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 file for staff person #1 was observed to lack documentation of current, valid certification in pediatric first aid and pediatric cardiopulmonary resuscitation (CPR) on or before the expiration of the most current certification. This was evidence by the only certification in pediatric first aid and pediatric cardiopulmonary resuscitation (CPR) present in their file expired on 05/03/2025.

Corrected Corrected by Jan 2, 2026

Category: ratio. Marked corrected in the state record.

3270.67(c) · Evidence of infestation of insects or rodents in the facility is not permitted.

The facility was observed to have Cockroaches.

Corrected Corrected by Feb 25, 2026

Marked corrected in the state record.

3270.82(g) · Toilet areas and fixtures shall be cleaned daily and be in good repair.

The facility was observed to have a sink that lacked a functioning water supply.

Corrected Corrected by Feb 25, 2026

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

3270.113(d) · A facility person may not use harsh, demeaning or abusive language in the presence of children.

Staff in the young toddler room routinely yell at the children as a means of redirection. Staff at the facility refer to children in demeaning language such as calling children "brats".

Corrected Corrected by Oct 30, 2025

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.

Based on the smoke detection system testing log, the smoke detectors were not tested every 30 days based on the following dates: 4-3-25 to 5-7-25 = 34 days; 7-18-25 to 8-20-25 = 33 days.

Corrected Corrected by Oct 2, 2025

Category: recordkeeping. Marked corrected in the state record.

3270.113(d) · A facility person may not use harsh, demeaning or abusive language in the presence of children.

During a complaint investigation, several staff members disclosed that they have observed other staff members continuing to yell at toddler aged children using a loud and harsh tone.

Corrected Corrected by Jul 25, 2025

Marked corrected in the state record.

3270.113(b) · A facility person may not use any form of physical punishment, including spanking a child.

During the course of a complaint investigation, it was revealed that Staff use loud boisterous shouts to redirect behavior. There was also evidence that they are lifting, carrying, and placing children in time out to correct undesirable behavior and/or to deter specific unwanted behaviors.

Corrected Corrected by Jun 3, 2025

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.

During a complaint investigation, it was revealed that staff will yell at the same select few young and old toddlers, who happen to be the same young and old toddlers that are having challenges learning self and impulse control. Staff use statements that are advanced beyond their developmental abilities and impede dignity. Examples provided were "Get over it", "Get in Line", "Life isn't fair".

Corrected Corrected by Jun 10, 2025

Marked corrected in the state record.

3270.113(d) · A facility person may not use harsh, demeaning or abusive language in the presence of children.

During a complaint investigation, it was revealed that staff uses loud boisterous shouting to correct undesirable behaviors and/or to prevent unwanted behaviors. Examples provided were "get over it", "get in line" and "life isn't fair".

Corrected Corrected by Jun 3, 2025

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 file for staff person #2 was observed to lack evidence that staff person #2 received training regarding the emergency plan at the time of initial employment.

Corrected Corrected by Feb 12, 2025

Category: ratio. Marked corrected in the state record.

3270.27(c) · The operator shall assure that each , 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 file for staff person #2 was observed to lack evidence that staff person #2 received training regarding the emergency plan at the time of initial employment.

Corrected Corrected by Feb 12, 2025

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 facility was observed to be providing the parent of each enrolled child a letter explaining the emergency procedures however this letter lacks information regarding the accommodations for infants, toddlers, children with disabilities and children with chronic medical conditions.

Corrected Corrected by Apr 3, 2025

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

3270.31(e)(4)(i)/3270.31(f)(10) · 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. Staff persons shall complete professional development in pediatric first aid and pediatric cardiopulmonary resuscitation within 90 days of hire.

The file for staff person #3 was observed to lack documentation staff person #3 renewed their certification in pediatric first-aid and pediatric cardiopulmonary resuscitation (CPR) on or before the expiration of the most current certification. this was evidence by a certificate dated 01/04/2023 present in the file.

Corrected Corrected by Apr 4, 2025

Category: ratio. 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.

The facility was observed to lack a protective receptacle cover in an electrical outlet accessible to children in the 2-year-old room at the corner of the blue wall.

Corrected Corrected by Feb 12, 2025

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.

An over-the-counter medication labeled "keep out of the reach of children" was observed stored in a staff's purse in the Pre-K room that was within the reach of children.

Corrected Corrected by Feb 12, 2025

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

3270.75(c) · A first-aid kit must contain the following: soap, an assortment of adhesive bandages, sterile gauze pads, tweezers, tape, scissors and disposable, nonporous gloves.

The facility was observed to have a first-aid kit in the Honeybee room that lacked tweezers and scissors.

Corrected Corrected by Feb 13, 2025

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.

A white board in the school-aged room was observed sitting on the floor and leaning against the wall instead of being secured to the wall allowing it to fall over. The purple wall in the preschool room was observed to have multiple chips in the paint.

Corrected Corrected by Feb 12, 2025

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.

The facility was observed to have sleep mats with tears at the corners on mats #11, #16 and #8 in the 2-year-old room, and mats numbered #2, #4, #5 and #6 with tears at the seams/corners in the pre-school room. A toy Walmart shopping cart with a broken corner was observed in the Pre-school room.

Corrected Corrected by Mar 3, 2025

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

3270.123(a)(7) · An agreement shall specify the services which are to be considered as extra.

The file for child #5 was observed to contain an agreement that did not specify the services which are to be considered as extra

Corrected Corrected by Apr 3, 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.

The files for children #7 and #8 were observed to contain emergency contact forms that did not include the work addresses and telephone numbers of the enrolling parents.

Corrected Corrected by Feb 20, 2025

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.

The file for child #7 was observed to contain an emergency contact form did not include health insurance coverage and policy number for a child under a family policy or Medical Assistance benefits, if applicable

Corrected Corrected by Apr 3, 2025

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.

The files for children #4, #6 and #10 were observed to contain emergency contact forms that did not include the name, address and telephone number of the individual designated by the parent to whom the child may be released

Corrected Corrected by Apr 3, 2025

Category: recordkeeping. Marked corrected in the state record.

3270.131(b)(1)/3270.181(c) · The operator shall require the parent to provide an updated health report at least every 6 months for an infant or young toddler. 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 #11 was observed to lack an updated health report at least every 6 months for an infant or young toddler. This was evidenced by the only 2 Health forms present in the file were dated 05/04/2023 and 07/19/2024.

Corrected Corrected by Apr 3, 2025

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.

The facility was observed to have medications in the school-age room for children #1 and #2 that lacked a label on the medication's container identifying the name of the medication and the name of the child for whom the medication is intended.

Corrected Corrected by Feb 12, 2025

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 facility was observed to have a medication log for the administration of a medication to child #2 that lacked a dated signature on the form. The facility was observed to have medication Zyrtec for child #4, and Rite Aid Acetaminophen for child #5 but lacked written consent for administration provided by a parent.

Corrected Corrected by Apr 3, 2025

Category: ratio. Marked corrected in the state record.

3270.133(7)(viii) · A medication log shall include special notes related to problems of administration.

The facility was observed to have a medication long for the administration of a medication for child #2, but the form lacked special notes, if any related to problems of administration.

Corrected Corrected by Apr 3, 2025

Category: ratio. Marked corrected in the state record.

3270.192(2)(iii) · 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 #1 was observed to lack documentation of 12 hours of annual professional development. This was evidenced by documentation of 7 hours present in the file.

Corrected Corrected by Mar 3, 2025

Category: recordkeeping. Marked corrected in the state record.

3270.31(g)/3270.192(2)(iii) · 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. A facility person's record shall include verification of child care experience, education and training following the outset of service at the facility.

The files for staff persons #1 and #2 were observed to lack documentation staff persons #1 and #2 had successfully completed pre-service training. Specifically, staff person #1 lacked documentation of competence in Pediatric First Aid and CPR and documentation of successful completion of the Get Started with Center Based Care-Revised 2022 Health and Safety training. The file for staff person #2 lacked documentation of successful completion of the Get Started with Center Based Care-Revised 2022 Health and Safety training.

Corrected Corrected by Jan 24, 2025

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

3270.52 · When children are grouped in mixed age levels, the age of the youngest child in the group determines the staff:child ratio and maximum group size in accordance with the requirements in § 3270.51 (relating to similar age level). The required staff:child ratios must be maintained at all times.The legal entity must submit documentation in a format approved by DHS proving that the facility is maintaining the required staff:child ratios at all times.

Based on information obtained during an unannounced visit, staff reported being over ratio with the following group of children: 1 - young toddler, 1 - older toddler, 1 - preschool age child and 5 school-age children.

Corrected Corrected by Dec 20, 2024

Category: ratio. Marked corrected in the state record.

3270.68(a) · Cigarettes, pipes or cigars may not be smoked in a child care space, a play space or a food preparation area when children are in care or when food is being prepared.

Observed staff #1 standing directly outside the preschool door that was propped open smoking and could be seen by another group of preschool children in the outdoor play space.

Corrected Corrected by Sep 20, 2024

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). SAFETY PLAN: The operator is required to submit to the Children and Youth Agency a plan of supervision or alternate arrangement as required by the Child Protective Services Law. LACKING REQUIRED HIRING DOCUMENTS: Facility Person #2 may not work in a child care position at the facility. PROVISIONAL HIRE UNSUPERVISED: A provisional employee may not be permitted to work alone with children and must work within the vicinity of a permanent employee. 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 #2 may not work in a child care position at the facility.

The file of staff #2 lacked a complete Child Abuse clearance, proof of fingerprinting for the DHS FBI clearance, and a dated Disclosure statement. The file of staff #3 had a Child Abuse clearance report dated 7-1-24 which was after initial employment (see LIS code sheet). The file of staff #4 lacked a dated Disclosure Statement.

Corrected Corrected by Sep 24, 2024

Category: supervision. 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.

Staff #1 was unable to name all 10 preschool aged children in the group located in the outdoor play space.

Corrected Corrected by Aug 27, 2024

Category: supervision. 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 file of facility person #4, a volunteer observed with a group of children lacked a health assessment.

Corrected Corrected by Oct 11, 2024

Category: ratio. Marked corrected in the state record.

3270.192(2)(iii) · 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 of staff #2, an AGS lacked proof of education to support the position.

Corrected Corrected by Aug 27, 2024

Category: recordkeeping. 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 files of staff #2 and #3 and facility person #4, a volunteer, all lacked 2 letters of recommendation.

Corrected Corrected by Sep 20, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.94(a)(1) · The Director or designated staff person who is responsible for compliance with this chapter shall conduct fire drills and ensure that fire drills are conducted at least once every 60 days.

Based on the fire drill log, fire drills were held more than 60 days apart on the following dates: 5-31-24 to 7-31-124 = 61 days.

Corrected Corrected by Sep 18, 2024

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.

Based on the smoke detection testing document testing of the smoke detection system occurred more than 30 days apart on the following dates: 5-7-24 to 6-5-24 = 31 days.

Corrected Corrected by Jul 1, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.32(a) · The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services).

Observed staff file #2, a provisional hire, contained a CPSL required NSOR verification letter, which was dated more than 45 days after their first day working in a childcare position. The file did not contain documentation of staff #2 being removed from a childcare position when the verification letter was not in the file within the 45-day time limit.

Corrected Corrected by Aug 1, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.37(c) · An aide or a combination of aides shall be supervised at all times by a staff person qualified at minimum as an assistant group supervisor.

Observed staff #3, an aide who was the only staff person responsible for supervising a group of napping preschool children, was not being supervised by a staff person qualified at minimum as an assistant group supervisor.

Corrected Corrected by Aug 1, 2024

Category: supervision. 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.

Observed staff file #1 contained only one written, nonfamily references from individuals attesting to the person's suitability to serve as a facility person.

Corrected Corrected by Aug 5, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.27(a)(6) · Emergency drills shall be conducted annually. Annual emergency drills shall be documented and on file at the facility.

Observed the documented emergency drill log revealed the most recent emergency drill was completed more than 16 months ago (2/14/23).

Corrected Corrected by Aug 1, 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 facility was observed to have an emergency plan that did not include a statement regarding the Continuity of Operations.

Corrected Corrected by May 28, 2024

Category: ratio. Marked corrected in the state record.

3270.31(e)(4)(i)/3270.31(f)(10) · Staff persons shall complete professional development within 90 days of hire as listed in subsections (f)1-10. Staff person #2 will have until May 20, 2024, 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 not staff available to supervise staff person #2, staff person #2 may not work in a child-care position at the facility.

The file for Staff person #2 was observed to lack documentation of competency in Pediatric first-aid and cardiopulmonary resuscitation (CPR).

Corrected Corrected by Apr 24, 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. Facility Person #3 may not work in a child care position at the facility.

The file for staff person #3 was observed to contain documentation that staff person #3 resided in the state of Maryland in the past 60 months, but lacked a Maryland State Police Clearance, as required.

Corrected Corrected by May 28, 2024

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

3270.75(c) · A first-aid kit must contain the following: soap, an assortment of adhesive bandages, sterile gauze pads, tweezers, tape, scissors and disposable, nonporous gloves.

The facility was observed to have a first-aid kit that lacked soap in the Honeybee's room.

Corrected Corrected by Feb 8, 2024

Marked corrected in the state record.

3270.105 · High chairs shall have a wide base and a T-shaped safety strap.

The facility was observed to have a feeding table that contained chairs that were missing their safety straps.

Corrected Corrected by Feb 21, 2024

Marked corrected in the state record.

3270.123(a) · An agreement shall be signed by the operator and the parent.

The file for child #7 was observed to lack an agreement that was signed by the parent.

Corrected Corrected by Mar 19, 2024

Category: recordkeeping. 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).

The files for children #5 and #6 were observed to lack the Department's approved form (Child Service Report) to provide information to the family about the child's growth and development in the context of the services being provided.

Corrected Corrected by Mar 27, 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.

The files for Children #6 & #7 were observed to contain emergency contact forms that failed to include the name, address and telephone number of the child's physician or source of medical care.

Corrected Corrected by May 16, 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.

The file for children #4 and #6 were observed to contain emergency contact forms that did not include the home and work addresses and telephone numbers of the enrolling parent.

Corrected Corrected by Apr 10, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.124(b)(5) · Emergency contact information must include information on the child's special needs, as specified by the child's parent, physician, physician's assistant or CRNP, which is needed in an emergency situation.

The file for child #7 was observed to contain an emergency contact form that failed to include information on the child's special needs, as specified by the child's parent, physician, physician's assistant or CRNP, which is needed in an emergency situation.

Corrected Corrected by Apr 10, 2024

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 file for child #6 was observed to contain and emergency contact form that failed to include health insurance coverage and policy number.

Corrected Corrected by Apr 10, 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.

The file for children #1, #2 and #4 were observed to contain emergency contact forms that did not include the name, address and telephone number of the individual designated by the parent to whom the child may be released.

Corrected Corrected by May 16, 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.

The file for Child #2 was observed to contain a financial agreement dated 06/20/23, evidence the parent had not reviewed and updated the financial agreement at least once in a 6-month period.

Corrected Corrected by Apr 17, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.131(b)(2)/3270.181(c) · 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 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 files for children #1 a school-aged child and #2 a preschool aged child were observed to contain health reports that were older than 12 months. Child #1 had a health exam dated 01/18/2023 present in the file, and child #2 had a health exam dated 11/17/2022 present in the file.

Corrected Corrected by Mar 21, 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).

The files for children #3, #6, & #8 were observed to contain immunization records that are not in accordance with the ACIP. Specifically, the immunization record for child #3, a preschool aged child only indicated 3 of the required 4 Pneumococcal immunizations. The immunization record for child #6, an infant was not on schedule with any immunizations as the immunization record was from 10/12/23. The immunization records for child #8, an older toddler aged child indicated only having received 3 pneumococcal immunizations.

Corrected Corrected by May 21, 2024

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 facility was observed to have a medication Mupirocin 2% ointment for child #6 but lacked written consent from the enrolling parent for administration of the medication.

Corrected Corrected by Feb 8, 2024

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 file for Staff person #1 was observed to lack an adult health assessment that includes tuberculosis screening by the Mantoux method at initial employment.

Corrected Corrected by Feb 8, 2024

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

3270.171(c) · Written notification of safe routes shall be posted by the operator at a conspicuous location in the child care facility.

The facility was observed to lack written notification of safe routes (pick up and drop off procedures) posted in a conspicuous location in the child care facility.

Corrected Corrected by Feb 8, 2024

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 provided accommodations for children with disabilities, and children with chronic medical conditions, but lacked to provides accommodations for infants, toddlers.

Corrected Corrected by Feb 9, 2024

Category: physical safety. 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 was observed to have an emergency plan that failed to provide or stipulate the accommodations for evacuation of children from the facility building and evacuation of children to a location away from the facility premises.

Corrected Corrected by Feb 9, 2024

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 file for Staff person #6, was observed to lack evidence of completing the Pennsylvania Health and safety Update 2022 by December 30, 2022. This was evidenced by the file for Staff person #6 being observed to contain a Pennsylvania Health and Safety Update 2022 certificate of completion dated 01/18/2023.

Corrected Corrected by Apr 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).

The files for Staff persons #4, and #8 were observed to have Mandated reporter training certificates obtained more than 60 months apart. This was evidenced by a mandated reporter certification of completions for Staff person #4 dated 09/02/2016 and 02/03/022, and for Staff person #8 dated 02/05/2018 and 02/07/2023 being present in their files.

Corrected Corrected by Feb 9, 2023

Category: recordkeeping. 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 facility's Honeybee room was observed to be without hospital, police, fire, ambulance and poison control telephone numbers posted in the childcare space.

Corrected Corrected by Feb 9, 2023

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.

A small plastic slide in the outdoor play area was observed to be cracked exposing rough edges and Pinch and crush points.

Corrected Corrected by Feb 10, 2023

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

3270.123(a) · An agreement shall be signed by the operator and the parent.

The file for child #2 was observed to contain an agreement that was not signed by the enrolling parent.

Corrected Corrected by Feb 9, 2023

Category: recordkeeping. 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 file for child #8 was observed to contain and agreement that failed to specify the amount of the fee to be charged per day or per week.

Corrected Corrected by Feb 9, 2023

Category: recordkeeping. 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).

The file for child #9 was observed to lack a form (CSR) providing information to the family about the child's growth and development in the context of the services being provided

Corrected Corrected by Apr 11, 2023

Category: recordkeeping. Marked corrected in the state record.

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

The file for child #8 was observed to contain an agreement that lacked the child's arrival and departure times.

Corrected Corrected by Apr 5, 2023

Category: recordkeeping. 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 file for child #8 was observed to contain an agreement that lacked to specify the person designated by a parent to whom the child may be released.

Corrected Corrected by Apr 5, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.123(a)(6) · An agreement shall specify the date of the child's admission.

The files for children #1, #4, and #8 were observed to contain and agreement that failed to specify the date of the child's admission.

Corrected Corrected by Apr 13, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.123(a)(7) · An agreement shall specify the services which are to be considered as extra.

The files for children #2, and #9 were observed to contain an agreement that failed to specify the service which are to be considered as extra.

Corrected Corrected by Apr 13, 2023

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.

The file for child #9 was observed to contain an emergency contact form that lacked the telephone number of the child's physician or source of medical care.

Corrected Corrected by Apr 12, 2023

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.

The files for children #2, #3, #6, and #9, were observed to contain an emergency contact form that lacked the work address and work phone number of the enrolling parent.

Corrected Corrected by Apr 18, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.124(b)(5) · Emergency contact information must include information on the child's special needs, as specified by the child's parent, physician, physician's assistant or CRNP, which is needed in an emergency situation.

The files for children #3 and #9 were observed to contain an emergency contact form that lacked to specify whether or not the child has special needs as specified by the child's parent or physician.

Corrected Corrected by Apr 13, 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 files for children #1 and #9 were observed to contain emergency contacts that failed to include health insurance coverage and policy numbers.

Corrected Corrected by Apr 13, 2023

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.

The file for child #8 was observed to contain an emergency contact that failed to include the name address and telephone number of the individual designated by the parent to who the child may be released.

Corrected Corrected by Apr 13, 2023

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 file for Child #9 was observed to contain a health report that was not signed by a physician, physician's assistant or a CRNP.

Corrected Corrected by Apr 12, 2023

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

3270.131(d)(1) · A health report shall include a review of the child's health history.

The file for child #5 was observed to contain a health report that failed to include a review of the child's health history.

Corrected Corrected by Apr 17, 2023

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

3270.131(d)(3) · A health report shall include a list of the child's current medication and the reason for the medication.

The file for child #5 was observed to contain a health report that failed to indicate if the child is or is not currently taking medication.

Corrected Corrected by Apr 17, 2023

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).

The files for children #5, #7, #8, and #9 were observed to lack documentation of the child's immunized status according to recommendations of the ACIP, and/or a request for exemption by a written, signed and dated statement from the child's parent or guardian.

Corrected Corrected by Apr 18, 2023

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 #9 was observed to lack updated written verification from a physician, physician's assistant, CRNP, the Department of Health or a local health department of ongoing vaccines in accordance with the schedule recommended by the ACIP.

Corrected Corrected by Apr 20, 2023

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

3270.133(1) · A prescription or nonprescription medication may be accepted only in an original container. The medication shall remain in the container in which it was received.

Albuterol medication that was not in the original package was observed to be in the Honeybee classroom.

Corrected Corrected by Feb 13, 2023

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.

A medication prescribed to child #10 was observed to lack a medication log with a signature by the parent giving permission to administer the medication documented on the medication log.

Corrected Corrected by Feb 24, 2023

Category: ratio. 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 have a financial agreement that was not dated at the 6 month update.

Corrected Corrected by Apr 3, 2023

Category: recordkeeping. 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 files for Staff persons #1, #2, #3, #4, #5, #7 were observed to lack evidence that a PQAS pediatric first aid/CPR course had been successfully completed in a timely manner when regulations changed, as evidenced by Pediatric first aid/CPR cards dated 06/29/2021 in the files.

Corrected Corrected by May 10, 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.

Staff person #2, #4, #5, #6, #8, #10, #11, and #12 were observed to be caring for children unsupervised. Staff person #2, #4, #5, #6, #8, #10, #11, and #12 have not completed the following pre-service training required prior to caring for children unsupervised: Pediatric first-aid training and pediatric cardiopulmonary resuscitation (CPR).

Corrected Corrected by Nov 10, 2022

Category: supervision. 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. Staff person #1, #2, #3, #4, #5, #6, #7, #8, #9. #10, #11 will have until November 17, 2022, to complete the required training. Until such time as the required training has been completed, Staff Person #1, #2, #3, #4, #5, #6, #7, #8, #9. #10, #11, 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 #1, #2, #3, #4, #5, #6, #7, #8, #9. #10, #11, staff person #1, #2, #3, #4, #5, #6, #7, #8, #9. #10, #11 may not work in a child-care position at the facility.

Staff person #1, #2, #3, #4, #5, #6, #7, #8, #9. #10, #11, and #12 has not completed the following required per-service training within 90 days of their date of hire (see LIS code sheet): Pediatric first-aid training and pediatric cardiopulmonary resuscitation (CPR).

Corrected Corrected by Nov 10, 2022

Category: supervision. Marked corrected in the state record.

3270.106(j)/3270.119 · Toys, bumper pads, or pillows may not be present in a crib while an infant is sleeping in the crib. Infants shall be placed in the sleeping position recommended by the American Academy of Pediatrics unless there is a medical reason an infant should not sleep in this position. The medical reason shall be documented in a statement signed by a physician, physician's assistant or CRNP and placed in the child's record at the facility.

Child #1, Child #2, and Child #3 were observed to be sleeping in their crib, while laying on a Boppy nursing pillow. Child #2 was also observed to have a stuffed toy in the crib with them.

Corrected Corrected by Oct 18, 2022

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

3270.136(d) · A facility person who knows of a communicable disease for which 28 Pa. Code Chapter 27 (relating to communicable and noncommunicable diseases) requires reporting, or who knows of a group expression of an illness which may be of public concern, whether or not it is known to be of a communicable nature, shall report it promptly to the appropriate division of the Department of Health as specified in Chapter 27, or to a local department of health.

The Facility had knowledge of a communicable disease (Covid19) on October 5, 2022, and did not report the information to OCDEL

Corrected Corrected by Oct 18, 2022

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

3270.113(e) · A facility person may not restrain a child by using bonds, ties or straps to restrict a child's movement or by enclosing the child in a confined space, closet or locked room. The prohibition against restraining a child does not apply to the use of adaptive equipment prescribed for a child with special needs.

It was disclosed during interviews with staff that staff #1, and staff #2 at times put their legs, arms and torso across the children so that they are not able to get up from the sleep mats during nap time.

Corrected Corrected by Oct 21, 2022

Category: recordkeeping. 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.

In the School Age Room a cordless drill was observed in the cupboard by the sink exposing children to serious bodily injury that could result from improper or unsafe use of the cordless driver drill.

Corrected Corrected by Feb 15, 2022

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 file for staff person #1, was observed not to have on file documentation of Pediatric First Aid and Pediatric CPR on or before the expiration of the most recent certification on file dated 6/6/2019.

Corrected Corrected by Jun 29, 2021

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.

It was observed that the plastic swimming pool covering the sandbox was cracked leaving 4 inches of stagnant and dirty water in the sandbox causing unsanitary conditions. Staff verified the sandbox was to heavy to lift and dump.

Corrected Corrected by Apr 1, 2022

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 outdoor play space it was observed that peeling and damaged paint was observed on the poles at the bottom of the large fenced area as well as on the large mounted equipment.

Corrected Corrected by Apr 1, 2022

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.

It was observed that hand washing signs were not posted above the toilets in the Pre K rooms.

Corrected Corrected by Feb 5, 2022

Category: health medication. 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.

It was observed in the outdoor play space a pink flyer bike that was cracked along the side edge, 3 cracked hula hoops and sharp metal umbrella stands exposing children in care to rough edges and sharp corners.

Corrected Corrected by Mar 23, 2022

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

3270.102(c) · Outdoor equipment that requires embedded mounting must be mounted over a loose-fill or unitary playground protective surface covering that meets the recommendations of the United States Consumer Product Safety Commission. The equipment must be anchored firmly and be in good repair.

The loose fill in the outdoor play area under the large mounted equipment measured approximately at 8 inches and does not meet surface covering recommendations of the United States Consumer Product Safety Commission.

Corrected Corrected by Apr 4, 2022

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.

It was observed that plastic bags located in a bin on the floor in the preschool room were accessible to children in care causing a suffocation hazard

Corrected Corrected by Feb 5, 2022

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

3270.104(a) · Furniture must be durable, safe, easily cleaned and appropriate for the child's size, age and special needs.

In the Older Toddler room an unsteady cupboard approximately 6 feet tall by 3 feet wide was not attached to the wall.

Corrected Corrected by Feb 26, 2022

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.

A Tylenol bottle was observed in the Older Toddler room lacking the name of the child for whom the medication is intended.

Corrected Corrected by Feb 15, 2022

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.

Expired diaper cream was observed in the younger toddler room.

Corrected Corrected by Feb 15, 2022

Category: health medication. 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 for staff person # 2, hired before 12/20/2020 (See LIS Code Sheet) was observed not to have on file documentation of Pediatric First Aid and Pediatric CPR by 6/17/2021.

Corrected Corrected by Jun 29, 2021

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

3270.113(a) · Children on the facility premises and on facility excursions off the premises shall be supervised by a staff person at all times. Outdoor play space used by the facility is considered part of the facility premises.

At approximately 1:00 PM CR observed 1 child lying on rest equipment between a table and a kitchen play set in the Owls Classroom and another child on rest equipment behind a book shelf. This prevented from being effectively able to see, hear, direct, and assess the child sleeping.

Corrected Corrected by Jan 26, 2022

Category: supervision. Marked corrected in the state record.