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 Room 1, peeling blue paint was observed on the wall in the dramatic play area. In Room 5, peeling beige paint was observed on the wall by the circle table.

Corrected Corrected by Jun 10, 2025

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

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

The file for Staff #1 contained a mandated reporter training dated 9/18/24, more than 90 days after the date of hire.

Corrected Corrected by Jun 4, 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. Staff Person #5--- may not work in a childcare position at the facility.

The file for Staff #5 lacked an NSOR clearance.

Corrected Corrected by May 29, 2025

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

3270.36(b)(1) · An assistant group supervisor shall have a high school diploma or a general educational development certificate and 30 credit hours from an accredited college or university in early childhood education, child development, special education, elementary education or the human services field.

The record of the required education on file for Staff #3 to be classified as an assistant group supervisor was an international diploma, not translated by an approved evaluator with no equivalency on file.

Corrected Corrected by Jun 9, 2025

Category: supervision. 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.

In Room 5, a mini hand sanitizer labeled "Keep Out of the Reach of Children" was observed in an unlocked drawer and accessible to children. In Room 5, through conversations with the staff, a can of shaving cream labeled "Keep Out of the Reach of Children" was used for art projects with direct contact to children. In Room 7, sunscreen labeled "Keep Out of the Reach of Children" was observed in a child's bookbag and accessible to children.

Corrected Corrected by May 29, 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.

In Room 7, a magnet tile was observed to be cracked creating rough edges.

Corrected Corrected by May 29, 2025

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

3270.133(5) · Medication shall be stored in accordance with the manufacturer's or health professional's instructions on the original label.

A container of Zyrtec for Child #1 was labeled with an expiration date of 3/2025.

Corrected Corrected by May 29, 2025

Category: ratio. Marked corrected in the state record.

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

The health assessment on file for Staff #4 was not dated by the physician, making it invalid.

Corrected Corrected by Jun 13, 2025

Category: ratio. 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 lacked one written, nonfamily reference.

Corrected Corrected by Jun 2, 2025

Category: recordkeeping. Marked corrected in the state record.

3270.31(f)(10) · Staff persons shall complete professional development in pediatric first aid and pediatric cardiopulmonary resuscitation within 90 days of hire.

The file for Staff #2, employed for more than 90 days, lacked a First Aid/CPR certificate. The file for Staff #1 contained a First Aid/CPR certificate dated 9/18/24, more than 90 days after the date of hire.

Corrected Corrected by May 30, 2025

Category: health medication. 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 facility's fire detection log documented dates 11/26/24-1/10/25, more than 30 days apart.

Corrected Corrected by Jun 4, 2025

Category: recordkeeping. 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 two most recent emergency drill logs were dated 7/27/23-12/2/24, exceeding the 12-month annual update.

Corrected Corrected by Dec 20, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.31(e)(4)(i) · Competence is the completion of training by a professional in the field of first-aid and cardiopulmonary resuscitation (CPR). All staff persons shall renew their certification in pediatric first aid and pediatric cardiopulmonary resuscitation (CPR) on or before the expiration of the most current certification.

The two most recent Pediatric First Aid/CPR certifications on file for Staff Person #3, Staff Person #6, and Staff Person #9 were dated more than 24 months apart, exceeding the expiration dates.

Corrected Corrected by Dec 20, 2024

Category: ratio. Marked corrected in the state record.

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

The two most recent fire safety trainings for Staff Person #2 are dated more than 12 months apart.

Corrected Corrected by Dec 20, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.32(a)/3270.192(4) · The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). LACKING REQUIRED HIRING DOCUMENTS: Staff Person #8 -- may not work in a childcare position at the facility. 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. Staff Person #8 --- may not work in a childcare position at the facility.

The file for Staff Person #8, an employee for more than 45 days, lacked an NSOR clearance. (SEE LIS CODE SHEET)

Corrected Corrected by Dec 20, 2024

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

3270.36(b)(5)/3270.192(2)(iv) · 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 acceptable verification of experience, education or training is a transcript or a diploma or a letter signed by a representative of the experiential, educational or training entity.

The record of the required education on file for Staff Person #5 to be classified as an assistant group supervisor was an international diploma, not translated by an approved evaluator with no equivalency on file.

Corrected Corrected by Dec 18, 2024

Category: supervision. Marked corrected in the state record.

3270.37(b)(1)/3270.192(2)(iv) · An aide shall have a high school diploma or a general educational development certificate. A facility person's record shall include acceptable verification of experience, education or training is a transcript or a diploma or a letter signed by a representative of the experiential, educational or training entity.

The record of the required education on file for Staff Person #1 and Staff Person #7 to be classified as an aide was an international diploma, not translated by an approved evaluator with no equivalency on file.

Corrected Corrected by Dec 20, 2024

Category: recordkeeping. Marked corrected in the state record.

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

In Room 7, magnet tiles were observed to be cracked with sharp edges, which could cause injury.

Corrected Corrected by Dec 11, 2024

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

3270.124(b)(6) · Emergency contact information must include health insurance coverage and policy number for a child under a family policy or Medical Assistance benefits, if applicable.

The emergency contact form for Child #1 lacked the name of the health insurance coverage.

Corrected Corrected by Dec 11, 2024

Category: health medication. 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 file for Child #1, Child #2, and Child #3 contained an emergency contact form that was not updated within 6 months of the previous update.

Corrected Corrected by Oct 8, 2024

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 reports on file for Child #2 (young toddler) were dated 3/16/23-1/12/24, exceeding the 6-month update. The health report on file for Child #3 (young toddler) is dated 4/15/24, more than 6 months prior.

Corrected Corrected by Jan 16, 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 report form for Child #3 stated that the child is not able to participate in childcare and/or not free from communicable diseases.

Corrected Corrected by Dec 20, 2024

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

3270.151(a)/3270.192(3) · A facility person providing direct care who comes into contact with the children or who works with food preparation shall have a health assessment conducted within 12 months prior to providing initial service in a child care setting and every 24 months thereafter. A health assessment is valid for 24 months following the date of signature, if the person does not contract a communicable disease or develop a medical problem. A facility person's record shall include a written report of initial and subsequent health assessments, including the results of initial and subsequent tuberculin skin tests, x-rays or other medical documentation necessary to confirm freedom from communicable tuberculosis.

The two most recent health assessments Staff Person #2, Staff Person #3, and Staff Person #6 exceeded the 24-month update. The health assessment form for Staff Person #1 did not contain a date of signature from the physician. The initial health assessment for Staff Person #4 was dated 6/8/24, after the date of hire (SEE LIS CODE SHEET).

Corrected Corrected by Dec 20, 2024

Category: ratio. Marked corrected in the state record.

3270.151(b)/3270.192(3) · A health assessment shall be conducted and a report shall be written and signed by a physician, physician's assistant or CRNP. The signature must include the individual's professional title. 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 health assessment form for Staff Person #8 was not signed by a physician, physician's assistant, or CRNP.

Corrected Corrected by Dec 20, 2024

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

3270.181(c) · 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 file for Child #1, Child #2, and Child #3 contained a financial agreement form that was not updated within 6 months of the previous update.

Corrected Corrected by Dec 20, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.95(a)/3270.95(b) · Fire detection devices or systems must be in compliance with standards established under section 1016(c) of the act (62 P.S. §  1016(c)). The Director or designated staff person who is responsible for compliance with this chapter shall ensure the requirements under subsection (a) are met.

The facility's fire detection logs documented dates 5/1/24-6/5/24 exceeding the 30-day testing.

Corrected Corrected by Dec 20, 2024

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.

The facility's updated emergency plan was not sent to county emergency management.

Corrected Corrected by Dec 20, 2024

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

3270.131(a)/3270.182(1) · The operator shall require the parent of an enrolled child, including a child, a foster child and a relative of an operator or a facility person, to provide an initial health report no later than 60 days following the first day of attendance at the facility. A child's record shall contain initial and subsequent health reports.

The initial health report for Child #3 is dated 11/1/23, exceeding 60 days from the child's first day of attendance.

Corrected Corrected by Dec 20, 2024

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 annual written traffic letter to local safety authorities, dated 12/2/24, exceeded the 12-month update.

Corrected Corrected by Dec 20, 2024

Marked corrected in the state record.

3270.74 · The telephone number of the nearest hospital, police department, fire department, ambulance and poison control center shall be posted by each telephone in the facility.

The telephone number of the nearest hospital, police department, fire department, ambulance and poison control center was not posted by the telephone in the TK room.

Corrected Corrected by Dec 5, 2023

Category: physical safety. 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.

Standing water was observed in a container connected to a small playhouse on the outdoor toddler playground. The fire extinguisher in the Discovery/PS room was serviced in May of 2022. The directions on the tag of the extinguisher read to 'void 1 year from date punched on tag', meaning the fire extinguisher inspection was not current and was out of date.

Corrected Corrected by Dec 12, 2023

Category: health medication. 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 lacked a letter to parents in the emergency plan addressing the following topics: 1. Shelter of children during an emergency including lock-down, shelter in place at the facility and shelter at locations away from the facility premises, 2. Evacuation of children from the facility building and evacuation of children to a location away from the facility premises, 3. A method for facility persons to contact parents as soon as reasonably possible when an emergency situation arises, 4. 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, and 5. Accommodations for infants, toddlers, children with disabilities and children with chronic medical conditions.

Corrected Corrected by Dec 5, 2023

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

3270.31(f) · Staff persons shall complete professional development within 90 days of hire as listed in subsections (f)1-10.

Staff #4 did not complete the following required pre-service training within 90 days of their date of hire (see LIS code sheet): Get Started with Center-based Care: Building Blocks for Quality.

Corrected Corrected by Nov 13, 2023

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

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

The most recent Mandated Reporter training for Staff #2 is dated 5/31/18, more than 60 months ago.

Corrected Corrected by Dec 7, 2023

Category: recordkeeping. Marked corrected in the state record.

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

Staff person #4 did not complete the Mandated Reporter training within 90 days of their date of hire (see LIS code sheet).

Corrected Corrected by Oct 18, 2023

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 did not contain documentation of application of a Maryland Child Abuse clearance prior to date of hire (See LIS Code Sheet) required for provisional hiring under the CPSL. The Maryland Child Abuse clearance for Staff #1 is dated 11/22/23, more than the 45 days after hire (See LIS Code Sheet) required for provisional hiring under the CPSL. The file for Staff #3 included an NSOR certificate dated 11/28/23, more than 45 days after hire (See LIS Code Sheet) required for provisional hiring under the CPSL. The file for Staff #4 included an NSOR certificate dated 11/16/2023, more than 45 days after hire (See LIS Code Sheet) required for provisional hiring under the CPSL. The NSOR on file for Staff #4 did not have Staff #4's name printed on it, making it invalid. Staff #4 must be removed from the child care facility on 12/5/23, until the corrected NSOR is received. The file for Staff #5 included an NSOR certificate dated 11/16/2023, more than 45 days after hire (See LIS Code Sheet) required for provisional hiring under the CPSL. The file for Staff #5 did not contain documentation of application of a Texas Child Abuse clearance prior to date of hire (See LIS Code Sheet) required for provisional hiring under the CPSL. The Texas Child Abuse clearance for Staff #5 is dated 5/15/23, more than the 45 days after hire (See LIS Code Sheet) required for provisional hiring under the CPSL.

Corrected Corrected by Dec 8, 2023

Category: background checks. 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 Toddler B was missing gloves. In the Preschool room, the First Aid kit was missing tweezers.

Corrected Corrected by Dec 5, 2023

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

3270.102(a)/3270.103 · Toys, play equipment and other indoor and outdoor equipment used by the children shall be clean, in good repair and free from rough edges, sharp corners, pinch and crush points, splinters and exposed bolts. Toys and objects with a diameter of less than 1 inch, objects with removable parts that have a diameter of less than 1 inch, plastic bags and styrofoam objects may not be accessible to children who are still placing objects in their mouths.

A couch in the Toddler B room was observed with peeling and torn plastic and a foam climber on the outdoor Toddler playground was observed with peeling plastic. Both items were located in spaces accessible to children who are still placing objects in their mouths

Corrected Corrected by Dec 5, 2023

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

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

In the Pre-K room, cracked magnatiles and a broken chair with pinch points were observed accessible to children, which could be hazardous. A small white table with a broken plastic leg with sharp edges was observed on the Toddler Playground. On the Preschool Playground, a balance beam with worn and ripped corners was not in good repair. A cracked red tricycle seat on the Preschool Playground was observed, which could cause injury or pinch points.

Corrected Corrected by Dec 5, 2023

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

3270.102(c) · Outdoor equipment that requires embedded mounting must be mounted over a loose-fill or unitary playground protective surface covering that meets the recommendations of the United States Consumer Product Safety Commission. The equipment must be anchored firmly and be in good repair.

The facility's outdoor equipment located in the outdoor play space was observed to be embedded, but lacked sufficient documentation from installer detailing the fall height of the equipment.

Corrected Corrected by Dec 7, 2023

Category: physical safety. 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 on file for Child #1, Child #2, Child #3, Child #4, Child #5, Child #6, and Child #7 were original copies.

Corrected Corrected by Dec 5, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.124(b)(4)/3270.182(3) · Emergency contact information must include the written consent signed by a parent for emergency medical care. A child's record shall 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 Dec 5, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.124(b)(5) · Emergency contact information must include information on the child's special needs, as specified by the child's parent, physician, physician's assistant or CRNP, which is needed in an emergency situation.

The current Emergency Contact form on file for Child #3 does not indicate if the child has any special needs, which is needed in an emergency situation.

Corrected Corrected by Dec 5, 2023

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

3270.124(b)(6) · Emergency contact information must include health insurance coverage and policy number for a child under a family policy or Medical Assistance benefits, if applicable.

The Emergency Contact Form for Child #4 lacked the Health Insurance/MA Coverage and Health Insurance/MA Policy Number.

Corrected Corrected by Dec 6, 2023

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 #2, Child #4, and Child #5 does not include a complete address for all listed release persons.

Corrected Corrected by Dec 5, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.131(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 two most recent health assessments on file for Child #3, who is a preschool age child, are dated 9/15/21 and 1/19/23, more than 1 year apart.

Corrected Corrected by Dec 5, 2023

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

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

There were no written feeding plans given by the parent for any of the infants under 1 year old who were receiving care.

Corrected Corrected by Dec 5, 2023

Category: nutrition. Marked corrected in the state record.

3270.131(d)(5)/3270.131(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 files for Child #2(6mo), Child #6 (11mo), did not contain documentation of an influenza vaccination or a written exemption letter signed by the parent. Child #2 and Child #6 must be dismissed from care by close of business on 12/5/23 and may only return to care when the immunization record is update or when the parent provides a written signed exemption letter.

Corrected Corrected by Dec 7, 2023

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

3270.133(1) · A prescription or nonprescription medication may be accepted only in an original container. The medication shall remain in the container in which it was received.

Two Epi Pens for Child #8 in the Discovery/PS room lacked the original container for the medication. An Epi Pen in the Toddler B classroom for Child #9 did not contain the original container for the medication.

Corrected Corrected by Dec 5, 2023

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

3270.133(5) · Medication shall be stored in accordance with the manufacturer's or health professional's instructions on the original label.

Two Epi Pens in the medication bin in the Discovery/PS room for Child #8 had expired in10/22, and was therefore not in accordance with the manufacturer's original label.

Corrected Corrected by Dec 5, 2023

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

3270.151(c)(3) · An adult health assessment must include an examination for communicable diseases and the results of that examination.

The current health assessment on file for Staff #5 indicates that the staff person has a communicable/contagious disease, with no additional information given.

Corrected Corrected by Dec 18, 2023

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

3270.151(c)(3)/3270.192(3) · An adult health assessment must include an examination for communicable diseases and the results of that examination. A facility person's record shall include a written report of initial and subsequent health assessments, including the results of initial and subsequent tuberculin skin tests, x-rays or other medical documentation necessary to confirm freedom from communicable tuberculosis.

The two most recent health assessments on file for Staff #6 are dated 8/31/21 and 11/8/23, more than 24 months apart.

Corrected Corrected by Dec 5, 2023

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

3270.182(5) · A child's record shall 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 a signature for "Consent for Minor First Aid."

Corrected Corrected by Dec 5, 2023

Category: ratio. 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 fire alarm 30-day test log includes test dates 2/23/23-3/30/23, 5/24/23-6/26/23, and 9/15/23-10/18/23, more than 30 days apart.

Corrected Corrected by Dec 5, 2023

Category: recordkeeping. 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 #12, lacks a health assessment which has been completed within the past 24 months. Previously cited under SIN-00215747.

Corrected Corrected by Mar 7, 2023

Category: ratio. 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.

There was more than 12 months between emergency plan trainings for staff 4, 7, 8, 10, 11, 12 and 13. Staff #4, 7. 8, 11, 12 and 13 now have emergency plan training on file and dated 11/30/22, Staff #10 now has emergency plan training on file and dated 11/23/22. Staff #2 lacked emergency plan training at initial hire. There is now emergency plan training on file and dated 11/30/22. SEE LIS CODE SHEET.

Corrected Corrected by Feb 2, 2023

Category: recordkeeping. Marked corrected in the state record.

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

There was more than 12 months between fire safety trainings on file for staff #7, 8, 10. 11,and 13. There is now current fire safety training on file and dated: Staff #7 and 8 and 11 - 11/2/21 and 11/22/22, Staff #10 - 2/21/21 and 7/29/22 ,Staff #13- 2/19/21 and 2/23/22.

Corrected Corrected by Feb 2, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.31(f) · Staff persons shall complete professional development within 90 days of hire as listed in subsections (f)1-10.

Staff persons#1 and 5 did not complete the following pre-service training within 90 days of their date of hire (see LIS code sheet): Staff #1 - Health and Safety training. There is current health and safety training on file and dated 10/18/22. Staff #5 - Pediatric CPR/FA. There is now current Pediatric CPR/FA on file and dated 5/44/22.

Corrected Corrected by Feb 2, 2023

Category: health medication. 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). Facility Person #2, 3, and 6- may not work at the facility. 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, State Police, Child Abuse and NSOR clearance on or before start date in a child care position. There are now current clearances on file and dated -disclosure - 2/28/22, State Police - 2/25/22, Child Abuse - 2/25/22 and NSOR - 3/24/22. SEE LIS CODE SHEET The file for staff #2, who lived outside of PA within the past 5 years, lacked a Virginia Child Abuse, Virginia criminal background check and Virginia sex offender check. There is now a VA child abuse check on file and dated 4/4/22. There is no VA criminal background and VA sex offender registry check on file. SEE LIS CODE SHEET. The file for staff #3, who has lived outside of PA within the past 5 years, lacks a West Virginia sex offender check on or before initial start date in a child care position. The file for staff #6, who has lived outside of PA within the past 5 years lacks a West Virginia Child Abuse check on or before initial start date in a child care position. There is a sex offender registry check on file but no date is on the form. The file for staff #9 lacked the correct State Police clearance form on file on or before initial start date in a child care position. On the day of inspection, the correct form was printed and placed in staff's file with date of 5/17/22.

Corrected Corrected by Feb 2, 2023

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

3270.32(a) · The operator shall comply with the CPSL and with Chapter 3490 (relating to Child Protective Services). Staff person #12 will have 15 days from POC requested date to complete the mandated reporter training. Until such time as the required training has been completed, staff person #12 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 person(s) available to supervise staff person #12, staff person# 12 may not work in a child-care position at the facility.

Staff person # 12 has not completed mandated reporter training within the last 60 months. This is evidenced by the previously documented mandated reporter training on file being dated 12/29/15.

Corrected Corrected by Feb 2, 2023

Category: supervision. Marked corrected in the state record.

3270.33(a)/3270.192(2)(ii) · A staff person or a substitute staff person shall meet one of the applicable staff qualifications for the position in which the person is performing. 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 #2, who holds the title of group supervisor, lacks verification of a Bachelor's Degree in Education.

Corrected Corrected by Feb 2, 2023

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 last staff evaluation on file for staff #10 was not completed within the past year and is dated 3/8/21. There was more than 12 months between the previous and most current staff evaluation for staff #12. Dates are as follows: 3/8/21 and 4/22/22.

Corrected Corrected by Feb 2, 2023

Category: recordkeeping. Marked corrected in the state record.

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

In the outdoor play space, observed a child's black and white riding toy which had approximately an inch crack in the area by the bottom of the front of the vehicle.

Corrected Corrected by Feb 2, 2023

Category: transportation. Marked corrected in the state record.

3270.124(b)(3)/3270.124(b)(7) · Emergency contact information must include the home and work addresses and telephone numbers of the enrolling parent. 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 on file for children #2 and 3 lack the work address and telephone numbers of the enrolling parents. The emergency contact information for children 4, 5 and 6 lack the address of all persons designated by the parent to whom the child may be released. The emergency contact information on file for children #5 and 7 lack the work phone of the enrolling parents.

Corrected Corrected by Feb 2, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.131(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 immunization records on file for children #1 and 6 lack verification that the children's immunizations are in accordance with the schedule recommended by the ACIP.

Corrected Corrected by Feb 2, 2023

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

3270.133(6) · A parent shall provide written consent for administration of medication or a special diet.

Written parental permission expired 1/1/23 for the medication on site for child # 8.

Corrected Corrected by Feb 2, 2023

Category: ratio. 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 Toddler B Room, observed a diaper can which was not hands-free.

Corrected Corrected by Feb 2, 2023

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

3270.151(a)/3270.192(3) · A facility person providing direct care who comes into contact with the children or who works with food preparation shall have a health assessment conducted within 12 months prior to providing initial service in a child care setting and every 24 months thereafter. A health assessment is valid for 24 months following the date of signature, if the person does not contract a communicable disease or develop a medical problem. A facility person's record shall include a written report of initial and subsequent health assessments, including the results of initial and subsequent tuberculin skin tests, x-rays or other medical documentation necessary to confirm freedom from communicable tuberculosis.

The file for staff #1 lacked a health assessment at initial hire. There is now a current health assessment on file. There was more than 24 months between the previous and most current and updated health assessment on file for staff #10. The file for staff #12 lacks a health assessment which has been completed within the past 24 months.

Corrected Corrected by Feb 2, 2023

Category: ratio. Marked corrected in the state record.

3270.151(c)(2)/3270.192(3) · An adult health assessment must include tuberculosis screening by the Mantoux method at initial employment. Subsequent tuberculosis screening is not required unless directed by a physician, physician's assistant, CRNP, the Department of Health or a local health department. A facility person's record shall include a written report of initial and subsequent health assessments, including the results of initial and subsequent tuberculin skin tests, x-rays or other medical documentation necessary to confirm freedom from communicable tuberculosis.

The file for staff #1 lacked a TB screening at initial hire. There is now a current TB screening on file.

Corrected Corrected by Feb 2, 2023

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

3270.151(c)(3) · An adult health assessment must include an examination for communicable diseases and the results of that examination.

The most current health assessment on file for staff #7 lacks the results of the examination for communicable disease.

Corrected Corrected by Feb 3, 2023

Category: health medication. 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.

There was more than 30 days between manual checks of the fire detection system and dated as such: 2/24/22 and 3/28/22, 5/12/22 and 6/21/22, 6/21/22 and 7/29/22, 8/19/22 and 9/20/22 and 10/18 22 and 11/21/22.

Corrected Corrected by Feb 2, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.113(a)(1) · Each staff person shall be assigned the responsibility for supervision of specific children. The staff person shall know the names and whereabouts of the children in his assigned group. The staff person shall be physically present with the children in his group on the facility premises and on facility excursions off the facility premises.

Based on statements from staff, it was verified that on 3/23/2022 at approximately 4:45 p.m. staff #1 accompanied a group of children into the facility from the outdoor play space and upon entering the building, the children were counted and it was discovered that one of the children assigned to the supervision of staff #1 had been left behind in the outdoor play space with for staff and the children assigned to their who had remained in that area.

Corrected Corrected by May 26, 2022

Category: supervision. Marked corrected in the state record.

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

Peeling paint was observed on the door of the shed in the outdoor play space.

Corrected Corrected by Dec 21, 2021

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

3270.133(4) · Medication shall be stored in a locked area of the facility or in an area that is out of the reach of children.

A bottle of Airborne that belonged to a staff person was observed in an unlocked drawer in the foyer, accessible to children in care.

Corrected Corrected by Dec 7, 2021

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.

There were (2) nails observed protruding from the wooden fence in the outdoor play space and there were metal links sticking out along the bottom of the gate on the chain link fence , posing a potential hazard to children in care.

Corrected Corrected by Dec 21, 2021

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

3270.31(e)(4)(i) · Competence is the completion of training by a professional in the field of first-aid and cardiopulmonary resuscitation (CPR). All staff persons shall renew their certification in pediatric first aid and pediatric cardiopulmonary resuscitation (CPR) on or before the expiration of the most current certification.

The record for staff #3 included current certification in CPR renewed on 8/12/2021, following the expiration of their previous certification completed on 5/22/2018.

Corrected Corrected by Jan 4, 2022

Category: ratio. 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 record for staff #2 included a current FBI clearance dated 11/19/2019, more than 60 months following the previous clearance dated 11/4/2014. The record for staff #5, who began working in child care on 6/30/2021, included a state police clearance dated 12/1/2021 and a NSOR dated 11/22/2021. The record for staff #7, who began working in child care on 9/13/2021, The record for staff #9 included a disclosure statement that was not dated.

Corrected Corrected by Dec 27, 2021

Category: background checks. 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.

The following cleaning materials and other toxic materials labeled keep out of the reach of children were observed in an area that was accessible to children in care: hand sanitizer was located on a table and a desk in the foyer; (2) bottles of essential oils and a refill for a plug in air freshener was in an unlocked drawer the foyer; hand sanitizer was attached to a child's book bag and (2) disinfectant sanitizer, TB cleaner, glass and multi surface cleaner, restroom cleaner and Triple Paste diaper rash cream was kept under the changing table in room 2.

Corrected Corrected by Dec 7, 2021

Category: health medication. 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.

In room 2, three sensory bottles with removeable lids that contained glitter and empty garbage bags stored under the changing table were accessible to children who are still placing objects in their mouths.

Corrected Corrected by Dec 7, 2021

Marked corrected in the state record.

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

The agreement for child #3 was dated 8/4/2021, following the child's first day of attendance on 8/24/2020.

Corrected Corrected by Aug 4, 2021

Category: recordkeeping. Marked corrected in the state record.

3270.123(a)(1) · An agreement shall specify the amount of the fee to be charged per day or per week.

The agreement for child #1 did not specify the amount of the fee to be charged per day or per week.

Corrected Corrected by Jan 27, 2022

Category: recordkeeping. Marked corrected in the state record.

3270.124(a) · Emergency contact information is required for each enrolled child. Emergency contact information must reference who shall be contacted in an emergency.

The emergency contact information for child #3 was dated 8/4/2021, following the child's first day of attendance on 8/24/2020.

Corrected Corrected by Aug 4, 2021

Category: recordkeeping. Marked corrected in the state record.

3270.124(b)(4)/3270.182(3) · Emergency contact information must include the written consent signed by a parent for emergency medical care. A child's record shall contain signed parental consent for emergency medical care for the child. Written consent is required prior to admission.

The emergency contact information for child #4 did not include the written consent signed by a parent for emergency medical care.

Corrected Corrected by Feb 11, 2022

Category: recordkeeping. 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 information for child #2 and #5 did not include the address of the individual designated by the parent to whom the child may be released.

Corrected Corrected by Feb 11, 2022

Category: recordkeeping. 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 record for staff #2 included a current health assessment dated more than 24 months following their previous health assessment. The record for staff #5 included a current health assessment dated following their first day working in child care. The record for staff #8 included a health assessment that was not dated and therefore, it is not valid, because compliance cannot be assessed.

Corrected Corrected by Jan 28, 2022

Category: ratio. Marked corrected in the state record.

3270.182(5) · A child's record shall contain signed parental consent for administration of minor first-aid procedures by facility staff. Written consent is required prior to admission.

The record for child #4 did not contain signed parental consent for administration of minor first-aid procedures by facility staff.

Corrected Corrected by Feb 11, 2022

Category: ratio. Marked corrected in the state record.

3270.31(f)(10) · Staff persons shall complete professional development in pediatric first aid and pediatric cardiopulmonary resuscitation within 90 days of hire.

The record for staff #4 included PD in pediatric first aid and pediatric CPR completed on 8/12/2021, more than 180 days following the implementation of the current regulations. The record for staff #6, who began working in child care on 4/19/2021, and staff #7, who began working in child care on 5/6/2021, included PD in pediatric first aid and pediatric CPR completed on 8/12/2021, more than 90 days following there first day working in child care. The record for staff #8, who began working in child care on 9/13/2021, did not include PD in pediatric first aid and pediatric CPR, more than 90 days following their first day working in child care. The record for staff #11, who began working in child care on 9/7/2021, included PD in pediatric first aid and pediatric CPR completed on 12/16/2021, more than 90 days following there first day working in child care.

Corrected Corrected by Jan 25, 2022

Category: health medication. 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 operator did not have the proof of purchase for the interconnected fire detection system installed at the facility.

Corrected Corrected by Dec 7, 2021

Category: recordkeeping. Marked corrected in the state record.

3270.131(a)/3270.182(1) · The operator shall require the parent of an enrolled child, including a child, a foster child and a relative of an operator or a facility person, to provide an initial health report no later than 60 days following the first day of attendance at the facility. A child's record shall contain initial and subsequent health reports.

The record for child #2 included an initial health report dated more than 60 days (or 90 days as per C-20-04) following the first day of attendance at the facility.

Corrected Corrected by Nov 20, 2020

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