Bethlehem Ymca Childcare

Regulation: 3270.113(a)/3270.113(a)(1)

Description: Supervised at all times /Staff assigned to specific children

Noncompliance Area: An investigation was conducted at the facility on 4/26/24 in response to a self-reported incident. On 4/15/24, a lapse of supervision occurred when Staff Person #1 was unaware that Child #1 left the playground and was missing for approximately two-three minutes before being discovered on the sidewalk next to the parking lot by a non child care YMCA staff person.

Correction Required: 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. Children must be supervised at all times. 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.

Regulation: 3270.113(a)/3270.113(a)(1)

Description: Supervised at all times /Staff assigned to specific children

Noncompliance Area: An investigation was conducted at the facility on 4/26/24 in response to self-reported incident. On 4/15/24, a lapse of supervision occurred when Staff Person #1 was unaware that Child #1 left the playground and was missing for approximately two-three minutes before being discovered on the sidewalk next to the parking lot by a non child care YMCA staff person.

Correction Required: 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. Children must be supervised at all times. 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. The legal entity must create a policy in order to maintain proper supervision. This policy will ensure that all children are properly assigned to a staff person and supervised at all times. This policy must address supervision during transition times, such as supervision on the playground and while children are using the bathroom. The legal entity must receive approval of the policy from the Regional Office. Once approved by the Regional Office, the legal entity must review policy with all staff and have staff sign off that the understand and will follow the supervision policy.

Regulation: 3270.113(a)/3270.113(a)(1)

Description: Supervised at all times /Staff assigned to specific children

Noncompliance Area: An investigation was conducted at the facility on 4/26/24 in response to a self-reported incident. On 4/15/24, a lapse of supervision occurred when Staff Person #1 was unaware that Child #1 left the playground and was missing for approximately two-three minutes before being discovered on the sidewalk next to the parking lot by a non child care YMCA staff person.

Correction Required: 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. Children must be supervised at all times. 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. The legal entity must arrange for all staff to receive a minimum of three hours of training regarding Supervision. The training must be PQAS approved, in-person, and outside of childcare hours. The legal entity must receive DHS approval of the training content prior to scheduling the training.

Regulation: 3270.102(a)

Description: Clean and good repair

Noncompliance Area: During the renewal inspection, the outdoor tree house was cracked at the base exposing sharp plastic corners.

Correction Required: 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.

Regulation: 3270.123(a)(5)

Description: Designated release persons

Noncompliance Area: During the renewal inspection, the agreement form on file for child #1 - child #10 did not specify the persons designated by a parent to whom the child may be released.

Correction Required: An agreement shall specify the persons designated by a parent to whom the child may be released.

Regulation: 3270.124(b)(2)

Description: Physician name, address, phone

Noncompliance Area: During the renewal inspection, the name, address and telephone number of the child's physician or source of medical care was missing from the emergency contact form of child #8.

Correction Required: Emergency contact information must include the name, address and telephone number of the child's physician or source of medical care.

Regulation: 3270.124(b)(3)

Description: Parent home/work address, phone

Noncompliance Area: During the renewal inspection, the work address and phone number of the enrolling parent was missing from the emergency contact for child #8.

Correction Required: Emergency contact information must include the home and work addresses and telephone numbers of the enrolling parent.

Regulation: 3270.124(e)

Description: Written emergency plan posted

Noncompliance Area: During the renewal inspection, a written plan identifying the means of transporting a child to emergency care and staffing provisions in the event of an emergency were not displayed in every child care space.

Correction Required: A written plan identifying the means of transporting a child to emergency care and staffing provisions in the event of an emergency shall be displayed conspicuously in every child care space and shall accompany a staff person who leaves on an excursion with children.

Regulation: 3270.124(f)/3270.181(c)

Description: Updated every 6 months/Emergency info/agreement updated 6 mos

Noncompliance Area: During the renewal inspection, child #2 did not have the emergency contact form updated within the past 6 months.

Correction Required: 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.

Regulation: 3270.131(a)

Description: Health information

Noncompliance Area: During the renewal inspection, the initial health assessment on file for child #5 was dated 9/1/22. The initial health assessment for child #6 was dated 1/4/23. The initial health assessment on file for child #10 was dated 1/16/23. All of these health assessments reflect more than 60 days from the child's first day of attendance (see code sheet for date of admission).

Correction Required: 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.

Regulation: 3270.131(d)(5)/3270.131(e)(3)

Description: Immunization record/Dismissal policy

Noncompliance Area: During the renewal inspection, child #4 is missing Pneumococcal vaccine #4. Child #5 is missing Hepatitis A #2 vaccine. Child #6 is missing Hepatitis A #2 vaccine. These children are not in compliance with the immunized status according to recommendations of the ACIP.

Correction Required: 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 #4, child #5 and child #6 will be removed from care by close of business on 2/10/23 until either the vaccination record is updated according to the ACIP recommended schedule or the parent provides an exemption letter.

Regulation: 3270.131(d)(7)

Description: Free from contagious/communicable disease

Noncompliance Area: During the renewal inspection, child #8 did not have a statement on the health report stating that the child is able to participate in child care and appears to be free from contagious or communicable disease.

Correction Required: A health report shall include a statement that the child is able to participate in child care and appears to be free from contagious or communicable disease.

Regulation: 3270.161(d)

Description: Potentially hazardous food refrigerated

Noncompliance Area: During the renewal inspection, in the PKC-D classroom, a container of Nesquick chocolate milk stating to "refrigerate after opening" was found opened and inside a child's cubby. A lunch box containing chicken nuggets was also observed.

Correction Required: Potentially hazardous food brought from the child's home or provided by the facility shall be refrigerated.

Regulation: 3270.171(a)

Description: Pick-up and drop-off points

Noncompliance Area: During the renewal inspection, the Director did not have verification that the local traffic safety authorities are notified annually in writing of the location of the facility and the program's use of pedestrian and vehicular routes around the child care facility.

Correction Required: An operator shall notify local traffic safety authorities annually in writing of the location of the facility and the program's use of pedestrian and vehicular routes around the child care facility.

Regulation: 3270.31(f)

Description: Health and Safety Training

Noncompliance Area: During the renewal inspection, staff person #2 has acceptable pediatric first aid/CPR training in an approved curriculum; however, the trainer has not provided documentation that they are PQAS-certified in that training topic.

Correction Required: Staff persons shall complete professional development in the topics of 3270.31(f)(10), within 90 days of hire. Staff person #2 must do one of the following: provide documentation that the trainer has become PQAS-certified or at least is on the waiting list, request the instructor provide documentation, such as their Pediatric First-Aid/CPR Instructor Card from the PQAS-approved organization or the approved curriculum organization, that the instructor is approved to offer Pediatric First-Aid/CPR training on behalf of their organization, or receive pediatric first-aid/CPR training in an approved curriculum by a PQAS-certified trainer.

Regulation: 3270.35(b)/3270.192(2)(iv)

Description: Group sup qualifications/Transcript, diploma and letters

Noncompliance Area: During the renewal inspection, staff #3 had a Bachelor of Science degree but no transcript to determine the major of the degree. Therefore, staff #3 is not qualified to be a Group Supervisor.

Correction Required: A group supervisor shall have attained one of the qualification levels specified at §3270.35(b)(1)-(4). A facility person's record shall include acceptable verification of experience, education or training is a transcript or a diploma or a letter signed by a representative of the experiential, educational or training entity.

Regulation: 3270.36(b)(3)

Description: HS/GED, 15 credits + 1 yr

Noncompliance Area: During the renewal inspection, staff #4 did not have 1 year (1,250 hours) of documented child care experience to accompany the diploma and 24 credits in order to be classified as an assistant group supervisor.

Correction Required: An assistant group supervisor shall have a high school diploma or a general educational development certificate, 15 credit hours from an accredited college or university in early childhood education, child development, special education, elementary education or the human services field and 1 year of experience with children.

Regulation: 3270.69(b)

Description: 110º F or less

Noncompliance Area: During the renewal inspection, the water in the PKC A room measured 112.5° F.

Correction Required: Hot water temperature, in areas accessible to children, may not exceed 110° F.

Regulation: 3270.82(h)

Description: Handwashing signs

Noncompliance Area: During the renewal inspection, handwashing signs were not posted at each toilet.

Correction Required: 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.

Regulation: 3270.191

Description: Individual Records

Noncompliance Area: During an onsite inspection, staff #2 did not have a file for review.

Correction Required: An individual record is required for each facility person.

Regulation: 3270.31(f)

Description: Health and Safety Training

Noncompliance Area: During an unannounced inspection, staff person #3 has not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): "Get Started with Center-Based Care" health and safety training topics.

Correction Required: Staff person(s) shall complete professional development in the topics of 3270.31(f)(1 -9) within 90 days of hire. Staff person #3 will have until 2/9/23 to complete the required training. Until such time as the required training has been completed, staff person #3 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 #3, staff person #3 may not work in a child-care position at the facility.

Regulation: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: During an unannounced inspection, staff person #1 was observed working as a lifeguard and did not have a completed FBI clearance on file. Staff person #1 has been employed by the LE for more than 45 days (see code sheets for date of hire with LE and date of hire with childcare program).

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). Facility Person #1 may not work in a childcare position at the facility.

Regulation: 3270.95(a)/3270.95(b)

Description: Devices must be compliant/Director or designated staff person ensure compliance

Noncompliance Area: During an onsite inspection, the facility was unable to test their inter-connected fire detection system. The annual fire inspection report was conducted on 1/10/23 and contained deficiencies with the fire detection system. Due to being unable to test the system and the uncorrected deficiencies, the facility was not in compliance with standards established under section 1016(c) of the act (62 P.S. § 1016(c).

Correction Required: 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 provider will not operate under current fire detection system. The provider must temporarily install operable smoke detectors on each floor and demonstrate compliance with a DHS certification representative before being allowed to reopen.

Regulation: 3270.95(a)/3270.95(b)

Description: Devices must be compliant/Director or designated staff person ensure compliance

Noncompliance Area: During an onsite inspection, the facility was unable to test their inter-connected fire detection system. The annual fire inspection report was conducted on 1/10/23 and contained deficiencies with the fire detection system. Due to being unable to test the system and the uncorrected deficiencies, the facility was not in compliance with standards established under section 1016(c) of the act (62 P.S. § 1016(c).

Correction Required: 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 provider will come into compliance with ACT 62 by having an operable fire detection system at all times. The provider will demonstrate operation and compliance with DHS certification representative.

Regulation: 3270.119

Description: Infant sleep position

Noncompliance Area: During the unannounced inspection, an infant was observed sleeping while sitting upright in a swing. The infant was not in a sleeping position recommended by the American Academy of Pediatrics and there was no medical explanation on file for the infant to be sleeping in the swing or in that position.

Correction Required: 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.

Regulation: 3270.151(c)(2)

Description: Mantoux TB

Noncompliance Area: During an inspection on 9/20/22, staff #21 did not have a tuberculosis screening at initial employment (see LIS code sheet for date of hire).

Correction Required: 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.

Regulation: 3270.31(e)(4)(i)

Description: Age and Training

Noncompliance Area: During the inspection on 9/20/22, staff person #23 had an expired Pediatric First Aid/CPR training on file. The training expired on 9/18/22.

Correction Required: 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. Staff person(s) shall complete professional development in Pediatric First Aid/CPR training. Staff #23 will have until 10/18/22 to complete the required training. Until such time as the required training has been completed, staff #23 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 staff #23 may not work in a child-care position at the facility.

Regulation: 3270.31(e)(4)(ii)

Description: Fire safety - 1 yr.

Noncompliance Area: During an onsite inspection on 8/29/22, Staff #1 was unable to provide documentation that fire safety training was taken annually by staff #1, staff #3, staff #4, staff #5, staff #6, staff #7, staff #8, staff #10, staff #11, staff #13, staff #14, staff #15 and staff #16. An acceptable plan was correction was received stating the correction would be implemented by 9/16/22. During an inspection on 9/20/22, staff #1 still did not have verification of fire safety training conducted within the past 12 months.

Correction Required: 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.

Regulation: 3270.31(f)

Description: Health and Safety Training

Noncompliance Area: During an onsite inspection on 8/29/22, staff person #3 and staff #14 have not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): Health and Safety topics and Pediatric First Aid/CPR. Staff person #10, staff #13 and staff #16 have not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): Pediatric First Aid/CPR. Staff person #1 and staff #12 have not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): Health and Safety topics. An acceptable plan of correction was received stating that corrections would be implemented by 9/16/22 and that "All staff will complete pre-service trainings within 90 days and will not be left alone until the pre-service training is completed." An inspection occurred on 9/20/22. Additional staff files were reviewed. Staff person #1, staff #12 and staff #23 have not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): Health and Safety topics. Staff person #21 and staff #22 have not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): Health and Safety topics and Pediatric First Aid/CPR.

Correction Required: Staff person(s) shall complete professional development in the topics of 3270.31(f)(1 -- 10), within 90 days of hire. Staff person #1, staff #12, staff #21, staff #22 and staff #23 will have until 10/18/22 to complete the required training. Until such time as the required training has been completed, staff person #1, staff #12, staff #21, staff #22 and staff #23 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 #12, staff #21, staff #22 and staff #23 then staff person#1, staff #12, staff #21, staff #22 and staff #23 may not work in a child-care position at the facility.

Regulation: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: During an onsite inspection on 8/29/22, staff #12 did not have a completed FBI clearance and NSOR certificate on file and has been employed at the facility for more than 45 days (see code sheet for date of hire).Staff #14, who has resided in the state of New York in the previous 5 years, did not have a child abuse clearance or sex offender registry check from the state of New York on file. Staff #14 did not have a witness signature on the disclosure statement that was on file. Staff #16 does not have a witness signature on the disclosure statement on file. Staff #17, who has resided in the state of New York in the previous 5 years, did not have a child abuse clearance or sex offender registry check from the state of New York on file. Staff #17 did not have a date on the disclosure statement that was on file. An acceptable plan of correction was obtained stating that the correction would be implemented by 9/16/22. Staff #17 was removed from child care on 8/29/22 for failure to have the NY Child Abuse clearance and NY Sex Offender registry check on file. A plan of correction was given from the facility stating that staff person #17 would not return to working with children until the NY Child Abuse clearance and sex offender registry check are obtained. During an unannounced inspection on 9/20/22, staff #17 was observed working in a child care position. When asked about the clearances, staff #1 provided a NY Criminal Background check clearance and not the NY Child Abuse clearance for staff #17. There were no results of the NY Sex Offender registry check.

Correction Required: 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. Staff who have resided outside of Pennsylvania in the past 5 years must obtain a state history criminal check, child abuse and neglect registry check and state sex offender registry check for the states they resided in the previous 5 years. Facility Person #17 may not work in a child care position at the facility.

Regulation: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: During an onsite inspection on 8/29/22, staff #12 did not have a completed FBI clearance and NSOR certificate on file and has been employed at the facility for more than 45 days (see code sheet for date of hire).Staff #14, who has resided in the state of New York in the previous 5 years, did not have a child abuse clearance or sex offender registry check from the state of New York on file. Staff #14 did not have a witness signature on the disclosure statement that was on file. Staff #16 does not have a witness signature on the disclosure statement on file. Staff #17, who has resided in the state of New York in the previous 5 years, did not have a child abuse clearance or sex offender registry check from the state of New York on file. Staff #17 did not have a date on the disclosure statement that was on file. An acceptable plan of correction was obtained stating that the correction would be implemented by 9/16/22. Staff #17 was removed from child care on 8/29/22 for failure to have the NY Child Abuse clearance and NY Sex Offender registry check on file. A plan of correction was given from the facility stating that staff person #17 would not return to working with children until the NY Child Abuse clearance and sex offender registry check are obtained. During an unannounced inspection on 9/20/22, staff #17 was observed working in a child care position. When asked about the clearances, staff #1 provided a NY Criminal Background check clearance and not the NY Child Abuse clearance for staff #17. There were no results of the NY Sex Offender registry check.

Correction Required: 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 #17 will not work in a child care position. The legal entity will submit complete files for any new hires for a period of three months to the Northeast Regional Office. During that time, new hires may not begin to work in child care until their file has been approved by the Northeast Regional Office. Submitted files will be reviewed within 1 week of submission.

Regulation: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: During an onsite inspection on 8/29/22, staff #12 did not have a completed FBI clearance and NSOR certificate on file and has been employed at the facility for more than 45 days (see code sheet for date of hire).Staff #14, who has resided in the state of New York in the previous 5 years, did not have a child abuse clearance or sex offender registry check from the state of New York on file. Staff #14 did not have a witness signature on the disclosure statement that was on file. Staff #16 does not have a witness signature on the disclosure statement on file. Staff #17, who has resided in the state of New York in the previous 5 years, did not have a child abuse clearance or sex offender registry check from the state of New York on file. Staff #17 did not have a date on the disclosure statement that was on file. An acceptable plan of correction was obtained stating that the correction would be implemented by 9/16/22. Staff #17 was removed from child care on 8/29/22 for failure to have the NY Child Abuse clearance and NY Sex Offender registry check on file. A plan of correction was given from the facility stating that staff person #17 would not return to working with children until the NY Child Abuse clearance and sex offender registry check are obtained. During an unannounced inspection on 9/20/22, staff #17 was observed working in a child care position. When asked about the clearances, staff #1 provided a NY Criminal Background check clearance and not the NY Child Abuse clearance for staff #17. There were no results of the NY Sex Offender registry check.

Correction Required: 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 #17 will not work in a child care position. The legal entity will contact the Northeast Regional office to register and attend an Existing Provider Orientation scheduled for November 30, 2022.

Regulation: 3270.102(a)

Description: Clean and good repair

Noncompliance Area: During an onsite inspection on 8/29/22, the fence surrounding the outdoor playground had exposed bolts facing towards the inside of the playground. This poses a hazard to children.

Correction Required: 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.

Regulation: 3270.113(b)/3270.113(c)

Description: No physical punishment /No ridicule or threaten harm

Noncompliance Area: During an onsite inspection on 8/29/22, staff #1 had stated that staff #2 was terminated on 8/25/22 due to other child care staff observing staff #2 grabbing a child's arms, hitting him on his back, telling him to "sit his ass down" and dragging him away from a table while on the playground.

Correction Required: A facility person may not use any form of physical punishment, including spanking a child. A facility person may not single out the child for ridicule, threaten harm to the child or the child's family and may not specifically aim to degrade the child or the child's family. The legal entity must arrange for all facility staff hired by the date of the training to receive a minimum of two hours of training regarding Appropriate interactions with children. The legal entity must receive DHS approval of the training content prior to scheduling the training.

Regulation: 3270.113(b)/3270.113(c)

Description: No physical punishment /No ridicule or threaten harm

Noncompliance Area: During an onsite inspection on 8/29/22, staff #1 had stated that staff #2 was terminated on 8/25/22 due to other child care staff observing staff #2 grabbing a child's arms, hitting him on his back, telling him to "sit his ass down" and dragging him away from a table while on the playground.

Correction Required: A facility person may not use any form of physical punishment, including spanking a child. A facility person may not single out the child for ridicule, threaten harm to the child or the child's family and may not specifically aim to degrade the child or the child's family.

Regulation: 3270.113(d)

Description: No harsh language

Noncompliance Area: During an onsite inspection on 8/29/22, staff #1 had stated that staff #2 was terminated on 8/25/22 due to other child care staff observing staff #2 grabbing a child's arms, hitting him on his back, telling him to "sit his ass down" and dragging him away from a table while on the playground.

Correction Required: A facility person may not use harsh, demeaning or abusive language in the presence of children.

Regulation: 3270.14/3270.21

Description: Pertinent Laws & Regulations/General Health and Safety

Noncompliance Area: During an onsite inspection on 8/29/22, the provider did not have requirements for volunteer emergency preparedness training, practice drills and continuity of operations included in their emergency plan.

Correction Required: 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. To maintain full compliance with 45 CFR § 98.41(a)(1)(vii), child care facilities must have requirements for volunteer emergency preparedness training, practice drills and continuity of operations included in their emergency plan.

Regulation: 3270.151(a)

Description: 12 months prior to service and every 24 months thereafter

Noncompliance Area: During an onsite inspection on 8/29/22, staff #7, staff #10 and staff #15 did not have a health assessment conducted within the past 24 months. Staff #12 did not have an initial health assessment at time of employment on file (see code sheet for date of hire).

Correction Required: 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.

Regulation: 3270.151(c)(3)

Description: Exam communicable disease

Noncompliance Area: During an onsite inspection on 8/29/22, staff #3 and staff #8's health assessment did not have question #2 answered regarding if the staff person had an examination for communicable diseases and the results of that examination.

Correction Required: An adult health assessment must include an examination for communicable diseases and the results of that examination.

Regulation: 3270.19(a)/3270.19(b)

Description: Required to report/Child abuse reporting

Noncompliance Area: During an onsite inspection on 8/29/22, staff #14, staff #15, staff #18, staff #19, staff #20 had written statements that they observed staff #2 hit a child on his back and demean him by telling him to "sit his ass down" on 8/25/22. Staff #14, staff #15, staff #18, staff #19, staff #20 failed to make a report to Child Line regarding the suspected child abuse from staff #2. Staff #1 had stated that she did not yet make a report to Child Line regarding the suspected child abuse from staff #2 that occurred on 8/25/22 until she was directed to do so on 8/29/22 by DHS.

Correction Required: An operator or a staff person who has reason to believe that a child enrolled in the facility has been abused is required to report suspected child abuse to ChildLine as mandated by the CPSL.A facility person who has reasonable cause to suspect that a child is a victim of child abuse shall immediately make a report of suspected child abuse to ChildLine through the hotline at (800) 932-0313, online, or any other method as prescribed by the Department.

Regulation: 3270.27(a)(6)

Description: Emergency plan

Noncompliance Area: During an onsite inspection on 8/29/22, the provider did not have documentation of an emergency drill being conducted in the past 12 months.

Correction Required: Emergency drills shall be conducted annually. Annual emergency drills shall be documented and on file at the facility.

Regulation: 3270.27(c)

Description: Training regarding plan

Noncompliance Area: During an onsite inspection on 8/29/22, staff #3 and staff #12 did not have verification of emergency plan training on file.

Correction Required: 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.

Regulation: 3270.31(e)(4)(ii)

Description: Fire safety - 1 yr.

Noncompliance Area: During an onsite inspection on 8/29/22, Staff #1 was unable to provide documentation that fire safety training was taken annually by staff #1, staff #3, staff #4, staff #5, staff #6, staff #7, staff #8, staff #10, staff #11, staff #13, staff #14, staff #15 and staff #16.

Correction Required: 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.

Regulation: 3270.31(f)

Description: Health and Safety Training

Noncompliance Area: During an onsite inspection on 8/29/22, staff person #3 and staff #14 have not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): Health and Safety topics and Pediatric First Aid/CPR. Staff person #10, staff #13 and staff #16 have not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): Pediatric First Aid/CPR Staff person #1 and staff #12 have not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): Health and Safety topics

Correction Required: Staff person(s) shall complete professional development in the topics of 3270.31(f)(1 -- 10), within 90 days of hire. Staff person #1, staff #3, staff #10, staff #12, staff #13, staff #14, staff #16 will have until 9/16/22 to complete the required training. Until such time as the required training has been completed, staff person #1, staff #3, staff #10, staff #12, staff #13, staff #14, staff #16 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 #3, staff #10, staff #12, staff #13, staff #14 and staff #16 then staff person#1, staff #3, staff #10, staff #12, staff #13, staff #14 and staff #16 may not work in a child-care position at the facility.

Regulation: 3270.32(a)

Description: Comply with CPSL

Noncompliance Area: During an onsite inspection on 8/29/22, staff person #3 has not completed the mandated reporter training within 90 days of their date of hire (see LIS code sheet). Staff person #8 has not completed mandated reporter training within the last 60 months. This is evidenced by the previously documented mandated reporter training on file being dated 1/7/17.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to Child Protective Services). Staff person #3 and staff #8 will have until 9/16/22 to complete the mandated reporter training. Until such time as the required training has been completed, staff person #3 and staff #8 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 #3 and staff #8, staff person #3 and staff #8 may not work in a child-care position at the facility.

Regulation: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: During an onsite inspection on 8/29/22, staff #12 did not have a completed FBI clearance and NSOR certificate on file and has been employed at the facility for more than 45 days (see code sheet for date of hire). Staff #14, who has resided in the state of New York in the previous 5 years, did not have a child abuse clearance or sex offender registry check from the state of New York on file. Staff #14 did not have a witness signature on the disclosure statement that was on file. Staff #16 does not have a witness signature on the disclosure statement on file. Staff #17, who has resided in the state of New York in the previous 5 years, did not have a child abuse clearance or sex offender registry check from the state of New York on file. Staff #17 did not have a date on the disclosure statement that was on file.

Correction Required: 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. Staff who have resided outside of Pennsylvania in the past 5 years must obtain a state history criminal check, child abuse and neglect registry check and state sex offender registry check for the states they resided in the previous 5 years. Staff #12 was hired under the previous ACT 12 hiring requirements. Staff Person #12, staff # 14, and staff #17 may not work in a child care position at the facility.

Regulation: 3270.33(a)/3270.192(2)(iv)

Description: Each staff person meets quals/Transcript, diploma and letters

Noncompliance Area: During an onsite inspection on 8/29/22, staff #7 did not have a high school diploma on file. Staff #14 did not have a transcript to accompany the Bachelor of Art degree to determine what the degree was in. Staff #17 did not have a high school diploma to accompany the human service credits on file. With these items missing from the files, these people are not qualified as staff.

Correction Required: 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 acceptable verification of experience, education or training is a transcript or a diploma or a letter signed by a representative of the experiential, educational or training entity.

Regulation: 3270.124(b)(6)

Description: Insurance coverage information

Noncompliance Area: Child # 2 enrolled and attending facility since 3/1/20 has no health insurance policy or number on file. Child # 5 enrolled and attending facility has no health insurance policy or number on file. Child #8 enrolled and attending facility since 1/26/21 has no health insurance policy or number on file.

Correction Required: Emergency contact information must include health insurance coverage and policy number for a child under a family policy or Medical Assistance benefits, if applicable.

Regulation: 3270.131(a)

Description: Health information

Noncompliance Area: Child # 8 enrolled and attending facility since 1/26/21 does not have a health assessment on file.

Correction Required: 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.

Regulation: 3270.131(d)(5)/3270.131(e)(2)(i)

Description: Immunization record/Exemption documentation from parent/guardian

Noncompliance Area: Child # 2 enrolled and attending since 3/1/20 has no immunizations on file. Child # 4,# 8 & # 9 have no proof of being immunized for influenza nor do they have an exemption on file for religious beliefs or a strong personal objection documented and signed by a parent or guardian.

Correction Required: A health report shall include a review of the child's immunized status according to recommendations of the ACIP.Exemption from immunization for religious belief or strong personal objection equated to a religious belief shall be documented by a written, signed and dated statement from the child's parent or guardian. The statement shall be kept in the child's record.

Regulation: 3270.151(a)

Description: 12 months prior to service and every 24 months thereafter

Noncompliance Area: Facility person # 3 hired and working at facility since 1/18/22 has a health assessment on file that is not dated.

Correction Required: 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.

Regulation: 3270.151(c)(3)/3270.151(c)(4)

Description: Exam communicable disease/Information re: medical problems

Noncompliance Area: Facility person # 1 has a health assessment on file that does not include an examine for communicable diseases and the results or an assessment of medical problems that might threaten the health of children or prohibit a staff person from providing adequate care to children.

Correction Required: An adult health assessment must include an examination for communicable diseases and the results of that examination. An adult health assessment must include information on medical problems that might threaten the health of the children or prohibit a staff person from providing adequate care to children.

Regulation: 3270.181(c)/3270.181(e)

Description: Emergency info/agreement updated 6 mos/Emergency master file updated

Noncompliance Area: Child # 1, 2,3,4,5,6,7,8,9,10 have emergency contact forms and fee agreements that have not been updated or reviewed in over 6 months. Child # 11's emergency contact form in the classroom emergency bag has not been updated in over 6 months since 7/27/21.

Correction Required: 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. If emergency information is updated in a master file, it shall be updated accordingly in other facility records.

Regulation: 3270.182(2)

Description: Application, admission, withdrawal dates

Noncompliance Area: Child # 1,3 & 5 do not have admission dates on file.

Correction Required: A child's record shall contain the dates of application, admission and withdrawal of the child.

Regulation: 3270.182(3)/3270.182(5)

Description: Consent for emergency medical care required prior to admission/Consent for administration of minor first-aid required prior to admission

Noncompliance Area: Child # 1,2,3,4,5,6,7,8,9 & 10 do not have consent for emergency medical care or minor first aid.

Correction Required: A child's record shall contain signed parental consent for emergency medical care for the child. Written consent is required prior to admission.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.

Regulation: 3270.27(a)(5)/3270.27(a)(6)

Description: Emergency plan/Emergency plan

Noncompliance Area: The facility emergency plan does not include accommodations for infants, toddlers, children with disabilities and children with chronic medical conditions. There is no proof or documentation on file at facility that an annual emergency drill was conducted for 2021.

Correction Required: The facility shall have an emergency plan that provides for accommodations for infants, toddlers, children with disabilities, and children with chronic medical conditions. Emergency drills shall be conducted annually. Annual emergency drills shall be documented and on file at the facility.

Regulation: 3270.27(c)/3270.27(f)

Description: Training regarding plan/Emergency plan

Noncompliance Area: Facility person # 1 hired and working at facility since 11/18/21 did not have emergency plan training within 7 days from time of hire. Emergency plan training was done for staff # 1 on 12/2/21. Facility person # 2 hired and working at facility since 1/31/22 did not have emergency plan training within 7 days from time of hire. Emergency plan training was done for staff # 2 on 2/15/22. Facility person # 3 hired and working at facility since 1/18/22 does not have proof of emergency plan training on file.

Correction Required: 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 operator shall send a copy of the emergency plan and subsequent plan updates to the local municipality and to the county emergency management agency.

Regulation: 3270.82(h)

Description: Handwashing signs

Noncompliance Area: There are no hand washing signs posted at the sinks in the classrooms and bathroom sinks of the Pre K Counts Classroom A sink, The Young Toddlers room sink, The Pre K Counts Classroom B sink, The Pre K Counts Classroom C sink, The Infant room sink and the Pre K Counts Classroom D sink.

Correction Required: 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.

Regulation: 3270.95(a)/3270.95(b)

Description: Devices must be compliant/Director or designated staff person ensure compliance

Noncompliance Area: Fire alarm testing has not been conducted in over 30 days from 1/12/22 to 2/17/22.

Correction Required: 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.