3280.14/3280.20 · 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's emergency plan was observed to not have documentation to address continuity of operations.

Corrected Corrected by Aug 12, 2024

Category: ratio. Marked corrected in the state record.

3280.20 · Conditions at the facility may not pose a threat to the health or safety of the children.

The sheets in the crib were observed to be loose fitting on the mattress.

Corrected Corrected by Aug 12, 2024

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

3280.66(a) · 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 kept in a locked area or in an area inaccessible to children, and shall be stored away from food, food preparation areas and child care spaces.

It was observed in the unlocked shed, that a gallon of Moto-Mix oil that says "Keep out of reach of Children", was accessible to the children in care.

Corrected Corrected by Aug 12, 2024

Category: ratio. Marked corrected in the state record.

3280.102(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 that the front wooden ledge of the sandbox was cracked and splintering.

Corrected Corrected by Aug 19, 2024

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

3280.123(a)(7) · An agreement shall specify the services which are to be considered as extra.

The agreement on file for Child #1, Child #2, Child #3, Child #4, Child #5 were observed not to specify the services which are to be considered as extra.

Corrected Corrected by Aug 19, 2024

Category: recordkeeping. Marked corrected in the state record.

3280.94(a)(5) · The primary staff person or designated staff person who is responsible for compliance with this chapter shall conduct fire drills and ensure that evacuation routes are posted in a conspicuous location on each floor of the facility.

It was observed that the evacuation route was not posted in a conspicuous location on the second floor.

Corrected Corrected by Aug 19, 2024

Category: recordkeeping. Marked corrected in the state record.

3280.95(a)/3280.95(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 primary staff person or designated staff person who is responsible for compliance with this chapter shall ensure the requirements in subsection (a) are met.

The facility's fire drill log was observed to not be testing the smoke alarm system every 30 days. This is evidenced by the dates of testing 3/18/24 to 4/22/24.

Corrected Corrected by Aug 12, 2024

Category: recordkeeping. Marked corrected in the state record.

3280.14/3280.20 · 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 lacks a continuity of operations plan for the after math of a disaster.

Corrected Corrected by Aug 24, 2023

Category: ratio. Marked corrected in the state record.

3280.26(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 parent letter lacks a letter explaining the updates to the emergency plan which include lockdown, accommodations for infants and toddlers and children with chronic medical conditions.

Corrected Corrected by Aug 24, 2023

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

3280.32(a)/3280.192(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.

There was more than 60 months between the previous and most current and updated PA State Police clearances on file for household member #3. Dates are 4/4/17 and 6/15/23.

Corrected Corrected by Jun 15, 2023

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

3280.123(a)(3) · An agreement shall specify 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 at § 3280.124(f).

The files for children #1, 2, 3, 4, and 5 lack a child service report which was completed within the past six months.

Corrected Corrected by Aug 24, 2023

Category: recordkeeping. Marked corrected in the state record.

3280.131(b)(2)/3280.182(1) · The operator shall require the parent to provide an updated health report at least every 12 months for an older toddler or preschool child. A child's record must contain initial and subsequent health reports.

The files for children #2 and 3, both who are older toddler or preschool age children, lack a health assessment which was completed within the past 12 months.

Corrected Corrected by Aug 24, 2023

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

3280.131(d)(5)/3280.131(e)(3) · Child(ren) # 5 must be dismissed from care by close of business (DATE of provider notification) and may only return to care when the immunization record is updated or when a parent provides a written, signed exemption letter. 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 file for child #5 lacks a flu shot within the past year as in accordance with the schedule recommended by the ACIP.

Corrected Corrected by Jul 31, 2023

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

3280.26(a)(6) · Emergency drills shall be conducted annually. Annual emergency drills shall be documented and on file at the facility.

The facility file lacked documentation of an emergency drill, with all information required, within the past year.

Corrected Corrected by Aug 24, 2023

Category: recordkeeping. Marked corrected in the state record.

3280.95(a)/3280.95(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 primary staff person or designated staff person who is responsible for compliance with this chapter shall ensure the requirements in subsection (a) are met.

A manual fire detection check has not been completed within the past 30 days. This is evidenced by the most current check being completed on 6/23/23.

Corrected Corrected by Aug 24, 2023

Category: recordkeeping. Marked corrected in the state record.

3280.24(a) · The facility's current certificate of compliance shall be posted in a conspicuous location used by parents. The operator shall provide the parent of each child enrolled with information on how to access the regulations in this chapter electronically and with instructions for contacting the appropriate regional child care office.

The facility's current certificate of compliance was not posted.

Corrected Corrected by Aug 10, 2023

Marked corrected in the state record.

3280.14/3280.20 · 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 files for staff #1 and 2 lack documentation of the one-hour Health and Safety update which was to be completed by 12/30/22.

Corrected Corrected by May 15, 2023

Category: ratio. Marked corrected in the state record.

3280.53(a) · The related or foster children of an operator and the children or foster children of a staff person shall be counted in the staff:child ratio requirements.

On 4/3/23, observed staff #1 alone and providing care to 5 children. The youngest child in care was an infant. One of the children was a relative of staff #1.

Corrected Corrected by Apr 3, 2023

Category: ratio. Marked corrected in the state record.

3280.31(e)(4)(i) · Competence is the completion of training by a professional in the field of first-aid and 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.

CPR/FA training was not completed before the expiration of the most current certification for staff #1 and 2. Expiration date for CPR/FA was 2/2021 and CPR/FA was not completed again until 7/1/21.

Corrected Corrected by Jul 29, 2022

Category: ratio. Marked corrected in the state record.

3280.32(a) · The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services).

There was more than 60 months between the previous and most current mandated reporter trainings on file for staff #1 and 2. Dates are as follows: Staff #1 - 5/13/17 and 6/24/22. Staff #2 - 5/15/17 and 7/1/22.

Corrected Corrected by Jul 29, 2022

Category: recordkeeping. Marked corrected in the state record.

3280.32(a)/3280.192(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 #1's State Police information on file and dated 6/21/20 is not the required State Police clearance form required under the CPSL. On the day of inspection, staff #1 obtained a new State Police clearance and it is dated 7/26/22. There was more than 60 months between the previous and most current State Police, Child Abuse and FBI clearances on file for staff #2. Dates are as follows: State Police - 4/4/17 and 5/1/22, Child Abuse - 4/10/17 and 5/11/22 and FBI- 4/7/17 and 5/3/22. There was more than 60 months between the previous and most current Child Abuse and FBI clearances on file for household member #3. Dates are as follows: Child Abuse - 4/15/17 and 5/11/22 and FBI- 4/13/17 and 5/9/22.

Corrected Corrected by Jul 29, 2022

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

3280.102(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 outdoor play space, observed a large child's play house with an attached table on the inside of the house. The attached table had cracks on the middle of the table. On the outside play space fence, exposed bolts were observed at each of the three gate doors and the bolts were facing the inside of the play space.

Corrected Corrected by Aug 8, 2022

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

3280.131(a)(3) · The initial health report for an older toddler or preschool child shall be dated no more than 1 year prior to the first day of attendance at the facility.

The initial health report on file for child #3 did not contain a date that the health report was conducted. Therefore, documentation was not on file which verified that the health report was dated no more than 1 year prior to the first day of attendance at the facility.

Corrected Corrected by Aug 2, 2022

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

3280.131(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 health report on file for child #3 was not signed by a physician, physician's assistant or a CRNP and therefore, there was no professional title on the form.

Corrected Corrected by Aug 2, 2022

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

3280.131(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 files for children #1, 2 and 3 lack verification of a flu shot within the past year as in accordance with the schedule recommended by the ACIP.

Corrected Corrected by Aug 2, 2022

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

3280.182(3)/3280.182(5) · A child's record must contain signed parental consent for emergency medical care for the child. Written consent is required prior to admission.A child's record must contain signed parental consent for administration of minor first-aid procedures by facility staff. Written consent is required prior to admission.

The file for child #4 lacked signed parental consent for emergency medical care for the child and for administration of minor first-aid procedures by facility staff

Corrected Corrected by Aug 2, 2022

Category: ratio. Marked corrected in the state record.

3280.182(8) · A child's record must contain a copy of the initial agreement and subsequent written agreements between the parent and the operator. The parent receives the original agreement.

The file for child #1 lacks an initial fee agreement.

Corrected Corrected by Aug 2, 2022

Category: recordkeeping. Marked corrected in the state record.

3280.24(a) · The facility's current certificate of compliance shall be posted in a conspicuous location used by parents. The operator shall provide the parent of each child enrolled with information on how to access the regulations in this chapter electronically and with instructions for contacting the appropriate regional child care office.

The operator did not provide the parent of each child enrolled with information on how to access the regulations in this chapter electronically.

Corrected Corrected by Jul 29, 2022

Marked corrected in the state record.

3280.26(b)/3280.192(2)(iii) · The operator shall review the emergency plan at least annually and update the plan as needed. Each review and update of the emergency plan shall be documented in writing and kept on file at the facility.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 of staff #1 and #2 lacked documentation of reviewing the Emergency Plan annually.

Corrected Corrected by Aug 13, 2021

Category: recordkeeping. Marked corrected in the state record.

3280.123(a)(4) · An agreement shall specify the child's arrival and departure times.

The file of child #1 lacked an agreement with the child's arrival and departure times.

Corrected Corrected by Aug 13, 2021

Category: recordkeeping. Marked corrected in the state record.

3280.123(a)(6)/3280.182(2) · An agreement shall specify the date of the child's admission. A child's record must contain the dates of application, admission and withdrawal of the child.

The files of children #1 and #2 lacked agreements with each child's enrollment date.

Corrected Corrected by Aug 13, 2021

Category: recordkeeping. Marked corrected in the state record.

3280.124(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 of children #1 and #2 lacked emergency contact forms with the health insurance coverage and policy number for a child under a family policy or Medical Assistance benefits, if applicable.

Corrected Corrected by Aug 13, 2021

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

3280.26(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.

At the time of the inspection, the Emergency Plan did not provide for accommodations for infants, toddlers, children with disabilities and children with chronic medical conditions.

Corrected Corrected by Aug 13, 2021

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