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). The required staff:child ratios must be maintained at all times.

As of the date of this verification inspection there is continued non compliance with regards to ratio requirements: in the rear room a single staff person was caring for a group of 7 older toddlers.

Corrected Corrected by Oct 2, 2024

Category: ratio. Marked corrected in the state record.

3270.31(e)(4)(i) · Competence is the completion of training by a professional in the field of first-aid and cardiopulmonary resuscitation (CPR). All staff persons shall renew their certification in pediatric first aid and pediatric cardiopulmonary resuscitation (CPR) on or before the expiration of the most current certification.

As of the date of this verification inspection there is continued non compliance with regards to the record of staff person #3 and Staff person #4 did not contain a current valid first aide certification.

Corrected Corrected by Oct 18, 2024

Category: ratio. Marked corrected in the state record.

3270.31(e)(4)(ii) · Staff persons shall participate, at least annually, in firesafety training conducted by a fire protection professional. Staff persons and volunteers shall receive training in maintenance of smoke detectors, the duties of facility persons during a fire drill and during a fire and the use of the facility's fire extinguishers, not including discharge of the fire suppressant agent.

As of the date of this verification inspection there is continued non compliance with regards to the records of the following staff persons (all having served the facility over one year) were lacking the proof of the current fire safety training. Staff person #2, , Staff person #3, Staff person #5, and staff person #1

Corrected Corrected by Oct 18, 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). Facility Person # 8, #7, #6, #5, and #2 may not work in a child care position at the facility. 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.

Continued noncompliance with CPSL requirements: person #6 was lacking was lacking both the state police and the FBi clearance, Staff person #7 was lacking Child Abuse Clearance, Staff person #8 was lacking FBI clearance, Child Abuse Clearance and State police clearance.

Corrected Corrected by Oct 2, 2024

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.

As of the date of this verification inspection there is continued noncompliance with regards to the record of staff person #9 lacking the verification of child care experience qualifications for the position they were serving.

Corrected Corrected by Oct 11, 2024

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.

As of the date of this verification inspection there is continued non compliance with regards to the following staff records did not contain the two required reference letters. #7, #8 and #9

Corrected Corrected by Oct 18, 2024

Category: recordkeeping. Marked corrected in the state record.

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

As of the date of this verification inspection there is continued non compliance with regards to the records of the following staff persons had verification of completion of the health and safety trainings which were created prior to the most recent update. Staff person #1 and Staff person #3.

Corrected Corrected by Oct 18, 2024

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.

As of the date of this verification inspection there is continued non compliance with regards to the records of the following staff persons (all having worked at the facility over one year) were lacking the proof of the annual minimum of 12 clock hours of child care training. Staff person #1, Staff person #2, Staff Person #3.

Corrected Corrected by Oct 18, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.54(b) · At least two facility persons shall be present when children are on an excursion away from the facility. At a minimum, one of the facility persons shall be a staff person.

At the time of the inspection staff person #8 took a group of school aged children on a walking excursion.

Corrected Corrected by Aug 26, 2024

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.

At the time of the inspection the record of staff person # 1 did not contain current written verification of the training regarding the emergency plan at the time on an annual basis.

Corrected Corrected by Aug 26, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.31(e)(4)(i) · Competence is the completion of training by a professional in the field of first-aid and cardiopulmonary resuscitation (CPR). All staff persons shall renew their certification in pediatric first aid and pediatric cardiopulmonary resuscitation (CPR) on or before the expiration of the most current certification.

At the time of the inspection the record of staff person #3 and Staff person #4 did not contain a current valid first aide certification.

Corrected Corrected by Aug 30, 2024

Category: ratio. Marked corrected in the state record.

3270.31(e)(4)(ii) · Staff persons shall participate, at least annually, in firesafety training conducted by a fire protection professional. Staff persons and volunteers shall receive training in maintenance of smoke detectors, the duties of facility persons during a fire drill and during a fire and the use of the facility's fire extinguishers, not including discharge of the fire suppressant agent.

At the time of the inspection the records of the following staff persons (all having served the facility over one year) were lacking the proof of the current fire safety training. Staff person #2, , Staff person #3, Staff person #5, and staff person #1

Corrected Corrected by Sep 12, 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). Facility Person # 8, #7, #6, #5, and #2 may not work in a child care position at the facility. A provisional employee may not be permitted to work alone with children and must work within the vicinity of a permanent employee. 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.

At the time of the inspection the following CPSL violations were observed in the staff records: Staff person #2 did not have a current valid Mandated Reporter training in their file. Staff person #3 did not have a current valid Pennsylvania State Police clearance, Staff Person #5 did not have a completed National Sex Offender clearance letter. Staff person #6 was lacking was lacking both the state police and the FBi clearance, Staff person #7 was lacking Child Abuse Clearance, Staff person #8 was lacking FBI clearance, Child Abuse Clearance and State police clearance. Staff person #8 was observed taking a group of children in care ona walking excursion.

Corrected Corrected by Aug 26, 2024

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.

At the time of the inspection the record of staff person #9 was lacking the verification of child care experience qualifications for the position they were serving.

Corrected Corrected by Aug 30, 2024

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). The required staff:child ratios must be maintained at all times.

At the time of the inspection the rear room had a group of 11 children, including a two year old child, in the care of a single staff person

Corrected Corrected by Aug 19, 2024

Category: ratio. Marked corrected in the state record.

3270.75(d)/3270.124(d) · One first-aid kit per child care group must accompany children and facility persons on excursions from the facility. Each first aid kit taken on an excursion must contain a bottle of water in addition to the items specified at §3270.75(c). When children leave the facility on walking and riding excursions, emergency contact information specific to each child on the excursion shall accompany a staff person on the excursion.

Staff person #8 did take a group of school aged children on a walking excursion and did not bring either a first aid kit or the children's emergency contact forms.

Corrected Corrected by Aug 26, 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. Children must be supervised at all times. The legal entity must arrange for all facility staff to receive a minimum of two hours of training regarding supervision of children. The legal entity must receive DHS approval of the training content prior to scheduling the training.

At the time of the inspection on more than one occasion, when the doorbell rang, staff person #8 did leave the primary care group unsupervised while they went to answer the front door.

Corrected Corrected by Aug 19, 2024

Category: supervision. Marked corrected in the state record.

3270.123(a)(6) · An agreement shall specify the date of the child's admission.

At the time of the inspection the agreement of child #1 did not l specify the date of the child's admission.

Corrected Corrected by Aug 26, 2024

Category: recordkeeping. 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.

At the time of the inspection the emergency contact information for child #2 was not in the space where they were receiving care.

Corrected Corrected by Aug 26, 2024

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.

At the time of the inspection the records of the following children did not contain current valid health assessments. #1, #3, #4

Corrected Corrected by Aug 26, 2024

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.

At the time of the inspection the following staff persons did not have current valid health assessments in their staff record: Staff person # 1

Corrected Corrected by Aug 30, 2024

Category: ratio. Marked corrected in the state record.

3270.181(a) · An operator shall establish and maintain an individual record for each child enrolled in the facility.

At the time of the inspection there was no individual record for child #5

Corrected Corrected by Aug 26, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.181(c) · 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.

At the time of the inspection the record of child # 1 and # 4 was not updated in over 6 months.

Corrected Corrected by Aug 29, 2024

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.

At the time of the inspection the following staff records did not contain the two required reference letters. #7, #8 and #9

Corrected Corrected by Aug 29, 2024

Category: recordkeeping. Marked corrected in the state record.

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

At the time of the inspection the records of the following staff persons had verification of completion of the health and safety trainings which were created prior to the most recent update. Staff person #1 and Staff person #3.

Corrected Corrected by Sep 13, 2024

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.

At the time of the inspection the records of the following staff persons (all having worked at the facility over one year) were lacking the proof of the annual minimum of 12 clock hours of child care training. Staff person #1, Staff person #2, Staff Person #3.

Corrected Corrected by Sep 13, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.24(a) · A staff person shall provide to agents of the Department immediate access to the facility, the children and the files and records.

At the time of the inspection when certification representative did ask for the record of child #1, provider stated that they could not provide it immediately and stated they would "look in the basement for it" and further they thought maybe the former director "shredded it"

Corrected Corrected by Jun 27, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.51/3270.52 · When children are grouped in similar age levels, the following maximum child group sizes and ratios of staff persons apply: Infants 1:4 with a maximum group size of 8; Young toddlers 1:5 with a maximum group size of 10; Older toddlers 1:6 with a maximum group size of 12; Preschool children 1:10 with a maximum group size of 20; Young school-age children 1:12 with a maximum group size of 24; Older school-age children 1:15 with a maximum group size of 30. The required staff:child ratios must be maintained at all times.

The rear classroom of the facility had 11 children, including multiple one year old children, in the care of a single staff person.

Corrected Corrected by Jul 8, 2024

Category: ratio. Marked corrected in the state record.

3270.70(b) · If the indoor temperature exceeds 82° F in a child care space, a means of mechanical air circulation must be operating.

At the time of the inspection the facility temperature was observed and recorded at 83 degrees, the air conditioner was not functional. There are no windows in the facility and there are no fans.

Corrected Corrected by Jun 26, 2024

Category: recordkeeping. 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.

At the time of the inspection the noncompliance with the record of staff person #1 continued as they had none of the applicable staff qualifications for the position in which the person is performing.

Corrected Corrected by Feb 27, 2024

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.

At the time of the inspection the record of staff person #1 displayed continued noncompliance as there still were no written, nonfamily references from individuals attesting to the person's suitability to serve as a facility person.

Corrected Corrected by Feb 27, 2024

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.

At the time of the inspection the record of staff person #1 was lacking training regarding the emegency plan.

Corrected Corrected by Mar 1, 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). Facility Person # 1 may not work in a child care position at the facility. 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.

At the time of the inspection the record of staff person #1, who was observed caring for children, was lacking the FBI clearance as well as the National Sex Offender clearance information.

Corrected Corrected by Mar 1, 2024

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

3270.33(a) · 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.

At the time of the inspection the record of staff person #1 had none of the applicable staff qualifications for the position in which the person is performing.

Corrected Corrected by Mar 1, 2024

Category: recordkeeping. 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.

At the time of the inspection the facility had no director. Certification representative did learn directly from the director that they had resigned, no new director was presented by the facility, nor was the office informed of the facility in need of a new director.

Corrected Corrected by Apr 12, 2024

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).

At the time of the inspection staff from the older toddler side did leave their primary care group and deliver the lunch to the infant side of the facility, which is a separate building (attached). The group they left had a single staff person caring for 8 children including 6 2-year-old children and 2 school aged children.

Corrected Corrected by Mar 1, 2024

Category: ratio. Marked corrected in the state record.

3270.192(2)(ii) · A facility person's record shall include verification of child care experience, education and training prior to service at the facility.

At the time of the inspection the record of staff person #1 had none of the applicable staff qualifications for the position in which the person is performing.

Corrected Corrected by Mar 1, 2024

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.

At the time of the inspection the record of staff person #1 did not include two written, nonfamily references from individuals attesting to the person's suitability to serve as a facility person.

Corrected Corrected by Mar 1, 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). Facility Person # 2 and #3 may not work in a child care position at the facility. 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.

At the time of the inspection the record of staff person #2 had a child abuse clearance dated 3/17/18 The record of staff person #3 had no state police clearance and a mandated reporter training dated 8/7/18 Staff persons #6, #9, #10, #11 all had no disclosure statement.

Corrected Corrected by Oct 5, 2023

Category: background checks. 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.

At the time of the inspection the record of staff persons #2 and #4 did not have proof of the current emergency plan training.

Corrected Corrected by Oct 25, 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.

At the time of the inspection the records of staff person #1 (start date 3/24/22) and staff person #4 (start date 4/26/22) did not have proof of the current year's required fire safety training.

Corrected Corrected by Oct 26, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.31(f) · Staff persons shall complete professional development within 90 days of hire as listed in subsections (f)1-10.

At the time of the inspection the records of staff persons #7 (start date 2/8/23) and #8 (start date 5/8/23) did not have proof of the required 10 hour health and safety training.

Corrected Corrected by Oct 27, 2023

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

3270.33(a)/3270.192(5) · 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 two written, nonfamily references from individuals attesting to the person's suitability to serve as a facility person.

At the time of inspection, the records of staff person #3 was lacking the required reference letters.

Corrected Corrected by Oct 5, 2023

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.

At the time of the inspection the records of staff person #1( start date (3/24/22) and Staff person #4 (start date 4/26/22) did not have a staff evaluation.

Corrected Corrected by Oct 5, 2023

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).

At the time of the inspection there were 13 children in the care of 2 staff persons on the infant toddler side of the facility, including 5 infants.

Corrected Corrected by Oct 5, 2023

Category: ratio. 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.

At the time of the inspection the records of staff person #1 and staff person #3, #4, #6, #9, #10 and #11 did not have a current valid health assessment.

Corrected Corrected by Oct 5, 2023

Category: ratio. Marked corrected in the state record.

3270.181(c) · 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.

At the time of the inspection the record of child #1 had not been updated in over 6 months.

Corrected Corrected by Oct 5, 2023

Category: recordkeeping. 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.

At the time of the inspection the record of staff person #5 (start date 4/10/23) and Staff person #8 (start date 5/8/23)did not have proof of the completion of the required pediatric first aid

Corrected Corrected by Oct 5, 2023

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

3270.94(a)(1)/3270.95(a) · The Director or designated staff person who is responsible for compliance with this chapter shall conduct fire drills and ensure that fire drills are conducted at least once every 60 days. Fire detection devices or systems must be in compliance with standards established under section 1016(c) of the act (62 P.S. §  1016(c)).

At the time of the inspection there had not been a fire drill documented at the facility in over 60 days.

Corrected Corrected by Oct 5, 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.

At the time of the inspection the records of staff person #1 ( start date (3/24/22) and staff person #4 did not have proof of the 12 hours of required child care training.

Corrected Corrected by Oct 26, 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.

At the time of the inspection the record of child # 2 did not have a current valid health assessment.

Corrected Corrected by Oct 5, 2023

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

3270.21/3270.113(a) · Conditions at the facility may not pose a threat to the health or safety of the children. 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.

On 6/27/23, at time of unannounced inspection, a fleece blanket was observed covering Child #3 complete face preventing proper supervision to determine distress and posing the threat of suffocation or breathing distress. Additionally (continued non-compliance from inspection dated 6/6/23): thin electrical cords belonging to the infant swing were observed on the carpet accessible to crawling infants and young toddlers. The loose electrical cords pose a safety hazard that could result in injury.

Corrected Corrected by Jul 6, 2023

Category: supervision. Marked corrected in the state record.

3270.106(a)/3270.119 · Individual, clean, age-appropriate rest equipment shall be provided for preschool, toddler and infant children as agreed between the child's parent and the operator. The rest equipment shall be labeled for the use of a specific child and used only by the specified child. 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.

On 6/29/23, at time of unannounced inspection, Child #1 was observed asleep in the facility's swing in an upright position, not recommended by the American Academy of Pediatrics.

Corrected Corrected by Jul 6, 2023

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

3270.166(6) · Neither an infant nor a toddler is permitted to sleep with a bottle in his mouth.

On 6/29/23, at time of unannounced inspection, Child #2 was observed asleep in the crib with a bottle. Additionally, young toddlers were observed asleep on a rest mat with a sippy cup.

Corrected Corrected by Jun 29, 2023

Category: physical safety. 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.

On 6/6/23, at time of unannounced inspection, thin electrical cords belonging to the infant swing were observed on the carpet accessible to crawling infants and young toddlers. The loose electrical cords pose a safety hazard that could result in injury.

Corrected Corrected by Jun 7, 2023

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

3270.52/3270.113(a)(2) · 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). The required staff:child ratios must be maintained at all times. The requirement for supervision on and off the facility premises includes compliance with the staff:child ratio requirements in §§ 3270.51--3270.55.

On 6/6/23, at approximately 12:40pm, Staff #1 and Staff #2 were observed out of ratio with 10 children in the Infant/Young Toddler room. The youngest children were infants.

Corrected Corrected by Jun 6, 2023

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.

On 6/6/23, at time of unannounced inspection, cleaning materials were observed accessible to children in an unlocked cabinet under the kitchen sink. Additionally, diaper cream instructing to "keep out of reach of children" was observed accessible to children on a low shelf under the diaper changing table located in the Infant/Young toddler room.

Corrected Corrected by Jun 6, 2023

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

3270.106(a) · Individual, clean, age-appropriate rest equipment shall be provided for preschool, toddler and infant children as agreed between the child's parent and the operator. The rest equipment shall be labeled for the use of a specific child and used only by the specified child.

On 6/6/23, at time of unannounced inspection, pack n plays located in the Infant/Young Toddler room were not labeled for the use of a specific child.

Corrected Corrected by Jun 7, 2023

Category: physical safety. 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.

On 6/6/23, at time of unannounced inspection, Child #1 emergency contact information was not present in the infant/young toddler room where Child #1 was receiving care.

Corrected Corrected by Jun 6, 2023

Category: recordkeeping. 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.

Continued non compliance: On 6/6/23, at the time of unannounced inspection, Staff #3 file did not contain an intial health assessment, including results of tuberculosis testing.

Corrected Corrected by Jun 20, 2023

Category: ratio. Marked corrected in the state record.

3270.166(4) · Disposable nursers and bottles shall be labeled with the child's name.

On 6/6/23, at the time of unannounced inspection, bottles observed in the infant/young toddler room were not labeled with the child's name.

Corrected Corrected by Jun 6, 2023

Marked corrected in the state record.

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

On 6/6/23, Child #1 was observed on a boppy pillow drinking a bottle that was propped under a blanket. (Child #1 younger than 6 months of age)

Corrected Corrected by Jun 7, 2023

Marked corrected in the state record.

3270.14 · 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.

On 4/11/23, at time of unannounced inspection, Staff #1 and Staff #2 files did not contain the one-hour Health & Safety Update required by OCDEL.

Corrected Corrected by Apr 23, 2023

Category: ratio. Marked corrected in the state record.

3270.32(a) · The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). LACKING REQUIRED HIRING DOCUMENTS: Facility Person # 3-- may not work in a child care position at the facility.

On 4/11/23, at time of unannounced inspection, Staff #3 file did not contain PA Criminal Clearance and FBI Clearance as required by CPSL.

Corrected Corrected by Apr 12, 2023

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

3270.33(a)/3270.192(2)(iv) · 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 acceptable verification of experience, education or training is a transcript or a diploma or a letter signed by a representative of the experiential, educational or training entity.

On 4/11/23, at time of unannounced inspection, Staff #4 file did not contain verification of education.

Corrected Corrected by Apr 30, 2023

Category: recordkeeping. 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.

On 4/11/23, at time of unannounced inspection, Staff #1, #2 and #4 files did not contain initial health assessments including results of tuberculosis testing.

Corrected Corrected by May 12, 2023

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.

On 4/11/23, at time of unannounced inspection, Staff #1, #3 and #4 files did not contain two letters of written references. (Staff #1 file only contained one letter).

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

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.

On 3/28/23, at time of inspection, Staff #2 reported that on 3/23/23, Staff #4, who is also the parent of Child #1, transported Child #1 to the hospital after ingesting ant poison at the facility. The operator did not notify the regional office within 24 hours of the emergency room treatment.

Corrected Corrected by Mar 28, 2023

Category: transportation. Marked corrected in the state record.

3270.66(a)/3270.66(c) · Cleaning materials and other toxic materials shall be kept in an area or container that is locked or made inaccessible to children. Cleaning materials and other toxic materials shall be used in a way that does not contaminate play surfaces, food, food preparation areas and does not constitute a hazard to the children.

On 3/28/23, Staff #3 reported that at approx. 4:00pm on 3/23/23, Staff #1 was taking a group of 4 children to the restroom. Upon leaving the restroom, Staff #1 stopped in the kitchen area with the children to complete a task. From an adjacent childcare space, Staff #3 noticed Child #1 had the liquid ant poison on their hands and mouth area. Child #1 was immediately brought into the bathroom to wash it out of mouth and hands. Additionally, at time of inspection on 3/28/23, cleaning materials were observed accessible to children under the kitchen sink.

Corrected Corrected by Mar 28, 2023

Category: ratio. 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. 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.

On 3/28/23, Staff #3 reported that at approx. 4:00pm on 3/23/23, Staff #1 was assigned to a group of 4 children for the purpose of supervision. Staff #1 was taking the group of 4 children to the restroom. Upon leaving the restroom, Staff #1 stopped in the kitchen area with the children to complete a task. During this time, Child #1 accessed an ant trap containing liquid ant poison. The liquid poison was observed on Child #1 hands and mouth by Staff #3 who was in another room.

Corrected Corrected by Mar 28, 2023

Category: supervision. 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.

On 3/28/23, at time of inspection, an incident report detailing the incident that occurred on 3/23/23 where Child #1 ingested ant poison was not on file at the facility.

Corrected Corrected by Mar 28, 2023

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

3270.51/3270.113(a)(2) · The required staff:child ratios must be maintained at all times. When children are grouped in similar age levels, the following maximum child group sizes and ratios of staff persons apply: Infants 1:4 with a maximum group size of 8; Young toddlers 1:5 with a maximum group size of 10; Older toddlers 1:6 with a maximum group size of 12; Preschool children 1:10 with a maximum group size of 20; Young school-age children 1:12 with a maximum group size of 24; Older school-age children 1:15 with a maximum group size of 30. The requirement for supervision on and off the facility premises includes compliance with the staff:child ratio requirements in §§ 3270.51--3270.55.

Continued Noncompliance: On 3/9/23, at approximately 10:15am, Staff #1 was observed out of ratio with 6 children. The youngest children were Young Toddlers.

Corrected Corrected by Mar 9, 2023

Category: supervision. 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.

On 2/8/23, at time of unannounced inspection, Staff person #2 and Staff person #3 were observed to be caring for children unsupervised. Staff person #2 and Staff person #3 have not completed the following pre-service trainings required prior to caring for children unsupervised: Mandated Reporter Training, Health & Safety Training, Pediatric First Aid/CPR. (Staff #3 did not have a file)

Corrected Corrected by Feb 9, 2023

Category: supervision. Marked corrected in the state record.

3270.52/3270.113(a)(2) · 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). The required staff:child ratios must be maintained at all times. The requirement for supervision on and off the facility premises includes compliance with the staff:child ratio requirements in §§ 3270.51--3270.55.

On 2/8/23, at approximately 9:10am, Staff #1 was observed out of ratio for approximately 45 minutes with 11 children; the youngest children were 2 years old.

Corrected Corrected by Mar 8, 2023

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.

On 2/8/23, at approximately 9:10am, Staff #1 was observed out of ratio with 11 children, the youngest children were 2 yr olds. Staff #1 was observed leaving the children unsupervised in the middle childcare space, where half walls prevent visibility of children, to answer the door and retrieve items in the back of the facility.

Corrected Corrected by Mar 9, 2023

Category: supervision. 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.

On 2/8/23, at time of unannounced inspection, Staff #2 File did not contain training in the facility's emergency plan.

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

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: Facility Person #1 may not work in a child care position at the facility. 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 may not work in a child care position at the facility.

On 2/8/23, at the time of unannounced inspection, Staff #2 file did not contain a signed Disclosure Statement. Additionally, Staff #1 did not have results of Child Abuse clearance. Staff #1 did not have proof of requests for Criminal History, Child Abuse and NSOR clearances and a signed Disclosure Statement required by CPSL.

Corrected Corrected by Feb 8, 2023

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

3270.92(a) · Portable space heaters are not permitted.

On 2/8/23, at the time of unannounced inspection, a portable heater was observed in the OT/PS childcare space.

Corrected Corrected by Feb 8, 2023

Category: physical safety. 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.

On 2/8/23, at the time of unannounced inspection, Staff #2 file did not contain an initial health assessment. Staff #2 file only contained results of Tuberculosis testing by Mantoux method.

Corrected Corrected by Feb 17, 2023

Category: ratio. Marked corrected in the state record.

3270.191 · An individual record is required for each facility person.

On 2/8/23, at the time of unannounced inspection, Staff #1 was observed caring for children in the Infant/Young toddler childcare space. Staff #1 did not have an individual record at the facility which includes required CPSL clearances, signed disclosure statement, initial health assessment, verification of education/experience, 2 written references, and training in the facility's emergency plan.

Corrected Corrected by Feb 8, 2023

Category: background checks. 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 2/8/23, at the time of unannounced inspection, Staff #2 file did not contain two written references.

Corrected Corrected by Feb 17, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.32(a) · The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). LACKING REQUIRED HIRING DOCUMENTS: Facility Person #1 -- may not work in a childcare position at the facility.

On 12/20/22, during unannounced inspection, Staff #1 file did not contain a completed Child Abuse Clearance as required by CPSL.

Corrected Corrected by Dec 21, 2022

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

3270.166(4) · Disposable nursers and bottles shall be labeled with the child's name.

On 12/20/22, during unannounced inspection, Child #1 bottle was not labeled.

Corrected Corrected by Dec 20, 2022

Marked corrected in the state record.

3270.166(6) · Neither an infant nor a toddler is permitted to sleep with a bottle in his mouth.

On 12/20/22, during unannounced inspection, Child #1 was observed in the crib with a bottle.

Corrected Corrected by Dec 20, 2022

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

3270.31(f)/3270.31(f)(10) · Staff persons shall complete professional development within 90 days of hire as listed in subsections (f)1-10.Staff persons shall complete professional development in pediatric first aid and pediatric cardiopulmonary resuscitation within 90 days of hire.

On 9/22/22, Staff #1 has not completed the required pre-service training within 90 days of their hire date: Pediatric First Aid & Pediatric CPR.

Corrected Corrected by Oct 14, 2022

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

3270.33(a)/3270.192(2)(iv) · 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 acceptable verification of experience, education or training is a transcript or a diploma or a letter signed by a representative of the experiential, educational or training entity.

On 9/22/22, verification of education was not observed in the file belonging to Staff #2.

Corrected Corrected by Oct 10, 2022

Category: recordkeeping. Marked corrected in the state record.

3270.52/3270.113(a)(1) · 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). 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.

On 9/22/22, Staff #1 was observed out of ratio with 7 children (youngest children were infants) while Staff #3 was in the kitchen area preparing lunch for the facility. Staff #3 could not properly supervise the children in her assigned group from the kitchen area.

Corrected Corrected by Sep 22, 2022

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.

On 9/22/22, hand sanitizer instructing to "keep out of reach of children" was observed on a shelf accessible to children in the toddler space.

Corrected Corrected by Sep 22, 2022

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

3270.108(c) · Styrofoam cups and plates may not be used.

On 9/22/22, children were observed eating lunch from Styrofoam bowls.

Corrected Corrected by Sep 23, 2022

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.

On 9/22/22, an infant was observed asleep in a swing in an upright position which is not recommended by the AAP. A written medical reason signed by a physician was not on file at the facility.

Corrected Corrected by Sep 22, 2022

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

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

On 9/22/22, children in the toddler room were observed using hand sanitizer prior to eating lunch.

Corrected Corrected by Sep 22, 2022

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

3270.163(a)(1)/3270.163(a)(2) · A lunch or dinner prepared at the facility for children of toddler age or older shall include at least one dairy product. A lunch or dinner prepared at the facility for children of toddler age or older shall include at least one protein.

On 9/22/22, the lunch served to children did not include a dairy or protein item.

Corrected Corrected by Sep 23, 2022

Marked corrected in the state record.

3270.166(1) · A written statement giving the formula and feeding schedule for an infant shall be obtained from the parent.

On 9/22/22, a written statement giving formula and feeding schedule for enrolled infants were not observed on file.

Corrected Corrected by Oct 7, 2022

Category: nutrition. Marked corrected in the state record.

3270.94(a)(1)/3270.94(a)(9) · The Director or designated staff person who is responsible for compliance with this chapter shall conduct fire drills and ensure that fire drills are conducted at least once every 60 days.The Director or designated staff person who is responsible for compliance with this chapter shall conduct fire drills and ensure that a written record is maintained on file at the facility indicating the specific time of day of the drill, the hypothetical location of the fire, the evacuation time, and the names of the facility persons and the number of children who participate in the fire drill.

On 9/22/22, evidence that fire drills are being conducted at least every 60 days was not on file at the facility. The last fire drill logged was dated 6/24/22.

Corrected Corrected by Sep 30, 2022

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.

On 9/22/22, a 30 day fire detection log required by Panic Fire Act of November 2020 was not observed on file at the facility.

Corrected Corrected by Sep 22, 2022

Category: recordkeeping. 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.

On 2/27/22, during initial inspection, an updated health assessment was not observed in the file belonging to Staff #1. The health assessment was dated 2/7/20.

Corrected Corrected by May 2, 2022

Category: ratio. 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.

On 2/27/22, during initial inspection, documentation of date fire detection system was installed at the facility was not on file as required by Fire & Panic Act 62 of 2020.

Corrected Corrected by May 2, 2022

Category: recordkeeping. 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.

On 4/27/22, during initial inspection, the facility's emergency plan did not contain accommodations for children during a Lock-down emergency.

Corrected Corrected by Apr 29, 2022

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