3270.123(a)(7) · An agreement shall specify the services which are to be considered as extra.

The file for child #1 was observed to contain agreement that did not specify the services which are to be considered as extra.

Corrected Corrected by Aug 7, 2024

Category: recordkeeping. 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.

The facility was observed to have an emergency plan that did not provide a method for facility persons to inform parents that the emergency has ended and provided instruction as to how parents can safely be reunited with their children.

Corrected Corrected by Aug 7, 2024

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

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

The facility was observed to have a table in room #204 that had visibly chipped, peeling and missing paint from the legs, and a "Road" table for miniature cars in rom #202 with loose and unsteady legs.

Corrected Corrected by Sep 15, 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 file for child #2 was observed to lack the Department's approved form (Child Service Report) to provide information to the family about the child's growth and development in the context of the services being provided.

Corrected Corrected by Aug 7, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.123(a)(5) · An agreement shall specify the persons designated by a parent to whom the child may be released.

The file for child #3 was observed to contain an agreement that did not specify the persons designated by a parent to whom the child may be released

Corrected Corrected by Aug 7, 2024

Category: recordkeeping. 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 file for child #2 was observed to contain an emergency contact form that did not include information on the child's special needs (if any), as specified by the child's parent, physician, physician's assistant or CRNP, which is needed in an emergency situation

Corrected Corrected by Aug 7, 2024

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

3270.134(a) · A staff person shall ensure that a child's hands are washed before meals and snacks, after toileting and after being diapered.

A staff member was observed to have failed to wash an infant's hands immediately following a diaper change. Following the diaper change and as the staff member was placing the infant down onto the floor, the staff member was prompted to wash the infant's hands, and immediately washed the infant's hands.

Corrected Corrected by Aug 7, 2024

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

3270.166(4) · Disposable nursers and bottles shall be labeled with the child's name.

The facility was observed to have bottles in room #205 that were not labeled with a child's name.

Corrected Corrected by Aug 7, 2024

Marked corrected in the state record.

3270.171(c) · Written notification of safe routes shall be posted by the operator at a conspicuous location in the child care facility.

The facility was observed to lack written notification of safe routes posted by the operator at a conspicuous location in the child care facility

Corrected Corrected by Aug 7, 2024

Marked corrected in the state record.

3270.119 · Infants shall be placed in the sleeping position recommended by the American Academy of Pediatrics unless there is a medical reason an infant should not sleep in this position. The medical reason shall be documented in a statement signed by a physician, physician's assistant or CRNP and placed in the child's record at the facility.

Observed during an unannounced verification visit, child #1, an infant sleeping in a swing rather than a flat firm surface; and child #2 was sleeping in a bouncer rather than a flat firm surface.

Corrected Corrected by Apr 30, 2024

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

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

Based on information gathered in interviews during an unannounced investigation, staff #1 smacked child #1.

Corrected Corrected by Mar 11, 2024

Marked corrected in the state record.

3270.52 · 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 in § 3270.51 (relating to similar age level). The required staff:child ratios must be maintained at all times.

On 3-18-24 during an unannounced visit, at approximately 9:45 a.m., CR observed staff #1 with 6 2-year-old children and 3 3-year-old children in the preschool room while staff #2 had 3 3-year-old children at the restroom down the hall. Therefore, staff #1 was over ratio in the preschool room.

Corrected Corrected by Mar 18, 2024

Category: ratio. Marked corrected in the state record.

3270.14/3270.21 · A facility shall be operated in conformity with applicable Federal and State laws and regulations. State agencies whose regulations may relate to the operation of a facility include the Department of Environmental Resources, the Department of Labor and Industry, the Department of Health, the Department of Education and the Department of Transportation. Conditions at the facility may not pose a threat to the health or safety of the children. Until such time as the required pre-service trainings are completed, staff person #1 and #2 must be supervised, when interacting with children, by an AGS who has completed the required training related to this citation. If there are no staff person(s) available to supervise staff person #1 and #2, staff person #1 and #2 may not work in a child-care position at the facility.

Staff person #1 and #2 were observed to be caring for children unsupervised. Staff person #1 and #2 have not completed the following pre-service training required prior to caring for children unsupervised:3270.31(f)(1-10).

Corrected Corrected by Dec 8, 2023

Category: supervision. 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). Facility Person # -3- may not work in a childcare position at the facility until all required valid clearances are obtained. 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.

Observed staff file #3, a provisional hire, contained a disclosure statement which was not dated to document the form was signed prior to starting in a childcare position, there was no application documenting the criminal background clearance was applied for prior to starting in a childcare position, and there was not a valid child abuse clearance which is required prior to starting as a provisional hire.

Corrected Corrected by Dec 8, 2023

Category: background checks. 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.

Observed a damaged leg on a small wooden table in the preschool room.

Corrected Corrected by Dec 8, 2023

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

3270.106(f) · At least 2 feet of space is required on three sides of a bed, cot, crib or other rest equipment while the equipment is in use.

Observed an infant in a pack n play which did not have 2 feet of space on three sides.

Corrected Corrected by Dec 8, 2023

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

3270.181(a) · An operator shall establish and maintain an individual record for each child enrolled in the facility.

Observed the operator did not have an established individual record for a staff's child receiving care at the facility on the day of the inspection.

Corrected Corrected by Dec 8, 2023

Category: recordkeeping. 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.

Staff person #1 had not completed the mandated reporter training within 60 months. This is evidenced by the previously documented mandated reporter trainings on file being dated 10-7-16 and 12-11-21 (see LIS code sheet). At the time of the inspection, the Emergency Plan lacked continuity of operations.

Corrected Corrected by Sep 13, 2023

Category: ratio. 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.

Observed in room 201, adult scissors stored on the third shelf of an unlocked cabinet accessible to the children receiving care in the room.

Corrected Corrected by Aug 18, 2023

Category: health medication. 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.

Observed in room 201, 4 Bingo dabbers and Barbasol brand shaving cream all labeled, "keep out of the reach of children" stored on the third shelf of an unlocked cabinet accessible to the children receiving care in the room.

Corrected Corrected by Sep 15, 2023

Marked corrected in the state record.

3270.74 · 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.

The telephone number of the nearest hospital, police department, fire department, ambulance and poison control center were not posted in room 204 at the time of the inspection.

Corrected Corrected by Aug 18, 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.

The sinks in the following rooms lacked hand washing signs: 1 in room 201, 2 in room 202, and 1 in room 205.

Corrected Corrected by Aug 18, 2023

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.

At the time of the inspection, there were not lidded waste receptacles being used in the men's and women's restrooms in the child care space and women's restroom in the indoor gross motor space.

Corrected Corrected by Aug 23, 2023

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.

Observed in room 204 a rug with frayed edges approximately 2 feet long.

Corrected Corrected by Aug 18, 2023

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

3270.106(f) · At least 2 feet of space is required on three sides of a bed, cot, crib or other rest equipment while the equipment is in use.

Observed cribs in use with child #1 and child #2 sleeping that were less than 2 feet apart from each other.

Corrected Corrected by Aug 21, 2023

Category: physical safety. 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 was not emergency contact information for child #3 in the child care space at the time of the inspection.

Corrected Corrected by Aug 18, 2023

Category: recordkeeping. 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 not written statements for the formula and feeding schedules of children #1, #2, and #3 at the time of the inspection.

Corrected Corrected by Aug 18, 2023

Category: nutrition. Marked corrected in the state record.

3270.31(f)(10) · Staff persons shall complete professional development in pediatric first aid and pediatric cardiopulmonary resuscitation within 90 days of hire.

Staff person(s) #2 and #3 had not completed the following required pre-service training within 90 days of their dates of hire (see LIS code sheet): first aid/CPR.

Corrected Corrected by Sep 13, 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.

Based on documentation, fire drills were held more than 60 days apart due to the fact they were tested 4-14-23 and 6-14-23 which is 61 days.

Corrected Corrected by Aug 18, 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.

There was no documentation of testing the smoke detectors every 30 days. The only documentation on file was from an outside company who tested the non-childcare space in September 2022. During the renewal inspection, there were not operable inter-connected smoke detectors in the child care spaces. Furthermore, operable inter-connected smoke detectors could only be heard in the upstairs church space, not audible when the doors of the child care rooms are closed.

Corrected Corrected by Aug 21, 2023

Category: recordkeeping. Marked corrected in the state record.

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

At the time of the inspection, there was no documentation the Emergency Plan was sent to the local municipality.

Corrected Corrected by Sep 13, 2023

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

3270.113(a) · The Legal Entity will arrange for all staff to attend a minimum of 3 hours of in person training on supervision conducted by ELRC Region 6. The training will be submitted to the regional office for approval prior to attendance. Proof of training will be submitted upon completion.

**Second citation previously cited on 9-29-22, at approximately 1:40 p.m. during naptime, cert rep observed in the preschool room staff #1 sitting at the front of the room near the door while 6 preschool aged children napped. One child was resting in the far back of the room with tables and chairs obscuring the staff's view in order to properly supervise the child. In addition, lighting was insufficient to properly supervise the children.

Corrected Corrected by Dec 8, 2022

Category: supervision. Marked corrected in the state record.

3270.113(a) · The operator will identify where staff should be sitting during nap time on a map of the classroom identifying where staff and children should be placed during naptime. This map will be posted in the classroom.

***Second citation previously cited on 9-29-22, at approximately 1:40 p.m. during naptime, cert rep observed in the preschool room staff #1 sitting at the front of the room near the door while 6 preschool aged children napped. One child was resting in the far back of the room with tables and chairs obscuring the staff's view in order to properly supervise the child. In addition, lighting was insufficient to properly supervise the children.

Corrected Corrected by Dec 13, 2022

Category: supervision. Marked corrected in the state record.

3270.113(a) · Children on the facility premises and on facility excursions off the premises shall be supervised by a staff person at all times. Outdoor play space used by the facility is considered part of the facility premises.

*Second citation previously cited on 9-29-22, at approximately 1:40 p.m. during naptime, cert rep observed in the preschool room staff #1 sitting at the front of the room near the door while 6 preschool aged children napped. One child was resting in the far back of the room with tables and chairs obscuring the staff's view in order to properly supervise the child. In addition, lighting was insufficient to properly supervise the children.

Corrected Corrected by Dec 13, 2022

Category: supervision. Marked corrected in the state record.

3270.113(a) · Children on the facility premises and on facility excursions off the premises shall be supervised by a staff person at all times. Outdoor play space used by the facility is considered part of the facility premises. Children must be supervised at all times.

At approximately 2:20 p.m. during naptime, cert rep observed in the preschool room staff #1 and staff #2 sitting at the front of the room near the door while 13 preschool aged children napped. 4 children were resting in the far back of the room with tables and chairs obscuring the staff's view in order to properly supervise the children.

Corrected Corrected by Oct 25, 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 persons #1, #2, and #4 shall complete professional development in the topics of 3270.31(f)(1-10) within 90 days of hire. Staff persons #1, #2, and #4 will have until 9-14-22 to complete the required training. Until such time as the required training has been completed, staff persons #1, #2, and #4 must be supervised, when interacting with children, by an AGS, GS, or Director who has completed the required training related to this citation. If there are no staff available to supervise staff persons #1, #2, and #4, staff persons #1, #2, and #4 may not work in a child care position at the facility.

Staff persons #1, #2, and #4, have not completed the following required pre-service training within 90 days of hire (see LIS code sheet): pediatric first aid/CPR from a PQAS approved and a PQAS approved curriculum. Staff person #5 has not completed the 10 hour health and safety training course due to the fact the health and safety course on file was 6 hours and dated 7-31-16 (see LIS code sheet).

Corrected Corrected by Sep 7, 2022

Category: supervision. 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 staff #3 did not complete the Mandated Reporter Training within 90 of their hire date due to the fact the date of completion was dated 2-16-22 (see LIS code sheet for hire date).

Corrected Corrected by Sep 7, 2022

Category: recordkeeping. Marked corrected in the state record.

3270.75(d)/3270.124(d) · One first-aid kit per child care group must accompany children and facility persons on excursions from the facility. Each first aid kit taken on an excursion must contain a bottle of water in addition to the items specified at §3270.75(c).When children leave the facility on walking and riding excursions, emergency contact information specific to each child on the excursion shall accompany a staff person on the excursion.

Observed staff #2 and #7 take the infants on a walk in strollers off the facility address without taking the first-aid kit and copies of the emergency contact forms for the group of infants.

Corrected Corrected by Sep 7, 2022

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.

Observed in room 201 2 broken Magntiles.

Corrected Corrected by Sep 7, 2022

Category: physical safety. 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.

At the time of reviewing the fire drill log during the renewal inspection, the last date documented of completion of a drill was 6-7-22 which was more than 60 days.

Corrected Corrected by Sep 7, 2022

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.

Observed a damaged rest mat with exposed foam labeled for child #2, a toddler and a damaged rest mat with exposed foam labeled for child #5, a toddler.

Corrected Corrected by Sep 7, 2022

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

3270.104(a) · Furniture must be durable, safe, easily cleaned and appropriate for the child's size, age and special needs.

Observed in room 202 a small white table with tan legs; three of the legs were loose.

Corrected Corrected by Sep 7, 2022

Marked corrected in the state record.

3270.131(c) · A health report must be written and signed by a physician, physician's assistant or a CRNP. The signature must include the individual's professional title.

The file of child #1 was observed to have an initial health assessment that lacked a signature by a physician, physician's assistant or a CRNP.

Corrected Corrected by Sep 21, 2022

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

3270.133(5) · Medication shall be stored in accordance with the manufacturer's or health professional's instructions on the original label.

Observed in room 205 Desitin labeled for child #3 with an expiration date of 5/22. Observed in room 202 Desitin labeled for child #4 with an expiration date of 12/2021.

Corrected Corrected by Sep 7, 2022

Category: ratio. Marked corrected in the state record.

3270.151(c)(2) · An adult health assessment must include tuberculosis screening by the Mantoux method at initial employment. Subsequent tuberculosis screening is not required unless directed by a physician, physician's assistant, CRNP, the Department of Health or a local health department.

The file of staff #6 had an initial health assessment with a tuberculosis screening more than 12 months prior to initial employment due to the fact the test read date was dated 2-7-20. (see LIS code sheet for hire date)

Corrected Corrected by Sep 7, 2022

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

3270.166(4) · Disposable nursers and bottles shall be labeled with the child's name.

Observed in the refrigerator located in room 202 a Nuk brand Minnie Mouse bottle not labeled for the use of a specific child.

Corrected Corrected by Sep 7, 2022

Marked corrected in the state record.

3270.27(a)(6) · Emergency drills shall be conducted annually. Annual emergency drills shall be documented and on file at the facility.

An emergency plan drill was not conducted by 12-19-21 due to the fact the only drill documented was dated 5-20-22.

Corrected Corrected by Sep 7, 2022

Category: recordkeeping. Marked corrected in the state record.

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

At the time of the inspection, there was not documentation to prove the plan was delivered to the local municipality and to the county emergency management agency.

Corrected Corrected by Sep 7, 2022

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

3270.182(1) · A child's record shall contain initial and subsequent health reports.

On 10/12/21 it was found that the facility failed to obtain initial and subsequent child health assessments when the parent of a child in care neglected to turn the required assessment into the facility.

Corrected Corrected by Nov 9, 2021

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). 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.

Staff #2 was observed having and employment date of 11/5/20 and National Sex Offender Registry (NSOR) certificate application completed after hire and NSOR dated 1/15/21.

Corrected Corrected by Sep 3, 2021

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

3270.32(a)/3270.192(2)(iii) · The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). A facility person's record shall include verification of child care experience, education and training following the outset of service at the facility.

Staff #3 was observed having Mandated Reporter trainings completed 3/8/16 and 6/17/21, exceeding every 60 months. Staff #4 was observed having Mandated Reporter trainings completed 6/23/15 and 3/3/21, exceeding every 60 months.

Corrected Corrected by Sep 10, 2021

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 file for staff #1 was observed having an employment date of 5/6/21 and initial health assessment dated 2/11/20, exceeding 12 months prior to employment. The file for staff #3 was observed having health assessments dated 3/8/19 and 6/21/21, exceeding every 24 months.

Corrected Corrected by Sep 3, 2021

Category: ratio. Marked corrected in the state record.

3270.166(4) · Disposable nursers and bottles shall be labeled with the child's name.

The infant room was observed having infant milk bottles which lacked a label of the child's name.

Corrected Corrected by Sep 3, 2021

Marked corrected in the state record.

3270.27(a)(5) · 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 lacked an emergency plan that provides for accommodations for infants, toddlers, children with disabilities, and children with chronic medical conditions.

Corrected Corrected by Sep 10, 2021

Category: physical safety. 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 facility lacked a record documenting the fire detection system has been checked on a monthly basis beginning in November 2020.

Corrected Corrected by Sep 3, 2021

Category: recordkeeping. Marked corrected in the state record.

3270.25(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 lacked information on how to access the regulations in this chapter electronically.

Corrected Corrected by Sep 3, 2021

Marked corrected in the state record.

3270.27(a)(1) · The facility shall have an emergency plan that provides for accommodations 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 emergency plan lacked accommodations for shelter of children during an emergency which included a lock-down.

Corrected Corrected by Sep 10, 2021

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