3270.27(b) · The operator shall review the emergency plan at least annually and update the plan as needed. The operator shall document in writing each review and update of the emergency plan and kept on file at the facility. Submit a written copy of the updated emergency plan. Ensure that the plan is reviewed and documented in writing annually as specified.

There was no written documentation indicating that the emergency plan had been reviewed and updated within the past 12 months in accordance with 55 PA CODE 3270 regulations. The posted plan was dated 2022 and the current plan was not presented at the time of the inspection.

Corrected Corrected by Jul 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. TIERED LIS: Children must be supervised at all times by2/20/25. The legal entity must arrange for all facility driver staff persons to receive 2 hours of DHS approved training in proper supervision of children, including transportation protocols for drivers to follow when dropping off children. Submit written verification of the completed training for all facility driver staff persons. Submit written documentation of the facility's transportation protocols by 3/20/25.

On 1/22/26, the bus driver dropped a child off at home and left child with a stranger. The parent had not given permission for the child to be released to this person.

Corrected Corrected by Mar 20, 2025

Category: supervision. 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. Submit a copy of the revised letter.

The letter given to parents regarding the emergency plan did not explain the emergency procedure /updates to the plan as required in 3270.27 subsection a. Revise the letter given to parents to ensure that it explains the emergency procedures/ and updates to the plan as required in 3270.27 subsection a.

Corrected Corrected by Oct 5, 2024

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

3270.123(a)/3270.123(a)(6) · An agreement shall be signed by the operator and the parent. An agreement shall specify the date of the child's admission. Obtain and submit a signed agreement for the indicated child that includes both the operator and parent's signature as specified. Specify the date of admission on the child's agreement and submit a copy of the properly completed agreement for verification of compliance. Ensure that all agreements are signed by the parent and include the date of the child's admission.as required.

One child's agreement was not signed by the operator and did not contain the date of admission. (child #2)

Corrected Corrected by Oct 5, 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). Complete and submit a current up-to-date child service report for the indicated child. Ensure that child service reports are completed for all children as specified in this regulation.

Several children's records did not contain a child service report that had been completed within the past 6 months. (child #2), (child #3) and (child #5)

Corrected Corrected by Oct 5, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.123(a)(5) · An agreement shall specify the persons designated by a parent to whom the child may be released. Update the agreements to specify the persons designated by a parent to whom the child may be released. Submit a copy of the updated agreements.

Several children's records contained agreements that did not specify the persons designated by a parent to whom the child may be released. (child #1-corrected) (child #2-corrected) (child #3-corrected) (child #4- not corrected)

Corrected Corrected by Oct 5, 2024

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. Obtain and submit the health insurance policy number for the identified child. Ensure that all children's records include the health insurance information as specified in this regulation.

One child's emergency contact information did not include the health insurance policy number. (child #4)

Corrected Corrected by Oct 5, 2024

Category: health medication. 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. Obtain and submit written verification of the updated emergency contact and financial agreement information for the identified children.

Two children's records did not contain emergency contact and financial agreement information that had been reviewed and updated within the past 6 months. (child #2 and child #3)

Corrected Corrected by Oct 5, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.131(b)(1) · The operator shall require the parent to provide an updated health report at least every 6 months for an infant or young toddler. Obtain and submit a current up-to-date health report for the indicated child. Ensure that an updated health report is obtained every 6 months for children from infant to young age.

One child's record did not contain a health report completed within the past 6 months as required for a child from infant to young toddler age. (child #2)

Corrected Corrected by Oct 5, 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. Amend the facility emergency plan to include accommodations for infants, toddlers, children with disabilities, and children with chronic medical conditions. Submit a written copy of the amended emergency plan.

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

Corrected Corrected by Oct 5, 2024

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

3270.27(a)(1) · The facility shall have an emergency plan that provides for accommodations for shelter of children during an emergency including lock-down, shelter in place at the facility and shelter at locations away from the facility premises. Amend the facility emergency plan to include lock down procedures. Submit a written copy of the amended emergency plan.

The facility's emergency plan did not provide for shelter of children during an emergency including lock down procedures.

Corrected Corrected by Oct 5, 2024

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

3270.20(a)(1) · The operator shall immediately notify a child's parent and shall telephone notice to the appropriate regional office within 24 hours if a child in care at the facility is hospitalized or receives emergency room treatment. Revise policies and practices to ensure that telephone notice is made to the appropriate regional office within 24 hours if a child in care at the facility is hospitalized or receives emergency room treatment.

On 2/2/24, a child sustained an injury to the eye while in care and was taken to the emergency room for treatment. The operator failed to notify the Regional Office within 24 hours as required.

Corrected Corrected by Mar 21, 2024

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

3270.182(7) · A child's record shall contain reports of accidents, injuries and illnesses involving a child in care at the facility. The original report shall be given to the parent on the day of the incident. The second copy of the report shall be retained at the facility in an accident file. The third copy of the report shall be retained at the facility in the child's file. Ensure that parents are provided the original report on the day of the incident. Revise and submit written policies and procedures to ensure that parents are provided the original incident report on the date of the incident.

On 2/2/24, a child sustained an injury to the eye while in care and the operator failed to provide the parent an injury report.

Corrected Corrected by Mar 21, 2024

Category: health medication. 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. TIERED LIS: Children must be supervised at all times -corrected by 2/21/24 The legal entity must arrange for all facility staff persons to receive at least 2 hours of training in supervision of children. Submit written verification of the completed training for all staff persons. - correction by 3/21/24

On 2/2/24, a child sustained an injury to the eye and staff persons were unaware of what caused the injury.

Corrected Corrected by Mar 21, 2024

Category: supervision. Marked corrected in the state record.

3270.37(b)(3) · An aide shall have a minimum of an 8th grade education and 2 years of experience with children. Obtain and submit written verification of education and experience for the identified staff person. Ensure that all staff records have written verification of education and experience for their positions.

One staff person's record did not contain written verification of education and experience for their aide position. (#3)

Corrected Corrected by Jan 12, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.113(a)(1) · 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 inform staff of these requirements and develop procedures for assigning staff the responsibility for supervision of specific children as well as for staff persons being physically present and knowing the names of the children in their assigned group. Submit written documentation of the facility's procedures for assigning supervision responsibility.

Two staff persons were observed caring for a group of 14 school-age children and none had been assigned responsibility for supervision of specific children in the group. (#1, #2 and #3)

Corrected Corrected by Nov 17, 2023

Category: supervision. Marked corrected in the state record.

3270.119 · Infants shall be placed in the sleeping position recommended by the American Academy of Pediatrics unless there is a medical reason an infant should not sleep in this position. The medical reason shall be documented in a statement signed by a physician, physician's assistant or CRNP and placed in the child's record at the facility. The legal entity must arrange for all facility staff persons to complete training in proper infant sleeping position and use of age-appropriate rest equipment. Submit written verification of the completed training for all facility staff.

An infant was observed in the infant room sleeping face down on a pillow on the floor. Staff acknowledged placing child face down to sleep. (child #6)

Corrected Corrected by Nov 17, 2023

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

3270.121(b) · At the time of enrollment, a parent shall receive in writing the facility's general daily schedule, hours for which care is provided, fees, responsibilities for meals, clothing, health policies, supervision policies, night care policies, dismissal policies, transportation and pick-up arrangements. Obtain and submit written verification that this information has been given to the parent. Ensure that the specified information is given to the parent in writing at the time of enrollment as specified in this regulation.

Two children's agreement did not indicate that at the time of enrollment, a parent received in writing the facility's general daily schedule, hours for which care is provided, fees, responsibilities for meals, clothing, health policies, supervision policies, night care policies, dismissal policies, transportation and pick-up arrangements. (#1 and #2)

Corrected Corrected by Jan 12, 2024

Category: supervision. 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. Update the agreement to specify the amount of the fee to be charged per day or per week. Submit a copy of the updated agreement. Ensure this information is completed for all children's files. T

One child's record contained an agreement that did not specify the amount of the fee to be charged per day or per week. (#3)

Corrected Corrected by Jan 12, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.123(a)(5) · An agreement shall specify the persons designated by a parent to whom the child may be released. Update the agreements to specify the persons designated by a parent to whom the child may be released. Submit a copy of the updated agreements.

Two children's records contained agreements that did not specify the persons designated by a parent to whom the child may be released. (#1 and #4)

Corrected Corrected by Jan 12, 2024

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. Obtain and submit the telephone number of the child's physician or source of medical care for the identified child. Ensure that all children's records include this information as specified in this regulation.

One child's emergency contact information did not include the telephone number of the child's physician or source of medical care. (#1)

Corrected Corrected by Jan 12, 2024

Category: health medication. 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. Obtain and submit the missing required information. Ensure that the contact information includes the home and work addresses and telephone numbers of the enrolling parent.

One child's emergency contact information did not include the home and work addresses and telephone numbers of the enrolling parent. (#2)

Corrected Corrected by Jan 12, 2024

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. Obtain and submit a written copy of the missing health insurance information for the identified child. Ensure that all children's records contain emergency contact information as specified in these regulations.

Several children's emergency contact information did not include health insurance coverage and policy number information. (#2, #4 and #5)

Corrected Corrected by Jan 12, 2024

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. Obtain and submit a written copy of this missing contact information for the identified child. Ensure that all children's records contain emergency contact information as specified in these regulations.

One child's emergency contact information did not include the complete contact information- name, address and telephone number of the individual designated by the parent to whom the child may be released. (#1)

Corrected Corrected by Jan 12, 2024

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. Obtain and submit a current up-to-date health assessment for the identified staff person including negative TB skin testing. Ensure that health assessments contain the required information and are completed within the required timeframes.

One staff person's record/s did not contain a health assessment including negative TB skin testing completed within 12 months prior to the date of hire. (#3)

Corrected Corrected by Jan 12, 2024

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. Obtain and submit written verification of negative TB skin testing for the identified staff person. Ensure that facility persons' health assessments include written verification of tuberculosis screening by the Mantoux method.

Two staff person's records did not contain a health assessment including negative TB skin testing completed within 12 months prior to the date of hire. (#1and #4 )

Corrected Corrected by Jan 12, 2024

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