3270.51 · * When children are grouped in similar age levels, the following maximum child group sizes and ratios of staff persons apply: Infants 1:4 with a maximum group size of 8; Young toddlers 1:5 with a maximum group size of 10; Older toddlers 1:6 with a maximum group size of 12; Preschool children 1:10 with a maximum group size of 20; Young school-age children 1:12 with a maximum group size of 24; Older school-age children 1:15 with a maximum group size of 30.

* Previously cited on 10/15/24. On 12/17/24, observed staff #1 leave the infant room and walk to the front door for approximately one minute. This left the infant room out of ratio with 1 staff to 5 infants.

Corrected Corrected by Jan 10, 2025

Category: ratio. Marked corrected in the state record.

3270.51 · ** The required staff:child ratios must be maintained at all times. The Legal Entity will arrange for all staff to attend a minimum of 2 hours of online training on ratio. The training will be submitted to the regional office for approval prior to attendance. Proof of training will be submitted upon completion.

** Previously cited on 10/15/24. On 12/17/24, observed staff #1 leave the infant room and walk to the front door for approximately one minute. This left the infant room out of ratio with 1 staff to 5 infants.

Corrected Corrected by Jan 10, 2025

Category: ratio. 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 one year between fire safety trainings on file for staff #3. This is evidenced by the fire safety trainings on file with dates of 4/17/23 and 6/13/24.

Corrected Corrected by Nov 1, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.31(f)/3270.192(2)(iii) · Staff persons shall complete professional development within 90 days of hire as listed in subsections (f)1-10. A facility person's record shall include verification of child care experience, education and training following the outset of service at the facility.

The revised 10-hour health and safety training on file for staff #2 was completed on 9/19/24 which was more than 90 days past their hire date. SEE IS CODE SHEET.

Corrected Corrected by Nov 1, 2024

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). 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, who was a rehire, lacked a disclosure statement on or before initial start date in a child care position. SEE IS CODE SHEET.

Corrected Corrected by Nov 1, 2024

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

3270.51 · When children are grouped in similar age levels, the following maximum child group sizes and ratios of staff persons apply: Infants 1:4 with a maximum group size of 8; Young toddlers 1:5 with a maximum group size of 10; Older toddlers 1:6 with a maximum group size of 12; Preschool children 1:10 with a maximum group size of 20; Young school-age children 1:12 with a maximum group size of 24; Older school-age children 1:15 with a maximum group size of 30.

On 10/15/24, observed 12 older toddlers in the toddler room with staff #4 and 5. Observed staff #4 walk out of the room and down the hall and out the back door for approximately one minute. This left staff #5 alone in the room with 12 older toddlers. Ratio 1:12.

Corrected Corrected by Nov 1, 2024

Category: ratio. 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 school age room lacked nonporous gloves.

Corrected Corrected by Nov 1, 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.

In the 3- 4-year-old room, observed a blue bin of toys on the toy shelf. The hard plastic blue toy bin was cracked causing a pinch and crush point to the children in care.

Corrected Corrected by Nov 1, 2024

Category: physical safety. 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 the 2-3 year old room, observed foam blocks with teeth marks in them on a toy shelf and foam letters in a clear bin with a white plastic lid.

Corrected Corrected by Nov 1, 2024

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. This is evidenced by the fire detection checks on file which are dated 5/3/24 and 6/3/24.

Corrected Corrected by Nov 1, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.113(b) · A facility person may not use any form of physical punishment, including spanking a child.

Per staff statements, staff #1 has used physical punishment with children by pushing children, grabbing children by the arm and yanking children's arms.

Corrected Corrected by Oct 15, 2024

Marked corrected in the state record.

3270.113(c) · A facility person may not single out the child for ridicule, threaten harm to the child or the child's family and may not specifically aim to degrade the child or the child's family.

Per staff statements, staff #1 has threaten a child by raising their hand in a striking position to the child. Staff #1 has called children degrading names, such as stupid and retarded.

Corrected Corrected by Oct 15, 2024

Marked corrected in the state record.

3270.113(d) · A facility person may not use harsh, demeaning or abusive language in the presence of children.

Per staff statements, staff #1 has used harsh and demeaning language in the presence of children, including: curse words, shut up and name calling.

Corrected Corrected by Oct 15, 2024

Marked corrected in the state record.

3270.136(b) · The operator shall inform parents of enrolled children when there is a suspected outbreak of a communicable disease or an outbreak of an unusual illness that represents a public health emergency in the opinion of the Department of Health.

The operator did not inform parents of enrolled children of a suspected outbreak of lice in the facility.

Corrected Corrected by Oct 15, 2024

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

3270.137 · An operator who observes an enrolled child with symptoms of a communicable disease or infection that can be transmitted directly or indirectly and which may threaten the health of children in care shall exclude the child from attendance until the operator receives notification from a physician or a CRNP that the child is no longer considered a threat to the health of others. The notification shall be retained in the child's file. Diseases and conditions which require exclusion are specified in 28 Pa. Code Chapter 27 (relating to communicable and noncommunicable diseases).

Per document review and staff statements, children with symptoms of lice were not excluded from child care until the child was no longer considered a threat to the health of others.

Corrected Corrected by Oct 15, 2024

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

3270.153 · A facility person with symptoms of a communicable disease or infection that can be transmitted directly or indirectly and which may threaten the health of children in care shall be excluded from attendance until the facility operator receives notification from a physician or CRNP that the person is no longer considered a threat to the health of others. The notification shall be retained in the facility person's file. Exclusion from the facility is required for diseases and conditions specified in 28 Pa. Code Chapter 27 (relating to communicable and noncommunicable diseases).

Per document review and staff statements, staff with symptoms of lice were not excluded from child care until the staff was no longer considered a threat to the health of others.

Corrected Corrected by Oct 17, 2024

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

3270.14/3270.21 · A facility shall be operated in conformity with applicable Federal and State laws and regulations.State agencies whose regulations may relate to the operation of a facility include the Department of Environmental Resources, the Department of Labor and Industry, the Department of Health, the Department of Education and the Department of Transportation. Conditions at the facility may not pose a threat to the health or safety of the children.

The operator lacked a section addressing the prevention and identification of Child Maltreatment in their Shaken Baby syndrome, abusive head trauma and child maltreatment policy and procedure to maintain compliance with 45 CFR 98.41(a)(1)(vi) and in accordance with Announcement C-22-03.

Corrected Corrected by Nov 8, 2023

Category: ratio. Marked corrected in the state record.

3270.14/3270.21 · A facility shall be operated in conformity with applicable Federal and State laws and regulations.State agencies whose regulations may relate to the operation of a facility include the Department of Environmental Resources, the Department of Labor and Industry, the Department of Health, the Department of Education and the Department of Transportation. Conditions at the facility may not pose a threat to the health or safety of the children.

The operator lacked updated sections in their emergency plan that addresses the operators plans for continuity of operations in response to an emergency to maintain compliance with 45 CFR § 98.41(a)(1)(vii) per Announcement C-22-04.

Corrected Corrected by Nov 8, 2023

Category: ratio. 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 operator's letter to the parents of enrolled children explaining the emergency plan procedures was not updated to include the update regarding the accommodations for infants, toddlers, children with special needs and medical conditions.

Corrected Corrected by Nov 8, 2023

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

3270.66(e) · Arts and crafts materials shall be nontoxic.

The school age room had shaving cream that stated "keep out of reach of children" on the label and was intended to be used in arts and crafts with the children.

Corrected Corrected by Nov 8, 2023

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 located in the preschool 5's room lacked nonporous gloves in the kit.

Corrected Corrected by Nov 8, 2023

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

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

The file for staff person #2 lacked a health assessment that was completed 24 months from the previous health assessment. The health assessments in the file are dated 7/20/20 and 8/25/22.

Corrected Corrected by Dec 29, 2022

Category: ratio. Marked corrected in the state record.

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

The file for staff person #1 lacked training in health and safety topics numbers 1-9 as listed in the regulation 3270.31(f) within 90 days of hire. The health and safety training in the file is dated 8/31/22.

Corrected Corrected by Dec 29, 2022

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

3270.31(f) · Staff persons shall complete professional development in the topics of 3270.31(f)(1 -- 10) within 90 days of hire. Staff persons #1, #2, and #4 will have until 11/12/22 to complete the required training. Until such time as the required training has been completed, staff persons #1, #2, and #4 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 persons #1, #2, and #4, staff persons #1, #2, and #4 may not work in a child-care position at the facility.

Staff persons #1, #2, and #4 have not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): Getting Started with Center Based Care: Building Blocks for Quality.

Corrected Corrected by Nov 2, 2022

Category: supervision. 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 #3 will have until 11/12/22 to complete the mandated reporter training. Until such time as the required training has been completed, staff person #3 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 #3, staff person #3 may not work in a child-care position at the facility.

Staff person #3 has not completed the mandated reporter training within 90 days of their date of hire (see LIS code sheet).

Corrected Corrected by Oct 25, 2022

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 Pediatric CPR/First Aid training on file for staff #1 expired 9/19/19.

Corrected Corrected by Dec 18, 2021

Category: ratio. Marked corrected in the state record.

3270.31(f)/3270.31(h) · Staff persons shall complete professional development in the following topics within 90 days of hire:All staff persons shall complete the professional development under subsection (f).

The file for staff #3, 4 and 6, all who have been employed for longer than 90 days, lack the required Pediatric/First Aid/CPR training. The file for staff #4, with start date of 6/9/21, lacked health and safety training within 90 days of start date. There is now health and safety training on file and dated 9/8/21.

Corrected Corrected by Dec 18, 2021

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 files for staff #2 and 5 acked mandated reporter training within 90 days of hire. There is now current mandated reporter training on file.

Corrected Corrected by Nov 16, 2021

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 file for child #1 lacked verification of a flu shot within the past year as in accordance with the schedule recommended by the ACIP.

Corrected Corrected by Nov 19, 2021

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. Proof of purchase of all interconnected fire detection systems/devices shall be on file at the facility.

The facility lacked proof of purchase of all interconnected fire detection devices. The fire panel and 5 interconnected smoke alarms were replaced in 2019 and proof of purchase is on file.However, not all of the facility's interconnected smoke alarms were replaced at that time and their proof of purchase is not on file.

Corrected Corrected by Nov 16, 2021

Category: recordkeeping. Marked corrected in the state record.

3270.25(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 operator did not provide the parent of each child enrolled with information on how to access the regulations in this chapter electronically.

Corrected Corrected by Nov 16, 2021

Marked corrected in the state record.

3270.27(a)(1)/3270.27(a)(5) · The facility shall have an emergency plan that provides for accommodations for shelter of children during an emergency including lock-down, shelter in place at the facility and shelter at locations away from the facility premises.The facility 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 a plan that provides for shelter of children during lock-down and a plan that provides for accommodations for infants, toddlers and children with disabilities.

Corrected Corrected by Nov 16, 2021

Category: physical safety. 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 operator did not sent a copy of the emergency plan to the local municipality.

Corrected Corrected by Nov 19, 2021

Category: physical safety. 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).

On 9/17/21, at approximately 8:15 AM, observed staff #1 and #2 outside waiting for the school bus and supervising 17 young school age children and 1 infant.

Corrected Corrected by Sep 17, 2021

Category: supervision. Marked corrected in the state record.