3270.32(a)/3270.192(4) · The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). A facility person's record shall include a copy of requests for the criminal history record and child abuse registry clearance information, a copy of the disclosure statement and a copy of the completed clearance information required under the CPSL.

The files for Staff #1 and #2 contained a disclosure statement that lacked a witness. Although the file for Staff #3 contained a National Sex Offender Registry (NSOR) Certificate it was observed that Staff #3 obtained their NSOR certificate after their first day caring for children.

Corrected Corrected by Sep 8, 2025

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

3270.34(b)(1)/3270.192(2)(iv) · A director shall have attained a bachelor's degree from an accredited college or university in early childhood education, child development, special education, elementary education or the human services field and 1 year of experience with children. 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.

The file for Staff #2, a director, lacked verification of 1 year of experience with children.

Corrected Corrected by Aug 28, 2025

Category: recordkeeping. Marked corrected in the state record.

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

In the Bunnies Room, a red colored foam mat was observed to be ripping along the seam leaving foam exposed and accessible to the children in care who are still placing objects in their mouths.

Corrected Corrected by Aug 28, 2025

Marked corrected in the state record.

3270.135(a)(3) · If disposable diapers are provided by a parent or by a facility, a soiled diaper shall be discarded by immediately placing the diaper into a plastic-lined, hands-free covered can.

The two trash cans in the diapering area in the Starfish Room were observed to have broken foot pedals, resulting in the cans no longer beings hands-free.

Corrected Corrected by Aug 28, 2025

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

3270.115(b)(1) · Staff persons shall supervise children in care using wading pools. Staff: child ratios in subsection (a) apply when children are wading.

At approximately 10:15 AM Cert Rep observed 8 children including 1 Older Toddler and 7 Young Toddlers wading in the Infant/Toddler Play space. At this time during swim ratio there were two staff present: therefore, ratio was 1:4. At approximately 10:15 AM Cert Rep observed 28 children including; 26 Older Toddlers and 2 Preschool Aged Children Preschool wading in the Preschool Play space. At this time during swim ratio there were five staff present: 2 staff identified their children in ratio as 1:5 older toddlers, 2 staff identified their children in ratio as 1:6 older toddlers, and 1 staff identified their children in ratio as 1:6 including 2 preschool aged children and 4 older toddlers.

Corrected Corrected by Aug 28, 2025

Category: supervision. Marked corrected in the state record.

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

The last two Fire Safety trainings in the file for Staff #1 were dated more than 12 months apart.

Corrected Corrected by Jan 9, 2025

Category: recordkeeping. Marked corrected in the state record.

3270.64 · Outside walkways shall be free from ice, snow, leaves, equipment and other hazards.

The outside walkways were covered with snow around the exterior of the building, including exits from the classrooms on the first floor.

Corrected Corrected by Jan 9, 2025

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

3270.66(d) · Toxic plants are not permitted in a child care space.

In Room 205 and Room 209, there was a toxic plant in each room on a ledge by the door to the classroom.

Corrected Corrected by Jan 3, 2025

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

3270.77(a) · Peeled or damaged paint or damaged plaster is not permitted on indoor or outdoor surfaces in the child care facility.

In Room 211, there were a couple of areas of peeling paint on the right wall near the back of the room.

Corrected Corrected by Jan 9, 2025

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

3270.91(a) · Stairways, hallways, exits from rooms, exits from the facility and other means of egress serving as an exit shall be unobstructed.

On the side of the building, there was a table turned upside down in front of the gate that obstructed the fire exit from the facility.

Corrected Corrected by Jan 9, 2025

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

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

In Room 117, there was a cracked clear bin containing toys that created a pinching hazard to the children in care.

Corrected Corrected by Jan 3, 2025

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

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

In Room 111 and Room 119 children were observed playing with small pieces of various kinds of papers that had a diameter of less than 1 inch. These classrooms had children in care who are still placing objects in their mouths. In Room 118, an Infant Classroom, the foam rug on the floor had a peeling material that was flaking off and creating a choking hazard to the children in care who are still placing objects in their mouths.

Corrected Corrected by Jan 6, 2025

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

3270.131(b)(1)/3270.182(1) · The operator shall require the parent to provide an updated health report at least every 6 months for an infant or young toddler. A child's record shall contain initial and subsequent health reports.

The file for Child #3, a Young Toddler, contained Health Reports that were updated in an interval greater than 6 months.

Corrected Corrected by Jan 9, 2025

Category: health medication. 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.

The files for Child #1 and Child #2, both Preschoolers, contained Health Reports that had been updated in an interval greater than 12 months.

Corrected Corrected by Jan 9, 2025

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

3270.135(a)(3) · If disposable diapers are provided by a parent or by a facility, a soiled diaper shall be discarded by immediately placing the diaper into a plastic-lined, hands-free covered can.

The trash can in the diapering area in Room 114 was observed to have a broken foot pedal, resulting in the can no longer being hands-free.

Corrected Corrected by Jan 7, 2025

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

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

The file for Staff #1 contained a Health Assessment that stated they had a communicable disease. There was no accompanying documentation stating the condition and the risk it might pose to others exposed to this individual.

Corrected Corrected by Jan 7, 2025

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

3270.51 · 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.

During a complaint investigation conducted on 6/4/24, according to staff statements, it was determined that while transitioning from the classroom to the outdoor play space an older toddler was left behind in the classroom for approximately two minutes without any staff present resulting in the staff:child ratio being 0:1.

Corrected Corrected by Jun 29, 2023

Category: ratio. 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.

During a complaint investigation conducted on 6/4/24, according to staff statements, it was determined that while transitioning from the classroom to the outdoor play space an older toddler was left behind in the classroom for approximately two minutes without being supervised by any staff person.

Corrected Corrected by Aug 1, 2024

Category: supervision. Marked corrected in the state record.

3270.113(a)(1) · ***The director will physically observe and evaluate various transition periods where staff are moving groups of children from one area of the facility to another, for at least 3 transition periods per month for the next 3 months, following the approval of this plan of correction using a log. The director(s) will develop this log to include the date, time, classroom, number/ names of staff persons, number and ages of children, where transitioning to/from, and indicate whether or not supervision and ratio was compliant during the transition. The director(s) will submit the log to the Western Regional office for review prior to use. The log must be made available to OCDEL-DHS representatives upon request during the monitoring period.

***During a complaint investigation conducted on 6/4/24, according to staff statements, it was determined that while transitioning from the classroom to the outdoor play space an older toddler was left behind in the classroom for approximately two minutes. No staff person was physically present with the child.

Corrected Corrected by Nov 1, 2024

Category: supervision. 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.

*During a complaint investigation conducted on 6/4/24, according to staff statements, it was determined that while transitioning from the classroom to the outdoor play space an older toddler was left behind in the classroom for approximately two minutes. No staff person was physically present with the child.

Corrected Corrected by Aug 1, 2024

Category: supervision. Marked corrected in the state record.

3270.113(a)(1) · **The director will ensure all staff, including the director(s), complete the following one-hour training from Better Kid Care titled Supervision: Moving Children. Proof of training will be submitted upon completion to OCDEL Western Region Certification Representative and may be counted towards annual training hours.

**During a complaint investigation conducted on 6/4/24, according to staff statements, it was determined that while transitioning from the classroom to the outdoor play space an older toddler was left behind in the classroom for approximately two minutes. No staff person was physically present with the child.

Corrected Corrected by Aug 30, 2024

Category: supervision. Marked corrected in the state record.

3270.113(b) · A facility person may not use any form of physical punishment, including spanking a child.

During a complaint investigation conducted on 6/4/24, according to staff statements, it was determined that a staff person was observed to have picked up an infant too rough and placed them forcefully into a crib.

Corrected Corrected by Aug 1, 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.

During a complaint investigation conducted on 6/4/24, it was disclosed that the directors allowed parents the opportunity to backdate and/ or provide inaccurate dates on their children's signed periodic reviews in order to reflect compliance.

Corrected Corrected by Aug 1, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.181(d) · Following review, a parent shall attest to the accuracy of information in the emergency contact information and the financial agreement at each review by affixing a dated signature to the record.

During a complaint investigation conducted on 6/4/24, it was disclosed that the directors allowed parents the opportunity to backdate and/ or provide inaccurate dates on their children's signed periodic reviews in order to reflect compliance.

Corrected Corrected by Aug 1, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.107 · A facility shall have an operable, clean refrigerator used to store potentially hazardous foods. The refrigerator shall be capable of maintaining food at 45° F or below. An operating thermometer shall be placed in the refrigerator.

In Room 111, there was a broken thermometer in the refrigerator.

Corrected Corrected by Jun 5, 2024

Category: nutrition. Marked corrected in the state record.

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

In Room 201 there were two empty plastic bags and a deflated helium balloon that posed a choking hazard to the children.

Corrected Corrected by Jun 4, 2024

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

3270.32(a)/3270.192(4) · The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). A facility person's record shall include a copy of requests for the criminal history record and child abuse registry clearance information, a copy of the disclosure statement and a copy of the completed clearance information required under the CPSL. Facility Person #2 may not work in a childcare position at the facility.

The file for Staff #2, employed for more than 45 days contained only the State Police Clearance request and therefore was incorrectly provisionally hired.

Corrected Corrected by Jun 5, 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.

Staff #4, acting as an assistant group supervisor, lacked documentation of the qualifications required.

Corrected Corrected by Jun 19, 2024

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.

In the bathroom connected to Room 205 there was Aquaphor, labeled "keep out of reach of children" on a low shelf accessible to the children in care.

Corrected Corrected by Jun 4, 2024

Marked corrected in the state record.

3270.75(c) · A first-aid kit must contain the following: soap, an assortment of adhesive bandages, sterile gauze pads, tweezers, tape, scissors and disposable, nonporous gloves.

The first aid kit located in Room 205 lacked nonporous gloves and tape. The first aid kit located in Room 206 lacked tweezers.

Corrected Corrected by Jun 4, 2024

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

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

The face plate on the electrical outlet in the back right corner of Room 211 was cracked, therefore allowing access to the electrical wires.

Corrected Corrected by Jun 5, 2024

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

3270.77(a) · Peeled or damaged paint or damaged plaster is not permitted on indoor or outdoor surfaces in the child care facility.

In Room 118 behind the crib next to the refrigerator was peeling paint. In Room 121 on the half wall in front of the changing table there was peeling paint.

Corrected Corrected by Jun 9, 2024

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

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

In Room 115 there were multiple cardboard building blocks that were ripped and in disrepair.

Corrected Corrected by Jun 5, 2024

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

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

The files for Child #1, #2, #4, #5, #6, #7 and #8 lacked child service forms that provide information to the family about the child's growth and development in the context of the services being provided.

Corrected Corrected by Jun 20, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.131(d)(5)/3270.131(e)(1) · A health report shall include a review of the child's immunized status according to recommendations of the ACIP. The facility shall implement dismissal policies in accordance with the Department of Health regulation in 28 Pa. Code § 27.77 (relating to immunization requirements for children in child care group settings). Child #7 and Child #9 must be dismissed from care by close of business 6/14/24 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 #7, enrolled for more that 60 days at the facility, did not contain documentation of a 4th dose of the DTAP vaccination as required based on the child's age as per the ACIP recommended schedule. The file for Child #9, enrolled for more that 60 days at the facility, did not contain documentation of a 4th dose of the DTAP vaccination or a Hep A vaccination as required based on the child's age as per the ACIP recommended schedule.

Corrected Corrected by Jun 4, 2024

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

3270.133(4) · Medication shall be stored in a locked area of the facility or in an area that is out of the reach of children.

In Room 117 there was a staff purse on the ground that was accessible to the children that contained ibuprofen.

Corrected Corrected by Jun 4, 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.

Although the file for Staff #1 contained a Health Assessment at the time of Renewal Inspection, it was observed that Staff #1 did not obtain the Health Assessment prior to providing initial service in a childcare setting. The file for Staff #3 contained a Health Assessment that had a future date listed as the date of the exam. Therefore, it could not be determined when the physical examination for Staff #3 took place.

Corrected Corrected by Jun 4, 2024

Category: ratio. Marked corrected in the state record.

3270.151(c)(2)/3270.192(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.

Although the file for Staff #1 contained tuberculosis screening at the time of Renewal Inspection, it was observed that Staff #1 did not obtain tuberculosis screening prior to providing initial service in a childcare setting.

Corrected Corrected by Jun 5, 2024

Category: health medication. 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.

The files for Child #1 and #2 contained financial agreement forms that were not updated within 6 months of the previous update.

Corrected Corrected by Jun 4, 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.

The file for Staff #5, lacked two written, nonfamily references from individuals attesting to the suitability to serve as a facility person.

Corrected Corrected by Jun 18, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.27(f) · The operator shall send a copy of the emergency plan and subsequent plan updates to the local municipality and to the county emergency management agency.

Based on conversations with the operator, the operator did not send a copy of the emergency plan to the local municipality.

Corrected Corrected by Jun 18, 2024

Category: physical safety. 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.

The file for Child #7 contained Health Reports and Immunization Records at the time of inspection, it was observed they did not have a Health Report and Immunization Record within 60 days of enrollment

Corrected Corrected by Jun 4, 2024

Category: health medication. 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. Until such time as the required pre-service trainings are completed, staff person #1 must be supervised, when interacting with children, by an AGS who has completed the required training related to this citation. If there are no staff person(s) available to supervise staff person #1, staff person #1 may not work in a child-care position at the facility.

Staff person #1 was observed to be caring for children unsupervised. Staff person #1 has not completed the following pre-service trainings required prior to caring for children unsupervised: Health and Safety Training in the topics of 3270.31(f)(1-9), Pediatric first-aid/CPR training.

Corrected Corrected by Jan 30, 2024

Category: supervision. 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.

Staff person #5 had not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): Health and Safety Training. Staff person #5 completed Health and Safety Training on 10/12/22.

Open Not marked corrected in the state record

Category: health medication. 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). A facility person's record shall include a copy of requests for the criminal history record and child abuse registry clearance information, a copy of the disclosure statement and a copy of the completed clearance information required under the CPSL.

The file for Staff person #2 was observed not to contain a valid NSOR within 45 days of hire (See IS CODE SHEET). Staff person #2's NSOR on file is dated 5/26/23.

Corrected Corrected by Jul 13, 2023

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

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

The staff file for Staff person #4 lacked an annual staff evaluation for 2022; the two most recent evaluations were dated 11/16/21 and 1/13/23.

Corrected Corrected by Jun 29, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.82(i) · A toilet area, training chair area, diapering area and sink area shall be equipped with a clean, lidded waste receptacle.

In Room 206/Tigers, the restroom on the right was observed to lack a lidded waste receptacle.

Corrected Corrected by Jun 29, 2022

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.

In Room 115/Zebras, one cot used by an older toddler at naptime was observed to not be labeled with the child's name. In Room 211/Goldfish, eight cots used by preschool age children in care at naptime were observed to not be labeled with the child's name; the cots were individually numbered however the corresponding chart did not contain the names of the children next to those numbers.

Corrected Corrected by Jun 29, 2023

Category: physical safety. 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.

The child file for Child #2 was observed to contain an emergency contact form that was observed to lack the address(s) for the designated release person(s) listed.

Corrected Corrected by Jul 13, 2023

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.

The child file for Child #1, who is a young toddler, was observed to lack an updated health report; the most recent health report on file is dated 9/27/22.

Corrected Corrected by Jul 13, 2023

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

3270.131(b)(2) · The operator shall require the parent to provide an updated health report at least every 12 months for an older toddler or preschool child.

The child file for Child #5, who is a preschool age child, was observed to lack an updated health report; a health report on file is dated 3/30/22 which is more than 12 months old.

Corrected Corrected by Jul 13, 2023

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

3270.131(d)(5)/3270.131(e)(3) · A health report shall include a review of the child's immunized status according to recommendations of the ACIP. The facility shall implement dismissal policies in accordance with the Department of Health regulation in 28 Pa. Code § 27.77 (relating to immunization requirements for children in childcare group settings). Child #1 must be dismissed from care by close of business 6/13/23 and may only return to care when the immunization record is updated or when a parent provides a written, signed exemption letter.

The child file for Child #1 was observed to lack the 4th dose of DTaP vaccine.

Corrected Corrected by Jul 13, 2023

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

3270.131(d)(8) · A health report shall include a statement that age-appropriate screenings recommended by the American Academy of Pediatrics were conducted since the time of the previous health report required by this section.

The child file for Child #4, who is a preschool age child, was observed to contain a current health report dated 5/18/23 that indicated the required age-appropriate screenings recommended by the American Academy of Pediatrics had not been conducted since the previous health report.

Corrected Corrected by Jul 13, 2023

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

3270.151(c)(2)/3270.192(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 staff file for Staff person #1, Staff person #3, Staff person #6, and Staff person #7 was observed to contain a tuberculosis screening test results dated more than 12 months prior to providing initial service in a childcare setting (See IS CODE SHEET).

Corrected Corrected by Jul 13, 2023

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

3270.151(c)(3)/3270.192(3) · An adult health assessment must include an examination for communicable diseases and the results of that examination. 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 staff file for Staff person #7 contained a current health assessment dated 5/18/23 that had 'Yes' checked off to having a communicable disease and additional information describing the condition and the risk it might pose was not provided.

Corrected Corrected by Jul 13, 2023

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

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

Upon review of the facility's 30-day fire testing documentation, the following tests were observed to have been conducted more than 30 days apart: 8/16/22 - 9/16/22 (31 Days), 10/11/22 - 11/28/22 (48 Days), 12/14/22 - 1/18/23 (35 Days), 1/18/23 - 2/22/23 (35 Days).

Corrected Corrected by Jul 13, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.131(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 #3, was observed to not contain documentation of an initial health report within 60 days of enrollment (See IS CODE SHEET). An initial health report dated 3/28/22 is on file.

Corrected Corrected by Jul 13, 2023

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. Compliance will be verified through two unannounced visits.

*During a complaint investigation conducted on 3/2/23, the operator offered video footage of a child who was injured in an incident that occurred on 2/24/23 at approximately 10:00am in the gross motor room. In the video, Child #1 was observed jumping up and down on a blue soft foam block, losing their footing, and falling face-first onto the floor. The fall resulted in Child #1 sustaining an injury to their nose and right arm. During the video, Staff person #1, who was responsible for supervising Child #1, was observed on the opposite side of the room, engaged in conversation with Staff person #2, with their head turned away from the play area before, during and immediately after the fall. Therefore, Staff person #1 did not see, hear, nor direct the child at the time of the fall and approximately thirteen seconds had gone by after Child #1 fell before Staff person #1 noticed and went over to assess the needs of the child. Staff person #2 and Staff person #3, who were also present and facing in the direction where Child #1 was playing, did not notice the fall.

Corrected Corrected by Apr 14, 2023

Category: supervision. Marked corrected in the state record.

3270.113(a) · The legal entity shall arrange for all staff persons to attend an in-person training conducted by the ELRC in the area of supervision and classroom positioning within three months of the acceptance of the plans of correction. Proof of training will be submitted to the OCDEL Western Region Certification Rep upon completion and may be counted towards annual training hours.

***During a complaint investigation conducted on 3/2/23, the operator offered video footage of a child who was injured in an incident that occurred on 2/24/23 at approximately 10:00am in the gross motor room. In the video, Child #1 was observed jumping up and down on a blue soft foam block, loses their footing, and falls face-first onto the floor. The fall resulted in Child #1 sustaining an injury to their nose and right arm. During the video, Staff person #1, who was responsible for supervising Child #1, was observed on the opposite side of the room, engaged in conversation with Staff person #2, with their head turned away from the play area before, during and immediately after the fall. Therefore, Staff person #1 did not see, hear, nor direct the child at the time of the fall and approximately thirteen seconds had gone by after Child #1 fell before Staff person #1 noticed and went over to assess the needs of the child. Staff person #2 and Staff person #3, who were also present and facing in the direction where Child #1 was playing, did not notice the fall.

Corrected Corrected by Jun 30, 2023

Category: supervision. Marked corrected in the state record.

3270.113(a) · The legal entity shall develop a supervision policy regarding staff positioning while in the gross motor room to ensure staff are positioned in such a way to be able to supervise all of the children at all times. This policy will be posted in the gross motor room and included in the staff handbook.

**During a complaint investigation conducted on 3/2/23, the operator offered video footage of a child who was injured in an incident that occurred on 2/24/23 at approximately 10:00am in the gross motor room. In the video, Child #1 was observed jumping up and down on a blue soft foam block, loses their footing, and falls face-first onto the floor. The fall resulted in Child #1 sustaining an injury to their nose and right arm. During the video, Staff person #1, who was responsible for supervising Child #1, was observed on the opposite side of the room, engaged in conversation with Staff person #2, with their head turned away from the play area before, during and immediately after the fall. Therefore, Staff person #1 did not see, hear, nor direct the child at the time of the fall and approximately thirteen seconds had gone by after Child #1 fell before Staff person #1 noticed and went over to assess the needs of the child. Staff person #2 and Staff person #3, who were also present and facing in the direction where Child #1 was playing, did not notice the fall.

Corrected Corrected by Apr 14, 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.

During a complaint investigation conducted on 3/2/23, upon watching the video footage of the incident that occurred on 2/24/23 at approximately 10:00am in the gross motor room, Child #1 had fallen off a blue soft foam block and sustained an injury to their nose and right arm. When asked, Staff person #1, who was responsible for supervising Child #1, disclosed that an incident report was not written up and provided to the parents until the following business day on 2/27/23.

Corrected Corrected by Apr 14, 2023

Category: supervision. 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.

At approximately 10:13am outside on the 2-year-old playground, during the outset of supervision and ratio, 5 staff and 18 older toddlers were observed. Staff person #1 identified and named responsibility for 5 older toddlers, Staff person #2 identified and named responsibility for 4 older toddlers, Staff person #3 identified and named responsibility for 4 older toddlers, and Staff person #4 identified and named responsibility for 3 older toddlers, thus leaving the 2 remaining older toddlers unaccounted for. None of the staff who were physically present on the playground were assigned or claimed responsibility for those two remaining older toddlers. The two remaining older toddlers were responsibility of Staff person #5 who had left the playground area to accompany two other older toddlers inside to the restroom.

Corrected Corrected by Apr 14, 2023

Category: supervision. Marked corrected in the state record.

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

In Room 114 / Two year olds, numerous lanyards used to identify the designated play areas throughout the room were observed attached to the wall via Velcro at a height that allowed the string of the lanyards to hang one foot off the ground causing a potential strangulation hazard.

Corrected Corrected by Jun 12, 2022

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

3270.36(b)(1)/3270.192(2)(iv) · An assistant group supervisor shall have a high school diploma or a general educational development certificate and 30 credit hours from an accredited college or university in early childhood education, child development, special education, elementary education or the human services field.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.

The staff file for Staff person #2, who is functioning as an assistant group supervisor, contained a foreign degree that lacked additional documentation to show that the degree had been evaluated to determine it's validity and whether or not it meets qualifications for the position.

Corrected Corrected by Jul 29, 2022

Category: supervision. Marked corrected in the state record.

3270.75(b) · A first-aid kit must be inaccessible to children.

A bookbag containing the first-aid kit was observed on the ground accessible to the children who were playing outside on the toddler playground.

Corrected Corrected by Jun 7, 2022

Marked corrected in the state record.

3270.82(h) · A facility person and an able child shall wash his hands after toileting and before eating. A sign on which this requirement is written shall be posted at each toilet, training chair, diapering area and sink in the facility.

Room 209, 211, and the bathroom shared between Room 205 and 203 and between Room 121 and 119 were observed to lack a handwashing sign above each toilet.

Corrected Corrected by Jun 7, 2022

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

3270.131(e)(1)/3270.182(1) · The facility shall require the parent to provide updated written verification from a physician, physician's assistant, CRNP, the Department of Health or a local health department of ongoing vaccines administered to an infant, toddler or preschool child in accordance with the schedule recommended by the ACIP.A child's record shall contain initial and subsequent health reports.

The child file for Child #2 lacked flu shot for 2021.

Corrected Corrected by Jun 9, 2022

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

3270.151(a) · A facility person providing direct care who comes into contact with the children or who works with food preparation shall have a health assessment conducted within 12 months prior to providing initial service in a child care setting and every 24 months thereafter. A health assessment is valid for 24 months following the date of signature, if the person does not contract a communicable disease or develop a medical problem.

The staff file for Staff person #4, contained a current health assessment dated 10/14/21 which was conducted more than 24 months from the previously dated 9/13/19 health assessment on file. A health assessment dated 12/14/20 was on file but it is considered an invalid health assessment as it was not competed on our approved DHS staff health assessment form.

Corrected Corrected by Jun 7, 2022

Category: ratio. Marked corrected in the state record.

3270.151(b) · A health assessment shall be conducted and a report shall be written and signed by a physician, physician's assistant or CRNP. The signature must include the individual's professional title.

The staff file for Staff person #3 contained a health assessment dated 6/2/21 which was observed to contain a signature that lacked the individual's professional title with that signature.

Corrected Corrected by Jun 24, 2022

Category: health medication. 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.

The staff file for Staff person #1 contained a tuberculosis screening test and results that where more than 12 months old from the date of hire (See IS CODE SHEET).

Corrected Corrected by Jun 24, 2022

Category: health medication. 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.

The child file for Child #1 contained a financial agreement and an emergency contact information form that were not reviewed and updated by the parent at least once in a 6-month period; the dates of the most recent reviews were 9/2/21 and 4/11/22 for the financial agreement and 9/2/21 and 4/2/22 for the emergency contact information form.

Corrected Corrected by Jun 8, 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.

The director self reported that they had not been testing the smoke detection system every 30 days as required by Act 62.

Corrected Corrected by Jun 7, 2022

Category: recordkeeping. Marked corrected in the state record.