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 front and back ends of a caterpillar tunnel climber in the outdoor play space were removed from the body of the climber exposing 4 plastic connector bolts which extend out about 1 - 1.5 inches from the play structure.

Corrected Corrected by Nov 7, 2024

Category: physical safety. 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 #1 was not signed by the operator.

Corrected Corrected by Nov 7, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.123(b) · A parent shall receive the original agreement. The facility shall retain a copy of the agreement.

The original financial agreement was on file for child #1.

Corrected Corrected by Nov 7, 2024

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 forms of child #1 and #3 did not include the work address and work telephone number of the enrolling parent.

Corrected Corrected by Nov 11, 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 emergency contact forms of child #1 and #2 did not include information on the child's special needs which is required in an emergency situation or documentation this is not applicable to the child.

Corrected Corrected by Nov 11, 2024

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 #1 did not include the name or policy number of the health insurance of the coverage for the child.

Corrected Corrected by Nov 18, 2024

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

3270.131(b)(1)/3270.182(1) · The operator shall require the parent to provide an updated health report at least every 6 months for an infant or young toddler. A child's record shall contain initial and subsequent health reports.

The file of child #1, identified as an infant (see LIS code sheet), contained a health assessment dated 1/25/2024 but did not contain documentation of an updated health assessment within 6 months of the prior assessment.

Corrected Corrected by Nov 11, 2024

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

3270.131(b)(2)/3270.182(1) · The operator shall require the parent to provide an updated health report at least every 12 months for an older toddler or preschool child. A child's record shall contain initial and subsequent health reports.

The 2 most recent health assessment on file for child #2, identified as a preschool age child (see LIS code sheet), were dated 1/20/2022 and 2/12/2024, exceeding 12 months. The file of child #3, also identified as a preschool age child (see LIS code sheet), did not contain an updated health assessment within 12 months of the prior assessment dated 5/17/2023.

Corrected Corrected by Nov 18, 2024

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

3270.131(d)(5)/3270.131(e)(3) · A health report shall include a review of the child's immunized status according to recommendations of the ACIP. The facility shall implement dismissal policies in accordance with the Department of Health regulation in 28 Pa. Code § 27.77 (relating to immunization requirements for children in child care group settings).

Based on the immunization record on file for child #1, their immunization status was not in accordance with the recommendations of the ACIP lacking 1 of 2 Hep B, 2 of 3 Rotavirus, 2 of 3 DTaP, 1/2 HIB, 2 of 3 Pneumococcal, and 1 of 2 Polio vaccinations or an acceptable exemption.

Corrected Corrected by Nov 11, 2024

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

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

The name of the child for which the Tylenol was intended in the infant and toddler classroom was partially peeled off making it unclear as to whom the medication is designated for.

Corrected Corrected by Nov 7, 2024

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

3270.181(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 file of child #1 contained documentation of review and/or update to the emergency contact form and financial agreement which exceeded 6 months (dated 10/19/2023 and 8/1/2024).

Corrected Corrected by Nov 7, 2024

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.

The emergency plan for the facility lacked continuity of operations as required by Federal Regulation.

Corrected Corrected by Nov 15, 2023

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.

The fire safety trainings on file for Staff Person's #1 and #2 exceeded 12 months between update. The trainings for Staff Person #1 were completed on 9.30.22 and 10.9.23 and the trainings on file for Staff Person #2 were completed on 9.28.22 and 10.11.23.

Corrected Corrected by Nov 14, 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 agreement for Child #2 lacked an admission date for the child.

Corrected Corrected by Nov 14, 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 for Children #1 and #3 lacked the complete addresses for the release persons listed.

Corrected Corrected by Nov 14, 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). Child #4 will be dismissed from care at the close of business on 11.14.23.

The current immunization record on file for Child #4 lacked verification that the child had received an annual influenza vaccination. A written exemption was not on file at the time of the inspection.

Corrected Corrected by Nov 14, 2023

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.

An expired Tylenol was observed in the medication box in the Infant/Toddler classroom.

Corrected Corrected by Nov 14, 2023

Category: health medication. 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 emergency plan for the facility lacked accommodations for infants and toddlers.

Corrected Corrected by Dec 1, 2023

Category: physical safety. 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 contains an emergency contact form that is lacking the name address and phone number of the child's physician.

Corrected Corrected by Dec 7, 2022

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

3270.124(b)(4) · Emergency contact information must include the written consent signed by a parent for emergency medical care.

The file for Child #3 contains an emergency contact form that is lacking signed parental consent for emergency medical care.

Corrected Corrected by Dec 7, 2022

Category: recordkeeping. Marked corrected in the state record.

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

The file for Child #1 contained an agreement form that was lacking the Child's admission date.

Corrected Corrected by Dec 7, 2022

Category: recordkeeping. Marked corrected in the state record.

3270.131(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 file for Child #2 contained an immunization record that was lacking the annual influenza vaccine.

Corrected Corrected by Dec 7, 2022

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

3270.182(5) · A child's record shall contain signed parental consent for administration of minor first-aid procedures by facility staff. Written consent is required prior to admission.

The file for Child #3 contains an emergency contact sheet that was lacking signed parental consent for administration of minor first aid procedures.

Corrected Corrected by Dec 7, 2022

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 of facility person #3 was dated 10/3/2020 and updated on 11/3/2021 exceeding 1 year.

Corrected Corrected by Nov 17, 2021

Category: recordkeeping. Marked corrected in the state record.

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

Pediatric first aid and CPR was not completed for facility person #2 (start date 3/29/2021) by 6/27/2021.

Corrected Corrected by Dec 18, 2021

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

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

Documentation of the previous and current PA state police, child abuse and FBI clearances of facility person #1 exceed 60 months as required by the Child Protective Service Law.

Corrected Corrected by Nov 17, 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.

Documentation of previous and current mandated reporter training of facility person #1 exceeded 60 months.

Corrected Corrected by Nov 17, 2021

Category: recordkeeping. 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.

In the back classroom, a facility person changed the diaper of an able child and did not wash their hands or the child's hands with soap and running water. The changing table in the infant area of the back classroom did not have a posted handwashing sign.

Corrected Corrected by Nov 17, 2021

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.

The lid to a bin containing manipulatives in the from preschool classroom was cracked.

Corrected Corrected by Nov 10, 2021

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.

In the back infant toddler classroom, a facility person was using glue sticks with a removeable cap less than an inch in diameter with children still placing objects in their mouths.

Corrected Corrected by Nov 17, 2021

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.

At approximately 12:10 pm, facility person #4 left their 6 children unsupervised in the infant and toddler classroom when they brought the lunch cart to the preschool classroom and briefly entered the classroom.

Corrected Corrected by Nov 17, 2021

Category: supervision. Marked corrected in the state record.

3270.124(a) · Emergency contact information is required for each enrolled child. Emergency contact information must reference who shall be contacted in an emergency.

The emergency contact form of child #2 contained a emergency contact person that did not have a telephone number listed.

Corrected Corrected by Nov 17, 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 forms of child #1 did not contain the telephone number and child #2 did not contain the address and telephone number of all the release person designated by the parent to whom the child may be released.

Corrected Corrected by Nov 17, 2021

Category: recordkeeping. Marked corrected in the state record.

3270.131(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 of child #2 did not contain and exemption or documentation of ongoing vaccines in accordance with the schedule recommended by the ACIP.

Corrected Corrected by Nov 17, 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 time between the previous and current health assessments of facility person #1 exceeded 24 months.

Corrected Corrected by Nov 19, 2021

Category: ratio. Marked corrected in the state record.

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

A bottle in the infant and toddler classroom was not labeled with the child's name for which it was intended.

Corrected Corrected by Nov 10, 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.

Documentation of testing of the fire detection system exceeded 30 days: 4/2/2021 to 5/3/2021, 8/2/2021 to 9/2/2021, 7/2/2021 to 8/2/2021 and 10/1/2021 to 11/1/2021.

Corrected Corrected by Nov 10, 2021

Category: recordkeeping. Marked corrected in the state record.