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 shaken baby syndrome, abusive head trauma and child maltreatment policy did not include the prevention and identification of child maltreatment. The facility's emergency plan did not include continuity of operations.

Corrected Corrected by May 5, 2025

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.

Loose sheets were observed in a crib in use by an infant, which poses a suffocation hazard for the child using the equipment.

Corrected Corrected by May 5, 2025

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's parent letter did not include their lockdown procedure and their plan to provide accommodations for infants and toddlers, children with disabilities, and children with chronic medical conditions.

Corrected Corrected by May 6, 2025

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). 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 #4 may not work in a child care position at the facility.

The record for staff #4 lacked a disclosure statement and included a PA state police clearance that did not have a dissemination date, which is not considered a valid clearance.

Corrected Corrected by May 5, 2025

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

3270.34(b)(3)/3270.192(2)(ii) · A director shall have attained an associate's degree from an accredited college or university in early childhood education, child development, special education, elementary education or the human services field and 3 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.

The record for staff #1, who was identified as the director, lacked verification of 3 years of experience with children.

Corrected Corrected by Apr 29, 2025

Category: recordkeeping. Marked corrected in the state record.

3270.36(b)(5)/3270.192(2)(ii) · An assistant group supervisor shall have a high school diploma or a general educational development certificate and 2 years experience with children. A facility person's record shall include verification of child care experience, education and training prior to service at the facility.

The record for staff #2, who was identified as an AGS, lacked verification of a HS diploma.

Corrected Corrected by May 7, 2025

Category: supervision. 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.

Based on a conversation with staff, the facility retained the original agreement for all enrolled children.

Corrected Corrected by May 5, 2025

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 #1 did not include the work telephone number of the enrolling parent.

Corrected Corrected by May 5, 2025

Category: recordkeeping. Marked corrected in the state record.

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

The emergency contact information for child #1 and #2 did not include the address of the individual designated by the parent to whom the child may be released.

Corrected Corrected by May 5, 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.

A parent did not review and update the emergency contact information for child #1 at least once in a 6-month period between 6/18/2024 and 1/2/2025.

Corrected Corrected by May 5, 2025

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.

The diaper cans used to discard disposable diapers in the infant room and the toddler room were not hands-free.

Corrected Corrected by May 2, 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 record for staff #3 lacked a health assessment.

Corrected Corrected by May 7, 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.

The record for staff #2 did not include the results of a TB test.

Corrected Corrected by May 7, 2025

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

3270.165 · An operator shall conspicuously post the menu at least 1 week in advance or provide a menu to each family.

The operator did not post the menu at least 1 week in advance.

Corrected Corrected by May 5, 2025

Marked corrected in the state record.

3270.193(a) · Facility persons' records are confidential and shall be stored in a locked cabinet.

The facility persons' records were not stored in a locked cabinet.

Corrected Corrected by Apr 29, 2025

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 fire detection system was not tested at least once in a 30-day period between 11/1 and 12/2/2024; and 12/2 to 1/2/2025.

Corrected Corrected by Apr 29, 2025

Category: recordkeeping. Marked corrected in the state record.

3270.18(a) · The legal entity shall have comprehensive general liability insurance to cover the persons who are on the premises. A current copy of the insurance policy shall be on file at the facility.

The legal entity did not have comprehensive general liability insurance to cover the persons who are on the premises.

Corrected Corrected by Jul 31, 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.

The emergency plan did not address continuity of operations.

Corrected Corrected by Jul 15, 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 parent letter explaining the emergency procedures that the operator provided to the parent of each enrolled child did not include the method to inform parents an emergency has happened, a method to inform parents the emergency has ended and how to safely be reunited with their children, or accommodations for infants, toddlers, children with disabilities and children with chronic medical conditions.

Corrected Corrected by Jul 15, 2024

Category: physical safety. 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 baseboard in the infant room to the left was peeling away from the wall. Outside in the outdoor play space is a tree stump that is rotting and falling apart causing a visible hazard.

Corrected Corrected by Jul 15, 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.

There was damaged plaster to the right of the infant room door.

Corrected Corrected by Jul 15, 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.

In the preschool and older toddler room there where cracked magna tiles with sharp edges. On the fence to the outside play space accessible to children were 7 exposed bolts.

Corrected Corrected by Jul 15, 2024

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

3270.103 · Toys and objects with a diameter of less than 1 inch, objects with removable parts that have a diameter of less than 1 inch, plastic bags and styrofoam objects may not be accessible to children who are still placing objects in their mouths.

In the preschool and older toddler room their where small stampers less than an inch in diameter and foam painters in plastic pull out drawers by the closet accessible to children still placing objects in their mouths.

Corrected Corrected by Jul 15, 2024

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 file #1, 3, and 5 did not contain a child service report.(See LIS code sheet) Child #2 file contain services reports date 11/1/22 and 3/31/24 which was more than 6 months apart. Child #4 contain a service report that was dated 3/1/23 more than 6 months ago.

Corrected Corrected by Jul 17, 2024

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 #4 file did not have an address for the child's physician or source of medical care.

Corrected Corrected by Jul 15, 2024

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 #1 file did not contain a work phone number for the enrolling parent.

Corrected Corrected by Jul 19, 2024

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 #1 file did not contain the child's health insurance/MA coverage.

Corrected Corrected by Jul 19, 2024

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 #4 file did not contain release person's address. Child #5 file the release person's address did not contain house numbers or street names

Corrected Corrected by Jul 17, 2024

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.

Child #3 emergency contact was reviewed 8/28/23 and then again 7/2/24 which was more than 6 months apart.

Corrected Corrected by Jul 15, 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.

Child #2 file contained health reports dated 3/14/23 and 4/8/24 more than 12 months apart.

Corrected Corrected by Jul 15, 2024

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

3270.131(d)(5)/3270.131(e)(1) · A health report shall include a review of the child's immunized status according to recommendations of the ACIP. The facility shall require the parent to provide updated written verification from a physician, physician's assistant, CRNP, the Department of Health or a local health department of ongoing vaccines administered to an infant, toddler or preschool child in accordance with the schedule recommended by the ACIP.

The immunization record on file for Child #2, older toddler age child, includes 3 of 4 Pneumococcal vaccines recommended by the ACIP for a child this age and 0 of 2 Hepatitis A vaccines recommended by the ACIP for a child this age(See LIS Code Sheet).

Corrected Corrected by Jul 19, 2024

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

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

Child #3 financial agreement was signed and dated 8/28/23 more than 6 months prior.

Corrected Corrected by Jul 15, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.183(a) · Child records are confidential and shall be stored in a locked cabinet.

The child records are not stored in a locked cabinet they stored in a locked closet in the Preschool/Older toddler room.

Corrected Corrected by Jul 24, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.31(g) · Completion of professional development shall be documented by the signature and title of a representative of the professional development entity and include the date professional development was completed. Documentation shall be retained in the facility person's file or maintained in an electronic system as designated by the Department. Documentation of the completion of the professional development under subsection (f) taken from September 30, 2016, forward satisfies this requirement.

The file for staff #1 contained a 6-hour Health and Safety training that was taken on 11/4/18 which is not an acceptable Health and Safety training.

Corrected Corrected by Jul 15, 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 fire alarm testing log included testing dates 2/7/24-3/12/24(34 days), (3/2/24-4/16/24(35 days), and 4/16/24-5/22/24(36 days) which are more than 30 days apart.

Corrected Corrected by Jul 15, 2024

Category: recordkeeping. Marked corrected in the state record.

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

The file for child #1 does not contain a signed health report within 60 days of child's enrollment(See LIS Code Sheet).

Corrected Corrected by Jul 19, 2024

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

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

The operator did not have written letter to notify local traffic safety authorities.

Corrected Corrected by Jul 15, 2024

Marked corrected in the state record.