3270.27(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 parent letter in the Emergency Plan lacked plans for accommodations for infants, toddlers, children with disabilities and children with chronic medical conditions.

Corrected Corrected by Mar 22, 2024

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.

Staff #4 and Staff #8 have acceptable Pediatric First Aid/CPR training in an approved curriculum; however, the trainer has not provided documentation that they are PQAS-certified in that training topic. Staff #3 did not complete the following required pre-service training within 90 days of their date of hire: Pediatric First Aid/CPR: Completed 10/9/23 (SEE IS CODE SHEET).

Corrected Corrected by Apr 8, 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).Facility Person #2 and #8 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 #2 & #8 may not work in a child care position at the facility.

The file for Staff #2 lacked a criminal history record with the State Police clearance, which indicated the person has a record, required for CPSL compliance. The file for Staff #2 contained an FBI rap sheet that did not include a disposition for all listed charges, making it invalid. The two most recent State Police and FBI clearances for Staff #5 were dated more than 60 months apart. The file for Staff #8 includes an incomplete criminal history clearance that did not include a dissemination date, making it invalid. The file for Staff #8 observed not to include a rap sheet with the FBI clearance, which indicated the person has a record required for CPSL compliance.

Corrected Corrected by Apr 19, 2024

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 two most recent staff evaluations on file for Staff #1 were dated 6/14/21 and 5/11/23, more than one year apart.

Corrected Corrected by Mar 19, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.102(a)/3270.103 · 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. 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.

Peeling plastic less than 1 inch in diameter was observed on a highchair cover in the Infant Room. Foam cubes with peeling plastic and paper books with ripped torn edges were less than 1 inch in diameter were observed accessible to children who are still placing objects in their mouths in the Toddler Room. Cracked plastic balls with sharp edges and a cracked plastic basketball hoop with pinch points were observed in the Front Toddler play space, which could be harmful to children.

Corrected Corrected by Mar 19, 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.

Broken magnatiles and foam letter blocks with teeth marks were observed in the Preschool Room, which could be hazardous to children.

Corrected Corrected by Mar 19, 2024

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

3270.124(f)/3270.181(c) · The parent shall update in writing emergency contact information once in a 6-month period or as soon as there is a change in the information. 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 two most recent Emergency Contact updates on file for Child #1 were dated 8/28/23 and 3/6/24, more than 6 months apart.

Corrected Corrected by Mar 19, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.151(a)/3270.192(3) · 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. 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 file for Staff #2 includes a health assessment and tuberculosis screening which are dated more than 12 months prior to hire. The file for Staff #6 contained a health assessment which is dated after hire and a tuberculosis screening which is dated more than 12 months prior to date of hire. (See LIS CODE SHEET)

Corrected Corrected by Apr 5, 2024

Category: ratio. Marked corrected in the state record.

3270.192(5) · A facility person's record shall include two written, nonfamily references from individuals attesting to the person's suitability to serve as a facility person.

The file for Staff #7 includes only 1 written nonfamily reference.

Corrected Corrected by Mar 19, 2024

Category: recordkeeping. 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 lacked plans for accommodations for infants, toddlers, children with disabilities and children with chronic medical conditions.

Corrected Corrected by Mar 22, 2024

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 fire alarm 30-day test log includes test dates 10/13/23-11/19/2023, more than 30 days apart.

Corrected Corrected by Mar 19, 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. Until such time as the required pre-service trainings are completed, Facility Person #1 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 Facility Person #1 Facility Person #-1 may not work in a child-care position at the facility.

Facility person #1 was observed to be caring for children unsupervised. Facility Person #1 has not completed the following pre-service training required prior to caring for children unsupervised: approved pediatric first aid and CPR.

Corrected Corrected by Jun 21, 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.

Documentation of smoke detector testing indicates that tests occurred on 3/27/23 and next again on 4/27/23 - more than 30 days apart.

Corrected Corrected by Jun 21, 2023

Category: recordkeeping. 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.

There was no lidded trash can in the girls restroom.

Corrected Corrected by Apr 13, 2023

Category: health medication. 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 agreements on file for children #1, #2, #3, #4, #6, and #7 were the originals.

Corrected Corrected by Mar 28, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.77(a) · Peeled or damaged paint or damaged plaster is not permitted on indoor or outdoor surfaces in the child care facility.

There was peeling paint on the wall in a toy storage closet in the Sunny Days room.

Corrected Corrected by Mar 29, 2023

Category: physical safety. 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 facility's emergency plan did not include a plan for continuity of operations in the event of an emergency, as required by federal regulation.

Corrected Corrected by Apr 28, 2023

Category: ratio. Marked corrected in the state record.

3270.27(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 letter to be given to parents explaining the emergency plan did not include information regarding the facility's plan for a lockdown.

Corrected Corrected by Mar 29, 2023

Category: physical safety. 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 most recent evaluation completed and on file for Facility Person #4 was completed on 1/31/22 by an assistant group supervisor.

Corrected Corrected by Apr 19, 2023

Category: supervision. Marked corrected in the state record.

3270.36(b)(5)/3270.192(2)(iv) · An assistant group supervisor shall have a high school diploma or a general educational development certificate and 2 years experience with children. 3270.4 indicates that the term "child care experience" does not does not include care of related children who reside with an individual. A facility person's record shall include acceptable verification of experience, education or training which is a transcript or a diploma or a letter signed by a representative of the experiential, educational or training entity.

Facility Persons #1-#6 are classified as assistant group supervisors based on completion of high school and at least two years (2500 hours) of child care experience. The required documentation of child care experience on file for each of these staff includes written statements from the staff persons themselves initialed by a representative of the operator, who states this was to document a phone conversation with a representative of the experiential entity to verify the hours of child care experience written by the employee. The written statements do not include the name of the representative of the experiential entity whom the operator's representative spoke with. There was less than two years of child care experience documented and on file for Facility Person #6 as a portion of the hours documented were of care to related child living in the same household as Facility Person #6 when the care was provided.

Corrected Corrected by Apr 12, 2023

Category: supervision. 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.

There were two suncreens labeled "keep out of reach of children" in an unlocked drawer near the diapering area, in reach of children, in the Sunny Days room.

Corrected Corrected by Mar 27, 2023

Category: health medication. 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.

The medical emergency transportation plan was not posted in the Sunny Days and Rainbow rooms. The medical emergency transportation plan posted in the other spaces did not include the plan for staffing provisions in the event of an emergency.

Corrected Corrected by Apr 7, 2023

Category: transportation. Marked corrected in the state record.

3270.151(a)/3270.151(b) · 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. A health assessment shall be conducted and a report shall be written and signed by a physician, physician's assistant or CRNP. The signature must include the individual's professional title.

The initial health assessment on file for Facility Person #3 was not signed or dated by the physician, physician's assistant or CRNP who conducted the exam.

Corrected Corrected by Apr 5, 2023

Category: ratio. 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 agreement on file for child #5 was not reviewed and updated by a parent in writing in the previous 6 months.

Corrected Corrected by Mar 27, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.94(a)(9) · The Director or designated staff person who is responsible for compliance with this chapter shall conduct fire drills and ensure that a written record is maintained on file at the facility indicating the specific time of day of the drill, the hypothetical location of the fire, the evacuation time, and the names of the facility persons and the number of children who participate in the fire drill.

The fire drill log did not list the names of the facility persons who participated in each fire drill.

Corrected Corrected by Mar 27, 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 on file at the facility indicating that facility's smoke detectors were tested between July 2022 and 1/26/23. The most recent test documented was notated as occurring on 2/23/23. The smoke detectors were tested on the day of the inspection, more than 30 days later. Smoke detectors are required to be tested at least every 30 days and the testing documented under Act 62.

Corrected Corrected by Mar 27, 2023

Category: recordkeeping. 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.

A crib containing a sleeping infant was observed to lack 2 feet of space on 3 sides in the Little Lambs Room.

Corrected Corrected by Sep 15, 2022

Category: physical safety. 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.

During an observed bathroom break on 9/15/22 at approximately 10:50 AM, 1 staff was observed with 3 PS girls and 3 PS boys. The children entered their respective bathrooms, which were 12 feet apart, while the staff member waited in the hall. The staff then entered the girls' bathroom to assist one of the children, leaving the 3 PS boys unsupervised in the boys' bathroom.

Corrected Corrected by Oct 18, 2022

Category: supervision. Marked corrected in the state record.

3270.113(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.

Upon assessment of supervision and ratio in the Shining Stars Room 9/15/22 at 10:40 AM, Staff #1 named 5 PS and Staff #2 named 5 PS. There were 11 children in the room at that time. Staff were asked to name their groups three different times with the same result.

Corrected Corrected by Oct 18, 2022

Category: supervision. 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.

According to a reported incident from the facility, Child #1 was injured and fractured his femur after falling from the window ledge in the Shining Stars Room. During interviews conducted as part of the investigation, it was reported staff permitted the children to climb on the window ledge

Corrected Corrected by Aug 30, 2022

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

3270.113(d) · A facility person may not use harsh, demeaning or abusive language in the presence of children.

Staff #1 in the Infant Room was heard outside the room, with the door closed, screaming about her work assignment. When observed, Staff #1 had been holding a YT while screaming.

Corrected Corrected by Aug 30, 2022

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.

A child was injured while placing his finger between the sections of a folding cabinet door in the Sunny Days Room, which was off the upper track and unable to open and close properly due to its disrepair.

Corrected Corrected by Jul 6, 2022

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

3270.76 · 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.

A folding cabinet door was reported to have been off the upper track in the Sunny Days Room, making it unable to open and close properly.

Corrected Corrected by Jul 6, 2022

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

3270.31(e)(4)(i) · Competence is the completion of training by a professional in the field of first-aid and cardiopulmonary resuscitation (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.

The file for staff #1lacked pediatric Firs-Aid and pediatric CPR certificate. The staff start date was 11/22/21.The training certificate was due on 2/22/22.

Corrected Corrected by May 9, 2022

Category: ratio. 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.

In the Preschool/ Pre-k room the following toxics items labeled, Keep out of reach of children, and adult supervision recommended "were accessible to children in care: Germ X sanitizer, carpet square acrylic paint, champagne body cream on the counters top and chap stick. In the rainbow room the following toxic items labeled "not for children under 3 years" were used with 1 and 2 years old children. In the laundry area on the hallway the following cleaning items labeled "keep out of reach of children"were accessible to children in care: Gain dish soap, antibacterial source soap and wind fresh laundry detergent.

Corrected Corrected by May 9, 2022

Category: supervision. Marked corrected in the state record.

3270.75(c) · A first-aid kit must contain the following: soap, an assortment of adhesive bandages, sterile gauze pads, tweezers, tape, scissors and disposable, nonporous gloves.

The first aid kit in the preschool/pre-k room lacked tape.

Corrected Corrected by May 9, 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.

There was a pink and yellow climbing matt ripped on the left top corner, a blue toy sofa ripped on the back and on the left leg exposing the wood in the Sunny Day room . There was a cracked bin in the Rainbow room and in the Smiley room.

Corrected Corrected by May 9, 2022

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

3270.123(a)(6)/3270.182(2) · An agreement shall specify the date of the child's admission.A child's record shall contain the dates of application, admission and withdrawal of the child.

The file for child # 1 lacked the admission date on the agreement form.

Corrected Corrected by May 9, 2022

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 for child #1and 3 lacked the work address of the enrolling parent on the emergency contact form.

Corrected Corrected by May 9, 2022

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 lacked the information on disabilities on the emergency contact form.

Corrected Corrected by May 9, 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 files for child #1 and 2 lacked the address and telephone number of the individual designated by the parent to whom the child may be released on the emergency contact form.

Corrected Corrected by May 9, 2022

Category: recordkeeping. Marked corrected in the state record.

3270.131(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 lacked an updated health report. The last health report in file was dated 1/5/21.

Corrected Corrected by May 9, 2022

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

3270.131(e)/3270.131(e)(1) · 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 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 #2,3, and 4 lacks documentation of a current influenza immunization as recommended by the ACIP.

Corrected Corrected by May 9, 2022

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.

In the Rainbow room was a mupirocin medication with out the label of the medication and the name of the child for whom the medication is intended.

Corrected Corrected by May 9, 2022

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

3270.161(d) · Potentially hazardous food brought from the child's home or provided by the facility shall be refrigerated.

There was a white, liquid in a plastic bottle in a lunch bag in the pre-k room. Per staff the liquid was a plant based milk. There was cheese, yogurt and lunch meat in two lunch boxes in the Smiley room.

Corrected Corrected by May 9, 2022

Category: nutrition. 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 lacked accommodations for infants, toddlers, children with disabilities and children with chronic medical conditions.

Corrected Corrected by May 9, 2022

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 provider lacked proof of purchase of the interconnected alarm system.

Corrected Corrected by May 9, 2022

Category: recordkeeping. Marked corrected in the state record.