3270.77(a) · Peeled or damaged paint or damaged plaster is not permitted on indoor or outdoor surfaces in the child care facility.

In the sensory room, there was peeling paint in one area on the front left wall.

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 #2 will have until 11-29-24 to complete the required training. Until such time as the required training has been completed, staff person #2 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 #2, staff person #2 may not work in a child-care position at the facility.

Staff person #2 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 training.

Corrected Corrected by Nov 15, 2024

Category: supervision. 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 file for child #2, an older toddler, had a health assessment that exceeded 12 months between assessments.

Corrected Corrected by Nov 8, 2024

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

3270.131(e)/3270.131(e)(3) · The facility may not accept or retain an infant 2 months of age or older, a toddler or a preschool child at the facility for more than 60 days following the first day of attendance at the facility unless the parent provides written verification from a physician, physician's assistant, CRNP, the Department of Health or a local health department of the dates (month, day and year) the child was administered immunizations in accordance with the 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 #1 must be dismissed from care by close of business on 11-8-24 and may only return to care when the immunization record is updated or when a parent provides a written, signed exemption letter.

The file for child #1 lacked an immunization record within 60 days of the child's first day of attendance at the facility and requires a current immunization record.

Corrected Corrected by Nov 8, 2024

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

3270.151(c)(3)/3270.151(c)(5) · An adult health assessment must include an examination for communicable diseases and the results of that examination. An adult health assessment must include the physician's or CRNP's assessment of the person's suitability to provide child care.

The file for staff person #1 had a health assessment that lacked an examination for communicable diseases and the results of that examination and the physician's or CRNP's assessment of the person's suitability to provide child care.

Corrected Corrected by Nov 8, 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.

The file for child #2 had an agreement that exceeded 6 months between parent updates.

Corrected Corrected by Nov 8, 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 lacked an initial health assessment within 60 days of the child's first day of attendance at the facility and requires a current health assessment.

Corrected Corrected by Nov 15, 2024

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

3270.27(c) · The operator shall assure that each facility person receives training regarding the emergency plan at the time of initial employment, on an annual basis and at the time of each plan update. The operator shall document the date of each training and the names of all facility persons who received the training and kept on file at the facility.

The files for staff person #3 and volunteer #4 had emergency plan training that exceeded a year between trainings.

Corrected Corrected by Nov 16, 2023

Category: recordkeeping. 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 operator's letter provided to the parent of each enrolled child explaining the emergency procedures lacked the accommodations for toddlers and children with chronic medical conditions.

Corrected Corrected by Nov 16, 2023

Category: physical safety. 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 #5 will have until 12-23-23 to complete the mandated reporter training. Until such time as the required training has been completed, staff person #5 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 #5, staff person #5 may not work in a child-care position at the facility.

Staff person #5 has not completed the mandated reporter training within 90 days of their date of hire (see LIS code sheet).

Corrected Corrected by Nov 22, 2023

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. Volunteer #4 and Volunteer #6 may not work at the facility.

The file for volunteer #4 lacked a current FBI clearance updated within the last 60 months. The file for volunteer #6 lacked an NSOR verification certificate at their start date and requires a current NSOR verification certificate. The file for volunteer #1 had an FBI clearance and NSOR verification certificate that were dated after their start date.

Corrected Corrected by Nov 17, 2023

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

3270.33(a)/3270.192(2)(ii) · A staff person or a substitute staff person shall meet one of the applicable staff qualifications for the position in which the person is performing. A facility person's record shall include verification of child care experience, education and training prior to service at the facility.

The file for staff person #2, functioning as a staff person, lacked verification of education/experience to qualify as a staff person. The file for volunteer #6, observed to be supervising children, and therefore functioning as a staff person, lacked verification of education/experience to qualify as a staff person.

Corrected Corrected by Nov 21, 2023

Category: supervision. Marked corrected in the state record.

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

The eating area, which is measured child care space, lacked a first-aid kit.

Corrected Corrected by Nov 16, 2023

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.

In the sensory room, there were multiple areas of peeling paint on the right wall. In the remote classroom, there was one area of peeling paint on the front wall to the right of the outlet.

Corrected Corrected by Nov 16, 2023

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

3270.113(a)(1) · Each staff person shall be assigned the responsibility for supervision of specific children. The staff person shall know the names and whereabouts of the children in his assigned group. The staff person shall be physically present with the children in his group on the facility premises and on facility excursions off the facility premises.

On 11-16-23 at approximately 10:24 a.m. in the 3-4 year old room with a total of 9 children, staff person #7 identified 5 preschoolers in their group and volunteer #6 identified 4 preschoolers in their group. At the time of observation, volunteer #6 was functioning as a staff person and not as a volunteer. Upon further investigation, it was determined that volunteer #6 did not have the qualifications on file to be a staff person. As a result, 4 children were not assigned to a staff person responsible for supervision.

Corrected Corrected by Nov 16, 2023

Category: supervision. 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 #1 must be dismissed from care by close of business on 11-16-23 and may only return to care when the immunization record is updated or when a parent provides a written, signed exemption letter.

The file for child #1, a 2 year old, had an immunization record that lacked documentation of the 1st and 2nd doses of the Hepatitis A vaccination by age 23 months being administered in accordance with the schedule recommended by the ACIP and lacked exemption documentation.

Corrected Corrected by Nov 17, 2023

Category: health medication. 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 #4 had a health assessment that lacked a statement that age-appropriate screenings recommended by the American Academy of Pediatrics were conducted since the time of the previous health assessment.

Corrected Corrected by Nov 17, 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.

In the infant/toddler room, there were diapers observed that were placed in a plastic bag inside the plastic-lined hands-free covered can that were not immediately thrown away in the hands-free covered can. Staff in the room stated that soiled diapers are placed in a plastic bag first, and then thrown away in the hands-free diapering can.

Corrected Corrected by Nov 16, 2023

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 #3 lacked a tuberculosis screening by the Mantoux method at initial employment and requires a current tuberculosis screening by the Mantoux method.

Corrected Corrected by Nov 17, 2023

Category: ratio. 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 file for volunteer #1 had a health assessment that said "Yes" to having any communicable diseases and lacked an explanation of the results of the examination.

Corrected Corrected by Nov 17, 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 file for volunteer #6 had one written, nonfamily reference and lacked a second written, nonfamily reference.

Corrected Corrected by Nov 17, 2023

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 #5 had an initial health assessment that was dated over 60 days after the child's first day of attendance at the facility.

Corrected Corrected by Nov 22, 2023

Category: health medication. 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 lacked requirements for volunteer emergency preparedness training and continuity of operations according to federal requirements at 45 CFR § 98.41(a)(1)(vii).

Corrected Corrected by Dec 16, 2022

Category: ratio. 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 Person #1, Staff Person #3, Staff Person #5, and Staff Person #6 may not work at the facility.

The files for staff person #1 and #3 had a Department of Education FBI clearance and lacked a DHS FBI clearance. The file for volunteer #2 had an NSOR verification certificate that was dated after their start date. The file for facility person #5 lacked a current state police clearance. The file for staff person #6, hired provisionally, lacked the out of state Sex Offender and Child Abuse & Neglect registry checks or application for the registry checks at their start date and requires current out of state Sex Offender and Child Abuse & Neglect registry checks. (See LIS CODE SHEET)

Corrected Corrected by Dec 16, 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 protective services).

Staff person #4 had mandated reporter trainings dated 5-26-17 and 11-28-22 that were over 5 years between trainings.

Corrected Corrected by Dec 16, 2022

Category: recordkeeping. 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 peeling paint in one area in the back hall to the right of the exit door. In the infant/toddler room, there was peeling paint in multiple areas including on the back wall above the play kitchen, the back wall and corner near the easel, and the back wall on the right, and there was damaged plaster and paint on the right wall. In the large preschool/pre-k room, there was peeling paint in multiple areas on the front right wall.

Corrected Corrected by Dec 16, 2022

Category: physical safety. 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 file for child #2 had an emergency contact form that lacked the name of the health insurance and the policy number.

Corrected Corrected by Dec 16, 2022

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

3270.131(e)(1)/3270.182(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. A child's record shall contain initial and subsequent health reports.

The file for child #1, a 3 year old, had an immunization record that lacked documentation of the 2nd dose of the Hepatitis A vaccination by age 23 months in accordance with the schedule recommended by the ACIP and lacked exemption documentation.

Corrected Corrected by Dec 16, 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 file for facility person #5 had a health assessment that exceeded 24 months between assessments.

Corrected Corrected by Dec 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 file for volunteer #2 had a tuberculosis screening by the Mantoux method that was dated after initial employment at the facility.

Corrected Corrected by Dec 16, 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's emergency plan lacked a plan that provides for accommodations for toddlers.

Corrected Corrected by Dec 16, 2022

Category: physical safety. 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.

According to the log, the operator did not manually test the interconnected fire detection system in the facility at least once every 30 days on multiple occasions within the last year including with the most recent tests on 10-14-22 and 11-16-22.

Corrected Corrected by Dec 16, 2022

Category: recordkeeping. Marked corrected in the state record.

3270.27(a)(2) · The facility shall have an emergency plan that provides for accommodations for evacuation of children from the facility building and evacuation of children to a location away from the facility premises. The evacuation routes and evacuation plans to exit the building may be the same as those required by §3270.94 (relating to fire drills).

The facility's emergency plan lacked a plan that provides for accommodations for evacuation of children to a location away from the facility premises.

Corrected Corrected by Dec 16, 2022

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

3270.27(f) · The operator shall send a copy of the emergency plan and subsequent plan updates to the local municipality and to the county emergency management agency.

The operator lacked documentation of sending a copy of the updated emergency plan to the county emergency management agency.

Corrected Corrected by Dec 20, 2022

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

3270.31(e)(4)(ii)/3270.192(2)(iii) · 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. 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 Person #2 did not contain documentation of Fire Safety Training conducted within the past 12 months: 9/28/20.

Corrected Corrected by Dec 21, 2021

Category: recordkeeping. Marked corrected in the state record.

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

The file for Staff Person #5, who has been working at the facility for more than 90 days (6/3/21), did not include documentation of certification in Pediatric First Aid/CPR.

Corrected Corrected by Dec 21, 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.

The most recent required clearances in the following Staff Files exceeded 60 months between clearances: Staff Person #2: State Police: 5/10/16-10/29/21. Child Abuse: 9/28/15-11/23/20. Staff Person #6: State Police: 2/9/16-5/21/21.

Corrected Corrected by Nov 22, 2021

Category: background checks. 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 most recent Mandated Reporter Trainings in the files for the following staff persons exceeded 60 months between trainings: Staff Person #1: 11/11/15-10/24/21. Staff Person #3: 10/19/15-10/7/21. Staff Person #7: 4/2/16-4/10/21.

Corrected Corrected by Nov 22, 2021

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 most recent health report in the file for Child #1 did not include a statement that the child is able to participate in child care and appears to be free from contagious or communicable disease.

Corrected Corrected by Dec 21, 2021

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

3270.131(e)(1)/3270.182(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. A child's record shall contain initial and subsequent health reports.

The most recent immunization record in the file for Child #1 did not contain documentation of a flu shot administered within the past 12 months or a letter of exemption from the parent or physician.

Corrected Corrected by Dec 21, 2021

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 most recent health assessments in the files for Staff Person's #2, #3, #4, and #8 exceeded 24 months between assessments.

Corrected Corrected by Nov 22, 2021

Category: ratio. Marked corrected in the state record.