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.

Staff persons #1, #2, and #3 did not renew their certification in Pediatric First Aid and CPR before the expiration of the previous certification. The previous certifications were dated 11/17/21 and the current certifications are dated 7/24/24.

Corrected Corrected by Jul 23, 2024

Category: ratio. Marked corrected in the state record.

3270.75(b) · A first-aid kit must be inaccessible to children.

A first-aid kit in a classroom with older toddlers and preschoolers was accessible to children.

Corrected Corrected by Aug 7, 2024

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 for child #2 did not specify the persons designated by a parent to whom the child may be released.

Corrected Corrected by Aug 21, 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 information for child #1 did not 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

Corrected Corrected by Sep 5, 2024

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 health current health assessment for staff person #2 was dated more than 24 months after the previous assessment. The previous assessment was dated 9/20/21 and the current assessment was dated 7/22/24.

Corrected Corrected by Aug 7, 2024

Category: ratio. Marked corrected in the state record.

3270.131(a) · The operator shall require the parent of an enrolled child, including a child, a foster child and a relative of an operator or a facility person, to provide an initial health report no later than 60 days following the first day of attendance at the facility.

The records for child #2 and child #3 did not include an initial health report dated within 60 days of the first day of attendance at the facility.

Corrected Corrected by Aug 7, 2024

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

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

The facility has not conducted an annual emergency drill.

Corrected Corrected by Aug 25, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.123(a)(6) · An agreement shall specify the date of the child's admission.

The child file for Child #5 contained a financial agreement form that lacked their admission date.

Corrected Corrected by Aug 17, 2023

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.

Staff person #1, Staff person #2, Staff person #3, Staff person #4, Staff person #5, and Staff person #6, have not completed the one-hour Pennsylvania Health and Safety Update 2022 training by 12/30/22 as required per announcement C-22-06.

Corrected Corrected by Sep 29, 2023

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 Room 1 (Infant/Young Toddler Room), the bed sheet being used in a Pack N Play yard used by an infant in care was observed to be loose fitting thus allowing them to bunch up and cause a potential suffocation hazard.

Corrected Corrected by Aug 18, 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). LACKING REQUIRED HIRING DOCUMENTS: Staff Person #2 and Staff Person #3 may not work in 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 #2 and Staff Person #3 may not work in the facility.

The staff file for Staff person #2 contained a current DHS FBI clearance dated 8/15/23 which was not renewed within 60 months of the previously dated 6/15/18 DHS FBI clearance expiring. The staff file for Staff person #2 also lacked a valid State Police clearance and Child Abuse clearance; the State Police clearance on file is dated 6/13/18 and the Child Abuse clearance on file is dated 6/24/18 which are more than 60 months old. The staff file for Staff person #3 contained a current Child Abuse clearance and State Police clearance dated 7/14/23 both of which were not renewed within 60 months of the previously dated 5/16/18 Child Abuse clearance and 5/8/18 State Police clearance expiring. The staff file for Staff person #3 also lacked a valid DHS FBI clearance; the DHS FBI clearance on file is dated 5/15/18 which is more than 60 months old.

Corrected Corrected by Sep 4, 2023

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

3270.82(e) · Toilets and sinks shall be at proper heights for children using them or shall be easily approached by means of platforms or steps.

The portable sink in Room 1 (Infant/Toddler Room) and Room 2 (Older Toddler/Preschool Room), which is used by the toddlers in care, was observed to lack a platform or steps for the toddlers to use while washing their hands.

Corrected Corrected by Aug 17, 2023

Marked corrected in the state record.

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

In Room 2 (Toddler/Preschool Room) a portable sink used in the toddler diapering area for handwashing was observed to not be working.

Corrected Corrected by Aug 25, 2023

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 1 (Infant/Toddler Room), a bassinet used by an infant in care was observed to not be labeled for the use of that specific child. In Room 2 (Older Toddler/Preschool Room), the cots used for napping were observed not to be labeled for the use of specific children.

Corrected Corrected by Aug 17, 2023

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

3270.123(a)/3270.182(8) · An agreement shall be signed by the operator and the parent. 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 child file for Child #2 lacked a financial agreement form.

Corrected Corrected by Aug 18, 2023

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 child file for Child #4 contained a current financial agreement form that lacked the fee amount.

Corrected Corrected by Aug 17, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.123(a)(3) · The services to be provided to the family and the child, including the Department's approved form to provide information to the family about the child's growth and development in the context of the services being provided. The operator shall complete and update the form and provide a copy to the family in accordance with the updates regarding emergency contact information in § 3270.124(f) (relating to emergency contact information).

The child file for Child #1, Child #2, Child #3, Child #4 and child #5 lacked a child service report every 6 months.

Corrected Corrected by Aug 23, 2023

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 child file for Child #1 contained an emergency contact information form that lacked addresses for seven of the designated release persons listed.

Corrected Corrected by Aug 24, 2023

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 child file for Child #4, who is a young toddler, was observed to contain updated health reports dated 3/7/23 and 7/19/23 which was conducted more than 6 months between dates.

Corrected Corrected by Aug 17, 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 child file for Child #3 who is a preschool child. was observed to lack an updated health report; the most recent health report on file is dated 3/9/21. The child file for Child #5 who is an older toddler. was observed to lack an updated health report; the most recent health report on file is dated 7/5/21.

Corrected Corrected by Sep 29, 2023

Category: health medication. 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 childcare group settings). Child #3 and Child #5 must be dismissed from care by close of business 8/17/23 and may only return to care when the immunization record is updated or when a parent provides a written, signed exemption letter.

The child file for Child #3 lacked a flu shot for 2022 and the second dose of Hep A. The child file for Child #5 lacked a flu shot for 2022, two doses of Hep A vaccine, one dose of Varicella vaccine, the 3rd and/or 4th dose of HiB vaccine, and the fourth dose of DTAP vaccine.

Corrected Corrected by Sep 29, 2023

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 child file for Child #2 contained a current health report dated 2/24/23 that lacked a statement that the child is able to participate in childcare and is free from communicable disease.

Corrected Corrected by Aug 18, 2023

Category: health medication. 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 staff file for Staff person #1 was observed to lack two non-family references.

Corrected Corrected by Sep 4, 2023

Category: recordkeeping. 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.

Staff person #4 self-reported that after a diaper change the soiled diaper is placed in a plastic bag, tied shut, and then thrown away in the plastic-lined hands-free cover can.

Corrected Corrected by Aug 17, 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 staff file for Staff person #1 contained a current health assessment dated 8/23/22 which was not conducted prior to providing initial service in a childcare setting.

Corrected Corrected by Aug 17, 2023

Category: ratio. Marked corrected in the state record.

3270.151(c)(2) · An adult health assessment must include tuberculosis screening by the Mantoux method at initial employment. Subsequent tuberculosis screening is not required unless directed by a physician, physician's assistant, CRNP, the Department of Health or a local health department.

The staff file for Staff person #1 contained a current tuberculosis screening and results dated 8/25/22 which was not conducted prior to providing initial service in a childcare setting.

Corrected Corrected by Aug 17, 2023

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

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

Four lunchboxes that were brought in from the child's home and contained potentially hazardous foods with ice packs to keep them cold were observed being stored in the hallway and not in a refrigerator.

Corrected Corrected by Aug 18, 2023

Category: nutrition. 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 child file for Child #1, and Child #3 contained a financial agreement and an emergency contact information form that were not reviewed and updated by the parent at least once in a 6-month period; the dates of the most recent review was 9/14/22 for Child #1 and 9/12/22 for Child #3 The child file for Child #4 contained a financial agreement and an emergency contact information form that were not reviewed and updated by the parent at least once in a 6-month period; the dates of the most recent review was dated 5/25/22. The child file for Child #5 contained a financial agreement and an emergency contact information form that were not reviewed and updated by the parent at least once in a 6-month period; the dates of the most recent review was dated 5/28/21. Child #4, and Child #5 contained a financial agreement and an emergency contact information form that were not reviewed and updated by the parent at least once in a 6-month period; the dates of the most recent updates were x/xx/xx for the financial agreement and x/x/xx for the emergency contact information form.

Corrected Corrected by Sep 5, 2023

Category: recordkeeping. Marked corrected in the state record.

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

Documentation of Staff person #2's completed emergency plan training and fire safety training for 2022, which have been previously viewed by the certification representative, were observed to not be in the file at the of inspection.

Corrected Corrected by Aug 17, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.123(a)(6) · An agreement shall specify the date of the child's admission.

The child file for Child #3, Child #4, Child #5 contained a financial agreement form that lacked the child's admission date.

Corrected Corrected by Aug 11, 2022

Category: recordkeeping. 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 staff file for Staff person #1, Staff person #2, Staff person #4, and Staff person #6 lacked a completed staff evaluation for 2021.

Corrected Corrected by Sep 16, 2022

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 #1 and Staff person #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 person(s) available to supervise Staff person #1 and Staff person #4 may not work in a child-care position at the facility.

The facility lacked a handwritten policy and procedure identifying the prevention of shaken baby syndrome, abusive head trauma, and child maltreatment. Staff person #1 and Staff person #4 were observed to be caring for children unsupervised. Staff person #1, and Staff person #4 have not completed the following pre-service training required prior to caring for children unsupervised: Mandated Reporter Training.

Corrected Corrected by Sep 16, 2022

Category: supervision. Marked corrected in the state record.

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

In Room #2 (Toddler/PS Room) the teachers desk located on the toddler side of the room was observed to contain a pair of adult scissors and a stapler inside the top right drawer of the desk which was unlocked making the scissors accessible to the toddlers in care. On the preschool side of the room four adult scissors and two claw stapler removers were observed inside an unlocked second top drawer of a plastic white storage unit thus making them accessible to the preschool aged children in care.

Corrected Corrected by Aug 11, 2022

Category: health medication. 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 staff file for Staff person #2 lacked fire safety training for 2021, the last documented fire safety training on file is dated 11/16/20.

Corrected Corrected by Oct 21, 2021

Category: recordkeeping. Marked corrected in the state record.

3270.31(f) · Staff person(s) shall complete professional development in the topics of 3270.31(f)(1 -- 10) within 90 days of hire. Staff person #3 will have until 9/6/22 to complete the required 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 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 following required pre-service training within 90 days of their date of hire (see LIS code sheet): Pediatric First Aid/CPR.

Corrected Corrected by Aug 31, 2022

Category: supervision. 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 staff file for Staff person #3 contained documentation of health and safety training dated 8/2/22 which was completed more than 90 days from date of hire (See IS CODE SHEET).

Corrected Corrected by Aug 11, 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). LACKING REQUIRED HIRING DOCUMENTS: Facility Person #3 -- 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. Facility Person #3 may not work at the facility.

The staff file for Staff person #3 and Staff person #5 lacked a disclosure statement and a DHS FBI clearance. Staff person #3 contained a National Sex Offender Registry (NSOR) certificate dated 4/19/22 and there was no proof of application of having applied for the NSOR certificate on file prior to working with children. The staff file for Staff person #5 contained a NSOR certificate dated 6/9/21 and there was no proof of application of having applied for the NSOR certificate on file prior to working with children. [See IS CODE SHEET]

Corrected Corrected by Sep 6, 2022

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 #1 and Staff person #4 will have until 9/6/22 to complete the mandated reporter training. Until such time as the required training has been completed, Staff person #1 and Staff person #4 must be supervised, when interacting with children, by an (AGS, primary staff person, or family child care home staff person) who has completed the required training related to this citation. If there are no staff person(s) available to supervise Staff person #1 and Staff person #4, Staff person #1 and Staff person #4 may not work in a child-care position at the facility.

Staff person #1 and Staff person #4 have not completed mandated reporter training within the last 60 months. This is evidenced by the previously documented mandated reporter training on file being dated 3/28/16 for Staff person #2 and 3/8/17 for Staff person #4.

Corrected Corrected by Sep 5, 2022

Category: supervision. Marked corrected in the state record.

3270.34(b)(1)/3270.192(2)(ii) · A director shall have attained a bachelor's degree 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.

The staff file for Staff person #3, who is functioning as the director, lacked proof of education and documentation of 1 year of experience working with children.

Corrected Corrected by Sep 16, 2022

Category: recordkeeping. 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 #2 (Toddler/PS Room) a 6 outlet surge protector located to the left of the teachers desk, and accessible to children under 5 years of age, was observed to be missing 4 protective receptacle covers.

Corrected Corrected by Aug 11, 2022

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 #2 (Toddler/PS Room) the teachers desk located on the toddler side of the room was observed to contain a 1oz. travel sized hand sanitizer inside the top right drawer of the desk which was unlocked making the hand sanitizer accessible to the toddlers in care. On the preschool side of the room, a bottle of hand sanitizer labeled 'Keep Out of Reach of Children' was observed on the teacher desk accessible to the preschool age children in the room. In the hallway a tube of Destin diaper crème labeled 'Keep Out of Reach of Children' was observed inside a red plastic bin located on the bottom right hand corner of a shelving unit to the right of the preschool room doorway causing the diaper crème to be accessible to the children in care.

Corrected Corrected by Aug 11, 2022

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

3270.76 · Floors, walls, ceilings and other surfaces, including the facility's outdoor play space surfaces shall be kept clean, in good repair and free from visible hazards.

In Room #2 (Toddler/PS Room) the rubber wall cove base located to the left of the exit door was observed to be detached from the wall causing it not to be in good repair. In Room #3 (PreK Room) the rubber wall cove base located underneath the white shelving unit was observed to be detached from the wall causing it not to be in good repair.

Corrected Corrected by Sep 16, 2022

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.

The metal chain link fence surrounding the outdoor play space was observed to have 4 exposed bolts facing inward; 2 exposed bolts were observed on the fence located to the left of the plastic toy play structure, 1 exposed bolt was observed to the left of the walk-thru chain link fence towards the back right corner of the fence, and 1 exposed bolt was observed on the bottom left corner of the chain link fence when facing the field.

Corrected Corrected by Sep 16, 2022

Category: physical safety. 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 child file for Child #3 contained a financial agreement form that lacked the name(s) of the person(s) designated by the parent to whom the child may be released to.

Corrected Corrected by Sep 2, 2022

Category: recordkeeping. 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 child file for Child #4 contained an emergency contact information form that lacked the health insurance name and policy number.

Corrected Corrected by Sep 16, 2022

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 child file for Child #2, Child #3, and Child #5 contained an emergency contact information form that lacked the addresses of the individuals designated by the parent to whom the child may be released to.

Corrected Corrected by Sep 16, 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 child file for Child #3, who is a young toddler [See IS CODE SHEET], was observed to lack an updated health report at least every 6 months; the most recent health report on file is dated 6/21/21. The child file for Child #4, who was a young toddler [See IS CODE SHEET], was observed to lack an updated health report at least every 6 months; the most recent health report on file is dated 8/13/21.

Corrected Corrected by Sep 16, 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 child file for Child #2, who is a preschool aged child [See IS CODE SHEET], lacked an updated health assessment at least every 12 months; the most recent health report on file is dated 12/14/20. The child file for Child #5, who is a preschool aged child [See IS CODE SHEET], lacked an updated health assessment at least every 12 months; the most recent health report on file is dated 3/9/21.

Corrected Corrected by Sep 16, 2022

Category: health medication. 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 child file for Child #2, Child #3, and Child #5 lacked a flu shot for 2021.

Corrected Corrected by Aug 11, 2022

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 staff file for Staff person #1 lacked an updated health assessment; the most recent health assessment on file is dated 10/14/19 which is more than 24 months old.

Corrected Corrected by Sep 16, 2022

Category: ratio. Marked corrected in the state record.

3270.151(c)(2) · An adult health assessment must include tuberculosis screening by the Mantoux method at initial employment. Subsequent tuberculosis screening is not required unless directed by a physician, physician's assistant, CRNP, the Department of Health or a local health department.

The staff file for Staff person #5, was observed to contain a tuberculosis screening test results dated 9/9/21 which was not conducted prior to providing initial service in a child care setting (See IS CODE SHEET).

Corrected Corrected by Aug 11, 2022

Category: health medication. 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 one bottle used by an infant in care was observed to not be labeled with the child's name.

Corrected Corrected by Aug 11, 2022

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 child file for Child #1 contained a financial agreement and an emergency contact information form that were not reviewed and updated by the parent at least once in a 6-month period; the dates of the most recent update were 8/16/21 for the financial agreement and 8/17/21 for the emergency contact information form. The child file for Child #4 contained a financial agreement and an emergency contact information form that were not reviewed and updated by the parent at least once in a 6-month period; the dates of the most recent update were 3/14/21 for the financial agreement and 1/24/22 for the emergency contact information form. The child file for Child #5 contained a financial agreement and an emergency contact information form that were not reviewed and updated by the parent at least once in a 6-month period; the dates of the most recent update were 3/25/21 for the financial agreement and 12/3/21 for the emergency contact information form.

Corrected Corrected by Sep 16, 2022

Category: recordkeeping. Marked corrected in the state record.

3270.182(3) · A child's record shall contain signed parental consent for emergency medical care for the child. Written consent is required prior to admission.

The child file for Child #4 and Child #5 contained an emergency contact information form that lacked signed parental consent for emergency medical care for the child.

Corrected Corrected by Sep 16, 2022

Category: recordkeeping. 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 child file for Child #4 and Child #5 contained an emergency contact information form that lacked signed parental consent for administration of minor first-aid procedures by facility staff.

Corrected Corrected by Sep 16, 2022

Category: ratio. Marked corrected in the state record.

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

The facility has not conducted an annual emergency drill.

Corrected Corrected by Aug 16, 2022

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.

Upon review of the facility's 30 day fire alarm testing log the tests conducted on 6/17/22 and 7/18/22 were observed to be more than 30 days.

Corrected Corrected by Aug 15, 2022

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 facility's certificate of compliance was observed to not be current as evidence by the date of expiration on the posted certificate of compliance was 11/11/21.

Corrected Corrected by Aug 12, 2022

Category: ratio. Marked corrected in the state record.

3270.31(e) · A staff person shall obtain an annual minimum of 12 clock hours of child care training.

The staff file for Staff person #1 contained 6 of 12 clock hours of childcare training completed for 12/19/20 - 12/19/21. The staff file for Staff person #2, Staff person #4, and Staff person #6 lacked 12 clock hours of childcare training completed for 12/19/20 - 12/19/21.

Corrected Corrected by Sep 16, 2022

Category: recordkeeping. 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.

Room 1 lacked a handwashing sign at the diapering area.

Corrected Corrected by Sep 3, 2021

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

3270.111(b) · The written plan of daily activities shall be posted in the group space.

Room 3 lacked a posting of the written plan of daily activities.

Corrected Corrected by Sep 3, 2021

Category: physical safety. 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.

Child files #1 and #2 lacked the date of admission on the agreement form.

Corrected Corrected by Sep 6, 2021

Category: recordkeeping. 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 file #1 lacked the health insurance coverage and policy number on the emergency contact form.

Corrected Corrected by Sep 8, 2021

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

3270.31(f) · Staff persons shall complete professional development in the following topics within 90 days of hire:

Staff file #3 lacked documentation of completion of Health and Safety training topics within 180 days of regulation.

Corrected Corrected by Oct 31, 2021

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.

Staff file #6 lacked a dated copy of the most current disclosure form in the file.

Corrected Corrected by Aug 31, 2021

Category: background checks. 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.

Room 2 lacked a protective receptacle cover in an outlet located near the refrigerator and accessible to children who are 5 years and younger.

Corrected Corrected by Aug 31, 2021

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 2 lacked soap in the kit.

Corrected Corrected by Sep 2, 2021

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

3270.78/3270.113(a) · Rooms, hallways, stairways, outside steps, porches and ramps shall be lighted by artificial or natural light.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. Children must be supervised at all times.

There was not enough lighting in room 1 for staff to supervise the infants and young toddlers who were sleeping in the pack n plays.

Corrected Corrected by Sep 2, 2021

Category: supervision. 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.

Staff file #3 lacked an updated health assessment within 24 months of last health assessment dated 11/14/18.

Corrected Corrected by Sep 20, 2021

Category: ratio. Marked corrected in the state record.

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

The facility lacked an emergency plan with accommodations for infants, toddlers, children with disabilities, and children with chronic medical conditions.

Corrected Corrected by Sep 17, 2021

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

3270.31(f)(10) · Pediatric first aid and pediatric cardiopulmonary resuscitation.

All staff files lacked documentation of completion of pediatric first aid and pediatric CPR completed within 180 days of the regulation effective date of 12/19/2020.

Corrected Corrected by Oct 31, 2021

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

3270.33(d) · One or more facility persons competent in pediatric first-aid and pediatric cardiopulmonary resuscitation techniques shall be at the facility when one or more children are in care.

The facility lacked one or more staff persons competent in pediatric first-aid and pediatric CPR on site while the children were in care.

Corrected Corrected by Oct 30, 2021

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