3270.31(e)(4)(i) · Competence is the completion of training by a professional in the field of first-aid and cardiopulmonary resuscitation (CPR). All staff persons shall renew their certification in pediatric first aid and pediatric cardiopulmonary resuscitation (CPR) on or before the expiration of the most current certification. Staff person #4, staff person #5 will have until 11/6/24 to complete PQAS approved Pediatric First Aid/CPR training. Until such time as the required training has been completed, staff person #4 and staff person #5 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 person(s) available to supervise staff person #4 and staff person #5, staff person #4 and staff person #5 may not work in a child-care position at the facility.

During the inspection on 10/7/24, staff person #4 and staff person #5 did not have current PQAS approved Pediatric First Aid/CPR on file. This is evidenced by the training on file dated 8/8/22.

Corrected Corrected by Oct 7, 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.

During the inspection on 10/7/24, staff person #3 did not update the PA State Police clearance every 60 months as required. This is evidenced by the current PA State Police clearance on file dated 8/20/24 and the previous clearance dated 8/13/19.

Corrected Corrected by Oct 7, 2024

Category: background checks. 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.

During the inspection, the emergency contact form on file for child #2, child #3 and child #4 did not include the work address of the enrolling parent. The emergency contact form for child #4 did not include the health insurance policy number.

Corrected Corrected by Oct 7, 2024

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). Child #2 must be dismissed from care by close of business 10/7/24 and may only return to care when the immunization record is updated or when a parent provides a written, signed exemption letter.

During the inspection, child #2's immunization record was not in compliance with the recommendations of the ACIP and missing the following vaccinations: HEP A#2.

Corrected Corrected by Oct 7, 2024

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

3270.133(6) · A parent shall provide written consent for administration of medication or a special diet.

During the inspection, there was no parental written consent for the Hyland's Cold medicine for child #6.

Corrected Corrected by Oct 7, 2024

Category: ratio. 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.

During the inspection on 10/7/24, the health assessment and TB test on file for volunteer #7 was dated 7/17/23 and not within 12 months of initial service in the childcare facility (see LIS code sheet for date of volunteering).

Corrected Corrected by Oct 7, 2024

Category: ratio. Marked corrected in the state record.

3270.151(c)(3) · An adult health assessment must include an examination for communicable diseases and the results of that examination.

During the inspection, the health assessment dated 9/25/23 for staff person #2 stated "yes" to communicable diseases but no additional documentation was provided as required.

Corrected Corrected by Oct 7, 2024

Category: health medication. 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, the emergency drill was not conducted annually as required. This is evidenced by the current emergency drill date of 9/23/24 and the previous drill date of 4/5/23.

Corrected Corrected by Oct 7, 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)). The Director or designated staff person who is responsible for compliance with this chapter shall ensure the requirements under subsection (a) are met.

At the time of the inspection, the manual monthly monitoring of the fire detection system was not conducted every 30 days as required. This is evidenced by the manual monthly monitoring log dates of 9/25/24 and 8/23/24.

Corrected Corrected by Oct 7, 2024

Category: recordkeeping. Marked corrected in the state record.

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

There was a water-stained ceiling tile in the Preschool room, a broken ceiling tile above the circle area in the Pre-K room, and 2 water stained ceiling tiles in the Toddler room.

Corrected Corrected by Oct 13, 2023

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.

STAFF # 1 (see code sheet for start date) did not have verification of facility emergency plan training. It is past the 90 day period to complete pre-service training.

Corrected Corrected by Oct 20, 2022

Category: recordkeeping. 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.

During renewal inspection on 10/14/21 cert rep reviewed several staff files. STAFF # 1 and STAFF # 2 last evaluation was dated 8/28/20. These were completed approximately 14 months ago.

Corrected Corrected by Oct 22, 2021

Category: recordkeeping. 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.

During renewal inspection on 10/14/21 cert rep checked each first aid kit. The first aid kit in the YSA room did not have tape or soap.

Corrected Corrected by Oct 14, 2021

Category: health medication. 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.

During renewal inspection on 10/14/21 cert rep reviewed several children's files. CHILD # 1 emergency contact form did not include the child's health insurance policy number. CHILD # 4 and 5 emergency contact form did not include the child's health insurance coverage or policy number.

Corrected Corrected by Oct 22, 2021

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.

During renewal inspection on 10/14/21 cert rep reviewed several children's files. CHILD # 1, 2, 3, 4, 5, 6 emergency contact form did not include addresses for release persons.

Corrected Corrected by Oct 22, 2021

Category: recordkeeping. Marked corrected in the state record.

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

During renewal inspection on 10/14/21 cert rep checked children's medications that were kept at the facility. CHILD # 1 had an Epi-pen with an expiration date of 3/2021 and Diphenhydramine with an expiration of 8/25/21.

Corrected Corrected by Oct 22, 2021

Category: ratio. Marked corrected in the state record.