3270.21 · Conditions at the facility may not pose a threat to the health or safety of the children.

A loose crib sheet was observed in the Infant room and could cause suffocation.

Corrected Corrected by Sep 2, 2025

Category: health medication. 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.

The file for Staff #10 contained initial emergency plan training dated 6/10/25, more than 90 days after Staff #10's date of hire (SEE IS CODE SHEET).

Corrected Corrected by Aug 28, 2025

Category: recordkeeping. Marked corrected in the state record.

3270.31(e)(4)(i) · Competence is the completion of training by a professional in the field of first-aid and cardiopulmonary resuscitation (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.

Staff #2 has not completed Pediatric First Aid/CPR training on or before the expiration of the most current certification. This is evidenced by the previously documented Pediatric First Aid/CPR training on file expiring 12/2024. Documentation of updated Pediatric First Aid/CPR training is on file and dated 1/11/25.

Corrected Corrected by Aug 28, 2025

Category: ratio. 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. Until such time as the required training has been completed, Staff #3 must be supervised, when interacting with children at a minimum, by an Assistant Group Supervisor who has completed all preservice trainings and has all qualifications to care for children unsupervised. If there are no staff available to supervise Staff #3, Staff #3 may not work in a child care position at the facility.

Staff #3 has completed Pediatric First Aid/CPR training however the training was not completed through a Pennsylvania Quality Assurance System (PQAS) approved curriculum. Staff #9 has not completed the following required pre-service training within 90 days of their date of hire (SEE IS CODE SHEET): PA Required Health and Safety for Centers-Group Child Care Part 2.

Corrected Corrected by Aug 28, 2025

Category: supervision. Marked corrected in the state record.

3270.32(a)/3270.192(4) · 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.

The two most recent State Police clearances (7/20/20 & 7/22/25) and NSOR certificates (1/30/20 & 7/3/25) on file for Staff #1 are dated more than 60 months apart. The two most recent NSOR certificates (1/22/20 & 7/3/25) on file for Staff #2 are dated more than 60 months apart. The two most recent NSOR certificates (2/7/20 & 7/23/25) on file for Staff #7 are dated more than 60 months apart. The two most recent FBI clearances (5/26/20 & 7/25/25) on file for Staff #10 are dated more than 60 months apart. The files for Staff #3, Staff #4, Staff #5, and Staff #8 contained a volunteer disclosure statement, not the required disclosure statement for employment, making it invalid.

Corrected Corrected by Aug 28, 2025

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

3270.34(a)(6) · A director is responsible for written evaluation of staff persons on a regular basis, a minimum of one evaluation every 12 months.

The most recent staff evaluation on file for Staff #1 is dated 10/5/23, more than 12 months prior. The two most recent staff evaluations on file for Staff #7 are dated 9/1/23 and 10/10/24, more than 12 months apart.

Corrected Corrected by Aug 28, 2025

Category: recordkeeping. 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: Infants 1:4 with a maximum group size of 8; Young toddlers 1:5 with a maximum group size of 10; Older toddlers 1:6 with a maximum group size of 12; Preschool children 1:10 with a maximum group size of 20; Young school-age children 1:12 with a maximum group size of 24; Older school-age children 1:15 with a maximum group size of 30.

At approximately 10:40 AM on 8/14/25, Child #3 was observed in Room 113 receiving services with a therapist. The facility lacked signed parental consent from the parent releasing the child to the service provider. The child was not currently present with a staff person to meet the required Staff:Child ratio requirements.

Corrected Corrected by Aug 28, 2025

Category: ratio. Marked corrected in the state record.

3270.65 · Protective receptacle covers shall be placed in electrical outlets accessible to children 5 years of age or younger.

An outlet under the windows on the left side of the room, in the Infant Room, lacked a protective electrical cover.

Corrected Corrected by Aug 28, 2025

Marked corrected in the state record.

3270.66(a) · Cleaning materials and other toxic materials shall be kept in an area or container that is locked or made inaccessible to children.

Clorox wipes and spray bottles containing cleaning products were observed to be accessible in an unlocked closet in Room 113, which could be harmful to children.

Corrected Corrected by Aug 28, 2025

Marked corrected in the state record.

3270.67(a) · Trash shall be removed from the facility at least once per day.

A trash can in the outside play space was observed to be full and with garbage from days prior.

Corrected Corrected by Aug 28, 2025

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

3270.72(d) · Windows or doors above the ground floor that open directly to the outdoors and are accessible to children shall be constructed, modified or adapted to limit the opening to 6 or fewer inches.

Windows in Room 101, Room 112, and Room 114, located on the second floor of the building, lacked any form of window restrictions limiting the window opening to six inches or less.

Corrected Corrected by Aug 28, 2025

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

3270.113(a)(1) · 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.

At approximately 10:40 AM on 8/14/25, Child #3 was observed in Room 113 receiving services with a therapist. The facility lacked signed parental consent from the parent releasing the child to the service provider. The child was not currently present with a staff person to meet the required Staff:Child ratio requirements.

Corrected Corrected by Aug 28, 2025

Category: supervision. 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.

A ceiling tile was observed to be missing in Room 101 and Room 113. A hole was observed in the floor of the hallway leading to the girl's bathroom and not in good repair. A square of thick plastic attached to the wall was observed to be broken with a piece of plastic missing in the girl's bathroom near the kitchen, which could cause injury to children.

Corrected Corrected by Aug 28, 2025

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

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

Peeling paint was observed under the glass windows and the serving window in Room 101.

Corrected Corrected by Aug 28, 2025

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

3270.82(h) · A facility person and an able child shall wash his hands after toileting and before eating. A sign on which this requirement is written shall be posted at each toilet, training chair, diapering area and sink in the facility.

The boy's bathroom near the kitchen lacked handwashing signs at every toilet, urinal, and sink.

Corrected Corrected by Aug 28, 2025

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

3270.102(a)/3270.103 · 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. 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.

Torn vinyl was observed on a soft climber in Room 109 and was accessible to young toddlers who are still placing objects in their mouths.

Corrected Corrected by Aug 28, 2025

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

3270.113(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.

At approximately 10:40 AM on 8/14/25, Child #3 was observed in Room 113 receiving services with a therapist. The facility lacked signed parental consent from the parent releasing the child to the service provider. The child was not currently present with a staff person to meet the required Staff:Child ratio requirements.

Corrected Corrected by Aug 28, 2025

Category: supervision. Marked corrected in the state record.

3270.123(a)(3) · 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 in § 3270.124(f) (relating to emergency contact information).

The file for Child #1 lacked a child service report and is beyond 6 months from date of enrollment (SEE IS CODE SHEET).

Corrected Corrected by Aug 28, 2025

Category: recordkeeping. Marked corrected in the state record.

3270.123(b)/3270.182(8) · A parent shall receive the original agreement. The facility shall retain a copy of the agreement. A child's record shall contain a copy of the initial agreement and subsequent written agreements between the parent and the operator. The parent receives the original agreement.

The file for Child #1 contained the original financial agreement when the parent is to receive the original agreement.

Corrected Corrected by Aug 28, 2025

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.

The emergency contact form on file for Child #5 lacked the address for the child's physician or source of medical care.

Corrected Corrected by Aug 28, 2025

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.

The emergency contact form on file for Child #2, Child #3, Child #4, and Child #5 lacked the enrolling parent's work address and telephone number.

Corrected Corrected by Aug 28, 2025

Category: recordkeeping. Marked corrected in the state record.

3270.124(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.

The emergency contact forms for Child #1, Child #2, and Child #3 lacked the child's health insurance coverage name or health insurance policy number.

Corrected Corrected by Aug 28, 2025

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

3270.124(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.

The emergency contact form on file for Child #1 and Child #4 lacked complete addresses for all listed release persons.

Corrected Corrected by Aug 28, 2025

Category: recordkeeping. Marked corrected in the state record.

3270.131(b)(1)/3270.182(1) · The operator shall require the parent to provide an updated health report at least every 6 months for an infant or young toddler. A child's record shall contain initial and subsequent health reports.

The most recent health assessment on file for Child #1 (Young Toddler) is dated 1/22/25, more than 6 months prior. The two most recent health assessments on file for Child #2 (Younger Toddler at the time) are dated 4/22/24 and 3/27/25, more than 6 months apart.

Corrected Corrected by Oct 3, 2025

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

3270.131(d)(5)/3270.131(e)(1) · A health report shall include a review of the child's immunized status according to recommendations of the ACIP. 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 immunization record for Child #3 (PSA) lacked the following immunizations: 2 doses of Rotavirus without a Letter of Exemption in the file. Child #3 must be dismissed from care by close of business on 8/14/25 and may only return to care when the immunization record is updated or when a parent provides a written, signed exemption letter.

Corrected Corrected by Aug 28, 2025

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.

The file for Child #1 lacked an immunization record or a written letter of exemption and the child has been enrolled for more than 60 days (SEE IS CODE SHEET). Child #1 must be dismissed from care by close of business on 8/14/25 and may only return to care when the immunization record is received or when a parent provides a written, signed exemption letter.

Corrected Corrected by Aug 28, 2025

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

3270.151(a)/3270.192(3) · A facility person providing direct care who comes into contact with the children or who works with food preparation shall have a health assessment conducted within 12 months prior to providing initial service in a child care setting and every 24 months thereafter. A health assessment is valid for 24 months following the date of signature, if the person does not contract a communicable disease or develop a medical problem. 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.

The two most recent health assessments on file for Staff #2 are dated 9/1/22 and 11/11/24, more than 24 months apart. The file for Staff person #10 includes a health assessment screening dated 1/3/24, more than 12 months prior to Staff #10's date of hire (See LIS CODE SHEET).

Corrected Corrected by Aug 28, 2025

Category: ratio. Marked corrected in the state record.

3270.151(b) · A health assessment shall be conducted and a report shall be written and signed by a physician, physician's assistant or CRNP. The signature must include the individual's professional title.

The file for Staff #3 contained a health assessment dated 12/20/24 which was not conducted and signed by a physician, physician's assistant, or CRNP. The health assessment form was completed by a Certified Medical Assistant and is unacceptable.

Corrected Corrected by Aug 28, 2025

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

3270.151(c)(5) · An adult health assessment must include the physician's or CRNP's assessment of the person's suitability to provide child care.

The health assessment on file for Staff #8 does not include the physician or health care professional's assessment of the person's suitability to provide child care.

Corrected Corrected by Aug 28, 2025

Category: health medication. 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.

The fire drill log on file included fire drills conducted 4/11/25-6/11/25, more than 60 days apart.

Corrected Corrected by Aug 28, 2025

Category: recordkeeping. 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.

The two most recent annual fire detection reports are dated 7/29/24 and 8/6/25, more than 12 months apart.

Corrected Corrected by Aug 28, 2025

Category: recordkeeping. Marked corrected in the state record.

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

In Room 107, peeling paint was observed in the bathroom on the wall next to the toilet.

Corrected Corrected by Sep 17, 2024

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

3270.31(e) · A staff person shall obtain an annual minimum of 12 clock hours of child care training.

The file for Staff #4 contained 11 of 12 required annual childcare training hours.

Corrected Corrected by Sep 17, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.65 · Protective receptacle covers shall be placed in electrical outlets accessible to children 5 years of age or younger.

An outlet in the Gym, along the back wall, lacked a protective receptacle cover.

Corrected Corrected by Sep 17, 2024

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.

The facility's Emergency Plan lacked a Continuity of Operations policy.

Corrected Corrected by Sep 16, 2024

Category: ratio. Marked corrected in the state record.

3270.27(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 Emergency Plan lacked a method for facility persons to contact parents when an emergency arises.

Corrected Corrected by Sep 16, 2024

Category: physical safety. 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.

In Room 112, the First Aid kit lacked gloves.

Corrected Corrected by Sep 17, 2024

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

3270.27(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 Emergency Plan lacked a method for parents to be informed when the emergency has ended and information regarding how they are to be reunited with their child.

Corrected Corrected by Sep 16, 2024

Category: physical safety. 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.

The facility's emergency plan lacked a letter to parents explaining the emergency procedures for the following topics: shelter and lockdown, evacuation, method to contact parents during an emergency, method to inform parents the emergency has ended and instructions on how to safely be reunited with their children, and accommodations for infants, toddlers, children with disabilities and chronic medical conditions.

Corrected Corrected by Sep 17, 2024

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

3270.31(e)(4)(i)/3270.192(2)(iii) · Competence is the completion of training by a professional in the field of first-aid and cardiopulmonary resuscitation (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 verification of child care experience, education and training following the outset of service at the facility.

The two most recent Pediatric First Aid/CPR trainings on file for Staff #2 (4/28/22 & 7/21/24) and Staff #3 (12/5/21 & 1/12/24) are dated more than 24 months apart.

Corrected Corrected by Sep 17, 2024

Category: ratio. Marked corrected in the state record.

3270.31(e)(4)(ii) · Staff persons shall participate, at least annually, in firesafety training conducted by a fire protection professional. Staff persons and volunteers shall receive training in maintenance of smoke detectors, the duties of facility persons during a fire drill and during a fire and the use of the facility's fire extinguishers, not including discharge of the fire suppressant agent.

The two most recent fire safety trainings on file for Staff #1 (12/28/22 & 3/8/24) and Staff #3 (6/14/23 & 7/22/24) are dated more than 12 months apart.

Corrected Corrected by Sep 17, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.32(a)/3270.192(4) · 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.

The two most recent Mandated Reporter trainings on file for Staff #5 are dated 10/19/18 and 3/14/24, more than 60 months apart.

Corrected Corrected by Sep 17, 2024

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

3270.32(a)/3270.192(4) · 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.

The file for Facility Person #7 contained a Child Abuse clearance dated 8/13/24, which was beyond Facility Person #7's date of hire (SEE IS CODE SHEET).

Corrected Corrected by Sep 17, 2024

Category: background checks. 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.

In Room 115, three plastic chairs were observed with cracks that created pinch points, which could be harmful to children.

Corrected Corrected by Sep 17, 2024

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

3270.123(a)(5) · An agreement shall specify the persons designated by a parent to whom the child may be released.

The financial agreement on file for Child #4 lacked persons whom the child can be released to.

Corrected Corrected by Sep 17, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.123(b)/3270.182(8) · A parent shall receive the original agreement. The facility shall retain a copy of the agreement. A child's record shall contain a copy of the initial agreement and subsequent written agreements between the parent and the operator. The parent receives the original agreement.

The Financial Agreement forms on file for Child #1, Child #3, and Child #5 were observed to be the original, when the parent is to receive the original copy.

Corrected Corrected by Sep 17, 2024

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.

The Emergency Contact form for Child #1, Child #3, and Child #4 lacked the phone number of the child's physician or source for medical care.

Corrected Corrected by Sep 17, 2024

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

3270.124(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.

The Emergency Contact forms for Child #1 and Child #3 lacked the child's health insurance policy number for the child's health care benefits.

Corrected Corrected by Sep 17, 2024

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

3270.131(b)(1)/3270.182(1) · The operator shall require the parent to provide an updated health report at least every 6 months for an infant or young toddler. A child's record shall contain initial and subsequent health reports.

The two most recent health assessments for Child #2 (Younger Toddler at the time) are dated 11/16/23 and 7/11/24, more than 6 months apart.

Corrected Corrected by Sep 17, 2024

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

3270.27(f) · 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.

The facility lacked documentation verifying that the most recent emergency plan was submitted to the local municipality.

Corrected Corrected by Sep 17, 2024

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

3270.131(d)(5)/3270.131(e)(1) · A health report shall include a review of the child's immunized status according to recommendations of the ACIP. 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 immunization record for Child #1 (Infant) lacked the following immunizations: 1 dose of DTAP and 1 dose of Pneumococcal without a Letter of Exemption in the file. The immunization record for Child #4 (PSA) lacked the following immunizations: 1 dose of HIB and 1 dose of Pneumococcal without a Letter of Exemption in the file. Child #1 and Child #4 must be dismissed from care by close of business on 8/26/24 and may only return to care when the immunization record is updated or when a parent provides a written, signed exemption letter.

Corrected Corrected by Sep 17, 2024

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

3270.151(a)/3270.192(3) · A facility person providing direct care who comes into contact with the children or who works with food preparation shall have a health assessment conducted within 12 months prior to providing initial service in a child care setting and every 24 months thereafter. A health assessment is valid for 24 months following the date of signature, if the person does not contract a communicable disease or develop a medical problem. 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.

The two most recent health assessments on file for Staff #2 (4/29/22 & 5/6/24) and Staff #6 (11/1/21 & 1/3/24) are dated more than 24 months apart.

Corrected Corrected by Sep 17, 2024

Category: ratio. Marked corrected in the state record.

3270.151(c)(2)/3270.192(3) · An adult health assessment must include tuberculosis screening by the Mantoux method at initial employment. Subsequent tuberculosis screening is not required unless directed by a physician, physician's assistant, CRNP, the Department of Health or a local health department. 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.

The file for Staff #4 lacked documentation of a Tuberculosis test.

Corrected Corrected by Sep 17, 2024

Category: health medication. 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.

The fire drill log on file included fire drills conducted 9/1/23-11/2/23, 11/2/23-1/2/24, 3/1/24-5/1/24, more than 60 days apart.

Corrected Corrected by Sep 17, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.27(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.

The facility's Emergency Plan lacked lockdown procedures during an emergency.

Corrected Corrected by Sep 17, 2024

Category: physical safety. 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.

Observed exposed bolts (visible hazard) on a new gate in the outside paly space.

Corrected Corrected by Sep 28, 2023

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

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

Observed peeling paint on the ceiling in the large muscle room (gym).

Corrected Corrected by Sep 28, 2023

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

3270.31(e)(4)(ii)/3270.192(2)(iii) · Staff persons shall participate, at least annually, in firesafety training conducted by a fire protection professional. Staff persons and volunteers shall receive training in maintenance of smoke detectors, the duties of facility persons during a fire drill and during a fire and the use of the facility's fire extinguishers, not including discharge of the fire suppressant agent. A facility person's record shall include verification of child care experience, education and training following the outset of service at the facility.

The files for staff #5 and #6 lack firesafety training conducted by a fire protection professional. The training was due 12/2022 and 11/2022.

Corrected Corrected by Sep 28, 2023

Category: recordkeeping. 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.

The files for staff #1 and #2 contain pediatric first and cpr that were renewed late. Staff #1 was due 4/2023 and obtained 5/2023. Staff #2 was due 11/2022 and obtained 12/2022.

Corrected Corrected by Sep 28, 2023

Category: health medication. 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.

The files for staff #3 and #4 contain health and safety update trainings that were obtained late. The trainings were due 12/2022 and ware obtained 1/2023.

Corrected Corrected by Sep 28, 2023

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

3270.32(a) · The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services).

The file for staff #3 contains mandated reporter training that was renewed late. The training was due 12/2022 and obtained 2/2023.

Corrected Corrected by Sep 28, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.34(a)(6) · A director is responsible for written evaluation of staff persons on a regular basis, a minimum of one evaluation every 12 months.

The file for staff #5 lacks a written evaluation. The evaluation was due 6/2023.

Corrected Corrected by Sep 28, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.72(d) · Windows or doors above the ground floor that open directly to the outdoors and are accessible to children shall be constructed, modified or adapted to limit the opening to 6 or fewer inches.

Observed 2 windows in room 108 that are above the ground floor that open directly to the outdoors and are accessible to children that were not constructed, modified or adapted to limit the opening to 6 or fewer inches.

Corrected Corrected by Sep 28, 2023

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

3270.123(a)(3) · 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 in § 3270.124(f) (relating to emergency contact information).

The file for child #1 contains an assessment of the child's progress however, it is not 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.

Corrected Corrected by Sep 28, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.131(d)(5)/3270.182(1) · A health report shall include a review of the child's immunized status according to recommendations of the ACIP. A child's record shall contain initial and subsequent health reports.

The files for children #1 and #2 lack an updated review of the child's immunized status according to recommendations of the ACIP. Some of the immunizations are on file, however, not all of them are current.

Corrected Corrected by Sep 28, 2023

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

3270.131(e)(3)/3270.182(1) · 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). A child's record shall contain initial and subsequent health reports.

The facility did not 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) for child #1 and #2.

Corrected Corrected by Sep 28, 2023

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

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

Observed peeling paint on the ceiling in the gym (large muscle space).

Corrected Corrected by Oct 20, 2022

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.

Observed one crib that was not labeled for the use of a specific child.

Corrected Corrected by Oct 20, 2022

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 informationA 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.

The file for child #2 lacks an updated parental signature on the agreement and the emergency contact form.

Corrected Corrected by Oct 20, 2022

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.

The file for child #2 lacks an updated health assessment.

Corrected Corrected by Oct 20, 2022

Category: health medication. 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.

The file for child #1 contains an initial health report that was obtain later than 60 days following the first day of attendance at the facility.

Corrected Corrected by Oct 20, 2022

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

3270.66(a) · Cleaning materials and other toxic materials shall be kept in an area or container that is locked or made inaccessible to children.

There was an unlidded bucket of rock salt in the hallway leading to the outside play space.

Corrected Corrected by Feb 11, 2022

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

3270.113(a)(1) · 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.

At approximately 9:40 am, staff person #1 and #2 were on the far side of the gym with 13 children, a combined group of 9 preschoolers and 4 school-agers. Staff person #1 identified 8 preschoolers and staff person #2 identified 4 school-agers. Staff person #2 was asked to repeat the child's names and again named 4 kids. At this time, staff person #1 walked over and whispered something into staff person #2's ear. Staff person #2 then identified a 5th child. When asked if staff person #1 had whispered the child's name into their ear, staff person #2 said yes. Staff person #2 stated they did not know the child was in their group.

Corrected Corrected by Feb 11, 2022

Category: supervision. Marked corrected in the state record.

3270.52 · When children are grouped in mixed age levels, the age of the youngest child in the group determines the staff:child ratio and maximum group size in accordance with the requirements in § 3270.51 (relating to similar age level).

At approximately 9:15 am, staff person #1 left the lunch room and answered the inner door to the facility, leaving staff person #2 alone in the lunch room with 8 children, a combined group of 7 preschoolers and 1 older toddler.

Corrected Corrected by Nov 19, 2021

Category: ratio. Marked corrected in the state record.

3270.52 · The director will conduct random assessments of each classroom at least once daily, at various times of the day, for the next 3 months. During the assessment, the director will ask each staff person in each classroom to identify the children that are in their group, and are therefore, responsible for. The director will document all assessments in a log, including the date, time, staff persons, number and ages of children. The log will be submitted to the Department for approval prior to implementation. The log will be made available to OCDEL-DHS representatives upon request.

*At approximately 9:15 am, staff person #1 left the lunch room and answered the inner door to the facility, leaving staff person #2 alone in the lunch room with 8 children, a combined group of 7 preschoolers and 1 older toddler.

Corrected Corrected by Mar 17, 2022

Category: recordkeeping. Marked corrected in the state record.

3270.31(f)(10) · Pediatric first aid and pediatric cardiopulmonary resuscitation.

2nd citation: The file for staff person #3, who was beyond their first 90 days working with children, did not include pediatric first-aid/CPR training. Based on conversation with the operator, the staff person did not show up to the first-aid/CPR training scheduled at the facility on 11/6/21.

Corrected Corrected by Nov 10, 2021

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

3270.192(4) · 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 #--- may not work in a child care position at the facility.

The file for staff person #1, hired provisionally and employed less than 45 days, did not include a child abuse clearance or proof of the request for the child abuse clearance.

Corrected Corrected by Nov 3, 2021

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

3270.18(a) · The legal entity shall have comprehensive general liability insurance to cover the persons who are on the premises. A current copy of the insurance policy shall be on file at the facility.

The comprehensive liability presented at the inspection did not include the physical address of the facility.

Corrected Corrected by Nov 8, 2021

Category: recordkeeping. Marked corrected in the state record.

3270.21 · Conditions at the facility may not pose a threat to the health or safety of the children.

There was a large pair of scissors in the top drawer of a plastic cart, making them accessible to the preschoolers in the room at the time of the inspection.

Corrected Corrected by Sep 23, 2021

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

3270.25(b) · The operator shall post a copy of each inspection summary issued by the Department in a conspicuous location used by parents. The inspection summary shall remain posted until an agent of the Department verifies that each regulatory noncompliance item cited on the inspection summary has been corrected.

Based on observation and on conversation with staff person #1, the director, and staff person #12, the legal entity, the following inspection summaries, which included items that were not yet corrected, were not posted anywhere in the facility.

Corrected Corrected by Nov 8, 2021

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.

There was no emergency plan training in the file for facility person #6 and facility person #7, both beyond their initial employment. The emergency plan training in the file for staff person #9 was dated beyond initial employment.

Corrected Corrected by Sep 23, 2021

Category: recordkeeping. Marked corrected in the state record.

3270.31(e)(4)(ii) · Staff persons shall participate, at least annually, in fire safety training conducted by a fire protection professional. Staff persons and volunteers shall receive training in maintenance of smoke detectors, the duties of facility persons during a fire drill and during a fire and the use of the facility's fire extinguishers, not including discharge of the fire suppressant agent.

The last fire safety training in the file for staff person #1, the director, and staff person #2 was dated more than 12 months ago.

Corrected Corrected by Nov 8, 2021

Category: recordkeeping. Marked corrected in the state record.

3270.32(a)/3270.192(4) · 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.

The file for staff person #11, who was hired provisionally and was beyond their 45-day provisional period, did not include an FBI clearance and continued to work with children. health assessment and TB in the file for staff person #9, who was a seasonal employee, and was not listed on the staff sheets at the renewal inspection in 2020 and whose file was, therefore, not reviewed, did not include a disclosure statement. The file for staff person #11, who was hired provisionally and was beyond their 45-day provisional period, did not include an FBI clearance and continued to work with children. The file for staff person #9, who was a seasonal employee, and was not listed on the staff sheets at the renewal inspection in 2020 and whose file was, therefore, not reviewed, did not include a disclosure statement. The file for facility person #6 and #7 did not include a disclosure statement.

Corrected Corrected by Sep 23, 2021

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

3270.32(a)/3270.192(2)(iii) · The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). A facility person's record shall include verification of child care experience, education and training following the outset of service at the facility.

The file for facility person #6 and #7, employed more than 90 days and on site while children are in care at the facility, did not include mandated reporter training.

Corrected Corrected by Nov 8, 2021

Category: recordkeeping. Marked corrected in the state record.

3270.34(a)(6) · A director is responsible for written evaluation of staff persons on a regular basis, a minimum of one evaluation every 12 months.

The most recent evaluation in the file for staff person #3 and #10 was not dated, therefore it could not be verified that the director completed the evaluation timely.

Corrected Corrected by Nov 8, 2021

Category: recordkeeping. Marked corrected in the state record.

3270.66(a) · Cleaning materials and other toxic materials shall be kept in an area or container that is locked or made inaccessible to children.

There was a jar of Elmer's rubber cement on a low shelf in an unlocked cabinet in the preschool room. There were two containers of Lysol wipes on the floor and one container of Lysol wipes on a low shelf in an unlocked closet in the preschool room, making them accessible to the preschoolers in the room at the time. There were 2 bottles of hand sanitizer sitting on tables in the main hall of the facility, outside the preschool and school-age rooms, making them accessible to the children in care at the time. All items included instructions to keep out of the reach of children. Two bottles of hand sanitizer on tables in the hallway unattended

Corrected Corrected by Sep 23, 2021

Marked corrected in the state record.

3270.106(j) · Toys, bumper pads, or pillows may not be present in a crib while an infant is sleeping in the crib.

At approximately 10:30 on 8/24/21, child # 4, a 10 month-old, was observed sleeping with a bib around their neck in the infant room, creating a potential strangulation hazard.

Corrected Corrected by Aug 24, 2021

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

3270.113(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.

At approximately 10:15 am on 9/14, upon entering the preschool room, staff person #1 was observed at the room's half door, speaking to staff person #2 and #3 in the adjacent toddler room. No children were visible in the preschool room at this time. A few moments later, child #1 came out from behind a cubby that was to left of the doorway between the preschool room and the toddler room. At approximately 1:00 pm, staff person #3 was observed standing at the cubbies to the right of the doorway. At this time, staff person #3 had their back to the room and the 9 toddlers sleeping in the room. Even when the staff person turned around, one of the children could not be supervised properly as their face and head were behind a piece of furniture.

Corrected Corrected by Sep 14, 2021

Category: supervision. 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.

At approximately 10:30 on 8/24/21, child #1, a 3 month-old, was observed sleeping on their stomach in the infant room. Based on conversation with staff person #10, they had placed the infant on their stomach to sleep and the child is not able to roll over on their own.

Corrected Corrected by Sep 14, 2021

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

3270.131(e)(2)(i) · Exemption from immunization for religious belief or strong personal objection equated to a religious belief shall be documented by a written, signed and dated statement from the child's parent or guardian. The statement shall be kept in the child's record.

The file for child #1, now a 4 month old, was missing the following immunizations: 1 of 2 Rotovirus, 1 of 2 DTAP, 1 of 2 HIB, 1 of 2 Pneumococcal and 1 of 2 Polio. The file for child #2, a 23 month old, was missing the following immunizations: 1 of 4 DTAP and 1 of 3 HIB. Neither file included a written statement of exemption by a parent.

Corrected Corrected by Nov 8, 2021

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

3270.151(a) · A facility person providing direct care who comes into contact with the children or who works with food preparation shall have a health assessment conducted within 12 months prior to providing initial service in a child care setting and every 24 months thereafter. A health assessment is valid for 24 months following the date of signature, if the person does not contract a communicable disease or develop a medical problem.

The last health assessment in the file for staff person #4 was dated more than 24 months ago. health assessment and TB in the file for staff person #9, who was a seasonal employee, and was not listed on the staff sheets at the renewal inspection in 2020 and whose file was, therefore, not reviewed, included a health assessment and TB screening dated more than 12 months before they started working with children again on 5/16/21.

Corrected Corrected by Sep 24, 2021

Category: ratio. Marked corrected in the state record.

3270.151(c)(2) · An adult health assessment must include tuberculosis screening by the Mantoux method at initial employment. Subsequent tuberculosis screening is not required unless directed by a physician, physician's assistant, CRNP, the Department of Health or a local health department.

The health assessment and TB in the file for staff person #9, who was a seasonal employee, and was not listed on the staff sheets at the renewal inspection in 2020 and whose file was, therefore, not reviewed in 2020, included a health assessment and TB screening dated more than 12 months before they started working with children again on 5/16/21.

Corrected Corrected by Sep 23, 2021

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

3270.151(c)(2) · An adult health assessment must include tuberculosis screening by the Mantoux method at initial employment. Subsequent tuberculosis screening is not required unless directed by a physician, physician's assistant, CRNP, the Department of Health or a local health department.

The TB screening in the file for staff person #2 was dated after the individual's first day working with children.

Corrected Corrected by Sep 23, 2021

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

3270.151(c)(3)/3270.151(c)(5) · An adult health assessment must include an examination for communicable diseases and the results of that examination. An adult health assessment must include the physician's or CRNP's assessment of the person's suitability to provide child care.

The health assessment in the file for staff person #11 did not include the physician's or CRNP's assessment of the person's suitability to provide child care or the results of an examination for communicable disease.

Corrected Corrected by Sep 23, 2021

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

3270.166(1) · A written statement giving the formula and feeding schedule for an infant shall be obtained from the parent.

Based on review of the file and on conversation with the operator, there was not a feeding schedule for child #1, a 4 month old,

Corrected Corrected by Nov 8, 2021

Category: nutrition. 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

The file for facility person #6 and #7 did not include 2 letters of reference.

Corrected Corrected by Sep 14, 2021

Category: recordkeeping. Marked corrected in the state record.

3270.31(f)(10) · Pediatric first aid and pediatric cardiopulmonary resuscitation.

The file for staff person #5, #8, #9 and #10, all beyond their first 90 days working with children, .did not include pediatric first-aid/CPR training.

Corrected Corrected by Nov 8, 2021

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

3270.31(h) · All staff persons shall complete the professional development under subsection (f).

The file for staff person #5, #8, #9 and #10, all beyond their first 90 days working with children, did not include training in the health and safety topics as required by regulation 31f.

Corrected Corrected by Nov 8, 2021

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

3270.113(a) · The legal entity will arrange for all staff persons to receive a minimum of 4 hours of OCDEL approved supervision training. The legal entity will be required to receive approval of the supervision training from OCDEL prior to scheduling the training. The LE shall send proof of the completion of the training to the assigned certification representative within 7 days of completion. Proof of completion shall include a staff attendance sign in sheet as well as trainer acknowledgement.

**2nd citation: At approximately 2:30 pm, upon entering the facility for a scheduled meeting with staff person #1, the operator, staff person #2 was observed in the large school-age room with 5 children. Staff person #2 was sitting close to the door. Four children were sleeping on cots that were spaced far apart in the large room. One child was sitting in a chair closer to the opposite corner of the room from where staff person #2 was sitting. A large TV screen was on in the room but the room was very dark. When staff person #2 was asked to identify their group, they stated "I can't see them" approximately 3-4 times. After suggesting the staff person get closer to the children to help identify them, the staff person still had troubling identifying the children and had to bend over and get closer to the children's faces before they could properly identify each child. The four sleeping children could not be supervised properly as the staff person could not see, hear, direct and assess those four children. Previously cited on 5/27/21.

Corrected Corrected by Nov 8, 2021

Category: supervision. Marked corrected in the state record.

3270.113(a) · The legal entity will conduct mandatory staff meetings at least once per month for a period of 3 months following the approval of this plan of correction. At each staff meeting, time will be set aside to review and discuss the facility's previous regulatory non-compliance items documented on inspection summaries issued in the last year, as well as, the Department of Human Services' regulations related to staff:child ratios and supervision of children. An agenda will be prepared for each staff meeting and a log identifying the date, time and persons attending each meeting will be maintained. The staff meeting agendas and logs will be kept on site and made available to OCDEL-DHS representatives upon request.

***2nd citation: At approximately 2:30 pm, upon entering the facility for a scheduled meeting with staff person #1, the operator, staff person #2 was observed in the large school-age room with 5 children. Staff person #2 was sitting close to the door. Four children were sleeping on cots that were spaced far apart in the large room. One child was sitting in a chair closer to the opposite corner of the room from where staff person #2 was sitting. A large TV screen was on in the room but the room was very dark. When staff person #2 was asked to identify their group, they stated "I can't see them" approximately 3-4 times. After suggesting the staff person get closer to the children to help identify them, the staff person still had troubling identifying the children and had to bend over and get closer to the children's faces before they could properly identify each child. The four sleeping children could not be supervised properly as the staff person could not see, hear, direct and assess those four children. Previously cited on 5/27/21.

Corrected Corrected by Nov 8, 2021

Category: supervision. Marked corrected in the state record.

3270.113(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.

2nd citation: At approximately 2:30 pm, upon entering the facility for a scheduled meeting with staff person #1, the operator, staff person #2 was observed in the large school-age room with 5 children. Staff person #2 was sitting close to the door. Four children were sleeping on cots that were spaced far apart in the large room. One child was sitting in a chair closer to the opposite corner of the room from where staff person #2 was sitting. A large TV screen was on in the room but the room was very dark. When staff person #2 was asked to identify their group, they stated "I can't see them" approximately 3-4 times. After suggesting the staff person get closer to the children to help identify them, the staff person still had troubling identifying the children and had to bend over and get closer to the children's faces before they could properly identify each child. The four sleeping children could not be supervised properly as the staff person could not see, hear, direct and assess those four children. Previously cited on 5/27/21.

Corrected Corrected by Sep 14, 2021

Category: supervision. Marked corrected in the state record.

3270.182(7) · A child's record shall 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.

Based on conversation with staff person #1, the operator, an incident report was not provided to a parent of child #1 for an injury on 5/7/21 until 4 days later and no report was provided to the child's parent for a second injury on 5/13. Staff person #1 also stated that they had not retained a copy of incident reports in an accident file as they did not know that was required. Based on conversation with multiple staff, they have never completed an incident report for injuries or illnesses.

Corrected Corrected by Aug 16, 2021

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