3290.32(a) · The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services).

Observed household member #1 contained an updated Department of Education FBI fingerprint clearance dated 1/10/23. Household members in a certified childcare facility must have the required DHS FBI fingerprint clearance.

Corrected Corrected by Feb 16, 2025

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

3290.64(a) · 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 kept in a locked area or in an area inaccessible to children, and shall be stored away from food, food preparation areas and child care spaces.

Observed nose spray, labeled keep out of the reach of children, accessible to children in an unlocked drawer of the diaper changing table. Observed diaper cream, labeled keep out of reach of children, accessible to children in a bin which contained the child's diapers.

Corrected Corrected by Feb 16, 2025

Category: ratio. Marked corrected in the state record.

3290.69 · Hot water pipes and other sources of heat exceeding 110° F that are accessible to children shall be equipped with protective guards or shall be insulated to prevent direct contact.

Observed the stove located in the area where the children eat, did not have some form of knob locks to prevent the stove from accidentally being turned on.

Corrected Corrected by Feb 16, 2025

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

3290.105(j)/3290.118 · Toys, bumper pads, or pillows may not be present in a crib while an infant is sleeping in the crib. 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.

Observed an infant sleeping on a boppy pillow in a pack n play. While the infant was sleeping there were also toys in the pack n play.

Corrected Corrected by Feb 16, 2025

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

3290.131(a) · The operator shall require the parent of an enrolled child to provide an initial health report no later than 60 days following the first day of attendance at the facility.

Observed child file #1 contained an initial health report which was dated more than 60 days following the first day of attendance at the facility.

Corrected Corrected by Feb 16, 2025

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

3290.133(4) · Medication shall be stored in a locked area of the facility or in an area that is out of the reach of children.

Observed medication on the countertop and in an unlocked wall cabinet in the area where the children eat.

Corrected Corrected by Feb 16, 2025

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

3290.95(a)/3290.95(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 operator or designated staff person who is responsible for compliance with this chapter shall ensure the requirements in § 3290.95(a) are met.

Observed 2 times in the previous 12 months (9/13/24-10/15/24 and 1/10/25-2/10/25) the fire alarms were tested more than 30 days apart.

Corrected Corrected by Feb 16, 2025

Category: recordkeeping. Marked corrected in the state record.

3290.134(a) · A staff person shall ensure that a child's hands are washed before meals and snacks, after toileting and after being diapered.

2nd citation. Previously cited on 2/26/24. Staff #1 did not ensure a child's hands were washed after being diapered.

Corrected Corrected by Apr 4, 2024

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

3290.64(a) · 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 kept in a locked area or in an area inaccessible to children, and shall be stored away from food, food preparation areas and child care spaces.

Observed A&D Ointment, Desitin, and Lysol Disinfecting Wipes which indicated "keep out of the reach of children" in the top drawer of the changing table which were accessible to children.

Corrected Corrected by Mar 13, 2024

Category: ratio. Marked corrected in the state record.

3290.102(a) · Toys, play equipment and other indoor and outdoor equipment used by the children shall be clean, in good repair and free from rough edges, sharp corners, pinch and crush points, splinters and exposed bolts.

Observed a Step 2 Playhouse with rough edges where the doorbell was missing in the outdoor play space.

Corrected Corrected by Mar 13, 2024

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

3290.117(c) · A veterinarian's certificate of current rabies immunization is required for a cat or dog at the facility. The certificate shall be on file when the cat or dog is present.

A veterinarian's certificate of current rabies immunization was not on file for a dog who was present at the facility. The certificate of rabies immunization expired on 2/25/24.

Corrected Corrected by Apr 4, 2024

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

3290.123(b)/3290.182(8) · A parent shall receive the original agreement. The facility shall retain a copy of the agreement. A child's record must contain a copy of the initial agreement and subsequent written agreements between the parent and the operator. The parent receives the original agreement.

The files of Children #1, #3, and #4 contained the original agreement. The facility did not make a copy for the file and give the original to the parent.

Corrected Corrected by Mar 13, 2024

Category: recordkeeping. Marked corrected in the state record.

3290.124(b)(4)/3290.182(3) · Emergency contact information must include the written consent signed by a parent for emergency medical care. A child's record must contain signed parental consent for emergency medical care for the child. Written consent is required prior to admission.

The file of Child #2 lacked signed parental consent for emergency medical care prior to admission on the emergency contact form. Child #2 had an admission date of 10/30/23 with an emergency contact form signed on 10/31/23.

Corrected Corrected by Mar 13, 2024

Category: recordkeeping. Marked corrected in the state record.

3290.124(b)(7) · Emergency contact information must include the name, address and telephone number of the individual designated by the parent to whom the child may be released.

Emergency contact information for Children #3 and #4 did not include the address of the individual designated by the parent to whom the child may be released.

Corrected Corrected by Mar 13, 2024

Category: recordkeeping. Marked corrected in the state record.

3290.131(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 file of Child #1 lacked an updated health report at least every 6 months for an infant or young toddler. The file of Child #1 contained health reports dated 2/10/23 and 5/12/23.

Corrected Corrected by Mar 13, 2024

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

3290.134(a) · A staff person shall ensure that a child's hands are washed before meals and snacks, after toileting and after being diapered.

Staff #1 did not ensure that a child's hands were washed before meals. Staff #1 used a dishcloth with soap to wash the mobile child's hands.

Corrected Corrected by Mar 13, 2024

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

3290.182(5) · A child's record must contain signed parental consent for administration of minor first-aid procedures by facility staff. Written consent is required prior to admission.

The file of Child #2 lacked signed parental consent for administration of minor first-aid procedures by facility staff prior to admission on the emergency contact form. Child #2 had an admission date of 10/30/23 with an emergency contact form signed on 10/31/23.

Corrected Corrected by Mar 13, 2024

Category: ratio. Marked corrected in the state record.

3290.182(8) · A child's record must contain a copy of the initial agreement and subsequent written agreements between the parent and the operator. The parent receives the original agreement.

It was observed that the agreement was not on file at the date of enrollment. Child #2's date of admission was 10/30/23 with an agreement dated 10/31/23.

Corrected Corrected by Mar 13, 2024

Category: recordkeeping. Marked corrected in the state record.

3290.24(a)(5) · The facility shall have an emergency plan that provides for accommodations of infants and toddlers, children with disabilities, and children with chronic medical conditions.

The facility did not have an emergency plan that provides for accommodations of infants and toddlers.

Corrected Corrected by Mar 13, 2024

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

3290.94(a)(1) · The operator or designated staff person who is responsible for compliance with this chapter shall conduct fire drills and ensure that fire drills are conducted at least once every 60 days.

The operator or designated staff person did not ensure that fire drills were conducted at least once every 60 days. The facility provided documentation of fire drills being conducted on 1/12/23, 3/13/23, 5/15/23, 7/11/23, 9/8/23, 11/7/23 and 1/2/24.

Corrected Corrected by Mar 13, 2024

Category: recordkeeping. Marked corrected in the state record.

3290.95(a)/3290.95(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 operator or designated staff person who is responsible for compliance with this chapter shall ensure the requirements in § 3290.95(a) are met.

The facility was unable to provide written documentation that the fire detection system was manually tested at least every 30 days. The facility provided a written record that the fire detection system was manually tested on 1/1/23, 1/30/23, 3/1/23, 3/31/23, 4/30/23, 5/30/23, 6/30/23, 7/30/23, 8/29/23, 9/28/23, 10/28/23, 11/27/23, 12/27/23, 1/1/24, and 1/29/24. The operator lacked documentation of the proof and date of purchase of the interconnected smoke alarms.

Corrected Corrected by Mar 13, 2024

Category: recordkeeping. Marked corrected in the state record.

3290.18 · Conditions at the facility may not pose a threat to the health or safety of the children.

The emergency plan did not address continuity of operations.

Corrected Corrected by Mar 1, 2023

Category: ratio. Marked corrected in the state record.

3290.32(a)/3290.192(3) · The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). A facility person's record shall include a copy of requests for the criminal history record and child abuse registry clearance information, a copy of the disclosure statement and a copy of the completed clearance information required under the CPSL.

The files of Staff #1, Household Member #2, and Household Member #3 lacked documentation of the National Sex Offender Registry Verification Certificate by July 1, 2020 (SEE LIS Code Sheet). The files of Staff #1, Household Member #2, and Household Member #3 contained a NSOR dated 7/2/20. The file of Staff #1 lacked an FBI Clearance updated every 60 months. Staff #1 had an FBI Clearance dated 10/22/20 with a previous one dated 8/28/15.

Corrected Corrected by Mar 1, 2023

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

3290.103 · Toys and objects with a diameter of less than 1 inch, objects with removable parts that have a diameter of less than 1 inch, plastic bags and styrofoam objects may not be accessible to children who are still placing objects in their mouths.

On 2/8/23 observed river rock with a diameter of less than 1 inch along the house in the Outdoor Play Space which were accessible to children.

Corrected Corrected by Mar 13, 2023

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

3290.105(a) · Individual, clean, age-appropriate rest equipment shall be provided for preschool, toddler and infant children as agreed between the parent and the operator. The rest equipment must be labeled with the child's name and used only by the named child while enrolled in the program.

On 2/8/23 observed rest equipment not labeled with the child's name and used only by the named child while enrolled in the program.

Corrected Corrected by Feb 8, 2023

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

3290.118 · 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.

Staff #1 disclosed that infants are sleeping in baby swings.

Corrected Corrected by Feb 9, 2023

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

3290.123(a)(3) · An agreement shall specify 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 at § 3290.124(e).

The file of Child #5 lacked a child service report with the reinstating of this regulation on 10/31/22. The file of Child #5 contained child service reports dated 6/1/22 and 1/1/23.

Corrected Corrected by Feb 8, 2023

Category: recordkeeping. Marked corrected in the state record.

3290.124(b)(3) · Emergency contact information must include the home and work addresses and telephone numbers of the enrolling parent.

The file of Child #1 lacked the work telephone number of the enrolling parent on the emergency contact form.

Corrected Corrected by Feb 8, 2023

Category: recordkeeping. Marked corrected in the state record.

3290.124(b)(7) · Emergency contact information must include the name, address and telephone number of the individual designated by the parent to whom the child may be released.

The files of Children #1 and #2 lacked the complete address of the individual designated by the parent to whom the child may be released on the emergency contact form.

Corrected Corrected by Feb 8, 2023

Category: recordkeeping. Marked corrected in the state record.

3290.131(d)(5) · A health report shall include a review of the child's immunized status according to recommendations of the ACIP.

The files of Children #1, #2, #3, #4, and #5 lacked a current influenza immunization according to recommendations of the ACIP.

Corrected Corrected by Feb 24, 2023

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

3290.134(b) · Cloth towels and washcloths shall be labeled with the child's name, used by only the named child and laundered weekly. The operator shall arrange a laundry schedule with the parent.

On 2/8/23 observed a hand towel in the bathroom which was not labeled with a child's name.

Corrected Corrected by Feb 8, 2023

Marked corrected in the state record.

3290.166(1) · A written statement giving the formula and feeding schedule for an infant shall be obtained from the parent.

A written statement giving the formula and feeding schedule for infants was not obtained from the parents.

Corrected Corrected by Feb 9, 2023

Category: nutrition. Marked corrected in the state record.

3290.181(c) · A parent is required to review and update the emergency contact information and the financial agreement at least once in a 6-month period or as soon as there is a change in the information.

The emergency contacts and agreements for Children #1 and #5 were not reviewed and updated at least once in a 6-month period. Child #1's emergency contact was signed on 3/1/22 and reviewed on 1/23/23. Child #1's agreement was signed on 3/1/22 and reviewed on 10/30/22 and 1/23/23. Child #5's emergency contact was reviewed on 1/1/22 and 1/23/23. Child #5's agreement was reviewed on 2/27/22, 10/30/22, and 1/23/23.

Corrected Corrected by Feb 28, 2023

Category: recordkeeping. Marked corrected in the state record.

3290.94(a)(1) · The operator or designated staff person who is responsible for compliance with this chapter shall conduct fire drills and ensure that fire drills are conducted at least once every 60 days.

The operator or designated staff person did not ensure that fire drills were conducted at least once every 60 days. The facility provided documentation of fire drills being conducted on 1/10/22, 3/4/22, 5/6/22, 7/5/22, 9/2/22, 11/11/22, and 1/2/23.

Corrected Corrected by Feb 28, 2023

Category: recordkeeping. Marked corrected in the state record.

3290.94(a)(4) · The operator 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.

The operator or designated staff person did not 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.

Corrected Corrected by Feb 28, 2023

Category: recordkeeping. Marked corrected in the state record.

3290.95(a)/3290.95(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 operator or designated staff person who is responsible for compliance with this chapter shall ensure the requirements in § 3290.95(a) are met.

The facility was unable to provide written documentation that the fire detection system was manually tested at least every 30 days. The facility provided a written record that the fire detection system was manually tested on 2/1/22, 3/1/22, 4/1/22, 5/1/22, 6/1/22, 7/1/22, 8/1/22, 9/1/22, 10/1/22, 11/1/22, 12/1/22, 1/2/23, and 2/1/23.

Corrected Corrected by Feb 28, 2023

Category: recordkeeping. Marked corrected in the state record.

3290.24(d) · Emergency drills shall be conducted annually. Annual emergency drills shall be documented and on file at the facility.

An emergency drill was not conducted annually. The operator did not have documentation of an emergency drill being conducted in 2021 or 2022.

Corrected Corrected by Feb 28, 2023

Category: recordkeeping. Marked corrected in the state record.

3290.166(7) · Neither bottled formula nor human milk may be heated in a microwave oven.

On 2/8/23 observed Staff #1 place human milk in the microwave oven to heat it.

Corrected Corrected by Feb 9, 2023

Category: nutrition. Marked corrected in the state record.

3290.64(a) · 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 kept in a locked area or in an area inaccessible to children, and shall be stored away from food, food preparation areas and child care spaces.

On the day of inspection it was observed that Bleach marked Keep Out of Reach of Children was on the bench on the floor beside the washer and dryer accessible to children.

Corrected Corrected by Feb 11, 2022

Category: ratio. Marked corrected in the state record.

3290.73(c) · A first-aid kit must contain the following: soap, an assortment of adhesive bandages, sterile gauze pads, tweezers, tape, scissors and disposable, nonporous gloves.

The facility's first aid kit was observed not to have scissors or soap.

Corrected Corrected by Mar 11, 2022

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

3290.124(b)(5) · Emergency contact information must include information on the child's special needs, as specified by the child's parent, physician, physician's assistant of CRNP, which is needed in an emergency situation.

The Emergency Contact Form on file for child #1 did not have documentation for information on a disability.

Corrected Corrected by Feb 11, 2022

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

3290.124(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 Emergency Contact Form on file for child #1 did not have documentation of Health Insurance.

Corrected Corrected by Feb 11, 2022

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

3290.131(e)(1) · The facility shall require the parent to provide updated written verification from a physician, physician's assistant, CRNP, the Department of Health or a local health department of ongoing vaccines administered to an infant, toddler or preschool child in accordance with the schedule recommended by the ACIP.

The health report on file for Child #1, #2 and #3 did not contain documentation of an influenza shot being administered within the last year in accordance with the recommendations of the ACIP.

Corrected Corrected by Feb 11, 2022

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

3290.94(a)(5) · The operator or designated staff person who is responsible for compliance with this chapter shall conduct fire drills and ensure that evacuation routes are posted in a conspicuous location on each floor of the facility.

It was observed that the facility did not have posted evacuation routes in a conspicuous location on each floor of the facility.

Corrected Corrected by Feb 11, 2022

Category: recordkeeping. Marked corrected in the state record.