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

Based on interviews with multiple staff at the facility, Staff person #1 was observed to be asleep while in ratio and responsible for supervising a group of children in the infant room on two occasions.

Corrected Corrected by Aug 30, 2024

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.

Based on interviews with multiple staff at the facility, Staff person #1 was observed to be asleep while in ratio and responsible for supervising a group of children in the infant room on two occasions.

Corrected Corrected by Aug 30, 2024

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.

Based on interviews with multiple staff at the facility, Staff person #1 was observed to be asleep while in ratio and responsible for supervising a group of children in the infant room on two occasions.

Corrected Corrected by Aug 30, 2024

Category: supervision. Marked corrected in the state record.

3270.131(b)(1) · The operator shall require the parent to provide an updated health report at least every 6 months for an infant or young toddler.

The most recent health assessment on file for child #3 was completed more than 6 months prior.

Corrected Corrected by May 22, 2024

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

3270.27(e) · The operator shall provide to the parent of each enrolled child a letter explaining the emergency procedures as specified in subsection (a). The operator shall also provide to the parent of each enrolled child a letter explaining any subsequent update to the plan.

The letter to the families explaining the emergency plan did not include information regarding annual emergency drills.

Corrected Corrected by May 24, 2024

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

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

Documentation of firesafety training on file for Facility Persons # 2 and #4 indicate that the current firesafety training was completed more than 12 months after the previous firesafety training.

Corrected Corrected by May 21, 2024

Category: recordkeeping. Marked corrected in the state record.

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

There was no proof of application on file for a criminal history clearance for Facility Person #1 and an NSOR clearance on file for Facility Person #2. Both of these clearances were obtained after the respective Facility Person's start date. The current FBI clearance on file for Facility Person #2 was completed more than 60 months after the previous FBI clearance on file.

Corrected Corrected by May 21, 2024

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

3270.36(b)(5)/3270.192(2)(ii) · 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 prior to service at the facility.

Facility Person #5 was classified as an assistant group supervisor based on completion of high school and 2 years of child care experience. The experience documented on file was not child care experience.

Corrected Corrected by May 30, 2024

Category: supervision. Marked corrected in the state record.

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

There was a hand sanitizer, labeled keep out of reach of children, on a shelf in reach of children on the stage in the gym. The stage is accessible to children by unobstructed stairs.

Corrected Corrected by May 21, 2024

Marked corrected in the state record.

3270.72(d) · Windows or doors above the ground floor that open directly to the outdoors and are accessible to children shall be constructed, modified or adapted to limit the opening to 6 or fewer inches.

There was a window in the second floor Pre-K room, accessible to school-age children who receive care in the room, that was not restricted to opening less than 6 inches.

Corrected Corrected by May 21, 2024

Category: physical safety. 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.

The steps to the stage in the gym were accessible to children in care, allowing children access to stage. There was no railing or other barrier preventing a child from falling from the stage to the floor of the gym.

Corrected Corrected by Jun 17, 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.

There was a small spot of peeling paint in the Pre-K room on a wall under the last window on the right when facing the windows.

Corrected Corrected by May 21, 2024

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

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

There was a ball in the gym with small pieces of the ball's outer layer detaching, creating small removable pieces that present a choking hazard.

Corrected Corrected by May 21, 2024

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.

There was a child sleeping on a mat in the infant room that was no labeled with the child's name.

Corrected Corrected by May 21, 2024

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

3270.107 · A facility shall have an operable, clean refrigerator used to store potentially hazardous foods. The refrigerator shall be capable of maintaining food at 45° F or below. An operating thermometer shall be placed in the refrigerator.

The bottom of the refrigerator in the information was not clean.

Corrected Corrected by May 21, 2024

Category: nutrition. Marked corrected in the state record.

3270.123(a)(5)/3270.124(b)(7) · An agreement shall specify the persons designated by a parent to whom the child may be released. 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 on file for child #1 did not include the addresses of all release persons. The release persons listed on the agreement for child #6 were not listed on the child's emergency contact form on file.

Corrected Corrected by May 28, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.124(b)(2) · Emergency contact information must include the name, address and telephone number of the child's physician or source of medical care.

The emergency contact form on file for child #1 did not include the physician's phone number.

Corrected Corrected by May 24, 2024

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

3270.131(a)(1) · The initial health report for an infant must be dated no more than 3 months prior to the first day of attendance at the facility.

The initial health assessments on file for children #1, #4 and #5 were each completed more than 60 days after the respective child's start date.

Corrected Corrected by May 21, 2024

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

3270.131(c) · A health report must be written and signed by a physician, physician's assistant or a CRNP. The signature must include the individual's professional title.

The current health assessment on file for child #2 was not signed by a physician, physician's assistant or a CRNP.

Corrected Corrected by Jun 17, 2024

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

3270.131(d)(8) · A health report shall include a statement that age-appropriate screenings recommended by the American Academy of Pediatrics were conducted since the time of the previous health report required by this section.

The health assessment on file for child #2 did not include a statement that age-appropriate screenings recommended by the American Academy of Pediatrics were conducted since the time of the previous health report required by this section.

Corrected Corrected by Jun 17, 2024

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

3270.183(a) · Child records are confidential and shall be stored in a locked cabinet.

Child records were not stored in a locked cabinet.

Corrected Corrected by May 21, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.193(a) · Facility persons' records are confidential and shall be stored in a locked cabinet.

The facility persons' records were not stored in a locked filing cabinet.

Corrected Corrected by May 21, 2024

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.

There was documentation of 8 hours of child care training on file completed during the most recent review year for Facility Person #2.There was documentation of 2 hours of child care training on file completed during the most recent review year for Facility Person #4.

Corrected Corrected by May 21, 2024

Category: recordkeeping. Marked corrected in the state record.

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

There were two infant bottles not labeled with the child's name in the refrigerator in the toddler room.

Corrected Corrected by Jun 23, 2023

Marked corrected in the state record.

3270.166(1) · A written statement giving the formula and feeding schedule for an infant shall be obtained from the parent.

There were no written feeding schedules from the parents of eight enrolled infants.

Corrected Corrected by Jun 23, 2023

Category: nutrition. 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.

At the time of the inspection, the continuity of operations could not be located in the facility's emergency plan.

Corrected Corrected by Jun 23, 2023

Category: ratio. Marked corrected in the state record.

3270.27(e) · The operator shall provide to the parent of each enrolled child a letter explaining the emergency procedures. The operator shall also provide to the parent of each enrolled child a letter explaining any subsequent update to the plan.

The letter provided to parents explaining the emergency plan did not include information regarding lockdown procedures, accommodations for infants and toddlers and accommodations for children with special needs or chronic medical conditions.

Corrected Corrected by Jun 23, 2023

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

3270.31(f) · Staff person(s) shall complete professional development in the topics of 3270.31(f)(1 -- 10) within 90 days of hire. Staff person #1 will have until 6/30/23 to complete the required 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 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 the following required pre-service training within 90 days of their date of hire (see LIS code sheet): Health and Safety training.

Corrected Corrected by Jun 23, 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 #2 may not work in a child care position at the facility.

The file for staff person #2, who is beyond their 45 day provisional period included an FBI clearance that indicated charges, but there was no rap sheet attached.

Corrected Corrected by Jun 23, 2023

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

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

The hot water temperature at the sink in the gym restroom, which is accessible to children, was 120° F.

Corrected Corrected by Jun 23, 2023

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

3270.107 · A facility shall have an operable, clean refrigerator used to store potentially hazardous foods. The refrigerator shall be capable of maintaining food at 45° F or below. An operating thermometer shall be placed in the refrigerator.

There was no thermometer in the refrigerator in the toddler room.

Corrected Corrected by Jun 23, 2023

Category: nutrition. Marked corrected in the state record.

3270.135(e) · A staff person shall check a child's diaper at least every 2 hours and whenever the child indicates discomfort or exhibits behavior that suggests a soiled diaper. A staff person shall change a child's diaper when the diaper is soiled.

According to documentation in the classroom, a child in the infant room was diapered at 9:00AM, then napped until 11:30am. According to statement of room staff, as of 11:55 the child's diaper had not yet been changed.

Corrected Corrected by Jun 23, 2023

Category: health medication. 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 menu was not posted at least a week in advance.

Corrected Corrected by Jun 23, 2023

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 and #3 may not work in a child care position at the facility.

The disclosure statement in the file for staff person #1 and #3, both from a substitute staffing agency, was signed when they were hired at that agency. They did not sign a disclosure statement when they began working at the child care facility.

Corrected Corrected by May 18, 2022

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

3270.34(a)(6) · A director is responsible for written evaluation of staff persons on a regular basis, a minimum of one evaluation every 12 months.

The last two evaluations in the file for staff person #2 were dated in 2019 and 2022. The staff person was on leave during the time an updated evaluation was due, but one was not completed until 3 months after they returned..

Corrected Corrected by Mar 3, 2022

Category: recordkeeping. Marked corrected in the state record.

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

In an unlocked closet in the bathroom used by school-agers on the second floor, there was a bottle of "Damp Mop" detergent on the floor, making it accessible to the children in care.

Corrected Corrected by May 19, 2022

Marked corrected in the state record.

3270.74 · The telephone number of the nearest hospital, police department, fire department, ambulance and poison control center shall be posted by each telephone in the facility.

The number of the nearest hospital, police department, fire department, ambulance and poison control center was not posted in the infant or preschool 1 room. The list of emergency phone numbers posted in the toddler and preschool 2 room did not include a listing for "ambulance."

Corrected Corrected by May 18, 2022

Category: physical safety. 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 was a cord lying across the floor of the path that leads from the older toddler are to the younger toddler area in the toddler room, causing a potential tripping hazard.

Corrected Corrected by May 19, 2022

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 most recent emergency contact information in the file for child #3 includes a policy number for the child's health insurance but listed "none" for the name of the insurance coverage.

Corrected Corrected by May 19, 2022

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

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

The emergency contact information in the file for child #1 did not include a complete address for the three release persons listed, as there was no house number or street name.

Corrected Corrected by May 19, 2022

Category: recordkeeping. Marked corrected in the state record.

3270.124(f)/3270.181(c) · The parent shall update in writing emergency contact information once in a 6-month period or as soon as there is a change in the information. A parent is required to review and update the emergency contact information and the financial agreement at least once in a 6-month period or as soon as there is a change in the information.

The last 2 updates in writing by a parent on the emergency contact information in the file for child #2 were dated approximately 12 months apart.

Corrected Corrected by Feb 15, 2022

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 only health assessment in the file for staff person #3 was dated more than 24 months ago.

Corrected Corrected by May 18, 2022

Category: ratio. Marked corrected in the state record.

3270.175(c) · Manufacturers' instructions for use of safety restraints shall be kept in the vehicle at all times.

The manufactures' instructions for use of safety restraints was not in one of the two facility vans used daily to transport school-agers.

Corrected Corrected by May 19, 2022

Category: transportation. Marked corrected in the state record.

3270.191 · An individual record is required for each facility person.

The paperwork for staff person #1 and #3, both hired from a substitute staffing agency, were maintained in a single folder.

Corrected Corrected by May 18, 2022

Category: recordkeeping. Marked corrected in the state record.

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

The facility did not have proof of purchase of the fire detection system.

Corrected Corrected by May 20, 2022

Category: recordkeeping. Marked corrected in the state record.