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.

Small stickers less than 1 inch were observed on the walls and accessible to the children in the Young Toddler and Older Toddler room, who are still placing objects in their mouths.

Corrected Corrected by Aug 16, 2024

Marked corrected in the state record.

3270.14/3270.21 · A facility shall be operated in conformity with applicable Federal and State laws and regulations.State agencies whose regulations may relate to the operation of a facility include the Department of Environmental Resources, the Department of Labor and Industry, the Department of Health, the Department of Education and the Department of Transportation. Conditions at the facility may not pose a threat to the health or safety of the children.

The emergency plan on site does not include provisions regarding the facility's continuity of operations, required as of 7/1/22, as per Announcement C-22-04.

Corrected Corrected by Aug 19, 2024

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 file for Staff person #3 includes verification of First Aid/CPR training dated 8/14/23, after the expiration date of 1/23.

Corrected Corrected by Aug 19, 2024

Category: ratio. 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.

Staff person #8 had a fire safety training on file from 5/1/23, over 1 year ago.

Corrected Corrected by Aug 20, 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 person #3, #4 and #8 did not complete the following required pre-service training, which was required to be completed by 6/17/21, as per the updates to Chapter 3270 Child Care Center regulations, effective 12/19/20: Get Started with Center-Based Care; Building Blocks for Quality. The training for staff person #3 was completed on 12/1/18, the training for staff person #4 was completed on 7/14/16 and the training for staff person #8 was completed 7/11/16 which were all not within the approved 6-hour training date window of 9/30/16 to 6/30/18.

Corrected Corrected by Aug 20, 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 #2 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 Aug 23, 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).

The file for staff person #3 has mandated reporter training dated 12/1/18 and 12/11/23 which is more 60 months apart. The file for Staff person #5 includes criminal history clearances dated 1/15/19 and 3/18/24; child abuse clearances dated 1/15/19 and 3/19/24; and FBI clearances dated 1/13/19 and 4/6/24, all more than 60 months apart. The file for staff person #5 was observed not to contain a valid NSOR certificate within 45 days of hire (See IS CODE SHEET). The file for Staff person #6 includes criminal history clearances dated 4/6/18 and 11/16/23; child abuse clearances dated 4/11/18 and 11/22/23; and FBI clearances dated 4/11/18 and 11/22/23, all more than 60 months apart. The file for Staff person #7 does not include a signed disclosure statement.

Corrected Corrected by Aug 21, 2024

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

3270.66(a) · Cleaning materials and other toxic materials shall be kept in an area or container that is locked or made inaccessible to children.

A bag of topsoil was observed under the sink in an unlocked cabinet in the Preschool classroom which was labeled "keep out of reach of children."

Corrected Corrected by Aug 19, 2024

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 broken bin with sharp edges that could be a hazard to children was observed in the preschool room.

Corrected Corrected by Aug 16, 2024

Category: physical safety. 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 agreement on file for Child #1, Child #2, Child #3, Child #4, Child #5, Child #6, and Child #7 was the original and not a copy.

Corrected Corrected by Aug 20, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.151(c)(1)/3270.192(3) · An adult health assessment must include a physical 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 assessments on file for staff person #1 were dated 8/13/21 and 4/9/24 which are more than 24 months apart. The health assessments on file for staff person #4 were dated 7/13/21 and 12/13/23 which are more than 24 months apart. The health assessments on file for staff person #6 were dated 3/16/21 and 10/12/23 which are more than 24 months apart.

Corrected Corrected by Aug 16, 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 emergency plan on file was observed to be lacking a section that provided accommodations for infants, toddlers, children with disabilities, and children with chronic medical conditions.

Corrected Corrected by Aug 19, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.27(a)(6) · Emergency drills shall be conducted annually. Annual emergency drills shall be documented and on file at the facility.

The most recent emergency drill on file at the facility was from 6/12/23 which is more than one year ago.

Corrected Corrected by Aug 19, 2024

Category: recordkeeping. 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.

Staff # 1 has not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): pediatric first aid/CPR .

Corrected Corrected by Aug 15, 2023

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 files for staff # 3 contained a current Pediatric First Aid and Pediatric CPR certificate that was taken after 90 day of initial employment. Staff person(s) shall complete professional development in the topics of 3270.31(f)(1 -- 10) within 90 days of hire. The certificates for staff # 3 is date 1/12/23.

Corrected Corrected by Aug 9, 2023

Category: health medication. 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 file for staff # 2 contained a current mandated reporter training certificate dated 7/8/20 that was not obtained within 60 months of the previous certificate dated 3/3/15.

Corrected Corrected by Aug 9, 2023

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.

The side wall of the sink cabinet was damaged and exposing splinters in the preschool bathroom. There was wallpaper peeling off the wall near the window in the older toddler room. The rubber board near the bathroom door in the school age room was pulling of the wall. There was a piece of metal with exposed screws on the wall near the bathroom door in the school age room.

Corrected Corrected by Aug 9, 2023

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

3270.82(g) · Toilet areas and fixtures shall be cleaned daily and be in good repair.

The portable sink in the young toddler room, was clogged and not draining water properly. The sink was filled with water.

Corrected Corrected by Aug 8, 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.

There was a cracked pink plastic bin in the preschool room. There was a cracked toy hotdog in the preschool room.

Corrected Corrected by Aug 8, 2023

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

3270.106(h) · Soiled bedding shall be cleaned before it is reused.

There was a sheet with few stains in the infant room.

Corrected Corrected by Aug 8, 2023

Marked corrected in the state record.

3270.131(a)(4) · The initial health report for a school-age child must be dated in accordance with the requirements for medical examinations for school attendance in 28 Pa. Code § 23.2 (relating to medical examinations).

The file for child # 1 a school age contained an initial health report dated more than 1 year prior to the first day of attendance at the facility.

Corrected Corrected by Aug 25, 2023

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

3270.131(b)(2)/3270.131(e)(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. 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. Child #1 must be dismissed from care by close of business 8/8/23 and may only return to care when the immunization record is provided or when a parent provides a written, signed and dated exemption letter.

The file for child # 2 a preschooler lacked an updated health report. The prior report was dated 5/21/21. The child cannot return until the facility has a copy of the immunizations record. The child start date was. 3/22/21. The file for child # 3 a preschooler contained a current health report dated 6/7/23. The report was not updated within 12 months. The previous report was dated. 4/4/22.

Corrected Corrected by Aug 25, 2023

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

3270.151(a) · A facility person providing direct care who comes into contact with the children or who works with food preparation shall have a health assessment conducted within 12 months prior to providing initial service in a child care setting and every 24 months thereafter. A health assessment is valid for 24 months following the date of signature, if the person does not contract a communicable disease or develop a medical problem.

The file for staff # 1 contained a current health assessment dated 1/9/23. It was not obtained within 24 months of the previous assessment dated 8/20/20 .

Corrected Corrected by Aug 8, 2023

Category: ratio. Marked corrected in the state record.

3270.178 · A first-aid kit, including the contents as specified in §3270.75 (relating to first-aid kit) shall be in the vehicle when children are being transported.

The vehicle first-aid kit lacked tweezers.

Corrected Corrected by Aug 8, 2023

Category: health medication. 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.

The file for staff # 1 lacked 5 out of 12 required hours of annual childcare training, from 12/19/21 to 12/19/22.

Corrected Corrected by Aug 8, 2023

Category: recordkeeping. 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.

There was peeling paint on the gray wall with a sun on the left side by the window and on the right side above the chair label. There was peeling paint on the preschool room in the wall under the left window.

Corrected Corrected by Aug 22, 2022

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 files for staff #2 and #3 lacked annual Fire Safety training between May 2021 and May 2022. The file for staff #2 contained certificates dated 9/22/20 and 5/4/22. The file for staff #3 contained certificates dated 9/23/20 and 5/3/22.

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

3270.31(f) · Staff person(s) shall complete professional development in the topics of 3270.31(f)(1 -- 10), within 90 days of hire. Staff person #1 will have until 9/1/22 to complete the required training. Until such time as the required training has been completed, staff person # 1 must be supervised, when interacting with children, by an AGS who has completed the required training related to this citation. If there are no staff available to supervise staff person #1, staff person #1 may not work in a child-care position at the facility.

Staff person #1 has not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): 3270.31(f)(1)-(9). Staff #1 completed a 6 hour Health and Safety training on 5/28/19. The training taken was not valid past 6/30/18.

Corrected Corrected by Aug 22, 2022

Category: supervision. Marked corrected in the state record.

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

The file for staff #2 contained a current State Police clearance and Child Abuse clearance that were not renewed within 60 months of the previous clearance. The State Police clearance dates are 3/30/15 and 6/22/20. The Child Abuse clearance dates are 4/13/15 and 6/22/20. The file for staff #3 contained a current State Police clearance and Child Abuse clearance that were not renewed within 60 months of the previous clearance. The State Police clearance dates are 3/29/13 and 4/6/18. The Child Abuse clearance dates are 3/29/13 and 4/11/18.

Corrected Corrected by Aug 22, 2022

Category: background checks. 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 older toddler room lacked tweezers.

Corrected Corrected by Aug 22, 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.

There was wall paper peeling of the wall with the cubbies in the Older Toddler room . There was wall paper peeling off the wall l under the summer bulleting in the preschool room. There was wall paper peeling of the refrigerator in the school age room. There was a piece of broken mirror attached to the refrigerator with sharp edges accessible to children. The rubber wall baseboard on preschool bathroom wall was pulled off by the sink area. he side wall of the sink cabinet was damaged and exposing splinters.

Corrected Corrected by Aug 22, 2022

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

3270.82(g) · Toilet areas and fixtures shall be cleaned daily and be in good repair.

The sink faucet in the preschool room and the young toddler room appeared to be corroded.

Corrected Corrected by Aug 29, 2022

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.

The source of running water for handwashing, in the young toddler room, a portable sink, was empty and did not contain any water for handwashing.

Corrected Corrected by Aug 22, 2022

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.

There was a blue cracked bin holding Legos in the school age room. There was a broken bat and pieces of a broken toy in the school age play ground.

Corrected Corrected by Aug 22, 2022

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.

There was an eating chair in the young toddler room that is broken on the right corner creating sharp edges.

Corrected Corrected by Aug 22, 2022

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 thermometer in the refrigerator in the kitchen by the infant room was 50° .

Corrected Corrected by Aug 22, 2022

Category: nutrition. 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 file for child # 3 lacked the persons designated by a parent to whom the child may be released on the agreement form.

Corrected Corrected by Aug 22, 2022

Category: recordkeeping. Marked corrected in the state record.

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

The file for child # 3 lacked the admission date on the agreement form.

Corrected Corrected by Aug 22, 2022

Category: recordkeeping. Marked corrected in the state record.

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

The file for child # 1 lacked home addresses and work telephone numbers of the enrolling parent on the emergency contact form.

Corrected Corrected by Aug 22, 2022

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 informationA 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 files for child # 2 and 3 have an emergency contact and agreement form that were not updated in a 6 months period.

Corrected Corrected by Aug 22, 2022

Category: recordkeeping. 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 file for Child # 4 lacks documentation of a current influenza immunization as recommended by the ACIP

Corrected Corrected by Aug 26, 2022

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

3270.192(2)(iii) · 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 #3 contained a current mandated reporter training certificate (6/29/20) that was renewed beyond 60 months after the previous certificate (2/18/15).

Corrected Corrected by Aug 22, 2022

Category: recordkeeping. 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 emergency plan lacked accommodations for infants, toddlers and children with disabilities and children with chronic medical conditions.

Corrected Corrected by Aug 22, 2022

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

3270.131(a)/3270.182(1) · The operator shall require the parent of an enrolled child, including a child, a foster child and a relative of an operator or a facility person, to provide an initial health report no later than 60 days following the first day of attendance at the facility. A child's record shall contain initial and subsequent health reports.

The files for child # 4 and 5 lacked and initial health report.

Corrected Corrected by Aug 22, 2022

Category: health medication. 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.

A loose crib sheet was observed on the crib labeled for an infant, causing a risk of suffocation.

Corrected Corrected by Aug 4, 2021

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 #1, an existing staff member, contained documentation of certification of pediatric first-aid and CPR which expired 5/7/21.

Corrected Corrected by Aug 9, 2021

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 #7 may not work in a child care position in the facility.

The file for Staff #4, with a start date of 5/23/21, contained a receipt for fingerprint and DHS FBI clearance dated 6/28/21. The file for Staff #5, with a start date of 4/30/21, contained a child abuse clearance dated 5/5/21 and lacked a receipt of application for the child abuse clearance. The file for Staff #7, with a start date of 3/19/21, contained a receipt for fingerprint and DHS FBI clearance dated 7/14/21 and lacked an NSOR application or NSOR clearance.

Corrected Corrected by Aug 10, 2021

Category: background checks. 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.

An unlabeled spray bottle, containing what staff reported to be a toxic cleaner titled Fabuloso, was observed in the PS Room.

Corrected Corrected by Aug 4, 2021

Category: ratio. 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.

Used tissues containing human secretions were observed on the ground of the toddler playground, not in a closed, plastic-lined receptacle.

Corrected Corrected by Aug 10, 2021

Marked corrected in the state record.

3270.81 · A visual strip or other visual identification shall be placed on glass located in a traffic area, a child care space or a play space.

The back glass door in the infant room was observed to lack a visual strip or other visual identification.

Corrected Corrected by Aug 9, 2021

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

3270.82(i) · A toilet area, training chair area, diapering area and sink area shall be equipped with a clean, lidded waste receptacle.

The bathrooms in the PS Room and YT/SA Room were observed to lack lidded waste receptacles.

Corrected Corrected by Aug 4, 2021

Category: health medication. 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.

The sink near the changing table in the YT Room was observed to not work properly, with no water running out of the faucets.

Corrected Corrected by Aug 4, 2021

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.

The toy kitchen oven door was observed to contain loose plastic with a sharp edge. The pink tunnel and plastic viewer on the climber on the front playground was observed to be cracked, causing pinch points.

Corrected Corrected by Aug 4, 2021

Category: physical safety. 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 file for Child #2, age 2, contained documentation of immunization history which lacked current influenza, varicella and Hepatitis A vaccinations. The record contained 2 of 3 required DTAP, Hib, and Polio vaccinations and 2 of 4 required Pneumococcal vaccinations. The file for Child #3, age 2, contained documentation of immunization history which lacked the second Hepatitis A vaccination. The file for Child #4, age 3, contained documentation of immunization history which lacked a current influenza vaccination.

Corrected Corrected by Aug 20, 2021

Category: health medication. 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 expired Tylenol was observed in the Toddler Room.

Corrected Corrected by Aug 4, 2021

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.

Staff reported that soiled diapers are placed into a plastic bag before being placed into a plastic-lined, hands-free covered can.

Corrected Corrected by Aug 4, 2021

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

3270.151(a) · A facility person providing direct care who comes into contact with the children or who works with food preparation shall have a health assessment conducted within 12 months prior to providing initial service in a child care setting and every 24 months thereafter. A health assessment is valid for 24 months following the date of signature, if the person does not contract a communicable disease or develop a medical problem.

The file for Staff #2 contained consecutive health assessments dated more than 24 months apart. The file for Staff #3 contained an initial health report dated more than 12 months prior to the first day of employment in a child care position.

Corrected Corrected by Aug 10, 2021

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 files for Staff #3 and #6 contained initial tuberculosis screenings dated more than 12 months prior to their start of employment.

Corrected Corrected by Aug 16, 2021

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

3270.166(5) · An infant 6 months of age or younger shall be held while being bottle fed.

An infant less than 6 months of age was observed being fed a bottle while sitting in a swing.

Corrected Corrected by Aug 4, 2021

Marked corrected in the state record.

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

The file for Child #4 contained an emergency contact form which lacked signed parental consent for emergency medical care.

Corrected Corrected by Aug 6, 2021

Category: recordkeeping. Marked corrected in the state record.

3270.182(5) · 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 files for Child #1 and #4 contained emergency contact forms which lacked signed parental consent for administration of first-aid.

Corrected Corrected by Aug 6, 2021

Category: ratio. Marked corrected in the state record.

3270.31(f)(10)/3270.192(2)(iii) · Pediatric first aid and pediatric cardiopulmonary resuscitation. 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, with a start date of 4/30/21, lacked documentation of certification in pediatric first-aid and CPR. Certification was required within 90 days following the start of employment in a child care position.

Corrected Corrected by Aug 10, 2021

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

3270.31(h)/3270.192(2)(iii) · All staff persons shall complete the professional development under subsection (f). 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, with a start date of 4/30/21, lacked documentation of health and safety training numbers 1 - 9, as listed in the regulation 3270.31(f). Training was required within 90 days following the start of employment in a child care position.

Corrected Corrected by Aug 10, 2021

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

3270.94(a)(4) · 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 hypothetical locations for fires in the same location for 5/21 and 6/21.

Corrected Corrected by Aug 4, 2021

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

3270.95(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)).

The interconnected fire detection system lacked a proof of purchase.

Corrected Corrected by Aug 19, 2021

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

3270.131(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 #4, with an enrollment date of 9/1/20, contained an initial health report dated 7/12/21. The health report would have been due 12/1/20, with the extension of the regulation due to the COVID-19 pandemic.

Corrected Corrected by Aug 4, 2021

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