3270.31(e)(4)(ii)/3270.192(2)(iii) · 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. A facility person's record shall include verification of child care experience, education and training following the outset of service at the facility.

The file for staff #2 contains fire safety training that was updated late. It was due 10/2024 and obtained 11/2024.

Corrected Corrected by Nov 4, 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 person #3 had not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): health and safety training, and first aid/cpr training. It was due 5/4/2024 and obtained 10/2024 and 5/20/2024.

Corrected Corrected by Oct 28, 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'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 file for staff #4 contains a late criminal clearance. It was due 6/2024 and obtained 10/2024. The file for staff #5 contained a late child abuse clearance. A volunteer clearance dated 1/22/2022 was on file. The facility obtained an employment child abuse clearance on 11/11/24. The employment clearance was due 8/2024.

Corrected Corrected by Nov 11, 2024

Category: background checks. 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 person #3 had not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): mandated reporter training. It was due 5/2024 and obtained 10/2024.

Corrected Corrected by Oct 2, 2024

Category: background checks. 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.

Observed exposed bolts on the toilet used by children in the bathroom attached to PS room.

Corrected Corrected by Nov 13, 2024

Category: physical safety. 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.

The lid on the waste can in the bathroom attached to the preschool room was broken.

Corrected Corrected by Nov 13, 2024

Category: health medication. 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 files for children #1- #3 contain agreements and emergency contact information that were updated annually as opposed to every 6 months. The forms are now current.

Corrected Corrected by Nov 13, 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 files for staff #1 and #6 contain health assessments that were updated late. #1 was due 5/2024 and obtained 6/2024. #6 was due 5/2024 and obtained 10/2024.

Corrected Corrected by Oct 18, 2024

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.

Per a facility self-reported incident and staff statements, on 11/8/23, staff #1 fed a bottle of breast milk labeled for another child to child #1. The bottle was labeled with the correct child's name. Staff #1 did not look at the label before feeding it to child #1.

Corrected Corrected by Nov 13, 2023

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

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

Per a facility self-reported incident and staff statements, on 11/8/23, staff #1 fed a bottle of breast milk labeled for another child to child #1. The bottle was labeled with the correct child's name. Staff #1 did not look at the label before feeding it to child #1.

Corrected Corrected by Nov 13, 2023

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 file for Staff #3 contained Emergency Plan trainings dated 5/22/22 and 10/9/23, which is more than 12 months apart.

Corrected Corrected by Nov 7, 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 protective services).

The two most recent Mandated Reporter trainings on file for Staff #1 were dated 10/3/18 & 10/13/23, which are more than 60 months apart.

Corrected Corrected by Nov 7, 2023

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 file for Staff #2 contained State Police clearances dated 5/10/18-5/19/23, Child Abuse clearances 5/19/18/-5/24/23, and FBI clearances 5/11/18-5/17/23, which are all more than 60 months apart. The file for Staff #8 contained Child Abuse clearances dates 8/22/18-9/29/23, which are more than 60 months apart. The file for Staff #11 contained a Child Abuse clearance dated 6/27/23, which is more than 45 days after the Staff Person's start date. (SEE LIS CODE SHEET)

Corrected Corrected by Nov 9, 2023

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

3270.33(a)/3270.192(2)(iv) · 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. 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 for Staff #3, #5, #6, #7, #8, #10, and #13 did not include hours/years of experience in child care. Staff #4, functioning as an Assistant Group Supervisor, had only 1385 hours of child care experience documented. Staff #9, functioning as an Assistant Group Supervisor, had only 1888 hours of documented child care experience.

Corrected Corrected by Nov 9, 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. 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 for Staff #15 contained documentation of a high school diploma that requires translation to verify the education requirements.

Corrected Corrected by Nov 9, 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.

Toxics were accessible in an unlocked utility closet in the Toddler B classroom.

Corrected Corrected by Nov 7, 2023

Marked corrected in the state record.

3270.69(b) · Hot water temperature, in areas accessible to children, may not exceed 110° F.

The water in the bathroom in the 4B classroom exceeded 110 degrees Fahrenheit.

Corrected Corrected by Nov 7, 2023

Category: physical safety. 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 kits in the Toddler A and Toddler B classrooms were missing tweezers.

Corrected Corrected by Nov 7, 2023

Category: health medication. 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 Preschool, 4B, and Discovery classroom bathrooms, there was not a handwashing sign for every sink and every toilet.

Corrected Corrected by Nov 7, 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.

On the Toddler Playground, a Little Tikes car was missing a steering wheel which caused broken plastic with sharp edges that could be harmful to children.

Corrected Corrected by Nov 7, 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.

SECOND CITATION: The infant room contained cribs that were not two feet apart on three sides while in use. PREVIOUSLY CITED ON 2/3/23

Corrected Corrected by Nov 7, 2023

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 file for Child #4 contained an emergency contact form and financial agreement that was not updated within 6 months of the previous date. (6/5/22 & 2/2023)

Corrected Corrected by Nov 7, 2023

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 most recent health assessment on file for Child #2, a Young Toddler, is dated 4/10/23, more than 6 months ago.

Corrected Corrected by Nov 13, 2023

Category: health medication. 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 (OT) lacked updated written verification of ongoing administered vaccines: 1 Dose of DTAP and 1 Dose of Hepatitis A and lacked an Influenza shot with no Letter of Exemption in the File. Child file #4 (OT) lacked updated written verification of ongoing administered vaccines: 1 Dose of Hepatitis A with no Letter of Exemption in the File. Child #2 and Child #4 must be dismissed from care by close of business 11/7/2023 and may only return to care when the immunization record is updated or when a parent provides a written, signed exemption letter.

Corrected Corrected by Nov 7, 2023

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 current health assessment on file for Staff #2, dated 11/14/22, did not indicate if Staff #2 is suitable to work in child care.

Corrected Corrected by Nov 9, 2023

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 #12 includes only 1 written nonfamily reference letter.

Corrected Corrected by Nov 10, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.15(b) · The legal entity shall maintain ongoing compliance with the applicable requirements prescribed by the Department of Labor and Industry in 34 Pa. Code § 403.23 and under section 1016(c) of the act at all times following issuance of any certificate of compliance issued by the Department under this chapter.

The facility was unable to provide a copy of the certificate of occupancy for the childcare facility.

Corrected Corrected by Feb 1, 2024

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 5/11/23-6/12/23, 6/12/23-7/17/23, and 7/17/23-8/18/23, more than 30 days apart.

Corrected Corrected by Jan 8, 2024

Category: recordkeeping. 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 emergency plan on site at the facility does not include shelter and lockdown in the letter to parents/guardians.

Corrected Corrected by Nov 13, 2023

Category: physical safety. 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.

The facility does not have documentation verifying that the most recent emergency plan was submitted to the local municipality and to the county emergency management agency.

Corrected Corrected by Nov 9, 2023

Category: physical safety. 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 for Child #3, Child #6, and Child #7, enrolled for more than 60 days, do not contain an initial child health assessment. (SEE LIS CODE SHEET)

Corrected Corrected by Jan 15, 2024

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

3270.51 · When children are grouped in similar age levels, the following maximum child group sizes and ratios of staff persons apply: Infants 1:4 with a maximum group size of 8; Young toddlers 1:5 with a maximum group size of 10; Older toddlers 1:6 with a maximum group size of 12; Preschool children 1:10 with a maximum group size of 20; Young school-age children 1:12 with a maximum group size of 24; Older school-age children 1:15 with a maximum group size of 30.

Based on interviews, On 2/3/23 Staff person #3 was walking down the hall and discovered 10 preschool children alone in the Preschool room. Staff person #3 stayed in the room for up to four to five minutes before both staff person #1 and staff person #2 returned.

Corrected Corrected by Feb 6, 2023

Category: ratio. 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.

Interviews of facility persons established that rest mats are not consistently positioned with two feet of clearance on three sides.

Corrected Corrected by Feb 6, 2023

Category: background checks. 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.

While completing an investigation at the facility, staff interviews revealed that on 2/3/23 at approximately 10:00am, Facility Persons #1 and #2 left 10 preschool-aged children unsupervised in the Preschool Room for a period of time of roughly four minutes.

Corrected Corrected by Feb 6, 2023

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.

While completing an investigation at the facility, staff interviews revealed that on 2/3/23 at approximately 10:00am, Facility Persons #1 and #2 left 10 preschool-aged children unsupervised in the Preschool Room for a period of time of roughly four minutes.

Corrected Corrected by Feb 3, 2023

Category: supervision. Marked corrected in the state record.

3270.27(a)(3) · The facility shall have an emergency plan that provides for a method for facility persons to contact parents as soon as reasonably possible when an emergency situation arises.

The observed emergency plan lacked a method for facility persons to contact parents when an emergency arises.

Corrected Corrected by Nov 23, 2022

Category: physical safety. 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 observed emergency plan lacked a method for facility persons to inform parents that the emergency has ended.

Corrected Corrected by Nov 23, 2022

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

3270.27(b) · The operator shall review the emergency plan at least annually and update the plan as needed. The operator shall document in writing each review and update of the emergency plan and kept on file at the facility.

The observed emergency plan was not updated in the past 12 months.

Corrected Corrected by Nov 22, 2022

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 person #11 had not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): health and safety training. Observed health and training certificate was dated 11/19/22.

Corrected Corrected by Nov 22, 2022

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. Facility Person #3, #4, #8 may not work at the facility.

The file for Staff #3 lacked an FBI clearance and receipt for FBI clearance. The file for Staff #4 lacked an NSOR clearance and application for NSOR clearance. The file for Staff #8 lacked an NSOR clearance and contained an application for NSOR dated 5/6/22.

Corrected Corrected by Nov 23, 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 for Staff #7 lacked documentation of written staff evaluations. The files for Staff #9 and #10 contained consecutive staff evaluations dated more than 12 months apart.

Corrected Corrected by Nov 29, 2022

Category: recordkeeping. 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.

Emergency numbers in the Toddler B Room were not posted near the telephone.

Corrected Corrected by Nov 22, 2022

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

3270.75(b) · A first-aid kit must be inaccessible to children.

The first-aid kit in the PS Room was observed to be accessible to children.

Corrected Corrected by Nov 22, 2022

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 Discovery PS Room was observed to lack tweezers. The first-aid kit in the Pre-K Room was observed to lack tape, tweezers and soap.

Corrected Corrected by Nov 22, 2022

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.

The bathroom in the Discovery PS room was observed to lack a lidded waste can.

Corrected Corrected by Nov 22, 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.

A broken easel attachment was observed in the Toddler PG, causing a rough edge.

Corrected Corrected by Nov 22, 2022

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

3270.111(b) · The written plan of daily activities shall be posted in the group space.

A daily plan of activities was not posted in the Pre-K or Infant Rooms.

Corrected Corrected by Nov 23, 2022

Category: physical safety. 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 Discovery PS Room at 9:55 AM on 11/22/22, Staff #13 named 5 OT and Staff #3 named 5 OT. There were 11 children in the room at that time. Staff were given another attempt to name their supervisory groups, with the same results.

Corrected Corrected by Nov 23, 2022

Category: supervision. Marked corrected in the state record.

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

The files for Child #1, #2, #3, #4, #6, #7, #8 and #9 contained agreements which lacked a signature by the operator.

Corrected Corrected by Dec 12, 2022

Category: recordkeeping. Marked corrected in the state record.

3270.123(a)(1) · An agreement shall specify the amount of the fee to be charged per day or per week.

The files for Child #2, #3, #4, #6, #7, #8, and #9 contained agreements which lacked the fee to be charged.

Corrected Corrected by Dec 12, 2022

Category: recordkeeping. 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 files for Child #6 and #7 contained child service reports dated more than six months in the past.

Corrected Corrected by Dec 14, 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 files for Child #1, #2, #3, #4, #6, #7, #8, and #9 contained agreements which lacked the children's dates of admissions.

Corrected Corrected by Dec 12, 2022

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 files for Child #1, #2, #3, #4, #5, #6, #7, #8, #9 and #10 contained the original agreements.

Corrected Corrected by Dec 12, 2022

Category: recordkeeping. 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 file for Child #6 contained an emergency contact form which lacked the last name and telephone number of the emergency contact person. The file for Child #10 contained an emergency contact form which lacked the name and telephone number of an emergency contact person.

Corrected Corrected by Dec 15, 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 file for Child #2 contained an emergency contact form which lacked the telephone number of the child's medical provider. The file for Child #8 contained an emergency contact form lacked the name, telephone number and address of the child's medical provider.

Corrected Corrected by Dec 15, 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 for Child #10 contained an emergency contact form which lacked the work address and telephone number of the enrolling parent.

Corrected Corrected by Dec 15, 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 for Child #6 and #8 contained emergency contact forms which lacked the children's health insurance name and policy number. the file for Child #10 contained an emergency contact form which lacked the child's health insurance policy number.

Corrected Corrected by Dec 15, 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 for Child #1 contained an emergency contact form which lacked the release persons names, addresses and phone numbers. The files for Child #2, #3, #7 and #8 contained emergency contact forms which lacked the release persons addresses.

Corrected Corrected by Dec 15, 2022

Category: recordkeeping. Marked corrected in the state record.

3270.131(b)(2) · The operator shall require the parent to provide an updated health report at least every 12 months for an older toddler or preschool child.

The file for Child #10 contained a most recent health report dated more than 12 months in the past.

Corrected Corrected by Nov 23, 2022

Category: health medication. 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 files for Child #3 and #7 lacked records of immunization history. The file for Child #5 contained a record of immunization history which documented 1 of 2 required Hepatitis A vaccinations.

Corrected Corrected by Dec 15, 2022

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.

During an observed diaper change in the Discovery PS Room, a child's hands were not washed after the change.

Corrected Corrected by Nov 22, 2022

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

3270.135(a)(3) · If disposable diapers are provided by a parent or by a facility, a soiled diaper shall be discarded by immediately placing the diaper into a plastic-lined, hands-free covered can.

During an observed diaper change in the Discovery PS Room, the soiled diaper was left setting on the changer throughout the change.

Corrected Corrected by Nov 22, 2022

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

3270.151(c)(2)/3270.192(3) · 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. 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 #8 lacked an initial tuberculosis screening by the Mantoux method.

Corrected Corrected by Nov 22, 2022

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

3270.151(c)(5) · An adult health assessment must include the physician's or CRNP's assessment of the person's suitability to provide child care.

The file for Staff #6 contained a health assessment which lacked the medical provider's assessment of the person's suitability to provide child care.

Corrected Corrected by Nov 23, 2022

Category: health medication. 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 observed fire drill log lacked the evacuation times of the drills.

Corrected Corrected by Nov 23, 2022

Category: recordkeeping. Marked corrected in the state record.

3270.181(c)/3270.181(d) · 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. Following review, a parent shall attest to the accuracy of information in the emergency contact information and the financial agreement at each review by affixing a dated signature to the record.

The file for Child #2 lacked updates within the past 6-month period to the emergency contact and agreement forms. The file for Child #5 contained consecutive updates to the emergency contact form dated more than 6 months apart and a most recent updated to the agreement dated more than 6 months in the past. The files for Child #6 and #10 contained consecutive updates to the emergency contact and agreement forms dated more than 6 months apart.

Corrected Corrected by Dec 22, 2022

Category: recordkeeping. Marked corrected in the state record.

3270.182(3) · A child's record shall contain signed parental consent for emergency medical care for the child. Written consent is required prior to admission.

The file for Child #3 contained an emergency contact form which lacked signed parental consent for emergency care.

Corrected Corrected by Dec 19, 2022

Category: recordkeeping. 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 contained an emergency contact form which lacked signed parental consent for the administration of first aid.

Corrected Corrected by Dec 15, 2022

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 files for Staff #1, #2, and #5 lacked two written, nonfamily references. The file for Staff #4 contained one of the two required written, nonfamily references.

Corrected Corrected by Nov 23, 2022

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 observed emergency plan lacked accommodations for infants, toddlers, children with disabilities, and children with chronic medical conditions.

Corrected Corrected by Nov 23, 2022

Category: physical safety. 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.

The facility lacked documentation of an emergency drill had between 12/19/20 and 12/19/21.

Corrected Corrected by Nov 23, 2022

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.

The observed log of testing of smoke detectors contained entries dated more than 30 days apart.

Corrected Corrected by Dec 15, 2022

Category: recordkeeping. Marked corrected in the state record.

3270.27(a)(2) · The facility shall have an emergency plan that provides for accommodations for evacuation of children from the facility building and evacuation of children to a location away from the facility premises. The evacuation routes and evacuation plans to exit the building may be the same as those required by §3270.94 (relating to fire drills).

The observed emergency plan lacked accommodations for the evacuation of children from the facility building away from facility premises.

Corrected Corrected by Nov 23, 2022

Category: physical safety. 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.

According to operator report, the emergency plan updates were provided to the county EMA but not the local municipality.

Corrected Corrected by Nov 23, 2022

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

3270.31(e)/3270.192(2)(iii) · A staff person shall obtain an annual minimum of 12 clock hours of child care training. A facility person's record shall include verification of child care experience, education and training following the outset of service at the facility.

The files for Staff #7, #9 and #10 contained 5 of the 12 required annual child care training hours between 12/19/20 and 12/19/21. The file for Staff #12 contained 7 of the 12 required annual child care training hours between 12/19/20.

Corrected Corrected by Nov 23, 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 for Child #2, #6, #7 and #8 contained initial health reports dated more than 60 days after the children's enrollment date. The file for Child #3 lacked an initial health report.

Corrected Corrected by Nov 23, 2022

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

3270.171(a) · An operator shall notify local traffic safety authorities annually in writing of the location of the facility and the program's use of pedestrian and vehicular routes around the child care facility.

Documentation of the annual local traffic safety authorities letter notifying them of the location of the facility and the use routes around the facility was unavailable at the time of inspection.

Corrected Corrected by Nov 23, 2022

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.

Lysol disinfecting spray and Clorox disinfecting wipes were located in a low, unlocked cabinet below the sink in the Infant room. Both cleaners were labeled "Keep out of reach of children," and were accessible to children in care.

Corrected Corrected by Dec 6, 2021

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.

A wooden cabinet, on which the CD player was placed, had two places on the top surface which was peeled / splintered, and contained an unsecured screw which was sticking out approximately 1/2", which was accessible to children and created a scraping / cutting hazard for children in care, in the K room.

Corrected Corrected by Dec 6, 2021

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

3270.123(a)(1) · An agreement shall specify the amount of the fee to be charged per day or per week.

The Agreements for Child #1, Child #2, and Child #3 did not contain the fee amount.

Corrected Corrected by Dec 6, 2021

Category: recordkeeping. Marked corrected in the state record.

3270.123(a)(2) · An agreement shall specify the date on which the fee is to be paid.

The Agreement for Child #1, Child #2, and Child #3 did not contain the date on which the fee is to be paid.

Corrected Corrected by Dec 6, 2021

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 the parent to whom the child may be released.

Corrected Corrected by Dec 6, 2021

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 plan identifying the means of transporting a child to emergency care and staffing provision in the event of an emergency was not displayed in the Pre-K room.

Corrected Corrected by Dec 6, 2021

Category: transportation. Marked corrected in the state record.

3270.131(d)(5)/3270.131(e)(1) · A health report shall include a review of the child's immunized status according to 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 Health Report for Child #4 did not contain verification of the influenza vaccine or a letter of exemption.

Corrected Corrected by Dec 7, 2021

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