3270.151(a)/3270.192(3) · A facility person providing direct care who comes into contact with the children or who works with food preparation shall have a health assessment conducted within 12 months prior to providing initial service in a child care setting and every 24 months thereafter. A health assessment is valid for 24 months following the date of signature, if the person does not contract a communicable disease or develop a medical problem. A facility person's record shall include a written report of initial and subsequent health assessments, including the results of initial and subsequent tuberculin skin tests, x-rays or other medical documentation necessary to confirm freedom from communicable tuberculosis.

An unannounced inspection occurred at the facility. A review of staff files was conducted. See the code sheet for the date of hire. Regulation requires staff to have on file a health assessment prior to providing child care. Staff #3 has worked in a child care role at the facility and the file did not contain a health assessment at the time of this inspection.

Corrected Corrected by May 9, 2025

Category: ratio. 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. Staff person(s) shall complete professional development in the topics of 3270.31(f)( 10). Staff person #4 will have until 10/11/24 to complete the required training. Until such time as the required training has been completed, staff person #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 #4, staff person #4 may not work in a child-care position at the facility.

During the inspection, staff person #4 did not have documentation of current PQAS approved Pediatric First Aid/CPR training on file. This is evidenced by the documentation on file for PQAS approved Pediatric First Aid/CPR dated 3/10/22 which is no longer valid. Staff person #8 had a current Pediatric First Aid/CPR training on file dated 9/28/22. The previous date of Pediatric First Aid/CPR training was dated 8/21/20. This reflects a timeframe of when staff person #8 did not have current Pediatric First Aid/CPR.

Corrected Corrected by Sep 24, 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 -9) within 90 days of hire. Staff person #12 will have until 10/11/24 to complete the required training. Until such time as the required training has been completed, staff person #12 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 #12, staff person #12 may not work in a child-care position at the facility.

Staff person #12 has not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): CENTER BASED HEALTH AND SAFETY TRAINING.

Corrected Corrected by Oct 3, 2024

Category: supervision. Marked corrected in the state record.

3270.32(a)/3270.192(4) · The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). . A facility person's record shall include a copy of requests for the criminal history record and child abuse registry clearance information, a copy of the disclosure statement and a copy of the completed clearance information required under the CPSL. Facility Person #1 may not work in the facility until the PA State Police clearance is received.

During the inspection, facility person #1 had a PA State Police clearance dated 7/6/23 that stated, " Request Pending" and no dissemination date making this an incomplete clearance. Staff person #10 did not complete mandated reporter training every 60 months as required. The current training on file is dated 9/18/23 and the previous training is dated 9/6/18 showing a timeframe where mandated reporter training was not current.

Corrected Corrected by Sep 23, 2024

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 monkey bars and large embedded climber in the school age play yard shall be made inaccessible and will not be used by the children until such time as the loose impact absorbing material meets the recommendations of the United States Consumer Product Safety Commission. For this piece of equipment there needs to be nine inches of loose-fill impact absorbing material under the climber.

During the inspection, on the school age playground, the embedded monkey bars had a fall height of 84" and there was only 7 inches of loose-fill wood mulch under them. The large, embedded climber had a fall height of 5 1/2' and only had 7 1/2 inches of loose fill wood mulch around the equipment. At minimum, embedded equipment requires there to be 9 inches of loose fill mulch around the equipment.

Corrected Corrected by Sep 23, 2024

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

3270.102(c) · Outdoor equipment that requires embedded mounting must be mounted over a loose-fill or unitary playground protective surface covering that meets the recommendations of the United States Consumer Product Safety Commission. The equipment must be anchored firmly and be in good repair. The operator shall more loose-fill impact absorbing material to bring the depth into compliance with the recommendations of the United States Consumer Product Safety Commission.

During the inspection, on the school age playground, the embedded monkey bars had a fall height of 84" and there was only 7 inches of loose-fill wood mulch under them. The large, embedded climber had a fall height of 5 1/2' and only had 7 1/2 inches of loose fill wood mulch around the equipment. At minimum, embedded equipment requires there to be 9 inches of loose fill mulch around the equipment.

Corrected Corrected by Sep 24, 2024

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

3270.124(b)(6) · Emergency contact information must include health insurance coverage and policy number for a child under a family policy or Medical Assistance benefits, if applicable.

The emergency contact form for child #8 did not include health insurance coverage and a policy number for a child under a family policy or Medical Assistance benefits.

Corrected Corrected by Sep 25, 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 emergency contact form for child #4 did not include the address of the individual designated by the parent to whom the child may be released.

Corrected Corrected by Sep 24, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.124(f) · The parent shall update in writing emergency contact information once in a 6-month period or as soon as there is a change in the information.

The parent of child #3 did not review/update the emergency contact form and agreement every 6 months as required. This is evidenced by the last documented review/update date of 9/14/23.

Corrected Corrected by Sep 24, 2024

Category: recordkeeping. 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.

Facility person #1 did not receive a health assessment at initial hire. This is evidenced by the health assessment on file dated 6/14/23. The TB screening on file for facility person #1 was dated 3/19/08 and not within 12 months of initial hire (see LIS code sheet for date of hire). Staff person #7 and staff person #18 did not update the health assessment every 24 months as required. This is evidenced by the current health assessment on file dated 4/23/24 and 6/17/24, respectively. The previous health assessment on file is dated 2/21/22 and 5/11/22, respectively.

Corrected Corrected by Oct 9, 2024

Category: ratio. Marked corrected in the state record.

3270.21/3270.133 · Conditions at the facility may not pose a threat to the health or safety of the children. The operator shall make reasonable accommodation in accordance with applicable federal and state laws to facilitate administration of medication or a special diet that is prescribed by a physician, physician's assistant or CRNP as treatment related to the child's special needs. Facility persons are not required to administer medication or special diets which are requested or required by a parent, a physician, a physician's assistant or a CRNP but are not treatment related to the child's special needs. All staff will participate in training related to this citation. Training must be approved by OCDEL.

During the self-reported non-compliance investigation conducted on 3/27/2024 it was verified that Child #1 joined another class while his class was napping. While with the other class, he was mistakenly given milk to drink of which he is highly allergic. Staff person #1 noticed that he was breaking out and that his lip was a bit swollen. She called the director for help. The director administered his Epi-pen and called mom immediately. Mother transported him to the ER. It is documented on the child's emergency contact form and health assessment that he is allergic to dairy.

Corrected Corrected by May 18, 2024

Category: ratio. Marked corrected in the state record.

3270.21/3270.133 · Conditions at the facility may not pose a threat to the health or safety of the children. The operator shall make reasonable accommodation in accordance with applicable federal and state laws to facilitate administration of medication or a special diet that is prescribed by a physician, physician's assistant or CRNP as treatment related to the child's special needs. Facility persons are not required to administer medication or special diets which are requested or required by a parent, a physician, a physician's assistant or a CRNP but are not treatment related to the child's special needs.

During the self-reported non-compliance investigation conducted on 3/27/2024 it was verified that Child #1 joined another class while his class was napping. While with the other class, he was mistakenly given milk to drink of which he is highly allergic. Staff person #1 noticed that he was breaking out and that his lip was a bit swollen. She called the director for help. The director administered his Epi-pen and called mom immediately. Mother transported him to the ER. It is documented on the child's emergency contact form and health assessment that he is allergic to dairy.

Corrected Corrected by May 18, 2024

Category: ratio. 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. Children must be supervised at all times.

During the unannounced monitoring inspection conducted on 3/27/2024 observed staff in the PVE room named 18 out of the 21 children present that they were responsible for supervision of leaving 3 children unaccounted for. One child was named twice by different staff. Observed the staff in the Pre-K Counts Rachel room named 13 children out of the 14 children present that they were responsible for supervision of leaving 1 child unaccounted for. Observed the staff in the Pre-K Counts Kimberly room named 11 children out of the 13 children present that they were responsible for supervision of leaving 2 children unaccounted for.

Corrected Corrected by May 18, 2024

Category: supervision. Marked corrected in the state record.

3270.113(a)(1) · Each staff person shall be assigned the responsibility for supervision of specific children. The staff person shall know the names and whereabouts of the children in his assigned group. The staff person shall be physically present with the children in his group on the facility premises and on facility excursions off the facility premises. The legal entity must arrange for all facility staff to receive a minimum of two hours of in person training regarding supervision of children. The legal entity must receive DHS approval of the training content prior to scheduling the training.

During the unannounced monitoring inspection conducted on 3/27/2024 observed staff in the PVE room named 18 out of the 21 children present that they were responsible for supervision of leaving 3 children unaccounted for. One child was named twice by different staff. Observed the staff in the Pre-K Counts Rachel room named 13 children out of the 14 children present that they were responsible for supervision of leaving 1 child unaccounted for. Observed the staff in the Pre-K Counts Kimberly room named 11 children out of the 13 children present that they were responsible for supervision of leaving 2 children unaccounted for.

Corrected Corrected by May 18, 2024

Category: supervision. 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.

During the unannounced monitoring inspection conducted on 3/27/2024 observed staff person #1's file did not include a health assessment within the 24-month time frame. The last health assessment on file is dated 1/17/2022.

Corrected Corrected by May 18, 2024

Category: ratio. Marked corrected in the state record.

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

The file of STAFF #1 (see code sheet for start date) contains a child abuse clearance dated 8/31/18. This is more than 60 months old.

Corrected Corrected by Oct 30, 2023

Category: background checks. 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 of STAFF #1 (see code sheet for start date) contains a health assessment dated 9/23/21. This is more than 24 months old. The file of STAFF #2 (see code sheet for start date) contains a health assessment dated 9/22/21. This is more than 24 months old.

Corrected Corrected by Oct 30, 2023

Category: ratio. 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.

During the onsite renewal inspection on 10/11/23 the annual testing report from Johnson Controls on 9/8/23 stated that there was a deficiency during the annual alarm system inspection. A strobe light in the boiler room was deficient. As of 10/11/23 there is no verification that the deficiency was corrected.

Corrected Corrected by Oct 30, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.21/3270.63 · Conditions at the facility may not pose a threat to the health or safety of the children. If unsafe areas or conditions are in or near an outdoor play space, fencing or natural barriers are required to restrict children from those unsafe areas or conditions.

On 6/6/22 or 6/7/22 preschool students went outside to release butterflies. They went to a grassy area at the side of the building. This area was next to a parking lot and not fenced in. After releasing the butterflies, the children were running relay races. CHILD #1 attempted to run away from the group. STAFF #1 followed and brought CHILD #1 back to the group.

Corrected Corrected by Feb 23, 2023

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

3270.182(5) · A child's record shall contain signed parental consent for administration of minor first-aid procedures by facility staff. Written consent is required prior to admission.

Child # 1 (start date 8/4/21) emergency contact form did not include signed parental consent for administration of minor first-aid procedures by facility staff.

Corrected Corrected by Oct 11, 2022

Category: ratio. Marked corrected in the state record.

3270.76/3270.77(a) · 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. Peeled or damaged paint or damaged plaster is not permitted on indoor or outdoor surfaces in the child care facility.

During renewal inspection on 10/3/22 cert rep observed damaged paint as follows: library in reading corner; room 103 by the changing table; room 104 book area under chalk board/writing desk/wall by changing table; room 108 writing table wall; room 107 corner by cubbies/dramatic play/block area/library area; room 105 library wall; room 106 corner and wall by game table; room 110 next to science shelf/library/block area; room 113 dramatic play & wall by door; room 109 bathroom corner.

Corrected Corrected by Oct 11, 2022

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.

During renewal inspection on 10/3/22 cert rep observed a rug in the OT room that was missing approximately 20 inches of binding and the edges were fraying.

Corrected Corrected by Oct 3, 2022

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

3270.124(b)(4)/3270.182(3) · Emergency contact information must include the written consent signed by a parent for emergency medical care. A child's record shall contain signed parental consent for emergency medical care for the child. Written consent is required prior to admission.

Child # 1 (start date 8/4/21) emergency contact form did not include written consent signed by a parent for emergency medical care.

Corrected Corrected by Oct 11, 2022

Category: recordkeeping. Marked corrected in the state record.

3270.131(d)(5)/3270.131(e)(2)(i) · A health report shall include a review of the child's immunized status according to recommendations of the ACIP. Exemption from immunization for religious belief or strong personal objection equated to a religious belief shall be documented by a written, signed and dated statement from the child's parent or guardian. The statement shall be kept in the child's record.

Child #2 and child #3 (see code sheet for DOB) did not have documentation of influenza immunization. This is not in accordance with ACIP recommendations. There was no exemption letter in file for either child.

Corrected Corrected by Oct 11, 2022

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

3270.27(a)(5) · The facility shall have an emergency plan that provides for accommodations for infants, toddlers, children with disabilities, and children with chronic medical conditions.

Per the renewal inspection review of the emergency plan, the plan does not provide for required accommodations.

Corrected Corrected by Nov 8, 2021

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

3270.25(b) · The operator shall post a copy of each inspection summary issued by the Department in a conspicuous location used by parents. The inspection summary shall remain posted until an agent of the Department verifies that each regulatory noncompliance item cited on the inspection summary has been corrected.

During renewal inspection it was revealed that an inspection summary with a item not corrected was not posted.

Corrected Corrected by Nov 8, 2021

Marked corrected in the state record.

3270.25(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.

During renewal inspection, it was revealed that parents have not been given information on how to electronically access the regulations.

Corrected Corrected by Nov 8, 2021

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.

Per investigation on 10/13/21 interviews and documents did reveal that the facility has a history of informing parents of communicable diseases, however staff admitted that notice of one child having a positive COVID result was not sent out to parents.

Corrected Corrected by Nov 3, 2021

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