3270.31(e)(4)(ii)/3270.192(2)(iii) · 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. A facility person's record shall include verification of child care experience, education and training following the outset of service at the facility.

The file of facility person #4, who has been volunteering at the facility for more than a year (see coded LIS sheet), did not contain documentation of fire safety training.

Corrected Corrected by Nov 11, 2024

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 Classroom 212, where older toddlers were receiving care, 4 magic eraser sponges were in a drawer under the microwave, the sand/water table contained foam blocks (a few with teeth marks) and on a shelf, crayons and markers with the caps, which were less than an inch in diameter, were all accessible to children still placing objects in their mouths.

Corrected Corrected by Oct 29, 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 Ounce Assessments to provide information to the family about the child's growth and development were dated 11/2023 and 10/2024, more than 6 months apart for child #1.

Corrected Corrected by Oct 29, 2024

Category: recordkeeping. 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 health assessment if child #2, identified as a preschool age child (see LIS code sheet), contained a health assessment dated 2/22/2023 and an updated health assessment dated 3/14/2024, exceeding 12 months.

Corrected Corrected by Oct 29, 2024

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

3270.151(c)(1) · An adult health assessment must include a physical examination.

The health assessment of staff #3 was not clear if a physical examination was conducted as looked as if both the "yes" and "no" boxes were marked on the health assessment form.

Corrected Corrected by Nov 30, 2024

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

3270.151(c)(4) · An adult health assessment must include information on medical problems that might threaten the health of the children or prohibit a staff person from providing adequate care to children.

The health assessment of staff #3 did not include information that the staff person was suitable to provide childcare.

Corrected Corrected by Nov 30, 2024

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 conducted was dated 8/29/2024, more than 60 days prior to the date of the inspection.

Corrected Corrected by Nov 15, 2024

Category: recordkeeping. Marked corrected in the state record.

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

The evacuation time was not listed on the fire drill log for the fire drill conducted on 8/29/2024.

Corrected Corrected by Nov 15, 2024

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 file of staff #1, with an annual training year of 12/2022 to 12/2023, contained 11.5 hours of training lacking .5 hours. Staff #1 is now in compliance with an additional 1 hour of training taken on 4/8/2024. The file of staff #2, with an annual training year of 12/2022 to 12/2023, contained 6.5 hour of training lacking 5.5 hours. Staff #2 is now in compliance with an additional 4 hours taken on 1/19/2024 and 5 hours taken on 6/18/2024.

Corrected Corrected by Oct 29, 2024

Category: recordkeeping. 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.

It was self-reported by the facility and confirmed thru investigation that Child #1, who has a known allergy, was inadvertently given a cupcake containing the known allergen during a classroom celebration. Child #1 had a bite or two of the cupcake before staff realized it contained the known allergen. Child #1 experienced an allergic reaction due to the ingestion of the known allergen that required the injection of an EPIPEN.

Corrected Corrected by Aug 2, 2024

Category: ratio. Marked corrected in the state record.

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

Documentation of fire safety training for facility person #3 was dated 4/18/2022 and updated on 5/2/2023 exceeding 12 months.

Corrected Corrected by Oct 23, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.32(a) · The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). Facility Person # 4 may not work at the facility.

The file of facility person #1 contained a disclosure statement which did not contain a witness signature. The file of facility person #4 contained a PA state police which expired 9/18/2023 and documentation of a PA state police clearance "pending" results dated 1/5/2023.

Corrected Corrected by Oct 24, 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 annual evaluations of facility person #2 were dated 10/22/2020 and 1/30/2023, which exceeded 12 months.

Corrected Corrected by Oct 23, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.123(a)(4) · An agreement shall specify the child's arrival and departure times.

The financial agreement of child #1 did not contain the arrival and departure times of the child.

Corrected Corrected by Oct 23, 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).

The immunization record of child #2 did not contain documentation of a current influenza vaccination as recommended by the ACIP or documentation of an acceptable exemption.

Corrected Corrected by Oct 25, 2023

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 #2 and 3 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 staff person #2 and 3, staff person #2 and 3 may not work in a child-care position at the facility.

Staff person #2 and 3 were observed to be caring for children unsupervised. Staff person #2 and 3 had not completed the following pre-service training required prior to caring for children unsupervised: Health and Safety Topics were completed prior to 9/30/2016.

Corrected Corrected by Oct 17, 2022

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.

Adult scissors, which could cause laceration or puncture injury, were accessible to children in the craft box in Room 209 and in an unlocked drawer in the teacher's desk and unlocked cabinet in Room 224.

Corrected Corrected by Oct 14, 2022

Category: ratio. Marked corrected in the state record.

3270.31(f) · Staff person(s) shall complete professional development in the topics of 3270.31(f)(1 -- 10) within 90 days of hire. Staff person #2, 3 and 4 will have until 11/11/2022 (actual date-15 days from POC requested date) to complete the required training. Until such time as the required training has been completed, staff person #2, 3 and 4 must be supervised, when interacting with children, by an AGS, primary staff person who has completed the required training related to this citation. If there are no staff available to supervise staff person #2, 3 and 4, staff person #2, 3 and 4 may not work in a child-care position at the facility.

Staff person #2, 3 and 4 had not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): Health and Safety Topics were taken before 9/30/2016

Corrected Corrected by Oct 19, 2022

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 #1 completed the health and safety topics more than the 180 days from 12/19/2020 (dated 4/27/2022) based on their start date (see LIS code sheet).

Corrected Corrected by Oct 14, 2022

Category: health medication. 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 most current written staff evaluation by the director for staff #1 was dated 7/2020 and #7 was dated 10/2020, which was more than 12 months ago and the evaluations of staff #2, 3, 4 and 6 exceeded 12 months being competed in 10/2020 and 1/2022.

Corrected Corrected by Nov 30, 2022

Category: recordkeeping. Marked corrected in the state record.

3270.65 · Protective receptacle covers shall be placed in electrical outlets accessible to children 5 years of age or younger.

An electrical outlet accessible to children under the age of 5, did not have a protective cover in Room 117.

Corrected Corrected by Oct 14, 2022

Marked corrected in the state record.

3270.81 · A visual strip or other visual identification shall be placed on glass located in a traffic area, a child care space or a play space.

The 2 bottom windows to the hallway from Room 201, an infant room, did not contain visual strips.

Corrected Corrected by Oct 17, 2022

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.

A red Lego baseplate had a broken corner exposing rough edges in Room 224.

Corrected Corrected by Oct 14, 2022

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.

Foam peg boards in Room 116 (young and older toddler classroom) were accessible to children still placing objects in their mouths which was evidenced by teeth marks.

Corrected Corrected by Oct 14, 2022

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 their admission date.

Corrected Corrected by Oct 17, 2022

Category: recordkeeping. Marked corrected in the state record.

3270.124(b)(2) · Emergency contact information must include the name, address and telephone number of the child's physician or source of medical care.

The emergency contact form of child #1 did not contain the telephone of the child's physician or source of medical care.

Corrected Corrected by Oct 17, 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 information of child #1 did not contain the addresses and telephone numbers of 2 release persons listed.

Corrected Corrected by Oct 17, 2022

Category: recordkeeping. 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 health assessment of facility person #5 does not include an examination for communicable diseases and the results of that examination.

Corrected Corrected by Oct 31, 2022

Category: health medication. 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 file of staff person #3, hired prior to 12/19/2020 (see coded LIS sheet), contained 7.5 training hours between 12/19/2020 and 12/19/2021 and 4 additional hours dated 2/10/2022. The file of staff person #4, hired prior to 12/19/2020 (see coded LIS sheet), contained 9.5 training hours between 12/19/2020 and 12/19/2021 and 4 additional hours dated 1/11/2022. The file of staff person #6 hired prior to 12/19/2020 (see coded LIS sheet), contained 5 training hours between 12/19/2020 and 12/19/2021 and 4 additional hours dated 1/3/2022, 2 hours dated 1/5/2022 and 1 hour dated 1/6/2022.

Corrected Corrected by Oct 17, 2022

Category: recordkeeping. 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.

An injury report was not provided to the parent of child #1 on 4/22/2022, the day the child fell, and was injured at the facility.

Corrected Corrected by Apr 29, 2022

Category: health medication. 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.

The upstairs boys' bathroom was observed to lack a lidded waste receptacle.

Corrected Corrected by Oct 21, 2021

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

3270.27(c)/3270.192(2)(iii) · The operator shall assure that each facility person receives training regarding the emergency plan at the time of initial employment, on an annual basis and at the time of each plan update. The operator shall document the date of each training and the names of all facility persons who received the training and kept on file at the facility. A facility person's record shall include verification of child care experience, education and training following the outset of service at the facility.

The file for Staff #3 contained documentation of consecutive emergency plan training conducted more than 12 months apart.

Corrected Corrected by Nov 2, 2021

Category: recordkeeping. Marked corrected in the state record.

3270.32(a)/3270.192(4) · The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services).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 #4 and Staff #5 existing volunteers whom were on leave from 3/13/20 - 7/26/21, contained documentation of NSOR clearances dated 7/29/21.The file for Staff #6, an existing facility person, contained documentation of NSOR clearance dated 7/2/20.

Corrected Corrected by Nov 2, 2021

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 file for Staff #1 contained documentation of consecutive staff evaluations completed more than 12 months apart. The files for Staff #2 and #3 contained most recent staff evaluations dated more than 12 months ago.

Corrected Corrected by Dec 1, 2021

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.

Toxic paint and hand sanitizer were observed to be accessible to children on a table in Room B-9.

Corrected Corrected by Oct 21, 2021

Marked corrected in the state record.

3270.124(b)(2) · Emergency contact information must include the name, address and telephone number of the child's physician or source of medical care.

The file for Child #1 contained an emergency contact form which lacked the telephone number of the child's medical provider.

Corrected Corrected by Oct 21, 2021

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 file for Staff #1 contained documentation of consecutive health assessments dated more than 24 months apart.

Corrected Corrected by Nov 2, 2021

Category: ratio. Marked corrected in the state record.

3270.165 · An operator shall conspicuously post the menu at least 1 week in advance or provide a menu to each family.

The observed posted menu contained menu items for the current week, yet lacked a menu for 1 week in advance.

Corrected Corrected by Dec 1, 2021

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.

Proof of purchase for the interconnected fire detection system was unavailable at the time of inspection.

Corrected Corrected by Jan 1, 2022

Category: recordkeeping. Marked corrected in the state record.