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.

Staff person #1 did not promote the development of skills, social competence and self-esteem or recognize child #1 as an individual when they admitted to forcing a preschool aged child to clean themselves up after having an accident. Staff person #1 believes that the child is fully capable of using the bathroom on their own, and that they need to be ready for kindergarten.

Corrected Corrected by Sep 27, 2023

Category: background checks. 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. Staff #1 is required to receive a minimum of 3 hours of PQAS-approved training regarding important kindergarten readiness skills such as: age-appropriate self-help skills, helping a child develop social/emotional skills, and toilet training. The legal entity must receive DHS approval of the training content prior to scheduling the training.

Staff person #1 did not promote the development of skills, social competence and self-esteem or recognize child #1 as an individual when they admitted to forcing a preschool aged child to clean themselves up after having an accident. Staff person #1 believes that the child is fully capable of using the bathroom on their own, and that they need to be ready for kindergarten.

Corrected Corrected by Sep 27, 2023

Category: background checks. 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 embedded outdoor play equipment must immediately be made inaccessible until the loose-fill or unitary playground protective surface meets the recommendations of the United States Consumer Product Safety Commission.

During a complaint investigation on 9/22/23, an incident report was submitted to OCDEL explaining that child #1 needed emergency care on 9/21/23, after falling from a piece of embedded equipment in the facility's outdoor play space. It was observed at the time of the investigation that the wooden mulch depth where the child fell only measured approximately 6 inches deep. In addition, there were other areas of wooden mulch measuring between approximately 4-6 inches around the two pieces of embedded equipment located in this same outdoor play space. This depth, at these measured locations, does not meet the recommended United States Consumer Product Safety Commission depth of 9 inches.

Corrected Corrected by Sep 27, 2023

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.

During a complaint investigation on 9/22/23, an incident report was submitted to OCDEL explaining that child #1 needed emergency care on 9/21/23, after falling from a piece of embedded equipment in the facility's outdoor play space. It was observed at the time of the investigation that the wooden mulch depth where the child fell only measured approximately 6 inches deep. In addition, there were other areas of wooden mulch measuring between approximately 4-6 inches around the two pieces of embedded equipment located in this same outdoor play space. This depth, at these measured locations, does not meet the recommended United States Consumer Product Safety Commission depth of 9 inches.

Corrected Corrected by Sep 27, 2023

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 #1 will have until 05/30/23 to complete the required training. Until such time as the required training has been completed, staff person #1 must be supervised, when interacting with children, by an AGS or GS who has completed the required training related to this citation. If there are no staff available to supervise staff person #1, staff person #1 may not work in a child-care position at the facility.

Staff person #1 has not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): Health and Safety Topics.

Corrected Corrected by May 15, 2023

Category: supervision. 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 in the young toddler room that a plastic bag was accessible to children still placing objects in their mouth.

Corrected Corrected by Feb 15, 2023

Marked corrected in the state record.

3270.106(f) · At least 2 feet of space is required on three sides of a bed, cot, crib or other rest equipment while the equipment is in use.

It was observed in the Young PreK room that a child was laying on their rest mat during rest time and did not have at least 2 feet of space on at least 3 sides of that rest mat.

Corrected Corrected by Feb 15, 2023

Category: physical safety. 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.

File for child #3, see code sheet for enrollment and birth date, contained a health report dated 12/31/21, but an updated health report completed within the last 12 months was not found on file.

Corrected Corrected by Feb 17, 2023

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.

It was observed that medication for child #1 was both present during inspection and logged on the medication log as having been administered by facility staff on 2/9/23. The medication label showed the manufacturer's expiration date for this medication was 1/2023.

Corrected Corrected by Feb 15, 2023

Category: ratio. Marked corrected in the state record.

3270.133(7) · An operator is responsible to establish and maintain a medication log if prescription or nonprescription medication is administered.

It was observed that medication and an established medication log was present for child #2. The medication log instructed the operator to administered the medication to the child daily. On 2/10/23, staff confirmed that the child was present, but the medication log only showed a date and did not include the dosage of the medication, the time the medication was administered, or the staff person's initials. Staff stated they did administer the medication to the child on 2/10/23, therefore staff did not maintain the medication log as required.

Corrected Corrected by Feb 15, 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.

It was observed that the garbage cans used to discard soiled diapers in the Tod 2 and Older Toddler (Tod 3) rooms were both broken and therefore were no longer a hands-free covered can.

Corrected Corrected by Feb 15, 2023

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

3270.163(b) · Breakfast prepared at the facility for children of toddler age or older shall have at least one item from three of the following four food groups: dairy, protein, fruit and vegetable, grain.

It was observed on the facility's menu and confirmed by staff that on Mondays and Fridays the facility was only serving cereal and milk to the children for breakfast. At least one item from three of the four food groups listed was not being offered to children on those days.

Corrected Corrected by Feb 15, 2023

Category: nutrition. Marked corrected in the state record.

3270.113(a)/3270.113(a)(1) · 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. Children must be supervised at all times. 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. The Legal Entity / Director will establish a supervision and ratio policy. The policy will include how the facility will demonstrate their knowledge and ability to adequately supervise children while maintaining appropriate ratio at all times. The policy must focus on ensuring that each child is seen, heard, assessed and able to be directed at all times. The policy must include the required staff:child ratios for each age group. The policy must include how the facility will ensure appropriate supervision and ratios during transition times and while in the outdoor play area. The policy must include how the facility will ensure appropriate supervision and ratios during nap time. The policy must also include a plan for each staff to be assigned the responsibility for supervision of specific children, including the requirement that the staff person know the names and whereabouts of the children in his assigned group and be physically present with the children in his group on the facility premises and on facility excursions off the facility premises. The policy must also address how these groups will be transitioned from one staff person to another during staffing changes. This supervision and ratio policy must be submitted to the Department prior to implementation for approval. Once approved by the Department, the director will ensure that all current employees and any new hires are trained on this policy.

It was self-reported to the Regional Office, that on 12/30/22, some time between 2:45-3pm, staff person #1 left the Prek2 room taking approximately 5 children with her but left child #1 sleeping in the Prek2 classroom alone and unsupervised for approximately 20-23 seconds.

Corrected Corrected by Jan 12, 2023

Category: supervision. Marked corrected in the state record.

3270.113(a)/3270.113(a)(1) · 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. Children must be supervised at all times. 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.

It was self-reported to the Regional Office, that on 12/30/22, some time between 2:45-3pm, staff person #1 left the Prek2 room taking approximately 5 children with her but left child #1 sleeping in the Prek2 classroom alone and unsupervised for approximately 23-23 seconds.

Corrected Corrected by Jan 12, 2023

Category: supervision. Marked corrected in the state record.

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

It was observed that the toilet used by the young preschool room was dirty and had not been cleaned daily.

Corrected Corrected by Feb 3, 2022

Marked corrected in the state record.

3270.111(b) · The written plan of daily activities shall be posted in the group space.

It was observed that a daily schedule was not posted in school age room 1 and school age room 2.

Corrected Corrected by Feb 3, 2022

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

3270.133(6) · A parent shall provide written consent for administration of medication or a special diet.

It was observed that medication present for child #1 and child #2 did not have signed parental consent for administration of that medication.

Corrected Corrected by Feb 7, 2022

Category: ratio. Marked corrected in the state record.

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

It was observed that two baby bottles in the infant room were not labeled.

Corrected Corrected by Feb 3, 2022

Marked corrected in the state record.

3270.76/3270.82(g) · 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. Toilet areas and fixtures shall be cleaned daily and be in good repair.

The following was observed during a complaint investigation on 9/28/21: The changing tables in the infant room, young toddler room, and older toddler rooms were not adequately cleaned and visible dirt was found under the changing table pads. It was observed in the facility's bathrooms that the walls contained excessive dried soap from the soap dispenser which was left dripping down the walls and on floors, bathroom sinks contained a thick layer of soap scum, and the back of the toilets were dirty. Classroom sinks were not being adequately cleaned and were dirty. Therefore, the bathrooms, both sink and toilet areas, throughout the facility are not being cleaned daily. In the young toddler room the steps the children use to access the classroom sink was dirty. It was observed in the young preschool room that the door leading to the outside parking lot was not in good repair. It was missing the weather stripping which allowed for a large gap from the bottom of the door to the floor. It was observed during inspection and stated by staff that they use a towel at this time to keep rain, cold air, and insects from coming into the classroom.

Corrected Corrected by Nov 1, 2021

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

3270.136(b)/3270.136(d) · The operator shall inform parents of enrolled children when there is a suspected outbreak of a communicable disease or an outbreak of an unusual illness that represents a public health emergency in the opinion of the Department of Health. 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.

During a complaint investigation conducted on 9/28/21, it was stated that on 9/18/21, the facility had been made aware of child #1 being diagnosed with respiratory syncytial virus (RSV) which is on the list of reportable diseases according to the Department of Health. Facility stated that they had received four additional reports of children having tested positive for RSV within the facility across four different classrooms. The operator did not inform parents of the suspected outbreak until 9/27/21, and the operator did not report it promptly to the appropriate division of the Department of Health as specified in Chapter 27, or to a local department of health.

Corrected Corrected by Oct 20, 2021

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

3270.66(b) · Cleaning materials and other toxic materials shall be stored in an original labeled container or in a container that specifies the content. Toxics shall be stored away from food, food preparation areas and child care spaces.

It was observed during a complaint investigation on 9/28/21, that a bottle of cleaner in each of the young and older toddler rooms were unlabeled. Staff had stated that those unlabeled bottles contained cleaning materials.

Corrected Corrected by Oct 19, 2021

Category: ratio. Marked corrected in the state record.