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

At the time of the inspection, in a cabinet in the kitchen, roaches were observed on a sticky trap.

Corrected Corrected by Apr 5, 2024

Marked corrected in the state record.

3290.63 · Protective receptacle covers shall be placed in electrical outlets accessible to children 5 years of age or younger.

At the time of the inspection, protective receptacle covers were missing from numerous outlets in the first floor. These outlets were accessible to children under 5 years of age.

Corrected Corrected by Mar 22, 2024

Marked corrected in the state record.

3290.64(a) · 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.

At the time of the inspection, alcohol prep pads and CPAP cleansing wipes which both stated "keep out of reach of children" were on a shelf in the childcare space and were accessible to children. Listerine was observed on the counter in the second-floor bathroom and was accessible to children.

Corrected Corrected by Mar 22, 2024

Category: ratio. Marked corrected in the state record.

3290.69/3290.74(a) · 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. Floors, walls, ceilings and other surfaces, including the facility's outdoor play area, shall be kept clean, in good repair and free from visible hazards.

At the time of the inspection, the child safety knob on the stove was broken which would allow a child to turn the stove on posing a hazard.

Corrected Corrected by Mar 22, 2024

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

3290.102(f) · Children's toys and equipment, including furniture and rest equipment, described as hazardous by the United States Consumer Product Safety Commission may not be used by children at the facility.

At the time of the inspection, a Fisher Price Infant to Toddler rocker was observed in the home. This piece of equipment was deemed hazardous by the United States Consumer Product Safety Commission on 6/14/22 and cannot be used in the home.

Corrected Corrected by Mar 22, 2024

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

3290.103 · 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.

At the time of the inspection, diapers wrapped in plastic bags were observed on a lower changing table shelf and were accessible to children who are still placing objects in their mouths.

Corrected Corrected by Mar 22, 2024

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

3290.105(a) · 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.

At the time of the inspection, the pack and play as well as the cots used for rest time were not labeled with the child's name who uses them.

Corrected Corrected by Mar 22, 2024

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

3290.121(a)/3290.121(b) · The operator shall review with the parent, at the time of application, the facility's general daily schedule, hours for which care is provided, fees, responsibilities for meals, clothing, health policies, supervision policies, night care policies, dismissal policies, transportation and pick-up arrangements. At the time of enrollment, a parent shall receive in writing the facility's general daily schedule, hours for which care is provided, fees, responsibilities for meals, clothing, health policies, supervision policies, night care policies, dismissal policies, transportation and pick-up arrangements.

At the time of the inspection, the operator did not have transportation policies listed in the parent handbook.

Corrected Corrected by Apr 5, 2024

Category: supervision. Marked corrected in the state record.

3290.123(a)/3290.123(b) · An agreement shall be signed by the operator and the parent. A parent shall receive the original agreement. The facility shall retain a copy of the agreement.

At the time of the inspection, the operator did not sign any of the child agreements and admitted that the parents do not receive the original agreement and the facility keeps the copy.

Corrected Corrected by Apr 5, 2024

Category: recordkeeping. Marked corrected in the state record.

3290.123(a)(4)/3290.123(a)(5) · An agreement shall specify the child's arrival and departure times. An agreement shall specify the persons designated by a parent to whom the child may be released.

At the time of the inspection, the agreement for child #1, child #2 and child #5 did not include the child's arrival and departure times. The agreement for child #1, child #3 and child #5 did not specify the persons designated by a parent to whom the child may be released.

Corrected Corrected by Apr 5, 2024

Category: recordkeeping. Marked corrected in the state record.

3290.123(a)(6)/3290.182(2) · An agreement shall specify the date of the child's admission. A child's record must contain the dates of application, admission and withdrawal of the child.

At the time of the inspection, the agreements for each child did not have a date of admission.

Corrected Corrected by Apr 5, 2024

Category: recordkeeping. Marked corrected in the state record.

3290.124(b)(2) · Emergency contact information must include the name, address and telephone number of the child's physician or source of medical care.

At the time of the inspection, the emergency contact form for child #1 through child #5 did not include the name, address and telephone number of the child's physician or source of medical care.

Corrected Corrected by Apr 5, 2024

Category: health medication. 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.

At the time of the inspection, the emergency contact form for child #1, child #2 and child #5 did not include the work address and phone number of the enrolling parent.

Corrected Corrected by Apr 5, 2024

Category: recordkeeping. Marked corrected in the state record.

3290.124(b)(6) · Emergency contact information must include health insurance coverage and policy number for a child under a family policy or Medical Assistance benefits, if applicable.

At the time of the inspection, the emergency contact form for child #2, child #3 and child #4 did not include both the health insurance coverage and policy number for the child.

Corrected Corrected by Apr 5, 2024

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

3290.124(b)(7) · 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.

At the time of the inspection, the emergency contact form for child #1, child #3 and child #5 did not include both the address and phone number of the individual designated by the parent to whom the child may be released.

Corrected Corrected by Mar 22, 2024

Category: recordkeeping. Marked corrected in the state record.

3290.134(a)/3290.152 · A staff person shall ensure that a child's hands are washed before meals and snacks, after toileting and after being diapered. A facility person shall wash his hands before meals and snacks, and after toileting and after diapering a child.

At the time of the inspection, child #1 was having a diaper change. The operator did not wash both her hands and the child's hands after the diaper change.

Corrected Corrected by Mar 19, 2024

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

3290.135(c) · The diapering area may not be used for food preparation or food service.

At the time of the inspection, infant formula was observed on the shelf of the diaper changing table.

Corrected Corrected by Mar 19, 2024

Category: ratio. Marked corrected in the state record.

3290.165/3290.166(4) · The operator shall discuss the general menu plan with the parent so that the daily nutritional needs of the child can be met. Disposable nursers and bottles shall be labeled with the child's name.

At the time of the inspection, the bottles for child #1 were not labeled. The operator admitted to not having a general menu which is discussed with the parent.

Corrected Corrected by Mar 22, 2024

Category: nutrition. Marked corrected in the state record.

3290.182(3)/3290.182(5) · A child's record must contain signed parental consent for emergency medical care for the child. Written consent is required prior to admission. A child's record must contain signed parental consent for administration of minor first-aid procedures by facility staff. Written consent is required prior to admission.

At the time of the inspection, child #1, child #3, child #4 and child #5 did not have signed parental consent for emergency medical care for the child or signed parental consent for administration of minor first-aid procedures by facility staff on the emergency contact form.

Corrected Corrected by Apr 5, 2024

Category: ratio. Marked corrected in the state record.

3290.182(7) · A child's record must contain reports of accidents, injuries and illnesses involving a child in care at the facility. The original report shall be given to the parent on the day of the incident. The second copy of the report shall be retained at the facility in an accident file. The third copy of the report shall be retained at the facility in the child's file.

At the time of the inspection, the operator did not have a facility file for incident reports of children.

Corrected Corrected by Mar 22, 2024

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.

At the time of the inspection, the operator admitted to not conducting a fire drill every 60 days as required since the facility opened in December 19, 2023. A fire drill would have been required to be conducted on 2/19/24.

Corrected Corrected by Mar 22, 2024

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.

At the time of the inspection, the operator admitted to not manually testing the smoke detectors every 30 days as required since the facility opened in December 19, 2023. Manual monthly monitoring of the smoke detectors would have been required to be conducted on 1/19/24 and 2/19/24.

Corrected Corrected by Mar 22, 2024

Category: recordkeeping. Marked corrected in the state record.

3290.24(f) · The operator shall provide to the parent of each enrolled child a letter explaining the emergency procedures described in subsection (a). The operator shall also provide to the parent of each enrolled child a letter explaining any subsequent update to the plan.

At the time of the inspection, the operator admitted to not providing the parents of each enrolled child a letter explaining the emergency plan procedures.

Corrected Corrected by Mar 22, 2024

Category: physical safety. 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 sections of their emergency plans that must address volunteer emergency preparedness training, practice drills, and continuity of operations.

At the time of the inspection, the operator did not have continuity of operations in the emergency plan.

Corrected Corrected by Dec 7, 2023

Category: ratio. 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. To maintain compliance with 45 CFR 98.41(a)(1)(vi), in addition to the training requirements, child care providers must have a policy and procedure 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.

At the time of the initial inspection, the operator did not have written policies regarding the 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 addressing the prevention and identification of child maltreatment.

Corrected Corrected by Dec 9, 2023

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

3290.64(a) · 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.

At the time of the inspection, on the second floor, perfumes and lotions were observed in an unlocked bedroom. These perfumes and lotions were accessible to children.

Corrected Corrected by Dec 7, 2023

Category: ratio. 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.

At the time of the inspection, the first aid kit did not contain soap.

Corrected Corrected by Dec 7, 2023

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

3290.74(a) · Floors, walls, ceilings and other surfaces, including the facility's outdoor play area, shall be kept clean, in good repair and free from visible hazards.

At the time of the inspection, the shelves in the childcare space were easily able to be tipped over. This poses a hazard to the children.

Corrected Corrected by Dec 7, 2023

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

3290.101(b) · Play equipment and materials shall include the items specified at §3290.101(c)(1) - (6).

At the time of the inspection, the operator did not have dramatic play materials and art materials as part of the materials provided to children.

Corrected Corrected by Dec 9, 2023

Category: physical safety. 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. Operators are required to have smoke alarms on each floor and in the basement that**: · Are interconnected, via hardwire, Bluetooth connectivity or any other means that allow for communication between smoke alarms (35 P.S. § 1223.6(f.1)(1.1)). · When activated, the resulting alarm is audible to persons in the indoor child-care space with all intervening doors closed (35 P.S. § 1223.6(f.1)(1.1)(i)). · Each smoke alarm, at the time of installation, be approved by a testing laboratory recognized by the Occupational Safety and Health Administration (OSHA) of the United States Department of Labor2 to test and certify smoke alarms.

At the time of the inspection, the operator did not have interconnected and OSHA approved smoke detectors on each floor of her home.

Corrected Corrected by Dec 9, 2023

Category: ratio. Marked corrected in the state record.

3290.24(a)(1)/3290.24(a)(5) · 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. The facility shall have an emergency plan that provides for accommodations of infants and toddlers, children with disabilities, and children with chronic medical conditions.

At the time of the inspection, the operator did not have lockdown procedures specific to the facility in the emergency plan. Accommodations for infants, toddlers and children with special needs during an emergency were also missing from the emergency plan.

Corrected Corrected by Dec 7, 2023

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

3290.24(e)/3290.24(g) · The emergency plan shall be posted in the facility at a conspicuous location. The operator shall send a copy of the emergency plan and subsequent plan updates to the local municipality and to the county emergency management agency.

At the time of the inspection, the operator did not have the emergency plan posted. There was also no documentation showing that the emergency plan was sent to both the county and local emergency management agencies for review.

Corrected Corrected by Dec 7, 2023

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