3270.51 · TIERED LIS; 1. 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. 2. The Legal Entity will require all staff at the facility to attend a 2-hour minimum, in person training regarding maintaining proper ratio of children to staff presented by ELRC 1. The training may count towards the mandatory 12 training hours required by the Department. Documentation of training for each staff will be submitted to the department within 5 days of the completion of the training.

Continued Noncompliance: At approximately 11am on 4/29/25 it was observed that the preschool class was outside in the fenced in play space. While conducting ratio and supervision checks there was one teacher outside with 12 preschool age children. Previously cited on 3/18/25 and 4/8/25

Corrected Corrected by Jun 3, 2025

Category: supervision. Marked corrected in the state record.

3270.33(a) · 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.

Staff person #2 was functioning as an Aide without having the applicable qualifications documented.

Corrected Corrected by May 30, 2025

Category: recordkeeping. Marked corrected in the state record.

3270.37(c) · An aide or a combination of aides shall be supervised at all times by a staff person qualified at minimum as an assistant group supervisor.

Staff person # 2 was walking children alone from one room to another without been supervised by a staff person qualified at minimum as an assistant group supervisor.

Corrected Corrected by May 30, 2025

Category: supervision. 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 4/8/25 approximately at 8:40 am staff #1 was alone caring for 11 preschool age children.

Corrected Corrected by May 30, 2025

Category: ratio. Marked corrected in the state record.

3270.31(b) · A staff person shall be 18 years of age or older.

Staff person #3, 5 and 7 that were classified as aides were not 18 years of age or older, nor have they completed or are enrolled in an approved training curriculum.

Corrected Corrected by Mar 18, 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).

The file for staff #3 was observed to contain a Child Abuse Clearance date 12/3/24 which was after date of hire(See LIS Code Sheet), and a NSOR Certificate dated 1/3/25 which was more than 45 days after date of hire(Se LIS Code Sheet). The file for staff #4 was observed to contain an NSOR Certificate dated 11/21/24 which was more than 45 days after date of hire(See LIS Code Sheet). The file for staff #5 was observed to contain an NSOR Certificate dated 11/21/24 which was more than 45 days after date of hire(See LIS Code Sheet). The file for staff #7 was observed to contain a DHS FBI clearance dated 2/27/25 which was more than 45 days after date of hire(See LIS Code Sheet).

Corrected Corrected by Mar 18, 2025

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

3270.36(b)(3)/3270.192(2)(ii) · An assistant group supervisor shall have a high school diploma or a general educational development certificate, 15 credit hours from an accredited college or university in early childhood education, child development, special education, elementary education or the human services field and 1 year of experience with children. A facility person's record shall include verification of child care experience, education and training prior to service at the facility.

Staff #1 and 6's files did not contain verification of child care experience.

Corrected Corrected by Mar 20, 2025

Category: supervision. Marked corrected in the state record.

3270.37(b)(3)/3270.192(2)(ii) · An aide shall have a minimum of an 8th grade education and 2 years of experience with children. A facility person's record shall include verification of child care experience, education and training prior to service at the facility.

Staff person #4's file did not have proof of at least a minimum of an 8th grade education and 2 years of experience with children.

Corrected Corrected by Mar 19, 2025

Category: recordkeeping. 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).

In room #3 at approximately 10am there were 5 Older Toddlers and 4 Young Toddlers in care. Both staff members named the entire group as being the group they were in charge of. One staff member qualified as an AGS and the other staff member, staff #5, only qualified as a volunteer. Due to staff #5 not being able to count in ratio this put them out of ratio.

Corrected Corrected by Mar 19, 2025

Category: ratio. Marked corrected in the state record.

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

In room 8 two protective outlet covers were missing by the rocking chair and one was missing by the large wooden cube.

Corrected Corrected by Mar 18, 2025

Marked corrected in the state record.

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

In room 4 the cabinet under the diaper table was not locked and accessible to children. The cabinet contained Window cleaner, Aquaphor Diaper Rash Paste, and Boudreaux's Butt Paste which state keep out of reach of children.

Corrected Corrected by Mar 18, 2025

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

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

The trash in rooms 6 and 7 were not removed daily per discussion with operator.

Corrected Corrected by Mar 18, 2025

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 room 6 was missing tape. The first aid kit in room 4 was missing gloves.

Corrected Corrected by Mar 18, 2025

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

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

Handwashing signs were missing in the women's bathroom near 2 toilets and the men's bathroom near the urinal.

Corrected Corrected by Mar 27, 2025

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 room 6 the block bin was cracked causing a pinching hazard.

Corrected Corrected by Mar 18, 2025

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

3270.104(a) · Furniture must be durable, safe, easily cleaned and appropriate for the child's size, age and special needs.

In Room 6 there was a tall brown cabinet that was unstable when touched that was not attached to the wall. Outside room 6 was tall children's cubbies that were not attached to the wall. In room 8 the cubbies were not attached to the wall.

Corrected Corrected by Mar 21, 2025

Marked corrected in the state record.

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

The thermometer in refrigerator in room 3 was not working properly.

Corrected Corrected by Mar 18, 2025

Category: nutrition. Marked corrected in the state record.

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

In room 7 there was no written daily schedule posted.

Corrected Corrected by Mar 18, 2025

Marked corrected in the state record.

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

Child #1's file did not contain a signed financial agreement.

Corrected Corrected by Mar 21, 2025

Category: recordkeeping. Marked corrected in the state record.

3270.124(b)(2) · Emergency contact information must include the name, address and telephone number of the child's physician or source of medical care.

Child #3's file did not contain the telephone number of the child's physician or source of medical care.

Corrected Corrected by Mar 21, 2025

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

3270.124(b)(3) · Emergency contact information must include the home and work addresses and telephone numbers of the enrolling parent.

Child #3's file did not contain the work address and telephone number of the enrolling parent.

Corrected Corrected by Mar 21, 2025

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.

Child #3's file did not contain 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.

Corrected Corrected by Mar 19, 2025

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.

Child #2's file did not contain the health insurance policy number for a child under a family policy or Medical Assistance benefits.

Corrected Corrected by Mar 19, 2025

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

3270.124(b)(7) · Emergency contact information must include the name, address and telephone number of the individual designated by the parent to whom the child may be released.

Child #3's file did not contain the telephone numbers for 2 individuals designated by the parent to whom the child may be released.

Corrected Corrected by Mar 19, 2025

Category: recordkeeping. Marked corrected in the state record.

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

The two most recent 6-month review signatures for the emergency contact form on file for child #1 are 7/1/24 and 2/14/25 which are more than 6 months apart.

Corrected Corrected by Mar 21, 2025

Category: recordkeeping. Marked corrected in the state record.

3270.131(b)(1) · The operator shall require the parent to provide an updated health report at least every 6 months for an infant or young toddler.

The two most recent health assessments on file for Child #2, who is an infant age child(See LIS Code Sheet), are dated 5/14/24 and 1/29/25, more than 6 months apart.

Corrected Corrected by Mar 18, 2025

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

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

The initial health assessment on file for staff #1 is dated 2/12/25 which is after staff #1's date of hire(See LIS Code Sheet). The initial health assessment on file for staff #3 is dated 11/18/24 which is after staff #3's date of hire(See LIS Code Sheet). The initial health assessment on file for staff #5 is dated 10/2/24 which is after staff #5's date of hire(See LIS Code Sheet).

Corrected Corrected by Mar 18, 2025

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.

Staff #1 initial TB test was dated 2/14/25 which is after staff # 1's date of hire(See LIS Code Sheet). Staff #3's initial TB test was dated 11/18/24 which is after staff #3's date of hire(See LIS Code Sheet). Staff #5's initial TB test was dated 10/2/24 which is after staff #5's date of hire(See LIS Code Sheet). Staff #6's file did not contain a TB test.

Corrected Corrected by Apr 4, 2025

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

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

The health assessment on file for Staff person #2 does not include the physician or health care professional's assessment of the person's suitability to provide child care.

Corrected Corrected by Apr 1, 2025

Category: health medication. 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 person #3, was observed not to have completed pre-service training: Pediatric CPR/First Aid within 90 days of hire (See LIS CODE SHEET). The pre-service training on file for staff person #3 was dated 2/6/25. The file for staff person #7, was observed not to have completed pre-service training: Pediatric First Aid/CPR within 90 days of hire (See LIS CODE SHEET). The pre-service training on file for staff person #7 was dated 12/17/24.

Corrected Corrected by Mar 18, 2025

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

3270.182(8) · 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.

There was no agreement on file for Child #3.

Corrected Corrected by Apr 8, 2024

Category: recordkeeping. Marked corrected in the state record.

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

Observed that the Pre-K children bring ice packs in their lunches but they are not refrigerated. Observed six lunch bags which included yogurts and cottage cheese.

Corrected Corrected by Apr 8, 2024

Category: nutrition. Marked corrected in the state record.

3270.166(4) · Disposable nursers and bottles shall be labeled with the child's name.

In the Infant Room, observed bottles for children #7 and 8 which lack the child's name.

Corrected Corrected by Mar 27, 2024

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 Room 8 lacked sterile gauze pads.

Corrected Corrected by Apr 4, 2024

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

3270.106(a) · Individual, clean, age-appropriate rest equipment shall be provided for preschool, toddler and infant children as agreed between the child's parent and the operator. The rest equipment shall be labeled for the use of a specific child and used only by the specified child.

In Room 4, observed an unlabeled pack n play for child #6.

Corrected Corrected by Apr 5, 2024

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

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

The facility's emergency plan lacked a continuity of operations plan for the aftermath of a disaster .

Corrected Corrected by Apr 3, 2024

Category: ratio. Marked corrected in the state record.

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

In the outside toddler/PS play space, observed an area of standing water in the back corner of the play space which was approximately 10 ft x 5 ft and approximately 2-3 inches deep posing a threat to the health and safety of the children.

Corrected Corrected by Apr 3, 2024

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 parent letter which explained shelter and lockdown, evacuation, method to contact parents when it is reasonably possible when an emergency situation arises, method to inform parents that the emergency has ended and instruction for how to safely be reunited with their children, accommodations for infants, toddlers, children with disabilities and children with chronic medical conditions.

Corrected Corrected by Apr 4, 2024

Category: physical safety. 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 -- may not work in a child care 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.

The clearances on file for Staff #1 are dated: 6/21/23 (State Police); 6/29/23 (Child Abuse); 7/13/23 (DHS FBI); 6/23/23 (NSOR). All of the dates are after the date of hire/first date of caring for children. (See IS code sheet) The FBI clearance on file for staff #2 was for Department of Education, not DHS and the NSOR certificate for Staff #2 is dated 2/14/23, which is after their first day of caring for children. (See IS code sheet) The NSOR certificate for Staff #3 is dated 1/17/24, which is after their first day of caring for children. (See IS code sheet)

Corrected Corrected by Apr 4, 2024

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

3270.113(a) · Children on the facility premises and on facility excursions off the premises shall be supervised by a staff person at all times. Outdoor play space used by the facility is considered part of the facility premises.

At nap time on 3/27/24, observed staff #4 with four toddlers. Three of the toddlers were on one side of the room and one toddler was on the other side of them lying beside a toy shelf. The area where the three toddlers were laying had enough light coming in through a window and could be appropriately supervised. The area where the one toddler was lying was too dark and the child's face could not be seen from where staff was sitting in the room. Additionally, based on a conversation with staff #4, this child has a hard time sleeping so she usually goes over to the child and can see her because she sits directly beside her while she rubs her back to put her to sleep. Based on the review of the room set-up, staff #4 would not then be able to appropriately supervise the other three children.

Corrected Corrected by Apr 3, 2024

Category: supervision. Marked corrected in the state record.

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

The agreement on file for Child #1 does not include release persons.

Corrected Corrected by Apr 10, 2024

Category: recordkeeping. Marked corrected in the state record.

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

The agreements on file for Children #2, #3, and #5 do not include the child's date of admission.

Corrected Corrected by Apr 4, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.124(b)(3) · Emergency contact information must include the home and work addresses and telephone numbers of the enrolling parent.

The emergency contact forms on file for Children #1, #2, and #4 do not include enrolling parent's work address or phone number.

Corrected Corrected by Apr 4, 2024

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 emergency contact forms on file for Children #1, #2, and #5 do not include information on disability.

Corrected Corrected by Apr 4, 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 health assessment on file for Staff #1 is dated 2/3/24, which is after their start date. SEE IS CODE SHEET>

Corrected Corrected by Feb 3, 2024

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 #3 did not include two written nonfamily references.

Corrected Corrected by Apr 8, 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.

There were more than 30 days between manual checks of the fire detection system; Dates are as follows: 5/14/23 and 6/28/23, 7/18/23 and 8/22/23, 10/19/23, 11/21/23, 12/22/23 and 1/31/24.

Corrected Corrected by Apr 4, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.14/3270.21 · A facility shall be operated in conformity with applicable Federal and State laws and regulations. State agencies whose regulations may relate to the operation of a facility include the Department of Environmental Resources, the Department of Labor and Industry, the Department of Health, the Department of Education and the Department of Transportation. Conditions at the facility may not pose a threat to the health or safety of the children. Until such time as the required pre-service trainings are completed, staff person #6 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 #6, staff person #6 may not work in a child-care position at the facility.

Staff person #6 was observed to be caring for children unsupervised. Staff person #6 has not completed the following pre-service training required prior to caring for children unsupervised: 6 hour health and safety training dated 8/30/16 thru 6/30 18. 6 hour training on file is dated 8/20/16.

Corrected Corrected by Apr 2, 2023

Category: supervision. 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 files for staff #1, 2, 3, 4, 5, 8, 11 and 12 lacked the one hour health and safety update that was to be completed by 12/30/22. The one hour health and safety update is now on file for staff #1, 2, 3, 4, 5, 8, 11 and 12. Dates are as follows; Staff #1 - 3/18/23, #2 - 3/22/23, #3 - 3/20/23, #4 - 4/2/23, #5 - 3/20/23, #8 - 3/13/23, #11 - 3/20/23, #12 - 3/20/23.

Corrected Corrected by Apr 2, 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.

The file for staff #2 lacked initial emergency plan training within 90 days of hire. SEE LIS CODE SHEET. There is now training on file and dated 10/18/22. There was more than 12 months between the previous and most current emergency plan trainings on file for staff #4. Dates are as follows; 2/13/20 and 10/18/22.

Corrected Corrected by Oct 18, 2022

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 the previous and most current fire safety training on file for staff #4. Dates are as follows; 2/13/20 and 10/18/22.

Corrected Corrected by Oct 18, 2022

Category: recordkeeping. Marked corrected in the state record.

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

The files for staff #1, 3, 4, 5, 6, 8, 9, 10 and 11 lacked documentation of Pediatric CPR/FA from a PQUA certified instructor by 4/29/22. There are now current CPR/FA training from a PQUA certified instructor and all dated 5/9/22.

Corrected Corrected by May 9, 2022

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 #7 -- may not work in a child care 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..

The file for staff #7, who was a provisional hire, contained applications for an FBI and NSOR clearance on or before start date in a child care position. However, a State Police clearance was not on file on or before start date in a child care position. SEE LIS CODE SHEET. There is now a State Police clearance on file and dated 3/2/23. There are no FBI or NSOR clearances on file. The file for staff #12 lacked a Child Abuse clearance on or before initial start date in a child care position. There is now a Child Abuse clearance on file and dated 10/11/22. SEE LIS CODE SHEET.

Corrected Corrected by Apr 12, 2023

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

3270.92(a) · Portable space heaters are not permitted.

At the hallway entrance of the facility, observed a portable space heater

Corrected Corrected by Mar 16, 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 outside play space, which is located directly outside the door of the facility, observed exposed bolts on the fence which were facing the inside of the play space. In the new outside play space, observed exposed bolts which were facing the inside of the play space. In the new outside play space, observed a children's play house with a cracked green roof causing a pinch point. In Room 6 observed a gray toy bin which had a crack on the right side.

Corrected Corrected by Apr 12, 2023

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 room 5, observed a bin of foam blocks. One of the green foam blocks had teeth marks.

Corrected Corrected by Apr 12, 2023

Marked corrected in the state record.

3270.113(a) · Children on the facility premises and on facility excursions off the premises shall be supervised by a staff person at all times. Outdoor play space used by the facility is considered part of the facility premises.

On 3/16/23, during nap time in the toddler room, observed that staff #11 was unable to see and assess two of the children from where staff was sitting and where the children were positioned for nap.

Corrected Corrected by Apr 12, 2023

Category: supervision. Marked corrected in the state record.

3270.123(a)/3270.123(a)(6) · An agreement shall be signed by the operator and the parent. An agreement shall specify the date of the child's admission.

The most current fee agreements on file for children #2, 3, 5, 7 and 8 were not signed by the operator. The most current fee agreements on file for children #1, 2, 4, 7 and 8 lacked the child's date of admission.

Corrected Corrected by Apr 12, 2023

Category: recordkeeping. Marked corrected in the state record.

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

The most current fee agreements on file for children #1, 3, 4, 5, 7 and 8 were the originals. Therefore, the parent did not receive the original agreements.

Corrected Corrected by Apr 12, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.124(b)(2)/3270.124(b)(6) · Emergency contact information must include the name, address and telephone number of the child's physician or source of medical care. 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 most current emergency contact information on file for child #2 lacks the phone number of the child's physician or source of medical care. The most current emergency contact information on file for child #6 lacks a health insurance policy number.

Corrected Corrected by Apr 12, 2023

Category: health medication. 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 most current emergency contact information on file for child #1 lacks the enrolling parents work address and work phone and the address of all individuals to whom the child may be released. The most current emergency contact information on file for child #8 lacks the address of all individuals to whom the child may be released.

Corrected Corrected by Apr 28, 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 most current emergency contact information on file for child #6 lacks written consent signed by a parent for emergency medical care.

Corrected Corrected by Apr 28, 2023

Category: recordkeeping. Marked corrected in the state record.

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

There was more than six months between the most current six month reviews/updates of the fee agreements and emergency contact information on file for children #1, 2, 3, 4, 5, 6 and 7. There are now current reviews/updates on file.

Corrected Corrected by Apr 12, 2023

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 files for children #2, 5 and 8, al who are young toddlers, lack verification of a health assessment which was completed within the past six months. There was more than six months between health assessments on file for child #4, who was a young toddler when the health assessment was due. There is now a current health assessment on file for child #4.

Corrected Corrected by Apr 12, 2023

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

3270.131(b)(2)/3270.182(1) · The operator shall require the parent to provide an updated health report at least every 12 months for an older toddler or preschool child. A child's record shall contain initial and subsequent health reports.

The file for child #3, who is of preschool age, lacks a health assessment which has been completed within the past 12 months.

Corrected Corrected by Apr 28, 2023

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

3270.131(d)(5)/3270.131(e)(3) · Child(ren) # 1, 3, 5, 7 and 8 must be dismissed from care by close of business of provider notification and may only return to care when the immunization record is updated or when a parent provides a written, signed exemption letter. 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 children #1, 3, 7 and 8 lack verification of a flu shot within the past year as in accordance with the schedule recommended by the ACIP. The file for child #5 contains 3 of the 4 DTAP and Pneumococcal immunizations and lacks a flu shot within the past 12 months as in accordance with the schedule recommended by the ACIP.

Corrected Corrected by Apr 28, 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.

Observed All Day Allergy medication for child #9 which expired 2/2023 and Benadryl for child #6 which expired 3/2023.

Corrected Corrected by Apr 12, 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.

There was more than 24 months between the previous and the most current and updated health assessments on file for staff #1. The files for staff #7 and 12 lacked a health assessment that was completed 12 months prior to providing initial service in a child care setting. There are now a current health assessments on file on file for staff #7 and 12.

Corrected Corrected by Apr 12, 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 #7 lacks a TB test at initial hire. The file for staff #12 lacked a TB test at initial hire. There is now a TB test on file for staff #12.

Corrected Corrected by Apr 12, 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 file for child #6 lacks signed parental consent for administration of minor first-aid procedures by facility staff.

Corrected Corrected by Apr 12, 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.

There was more than 30 days between checks of the fire detection system which are dated 1/18/23 and 2/24/23. The facility file lacked documentation of the proof of purchase of the fire detection system. There is a proof of purchase on file of the pull station. However, a pull down station was replaced in 2020 and proof of puchase is not on file.

Corrected Corrected by Apr 12, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.27(c) · The operator shall assure that each facility person receives training regarding the emergency plan at the time of initial employment, on an annual basis and at the time of each plan update. The operator shall document the date of each training and the names of all facility persons who received the training and kept on file at the facility.

Although the file for Staff #1 contained documentation of the completion of emergency plan training in the past 12 months, the previously complete emergency plan training was more than 12 months prior to the completion date of her current training.

Corrected Corrected by Apr 4, 2022

Category: recordkeeping. Marked corrected in the state record.

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

The file for Staff #5, who has been employed in a child care position for more than 90 days, did not include documentation of the completion of Health and Safety Basics training. The file for Staff #4 contained documentation of the completion of Health and Safety Basics training; however, said training was completed more than 90 days after first date in a child care position.

Corrected Corrected by Mar 4, 2022

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.

Although the file for Staff #2 contained documentation of the current completion of mandated reporter training, the previous training was complete more than 60 months prior.

Corrected Corrected by Apr 5, 2022

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. Facility Person # 2 may not work in a child care position at the facility.

The file for Staff #2 contained a DHS Child Abuse Clearance that was completed more than 60 months ago. Staff #2 cannot work at the child care facility until an updated clearance is obtained and placed on file.

Corrected Corrected by Mar 23, 2022

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

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

Although the file for Staff #1 contained a staff evaluation completed in the past 12 months, the evaluation prior to the current evaluation was completed more than 12 months prior.

Corrected Corrected by Mar 21, 2022

Category: recordkeeping. Marked corrected in the state record.

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

A roughly 12"x2" area of peeling paint was observed in an area accessible to children in care in the child care space on the right side of the hallway at the end of building farthest from the office.

Corrected Corrected by Mar 23, 2022

Category: physical safety. 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 files for Child #4 and #5 contained emergency contact forms that did not include written parental consent for emergency medical care.

Corrected Corrected by Mar 24, 2022

Category: recordkeeping. Marked corrected in the state record.

3270.131(b)(1) · The operator shall require the parent to provide an updated health report at least every 6 months for an infant or young toddler

The file for Child #1, an infant, contained a health assessment that was completed more than six months ago.

Corrected Corrected by Mar 29, 2022

Category: health medication. 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 file for Child #3, a Preschool-aged child, contained a health assessment that was completed more than 12 months ago.

Corrected Corrected by Apr 5, 2022

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

3270.131(d)(5) · A health report shall include a review of the child's immunized status according to recommendations of the ACIP.

The file for Child #1 contained an immunization record that, based upon the recommendations of the ACIP, did not include documentation of the following immunizations: * Second Dtap * Second HIB * Second IPV * Second PCV 13

Corrected Corrected by Apr 6, 2022

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.

Although the file for Staff #3 contained a current health assessment, the previously administered health assessment was dated as conducted more than 24 months prior. The file for Staff #4 contained a health assessment that was completed after her first date in a child care position.

Corrected Corrected by Apr 6, 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 files for Child #2, #4, and #5 contained emergency contact forms that did not include written parental consent for the administration of minor first-aid procedures by facility staff members.

Corrected Corrected by Apr 5, 2022

Category: ratio. Marked corrected in the state record.