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 11:15 AM on 5/8/25, Staff #1 was observed working alone in the Main Room (L) with 1 infant and 5 young toddlers.

Corrected Corrected by May 8, 2025

Category: ratio. Marked corrected in the state record.

3270.105 · High chairs shall have a wide base and a T-shaped safety strap.

A child (Young Toddler) was observed in a high chair in the Main Room (L) and was not buckled in using the T-shaped safety straps.

Corrected Corrected by Apr 6, 2025

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. Until such time as the required trainings are completed, Staff #2 and Staff #3 must be supervised, when interacting with children, by an Assistant Group Supervisor at minimum who has completed the required training related to this citation. If there are no staff person(s) available to supervise Staff #2 and Staff #3, Staff #2 and Staff #3 may not work in a child care position at the facility.

At the time of inspection, the facility lacked documentation of the facility's Shaken Baby Syndrome/Child Maltreatment policy. The facility's Emergency Plan lacked the following policies: Continuity of Operations and Emergency Plan training for volunteers. Staff #2 and Staff #3 were observed to be caring for children unsupervised. Staff #2 and Staff #3 do not have a current Pediatric First Aid/CPR training. This is evidenced by the previously documented Pediatric First Aid/CPR training on file for Staff #2 and Staff #3 with an expiration date of 1/2025.

Corrected Corrected by Apr 15, 2025

Category: supervision. 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.

In the Main Room (R), adult scissors were observed accessible to children in a drawer in a storage tower along the wall.

Corrected Corrected by Apr 6, 2025

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 facility's Emergency Plan lacked information regarding how parents are to be reunited with their child.

Corrected Corrected by Apr 15, 2025

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

3270.27(b) · The operator shall review the emergency plan at least annually and update the plan as needed. The operator shall document in writing each review and update of the emergency plan and kept on file at the facility.

The most recent annual review by the operator of the facility's Emergency Plan is dated 2/1/24, more than 12 months prior.

Corrected Corrected by Apr 15, 2025

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.

The most recent Emergency Plan training on file for Staff #2 (dated 1/24/23) and Staff #3 (dated 4/3/22) are dated more than 12 months prior and should be completed at initial hire, annually, and with any updates.

Corrected Corrected by Apr 15, 2025

Category: recordkeeping. 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 Apr 15, 2025

Category: physical safety. 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 file for Staff #1 and Staff #2 lacked documentation that fire safety training has been completed annually. The most recent fire safety training on file for Staff #3 is dated 1/22/23, more than 12 months prior.

Corrected Corrected by Apr 15, 2025

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 #1 lacked a disclosure statement.

Corrected Corrected by Apr 6, 2025

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 two most recent State Police clearances on file for Staff #3 are dated 3/1/22 and 3/2/25. The clearance dated 3/1/22 lacked a dissemination date, making it invalid. The two most recent State Police clearances on file for Staff #4 are dated 6/11/19 and 3/4/25, more than 60 months apart.

Corrected Corrected by Apr 15, 2025

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

3270.103 · 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.

Plastic bags were observed in an open area under the sink in the Infant Room and could cause suffocation.

Corrected Corrected by Apr 6, 2025

Marked corrected in the state record.

3270.32(a) · The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). A provisional employee may not be permitted to work alone with children and must work within the vicinity of a permanent employee.

Staff #5 and Staff #6, working as provisional hires, were observed working unsupervised at the time of inspection.

Corrected Corrected by Apr 6, 2025

Category: supervision. 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 files for Staff #2 and Staff #3 lacked documentation that the director has completed written evaluations of each staff member on a regular basis, at minimum of one evaluation every 12 months.

Corrected Corrected by Apr 6, 2025

Category: recordkeeping. Marked corrected in the state record.

3270.36(b)(5)/3270.192(2)(iii) · An assistant group supervisor shall have a high school diploma or a general educational development certificate and 2 years experience with children. A facility person's record shall include verification of child care experience, education and training following the outset of service at the facility.

The file for Staff #5, classified as an Assistant Group Supervisor, lacked acceptable documentation that Staff #5 has completed high school or a GED. The file for Staff #6, classified as an Assistant Group Supervisor, lacked documentation that Staff #6 has completed high school or a GED.

Corrected Corrected by Jun 1, 2025

Category: supervision. 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.

Outlet covers were missing in the Main Rooms (L & R).

Corrected Corrected by Apr 6, 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.

A backpack belonging to Staff #6 was observed on top of a 3-drawer storage unit in the Upstairs Room (L). The front pocket was unzippered and contained prescription pills and Tylenol, which was accessible to the children in care.

Corrected Corrected by Apr 6, 2025

Marked corrected in the state record.

3270.71 · 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.

In the Gym, a food warmer was observed accessible to children and was 118 degrees.

Corrected Corrected by Apr 6, 2025

Category: nutrition. 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 the Upstairs (R) Room, the first aid kit lacked soap.

Corrected Corrected by Apr 15, 2025

Category: health medication. 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.

In the Upstairs Room (R), a coaxial cable was sticking out of the wall, which could be hazardous to children. In the Main Room (L), an accessible wooden baseboard on the left side of the door was observed to be broken and contained splintered wood pieces, which could cause injury to children.

Corrected Corrected by Apr 21, 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 bathroom used by children lacked a handwashing sign at every sink, toilet, and changing table. After a diaper change in the Upstairs Room (L), Staff #6 was observed using baby wipes to wash an able child's hands (Older Toddler).

Corrected Corrected by Apr 15, 2025

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

3270.91(a) · Stairways, hallways, exits from rooms, exits from the facility and other means of egress serving as an exit shall be unobstructed.

In the Main Room (L), a play kitchen was observed in front of an exit at the facility, making the exit obstructed.

Corrected Corrected by Apr 6, 2025

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.

A toy tool bench that was accessible to children was observed to be broken and lopsided in the Main Room (R). A carpet in the Gym was observed to be bunching in areas and not laying flat on the floor, which cause a tripping hazard. A chair used by staff in the Upstairs Room (R) that was accessible to children was observed to have a broken arm, which exposed a metal pole with a sharp edges and could cause injury. A red wood chair used by children was observed to be broken in the Upstairs Room (R). Mats used as rest equipment were observed with torn plastic and exposed foam, which could be harmful to children. In the bathroom, an accessible plastic tote with broken pieces and sharp edges was observed in the shower stall, which could cause injury.

Corrected Corrected by Apr 25, 2025

Category: physical safety. 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 foam less than one inch in diameter was observed on a high chair used by and accessible to children who are still placing objects in their mouths. In the Infant Room, the safety railing on the changing table was observed to be broken with exposed wood pieces and could be harmful to children.

Corrected Corrected by Apr 15, 2025

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.

Cribs and mats used as age-appropriate rest equipment were not labeled for the use of a specific child and used only by the specified child.

Corrected Corrected by Apr 6, 2025

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

3270.107 · A facility shall have an operable, clean refrigerator used to store potentially hazardous foods. The refrigerator shall be capable of maintaining food at 45° F or below. An operating thermometer shall be placed in the refrigerator.

In the Infant Room, the thermometer in the refrigerator read 50 degrees and is not to exceed 45 degrees.

Corrected Corrected by Apr 6, 2025

Category: nutrition. Marked corrected in the state record.

3270.123(a) · An agreement shall be signed by the operator and the parent.

The financial agreement form on file for Child #2 lacked the operator's signature.

Corrected Corrected by Apr 6, 2025

Category: recordkeeping. 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 #3 contained a child service report dated 2/25/25 and none prior (SEE IS CODE SHEET). The files for Child #4 and Child #5 contained child service reports dated 2/27/24 and 2/25/25, more than 6 months apart.

Corrected Corrected by Apr 15, 2025

Category: recordkeeping. Marked corrected in the state record.

3270.123(a)(6)/3270.182(2) · An agreement shall specify the date of the child's admission. A child's record shall contain the dates of application, admission and withdrawal of the child.

The financial agreement form on file for Child #2 lacked the child's date of admission.

Corrected Corrected by Apr 15, 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 financial agreement forms on file for Child #2, Child #3, and Child #4 were the original agreement forms. The parent is to receive the original agreement and the facility is to obtain a copy.

Corrected Corrected by Apr 6, 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 for Child #3 lacked a complete address for the child's physician or source of medical care.

Corrected Corrected by Apr 15, 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 forms for Child #1, Child #3, and Child #5 lacked complete addresses for all listed release persons.

Corrected Corrected by Apr 15, 2025

Category: recordkeeping. Marked corrected in the state record.

3270.124(f)/3270.181(c) · The parent shall update in writing emergency contact information once in a 6-month period or as soon as there is a change in the information. A parent is required to review and update the emergency contact information and the financial agreement at least once in a 6-month period or as soon as there is a change in the information.

The emergency contact and financial agreement 6-month parent review and updates on file for Child #3 (10/30/23 & 10/28/24), Child #4 (10/6/23 & 10/6/24), and Child #5 (9/26/23 & 9/26/24) were dated more than 6 months apart. The most recent emergency contact and financial agreement 6-month parent review and update on file for Child #3 (10/28/24), Child #4 (10/6/24), and Child #5 (9/26/24) are invalid because they are photocopies of the 2023 update with whiteout over the 2023 date with the 2024 date handwritten and confirmed by the operator.

Corrected Corrected by Apr 15, 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 two most recent health assessments on file for Child #4 (Younger Toddler at the time) are dated 10/31/23 & 2/11/25, more than 6 months apart. The two most recent health assessments on file for Child #5 (Younger Toddler at the time) are dated 2/1/23 & 12/5/24, more than 6 months apart.

Corrected Corrected by Apr 15, 2025

Category: health medication. 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 two most recent health assessments on file for Child #3 (Preschool) are dated 10/24/22 and 8/28/24, more than 12 months apart.

Corrected Corrected by Apr 15, 2025

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

3270.131(d)(5)/3270.131(e) · A health report shall include a review of the child's immunized status according to recommendations of the ACIP. 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 immunization record for Child #3 (Preschool) lacked the following immunizations: 2 doses of Rotavirus and 1 dose of Pneumococcal without a Letter of Exemption in the file. Child #3 must be dismissed from care by close of business on 3/5/25 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 Apr 15, 2025

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

3270.131(d)(7) · A health report shall include a statement that the child is able to participate in child care and appears to be free from contagious or communicable disease.

The health assessment on file for Child #3 dated 8/28/24 does not include the physician's assessment if the child able to participate in child care and is free from communicable diseases.

Corrected Corrected by Apr 15, 2025

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

3270.134(d) · Liquid or powdered soap shall be used for handwashing.

The handwashing station in the Main Room (L) lacked liquid or powered soap required for handwashing.

Corrected Corrected by Apr 6, 2025

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

3270.135(a)(3) · If disposable diapers are provided by a parent or by a facility, a soiled diaper shall be discarded by immediately placing the diaper into a plastic-lined, hands-free covered can.

In the diapering areas of the Infant Room and Upstairs Room (L), a garbage can was observed with a swing lid and was not hands free.

Corrected Corrected by Apr 6, 2025

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

3270.135(b) · Diaper changing surfaces shall be cleaned after each use by wiping the surface with a sanitizing solution or by changing a pad or other surface covering.

Staff #6 was observed during a diaper change and did not clean the diaper changing area after each use by wiping the surface with a sanitizing solution or by a changing pad or other surface covering.

Corrected Corrected by Apr 6, 2025

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

3270.171(c) · Written notification of safe routes shall be posted by the operator at a conspicuous location in the child care facility.

The facility lacked written notification of safe routes posted in a conspicuous location in the child care facility.

Corrected Corrected by Apr 6, 2025

Marked corrected in the state record.

3270.183(a) · Child records are confidential and shall be stored in a locked cabinet.

The facility's child files were stored in a binder in the Main Room (R) and not in a locked cabinet.

Corrected Corrected by Apr 15, 2025

Category: recordkeeping. 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 Staff #4 contained 1 of 2 written nonfamily reference letters.

Corrected Corrected by Apr 15, 2025

Category: recordkeeping. Marked corrected in the state record.

3270.27(a)(5) · The facility shall have an emergency plan that provides for accommodations for infants, toddlers, children with disabilities, and children with chronic medical conditions.

The facility's Emergency Plan lacked accommodations for infants, toddlers, children with special needs, and chronic medical conditions.

Corrected Corrected by Apr 15, 2025

Category: physical safety. 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 inspection reports on file are dated 3/13/24 and 3/20/25, more than 12 months apart.

Corrected Corrected by Apr 15, 2025

Category: recordkeeping. 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.

At the time of inspection, the facility did not have documentation that the current emergency plan was sent to the local municipality and to the county emergency management agency.

Corrected Corrected by Apr 16, 2025

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 #1 contained 9 of 12 annual training hours within the training period of 12/19/23-12/19/24. The file for Staff #2 contained 0 of 12 hours of annual training hours within the training period of 12/1/23-12/1/24. The file for Staff #3 contained 10 of 12 annual training hours within the training period of 4/11/23-4/11/24.

Corrected Corrected by Apr 16, 2025

Category: recordkeeping. Marked corrected in the state record.

3270.131(a)/3270.131(e) · 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. 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 initial health assessment and immunization record on file for Child #2 is dated 1/14/25, more than 60 days after Child #2's date of enrollment (SEE IS CODE SHEET).

Corrected Corrected by Apr 15, 2025

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

3270.171(a) · An operator shall notify local traffic safety authorities annually in writing of the location of the facility and the program's use of pedestrian and vehicular routes around the child care facility.

The facility lacked annual written notification to local traffic safety authorities of location of the facility and program's use of pedestrian and vehicular routes around the facility.

Corrected Corrected by May 1, 2025

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.

On 6/20/24, Staff #2 was observed to be caring for children unsupervised. Staff person #2 did not completed the following pre-service training required prior to caring for children unsupervised: Pediatric First Aid/CPR (6/23/24) and Get Started with Center-Based Care - Revised 2022 (6/21/24).

Corrected Corrected by Apr 25, 2024

Category: supervision. 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 #4 were dated 4/9/22 and 5/13/24, more than 24 months apart.

Corrected Corrected by Jul 1, 2024

Category: ratio. 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 10:15 AM, Staff #1 and Staff #2 were observed in right side of the Main Room with a total of 14 children ranging in age from Older Toddler to Older School Age. At approximately 10:22 AM, Staff #2 and 6 Older Toddlers went to the Upstairs Right room. At approximately 10:23 AM, Staff #1 was observed with 3 Older Toddlers, 3 Preschool Aged Children, 1 Young School Age Child, and 1 Older School Age Child, leaving Staff #1 out of ratio. Staff #1 was out of ratio for approximately 29 minutes until Staff #3 arrived, putting the facility back in ratio.

Corrected Corrected by Jul 1, 2024

Category: ratio. Marked corrected in the state record.

3270.61(h) · The capacity established for an indoor space may not be exceeded.

At approximately 10:15 AM, Staff #1 and Staff #2 were observed in right side of the Main Room with a total of 14 children ranging in age from Older Toddler to Older School Age. The capacity of the right side of the Main Room is 11.

Corrected Corrected by Jul 12, 2024

Category: ratio. Marked corrected in the state record.

3270.27(a)(6) · Emergency drills shall be conducted annually. Annual emergency drills shall be documented and on file at the facility.

The facility has not done an emergency drill within the last 12 months.

Corrected Corrected by Apr 26, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.27(c)/3270.192(2)(iii) · 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. A facility person's record shall include verification of child care experience, education and training following the outset of service at the facility.

Staff file #2 lacks verification of emergency plan training.

Corrected Corrected by Apr 25, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.31(f) · Staff person(s) shall complete professional development in the topics of 3270.31(f)(1 -- 10) within 90 days of hire. Staff person #2 will have until 5/3/24 to complete the required training. Until such time as the required training has been completed, staff person #2 must be supervised, when interacting with children, by an AGS who has completed the required training related to this citation. If there are no staff available to supervise staff person #2, staff person #2 may not work in a child-care position at the facility.

Staff person #2 has not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): 10 hour health and safety training.

Corrected Corrected by Apr 25, 2024

Category: supervision. Marked corrected in the state record.

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

The first aid kit in the little room lacked scissors and tweezers, the kit in the left upstairs room lacked tweezers.

Corrected Corrected by Apr 25, 2024

Category: health medication. 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.

A sign on which the hand washing requirement is written was not posted at the changing tables in the diapering areas in the facility.

Corrected Corrected by Apr 25, 2024

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

3270.82(j) · A source of running water for handwashing shall be present in infant and toddler diapering areas. If the running water does not flow directly into a drain that is connected to a sewage system, a receptacle shall be provided to contain the water used for washing. The receptacle shall be emptied into an approved sewage system at least once a day.

Both upstairs classrooms a source of running water for handwashing. Both classrooms have toddler diapering areas/tables.

Corrected Corrected by Apr 25, 2024

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

3270.102(a) · Toys, play equipment and other indoor and outdoor equipment used by the children shall be clean, in good repair and free from rough edges, sharp corners, pinch and crush points, splinters and exposed bolts.

The wooden chairs in the left upstairs classroom were not clean. The small trampoline in the gym space had tears in the netting along the sides. Several rest mats in the main left room were torn. The windshield on the toy Barbie car was damaged and sharp.

Corrected Corrected by Apr 25, 2024

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.

Several mats in the main right room were not labeled with a child's name. Several cribs in the main left room were not labeled with a child's name.

Corrected Corrected by Apr 25, 2024

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

3270.108(c) · Styrofoam cups and plates may not be used.

The facility is using styrofoam plates to serve food to the children.

Corrected Corrected by Apr 25, 2024

Category: nutrition. Marked corrected in the state record.

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

Neither of the upstairs classrooms contained a written and posted plan of daily activities and routines, including a time for free play.

Corrected Corrected by Apr 18, 2024

Marked corrected in the state record.

3270.124(c) · When children are in the facility, emergency contact information shall be present in a child care space for children receiving care in the space.

Emergency contact information was not present in a both upstairs classrooms and the amin right room for the children receiving care in those spaces. Emergency contact sheets were present for some of the children in care in those rooms but not for all of the children in the room at the time of the inspection.

Corrected Corrected by Apr 25, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.124(e) · A written plan identifying the means of transporting a child to emergency care and staffing provisions in the event of an emergency shall be displayed conspicuously in every child care space and shall accompany a staff person who leaves on an excursion with children.

The upstairs classrooms lacked a written and posted plan identifying the means of transporting a child to emergency care and staffing provisions in the event of an emergency.

Corrected Corrected by Apr 26, 2024

Category: transportation. Marked corrected in the state record.

3270.135(a)(3) · If disposable diapers are provided by a parent or by a facility, a soiled diaper shall be discarded by immediately placing the diaper into a plastic-lined, hands-free covered can.

The bathroom off of the main right room lacked a plastic-lined, hands-free covered can. The waste can in the bathroom had a swing lid.

Corrected Corrected by Apr 26, 2024

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

3270.161(d) · Potentially hazardous food brought from the child's home or provided by the facility shall be refrigerated.

Observed baby bottles in the left main room that were in lunch bags with ice packs. They were not refrigerated.

Corrected Corrected by Apr 26, 2024

Category: nutrition. Marked corrected in the state record.

3270.94(a)(5) · The Director or designated staff person who is responsible for compliance with this chapter shall conduct fire drills and ensure that evacuation routes are posted in a conspicuous location on each floor of the facility.

The upstairs classrooms lacked evacuation routes posted in a conspicuous location.

Corrected Corrected by Apr 26, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.31(e)/3270.192(2)(iii) · A staff person shall obtain an annual minimum of 12 clock hours of child care training. 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 staff #1 lacks 8 of the annual 12 hours of child care training for the 12/2022-12/2023 period. The file for staff #2 contains 12 hours of annual child care training, however, 10 of the 12 hours were completed in 3/2024 and were due 2/2024.

Corrected Corrected by Apr 26, 2024

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.

The windows in the 2 upstairs child care rooms (left and right) above the ground floor open directly to the outdoors and are accessible to children were not constructed, modified or adapted to limit the opening to 6 or fewer inches.

Corrected Corrected by Jun 8, 2023

Category: physical safety. 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 file for staff #1 lacks an updated health assessment. The health assessment was due to be updated 11/2022.

Corrected Corrected by Jun 8, 2023

Category: ratio. Marked corrected in the state record.

3280.94(a)(1) · The primary staff person 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 drills that occurred in 1/2022 and 3/2022 as well as 8/2022 and 11/2022 exceeded 60 days.

Corrected Corrected by Feb 26, 2023

Category: recordkeeping. Marked corrected in the state record.

3280.31(e)/3280.192(2)(iii) · A staff person shall obtain an annual 12 clock hours of child care training. A facility person's record shall include verification of child care experience, education and training following the outset of service at the facility.

Staff #1 lacks 1 hour of the 12 clock hours of annual child care training for the 12/2021 - 12/2022 period.

Corrected Corrected by Feb 26, 2023

Category: recordkeeping. Marked corrected in the state record.

3280.14/3280.20 · 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. Until such time as the required pre-service trainings are completed, staff person #4 must be supervised, when interacting with children, by a primary staff person who has completed the required training related to this citation. If there are no staff person(s) available to supervise staff person #4, staff person #4 may not work in a child-care position at the facility.

Staff person #4 was observed to be caring for children unsupervised in the upstairs classroom. Staff person #4 has not completed the following pre-service training required prior to caring for children unsupervised: general health and safety training.

Corrected Corrected by Feb 26, 2023

Category: supervision. Marked corrected in the state record.

3280.17 · The legal entity shall have comprehensive general liability insurance to cover all persons who are on the premises. A current copy of the insurance policy shall be on file at the facility.

The legal entity did not have comprehensive general liability insurance proof on file to cover all persons who are on the premises. A current copy of the insurance policy shall be on file at the facility. The operator had a proposal for insurance on file at the facility.

Corrected Corrected by Feb 26, 2023

Category: recordkeeping. Marked corrected in the state record.

3280.26(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 operator did not send a copy of the emergency plan and subsequent plan updates to the local municipality and to the county emergency management agency.

Corrected Corrected by Feb 26, 2023

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

3280.161(c) · Potentially hazardous food brought from the child's home or provided by the facility shall be refrigerated.

Observed baby bottle with milk in them in bags with ice packs and not refrigerated in the infant area.

Corrected Corrected by Feb 26, 2023

Category: nutrition. Marked corrected in the state record.

3280.31(e)(4)(i) · 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.

Staff #1 did not renew her certification in pediatric first-aid and pediatric cardiopulmonary resuscitation (CPR) on or before the expiration of the most current certification. The certification expired in 1/2022 and was renewed in 4/2022. Current training is ow on file.

Corrected Corrected by Feb 26, 2023

Category: ratio. Marked corrected in the state record.

3280.32(a) · The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services).

Staff person #2 had not completed mandated reporter training within 90 days of hire. This is evidenced by the documented mandated reporter training on file being 8/27/22. (see LIS code sheet). Current mandated reporter training is on file for staff #2.

Corrected Corrected by Feb 26, 2023

Category: recordkeeping. Marked corrected in the state record.

3280.32(a) · The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services).

Staff persons #1 had not renewed mandated reporter training timely (within the last 60 months). Current mandated reporter training is currently on file. This is evidenced by the previously documented mandated reporter training on file being dated 2/2016 and 2/2022.

Corrected Corrected by Feb 26, 2023

Category: recordkeeping. Marked corrected in the state record.

3280.123(a)/3280.182(8) · An agreement shall be signed by the operator and the parent. A child's record must 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 #2 lacks an agreement.

Corrected Corrected by Feb 26, 2023

Category: recordkeeping. Marked corrected in the state record.

3280.124(c) · When children are in the facility, emergency contact information shall be present in a child care space for children receiving care in the space.

Emergency contact information was not present in the infant child care space for children receiving care in that space.

Corrected Corrected by Feb 26, 2023

Category: recordkeeping. Marked corrected in the state record.

3280.124(f)/3280.181(c) · The parent shall update in writing emergency contact information once in a 6-month period or as soon as there is a change in the information. A parent is required to review and update the emergency contact information and the financial agreement at least once in a 6-month period or as soon as there is a change in the information.

The files for children #1 and #4 contained emergency contact information and agreements that were updated late. Child #1 3/2020 update was due 3/2022 and obtained 1/2023. Child #4 6/2022 update was due 12/2022 and obtained 1/2023.

Corrected Corrected by Feb 26, 2023

Category: recordkeeping. Marked corrected in the state record.

3280.166(4) · Disposable nursers and bottles shall be labeled with the child's name.

Observed one unlabeled baby bottle in the infant area.

Corrected Corrected by Feb 26, 2023

Marked corrected in the state record.

3280.131(b)(1)/3280.182(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 must contain initial and subsequent health reports.

The file for child #4 contains a health assessment that was updated late. Due 12/2022 and obtained 1/2023.

Corrected Corrected by Feb 26, 2023

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

3280.131(b)(2)/3280.182(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 must contain initial and subsequent health reports.

The file for child #3 contains a health assessment that was updated late. Due 11/2021 and obtained 8/2022.

Corrected Corrected by Feb 26, 2023

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

3280.131(e)/3280.182(1) · 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. A child's record must contain initial and subsequent health reports.

The files for children #1 and #4 lack verification of the flu vaccination for the most recent full year.

Corrected Corrected by Feb 26, 2023

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

3280.131(e)(3) · 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 files for children #1 and #4 lack verification of the flu vaccination for the most recent full year.

Corrected Corrected by Feb 26, 2023

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

3280.151(a)/3280.192(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 file for staff #4 contains a health assessment that was obtained late. Staff #4 was a caregiver on 1/4/23 and obtained a health assessment on 1/6/23.

Corrected Corrected by Feb 26, 2023

Category: ratio. Marked corrected in the state record.

3280.151(c)(2)/3280.192(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 contains a TB test that was obtained late. Staff #4 was a caregiver on 1/4/23 and obtained a TB test on 1/6/23.

Corrected Corrected by Feb 26, 2023

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

3280.95(a)/3280.95(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 primary staff person or designated staff person who is responsible for compliance with this chapter shall ensure the requirements in subsection (a) are met.

The operator did not have proof that the fire detection system had been tested annually by a fire safety professional.

Corrected Corrected by Feb 26, 2023

Category: recordkeeping. Marked corrected in the state record.

3280.31(f) · Staff persons shall complete professional development within 90 days of hire as listed in subsections (f)1-10.

Staff person #2 had not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): pediatric first aid and cpr. Pediatric first aid and cpr was completed on 1/2023 and is now current.

Corrected Corrected by Feb 26, 2023

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

3280.31(f) · Staff persons #1, #2, #3 and #4 shall complete professional development in the topics of 3270.31(f)(1 -- 10) within 90 days of hire. Staff person #1,#2, #3 and #4 will have until 3/9/23 to complete the required training. Until such time as the required training has been completed, staff persons #1,#2, #3 and #4 must be supervised, when interacting with children, by a primary staff who has completed the required training related to this citation. If there are no staff available to supervise staff persons #1,#2, #3 and #4, staff persons #1,#2, #3 and #4 may not work in a child-care position at the facility.

Staff persons #2 and #4 had not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): general health and safety training. Staff persons #1 and #3 have not completed the 1 hour health and safety 2022 update training that was due 12/31/22.

Corrected Corrected by Feb 26, 2023

Category: supervision. Marked corrected in the state record.

3280.26(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.

The emergency plan training in the file for staff person #1 was from a previous employment period.

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

3280.32(a)/3280.192(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. Facility Person #2 cannot be a staff person at the facility.

The child abuse clearance in the file for staff person #2 was for volunteer purposes.

Corrected Corrected by Jul 5, 2022

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

3280.34(b)(5) · A primary staff person shall have attained a high school diploma or a general educational development certificate and 2 years of experience with children

The file for staff person #1, holding the title of primary staff person, included proof of high school, however, the dates on the employment verification form in the file appeared to be written over, therefore, the number of hours of child care experience could not be determined with this document. The file for staff person #2, holding the title of primary staff person, included verification of 2500 hours of child care experience, but did not include proof of a high school diploma.

Corrected Corrected by Jul 5, 2022

Category: recordkeeping. Marked corrected in the state record.

3280.192(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

One of the reference letters in the file for staff person #1 did not include the name or signature of the person who wrote the letter. The file for staff person #2 included one letter of reference.

Corrected Corrected by Jul 5, 2022

Category: recordkeeping. Marked corrected in the state record.

3280.221(a) · If a child is required to be enrolled in public or private school under the Public School Code of 1949 (24 P.S. §§ 1-101-27-2702) and if the child is not enrolled and if the child is not exempted from enrollment under the Public School Code, a child care facility may not admit the child for care during the hours when the child is required by law to attend public or private school.

A nine year-old child was observed in care at the time of the inspection. When the child was observed logging onto a laptop and discussion about schooling was heard, this certification representative asked if the child's school was closed due to COVID. The child stated that their school was not closed, that they attend school online.

Corrected Corrected by Jul 5, 2022

Marked corrected in the state record.

3280.26(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.

The last emergency plan training in the file for staff person #3 was dated more than 12 months ago.

Corrected Corrected by Apr 8, 2022

Category: recordkeeping. Marked corrected in the state record.

3280.31(e) · A staff person shall obtain an annual 12 clock hours of child care training.

In the file for staff person #2, there were 6 hours of child care training dated between 12/19/20 and 12/19/21. In the file for staff person #3, there were no hours of child care training dated between 12/19/20 and 12/19/21.

Corrected Corrected by Apr 18, 2022

Category: recordkeeping. Marked corrected in the state record.

3280.31(e)(4)(i) · 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.

The file for staff person #2 included an American Heart Association Basic Life Support CPR/AED training certificate dated 9/16/21, which is not an acceptable training. There was no evidence of current first-aid training. The prior pediatric first-aid and CPR training in the file for staff person #2 expired 1/31/22.

Corrected Corrected by Apr 18, 2022

Category: ratio. Marked corrected in the state record.

3280.32(a)/3280.192(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 last two mandated reporter trainings in the file for staff person #2 were dated more than 60 months apart.

Corrected Corrected by Apr 8, 2022

Category: recordkeeping. Marked corrected in the state record.

3280.32(a)/3280.192(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. LACKING REQUIRED HIRING DOCUMENTS: Facility Person #1 may not work in a child care position at the facility

The file for staff person #1 did not include a signed disclosure statement.

Corrected Corrected by Feb 16, 2022

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

3280.33(c) · One or more facility persons competent in pediatric first aid and pediatric cardiopulmonary resuscitation techniques shall be at the facility when one or more children are in care.

Staff person #2 and #4 were observed caring for 8 children at the time of the inspection and neither individual had current pediatric and first aid and CPR training. The file for staff person #2 included an American Heart Association Basic Life Support CPR/AED training certificate dated 9/16/21, which is not an acceptable training. There was no evidence of current first-aid training. The prior pediatric first-aid and CPR training in the file for staff person #2 expired 1/31/22.There was no evidence of pediatric CPR and first aid training in the file for staff person #4, employed

Corrected Corrected by Apr 18, 2022

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

3280.65 · Protective receptacle covers shall be placed in electrical outlets accessible to children 5 years of age or younger.

There was an uncovered outlet in the main child care space on the wall behind the desk, and on the wall beside the diapering area. There was an uncovered outlet on a wall in the gross motor room. Children in care at the time were 5 years old or younger.

Corrected Corrected by Apr 18, 2022

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

3280.66(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.

There was a bottle of white out labeled "keep out of reach of children" on the desk in the main child care space, able to reached by children in care.

Corrected Corrected by Apr 18, 2022

Category: ratio. Marked corrected in the state record.

3280.77(a) · Peeled or damaged paint or damaged plaster is not permitted on indoor or outdoor surfaces in the child care facility.

There was an area of damaged plaster/peeling paint on the wall next to the bottom of the steps leading up to the gross motor room.

Corrected Corrected by Apr 18, 2022

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

3280.105(f) · At least 2 feet of space is required on three sides of a bed, cot, crib or other rest equipment while the equipment is in use.

When the children were placed on their mats at nap time, four of the seven mats in use by children did not have two feet of space on three sides.

Corrected Corrected by Apr 18, 2022

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

3280.124(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 information in the file for child #1 did not include the address of the child's physician. The emergency contact information in the file for child #5 did not include the address or the phone number for the child's physician.

Corrected Corrected by Apr 18, 2022

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

3280.113(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.

Upon entering the facility at approximately 1:05 pm, staff person #2 and #4 were observed caring for 8 children in the main room. When staff person #4 was asked to identify the children for whom they were responsible, staff person #2, the operator, then handed staff person #4 the dry erase board that listed the children for whom each staff person was responsible. When staff person #4 hesitated to identify their children, staff person #2 then read the names of the children on the board assigned to staff person #4 and pointed to each child as they identified each child.

Corrected Corrected by Apr 18, 2022

Category: supervision. Marked corrected in the state record.

3280.123(a) · An agreement shall be signed by the operator and the parent.

There was no agreement form in the file for child #1

Corrected Corrected by Apr 18, 2022

Category: recordkeeping. Marked corrected in the state record.

3280.123(a)(1) · An agreement shall specify the amount of the fee to be charged per day or per week.

The agreement form in the file for child #3 and #4 did not specify the amount of the fee to be charged.

Corrected Corrected by Apr 8, 2022

Category: recordkeeping. Marked corrected in the state record.

3280.123(a)(2) · An agreement shall specify the date on which the fee is to be paid.

The agreement form in the file for child #3 and #5 did not specify the date on which the fee is to be paid.

Corrected Corrected by Apr 8, 2022

Category: recordkeeping. Marked corrected in the state record.

3280.123(a)(5) · An agreement shall specify the persons designated by a parent to whom the child may be released.

The agreement form in the file for child #2 did not specify the release persons.

Corrected Corrected by Apr 18, 2022

Category: recordkeeping. Marked corrected in the state record.

3280.123(b) · A parent shall receive the original agreement. The facility shall retain a copy of the agreement.

The agreement form in the file for child #2 and #3 include two different colors of ink. Based on conversation with the operator, the document was the original agreement.

Corrected Corrected by Apr 8, 2022

Category: recordkeeping. Marked corrected in the state record.

3280.124(b)(3) · Emergency contact information must include the home and work addresses and telephone numbers of the enrolling parent.

The emergency contact information in the file for child #5 did not include a complete work address for the child's mother, as there was not a city or zip code listed.

Corrected Corrected by Apr 18, 2022

Category: recordkeeping. Marked corrected in the state record.

3280.124(b)(4) · Emergency contact information must include the written consent signed by a parent for emergency medical care.

The emergency contact information in the file for child #4 did not include written parental consent for emergency medical care or minor first-aid.

Corrected Corrected by Apr 8, 2022

Category: recordkeeping. Marked corrected in the state record.

3280.124(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 information in the file for child #5 did not include addresses for the release persons.

Corrected Corrected by Apr 8, 2022

Category: recordkeeping. Marked corrected in the state record.

3280.124(e) · A written plan identifying the means of transporting a child to emergency care and staffing provisions in the event of an emergency shall be displayed conspicuously in every child care space and shall accompany a staff person who leaves on an excursion with children.

The medical emergency transportation plan was not posted in the main child care space.

Corrected Corrected by Apr 18, 2022

Category: transportation. Marked corrected in the state record.

3280.131(b)(1) · The operator shall require the parent to provide an updated health report at least every 6 months for an infant or young toddler

The last health report in the file for child #2, a 10 month old, was dated more than 6 months ago.

Corrected Corrected by Apr 18, 2022

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

3280.131(d)(7) · A health report shall include a statement that the child is able to participate in child care and appears to be free from contagious or communicable disease.

The health report in the file for child #1 did not include a statement that the child is able to participate in child care and appears to be free from contagious or communicable disease.

Corrected Corrected by Apr 18, 2022

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

3280.131(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 list of vaccinations in the file for child #1, a 4 year-old was missing all 4 pneumococcal shots, 1 varicella and the last flu shot was in 2020. The list of vaccinations in the file for child #2, a 10 month-old was missing 1 of 3 Dtap, 1 of 3 pneumococcal 1 varicella and did not include a flu shot. The list of vaccinations in the file for child #3, a 12-month old, and child #4, a 14 month old, did not include a flu shot. None of the files included a written statement of exemption by a parent.

Corrected Corrected by Apr 8, 2022

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

3280.182(3) · A child's record must contain signed parental consent for emergency medical care for the child. Written consent is required prior to admission.

The file for child #4 did not include written parental consent for emergency medical care or minor first-aid.

Corrected Corrected by Apr 8, 2022

Category: recordkeeping. Marked corrected in the state record.

3280.182(5) · 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.

The file for child #4 did not include written parental consent for emergency medical care or minor first-aid.

Corrected Corrected by Apr 8, 2022

Category: ratio. Marked corrected in the state record.

3280.182(6) · A child's record must contain signed parental consent for transportation, walking excursions, swimming and wading.

The emergency contact information in the file for child #2 did not include written parental consent for walking excursions. Based on conversation with the operator, the children are taken on walks.

Corrected Corrected by Apr 18, 2022

Category: transportation. Marked corrected in the state record.

3280.31(f)(10) · Staff persons shall complete professional development in pediatric first aid and pediatric cardiopulmonary resuscitation within 90 days of hire.

There was no evidence of pediatric CPR and first aid training in the file for staff person #4, employed more than 90 days.

Corrected Corrected by Apr 8, 2022

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

3280.31(h) · All staff persons shall complete the professional development under subsection(f).

The file for staff person #4, employed more than 90 days, did not include training on health and safety topics #1 though #9, as required by regulation 31f.

Corrected Corrected by Apr 18, 2022

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

3280.95(a)/3280.95(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 primary staff person or designated staff person who is responsible for compliance with this chapter shall ensure the requirements in subsection (a) are met.

The operator did not have proof of purchase of the facility's fire detection system at the time of the inspection.

Corrected Corrected by Apr 8, 2022

Category: recordkeeping. Marked corrected in the state record.

3280.24(a) · The facility's current certificate of compliance shall be posted in a conspicuous location used by parents. The operator shall provide the parent of each child enrolled with information on how to access the regulations in this chapter electronically and with instructions for contacting the appropriate regional child care office.

The link to the regulations was not posted or provided to parents.

Corrected Corrected by Apr 18, 2022

Marked corrected in the state record.

3280.113(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 3:30 pm, staff person #1 came out of the kitchenette and answered the front door of the facility, leaving child #4 through #8 unsupervised in the kitchenette, a combined group of 1 infant, 1 young toddler, 1 older toddler and 2 preschoolers. At the same time, staff person #2 was observed in the main room with child #1 through #3, all young toddlers. The kitchenette and main room are adjacent to one another, bur are measured as two separate spaces. When staff person #2 was asked to identify the children for whom they were responsible, they identified 4 children total: Child #1, #2, #4 and #8. Staff person #2 was not physically present with child #4 and #8 because the two children were sitting in high chairs in the kitchenette at the time. Staff person #1, who was back in the kitchenette, identified 6 children total: Child #3 through #8, the youngest being an infant, placing the staff person out of ratio. Staff person #1 was not physically present with child #3 as that child was in the main room at the time. The staff were using a dry erase board to track their supervision groups at the time of the inspection.

Corrected Corrected by Dec 17, 2021

Category: supervision. Marked corrected in the state record.

3280.34(c) · A primary staff person shall supervise the performance of a secondary staff person

At approximately 3:30 pm, staff person #1, holding the title of primary staff, was observed in the kitchenette with 5 children. Staff person #2, holding the title of secondary staff person, was observed in the main room with 3 children.. The main room and kitchenette are adjacent to one another, but are measured as two separate spaces.

Corrected Corrected by Dec 27, 2021

Category: supervision. Marked corrected in the state record.

3280.52(c) · 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 at §3280.52(b).

At approximately 3:30 pm, staff person #1, holding the title of primary staff, was observed coming out of the kitchenette and answering the front door of the facility. At the same time, staff person #2, holding the title of secondary staff, was observed in the main room with child #1 through #3, all young toddlers. The kitchenette and main room are adjacent to one another, bur are measured as two separate spaces. When staff person #1 was back in the kitchenette, they identified 6 children total: Child #3 through #8, a combined group of 1 infant, 2 young toddlers, 1 older toddler and 2 preschoolers, placing the staff person out of ratio.

Corrected Corrected by Dec 17, 2021

Category: ratio. Marked corrected in the state record.

3280.113(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 3:30 pm, staff person #1 came out of the kitchenette and answered the front door of the facility, leaving child #4 through #8 unsupervised in the kitchenette, a combined group of 1 infant, 1 young toddler, 1 older toddler and 2 preschoolers. At the same time, staff person #2 was observed in the main room with child #1 through #3, all young toddlers. The kitchenette and main room are adjacent to one another, bur are measured as two separate spaces

Corrected Corrected by Dec 17, 2021

Category: supervision. Marked corrected in the state record.

3280.35(3) · A secondary staff person shall have a minimum of an 8th grade education and 2 years of experience with children.

The file for staff person #1did not include evidence of education and approximately only 700 hours of experience. Based on conversation with the operator, the person holds the title of secondary staff person, and has completed 8th grade.

Corrected Corrected by Dec 31, 2021

Category: recordkeeping. Marked corrected in the state record.

3280.113(a)(1) · *The legal entity will arrange for all staff who did not complete the training to receive a minimum of 4 hours of OCDEL approved supervision training within 3 months of acceptance of this POC. 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. All new staff hired over the next 4 months must take the following supervision trainings on Better Kid Care: "What about Supervision: What's Required?" and "Supervision: Positioning, Where Do I Stand?" New staff must complete both trainings within 30 days after their first day working with children.

4th citation: Not all required staff attended the in-person training At approximately 10:50 am on 8/3/21, staff person #2, the operator, was observed right outside of the facility's front door, replacing the doorbell's battery. Upon entering the facility, staff person #1and #3 were present in the facility's indoor gross motor space with 6 children, a combined group of 2 preschoolers, an older toddler, a younger toddler and 2 infants. Staff person #3 identified the 3 youngest children in their group and then staff person #1 was asked to identify their group. Staff person #1 was unable to identify the children in their group. When staff person #1 was given a second opportunity to identify their group, staff person #2 the operator, pointed to each the 3 older children. Staff person #1 was able to state the names of two of those children, but still could not identify one child in their group. Previously cited on 1/25/21, 6/11/21 and 8/3/21.

Corrected Corrected by Feb 8, 2022

Category: supervision. Marked corrected in the state record.

3280.192(2)(ii) · A facility person's record shall include verification of child care experience, education and training prior to service at the facility.

The file for staff person #1 did not include evidence of education and approximately only 700 hours of experience. Based on conversation with the operator, the person holds the title of secondary staff person, and has completed 8th grade.

Corrected Corrected by Dec 31, 2021

Category: recordkeeping. Marked corrected in the state record.

3280.17 · The legal entity shall have comprehensive general liability insurance to cover all persons who are on the premises. A current copy of the insurance policy shall be on file at the facility.

2nd violation: Based on conversation with staff person #2, the operator, the facility has general liability insurance, but they did not have a copy of the policy. A current policy was presented, but there wasn't proof of medical expense coverage. Previously cited on 8/12/21.

Corrected Corrected by Oct 23, 2021

Category: recordkeeping. Marked corrected in the state record.

3280.35(3)/3280.192(2)(ii) · A secondary staff person shall have a minimum of an 8th grade education and 2 years of experience with children. A facility person's record shall include verification of child care experience, education and training prior to service at the facility.

2nd citation: The file for staff person #3 did not include evidence of education and approximately 700 hours of experience. Based on conversation with the operator, the person holds the title of secondary staff person, and has completed 8th grade. Previously cited 8/3/21.

Corrected Corrected by Oct 23, 2021

Category: recordkeeping. Marked corrected in the state record.

3280.113(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 11:55 am, upon entering the facility, staff person #1 and a sleeping young toddler were observed in the main room. Staff person #2 and #3 were observed finishing lunch in the kitchenette with 8 children, a combined group of 4 young toddlers, one older toddler and 3 preschoolers. The main room and kitchenette are measured as two separate spaces. Staff person #1, who was present in the main room, identified 5 children who were in the kitchenette, which is a separate space. Staff person #2 identified 4 children, including the young toddler sleeping in the main room, which is a separate space. There was a whiteboard that listed supervision groups that included 8 of the 9 children's names. Staff were able to identify their groups properly, but they were not observed using the hands-free method (ID tags) specified in their most recent plan of correction.

Corrected Corrected by Oct 20, 2021

Category: supervision. Marked corrected in the state record.

3280.131(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.

2nd citation: The last flu shot on the list of vaccinations in the file for child #1, a 4 year old, was in 2019. Non of the files included a written statement of exemption by a parent. Previously cited on 8/3/21.

Corrected Corrected by Oct 23, 2021

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

3280.31(h) · All staff persons shall complete the professional development under subsection(f).

2nd citation: The file for staff person #1, hired in January 2021 and beyond their first 90 days working with children, did not include evidence of training in health and safety topic #1 through #9, as required by regulation 31f. Previously cited on 8/3/21.

Corrected Corrected by Oct 23, 2021

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

3280.17 · The legal entity shall have comprehensive general liability insurance to cover all persons who are on the premises. A current copy of the insurance policy shall be on file at the facility.

Based on conversation with staff person #4, the operator, the facility has general liability insurance, but they did not have a copy of the policy.

Corrected Corrected by Oct 13, 2021

Category: recordkeeping. Marked corrected in the state record.

3280.24(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.

The previous inspection summary dated 6/11/21, which included items that were cited and not corrected, was not posted in the facility.

Corrected Corrected by Oct 13, 2021

Marked corrected in the state record.

3280.32(a)/3280.192(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 staff person #2, hired in January 2021 and beyond their first 90 days working with children, did not include Mandated Reporter training.

Corrected Corrected by Aug 19, 2021

Category: recordkeeping. Marked corrected in the state record.

3280.32(a)/3280.192(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 PA state police clearance in the file for staff person #1 contained another person's name and date of birth. The same staff person's file Included an FBI clearance with an M2 charge for resisting arrest less than 2 years ago. Based on a search of the individual's docket, the individual was awaiting trial, with a hearing scheduled 8/5/21.

Corrected Corrected by Aug 19, 2021

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

3280.35(3)/3280.192(2)(ii) · A secondary staff person shall have a minimum of an 8th grade education and 2 years of experience with children. A facility person's record shall include verification of child care experience, education and training prior to service at the facility.

The file for staff person #3 did not include evidence of education and approximately only 700 hours of experience. Based on conversation with the operator, the person holds the title of secondary staff person, and has completed 8th grade.

Corrected Corrected by Oct 13, 2021

Category: recordkeeping. Marked corrected in the state record.

3280.52(c) · 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 at §3280.52(b).

At approximately 1:00 pm on 8/19/21, staff person #2 stepped out of the main room and into the kitchenette, which is a separate space, to retrieve their face mask. This left staff person #3 alone in the main room with 5 sleeping children, a combined group of 1 infant, one young toddler, one older toddler and 2 preschoolers. At approximately 1:26 pm on 8/3/21, staff person #3 stepped out of the main room and into the kitchenette, which is a separate space, to retrieve items from the refrigerator. This left staff person #4, the operator, alone in the main room with 5 children, a combined group of 2 preschoolers, an older toddler, a younger toddler and an infant, until the certification representative informed the operator and the operator asked staff person #3 to come back into the room.. Staff person #2 was already in the kitchenette at this time.

Corrected Corrected by Aug 3, 2021

Category: ratio. Marked corrected in the state record.

3280.62(b) · Outdoor or indoor play space shall be measured at 65 square feet per child

At approximately 10:52 am, staff person #2 and #3 were present in the facility's indoor gross motor space with 6 children, a combined group of 2 preschoolers, an older toddler, a younger toddler and 2 infants. The capacity for the space is 4 preschoolers/school-age children.

Corrected Corrected by Aug 19, 2021

Category: ratio. Marked corrected in the state record.

3280.63 · If unsafe areas or conditions are in or near an outdoor play space, fencing or natural barriers are required to restrict children from those unsafe areas or conditions.

Based on conversation with staff person #4, the operator, staff had taken children out back behind the building and allowed them to play in a baby pool in an area adjacent to the back parking lot without a proper barrier between the lot and the children.

Corrected Corrected by Aug 12, 2021

Category: recordkeeping. Marked corrected in the state record.

3280.66(b) · Cleaning materials and other toxic materials shall be used in a way that does not contaminate play surfaces, food, food preparation areas and does not constitute a hazard to the children.

In the facility's kitchenette, the following toxics were observed stored in a way that could possibly contaminate food or food preparation areas:

Corrected Corrected by Aug 19, 2021

Category: ratio. Marked corrected in the state record.

3280.91(a) · Stairways, hallways, exits from rooms, exits from the facility and other means of egress serving as an exit shall be unobstructed.

On 8/3/21, the steps leading from the kitchenette to the landing at the back door were obstructed. Each side of the 4 steps was covered with clothing, craft items and other miscellaneous items.

Corrected Corrected by Aug 19, 2021

Marked corrected in the state record.

3280.102(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.

The white plastic ring on the front of the play tunnel in the gross motor space was cracked, creating a possible pinch point.

Corrected Corrected by Aug 19, 2021

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

3280.113(a)(1) · ***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.

3rd citation: At approximately 10:50 am on 8/3/21, staff person #4, the operator, was observed right outside of the facility's front door, replacing the doorbell's battery. Upon entering the facility, staff person #2 and #3 were present in the facility's indoor gross motor space with 6 children, a combined group of 2 preschoolers, an older toddler, a younger toddler and 2 infants. Staff person #3 identified the 3 youngest children in their group and then staff person #2 was asked to identify their group. Staff person #2 was unable to identify the children in their group. When staff person #2 was given a second opportunity to identify their group, staff person #4, the operator, pointed to each the 3 older children. Staff person #2 was able to state the names of two of those children, but still could not identify one child in their group. Previously cited on 1/25/21 and 6/11/21.

Corrected Corrected by Oct 23, 2021

Category: supervision. Marked corrected in the state record.

3280.113(a)(1) · **The facility is required to develop and maintain a hands-free method for identifying the specific children for which each staff person is responsible. It will include, minimally, the name and a picture of the child and staff will utilize the identification method appropriately at all times while on duty at the facility. When a new child enrolls at the facility, a supervision card will be present at the facility before the child's first day of attendance.

3rd citation: At approximately 10:50 am on 8/3/21, staff person #4, the operator, was observed right outside of the facility's front door, replacing the doorbell's battery. Upon entering the facility, staff person #2 and #3 were present in the facility's indoor gross motor space with 6 children, a combined group of 2 preschoolers, an older toddler, a younger toddler and 2 infants. Staff person #3 identified the 3 youngest children in their group and then staff person #2 was asked to identify their group. Staff person #2 was unable to identify the children in their group. When staff person #2 was given a second opportunity to identify their group, staff person #4, the operator, pointed to each the 3 older children. Staff person #2 was able to state the names of two of those children, but still could not identify one child in their group. Previously cited on 1/25/21 and 6/11/21.

Corrected Corrected by Aug 3, 2021

Category: supervision. Marked corrected in the state record.

3280.113(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.

3rd citation: At approximately 10:50 am on 8/3/21, staff person #4, the operator, was observed right outside of the facility's front door, replacing the doorbell's battery. Upon entering the facility, staff person #2 and #3 were present in the facility's indoor gross motor space with 6 children, a combined group of 2 preschoolers, an older toddler, a younger toddler and 2 infants. Staff person #3 identified the 3 youngest children in their group and then staff person #2 was asked to identify their group. Staff person #2 was unable to identify the children in their group. When staff person #2 was given a second opportunity to identify their group, staff person #4, the operator, pointed to each the 3 older children. Staff person #2 was able to state the names of two of those children, but still could not identify one child in their group. Previously cited on 1/25/21 and 6/11/21.

Corrected Corrected by Aug 3, 2021

Category: supervision. Marked corrected in the state record.

3280.114 · Weather permitting, children shall be taken out doors daily.

Based on conversation with staff person #4, the operator, the last time children had been taken outside was approximately 2 weeks ago because it has been raining. Staff person #1 and #2 stated that children are usually 3 out of 5 days per week, but it has been raining lately.

Corrected Corrected by Aug 19, 2021

Category: recordkeeping. Marked corrected in the state record.

3280.123(a)(4) · An agreement shall specify the child's arrival and departure times.

The agreement form in the file for child #3 did not specify the child's arrival and departure times.

Corrected Corrected by Oct 13, 2021

Category: recordkeeping. Marked corrected in the state record.

3280.123(a)(6) · An agreement shall specify the date of the child's admission.

The agreement form in the file for child #3 did not specify the child's date of admission.

Corrected Corrected by Oct 13, 2021

Category: recordkeeping. Marked corrected in the state record.

3280.124(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 information in the file for child #4 did not include the phone number for the child's physician.The emergency contact information in the file for child #5 did not include the address for the child's physician.

Corrected Corrected by Oct 13, 2021

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

3280.124(b)(3) · Emergency contact information must include the home and work addresses and telephone numbers of the enrolling parent.

The emergency contact information in the file for child #1 did not include the work address and phone number for the child's mother. The emergency contact information in the file for child #3 did not include the work phone number for the child's mother and father. The emergency contact information in the file for child #4 did not include the work address for the child's mother.

Corrected Corrected by Sep 13, 2021

Category: recordkeeping. Marked corrected in the state record.

3280.124(b)(4)/3280.182(3) · Emergency contact information must include the written consent signed by a parent for emergency medical care. A child's record must contain signed parental consent for emergency medical care for the child. Written consent is required prior to admission.

The emergency contact information in the file for child #2 did not include any signed parental consent for emergency medical care.

Corrected Corrected by Oct 13, 2021

Category: recordkeeping. Marked corrected in the state record.

3280.124(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 information in the file for child #2 did not include the name of the child's insurance. The emergency contact information in the file for child #4 did not include any health insurance information for the child.

Corrected Corrected by Oct 13, 2021

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

3280.124(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 information in the file for child #2 did not include a street address for the individuals designated by the parent to whom the child may be released.

Corrected Corrected by Oct 13, 2021

Category: recordkeeping. Marked corrected in the state record.

3280.131(d)(8) · A health report shall include a statement that age-appropriate screenings recommended by the American Academy of Pediatrics were conducted since the time of the previous health report required by this section.

The health report in the file for child #4 did not include statement that age-appropriate screenings recommended by the American Academy of Pediatrics were conducted since the time of the previous health report. The appropriate box was left blank.

Corrected Corrected by Oct 13, 2021

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

3280.131(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 list of vaccinations in the file for child #2, a 10 month old, was missing the following vaccinations: 1 of 3 DTAP, 1 of 3 Pneumococcal and no flu shot. The list of vaccinations in the file for child #3, a 21 month old, was missing the following vaccinations: 1 of 4 DTAP, 1 of 4 Pneumococcal and no flu shot. The last flu shot on the list of vaccinations in the file for child #4, a 4 year old, was in 2019. Non of the files included a written statement of exemption by a parent.

Corrected Corrected by Oct 22, 2021

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

3280.151(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 #2 was dated more than 24 months ago.

Corrected Corrected by Oct 13, 2021

Category: ratio. Marked corrected in the state record.

3280.151(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 results in the file for staff person #3 was dated after their first day working with children.

Corrected Corrected by Aug 19, 2021

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

3280.166(1) · A written statement giving the formula and feeding schedule for an infant shall be obtained from the parent.

Based on conversation with staff person #4, the operator, there was not a written formula and feeding schedule from a parent for child #1 and #5, both infants.

Corrected Corrected by Oct 13, 2021

Category: nutrition. Marked corrected in the state record.

3280.182(5) · 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.

The emergency contact information in the file for child #2 and #4 did not include any signed parental consent for administration of minor first-aid procedures by staff.

Corrected Corrected by Sep 13, 2021

Category: ratio. Marked corrected in the state record.

3280.192(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 staff person #4 included only one letter of reference.

Corrected Corrected by Sep 13, 2021

Category: recordkeeping. Marked corrected in the state record.

3280.26(a)(5) · The facility shall have an emergency plan that provides for accommodations for infants, toddlers, children with disabilities and children with chronic medical conditions.

Based on conversation with the operator, the facility's emergency plan does not provide provides for accommodations for infants, toddlers, children with disabilities and children with chronic medical conditions.

Corrected Corrected by Oct 13, 2021

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

3280.31(f)(10) · Pediatric first aid and pediatric cardiopulmonary resuscitation.

The file for staff person #2, hired in January 2021 and beyond their first 90 days working with children, did not include evidence of pediatric first aid/CPR training.

Corrected Corrected by Oct 13, 2021

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

3280.31(h) · All staff persons shall complete the professional development under subsection(f).

The file for staff person #2, hired in January 2021 and beyond their first 90 days working with children, did not include evidence of training in health and safety topic #1 through #9, as required by regulation 31f.

Corrected Corrected by Oct 13, 2021

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

3280.94(a)(1) · Fire drills are conducted at least once every 60 days.

Four out of the last five fire drills on the log were dated more than 60 days apart. The last fire drill documented on the log was dated more than 60 days ago.

Corrected Corrected by Oct 13, 2021

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

3280.94(a)(5) · Evacuation routes are posted in a conspicuous location on each floor of the facility.

There was not an evacuation route posted on the 2nd floor where the gross motor space is located.

Corrected Corrected by Aug 19, 2021

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

3280.95(a)/3280.95(b) · (a) Fire detection devices or systems must be in compliance with standards established under section 1016(c) of the act (62 P.S. §  1016(c)).(b) The primary staff person or designated staff person who is responsible for compliance with this chapter shall ensure the requirements in subsection (a) are met.

Based on review of a written report conducted by a fire safety professional on 6/10/21, the "*Batteries in Facp fail due to age and need replaced 2-12v 12ah batteries." There was no documentation showing that these deficiencies had been corrected.

Corrected Corrected by Aug 3, 2021

Category: recordkeeping. Marked corrected in the state record.

3280.24(a) · The facility's current certificate of compliance shall be posted in a conspicuous location used by parents. The operator shall provide the parent of each child enrolled with information on how to access the regulations in this chapter electronically and with instructions for contacting the appropriate regional child care office.

Based on observation and on conversation with staff person #4, the operator, parents have not been provided with information on how to access the group child care regulations electronically and there were no instructions for contacting

Corrected Corrected by Oct 13, 2021

Category: recordkeeping. Marked corrected in the state record.

3280.26(a)(1) · The facility shall have an emergency plan that provides 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.

Based on conversation with the provider, the emergency plan did not provide for shelter of children during an emergency lock-down.

Corrected Corrected by Oct 13, 2021

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