3290.32(a) · The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services).

The two most recent State Police clearances for Staff #1 and Staff #2 are dated 2/7/20 and 2/20/25, more than 60 months apart. The two most recent Child Abuse clearances on file for Staff #1 and Staff #2 are dated 2/19/20 and 2/26/25, more than 60 months apart. The most recent mandated reporter training on file for Staff #1 is dated 3/24/20, more than 60 months prior. The most recent mandated reporter training on file for Staff #2 is dated 3/29/20, more than 60 months prior.

Corrected Corrected by Jun 17, 2025

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

3290.64(a) · Cleaning materials and other toxic materials shall be stored in an original labeled container or in a container that specifies the content. Toxics shall be kept in a locked area or in an area inaccessible to children, and shall be stored away from food, food preparation areas and child care spaces.

A bottle of Equate sunscreen, Gorilla Glue, and Silicone caulk, labeled keep out of the reach of children, were observed on the kitchen table and accessible to children.

Corrected Corrected by Jun 5, 2025

Category: ratio. Marked corrected in the state record.

3290.123(a)(3) · An agreement shall specify the services to be provided to the family and the child, including the Department's approved form to provide information to the family about the child's growth and development in the context of the services being provided. the operator shall complete and update the form and provide a copy to the family in accordance with the updates regarding emergency contact information at § 3290.124(e).

The file for Child #2 lacked a current child service report to document the child's growth and development.

Corrected Corrected by Jun 14, 2025

Category: recordkeeping. Marked corrected in the state record.

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

The emergency contact forms for Child #2 and Child #4 lacked the enrolling parent's work address and work phone number.

Corrected Corrected by Jun 14, 2025

Category: recordkeeping. Marked corrected in the state record.

3290.124(b)(4)/3290.182(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 form for Child #3 lacked written parental consent for emergency medical care.

Corrected Corrected by Jun 14, 2025

Category: recordkeeping. Marked corrected in the state record.

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

The emergency contact form for Child #1 lacked the health insurance name and policy number.

Corrected Corrected by Jun 14, 2025

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

3290.182(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 form for Child #3 lacked parental consent for minor first-aid procedures.

Corrected Corrected by Jun 14, 2025

Category: ratio. Marked corrected in the state record.

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

The facility's emergency plan lacked continuity of operations.

Corrected Corrected by Jun 7, 2024

Category: ratio. Marked corrected in the state record.

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

The files for Staff Person #1 and Staff Person #2 lacked the Health and Safety 1 Hour Update professional development trainings, as per announcement C-22-06.

Corrected Corrected by Jun 7, 2024

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

3290.123(a)(3) · An agreement shall specify the services to be provided to the family and the child, including the Department's approved form to provide information to the family about the child's growth and development in the context of the services being provided. the operator shall complete and update the form and provide a copy to the family in accordance with the updates regarding emergency contact information at § 3290.124(e).

The file for Child #1 did not contain a child service report within 6 months of enrollment (See LIS Code Sheet).

Corrected Corrected by Jun 7, 2024

Category: recordkeeping. Marked corrected in the state record.

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

The file for Child #3 contained an initial health assessment that was dated 12/12/22, more than 60 days after enrollment (See LIS Code Sheet).

Corrected Corrected by Jun 24, 2024

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

3290.133(6) · A parent shall provide written consent for administration of medication or a special diet.

A prescription for Methylphenidate prescribed for Child #2 lacked written parental consent for administration. (See LIS Code Sheet)

Corrected Corrected by Jun 14, 2024

Category: ratio. Marked corrected in the state record.

3290.133(7) · An operator is responsible to establish and maintain a medication log if prescription or nonprescription medication is administered.

An administered prescription for Methylphenidate prescribed for Child #2 lacked a medication log. (See LIS Code Sheet)

Corrected Corrected by Jun 14, 2024

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

3290.24(b) · The operator shall review the emergency plan at least annually and update the plan as needed. Each review and update of the emergency plan shall be documented in writing and kept on file at the facility.

The facility's emergency plan's most recent review was 5/27/23, more than 12 months prior.

Corrected Corrected by Jun 7, 2024

Category: recordkeeping. Marked corrected in the state record.

3290.61 · 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.

In the outdoor play area, wood blocks were located on top of an unsecured plastic play kitchen that could be a toppling hazard.

Corrected Corrected by Jun 8, 2023

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

3290.64(a) · Cleaning materials and other toxic materials shall be stored in an original labeled container or in a container that specifies the content. Toxics shall be kept in a locked area or in an area inaccessible to children, and shall be stored away from food, food preparation areas and child care spaces.

In the kitchen, hand sanitizer was accessible on the table, white out was located in an unlocked drawer, and diaper cream was in a child's bag that was accessible to children. Multiple cleaning products were observed directly on top of the refrigerator, which could cause contamination of the food below if leaking occurred.

Corrected Corrected by Jun 8, 2023

Category: ratio. Marked corrected in the state record.

3290.102(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.

Two scooters in the outdoor play area were cracked and had sharp edges that could cause injury to a child.

Corrected Corrected by Jun 8, 2023

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

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

The emergency contact form on file for Child #3 does not include the phone number for the child's physician or source of medical care.

Corrected Corrected by Jun 8, 2023

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

3290.131(a)/3290.182(1) · The operator shall require the parent of an enrolled child to provide an initial health report no later than 60 days following the first day of attendance at the facility. A child's record must contain initial and subsequent health reports.

The initial health assessment on file for Child #3 was not obtained within 60 days of enrollment.

Corrected Corrected by Feb 26, 2023

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

3290.131(d)(5)/3290.131(e)(3) · A health report shall include a review of the child's immunized status according to recommendations of the ACIP. The facility shall implement dismissal policies in accordance with the Department of Health regulation in 28 Pa. Code § 27.77 (relating to immunization requirements for children in child care group settings).

The immunization record on file for Child #4, who is 2 years old, included 1 of 2 Hepatitis A vaccines recommended by the ACIP for a child this age. ·Child #4 must be dismissed from care by close of business on 6/08/23, 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 Jun 12, 2023

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

3290.24(c)/3290.192(4) · 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. A facility person's record shall include records of training required by the Department.

The file for Staff #2 lacked documentation of current emergency plan training.

Corrected Corrected by Jun 15, 2022

Category: recordkeeping. Marked corrected in the state record.

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

A working stove in the kitchen, observed to be in use, was unguarded and accessible to children who were in care in that space.

Corrected Corrected by Jun 7, 2022

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

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

A pack and play used as rest equipment for one of the children in care was observed to be unlabeled.

Corrected Corrected by Jun 6, 2022

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

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

The file for Child #3 contained an emergency contact form which lacked the telephone number of the child's medical provider.

Corrected Corrected by Jun 23, 2022

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

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

The file for Child #3 contained an emergency contact form which lacked the child's health insurance policy number.

Corrected Corrected by Jun 23, 2022

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

3290.124(b)(7) · Emergency contact information must include the name, address and telephone number of the individual designated by the parent to whom the child may be released.

The file for Child #3 contained an emergency contact form which lacked the address of the release persons.

Corrected Corrected by Jun 23, 2022

Category: recordkeeping. Marked corrected in the state record.

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

The files for Child #1 and #3 contained most recent health reports dated more than 12 months in the past.

Corrected Corrected by Jul 19, 2022

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

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

The file for Child #1 contained a record of immunization history which lacked a current influenza vaccination and contained 1 of 2 Hep A vaccinations. The file for Child #2 contained a record of immunization history which lacked a current influenza vaccination. The file for Child #4 contained a record of immunization history which contained 1 of 2 Hep A vaccinations.

Corrected Corrected by Jul 19, 2022

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

3290.135(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.

During an observed diaper change, the soiled diaper was placed on the wipe box and then put in a plastic bag, which was then placed in the trash can using the staff's hands, after the change was complete.

Corrected Corrected by Jun 7, 2022

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

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

The observed emergency plan lacked accommodations for infants and toddlers.

Corrected Corrected by Jul 13, 2022

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

3290.24(g) · 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.

According to operator statement, the observed emergency plan was sent to the county emergency management agency but was not sent to the local municipality.

Corrected Corrected by Jun 21, 2022

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

3290.94(a)(1) · The operator or designated staff person who is responsible for compliance with this chapter shall conduct fire drills and ensure that fire drills are conducted at least once every 60 days.

The observed fire drill contained record of the most recent fire drill conducted 5/4/21.

Corrected Corrected by Jun 8, 2022

Category: recordkeeping. Marked corrected in the state record.

3290.95(a)/3290.95(b) · Fire detection devices or systems must be in compliance with standards established under section 1016(c) of the act (62 P.S. § 1016(c))The operator or designated staff person who is responsible for compliance with this chapter shall ensure the requirements in § 3290.95(a) are met.

The proof of purchase for the observed interconnected smoke detectors was not available at the time of the inspection. Documentation of testing of the smoke detectors was observed, with the last test date being 5/4/21.

Corrected Corrected by Jun 7, 2022

Category: recordkeeping. Marked corrected in the state record.

3290.24(b) · The operator shall review the emergency plan at least annually and update the plan as needed. Each review and update of the emergency plan shall be documented in writing and kept on file at the facility.

The observed emergency plan contained an update dated more than 12 months in the past.

Corrected Corrected by Jun 8, 2022

Category: recordkeeping. Marked corrected in the state record.

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

Documentation of an emergency drill held in the past 12 months was not available at the time of the inspection.

Corrected Corrected by Jun 16, 2022

Category: recordkeeping. Marked corrected in the state record.

3290.31(g) · Staff persons shall complete professional development in the topics of 3290.31(g)(10) within 90 days of hire. Staff person #1 and #2--- must do one of the following: provide documentation that the trainer has become PQAS-certified or at least is on the waiting list, request the instructor provide documentation, such as their Pediatric First-Aid/CPR Instructor Card from the PQAS-approved organization or the approved curriculum organization, that the instructor is approved to offer Pediatric First-Aid/CPR training on behalf of their organization, or receive pediatric first-aid/CPR training in an approved curriculum by a PQAS-certified trainer.

Staff person #1 and #2 have acceptable pediatric first aid/CPR training in an approved curriculum; however, the trainer has not provided documentation that they are PQAS-certified in that training topic.

Corrected Corrected by Jun 25, 2022

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

3290.31(g) · Staff person( shall complete professional development in the topics of 3290.31(g) (1-10) within 90 days of hire. Staff person #2-- will have until 7/23/22 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 a primary staff person 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): health and safety topics.

Corrected Corrected by Jul 10, 2022

Category: supervision. Marked corrected in the state record.