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

At the time of the inspection, the emergency plan training on file for all staff was conducted in August 2024 and not in October 2024 when the plan was reviewed/updated.

Corrected Corrected by Dec 24, 2024

Category: recordkeeping. 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.

At the time of the inspection on 12/16/24, the Pediatric First Aid/CPR training on file for staff person #1, #2 and #3 was not completed within 90 days of hire as required. This is evidenced by the Pediatric First Aid/CPR training on file dated 1/18/24, 12/7/24 and 12/7/24, respectively (see LIS code sheet for date of hire).

Corrected Corrected by Dec 16, 2024

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. The CPSL was revised to include a 45 day provisional hiring period. The CPSL was updated to include that clearances are to be updated every 60 months. Staff Person #3 may not work in a child care position at the facility.

At the time of the inspection on 12/16/24, staff person #1 had a NSOR certificate dated 8/28/23, which was past the 45-day provisional hiring period. Staff person #3 was not hired in accordance with CPSL and Chapter 3490. She did not receive a PA State Police clearance until 9/6/24, a Child Abuse clearance until 9/16/24, and does not have a FBI clearance on file. Staff person #3 was present at the facility and is past the 45-day provisional hiring period. Staff person #9 did not receive a PA State Police clearance until 8/11/23 and not at time of hire (see LIS code sheet for dates of hire). Staff person #12 did not update the NSOR certificate every 60 months as required. This is evidenced by the current certificate date of 12/9/24 and the previous certificate date of 11/21/19.

Corrected Corrected by Dec 16, 2024

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

3270.33(a) · A staff person or a substitute staff person shall meet one of the applicable staff qualifications for the position in which the person is performing.

Staff person #8 had education on file from Jordan which was not evaluated and therefore, could not qualify for the position she was performing.

Corrected Corrected by Dec 17, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.102(a)/3270.135(b) · 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. Diaper changing surfaces shall be cleaned after each use by wiping the surface with a sanitizing solution or by changing a pad or other surface covering.

The changing table mats in both the infant and toddler rooms were torn exposing the inside foam, therefore, they were not able to be properly sanitized after each use.

Corrected Corrected by Dec 20, 2024

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

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

The emergency contact form for child #1 and child #3 did not include the work address and phone number of the enrolling parent.

Corrected Corrected by Dec 24, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.124(b)(7) · Emergency contact information must include the name, address and telephone number of the individual designated by the parent to whom the child may be released.

The emergency contact form for child #3 and child #5 did not include the address of the individual designated by the parent to whom the child may be released.

Corrected Corrected by Jan 10, 2025

Category: recordkeeping. Marked corrected in the state record.

3270.124(e) · A written plan identifying the means of transporting a child to emergency care and staffing provisions in the event of an emergency shall be displayed conspicuously in every child care space and shall accompany a staff person who leaves on an excursion with children.

A written plan identifying the means of transporting a child to emergency care and staffing provisions in the event of an emergency was not posted in the cafeteria space.

Corrected Corrected by Dec 20, 2024

Category: transportation. 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.

At the time of the inspection, there was no written statement regarding the formula and feeding schedule for an infant obtained from the parent.

Corrected Corrected by Dec 17, 2024

Category: nutrition. 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 #1 must be dismissed from care by close of business on 12/16/24 and may only return to care when the immunization record is updated or when a parent provides a written, signed exemption letter.

At the time of the inspection, child #1 was not immunized status according to recommendations of the ACIP. Child #1 was missing the following immunizations: DTAP #3 and Pneumococcal #3.

Corrected Corrected by Dec 16, 2024

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

3270.133(1)/3270.133(3) · A prescription or nonprescription medication may be accepted only in an original container. The medication shall remain in the container in which it was received. 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.

At the time of the inspection, the EPI-pens for child #6 and child #7 were not stored in the original box they came in and there was no label identifying the name of the medication and the name of the child for whom the medication is intended.

Corrected Corrected by Dec 24, 2024

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.

At the time of the inspection on 12/16/24, the manufacturer instructions on the Epi-Pen for child #9 stated to discard after July 2024.

Corrected Corrected by Dec 20, 2024

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

3270.133(6)/3270.133(7)(i) · A parent shall provide written consent for administration of medication or a special diet. A medication log shall include the name of the medication.

At the time of the inspection, there was no parental written consent for the Tylenol and Benadryl for child #3. There was no parental written consent for the EPI-pen and Cetirizine for child #8. The medication log for child #10 did not include the name of the medication to be administered.

Corrected Corrected by Dec 17, 2024

Category: ratio. Marked corrected in the state record.

3270.151(a)/3270.151(c)(2) · 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. 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.

At the time of the inspection, staff person #1 and staff person #3 did not receive a health assessment prior to providing initial service in a childcare setting. This is evidenced by the health assessments on file dated 7/12/23 and 9/18/24, respectively. Staff person #1 did not receive a TB screening until 7/12/23 which was not at initial service in a childcare setting. Staff person #2 had a health assessment and TB screening that the health assessment form was screenshot, and the dates were cut off making this form not valid.

Corrected Corrected by Dec 23, 2024

Category: ratio. Marked corrected in the state record.

3270.131(a) · 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 initial health report on file for child #2 was not provided within 60 days of first day of attendance in the facility. This is evidenced by the initial health report on file dated 9/18/23 (see LIS code sheet for date of admission).

Corrected Corrected by Dec 17, 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.

Through staff interviews and written documentation, it was confirmed that on 5/29/24 staff person #1 scolded a child to take a nap and then proceeded to hit the child with a ruler.

Corrected Corrected by Jun 7, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.113(b) · A facility person may not use any form of physical punishment, including spanking a child. Staff person #1 will take the two-hour training titled "Preschool Foundations: Nurture Interactions and Guide Behavior" that is available on Better Kid Care.

Through staff interviews and written documentation, it was confirmed that on 5/29/24 staff person #1 scolded a child to take a nap and then proceeded to hit the child with a ruler.

Corrected Corrected by Jun 28, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.113(b) · A facility person may not use any form of physical punishment, including spanking a child. The legal entity must update their written supervision policy and procedure to be implemented in the facility. The written policy must address 3270.113(b), 3270.113(c) and 3270.113(d). The updated policies must define the regulation and must address the prohibition singling out a child, using a harsh tone towards children and physical punishment. The legal entity will submit policy/procedure to the Northeast Regional Office for approval. All existing staff and new hires must be trained on the approved policy and procedure and it must be documented in their files.

Through staff interviews and written documentation, it was confirmed that on 5/29/24 staff person #1 scolded a child to take a nap and then proceeded to hit the child with a ruler.

Corrected Corrected by Jun 18, 2024

Category: supervision. Marked corrected in the state record.

3270.113(c)/3270.113(d) · A facility person may not single out the child for ridicule, threaten harm to the child or the child's family and may not specifically aim to degrade the child or the child's family. A facility person may not use harsh, demeaning or abusive language in the presence of children.

Through staff interviews and written documentation, it was confirmed that staff person #1 has a "drill sergeant" tone towards children, which often includes inappropriate scolding and making children stand for extended periods of time when the child is unable to complete tasks in the classroom.

Corrected Corrected by Jun 7, 2024

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 CPSL was revised to include a 45-day provisional hiring period. Facility Person #2 may not work in a child care position at the facility until all clearances are obtained.

During an unannounced inspection on 6/7/24, Staff #2 was observed to be working at this location. The same legal entity has a second facility in which this particular staff was suspended from care on 05/16/24 because the staff was missing DHS FBI clearance, Child Abuse clearance from the state of Arizona and the Child Abuse clearance from the state of New Jersey. Staff #2 began working with the operator's full knowledge that this individual was working without the proper paperwork on file. Also, staff did not obtain an NSOR certificate until 5/15/24, which was after the 45-day provisional hiring period (see LIS code sheet for date of hire).

Corrected Corrected by Jun 7, 2024

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

3270.69(a) · A facility shall provide running water and a safe and adequate supply of drinking water that complies with the standards established under the Pennsylvania Safe Drinking Water Act (35 P.S. §§721.1-721.17).

The facility has a PWS status compliance form from DEP dated 12/6/23 indicating a current violation for their well. The violation states they failed to meet "Design and Construction Standards." There is no additional documentation on file to indicate that they have corrected this violation.

Corrected Corrected by Jul 19, 2024

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.

At the time of the inspection on 6/7/24, the manual monthly monitoring log of the fire detection system was documented as last being tested on 4/23/24 and not every 30 days as required.

Corrected Corrected by Jun 13, 2024

Category: recordkeeping. 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 # 1 & 2 will have until 12/21/23 to complete the required training. Until such time as the required training has been completed, STAFF #1 & 2 must be supervised, when interacting with children, by an AGS or GS who has completed the required training related to this citation. If there are no staff available to supervise STAFF #1 & 2, STAFF #1 & 2 may not work in a childcare position at the facility.

STAFF # 1 & 2 (see code sheet) have not completed the following pre-service trainings within 90 days of their date of hire: STAFF #1 - Health & Safety (CCDBG) training. STAFF #2 - pediatric first aid & CPR by a PQAS-certified instructor.

Corrected Corrected by Dec 20, 2023

Category: supervision. Marked corrected in the state record.

3270.36(b)(5) · An assistant group supervisor shall have a high school diploma or a general educational development certificate and 2 years experience with children.

STAFF #1, listed as an assistant group supervisor, has a high school diploma. There is no verification of 2 years (2,500 hours) of previous childcare experience.

Corrected Corrected by Dec 20, 2023

Category: supervision. Marked corrected in the state record.

3270.14/3270.31(f) · 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. Staff persons shall complete professional development within 90 days of hire as listed in subsections (f)1-10.

Per inspection on 2/27/23 Staff # 2-3 have not completed and documented the required updated health and safety Pre-Service training within 90 days of hire.

Corrected Corrected by Mar 6, 2023

Category: ratio. Marked corrected in the state record.

3270.32(a) · The operator shall comply with the CPSL and with Chapter 3490 (relating to Child Protective Services). Staff person #-3-- will have until __3/15/23__ to complete the mandated reporter training. Until such time as the required training has been completed, staff person #3 must be supervised, when interacting with children, by an AGS, staff person who has completed the required training related to this citation. If there are no staff person(s) available to supervise staff person #-3- may not work in a child-care position at the facility.

Staff person #-3- has not completed mandated reporter training within the last 60 months. This is evidenced by the previously documented mandated reporter training on file being dated3/10/2017.

Corrected Corrected by Mar 6, 2023

Category: supervision. 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.

During inspection on 2/27/22 it was revealed that the operator does not have a history of fire system monthly testing and logging of test results.

Corrected Corrected by Mar 6, 2023

Category: recordkeeping. Marked corrected in the state record.