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

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

Corrected Corrected by Mar 22, 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 facility lacked an updated letter to the parents of enrolled children explaining the accommodations for infants, toddlers and children with special needs and medical conditions and the continuity of operations updates that were made to the emergency plan.

Corrected Corrected by Mar 22, 2024

Category: ratio. 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.

There were bottles with bleach/cleaning solutions located in the older toddler room and the supply closet in the kitchen that were not labeled with the contents of the bottles.

Corrected Corrected by Mar 22, 2024

Category: ratio. Marked corrected in the state record.

3270.75(a) · A first-aid kit shall be in a child care space.

The eating room lacked a first aid kit in the space while children are eating meals and snacks.

Corrected Corrected by Mar 22, 2024

Category: health medication. 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 files #1, #2 and #4 lacked copies of child service reports conducted every 6 months and provided to the families of the enrolled children.

Corrected Corrected by Mar 22, 2024

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.

Child files #1, #2 and #3 lacked the addresses of the persons to whom the child may be released on the emergency contact forms.

Corrected Corrected by Mar 22, 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 files #1, #2 and #4 lacked parent review and signature on the emergency contact form and the agreement form every 6 months as required.

Corrected Corrected by Mar 22, 2024

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.

Child file #1 contained health report dated 3/14/23 but lacked a subsequent health report every 6 months as required for a young toddler. (See LIS CODE SHEET)

Corrected Corrected by Mar 22, 2024

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.

Child file #4 contained health report dated 1/18/23 but lacked a subsequent health report every 12 months as required for an older toddler. (See LIS CODE SHEET)

Corrected Corrected by Mar 22, 2024

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 child care group settings).

Child file #4 lacked documentation of the 2nd Hepatis A vaccination according to the schedule recommended by the ACIP.

Corrected Corrected by Mar 22, 2024

Category: health medication. 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.

Child file #2 contained an initial health report dated 1/25/22 which was more than 60 days after the child's admission to the facility. (See LIS CODE SHEET)

Corrected Corrected by Mar 22, 2024

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

3270.72(d) · Windows or doors above the ground floor that open directly to the outdoors and are accessible to children shall be constructed, modified or adapted to limit the opening to 6 or fewer inches.

The large window in the infant room which is above ground level was able to be opened more than 6 inches and accessible to the children in care.

Corrected Corrected by Feb 23, 2022

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 operator lacked updated sections in their emergency plan that addresses volunteer emergency preparedness training and the operators plans for continuity of operations in response to an emergency.

Corrected Corrected by Mar 20, 2023

Category: ratio. Marked corrected in the state record.

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

Staff person #1 completed the Pennsylvania Health and Safety Update 2022 on 1/2/23 which was after the required date for completion of 12/30/22. Staff person #2 completed the Pennsylvania Health and Safety Update 2022 on 1/3/23 which was after the required date for completion of 12/30/22. Staff person #4 completed the Pennsylvania Health and Safety Update 2022 on 1/2/23 which was after the required date for completion of 12/30/22. Staff person #5 completed the Pennsylvania Health and Safety Update 2022 on 1/2/23 which was after the required date for completion of 12/30/22.

Corrected Corrected by Jan 3, 2023

Category: ratio. Marked corrected in the state record.

3270.32(a) · The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). Staff person #3 will have until 3/21/23 to complete the mandated reporter training. Until such time as the required training has been completed, staff person #3 must be supervised, when interacting with children, by an AGS who has completed the required training related to this citation. If there are no staff person(s) available to supervise staff person #3, staff person #3 may not work in a child-care position at the facility.

Staff person #3 has not completed mandated reporter training within the last 60 months. This is evidenced by the previously documented mandated reporter training on file being competed on 2/6/18.

Corrected Corrected by Feb 23, 2022

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

Staff person #4 file contained a PDE FBI Clearance dated 7/14/21 which is not acceptable for a valid DHS FBI clearance according to the CPSL. Staff person #5 contained a valid NSOR verification dated 2/6/23 which was not obtained within 45 days of initial employment. (See LIS CODE SHEET)

Corrected Corrected by Feb 23, 2022

Category: background checks. 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.

Child file #3 lacked written consent signed by a parent for emergency medical care on the emergency contact form.

Corrected Corrected by Mar 15, 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.

Child files #1, #2, and #3 lacked the address and telephone number of the release persons as designated by the parent on the emergency contact forms.

Corrected Corrected by Mar 20, 2023

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.

Child files #2, #3 and #4 lacked documentation of influenza vaccination in accordance with the schedule recommended by the ACIP or an exemption from the influenza vaccination in the child's file.

Corrected Corrected by Mar 20, 2023

Category: health medication. 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 facility lacked a plastic-lined, hands-free covered can to discard soiled diapers into in the diapering area.

Corrected Corrected by Mar 15, 2023

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

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

Staff file #2 lacked documentation of previous child care experience in the file.

Corrected Corrected by Mar 15, 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 facility lacked copy of the proof of purchase for their interconnected fire detection system as required.

Corrected Corrected by Mar 15, 2023

Category: recordkeeping. 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.

Child file #2 contained an initial health report dated 2/1/23 which was not obtained within 60 days of attendance at the facility. (See LIS CODE SHEET)

Corrected Corrected by Mar 15, 2023

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

3270.123(a)(4) · An agreement shall specify the child's arrival and departure times.

The Agreement in the file for Child #4 did not specify the child's departure time.

Corrected Corrected by Feb 23, 2022

Category: recordkeeping. Marked corrected in the state record.

3270.131(c) · A health report must be written and signed by a physician, physician's assistant or a CRNP. The signature must include the individual's professional title.

The Health Report for Child # 2 lacked a signature by a physician, physician's assistant or a CRNP and the individual's professional title.

Corrected Corrected by Feb 23, 2022

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: (1) Prevention and control of infectious diseases (including immunization); (2) Prevention of Sudden Infant Death Syndrome and use of safe sleep practices; (3) Administration of medication, consistent with standards for parental consent; (4) Prevention of and response to emergencies due to food and allergic reactions; (5) Building and physical premises safety, including identification of and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, and vehicular traffic; (6) Prevention of shaken baby syndrome and abusive head trauma; (7) Emergency preparedness and response planning for emergencies resulting from a natural disaster or a man-caused event (such as violence at a child care facility); (8) Handling and storage of hazardous materials and appropriate disposal of bio contaminants; (9) Precautions when transporting children.

The file for Staff #3 (start date 9/13/21) contained Health and Safety Basic training obtained after 90 days.

Corrected Corrected by Feb 23, 2022

Category: ratio. Marked corrected in the state record.

3270.32(a)/3270.192(2)(iii) · The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). A facility person's record shall include verification of child care experience, education and training following the outset of service at the facility.

The file for Staff #1 contained mandated reporter training that was not completed within 60 months of the previous training, 12/1/16 and 2/6/22. The file for Staff #3 contains verification of mandated reporter training completed more than 90 days after staff began employment.

Corrected Corrected by Feb 23, 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 #1 and #3 may not work in a child care position at the facility.

The file for Staff #1 contained a State Police clearance that was not obtained within 60 months of the previous clearance (7/26/16 and 2/4/22). The file for Staff #1 contained expired Child Abuse (7/28/16) and FBI (7/27/16) clearances. The file for Staff #3 (start date 9/13/21) lacked a NSOR certificate.

Corrected Corrected by Feb 23, 2022

Category: background checks. 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.

Located in the Preschool/Older Toddler Room there was Paint and Bubbles labeled "Chocking Hazard: Not for Children under 3 years" in an unlocked cabinet.

Corrected Corrected by Feb 23, 2022

Category: physical safety. 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 Agreement for Child #3 lacked the amount of the fee to be charged.

Corrected Corrected by Feb 23, 2022

Category: recordkeeping. Marked corrected in the state record.

3270.123(a)(2) · An agreement shall specify the date on which the fee is to be paid.

The Agreement for Child #2 and Child #3 lacked the date on which the fee is to be paid.

Corrected Corrected by Feb 23, 2022

Category: recordkeeping. 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 Health Report for Child #2 lacked a statement indicating the child is able to participate in child care and appears to be free from contagious or communicable disease.

Corrected Corrected by Feb 23, 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 Health Reports for the following children lacked verification of ongoing vaccines in accordance with the schedule recommended by the ACIP. The Reports for Child #1, #2, and #3 lacked an influenza vaccination.

Corrected Corrected by Feb 23, 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.

The files for Staff #1 and Staff #2 contained a health assessment that was conducted more than 24 months after the previous assessment.

Corrected Corrected by Feb 23, 2022

Category: ratio. Marked corrected in the state record.

3270.166(1) · A written statement giving the formula and feeding schedule for an infant shall be obtained from the parent.

The file for Child #5, an infant, lacked a written formula and feeding schedule obtained from the parent.

Corrected Corrected by Feb 23, 2022

Category: nutrition. Marked corrected in the state record.

3270.31(f)(10)/3270.31(h) · Staff persons shall complete professional development in the following topics within 90 days of the date of hire: pediatric first aid and pediatric cardiopulmonary resuscitation.

The file for Staff #3 (start date 9/13/21) did not contain professional development in Pediatric First Aid and Pediatric CPR.

Corrected Corrected by Feb 23, 2022

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