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 staff files for 1, 2 and the policies regarding recognition of potential signs and symptoms of shaken baby syndrome and abusive head trauma, strategies for coping with crying, fussing, or distraught children, and prevention and identification of child maltreatment and emergency were implemented on 11/21/23. *SECOND VIOLATION The file for staff person #3 has not completed the following pre-service training that was to be completed by 12/30/22: Pennsylvania Health and Safety Update 2022. Previously cited on SIN-00229861on 9/25/23.

Corrected Corrected by Nov 16, 2023

Category: ratio. Marked corrected in the state record.

3270.123(a)(3) · The services to be provided to the family and the child, including the Department's approved form to provide information to the family about the child's growth and development in the context of the services being provided. The operator shall complete and update the form and provide a copy to the family in accordance with the updates regarding emergency contact information in § 3270.124(f) (relating to emergency contact information).

*SECOND VIOLATION The agreement forms in the files for children #1, #2, #3, #4, and #5 lacked the services to be provided to the family and the child. Previously cited on SIN-00229861on 9/25/23.

Corrected Corrected by Nov 16, 2023

Category: recordkeeping. Marked corrected in the state record.

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

*SECOND VIOLATION The agreement forms in the files for children #1, #2, #3, #4, and #5 did not specify the services which are to be considered as extra. Previously cited on SIN-00229861on 9/25/23.

Corrected Corrected by Nov 16, 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.

*SECOND VIOLATION The facility lacked documentation of annual testing of the fire detection system from a fire safety professional within the last 12 months. The most recent documentation on file is dated 8/15/22. Previously cited on SIN-00229861on 9/25/23.

Corrected Corrected by Nov 16, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.14/3270.21 · A facility shall be operated in conformity with applicable Federal and State laws and regulations.State agencies whose regulations may relate to the operation of a facility include the Department of Environmental Resources, the Department of Labor and Industry, the Department of Health, the Department of Education and the Department of Transportation. Conditions at the facility may not pose a threat to the health or safety of the children.

The files for staff persons #1 and #3 have not completed the following pre-service training that was to be completed by 12/30/22: Pennsylvania Health and Safety Update 2022. The file for staff person #2 did not complete the pre-service training by 12/30/22: Pennsylvania Health and Safety Update 2022. The file for staff person #2 completed the training on 4/26/23. The facility lacked policies regarding recognition of potential signs and symptoms of shaken baby syndrome and abusive head trauma, strategies for coping with crying, fussing, or distraught children, and prevention and identification of child maltreatment. The facility's emergency plan was not present or available on the day of the inspection to determine the facility's plan for continuity of operations in an emergency.

Corrected Corrected by Nov 1, 2023

Category: ratio. Marked corrected in the state record.

3270.27(a) · The facility shall have an emergency plan.

The facility did not have documentation of an emergency plan on file at the time of inspection.

Corrected Corrected by Nov 1, 2023

Category: recordkeeping. 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 two most recent documentations of emergency plan training in the file for staff person #2 are dated more than 12 months apart: 1/7/22 and 4/28/23.

Corrected Corrected by Oct 20, 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 #1 had documentation of pediatric first aid/CPR training was not renewed before the expiration date of the most current certification: 2/16/21 and 3/3/23.

Corrected Corrected by Nov 1, 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 #1 had documentation of fire safety training was not renewed before the expiration date of the most current certification: 9/23/21 and 6/3/23.

Corrected Corrected by Nov 1, 2023

Category: ratio. Marked corrected in the state record.

3270.32(a)/3270.192(4) · The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services).

The file for staff person #1 had documentation of PA State Police Clearance that was not renewed before the expiration date of the most current certification: 6/12/17 and 6/13/22.

Corrected Corrected by Nov 1, 2023

Category: ratio. Marked corrected in the state record.

3270.34(a)(6) · A director is responsible for written evaluation of staff persons on a regular basis, a minimum of one evaluation every 12 months.

The file for staff person #1 did not have documentation of a written evaluation by the director within the last 12 months.

Corrected Corrected by Nov 1, 2023

Category: recordkeeping. 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.

The refrigerator in the PreK room did not have an operable thermometer.

Corrected Corrected by Oct 20, 2023

Category: nutrition. Marked corrected in the state record.

3270.123(a)(3) · The services to be provided to the family and the child, including the Department's approved form to provide information to the family about the child's growth and development in the context of the services being provided. The operator shall complete and update the form and provide a copy to the family in accordance with the updates regarding emergency contact information in § 3270.124(f) (relating to emergency contact information).

The agreement forms in the files for children #1, #3, #4, and #5 lacked the services to be provided to the family and the child.

Corrected Corrected by Nov 1, 2023

Category: recordkeeping. Marked corrected in the state record.

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

The agreement forms in the files for children #1, #3, #4, and #5 did not specify the services which are to be considered as extra.

Corrected Corrected by Nov 1, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.123(b)/3270.182(8) · A parent shall receive the original agreement. The facility shall retain a copy of the agreement. A child's record shall 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 #2 lacked a copy of a written agreement form between the parent and the operator.

Corrected Corrected by Oct 20, 2023

Category: recordkeeping. Marked corrected in the state record.

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

The two most recent health assessments on file for staff person #1 are dated more than 24 months apart: 8/17/21 and 9/12/23.

Corrected Corrected by Oct 20, 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.

The facility lacked documentation of annual testing of the fire detection system from a fire safety professional within the last 12 months. The most recent documentation on file is dated 8/15/22.

Corrected Corrected by Oct 20, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.171(a) · An operator shall notify local traffic safety authorities annually in writing of the location of the facility and the program's use of pedestrian and vehicular routes around the child care facility.

The operator did not have documentation on file of notifying local traffic safety authorities in writing of the location of the facility and the program's use of pedestrian and vehicular routes around the child care facility.

Corrected Corrected by Oct 6, 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 most recent pediatric first aid/CPR certification in the file for Staff Person #5 was conducted on 10/4/21. This was after the previous pediatric first aid/CPR certification expired on 4/19/21.

Corrected Corrected by Oct 4, 2022

Category: ratio. Marked corrected in the state record.

3270.31(e)(4)(ii)/3270.192(2)(iii) · 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. A facility person's record shall include verification of child care experience, education and training following the outset of service at the facility.

The most recent fire safety trainings in the files for Staff Person #1, #3, #4 and #5 exceeded 12 months between trainings. Online trainings were taken in August, September and October of 2020. Live training conducted at facility on 2/8/22.

Corrected Corrected by Feb 8, 2022

Category: recordkeeping. 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 FBI Clearance in the file for Staff Person #2 was dated 10/14/21, which was after the staff person's first day working in child care (see LIS Code Sheet). The file for Staff Person #2 did not contain documentation of a receipt for fingerprinting to verify clearance was applied for before start date.

Corrected Corrected by Oct 14, 2022

Category: background checks. 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. IF USING TIERED LIS: The required staff:child ratios must be maintained at all times. The legal entity must submit documentation in a format approved by DHS proving that the facility is maintaining the required staff:child ratios at all times. The legal entity will confirm continuing compliance by sending copies of the documentation to the -------- Region Office on a weekly basis for a period of three months after DHS approves the documentation format.

At approximately 12:00 PM on 10/3/22, Staff Person #1 was observed supervising 14 Preschool children who were getting their coats in the locker area of the hallway. Staff Person #2, who was sharing supervision of this group, was in the classroom for approximately 30 seconds before coming out into the hall.

Corrected Corrected by Oct 3, 2022

Category: supervision. 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.

Observed a nail on the ground in the Primary (Preschool) Playground.

Corrected Corrected by Oct 3, 2022

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

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

Observed peeling, flaking paint in the Primary (Preschool) Playground: on white white ceiling tile and along the top of the blue metal framework.

Corrected Corrected by Dec 2, 2022

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

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

The toilet stall in the boy's bathroom lacked a handwashing sign.

Corrected Corrected by Oct 3, 2022

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

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

The most recent health assessments in the files for Staff Person #3 and #5 exceeded 24 months between assessments.

Corrected Corrected by Oct 3, 2022

Category: ratio. 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 file for staff person #2 contains pediatric first-aid and pediatric CPR that expired 4/2021 and has not renewed their certification.

Corrected Corrected by Oct 16, 2021

Category: ratio. Marked corrected in the state record.

3270.32(a)/3270.192(4) · The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). 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 a child care position at the facility.

The file for staff person #1. hire date 1/25/2021, contains a disclosure statement that was electronically signed by staff #1 and electronically signed by a witness which is not acceptable under child protective service law.

Corrected Corrected by Sep 16, 2021

Category: background checks. 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.

On the outdoor play space it was observed that the large plastic caterpillar tunnel was cracked on the top posing a pinch hazard. In the child care classroom it was observed that the child's play kitchen sink and oven had loose handles posing a pinch hazard.

Corrected Corrected by Sep 16, 2021

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

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

The file for staff person #2 is lacking a health assessment completed during the previous 24 month period.

Corrected Corrected by Oct 16, 2021

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.

The provider was unable to provide documentation of proof of purchase of the hard-wired interconnected fire detection system.

Corrected Corrected by Oct 15, 2021

Category: recordkeeping. 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.

The provider did not provide the parent of each child enrolled with information on how to access the regulations electronically.

Corrected Corrected by Sep 16, 2021

Marked corrected in the state record.