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.

On 2/18/25 observed PS Clean Beauty Hydrating Deodorant which indicated "keep out of the reach of children" in the bottom drawer of the left bin in the handicap stall of the boys' bathroom which was accessible to children. On 2/18/25 observed Equate Petroleum Jelly which indicated "keep out of the reach of children" on top of the right bin in the handicap stall of the boys' bathroom which was accessible to children. On 2/18/25 observed Equate Petroleum Jelly, Lysol Air Sanitizer, A&D Ointment, and Equate Hydrocortisone Cream which indicated "keep out of the reach of children" in the bottom drawer of the right bin in the handicap stall of the boys' bathroom which were accessible to children. On 2/18/25 observed Isagel No-rinse Antiseptic Hand Cleansing Gel with Added Moisturizers which indicated "keep out of the reach of children" on the bench in the handicap stall of the girls' bathroom which was accessible to children.

Corrected Corrected by Mar 28, 2025

Category: ratio. Marked corrected in the state record.

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.

Based on lack of documentation at the facility and a conversation with the director, Staff #1 has not received training regarding the emergency plan for this facility.

Corrected Corrected by Mar 10, 2025

Category: recordkeeping. Marked corrected in the state record.

3270.27(d) · The operator shall post the emergency plan in the facility at a conspicuous location.

On 2/18/25 the operator did not post the emergency plan in the facility at a conspicuous location.

Corrected Corrected by Mar 10, 2025

Category: physical safety. 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.

The file of Staff #1 lacked documentation of completing health and safety training within 90 days of hire (SEE LIS Code Sheet). The file of Staff #1 contained documentation of completing health and safety training on 1/31/24.

Corrected Corrected by Mar 10, 2025

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.

On 2/18/25 observed a cracked Magna tile.

Corrected Corrected by Mar 10, 2025

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.

On 2/18/25 observed a doll house approximately 5 feet tall which was not anchored creating a potential tipping hazard.

Corrected Corrected by Mar 21, 2025

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

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

The agreement for Child #1 did not specify the child's departure time.

Corrected Corrected by Mar 17, 2025

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 agreement for Child #2 did not specify the persons designated by a parent to whom the child may be released.

Corrected Corrected by Mar 17, 2025

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.

Emergency contact information for Child #2 did not include the home and work addresses and telephone numbers of the enrolling parent.

Corrected Corrected by Mar 21, 2025

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.

Emergency contact information for Child #2 did not 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.

Corrected Corrected by Mar 21, 2025

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.

Emergency contact information for Child #2 did not include health insurance coverage and policy number for a child under a family policy or Medical Assistance benefits, if applicable.

Corrected Corrected by Mar 21, 2025

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

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

Emergency contact information for Child #3 did not include the complete address of the individual designated by the parent to whom the child may be released.

Corrected Corrected by Mar 28, 2025

Category: recordkeeping. Marked corrected in the state record.

3270.131(d)(1) · A health report shall include a review of the child's health history.

The health report of Child #4 did not include a review of the child's health history.

Corrected Corrected by Mar 28, 2025

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

3270.131(d)(2) · A health report shall include a list of the child's allergies.

The health report for Child #4 did not include a list of the child's allergies.

Corrected Corrected by Mar 28, 2025

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

3270.131(d)(3)/3270.133(8) · A health report shall include a list of the child's current medication and the reason for the medication. If a special diet is prescribed for a child and if the diet is administered to the child, written instructions and the parent's written consent shall be retained in the child's file.

The health report for Child #4 did not include a list of the child's current medication and the reason for the medication and any special diet the child receives and the reason for the special diet.

Corrected Corrected by Mar 28, 2025

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

3270.151(a) · A facility person providing direct care who comes into contact with the children or who works with food preparation shall have a health assessment conducted within 12 months prior to providing initial service in a child care setting and every 24 months thereafter. A health assessment is valid for 24 months following the date of signature, if the person does not contract a communicable disease or develop a medical problem.

The file of Staff #2 lacked a health assessment conducted within 12 months prior to providing initial service in a child care setting (SEE LIS Code Sheet). The file of Staff #2 contained a health assessment dated 10/11/13.

Corrected Corrected by Mar 28, 2025

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 #1 lacked an initial health assessment which included tuberculosis screening by the Mantoux method at initial employment (SEE LIS Code Sheet). The file of Staff #1 had a Mantoux test read date of 1/29/15.

Corrected Corrected by Mar 28, 2025

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

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

On 2/18/25 the operator did not conspicuously post the menu at least 1 week in advance.

Corrected Corrected by Mar 14, 2025

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 emergency contact and agreement for Child #1 were not reviewed and updated at least once in a 6-month period. Child #1's emergency contact and agreement were signed on 7/30/24 with no reviews. The emergency contact for Child #3 was not reviewed and updated at least once in a 6-month period. Child #3's emergency contact was reviewed on 2/1/23, 2/1/24, and 8/21/24. The emergency contact and agreement for Child #5 were not reviewed and updated at least once in a 6-month period. Child #5's emergency contact and agreement were signed on 7/31/24 with no reviews.

Corrected Corrected by Mar 21, 2025

Category: recordkeeping. 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.

The Director or designated staff person who is responsible for compliance with this chapter did not ensure that fire drills were conducted at least once every 60 days. The facility provided documentation that fire drills were conducted on 1/18/24, 2/23/24, 3/6/24, and 1/15/25.

Corrected Corrected by Mar 21, 2025

Category: recordkeeping. 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 files of Children #1, #2, and #5 lacked an initial health report no later than 60 days following the first day of attendance at the facility. Child #1, who had an admission date of 7/30/24, did not have a health report. Child #2, who had an admission date of 8/22/24, did not have a health report. Child #5, who had an admission date of 8/15/24, had a health report dated 1/31/25.

Corrected Corrected by Mar 21, 2025

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

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.

Based on a lack of documentation at the facility and conversation with staff #1, staff #1 had not received training regarding the emergency plan for this facility.

Corrected Corrected by Feb 22, 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 file of child #4 lacked an emergency contact form with the work address and telephone number of the enrolling parent.

Corrected Corrected by Mar 1, 2024

Category: recordkeeping. 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 file of child #4 lacked an emergency contact form with the health insurance coverage and policy number for a child under a family policy or Medical Assistance benefits, if applicable.

Corrected Corrected by Mar 1, 2024

Category: health medication. 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.

Based on documentation, an emergency drill was not conducted annually due to the fact the last date was 1-30-23.

Corrected Corrected by Mar 1, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.131(a)/3270.182(1) · 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. A child's record shall contain initial and subsequent health reports.

The files of children #1, #2, and #3 lacked health assessments.

Corrected Corrected by Mar 6, 2024

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

3270.131(a)/3270.182(1) · 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. A child's record shall contain initial and subsequent health reports.

The file of child #1, with an enrollment date of 8-24-22 lacked a health assessment.

Corrected Corrected by Mar 13, 2023

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

3270.34(b)(1)/3270.192(2)(iv) · A director shall have attained a bachelor's degree from an accredited college or university in early childhood education, child development, special education, elementary education or the human services field and 1 year of experience with children. A facility person's record shall include acceptable verification of experience, education or training is a transcript or a diploma or a letter signed by a representative of the experiential, educational or training entity.

The file of staff #1 lacked documentation of education due to the fact there was no transcript on file.

Corrected Corrected by Mar 7, 2023

Category: recordkeeping. Marked corrected in the state record.

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

The file of child #1 lacked the child's immunized status according to recommendations of the ACIP.

Corrected Corrected by Mar 17, 2023

Category: health medication. 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.

On 2/3/22 observed 2 pair of adult scissors on staff's desk and 2 pair of adult scissors in the orange cabinet labeled "first-aid" which were accessible to children.

Corrected Corrected by Feb 28, 2022

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

3270.27(d) · The operator shall post the emergency plan in the facility at a conspicuous location.

On 2/3/22 the emergency plan in the facility was not posted at a conspicuous location.

Corrected Corrected by Feb 28, 2022

Category: physical safety. 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 # 1 may not work in a child care position at the facility.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. Facility Person #1 may not work in a child care position at the facility.

Staff #1 lacked a State sex offender registry check from a State in which Staff #1 resided in the previous 5 years. Staff #2 lacked a NSOR dated prior to or on the date of providing initial care to children. Staff #2, with a start date of 2/11/20, had a NSOR request date of 2/12/20 and a NSOR dated 2/12/20.

Corrected Corrected by Feb 28, 2022

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

3270.34(a)(6) · A director is responsible for written evaluation of staff persons on a regular basis, a minimum of one evaluation every 12 months.

The file of Staff #2 lacked a written evaluation on a regular basis, a minimum of one evaluation every 12 months completed by the director. The file of Staff #2 contained a written evaluation dated 1/11/21 but did not contain one for 2022.

Corrected Corrected by Feb 28, 2022

Category: recordkeeping. 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.

On 2/3/22 observed a mat with approximately a 1 inch hole with exposed foam located under the fire extinguisher.

Corrected Corrected by Feb 28, 2022

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

3270.123(a) · An agreement shall be signed by the operator and the parent.

The file of Child #4 lacked an agreement signed by the parent.

Corrected Corrected by Feb 28, 2022

Category: recordkeeping. Marked corrected in the state record.

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

The file of Child #1 lacked the child's arrival and departure times on the agreement. The file of Child #3 lacked the child's departure time on the agreement.

Corrected Corrected by Feb 28, 2022

Category: recordkeeping. Marked corrected in the state record.

3270.123(b)/3270.182(8) · A parent shall receive the original agreement. The facility shall retain a copy of the agreement. A child's record shall contain a copy of the initial agreement and subsequent written agreements between the parent and the operator. The parent receives the original agreement.

The files of Children #1, #2, #3, #4, and #5 contained the original agreement. The facility did not make a copy for the file and give the original to the parent.

Corrected Corrected by Feb 28, 2022

Category: recordkeeping. Marked corrected in the state record.

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

The files of Children #1 and #5 lacked the complete address of the child's physician or source of medical care on the emergency contact form. The file of Child #4 lacked the address of the child's physician or source of medical care on the emergency contact form.

Corrected Corrected by Feb 28, 2022

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 file of Child #1 lacked the complete work address of the enrolling parent on the emergency contact form. The file of Child #2 lacked the work telephone number of the enrolling parent on the emergency contact form. The file of Child #5 lacked the complete home and work addresses of the enrolling parent on the emergency contact form.

Corrected Corrected by Feb 28, 2022

Category: recordkeeping. 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 files of Children #1 and #5 lacked the health insurance policy number for a child under a family policy or Medical Assistance benefits, if applicable, on the emergency contact form.

Corrected Corrected by Feb 28, 2022

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

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

The file of Child #4 lacked the address of the individual designated by the parent to whom the child may be released on the emergency contact form. The file of Child #5 lacked the complete address of the individual designated by the parent to whom the child may be released on the emergency contact form.

Corrected Corrected by Feb 28, 2022

Category: recordkeeping. 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 emergency contact and agreement for Children #4 and #5 were not updated by 1/6/22 when the regulation was reinstated. Children #4 and #5's emergency contact form and agreement were not reviewed during the time period when the regulation was suspended. Child #4's emergency contact form and agreement were signed on 11/6/19 and then reviewed on 2/1/22. Child #5's emergency contact form and agreement were signed on 2/2/21 and then reviewed on 2/1/22.

Corrected Corrected by Feb 28, 2022

Category: recordkeeping. Marked corrected in the state record.

3270.183(a) · Child records are confidential and shall be stored in a locked cabinet.

On 2/3/22 observed the child records were not stored in a locked cabinet.

Corrected Corrected by Feb 28, 2022

Category: recordkeeping. 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 files of Children #1, #2, #3 and #5 lacked an initial health report no later than 90 days following the first day of attendance at the facility. Child #1 had a start date of 8/2/20 with no health report signed by a physician, physician's assistant, or a CRNP on file. Child #2 had a start date of 8/26/21 with no health report signed by a physician, physician's assistant, or a CRNP on file. Child #3 had a start date of 8/25/21 with no health report signed by a physician, physician's assistant, or a CRNP on file. Child #5 had a start date of 2/8/21 with no health report on file.

Corrected Corrected by Feb 28, 2022

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