3270.133(6)/3270.133(7) · A parent shall provide written consent for administration of medication or a special diet. An operator is responsible to establish and maintain a medication log if prescription or nonprescription medication is administered.

During the inspection, a medication log for Child #1 was not available for albuterol, which was onsite at the facility.

Corrected Corrected by Jan 11, 2025

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.

Documentation of a written policy addressing shaken baby syndrome, abusive head trauma, and child maltreatment was not available. Documentation of a plan for continuity of operations was not available within the emergency plan.

Corrected Corrected by Jan 11, 2025

Category: ratio. Marked corrected in the state record.

3270.27(c)/3270.31(e)(4)(ii) · 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. 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.

Documentation of annual fire safety training was not available. Documentation of annual emergency plan training was not available. The director explained that they conducted the training on 9/4/24 (fire safety) 9/24/24 (emergency plan training) and updated the Staff Data Sheet with the date for all staff.

Corrected Corrected by Jan 11, 2025

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. Facility Person #1 may not work in a child care position at the facility.

During paperwork review, it was noted that Staff #1 had an FBI clearance form dated 3/6/2019. This is 9 months past the requirement to have clearances updated every 60 months.

Corrected Corrected by Dec 18, 2024

Category: background checks. 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.

During the inspection, it was observed that a bottle of sunscreen was kept in a child's cubby. Vaseline was stored under the bathroom sink. Both items were accessible to children and labeled Keep out of Reach of Children. On the playground, the shed door was observed to be unlocked. A gas can and lawn tools were located in the shed. ALL ITEMS CORRECTED ON SIGHT.

Corrected Corrected by Jan 11, 2025

Marked corrected in the state record.

3270.69(b) · Hot water temperature, in areas accessible to children, may not exceed 110° F.

During the inspection, the water temperature from the bathroom sink measured 132 degrees F.

Corrected Corrected by Jan 11, 2025

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

3270.75(a) · A first-aid kit shall be in a child care space.

First aid kits were not available in all child care spaces. There are two distinct spaces for children and an outdoor space. There is one first aid kit, which did not travel to the outdoor play space with the children.

Corrected Corrected by Jan 11, 2025

Category: health medication. 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.

A wooden tabletop that was splintering was located on the playground. CORRECTED ON SITE.

Corrected Corrected by Dec 10, 2024

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

3270.118(c) · A veterinarian's certificate of current rabies immunization is required for a cat or dog at the facility. The certificate shall be on file when the cat or dog is present.

During the inspection, it was noted that a veterinarian's certificate of current rabies immunization was not available for one dog (Moses).

Corrected Corrected by Jan 15, 2025

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

3270.123(a) · An agreement shall be signed by the operator and the parent.

A space for the operator signature was not available on the Agreement Form.

Corrected Corrected by Jan 11, 2025

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.

During paperwork review, it was noted that Staff #2 provided a health assessment dated 7/31/23, which was beyond one year prior to start date.

Corrected Corrected by Jan 11, 2025

Category: ratio. 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.

Documentation addressing accommodations for infants, toddlers, children with disabilities, and children with chronic medical conditions were not included in the emergency plan, which is also posted for families.

Corrected Corrected by Jan 11, 2025

Category: physical safety. 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.

During the inspection, documentation that the annual traffic letter was sent to the local authorities was not available.

Corrected Corrected by Jan 13, 2025

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 #1 had Mandated Reporter training completed on 5/6/18 and updated on 8/7/23, which is greater than 60 months. Updated Mandated Reporter training is on file.

Corrected Corrected by Jan 21, 2024

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

3270.131(e)(2)(i) · 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 #1 did not have a handwritten exemption for immunizations on file. Document on file was a form letter signed by the parent, which is not accepted.

Corrected Corrected by Jan 24, 2024

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

3270.133(1) · A prescription or nonprescription medication may be accepted only in an original container. The medication shall remain in the container in which it was received.

Medication for child #1 was not in the original box.

Corrected Corrected by Jan 22, 2024

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

3270.133(3) · The label of a medication container shall identify the name of the medication and the name of the child for whom the medication is intended. Medication shall be administered to only the child whose name appears on the container.

Medication for child #1 did not contain the child's full name.

Corrected Corrected by Jan 22, 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.

There was no parental consent to administer medication on file.

Corrected Corrected by Jan 22, 2024

Category: ratio. Marked corrected in the state record.

3270.151(c)(2)/3270.192(3) · 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 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.

Staff number 3 had a TB test dated November 2017, which was not completed within 12 months prior to employment.

Corrected Corrected by Jan 22, 2024

Category: health medication. 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.

There was no record on file of a completed Emergency Drill within the past 12 months.

Corrected Corrected by Jan 24, 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.

Fire detection testing was completed on 11/4/23 and again on 12/19/23, which is greater than 30 days.

Corrected Corrected by Jan 21, 2024

Category: recordkeeping. 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.

Agreement form for child number 4 does not list release persons

Corrected Corrected by Feb 1, 2023

Category: recordkeeping. 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 was observed to be missing gloves. Corrected on site.

Corrected Corrected by Jan 5, 2023

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

3270.123(a) · An agreement shall be signed by the operator and the parent.

Agreement form for child number 1, 2, 3, 4, and 5 were not signed by the operator.

Corrected Corrected by Jan 30, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.123(a)(4) · An agreement shall specify the child's arrival and departure times.

Agreement form for child number 1 did not include the child's arrival or departure times Agreement form for child number 4 did not include the child's arrival or departure times.

Corrected Corrected by Jan 30, 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.

Staff person number 1 and number 2 were observed to be caring for children unsupervised. Staff person number 1 and number 2 did not have pediatric CPR/First Aide on file while caring for children.

Corrected Corrected by Jan 13, 2023

Category: supervision. 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. Directed Plan of Correction: Staff person(s) shall complete professional development in the topics of 3270.31(f) within 90 days of hire. Staff person #1,2,3,4, and 5 will have until 2/10/23 to complete the required training. Until such time as the required training has been completed, staff person #1,2,3,4 and 5 must be supervised, when interacting with children, by an (AGS, primary staff person, or family child care home staff person) who has completed the required training related to this citation. If there are no staff available to supervise staff person #1,2,3,4, and 5, staff person #1,2,3,4,and 5 may not work in a child-care position at the facility.

Staff number 1, 2, 3, 4, and 5 did not have Pediatric CPR/First Aide on file

Corrected Corrected by Jan 13, 2023

Category: supervision. Marked corrected in the state record.

3270.31(f)/3270.31(h) · Staff persons shall complete professional development within 90 days of hire as listed in subsections (f)1-10. All staff persons shall complete the professional development under subsection (f).

Staff person #1,2,3,4 and 5 did not have the updated health and safety training on file. Staff person #1,2,3,4, and 5 may not be left unsupervised until updated health and safety training has been completed.

Corrected Corrected by Feb 1, 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 #2 did not have an FBI clearance on file. Staff person #2 may not work in a child care setting until clearance if obtained. Staff Person #4 did not have a valid State Police Clearance on file. Clearance on file listed result as "Request Under Review" and did not list the results of the background check. Staff #5 did not have a completed state police clearance on file. Document on file was the receipt of registration but the clearance document with results of the check was not on file.

Corrected Corrected by Feb 1, 2023

Category: ratio. Marked corrected in the state record.

3270.123(a)(6)/3270.182(2) · An agreement shall specify the date of the child's admission. A child's record shall contain the dates of application, admission and withdrawal of the child.

Agreement form for child number 1, 2, 3, 4, and 5 did not include the child's date of admission.

Corrected Corrected by Jan 30, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.124(b)(3) · Emergency contact information must include the home and work addresses and telephone numbers of the enrolling parent.

Emergency contact form for child number 1 did not include the father's work address. Emergency contact form for child number 2 did not include the father's work address. Emergency contact form for child number 3 did not include the father's work address. Emergency contact form for child number 4 did not include a work address or phone number for the mother and father

Corrected Corrected by Jan 30, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.124(b)(5) · Emergency contact information must include information on the child's special needs, as specified by the child's parent, physician, physician's assistant or CRNP, which is needed in an emergency situation.

Emergency contact form for child number 3 did not include information on the child's special needs or disabilities. Emergency contact form for child number 5 did not include information on the child's special needs or disabilities.

Corrected Corrected by Jan 30, 2023

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.

Emergency contact form for child number 2 did not include the address for the persons to whom the child may be released. Emergency contact form for child number 4 did not include the address for the persons to whom the child may be released. Emergency contact form for child number 5 did not include the address for the persons to whom the child may be released.

Corrected Corrected by Jan 30, 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.

Staff person #5 had a health assessment dated 11/18/22, which was completed after the start date.

Corrected Corrected by Jan 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.

Fire detection testing was completed on 1/1/22 and again on 2/1/22, which is greater than 30 days Fire detection testing was completed on 3/1/22 and again on 4/1/22, which is greater than 30 days Fire detection testing was completed on 10/1/22 and again on 11/1/22, which is greater than 30 days.

Corrected Corrected by Jan 30, 2023

Category: recordkeeping. Marked corrected in the state record.