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

The facility did not have a written policy that addressed the prevention and identification of child maltreatment. The facility's emergency plan did not address continuity of operations.

Corrected Corrected by Sep 11, 2024

Category: ratio. Marked corrected in the state record.

3290.24(a)(3) · The facility shall have an emergency plan that provides for a method for facility persons to contact parents as soon as reasonably possible when an emergency situation arises.

The facility's emergency plan did not contain a method to contact parents when an emergency occurs.

Corrected Corrected by Sep 11, 2024

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

3290.24(a)(4) · The facility shall have an emergency plan that provides for a method for facility persons to inform parents that the emergency has ended and to provide instruction as to how parents can safely be reunited with their children.

The facility's emergency plan did not contain a method to inform parents emergency has ended and instructions for how to safely be reunited with their children.

Corrected Corrected by Sep 11, 2024

Category: physical safety. 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.

The far-right bottom kitchen cabinet that was unlocked and accessible to children contained a bottle of vodka and a bottle of whiskey.

Corrected Corrected by Sep 11, 2024

Category: ratio. 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.

The stove in the kitchen had knobs on the front without covers that were accessible to children.

Corrected Corrected by Sep 11, 2024

Category: physical safety. 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).

Child #1 most recent and only child service report was dated 10/26/23, this was completed longer than 6 months ago.

Corrected Corrected by Sep 11, 2024

Category: recordkeeping. Marked corrected in the state record.

3290.124(b)(5) · Emergency contact information must include information on the child's special needs, as specified by the child's parent, physician, physician's assistant of CRNP, which is needed in an emergency situation.

Child #1 and 3's file did not contain information on the child's special needs.

Corrected Corrected by Sep 11, 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.

Child #2, 3, and 4's files did not contain the address for one individual designated by the parent to whom the child may be released.

Corrected Corrected by Sep 11, 2024

Category: recordkeeping. 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).

The immunization record on file for Child #4, who is a preschool age child(See LIS Code Sheet), contains 0 of 4 Pneumococcal vaccines recommended by the ACIP for a child this age and 0 of 2 Hepatitis A vaccines recommended by the ACIP for a child this age.

Corrected Corrected by Sep 11, 2024

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

3290.151(c)(3)/3290.192(2) · An adult health assessment must include an examination for communicable diseases and the results of that examination. 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.

Staff #1's current health assessment dated 7/2/24 did not have anything marked for question 2 "Did this individual have any communicable diseases?"

Corrected Corrected by Sep 11, 2024

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

3290.182(4) · A child's record must contain signed parental consent for administration of medications or special dietary needs.

Child #1 and 3's files did not contain signed parental consent for administration of medications or special dietary needs.

Corrected Corrected by Sep 11, 2024

Category: ratio. Marked corrected in the state record.

3290.94(a)(1) · 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 facilities fire drill log contained the following dates 3/17/24-7/15/24 which is more than 60 days apart.

Corrected Corrected by Sep 11, 2024

Category: recordkeeping. Marked corrected in the state record.

3290.94(a)(2) · 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 different times of the day or night, or both, if applicable.

The fire drill log did not contain the time of day or night that they were conducted.

Corrected Corrected by Sep 11, 2024

Category: recordkeeping. Marked corrected in the state record.

3290.94(a)(4) · 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 fire drill log did not contain the hypothetical locations of the fire in the facility.

Corrected Corrected by Sep 11, 2024

Category: recordkeeping. Marked corrected in the state record.

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 facility persons and children in attendance participate in the fire drill.

The fire drill log did not contain the facility persons names or the number of children in attendance that participated in the fire drill.

Corrected Corrected by Sep 11, 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.

The facilities fire alarm testing log contain the following dates 7/15/24-8/19/24 which are more than 30 days apart.

Corrected Corrected by Sep 11, 2024

Category: recordkeeping. Marked corrected in the state record.

3290.24(d) · Emergency drills shall be conducted annually. Annual emergency drills shall be documented and on file at the facility.

The 2 most recent documented emergency drills were dated 8/30/22 and 7/12/24 which are more than 12 months apart. The emergency drill log did not contain the number of children that participated.

Corrected Corrected by Sep 11, 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.

The emergency parent letter that is to be provided to the parent of each enrolled child did not include the method to contact parents when an emergency has occurred, the method to inform parents emergency has ended and instructions for how to safely be reunited with their children, or accommodations for infants, toddlers, children with disabilities, or children with chronic medical conditions.

Corrected Corrected by Sep 11, 2024

Category: physical safety. 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).

The files for Child #3 and #5, who are both enrolled in the facility for 6 months or more, were lacking Child Service Reports.

Corrected Corrected by Sep 6, 2023

Category: recordkeeping. Marked corrected in the state record.

3290.124(b)(1) · Emergency contact information must include the name and birth date of the child.

The file for Child #2 contained an emergency contact form that was lacking the child's birthdate.

Corrected Corrected by Aug 23, 2023

Category: recordkeeping. Marked corrected in the state record.

3290.131(d)(5) · A health report shall include a review of the child's immunized status according to recommendations of the ACIP.

The file for Child #1, 2, and 3 were all lacking the annual influenza immunization. The file #3 and 4 were both lacking 3 doses of Rotovirus immunization.

Corrected Corrected by Oct 6, 2023

Category: health medication. 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.

The file for Child #1 contains a health assessment that was obtained more than 60 days after the child's enrollment date.

Corrected Corrected by Aug 23, 2023

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

3290.131(a) · The operator shall require the parent of an enrolled child to provide an initial health report no later than 60 days following the first day of attendance at the facility.

The files for Child #3 and #4 contain health assessments that were obtained more than 60 days after their first day of attendance.

Corrected Corrected by Aug 25, 2022

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

3290.131(e)(1) · The facility shall require the parent to provide updated written verification from a physician, physician's assistant, CRNP, the Department of Health or a local health department of ongoing vaccines administered to an infant, toddler or preschool child in accordance with the schedule recommended by the ACIP.

The file for Child #1 was lacking the annual influenza vaccine. The file for Child #2 was lacking one dose of rotovirus, two doses of DTAP, 1 dose of HIB, two doses of Pneumococcal, one dose Polio, one dose Hep A and the annual influenza vaccine. The file for Child #4 was lacking 2-3 doses of rotovirus, one dose of HIB, one dose of Pneumococcal, one dose of Polio, one dose of Hep A and the annual influenza vaccine. The file for Child #5 was lacking the annual influenza vaccine.

Corrected Corrected by Sep 5, 2022

Category: health medication. 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.

The provider was lacking proof of purchase for their fire detection system.

Corrected Corrected by Aug 25, 2022

Category: recordkeeping. Marked corrected in the state record.

3290.131(d)(5) · A health report shall include a review of the child's immunized status according to recommendations of the ACIP.

The immunization record for child #3 lacked an influenza vaccination in accordance with the ACIP.

Corrected Corrected by Aug 11, 2021

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

3290.31(f)(4)(i)/3290.192(4) · Competence is the completion of training by a professional in the field of first-aid and CPR. All staff persons shall renew their certification in pediatric first aid and pediatric cardiopulmonary resuscitation (CPR) on or before the expiration of the most current certification.A facility person's record shall include records of training required by the Department.

Facility person #1 completed Pediatric first-aid and CPR training on 6/1/19, which expired on 6/1/21 and on 7/11/21, which is current.

Corrected Corrected by Aug 4, 2021

Category: ratio. 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.

On the back porch, it was observed that two outlets above the shoe rack lacked protective receptacle covers that were accessible to children.

Corrected Corrected by Aug 4, 2021

Marked corrected in the state record.

3290.91(a) · Stairways, hallways, exits from rooms, exits from the facility and other means of egress serving as an exit shall be unobstructed.

The doorway from the childcare space to the kitchen, was blocked with a cabinet and highchair.

Corrected Corrected by Aug 11, 2021

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

3290.113(a) · 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. The requirement for supervision on and off the facility premises includes compliance with the staff:child ratio requirements in §§ 3290.51-3290.52 (relating to maximum number of children; and staff:child ratio). TIERED LIS: Children must be supervised at all times. The legal entity must arrange for all facility staff to receive a minimum of two hours of training regarding supervision of children. The legal entity must receive DHS approval of the training content prior to scheduling the training. The legal entity must submit documentation in a format approved by DHS proving that the facility procedure for counting children is followed at all times e.g., a checklist. The legal entity will confirm continuing compliance by sending copies of the documentation to the Regional Office of Child Development and Early Learning on a weekly basis for a period of three months after DHS approves the documentation format.

It was observed at 10:30am on 8/4/21 that child #1 was in the front childcare space with facility person #1 and child #2 was on the screened in back porch by themselves.

Corrected Corrected by Aug 4, 2021

Category: supervision. 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.

Facility lacked an emergency plan that provides for accommodations of infants and toddlers, children with disabilities, and children with chronic medical conditions.

Corrected Corrected by Aug 4, 2021

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

3290.94(a)(1) · Fire drills are conducted at least once every 60 days.

Fire drills were conducted on 1/7/21, 4/10/21, and 7/3/21, which is not every 60 days.

Corrected Corrected by Aug 4, 2021

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

3290.94(a)(5) · Evacuation routes are posted in a conspicuous location on each floor of the facility.

Evacuation routes were not posted on the 2nd floor of the facility.

Corrected Corrected by Aug 4, 2021

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.

Facility lacked documentation of operability and proof of purchase of the inter-connected smoke alarms.

Corrected Corrected by Aug 4, 2021

Category: recordkeeping. 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.

Facility lacked an emergency plan that provides for accommodations for shelter of children during an emergency lock-down.

Corrected Corrected by Aug 4, 2021

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