3270.31(f) · Staff person(s) shall complete professional development in the topics of 3270.31(f)(1 -- 10) within 90 days of hire. Until such time as the required training has been completed, staff persons #1 and #2 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 persons #1 and #2, staff persons #1 and #2 may not work in a child-care position at the facility.

Staff persons #1 and #2 have not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): #1 - health and safety training and pediatric first aid/cpr; #2 - part 2 of health and safety training. Part #1 was completed late.

Corrected Corrected by Dec 17, 2025

Category: supervision. 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.

Adult scissors and a claw type staple remover with sharp points were accessible to children on the teacher's desk in the Red Preschool Room.

Corrected Corrected by Apr 22, 2025

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

3270.31(e)(4)(i)/3270.192(2)(iii) · Competence is the completion of training by a professional in the field of first-aid and cardiopulmonary resuscitation (CPR). All staff persons shall renew their certification in pediatric first aid and pediatric cardiopulmonary resuscitation (CPR) on or before the expiration of the most current certification. A facility person's record shall include verification of child care experience, education and training following the outset of service at the facility.

Staff #4 did not renew their certification in pediatric CPR and first aid on or before the expiration of the previous certification. The certifications are dated 6/12/22 and 9/17/24. Current training is now on file.

Corrected Corrected by Apr 22, 2025

Category: ratio. 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 #1completed the health and safety course titled Health and Safety Basics (6 hours), but did not complete the required health and safety update course titled Pennsylvania Health and Safety Update 2022 (1 hour) training within 90 days of hire. Documentation of completing Health and Safety Training Part 1 and Part 2 is now on file.

Corrected Corrected by Apr 22, 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.

The file for staff #1 contained an NSOR certificate dated 3/10/25 which is more than 45 days after their date of hire (SEE LIS CODE SHEET). Staff #1 was not suspended after 45 days. Staff #6 did not update mandated reporter training within 60 months. This is evidenced by the previously documented mandated reporter training on file being dated 5/05/19 and the most recent training being dated 6/03/24. Current mandated reporter training is now on file. The file for staff #5 lacked a disclosure statement.

Corrected Corrected by Apr 22, 2025

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

3270.61(c) · Indoor child care space is measured within permanent stationary partitions or walls. The allowable number of children in a space is determined by dividing the total square feet in a space by 40.

Based on schedules posted in the classrooms and statements made by staff, the Sanctuary is used by the program every Friday. The Sanctuary has not been measured and is not included on the facility's certificate of compliance.

Corrected Corrected by Apr 22, 2025

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

3270.62(b) · Outdoor or indoor play space shall be measured at 65 square feet per child.

Children were observed playing in an outdoor area which has not been measured and is not included in the facility's certificate of compliance. Based on statements made by staff, the area has been used regularly for several years. The area is located near the entry between the parking lot and two streets.

Corrected Corrected by Apr 22, 2025

Category: physical safety. 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.

The following toxics were observed to be accessible to children: sanitizer spray and wipes in an unlocked floor level cabinet in the Orange Room. The safety lock in place was not functioning as intended. Lysol spray in an unlocked drawer of the restroom connected to the school age loft room and used by preschoolers, and disinfecting wipes in an unlocked cabinet in the girl's restroom on the main floor.

Corrected Corrected by Apr 22, 2025

Category: physical safety. 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.

Stained ceiling tiles were observed in the following areas; 2 in the hallway outside the gym and two in the Blue Preschool room.

Corrected Corrected by May 13, 2025

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

3270.82(j) · A source of running water for handwashing shall be present in infant and toddler diapering areas. If the running water does not flow directly into a drain that is connected to a sewage system, a receptacle shall be provided to contain the water used for washing. The receptacle shall be emptied into an approved sewage system at least once a day.

In the Orange OT Room, the diapering area was approximately 13 feet from the source of running water. The activity/meal table was located on the route children travel from the diapering area to the sink.

Corrected Corrected by Apr 23, 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 cracked hand rail was observed on a plastic slide in the small outdoor play space. Exposed foam padding was observed on two pink child size folding chairs in the Purple Room.

Corrected Corrected by May 9, 2025

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

3270.103 · 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.

An empty plastic garbage bag was accessible to children in an unlocked cabinet in the boy's restroom on the main floor. A tear which exposed the inner foam filling was observed on the diapering pad in the Pink Room.

Corrected Corrected by Apr 22, 2025

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

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

A written plan of daily activities was not posted in the gym.

Corrected Corrected by Apr 22, 2025

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

3270.113(d) · A facility person may not use harsh, demeaning or abusive language in the presence of children.

At approximately 12:30 PM the certification representative heard staff #1 using harsh language which included shouting "Get down", "Stop it", and "You know you aren't allowed up there".

Corrected Corrected by Apr 22, 2025

Marked corrected in the state record.

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

The agreement for child #1 and child #3 did not include the services to be provided. The file for child #4 contained consecutive service reports dated more than 6 months apart; 3/11/24 and 2/09/25) A current report is now on file. The file for child #5 did not contain a current service report. The most recent report on file was dated 8/09/24.

Corrected Corrected by Apr 22, 2025

Category: recordkeeping. 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 contained consecutive health reports dated more than 6 months apart; 5/06/24 and 12/31/24. The most recent health report on file is now current.

Corrected Corrected by Apr 22, 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 include a health assessment. The file for staff #1 contained an initial health assessment dated after their first day in a child care position.

Corrected Corrected by May 9, 2025

Category: ratio. 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.

Based on the facility's fire drill log consecutive drills dated 10/15/24 and 1/13/25 were conducted 90 days apart.

Corrected Corrected by May 9, 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 9 of the 12 required hours of annual training completed between 12/2023 and 12/2024. Three additional hours are needed. The file for staff #4 contained 6 of the 12 required hours of annual training completed between 9/2023 and 9/2024. Six additional hours are needed.

Corrected Corrected by May 5, 2025

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 Loft lacked protective outlet covers, which was accessible to children ages 5 and younger.

Corrected Corrected by Apr 16, 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.

Lysol spray cleaner was observed under the sink in an unlocked cabinet and on the top of the toilet in the Nursery, which was accessible to children.

Corrected Corrected by Apr 4, 2024

Marked corrected in the state record.

3270.66(c) · Cleaning materials and other toxic materials shall be used in a way that does not contaminate play surfaces, food, food preparation areas and does not constitute a hazard to the children.

Cleaning toxics were observed uncontained and above loose diapers in the Yellow and Orange rooms, which could be hazardous to children.

Corrected Corrected by Apr 4, 2024

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.

Staff #5 and Staff #9 were observed working alone and did not complete the appropriate Heath and Safety training. Both Staff #5 and Staff #9 completed the 6 hour Health and Safety Basics training prior to 9/30/16, but needed the 10 hour Get Started with Center-Based Care: Building Blocks for Quality.

Corrected Corrected by Apr 10, 2024

Category: ratio. 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.

In the Loft, adult scissors were observed were accessible to children.

Corrected Corrected by Apr 4, 2024

Category: health medication. 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 person #7 had 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 (12/8/23). Staff #7 has acceptable pediatric first aid/CPR training in an approved curriculum; however, the trainer has not provided documentation that they are PQAS-certified in that training topic.

Corrected Corrected by Apr 19, 2024

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

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

Staff #7 did not complete the Mandated Reporter training within 90 days of their date of hire (SEE LIS CODE SHEET).

Corrected Corrected by Apr 15, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.32(a)/3270.192(4) · The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). A facility person's record shall include a copy of requests for the criminal history record and child abuse registry clearance information, a copy of the disclosure statement and a copy of the completed clearance information required under the CPSL.

The Child Abuse clearance on file for Staff #3 was dated 4/21/23, after their date of hire (SEE LIS CODE SHEET). The application for the DHS FBI clearance for Staff #3 (4/18/23) and Staff #8 (3/23/23) were dated after their date of hire. Therefore, Staff #3 and Staff #8 were incorrectly provisionally hired. (SEE LIS CODE SHEET). The disclosure statement on file for Staff #8 was dated 5/1/23, after their date of hire (SEE LIS CODE SHEET).

Corrected Corrected by Apr 15, 2024

Category: background checks. 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 trash receptacle in the Orange Room contained human secretions that were not contained in a closed, plastic-lined receptacle.

Corrected Corrected by Apr 4, 2024

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 Nursery lacked an assortment of bandages.

Corrected Corrected by Apr 15, 2024

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.

Ripped carpet and splintered wood pieces were observed on a riser in the Loft.

Corrected Corrected by Apr 16, 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.

Foam blocks with peeling plastic were observed in the Gym, which could be hazardous to children.

Corrected Corrected by Apr 4, 2024

Category: physical safety. 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.

Two cribs in the Nursery were observed to lack 2 feet on 3 sides, while the crib was in use.

Corrected Corrected by Apr 4, 2024

Category: physical safety. 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 Financial Agreement form on file for Child #5 lacked the Release Person's Name.

Corrected Corrected by Apr 15, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.123(b)/3270.182(8) · A parent shall receive the original agreement. The facility shall retain a copy of the agreement. A child's record shall contain a copy of the initial agreement and subsequent written agreements between the parent and the operator. The parent receives the original agreement.

The Financial Agreement forms on file for Child #3 and Child #7 were the original copies, which is to be given to the parent.

Corrected Corrected by Apr 16, 2024

Category: recordkeeping. 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 #2 lacked an address for the child's physician or source of medical care.

Corrected Corrected by Apr 16, 2024

Category: health medication. 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 for Child #1 lacked a complete home address for the enrolling parent.

Corrected Corrected by Apr 17, 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 Emergency Contact forms for Child #1, Child #4, and Child #5 lacked addresses for all listed release persons.

Corrected Corrected by Apr 17, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.133(5) · Medication shall be stored in accordance with the manufacturer's or health professional's instructions on the original label.

An Albuterol labeled for Child #6 with the expiration date of 1/2023 and an Epi-Pen for Child #7 with the expiration date of 1/2024, were observed in the locked medication drawer in the Office.

Corrected Corrected by Apr 4, 2024

Category: ratio. 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.

Based on a discussion with staff in the Orange Room, the staff person uses their hands to open the hands-free can when disposing a diaper.

Corrected Corrected by Apr 4, 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 two most recent health assessments on file for Staff #2 (1/8/21 & 2/24/23) Staff #6 (11/2/21 & 1/26/24) are dated more than 24 months apart. The file for Staff #7 contained an initial health assessment dated 3/7/24, which is beyond the date of hire (SEE LIS CODE SHEET).

Corrected Corrected by Apr 17, 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 #7 lacked documentation of a Tuberculosis screening. The file for Staff #3 (5/4/23) and Staff #8 (3/21/23) contained documentation of a Tuberculosis screening dated after their date of hire (SEE LIS CODE SHEET).

Corrected Corrected by Apr 17, 2024

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

3270.161(d) · Potentially hazardous food brought from the child's home or provided by the facility shall be refrigerated.

In the Blue Room, children's lunch boxes contained potentially hazardous food (yogurt, cheese stick, and chicken nuggets) which needed refrigerated.

Corrected Corrected by Apr 17, 2024

Category: nutrition. 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 two most recent parent updates of the Financial Agreement form on file for Child #4 (6/30/2023 & 3/1/2024) and Child #5 (8/16/23 & 4/1/2024) are dated, more than 6 months apart.

Corrected Corrected by Apr 18, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.31(g) · Completion of professional development shall be documented by the signature and title of a representative of the professional development entity and include the date professional development was completed. Documentation shall be retained in the facility person's file or maintained in an electronic system as designated by the Department. Documentation of the completion of the professional development under subsection (f) taken from September 30, 2016, forward satisfies this requirement.

The files for Staff #1, Staff #2, Staff #4. Staff #5, and Staff #9 contained the Health and Safety Basic Training 6 Hour Course dated prior to 9/30/2016, and therefore lacked the 10 hour Get Started with Center-Based Care: Building Blocks for Quality.

Corrected Corrected by Apr 18, 2024

Category: health medication. 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 fire drill log on file included fire drills conducted 5/15/23-7/15/23 & 7/15/23-9/15/23, more than 60 days apart.

Corrected Corrected by Apr 17, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.131(a)/3270.131(e) · 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. The facility may not accept or retain an infant 2 months of age or older, a toddler or a preschool child at the facility for more than 60 days following the first day of attendance at the facility unless the parent provides written verification from a physician, physician's assistant, CRNP, the Department of Health or a local health department of the dates (month, day and year) the child was administered immunizations in accordance with the recommendations of the ACIP.

The file for Child #1 did not contain an initial health assessment and written verification of immunizations within 60 days from enrollment (SEE LIS CODE SHEET). The initial health assessment and written verification of immunizations on file for Child #3 are dated 2/5/24, which is more than 60 days from date of enrollment (SEE LIS CODE SHEET). Child #1 must be dismissed from care by close of business on 4/10/24 and may only return to care when the immunization record is update or when the parent provides a written, signed exemption letter.

Corrected Corrected by Apr 10, 2024

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

3270.31(e)(4)(i)/3270.192(2)(iii) · Competence is the completion of training by a professional in the field of first-aid and cardiopulmonary resuscitation (CPR). All staff persons shall renew their certification in pediatric first aid and pediatric cardiopulmonary resuscitation (CPR) on or before the expiration of the most current certification. A facility person's record shall include verification of child care experience, education and training following the outset of service at the facility.

The file for Staff #2 contained documentation of Pediatric First-Aid/CPR training on 5.7.19 and 5.20.21, which exceeded the expiration date of the previous training.

Corrected Corrected by May 12, 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.

The file for Staff #3 contained State Police Clearances dated 8.8.15 and 8.25.20, and Child Abuse Clearances dated 8.19.15 and 8.21.20, which exceeded the 60-month renewal requirement. The file for Staff #6 contained FBI Clearances dated 3.4.16 and 3.9.21, which exceeded the 60-month renewal requirement. The file for Staff #7 contained State Police Clearances dated 9.25.13 and 4.9.19, Child Abuse Clearances dated 10.1.13 and 4.19.19, and FBI Clearances dated 10.1.13 and 4.11.19, which exceeded the 60-month renewal requirement.

Corrected Corrected by May 12, 2023

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

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

The file for Staff #3 contained documentation of Mandated Reporter Training on 8.14.15 and 8.26.20, which exceeded the 60-month renewal requirement. The file for Staff #4 contained documentation of Mandated Reporter Training on 5.6.15 and 5.19.20, which exceeded the 60-month renewal requirement. The file for Staff #7 contained documentation of Mandated Reporter Training on 6.23.15 and 3.14.21, which exceeded the 60-month renewal requirement.

Corrected Corrected by May 12, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.63 · If unsafe areas or conditions are in or near an outdoor play space, fencing or natural barriers are required to restrict children from those unsafe areas or conditions.

A black cable line, which was strung along the back of the building in the small outdoor, fenced play yard, was loose in one (1) area, hung down low, was accessible to children, and created a choking/strangling hazard for children in care.

Corrected Corrected by May 12, 2023

Category: physical safety. 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.

A bottle of Purell Professional Surface Disinfectant, 128 oz, was located in a closet with a curtain in the school-age room, which stated, "Keep out of reach of children," and was accessible to children.

Corrected Corrected by May 12, 2023

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 two (2) toilets in the school-age room.

Corrected Corrected by May 12, 2023

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 files for Child #1 and Child #2 did not contain documentation of the Influenza vaccination in accordance with the ACIP recommendations.

Corrected Corrected by May 12, 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 two most recent Health Assessments in the file for Staff #1, Staff #5, and Staff #8 exceeded the 24-month renewal requirement. The file for Staff #10 did not contain documentation of a Health Assessment or Mantoux test at initial hire or thereafter.

Corrected Corrected by May 12, 2023

Category: ratio. 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 #10, did not contain two, written, nonfamily references.

Corrected Corrected by May 31, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.31(f)(10) · Staff persons shall complete professional development in pediatric first aid and pediatric cardiopulmonary resuscitation within 90 days of hire.

The file for Staff #9 (see IS Code Sheet) contained documentation of Pediatric First-Aid/CPR training on 9.22.22, which exceeded 90 days of hire.

Corrected Corrected by May 12, 2023

Category: health medication. 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 proof of purchase for the interconnected fire detection system was not available at the time of the inspection.

Corrected Corrected by Jun 23, 2022

Category: recordkeeping. Marked corrected in the state record.

3270.75(b) · A first-aid kit must be inaccessible to children.

The first-aid kit in the SA Room was observed to be accessible to children on a low shelf.

Corrected Corrected by Apr 20, 2022

Marked corrected in the state record.

3270.31(f)/3270.192(2)(iii) · Staff persons shall complete professional development in the following topics within 90 days of hire: 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 #2 and #5 contained health and safety basics training completed more than 90 days after hire.

Corrected Corrected by May 16, 2022

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 file for Staff #2 contained application for NSOR clearance and completed NSOR clearance, both dated after the date of hire. The file for Staff #5 contained an NSOR clearance after the date of hire, with no application for NSOR clearance present in file.

Corrected Corrected by May 16, 2022

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

3270.32(a)/3270.192(2)(iii) · The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services).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 #2 and #5 contained documentation of mandated reporter training completed more than 90 days after hire. The files for Staff #3 and #4 contained current mandated reporter training but lacked documentation of previous mandated reporter training, making in unable to be determined if current training was completed within 60 months of previous training.

Corrected Corrected by May 16, 2022

Category: recordkeeping. 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.

During assessment of supervision and ratio in the Red Room 4/20/22 at 11 AM, one PS child was observed to be alone and unsupervised in the bathroom off the hall, outside of the Red Room.

Corrected Corrected by Apr 20, 2022

Category: supervision. 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.

Toxic paint and primer were observed in a unlocked closet outside the boys bathroom,.

Corrected Corrected by Apr 20, 2022

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.

Splintered wooden fence slats were observed on the left side slats of the small playground. Pieces of glass were observed on the ground near the right upper fence of the large playground. Animal feces were observed on the ground near the top fight of the large playground.

Corrected Corrected by May 18, 2022

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.

The rest equipment in the gym was observed to lack labels for some of the children using the rest equipment.

Corrected Corrected by Apr 20, 2022

Category: physical safety. 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.

During assessment of supervision and ratio in the Red Room 4/20/22 at 11 AM, one PS child was observed to be alone and unsupervised in the bathroom off the hall, outside of the Red Room.

Corrected Corrected by Apr 20, 2022

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.

During assessment of supervision and ratio in the Red Room 4/20/22 at 11 AM, one PS child was observed to be alone and unsupervised in the bathroom off the hall, outside of the Red Room.

Corrected Corrected by Apr 20, 2022

Category: supervision. 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 file for Child #4 contained an emergency contact form which lacked the telephone number of the child's medical provider.

Corrected Corrected by Jun 23, 2022

Category: health medication. 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 file for Child #1 contained an emergency contact form which lacked the home telephone number of the enrolling parent. The files for Child #3 and #5 contained emergency contact forms which lacked the work address and telephone number of the enrolling parents.

Corrected Corrected by Jun 23, 2022

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 #2 contained an emergency contact form which lacked the full address of the release person. The file for Child #4 contained an emergency contact form which lacked the address and telephone number of the release person.

Corrected Corrected by Jun 23, 2022

Category: recordkeeping. Marked corrected in the state record.

3270.131(b)(2) · The operator shall require the parent to provide an updated health report at least every 12 months for an older toddler or preschool child.

The file for Child #2 contained consecutive health reports dated more than 12 months apart.

Corrected Corrected by May 16, 2022

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

3270.131(e)(1) · The facility shall require the parent to provide updated written verification from a physician, physician's assistant, CRNP, the Department of Health or a local health department of ongoing vaccines administered to an infant, toddler or preschool child in accordance with the schedule recommended by the ACIP.

The files for Child #2 and #4 contained record of immunization history which lacked current influenza vaccinations.

Corrected Corrected by Jun 2, 2022

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.

During an observed diaper change in the Nursery, the hands-free mechanism of the lidded can was not operable.

Corrected Corrected by Apr 21, 2022

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 files for Staff #1, #4, #6 and #7 contained consecutive health assessments dated more than 24 months apart. The file for Staff #3 contained a most recent health assessment conducted more than 24 months ago.

Corrected Corrected by Jun 30, 2022

Category: ratio. Marked corrected in the state record.

3270.192(4) · 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 #3 contained documentation of current state police, child abuse and FBI clearances, yet lacked documentation of previous clearances. The clearances had been reviewed at a previous inspection.

Corrected Corrected by Jun 23, 2022

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

3270.31(f)(10)/3270.192(2)(iii) · Staff persons shall complete professional development in pediatric first aid and pediatric cardiopulmonary resuscitation within 90 days of hire.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 #5 contained certification in pediatric first-aid and CPR obtained more than 90 days after hire.

Corrected Corrected by Jun 12, 2022

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