, 2022

Marked corrected in the state record.

3290.111(b) · The written plan of daily activities and routines shall be posted in a traffic area used by parents.

During renewal inspection conducted 9/15/2022, facility did not have a written plan of daily activities and routines posted in a traffic area used by parents.

Corrected Corrected by Sep 23, 2022

Marked corrected in the state record.

3290.124(b)(3) · Emergency contact information must include the home and work addresses and telephone numbers of the enrolling parent.

During renewal inspection conducted 9/15/2022, the following was missing from emergency contact form: Child #1: Parent's address and telephone number

Corrected Corrected by Sep 15, 2022

Category: recordkeeping. Marked corrected in the state record.

3290.124(c)/3290.176 · When children leave the facility on walking and riding excursions, emergency contact information specific to each child on the excursion shall accompany a staff person on the excursion.A first-aid kit, including the contents as specified in §3290.73 (relating to first-aid kit) shall be in the vehicle when children are being transported.

During renewal inspection conducted 9/15/2022, emergency contact information was not in facility's vehicle or emergency bag. Operator reports that emergency contact information is not taken with facility staff during transportation. First-aid kit located in the vehicle was missing tweezers and scissors.

Corrected Corrected by Sep 23, 2022

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

3290.135(b) · Diaper changing surfaces shall be cleaned after each use by wiping the surface with a sanitizing solution or by changing a pad or other surface covering.

During renewal inspection conducted 9/15/2022, diaper pad was covered in a cloth covering. Diaper pad was unable to be cleaned after each use.

Corrected Corrected by Sep 23, 2022

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

3290.181(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 renewal inspection conducted 9/15/2022, the following emergency contact form and fee agreements were not updated within the past 6 months: Child #2: Last update was 3/6/2022. Child #3: Last update was 3/14/2022.

Corrected Corrected by Sep 18, 2022

Category: recordkeeping. Marked corrected in the state record.

3290.95(a)/3290.95(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 operator or designated staff person who is responsible for compliance with this chapter shall ensure the requirements in § 3290.95(a) are met.

During renewal inspection conducted 9/15/2022, facility did not have proof of purchase on file for 10-year lithium ion battery-operated smoke detectors.

Corrected Corrected by Sep 23, 2022

Category: recordkeeping. Marked corrected in the state record.

3290.118 · 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 unannounced inspection conducted on 2/15/2022, operator admitted to placing the infant child on her stomach to sleep.

Corrected Corrected by Feb 25, 2022

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

3290.94(a)(1)/3290.94(a)(9) · The operator 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.The operator or designated staff person who is responsible for compliance with this chapter shall conduct fire drills and ensure that a written record is maintained on file at the facility indicating the specific time of day of the drill, the hypothetical location of the fire, the evacuation time, and the names of the facility persons and the number of children who participate in the fire drill.

On unannounced inspection completed on 2/15/2022, fire drill log indicated last fire drill was held on 10/17/2021. The provider reports that last fire drill was held in December 2021 but did not provide a date. December's drill was not documented.

Corrected Corrected by Feb 17, 2022

Category: recordkeeping. Marked corrected in the state record.

3290.95(a)/3290.95(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 operator or designated staff person who is responsible for compliance with this chapter shall ensure the requirements in § 3290.95(a) are met.

On unannounced inspection completed on 2/15/2022, fire detection testing log indicated that last testing was completed on 11/17/2021. Provider reported that fire detection system was last tested in December 2021 but was not documented.

Corrected Corrected by Feb 15, 2022

Category: recordkeeping. Marked corrected in the state record.

3290.24(a)(5) · The facility shall have an emergency plan that provides for accommodations of infants and toddlers, children with disabilities, and children with chronic medical conditions.

During onsite renewal inspection on 9/27/21 cert rep reviewed that facility emergency plan. The emergency plan did not include provisions for accommodations of infants and toddlers, children with disabilities, and children with chronic medical conditions.

Corrected Corrected by Oct 1, 2021

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

3290.24(a)(1) · The facility shall have an emergency plan that provides for accommodations for shelter of children during an emergency including lock-down, shelter in place at the facility and shelter at locations away from the facility premises.

During onsite renewal inspection on 9/27/21 cert rep reviewed the emergency plan. The plan did not include instructions for lock-down.

Corrected Corrected by Oct 1, 2021

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