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 has a policy that addresses the recognition of potential signs and symptoms of shaken baby syndrome and abusive head trauma and strategies for coping with a crying, fussing, or distraught child, but it did not address the prevention and identification of child maltreatment.

Corrected Corrected by Nov 17, 2024

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 letter provided to the parent explaining emergency procedures did not address accommodations for infants, toddlers, children with disabilities, and children with chronic medical conditions.

Corrected Corrected by Nov 18, 2024

Category: physical safety. 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 #1 will have until November 30, 2024, to complete the required training. Until such time as the required training has been completed, staff person #1 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 #1, staff person #1 may not work in a child-care position at the facility.

Staff person #1 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 from a PQAS approved trainer and a PQAS approved curriculum

Corrected Corrected by Nov 26, 2024

Category: supervision. 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 of Staff #2 lacked a disclosure statement signed at the time of initial service in a child care setting (SEE LIS Code Sheet). The file of Staff #2 contained a disclosure statement dated 3/18/23.

Corrected Corrected by Nov 17, 2024

Category: background checks. 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).

Child #4 lacked child service reports completed at least every 6 months. Child #4, who had an admission date of 3/25/24, did not have a child service report in the file.

Corrected Corrected by Nov 17, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.36(b)(3) · 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.

The file of Staff #1, who was designated as an assistant group supervisor, lacked documentation of 1 year of experience with children.

Corrected Corrected by Nov 17, 2024

Category: supervision. Marked corrected in the state record.

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

On 11/4/24 observed Bic Wite-Out which indicated "keep out of the reach of children" in the top drawer of the teacher's desk which was accessible to children. On 11/4/24 observed 4 bottles of Bath and Body Works Concentrated Room Sprays, including 2 Vanilla Bean Noel, 1 Champagne Toast, and 1 Flannel, which indicated "keep out of the reach of children" on the bottom shelf above the changing table in the Toddler Room which were accessible to children.

Corrected Corrected by Nov 17, 2024

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.

On 11/4/24 observed rust on the heat register in the bathroom located in the Toddler Room.

Corrected Corrected by Nov 22, 2024

Category: physical safety. 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.

On 11/4/24 observed peeling paint on the heat register and to the right of the heat register in the bathroom located in the Toddler Room.

Corrected Corrected by Nov 22, 2024

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.

On 11/4/24 observed 2 cracked clear yellow blocks in the Preschool Room.

Corrected Corrected by Nov 17, 2024

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 agreements for Children #1, #2, #3, #4, and #5 did not specify the persons designated by a parent to whom the child may be released.

Corrected Corrected by Nov 17, 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.

Emergency contact information for Child #4 lacked the complete work address of the enrolling parent. Emergency contact information for Child #5 lacked the home telephone number of the enrolling parent.

Corrected Corrected by Nov 17, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.131(b)(2) · The operator shall require the parent to provide an updated health report at least every 12 months for an older toddler or preschool child.

The file of Child #2 lacked an updated health report at least every 12 months for an older toddler or preschool child. The file of Child #2 contained a health report dated 11/1/24 with a previous one dated 10/20/23.

Corrected Corrected by Nov 17, 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 file of Staff #3 lacked a health assessment conducted every 24 months. The file of Staff #3 contained a current health assessment dated 5/2/23 with a previous one dated 3/1/21.

Corrected Corrected by Nov 17, 2024

Category: ratio. Marked corrected in the state record.

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

On 11/4/24 observed bottles which were not labeled with the child's name in the Infant Room.

Corrected Corrected by Nov 17, 2024

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 of Staff #2 lacked documentation of completing professional development in pediatric first-aid and pediatric cardiopulmonary resuscitation within 90 days of hire (SEE LIS Code Sheet). The file of Staff #2 contained documentation of completing pediatric first aid and pediatric cardiopulmonary resuscitation on 8/28/24.

Corrected Corrected by Nov 17, 2024

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

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

The facility was unable to provide documentation that the fire detection system was manually tested at least every 30 days. The facility provided documentation that the fire detection system was manually tested on 11/3/23, 12/29/23, 1/26/24, 2/23/24, 3/22/24, 4/19/24, 5/17/24, 6/14/24, 7/12/24, 8/9/24, 9/9/24, 10/4/24, and 11/1/24.

Corrected Corrected by Nov 17, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.171(a) · An operator shall notify local traffic safety authorities annually in writing of the location of the facility and the program's use of pedestrian and vehicular routes around the child care facility.

The operator lacked documentation of notifying local traffic safety authorities annually in writing of the location of the facility and the program's use of pedestrian and vehicular routes around the child care facility. The operator provided documentation of notifying local traffic safety authorities on 10/6/23 and 11/1/24.

Corrected Corrected by Nov 17, 2024

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 written policy to identify the prevention of shaken baby syndrome, abusive head trauma, and child maltreatment does not address the prevention and identification of child maltreatment.

Corrected Corrected by Nov 19, 2023

Category: ratio. Marked corrected in the state record.

3270.27(a)(4) · The facility shall have an emergency plan that provides for a method for facility persons to inform parents that the emergency has ended and to provide instruction as to how parents can safely be reunited with their children.

The facility was observed to have an Emergency Plan that does not provide a method for facility persons to inform parents that the emergency has ended and to provide instruction as to how parents can safely be reunited with their children.

Corrected Corrected by Nov 19, 2023

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

3270.71 · Hot water pipes and other sources of heat exceeding 110° F that are accessible to children shall be equipped with protective guards or shall be insulated to prevent direct contact.

The heat pipe in the infant room which was covered in a wooden protective cover was missing the end cap and exposing the hot pipe.

Corrected Corrected by Nov 27, 2023

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

3270.124(f) · 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.

The file for child #1 was observed to contain an emergency contact that was dated 02/01/2021, and not updated until 08/16/22 therefore not updated once in a 6-month period.

Corrected Corrected by Nov 19, 2023

Category: recordkeeping. Marked corrected in the state record.

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

The file for child #1 was observed to contain a financial agreement dated 02/01/2022 with no update at least once in a 6-month period.

Corrected Corrected by Nov 19, 2023

Category: recordkeeping. Marked corrected in the state record.

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

The facilities documentation of testing every 30 days indicates that a period of 31 days occurred between the testing on January 3, 2023 and February 3, 2023.

Corrected Corrected by Nov 8, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.14 · The Emergency Plan shall include a statement regarding the continuity of operations in the event of an emergency at the facility

The facility was observed to have an Emergency Plan that did not include continuity of operations in the event of an emergency at the facility

Corrected Corrected by Dec 8, 2022

Category: ratio. Marked corrected in the state record.

3270.31(f) · Staff person(s) #1, and #2 shall complete professional development in the topics of 3270.31(f)(1-10), within 90 days of hire. Staff person(s) #1, and #2 will have until December 15, 2022 to complete the required training. Until such time as the required training has been completed, staff person(s) #1, and #2 must be supervised when interacting with children by an AGS who has completed the required training related to this citation. If there are not staff available to supervise staff person(s) #1, and #2, staff person(s) #1, and #2 may not work in a child-care position at the facility.

The files for staff person(s) #1, and #2 were observed to lack documentation of completion of the following required pre-service training within 90 days of the date of hire (see LIS code sheet): CCDBG health and safety professional development.

Corrected Corrected by Dec 8, 2022

Category: supervision. Marked corrected in the state record.

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

A clear bag containing toothpaste and other oral health products labeled with warnings to keep out of reach of children were observed to be within reach of children in the toddler space. These products were observed in a red bag, hanging on the bottom row of coat hooks mounted to the interior wall of the bathroom.

Corrected Corrected by Dec 8, 2022

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

3270.66(b) · Cleaning materials and other toxic materials shall be stored in an original labeled container or in a container that specifies the content. Toxics shall be stored away from food, food preparation areas and child care spaces.

A white bottle without an original label or label that specified contents was observed in the locked right-hand cabinet in the pre-school bathroom. Staff person #1 verified that this white bottle contained a "cleaning solution", that was not specified on the label.

Corrected Corrected by Dec 8, 2022

Category: ratio. 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.

The carpet on the 4th street side of the building in the toddler space was observed to be torn and presenting with strings and fringes posing a trip hazard. The corners of 2 metal air conditioning units present with sharp metal corners that protrude into the outdoor play space. The height of the AC unit's sharp metal corners are low enough to pose a hazard.

Corrected Corrected by Dec 8, 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.

Two plastic bins in the toddler space, one containing toy cars and one containing toy animals, were observed to have cracks and breaks, creating sharp edges, pinch and crush points.

Corrected Corrected by Dec 8, 2022

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

3270.106(f) · At least 2 feet of space is required on three sides of a bed, cot, crib or other rest equipment while the equipment is in use.

A pack and play in the infant childcare space, located in the front of the building was observed to be occupied by an infant, who was nursing with a bottle, was without at least 2 feet of space on three sides of the bed. This occupied pack and play was against the sink on one side, and against a cabinet on another side, leaving only 2 sides with the 2 feet of space.

Corrected Corrected by Dec 8, 2022

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

3270.131(d)(8) · A health report shall include a statement that age-appropriate screenings recommended by the American Academy of Pediatrics were conducted since the time of the previous health report required by this section.

The file for child #1, was observed to lack a health report that included a statement that age-appropriate screenings recommended by the American Academy of Pediatrics were conducted since the time of the previous health report required by this section.

Corrected Corrected by Dec 8, 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 file for child #2 was observed to lack written verification from a physician, physician's assistant, CRNP, the Department of Health or a local health department of an annual flu vaccine administered to an infant, toddler or preschool child in accordance with the schedule recommended by the ACIP.

Corrected Corrected by Dec 8, 2022

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

3270.131(e)(2)(i) · Exemption from immunization for religious belief or strong personal objection equated to a religious belief shall be documented by a written, signed and dated statement from the child's parent or guardian. The statement shall be kept in the child's record.

The file for child #2 was observed to lack a signed and dated statement of exemption from immunization for religious belief or strong personal objection equated to a religious belief from the child's parent or guardian.

Corrected Corrected by Dec 8, 2022

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

3270.133(3) · The label of a medication container shall identify the name of the medication and the name of the child for whom the medication is intended. Medication shall be administered to only the child whose name appears on the container.

Medication Albuterol, and Tylenol was observed to lack a label identifying the name of the child for whom the medication is intended.

Corrected Corrected by Dec 8, 2022

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

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

Medication Albuterol, was observed to be within the reach of children, specifically located in a Red bag hanging on the bottom row of coat hooks mounted to the interior wall of the bathroom in the toddler space.

Corrected Corrected by Dec 8, 2022

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

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

The file for child #1 was observed to lack written consent for administration of Albuterol medication

Corrected Corrected by Dec 8, 2022

Category: ratio. Marked corrected in the state record.

3270.133(7) · An operator is responsible to establish and maintain a medication log if prescription or nonprescription medication is administered.

The facility was observed to lack a medication Log for medication(s) Albuterol and Tylenol that was present at the facility

Corrected Corrected by Dec 8, 2022

Category: health medication. 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 was observed to have an emergency plan that did not provide for accommodations for infants, toddlers, children with disabilities, and children with chronic medical conditions.

Corrected Corrected by Dec 8, 2022

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

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

On 11/9/21 observed a pairing knife in the 2nd drawer from the bathroom door in the Toddler Classroom which was accessible to children.

Corrected Corrected by Nov 9, 2021

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

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

The files of Staff #2 and #3 lacked documentation of valid pediatric first-aid and pediatric cardiopulmonary resuscitation.

Corrected Corrected by Dec 10, 2021

Category: ratio. 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.

On 11/9/21 observed paper clips in the drawer beside the bathroom door in the Toddler Classroom which were accessible to children who are still placing objects in their mouths.

Corrected Corrected by Nov 9, 2021

Marked corrected in the state record.

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

The file of Staff #3 lacked documentation of completing the health and safety training within 90 days of hire. Staff #3 had a hire date of 6/21/21 with documentation of completing the health and safety training on 10/6/21.

Corrected Corrected by Nov 9, 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.

Staff #4 lacked documentation of mandated reporter training completed every 60 months. Staff #4 had documentation of mandated reporter training completed on 9/10/21 with previous training completed on 8/28/16.

Corrected Corrected by Nov 9, 2021

Category: recordkeeping. Marked corrected in the state record.

3270.32(a)/3270.192(4) · The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services).A facility person's record shall include a copy of requests for the criminal history record and child abuse registry clearance information, a copy of the disclosure statement and a copy of the completed clearance information required under the CPSL.

The file of Staff #1 lacked a State Police Clearance and Child Abuse Clearance updated every 60 months. The file of Staff #1 contained a State Police Clearance dated 7/14/21 with a previous one dated 7/13/16. The file of Staff #1 contained a Child Abuse Clearance dated 7/16/21 with a previous one dated 7/13/16. The file of Staff #2 lacked a valid State Police Clearance because it did not contain a disseminated by date. The file of Staff #4 lacked documentation of the National Sex Offender Registry Verification Certificate by July 1, 2020. Staff #4 had a start date of 3/5/19 with a NSOR dated 9/17/20.

Corrected Corrected by Nov 29, 2021

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

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

On 11/9/21 observed Dove deodorant which indicated "keep out of reach of children" in the drawer beside the bathroom door in the Toddler Classroom.

Corrected Corrected by Nov 9, 2021

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.

On 11/9/21 observed torn rest mats with exposed foam in the Preschool Classroom.

Corrected Corrected by Nov 17, 2021

Category: physical safety. 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 files of Children #1, #2, #3, #4, and #5 lacked the work telephone number of the enrolling parent on the emergency contact form.

Corrected Corrected by Nov 17, 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 of Child #1, a 7 month old, lacked documentation of the influenza immunization in accordance with the schedule recommended by the ACIP. The file of Child #1 also lacked documentation of the DTAP/DTP/TD and the Pneumococcal immunizations in accordance with the schedule recommended by the ACIP. The file of Child #1 contained documentation of 2 DTAP/DTP/TD immunizations and 2 Pneumococcal immunizations.

Corrected Corrected by Nov 9, 2021

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 of Staff #4 lacked a health assessment conducted every 24 months. The file of Staff #4 contained a current health assessment dated 4/12/21 with a previous one dated 3/4/19.

Corrected Corrected by Nov 9, 2021

Category: ratio. Marked corrected in the state record.

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

The facility was unable to provide a written record that the fire detection system was manually tested at least every 30 days. The facility provided a written record that the fire detection system was manually tested on 11/24/20, 12/17/20, 1/12/21, 7/1/21, 8/1/21, 9/1/21, 10/1/21, and 11/1/21.

Corrected Corrected by Nov 29, 2021

Category: recordkeeping. Marked corrected in the state record.