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

The health assessment on file staff person #2, dated 6/27/24, did not include an examination for communicable disease and the results of the examination.

Corrected Corrected by Oct 10, 2024

Category: health medication. 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 two most recent fire safety trainings in the file for staff person #1 are dated 6/8/23 and 9/3/24, which are more than one year apart.

Corrected Corrected by Sep 3, 2024

Category: recordkeeping. 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 in the two-year-old room did not include tweezers.

Corrected Corrected by Oct 9, 2024

Category: health medication. 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 the outdoor PS/SA Playground II, two children's playhouse equipment were observed to be cracked with rough edges and were not in good repair.

Corrected Corrected by Oct 9, 2024

Category: physical safety. 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 diapering area in the YPS Room had a plastic-lined covered can but was not hands-free.

Corrected Corrected by Oct 12, 2024

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

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

The file of facility person #2 contained documentation their pediatric first aid and pediatric CPR expired 3/3023 and was updated on 4/6/2023, after the expiration of the prior.

Corrected Corrected by Oct 17, 2023

Category: ratio. Marked corrected in the state record.

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

The file of facility person #1, a recent hire (see coded LIS sheet), contained a completed disclosure statement, however it was not on the current form.

Corrected Corrected by Oct 17, 2023

Category: recordkeeping. 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.

Sections of the surfacing in the outdoor toddler play space is pulling apart and not secured to the ground and could cause a child to trip and fall.

Corrected Corrected by Oct 17, 2023

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.

A toilet in the restroom by the large preschool/school-age classroom did not have a posted handwashing sign.

Corrected Corrected by Oct 17, 2023

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

3270.123(a) · An agreement shall be signed by the operator and the parent.

The financial agreement of child #3 did not contain the signature of the operator.

Corrected Corrected by Oct 18, 2023

Category: recordkeeping. Marked corrected in the state record.

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

The file of child #5 contained documentation of providing information to the family about the child's growth and development on an approved form dated 5/2022 but did not contain documentation of a current reports in the past 12 months.

Corrected Corrected by Nov 30, 2023

Category: recordkeeping. Marked corrected in the state record.

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

The financial agreement of child #1 did not contain the date of the child's admission.

Corrected Corrected by Oct 17, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.124(b)(3) · Emergency contact information must include the home and work addresses and telephone numbers of the enrolling parent.

The emergency contact form of child #2 did not contain the work address and work telephone number of the enrolling parent.

Corrected Corrected by Oct 24, 2023

Category: recordkeeping. 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 form of child #4 did not include the phone number of one of the release persons designated by the parent to whom the child may be released.

Corrected Corrected by Oct 18, 2023

Category: recordkeeping. 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).

Based on the immunization records, the administered immunizations of child #2 were not accordance with the recommendations of the ACIP and an acceptable exemption was not on file.

Corrected Corrected by Oct 24, 2023

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 health assessments of facility persons #3 and #4 were updated more than 24 months from the prior.

Corrected Corrected by Oct 17, 2023

Category: ratio. 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.

Child #1 sustained injuries to the face, head and elbow on 1/4/2023 and an incident report was not provided to explain the injuries to the child.

Corrected Corrected by Jan 9, 2023

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

3270.94(a)(1) · The Director or designated staff person who is responsible for compliance with this chapter shall conduct fire drills and ensure that fire drills are conducted at least once every 60 days.

Documentation of the last fire drill was dated 11/3/2021, which exceeded 60 days from the day of the on-site visit (1/9/2023).

Corrected Corrected by Jan 13, 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 the annual inspection report of the fire detection system was dated 11/19/2021 and a current report was not present. The facility activated the fire detection system on 1/11/2023 and it was operable at that time.

Corrected Corrected by Jan 11, 2023

Category: recordkeeping. Marked corrected in the state record.

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

The first-aid kit in the Main Activity room was on a storage tote, next to the refrigerator, accessible to children.

Corrected Corrected by Oct 18, 2022

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.

Adult scissors, which can cause a puncture wound, were observed on desks, accessible to children in the Main Activity and Older Preschool 2 classroom.

Corrected Corrected by Oct 18, 2022

Category: health medication. 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). LACKING REQUIRED HIRING DOCUMENTS: Facility Person #1 may not work at the facility. A facility person's record shall include a copy of requests for the criminal history record and child abuse registry clearance information, a copy of the disclosure statement and a copy of the completed clearance information required under the CPSL. Facility Person #1 may not work at the facility.

The file of facility person/volunteer #1 did not contain documentation of submission, or a completed FBI clearance within 45 days of hire (see coded LIS sheet) and had a completed disclosure statement, but it was not the current disclosure statement.

Corrected Corrected by Nov 10, 2022

Category: background checks. 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/volunteer #1 will have until 11/22/2022 to complete the mandated reporter training. Until such time as the required training has been completed, facility person/volunteer #1 must be supervised, when interacting with children, by an (AGS, primary staff person, or family child care home staff person) who has completed the required training related to this citation. If there are no staff person(s) available to supervise facility person/volunteer #1, facility person/volunteer #1 may not work in a child-care position at the facility.

Facility person/volunteer #1 has not completed the mandated reporter training within 90 days of their date of hire (see LIS code sheet). Mandated reporter training of facility person #6 exceeded 60 months but is now current (12/28/2016 and 1/19/2022).

Corrected Corrected by Oct 18, 2022

Category: supervision. Marked corrected in the state record.

3270.66(a) · Cleaning materials and other toxic materials shall be kept in an area or container that is locked or made inaccessible to children.

Cleaning materials and other toxics were accessible to children in the Main Activity room in an unlocked drawer in the teacher desk (hand sanitizer and Frebreze), on the desk hutch (hand sanitizer), on a shelf by the storage room door (Clorox Wipes) and in a cabinet below the sink with a broken child lock (Ajax, Comet, and bleach solution). Liquid White-Out was on a teacher desk in the Older Preschool 2 room accessible to children. Cleaning materials and toxics were labeled "keep out of the reach of children."

Corrected Corrected by Oct 18, 2022

Marked corrected in the state record.

3270.66(c) · Cleaning materials and other toxic materials shall be used in a way that does not contaminate play surfaces, food, food preparation areas and does not constitute a hazard to the children.

Lysol Wipes and Lysol Spray were stored on a shelf directly above diapers/pull-ups in the Preschool Building causing a hazard to children if the product leaks and drips onto the diapers/pull-ups.

Corrected Corrected by Oct 18, 2022

Category: ratio. 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 in the Conference room did not contain an assortment of adhesive bandages.

Corrected Corrected by Oct 18, 2022

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 hallway by the Infant rooms had a cork board which was pulling and tearing from the wall and could be accessed by the children.

Corrected Corrected by Oct 19, 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.

The hallway by the Infant rooms had green paint peeling from the wall.

Corrected Corrected by Oct 19, 2022

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

3270.82(g) · Toilet areas and fixtures shall be cleaned daily and be in good repair.

Toilets in the Preschool building, Younger Preschool room, and Older Toddler room contained bolts protruding from the base of the toilets which could cause a puncture if stepped upon.

Corrected Corrected by Oct 20, 2022

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 the Older Toddler classroom, a play kitchen was missing the water faucet leaving the sharp end of the screw exposed, which was in reach of the children in care.

Corrected Corrected by Oct 18, 2022

Category: physical safety. 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 4:00 pm, a child was observed to come out of the restroom make a right and walk down the hall to the Main Activity room unsupervised as the staff were in the classroom at the time.

Corrected Corrected by Oct 18, 2022

Category: supervision. Marked corrected in the state record.

3270.124(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 emergency contact form of child #1, 3 and 4 did not contain 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 or documentation this is not applicable to the child.

Corrected Corrected by Oct 19, 2022

Category: health medication. 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 form of child #5 did not contain the policy number of the child's health insurance coverage.

Corrected Corrected by Oct 19, 2022

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 form of child #2 and 5 did not contain the addresses and telephone numbers of all the individuals designated by the parent to whom the child may be released.

Corrected Corrected by Oct 19, 2022

Category: recordkeeping. Marked corrected in the state record.

3270.124(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 Older Preschool 1 room did not have a written plan identifying the means of transporting a child to emergency care and staffing provisions in the event of an emergency posted in the classroom.

Corrected Corrected by Oct 18, 2022

Category: transportation. Marked corrected in the state record.

3270.124(f) · 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.

Documentation of the last review and/or update to the emergency contact information of child #1 was dated 3/17/2022, which was more than 6 months ago.

Corrected Corrected by Nov 9, 2022

Category: recordkeeping. Marked corrected in the state record.

3270.151(a)/3270.192(3) · A facility person providing direct care who comes into contact with the children or who works with food preparation shall have a health assessment conducted within 12 months prior to providing initial service in a child care setting and every 24 months thereafter. A health assessment is valid for 24 months following the date of signature, if the person does not contract a communicable disease or develop a medical problem. A facility person's record shall include a written report of initial and subsequent health assessments, including the results of initial and subsequent tuberculin skin tests, x-rays or other medical documentation necessary to confirm freedom from communicable tuberculosis.

The file of facility person #1 did not have a health assessment on file prior to their initial service in the child care setting and facility person #2 contained a current health assessment which was dated more than 24 months from the previous health assessment (6/24/2020 and 7/5/2022).

Corrected Corrected by Nov 4, 2022

Category: ratio. Marked corrected in the state record.

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

The file of facility person #1 did not have 2 written non-family references attesting to their suitability to serve as a facility person.

Corrected Corrected by Nov 9, 2022

Category: recordkeeping. Marked corrected in the state record.

3270.94(a)(1) · The Director or designated staff person who is responsible for compliance with this chapter shall conduct fire drills and ensure that fire drills are conducted at least once every 60 days.

The fire drill log documented a fire drill was conducted on 6/16/2022 with the next on 8/22/2022, exceeding 60 days.

Corrected Corrected by Oct 18, 2022

Category: recordkeeping. Marked corrected in the state record.

3270.31(e)/3270.192(2)(iii) · A staff person shall obtain an annual minimum of 12 clock hours of child care 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 files of facility person #3, 4 and 5, all hired prior to 12/19/2020, did not have documentation of 12 annual training hours dated between 12/19/2020 and 12/19/2021. Facility person #3: 6 hours between 12/19/2020 and 12/19/2021, 1 hour 1/25/2022, 1 hour 1/26/2022, 3 hours 5/11/2022 and 1 hour 7/23/2022. Facility person #4: 10 hours between 12/19/2020 and 12/19/2021 and 2 hours 1/2/2022. Facility person #5: 9 hours between 12/19/2020 and 12/19/2021, 1 hour 1/25/2022 and 2 hours 7/7/2022. Facilty person #3, 4 and 5 are now current with annual training hours.

Corrected Corrected by Oct 18, 2022

Category: recordkeeping. Marked corrected in the state record.

3270.131(a)/3270.182(1) · The operator shall require the parent of an enrolled child, including a child, a foster child and a relative of an operator or a facility person, to provide an initial health report no later than 60 days following the first day of attendance at the facility. A child's record shall contain initial and subsequent health reports.

The file of child #3, who has been enrolled for more than 60 days (see coded LIS sheet), did not contain an initial health assessment.

Corrected Corrected by Nov 4, 2022

Category: health medication. 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.

Staff stated that an accident/injury report was not completed on 3/23/22, when they found out about a child hitting another child.

Corrected Corrected by Apr 5, 2022

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

3270.27(a)(3) · The facility shall have an emergency plan that provides for a method for facility persons to contact parents as soon as reasonably possible when an emergency situation arises.

Facility lacked an emergency plan that provides for a method for facility persons to contact parents as soon as reasonably possible when an emergency situation arises.

Corrected Corrected by Oct 19, 2021

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

3270.27(a)(4) · The facility shall have an emergency plan that provides for a method for facility persons to inform parents that the emergency has ended and to provide instruction as to how parents can safely be reunited with their children.

Facility lacked an emergency plan that provides for a method for facility persons to inform parents that the emergency has ended and to provide instruction as to how parents can safely be reunited with their children.

Corrected Corrected by Oct 19, 2021

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

3270.27(c) · The operator shall assure that each facility person receives training regarding the emergency plan at the time of initial employment, on an annual basis and at the time of each plan update. The operator shall document the date of each training and the names of all facility persons who received the training and kept on file at the facility.

The file for facility person #1, with a start date of 8/9/21, completed emergency plan training on 8/23/21, which is not at initial hire.

Corrected Corrected by Oct 19, 2021

Category: recordkeeping. Marked corrected in the state record.

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

The bike room lacked a first-aid kit.

Corrected Corrected by Oct 19, 2021

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 the conference room, it was observed the wall behind the shelves, the plaster and paint were peeling.

Corrected Corrected by Oct 19, 2021

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.

It was observed in the Pre-k classroom that 1 toilet in the boys and girls bathroom was missing a handwashing sign.

Corrected Corrected by Oct 19, 2021

Category: health medication. 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.

In the Pre-k classroom, it was observed the doors at the end of the classroom were blocked by a chair and boxes.

Corrected Corrected by Oct 19, 2021

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.

It was observed in the younger preschool playground, that rocks on the Step 2 climbing wall were cracked along the tops and the Step 2 bridge was cracked exposing the children to pinch points. In the fenced in playground, it was observed that the oven door on the play kitchen was broken off, having sharp edges exposed. The Little Tikes picnic table had holes on each corner on the benches and was cracked along the bench edges, causing it to have pinch points.

Corrected Corrected by Oct 19, 2021

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 room off of the preschool room and the bike room lacked a daily activities schedule.

Corrected Corrected by Oct 19, 2021

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

3270.124(b)(3) · Emergency contact information must include the home and work addresses and telephone numbers of the enrolling parent.

The emergency contact form for child #1, #2, and #3 lacked the enrolling parent's work phone number. The emergency contact form for child #3 lacked the enrolling parent's work address.

Corrected Corrected by Oct 28, 2021

Category: recordkeeping. 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 form for child #3 lacked the release person's address.

Corrected Corrected by Oct 28, 2021

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 room off of the preschool room and the bike room lacked emergency contact forms.

Corrected Corrected by Oct 19, 2021

Category: recordkeeping. Marked corrected in the state record.

3270.124(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 room off of the preschool room and the bike room lacked the emergency transportation plan.

Corrected Corrected by Oct 19, 2021

Category: transportation. Marked corrected in the state record.

3270.131(d)(5) · A health report shall include a review of the child's immunized status according to recommendations of the ACIP.

The immunization record for child #4 lacked DTAP, Influenza, and Hepatitis A in accordance with the ACIP.

Corrected Corrected by Nov 5, 2021

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.

It was observed in the older preschool room that prescription Auvi-Q was present with no instructions from the individual who prescribed the medicine.

Corrected Corrected by Nov 4, 2021

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.

Facility lacked proof of purchase of the inter-connected smoke alarms.

Corrected Corrected by Nov 19, 2021

Category: recordkeeping. Marked corrected in the state record.