3270.124(a) · Emergency contact information is required for each enrolled child. Emergency contact information must reference who shall be contacted in an emergency.

The file for child #3 did not contain an emergency contact form.

Corrected Corrected by Feb 20, 2025

Category: recordkeeping. Marked corrected in the state record.

3270.27(c)/3270.192(2)(iii) · 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. 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 for staff #1, #4, and #5 lacked documentation of completing emergency plan training in 2024. Current training for all three staff is now on file.

Corrected Corrected by Feb 19, 2025

Category: recordkeeping. 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 facility's letter to parents explaining the emergency procedures did not include details regarding the accommodations made for infants, toddlers, children with disabilities and children with chronic medical conditions.

Corrected Corrected by Apr 30, 2025

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

3270.31(f)/3270.192(2)(iii) · Staff persons shall complete professional development within 90 days of hire as listed in subsections (f)1-10. A facility person's record shall include verification of child care experience, education and training following the outset of service at the facility.

Staff #3 did not complete health and safety training topics 1-9 within 90 days of hire. The training on file was dated 2/05/22. The 1-hour update was not completed within 90 days of hire. Part 1 and Part 2 of the new health and safety training were completed in February 2025. (SEE LIS CODE SHEET)

Corrected Corrected by Feb 21, 2025

Category: health medication. 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 #3, #4, #5, and #6 may not work in a child care position at the facility.

The file for staff #1 contained a state police clearance and a child abuse clearance which were not renewed within 60 months. The previous state police clearance was dated 11/06/19 and was renewed on 2/04/25. The previous child abuse clearance was dated 11/07/19 and was renewed 2/15/25. The file for staff #3 did not contain a completed NSOR clearance. The application was dated 2/05/25 which was after their date of hire. (See LIS CODE SHEET) The file for staff #3 also lacked a disclosure statement signed at initial hire. The disclosure on file was dated 10/29/24, however, this disclosure statement version was dated 1/01/25 and was not yet available in 10/2024. The file for staff #4 lacked a current NSOR. The NSOR on file was dated 12/10/19. The file for staff #5 lacked current state police, child abuse and NSOR clearances. The clearances on file were dated as follows; state police 2/04/20, child abuse 2/13/20, and NSOR 12/06/19. The file for staff #6 lacked a current NSOR clearance. The NSOR on file was dated 12/09/19. Staff #3, #4, #5, and #6 were observed caring for children. No staff with complete current clearances were on site at the time of the inspection.

Corrected Corrected by Mar 1, 2025

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

3270.71 · Hot water pipes and other sources of heat exceeding 110° F that are accessible to children shall be equipped with protective guards or shall be insulated to prevent direct contact.

Sources of heat in the multi-purpose/dining room, which included toaster ovens and an air fryer, were accessible to children due to a nonfunctional gate lock.

Corrected Corrected by Apr 30, 2025

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

3270.124(b)(2) · Emergency contact information must include the name, address and telephone number of the child's physician or source of medical care.

The emergency contact form for child #1 did not include the address or phone number of the child's physician or source of medical care.

Corrected Corrected by Feb 20, 2025

Category: health medication. 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.

The gate to the PS space was not fully attached at the hinges, creating a pinch point. Stained ceiling tiles were observed in the following areas; 1 in the multipurpose/dining room, 1 in the indoor play space which included visible streaks on the wall under the stain, and 1 in the school age gym. Additionally, in the gym, brown staining was observed inside a ceiling light near the stained tile and small exposed nails were observed on a wall mounted wooden shelf.

Corrected Corrected by Apr 30, 2025

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.

A TV in the school age room was broken in the center leaving sharp areas of glass accessible.

Corrected Corrected by Feb 19, 2025

Category: physical safety. 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.

Two flat screens, observed in the media center of the PS room and the school age room, were not anchored creating a risk of tipping over.

Corrected Corrected by Feb 19, 2025

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 larger refrigerator in the infant/toddler eating space lacked a thermometer.

Corrected Corrected by Feb 19, 2025

Category: nutrition. Marked corrected in the state record.

3270.111(b) · The written plan of daily activities shall be posted in the group space.

The multi-purpose/dining room lacked a posted written plan of daily activities.

Corrected Corrected by Feb 19, 2025

Category: physical safety. 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 #2 contained a child service report which was not dated therefore compliance could not be determined. The file for child #5 contained a child service report which lacked documentation of being shared with the parent. The report was not signed by the parent.

Corrected Corrected by Jan 31, 2025

Category: recordkeeping. 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 children #1 and #4 did not include complete health insurance coverage and policy number for the children.

Corrected Corrected by Feb 20, 2025

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 #1 lacked the complete addresses and the phone numbers for the individuals designated by the parent to whom the child may be released. The emergency contact information for child #5 did not include the addresses of the individuals designated by the parent to whom the child may be released.

Corrected Corrected by Feb 20, 2025

Category: recordkeeping. Marked corrected in the state record.

3270.124(f)/3270.181(c) · 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. A parent is required to review and update the emergency contact information and the financial agreement at least once in a 6-month period or as soon as there is a change in the information.

The emergency contact form and agreements for children #2 and #5 have not been reviewed and signed by the parent in over 6 months. The last review for child #2 was dated 6/24/24 and the last review for child #5 was dated 9/17/23.

Corrected Corrected by Feb 20, 2025

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 #5, a preschooler, did not contain a health report conducted within the last 12 months. The only health report on file was dated 3/17/23.

Corrected Corrected by Apr 30, 2025

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

3270.135(a)(3) · If disposable diapers are provided by a parent or by a facility, a soiled diaper shall be discarded by immediately placing the diaper into a plastic-lined, hands-free covered can.

The hands-free trash can at a diapering area in the infant/toddler room was not functional. The lid was detached from the hands-free mechanism.

Corrected Corrected by Feb 19, 2025

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 file for staff #5 did not contain a current health assessment. The most recent health assessment on file was dated 3/02/22. The files for staff #1 and #4 contained consecutive health assessments dated more than 24 months apart. Current health assessments are now on file for staff #1 and #4.

Corrected Corrected by Mar 3, 2025

Category: ratio. Marked corrected in the state record.

3270.181(d) · Following review, a parent shall attest to the accuracy of information in the emergency contact information and the financial agreement at each review by affixing a dated signature to the record.

The emergency contact form for child #1 was signed, but not dated by the parent.

Corrected Corrected by Feb 20, 2025

Category: recordkeeping. 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 #3 did not contain signed parental consent for emergency medical care or signed parental consent for administration of minor first-aid procedures by facility staff. The file lacked an emergency contact form.

Corrected Corrected by Feb 20, 2025

Category: ratio. 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.

An emergency drill has not been documented in over 12 months. The last documented emergency drill occurred 3/01/23.

Corrected Corrected by Feb 12, 2025

Category: recordkeeping. Marked corrected in the state record.

3270.31(e)/3270.192(2)(iii) · A staff person shall obtain an annual minimum of 12 clock hours of child care training. 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 #2 contained 11 of the 12 annual hours of training completed on time between 9/27/23 and 9/30/24. An additional hour was completed late in February 2025. The file for staff #5 contained 4.5 of the 12 annual hours of training completed on time between 12/2023 and 12/31/24. An addition 6.5 hours of training were completed late in February 2025. The training hours for staff #2 and #5 are now current.

Corrected Corrected by Feb 19, 2025

Category: recordkeeping. Marked corrected in the state record.

3270.21 · Conditions at the facility may not pose a threat to the health or safety of the children.

The fire extinguisher in the Kitchen/Multi-Purpose room was serviced in February of 2022. The directions on the tag of the extinguisher read to 'void 1 year from the date punched on tag', meaning the fire extinguisher inspection was not current and out of date.

Corrected Corrected by Feb 13, 2024

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

3270.27(b) · The operator shall review the emergency plan at least annually and update the plan as needed. The operator shall document in writing each review and update of the emergency plan and kept on file at the facility.

The operator did not document in writing a review of the emergency plan at least annually.

Corrected Corrected by Feb 8, 2024

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 file for Staff #8 did not contain documentation of Emergency Plan training within 90 days from date of hire. (SEE LIS CODE SHEET)

Corrected Corrected by Feb 8, 2024

Category: recordkeeping. 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 facility lacked a letter to parents in the emergency plan addressing the following topics: 1. Shelter of children during an emergency including lock-down, shelter in place at the facility and shelter at locations away from the facility premises, 2. Evacuation of children from the facility building and evacuation of children to a location away from the facility premises, 3. A method for facility persons to contact parents as soon as reasonably possible when an emergency situation arises, 4. A method for facility persons to inform parents that the emergency has ended and to provide instruction as to how parents can safely be reunited with their children, and 5. Accommodations for infants, toddlers, children with disabilities and children with chronic medical conditions.

Corrected Corrected by Feb 12, 2024

Category: physical safety. 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 two most recent fire safety trainings on file for Staff #1, #2, #3, #4, #5, and #6 were dated 2/26/22 and 3/5/23, more than one year apart. The two most recent fire safety trainings on file for Staff #7 were dated 2/11/22 and 3/5/23, more than one year apart.

Corrected Corrected by Feb 25, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.31(f) · Staff persons shall complete professional development within 90 days of hire as listed in subsections (f)1-10.

Staff #8 completed Pediatric First Aid/CPR on 1/18/24, more than 90 days from date of hire. (SEE LIS CODE SHEET)

Corrected Corrected by Jan 18, 2024

Category: health medication. 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 most recent FBI clearance on file for Staff #4 is dated 2/5/19, more than 60 months ago. The file for Staff #5 lacked an NSOR certification.

Corrected Corrected by Feb 9, 2024

Category: background checks. 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 #8 contained an old disclosure statement that is no longer accepted. (SEE LIS CODE SHEET)

Corrected Corrected by Feb 8, 2024

Category: background checks. 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 files for Staff #1, #3, #4, #5, #6, and #7 lacked a written evaluation that was conducted within the past 12 months.

Corrected Corrected by Feb 9, 2024

Category: recordkeeping. 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.

A power strip in the Preschool room and wall outlets in the Multi-Purpose room were missing protective receptacle covers, which was accessible to child 5 years of age or younger.

Corrected Corrected by Feb 8, 2024

Marked corrected in the state record.

3270.67(d) · Trash that has been contaminated by human secretions or excrement shall be contained in closed, plastic-lined receptacles.

A unlined garbage can containing tissues with human secretions was observed in the Preschool Room.

Corrected Corrected by Feb 8, 2024

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.

The Emergency Contact form on file for Child #1 did not contain the enrolling parent's work phone number.

Corrected Corrected by Feb 12, 2024

Category: recordkeeping. 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.

A broken telephone jack hanging from the wall and a dried substance hanging from the light fixture was observed in the School Age room. In the boys bathroom, rust was observed on the stall walls of the urinal. In the Multi-Purpose room, a cracked piece of plastic with an exposed screw was observed attached to the wall near the windows, which could be hazardous to children.

Corrected Corrected by Feb 8, 2024

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.

Peeling paint and plaster was observed at the base of the door frame and on the back wall by the basketball hoop in the School Age Play Area. Peeling paint was observed at the bottom of the utility sink door in the Boys Bathroom.

Corrected Corrected by Feb 9, 2024

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.

In the Kiddie Corral, a plastic bridge climber was observed with cracks that could cause pinch points. In the School Age room, a toy kitchen was observed with 4 exposed screws, which could be hazardous to children. Sleep mats with ripped and peeling plastic and a broken paper holder with exposed screws were observed in the Main Room's Art area.

Corrected Corrected by Feb 8, 2024

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

3270.102(a)/3270.103 · 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. Toys and objects with a diameter of less than 1 inch, objects with removable parts that have a diameter of less than 1 inch, plastic bags and styrofoam objects may not be accessible to children who are still placing objects in their mouths.

Wood chips and a foam climber with ripped plastic in the Kiddie Corral and broken Magnatiles and a foam cube with ripped plastic less than 1 inch in diameter in the Young Toddler room, were accessible to children who are still placing objects in their mouths.

Corrected Corrected by Feb 8, 2024

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

3270.106(a) · Individual, clean, age-appropriate rest equipment shall be provided for preschool, toddler and infant children as agreed between the child's parent and the operator. The rest equipment shall be labeled for the use of a specific child and used only by the specified child.

A crib in the Infant room did not contain a label identifying use by a specific child.

Corrected Corrected by Feb 8, 2024

Category: physical safety. 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 files for Child #1, Child #2, Child #3, and Child #4 did not contain an acceptable Child Service Report that was reviewed and signed by the parent every six months.

Corrected Corrected by Feb 9, 2024

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.

The emergency contact form for Child #5 was not present in the space that the child was receiving care.

Corrected Corrected by Feb 8, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.124(f)/3270.181(c) · 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. A parent is required to review and update the emergency contact information and the financial agreement at least once in a 6-month period or as soon as there is a change in the information.

The Emergency Contact and Financial Agreement forms for Child #1, #2, #3, and #4 did not contain documentation that both forms were reviewed, updated, and signed by the parent every six months.

Corrected Corrected by Feb 12, 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 #2 (MR 3/7/22), Child #3 (MR 10/19/20), and Child #4 (MR 2/28/22), preschool aged children, lacked an updated health report within the last year.

Corrected Corrected by Mar 15, 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).

The immunization record on file for Child #3 (PSA) lacked the following immunizations: 2 doses of Rotovirus, 1 dose of DTAP, and 1 dose of Pneumococcal with no Letter of Exemption in the file. Child #3 must be dismissed from care by close of business on 2/8/24 and may only return to care when the immunization record is updated or when a parent provides a written, signed exemption letter.

Corrected Corrected by Feb 8, 2024

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 file for Staff #6 (2/25/21 and 3/31/23) and Staff #7 (4/10/19 and 2/10/22) contained health assessments more than 24 months apart.

Corrected Corrected by Feb 14, 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.

The Tuberculosis screening on file for Staff #8 is dated 2/26/21, more than 1 year prior to date of hire. (SEE LIS CODE SHEET)

Corrected Corrected by Feb 14, 2024

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

3270.151(c)(3)/3270.192(3) · An adult health assessment must include an examination for communicable diseases and the results of that examination. 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 health assessment on file for Staff #8 dated 9/21/23 indicates that the staff person has a communicable/contagious disease, with no additional information given.

Corrected Corrected by Feb 14, 2024

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.

The facility's emergency plan did not provide accommodations for infants, toddlers, children with disabilities, and children with chronic medical conditions.

Corrected Corrected by Feb 12, 2024

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

3270.94(a)(1) · The Director or designated staff person who is responsible for compliance with this chapter shall conduct fire drills and ensure that fire drills are conducted at least once every 60 days.

The most recent fire drill documented on the fire drill log was on 12/7/23, more than 60 days ago.

Corrected Corrected by Feb 9, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.31(e) · A staff person shall obtain an annual minimum of 12 clock hours of child care training.

Staff #1, #2, #3, #4, #5, #6, and #7 did not obtain the annual minimum of 12 clock hours of child care training.

Corrected Corrected by Mar 22, 2024

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 annual written notification to local traffic safety authorities of location of facilities and vehicular routes around the facility was dated 1/5/23.

Corrected Corrected by Feb 9, 2024

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.

On 1/25/24 at approximately 9:15 am, staff #3 took a group of 9 preschoolers to the bathroom, located in the main entrance, past the double doors. Staff #3 returned to the classroom with the preschoolers. 1 preschooler was left alone in the bathroom for approximately 10 mins. The child was singing and the Certification Representative (CR) was in the main entrance and heard the child. When the CR entered the bathroom, the child was observed to be alone. The CR escorted the child back and released child #1 to staff #1.

Corrected Corrected by Jan 26, 2024

Category: ratio. 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).

*On 1/25/24, at 8:33 am, staff #2 and #3 were observed caring for 1 Infant, 3 Young Toddlers, 4 Older Toddlers, and 9 Pre-School aged children in the Toddler room.

Corrected Corrected by Jan 26, 2024

Category: ratio. Marked corrected in the state record.

3270.52 · **All staff persons at the facility will be required to attend the in-person supervision & ratio training, 'Count, Count, Count' provided by ELRC 5 within 3 months of the approval of this plan of correction. The training may count towards the mandatory 12 training hours required by the Department.

**On 1/25/24, at 8:33 am, staff #2 and #3 were observed caring for 1 Infant, 3 Young Toddlers, 4 Older Toddlers, and 9 Pre-School aged children in the Toddler room.

Corrected Corrected by Mar 11, 2024

Category: supervision. Marked corrected in the state record.

3270.52 · ***The legal entity shall develop and implement a tangible, identification system for each staff to identify the specific children in their supervisory group. All staff will utilize the identification method appropriately at all times while supervising children. The identification system must be approved by DHS and utilized by all staff for a minimum of 3 months after DHS approval of the system. Multiple unannounced inspections may be used to assess compliance.

***On 1/25/24, at 8:33 am, staff #2 and #3 were observed caring for 1 Infant, 3 Young Toddlers, 4 Older Toddlers, and 9 Pre-School aged children in the Toddler room.

Corrected Corrected by Jun 11, 2024

Category: supervision. 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.

On 1/25/24 at approximately 9:15 am, staff #3 took a group of 9 preschoolers to the bathroom, located in the main entrance, past the double doors. Staff #3 returned to the classroom with the preschoolers. 1 preschooler was left alone in the bathroom for approximately 10 mins. The child was singing and the Certification Representative (CR) was in the main entrance and heard the child. When the CR entered the bathroom, the child was observed to be alone. The CR escorted the child back and released child #1 to staff #1.

Corrected Corrected by Jan 26, 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.

On 1/25/24 at approximately 9:15 am, staff #3 took a group of 9 preschoolers to the bathroom, located in the main entrance, past the double doors. Staff #3 returned to the classroom with the preschoolers. 1 preschooler was left alone in the bathroom for approximately 10 mins. The child was singing and the Certification Representative (CR) was in the main entrance and heard the child. When the CR entered the bathroom, the child was observed to be alone. The CR escorted the child back and released child #1 to staff #1.

Corrected Corrected by Jan 26, 2024

Category: supervision. 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 file for staff # 3 lacked the one-hour updated health and safety training course, Pennsylvania Health and Safety Update 2022 by the deadline of 12/30/22.

Corrected Corrected by Jan 26, 2024

Category: ratio. Marked corrected in the state record.

3270.31(f) · Staff persons shall complete professional development within 90 days of hire as listed in subsections (f)1-10.

The file for staff # 7 lacked the Health and Safety training certificate.

Corrected Corrected by Jan 26, 2024

Category: health medication. 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).

On 8/22/23, at 1:30 PM, Staff Person #1 was observed supervising 2 Infants and 4 Young Toddlers in the Infant/Young Toddler Room. Also, based on conversations with Staff Person #1, #2 and #3, they were the only three staff present from 9:30 AM until 1:30 PM. Children in attendance from 9:30-1:30 were: 2 infants, 5 young toddlers, 3 older toddlers, 7 preschool, 6 younger school age and 1 older school age. This number of children requires at least four staff persons present. to meet the compliance of mix aged levels.

Corrected Corrected by Aug 23, 2023

Category: supervision. Marked corrected in the state record.

3270.106(f) · At least 2 feet of space is required on three sides of a bed, cot, crib or other rest equipment while the equipment is in use.

On 8/22/23, observed in the Infant/Young Toddler Room, less than two feet of space between pack n plays where Child #2 and Child #3 were napping.

Corrected Corrected by Aug 23, 2023

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

3270.119 · Infants shall be placed in the sleeping position recommended by the American Academy of Pediatrics unless there is a medical reason an infant should not sleep in this position. The medical reason shall be documented in a statement signed by a physician, physician's assistant or CRNP and placed in the child's record at the facility.

On 8/22/23 at 1:30 PM, Child #1, an infant, was observed sleeping in a baby carrier.

Corrected Corrected by Aug 23, 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.

The One Hour Health and Safety Updates in the files for Staff Person's #1 through #7 were conducted in February and March, 2023. This was after the prescribed timeframe of 12/30/22.

Corrected Corrected by Mar 31, 2023

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.

The facility's emergency plan did not include requirements for volunteer emergency preparedness training and continuity of operations (backing up or retrieving health and other key records/files and managing financial issues such as paying employees and bills during the aftermath of the disaster) to maintain compliance with 45 CFR § 98.41(a)(1)(vii).

Corrected Corrected by Apr 30, 2023

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.

The current Pediatric CPR/First Aid Certification in the file for Staff Person #2 was conducted on 3/5/23. This was after the previous certification had expired on 9/5/22.

Corrected Corrected by Mar 31, 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). 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 #5 may not work in a child care position at the facility.

The file for staff person #5 included a State Police and FBI Clearance, but the rap sheet did not include the dispositions. After review of the criminal docket sheets, it was determined staff person #5 was awaiting trial.

Corrected Corrected by Apr 30, 2023

Category: background checks. 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 ceiling tiles, which had been stained from water damage, in the dining area and in the School Age Playroom.

Corrected Corrected by Mar 31, 2023

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.

One sink in the men's restroom was missing a handwashing sign.

Corrected Corrected by Mar 31, 2023

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 right half of the hallway, which leads from the facility to the rear exit, was obstructed by storage boxes and equipment.

Corrected Corrected by Mar 24, 2023

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.

Observed a broken door on the play stove in the toddler room.

Corrected Corrected by Mar 31, 2023

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

3270.131(b)(1)/3270.182(1) · The operator shall require the parent to provide an updated health report at least every 6 months for an infant or young toddler. A child's record shall contain initial and subsequent health reports.

The file for Child #2, a young toddler, did not include an updated health report conducted within the past six months.

Corrected Corrected by Apr 17, 2023

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 updated health assessments in the files for Staff Persons #1, #2, #3 and #5 exceeded 24 months between assessments. The file for Staff Person #6 did not include an updated health assessment conducted within the past 24 months.

Corrected Corrected by Apr 17, 2023

Category: ratio. Marked corrected in the state record.

3270.181(c) · A parent is required to review and update the emergency contact information and the financial agreement at least once in a 6-month period or as soon as there is a change in the information.

The fee agreements and emergency contact forms in the files for Child #1 and #3 have not been updated by the parents within the last six months.

Corrected Corrected by Apr 17, 2023

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 current certificate of compliance was not posted at the facility.

Corrected Corrected by Mar 31, 2023

Marked corrected in the state record.

3270.27(b) · The operator shall review the emergency plan at least annually and update the plan as needed. The operator shall document in writing each review and update of the emergency plan and kept on file at the facility.

The operator did not document in writing a review of the emergency plan at least annually.

Corrected Corrected by Feb 28, 2022

Category: recordkeeping. Marked corrected in the state record.

3270.31(f) · Staff persons shall complete professional development in the following topics within 90 days of hire: 3270.31(f)(1-9).

Staff person #2 completed CCDGB health and safety training, more than 90 days following hire on 5/26/2021.

Corrected Corrected by Feb 5, 2022

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

3270.66(b) · 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 stored away from food, food preparation areas and child care spaces.

A container of bleach solution was stored on a shelf next to food in the kitchen area.

Corrected Corrected by Feb 28, 2022

Category: ratio. 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.

Emergency contact information for child #1 was not present in the infant/toddler room where the child was receiving care.

Corrected Corrected by Feb 28, 2022

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 record for staff #3 included a current health assessment dated more than 24 months following their previous health assessment.

Corrected Corrected by Feb 28, 2022

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.

The facility's emergency plan did not provide for accommodations for infants, toddlers, children with disabilities, and children with chronic medical conditions.

Corrected Corrected by Feb 28, 2022

Category: physical safety. 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.

An annual emergency drill was not conducted.

Corrected Corrected by Mar 31, 2022

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.

The operator was unable to present the proof of purchase for the fire detection system.

Corrected Corrected by Feb 28, 2022

Category: recordkeeping. Marked corrected in the state record.

3270.31(e) · A staff person shall obtain an annual minimum of 12 clock hours of child care training.

Staff #1, #3 and #4 did not obtain the annual minimum of 12 clock hours of child care training.

Corrected Corrected by Apr 15, 2022

Category: recordkeeping. Marked corrected in the state record.