Blessings from Above Quality Childcare a

Regulation: 3270.135(a)(3)

Description: Disposable diapers

Noncompliance Area: In the infant/toddler room the lid on the electric trash can used to dispose diapers did not open hands free.

Correction Required: If disposable diapers are provided by a parent or by a facility, a soiled diaper shall be discarded by immediately placing the diaper into a plastic-lined, hands-free covered can.

Regulation: 3270.65

Description: Protective Outlet Covers 5 yrs. or less

Noncompliance Area: One protective outlet cover was missing in the girl's bathroom by the sink.

Correction Required: Protective receptacle covers shall be placed in electrical outlets accessible to children 5 years of age or younger.

Regulation: 3270.107

Description: Refrigerator

Noncompliance Area: The thermometer in the 2nd refrigerator was broken.

Correction Required: 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.

Noncompliance Area: The schedule in the school age area did not reflect at time set aside for school age children to work on homework.

Correction Required: When a facility serves a school-age child, homework supervision shall be provided in accordance with arrangements determined by the parent and the operator.

Noncompliance Area: The files of Child #1, 2, and 3 were all lacking the departments for, Child Service Report, to provide information to the family about the child's growth and development. These are to be done after 6 months of enrollment and every 6 months thereafter.

Correction Required: The services to be provided to the family and the child, including the Department's approved form to provide information to the family about the child's growth and development in the context of the services being provided. The operator shall complete and update the form and provide a copy to the family in accordance with the updates regarding emergency contact information in 3270.124(f) (relating to emergency contact information).

Noncompliance Area: The files for Child #1 and 2 contained immunization records that were lacking the annual flu vaccine.

Correction Required: 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.

Noncompliance Area: The emergency plan at the facility has not been reviewed since 2015.

Correction Required: The operator shall review the emergency plan at least annually and update the plan as needed. The operator shall document in writing each review and update of the emergency plan and kept on file at the facility.

Noncompliance Area: The file for Staff #1 contained an FBI clearance dated 3/4/14 which is more than the required 60 months.

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

Noncompliance Area: At the time of inspection there was no one on site qualified to be the Director.

Correction Required: A director shall have attained one of the following qualification levels specified at 3270.34(b)(1) - (4).

Noncompliance Area: The first aid kit in the bag in the toddler room was lacking gloves.

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

Noncompliance Area: After reviewing the video from the daycare from March 9, 2019 it showed that Staff #1 did drag the child across the floor while trying to move him and his sleeping bag.

Correction Required: A facility person may not use any form of physical punishment, including spanking a child.

Noncompliance Area: The file for Child #1 contained a health assessment that was lacking the statement 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.

Noncompliance Area: The file for Staff Person #1 contained a state police clearance that was showing under review. All three of Staff #1's clearances are more than 60 months old.

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

Noncompliance Area: The facility is lacking a qualified director.

Correction Required: A director shall be employed by a facility and be present at the facility site a minimum of 30 hours per week.

Noncompliance Area: The file for Staff #1 was lacking proof of education prior to employment at the facility. Once looking further into the situation, Staff #1 was acting as an Assistant Group Supervisor but only having a 9th grade education, therefore the staff must act as an AIDE and be supervised at all times.

Correction Required: 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.

Noncompliance Area: The first aid kit in the excursion bag was lacking tweezers.

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

Noncompliance Area: The baseboard heater in the girls restroom was rusted, bent and cracked.

Correction Required: 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.

Noncompliance Area: The baseboard heater in the girls restroom was observed to have peeling paint on it.

Correction Required: Peeled or damaged paint or damaged plaster is not permitted on indoor or outdoor surfaces in the child care facility.

Noncompliance Area: The facility reported by parent and by staff remained open without running water on Tuesday January 9, 2018.

Correction Required: Conditions at the facility may not pose a threat to the health or safety of the children.A facility shall provide running water and a safe and adequate supply of drinking water that complies with the standards established under the Pennsylvania Safe Drinking Water Act (35 P.S. 721.1-721.17).

Noncompliance Area: On Thursday, January 11, 2018 at approximately 10:30 am, Certification Representative made an unannounced visit to conduct a complaint investigation concerning the temperature in the building being too cold, at that time the temperature measured in the main room at 59 degrees.

Correction Required: The indoor temperature shall be at least 65 F.

Noncompliance Area: The big long table by the door in the main room was observed to have loose legs potentially cause pinch points and safety hazards for the 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.

Noncompliance Area: There were pony beads observed down at child level in the main room where toddler age children have been observed to be receiving care at.

Correction Required: 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.

Noncompliance Area: When Certification Representative entered the infant room to inspect the room an infant was sleeping in their carseat, cert. rep continued to inspect the entire room and infant was left in the carseat the entire time. As per the Academy of Pediatrics, infants are expected to be put to sleep flat on their backs in a crib or pack in play.

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.

Noncompliance Area: The file for Child #3 contained an Agreement that was lacking the child's times of care on it.

Correction Required: An agreement shall specify the child's arrival and departure times.

Noncompliance Area: The file for Child #8 contained an Emergency contact form that was lacking the child's medical insurance policy number.

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.

Noncompliance Area: The file for Child #2 and7 had health assessments that were not dated within 60 days of their enrollments.

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

Noncompliance Area: In the toddler room there was a tube of desitin observed that had expired in May 2017.

Correction Required: Medication shall be stored in accordance with the manufacturer's or health professional's instructions on the original label.

Noncompliance Area: The file for Staff #1 contained an initial emergency plan training that was more than 7 days after hire.

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.

Noncompliance Area: The file for Staff #2 was lacking the Staff's 6 annual clock hours of child care training.

Correction Required: A staff person shall obtain an annual minimum of 6 clock hours of child care training.

Noncompliance Area: The file for Staff #1 was lacking a signed disclosure statement for her new hire date of 11.1.17.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services).

Noncompliance Area: Upon entering the facility ratio and supervision check was conducted, all rooms knew their supervision groups, the infant and toddler rooms were in ratio. The main room had one staff(Staff #3) and 11- 3-4 year olds putting her out of ratio.

Correction Required: 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. IF USING TIERED LIS: The required staff:child ratios must be maintained at all times. The legal entity must submit documentation in a format approved by DHS proving that the facility is maintaining the required staff:child ratios at all times. The legal entity will confirm continuing compliance by sending copies of the documentation to the -------- Region Office on a weekly basis for a period of three months after DHS approves the documentation format.

Noncompliance Area: Peeling paint was observed in the infant room on the baseboard heater.

Correction Required: Peeled or damaged paint or damaged plaster is not permitted on indoor or outdoor surfaces in the child care facility.

Noncompliance Area: In the boys restroom was lacking handwashing signs above the toilets.

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.

Noncompliance Area: RECITE: On 7/24/2017, posting were observed to be secured to the door above a crib where an infant aged child was napping with thumb tacks. Also, throughout the infant and toddler room postings were observed to be secured to the wall with staples. This creates a choking hazard tot he childrenin care due to thumb tacks and staples being less than one inch in diameter.

Correction Required: 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.

Noncompliance Area: RECITE: On 7/24/2017, a written plan identifying the means of transporting a child to emergency care and staffing provisions in the event of an emergency was observed not to be posted in the infant room.

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.

Noncompliance Area: RECITE: On 7/24/2017 documentation of completion of fire safety training was observed not to be on file for staff person #1.

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.

Noncompliance Area: RECITE: On 7/24/2017, one bottle of blue cleaner located on top of the cubby's located outside of the toddler room was observed not to be labeled with it's contents.

Correction Required: Cleaning materials and other toxic materials shall be stored in an original labeled container or in a container that specifies the content. Toxics shall be stored away from food, food preparation areas and child care spaces.

Noncompliance Area: On 7/24/2017, the rear exit of the child care facility was observed to be obstructed with three cribs making the exit inacessible.

Correction Required: Stairways, hallways, exits from rooms, exits from the facility and other means of egress serving as an exit shall be unobstructed.

Noncompliance Area: On 6/22/2017, plexi glass located on the side of one of the infant cribs in the infant room was observed to be cracked exposing the children in care to rough edges and sharp corners, also, in the infant room the arms to the rocking chair were observed to be coming away from the spindles created pinch and crush points to the children in care.

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.

Noncompliance Area: On 6/22/2017, thumb tacks and staples were observed being used to hang art work and postings on the walls. Particularly thumb tacks were observed being used to hang postings on a cork board hung over top of a crib. This creates a choking hazard to the children in care due to the staples and tacks being less than one inch in diameter. Also, in the toddler room staples were observed being used to hang art work creating a choking hazard to the children in care due to them being less than one inch in diameter.

Correction Required: 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.

Noncompliance Area: On 6/22/2017, in the toddler room the second seat from the right on the feeding table was observed not to contain a safety strap.

Correction Required: High chairs shall have a wide base and a T-shaped safety strap.

Noncompliance Area: On 6/22/2017, the emergency contact form on file for child #6 and #7 were observed not to include complete health insurance information.

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.

Noncompliance Area: On 6/22/2017, the emergency contact form on file for child #7 was observed not to contain complete contact information for the person's whom he is authorized to be released to.

Correction Required: 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.

Noncompliance Area: On 6/22/2017, emergency contact forms were observed not to be present in the toddler child care space.

Correction Required: When children are in the facility, emergency contact information shall be present in a child care space for children receiving care in the space.

Noncompliance Area: On 6/22/2017, a written plan identifying the means of transporting a child to emergency care and staffing provision in the event of an emergency were observed not to be posted in the infant or toddler rooms.

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.

Noncompliance Area: On 6/22/2017, the emergency contact form and agreement on file for children #2, #4 and #5 were observed not to have been reviewed with the parent and documented with a written signature within the last 6 months.

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. Following review, a parent shall attest to the accuracy of information in the emergency contact information and the financial agreement at each review by affixing a dated signature to the record.

Noncompliance Area: On 6/29/2017, the files for staff person's #1-#3 were observed not to contain documentation of completion of a minimum of 6 clock hours of annual child care training.

Correction Required: A staff person shall obtain an annual minimum of 6 clock hours of child care training.

Noncompliance Area: On 6/29/2017, the file for staff person's #1 and #2 were observed not to contain documentation of fire safety training within the last year.

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.

Noncompliance Area: On 6/29/2017, the file for staff person's #2 and #3 were observed not to contain documentation of completion of mandated reporter training.

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.

Noncompliance Area: On 6/29/2017, the file for staff person's #2 and #3 were observed not to contain documentation of an evaluation being completed by a facility director within the last 12 months.

Correction Required: A director is responsible for written evaluation of staff persons on a regular basis, a minimum of one evaluation every 12 months.

Noncompliance Area: On 6/22/2017 and 6/29/2017 it was observed that the facility did not have a director employeed and present at the facility a minimum of 30 hours per week.

Correction Required: A director shall be employed by a facility and be present at the facility site a minimum of 30 hours per week.

Noncompliance Area: On 6/22/2017 and 6/29/2017, it was observed that the child care facility did not have employeed a staff person qualified to work as a group supervisor.

Correction Required: In a facility in which 45 or fewer children are enrolled, a group supervisor or a director/group supervisor shall be employed by and be present at the facility site for a minimum of 30 hours per week.

Noncompliance Area: On 6/22/2017, the storage cupboard located to the right of the rear exit of the facility was observed not to be locked leaving the toxics stored inside accessible to the children in care.

Correction Required: Cleaning materials and other toxic materials shall be kept in an area or container that is locked or made inaccessible to children.

Noncompliance Area: On 6/22/2017, two spray bottles located on top of the cubbies located in the hallway outside of the toddler room were observed not to be labeled with their contents.

Correction Required: Cleaning materials and other toxic materials shall be stored in an original labeled container or in a container that specifies the content. Toxics shall be stored away from food, food preparation areas and child care spaces.

Noncompliance Area: On 6/22/2017, children in care were observed using bingo dobbers labeled keep away from children, for arts and crafts.

Correction Required: Arts and crafts materials shall be nontoxic.

Noncompliance Area: On 6/22/2017, in the outdoor play space the window air conditioning unit was observed to be protruding from the window in the toddler room. The air conditioner was aspproximately 4 feet off of the ground and created a visible hazard due to its sharp edges and corners. Through out the facility staples were observed being used to hang pictures from the wall. In multiple locations the staples were observed protruding from the wall creating a visible hazard to the children due to the rough edges created from the staples.

Correction Required: 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.

Noncompliance Area: On 6/22/2017, in the outdoor play space the door to the right of the door that is used to enter the facility was observed to be splintering and have paint peeling from the bottom of the door jamb. In the infant room peeling paint was observed behind the rocking chair.

Correction Required: Peeled or damaged paint or damaged plaster is not permitted on indoor or outdoor surfaces in the child care facility.

Noncompliance Area: On 2/8/2017 in the toddler room, "googly eyes", small fabric balls, and glitter, all items with a diameter of less than 1 inch were observed to be accessible to the infant and toddler aged children cared for in this child care space. These items were located in the pink chest of drawer's.

Correction Required: 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.

Noncompliance Area: **On 1/31/2017 at approximately 12:00 staff person #1 and staff person #2 were observed to be caring for a group of 12 preschool aged children. When asked to identify the children they were assigned the specific responsibility to supervise staff person #1 stated that they have the children split up into two groups of 6. Staff person #1 named a group of 6 children and staff person #2 named a group of 5 children. Staff person #1 and staff person #2 both identified being assigned the specific responsibility to supervise the same child. When staff person #2 was asked to name all 12 of the children in the group staff person #2 did not know the names off all of the children in the group. On 2/8/2017 at approximately 9:05 a. m. staff person #4 identified being assigned the specific responsibility to supervise a group of 11 children. Staff person #4 then identified only 10 children in her group.

Correction Required: The legal entity must arrange for all facility staff to receive training regarding supervision of children. The legal entity must receive DPW approval of the training content prior to scheduling the training.

Noncompliance Area: On 1/31/2017, staff person #3 was observed changing an infant aged child's diaper in the infant room. The child's hands were not washed once diapering was completed.

Correction Required: A staff person shall ensure that a child`s hands are washed before meals and snacks, after toileting and after being diapered.

Noncompliance Area: On 1/31/2017, staff person #3 was observed changing an infant aged child's diaper on the bare floor of the infant room. The floor was not wiped or sanitized after.

Correction Required: Diaper changing surfaces shall be cleaned after each use by wiping the surface with a sanitizing solution or by changing a pad or other surface covering.

Noncompliance Area: On 2/8/2017, the file for staff person #3 was observed not to contain documentation of a health assessment being conducted within 1 year of the onset of employment at the child care facility.

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.

Noncompliance Area: On 2/8/2017, the file for staff person #3 was observed not to contain documentation of a TB test being completed. Also, the file for staff person #6 was observed not to contain documentation of the date her TB test was read.

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.

Noncompliance Area: On 1/31/2017, staff person #3 was observed changing the diaper of child #3 in the infant room. When diapering was finished staff person #3 did not wash her hands.

Correction Required: A facility person shall wash his hands before meals and snacks, and after toileting and after diapering a child.

Noncompliance Area: On 2/8/2017, the facility was observed to still be washing infant bottles by hand. The child care facility does not have a commercial dishwasher.

Correction Required: Disposable nursers shall be used for infants unless bottles are provided by the parent or unless a commercial dishwasher is used by the facility.

Noncompliance Area: On 2/8/2017, the facility was observed to not have all of the bottles used by the infant aged children in care labeled for the child whom they are intended for.

Correction Required: Disposable nursers and bottles shall be labeled with the child`s name.

Noncompliance Area: On 2/8/2017, the faciltiy's staff files were observed not to be locked. This is evidenced by the files being on a pile ontop of the teacher's desk located in the preschool child care space.

Correction Required: Facility persons` records are confidential and shall be stored in a locked cabinet.

Noncompliance Area: On 2/8/2017, the file for staff person #7 was observed to still be lacking 6 clock hours of annual child care training.

Correction Required: A staff person shall obtain an annual minimum of 6 clock hours of child care training.

Noncompliance Area: On 2/8/2017, at approximately 9:05 a. m. staff person's #4 and #5 were observed to be the only staff person's present in the child care facility. Upon review fo their files, it was observed that neither staff person #4 nor #5 had a current and valid first aid certification.

Correction Required: Competence in first-aid is demonstrated by the completion of training by a professional in the field of first-aid. First-aid training shall be renewed on or before expiration of certification or every 3 years, as applicable.

Noncompliance Area: On 2/8/2017, the file for staff person #3 was observed not to contain documentation of a child abuse clearance applied for prior to the start of her employment at the child care facility. Also, the file for staff person #5 was observed not to have a complete Pennsylvania State Police Criminal History clearance.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). Staff Person #3 may not work in a child care position at the facility. 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 Person #3 may not work in a child care position at the facility.

Noncompliance Area: On 2/8/2017, at approximately 9:05 a. m. staff person's #4 and #5 were observed to be the only staff person's present in the child care facility. Upon review of their files, it was observed that neither staff person #4 nor #5 had a current and valid first aid certification.

Correction Required: One or more facility persons competent in first-aid techniques shall be at the facility when one or more children are in care.

Noncompliance Area: On 2/8/2017, the facility was observed to not have a facility director employed. The facility has been without a director since 9/12/2016.

Correction Required: A director shall be employed by a facility and be present at the facility site a minimum of 30 hours per week.

Noncompliance Area: On 2/8/2017, the file for staff person #3 who is classified as an assistant group supervisor was observed not to contain documentation of experience working with children to qualify her to work in this capacity.

Correction Required: 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.

Noncompliance Area: On 2/8/2017, super glue and hand sanitizer was observed accessible to the children in the drawer's of the teachers desk located in the child care space.

Correction Required: Cleaning materials and other toxic materials shall be kept in an area or container that is locked or made inaccessible to children.

Noncompliance Area: On 1/31/2017, Staff person #3 was observed changing the diaper of an infant aged child in the infant room. The infant room is not equipped with a diaper changing table or a source of running water.

Correction Required: A source of running water for handwashing shall be present in infant and toddler diapering areas. If the running water does not flow directly into a drain that is connected to a sewage system, a receptacle shall be provided to contain the water used for washing. The receptacle shall be emptied into an approved sewage system at least once a day.