3280.26(c)/3280.192(2)(iii) · 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. A facility person's record shall include verification of child care experience, education and training following the outset of service at the facility.

The file for staff person #2 lacked documentation of Emergency Plan Training for 2023.

Corrected Corrected by Nov 13, 2024

Category: recordkeeping. Marked corrected in the state record.

3280.31(e)(4)(i) · Competence is the completion of training by a professional in the field of first-aid and 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.

The two most recent Pediatric First Aid and Pediatric CPR Trainings for Staff #1 and #2 were dated more than 24-months apart. (SEE LIS CODE SHEET)

Corrected Corrected by Nov 13, 2024

Category: ratio. Marked corrected in the state record.

3280.32(a)/3280.192(4) · The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). LACKING REQUIRED HIRING DOCUMENTS: Facility Person #2 -- may not work in a childcare 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 #2 --- may not work in a childcare position at the facility.

Staff File #2 lacked a Disclosure Statement. (SEE LIS CODE SHEET)

Corrected Corrected by Nov 13, 2024

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

3280.33(a)/3280.192(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.

The file for Staff #2 lacked documentation of education and previous childcare experience, making it unable to be determined if the individual qualified as a staff person.

Corrected Corrected by Nov 13, 2024

Category: recordkeeping. Marked corrected in the state record.

3280.123(a)(3) · An agreement shall specify 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 at § 3280.124(f).

The Child Service Reports for child files #1 and #4 were not updated within six (6) months.

Corrected Corrected by Nov 13, 2024

Category: recordkeeping. Marked corrected in the state record.

3280.124(b)(2) · Emergency contact information must include the name, address and telephone number of the child's physician or source of medical care.

The Emergency Contact Form for Child #5 lacked the Phone Number of the Physician or Medical Care Provider. (SEE LIS CODE SHEET)

Corrected Corrected by Nov 13, 2024

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

3280.124(b)(4)/3280.182(3) · Emergency contact information must include the written consent signed by a parent for emergency medical care. A child's record must 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 written parental consent for emergency medical care.

Corrected Corrected by Nov 13, 2024

Category: recordkeeping. Marked corrected in the state record.

3280.124(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.

The Emergency Contact Form for Child #2 lacked the Health Insurance/MA Coverage.

Corrected Corrected by Nov 13, 2024

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

3280.124(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.

The Emergency Contact forms for child files #2 lacked the address of the listed release person.

Corrected Corrected by Nov 13, 2024

Category: recordkeeping. Marked corrected in the state record.

3280.124(f)/3280.181(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.

The files for children #1, #3 and #4 contained Emergency Contact forms that were not updated within 6 months of the previous update. (SEE LIS CODE SHEET)

Corrected Corrected by Nov 13, 2024

Category: recordkeeping. Marked corrected in the state record.

3280.151(a)/3280.192(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.

The file for Staff #2 lacked an updated Health Assessment. The last Health Assessment on file dated: 03/2022.

Corrected Corrected by Nov 13, 2024

Category: ratio. Marked corrected in the state record.

3280.181(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.

The Financial Agreement and Emergency Contact Forms for children #1, #3 and #4 were dated more than six months apart.

Corrected Corrected by Nov 13, 2024

Category: recordkeeping. Marked corrected in the state record.

3280.182(5) · A child's record must 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 Nov 13, 2024

Category: ratio. Marked corrected in the state record.

3280.192(5) · A facility person's record shall include two written, nonfamily references from individuals attesting to the person's suitability to serve as a facility person.

Staff #2 was lacking two written, nonfamily references from individuals attesting to the person's suitability to serve as a facility person.

Corrected Corrected by Nov 13, 2024

Category: recordkeeping. Marked corrected in the state record.

3280.94(a)(1) · The primary staff person 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 drills were not conducted every 60 days with the last documented fire drill dated 09/02/2024. (07/03/2024 - 09/02/2024; 61 DAYS)

Corrected Corrected by Nov 13, 2024

Category: recordkeeping. Marked corrected in the state record.

3280.31(f) · Staff person(s) shall complete professional development in the topics of 3280.31(f) (1-10) within 90 days of hire. Staff person #2 -- will have until 11/16/2024 to complete the required training. Until such time as the required training has been completed, staff person #2--- must be supervised, when interacting with children, by an (AGS, primary staff person, or family childcare home staff person) who has completed the required training related to this citation. If there are no staff available to supervise staff person #2--, staff person #2-- may not work in a child-care position at the facility.

Staff person #2 --- has not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): (Health and Safety).

Corrected Corrected by Nov 22, 2024

Category: supervision. Marked corrected in the state record.

3280.131(a)/3280.182(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 must contain initial and subsequent health reports.

The Updated Child Health Assessment for Child #4 was dated more than 12 months apart. (SEE LIS CODE SHEET)

Corrected Corrected by Nov 13, 2024

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

3280.14/3280.20 · 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. Until such time as the required pre-service trainings are completed, staff person #4 must be supervised, when interacting with children, by a primary staff person who has completed the required training related to this citation. If there are no staff person(s) available to supervise staff person #4, staff person #4 may not work in a child-care position at the facility.

Staff person #4 was observed to be caring for children unsupervised. Staff person #4 has not completed the following pre-service trainings required prior to caring for children unsupervised: Mandated reporter training, Health and Safety Training in the topics of 3280.31(f)(1-9).

Corrected Corrected by Nov 8, 2023

Category: supervision. Marked corrected in the state record.

3280.14/3280.20 · A facility shall be operated in conformity with applicable Federal and State laws and regulations. State agencies whose regulations may relate to the operation of a facility include the Department of Environmental Resources, the Department of Labor and Industry, the Department of Health, the Department of Education and the Department of Transportation. Conditions at the facility may not pose a threat to the health or safety of the children.

Staff person #2, with health and safety training completed prior to 10-4-22, lacked the Pennsylvania Health and Safety Update 2022 Training required by 12-30-22 and requires current training. (See LIS CODE SHEET)

Corrected Corrected by Nov 8, 2023

Category: ratio. Marked corrected in the state record.

3280.32(a)/3280.192(4) · The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). A facility person's record shall include a copy of requests for the criminal history record and child abuse registry clearance information, a copy of the disclosure statement and a copy of the completed clearance information required under the CPSL. Staff Person #3 and Staff Person #4 may not work at the facility.

The file for staff person #3 had a state police clearance that lacked the corresponding rap sheet and requires a current rap sheet. The file for staff person #4, hired provisionally, had proof of application for the NSOR verification certificate at their start date and lacked the NSOR verification certificate within 45 days of their start date as required for a provisional hire and requires a current NSOR verification certificate. (See LIS CODE SHEET)

Corrected Corrected by Nov 8, 2023

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

3280.33(a)/3280.192(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.

The file for staff person #4, functioning as a primary staff person, lacked verification of education/experience to qualify as a primary staff person.

Corrected Corrected by Nov 8, 2023

Category: recordkeeping. Marked corrected in the state record.

3280.52(c) · 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 at §3280.52(b).

At approximately 10:07 a.m. in the child care room, staff person #1 was observed supervising 7 children in the room, including older toddlers, resulting in staff person #1 being out of ratio. At that time, staff person #1 was in the child care room without another staff person present as staff person #4 was in the bathroom and staff person #3 was in the kitchen in separate rooms from the child care room.

Corrected Corrected by Nov 8, 2023

Category: supervision. Marked corrected in the state record.

3280.66(a) · Cleaning materials and other toxic materials shall be stored in an original labeled container or in a container that specifies the content. Toxics shall be kept in a locked area or in an area inaccessible to children, and shall be stored away from food, food preparation areas and child care spaces.

In the bathroom in an unlocked cabinet under the sink, there were multiple containers of Disinfex Disinfectant Wipes and 3 containers of A+D Ointment on a shelf on the diaper changing table that were labeled "Keep out of reach of children" and were accessible to children.

Corrected Corrected by Nov 8, 2023

Category: ratio. Marked corrected in the state record.

3280.123(a)(3) · An agreement shall specify 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 at § 3280.124(f).

Child #3, #4, and #5 lacked a current child service report updated within the last 6 months. Child #1 and #2 had a child service report that exceeded 6 months between reports.

Corrected Corrected by Nov 8, 2023

Category: recordkeeping. Marked corrected in the state record.

3280.124(b)(2) · Emergency contact information must include the name, address and telephone number of the child's physician or source of medical care.

The file for child #4 had an emergency contact form that lacked the address of the child's physician.

Corrected Corrected by Nov 8, 2023

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

3280.124(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.

The file for child #1 had an emergency contact form that lacked the health insurance policy number.

Corrected Corrected by Nov 8, 2023

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

3280.124(e) · A written plan identifying the means of transporting a child to emergency care and staffing provisions in the event of an emergency shall be displayed conspicuously in every child care space and shall accompany a staff person who leaves on an excursion with children.

The emergency transportation plan was not posted in the child care room.

Corrected Corrected by Nov 8, 2023

Category: transportation. Marked corrected in the state record.

3280.131(b)(2)/3280.182(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 must contain initial and subsequent health reports.

The files for child #1, an older toddler, and child #2, a preschooler, lacked a current health assessment updated within the last 12 months.

Corrected Corrected by Nov 8, 2023

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

3280.131(d)(5)/3280.131(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). Children #2 and #4 must be dismissed from care by close of business on 10-13-23 and may only return to care when the immunization record is updated or when a parent provides a written, signed exemption letter.

The files for child #2, a 3 year old, and child #4, a 4 year old, had an immunization record that lacked verification of the Influenza vaccination being administered within the last calendar year in accordance with the schedule recommended by the ACIP and lacked exemption documentation.

Corrected Corrected by Nov 8, 2023

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

3280.131(e)/3280.131(e)(3) · The facility may not accept or retain an infant 2 months of age or older, a toddler or a preschool child at the facility for more than 60 days following the first day of attendance at the facility unless the parent provides written verification from a physician, physician's assistant, CRNP, the Department of Health or a local health department of the dates (month, day and year) the child was administered immunizations in accordance with the 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 #1 must be dismissed from care by close of business on 10-13-23 and may only return to care when the immunization record is updated or when a parent provides a written, signed exemption letter.

The file for child #1, an older toddler, lacked an immunization record within 60 days of the child's first day of attendance at the facility and requires a current immunization record.

Corrected Corrected by Nov 8, 2023

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

3280.181(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.

The file for child #4 lacked a current emergency contact form and agreement updated within the last 6 months.

Corrected Corrected by Nov 8, 2023

Category: recordkeeping. Marked corrected in the state record.

3280.182(3)/3280.182(5) · A child's record must contain signed parental consent for emergency medical care for the child. Written consent is required prior to admission. A child's record must contain signed parental consent for administration of minor first-aid procedures by facility staff. Written consent is required prior to admission.

The files for child #1 and #5 had an emergency contact form that lacked signed parental consent for emergency medical care for the child and signed parental consent for administration of minor first-aid procedures by facility staff.

Corrected Corrected by Nov 8, 2023

Category: ratio. Marked corrected in the state record.

3280.95(a)/3280.95(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 primary staff person or designated staff person who is responsible for compliance with this chapter shall ensure the requirements in subsection (a) are met.

According to the log, the operator did not manually test the smoke detectors in the facility at least once every 30 days on multiple occasions within the last year.

Corrected Corrected by Nov 8, 2023

Category: recordkeeping. Marked corrected in the state record.

3280.31(f) · Staff persons shall complete professional development within 90 days of hire as listed in subsections (f)1-10.

Staff person #3 completed the following required pre-service training on 11-23-22 that was over 90 days after their date of hire (see LIS code sheet): Health and Safety Training in the topics of 3280.31(f)(1-9).

Corrected Corrected by Nov 8, 2023

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

3280.131(a)/3280.182(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 must contain initial and subsequent health reports.

The file for child #4 had an initial health assessment that was dated over 60 days after the child's first day of attendance at the facility.

Corrected Corrected by Nov 8, 2023

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

3280.124(b)(2) · Emergency contact information must include the name, address and telephone number of the child's physician or source of medical care.

The file for child # 2 lacked the address of the physician or source of medical care on the emergency contact form.

Corrected Corrected by Oct 21, 2022

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

3280.76 · 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 hole on the bottom of the wall in front of the window in the playroom.

Corrected Corrected by Oct 21, 2022

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

3280.102(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.

There was a rocking chair with a hole exposing the foam in the main room. The red table border in the main room was pulling off. There was a shelf with exposed splinter in the play room. The foam blocks in the playroom had teeth marks. There was a cardboard block with a hole in the play room.

Corrected Corrected by Oct 21, 2022

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

3280.124(b)(3) · Emergency contact information must include the home and work addresses and telephone numbers of the enrolling parent.

The files for child # 1,2,3 and 4 lacked the home and work addresses and telephone numbers of the enrolling parent on the emergency contact form.

Corrected Corrected by Oct 21, 2022

Category: recordkeeping. Marked corrected in the state record.

3280.124(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 child # 1 and 4 lacked 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 on the emergency contact form.

Corrected Corrected by Oct 21, 2022

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

3280.124(b)(6) · Emergency contact information must include health insurance coverage and policy number for a child under a family policy or Medical Assistance benefits.

The file for child # 3 lacked the policy number for a child under a family policy or Medical Assistance benefits on the emergency contact form.

Corrected Corrected by Oct 21, 2022

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

3280.131(b)(2)/3280.182(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 must contain initial and subsequent health reports.

The file for child # 3 a preschooler lacked an updated health report . The previous report was dated 7/23/21.

Corrected Corrected by Oct 21, 2022

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

3280.134(a) · A staff person shall ensure that a child's hands are washed before meals and snacks, after toileting and after being diapered.

The operator reported that the child's hands are being wiped after diapering, instead of being washed.

Corrected Corrected by Oct 21, 2022

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

3280.151(c)(2)/3280.192(3) · An adult health assessment must include tuberculosis screening by the Mantoux method at initial employment. Subsequent tuberculosis screening is not required unless directed by a physician, physician's assistant, CRNP, the Department of Health or a local health department. A 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.

The file for staff # 2 lacked tuberculosis screening by the Mantoux method at initial employment.

Corrected Corrected by Oct 21, 2022

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

3280.152 · A facility person shall wash his hands before meals and snacks, and after toileting and after diapering a child.

The operator reported that the staff were using wipes to clean their hands after diapering, instead of washing their hands.

Corrected Corrected by Oct 21, 2022

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

3280.171(c) · Written notification of safe routes shall be posted by the operator at a conspicuous location in the child care facility.

The facility lacked the pick-up and drop-off notification of safe routes posted by the operator at a conspicuous location in the child care facility.

Corrected Corrected by Oct 21, 2022

Marked corrected in the state record.

3280.182(5) · A child's record must contain signed parental consent for administration of minor first-aid procedures by facility staff. Written consent is required prior to admission.

The file for child #1 lacked signed parental consent for administration of minor first-aid procedures by facility staff. Written consent is required prior to admission on the emergency contact form.

Corrected Corrected by Oct 21, 2022

Category: ratio. Marked corrected in the state record.

3280.192(4) · 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 #2 may not work in a childcare position at the facility.

The file for staff # 1 lacked the date on the Disclosure statement form.

Corrected Corrected by Oct 21, 2022

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

3280.192(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.

The file for staff #2 lacked two written, nonfamily references from individuals attesting to the person's suitability to serve as a facility person.

Corrected Corrected by Oct 21, 2022

Category: recordkeeping. Marked corrected in the state record.

3280.35(1)/3280.192(2)(ii) · A secondary staff person shall have obtained a high school diploma or a general educational development certificate. A facility person's record shall include verification of child care experience, education and training prior to service at the facility.

The staff file for Staff person #1, who is a secondary staff person, lacked proof of high school diploma.

Corrected Corrected by Nov 30, 2021

Category: recordkeeping. Marked corrected in the state record.

3280.123(a)(5) · An agreement shall specify the persons designated by a parent to whom the child may be released.

The child file for Child #1 contained a financial agreement form that lacked the name(s) of the individual(s) to whom the child may be released to.

Corrected Corrected by Oct 31, 2021

Category: recordkeeping. Marked corrected in the state record.

3280.131(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 child file for Child #2, who is a preschool aged child, lacked a flu shot for 2020.

Corrected Corrected by Oct 31, 2021

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

3280.94(a)(4) · The primary staff person or designated staff person who is responsible for compliance with this chapter shall conduct fire drills and ensure that the hypothetical locations of the fire are rotated around the facility for each drill such that the hypothetical location is never the same for consecutive drills.

Upon review of the facility fire drill log it was observed that the playroom was being used as the hypothetical location for every consecutive fire drill that was conducted.

Corrected Corrected by Oct 31, 2021

Category: recordkeeping. Marked corrected in the state record.

3280.26(a)(1)/3280.26(a)(5) · The facility shall have an emergency plan that provides 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. The facility shall have an emergency plan that provides for accommodations for infants, toddlers, children with disabilities and children with chronic medical conditions.

As of 12/19/20, the facilities emergency plan did not contain a lockdown procedure until 9/27/21.

Corrected Corrected by Oct 31, 2021

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

3280.131(a) · The operator shall require the parent of an enrolled child, including a child, a foster child and a relative of an operator or a facility person, to provide an initial health report no later than 60 days following the first day of attendance at the facility.

The child file for Child #2, who has an enrollment date of 11/23/20, lacked an initial health report.

Corrected Corrected by Oct 31, 2021

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

3280.14/3280.20 · 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.

During an unannounced complaint investigation conducted on 9/30/21, two staff were observed to not be wearing masks. When the operator was asked why, she only indicated that "we normally wear masks." Upon further investigation, masks were observed to be in the office and not readily accessible to the children or staff in the child care spaces.

Corrected Corrected by Sep 30, 2021

Category: ratio. Marked corrected in the state record.