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).

A renewal inspection occurred at the facility. A review of children's files was conducted. Regulation requires child service reports to be conducted on children every 6 months. A the time of the inspection, the director was unable to provide child service reports for the following children: Child #2 and #5.

Corrected Corrected by Jun 27, 2025

Category: recordkeeping. Marked corrected in the state record.

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

A renewal inspection occurred at the facility. A review of children's files was conducted. Regulation requires children's emergency contact and agreement forms to be reviewed and updated at least every 6-month period. The following children's forms were not updated at least every 6-month period: Child #2 (previous emergency contact 4/18/24 and current 2/21/25; previous agreement 4/18/24 and current 4/8/25) and Child #5 (previous emergency contact and agreement 11/11/24; no current emergency contact or agreement).

Corrected Corrected by Jun 27, 2025

Category: recordkeeping. Marked corrected in the state record.

3270.131(b)(2)/3270.182(1) · The operator shall require the parent to provide an updated health report at least every 12 months for an older toddler or preschool child. A child's record shall contain initial and subsequent health reports.

A renewal inspection occurred at the facility. A review of children's files was conducted. Regulation requires children to provide an updated health report every 12 months for an older toddler and preschool child. The following children were of these ages and the file did not contain updated health reports: Child #2 (previous 11/30/23, current 1/28/25) and Child #5 (previous 11/21/23, no current).

Corrected Corrected by Jun 27, 2025

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.

A renewal inspection occurred at the facility. A review of staff files was conducted. Regulation requires staff to participate in annual 12 hours of child care training. At the time of the inspection, the file of Staff #1 only contained 4 hours of annual child care training. Staff #1 did not have a total of 12 hours of annual child care training as required by regulation.

Corrected Corrected by Jun 27, 2025

Category: recordkeeping. 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.

A renewal inspection occurred at the facility. A review of children's files was conducted. Regulation requires a health report in a child's file within 60 days of enrollment. The following children were enrolled at the facility for more than 60 days and the files did not contain a health report: Child #1 and Child #4.

Corrected Corrected by Jun 27, 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. TIERED LIS: 1. Facility Person #7 may not work in a child care position at the facility. This portion of the plan shall have an immediate date of correction. 2. The Legal Entity/Director will call the Northeast Daycare Regional Office (800-222-2108) to schedule the legal entity, director and any one responsible for maintaining staff files to participate in the next Existing Provider Orientation. The Legal Entity, Director or any other appropriate staff will submit documentation to the Northeast Daycare Regional Office that they have attended the orientation. The operator shall provide a date for when this training shall be completed.

CONTINUED NON-COMPLIANCE. A renewal inspection occurred at the facility during the period of 11/5/24 to 12/4/24. A review of staff files was conducted. See the code sheet for the staff's dates of hire. Staff #3 was hired as a provisional hire and did not apply for a state police clearance until 10/2/24 as required by the CPSL for a provisional hire. Staff #3 began working in child care prior to applying for the state police clearance. Staff #3 was working in child care on 11/5/24 and on 11/18/24 and was not hired correctly as a provisional hire per the CPSL. Staff #3 did not have on file a state police clearance, documentation of applying for an FBI clearance, the official child abuse clearance or documentation of applying for an NSOR clearance. The file of Staff #3 also indicated this staff has lived out of state within the last 5 years and Staff #3 did not apply for that states clearances prior to providing child care. Staff #3 was observed working in child care on two occasions and was not hired correctly as a provisional hire. Staff #6 did not have a signed disclosure statement on file at the time of the inspection. An acceptable plan of correction was received on 1/29/25. An unannounced inspection occurred at the facility on 3/31/25. A review of staff files was conducted. See the code sheet for the date of hire. Staff #7 was hired incorrectly in relation to the CPSL. Staff #7 did not apply for the state police clearance prior to working in child care. Staff #7 did not receive a state police clearance until 1/9/25, which was after this staff's hire date.

Corrected Corrected by May 15, 2025

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

3270.33(a)/3270.192(2)(ii) · A staff person or a substitute staff person shall meet one of the applicable staff qualifications for the position in which the person is performing. A facility person's record shall include verification of child care experience, education and training prior to service at the facility.

An unannounced inspection occurred at the facility on 3/31/25. A review of staff files was conducted. See the code sheet for the date of hire. Regulation requires proof of education on file prior to a staff providing child care. Staff #7 was providing child care during this inspection and the file did not contain proof of education. Staff #7 could not be appropriately qualified as a staff person due to the lack of education on file.

Corrected Corrected by Apr 14, 2025

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.

CONTINUED NON-COMPLIANCE. A renewal inspection occurred at the facility during the period of 11/5/24 to 12/4/24. A review of children's files was conducted. See the code sheet for the children's dates of enrollment. At the time of this inspection, the following children's files were missing the enrolling parents work address and phone number: Child #1, #2, #4, #5 and #6. These children were observed receiving care during this inspection. An acceptable plan of correction was received on 1/21/25. An unannounced inspection occurred at the facility on 3/31/25. A review of staff files was conducted. At the time of this inspection, the following child's file was missing the enrolling parents work address and phone number as required by regulation: Child #5.

Corrected Corrected by Apr 14, 2025

Category: recordkeeping. Marked corrected in the state record.

3270.124(b)(4)/3270.182(3) · Emergency contact information must include the written consent signed by a parent for emergency medical care. A child's record shall contain signed parental consent for emergency medical care for the child. Written consent is required prior to admission.

CONTINUED NON-COMPLIANCE. A renewal inspection occurred at the facility during the period of 11/5/24 to 12/4/24. A review of children's files was conducted. See the code sheet for the children's dates of enrollment. Regulation requires enrolled children to have written consent for emergency medical care. The following enrolled children did not have consent for emergency medical care in their file: Child #1, #2, #3, #5 and #7. An acceptable plan of correction was received on 1/21/25. An unannounced inspection occurred at the facility on 3/31/25. A review of child files was conducted. Regulation requires enrolled children to have written consent for emergency medical care. The following enrolled child did not have consent for emergency medical care in their file: Child #1.

Corrected Corrected by Apr 14, 2025

Category: recordkeeping. Marked corrected in the state record.

3270.124(b)(6) · Emergency contact information must include health insurance coverage and policy number for a child under a family policy or Medical Assistance benefits, if applicable.

CONTINUED NON-COMPLIANCE. A renewal inspection occurred at the facility during the period of 11/5/24 to 12/4/24. A review of children's files was conducted. See the code sheet for the children's dates of enrollment. At the time of this inspection, the following children were observed receiving care at the facility and the file was missing the child's health insurance coverage and policy number: Child #1, #2, #3 (policy number only), #4, #5 (policy number only) and #6. An acceptable plan of correction was received on 1/21/25. An unannounced inspection occurred at the facility on 3/31/25. A review of children's files was conducted. See the code sheet for the children's dates of enrollment. At the time of this inspection, the following children were observed receiving care at the facility and the file was missing the child's health insurance coverage and policy number as required by regulation: Child #1, #3 (policy number only) and #5 (policy number only).

Corrected Corrected by Apr 14, 2025

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

3270.124(b)(7) · Emergency contact information must include the name, address and telephone number of the individual designated by the parent to whom the child may be released.

CONTINUED NON-COMPLIANCE. A renewal inspection occurred at the facility during the period of 11/5/24 to 12/4/24. A review of children's files was conducted. See the code sheet for the children's dates of enrollment. At the time of this inspection, the following children were observed receiving care and the file was missing complete release person's information: Child #3 (addresses only), Child #4 (addresses only) and Child #5 (addresses only). An acceptable plan of correction was received on 1/21/25. An unannounced inspection occurred at the facility on 3/31/25. A review of children's files was conducted. See the code sheet for the children's dates of enrollment. At the time of this inspection, the following children were observed receiving care and the file was missing complete release person's information as required by regulation: Child #5 (addresses only).

Corrected Corrected by Apr 14, 2025

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.

CONTINUED NON-COMPLIANCE. A renewal inspection occurred at the facility during the period of 11/5/24 to 12/4/24. A review of children's files was conducted. See the code sheet for the children's dates of enrollment. Regulation requires written consent for first aid procedures in the children's files. The following enrolled children's files were missing consent for first aid procedures: Child #1, #2, #3, # 5 and #7. An acceptable plan of correction was received on 1/21/25. An unannounced inspection occurred at the facility on 3/31/25. A review of children's files was conducted. See the code sheet for the child's date of enrollment. Regulation requires written consent for first aid procedures in the children's files. The following enrolled child's file was missing consent for first aid procedures: Child #1.

Corrected Corrected by Apr 14, 2025

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.

CONTINUED NON-COMPLIANCE. A renewal inspection occurred at the facility during the period of 11/5/24 to 12/4/24. A review of staff files was conducted. See the code sheet for the date of hire. Regulation requires staff files to contain two letters of written reference. At the time of this inspection, the following files were missing letters of reference: Staff #4 (2 letters) and Staff #6 (1 letter). Both staff were observed working in child care at the time of this inspection and the suitability of these staff could not be appropriately determined due to the lack of letters of reference. An acceptable plan of correction was received on 1/21/25. An unannounced inspection occurred at the facility on 3/31/25. A review of staff files was conducted. See the code sheet for the date of hire. Regulation requires staff files to contain two letters of written reference. At the time of this inspection, the following file was missing letters of reference: Staff #4 (2 letters).

Corrected Corrected by Apr 14, 2025

Category: recordkeeping. 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. Children must be supervised at all times.

A complaint inspection occurred at the facility. Interviews were conducted. Through these interviews, it was determined that on 11/18/24, Child #2 was in the supervision group of Staff #2. During nap time, Staff #2 was observed falling asleep and did not see Child #2 being scratched on both sides of their face by another child. These scratches were significant enough that medical attention was sought for the Child #2. Regulation requires children to be supervised at all times. It was determined that a lapse in supervision occurred during nap time and a child was injured due to that lapse in supervision.

Corrected Corrected by Nov 19, 2024

Category: supervision. Marked corrected in the state record.

3270.113(a) · Children on the facility premises and on facility excursions off the premises shall be supervised by a staff person at all times. Outdoor play space used by the facility is considered part of the facility premises. The Legal Entity / Director will establish a supervision policy. The policy must address all areas of 3270.113, including all areas under 3270.113 (a-e). The policy must also include how the facility will demonstrate their knowledge and ability to adequately supervise children while maintaining appropriate ratio at all times. The policy must focus on ensuring that each child is seen, heard, assessed and able to be directed at all times. The policy must also include how the facility will ensure appropriate supervision and ratios during nap time. The policy must be submitted to the Northeast Regional Office for review and approval. Once approved, the policy must be reviewed and discussed with all staff. Staff's signature will indicate their knowledge of the policy and ensuring proper supervision and ratios at all times. This documentation of signatures must be maintained at the facility.

A complaint inspection occurred at the facility. Interviews were conducted. Through these interviews, it was determined that on 11/18/24, Child #2 was in the supervision group of Staff #2. During nap time, Staff #2 was observed falling asleep and did not see Child #2 being scratched on both sides of their face by another child. These scratches were significant enough that medical attention was sought for the Child #2. Regulation requires children to be supervised at all times. It was determined that a lapse in supervision occurred during nap time and a child was injured due to that lapse in supervision.

Corrected Corrected by Feb 19, 2025

Category: supervision. Marked corrected in the state record.

3270.124(b)(5) · Emergency contact information must include information on the child's special needs, as specified by the child's parent, physician, physician's assistant or CRNP, which is needed in an emergency situation.

A complaint inspection occurred at the facility. A review of the child's file was conducted as well as interviews conducted with staff. The file of Child #1 had listed food restrictions soy, gluten and dairy as listed by the parent on the emergency contact. Staff #1 admitted to giving the child food that contained these items, and the child had an allergic reaction to the food ingredients listed.

Corrected Corrected by Dec 3, 2024

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

3270.131(d)(2)/3270.131(d)(4) · A health report shall include a list of the child's allergies. A health report shall include an assessment of an acute or chronic health problem or special need and recommendations for treatment or services, including information regarding abnormal results of screening tests for vision, hearing or lead poisoning.

A complaint inspection occurred at the facility. A review of the child's file was conducted as well as interviews conducted with staff. The file of Child #1 had listed a lactose free diet (allergy to cow's milk protein) on the child's health assessment. Staff #1 admitted to giving the child food that contained this item, and the child had an allergic reaction to the food item listed.

Corrected Corrected by Dec 9, 2024

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

3270.133(8)/3270.162(b) · If a special diet is prescribed for a child and if the diet is administered to the child, written instructions and the parent's written consent shall be retained in the child's file. Meals and snacks may be provided by the parent, upon agreement between the parent and the operator.

A complaint inspection occurred at the facility. A review of the child's file was conducted as well as interviews conducted with staff. The file of Child #1 had listed food restrictions soy, gluten and dairy as listed by the parent on the emergency contact. Staff #1 admitted to giving the child food that contained these items, and the child had an allergic reaction to the food ingredients listed. The file of Child #1 also had listed a lactose free diet (allergy to cow's milk protein) on the child's health assessment. Staff #1 admitted to giving the child food that contained this item, and the child had an allergic reaction to the food item listed. Staff #1 admitted to allowing Child #1 to eat food that was not provided by the parent.

Corrected Corrected by Dec 30, 2024

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

3270.14/3270.21 · A facility shall be operated in conformity with applicable Federal and State laws and regulations. State agencies whose regulations may relate to the operation of a facility include the Department of Environmental Resources, the Department of Labor and Industry, the Department of Health, the Department of Education and the Department of Transportation. Conditions at the facility may not pose a threat to the health or safety of the children. The OCDEL ANNOUNCEMENT C-22-04 requires facility emergency plans to include continuity of operations during and after an emergency that includes continuing daily operations, backing up or retrieving health and other key records/files and managing financial issues such as paying employees and bills during the aftermath of the disaster.

A renewal inspection occurred at the facility. A review of the facility's emergency plan was conducted. The OCDEL ANNOUNCEMENT C-22-04 requires facility emergency plans to include continuity of operations for before and after an emergency. At the time of the inspection, the facility did not provide for review a copy of the facility's continuity of operations.

Corrected Corrected by Feb 12, 2025

Category: ratio. Marked corrected in the state record.

3270.27(c) · The operator shall assure that each facility person receives training regarding the emergency plan at the time of initial employment, on an annual basis and at the time of each plan update. The operator shall document the date of each training and the names of all facility persons who received the training and kept on file at the facility.

A renewal inspection occurred at the facility. A review of staff files was conducted. See the code sheet for the staff's date of hire. Regulation requires staff to review the emergency plan on an annual basis. Staff #1 and #2 have not reviewed the emergency plan since 9/5/23. Regulation requires staff to review the emergency play within 90 days of their hire date. At the time of the inspection, the following staff still did not review the emergency plan: Staff #5.

Corrected Corrected by Feb 5, 2025

Category: recordkeeping. 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.

A renewal inspection occurred at the facility. A review of staff files was conducted. Regulation requires staff to participate in annual fire safety training. At the time of the inspection, Staff #2 had not yet completed annual fire safety training. At the time of this inspection, the file did not contain annual fire safety training since this staff's date of hire.

Corrected Corrected by Jan 10, 2025

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. Facility Person #3 may not work in a child care position at the facility. The Legal Entity/Director will call the Northeast Daycare Regional Office (800-222-2108) to schedule the legal entity, director and any one responsible for maintaining staff files to participate in the next Existing Provider Orientation. The Legal Entity, Director or any other appropriate staff will submit documentation to the Northeast Daycare Regional Office that they have attended the orientation.

A renewal inspection occurred at the facility. A review of staff files was conducted. See the code sheet for the staff's dates of hire. Staff #3 was hired as a provisional hire and did not apply for a state police clearance until 10/2/24 as required by the CPSL for a provisional hire. Staff #3 began working in child care prior to applying for the state police clearance. Staff #3 was working in child care on 11/5/24 and on 11/18/24 and was not hired correctly as a provisional hire per the CPSL. Staff #3 did not have on file a state police clearance, documentation of applying for an FBI clearance, the official child abuse clearance or documentation of applying for an NSOR clearance. The file of Staff #3 also indicated this staff has lived out of state within the last 5 years and Staff #3 did not apply for that states clearances prior to providing child care. Staff #3 was observed working in child care on two occasions and was not hired correctly as a provisional hire. Staff #6 did not have a signed disclosure statement on file at the time of the inspection.

Corrected Corrected by Feb 12, 2025

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

3270.32(a)/3270.192(4) · The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). A facility person's record shall include a copy of requests for the criminal history record and child abuse registry clearance information, a copy of the disclosure statement and a copy of the completed clearance information required under the CPSL. Facility Person #3 may not work in a child care position at the facility.

A renewal inspection occurred at the facility. A review of staff files was conducted. See the code sheet for the staff's dates of hire. Staff #3 was hired as a provisional hire and did not apply for a state police clearance until 10/2/24 as required by the CPSL for a provisional hire. Staff #3 began working in child care prior to applying for the state police clearance. Staff #3 was working in child care on 11/5/24 and on 11/18/24 and was not hired correctly as a provisional hire per the CPSL. Staff #3 did not have on file a state police clearance, documentation of applying for an FBI clearance, the official child abuse clearance or documentation of applying for an NSOR clearance. The file of Staff #3 also indicated this staff has lived out of state within the last 5 years and Staff #3 did not apply for that states clearances prior to providing child care. Staff #3 was observed working in child care on two occasions and was not hired correctly as a provisional hire. Staff #6 did not have a signed disclosure statement on file at the time of the inspection.

Corrected Corrected by Nov 5, 2024

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

3270.34(a)(6) · A director is responsible for written evaluation of staff persons on a regular basis, a minimum of one evaluation every 12 months.

A renewal inspection occurred at the facility. A review of staff files was conducted. Regulation requires written evaluations for staff to be conducted on at least an annual basis. The following staff files were missing annual staff evaluations: Staff #1 and #2.

Corrected Corrected by Jan 7, 2025

Category: recordkeeping. Marked corrected in the state record.

3270.52 · When children are grouped in mixed age levels, the age of the youngest child in the group determines the staff:child ratio and maximum group size in accordance with the requirements in § 3270.51 (relating to similar age level).

A renewal inspection occurred at the facility. A physical site review was conducted. On 11/5/24, the facility contained 2 staff with 14 children ages infant to preschool. When the children's similar ages were grouped, these 14 children would have required at least 3 staff. The facility was not in compliance with staff:child ratios from 9:42am until 10:15am. On 11/26/24, Staff #1 was with 5 children. The age of the youngest child was an infant. This number of children would have needed a second staff person to meet appropriate supervision ratios.

Corrected Corrected by Nov 5, 2024

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.

A renewal inspection occurred at the facility. A physical site review as conducted. On the rear left half wall, a bottle of cleaner (Oxydol Oxygen Orange Cleaner) was observed accessible to children. The bottle indicated the need to keep out of reach of children. Also, next to this bottle was a mop and bucket. The bucket contained dirty water that smelled of the cleaner listed above. Children were observed receiving care in this area, and the bottle of cleaner was accessible to children.

Corrected Corrected by Jan 28, 2025

Category: physical safety. 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 renewal inspection occurred at the facility. A physical site review was conducted. Garbage cans throughout the facility were found with items such as tissues, napkins and discarded paper plates. These garbage cans were not lidded/closed.

Corrected Corrected by Jan 28, 2025

Marked corrected in the state record.

3270.76 · Floors, walls, ceilings and other surfaces, including the facility's outdoor play space surfaces shall be kept clean, in good repair and free from visible hazards.

A renewal inspection occurred at the facility. A physical site review was conducted. Near the tables used for eating in the preschool section, spilled milk and cereal was found on the floor. The teal top paint of the orange half walls was observed peeling.

Corrected Corrected by Jan 10, 2025

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

3270.112 · Infants and toddlers shall be provided stimulation by being held, rocked, talked to, played with and carried.

A renewal inspection occurred at the facility. A physical site review as conducted. An infant was observed in an infant rocker seat from 9:45am until 11:15am. The child was observed to have limited interaction or supervision from staff. It was also observed the child was not belted into this rocker as the child moved and the straps were viewed not in use.

Corrected Corrected by Jan 28, 2025

Category: supervision. Marked corrected in the state record.

3270.113(a)/3270.113(a)(1) · 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. Children must be supervised at all times. 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. The legal entity must arrange for all facility staff to receive a minimum of three hours of in-person PQAS-approved training, regarding supervision and appropriate ratios of children. The legal entity must receive DHS approval of the training content prior to scheduling the training.

A renewal inspection occurred at the facility. A physical site review was conducted. On 11/26/24, Staff #1 and #4 were in a group of 13 children. When asked the supervision children's groups that each staff was assigned to, Staff #1 and # 4 only accounted for 12 of the 13 children. One child was not accounted for in a supervision/ratio group with a staff member.

Corrected Corrected by Feb 28, 2025

Category: supervision. Marked corrected in the state record.

3270.113(a)/3270.113(a)(1) · 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. Children must be supervised at all times. 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.

A renewal inspection occurred at the facility. A physical site review was conducted. On 11/5/24, the facility contained 2 staff and 14 children, ages infant to preschool. When Staff #2 and # 5 were asked what children, they were assigned to them, both staff were unable to provide the names of the children assigned to them for the responsibility of supervision.

Corrected Corrected by Nov 5, 2024

Category: supervision. Marked corrected in the state record.

3270.123(a)/3270.182(8) · An agreement shall be signed by the operator and the parent. 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.

A renewal inspection occurred at the facility. A review of children's files was conducted. See the code sheet for the children's enrollment dates. At the time of the inspection, the files of the following children did not contain an agreement form with all the appropriate information as required by regulation: Child #1, #2, #3, #4, #6 and #7.

Corrected Corrected by Dec 3, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.123(a)(1) · An agreement shall specify the amount of the fee to be charged per day or per week.

A renewal inspection occurred at the facility. A review of children's files was conducted. The file of Child #5 was missing the fee amount to be charged as required by regulation.

Corrected Corrected by Dec 3, 2024

Category: recordkeeping. 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).

A renewal inspection occurred at the facility. A review of children's files was conducted. See the code sheet for the children's dates of enrollments. The following children have been enrolled at the facility for more than 6 months and the file did not contain any child service reports: Child #1 and #5.

Corrected Corrected by Dec 2, 2024

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.

A renewal inspection occurred at the facility. A review of children's files was conducted. The date of admission is required to be listed in children's files. The following children's files were missing dates of admission: Child #2 and #7.

Corrected Corrected by Nov 26, 2024

Category: recordkeeping. Marked corrected in the state record.

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

A renewal inspection occurred at the facility. A review of children's files was conducted. See the code sheet for the children's dates of enrollment. At the time of this inspection, the following children's files were missing an emergency contact person and their contact information: Child #2, #4 and #6. These children were observed receiving care at the facility. At the time of the inspection, Child #7 was observed receiving care and the file did not contain a fully completed emergency contact form.

Corrected Corrected by Dec 4, 2024

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.

A renewal inspection occurred at the facility. A review of children's files was conducted. See the code sheet for the children's dates of enrollment. At the time of this inspection, the following children's files were missing the enrolling parents work address and phone number: Child #1, #2, #4, #5 and #6. These children were observed receiving care during this inspection.

Corrected Corrected by Jan 10, 2025

Category: recordkeeping. Marked corrected in the state record.

3270.124(b)(4)/3270.182(3) · Emergency contact information must include the written consent signed by a parent for emergency medical care. A child's record shall contain signed parental consent for emergency medical care for the child. Written consent is required prior to admission.

A renewal inspection occurred at the facility. A review of children's files was conducted. See the code sheet for the children's dates of enrollment. Regulation requires enrolled children to have written consent for emergency medical care. The following enrolled children did not have consent for emergency medical care in their file: Child #1, #2, #3, #5 and #7.

Corrected Corrected by Jan 10, 2025

Category: recordkeeping. Marked corrected in the state record.

3270.124(b)(6) · Emergency contact information must include health insurance coverage and policy number for a child under a family policy or Medical Assistance benefits, if applicable.

A renewal inspection occurred at the facility. A review of children's files was conducted. See the code sheet for the children's dates of enrollment. At the time of this inspection, the following children were observed receiving care at the facility and the file was missing the child's health insurance coverage and policy number: Child #1, #2, #3 (policy number only), #4, #5 (policy number only) and #6.

Corrected Corrected by Jan 10, 2025

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

3270.124(b)(7) · Emergency contact information must include the name, address and telephone number of the individual designated by the parent to whom the child may be released.

A renewal inspeciton occurred at the facility. A review of children's files was conducted. See the code sheet for the children's dates of enrollment. At the time of this inspection, the following children were observed receiving care and the file was missing complete release person's information: Child #3 (addresses only), Child #4 (addresses only) and Child #5 (addresses only).

Corrected Corrected by Jan 10, 2025

Category: recordkeeping. Marked corrected in the state record.

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

A renewal inspection occurred at the facility. A review of children's files was conducted. Regulation requires children's emergency contact and agreement forms to be updated at least every 6 months. The following children's forms were not updated at least every 6 months: Child #1 (emergency contact last updated4/22/24) and Child #5 (both emergency contact and agreement form last updated 4/17/24).

Corrected Corrected by Jan 10, 2025

Category: recordkeeping. Marked corrected in the state record.

3270.133(4) · Medication shall be stored in a locked area of the facility or in an area that is out of the reach of children.

A renewal inspection occurred at the facility. A physical site review as conducted. Near the diaper changing area, in a cabinet, A&D ointment was found accessible to children. The tube indicated the need to keep out of reach of children. Children were observed receiving care in this area and the A&D ointment was accessible to children.

Corrected Corrected by Jan 10, 2025

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

3270.134(a)/3270.152 · A staff person shall ensure that a child's hands are washed before meals and snacks, after toileting and after being diapered. A facility person shall wash his hands before meals and snacks, and after toileting and after diapering a child.

A renewal inspection occurred at the facility. A review of the facility's diaper changing procedures was conducted. Regulation requires the hands of staff and children to be washed after diapering. Staff #6 did not wash their hands or the hands of the child whose diaper was being changed.

Corrected Corrected by Jan 28, 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.

A renewal inspection occurred at the facility. A review of staff files was conducted. See the code sheet for the staffs dates of hire. Staff #3 began working in child care prior to receiving a health assessment. Staff #3 did not receive a health assessment until 11/1/24. Staff #4 began working in child care prior to receiving a health assessment. Staff #4 did not have a health assessment on file at the time of this inspection and was observed working in child care. Staff #6 began working in child care prior to receiving a health assessment. Staff #6 did not have a health assessment on file at the time of this inspection and was observed working in child care.

Corrected Corrected by Jan 10, 2025

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.

A renewal inspection occurred at the facility. A review of staff files was conducted. See the code sheet for the staffs dates of hire. Staff #3 did not receive a tuberculosis screening prior to working in child care. Staff #3 did not receive a tuberculosis screening until 10/30/24. Staff #4 and Staff #6 were both observed working in child care and these staff did not have on file at the time of this inspection, a tuberculosis screening.

Corrected Corrected by Jan 10, 2025

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

3270.161(a)/3270.166(5) · Food stored, prepared or served shall be clean, wholesome, free from spoilage, free from adulteration and safe for human consumption. An infant 6 months of age or younger shall be held while being bottle fed.

A renewal inspection occurred at the facility. A physical site review as conducted. An infant was observed drinking, with a bottle at 9:45am. This bottle was observed with the child, in the child's rocker seat. At roughly 11:15am, staff offered this bottle again to the infant. According to the American Academy of Pediatrics, this bottle should have been discarded after 1-hour and should have been discarded at roughly 10:45am and not offered to the child again at 11:15am. The infant was also identified as being under the age of 6 months and was not held while being bottle fed.

Corrected Corrected by Jan 28, 2025

Category: ratio. Marked corrected in the state record.

3270.165 · An operator shall conspicuously post the menu at least 1 week in advance or provide a menu to each family.

A renewal inspection occurred at the facility. A physical site review as conducted. At the time of the inspection, a menu was not posted at the facility and was not provided to the families.

Corrected Corrected by Jan 10, 2025

Marked corrected in the state record.

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

A renewal inspection occurred at the facility. A physical cite review was conducted. At the time of the inspection, the facility's safe routes were not posted in a conspicuous location at the facility.

Corrected Corrected by Jan 10, 2025

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.

A renewal inspection occurred at the facility. A review of children's files was conducted. See the code sheet for the children's dates of enrollment. Regulation requires written consent for first aid procedures in the children's files. The following enrolled children's files were missing consent for first aid procedures: Child #1, #2, #3, # 5 and #7.

Corrected Corrected by Jan 10, 2025

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.

A renewal inspection occurred at the facility. A review of staff files was conducted. Regulation requires staff files to contain two letters of written reference. At the time of this inspection, the following files were missing letters of reference: Staff #4 (2 letters) and Staff #6 (1 letter). Both staff were observed working in child care at the time of this inspection and the suitability of these staff could not be appropriately determined due to the lack of letters of reference.

Corrected Corrected by Jan 10, 2025

Category: recordkeeping. Marked corrected in the state record.

3270.95(a)/3270.95(b) · Fire detection devices or systems must be in compliance with standards established under section 1016(c) of the act (62 P.S. §  1016(c)). The Director or designated staff person who is responsible for compliance with this chapter shall ensure the requirements under subsection (a) are met.

A renewal inspection occurred at the facility. A review of the facility's fire safety system testing log was conducted. Regulation requires the fire safety system to be tested once at least every 30 days. The following tests of the fire safety system were not conducted at least every 30 days: 9/28/24-10/30/24.

Corrected Corrected by Nov 11, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.113(b) · A facility person may not use any form of physical punishment, including spanking a child. For a period of 3 months, the facility shall have no occurrences of non-compliance related to physical discipline or restraints of children. The operator shall demonstrate compliance on unannounced visits over the next 3 months.

A complaint inspection occurred at the facility. Interviews were conducted. Through these interviews, it was determined on 10/28/24 that Staff #1 slapped Child #1 in the face with an open hand, causing redness and slight swelling on the right side of the child's face. Regulation does not allow for the use of physical discipline by staff in child care.

Corrected Corrected by May 5, 2025

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

3270.113(b) · A facility person may not use any form of physical punishment, including spanking a child.

A complaint inspection occurred at the facility. Interviews were conducted. Through these interviews, it was determined that on 10/28/24 Staff #1 slapped Child #1 in the face with an open hand, causing redness and slight swelling on the right side of the child's face. Regulation does not allow for the use of physical discipline by staff in child care.

Corrected Corrected by Nov 5, 2024

Marked corrected in the state record.

3270.113(b) · A facility person may not use any form of physical punishment, including spanking a child. The Legal Entity must arrange for all staff employed at the facility as of the date of the training to receive a minimum of two hours of PQAS-approved in-person training, regarding Behavior Management of children. The legal entity must receive DHS approval of the training content prior to scheduling the training.

A complaint inspection occurred at the facility. Interviews were conducted. Through these interviews, it was determined that on 10/28/24 Staff #1 slapped Child #1 in the face with an open hand, causing redness and slight swelling on the right side of the child's face. Regulation does not allow for the use of physical discipline by staff in child care.

Corrected Corrected by Mar 5, 2025

Category: recordkeeping. Marked corrected in the state record.

3270.27(c) · The operator shall assure that each facility person receives training regarding the emergency plan at the time of initial employment, on an annual basis and at the time of each plan update. The operator shall document the date of each training and the names of all facility persons who received the training and kept on file at the facility.

A unannounced inspection occurred at the facility. A review of staff files was conducted. See the code sheet for the date of hire. Staff #2 was viewed working in child care and the file did not contain documentation that this staff had reviewed the facility's emergency plan within 90 days of their hire date.

Corrected Corrected by Sep 6, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.31(f) · Staff person(s) shall complete professional development in the topics of 3270.31(f)(10) within 90 days of hire. Staff person #2 will have until 9/27/24 to complete the required training. Until such time as the required training has been completed, staff person #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 person #2, staff person #2 may not work in a child-care position at the facility.

An unannounced inspection occurred at the facility. A review of staff files was conducted. Staff person #2 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 Sep 6, 2024

Category: supervision. Marked corrected in the state record.

3270.32(a)/3270.192(4) · The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). A facility person's record shall include a copy of requests for the criminal history record and child abuse registry clearance information, a copy of the disclosure statement and a copy of the completed clearance information required under the CPSL. Facility Person # 1 and #2 may not work in a child care position at the facility.

An unannounced inspection occurred at the facility. A review of staff files was conducted. See the code sheet for the date of hire. Staff #1 was viewed working in child care and did not have valid clearances. In the file was a state police clearance dated 3/8/19, a child abuse clearance dated 1/7/19 and an FBI clearance dated 1/8/19. Staff #1 did not apply for updated clearances at their rehire date. Staff #2 was viewed working in child care past their provisional hire period and did not have on file a valid FBI clearance.

Corrected Corrected by Sep 6, 2024

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

3270.151(a)/3270.151(c)(2) · 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. 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.

An unannounced inspection occurred at the facility. A review of staff files was conducted. See the code sheet for the date of hire. Staff #1 worked in child care and did not receive a health assessment and TB screening until 7/2/24.

Corrected Corrected by Sep 6, 2024

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.

An unannounced inspection occurred at the facility. A review of staff files was conducted. See the code sheet for the date of hire. Staff #2 was viewed working in child care and the file was missing one letter of written reference.

Corrected Corrected by Sep 6, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.95(a)/3270.95(b) · Fire detection devices or systems must be in compliance with standards established under section 1016(c) of the act (62 P.S. §  1016(c)). T The Director or designated staff person who is responsible for compliance with this chapter shall ensure the requirements under subsection (a) are met.

An unannounced inspection occurred at the facility. A review of the facility's fire safety system testing log was conducted. The following fire safety system tests were not conducted at least every 30 days as required by regulation: 1/3/24, 2/14/24, 3/25/24, 4/9/24, 5/31/24, 6/12.24, 7/23/24 and 8/30/24.

Corrected Corrected by Sep 27, 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. Facility Persons # 2 may not work in a child care position at the facility until the clearances are completed and on file.

On 11/17/2023, a Renewal Inspection was conducted. Staff #2 and #3, who have lived outside of PA within the last five years, do not have out-of-state clearances on file from those states. An acceptable plan of correction was received on 12/13/23, stating that the violation would be fixed. On 1/22/2024, an inspection to verify the corrections was conducted. Staff #2, who has lived outside of PA within the last five years, still did not have proof of completion of the NY Sex Offender Registry Check. Staff #5 was observed to be supervising children, but there was no record on file which showed that the staff had the required clearances, the requests for additional clearances, or the signed, witnessed, and dated disclosure statement prior to working with the children.

Corrected Corrected by Jan 22, 2024

Category: supervision. 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.

On 11/17/2023, a Renewal Inspection was conducted. Staff person #1, #2, and #3 have not completed 12 hours of annual professional development training for the previous year of employment. An acceptable plan of correction was received on 12/13/23, stating that the violation would be fixed. On 1/22/24, an inspection to verify the corrections was conducted. Staff person #1 still did not have any documentation which showed that they completed any annual professional development hours per the plan of correction. Staff person #2 only completed three hours of annual professional development training on 1/16/2024. Staff person #2 is required to complete 9 more hours of training.

Corrected Corrected by Jan 26, 2024

Category: recordkeeping. 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 persons shall complete updated professional development by 2/7/24.

On 11/17/2023, a Renewal Inspection was conducted. Staff #1, #2, and #3 have no documentation showing their completion of the required one-hour Health and Safety training update. This training was required to be completed by 12/30/22 for all existing staff. An acceptable plan of correction was received on 12/13/23, stating that the violation would be fixed. On 1/22/24, an inspection to verify that the violations were fixed was conducted. Staff #2 was still observed to have no documentation showing their completion of the required one-hour Health and Safety training update.

Corrected Corrected by Jan 22, 2024

Category: ratio. Marked corrected in the state record.

3270.27(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.

On 11/17/2023, a Renewal Inspection was conducted. The emergency plan, that was provided during the inspection, did not include a method to contact parents and provide them with emergency related information, such as how they can be reunited with their children. An acceptable plan of correction was received on 12/13/23, stating that the violation would be fixed. On 1/22/2024, an inspection to verify the corrections was conducted. The emergency plan, that was provided during the inspection, still did not include a method to contact parents and provide them with emergency related information, such as how they can be reunited with their children.

Corrected Corrected by Jan 26, 2024

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

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

On 11/17/2023, a Renewal Inspection was conducted. No Child Service Reports (CSR) indicating the child's growth and development in the context of the services being provided were observed in child #3"s or child #4's file, and both children have been enrolled for more than six months. An acceptable plan of correction was received on 12/13/23, stating that the violation would be fixed. On 1/22/2024, an inspection to verify the corrections was conducted. There were still no Child Service Reports (CSR) in child #4's file which documented the child's growth and development in the context of the services provided, and the child has been enrolled for more than six months.

Corrected Corrected by Jan 26, 2024

Category: recordkeeping. Marked corrected in the state record.

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

On 11/17/2023, a Renewal Inspection was conducted. During the inspection, no emergency transportation plan was on file or posted in the child care space. An acceptable plan of correction was received on 12/13/23, stating that the violation would be fixed. On 1/22/2024, an inspection to verify the corrections was conducted and there was still no emergency transportation plan was on file or posted in the child care space.

Corrected Corrected by Jan 26, 2024

Category: transportation. Marked corrected in the state record.

3270.124(f) · The parent shall update in writing emergency contact information once in a 6-month period or as soon as there is a change in the information.

On 11/17/2023, a Renewal Inspection was conducted. The emergency contact information for Child #1 had a signature but no date to indicate that it had been reviewed within the last six months. An acceptable plan of correction was received on 12/13/23, stating that the violation would be fixed. On 1/22/2024, an inspection to verify the corrections was conducted. The emergency contact information for Child #1 had a signature but still no date to indicate that it had been reviewed within the last six months.

Corrected Corrected by Jan 22, 2024

Category: recordkeeping. Marked corrected in the state record.

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

On 11/17/2023, a Renewal Inspection was conducted. During the inspection, there were no posted notifications which indicated a safe route for parents to pick-up and drop-off their children. An acceptable plan of correction was received on 12/13/23, stating that the violation would be fixed. On 1/22/2024, an inspection to verify the corrections was conducted. There were still no posted notifications which indicated a safe route for parents to pick-up and drop-off their children.

Corrected Corrected by Jan 26, 2024

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.

On 1/22/2024, while conducting an inspection to verify corrections, another regulatory violation was observed. Staff #5 (see code sheet for date of hire) did not have documentation on file which included two written, nonfamily references from individuals attesting to the person's suitability to serve as a facility person.

Corrected Corrected by Jan 22, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.124(f) · The parent shall update in writing emergency contact information once in a 6-month period or as soon as there is a change in the information.

The emergency contact information for Child #1 had a signature but no date to indicate that it had been reviewed within the last six months.

Corrected Corrected by Nov 22, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.192(5) · A facility person's record shall include two written, nonfamily references from individuals attesting to the person's suitability to serve as a facility person.

Staff #3 and staff #4 did not have two written, nonfamily references in their file.

Corrected Corrected by Dec 15, 2023

Category: recordkeeping. 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 #1, #2, #3, and #4 did not have any documentation on file which indicated that they participated in an annual fire safety training.

Corrected Corrected by Dec 15, 2023

Category: recordkeeping. 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 persons shall complete updated professional development by 12/12/23.

Staff #1, #2, and #3 have no documentation showing their completion of the required one-hour Health and Safety training update. This training was required to be completed by 12/30/22 for all existing staff.

Corrected Corrected by Dec 15, 2023

Category: ratio. Marked corrected in the state record.

3270.14/3270.21 · A facility shall be operated in conformity with applicable Federal and State laws and regulations.State agencies whose regulations may relate to the operation of a facility include the Department of Environmental Resources, the Department of Labor and Industry, the Department of Health, the Department of Education and the Department of Transportation. Conditions at the facility may not pose a threat to the health or safety of the children. The provider must have a written policy that includes, but is not limited to: Recognition of potential signs and symptoms of shaken baby syndrome and abusive head trauma. Strategies for coping with a crying, fussing, or distraught child; and address the prevention and identification of child maltreatment.

The facility did not have a written policy to address the following: Recognition of potential signs/ symptoms of shaken baby syndrome and abusive head trauma, strategies for coping with a crying, fussing, or distraught child, and the prevention and identification of child maltreatment

Corrected Corrected by Dec 1, 2023

Category: ratio. Marked corrected in the state record.

3270.27(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 emergency plan, that was provided during the inspection, did not include a method to contact parents and provide them with emergency related information, such as how they can be reunited with their children.

Corrected Corrected by Jan 5, 2024

Category: physical safety. 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 #4 will have until 12/12/23 to complete the required training. Until such time as the required training has been completed, staff person #4 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 #4, staff person #4 may not work in a child care position at the facility.

Staff #4 has not completed the following required pre-service training within 90 days of their day of hire (see LIS code sheet): 10 hour Health and Safety training.

Corrected Corrected by Nov 20, 2023

Category: supervision. 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 person #4 did not complete their mandated reporter training within 90 days from their date of hire (see code sheet for date of hire). Staff person had completed this training by the date of the renewal inspection.

Corrected Corrected by Nov 20, 2023

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. Facility Persons # 2 and 3 may not work in a child care position at the facility until the clearances are completed and on file.

Staff #2 and #3, who have lived outside of PA within the last five years, do not have out-of-state clearances on file from those states.

Corrected Corrected by Nov 20, 2023

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

3270.33(a)/3270.37(b) · A staff person or a substitute staff person shall meet one of the applicable staff qualifications for the position in which the person is performing. An aide shall have attained one of the qualification levels specified in §3270.37(b)(1)-(3).

Staff #4 does not have any education or experience qualifications on file to qualify as a staff person at the facility. Staff #4 was working in ratio during the inspection.

Corrected Corrected by Dec 1, 2023

Category: ratio. 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.

During the inspection, two hand sanitizer jugs were observed on a children's table. Two jugs each of hand sanitizer were also found in the cabinet under the sink in the second and third bathrooms on the right and were accessible to the children. "The Works" cleaner was in an unlocked bathroom cabinet that was accessible to children. This cleaner was observed in the first bathroom and had a warning label that indicated that the cleaner should be stored out of the reach of children. Access to the kitchen was not restricted by a child gate. The kitchen area was left open, and the stove, knives, and cleaning materials were accessible to children.

Corrected Corrected by Nov 20, 2023

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

3270.75(c) · A first-aid kit must contain the following: soap, an assortment of adhesive bandages, sterile gauze pads, tweezers, tape, scissors and disposable, nonporous gloves.

The first-aid kit did not include all of the necessary components and was missing soap and a tweezer.

Corrected Corrected by Nov 21, 2023

Marked corrected in the state record.

3270.76/3270.77(a) · 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. Peeled or damaged paint or damaged plaster is not permitted on indoor or outdoor surfaces in the child care facility.

During the inspection, the carpet by the middle exit door had plant soil and other debris on it. The first bathroom had peeling paint to the left of the sink area. This same bathroom had two wooden boards with screws in it and there was a rusty radiator. Upon touching the radiator, rust had come off of it. The second bathroom had multiple holes in the drywall accessible to children. The third bathroom had two screws that were poking out of the drywall that were to the left of the sink. The corner of the wall, between the first and second rooms, had screws showing. An area of the wall had a bulletin board which contained thumb tacks that were easily accessible to children. The following was observed in the outdoor play space: There was paint peeling on the rail of the pirate ship. The fence's crossbar, near the big gate, was broken and hanging loose. There was standing water in the water play table. There was a rough wooden board with nails in it underneath the pirate ship. There were several large weeds throughout the outdoor play space. Also, the green outdoor carpet was peeling up and a piece of wood was also found on the infant/ toddler side of the outdoor play space.

Corrected Corrected by Nov 27, 2023

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

3270.82(h) · A facility person and an able child shall wash his hands after toileting and before eating. A sign on which this requirement is written shall be posted at each toilet, training chair, diapering area and sink in the facility.

Hand washings signs were not posted by the sink in the first or second bathrooms.

Corrected Corrected by Nov 20, 2023

Category: health medication. 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 trash cans in the second and third bathrooms were unlidded.

Corrected Corrected by Dec 1, 2023

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

3270.91(a) · Stairways, hallways, exits from rooms, exits from the facility and other means of egress serving as an exit shall be unobstructed.

During the inspection, an exit door in the middle of the facility was deadbolted shut while children were in care. Also, the half door near the entrance was locked with a chain.

Corrected Corrected by Nov 20, 2023

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.

During the inspection, the following violations were observed in the outdoor play space: A green plastic bench had a crack in it. There was a small broken yellow chair. A foot/ hand hold piece of the pirate ship had broken off and was on the ground.

Corrected Corrected by Nov 27, 2023

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

3270.102(e) · Pea gravel and other materials with a diameter of less than 1 inch may not be used in spaces where infants or toddlers receive care.

Small rubber mulch pieces that were less than an inch in diameter were observed on the infant/ toddler side of the outdoor play space.

Corrected Corrected by Nov 21, 2023

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

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

No Child Service Reports (CSR) indicating the child's growth and development in the context of the services being provided were observed in child #3"s or child #4's file, and both children have been enrolled for more than six months.

Corrected Corrected by Nov 17, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.123(a)(5)/3270.124(b)(7) · An agreement shall specify the persons designated by a parent to whom the child may be released. 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 record for child #5 did not contain the release person's address or specify the persons to whom the child may be released.

Corrected Corrected by Nov 17, 2023

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 information for child #4 was missing the address of the child's physician or source of medical care.

Corrected Corrected by Nov 20, 2023

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

3270.124(b)(3)/3270.124(b)(6) · Emergency contact information must include the home and work addresses and telephone numbers of the enrolling parent. Emergency contact information must include health insurance coverage and policy number for a child under a family policy or Medical Assistance benefits, if applicable.

There was no documentation on file that included a parent's work address and work phone number for Child #2. Child #3's emergency contact information was missing the health insurance coverage and health insurance policy number.

Corrected Corrected by Nov 17, 2023

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

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

During the inspection, no emergency transportation plan was on file or posted in the child care space.

Corrected Corrected by Dec 22, 2023

Category: transportation. 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 records for child #2 and child #4 only included initial health assessments. Both children require an updated health report within the last 12 months (see code sheet).

Corrected Corrected by Dec 22, 2023

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

3270.131(d)(5)/3270.131(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 records for child #2 and child #5 did not have proof of influenza vaccination for the year of 2022. The record for child #4 is missing the current doses of the following vaccinations: DTAP/DTP/TD, HIB, Pneumococcal, Influenza, MMR, Varicella, or Hepatitis A.

Corrected Corrected by Nov 22, 2023

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

3270.131(e)(2)(i)/3270.131(e)(2)(ii) · Exemption from immunization for religious belief or strong personal objection equated to a religious belief shall be documented by a written, signed and dated statement from the child's parent or guardian. The statement shall be kept in the child's record. Exemption from immunization for reasons of medical need must be documented by a written, signed and dated statement from the child's physician, physician's assistant or CRNP. The statement shall be kept in the child's record.

Child #2 did not have any documents on file that indicated their exemption from immunizations.

Corrected Corrected by Nov 22, 2023

Category: health medication. 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.

Staff #4 (see code sheet for date of hire) did not complete an initial health assessment to providing child care services. Date of provided health assessment is 9/25/23.

Corrected Corrected by Nov 20, 2023

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

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

During the inspection, there were no posted notifications which indicated a safe route for parents to pick-up and drop-off their children.

Corrected Corrected by Nov 22, 2023

Marked corrected in the state record.

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

There was no documentation of any fee agreement, signed by the operator, for child #3, #4, or #5.

Corrected Corrected by Dec 1, 2023

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 facility's emergency plan did not include provisions for accommodating infants, toddlers, children with disabilities, and children with chronic medical conditions.

Corrected Corrected by Jan 5, 2024

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

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

During the inspection, there was no annual emergency drill log on file at the facility.

Corrected Corrected by Nov 21, 2023

Category: recordkeeping. Marked corrected in the state record.

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

There was no documentation on file during the inspection that the full emergency plan was submitted to the local municipality and the county emergency management agency.

Corrected Corrected by Nov 27, 2023

Category: recordkeeping. Marked corrected in the state record.

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

Staff person #1, #2, and #3 have not completed 12 hours of annual professional development training for the previous year of employment.

Corrected Corrected by Dec 1, 2023

Category: recordkeeping. Marked corrected in the state record.

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

The record for child #5 (see code sheet for date of admission) did not contain an initial health assessment.

Corrected Corrected by Dec 22, 2023

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

3270.21/3270.133 · Conditions at the facility may not pose a threat to the health or safety of the children. The operator shall make reasonable accommodation in accordance with applicable federal and state laws to facilitate administration of medication or a special diet that is prescribed by a physician, physician's assistant or CRNP as treatment related to the child's special needs. Facility persons are not required to administer medication or special diets which are requested or required by a parent, a physician, a physician's assistant or a CRNP but are not treatment related to the child's special needs.

During inspection on 2/22/23 document review and interviews revealed that accommodations were in place to provide special diet for child #1 excluding tomatoes as prescribed by physician and parent per child allergy. On 1/19/23 staff # 2 provided tomatoes to child #1 as part of served lunch resulting in an allergic reaction and documented incident.

Corrected Corrected by Feb 24, 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). LACKING REQUIRED HIRING DOCUMENTS: A facility person's record shall include a copy of requests for the criminal history record and child abuse registry clearance information, NSOR clearance, a copy of the disclosure statement and a copy of the completed clearance information required under the CPSL. Staff Person #-1-- may not work in a childcare position at the facility.

Staff #1 does not have a record of NSOR clearance per the requirements of the CPSL.

Corrected Corrected by Dec 6, 2022

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

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

Staff number 1&2 have not completed Professional development training in any of the required topics.

Corrected Corrected by Feb 14, 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. Staff Person #-3-- may not work in a child care position at the facility.

Staff number 3 start date 1/6/22 does not have a record of a state police clearance.

Corrected Corrected by Feb 9, 2022

Category: background checks. 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.

During the inspection it was revealed that staff number 2 & 3 does not have a record of a health assessment.

Corrected Corrected by Feb 9, 2022

Category: ratio. 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.

Staff number 1 & 2 has not completed pediatric first aid and cardiopulmonary resuscitation within 90 days.

Corrected Corrected by Feb 11, 2022

Category: health medication. 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.

Child number 1 and number 2 does not have a history of a valid health assessment on file at the facility

Corrected Corrected by Feb 9, 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). LACKING REQUIRED HIRING DOCUMENTS: Staff Person # -2- may not work in a child care position at the facility.

Staff #2 does not have a record of NSOR, FBI & New Jersey child abuse clearance.

Corrected Corrected by Sep 1, 2021

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

3270.92(b) · A fixed space heater shall be approved for use by a local fire safety professional. Written approval of the installation and written approval for use shall be on file at the facility.

Operator does not have a record of the facility fixed space heater approval by a local fire safety professional.

Corrected Corrected by Sep 3, 2021

Category: recordkeeping. 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.

Outdoor equipment within the outdoor space is not in good repair.

Corrected Corrected by Sep 3, 2021

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

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

Operator has not sent the emergency plan to the local municipality and the county EMA.

Corrected Corrected by Sep 1, 2021

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