3280.14/3280.20 · 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 details regarding continuity of operations as required by Announcement C-22-04.

Corrected Corrected by Sep 24, 2024

Category: ratio. Marked corrected in the state record.

3280.14/3280.20 · 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 lacked a written policy and procedure to identify the prevention of shaken baby syndrome, abusive head trauma, and child maltreatment as required by Announcement C-22-03.

Corrected Corrected by Sep 24, 2024

Category: ratio. Marked corrected in the state record.

3280.76 · 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.

Dog feces was observed in the outdoor play space.

Corrected Corrected by Sep 24, 2024

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

3280.102(a)/3280.103 · 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.

Torn corners exposing the inner foam filling were observed on the plastic covered pad used for diaper changing.

Corrected Corrected by Sep 24, 2024

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

3280.123(a)(3) · An agreement shall specify 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 at § 3280.124(f).

The files for children #1, #2, and #5 contained consecutive child service reports signed by the parents at intervals greater than 6 months. The reports were dated for June 2023 with the next reports dated in January 2024. All three files now contain current child service reports.

Corrected Corrected by Sep 24, 2024

Category: recordkeeping. Marked corrected in the state record.

3280.123(a)(4) · An agreement shall specify the child's arrival and departure times.

The agreements for children #1, #3, and #4 did not include the child's arrival and departure times.

Corrected Corrected by Sep 24, 2024

Category: recordkeeping. Marked corrected in the state record.

3280.131(b)(1)/3280.182(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 must contain initial and subsequent health reports.

The file for child #2, a YT at the time, contained consecutive health reports dated more than 6 months apart; 5/16/23 and 1/30/24. A current health report is now on file.

Corrected Corrected by Sep 24, 2024

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

3280.94(a)(4) · The primary staff person or designated staff person who is responsible for compliance with this chapter shall conduct fire drills and ensure that the hypothetical locations of the fire are rotated around the facility for each drill such that the hypothetical location is never the same for consecutive drills.

The facility's fire drill log indicated the same hypothetical location for consecutive fire drills dated 4/12/24 and 5/17/24 and drills dated 8/16/24 and 9/16/24.

Corrected Corrected by Sep 24, 2024

Category: recordkeeping. Marked corrected in the state record.

3280.95(a)/3280.95(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 primary staff person or designated staff person who is responsible for compliance with this chapter shall ensure the requirements in subsection (a) are met.

The facility's log of the 30 day tests of the fire alarms indicated 35 days between consecutive tests on 5/17/24 and 6/21/24. The log is now current with 30 days or less between tests conducted after 6/21/24.

Corrected Corrected by Sep 24, 2024

Category: recordkeeping. Marked corrected in the state record.

3280.26(a)(6) · Emergency drills shall be conducted annually. Annual emergency drills shall be documented and on file at the facility.

The most recent written documentation of an emergency drill on file at the facility is dated 4/8/22, more than 1 year ago.

Corrected Corrected by Oct 17, 2023

Category: recordkeeping. Marked corrected in the state record.

3280.94(a)(1) · The primary staff person 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 60-day test log includes test dates 11/21/22-1/21/23 and 6/21/23-8/21/23, which are more than 60 days apart.

Corrected Corrected by Oct 17, 2023

Category: recordkeeping. Marked corrected in the state record.

3280.26(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 and to the county emergency management agency.

Corrected Corrected by Oct 17, 2023

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

3280.31(e)(4)(i)/3280.192(2)(iii) · Competence is the completion of training by a professional in the field of first-aid and 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 files for Staff #1, #2, and #3 includes verification of CPR/First Aid training expiring on 9/14/23, without have an updated CPR/First Aid training completed. The facility must remain closed after close of business on 9/27/23 until valid CPR/First Aid training is obtained. The CPR/First Aid training on file for Staff #1, #2, and #3 dated 9/14/23 was not taught by a PQAS approved instructor.

Corrected Corrected by Sep 30, 2023

Category: ratio. Marked corrected in the state record.

3280.123(a)(3) · An agreement shall specify 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 at § 3280.124(f).

The Child Service Reports for Child #2 were completed on 1/7/23 and 8/30/23, which is more than 6 months apart

Corrected Corrected by Oct 17, 2023

Category: recordkeeping. Marked corrected in the state record.

3280.124(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 on file for Child #5 does not include a complete address for the child's pediatrician/source for medical care.

Corrected Corrected by Oct 17, 2023

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

3280.124(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.

In the file for Child #1, the Emergency Contact form did not contain the health insurance policy number for the child.

Corrected Corrected by Oct 17, 2023

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

3280.131(b)(1)/3280.182(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 must contain initial and subsequent health reports.

The two most recent health assessments on file for Child #5, who was a young toddler at the time, are dated 9/29/22 and 4/3/2023, more than 6 months apart.

Corrected Corrected by Oct 17, 2023

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

3280.131(d)(5)/3280.131(e)(1) · A health report shall include a review of the child's immunized status according to recommendations of the ACIP. 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 immunization record on file for Child #1, who is 2 years old, included 3 of 4 DTAP vaccines recommended by the ACIP for a child this age. The most recent influenza vaccination on file for Child #3, who is 3 years old, is dated 10/26/21, more than 1 year ago, as is recommended annually by the ACIP. The most recent influenza vaccination on file for Child #5, who is 2 years old, is dated 1/31/22, more than 1 year ago, as is recommended annually by the ACIP. Child #1, #3, and #5 must be dismissed from care by close of business on 9/27/23 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 Oct 17, 2023

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

3280.15(a) · (a) A certificate of compliance will not be granted by the Department until the legal entity provides a certificate of occupancy as proof of compliance with the applicable requirements of the Department of Labor and Industry in 34 Pa. Code § 403.23 (relating to child day care facilities) and under section 1016(c) of the act (62 P.S. §  1016(c)).

The facility was unable to provide a copy of the certificate of occupancy for the child care facility.

Corrected Corrected by Oct 31, 2023

Marked corrected in the state record.

3280.94(a)(4) · The primary staff person or designated staff person who is responsible for compliance with this chapter shall conduct fire drills and ensure that the hypothetical locations of the fire are rotated around the facility for each drill such that the hypothetical location is never the same for consecutive drills.

The fire drill log on file included multiple consecutive hypothetical locations of the fire used for the drill.

Corrected Corrected by Oct 17, 2023

Category: recordkeeping. Marked corrected in the state record.

3280.95(a)/3280.95(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 primary staff person or designated staff person who is responsible for compliance with this chapter shall ensure the requirements in subsection (a) are met.

The fire alarm 30-day test log includes test dates 3/3/23-4/3/23, 5/1/23-6/1/23, 6/1/23-7/3/23, 8/1/23-9/1/23, which are more than 30 days apart.

Corrected Corrected by Oct 17, 2023

Category: recordkeeping. Marked corrected in the state record.

3280.26(a)(3) · The facility shall have an emergency plan that provides for a method for facility persons to contact parents as soon as reasonably possible when an emergency situation arises.

The observed emergency plan lacked documentation of the method used to contact parents in an emergency.

Corrected Corrected by Nov 14, 2022

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

3280.26(a)(4) · The facility shall have an emergency plan that provides for 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.

The observed emergency plan lacked documentation of the method used to inform parents that the emergency has ended.

Corrected Corrected by Nov 14, 2022

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

3280.123(a)(4) · An agreement shall specify the child's arrival and departure times.

The file for Child #1 contained an agreement form which lacked the arrival and departure times for the child.

Corrected Corrected by Nov 14, 2022

Category: recordkeeping. Marked corrected in the state record.

3280.124(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 plan identifying the means of transporting a child to emergency care and staffing provisions in the event of an emergency was not posted in the back room.

Corrected Corrected by Sep 28, 2022

Category: transportation. Marked corrected in the state record.

3280.192(3) · 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 #1 lacked documentation of the initial tuberculosis skin test. Documentation of the test was reviewed at a previous inspection.

Corrected Corrected by Nov 14, 2022

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

3280.26(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 observed emergency plan lacked accommodations for infants and toddlers.

Corrected Corrected by Nov 14, 2022

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

3280.26(a)(6) · Emergency drills shall be conducted annually. Annual emergency drills shall be documented and on file at the facility.

Documentation of a current emergency drill was observed, yet documentation of an emergency drill conducted between 12/19/20 and 12/19/21 was not available at the time of inspection.

Corrected Corrected by Nov 14, 2022

Category: recordkeeping. Marked corrected in the state record.

3280.94(a)(4) · The primary staff person or designated staff person who is responsible for compliance with this chapter shall conduct fire drills and ensure that the hypothetical locations of the fire are rotated around the facility for each drill such that the hypothetical location is never the same for consecutive drills.

The observed fire drill log contained consecutive fire drills in which the hypothetical location of the fire had not changed.

Corrected Corrected by Nov 14, 2022

Category: recordkeeping. Marked corrected in the state record.

3280.95(a)/3280.95(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 primary staff person or designated staff person who is responsible for compliance with this chapter shall ensure the requirements in subsection (a) are met.

Documentation of the tests of the fire detection system was observed to show more than 30 days between tests.

Corrected Corrected by Nov 14, 2022

Category: recordkeeping. Marked corrected in the state record.

3280.26(a)(1) · The facility shall have an emergency plan that provides for shelter of children during an emergency including lock-down, shelter in place at the facility and shelter at locations away from the facility premises.

The observed emergency plan lacked documentation of the shelter in place, and lockdown at the facility in the case of emergency.

Corrected Corrected by Nov 14, 2022

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

3280.131(a) · 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 file for Child #1 contained an initial health report dated more than 60 days after enrollment.

Corrected Corrected by Sep 28, 2022

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

3280.75(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 lacked tweezers.

Corrected Corrected by Sep 21, 2021

Marked corrected in the state record.

3280.123(a)(4) · An agreement shall specify the child's arrival and departure times.

The agreement for child #1 did not specify the child's arrival and departure times.

Corrected Corrected by Sep 28, 2021

Category: recordkeeping. Marked corrected in the state record.

3280.123(b)/3280.182(8) · A parent shall receive the original agreement. The facility shall retain a copy of the agreement. A child's record must contain a copy of the initial agreement and subsequent written agreements between the parent and the operator. The parent receives the original agreement.

The facility retained the original copy of the agreement for child #2.

Corrected Corrected by Sep 28, 2021

Category: recordkeeping. Marked corrected in the state record.

3280.151(a)/3280.192(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 #1 and #2 included a current health assessment dated more than 24 months following the date of their previous health assessment.

Corrected Corrected by Sep 21, 2021

Category: ratio. Marked corrected in the state record.

3280.95(a)/3280.95(b) · (a) Fire detection devices or systems must be in compliance with standards established under section 1016(c) of the act (62 P.S. §  1016(c)).(b) The primary staff person or designated staff person who is responsible for compliance with this chapter shall ensure the requirements in subsection (a) are met.

The operator did not maintain the proof of purchase for the interconnected fire detection system.

Corrected Corrected by Sep 21, 2021

Category: recordkeeping. Marked corrected in the state record.