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 person #1 lacked a written staff evaluation by the director that was completed 12 months from the previous written staff evaluation. The written staff evaluations in the file were dated 5/18/23 and 6/21/24.

Corrected Corrected by Sep 25, 2024

Category: recordkeeping. Marked corrected in the state record.

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

In the main room a first-aid kit was observed on a low shelf accessible to children.

Corrected Corrected by Sep 25, 2024

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.

In the main room a toy food tray was cracked creating rough edges and sharp corners.

Corrected Corrected by Sep 25, 2024

Category: nutrition. Marked corrected in the state record.

3270.131(d)(7) · A health report shall include a statement that the child is able to participate in child care and appears to be free from contagious or communicable disease.

The file for child #1 lacked a health report that included a statement that the child is able to participate in child care and appears to be free from contagious or communicable disease. The question was not answered on the form.

Corrected Corrected by Oct 17, 2024

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

3270.32(a)/3270.192(2)(iii) · The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). A facility person's record shall include verification of childcare experience, education and training following the outset of service at the facility.

The file for staff # 1 contained a current mandated reporter training certificate dated 7/8/20 that was not obtained within 60 months of the previous certificate dated 6/25/15.

Corrected Corrected by Sep 22, 2023

Category: recordkeeping. 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.

At 10:40 staff # 2 was out of ration in the toddler room. Staff # 2 was alone with 9 children 3 young toddlers and 6 older toddlers while staff # 1 was taking a child to the restroom.

Corrected Corrected by Sep 11, 2023

Category: ratio. Marked corrected in the state record.

3270.102(a) · Toys, play equipment and other indoor and outdoor equipment used by the children shall be clean, in good repair and free from rough edges, sharp corners, pinch and crush points, splinters and exposed bolts.

There was a cracked clear science cylinder in the school age room. There were few foam blocks with teeth marks in the preschool room.

Corrected Corrected by Sep 11, 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.

During naptime there were two mats with less than 2 feet of space on three sides of the mat while the equipment was in use, one in the preschool and one in the toddler room.

Corrected Corrected by Sep 11, 2023

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

3270.106(j) · Toys, bumper pads, or pillows may not be present in a crib while an infant is sleeping in the crib.

There was a toy in the crib while an infant was sleeping in the crib.

Corrected Corrected by Sep 11, 2023

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

3270.124(b)(6) · Emergency contact information must include health insurance coverage and policy number for a child under a family policy or Medical Assistance benefits, if applicable.

The file for child # 1 lacked insurance policy number for a child under a family policy or Medical Assistance benefits on the emergency contact form.

Corrected Corrected by Sep 30, 2023

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

3270.131(a)(4) · The initial health report for a school-age child must be dated in accordance with the requirements for medical examinations for school attendance in 28 Pa. Code § 23.2 (relating to medical examinations).

The file for child # 4 a school age lacked documentation of an initial health report. The child was in care longer that 60 days without initial health report.

Corrected Corrected by Sep 11, 2023

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

3270.131(d)(5)/3270.131(e)(3) · A health report shall include a review of the child's immunized status according to recommendations of the ACIP. The facility shall implement dismissal policies in accordance with the Department of Health regulation in 28 Pa. Code § 27.77 (relating to immunization requirements for children in child care group settings). .Child # 2 must be dismissed from care by close of business 9/11/23and may only return to care when the immunization records are provided or when a parent provides a written, signed and dated exemption letter.

The files for child # 2 is missing a dose of the influenza and Hepatitis A vaccine.

Corrected Corrected by Sep 15, 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 was not maintaining a medication log for a Prescription and nonprescription medication, 2 Albutero Sulfate Inhaler, I Flovent HFA inhaler, Motrin and Blistex medicate mint balm for child #1. The operator was not maintaining a medication log for a prescription medication, EPI pen for child #5.

Corrected Corrected by Sep 21, 2023

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

3270.161(c) · Food that has been previously served to a person or returned from a table shall be discarded.

There were two bottles with milk on top of the counter in the infant room that was not discarded after been served. One of the bottles was observed on the counter for about 2 hours.

Corrected Corrected by Sep 11, 2023

Category: nutrition. Marked corrected in the state record.

3270.25(a) · The facility's current certificate of compliance shall be posted in a conspicuous location used by parents. The operator shall provide the parent of each child enrolled with information on how to access the regulations in this chapter electronically and with instructions for contacting the appropriate regional child care office.

The Certificate of Compliance posted in a conspicuous location used by parents was dated 12/27/21 to 12/27/22.

Corrected Corrected by Sep 11, 2023

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 for child # 3 a school age contained a current health report that was provided after 60 days. The child was in care longer that 60 days without initial health report.

Corrected Corrected by Sep 11, 2023

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

3270.31(e)(4)(i) · Competence is the completion of training by a professional in the field of first-aid and cardiopulmonary resuscitation (CPR). All staff persons shall renew their certification in pediatric first aid and pediatric cardiopulmonary resuscitation (CPR) on or before the expiration of the most current certification.

The file for staff #3 has a current pediatric first-aid and pediatric CPR certification dated 9/4/21-9/4/23. .The certification was not renewed prior to the expiration of the previous certification dated 8/10/19-8/10/21.

Corrected Corrected by Sep 20, 2022

Category: ratio. Marked corrected in the state record.

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

Child files #1 -#10, lacked the operator's signature on the agreement form.

Corrected Corrected by Sep 22, 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 for staff # 1 and 2 contained a current Fire Safety training certificate dated 6/6/22. The files lacked Fire Safety training for the prior year.

Corrected Corrected by Sep 20, 2022

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 #1 contained a current Child Abuse clearance that was not renewed within 60 months of the previous clearance. The child Abuse clearance dates are 3/20/15 and 4/14/20. The files for Staff # 3 contained a current Child Abuse clearance , State Police clearance and a current FBI clearance that were not renewed within 60 months of the previous clearance. The child Abuse clearance dates are 9/3/15 and 9/25/20. The State Police clearance dates are 9/23/15 and 8/13/21. The FBI clearance dates are 9/23/15 and 9/24/20,

Corrected Corrected by Sep 20, 2022

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.

There were 2 damage ceiling tiles between the bathrooms. There was a damage vent on the back wall in the infant room.

Corrected Corrected by Sep 27, 2022

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

3270.82(g) · Toilet areas and fixtures shall be cleaned daily and be in good repair.

The fixture under the sink in the left side bathroom and the bathroom on the right side appeared to be corroded. The toilet in the first bathroom on the left was soiled with urine.

Corrected Corrected by Sep 25, 2022

Marked corrected in the state record.

3270.102(a) · Toys, play equipment and other indoor and outdoor equipment used by the children shall be clean, in good repair and free from rough edges, sharp corners, pinch and crush points, splinters and exposed bolts.

There were 16 foam blocks with teeth marks in the toddler room. There was a yellow cracked scooter in the playground. There was a brown couch with a spot that was peeling off in the infant room. There was a wooden manipulative toy with a chipped corner in the infant room.

Corrected Corrected by Sep 20, 2022

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

3270.111(a) · A written plan of daily activities and routines, including a time for free play shall be established for each group. The plan shall be flexible to accommodate the needs of individual children and the dynamics of the group.

The school age room lacked daily activities posted.

Corrected Corrected by Sep 20, 2022

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 # 4 a preschooler lacked an updated health report within 12 months. The previous report was dated 7/8/21.

Corrected Corrected by Sep 27, 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 # 1,2,3 and 4 lacks documentation of a current influenza immunization as recommended by the ACIP.

Corrected Corrected by Sep 27, 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.

Staff # 4 did not wash the child's hands after diapering .

Corrected Corrected by Sep 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.

In the infant room, Staff # 4 kept a soiled diaper in her hand, then placed it on the changing table until the diaper change was complete before discarding it into a trash can. The hand -free trash can in the infant room and the hand-free trash can in the toddler diaper changing area were broken. Neither trash can was able to be operated hands-free.

Corrected Corrected by Sep 22, 2022

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

3270.192(2)(iii) · 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 #1 contained a current mandated reporter training certificate dated 7/7/20 that was not obtained within 60 months of the previous certificate dated 6/14/15 .

Corrected Corrected by Sep 20, 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 emergency plan lacked accommodations for children with disabilities and children with chronic medical conditions.

Corrected Corrected by Sep 21, 2022

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

3270.25(a) · The facility's current certificate of compliance shall be posted in a conspicuous location used by parents. The operator shall provide the parent of each child enrolled with information on how to access the regulations in this chapter electronically and with instructions for contacting the appropriate regional child care office.

The Certificate of Compliance posted in a conspicuous location used by parents was dated 12/27/19 to 12/27/20. The information on how to access the regulations electronically was not provided to the parents of each enrolled child.

Corrected Corrected by Sep 28, 2022

Marked corrected in the state record.

3270.113(b) · A facility person may not use any form of physical punishment, including spanking a child.

Based on staff statements, staff #1 has grabbed children by the arm , the wrist and the head/hair to redirect them on multiple occasions.

Corrected Corrected by Jun 7, 2022

Marked corrected in the state record.

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

Based on staff statements, staff #1 has often been overheard yelling and screaming at the children in her care.

Corrected Corrected by Jun 7, 2022

Marked corrected in the state record.

3270.21/3270.113(a) · Conditions at the facility may not pose a threat to the health or safety of the children.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.

There was an 3 month old infant sleeping in a crib with a blanket over the infant's face.

Corrected Corrected by Aug 26, 2022

Category: supervision. Marked corrected in the state record.

3270.113(a)(1) · Each staff person shall be assigned the responsibility for supervision of specific children. The staff person shall know the names and whereabouts of the children in his assigned group. The staff person shall be physically present with the children in his group on the facility premises and on facility excursions off the facility premises.

On 6/7/22, at 9:11 am, 14 older toddlers and 3 staff were observed in the Older Toddler room. When each staff was asked to identify their assigned group, staff #1 identified 5 out of 6 of the children in her assigned group. 1 older toddler was not identified by any of the three staff.

Corrected Corrected by Jun 7, 2022

Category: supervision. 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 for staff persons #1 - #7 lacked emergency plan training that was completed one year from the previous emergency plan training. The file for staff person #1 had emergency plan training in the file dated 6/10/20 and 7/9/21. The file for staff person #2 had emergency plan training in the file dated 2/6/20 and 7/12/21. The file for staff person #3 had emergency plan training in the file dated 1/9/20 and 7/7/21. The file for staff person #4 had emergency plan training in the file dated 6/17/20 and 7/14/21. The file for staff person #5 had emergency plan training in the file dated 6/15/20 and 7/8/21. The file for staff person #6 had emergency plan training in the file dated 6/17/20 and 7/9/21. The file for staff person #7 had emergency plan training in the file dated 10/12/18 and 7/8/21.

Corrected Corrected by Sep 30, 2021

Category: recordkeeping. Marked corrected in the state record.

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 person #8 lacked firesafety training that was completed one year from the previous firesafety training. The firesafety trainings in the file were dated 12/11/19 and 9/2/21.

Corrected Corrected by Sep 30, 2021

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 person #1, whom was hired on 9/8/15 as a group supervisor, lacked child abuse and FBI clearances that were completed 60 months from the previous clearances. The child abuse clearances in the file were dated 9/3/15 and 9/25/20. The FBI clearances in the file were dated 9/23/15 and 9/24/20.

Corrected Corrected by Sep 30, 2021

Category: supervision. Marked corrected in the state record.

3270.32(a)/3270.192(2)(iii) · The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). 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 person #6 lacked mandated reporter training that was completed 60 months from the previous mandated reporter training. The mandated reporter trainings in the file were dated 6/14/15 and 7/7/20.

Corrected Corrected by Sep 30, 2021

Category: recordkeeping. Marked corrected in the state record.

3270.151(a)/3270.192(3) · A facility person providing direct care who comes into contact with the children or who works with food preparation shall have a health assessment conducted within 12 months prior to providing initial service in a child care setting and every 24 months thereafter. A health assessment is valid for 24 months following the date of signature, if the person does not contract a communicable disease or develop a medical problem. A facility person's record shall include a written report of initial and subsequent health assessments, including the results of initial and subsequent tuberculin skin tests, x-rays or other medical documentation necessary to confirm freedom from communicable tuberculosis.

The file for staff person #3 lacked a health assessment that was completed 24 months from the previous health assessment. The health assessments in the file were dated 8/4/19 and 8/28/21.

Corrected Corrected by Sep 30, 2021

Category: ratio. 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 person #6 lacked a health assessment that included the physician's or CRNP's assessment of the person's suitability to provide child care.

Corrected Corrected by Sep 30, 2021

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