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.

2nd citation. Previously cited on 4/10/24. The emergency contact for Child #1 was not reviewed and updated at least once in a 6-month period. Child #1's emergency contact was signed on 7/15/23.

Corrected Corrected by Jun 14, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.34(b)(1)/3270.192(2)(ii) · 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 verification of child care experience, education and training prior to service at the facility.

2nd citation. Previously cited on 4/10/24. The file of Staff #1, who was designated as the director, lacked documentation of 1 year of experience with children.

Corrected Corrected by Jun 14, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.65 · Protective receptacle covers shall be placed in electrical outlets accessible to children 5 years of age or younger.

2nd citation. Previously cited on 4/9/24. Observed an electrical outlet which lacked a protective receptacle cover under the white board in the LGI Room.

Corrected Corrected by May 29, 2024

Marked corrected in the state record.

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

2nd citation. Previously cited on 4/9/24. The hot water temperature at the sink in Room B106 was 115.7 degrees. The hot water temperature at the sink in Room B107 was 118 degrees.

Corrected Corrected by May 29, 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.

Observed 2 protruding bolts on the bottom step of the two-tunnel climber in the outdoor play space. Observed rust on the swing of the two-tunnel climber in the outdoor play space.

Corrected Corrected by May 29, 2024

Category: physical safety. 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 facility did not 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.

Corrected Corrected by May 10, 2024

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 facility did not 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 safety be reunited with their children.

Corrected Corrected by May 10, 2024

Category: physical safety. 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.

The files of Staff #2, #3, and #8 lacked documentation of training regarding the emergency plan on an annual basis. The files of Staff #2, #3, and #8 contained documentation of emergency plan training completed on 10/10/23 with a previous one completed on 9/13/22. The file of Staff #4 lacked documentation of training regarding the emergency plan at the time of initial employment (SEE LIS Code Sheet). The file of Staff #4 contained documentation of emergency plan training completed on 10/10/23.

Corrected Corrected by Apr 10, 2024

Category: recordkeeping. 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 provided to the parent explaining emergency procedures did not address accommodations for infants, toddlers, children with disabilities, and children with chronic medical conditions.

Corrected Corrected by Apr 10, 2024

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

3270.31(e)(4)(ii) · Staff persons shall participate, at least annually, in firesafety training conducted by a fire protection professional. Staff persons and volunteers shall receive training in maintenance of smoke detectors, the duties of facility persons during a fire drill and during a fire and the use of the facility's fire extinguishers, not including discharge of the fire suppressant agent.

The files of Staff #2, #3, and #8 lacked documentation of participating, at least annually, in fire safety training conducted by a fire protection professional. The files of Staff #2, #3, and #8 contained documentation of fire safety training completed on 10/10/23 with a previous one completed on 9/13/22.

Corrected Corrected by Apr 10, 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.

The files of Staff #6 and #7 lacked documentation of completing health and safety training within 90 days of hire (SEE LIS Code Sheet). The file of Staff #6 contained documentation of completing health and safety training on 3/15/24. The file of Staff #7 contained documentation of completing health and safety training on 11/27/23.

Corrected Corrected by Apr 10, 2024

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

3270.32(a)/3270.192(4) · The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). A facility person's record shall include a copy of requests for the criminal history record and child abuse registry clearance information, a copy of the disclosure statement and a copy of the completed clearance information required under the CPSL.

The file of Staff #1, a provisional hire, lacked a National Sex Offender Registry Certificate within 45 days of start (SEE LIS Code Sheet). The file of Staff #1 contained a NSOR dated 3/13/24, and no documentation indicated Staff #1 was suspended after 45 days.

Corrected Corrected by Apr 10, 2024

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

3270.32(a) · The operator shall comply with the CPSL and with Chapter 3490 (relating to Child Protective Services). Staff person #5 will have until May 11, 2024, to complete the mandated reporter training. Until such time as the required training has been completed, staff person #5 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 staff person #5, staff person #5 may not work in a child-care position at the facility.

Staff person #5 has not completed the mandated reporter training within 90 days of their date of hire (see LIS code sheet).

Corrected Corrected by May 10, 2024

Category: supervision. 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 #3 lacked a written evaluation on a regular basis, a minimum of one evaluation every 12 months. The file of Staff #3 contained a written evaluation dated for January 2023 to January 2024 with a previous one dated 1/25/22.

Corrected Corrected by Apr 10, 2024

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.

On 4/9/24 observed the sink in Room B106 lacked a clean, lidded waste receptacle. On 4/9/24 observed the sink in Room B107 lacked a clean, lidded receptacle.

Corrected Corrected by May 10, 2024

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

3270.34(b)(1)/3270.192(2)(ii) · 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 verification of child care experience, education and training prior to service at the facility.

The file of Staff #5, who was designated as the director, lacked documentation of 1 year of experience with children.

Corrected Corrected by May 10, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.65 · Protective receptacle covers shall be placed in electrical outlets accessible to children 5 years of age or younger.

On 4/9/24 observed an electrical outlet which lacked a protective receptacle cover behind the 2nd level of an open shelf by the teacher's desk in Room B106. On 4/9/24 observed an electrical outlet which lacked a protective receptacle cover on the right wall to the left of the bump out in the LGI Room. On 4/9/24 observed an electrical outlet which lacked a protective receptacle cover under the white board in the LGI Room.

Corrected Corrected by Apr 15, 2024

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.

On 4/9/24 observed Clorox Disinfecting Wipes and Fantastik Multi-surface Disinfectant Greaser which indicated "keep out of the reach of children" on the 2nd shelf from the bottom of the metal cabinet which were accessible to children in the LGI Room.

Corrected Corrected by May 10, 2024

Marked corrected in the state record.

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

On 4/9/24 the hot water temperature at the sink in Room B106 was 117.5 degrees F. On 4/9/24 the hot water temperature at the sink in Room B107 was 117.1 degrees F.

Corrected Corrected by May 10, 2024

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

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

On 4/9/24 observed two first aid kits on the 2nd shelf from the bottom of the metal cabinet which were accessible to children in the LGI Room.

Corrected Corrected by May 10, 2024

Category: health medication. 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.

On 4/9/24 observed peeling paint in the right corner by the white board in the Indoor Play Space.

Corrected Corrected by May 10, 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.

On 4/9/24 observed a waste receptacle with a broken lid in Room B107. On 4/9/24 observed a cracked Little Tykes label on a child's wheelbarrow creating rough edges in the Toddler Outdoor Play Space. On 4/9/24 observed waste receptacles with broken lids at the bathrooms located in the hall. On 4/9/24 observed a torn mat with exposed foam in Room B106. On 4/9/24 observed cracked blue triangle Magna Tile in Room B108. On 4/9/24 observed a cracked corner on a green LEGO base creating rough edges in the LGI Room.

Corrected Corrected by Apr 10, 2024

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 4/9/24 observed a white shelf by the teacher's desk in Room B106 which moved from side to side.

Corrected Corrected by Apr 10, 2024

Marked corrected in the state record.

3270.106(a) · Individual, clean, age-appropriate rest equipment shall be provided for preschool, toddler and infant children as agreed between the child's parent and the operator. The rest equipment shall be labeled for the use of a specific child and used only by the specified child.

On 4/9/24 observed rest equipment not labeled for the use of a specific child in Room B106.

Corrected Corrected by Apr 10, 2024

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

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

The agreement for Child #3 was not signed by the operator.

Corrected Corrected by Apr 10, 2024

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 agreement for Child #3 did not include the services to be provided to the family and the child.

Corrected Corrected by Apr 10, 2024

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 #3 did not specify the persons designated by a parent to whom the child may be released.

Corrected Corrected by Apr 10, 2024

Category: recordkeeping. 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 agreement for Child #3 did not specify the date of the child's admission.

Corrected Corrected by Apr 10, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.123(a)(7) · An agreement shall specify the services which are to be considered as extra.

The agreement for Child #3 did not specify services which are to be considered as extra.

Corrected Corrected by Apr 10, 2024

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 file of Child #1 contained the original agreement. The facility did not make a copy for the file and give the original to the parent.

Corrected Corrected by May 10, 2024

Category: recordkeeping. Marked corrected in the state record.

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

Emergency contact information for Child #2 did not include the complete address of the individual designated by the parent to whom the child may be released.

Corrected Corrected by May 10, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.124(c) · When children are in the facility, emergency contact information shall be present in a child care space for children receiving care in the space.

On 4/9/24 when Child #5 was receiving care in Room B107, emergency contact information for Child #5 was not present in the child care space. On 4/9/24 when Child #6 was receiving care in Room B108, emergency contact information for Child #6 was not present in the child care space.

Corrected Corrected by May 10, 2024

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 of Child #4 lacked an updated health report at least every 12 months for an older toddler or preschool child. The file of Child #4 contained a health report dated 9/1/22.

Corrected Corrected by Apr 25, 2024

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

3270.133(6) · A parent shall provide written consent for administration of medication or a special diet.

On 4/9/24 observed the parent did not provide written consent for administration of medication for Child #1.

Corrected Corrected by Apr 9, 2024

Category: ratio. Marked corrected in the state record.

3270.133(7) · An operator is responsible to establish and maintain a medication log if prescription or nonprescription medication is administered.

On 4/9/24 the operator did not establish and maintain a medication log for nonprescription medication for Child #7.

Corrected Corrected by May 10, 2024

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

3270.181(c) · A parent is required to review and update the emergency contact information and the financial agreement at least once in a 6-month period or as soon as there is a change in the information.

The emergency contact for Child #2 was not reviewed and updated at least once in a 6-month period. Child #2's emergency contact was signed on 7/28/23 and reviewed on 2/7/24. The emergency contact for Child #4 was not reviewed and updated at least once in a 6-month period. Child #4's emergency contact was signed on 7/15/23.

Corrected Corrected by Apr 25, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.182(8) · 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.

It was observed that an agreement was not on file at the date of enrollment for Children #2 and #4. Child #2 who had an admission date of 8/24/23 had an agreement dated 9/19/23. Child #4 who had an admission date of 8/24/23 had an agreement dated 9/6/23.

Corrected Corrected by Apr 10, 2024

Category: recordkeeping. Marked corrected in the state record.

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

The files of Staff #1 and #6 lacked documentation of completing professional development in pediatric first aid and pediatric cardiopulmonary resuscitation within 90 days of hire (SEE LIS Code Sheet). The file of Staff #1 contained documentation of completing pediatric first aid and pediatric cardiopulmonary resuscitation on 3/18/24. The file of Staff #6 contained documentation of completing pediatric first aid and pediatric cardiopulmonary resuscitation on 4/4/24.

Corrected Corrected by Apr 10, 2024

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

3270.31(e) · A staff person shall obtain an annual minimum of 12 clock hours of child care training.

The files of Staff #2 and #3 lacked documentation of obtaining an annual minimum of 12 clock hours of child care training.

Corrected Corrected by Apr 10, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.32(a)/3270.192(4) · The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). A facility person's record shall include a copy of requests for the criminal history record and child abuse registry clearance information, a copy of the disclosure statement and a copy of the completed clearance information required under the CPSL.

2nd citation. Previously cited on 10/23/23. The file of Staff #1 lacked a signed disclosure statement.

Corrected Corrected by Nov 28, 2023

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

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

2nd citation. Previously cited on 10/23/23. The file of Staff #1, who was designated as an assistant group supervisor, lacked documentation of 2 years experience with children.

Corrected Corrected by Dec 9, 2023

Category: supervision. Marked corrected in the state record.

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

2nd citation. Previously cited on 10/19/23. The hot water temperature at the handwashing sink in Room 104 was 117 degrees.

Corrected Corrected by Dec 9, 2023

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.

2nd citation. Previously cited on 10/19/23. Observed exposed nails and rotting wood on the bottom of the maroon shed in the Outdoor Play Space.

Corrected Corrected by Nov 28, 2023

Category: physical safety. 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.

2nd citation. Previously cited on 10/19/23. The sink in the last stall in the girl's bathroom lacked a handwashing sign.

Corrected Corrected by Nov 28, 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.

2nd citation. Previously cited on 10/19/23. Observed cracked Magna Tiles in the LGI Room.

Corrected Corrected by Nov 29, 2023

Category: physical safety. 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).

2nd citation. Previously cited on 10/23/23. The file of Child #1, a 2-year-old, lacked an influenza immunization according to the recommendations of the ACIP.

Corrected Corrected by Dec 9, 2023

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

3270.31(e) · A staff person shall obtain an annual minimum of 12 clock hours of child care training.

2nd citation. Previously cited on 10/23/23. The file of Staff #1 lacked documentation of obtaining an annual minimum of 12 clock hours of child care training,

Corrected Corrected by Dec 8, 2023

Category: recordkeeping. 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.

On 10/19/23 observed exposed nails and rotting wood on the bottom of the maroon shed in the Outdoor Play Space.

Corrected Corrected by Nov 25, 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 file of Staff #2 lacked documentation of completing the Pennsylvania Health and Safety Update 2022 by December 30, 2022 (SEE LIS Code Sheet). The file of Staff #2 contained no documentation of completing the health and safety update. The emergency plan did not address continuity of operations.

Corrected Corrected by Nov 18, 2023

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.

On 10/19/23 observed 3 pair of adult scissors in a plastic bin on the 2nd shelf from the bottom in the metal cabinet in the LGI Room which were accessible to children.

Corrected Corrected by Nov 18, 2023

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.

The files of Staff #1 and #2 lacked documentation of training regarding the emergency plan on an annual basis. The files of Staff #1 and #2 contained documentation of emergency plan training completed on 10/10/23 with a previous one completed on 9/13/22.

Corrected Corrected by Nov 18, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.31(e)(4)(ii) · Staff persons shall participate, at least annually, in firesafety training conducted by a fire protection professional. Staff persons and volunteers shall receive training in maintenance of smoke detectors, the duties of facility persons during a fire drill and during a fire and the use of the facility's fire extinguishers, not including discharge of the fire suppressant agent.

The files of Staff #1 and #2 lacked documentation of participating, at least annually, in fire safety training conducted by a fire protection professional. The files of Staff #1 and #2 contained documentation of fire safety training completed on 10/10/23 with a previous one completed on 9/13/22.

Corrected Corrected by Nov 16, 2023

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.

The file of Staff #4 lacked documentation of completing health and safety training within 90 days of hire (SEE LIS Code Sheet). The file of Staff #4 contained documentation of completing health and safety training on 11/17/22.

Corrected Corrected by Nov 16, 2023

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

3270.32(a)/3270.192(4) · The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). A facility person's record shall include a copy of requests for the criminal history record and child abuse registry clearance information, a copy of the disclosure statement and a copy of the completed clearance information required under the CPSL.

The files of Staff #1 and #2 lacked a signed disclosure statement. The file of Staff #6 lacked a DHS FBI Clearance prior to providing initial service in a child care setting (SEE LIS Code Sheet). The file of Staff #6 contained a DHS FBI Clearance dated 5/31/23.

Corrected Corrected by Nov 16, 2023

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 files of Staff #3 and #4 lacked a written evaluation on a regular basis, a minimum of one evaluation every 12 months (SEE LIS Code Sheet). The files of Staff #3 and #4 did not contain written evaluations.

Corrected Corrected by Nov 21, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.34(b)(1) · 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.

The file of Staff #6, who was designated as the director, lacked documentation of 1 year of experience with children.

Corrected Corrected by Nov 20, 2023

Category: recordkeeping. Marked corrected in the state record.

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

The written plan of daily activities was not posted in Room B115.

Corrected Corrected by Nov 20, 2023

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

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

The files of Staff #1 and #5, who were designated as an assistant group supervisor, lacked documentation of 2 years experience with children.

Corrected Corrected by Nov 16, 2023

Category: supervision. Marked corrected in the state record.

3270.65 · Protective receptacle covers shall be placed in electrical outlets accessible to children 5 years of age or younger.

On 10/19/23 observed an electrical outlet which lacked a protective receptacle cover under the Sweet Dreams Bulletin Board in Room 104. On 10/19/23 observed an electrical outlet which lacked a protective receptacle cover by the teacher's desk in Room 106. On 10/19/23 observed electrical outlets which lacked protective receptacle covers by the teacher's desk in Room 108. On 10/19/23 observed electrical outlets by the teacher's desk which lacked protective receptacle covers in Room B115. On 10/19/23 observed an electrical outlet by the sink which lacked a protective receptacle cover in Room B115. On 10/19/23 observed an electrical outlet under the white board which lacked a protective receptacle cover in Room B115. On 10/19/23 observed an electrical outlet which lacked a protective receptacle cover under the Smart TV in Room B115. On 10/19/23 observed an electrical outlet which lacked a protective receptacle cover on the white board in the LGI Room.

Corrected Corrected by Oct 19, 2023

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.

On 10/19/23 observed Clorox Disinfecting Wipes which indicated "keep out of the reach of children" on the 3rd shelf in the metal cabinet in the LGI Room which were accessible to children. On 10/19/23 observed 6 tubes of Sun Basics Sunscreen Lotion, Sport Sunscreen Lotion, and Buckeye Eco One Step Disinfectant Deodorizer Cleaner which indicated "keep out of the reach of children" on the top shelf at the entrance to the LGI Room which were accessible to children.

Corrected Corrected by Nov 20, 2023

Marked corrected in the state record.

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

On 10/19/23 the hot water temperature at the handwashing sink in Room 104 was 111.5 degrees.

Corrected Corrected by Nov 21, 2023

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

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

On 10/19/23 observed a first-aid kit on top of a drying rack in Room 108 which was accessible to children. On 10/19/23 observed a first-aid kit in a wagon in the LGI Room which was accessible to children.

Corrected Corrected by Nov 20, 2023

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.

On 10/19/23 the first-aid kit in Room 108 lacked soap.

Corrected Corrected by Nov 16, 2023

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.

On 10/19/23 the 1st three stalls in the girl's bathroom lacked handwashing signs. On 10/19/23 the 1st stall in the boy's bathroom lacked a handwashing sign.

Corrected Corrected by Nov 17, 2023

Category: health medication. 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.

On 10/19/23 the sink in Room 108 lacked a clean, lidded waste receptacle.

Corrected Corrected by Nov 20, 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 10/19/23 observed torn rest equipment with exposed foam in Room 108. On 10/19/23 observed cracked Magna Tiles in Room 108. On 10/19/23 observed cracked Magna Tiles in the LGI Room. On 10/19/23 observed a chipped corner on a LEGO platform creating rough edges in the LGI Room. On 10/19/23 observed torn rest equipment with exposed foam in the LGI Room.

Corrected Corrected by Nov 17, 2023

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

3270.103 · Toys and objects with a diameter of less than 1 inch, objects with removable parts that have a diameter of less than 1 inch, plastic bags and styrofoam objects may not be accessible to children who are still placing objects in their mouths.

On 10/19/23 observed foam blocks with bite marks in the Indoor Play Space.

Corrected Corrected by Nov 15, 2023

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 10/19/23 observed a microwave on top of a mini fridge in Room 107 which was not anchored creating a potential tipping hazard. On 10/19/23 observed a microwave on top of a min fridge in Room 106 which was not anchored creating a potential tipping hazard.

Corrected Corrected by Nov 16, 2023

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

3270.106(a) · Individual, clean, age-appropriate rest equipment shall be provided for preschool, toddler and infant children as agreed between the child's parent and the operator. The rest equipment shall be labeled for the use of a specific child and used only by the specified child.

On 10/19/23 observed rest equipment which was not labeled for the use of a specific child in Room 108.

Corrected Corrected by Nov 17, 2023

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

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

The agreement for Children #1 and #3 were not signed by the operator.

Corrected Corrected by Nov 20, 2023

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 of Children #1 and #3 lacked the services provided on the agreement.

Corrected Corrected by Nov 20, 2023

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 Children #1 and #3 did not specify the persons designated by a parent to whom the child may be released.

Corrected Corrected by Nov 20, 2023

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 files and give the original to the parent.

Corrected Corrected by Nov 20, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.124(b)(1) · Emergency contact information must include the name and birth date of the child.

Emergency contact information for Child #5 did not include the birth date of the child.

Corrected Corrected by Nov 17, 2023

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 for Children #4 and #5 did not include the work address and work telephone number of the enrolling parent.

Corrected Corrected by Nov 20, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.124(c) · When children are in the facility, emergency contact information shall be present in a child care space for children receiving care in the space.

Emergency contact information was not present for Child #6 when receiving care in Room 104. Emergency contact information was not present for Child #7 when receiving care in Room 108.

Corrected Corrected by Nov 20, 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, a 2-year-old, lacked an influenza immunization according to the recommendations of the ACIP.

Corrected Corrected by Nov 20, 2023

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

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

On 10/19/23 observed prescription medication for Child #8 which was not in an original container.

Corrected Corrected by Nov 16, 2023

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

3270.133(7) · An operator is responsible to establish and maintain a medication log if prescription or nonprescription medication is administered.

The operator did not establish and maintain a medication log for Children #3 and #8.

Corrected Corrected by Nov 20, 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.

On 10/19/23 observed bottles which were not labeled with the child's name in Room 104.

Corrected Corrected by Nov 15, 2023

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 operator lacked documentation of sending a copy of the emergency plan updates to the local municipality.

Corrected Corrected by Nov 18, 2023

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

3270.31(e) · A staff person shall obtain an annual minimum of 12 clock hours of child care training.

The files of Staff #1 and #2 lacked documentation of obtaining an annual minimum of 12 clock hours of child care training.

Corrected Corrected by Nov 25, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.52 · When children are grouped in mixed age levels, the age of the youngest child in the group determines the staff:child ratio and maximum group size in accordance with the requirements in § 3270.51 (relating to similar age level).

2nd citation. Previously cited on 2/28/23 under SIN-00219316. At approximately 8:00 AM on 8/3/23 Staff #1 was observed to be caring for a group of 8 mixed-age children which included 1 older toddler and 7 preschoolers in Room B115.

Corrected Corrected by Oct 18, 2023

Category: ratio. Marked corrected in the state record.

3270.182(6) · A child's record shall contain signed parental consent for transportation, walking excursions, swimming and wading.

The file of Child #1 lacked signed parental consent for swimming on the emergency contact form.

Corrected Corrected by Jul 18, 2023

Category: transportation. Marked corrected in the state record.

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

Based on interviews, Staff #1 and Staff #2, who are designated as aides, were caring for children unsupervised.

Corrected Corrected by May 16, 2023

Category: supervision. 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, staff indicated the facility was out of ratio in a group of children of the same age group. Staff identified being out of ratio with 1 staff and 10 older toddlers once in February.

Corrected Corrected by May 16, 2023

Category: ratio. Marked corrected in the state record.

3270.52 · The facility will develop and implement a policy stating the child enrollment will coincide with the number of available staff so that staff:child ratio is maintained at all times.

***Based on interviews, staff indicated the facility was out of ratio multiple times in a group with mixed ages of children. Staff identified being of ratio with 1 staff with between 23 to 32 children including preschoolers, young school-age, and older school-age at least twice. Staff identified being out of ratio occasionally with 5 children including infants and young toddlers. Staff identified being out of ratio 4 times in February with 2 staff with between 20 to 30 older toddlers and preschoolers. Staff identified being out of ratio at least once per week with 1 staff with between 7 to 8 children including older toddlers and preschoolers.

Corrected Corrected by Sep 25, 2023

Category: ratio. Marked corrected in the state record.

3270.52 · *When children are grouped in mixed age levels, the age of the youngest child in the group determines the staff:child ratio and maximum group size in accordance with the requirements in § 3270.51 (relating to similar age level).

*Based on interviews, staff indicated the facility was out of ratio multiple times in a group with mixed ages of children. Staff identified being of ratio with 1 staff with between 23 to 32 children including preschoolers, young school-age, and older school-age at least twice. Staff identified being out of ratio occasionally with 5 children including infants and young toddlers. Staff identified being out of ratio 4 times in February with 2 staff with between 20 to 30 older toddlers and preschoolers. Staff identified being out of ratio at least once per week with 1 staff with between 7 to 8 children including older toddlers and preschoolers.

Corrected Corrected by May 16, 2023

Category: ratio. Marked corrected in the state record.

3270.52 · **The legal entity will ensure the director, or a designee will perform ratio checks three times per week in all classrooms during the AM and PM hours of operation, documenting the time, date, classroom, number of children by age group of children present in the classroom and the number of staff present in the classroom as well as their name and position (GS, AGS, Aid etc). Ratio check will be documented for a period of four months from the date this plan of correction is accepted. The completed forms will be made available to the department representative upon request.

**Based on interviews, staff indicated the facility was out of ratio multiple times in a group with mixed ages of children. Staff identified being of ratio with 1 staff with between 23 to 32 children including preschoolers, young school-age, and older school-age at least twice. Staff identified being out of ratio occasionally with 5 children including infants and young toddlers. Staff identified being out of ratio 4 times in February with 2 staff with between 20 to 30 older toddlers and preschoolers. Staff identified being out of ratio at least once per week with 1 staff with between 7 to 8 children including older toddlers and preschoolers.

Corrected Corrected by Sep 25, 2023

Category: ratio. 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, staff 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 staff person #1, staff person #1 may not work in a child-care position at the facility.

Based on interviews, Staff person #1 has been caring for children unsupervised. Staff person #1 has not completed the following pre-service training required prior to caring for children unsupervised: pediatric first aid/CPR from a PQAS approved trainer and a PQAS approved curriculum and health and safety training.

Corrected Corrected by May 16, 2023

Category: supervision. 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.

2nd citation. Previously cited on 10/31/22. The facility did not have a policy that addressed the recognition of potential signs and symptoms of shaken baby syndrome and abusive head trauma, strategies for coping with a crying, fussing, and distraught child, and the prevention and identification of child maltreatment. The emergency plan did not address practice drills.

Corrected Corrected by Jan 20, 2023

Category: ratio. 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 1/9/23.

Corrected Corrected by Jan 20, 2023

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

3270.113(a) · **The Legal Entity will arrange for all staff to attend a minimum of 3 hours of training on supervision conducted by ELRC Region 6. The training will be submitted to the regional office for approval prior to attendance. Proof of training will be submitted upon completion.

**2nd citation. Previously cited on 10/19/22. At approximately 2:11 PM on 1/10/23 Certification Staff observed 1 child lying on rest equipment behind an art easel with boxes underneath and 1 child lying on rest equipment behind a bookshelf in Classroom B115 which did not allow for critical oversight in which the supervisor could see, hear, direct, and assess the activity of the supervisees.

Corrected Corrected by Jan 20, 2023

Category: supervision. Marked corrected in the state record.

3270.113(a) · ***The operator will identify where staff should be sitting during nap time on a map of the classroom identifying where staff and children should be placed during naptime. This map will be posted in the classroom.

***2nd citation. Previously cited on 10/19/22. At approximately 2:11 PM on 1/10/23 Certification Staff observed 1 child lying on rest equipment behind an art easel with boxes underneath and 1 child lying on rest equipment behind a bookshelf in Classroom B115 which did not allow for critical oversight in which the supervisor could see, hear, direct, and assess the activity of the supervisees.

Corrected Corrected by Jan 20, 2023

Category: supervision. 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.

*2nd citation. Previously cited on 10/19/22. At approximately 2:11 PM on 1/10/23 Certification Staff observed 1 child lying on rest equipment behind an art easel with boxes underneath and 1 child lying on rest equipment behind a bookshelf in Classroom B115 which did not allow for critical oversight in which the supervisor could see, hear, direct, and assess the activity of the supervisees.

Corrected Corrected by Jan 20, 2023

Category: supervision. 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).

2nd citation. Previously cited on 10/31/22. The files of Children #1, #2, #3, #4, and #5 lacked child service reports with the reinstating of this regulation on 10/31/22.

Corrected Corrected by Jan 20, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.37(c) · An aide or a combination of aides shall be supervised at all times by a staff person qualified at minimum as an assistant group supervisor.

Certification Staff observed Staff #1, who was designated as an aide, working alone with 4 older toddlers and 2 preschoolers in Room B106.

Corrected Corrected by Jan 20, 2023

Category: supervision. 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. IF USING TIERED LIS: The required staff:child ratios must be maintained at all times. The legal entity must submit documentation in a format approved by DHS proving that the facility is maintaining the required staff:child ratios at all times. The legal entity will confirm continuing compliance by sending copies of the documentation to the -------- Region Office on a weekly basis for a period of three months after DHS approves the documentation format.

Based on interviews, staff indicated the facility was out of ratio multiple times for up to 30 minutes in a group of children of the same age group.

Corrected Corrected by Jan 20, 2023

Category: ratio. Marked corrected in the state record.

3270.52 · When children are grouped in mixed age levels, the age of the youngest child in the group determines the staff:child ratio and maximum group size in accordance with the requirements in § 3270.51 (relating to similar age level).

Based on interviews, staff indicated the facility was out of ratio multiple times for up to 30 minutes in a group with mixed ages of children.

Corrected Corrected by Jan 20, 2023

Category: ratio. 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 did not have a policy that addressed the recognition of potential signs and symptoms of shaken baby syndrome and abusive head trauma, strategies for coping with a crying, fussing, and distraught child, and the prevention and identification of child maltreatment. The emergency plan did not address practice drills.

Corrected Corrected by Dec 22, 2022

Category: ratio. 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, staff persons #3, #6, #8, #10, #12, and #13 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 staff persons #3, #6, #8, #10, #12, and #13, staff persons #3, #6, #8, #10, #12, and #13 may not work in a child-care position at the facility.

Staff persons #3, #6, #8, #10, #12, and #13 were observed to be caring for children unsupervised. Staff persons #3, #10, and #12 have not completed the following pre-service training required prior to caring for children unsupervised: pediatric first aid and CPR and health and safety training. Staff persons #6 and #8 have not completed the following pre-service training required prior to caring for children unsupervised: pediatric first aid and CPR. Staff person #13 has not completed the following pre-service training required prior to caring for children unsupervised: health and safety training.

Corrected Corrected by Dec 1, 2022

Category: supervision. Marked corrected in the state record.

3270.31(f) · Staff person(s) shall complete professional development in the topics of 3270.31(f) (1-10) within 90 days of hire. Staff persons #1, #2, #4, #6, #8, and #13 will have until December 6, 2022, to complete the required training. Until such time as the required training has been completed, staff persons #1, #2, #4, #6, #8, and #13 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 available to supervise staff persons #1, #2 #4, #6, #8, and #13, staff persons #1, #2, #4, #6, #8, and #13 may not work in a child-care position at the facility.

Staff persons #1 has 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 pediatric first aid and CPR from a PQAS approved trainer and a PQAS approved curriculum. Staff persons #2, #4, #6, and #8 have not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): pediatric first aid and CPR from a PQAS approved trainer and a PQAS approved curriculum. Staff person #13 has not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): health and safety training.

Corrected Corrected by Dec 6, 2022

Category: supervision. 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 trainings are completed, staff person #5 must be supervised, when interacting with children, by a AGS who has completed the required training related to this citation. If there are no staff person(s) available to supervise staff person #5, staff person #5 may not work in a child-care position at the facility.

Staff person #5 was observed to be caring for children unsupervised. Staff person #5 has not completed mandated reporter training within the last 60 months. This is evidenced by the previously documented mandated reporter training on file being dated (1/9/15).

Corrected Corrected by Oct 31, 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.

On 10/19/22 observed a pair of adult scissors at the stand in front of the entrance in Classroom B107 which were accessible to children.

Corrected Corrected by Dec 1, 2022

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.

The files of Staff #2, #5, and #7 lacked documentation of training regarding the emergency plan on an annual basis. The files of Staff #2, #5, and #7 contained documentation of emergency plan training completed on 9/13/22 with a previous one completed on 8/19/21.

Corrected Corrected by Dec 1, 2022

Category: recordkeeping. Marked corrected in the state record.

3270.31(e)(4)(ii) · Staff persons shall participate, at least annually, in firesafety training conducted by a fire protection professional. Staff persons and volunteers shall receive training in maintenance of smoke detectors, the duties of facility persons during a fire drill and during a fire and the use of the facility's fire extinguishers, not including discharge of the fire suppressant agent.

The files of Staff #2, #5, and #7 lacked documentation of participating, at least annually, in fire safety training conducted by a fire protection professional. The files of Staff #2, #5, and #7 contained documentation of fire safety training conducted on 9/13/22 with a previous one conducted on 8/18/21.

Corrected Corrected by Dec 1, 2022

Category: recordkeeping. Marked corrected in the state record.

3270.31(f) · Staff persons shall complete professional development in the topics of 3270.31(f)(10) 90 days of hire. Staff person #9 must do one of the following: provide documentation that the trainer has become PQAS-certified or at least is on the waiting list, request the instructor provide documentation, such as their Pediatric First-Aid/CPR Instructor Card from the PQAS-approved organization or the approved curriculum organization, that the instructor is approved to offer Pediatric First-Aid/CPR training on behalf of their organization, or receive pediatric first-aid/CPR training in an approved curriculum by a PQAS-certified trainer.

Staff person #9 has 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.

Corrected Corrected by Dec 1, 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.

The files of Staff #9, #10, #11, #12, and #13 lacked a valid disclosure statement (See LIS Code Sheet). The disclosure statement on file for Staff #9, #10, #11, #12, and #13 was not the one updated in 2020.

Corrected Corrected by Nov 30, 2022

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

3270.32(a) · The operator shall comply with the CPSL and with Chapter 3490 (relating to Child Protective Services). Staff person #5 will have until December 6, 2022, to complete the mandated reporter training. Until such time as the required training has been completed, staff person #5 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 staff person #5, staff person #5 may not work in a child-care position at the facility.

Staff person #5 has not completed mandated reporter training within the last 60 months. This is evidenced by the previously documented mandated reporter training on file being dated (1/9/15). Staff person #5 had documentation of completing mandated reporter on 1/29/18, but it was not an acceptable training.

Corrected Corrected by Oct 31, 2022

Category: supervision. Marked corrected in the state record.

3270.35(b)(1) · A group supervisor shall have 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.

The file of Staff #13, who was designated as a group supervisor, lacked documentation of 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.

Corrected Corrected by Nov 29, 2022

Category: supervision. Marked corrected in the state record.

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

The files of Staff #5, #7, and #10 who were designated as assistant group supervisors, lacked documentation of 2 years' experience with children.

Corrected Corrected by Nov 30, 2022

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.

On 10/19/22 observed Clorox Disinfecting Wipes which indicated "keep out of the reach of children" on the desk in B107 Classroom which were accessible to children. On 10/19/22 observed Keep Safe Hand Suave Hand Sanitizer which indicated "keep out of the reach of children" on the teacher's desk in B108 Classroom which was accessible to children.

Corrected Corrected by Dec 1, 2022

Marked corrected in the state record.

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

On 10/19/22 observed a first-aid kit in the top drawer of a two-drawer filing cabinet which was accessible to children in the LGI Classroom.

Corrected Corrected by Dec 1, 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.

On 10/19/22 the sink area located at the bathrooms lacked a clean, lidded waste receptacle. The sink area in the following classrooms lacked a clean, lidded waste receptacle: B106, B107, B108, and B115.

Corrected Corrected by Nov 30, 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.

On 10/31/22 observed approximately a 12-inch tear in the mesh of a blue, red, and yellow pop-up house in the Indoor Play Space. On 10/19/22 observed a torn blue chair and a torn green chair with exposed foam in B106 Classroom. On 10/19/22 observed 2 bookcases containing games in LGI Classroom which were not anchored creating a potential tipping hazard. On 10/19/22 observed a broken stencil in B115 Classroom. On 10/19/22 observed broken Lincoln Logs and wooden blocks with rough edges and splinters in the LGI Classroom.

Corrected Corrected by Dec 1, 2022

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

3270.102(c) · Outdoor equipment that requires embedded mounting must be mounted over a loose-fill or unitary playground protective surface covering that meets the recommendations of the United States Consumer Product Safety Commission. The equipment must be anchored firmly and be in good repair.

On 10/31/22 observed embedded equipment in the Preschool/School-Age Outdoor Play Space with approximately 4 inches of mulch. The Consumer Product Safety Commission recommends 9 inches of mulch as protective surface covering.

Corrected Corrected by Dec 1, 2022

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

3270.103 · Toys and objects with a diameter of less than 1 inch, objects with removable parts that have a diameter of less than 1 inch, plastic bags and styrofoam objects may not be accessible to children who are still placing objects in their mouths.

On 10/19/22 observed foam peg boards with bite marks in B106 Classroom. On 10/19/22 observed foam peg boards with bite marks in B108 Classroom. On 10/19/22 observed foam blocks with bite marks in B115 Classroom.

Corrected Corrected by Dec 1, 2022

Marked corrected in the state record.

3270.113(a) · Children on the facility premises and on facility excursions off the premises shall be supervised by a staff person at all times. Outdoor play space used by the facility is considered part of the facility premises.

At approximately 1:08 PM on 10/19/22 Certification Staff observed 3 children lying on rest equipment behind bookshelves and 1 child lying on rest equipment behind a book display in B108 Classroom which did not allow for critical oversight in which the supervisor could see, hear, direct, and assess the activity of the supervisees.

Corrected Corrected by Oct 20, 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 of Children #1, #2, #3, #4, #5, #6, #7, #8, and #9 lacked an agreement signed by the operator.

Corrected Corrected by Nov 30, 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 file of Child #8 lacked the amount of the fee to be charged per day or per week on the agreement.

Corrected Corrected by Nov 30, 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 of Children #1, #2, #3, #4, #5, #6, #7, #8, and #9 lacked the services to be provided to the family and child on the agreement. The files of Children #1, #2, #6, #7, and #8 lacked child service reports with the reinstating of this regulation on 10/31/22.

Corrected Corrected by Jan 6, 2023

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 files of Children #1, #2, #3, #4, #5, #6, #7, #8, and #9 lacked the persons designated by a parent to whom the child may be released on the agreement.

Corrected Corrected by Nov 30, 2022

Category: recordkeeping. 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 files of Children #1, #2, #3, #4, #5, #6, #7, #8, and #9 lacked the date of the child's admission on the agreement.

Corrected Corrected by Nov 30, 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, #5, #6, #7, #8, and #9 contained the original copies of the agreement. The facility did not make a copy for the files and give the original to the parent.

Corrected Corrected by Nov 30, 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 of Child #9 lacked the complete address of the child's physician or source of medical care on the emergency contact form.

Corrected Corrected by Nov 30, 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 files of Children #5 and #9 lacked the complete work address of the enrolling parent on the emergency contact form.

Corrected Corrected by Nov 30, 2022

Category: recordkeeping. Marked corrected in the state record.

3270.124(b)(4)/3270.182(3) · Emergency contact information must include the written consent signed by a parent for emergency medical care. 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 of Child #5 lacked written consent signed by a parent for emergency medical care prior to admission. The file of Child #5 did not contain signed parental consent for emergency medical care.

Corrected Corrected by Nov 30, 2022

Category: recordkeeping. Marked corrected in the state record.

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

The files of Children #1, #5, and #9 lacked the complete address of the individual designated by the parent to whom the child may be released on the emergency contact form. The file of Child #7 lacked the address of the individual designated by the parent to whom the child may be released on the emergency contact form.

Corrected Corrected by Nov 30, 2022

Category: recordkeeping. Marked corrected in the state record.

3270.124(c) · When children are in the facility, emergency contact information shall be present in a child care space for children receiving care in the space.

Emergency contact information for Children #10, #11, #12, #13, #14, and #15 were not present when they were receiving care in the LGI Classroom.

Corrected Corrected by Nov 30, 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 of Child #1 lacked an updated health report at least every 12 months for an older toddler or preschool child with the reinstating of this regulation on 1/6/22. The file of Child #1 contained a current health report dated 9/27/22 with a previous one dated 12/29/20.

Corrected Corrected by Nov 30, 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 file of Child #2 lacked a current influenza immunization in accordance with the schedule recommended by the ACIP.

Corrected Corrected by Nov 30, 2022

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

3270.181(c) · A parent is required to review and update the emergency contact information and the financial agreement at least once in a 6-month period or as soon as there is a change in the information.

The emergency contact and agreement for Children #1, #6, #7, and #9 were not reviewed and updated at least once every 6 months with the reinstating of this regulation on 1/6/22. Child #1's emergency contact form was reviewed on 7/30/21 and then again on 8/8/22. Child #1's agreement was reviewed on 7/19/21 and then again on 9/28/22. Child #6's emergency contact and agreement were signed on 8/2/21 and reviewed on 8/14/22. Child #7's emergency contact was reviewed on 7/28/21 and then again on 8/4/22. Child #7's agreement was reviewed on 7/28/21 and then again on 8/11/22. Child #9's emergency contact was reviewed on 7/19/21 and then again on 8/2/22. Child #9's agreement was reviewed on 7/19/21 and then again on 9/27/22. The emergency contact for Child #2 was not reviewed and updated at least once every 6 months with the reinstating of this regulation on 1/6/22. Child #2's emergency contact was signed on 3/26/22 and reviewed on 10/3/22.

Corrected Corrected by Nov 30, 2022

Category: recordkeeping. Marked corrected in the state record.

3270.182(4) · A child's record shall contain signed parental consent for administration of medications or special dietary needs.

The file of Child #5 lacked signed parental consent for administration of medications or special dietary needs.

Corrected Corrected by Nov 30, 2022

Category: ratio. 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 of Child #5 lacked signed parental consent for administration of minor first-aid procedures by facility staff prior to admission. The file of Child #5 did not contain signed parental consent for administration of minor first-aid procedures.

Corrected Corrected by Nov 30, 2022

Category: ratio. Marked corrected in the state record.

3270.182(6) · A child's record shall contain signed parental consent for transportation, walking excursions, swimming and wading.

The file of Child #5 lacked signed parental consent for transportation, walking excursions, swimming, and wading.

Corrected Corrected by Nov 30, 2022

Category: transportation. Marked corrected in the state record.

3270.182(8) · 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.

It was observed that the agreement was not on file at the date of enrollment for Child #5. Child #5's date of admission was 8/24/22 with an agreement dated 9/27/22.

Corrected Corrected by Nov 30, 2022

Category: recordkeeping. 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 of Staff #11 and #13 lacked two written, nonfamily references from individuals attesting to the person's suitability to serve as a facility person. The files of Staff #11 and #13 only contained one written, nonfamily reference.

Corrected Corrected by Nov 30, 2022

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 did not ensure that fire drills were conducted at least once every 60 days. The Director provided documentation of fire drills being conducted on 9/29/21, 11/23/21, 1/28/22, 2/11/22, 3/30/22, 4/29/22, 5/31/22, 6/24/22, 8/31/22, and 9/15/22.

Corrected Corrected by Nov 29, 2022

Category: recordkeeping. Marked corrected in the state record.

3270.94(a)(5) · The Director or designated staff person who is responsible for compliance with this chapter shall conduct fire drills and ensure that evacuation routes are posted in a conspicuous location on each floor of the facility.

The Director or designated staff person did not ensure that evacuation routes were posted in a conspicuous location on each floor of the facility. An evacuation route was posted on the first floor but not in the basement.

Corrected Corrected by Nov 30, 2022

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 Director or designated staff person did not ensure that a written record was maintained on file at the facility indicating the hypothetical location of the fire and the number of children who participated in the fire drill.

Corrected Corrected by Nov 29, 2022

Category: recordkeeping. Marked corrected in the state record.

3270.31(e) · A staff person shall obtain an annual minimum of 12 clock hours of child care training.

The files of Staff #2 and #7 lacked documentation of obtaining an annual of 12 clock hours of child care training.

Corrected Corrected by Dec 19, 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 file of Child #6 lacked an initial health report no later than 60 days following the first day of attendance at the facility. Child #6 had an admission date of 8/26/21 with a health report dated 8/18/22.

Corrected Corrected by Nov 30, 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.

The operator did not 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. The operator provided documentation that local traffic safety authorities were notified on 8/8/21 and then again on 10/4/22.

Corrected Corrected by Nov 30, 2022

Marked corrected in the state record.

3270.36(b)(5)/3270.192(2)(iii) · 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 verification of child care experience, education and training following the outset of service at the facility.

The file of staff #1, an Assistant Group supervisor, lacked documentation of education. The files of staff #2 and #3 Assistant Group Supervisors, lacked documentation of 2 years' experience.

Corrected Corrected by Nov 5, 2021

Category: supervision. 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.

The girls' restroom lacked handwashing signs posted at each of the 5 toilets. The boys' restroom lacked handwashing signs posted at each of the 4 toilets.

Corrected Corrected by Nov 5, 2021

Category: health medication. 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 of child #1 lacked an emergency contact form with the phone number of the emergency contact person designated by the parent.

Corrected Corrected by Nov 5, 2021

Category: recordkeeping. Marked corrected in the state record.

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

The file of child #1 lacked an emergency contact form with the full address of the individual designated by the parent to whom the child may be released.

Corrected Corrected by Nov 5, 2021

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 accommodations for infants and toddlers.

Corrected Corrected by Nov 5, 2021

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