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 #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 was observed to be caring for children unsupervised. Staff person #3 does not have current pediatric first-aid/CPR training. This is evidenced by the previously documented pediatric first-aid/CPR training expiration date of 11/13/22.

Corrected Corrected by Feb 14, 2025

Category: supervision. 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.

It was observed that the lockdown procedures and accommodations for infants, toddlers, children with disabilities, and children with chronic medical conditions were not explained in the parent letter.

Corrected Corrected by Feb 17, 2025

Category: physical safety. 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 file for staff person #1 lacked Pediatric First-Aid and CPR training that was completed within 90 days of hire (See LIS Code Sheet) as listed in subsections (f)1-10. The Pediatric First-Aid and CPR training in the file was dated 11/19/24.

Corrected Corrected by Feb 11, 2025

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

The file for staff person #2 who was hired as an assistant group supervisor on (See LIS Code Sheet) lacked child abuse and FBI clearances that were completed 60 months from the previous clearances. The child abuse clearances in the file were dated 3/10/19 and 3/11/24. The FBI clearances in the file were dated 6/24/19 and 7/17/24. The file for staff person #5 who was hired as an assistant group supervisor on (See LIS Code Sheet) lacked a child abuse clearance that was completed 60 months from the previous clearance. The child abuse clearances in the file were dated 5/28/19 and 6/26/24.

Corrected Corrected by Feb 11, 2025

Category: supervision. 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 lacked 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 Feb 24, 2025

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

3270.151(a)/3270.151(c)(2) · 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. 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 file for staff person #4 lacked a tuberculosis screening by the Mantoux method that was conducted within 12 months prior to providing initial service in a child care setting (See LIS Code Sheet).

Corrected Corrected by Feb 11, 2025

Category: ratio. Marked corrected in the state record.

3270.113(c) · A facility person may not single out the child for ridicule, threaten harm to the child or the child's family and may not specifically aim to degrade the child or the child's family.

Staff #1 singled out a child by taping their shoes to their ankles to prevent them from taking them off.

Corrected Corrected by Oct 29, 2024

Marked corrected in the state record.

3270.111(c) · Daily activities shall promote the development of skills, social competence and self-esteem. Daily experiences shall recognize the child as an individual and give some choice of activities that respect personal privacy, lifestyle and cultural background.

Daily experiences did not recognize a child as an individual and give some choice of activities that respect personal privacy when staff #1 taped the child's shoes to their ankles to prevent them from taking them off.

Corrected Corrected by Oct 29, 2024

Category: background checks. 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 Certificate of Liability Insurance on file at the time of the inspection lacked verification that the location was covered by the policy. The Certificate included another location address operated by the Legal Entity.

Corrected Corrected by Feb 8, 2024

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.

One uncovered electrical outlet was observed in Classroom 3.

Corrected Corrected by Feb 8, 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.

In Classroom 1, a heating vent cover on the floor was observed to be in disrepair allowing access to a sharp clip intended to connect the vent to the floor.

Corrected Corrected by Mar 8, 2024

Category: physical safety. 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.

A hand washing sign was missing from the toilet and the urinal in the restroom in Classroom 5.

Corrected Corrected by Feb 23, 2024

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

3270.82(i) · A toilet area, training chair area, diapering area and sink area shall be equipped with a clean, lidded waste receptacle.

The lids were missing from the garbage can at the classroom sink and in the restroom in Classroom 5.

Corrected Corrected by Feb 8, 2024

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 updates to the health reports on file for Child #1 exceeded 12 months between examinations on 9.9.22 and 12.2.23.

Corrected Corrected by Feb 8, 2024

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

3270.133(5) · Medication shall be stored in accordance with the manufacturer's or health professional's instructions on the original label.

One expired Motrin was observed in the medication box in Classroom 2.

Corrected Corrected by Feb 8, 2024

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

3270.151(c)(3) · An adult health assessment must include an examination for communicable diseases and the results of that examination.

The health assessment on file for Staff Person #2 lacked information related to an examination for communicable diseases.

Corrected Corrected by Mar 8, 2024

Category: health medication. 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 file for Staff Person #1 lacked 1 of their 12 hours of child care training in their respective training year (December 2022 through December 2023).

Corrected Corrected by Feb 8, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.27(a)(3)/3270.27(a)(4) · The facility shall have an emergency plan that provides for a method for facility persons to contact parents as soon as reasonably possible when an emergency situation arises. 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 emergency plan lacked information as to the method for facility persons to contact the parents to inform them that an emergency situation has arisen and instructions as to how the parent can be safety reunited with their children once the emergency situation has ended.

Corrected Corrected by May 9, 2023

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

3270.72(b) · Windows or doors used for ventilation shall be screened when open.

Upon arrival to the facility the window to Classroom #1 was observed to be open and two young toddlers were seen waving their hands outside the open window. There was no screen in the window.

Corrected Corrected by May 15, 2023

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.

The emergency contact form for Child #4 lacked the complete address information and the telephone number of the physician for the child.

Corrected Corrected by May 12, 2023

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

3270.124(c) · When children are in the facility, emergency contact information shall be present in a child care space for children receiving care in the space.

An emergency contact form was missing for a Preschool Age Child receiving care in Classroom #4.

Corrected Corrected by May 10, 2023

Category: recordkeeping. 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). Children #1, #2 and #4 will be dismissed from the facility at the close of business on 5.9.23.

The immunization records on file for Children #1, #2 and #4 lacked verification that the children have received an annual influenza vaccination as recommended by the ACIP.

Corrected Corrected by May 12, 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 hands free can in place at the changing table in Classroom #1 did not open when the foot pedal was pressed. This did not allow for soiled diapers to be disposed of without touching the lid of the can.

Corrected Corrected by May 10, 2023

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

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

An unlabeled bottle, intended for a child in care, was observed in the refrigerator in classroom #2.

Corrected Corrected by May 9, 2023

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 updates to the emergency contact form and financial agreements for Child #1 have exceeded 6 months since last review. The emergency contact form was dated 10.7.22 and the agreement was dated 9.26.22. The forms had been completed under ownership of the prior Legal Entity.

Corrected Corrected by May 19, 2023

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 emergency contact form for Child #3 lacked signed parental consent for administration of minor first aid by facility staff.

Corrected Corrected by May 12, 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.

The emergency plan on file lacked information related to the continuity of operations in the aftermath of a disaster at the facility as required by Federal Regulation.

Corrected Corrected by Feb 1, 2023

Category: ratio. Marked corrected in the state record.

3270.31(e)(4)(ii) · Staff persons shall participate, at least annually, in firesafety training conducted by a fire protection professional. Staff persons and volunteers shall receive training in maintenance of smoke detectors, the duties of facility persons during a fire drill and during a fire and the use of the facility's fire extinguishers, not including discharge of the fire suppressant agent.

The updates to the fire safety trainings on file for Facility Person #7 exceeded 12 months between trainings occurring on 1.25.21 and 2.3.22.

Corrected Corrected by Feb 1, 2023

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). Facility Person #3, #10. #1, #4, #5 and #9 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, #10, #1, #4, #5 and #9 may not work at the facility.

The files for Facility Person's #3 and #10 lacked required Out of State Clearances for States that they have resided in during the last 5 years. The requests for these clearances were not on file at the time of the inspection. The files for Facility Person's #1, #2, #3, #4, #5, #6, #7, #8, #9 and #11 lacked a signed copy of the current disclosure statement. The signed disclosure statements on file were older versions and did not include all needed information as required by the CPSL.

Corrected Corrected by Feb 1, 2023

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

3270.74 · The telephone number of the nearest hospital, police department, fire department, ambulance and poison control center shall be posted by each telephone in the facility.

The telephone numbers for the nearest hospital, police department, fire department, ambulance and poison control center were not posted at the telephone in Classroom #5.

Corrected Corrected by Feb 1, 2023

Category: physical safety. 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.

A hand washing sign was missing from the diapering area in Classroom #2.

Corrected Corrected by Feb 1, 2023

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

3270.124(b)(6) · Emergency contact information must include health insurance coverage and policy number for a child under a family policy or Medical Assistance benefits, if applicable.

The emergency contact form for Child #1 lacked the policy number for the child's health insurance.

Corrected Corrected by Feb 3, 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.

The file for Facility Person #7 lacked verification of experience to qualify them for the position they were hired to perform.

Corrected Corrected by Feb 1, 2023

Category: recordkeeping. Marked corrected in the state record.