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

In the Front Infant/Toddler Room, the sheets being used in two of the cribs used by an infant in care was observed to be loose fitting thus allowing them to bunch up and cause a potential suffocation hazard.

Corrected Corrected by Jul 31, 2024

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

3270.27(e) · The operator shall provide to the parent of each enrolled child a letter explaining the emergency procedures. The operator shall also provide to the parent of each enrolled child a letter explaining any subsequent update to the plan.

The letter to the parents explaining the emergency plan does not address annual emergency drills.

Corrected Corrected by Jul 29, 2024

Category: physical safety. 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 PreK 3 Room a Clean Smart Toy disinfectant labeled 'Keep Out of Reach of Children' was observed inside an unlocked storage cabinet in the bathroom; the lock on the storage cabinet was broken thus making the disinfectant accessible to the preschool age children in care.

Corrected Corrected by Jul 18, 2024

Marked corrected in the state record.

3270.69(b) · Hot water temperature, in areas accessible to children, may not exceed 110° F.

When tested the hot water coming from the upstairs bathroom sinks located to the right of the Flex PS Room, which are used by the children in care to wash their hands, both tested between 114° F and 115° F.

Corrected Corrected by Jul 18, 2024

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

3270.75(a) · A first-aid kit shall be in a child care space.

The Back Infant/Toddler Room was observed to lack a first-aid kit.

Corrected Corrected by Jul 18, 2024

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

3270.82(e) · Toilets and sinks shall be at proper heights for children using them or shall be easily approached by means of platforms or steps.

The sink in the Front Infant/Toddler Room, which is used by the toddlers in care, was observed to lack a platform or steps for the toddlers to use while washing their hands.

Corrected Corrected by Jul 18, 2024

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 child file for Child #4 contained a child service report in the file that lacked a date; therefore, it is unable to be determined if the child service report was completed within six months of the prior report.

Corrected Corrected by Jul 18, 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.

In the Front Infant/Toddler Room, 6 infants and 1 young toddler were observed to be receiving care in the space and their emergency contact forms were not present.

Corrected Corrected by Jul 18, 2024

Category: recordkeeping. Marked corrected in the state record.

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

The staff file for Staff person #1, contained a current health assessment dated 6/30/23 which was conducted more than 24 months from the previously dated 4/30/21 health assessment on file.

Corrected Corrected by Jul 18, 2024

Category: ratio. Marked corrected in the state record.

3270.182(6) · A child's record shall contain signed parental consent for transportation, walking excursions, swimming and wading.

The child file for Child #1 through Child #10 contained an updated emergency contact information form that lacked an area for signed parental consent for walking excursions.

Corrected Corrected by Jul 29, 2024

Category: transportation. 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 6/27/24 it was disclosed that the report for an incident which occurred on 6/12/24 at 5:00pm was not written up and given to the parent until the next morning on 6/13/24.

Corrected Corrected by Jul 31, 2024

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

3270.75(a) · A first-aid kit shall be in a child care space.

There was no first aid kit present in the Pre-K 4 Annex.

Corrected Corrected by Aug 1, 2023

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

3270.27(e) · The operator shall provide to the parent of each enrolled child a letter explaining the emergency procedures described in subsection (a). The operator shall also provide to the parent of each enrolled child a letter explaining any subsequent update to the plan.

The letter to the parents explaining the facility's emergency plan did not include the plan for lockdown or accommodations.

Corrected Corrected by Aug 1, 2023

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

3270.32(a) · The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services).

Facility Person #2 has not completed mandated reporter training within the last 60 months. This is evidenced by the previously documented mandated reporter training on file on 9/5/23 being dated 7/28/18.

Corrected Corrected by Sep 5, 2023

Category: recordkeeping. 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.

There were containers of disinfectant wipes on the floor outside of an unlocked exit door from the gym, accessible to children.

Corrected Corrected by Aug 1, 2023

Marked corrected in the state record.

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

First aid kits in rooms used by schoolagers (the Learning Hub, the upper hallway, the large gross motor room) were mounted on walls, in reach of schoolage children in care. There was a first aid kit in a low unlocked cabinet in reach of children.

Corrected Corrected by Aug 1, 2023

Category: health medication. 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.

There were areas of damaged plaster/peeling paint on a wall in the gross motor room near where the riding toys are stored. There were also some paint chips on the floor in this area.

Corrected Corrected by Aug 1, 2023

Category: physical safety. 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.

There was a bassinet in the infant room used by a child in care that was not labeled with the child 's name.

Corrected Corrected by Aug 1, 2023

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

3270.111(b) · The written plan of daily activities shall be posted in the group space.

The daily activity schedule posted in the Learning Hub, a space used by school agers, was the schedule that only addressed before and after school programming. During the summer months, when the inspection was conducted, shoolagers receive full day care in the classroom.

Corrected Corrected by Aug 1, 2023

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

3270.124(b)(6) · Emergency contact information must include health insurance coverage and policy number for a child under a family policy or Medical Assistance benefits, if applicable.

The emergency contact forms on file for children #1, #2, and #3 did not include the health insurance information.

Corrected Corrected by Aug 1, 2023

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

3270.124(b)(7) · Emergency contact information must include the name, address and telephone number of the individual designated by the parent to whom the child may be released.

The emergency contact forms on file for children #4 and #5 did not include addresses of all release persons listed.

Corrected Corrected by Aug 1, 2023

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.

The emergency contact forms present in the classrooms with the children did not include all information required under 3270.124 (physician's information, health insurance information, consent for emergency medical care).

Corrected Corrected by Aug 1, 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 child care group settings).

The immunization record on file for child #1 did not indicate the child had sufficient doses of the Hepatits A and DTAP vaccines as recommended for a child of their age by the ACIP. There was no documentation of a current influenza vaccine on file for child #4, recommended annually by the ACIP. Children #1 and #4 must be dismissed from care by close of business 8/1/23 and may only return to care when the immunization record is updated or when a parent provides a written, signed exemption letter.

Corrected Corrected by Aug 1, 2023

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

3270.133(3) · The label of a medication container shall identify the name of the medication and the name of the child for whom the medication is intended. Medication shall be administered to only the child whose name appears on the container.

There was triple antibiotic ointment cream in a first aid kit, not labeled with a specific child's name to only be used by that child.

Corrected Corrected by Aug 1, 2023

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.

There was insulin in a bag in a low unlocked cabinet in reach of children in the café.

Corrected Corrected by Aug 1, 2023

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

3270.152 · A facility person shall wash his hands before meals and snacks, and after toileting and after diapering a child.

A staff person caring for children in the infant room was observed changing an infant's diaper in the without washing their hands afterwards.

Corrected Corrected by Aug 1, 2023

Category: health medication. 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.

There were no written feeding schedules from parents at the facility for 2 enrolled infants.

Corrected Corrected by Aug 1, 2023

Category: nutrition. Marked corrected in the state record.

20.71(a)(7) · The Department may deny, refuse to renew or revoke a certificate of compliance for fraud or deceit in obtaining or attempting to obtain a certificate of compliance.

The mandated reporter training documentation on file for Facility Person #1, presented by the operator upon request for review, appeared to be manipulated. It was confirmed by the training entity that there was no record of Facility Person #1 having completed the mandated reporter training on the date listed on the certificate.

Corrected Corrected by Aug 1, 2023

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.

Documentation of smoke detector testing on file indicates testing was completed on 3/15/23 and then again on 4/20/23, more than 30 days apart.

Corrected Corrected by Aug 1, 2023

Category: recordkeeping. 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.

There was a Seventh Generation disinfectant cleaner in an unlocked cabinet in reach of children in the Learning Hub.

Corrected Corrected by Oct 18, 2022

Category: ratio. Marked corrected in the state record.

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

There was a loose face plate on a wall outlet in the Preschool 3 room.

Corrected Corrected by Oct 18, 2022

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.

There was an area of peeling paint and damaged plaster behind a trash can in the Preschool 3 room.

Corrected Corrected by Oct 19, 2022

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

3270.82(e) · Toilets and sinks shall be at proper heights for children using them or shall be easily approached by means of platforms or steps.

There was no stool at the sink in the front infant room to allow for the young toddlers in the room to stand on and reach the sink.

Corrected Corrected by Oct 18, 2022

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.

Eight of the rest mats in use in the Preschool 4 room and three in the front infant room were not labeled with the names of the children who were using them.

Corrected Corrected by Oct 18, 2022

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

3270.111(c) · Daily activities shall promote the development of skills, social competence and self-esteem. Daily experiences shall recognize the child as an individual and give some choice of activities that respect personal privacy, lifestyle and cultural background.

There was no daily activity schedule posted in the Preschool 4 Annex.

Corrected Corrected by Oct 18, 2022

Category: background checks. 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.

There were no emergency contact forms in the Preschool 4 room for the children who were receiving care in that room.

Corrected Corrected by Oct 18, 2022

Category: recordkeeping. Marked corrected in the state record.

3270.131(e)(2)(i) · Exemption from immunization for religious belief or strong personal objection equated to a religious belief shall be documented by a written, signed and dated statement from the child's parent or guardian. The statement shall be kept in the child's record.

The immunization exemptions for the flu vaccine written by the parents of children #1 and #2 were not signed by the parents.

Corrected Corrected by Oct 18, 2022

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

3270.133(2) · A staff person shall administer a prescription medication only if written instructions are provided from the individual who prescribed the medicine. Instructions for administration contained on a prescription label are acceptable.

There were 2 albuterol inhalers present in the cafe with no written instructions in the facility from the individuals who prescribed the medicines.

Corrected Corrected by Oct 18, 2022

Category: ratio. Marked corrected in the state record.

3270.133(3) · The label of a medication container shall identify the name of the medication and the name of the child for whom the medication is intended. Medication shall be administered to only the child whose name appears on the container.

There were sample packets of medication (burn cream, triple antibiotic ointment) in the first aid kit in the cafe, not labeled with any individual children's names.

Corrected Corrected by Oct 18, 2022

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

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

There was a tacrolimus ointment in the cafe with no written parental consent for administration on file.

Corrected Corrected by Oct 18, 2022

Category: ratio. Marked corrected in the state record.

3270.135(c) · The diapering area may not be used for food preparation or food service.

In the infant room bottles and a bottle warmer were located next to a sink where hands are washed after diapering.

Corrected Corrected by Oct 18, 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.

The most recent fire alarm test that was completed and documented on the facility's log was notated as completed on 8/4/22, more than 30 days prior.

Corrected Corrected by Oct 18, 2022

Category: recordkeeping. Marked corrected in the state record.

3270.113(a)(1) · Each staff person shall be assigned the responsibility for supervision of specific children. The staff person shall know the names and whereabouts of the children in his assigned group. The staff person shall be physically present with the children in his group on the facility premises and on facility excursions off the facility premises.

At approximately 4:35 in the indoor playground, Facility Persons #1, #2, and #3 were supervising 11 preschoolers. When asked to identify which children they were each supervising, FP #1 identified 3 children. Then FP #2 identified 5 children. Then, before FP #3 identified her children, FP#1 left the room and handed her supervision cards to FP #3 to assign them to her care. FP#3 then identified 4 children she was supervising, with the aid of the supervision cards. A total of 9 of the 11 present children were identified as supervised by one of the present staff. It was determined that there was one child in each supervision group that was not identified by the respective staff person.

Corrected Corrected by Oct 4, 2022

Category: supervision. Marked corrected in the state record.

3270.114 · Weather permitting, children shall be taken out doors daily.

According to staff statements, children are not taken outdoors. They had not taken the children outside since the program began providing care at the facility on 6/23/22.

Corrected Corrected by Oct 4, 2022

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.

There were areas of peeling paint and damaged plaster on the walls in the indoor playground.

Corrected Corrected by Jun 23, 2022

Category: physical safety. 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.

Handwashing signs were not present at toilets in the Indoor Playground restroom, the lobby restroom, the Preschool 3 restroom, and the Upstairs Hall restroom

Corrected Corrected by Jun 23, 2022

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.

There was no proof of purchase of the interconnected fire alarm system installed in the facility.

Corrected Corrected by Jun 23, 2022

Category: recordkeeping. Marked corrected in the state record.