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 #5 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 #5, staff person #5 may not work in a child-care position at the facility.

Staff person #5 was observed to be caring for children unsupervised. Staff person #5 has not completed the following pre-service training required prior to caring for children unsupervised: Pediatric first-aid/CPR training from a PQAS approved trainer.

Corrected Corrected by Jul 6, 2024

Category: supervision. 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 infants and toddlers.

Corrected Corrected by Aug 30, 2024

Category: physical safety. 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 #5 will have until 8-7-24 to complete the required training. Until such time as the required training has been completed, staff person #5 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 #5, staff person #5 may not work in a child-care position at the facility.

Staff person #5 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.

Corrected Corrected by Jul 6, 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 #2 had a disclosure statement that lacked the date. The file for staff person #3 had state police, child abuse, and FBI clearances that exceeded 60 months between clearances. The file for staff person #4, hired within the last year, had an outdated disclosure statement form and lacked the current disclosure statement form. (See LIS CODE SHEET) The file for staff person #5 had child abuse clearances that exceeded 60 months between clearances.

Corrected Corrected by Jul 8, 2024

Category: background checks. 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 lobby, there were three electrical outlets that lacked outlet covers and were accessible to children 5 years of age and younger. In the infant room with infants present in the room, there were two outlets that lacked outlet covers and were accessible to children 5 years of age and younger.

Corrected Corrected by Jul 3, 2024

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.

In the bathroom in the school-age room, there were 4 canisters of Clorox & Member's Mark Disinfecting Wipes labeled "Keep out of reach of children" that were located on a ledge that was accessible to children. In the preschool room on the desk, there were multiple bottles of toxics including Purrell Hand Sanitizer that were labeled "Keep out of reach of children" and were accessible to children.

Corrected Corrected by Jul 3, 2024

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.

A handwashing sign was not posted at the changing tables in the young toddler room and the older toddler room.

Corrected Corrected by Jul 3, 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.

The door between the preschool and infant rooms was obstructed by furniture in front of the door on both sides of the door in both rooms.

Corrected Corrected by Jul 3, 2024

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 file for child #4 had a child service report that exceeded 6 months between reports.

Corrected Corrected by Jul 3, 2024

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 Jul 3, 2024

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 #3 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 Aug 30, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.131(b)(2)/3270.182(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 shall contain initial and subsequent health reports.

The file for child #4, a preschooler, had a health assessment that exceeded 12 months between assessments.

Corrected Corrected by Aug 30, 2024

Category: health medication. 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 #2 must be dismissed from care by close of business on 7-2-24 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 #2, a 2 year old enrolled more than 60 days at the facility, lacked documentation of the 3rd HIB, Pneumococcal, & Polio vaccinations, the 3rd & 4th DTAP vaccinations, and the 1st & 2nd Hepatitis A vaccinations being administered in accordance with the schedule recommended by the ACIP and lacked exemption documentation.

Corrected Corrected by Jul 2, 2024

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 file for staff person #5 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 #1 had a health assessment that exceeded 24 months between assessments.

Corrected Corrected by Jul 3, 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 #5 had a tuberculosis screening by the Mantoux method that was dated after their initial employment at the facility.

Corrected Corrected by Jul 3, 2024

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 #5 had a health assessment that lacked an examination for communicable diseases and the results of that examination.

Corrected Corrected by Aug 26, 2024

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 #2 and #5 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 Aug 26, 2024

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

3270.182(3)/3270.182(5) · A child's record shall contain signed parental consent for emergency medical care for the child. Written consent is required prior to admission. 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.

The file for child #2 had an emergency contact form that lacked signed parental consent for emergency medical care for the child and signed parental consent for administration of minor first-aid procedures by facility staff.

Corrected Corrected by Jul 3, 2024

Category: ratio. Marked corrected in the state record.

3270.182(8) · 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 #3 lacked an agreement.

Corrected Corrected by Jul 8, 2024

Category: recordkeeping. 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 Aug 26, 2024

Category: recordkeeping. 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.

According to documentation, the last two emergency drills exceeded a year between drills.

Corrected Corrected by Aug 26, 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 smoke detectors in the facility at least once every 30 days on multiple occasions within the last year.

Corrected Corrected by Jul 3, 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 child #2 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 Jul 3, 2024

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

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

The water in the rear bathroom in the Yellow Preschool room measured 132 degrees Fahrenheit; the water in the Peach room sink measured 127 degrees Fahrenheit; the water at the sink in the Blue room measured 127 degrees Fahrenheit.

Corrected Corrected by Aug 24, 2023

Category: physical safety. 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 the Peach room did not include tweezers.

Corrected Corrected by Aug 24, 2023

Category: health medication. 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.

Peeling paint was present in the Green room, in the corner, under the cubbies.

Corrected Corrected by Sep 22, 2023

Category: physical safety. 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 on site does not include provisions regarding continuity of operations, required as of 7/1/22, as per Announcement C-22-04.

Corrected Corrected by Sep 18, 2023

Category: ratio. 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.

During the inspection, Staff #2 in the Peach room was observed not washing the child's hands following the diaper change.

Corrected Corrected by Sep 22, 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 #3 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 #3, staff person #3 may not work in a child-care position at the facility.

Staff person #3 was observed to be caring for children unsupervised. Staff person #3 has not completed the following pre-service training required prior to caring for children unsupervised: Get Started with Center-Based Care; Building Blocks for Quality.

Corrected Corrected by Aug 23, 2023

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 #1, #3 will have until 9/7/23 to complete the required training. Until such time as the required training has been completed, staff person #1, #3 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 #1, #3, staff person #1, #3 may not work in a child-care position at the facility.

Staff person #1, #3 has not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): Get Started with Center-Based Care; Building Blocks for Quality.

Corrected Corrected by Sep 18, 2023

Category: supervision. Marked corrected in the state record.

3270.33(a)/3270.192(2)(ii) · A staff person or a substitute staff person shall meet one of the applicable staff qualifications for the position in which the person is performing. 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 #4, classified as an assistant group supervisor, does not include a high school diploma or a general educational development certificate and 30 credit hours in education or a related human services field; or a high school diploma or a general educational development certificate with 15 credits in education or a related human services field and 1 year of experience with children; or a high school diploma or a general educational development certificate and 2 years experience with children

Corrected Corrected by Sep 18, 2023

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).

During a supervision and ratio check at 9:17 AM, Staff person #1 was with a group of 6 children in the Green room. She stated all 6 children were older toddlers, however, when reviewing the emergency contact forms, the CR discovered that 3 of the children were young toddlers, 2 were older toddlers, and 1 was preschool age. The ratio for this mixed group is 1:5, making the staff person out of ratio.

Corrected Corrected by Aug 23, 2023

Category: supervision. 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.

There was a power strip accessible to children who were 1 year and 2 years old, in the Blue room, that was lacking outlet covers.

Corrected Corrected by Jul 25, 2023

Marked corrected in the state record.

3270.104(a) · Furniture must be durable, safe, easily cleaned and appropriate for the child's size, age and special needs.

There was a cabinet in the back of the Yellow room that had a shelf in the cabinet that had fallen from the anchor at one end of the cabinet.

Corrected Corrected by Sep 22, 2023

Marked corrected in the state record.

3270.111(a) · A written plan of daily activities and routines, including a time for free play shall be established for each group. The plan shall be flexible to accommodate the needs of individual children and the dynamics of the group.

There was no written daily activity schedule in the Yellow room.

Corrected Corrected by Aug 24, 2023

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.

At 1:11 PM, a child was observed napping in the Yellow room with their face covered by a blanket so that their face could not be seen.

Corrected Corrected by Aug 24, 2023

Category: supervision. Marked corrected in the state record.

3270.123(a)(2) · An agreement shall specify the date on which the fee is to be paid.

The agreement on file for Child #4 does not include the date the fee is to be paid by the parent/guardian.

Corrected Corrected by Aug 24, 2023

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.

The agreement on file for Child #3 does not include the persons to whom the child can be released.

Corrected Corrected by Aug 24, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.124(c) · When children are in the facility, emergency contact information shall be present in a child care space for children receiving care in the space.

A child was observed receiving care in the Green Room without their emergency contact form being in the classroom.

Corrected Corrected by Aug 24, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.124(e) · A written plan identifying the means of transporting a child to emergency care and staffing provisions in the event of an emergency shall be displayed conspicuously in every child care space and shall accompany a staff person who leaves on an excursion with children.

A written emergency transportation plan detailing transportation procedures for a medical emergency was not posted in the Blue room.

Corrected Corrected by Aug 24, 2023

Category: transportation. 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).

The immunization record on file for Child #5, who is 23 months old, includes 3 of 4 DTAP vaccines recommended by the ACIP for a child this age; and 0 Influenza vaccinations, which are recommended annually by the ACIP for a child this age. The most recent influenza vaccination on file for Child #6, who is 4 years old, is dated 1/10/20, is dated more than 1 year ago, and is recommended annually by the ACIP.

Corrected Corrected by Aug 24, 2023

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 a Ventolin inhaler for Child #1 and Cetrizine for Child #2 in the Yellow room labeled for use by a specific child which did not have written parental permission to administer.

Corrected Corrected by Aug 24, 2023

Category: ratio. Marked corrected in the state record.

3270.166(1) · A written statement giving the formula and feeding schedule for an infant shall be obtained from the parent.

There were 2 children under 12 months old in the infant room who did not have a written feeding plan on file submitted by the parent.

Corrected Corrected by Sep 18, 2023

Category: nutrition. Marked corrected in the state record.

3270.171(c) · Written notification of safe routes shall be posted by the operator at a conspicuous location in the child care facility.

The facility did not have notification of safe routes posted in a conspicuous location in the facility.

Corrected Corrected by Aug 24, 2023

Marked corrected in the state record.

3270.183(a) · Child records are confidential and shall be stored in a locked cabinet.

The filing cabinet where the child files are located was not locked at the time of inspection.

Corrected Corrected by Jul 27, 2023

Category: recordkeeping. 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 does not include 2 written non-family references attesting to the staff person's suitability to work in child care.

Corrected Corrected by Aug 24, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.27(f) · The operator shall send a copy of the emergency plan and subsequent plan updates to the local municipality and to the county emergency management agency.

The facility does not have documentation verifying that the most recent emergency plan was submitted to the local municipality emergency management agency.

Corrected Corrected by Sep 22, 2023

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.

The facility did not have verification of notifying local traffic safety authorities of the facility location and use of pedestrian and vehicular routes around the facility.

Corrected Corrected by Aug 24, 2023

Marked corrected in the state record.

3270.18(a) · The legal entity shall have comprehensive general liability insurance to cover the persons who are on the premises. A current copy of the insurance policy shall be on file at the facility.

The facility did not have the liability insurance policy on file at the time of inspection.

Corrected Corrected by Feb 27, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.33(a)/3270.192(2)(ii) · A staff person or a substitute staff person shall meet one of the applicable staff qualifications for the position in which the person is performing. 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 #1, classified as an assistant group supervisor, does not include a high school diploma or a general educational development certificate and 30 credit hours in education or a related human services field; or a high school diploma or a general educational development certificate with 15 credits in education or a related human services field and 1 year of experience with children; or a high school diploma or a general educational development certificate and 2 years experience with children

Corrected Corrected by Feb 20, 2023

Category: supervision. 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.

There was an outlet accessible to children in the preschool room that did not have an outlet cover.

Corrected Corrected by Feb 13, 2023

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.

There was a hole in the wall with an exposed water pipe which had been disconnected from a water fountain that was removed, in the preschool room. There was a section of missing baseboard on the wall in the preschool room

Corrected Corrected by Feb 16, 2023

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