3270.32(a)/3270.192(4) · The operator shall comply with the CPSL and with Chapter 3490. Staff person #1 may not work in a childcare position at the facility until a new clearance is obtained. A facility person's record shall include a copy of requests for the criminal history record and child abuse registry clearance information, a copy of the disclosure statement and a copy of the completed clearance information required under the CPSL. Facility Person #1 may not work in a childcare position at the facility.

The DHS FBI clearance on file for staff person #1 was dated 9/12/19, which exceeds the 60-month requirement for updating clearances.

Corrected Corrected by Oct 26, 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 #1 will have until November 7, 2024 to complete the mandated reporter training. Until such time as the required training has been 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.

Staff person #1 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 9/12/19.

Corrected Corrected by Oct 26, 2024

Category: supervision. 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 agreement for child #2 did not include the amount of the fee to be charged per day or per week.

Corrected Corrected by Oct 26, 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 record for child #3 contained one child service report dated 3/1/24. A second child service report should have been completed for child #3 by 9/30/24. The record for child #4 did not include a child service report and the child has been enrolled for more than six months (see LIS code sheet).

Corrected Corrected by Oct 26, 2024

Category: recordkeeping. Marked corrected in the state record.

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

The agreement for child #2 did not include arrival and departure times.

Corrected Corrected by Oct 26, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.131(e) · The facility may not accept or retain an infant 2 months of age or older, a toddler or a preschool child at the facility for more than 60 days following the first day of attendance at the facility unless the parent provides written verification from a physician, physician's assistant, CRNP, the Department of Health or a local health department of the dates (month, day and year) the child was administered immunizations in accordance with the recommendations of the ACIP.

The records for child #1 did not include documentation of immunizations provided within 60 days of the child's date of enrollment. The immunizations were provided with the initial health assessment dated 6/3/24, which is more than 60 days after the child's date of enrollment (see LIS code sheet).

Corrected Corrected by Oct 26, 2024

Category: health medication. 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 initial health assessment for child #1 is dated 6/3/24, which is more than 60 days after the child's date of enrollment (see LIS code sheet).

Corrected Corrected by Oct 26, 2024

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

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

It was observed in the infant room that a bottle that was just prepared for a child was not labeled with the child's name.

Corrected Corrected by Apr 10, 2024

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.

It was observed in the downstairs men bathroom in the school age area that a piece of the tile flooring is ripped and is not in good repair which could cause a tripping hazard.

Corrected Corrected by Mar 14, 2024

Category: physical safety. 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.

It was observed in the downstairs preschool area that there was red peeling paint around the doorframe.

Corrected Corrected by Mar 14, 2024

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

3270.33(a)/3270.192(2)(ii) · A staff person or a substitute staff person shall meet one of the applicable staff qualifications for the position in which the person is performing. A facility person's record shall include verification of child care experience, education and training prior to service at the facility.

The file for Staff Person #1 contains a staff data sheet that stated that they graduated from a certain high school in 2007 and a diploma from a different high school with the graduation date of 2009. Based on the conflicting information, it could not be determined that Staff person #1 has the applicable qualifications for the position in which the staff person was performing.

Corrected Corrected by Feb 1, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.25(b) · The operator shall post a copy of each inspection summary issued by the Department in a conspicuous location used by parents. The inspection summary shall remain posted until an agent of the Department verifies that each regulatory noncompliance item cited on the inspection summary has been corrected.

Only one of the four open inspection summaries was posted on the parent board in the facility.

Corrected Corrected by Jan 4, 2024

Marked corrected in the state record.

3270.32(a) · The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). LACKING REQUIRED HIRING DOCUMENTS: Facility Person # 2-- may not work in a child care position at the facility.

The file for Staff person #1 did not contain documentation of their completed mandated reporter training. The file for Staff person #2 contained proof of applying for their NSOR but did not contain the certificate for the NSOR (see LIS Code sheet).

Corrected Corrected by Jan 5, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.95(a)/3270.95(b) · Fire detection devices or systems must be in compliance with standards established under section 1016(c) of the act (62 P.S. §  1016(c)). The Director or designated staff person who is responsible for compliance with this chapter shall ensure the requirements under subsection (a) are met.

The 30-day fire detection testing log included testing dates 10/28/23-11/28/23, which is more than 30 days apart.

Corrected Corrected by Jan 4, 2024

Category: recordkeeping. Marked corrected in the state record.

20.71(a)(7) · The Department may deny, refuse to renew or revoke a certificate of compliance for fraud or deceit in obtaining or attempting to obtain a certificate of compliance.

The file of facility person #1 contained two health assessments which appeared to be manipulated and after a conversation with representatives of each of the medical facilities listed on each health assessment, it was determined facility person #1 was not seen by the medical professional who signed, or at office listed on the assessments confirming it was in fact falsified.

Corrected Corrected by Oct 16, 2023

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

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

On 8/3 at approximately 10 am in the preschool room, staff person #9 was observed with 13 preschoolers. Staff person #9 stated the 11th child arrived at approx. 9:40 am. Based on staff interviews, all 3 rooms were out of ratio because a staff person was seriously injured the night before & was in the hospital and "We didn't know you were coming." The director was called and notified they were out of ratio and the director stated that they were trying to find additional staff. The director had been at the hospital , but was on their way to the facility. In addition, someone called off but they didn't know who and children showed up that weren't scheduled to attend.

Corrected Corrected by Aug 3, 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).

On 8/3 at approximately 9:55 am, staff person #6 was observed in the toddler room with 12 toddlers, a combined group of 7 young toddlers and 5 older toddlers. Approximately 2-3 minutes later, staff person #4 came up the stairs and into the room with 3 preschoolers. Staff #4 stated a child had just arrived and was playing on the steps and that's why they left the room. Approximately 2-3 minutes later in the infant room, staff person #5 was observed with 5 children, a combined group of 4 YT and one infant. Based on staff interviews, the 5th child had arrived at approximately 8:30 am. Based on staff interviews, all 3 rooms were out of ratio because a staff person was seriously injured the night before & was in the hospital and "We didn't know you were coming." The director was called and notified they were out of ratio and the director stated that they were trying to find additional staff. The director had been at the hospital , but was on their way to the facility. In addition, someone called off but they didn't know who and children showed up that weren't scheduled to attend that day.

Corrected Corrected by Nov 13, 2023

Category: ratio. 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.

On 8/3/23 at approximately 9:55 am, staff person #6 was observed in the toddler room with 12 toddlers, a combined group of 7 young toddlers and 5 older toddlers. There were at least 2 children near the water fountain and because of where staff person #6 was standing, they could not see the children as the fountain is around a corner and this cert rep brought their attention to it. At approximately 12:30 pm, the same day, upon returning to the facility, staff person #4 and #6 were in the toddler room with 12 children, a combination of 7 YT and 5 OT, all on their rest equipment. One child's head and face were completely covered, so staff could not see, hear, direct and assess the child. Next in the preschool room, staff person #9 was present in the preschool room with 16 preschoolers, all on their rest equipment. One child's head and face were completely covered and another child's face was covered so the staff could not see, hear, direct and assess the children.

Corrected Corrected by Aug 3, 2023

Category: supervision. Marked corrected in the state record.

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

The 3 menus posted at the facility were for the month of July.

Corrected Corrected by Oct 29, 2023

Marked corrected in the state record.

3270.14/3270.21 · A facility shall be operated in conformity with applicable Federal and State laws and regulations.State agencies whose regulations may relate to the operation of a facility include the Department of Environmental Resources, the Department of Labor and Industry, the Department of Health, the Department of Education and the Department of Transportation. Conditions at the facility may not pose a threat to the health or safety of the children.

The 1 hour health and safety training in the file for staff person #11 and #14, both hired before 10/4/22, was dated 3/8/23 and 3/15/23, respectively.

Corrected Corrected by Oct 29, 2023

Category: ratio. Marked corrected in the state record.

3270.24(a) · A staff person shall provide to agents of the Department immediate access to the facility, the children and the files and records.

On 8/3/23, the file for staff person #12, with a start date of (SEE LIS CODE SHEET), included a verification of employment completed by the operator stating that the individual had been a volunteer since January 2018. However, no file was presented for the individual at the renewal inspection on 7/28/22 or the renewal inspection on 7/11 and 7/12/23. Staff person #11, #13 and #14 were not listed on the renewal staff sheets which were completed by the operator and their files were not presented at the renewal inspection on 7/11 and 7/12/23. In an email from the operator on 8/22, the date of hire for staff person number #11 was (SEE LIS CODE SHEET) The Staff person #13 was observed at the facility working with children during the renewal inspection. The operator stated that staff person #14 had left in early June but on 8/3/23, it was observed that staff person #14 was listed as participating in the fire drills on 5/5/23, 6/23/23 and 7/31/23. On 8/3/23, it was observed that there were no school-age children in care at the time of the investigation. When asked where the school-agers were, neither the operator nor the staff identified where the children were. One staff stated that when no school-agers showed up that day, they were wondering why. On 8/8, when the operator was asked again where the school-agers were on 8/3, the operator stated that they were on a field trip to the park and Dairy Queen. When asked which staff and how many children were on the trip, the operator stated #15 and #16 were on the trip with approximately 7-8 children. Based on enrollment provided by the operator, there are 31 school-agers enrolled at the facility. When asked why staff previously stated that they didn't know where the school-agers were, the operator stated they probably didn't think about it. In an email from the operator 8/18, they stated the staff and children went to Dairy Queen and the park "on foot." On 8/21, the operator provided emergency contact forms for 7 school-agers who went on the field trip. One of the children participating in the field trp was a child of a staff person who was observed on site on 8/3. In an email from the operator on 8/22, they stated the field trip was to Universal Park in Penn Hills, however, staff person #16 told the operator they never made it to the park because "there was not enough sidewalk" and they returned to Dairy Queen. Universal Park is 6 miles away from the facility.

Corrected Corrected by Oct 29, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.32(a)/3270.192(4) · The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). A facility person's record shall include a copy of requests for the criminal history record and child abuse registry clearance information, a copy of the disclosure statement and a copy of the completed clearance information required under the CPSL. Facility Person #14 and #16 may not work in a child care position at the facility.

On 8/22/23, the file for staff person #14 was reviewed via email and included an expired child abuse clearance, dated 3/26/18 and the last two state police clearances were dated 4/19/18 and 5/2/23. The file also included a current FBI rap sheet with a missing disposition for an out of state felony charge from 2013. The file for staff person #12, with a start date of (SEE LIS CODE SHEET), included a verification of experience form completed by the operator which stated the individual had been a volunteer since 1/2018 and worked 25 hours per week. However, the individual turned 18 in December and there were no clearances on file for the individual until January of 2023. The file for staff person #16 did not include a signed and dated disclosure statement for this facility.On 8/8/23, the operator stated that staff person #16 had accompanied children on a field trip on 8/3/23. Staff person #16 was also listed on the facility's fire drill log on 7/3/23.

Corrected Corrected by Oct 29, 2023

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 protective services).

The last mandated reporter training in the file for staff person #14 was 3/5/18.

Corrected Corrected by Oct 29, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.152 · A facility person shall wash his hands before meals and snacks, and after toileting and after diapering a child.

At approximately 10:30 am on 8/3, when diapering was observed, staff #4 wore gloves, but did not wash their hands in between the 3 kids they changed nor after the last child was diapered. None of the toddlers washed their hands at the sink with soap and water after being diapered. Staff person #6 wore gloves, but did not wash their hands in between the 2 kids they changed but did wash them after the last child was diapered. Neither of the toddlers washed their hands at the sink with soap and water after being diapered. After diapering, the children sat down for a snack.

Corrected Corrected by Oct 29, 2023

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

3270.55(b) · Staff persons who are on duty but are not providing child care during naptime shall remain in the child care portion of the facility premises.

At approximately 12:30 pm on 8/3, upon returning to the facility, staff person #4 and #6 were in the todd room with 12 children, 7 YT and 5 OT, all on their rest equipment. Approximately 2 minutes later, staff person #9 was in the preschool room with 16 preschoolers, all on their rest equipment and children using the bathroom one at a time. Approx 4-5 minutes later, staff person #12 came into the building through the side door leading into the preschool room. They stated they were outside making a personal phone call. Staff person #1 and #11, who were on site earlier that day, were no longer present. When asked when staff person #11 left, staff stated the staff person left shortly after this cert rep did, which was approximately 11:30 am. When asked why staff person #11 left, staff stated they thought the staff person had an emergency. Because there were 5 staff and a total of 32 children (1 infant, 10 YT, 5 OT and 16 PS), the facility could not maintain awake ratios.

Corrected Corrected by Oct 29, 2023

Category: ratio. 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.

At approximately 10:30 am on 8/3, when diapering was observed, staff #4 wore gloves, but did not wash their hands in between the 3 kids they changed nor after the last child was diapered. None of the toddlers washed their hands at the sink with soap and water after being diapered. Staff person #6 wore gloves, but did not wash their hands in between the 2 kids they changed but did wash them after the last child was diapered. Neither of the toddlers washed their hands at the sink with soap and water after being diapered. After diapering, the children sat down for a snack.

Corrected Corrected by Oct 29, 2023

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 emergency contact information for child #4, #5, #6 and #8, sent electronically on 8/21/23, appeared to have areas that may have been whited out so some of the information could not be verified as accurate.

Corrected Corrected by Oct 29, 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.

The emergency contact information submitted electronically by the operator on 8/21/23, for child #5 through #7 and child #9, did not contain the correct date of birth for the child.

Corrected Corrected by Oct 29, 2023

Category: recordkeeping. 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.

At approximately 10:30 am on 8/3, when diapering was observed, staff #4 wore gloves, but did not wash their hands in between the 3 kids they changed nor after the last child was diapered. None of the toddlers washed their hands at the sink with soap and water after being diapered. Staff person #6 wore gloves, but did not wash their hands in between the 2 kids they changed but did wash them after the last child was diapered. Neither of the toddlers washed their hands at the sink with soap and water after being diapered. After diapering, the children sat down for a snack.

Corrected Corrected by Oct 29, 2023

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

3270.192(2)(ii) · A facility person's record shall include verification of child care experience, education and training prior to service at the facility.

The file for staff person #16, provided electronically on 8/8/23, did not include any proof of education or experience. The operator stated that staff person #16 had accompanied children on a field trip on 8/3/23. Staff person #16 was also listed on the facility's fire drill log on 7/31/23.

Corrected Corrected by Oct 29, 2023

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 file for staff person #16, provided electronically on 8/18/23, did not include 2 letters of reference.The operator stated that staff person #16 had accompanied children on a field trip on 8/3/23. Staff person #16 was also listed as participating in a fire drill on 7/31/23 on the facility's fire drill log.

Corrected Corrected by Oct 29, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.94(a)(4) · The Director or designated staff person who is responsible for compliance with this chapter shall conduct fire drills and ensure that the hypothetical locations of the fire are rotated around the facility for each drill such that the hypothetical location is never the same for consecutive drills.

On 8/3/23, it was observed that the hypothetical location listed for consecutive fire drills on 6/23 and 7/31/23 was "upper open space."

Corrected Corrected by Oct 29, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.14/3270.21 · A facility shall be operated in conformity with applicable Federal and State laws and regulations.State agencies whose regulations may relate to the operation of a facility include the Department of Environmental Resources, the Department of Labor and Industry, the Department of Health, the Department of Education and the Department of Transportation. Conditions at the facility may not pose a threat to the health or safety of the children.

On 7/11/23, the files for staff person #1 through #8 and #10, #11, #13 and #14, all hired before 10/4/22, included 1 hour health and safety trainings dated after 12/30/22. The file for staff person #9, hired before 10/4/22, did not include the 1 hour health and safety training.

Corrected Corrected by Sep 25, 2023

Category: ratio. Marked corrected in the state record.

3270.32(a)/3270.192(4) · The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). A facility person's record shall include a copy of requests for the criminal history record and child abuse registry clearance information, a copy of the disclosure statement and a copy of the completed clearance information required under the CPSL. Facility Person #4, #7, #9 and #10 may not work in a child care position at the facility.

On 7/11/23, the FBI clearance in the file for staff person #1, dated 10/28/20, was for the Department of Aging, and not a required Department of Human Services FBI Clearance. The state police clearance in the file for staff person #4 was missing at least one page of their FBI rap sheet, dated 2/6/23, making it an incomplete clearance. The disclosure statement in the file for staff person #7 and #9 were from a different location which is under a different legal entity, therefore, staff person #7 and #9 did not have an updated disclosure statement at the time of hire at this location on (SEE LIS CODE SHEET). The disclosure statement in the file for staff person #10 was not dated, so timeliness could not be assessed.

Corrected Corrected by Jul 11, 2023

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

3270.34(c) · A director shall be employed by a facility and be present at the facility site a minimum of 30 hours per week.

Based on conversation on 7/12/23 with staff person #1, the director, they don't have a set schedule. They are usually on site with kids M-F, 6-9a and then they leave after that. They might come back in the afternoon if needed, but sometimes they don't return. Children are in care 6a-9/10p, M-F. The facility offers Saturday hours, but the director stated there have been no children in care on Saturdays for the last 2 months. Based on this information, staff person #1 is not present at the facility a total of 30 hours a week when children are in care.

Corrected Corrected by Jul 11, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.35(d)/3270.35(e) · A director may not function as a group supervisor in a facility in which more than 45 children are enrolled. In a facility in which more than 45 children are enrolled, a group supervisor is required for the first group of 45 enrolled children and for each group or partial group of 45 additional enrolled children.

On 7/11/23, based on conversation with operator and staff, there is an average of 50-70 children in attendance daily. There were at least 47 children observed in care that day. The only group supervisor employed by the facility is staff person #2.

Corrected Corrected by Sep 24, 2023

Category: supervision. Marked corrected in the state record.

3270.66(a) · Cleaning materials and other toxic materials shall be kept in an area or container that is locked or made inaccessible to children.

On 7/12/23, the following items were observed in the unlocked closet in the school-age room and included instructions to keep out of the : Fabuloso, bleach, hand sanitizer and disinfectant spray.

Corrected Corrected by Sep 24, 2023

Marked corrected in the state record.

3270.75(a) · A first-aid kit shall be in a child care space.

On 7/12/23, there was not a first-aid kit present in the front gross motor space, in which preschoolers were receiving care before lunch.

Corrected Corrected by Sep 24, 2023

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

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

On 7/12/23, the first-aid kit in the toddler room did not contain soap.

Corrected Corrected by Sep 24, 2023

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 7/12/23, in the smaller preschool room downstairs, the bin containing dress up clothing had a large crack. The bottom drawer of the black 3-drawer plastic cart near the television was cracked.

Corrected Corrected by Sep 25, 2023

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

3270.113(a) · **The director will conduct random assessments of each classroom three times a week, at various times of the day, for the next 3 months. During the assessment, the director will ask each staff person in each classroom to identify the children that are in their group, and are therefore, responsible for. The director will document all assessments in a log, including the date, time, staff persons, number and ages of children. The log must first be approved by the DHS representative. The completed logs will be made available to DHS representatives upon request.

**On 7/11/23, at approximately 2:15 pm, staff persons #7 and #9 were in the large preschool/school-age room with 19 children, all of whom were on their rest equipment. Based on where the staff persons were sitting at the time, there was one child they could not see, hear, direct or assess because the child was lying close to the sink and garbage can, which obstructed their view. There was also another child who was completely covered in their sleeping bag, head to toe.

Corrected Corrected by Dec 25, 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.

*On 7/11/23, at approximately 2:15 pm, staff persons #7 and #9 were in the large preschool/school-age room with 19 children, all of whom were on their rest equipment. Based on where the staff persons were sitting at the time, there was one child they could not see, hear, direct or assess because the child was lying close to the sink and garbage can, which obstructed their view. There was also another child who was completely covered in their sleeping bag, head to toe.

Corrected Corrected by Jul 11, 2023

Category: supervision. Marked corrected in the state record.

3270.113(a)(1) · **The facility is required to maintain its hands-free method for identifying the specific children for which each staff person is responsible. It will include, minimally, the name and a picture of the child and staff will utilize the identification method appropriately by always keeping the tags on their person while on duty at the facility. When a new child enrolls at the facility, a supervision card will be present at the facility before the child's first day of attendance.

**On 7/11/23 at approximately 9:25 am, staff persons #1, #2 and #3 were observed in the middle preschool room downstairs with 19 children. Staff person #1 stated that they were not responsible for any children. Staff person #2 identified 8 children and staff person #3 identified 8 children, for a total of 16 children, leaving 3 children unidentified. Staff were working to to organize the tags at this time. Each time the staff were asked to name their supervision group, they were told to take their time and use their ID cards. In addition, the names of the children which staff identified were read back to them to confirm the names and number of children in their group. Staff person #2 then identified a 9th child, for a total of 17 children, leaving 2 children unidentified. At this point, staff were asked to identify the name of each child in the room to determine which children were not yet identified. When this certification rep provided the names of the 2 unidentified children to the staff, staff person #3 stated they were responsible for one of the two children and had the child's tag. When asked about the last unidentified child, staff person #3 stated that the child belonged in staff person #2's group. No one had a tag for the child.

Corrected Corrected by Jul 11, 2023

Category: supervision. Marked corrected in the state record.

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

On 7/11/23 at approximately 9:25 am, staff persons #1, #2 and #3 were observed in the middle preschool room downstairs with 19 children. Staff person #1 stated that they were not responsible for any children. Staff person #2 identified 8 children and staff person #3 identified 8 children, for a total of 16 children, leaving 3 children unidentified. Staff were working to to organize the tags at this time. Each time the staff were asked to name their supervision group, they were told to take their time and use their ID cards. In addition, the names of the children which staff identified were read back to them to confirm the names and number of children in their group. Staff person #2 then identified a 9th child, for a total of 17 children, leaving 2 children unidentified. At this point, staff were asked to identify the name of each child in the room to determine which children were not yet identified. When this certification rep provided the names of the 2 unidentified children to the staff, staff person #3 stated they were responsible for one of the two children and had the child's tag. When asked about the last unidentified child, staff person #3 stated that the child belonged in staff person #2's group. No one had a tag for the child.

Corrected Corrected by Jul 11, 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).

On 7/11/23, there were no child service reports in the file for child #1 and #2, both enrolled more than 6 months.

Corrected Corrected by Sep 25, 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.

On 7/11/23, the emergency contact information in the file for child #1 did not include the home phone number for the child's mother.

Corrected Corrected by Sep 25, 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.

On 7/11/23, there were no emergency contact forms present in the front gross motor space, in which preschoolers were receiving care before lunch.

Corrected Corrected by Sep 25, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.124(f) · The parent shall update in writing emergency contact information once in a 6-month period or as soon as there is a change in the information.

On 7/11/23, the last update in writing by a parent on the emergency contact information in the file for child #1 was dated 9/16/22. The last update in writing by a parent on the emergency contact information in the file for child #2 was dated 8/4/22. The last update in writing by a parent on the emergency contact information in the file for child #3 was dated 5/12/22

Corrected Corrected by Sep 25, 2023

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.

On 7/11/23, the last health report in the file for child #2, a 23 month old, was dated 12/9/21.

Corrected Corrected by Sep 25, 2023

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

3270.94(a)(4) · The Director or designated staff person who is responsible for compliance with this chapter shall conduct fire drills and ensure that the hypothetical locations of the fire are rotated around the facility for each drill such that the hypothetical location is never the same for consecutive drills.

On 7/12/23, based on review of the facility's fire drill log, the hypothetical location for back-to-back drills on 3/9/23 and 4/13/23 was listed as "Upper open space."

Corrected Corrected by Sep 25, 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). Child #2 must be dismissed from care by close of business and may only return to care when the immunization record is updated or when a parent provides a written, signed exemption letter.

On 7/11/23, the list of vaccinations in the file for child #2, a 23 month old, was missing 1 of the following vaccinations: Hep B, DTAP, HIB, Pneumococcal and polio and did not include evidence of a flu shot. There was not a written exemption letter by a parent.

Corrected Corrected by Jul 11, 2023

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.

On 7/11/23, the new wall-mounted diapering trash cans in the infant and toddler rooms were not hands-free, as they were topped with swinging lids.

Corrected Corrected by Sep 25, 2023

Category: health medication. 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.

On 7/11/23, the last two health assessments in the file for staff person #1 were dated 10/19/20 and 1/30/23. The last health assessment in the file for staff person #8 was dated 12/21/20.

Corrected Corrected by Sep 25, 2023

Category: ratio. Marked corrected in the state record.

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

On 7/11/23, the last update in writing by a parent on the emergency contact information and agreement form in the file for child #1 was dated 9/16/22. The last update in writing by a parent on the emergency contact information and the agreement form in the file for child #2 was dated 8/4/22. The last update in writing by a parent on the emergency contact information and agreement form in the file for child #3 was dated 5/12/22.

Corrected Corrected by Sep 25, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.61(h)/3270.61(h)(2)(ii) · The capacity established for an indoor space may not be exceeded. When the number of older toddler, preschool or school-age children participating in a program activity exceeds the capacity of the child care space each time period shall be designated on the facility's schedule of daily activities.

On 7/11/23, at approximately 9:25 am, there were 19 preschool children in the preschool room. Staff stated they were getting ready to transition outside but it was not designated on the facility's daily schedule.

Corrected Corrected by Jul 11, 2023

Category: ratio. Marked corrected in the state record.

3270.95(a)/3270.95(b) · Fire detection devices or systems must be in compliance with standards established under section 1016(c) of the act (62 P.S. §  1016(c)). The Director or designated staff person who is responsible for compliance with this chapter shall ensure the requirements under subsection (a) are met.

On 7/11/23, it was observed that the last two professional testing dates for the facility's fire detection system were 2/7/22 and 6/8/23. In addition, based on a written statement from the security company, they can be contacted for the system to be placed on test to check the system's function. The facility's fire detection system was not being tested and documented every 30 days or less.

Corrected Corrected by Sep 24, 2023

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.

On 7/11/23, Staff person #1, hired before 12/19/20, did not include 12 hours of training between 12/19/21 and 12/19/22.

Corrected Corrected by Sep 25, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.63 · If unsafe areas or conditions are in or near an outdoor play space, fencing or natural barriers are required to restrict children from those unsafe areas or conditions.

A large hole was observed at the bottom of the fence line in the far corner of the play space,behind the shed. The hole extended approximately 8 feet along the base of the fence, and its width was approximately a foot at the widest point. On the other side of the fence, there is a creek with running water, which is causing the hillside at the edge of the play space to erode. The erosion caused part of the outdoor play space to be missing near the fence.

Corrected Corrected by Jan 30, 2023

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

3270.68(b) · Ashes and cigarette or cigar butts are prohibited in a child care space, a play space or a food preparation area.

In the back play space, there were at least 30 cigarette butts observed on the ground throughout the space.

Corrected Corrected by Feb 1, 2023

Category: ratio. Marked corrected in the state record.

3270.68(a) · Cigarettes, pipes or cigars may not be smoked in a child care space, a play space or a food preparation area when children are in care or when food is being prepared.

In the back play space, there were at least 30 cigarette butts observed on the ground throughout the space. The operator reported that staff smoked in the back play space while on their breaks.

Corrected Corrected by Feb 1, 2023

Category: ratio. Marked corrected in the state record.

3270.32(a)/3270.192(4) · The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). A facility person's record shall include a copy of requests for the criminal history record and child abuse registry clearance information, a copy of the disclosure statement and a copy of the completed clearance information required under the CPSL. Facility Person #3 may not work in a child care position at the facility.

The most recent child abuse clearance in the file for staff person #3 was dated 8/31/17.

Corrected Corrected by Feb 1, 2023

Category: background checks. 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 approximately 10:00am in the large preschool room, staff person #3, #4 and #5 were present with 22 preschoolers. Staff person #3 identified 10 children, staff person #4 identified 5 children and staff person #5 identified 7 children. A few minutes later, staff person #5 left the room briefly and entered the adjacent room, which is a separate space, before turning around and going back into the large room with the 7 children they had previously identified. A moment later, when staff person #5 left the room again, they stated staff person #4 was now responsible for their 7 children, placing staff person #4 out of ratio with 12 preschoolers. Staff person #5 stated they left the room because a preschooler had just arrived and they needed to meet the child at the top of the steps.

Corrected Corrected by Jan 30, 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).

At approximately 9:45am in the toddler room, staff person #1 and #2 were present with 16 toddlers. Each staff person identified 8 children, placing them both out of ratio. Staff person #1 identified 6 young toddlers and 2 older toddlers and staff person #2 identified 2 young toddlers and 6 older toddlers.

Corrected Corrected by Jan 30, 2023

Category: ratio. 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.

In the large preschool room, there was an uncovered outlet behind the 2nd computer to the right of the doorway.

Corrected Corrected by Jan 30, 2023

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 the shed in the back play space, the lattice on the side of the shed was becoming detached and was cracked in 3 places. On the ramp leading up to the shed in the back play space, there were 11 exposed bolts on the side facing the facility.

Corrected Corrected by Feb 15, 2023

Category: physical safety. 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.

In the back play space, there was an area of chipping paint on the wall near the white drain pipe.

Corrected Corrected by Feb 15, 2023

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

3270.91(a) · Stairways, hallways, exits from rooms, exits from the facility and other means of egress serving as an exit shall be unobstructed.

At approximately 9:45 am in the toddler room, where staff person #1 and #2 were present with 16 toddlers, large pieces of plastic play equipment was observed being used as a barrier to keep the toddlers on one side of the room, therefore, obstructing the path to the main door.

Corrected Corrected by Jan 30, 2023

Category: recordkeeping. Marked corrected in the state record.

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

In the back play space, there was a basketball hoop that was toppled over onto the ground and the glass backboard had several large cracks. There was another basketball hoop that had toppled over and was lying on top of the children's plastic play house.

Corrected Corrected by Feb 15, 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.

At approximately 9:55 am in the infant room, a child was observed sleeping in a pack n play that was labeled with the number "1." However, there was not a corresponding chart that identified the name of the children assigned to each pack n play. At approximately 10 am in the large preschool room, a child was observed sleeping on the floor, while the other 21 children were sitting at tables or on couches.

Corrected Corrected by Jan 30, 2023

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

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

At approximately 10 am in the large preschool room, staff person #3, #4 and #5 were present with 22 preschoolers. Staff person #3 identified 10 children, staff person #4 identified 5 children and staff person #5 identified 7 children. A few minutes later, staff person #5 left the room briefly and entered the adjacent room, which is a separate space, before turning around and going back into the large room with the 7 children they had previously identified. A moment later, when staff person #5 left the room again, they stated staff person #4 was now responsible for their 7 children, placing staff person #4 out of ratio with 12 preschoolers. Staff person #5 stated they left the room because a preschooler had just arrived and they needed to meet the child at the top of the steps.

Corrected Corrected by Jan 30, 2023

Category: supervision. Marked corrected in the state record.

3270.32(a)/3270.192(4) · The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). A facility person's record shall include a copy of requests for the criminal history record and child abuse registry clearance information, a copy of the disclosure statement and a copy of the completed clearance information required under the CPSL. Facility Person #1 may not work in a child care position at the facility.

The file for staff person #1, observed alone in the preschool room with 6 children, did not include a disclosure statement, child abuse clearance or a copy of the request for the child abuse clearance.

Corrected Corrected by Nov 18, 2022

Category: background checks. 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 for staff person #1, observed alone in the preschool room with 6 children, included a high school diploma but no proof of child care experience, qualifying them as an aide.

Corrected Corrected by Nov 18, 2022

Category: supervision. Marked corrected in the state record.

3270.20(a)(1) · The operator shall immediately notify a child's parent and shall telephone notice to the appropriate regional office within 24 hours if a child in care at the facility is hospitalized or receives emergency room treatment.

Based on staff interviews, child #1 was crying when they arrived at the facility at approximately 9 am on 8.23.22. Approximately 20 minutes later, when the child could not be consoled, staff noticed that the child's arm appeared to be swollen and contacted a parent to pick up the child from the facility. The child was then taken to receive emergency medical care and the operator did not report this to the appropriate regional office.

Corrected Corrected by Nov 4, 2022

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

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

The current FA/CPR training in the file for staff person #2 was dated a few months after the previous certification had expired.

Corrected Corrected by Jul 30, 2022

Category: ratio. Marked corrected in the state record.

3270.32(a)/3270.192(4) · The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). A facility person's record shall include a copy of requests for the criminal history record and child abuse registry clearance information, a copy of the disclosure statement and a copy of the completed clearance information required under the CPSL. Facility Person #1 may not work in a child care position at the facility.

The disclosure statement in the file for staff person #1, who was observed alone and unsupervised in the infant room with 4 children, was not dated, so timeliness could not be assessed. The file also did not include a NSOR clearance, only the request for the clearance.

Corrected Corrected by Jul 30, 2022

Category: supervision. Marked corrected in the state record.

3270.33(a)/3270.36(b)(5) · 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.An assistant group supervisor shall have a high school diploma or a general educational development certificate and 2 years experience with children.

The file for staff person #1, holding the title of AGS and who was observed alone and unsupervised in the infant room with 4 children, included proof of a high school diploma, but did not include proof of 2500 hours of childcare experience as the 2 verification of employment forms were completed by the staff person.

Corrected Corrected by Jul 30, 2022

Category: supervision. 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.

The file for staff person #1, holding the title of AGS and who was observed alone and unsupervised in the infant room with 4 children, included proof of a high school diploma, but did not include proof of 2500 hours of childcare experience as the 2 verification of employment forms were completed by the staff person.

Corrected Corrected by Jul 28, 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.

The following items were observed in an unlocked closet in the school-age room, making them accessible to the children in care in the room at the time.: A can of hornet spray, a can of Lysol disinfectant spray, a bottle of Windex, 2 jugs of bleach and a bottle of Fabuloso.

Corrected Corrected by Jul 28, 2022

Marked corrected in the state record.

3270.66(b) · Cleaning materials and other toxic materials shall be stored in an original labeled container or in a container that specifies the content. Toxics shall be stored away from food, food preparation areas and child care spaces.

There was an unlabeled bottle of liquid in a closet in the school-age room. Based on conversation with staff, the liquid was Fabuloso.

Corrected Corrected by Jul 28, 2022

Category: ratio. 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 3 large tears in the artificial grass in the facility's outdoor space behind the building.

Corrected Corrected by Aug 31, 2022

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.

In the infant room, after staff person #1 was observed changing the diaper of 3 infants, neither the staff person or the children's hands were washed.

Corrected Corrected by Jul 30, 2022

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

3270.124(b)(4) · Emergency contact information must include the written consent signed by a parent for emergency medical care.

The emergency contact information in the file for child #1 did not include written consent by a parent for emergency medical care.

Corrected Corrected by Jul 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.

There was no emergency contact information for child #3 in the preschool room, where the child was observed receiving care. There was no emergency contact information for child #4 in the toddler room, where the child was observed receiving care.

Corrected Corrected by Jul 30, 2022

Category: recordkeeping. Marked corrected in the state record.

3270.124(f) · The parent shall update in writing emergency contact information once in a 6-month period or as soon as there is a change in the information

The last update in writing by a parent on the emergency contact information and agreement form in the file for child #2 was dated more than 6 months ago.

Corrected Corrected by Aug 31, 2022

Category: recordkeeping. 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.

In the infant room, after staff person #1 was observed changing the diaper of 3 infants, neither the staff person or the children's hands were washed.

Corrected Corrected by Jul 28, 2022

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

3270.135(b) · Diaper changing surfaces shall be cleaned after each use by wiping the surface with a sanitizing solution or by changing a pad or other surface covering.

In the infant room, staff person #1 was observed changing the diaper of 3 infants without sanitizing the changing table after each use.

Corrected Corrected by Jul 30, 2022

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

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

There were 4 unlabeled bottles in the refrigerator in the infant room.

Corrected Corrected by Jul 28, 2022

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 last update in writing by a parent on the emergency contact information and agreement form in the file for child #2 was dated more than 6 months ago.

Corrected Corrected by Jul 28, 2022

Category: recordkeeping. Marked corrected in the state record.

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

The emergency contact information in the file for child #1 did not include written consent by a parent for emergency medical care.

Corrected Corrected by Jul 30, 2022

Category: recordkeeping. Marked corrected in the state record.

3270.182(5) · A child's record shall contain signed parental consent for administration of minor first-aid procedures by facility staff. Written consent is required prior to admission.

The emergency contact information in the file for child #1 did not include written consent by a parent for minor first-aid.

Corrected Corrected by Jul 30, 2022

Category: ratio. Marked corrected in the state record.

3270.192(2)(ii) · A facility person's record shall include verification of child care experience, education and training prior to service at the facility.

The file for staff person #1, holding the title of AGS and who was observed alone and unsupervised in the infant room with 4 children, included proof of a high school diploma, but did not include proof of 2500 hours of childcare experience as the 2 verification of employment forms were completed by the staff person.

Corrected Corrected by Jul 28, 2022

Category: supervision. Marked corrected in the state record.

3270.27(a)(6) · Emergency drills shall be conducted annually. Annual emergency drills shall be documented and on file at the facility.

The first emergency drill conducted at the facility was 5/16/22.

Corrected Corrected by Jul 28, 2022

Category: recordkeeping. Marked corrected in the state record.

3270.95(a)/3270.95(b) · Fire detection devices or systems must be in compliance with standards established under section 1016(c) of the act (62 P.S. §  1016(c)).The Director or designated staff person who is responsible for compliance with this chapter shall ensure the requirements under subsection (a) are met.

Based on conversation with the operator, there was not proof of purchase of the fire detection system.

Corrected Corrected by Jul 28, 2022

Category: recordkeeping. Marked corrected in the state record.

3270.35(d) · A director may not function as a group supervisor in a facility in which more than 45 children are enrolled.

At the time of the inspection, there were 55 children observed at the facility. Based on conversation with the director, staff person #9 counts as the group supervisor for the first 45 children and is at the site more than 30 hours per week. However, they do not have a group supervisor employed at the facility for the partial group of 46+ enrolled children.

Corrected Corrected by Nov 4, 2022

Category: supervision. Marked corrected in the state record.

3270.35(e) · In a facility in which more than 45 children are enrolled, a group supervisor is required for the first group of 45 enrolled children and for each group or partial group of 45 additional enrolled children.

At the time of the inspection, there were 55 children observed at the facility. Based on conversation with the director, staff person #9 counts as the group supervisor for the first 45 children and is at the site more than 30 hours per week. However, they do not have a group supervisor employed at the facility for the partial group of 46+ enrolled children.

Corrected Corrected by Nov 4, 2022

Category: supervision. 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).

Before entering the facility at approximately 10 am, staff person #1 was observed standing outside the building, near the side entrance on the bottom floor, speaking to an unknown adult at the time. Upon entering the facility, staff person #2 and #3 were observed in the main toddler room with 13 children, a combined group of 2 younger toddler and 11 older toddlers. At the same time, staff person #1 entered the room. When staff were asked to identify their group while staff person #1 was outside, staff person #2 identified 7 children, including 2 young toddlers, placing them out of ratio. Staff person #3 was in ratio as they identified 6 older toddlers. A few minutes later, staff person #4 was observed in the large preschool/school-age room on the bottom floor with 14 children, a combined group of 11 young school-agers and 3 older school-agers, placing them out of ratio.

Corrected Corrected by Nov 4, 2022

Category: ratio. 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.

Upon entering the infant room at approximately 10:05, staff person #7 and #8 were observed in the room with 8 children, a combined group of 5 infants and 3 young toddlers. One of the infants was asleep in a bouncy seat. One of the younger toddlers was asleep in a bouncy seat and another young toddler was awake and strapped into a bouncy seat. Four pack n plays were open and two of them were being used. When asked where all of the children sleep, staff stated that the youngest kids sleep in the pack n plays and the older kids sleep in the bouncy seats. There were no names on the pack n plays. Staff stated that there were no names because the pack n plays were new. There was a dry erase board in the room for the purpose of assigning rest equipment, but none of the children's names were listed.

Corrected Corrected by Nov 4, 2022

Category: recordkeeping. Marked corrected in the state record.

3270.112 · Infants and toddlers shall be provided stimulation by being held, rocked, talked to, played with and carried.

Upon entering the infant room at approximately 10:05, staff person #7 and #8 were observed in the room with 8 children, a combined group of 5 infants and 3 young toddlers. One of the young toddlers was awake and strapped into a bouncy seat. When asked why the child was strapped in the seat, staff stated that they were about to read a story to the children.

Corrected Corrected by Nov 4, 2022

Category: recordkeeping. 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 10 am, staff person #2 answered the front door of the facility. Upon entering, staff person #2 and #3 were observed in the main toddler room with a group of children and staff person #1 was entering the room. A few moments later, as this certification representative was counting the children, a small child came from around the "blind" corner of the room that leads to both the infant room and the stairwell. At the time, because of where staff were standing, no one could see, direct or assess the child while the child was around the corner. A little later, when staff person #9 was in the main toddler room with 3 children, a young toddler was out of site briefly because they had wandered into the same blind corner.

Corrected Corrected by Nov 4, 2022

Category: supervision. Marked corrected in the state record.

3270.119 · Infants shall be placed in the sleeping position recommended by the American Academy of Pediatrics unless there is a medical reason an infant should not sleep in this position. The medical reason shall be documented in a statement signed by a physician, physician's assistant or CRNP and placed in the child's record at the facility.

Upon entering the infant room at approximately 10:05, staff person #7 and #8 were observed in the room with 8 children, a combined group of 5 infants and 3 young toddlers. One of the infants was asleep in a bouncy seat.

Corrected Corrected by Nov 4, 2022

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

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

Upon entering the facility at approximately 9:20 am, staff persons #1 through #4 were present in the main toddler room with 21 children, a combined group of 4 young toddlers, 15 older toddlers and 2 preschoolers. Staff person #1 identified 6 children in their group, staff person #2 identified 5 children in their group, staff person #3 identified 3 children in their group and staff person #4 identified 5 children in their group, for a total of 19 children, leaving 2 children unidentified.

Corrected Corrected by May 19, 2022

Category: supervision. 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.

Based on review of the fire drill log, the drills conducted between 12/20/21 and 4/7/22 listed "entire building" as the hypothetical location.

Corrected Corrected by May 19, 2022

Category: recordkeeping. Marked corrected in the state record.

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

The Director called DHS to report a child was left at their center. A staff person accepted the child but, this child is not enrolled. They have no way to contact the child's parents. Therefore there is no agreement for the child that was in care.

Corrected Corrected by Dec 20, 2021

Category: recordkeeping. Marked corrected in the state record.

3270.124(a) · Emergency contact information is required for each enrolled child. Emergency contact information must reference who shall be contacted in an emergency.

The Director called DHS to report a child was left at their center. A staff person accepted the child but, this child is not enrolled. They have no way to contact the child's parents. The child is about 2 years old.

Corrected Corrected by Dec 20, 2021

Category: recordkeeping. 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 file for facility person #5 with a hire date of 2/1/20 and facility person #6 with a hire date of 11/2/19, lacked emergency plan training.

Corrected Corrected by Jul 30, 2021

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 file for facility person #6 completed firesafety training on 9/29/19 and 1/19/21, which is not annually.

Corrected Corrected by Jul 30, 2021

Category: recordkeeping. Marked corrected in the state record.

3270.32(a) · The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services).

The file for facility person #1 contained a child abuse clearance dated for 1/4/16 and 3/1/21. The file for facility person #2 contained a child abuse clearance dated 1/4/16 and 2/2/21 and FBI clearance dated for 12/14/15 and 1/30/21, which is more than 60 months apart. The file for facility person #6, with a hire date of 11/2/19, contained a national sex offender registry verification certificate dated for 3/2/21.

Corrected Corrected by Jul 30, 2021

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

3270.75(a) · A first-aid kit shall be in a child care space.

The school age room lacked a first-aid kit.

Corrected Corrected by Jul 30, 2021

Category: physical safety. 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.

In the infant room, the yellow wall with an animal print boarder had chipping paint.

Corrected Corrected by Jul 30, 2021

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.

In the upper playground, it was observed that three picnic tables were cracked on the benches and one was cracked on the table, causing them to have pinch points.

Corrected Corrected by Jul 30, 2021

Category: physical safety. 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 emergency contact form for child #2, child #3, and child #5 lacked the enrolling parent's work address and work phone number.

Corrected Corrected by Jul 30, 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 emergency contact form for child #1 and child #4 lacked the release person's address and phone number.

Corrected Corrected by Jul 30, 2021

Category: recordkeeping. Marked corrected in the state record.

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

The file for facility person #1 contained a health assessment dated for 2/28/19 and 3/9/21 and facility person #3 contained a health assessment dated for 10/30/18 and 3/15/21, which is more than 24 months apart. The file for facility person #4, with a hire date of 6/1/21, contained a health report dated for 9/24/19, which is not at initial employment.

Corrected Corrected by Jul 30, 2021

Category: ratio. Marked corrected in the state record.

3270.151(c)(2) · An adult health assessment must include tuberculosis screening by the Mantoux method at initial employment. Subsequent tuberculosis screening is not required unless directed by a physician, physician's assistant, CRNP, the Department of Health or a local health department.

The file for facility person #3, with a hire date of 5/1/19, contained a tuberculosis screening from 9/8/18, facility person #4, with a hire date of 6/1/21, contained a tuberculosis screening from 9/26/19, which is not at initial employment.

Corrected Corrected by Jul 30, 2021

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

3270.94(a)(4) · The hypothetical locations of the fire are rotated around the facility for each drill such that the hypothetical location is never the same for consecutive drills.

The hypothetical location of the fire was listed as the entire building, in May 2021, June, 2021, and July 2021.

Corrected Corrected by Jul 30, 2021

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

3270.95(a)/3270.95(b) · Fire detection devices or systems must be in compliance with standards established under section 1016(c) of the act (62 P.S. §  1016(c)).The Director or designated staff person who is responsible for compliance with this chapter shall ensure the requirements under subsection (a) are met.

Facility lacked either the 30 day testing log or proof of operability of the smoke alarms. Facility lacked proof of purchase of the inter-connected smoke alarm system.

Corrected Corrected by Jul 30, 2021

Category: recordkeeping. Marked corrected in the state record.