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

On 12-23-25 in room #3, there were 4 toddlers observed unbuckled in bucket seats in a table. The T-shaped safety straps were observed in the chairs and were not buckled around each child.

Corrected Corrected by Jan 16, 2026

Marked corrected in the state record.

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

In room #3, there were 4 bucket chairs in a table that are used for young toddlers that each lacked a T-shaped safety strap.

Corrected Corrected by Jan 16, 2026

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.

According to staff statements, during naptime on multiple occasions, staff person #1 restrained a child for up to 5-10 minutes by using their hands to hold the child's legs down on the rest equipment.

Corrected Corrected by Jan 16, 2026

Category: recordkeeping. 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 completed the PA Required Health and Safety for Centers-Group Child Care Part 2 pre-service training over 90 days after their date of hire.

Corrected Corrected by Nov 25, 2025

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

3270.134(a) · A staff person shall ensure that a child's hands are washed before meals and snacks, after toileting and after being diapered.

On 9-24-25 in room #4, staff person #2 was observed changing a 2 year olds diaper and did not immediately wash the child's hands after diapering. The child was placed on the floor and given their binky by staff person #2 before the staff person and child washed their hands.

Corrected Corrected by Nov 25, 2025

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

3270.152 · A facility person shall wash his hands before meals and snacks, and after toileting and after diapering a child.

On 9-24-25 in room #4, staff person #2 was observed changing a 2 year olds diaper and did not immediately wash their hands after diapering. The child was placed on the floor and given their binky by staff person #2 before the staff person and child washed their hands.

Corrected Corrected by Nov 25, 2025

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

3270.51 · When children are grouped in similar age levels, the following maximum child group sizes and ratios of staff persons apply: Infants 1:4 with a maximum group size of 8; Young toddlers 1:5 with a maximum group size of 10; Older toddlers 1:6 with a maximum group size of 12; Preschool children 1:10 with a maximum group size of 20; Young school-age children 1:12 with a maximum group size of 24; Older school-age children 1:15 with a maximum group size of 30.

According to staff statements, there have been multiple occurrences in the mornings within the last month when a staff person was observed out of ratio with one staff supervising up to 7 older toddlers in their group and another staff supervising up to 8-9 young toddlers in their group.

Corrected Corrected by Jul 16, 2025

Category: supervision. 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).

According to staff statements, there have been multiple mornings within the last month when a staff person was observed supervising a mixed-age group of up to 8-12 young and older toddlers.

Corrected Corrected by Jul 16, 2025

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.

On 6-5-25 at approximately 9:50 a.m. with a total of 17 older toddlers on the outdoor play space, staff person #1 named 6 older toddlers in their group, staff person #2 named 5 older toddlers in their group, and staff person #3 named 5 older toddlers in their group, resulting in 1 child not being named in a group.

Corrected Corrected by Jun 12, 2025

Category: supervision. 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.

According to corroborating staff statements, multiple staff have been observed, while in ratio with children, on their phones and distracted from supervising children appropriately.

Corrected Corrected by Jun 5, 2025

Category: supervision. 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.

According to corroborating staff statements, multiple staff have been observed using inappropriate language, including profanity, in the presence of children.

Corrected Corrected by Jun 5, 2025

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 #1 had an emergency contact form that lacked the address of the individual designated by the parent to whom the child may be released.

Corrected Corrected by Apr 8, 2025

Category: recordkeeping. Marked corrected in the state record.

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

The file for staff person #3 lacked current fire safety training completed within the last year. The file for staff person #2 had fire safety training that exceeded a year between trainings.

Corrected Corrected by Apr 8, 2025

Category: recordkeeping. 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 #5 completed the following required pre-service training on 7-23-24 that was over 90 days after their date of hire (see LIS code sheet): Pediatric first-aid/CPR training.

Corrected Corrected by Apr 8, 2025

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

3270.32(a)/3270.192(4) · The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). A facility person's record shall include a copy of requests for the criminal history record and child abuse registry clearance information, a copy of the disclosure statement and a copy of the completed clearance information required under the CPSL. Staff Person #3, Staff Person #4, Staff Person #6, and Staff Person #7 may not work in a child care position at the facility.

The file for staff person #3 had an FBI clearance dated 3-16-20 and lacked a current clearance updated within the last 60 months. The files for staff person #4, #6, and #7 lacked an NSOR verification certificate at their start date and require a current NSOR verification certificate. (See LIS CODE SHEET)

Corrected Corrected by Apr 8, 2025

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 first-aid kit in room #1 lacked tape.

Corrected Corrected by Apr 8, 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.

On the outdoor play space, there were multiple holes on the back mesh fence.

Corrected Corrected by Apr 8, 2025

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

3270.82(e) · Toilets and sinks shall be at proper heights for children using them or shall be easily approached by means of platforms or steps.

In room #1 with 2 young toddlers that were walking and able to wash their hands, the sink near the changing table lacked a platform or steps and was unable to be reached by the children after diapering to wash their hands.

Corrected Corrected by Apr 8, 2025

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

3270.91(a) · Stairways, hallways, exits from rooms, exits from the facility and other means of egress serving as an exit shall be unobstructed.

In the bathroom in room #4, the exit door to the hallway was obstructed by a cabinet.

Corrected Corrected by Apr 8, 2025

Marked corrected in the state record.

3270.102(g) · Children's toys and equipment, including furniture and rest equipment, described as hazardous by the United States Consumer Product Safety Commission may not be used by children at the facility and may not be on the premises at the facility. At the time of inspection, the operator shall submit to the Department written affirmation on a form provided by the Department stating that the facility is in compliance with this requirement.

In the infant room, there were three 4moms MamaRoo baby swings that had been recalled by the United States Consumer Product Safety Commission.

Corrected Corrected by Apr 8, 2025

Category: physical safety. 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 3-31-25 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 enrolled more than 60 days at the facility, lacked documentation of the 3rd Hepatitis B and 1st and 2nd Hepatitis A vaccinations being administered in accordance with the schedule recommended by the ACIP and lacked exemption documentation.

Corrected Corrected by Apr 8, 2025

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

3270.151(c)(5) · An adult health assessment must include the physician's or CRNP's assessment of the person's suitability to provide child care.

The files for staff person #1 and #2 had a health assessment that lacked the physician's or CRNP's assessment of the person's suitability to provide child care.

Corrected Corrected by Apr 8, 2025

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 staff person #4 had one written, nonfamily reference and lacked a second written, nonfamily reference.

Corrected Corrected by Apr 8, 2025

Category: recordkeeping. Marked corrected in the state record.

3270.31(e)/3270.192(2)(iii) · A staff person shall obtain an annual minimum of 12 clock hours of child care training. 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 lacked 2 of the 12 required hours of annual child care training. The file for staff person #3 lacked 4.5 of the 12 required hours of annual child care training. The file for staff person #5 lacked 2 of the 12 required hours of annual child care training.

Corrected Corrected by Apr 8, 2025

Category: recordkeeping. 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 10-18-24 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 trainings within 90 days of their date of hire (see LIS code sheet): Pediatric first-aid/CPR training from a PQAS approved trainer and a PQAS approved curriculum, Pennsylvania Health and Safety Update 2022 Training (part of the Health and Safety Training topics of 3270.31(f)(1-9).

Corrected Corrected by Oct 21, 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.

The file for staff person #1 had a disclosure statement that was dated after their start date. (See LIS CODE SHEET)

Corrected Corrected by Oct 21, 2024

Category: background checks. 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 #1 had a health assessment and tuberculosis screening by the Mantoux method that were dated over 12 months prior to providing initial service in a child care setting at the facility and requires a current health assessment and tuberculosis screening by the Mantoux method.

Corrected Corrected by Oct 21, 2024

Category: ratio. 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 file for staff person #1 had emergency plan training that exceeded a year between trainings. The file for staff person #2 had emergency plan training that was dated after initial employment at the facility.

Corrected Corrected by Apr 10, 2024

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 children with chronic medical conditions.

Corrected Corrected by Apr 10, 2024

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 room #3, there was damaged plaster with a hole in the wall behind the door. In room #1, there was peeling paint in one area on the cabinet below the sink.

Corrected Corrected by Apr 10, 2024

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

3270.31(f) · Staff persons shall complete professional development within 90 days of hire as listed in subsections (f)1-10.

Staff person #2 completed the following required pre-service training on 1-16-24 that was over 90 days after their date of hire (see LIS code sheet): Health and Safety Training in the topics of 3270.31(f)(1-9). Staff person #4 completed the following required pre-service training on 2-24-24 that was over 90 days after their date of hire (see LIS code sheet): Health and Safety Training in the topics of 3270.31(f)(1-9). Staff person #7 completed the following required pre-service training on 2-3-24 that was over 90 days after their date of hire (see LIS code sheet): Health and Safety Training in the topics of 3270.31(f)(1-9). Staff person #9 completed the following required pre-service training on 3-10-24 that was over 90 days after their date of hire (see LIS code sheet): Health and Safety Training in the topics of 3270.31(f)(1-9).

Corrected Corrected by Apr 10, 2024

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 file for staff person #3 had a disclosure statement that was dated after their start date. The file for staff person #5 had state police clearances that exceeded 60 months between clearances.

Corrected Corrected by Apr 10, 2024

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 #2 completed mandated reporter training on 1-27-24 that was over 90 days after their date of hire. (see LIS code sheet) Staff person #5 had mandated reporter trainings dated 6-25-18 and 7-23-23 that were over 60 months between trainings.

Corrected Corrected by Apr 10, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.65 · Protective receptacle covers shall be placed in electrical outlets accessible to children 5 years of age or younger.

In the hallway on the right wall near room #3, there was an electrical outlet that was accessible to children 5 years of age and younger that lacked an outlet cover.

Corrected Corrected by Apr 10, 2024

Marked corrected in the state record.

3270.76 · Floors, walls, ceilings and other surfaces, including the facility's outdoor play space surfaces shall be kept clean, in good repair and free from visible hazards.

On the outdoor play space, there were cracks in the cement in multiple areas that were a tripping hazard.

Corrected Corrected by Apr 10, 2024

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

3270.82(h) · A facility person and an able child shall wash his hands after toileting and before eating. A sign on which this requirement is written shall be posted at each toilet, training chair, diapering area and sink in the facility.

In room #3, a handwashing sign was not posted at the left toilet in the bathroom and the diaper changing table in the room.

Corrected Corrected by Apr 10, 2024

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

3270.91(a) · Stairways, hallways, exits from rooms, exits from the facility and other means of egress serving as an exit shall be unobstructed.

In the bathroom in room #3, the door opening to the infant room next door was blocked by a crib in the infant room.

Corrected Corrected by Apr 10, 2024

Marked corrected in the state record.

3270.92(a) · Portable space heaters are not permitted.

There was a portable space heater observed in the staff bathroom.

Corrected Corrected by Apr 10, 2024

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.

In room #4 with 2 year olds present in the room, there was a playhouse with a crack in the plastic on the base of the doorframe that had sharp edges and pinch points.

Corrected Corrected by Apr 10, 2024

Category: physical safety. 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.

In the infant room, there were two children observed sleeping in pack 'n plays that lacked 2 feet of space on three sides.

Corrected Corrected by Apr 10, 2024

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

3270.123(b) · A parent shall receive the original agreement. The facility shall retain a copy of the agreement.

The files for child #3 and #4 had the original agreement in the file. According to staff, the parent of each enrolled child did not receive the original agreement.

Corrected Corrected by Apr 10, 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 file for child #4 had an emergency contact form that lacked the address of the child's physician.

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 child #4 had an emergency contact form that lacked the address of the individual designated by the parent to whom the child may be released.

Corrected Corrected by Apr 10, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.131(d)(5)/3270.131(e)(3) · A health report shall include a review of the child's immunized status according to recommendations of the ACIP. The facility shall implement dismissal policies in accordance with the Department of Health regulation in 28 Pa. Code § 27.77 (relating to immunization requirements for children in child care group settings). Children #1, #2, #3, #4, and #6 must be dismissed from care by close of business on 3-12-24 and may only return to care when the immunization record is updated or when a parent provides a written, signed exemption letter.

The files for child #1, a 17 month old, and child #6, a 17 month old, enrolled more than 60 days at the facility, lacked documentation of the 4th Pneumococcal vaccination being administered in accordance with the schedule recommended by the ACIP and lacked exemption documentation. The files for child #2, a 6 month old, and child #3, a 6 month old, enrolled more than 60 days at the facility, lacked documentation of the 2nd Rotavirus, DTAP, HIB, Pneumococcal, & Polio vaccinations being administered in accordance with the schedule recommended by the ACIP and lacked exemption documentation. The file for child #4, a 9 month old enrolled more than 60 days at the facility, lacked documentation of the 3rd DTAP and Pneumococcal vaccinations being administered in accordance with the schedule recommended by the ACIP and lacked exemption documentation.

Corrected Corrected by Apr 10, 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.

In room #1, there were Diazepam and Children's Motrin medications for child #7 that lacked written parental consent for administration of the medications.

Corrected Corrected by Apr 10, 2024

Category: ratio. 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 staff person #2 had a health assessment that was dated after the staff person provided initial service in a child care setting at the facility. The file for staff person #8 had a health assessment that exceeded 24 months between assessments.

Corrected Corrected by Apr 10, 2024

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 staff person #2 had a tuberculosis screening by the Mantoux method that was dated after initial employment at the facility.

Corrected Corrected by Apr 10, 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 #6 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 Apr 10, 2024

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

3270.192(4) · 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 file for staff person #7 had an FBI clearance with a record that lacked the required disposition.

Corrected Corrected by Apr 10, 2024

Category: background checks. 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.

Documentation of a current emergency drill conducted within the last year was not on file at the facility.

Corrected Corrected by Apr 10, 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 #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 Apr 10, 2024

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

3270.136(b) · 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.

There were multiple cases of children with RSV at the facility in December 2023. Parents of children enrolled at the facility were not informed of the RSV cases.

Corrected Corrected by Jan 31, 2024

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

3270.137 · An operator who observes an enrolled child with symptoms of a communicable disease or infection that can be transmitted directly or indirectly and which may threaten the health of children in care shall exclude the child from attendance until the operator receives notification from a physician or a CRNP that the child is no longer considered a threat to the health of others. The notification shall be retained in the child's file. Diseases and conditions which require exclusion are specified in 28 Pa. Code Chapter 27 (relating to communicable and noncommunicable diseases).

A child with symptoms of a communicable disease, RSV, returned to the facility without the operator receiving notification from a physician or a CRNP that the child is no longer considered a threat to the health of others.

Corrected Corrected by Dec 18, 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. Until such time as the required pre-service trainings are 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 person(s) available to supervise staff person #2, staff person #2 may not work in a child-care position at the facility.

Staff person #2 was observed to be caring for children unsupervised. Staff person #2 has not completed the following pre-service trainings required prior to caring for children unsupervised: Pediatric first-aid/CPR training, Health and Safety Training in the topics of 3270.31(f)(1-9).

Corrected Corrected by Feb 1, 2024

Category: supervision. 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 and staff person #4 will have until 15 days from the POC requested date to complete the required training. Until such time as the required training has been completed, staff person #2 and #4 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 and #4, staff person #2 and #4 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. Staff person #4 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 from a PQAS approved trainer and a PQAS approved curriculum.

Corrected Corrected by Feb 1, 2024

Category: supervision. 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 #1 will have until 15 days from the POC requested date to complete the mandated reporter training. Until such time as the required training has been completed, staff person #1 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 #1, staff person #1 may not work in a child-care position at the facility.

Staff person #1 has not completed mandated reporter training within the last 60 months. This is evidenced by the previously documented mandated reporter training on file being dated 10-22-18.

Corrected Corrected by Feb 1, 2024

Category: supervision. 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.

On 12-18-23, staff person #2, an aide, and staff person #3, an aide, were observed in the older 1 year old room, each supervising a group of 5 young toddlers, and were not supervised by a staff person qualifying at minimum as an assistant group supervisor.

Corrected Corrected by Feb 1, 2024

Category: supervision. Marked corrected in the state record.

3270.61(b) · Indoor child care space may not be used simultaneously as play space.

In room 4, measured as child care space, there were 2 staff persons with 10 older toddlers using the space as child care space. In a partitioned section of the room, there were 2 staff with 4 young toddlers using the partitioned space as gross motor play space in the same room that is measured as child care space.

Corrected Corrected by Feb 1, 2024

Category: recordkeeping. 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.

There were multiple cases of children with RSV at the facility in December 2023. A facility person did not report the cases of RSV to the Department of Health.

Corrected Corrected by Feb 1, 2024

Category: health medication. 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.

According to the fire drill log, a fire drill was not conducted at least once every 60 days between 9-7-23 to 11-7-23.

Corrected Corrected by Feb 1, 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.

According to the log, the operator did not manually test the interconnected fire detection system in the facility at least once every 30 days between 7-11-23 to 8-11-23, 8-11-23 to 9-11-23, and 10-9-23 to 11-9-23.

Corrected Corrected by Feb 1, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.151(c)(1) · An adult health assessment must include a physical examination.

The file for staff person #12 had a health assessment that lacked a physical examination.

Corrected Corrected by May 5, 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 continuity of operations according to federal requirements at 45 CFR § 98.41(a)(1)(vii).

Corrected Corrected by May 5, 2023

Category: ratio. Marked corrected in the state record.

3270.14/3270.21 · A facility shall be operated in conformity with applicable Federal and State laws and regulations. State agencies whose regulations may relate to the operation of a facility include the Department of Environmental Resources, the Department of Labor and Industry, the Department of Health, the Department of Education and the Department of Transportation. Conditions at the facility may not pose a threat to the health or safety of the children. Until such time as the required pre-service trainings are completed, staff person #6 and #22 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 #6 and #22, staff person #6 and #22 may not work in a child-care position at the facility.

Staff person #6 and #22 were observed to be caring for children unsupervised. Staff person #6 and #22 have not completed the following pre-service training required prior to caring for children unsupervised: Pediatric first-aid/CPR training from a PQAS approved curriculum.

Corrected Corrected by May 5, 2023

Category: supervision. 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, #4, #12, and #21 had emergency plan training that exceeded a year between trainings.

Corrected Corrected by May 5, 2023

Category: recordkeeping. 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 #2 had current pediatric first-aid and CPR training with a completion date of 4-5-22 that was after the February 2022 expiration of the prior training. The file for staff person #16 had current pediatric first-aid and CPR training with a completion date of 3-7-23 that was after the February 2023 expiration of the prior training.

Corrected Corrected by May 5, 2023

Category: ratio. Marked corrected in the state record.

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

The file for staff person #16 lacked current fire safety training completed within the last year.

Corrected Corrected by May 5, 2023

Category: recordkeeping. 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 #3, #4, #5, #6, #7, #8, #9, #10, #11, #18, #19, #20, #21, and #22 will have until 5-10-23 to complete the required training. Until such time as the required training has been completed, staff person #3, #4, #5, #6, #7, #8, #9, #10, #11, #18, #19, #20, #21, and #22 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 #3, #4, #5, #6, #7, #8, #9, #10, #11, #18, #19, #20, #21, and #22, staff person #3, #4, #5, #6, #7, #8, #9, #10, #11, #18, #19, #20, #21, and #22 may not work in a child-care position at the facility.

Staff person #5, #6, #8, #9, #10, #11, #19, #20, #21, and #22 have 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 from a PQAS approved curriculum. Staff person #18 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. Staff person #3, #4, #7 have not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): Approved Health and Safety Training in the topics of 3270.31(f)(1-9).

Corrected Corrected by Jun 23, 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. Staff Person #14, Staff Person #15, and Staff Person #17 may not work at the facility.

The file for staff person #14 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. The file for staff person #15 lacked a child abuse clearance and the out of state Sex Offender and Child Abuse & Neglect registry checks or application for the registry checks at their start date and requires a current child abuse clearance and out of state Sex Offender and Child Abuse & Neglect registry checks. The file for staff person #17 had an FBI clearance with a rap sheet that lacked the required disposition and 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. The file for staff person #1 had a Department of Education FBI clearance dated 10-10-22 and did not obtain a DHS FBI clearance until 2-22-23, which was after their start date. The files for staff person #2 and #16 had state police, child abuse, and FBI clearances that exceeded 60 months between clearances. The file for staff person #12 had an FBI clearance dated 3-22-22 that was after their start date.

Corrected Corrected by May 8, 2023

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 #2 had mandated reporter trainings dated 1-18-17 and 3-10-22 that were over 60 months between trainings. Staff person #4 had mandated reporter trainings dated 6-12-17 and 7-26-22 that were over 60 months between trainings.

Corrected Corrected by May 5, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.37(b)(1)/3270.192(2)(ii) · An aide shall have a high school diploma or a general educational development certificate. 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 #13, functioning as an aide, lacked verification of education to qualify as an aide.

Corrected Corrected by May 5, 2023

Category: recordkeeping. 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.

In the infant room during naptime, there was a 1 year old that was observed sleeping in a pack 'n play that lacked 2 feet of space on three sides.

Corrected Corrected by May 5, 2023

Category: physical safety. 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 #1 had an agreement that lacked the persons designated by a parent to whom the child may be released.

Corrected Corrected by May 8, 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 file for child #1 had an agreement that lacked the child's admission date.

Corrected Corrected by May 8, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.124(b)(7) · Emergency contact information must include the name, address and telephone number of the individual designated by the parent to whom the child may be released.

The file for child #1 had an emergency contact form that lacked the name, address and telephone number of the individual designated by the parent to whom the child may be released. The files for child #4 and #6 had an emergency contact form that lacked the address of the individual designated by the parent to whom the child may be released.

Corrected Corrected by May 8, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.131(d)(5)/3270.131(e)(3) · A health report shall include a review of the child's immunized status according to recommendations of the ACIP. The facility shall implement dismissal policies in accordance with the Department of Health regulation in 28 Pa. Code § 27.77 (relating to immunization requirements for children in child care group settings). Children #1, #2, #3, #4, and #5 must be dismissed from care by close of business on 4-25-23 and may only return to care when the immunization record is updated or when a parent provides a written, signed exemption letter.

The files for child #1, a 3 year old, child #3, a 2 year old, child #4, a 4 year old, and child #5, a 2 year old, had an immunization record that lacked verification of the Influenza vaccination being administered within the last calendar year in accordance with the schedule recommended by the ACIP and lacked exemption documentation. The file for child #2, a 2 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 May 8, 2023

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

3270.151(a) · A facility person providing direct care who comes into contact with the children or who works with food preparation shall have a health assessment conducted within 12 months prior to providing initial service in a child care setting and every 24 months thereafter. A health assessment is valid for 24 months following the date of signature, if the person does not contract a communicable disease or develop a medical problem.

The files for staff person #2, #5, #7, #9, and #21 had a health assessment that exceeded 24 months between assessments.

Corrected Corrected by May 5, 2023

Category: ratio. Marked corrected in the state record.

3270.151(c)(2)/3270.151(c)(2)(ii) · 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 record of a person with a positive tuberculin skin test shall include the results of a chest x-ray and evaluation for chemoprophylaxis.

The file for staff person #18 had the results of a chest x-ray and lacked verification of a positive tuberculin skin test or a tuberculosis screening by the Mantoux method at initial employment.

Corrected Corrected by May 5, 2023

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

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

The file for staff person #11 had a health assessment that lacked an examination for communicable diseases and the results of that examination. The file for staff person #17 had a health assessment that said "Yes" to having any communicable diseases without an explanation of the results.

Corrected Corrected by Jun 16, 2023

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

3270.151(c)(5) · 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 #11 had a health assessment that lacked the physician's or CRNP's assessment of the person's suitability to provide child care.

Corrected Corrected by May 5, 2023

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 infants and toddlers.

Corrected Corrected by May 5, 2023

Category: physical safety. 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.

The facility lacked documentation on file of an emergency drill being conducted within the last year.

Corrected Corrected by May 5, 2023

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.

According to the fire drill log, a fire drill was not conducted at least once every 60 days between 5-17-22 to 7-20-22, 9-16-22 to 12-16-22, and 12-16-22 to 2-21-23.

Corrected Corrected by May 5, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.94(a)(9) · The Director or designated staff person who is responsible for compliance with this chapter shall conduct fire drills and ensure that a written record is maintained on file at the facility indicating the specific time of day of the drill, the hypothetical location of the fire, the evacuation time, and the names of the facility persons and the number of children who participate in the fire drill.

The names of the facility persons who participated in the fire drill were not listed on the fire drill log for multiple fire drills within the last year.

Corrected Corrected by May 5, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.95(a)/3270.95(b) · Fire detection devices or systems must be in compliance with standards established under section 1016(c) of the act (62 P.S. §  1016(c)). The Director or designated staff person who is responsible for compliance with this chapter shall ensure the requirements under subsection (a) are met.

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.

Corrected Corrected by May 5, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.31(e)(4)(i)/3270.192(2)(iii) · 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. 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 #2 and #7, each employed in child care positions for more than 90 days, did not contain documentation of the completion of pediatric CPR/first-aid.

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.

3270.31(f)/3270.192(2)(iii) · Staff persons shall complete professional development in the following topics within 90 days of hire: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 #7, who has been employed in a child care position for more than 90 days, did not contain documentation of the completion of Health and Safety Basics training.

Corrected Corrected by Jun 21, 2022

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). LACKING REQUIRED HIRING DOCUMENTS: Facility Person #1, #3 may not work in a child care position at the facility. A facility person's record shall include a copy of requests for the criminal history record and child abuse registry clearance information, a copy of the disclosure statement and a copy of the completed clearance information required under the CPSL. Facility Person # 1, #3 may not work in a child care position at the facility.

The file for Staff #1 contained incomplete PA State Police and FBI Criminal History Clearances. The file for Staff #3 contained documentation of an FBI Criminal History Clearance that is not accepted by our department. Staff #3 cannot work at the facility until an acceptable FBI clearance is obtained. Although the file for Staff #6 contained a current PA DHS Child Abuse Clearance, the previously completed clearances were processed more than 60 months ago.

Corrected Corrected by Jun 21, 2022

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.

Although the file for Staff #6 contained current documentation of the completion of mandated reporter training, the previously completed training was dated more than 60 months prior.

Corrected Corrected by Jun 21, 2022

Category: recordkeeping. Marked corrected in the state record.

3270.65 · Protective receptacle covers shall be placed in electrical outlets accessible to children 5 years of age or younger.

An unused, unprotected electrical outlet was observed in an area in the Preschool Room that is accessible to children in care under the age of six.

Corrected Corrected by Jun 21, 2022

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.

A closet located in the main hallway was observed to have a locking mechanism that was not functioning. Toxic cleaning materials were observed inside of the closet in areas accessible to children in care.

Corrected Corrected by Jun 21, 2022

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.

Sharply edged pieces of metal trim were observed along the base of a room divider and at the base of a rear egress door in the Preschool Room. Both noted areas of concern were in areas accessible to children in care and presented the potential to cause laceration injuries.

Corrected Corrected by Jun 21, 2022

Category: ratio. 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.

In the Preschool Room and Older Toddler Rooms respectively, in areas accessible to children in care, an approximately 6" in diameter plastic storage bucket and an approximately 12" in diameter plastic storage basket were observed to have cracked edges that created the potential for laceration and/or puncture injuries.

Corrected Corrected by Jun 21, 2022

Category: ratio. Marked corrected in the state record.

3270.107 · A facility shall have an operable, clean refrigerator used to store potentially hazardous foods. The refrigerator shall be capable of maintaining food at 45° F or below. An operating thermometer shall be placed in the refrigerator.

A thermometer was not present in the refrigerator located in the Infant Room, which is used to store infant bottles.

Corrected Corrected by Jun 21, 2022

Category: nutrition. 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 #1 contained an emergency contact form that did not include the addresses of three persons listed as to whom the child can be released.

Corrected Corrected by Jun 21, 2022

Category: recordkeeping. Marked corrected in the state record.

3270.124(b)(7) · Emergency contact information must include the name, address and telephone number of the individual designated by the parent to whom the child may be released.

The file for Child #1 contained an emergency contact form that did not include the addresses of three authorized persons to whom the child can be released.

Corrected Corrected by Jun 21, 2022

Category: recordkeeping. 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.

Although the file for Staff #6 contained a current health assessment, the previously completed health assessment was administered more than 24 months prior.

Corrected Corrected by Jun 24, 2022

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 Staff #2 contained a health assessment that did not include the results of an examination for communicable diseases.

Corrected Corrected by Jun 21, 2022

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

3270.151(c)(5) · An adult health assessment must include the physician's or CRNP's assessment of the person's suitability to provide child care.

The files for Staff #2 and #4 contained health assessments that did not include the attestation of an accepted medical professional that each staff is suitable to provide child care.

Corrected Corrected by Jun 21, 2022

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 Staff #2 contained only one of the required two written, nonfamily references.

Corrected Corrected by Jun 21, 2022

Category: recordkeeping. Marked corrected in the state record.