3280.26(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 operator's letter provided to the parent of each enrolled child explaining the emergency procedures lacked the accommodations for toddlers.

Corrected Corrected by Sep 13, 2024

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

3280.69(a) · Hot water temperature, in areas accessible to children, may not exceed 110° F.

The water temperature at the sink in the kitchen was 150° F. According to staff, the sink in the kitchen is used by the children to wash their hands.

Corrected Corrected by Jul 30, 2024

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

3280.123(a)(3) · An agreement shall specify the services to be provided to the family and the child, including the Department's approved form to provide information to the family about the child's growth and development in the context of the services being provided. The operator shall complete and update the form and provide a copy to the family in accordance with the updates regarding emergency contact information at § 3280.124(f).

The file for child #2 lacked a current child service report updated within the last 6 months.

Corrected Corrected by Aug 5, 2024

Category: recordkeeping. Marked corrected in the state record.

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

The file for child #5 had an emergency contact form that lacked the health insurance policy number.

Corrected Corrected by Jul 30, 2024

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

3280.124(b)(7) · Emergency contact information must include the name, address and telephone number of the individual designated by the parent to whom the child may be released.

The file for child #4 had an emergency contact form that lacked the address of the individual designated by the parent to whom the child may be released.

Corrected Corrected by Aug 20, 2024

Category: recordkeeping. Marked corrected in the state record.

3280.131(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 file for child #2, a preschooler, lacked a current health assessment updated within the last 12 months. The file for child #1, a preschooler, had a health assessment that exceeded 12 months between assessments.

Corrected Corrected by Aug 12, 2024

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

3280.131(d)(5)/3280.131(e)(3) · A health report shall include a review of the child's immunized status according to recommendations of the ACIP. The facility shall implement dismissal policies in accordance with the Department of Health regulation in 28 Pa. Code § 27.77 (relating to immunization requirements for children in child care group settings). Child #2 must be dismissed from care by close of business on 7-30-24 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 #2, a 3 year old enrolled more than 60 days at the facility, lacked documentation of the 4th DTAP vaccination and 2nd Hepatitis A vaccination being administered in accordance with the schedule recommended by the ACIP and lacked exemption documentation.

Corrected Corrected by Aug 12, 2024

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

3280.131(e) · The facility may not accept or retain an infant 2 months of age or older, a toddler or a preschool child at the facility for more than 60 days following the first day of attendance at the facility unless the parent provides written verification from a physician, physician's assistant, CRNP, the Department of Health or a local health department of the dates (month, day and year) the child was administered immunizations in accordance with the recommendations of the ACIP. Child #3 must be dismissed from care by close of business on 7-30-24 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 #3 lacked an immunization record within 60 days of the child's first day of attendance at the facility and requires a current immunization record.

Corrected Corrected by Jul 30, 2024

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

3280.161(c) · Potentially hazardous food brought from the child's home or provided by the facility shall be refrigerated.

In the kitchen, a child's lunchbox was observed on the counter containing chicken nuggets that were not refrigerated.

Corrected Corrected by Jul 30, 2024

Category: nutrition. Marked corrected in the state record.

3280.26(a)(6) · Emergency drills shall be conducted annually. Annual emergency drills shall be documented and on file at the facility.

The current emergency drill log lacked the following requirements: Time to complete the drill, special accommodations the facility used, and problems that were encountered/observations during the drill.

Corrected Corrected by Sep 13, 2024

Category: recordkeeping. Marked corrected in the state record.

3280.94(a)(1) · The primary staff person or designated staff person who is responsible for compliance with this chapter shall conduct fire drills and ensure that fire drills are conducted at least once every 60 days.

According to the fire drill log, a fire drill was not conducted at least once every 60 days between 6-8-24 to 11-30-24.

Corrected Corrected by Jul 30, 2024

Category: recordkeeping. Marked corrected in the state record.

3280.95(a)/3280.95(b) · Fire detection devices or systems must be in compliance with standards established under section 1016(c) of the act (62 P.S. §  1016(c)). The primary staff person or designated staff person who is responsible for compliance with this chapter shall ensure the requirements in subsection (a) are met.

According to the log, the operator did not manually test the interconnected smoke alarms in the facility at least once every 30 days between 7-24-23 to 11-24-23.

Corrected Corrected by Jul 30, 2024

Category: recordkeeping. Marked corrected in the state record.

3280.108(a) · Furniture must be durable, safe, easily cleaned and appropriate for the child's size, age and special needs.

In the nursery there was a rocking chair without a seat cushion making the springs of the chair exposed.

Corrected Corrected by Aug 21, 2023

Marked corrected in the state record.

3280.14/3280.21 · 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. The operator shall establish oral or written communication in the language or mode of communication which is understandable to the parent.

The file for Staff person #1, #2, and #3 did not contain the PA Health and Safety 2022 1 hour update which was to be completed by 12-30-22.

Corrected Corrected by Aug 14, 2023

Category: ratio. Marked corrected in the state record.

3280.31(e) · A staff person shall obtain an annual 12 clock hours of child care training.

The file for Staff person #1 includes 6 hours of training from 12-19-21 to 12-19-22, the file for Staff person #2 includes 6 hours of training from 12-19-21 to 12-19-22, and the file for Staff person #3 includes 4 hours of training from 12-19-21 to 12-19-22.

Corrected Corrected by Aug 3, 2023

Category: recordkeeping. Marked corrected in the state record.

3280.31(e)(4)(i) · Competence is the completion of training by a professional in the field of first-aid and CPR. All staff persons shall renew their certification in pediatric first-aid and pediatric cardiopulmonary resuscitation (CPR) on or before the expiration of the most current certification.

Staff person #1,staff person #2, and staff person #3 have acceptable pediatric first aid/CPR training in an approved curriculum dated 2-25-23; however, the trainer has not provided documentation that they are PQAS-certified in that training topic.

Corrected Corrected by Aug 3, 2023

Category: ratio. Marked corrected in the state record.

3280.33(c) · One or more facility persons competent in pediatric first aid and pediatric cardiopulmonary resuscitation techniques shall be at the facility when one or more children are in care.

It was observed that no current staff at the facility has a valid pediatric CPR and first aid certificate by an approved trainer.

Corrected Corrected by Aug 3, 2023

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

3280.52(b) · 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 12; Young toddlers 1:5 with a maximum group size of 12; Older toddlers 1:6 with a maximum group size of 12; Preschool children 1:10 with a maximum group size of 12; Young school-age children 1:12 with a maximum group size of 12; Older school-age children 1:15 with a maximum group size of 15. IF USING TIERED LIS: The required staff:child ratios must be maintained at all times. The legal entity must submit documentation in a format approved by DHS proving that the facility is maintaining the required staff:child ratios at all times. The legal entity will confirm continuing compliance by sending copies of the documentation to the -------- Region Office on a weekly basis for a period of three months after DHS approves the documentation format.

At approximately 3:02PM Staff person #1 left the room to set off the smoke detection system leaving staff person #2 alone in the sleeping room with 5 children, with the youngest child being an infant.

Corrected Corrected by Aug 3, 2023

Category: ratio. Marked corrected in the state record.

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

There was diaper cream in the drawer of the diaper changing table in the bathroom that was accessible to the children.

Corrected Corrected by Jul 19, 2023

Category: ratio. Marked corrected in the state record.

3280.67(d)/3280.135(a)(3) · Trash that has been contaminated by human secretions or excrement shall be contained in closed, plastic-lined receptacles. 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.

It was observed in the bathroom that there was a bag of garbage that had soiled diapers on the floor next to the handsfree garbage can.

Corrected Corrected by Jul 19, 2023

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

3280.76 · Floors, walls, ceilings and other surfaces, including the facility's outdoor play space surfaces shall be kept clean, in good repair and free from visible hazards.

On the ceiling in the corner of the nursey there is a ceiling tile that has brown spots and is bulging down in the middle.

Corrected Corrected by Jul 31, 2023

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

3280.103 · 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.

There are foam peg boards with teeth marks and chunks missing in the miscellaneous toy room.

Corrected Corrected by Aug 3, 2023

Marked corrected in the state record.

3280.123(a)(3) · An agreement shall specify the services to be provided to the family and the child, including the Department's approved form to provide information to the family about the child's growth and development in the context of the services being provided. The operator shall complete and update the form and provide a copy to the family in accordance with the updates regarding emergency contact information at § 3280.124(f).

The most recent child service report on file for Child #3 is dated 11-28-22 which is greater than a 6 month period.

Corrected Corrected by Sep 29, 2023

Category: recordkeeping. Marked corrected in the state record.

3280.124(b)(1) · Emergency contact information must include the name and birth date of the child.

The emergency contact information for Child #2 has an incorrect date of birth listed.

Corrected Corrected by Sep 29, 2023

Category: recordkeeping. Marked corrected in the state record.

3280.124(b)(5) · Emergency contact information must include information on the child's special needs, as specified by the child's parent, physician, physician's assistant or CRNP, which is needed in an emergency situation.

The emergency contact form for Child #3 is lacking information on the child's special needs which is needed in an emergency situation.

Corrected Corrected by Sep 29, 2023

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

3280.131(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 file for Child #1 contained an initial health assessment dated 9-28-21 with an updated health assessment of 7-5-22, the child is still a young toddler. The file for Child #2 contains a most recent health assessment of 10-3-22, the child is a young toddler.

Corrected Corrected by Sep 29, 2023

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

3280.131(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 most recent health assessment for Child #1 is dated 7-5-22.

Corrected Corrected by Sep 29, 2023

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

3280.131(d)(4)/3280.131(d)(8) · A health report shall include an assessment of an acute or chronic health problem or special need and recommendations for treatment or services, including information regarding abnormal results of screening tests for vision, hearing or lead poisoning. 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 health assessment for Child #1 states that the child is not up to date on age appropriate screenings for vision, hearing and lead poisoning.

Corrected Corrected by Sep 29, 2023

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

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

It was observed that the children did not wash their hands before their afternoon snack.

Corrected Corrected by Jul 19, 2023

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

3280.151(c)(3) · An adult health assessment must include an examination for communicable diseases and the results of that examination.

The most recent health assessment for Staff #1 dated 8-31-22 states that the provider does not know if the person has a communicable disease.

Corrected Corrected by Sep 29, 2023

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

3280.181(c) · A parent is required to review and update the emergency contact information and the financial agreement at least once in a 6-month period or as soon as there is a change in the information.

The emergency contact and fee agreement for Child #3 was most recently updated on 11-27-22 which is greater than a 6 month period.

Corrected Corrected by Sep 29, 2023

Category: recordkeeping. Marked corrected in the state record.

3280.166(7) · Neither bottled formula nor human milk may be heated in a microwave.

It was observed that Staff person #2 heated a bottle of formula in a microwave.

Corrected Corrected by Jul 19, 2023

Category: nutrition. Marked corrected in the state record.

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

The facility's emergency plan was not updated by 7/1/22 to include volunteer emergency preparedness, training, drills, and continuity of operations.

Corrected Corrected by Oct 24, 2022

Category: ratio. Marked corrected in the state record.

3280.62(c) · Outdoor or indoor play space shall be safe for large muscle activity.

Observed several folding tables and chairs in the indoor gross motor space where the children were engaged in gross motor activity.

Corrected Corrected by Oct 21, 2022

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

3280.103 · 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.

Observed three small play figures with a diameter less than one inch in the Circle Time room where 1-year-old children were receiving care.

Corrected Corrected by Oct 21, 2022

Marked corrected in the state record.

3280.123(a)(3) · An agreement shall specify the services to be provided to the family and the child, including the Department's approved form to provide information to the family about the child's growth and development in the context of the services being provided. The operator shall complete and update the form and provide a copy to the family in accordance with the updates regarding emergency contact information at § 3280.124(f).

The agreement on file for child #3 lacks the services provided to the family and the child.

Corrected Corrected by Oct 24, 2022

Category: recordkeeping. Marked corrected in the state record.

3280.124(b)(7) · Emergency contact information must include the name, address and telephone number of the individual designated by the parent to whom the child may be released.

The file for child #1 and child #2 contains emergency contact information which lacks the complete address of the parent-designated release person(s).

Corrected Corrected by Oct 24, 2022

Category: recordkeeping. Marked corrected in the state record.

3280.131(a)/3280.131(e) · 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 facility may not accept or retain an infant 2 months of age or older, a toddler or a preschool child at the facility for more than 60 days following the first day of attendance at the facility unless the parent provides written verification from a physician, physician's assistant, CRNP, the Department of Health or a local health department of the dates (month, day and year) the child was administered immunizations in accordance with the recommendations of the ACIP.

The initial health report and immunization record on file for child #1 are dated more than 60 days following the child's first day of attendance at the facility.

Corrected Corrected by Oct 21, 2022

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

3280.52(c) · When children are grouped in mixed age levels, the age of the youngest child in the group determines the staff:child ratio and maximum group size in accordance with the requirements at §3280.52(b).

On 7/18/22 at approximately 11:07 a.m., observed staff person #1 supervising a group consisting of two young toddlers, one older toddler, and one preschooler who were at the bottom of the hallways steps, entering the multi-purpose room. Child #1 was observed exiting the bathroom which is located at the far end of the hall, creating a 0:1 staff:child ratio.

Corrected Corrected by Sep 22, 2022

Category: supervision. Marked corrected in the state record.

3280.113(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.

On 7/18/22 at approximately 11:07 a.m., observed staff person #1 supervising a group consisting of two young toddlers, one older toddler, and one preschooler who entering the multi-purpose room. Child #1 was observed exiting the bathroom which is located at the far end of the hall. Based on the location of child #1 and staff person #1, child #1 was not able to be supervised.

Corrected Corrected by Sep 22, 2022

Category: supervision. Marked corrected in the state record.

3280.52(b) · 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 12; Young toddlers 1:5 with a maximum group size of 12; Older toddlers 1:6 with a maximum group size of 12; Preschool children 1:10 with a maximum group size of 12; Young school-age children 1:12 with a maximum group size of 12; Older school-age children 1:15 with a maximum group size of 15.

On 3/31/22, at approximately 12:00 PM, observed an infant alone in the gross motor room with no staff present. Staff #1 stated that she forgot about the infant as she was getting the children's lunchboxes ready and had her other children in the kitchen. Staff #1 stated that she left the infant alone in the gross motor room for approximately 15 minutes from 11:45 AM to 12:00 PM. Ratio: 0:1. Second citation, previously cited on 2-9-22.

Corrected Corrected by Mar 31, 2022

Category: ratio. Marked corrected in the state record.

3280.52(b) · *** The required staff:child ratios must be maintained at all times. The legal entity must submit documentation in a format approved by OCDEL proving that the facility is maintaining the required staff:child ratios at all times. The legal entity will confirm continuing compliance by sending copies of the documentation to OCDEL on a weekly basis for a period of three months,

On 3/31/22, at approximately 12:00 PM, observed an infant alone in the gross motor room with no staff present. Staff #1 stated that she forgot about the infant as she was getting the children's lunchboxes ready and had her other children in the kitchen. Staff #1 stated that she left the infant alone in the gross motor room for approximately 15 minutes from 11:45 AM to 12:00 PM. Ratio: 0:1.

Corrected Corrected by Jul 19, 2022

Category: ratio. Marked corrected in the state record.

3280.52(c) · When children are grouped in mixed age levels, the age of the youngest child in the group determines the staff:child ratio and maximum group size in accordance with the requirements at §3280.52(b).

On 3/31/22, at approximately 11:55 AM, observed staff #1 alone in the kitchen with 5 young toddlers, 3 preschool age children and 1 older toddler. Staff #1 named all of the children in her supervisory group. Approximately 2 minutes later, staff #2 came into the kitchen with an infant and named the infant as the child in her supervisory group.

Corrected Corrected by Apr 5, 2022

Category: supervision. Marked corrected in the state record.

3280.113(a) · **All staff persons at the facility will be required to attend an OCDEL approved on-site training regarding ratio and supervision of children conducted by an Early Learning Resource Center representative. Proof of this training for all current staff will be submitted to the regional office.

On 3/31/22, at approximately 12:00 PM, observed an infant alone in the gross motor room with no staff present. Staff #1 stated that she forgot about the infant as she was getting the children's lunchboxes ready and had her other children in the kitchen. Staff #1 stated that she left the infant alone in the gross motor room for approximately 15 minutes from 11:45 AM to 12:00 PM

Corrected Corrected by May 1, 2022

Category: supervision. Marked corrected in the state record.

3280.113(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.

On 3/31/22, at approximately 12:00 PM, observed an infant alone in the gross motor room with no staff present. Staff #1 stated that she forgot about the infant as she was getting the children's lunchboxes ready and had her other children in the kitchen. Staff #1 stated that she left the infant alone in the gross motor room for approximately 15 minutes from 11:45 AM to 12:00 PM. Second citation, previously cited on 2-9-22"

Corrected Corrected by Mar 31, 2022

Category: supervision. Marked corrected in the state record.

3280.113(a)(1) · *** The facility is required to maintain identification tags for identifying the specific children for which each staff person is responsible. These will include, minimally, the name, birthday and age of the child. Staff will use this identification method appropriately at all times while on duty at the facility. When a new child enrolls at the facility, an identification tag will be present at the facility before the child's first day of attendance.

On 3/31/22, at approximately 12:00 PM, observed an infant alone in the gross motor room with no staff present. Staff #1 stated that she forgot about the infant as she was getting the children's lunchboxes ready and had her other children in the kitchen. Staff #1 stated that she left the infant alone in the gross motor room for approximately 15 minutes from 11:45 AM to 12:00 PM

Corrected Corrected by May 16, 2022

Category: recordkeeping. Marked corrected in the state record.

3280.113(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.

On 3/31/22, at approximately 12:00 PM, observed an infant alone in the gross motor room with no staff present. Staff #1 stated that she forgot about the infant as she was getting the children's lunchboxes ready and had her other children in the kitchen. Staff #1 stated that she left the infant alone in the gross motor room for approximately 15 minutes from 11:45 AM to 12:00 PM

Corrected Corrected by Mar 31, 2022

Category: supervision. Marked corrected in the state record.

3280.123(a)(4) · An agreement shall specify the child's arrival and departure times.

The fee agreement on file for child #1 lacked the child's arrival and departure times.

Corrected Corrected by Mar 31, 2022

Category: recordkeeping. Marked corrected in the state record.

3280.26(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.

When the emergency plan was updated in 2021, the operator did not provide the parent of each enrolled child a letter explaining updates to the plan.

Corrected Corrected by Mar 31, 2022

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

3280.26(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.

When the emergency plan was updated in 2021, the operator did not send the update to the plan to the local municipality.

Corrected Corrected by Mar 31, 2022

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

3280.31(e)/3280.192(2)(iii) · A staff person shall obtain an annual 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 for staff #1 lacked 3 of the required annual 12 hours of child care training. The file for staff #2 lacked 6 of the required annual 12 hours of child care training.

Corrected Corrected by Feb 11, 2022

Category: recordkeeping. Marked corrected in the state record.

3280.52(b) · 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 12; Young toddlers 1:5 with a maximum group size of 12; Older toddlers 1:6 with a maximum group size of 12; Preschool children 1:10 with a maximum group size of 12; Young school-age children 1:12 with a maximum group size of 12; Older school-age children 1:15 with a maximum group size of 15.

On 2/9/22, at approximately 10:30 AM, observed staff #1 leave the infant room, where two infant room were present, and walk into the hallway and then into the office and throw something away. This left 2 infants alone in the infant room and ratio was 0:2. for approximately one minute.

Corrected Corrected by Feb 11, 2022

Category: ratio. Marked corrected in the state record.

3280.61(c) · Indoor child care space is measured within permanent stationary partitions or walls. The allowable number of children in a space is determined by dividing the total square feet in a space by 40.

On 2/9/22, observed 8 children in the Circle Room which has a capacity of 5.

Corrected Corrected by Feb 9, 2022

Category: ratio. Marked corrected in the state record.

3280.74 · The telephone number of the nearest hospital, police department, fire department, ambulance and poison control center shall be posted by each telephone in the facility.

In the Circle Room, observed that the telephone number of the nearest hospital, police department, fire department, ambulance and poison control center was not posted by the telephone.

Corrected Corrected by Feb 9, 2022

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

3280.77(a) · Peeled or damaged paint or damaged plaster is not permitted on indoor or outdoor surfaces in the child care facility.

In a corner of the Nursery bathroom, observed an area of chipping paint and plaster.

Corrected Corrected by Mar 31, 2022

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

3280.106 · 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.

The refrigerator in the sleeping room, lacked an operating thermometer.

Corrected Corrected by Mar 31, 2022

Category: nutrition. Marked corrected in the state record.

3280.113(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.

On 2/9/22, at approximately 10:30 AM, observed staff #1 leave the infant room, where two infants were present, and walk into the hallway and then into the office and throw something away. This left 2 infants alone in the infant room unsupervised for approximately 1 minute.

Corrected Corrected by Feb 9, 2022

Category: supervision. Marked corrected in the state record.

3280.123(a)(1)/3280.123(a)(2) · An agreement shall specify the amount of the fee to be charged per day or per week. An agreement shall specify the date on which the fee is to be paid.

The fee agreement on file for child #1 lacked the amount of fee to be charged per day or week and the date on which the fee is to be paid.

Corrected Corrected by Mar 31, 2022

Category: recordkeeping. Marked corrected in the state record.

3280.123(b)/3280.182(8) · A parent shall receive the original agreement. The facility shall retain a copy of the agreement.A child's record must contain a copy of the initial agreement and subsequent written agreements between the parent and the operator. The parent receives the original agreement.

The original fee agreements on file for children #1, 2, 3, 4 and 5 were not provided to the parent as the original fee agreements were observed in the children's files.

Corrected Corrected by Mar 31, 2022

Category: recordkeeping. Marked corrected in the state record.

3280.131(e)(1) · The facility shall require the parent to provide updated written verification from a physician, physician's assistant, CRNP, the Department of Health or a local health department of ongoing vaccines administered to an infant, toddler or preschool child in accordance with the schedule recommended by the ACIP.

The immunization record on file for child #2 contained verification that the child received 3 of the 4 recommended DTAP immunizations as in accordance with the schedule recommended by the ACIP.

Corrected Corrected by Mar 31, 2022

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

3280.133(5) · Medication shall be stored in accordance with the manufacturer's or health professional's instructions on the original label.

In the Circle Room, observed A and D ointment which expired 7/2012.

Corrected Corrected by Feb 9, 2022

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

3280.151(c)(2)/3280.192(3) · An adult health assessment must include tuberculosis screening by the Mantoux method at initial employment. Subsequent tuberculosis screening is not required unless directed by a physician, physician's assistant, CRNP, the Department of Health or a local health department.A facility person's record shall include a written report of initial and subsequent health assessments, including the results of initial and subsequent tuberculin skin tests, x-rays or other medical documentation necessary to confirm freedom from communicable tuberculosis.

The initial TB screening on file for staff #1 lacks the results of the test.

Corrected Corrected by Mar 31, 2022

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

3280.26(a)(6) · Emergency drills shall be conducted annually. Annual emergency drills shall be documented and on file at the facility.

The facility file lacked documentation that an emergency drill had been conducted within the past year.

Corrected Corrected by Mar 31, 2022

Category: recordkeeping. Marked corrected in the state record.

3280.95(a)/3280.95(b) · Fire detection devices or systems must be in compliance with standards established under section 1016(c) of the act (62 P.S. §  1016(c)). The primary staff person or designated staff person who is responsible for compliance with this chapter shall ensure the requirements in subsection (a) are met. The operator shall manually test the facility's fire detection devices every 30 days.

There was more an 30 days between manual checks of the interconnected smoke detectors. The times which exceeded 30 days were 5/12/21 thru 6/16/21.

Corrected Corrected by Feb 9, 2022

Category: recordkeeping. Marked corrected in the state record.

3280.24(a) · The facility's current certificate of compliance shall be posted in a conspicuous location used by parents. The operator shall provide the parent of each child enrolled with information on how to access the regulations in this chapter electronically and with instructions for contacting the appropriate regional child care office.

The facility did not provide the parent of each child enrolled with information on how to access the regulations in this chapter electronically.

Corrected Corrected by Feb 22, 2022

Marked corrected in the state record.

3280.26(a)(1)/3280.26(a)(5) · The facility shall have an emergency plan that provides for shelter of children during an emergency including lock-down, shelter in place at the facility and shelter at locations away from the facility premises.The facility shall have an emergency plan that provides for accommodations for infants, toddlers, children with disabilities and children with chronic medical conditions.

The facility's emergency plan lacked a plan that provides for shelter of children during lockdown and accommodations for children with disabilities.

Corrected Corrected by Mar 31, 2022

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

3280.166(7) · Neither bottled formula nor human milk may be heated in a microwave.

Based on a conversation with the operator, as a microwave was present in the Sleeping Room, staff were heating bottled formula in the microwave.

Corrected Corrected by Mar 1, 2022

Category: nutrition. Marked corrected in the state record.