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 did not address Continuity of Operations as required by Announcement C-22-04 which states to maintain full compliance with 45 CFR § 98.41(a)(1)(vii), child care facilities must have requirements for volunteer emergency preparedness training, practice drills and continuity of operations included in their emergency plan.

Corrected Corrected by Sep 19, 2024

Category: ratio. Marked corrected in the state record.

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

In Room C, child scissors were accessible to toddlers.

Corrected Corrected by Sep 10, 2024

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

3270.27(a)(3)/3270.27(a)(4) · The facility shall have an emergency plan that provides for a method for facility persons to contact parents as soon as reasonably possible when an emergency situation arises. The 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 lacks a method for facility persons to contact parents when an emergency situation arises. It also lacks 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.

Corrected Corrected by Sep 19, 2024

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

3270.27(e) · The operator shall provide to the parent of each enrolled child a letter explaining the emergency procedures. The operator shall also provide to the parent of each enrolled child a letter explaining any subsequent update to the plan.

The facility lacked a parent letter explaining the emergency procedures.

Corrected Corrected by Sep 19, 2024

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.

There was an uncovered trash can in Room B with used napkins and tissues in it.

Corrected Corrected by Sep 10, 2024

Marked corrected in the state record.

3270.69(b) · Hot water temperature, in areas accessible to children, may not exceed 110° F.

The hot water temperature at the bathroom sink utilized by the children was 119° F.

Corrected Corrected by Sep 10, 2024

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

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

In Room C, play doh labeled or ages 3+ was accessible to children still placing objects in their mouths.

Corrected Corrected by Sep 10, 2024

Marked corrected in the state record.

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

The file for Child #3 lacked a current child service report. The most recent child service report was dated 10/20/23.

Corrected Corrected by Sep 16, 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.

The emergency contact form in the file for Child #1 lacked the parent's work address and work phone. The emergency contact form in the file for Child #2 lacked the parent's work address.

Corrected Corrected by Sep 10, 2024

Category: recordkeeping. 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.

The emergency contact form in the file for Child #1 lacked information on the child's special needs.

Corrected Corrected by Sep 10, 2024

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

3270.27(a)(5) · The facility shall have an emergency plan that provides for accommodations for infants, toddlers, children with disabilities, and children with chronic medical conditions.

The facility emergency plan lacked accommodations for children with disabilities and children with chronic medical conditions.

Corrected Corrected by Sep 23, 2024

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.

The facility sent the emergency plan to local police and fire chiefs. The facility lacked documentation that the emergency plan was submitted to the county EMA.

Corrected Corrected by Sep 23, 2024

Category: physical safety. 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 person #1 whom was hired at the facility as an assistant group supervisor on (See LIS Code Sheet) lacked state police and child abuse clearances that were completed 60 months from the previous clearances. The state police clearances in the file were dated 8/9/18 and 8/28/23. The child abuse clearances in the file were dated 8/2/18 and 8/29/23.

Corrected Corrected by Oct 11, 2023

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.

The files for children #1 and #4 lacked emergency contact information that included 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.

Corrected Corrected by Oct 11, 2023

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

3270.131(d)(5)/3270.131(e)(3) · A health report shall include a review of the child's immunized status according to recommendations of the ACIP. The facility shall implement dismissal policies in accordance with the Department of Health regulation in 28 Pa. Code § 27.77 (relating to immunization requirements for children in child care group settings).

The files for children #2 and #3 lacked a health report that included an influenza immunization according to recommendations of the ACIP and did not implement dismissal policies in accordance with the Department of Health regulation in 28 Pa. Code § 27.77 (relating to immunization requirements for children in child care group settings).

Corrected Corrected by Oct 11, 2023

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

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

The Fire Drill and Fire Detection Log was observed for the 30-day smoke detector check. There were 31 days between 3/31/23 and 5/1/23.

Corrected Corrected by Oct 11, 2023

Category: recordkeeping. 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 person #1 lacked a health assessment that was completed within 24 months from the previous health assessment. The health assessments in the file are dated 1/9/20 and 5/17/22.

Corrected Corrected by Oct 27, 2022

Category: ratio. Marked corrected in the state record.

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

In the restroom the screws on the bottom of the toilet were missing the covers.

Corrected Corrected by Sep 27, 2022

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

3270.31(f) · Staff persons shall complete professional development in the topics of 3270.31(f)(1 -- 10) within 90 days of hire. Staff persons #3 and #4 will have until 10/28/22 to complete the required training. Until such time as the required training has been completed, staff persons #3 and #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 persons #3 and #4, staff persons #3 and #4 may not work in a child-care position at the facility.

Staff persons #3 and #4 have not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): Pediatric First-Aid & CPR Training.

Corrected Corrected by Oct 31, 2022

Category: supervision. 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.

In Room C on the windowsill in the back of the room was observed to have metal that had sharp edges creating a visible hazard.

Corrected Corrected by Sep 27, 2022

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.

A handwashing sign was observed to be missing above the toilet in the restroom.

Corrected Corrected by Sep 28, 2022

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

3270.124(c) · When children are in the facility, emergency contact information shall be present in a child care space for children receiving care in the space.

The emergency contact information was missing for two of the children present and receiving care in Room C.

Corrected Corrected by Sep 27, 2022

Category: recordkeeping. Marked corrected in the state record.

3270.131(d)(1) · A health report shall include a review of the child's health history.

The file for child #2 lacked a health report that included a review of the child's health history.

Corrected Corrected by Oct 31, 2022

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

3270.131(e)(1)/3270.182(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. A child's record shall contain initial and subsequent health reports.

The files for children #1 and #3 lacked updated written verification from a physician, physician's assistant, CRNP, the Department of Health or a local health department of ongoing vaccines administered to a toddler and preschool child in accordance with the schedule recommended by the ACIP.

Corrected Corrected by Oct 31, 2022

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

3270.31(h) · All staff persons shall complete the professional development under subsection (f).

Staff persons #1 and #2 lacked training in health and safety topics numbers 1-9 as listed in the regulation 3270.31(f).

Corrected Corrected by Sep 27, 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.

In unlocked, child-height counter drawers in the lunch room, push pins, a pair of adult scissors and screws which pose a cutting or puncture hazard were observed.

Corrected Corrected by Oct 7, 2021

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

3270.27(a)(3)/3270.27(a)(4) · The facility shall have an emergency plan that provides for a method for facility persons to contact parents as soon as reasonably possible when an emergency situation arises. The 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 has not been updated to include: A method of how parents will be contacted when an emergency arises and not updated to include: how parents will be reunited with their children when the emergency ends.

Corrected Corrected by Nov 1, 2021

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

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

The file for Staff #1 lacked Emergency Plan Training at the time of initial employment.

Corrected Corrected by Nov 1, 2021

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.

The last fire safety training for Staff #2 and #3 was dated more than one year ago.

Corrected Corrected by Oct 26, 2021

Category: recordkeeping. Marked corrected in the state record.

3270.31(f)/3270.31(h) · All staff persons shall complete the professional development under subsection (f): Prevention and control of infectious diseases (including immunization); Prevention of Sudden Infant Death Syndrome and use of safe sleep practices; Administration of medication, consistent with standards for parental consent; Prevention of and response to emergencies due to food and allergic reactions; Building and physical premises safety, including identification of and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, and vehicular traffic; Prevention of shaken baby syndrome and abusive head trauma; Emergency preparedness and response planning for emergencies resulting from a natural disaster or a man-caused event (such as violence at a child care facility); Handling and storage of hazardous materials and appropriate disposal of bio contaminants; Precautions when transporting children.

The file for Staff #1 lacked training in 10 required health and safety topics.

Corrected Corrected by Nov 1, 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.

The disclosure statements in the files for Staff #1 and #3 both hired in 2021, were on outdated forms not used since prior to 2015. Staff File #1 lacked a copy of the FBI Clearance.

Corrected Corrected by Oct 26, 2021

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

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

The file for Staff #3 lacked staff evaluations.

Corrected Corrected by Oct 11, 2021

Category: recordkeeping. 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 small bottle of hand sanitizer labeled, "Keep out of the Reach of Children," was attached to the outside of the excursion bag hanging at a level accessible to children. An additional bottle of hand sanitizer was located inside.

Corrected Corrected by Oct 7, 2021

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.

In the outdoor play space, next to the fence, adjacent to the parking lot, lumber/railroad ties with spikes were not flush and poses a tripping and cutting hazard.

Corrected Corrected by Oct 7, 2021

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

3270.102(a) · Toys, play equipment and other indoor and outdoor equipment used by the children shall be clean, in good repair and free from rough edges, sharp corners, pinch and crush points, splinters and exposed bolts.

In the lunch room on the gray, plastic shelf was a clear plastic bin with a cracked corner which poses a cutting hazard. In the front room, a blue Lego bin had a broken lid posing a cutting hazard. Captain's Wheel on the "Step 2" plastic, outdoor play equipment, it was observed a cotton pin was bent outwards which poses a cutting or puncture risk. On the "Step 2" plastic outdoor play equipment was a hole which was observed at the top of the wall posing a cutting hazard.

Corrected Corrected by Oct 7, 2021

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

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

The multi-colored shelving unit outside the toileting area Googly Eyes, Rocks, Styrofoam balls and plastic coins were observed to be less than 1 inch in diameter and accessible to children who are still placing objects in their mouths. A plastic pear was observed to have had the stem chewed off, leaving a jagged edge which posed a cutting hazard.

Corrected Corrected by Oct 7, 2021

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.

In the lunch room, the back of a child's yellow chair was cracked causing a pinching or cutting hazard.

Corrected Corrected by Oct 7, 2021

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

3270.123(a)(4) · An agreement shall specify the child's arrival and departure times.

The Fee Agreement Form for Child File #4 lacked Arrival and Departure Times.

Corrected Corrected by Oct 7, 2021

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.

Although 10 children were present in the facility, only 8 Emergency contact forms were present in child care spaces which are used interchangeably.

Corrected Corrected by Oct 7, 2021

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 Emergency Contact Form for Child #2 and #3 lacked the Enrolling Parent's Work Address and Work Number.

Corrected Corrected by Oct 7, 2021

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 immunization record of Child #2 lacked a yearly Influenza shot with no Letter of Exemption in File.

Corrected Corrected by Oct 27, 2021

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

3270.135(a) · When children are diapered, the facility shall use disposable diapers, a diaper service or arrange with the parent to provide a daily diaper supply.

The provider was unable to demonstrate the trash receptacle can be used for diapering operated in a hands-free manner.

Corrected Corrected by Oct 7, 2021

Category: health medication. 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 Emergency Contact Form for Child #5 lacked a signature for Consent for Emergency Medical Care.

Corrected Corrected by Oct 27, 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 Emergency Contact Form for Child #5 lacked a signature for Consent for Minor First Aid.

Corrected Corrected by Oct 27, 2021

Category: ratio. Marked corrected in the state record.

3270.27(a)(5) · The facility shall have an emergency plan that provides for accommodations for infants, toddlers, children with disabilities, and children with chronic medical conditions.

The Emergency Plan has not been updated to include: Accommodations for infants, toddlers, children with disabilities and children with chronic medical conditions.

Corrected Corrected by Nov 1, 2021

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

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

The file for Staff #1 lacked Pediatric First Aid and CPR Training within 90 days of hire.

Corrected Corrected by Nov 1, 2021

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

3270.25(a) · The facility's current certificate of compliance shall be posted in a conspicuous location used by parents. The operator shall provide the parent of each child enrolled with information on how to access the regulations in this chapter electronically and with instructions for contacting the appropriate regional child care office.

A copy of how to access the DHS regulations electronically was not posted in a conspicuous place.

Corrected Corrected by Nov 1, 2021

Marked corrected in the state record.

3270.34(a)(1) · A director is responsible for administering finances, personnel, maintenance, meal planning and preparation and transportation.

Staff #1 staff evaluation was not completed by the facility director.

Corrected Corrected by Nov 10, 2021

Category: ratio. Marked corrected in the state record.

3270.34(c) · A director shall be employed by a facility and be present at the facility site a minimum of 30 hours per week.

The facility lacks a director.

Corrected Corrected by Nov 9, 2021

Marked corrected in the state record.