Faith Builders Day Care

Regulation: 3270.113(a)

Description: Supervised at all times

Noncompliance Area: Staff person #1 admitted that child #1 became separated from their presence during the lunch transition, when the child left line and returned to the classroom.

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.

Regulation: 3270.113(a)(1)

Description: Staff assigned to specific children

Noncompliance Area: Staff person #1 admitted that child #1 became separated from their presence during the lunch transition, when the child left line and returned to the classroom. Staff person #1 admitted to not knowing the whereabouts of child #1 and not being physically present with the child #1.

Correction Required: 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: 3270.107

Description: Refrigerator

Noncompliance Area: The facility was observed to have a refrigerator in the 3-year-old room, with the thermometer in the freezer.

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.

Regulation: 3270.124(b)(4)/3270.182(3)

Description: Written consent/Consent for emergency medical care required prior to admission

Noncompliance Area: The file for child #1 was observed to contain an emergency contact form that lack a parent's signature giving consent for emergency medical care.

Correction Required: Emergency contact information must include the written consent signed by a parent for emergency medical care. A child's record shall contain signed parental consent for emergency medical care for the child. Written consent is required prior to admission.

Regulation: 3270.124(b)(7)

Description: Name/address/phone release person

Noncompliance Area: The files for children #1 and #2 were observed to contain emergency contact forms the lacked the address of the individual designated by the parent to whom the child may be released.

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.

Regulation: 3270.14/3270.21

Description: Pertinent Laws & Regulations/General Health and Safety

Noncompliance Area: The file for staff person #1 was observed to lack documentation that staff person #1 completed annual training on the facility's emergency plan. This was evidenced by a training certificate from 09/05/2024 was the only training certificate present in the file.

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.

Regulation: 3270.178

Description: Transportation First Aid Kit

Noncompliance Area: The first-aid kit in the transportation van was observed to be lacking soap.

Correction Required: A first-aid kit, including the contents as specified in §3270.75 (relating to first-aid kit) shall be in the vehicle when children are being transported.

Regulation: 3270.182(5)

Description: Consent for administration of minor first-aid required prior to admission

Noncompliance Area: The file for child #1 was observed to contain an emergency contact form that lack a parent's signature giving consent for minor first-aid procedures by facility staff.

Correction Required: 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: 3270.192(5)

Description: Two written references

Noncompliance Area: The file for Staff person #1 was observed to lack two written, nonfamily references from individuals attesting to the person's suitability to serve as a facility person. This was evidenced by only one written reference present in the file.

Correction Required: A facility person's record shall include two written, nonfamily references from individuals attesting to the person's suitability to serve as a facility person.

Regulation: 3270.32(a)

Description: Comply with CPSL

Noncompliance Area: The file for staff person #2 was observed to lack a current valid PA state police clearance.

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

Regulation: 3270.37(b)(1)/3270.192(2)(ii)

Description: HS/GED/Exp, educ., training prior to facility

Noncompliance Area: The file for staff person #3 was observed to lack documentation of a high school diploma or a general educational development certificate

Correction Required: An aide shall have a high school diploma or a general educational development certificate. A facility person's record shall include verification of child care experience, education and training prior to service at the facility.

Regulation: 3270.66(b)

Description: Original container

Noncompliance Area: In the facility's kitchen/lunchroom area a clear Zep brand spray bottle which contained a clear liquid but lacked a label identifying the contents was observed. And clear bottles containing a clear liquid without identification of the contents were also observed in the facility's Infant and Older Infant rooms.

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.

Regulation: 3270.113(b)

Description: No physical punishment

Noncompliance Area: Staff person #1 admitted to and was observed on camera striking a child's hand in response to the child touching under another child's clothing.

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

Regulation: 3270.113(a)

Description: Supervised at all times

Noncompliance Area: Based on video footage and interviews, Child #1 exited the indoor play space unnoticed by Staff #1 and Staff #2. Video footage showed Child #1 climbing into a stroller located on the other side of the door from which Child #1 exited. Video footage showed Child #1's mother coming through the entrance door and going down the stairs at the entrance. Video footage then showed Child #1's mother coming up the stairs on the opposite side of the entrance and getting Child #1 out of the stroller. During the interview process, Staff #1 and Staff #2 indicated Child #1's mother came to the door of the play space to tell them she had Child #1. Based on video footage, Child #1 was alone in the lobby for approximately 1 minute.

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.

Regulation: 3270.14/3270.21

Description: Pertinent Laws & Regulations/General Health and Safety

Noncompliance Area: Staff person #2 has completed the health and safety course titled Get Started with Center-Based Care: Building Blocks for Quality but has not completed the required health and safety update course titled Pennsylvania Health and Safety Update 2022 (1 hour) training.

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. Staff person #2 must complete PA Required Health and Safety for Centers-Group Child Care Parts 1 and 2.

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

Description: Age and Training

Noncompliance Area: Staff #1 lacked renewal of their certification in pediatric first-aid and pediatric cardiopulmonary resuscitation on or before the expiration of the most current certification. Staff #1 had documentation of completing pediatric first-aid and cardiopulmonary resuscitation training on 7/2/24 with a previous one completed on 5/25/22.

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.

Regulation: 3270.52

Description: Mixed Age Level

Noncompliance Area: Based on video footage and interviews, Child #1 exited the indoor play space unnoticed by Staff #1 and Staff #2. Video footage showed Child #1 climbing into a stroller located on the other side of the door from which Child #1 exited. Video footage showed Child #1's mother coming through the entrance door and going down the stairs at the entrance. Video footage then showed Child #1's mother coming up the stairs on the opposite side of the entrance and getting Child #1 out of the stroller. During the interview process, Staff #1 and Staff #2 indicated Child #1's mother came to the door of the play space to tell them she had Child #1. Based on video footage, Child #1 was alone in the lobby for approximately 1 minute.

Correction Required: When children are grouped in mixed age levels, the age of the youngest child in the group determines the staff:child ratio and maximum group size in accordance with the requirements in § 3270.51 (relating to similar age level).

Regulation: 3270.91(a)

Description: Stairs, exits, etc. unobstructed

Noncompliance Area: Observed 2 strollers obstructing the middle doors of the indoor play space.

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

Regulation: 3270.94(a)(1)

Description: Every 60 days

Noncompliance Area: The Director or designated staff person who is responsible for compliance with this chapter did not ensure that fire drills were conducted at least once every 60 days. The facility provided documentation of fire drills being conducted on 3/26/24, 5/24/24, 7/23/24, 9/20/24, and 11/20/24.

Correction Required: The Director 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.

Regulation: 3270.123(a)(6)/3270.182(2)

Description: Admission date/Application, admission, withdrawal dates

Noncompliance Area: The files for children #1 and #6 were observed to contain financial agreements that failed to specify the date of the child's admission.

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

Regulation: 3270.123(a)(7)

Description: Services considered extra

Noncompliance Area: The files for children #1, #2, #3, #4, #5, #6, #7, #8 and #10 were observed to contain an agreement that failed to specify the services which are to be considered as extra.

Correction Required: An agreement shall specify the services which are to be considered as extra.

Regulation: 3270.123(b)/3270.182(8)

Description: Parent receives original/Copy of initial and subsequent agreements. Parent receives original.

Noncompliance Area: The file for child #1 was observed to contain an original agreement.

Correction Required: A parent shall receive the original agreement. The facility shall retain a copy of the agreement. A child's record shall contain a copy of the initial agreement and subsequent written agreements between the parent and the operator. The parent receives the original agreement.

Regulation: 3270.124(b)(3)

Description: Parent home/work address, phone

Noncompliance Area: The file for child #9 was observed to contain an emergency contact form that failed to include the work addresses and telephone numbers of the enrolling parent.

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

Regulation: 3270.124(b)(5)

Description: Information re: special needs

Noncompliance Area: The file for child #9 was observed to contain an emergency contact information that failed to include information (if any) on the child's special needs, as specified by the child's parent, physician, physician's assistant or CRNP.

Correction Required: Emergency contact information must include information on the child's special needs, as specified by the child's parent, physician, physician's assistant or CRNP, which is needed in an emergency situation.

Regulation: 3270.133(4)

Description: Locked

Noncompliance Area: A container of Vicks medication labeled "keep out of the reach of children" was observed stored in a child's cubby and therefore within the reach of children.

Correction Required: Medication shall be stored in a locked area of the facility or in an area that is out of the reach of children.

Regulation: 3270.133(6)

Description: Written consent

Noncompliance Area: The facility was observed to have a written consent for administration of Diazepam gel medication for child #11 that lacked the enrolling parent's signature.

Correction Required: A parent shall provide written consent for administration of medication or a special diet.

Regulation: 3270.133(7)(viii)

Description: Special notes

Noncompliance Area: The facility was observed to have a medication log for child #12 that failed to include special notes, if any related to problems of administration.

Correction Required: A medication log shall include special notes related to problems of administration.

Regulation: 3270.14/3270.21

Description: Pertinent Laws & Regulations/General Health and Safety

Noncompliance Area: The facility was observed to lack a written policy addressing Shaken Baby Syndrome and Abusive Head Trauma.

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.

Regulation: 3270.27(e)

Description: Letter to parents

Noncompliance Area: The facility was observed to be providing the parent of each enrolled child a letter explaining the emergency procedures, however this letter failed to include the accommodations for infants, toddlers, children with disabilities and children with chronic medical conditions.

Correction Required: The operator shall provide to the parent of each enrolled child a letter explaining the emergency procedures. The operator shall also provide to the parent of each enrolled child a letter explaining any subsequent update to the plan.

Regulation: 3270.66(b)

Description: Original container

Noncompliance Area: A clear spray bottle that contained a clear liquid and no written identification of the contents was observed sitting on the cubbies in the infant room.

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.

Regulation: 3270.75(b)

Description: Inaccessible to children

Noncompliance Area: A first-aid kit was observed to be accessible to children in the facility's 3-year-old room.

Correction Required: A first-aid kit must be inaccessible to children.

Regulation: 3270.75(c)

Description: Has all items

Noncompliance Area: A first-aid kit that contained the following: soap, an assortment of adhesive bandages, sterile gauze pads, tape, scissors and disposable, nonporous gloves, but did not contain, tweezers was observed in the facilities 4-year-old Classroom.

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.

Regulation: 3270.94(a)(1)

Description: Every 60 days

Noncompliance Area: The Director or designated staff person who is responsible for compliance with this chapter did not ensure fire drills were conducted at least once every 60 days. The facility provided documentation of fire drills being conducted on 9/29/23 and 3/26/24.

Correction Required: The Director 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.

Regulation: 3270.103

Description: Small Toys and Objects

Noncompliance Area: 2nd citation. Previously cited on 10/18/23. Observed hard corn kernels in the outdoor play space by the Step 2 Playhouse which were accessible to children.

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.

Regulation: 3270.123(a)(3)

Description: Services proceeded

Noncompliance Area: 2nd citation. Previously cited on 10/30/23. The files of Children #1, #2, #3, and #4 lacked child service reports completed at least every 6 months. The file of Child #1, who had an admission date of 8/23/21, did not contain a child service report. The file of Child #2, who had an admission date of August 2022, did not contain a child service report. The file of Child #3, who had an admission date of 8/23/21, did not contain a child service report. The file of Child #4, who had an admission date of 2/27/23, did not contain a child service report.

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).

Regulation: 3270.33(a)

Description: Each staff person meets quals

Noncompliance Area: 2nd citation. Previously cited on 10/30/23. The file of Staff #1, who was designated as a group supervisor, lacked documentation of meeting one of the applicable staff qualifications for the position in which the person is performing.

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.

Regulation: 3270.65

Description: Protective Outlet Covers 5 yrs. or less

Noncompliance Area: 2nd citation. Previously cited on 10/18/23. Observed an electrical outlet between the windows on the orange wall in Room 104 which lacked protective receptacle covers.

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

Regulation: 3270.66(a)

Description: Locked or inaccessible

Noncompliance Area: 2nd citation. Previously cited on 10/18/23. Observed Boudreaux's Butt Paste which indicated "keep out of the reach of children" in a plastic bin on the floor beside the changing table in the Women's Bathroom on the 2nd floor which was accessible to children.

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

Regulation: 3270.103

Description: Small Toys and Objects

Noncompliance Area: On 10/18/23 observed plastic grocery bags and ziploc bags on the 2nd shelf from the bottom on the bookcase beside the entrance in Room 102 which were accessible to children. On 10/18/23 observed hard corn kernels in the outdoor play space by the Step 2 Playhouse which were accessible to children.

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.

Regulation: 3270.104(a)

Description: Clean, good repair, proper size

Noncompliance Area: On 10/18/23 observed a microwave on top of a mini fridge in Room 102 which was not anchored creating a potential tipping hazard. On 10/18/23 observed a microwave on top of a mini fridge in the 3-year-old Room which was not anchored creating a potential tipping hazard. On 10/18/23 observed a microwave on top of a mini fridge in Room 104 which was not anchored creating a potential tipping hazard.

Correction Required: Furniture must be durable, safe, easily cleaned and appropriate for the child's size, age and special needs.

Regulation: 3270.106(a)

Description: Clean, age appropriate

Noncompliance Area: On 10/18/23 observed rest equipment not labeled for the use of a specific child in Room 103.

Correction Required: Individual, clean, age-appropriate rest equipment shall be provided for preschool, toddler and infant children as agreed between the child's parent and the operator. The rest equipment shall be labeled for the use of a specific child and used only by the specified child.

Regulation: 3270.107

Description: Refrigerator

Noncompliance Area: On 10/18/23 the refrigerator in Room 104 lacked an operating thermometer.

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.

Regulation: 3270.111(b)

Description: Posted in group space

Noncompliance Area: On 10/18/23 the written plan of daily activities was not posted in Room 303.

Correction Required: The written plan of daily activities shall be posted in the group space.

Regulation: 3270.123(a)(3)

Description: Services proceeded

Noncompliance Area: The files of Children #1, #2, #3, #5, and #6 lacked child service reports completed at least every 6 months. The file of Child #1, who had an admission date of 8/23/21, did not contain a child service report but contained Ages and Stages. The file of Child #2, who had an admission date of August 2022, did not contain a child service report but contained Ages and Stages. The file of Child #3, who had an admission date of 8/23/21, did not contain a child service report but contained Ages and Stages. The file of Child #5, who had an admission date of 2/27/23, did not contain a child service report but contained Ages and Stages. The file of Child #6, who had an admission date of 9/21/22, did not contain a child service report but contained Ages and Stages.

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).

Regulation: 3270.123(a)(6)/3270.182(2)

Description: Admission date/Application, admission, withdrawal dates

Noncompliance Area: The agreements for Children #1, #2, #3, #4, #5, and #6 lacked the date of the child's admission.

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

Regulation: 3270.124(b)(4)/3270.182(3)

Description: Written consent/Consent for emergency medical care required prior to admission

Noncompliance Area: The emergency contact for Child #1 did not include written consent signed by a parent for emergency medical care.

Correction Required: Emergency contact information must include the written consent signed by a parent for emergency medical care. A child's record shall contain signed parental consent for emergency medical care for the child. Written consent is required prior to admission.

Regulation: 3270.131(b)(1)

Description: Infant: updated health report every 6 months

Noncompliance Area: The file of Child #3 lacked an updated health report at least every 6 months for an infant or young toddler. The file of Child #3 contained health reports dated 1/28/22, 4/29/22, and 2/3/23.

Correction Required: The operator shall require the parent to provide an updated health report at least every 6 months for an infant or young toddler.

Regulation: 3270.131(b)(2)

Description: Toddler/preschool: updated health report every 12 months

Noncompliance Area: The file of Child #1 lacked an updated health report at least every 12 months for an older toddler or preschool child. The file of Child #1 contained a current health report dated 5/11/23 with a previous one dated 4/22/22.

Correction Required: The operator shall require the parent to provide an updated health report at least every 12 months for an older toddler or preschool child.

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

Description: Immunization record/Dismissal policy

Noncompliance Area: Child #6, a 16-month-old, lacked Pneumococcal immunizations according to the recommendations of the ACIP. Child #6 had documentation of 3 Pneumococcal immunizations.

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).

Regulation: 3270.14/3270.21

Description: Pertinent Laws & Regulations/General Health and Safety

Noncompliance Area: On 10/18/23 Staff person #2 was observed to be caring for children unsupervised. Staff person #2 has not completed the following pre-service training required prior to caring for children unsupervised: pediatric first aid and CPR training and 10-hour health and safety training.

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. Until such time as the required pre-service trainings are completed, staff person #2 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 #2, staff person #2 may not work in a child-care position at the facility.

Regulation: 3270.14/3270.21

Description: Pertinent Laws & Regulations/General Health and Safety

Noncompliance Area: The file of Staff #10 lacked documentation of completing the Pennsylvania Health and Safety Update 2022 by December 30, 2022 (SEE LIS Code Sheet). The file of Staff #10 contained documentation of completing the health and safety update on 6/12/23.

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.

Regulation: 3270.151(c)(3)

Description: Exam communicable disease

Noncompliance Area: The files of Staff #3 and #6 contained health assessments which did not include 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: 3270.151(c)(5)

Description: Physician/CRNP assessment

Noncompliance Area: The files of Staff #3 and #6 contained health assessments which did not include the physician's or CRNP's assessment of the person's suitability to provide child care.

Correction Required: An adult health assessment must include the physician's or CRNP's assessment of the person's suitability to provide child care.

Regulation: 3270.181(c)

Description: Emergency info/agreement updated 6 mos

Noncompliance Area: The emergency contacts for Children #1 and #6 were not reviewed and updated at least once in a 6-month period. Child #1's emergency contact was reviewed on 9/14/22, 1/17/23, and 10/9/23. Child #6's emergency contact was signed on 9/20/22 and reviewed on 1/17/23.

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.

Regulation: 3270.182(5)

Description: Consent for administration of minor first-aid required prior to admission

Noncompliance Area: The file of Child #1 did not contain signed parental consent for administration of minor first-aid procedures by facility staff on the emergency contact form.

Correction Required: 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: 3270.21

Description: General Health and Safety

Noncompliance Area: On 10/18/23 observed a pair of adult scissors in the drawer under the microwave and above the cabinet door labeled "bleach" in the kitchen which were accessible to children.

Correction Required: Conditions at the facility may not pose a threat to the health or safety of the children.

Regulation: 3270.27(c)

Description: Training regarding plan

Noncompliance Area: The files of Staff #8 and #9 lacked documentation of training regarding the emergency plan on annual basis. The file of Staff #8 contained documentation of emergency plan training completed on 12/22/22 with previous training completed on 9/3/21. The file of Staff #9 contained documentation of emergency plan training completed on 10/26/22 with previous training completed on 9/2/21.

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: 3270.27(f)

Description: Emergency plan

Noncompliance Area: On 10/18/23 the operator lacked documentation of sending a copy of the emergency plan updates to the local municipality and to the county emergency management agency.

Correction Required: 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: 3270.31(e)(4)(ii)

Description: Fire safety - 1 yr.

Noncompliance Area: The file of Staff #10 lacked documentation of participating, at least annually, in fire safety training conducted by a fire protection professional. The file of Staff #10 contained documentation of fire safety training completed on 8/22/23 with previous training completed on 5/18/22.

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: 3270.32(a)

Description: Comply with CPSL

Noncompliance Area: On 10/18/23 Certification Staff observed Staff #2, a provisional hire, taking children from the 3-Year-Old Classroom (Room 302) to the bathroom alone and not in the vicinity of a permanent employee.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). PROVISIONAL HIRE UNSUPERVISED: A provisional employee may not be permitted to work alone with children and must work within the vicinity of a permanent employee.

Regulation: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: The file of Staff #1, a provisional hire, lacked documentation of application for the National Sex Offender Registry Certificate and FBI fingerprint receipt dated prior to or on the date of initial hire (SEE LIS Code Sheet). The file of Staff #1 contained an FBI Clearance dated 5/24/22 and contained no NSOR. Staff #1 was not suspended after 45 days. The file of Staff #3, a provisional hire, lacked the results of the Child Abuse Clearance prior to employment (SEE LIS Code Sheet). The file of Staff #3 contained a Child Abuse Clearance dated 9/7/23. The file of Staff #5 lacked a valid FBI Clearance because it did not contain a disposition for charges. The files of Staff #8 and #9 lacked a disclosure statement signed at the time of initial employment (SEE LIS Code Sheet). The file of Staff #8 contained a disclosure statement dated 8/31/21. The file of Staff #9 contained a disclosure statement dated 8/26/21.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). LACKING REQUIRED HIRING DOCUMENTS: Facility Person # 1and #5 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. Facility Person #1 and #5 may not work in a child care position at the facility.

Regulation: 3270.33(a)

Description: Each staff person meets quals

Noncompliance Area: The files of Staff #4 and #7, who were designated as group supervisors, lacked documentation of meeting one of the applicable staff qualifications for the position in which the person is performing.

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.

Regulation: 3270.36(b)(5)/3270.192(2)(ii)

Description: HS/GED + 2 yrs/Exp, educ., training prior to facility

Noncompliance Area: The file of Staff #3, who was designated as an assistant group supervisor, lacked documentation of a high school diploma or general educational development certificate. The file of Staff #9, who was designated as an assistant group supervisor, lacked documentation of 2 years' experience with children.

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.

Regulation: 3270.65

Description: Protective Outlet Covers 5 yrs. or less

Noncompliance Area: On 10/18/23 observed an electrical outlet between the windows on the orange wall in Room 104 which lacked protective receptacle covers. On 10/18/23 observed electrical outlets on the power strip on the microwave which lacked protective receptacle covers in the 3-year-old Room. On 10/18/23 observed an electrical outlet which lacked a protective receptacle cover by the black cabinet in Room 303. On 10/18/23 observed an electrical outlet which lacked a protective receptacle cover to the left of the closet in Room 303.

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

Regulation: 3270.66(a)

Description: Locked or inaccessible

Noncompliance Area: On 10/18/23 observed Equate Sunscreen and Coppertone Pure and Simple 100 Mineral Sun Protection which indicated "keep out of the reach of children" in a plastic bin on the 2nd shelf from the bottom which were accessible to children in Room 103. On 10/18/23 observed Johnson Baby Lotion which indicated "keep out of the reach of children" in a plastic bin on the floor beside the changing table in the Women's Bathroom on the 2nd floor which was accessible to children.

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

Regulation: 3270.75(b)

Description: Inaccessible to children

Noncompliance Area: On 10/18/23 observed a first-aid kit on a hook approximately 2 1/2 feet from the floor in Room 104 which was accessible to children.

Correction Required: A first-aid kit must be inaccessible to children.

Regulation: 3270.76

Description: Building Surfaces

Noncompliance Area: On 10/18/23 observed the end cap of the baseboard heater was loose by the Lego table in Room 303.

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.

Regulation: 3270.77(a)

Description: No peeling paint or plaster

Noncompliance Area: On 10/18/23 observed peeling paint on the baseboard heater under numbers and the alphabet in Room 303. On 10/18/23 observed peeling paint in the left bottom corner of the bathroom stall closest to the window in the Women's Bathroom on the 2nd floor.

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

Regulation: 3270.82(e)

Description: Toilet and sinks proper height

Noncompliance Area: On 10/18/23 the counter height sinks in Rooms 201 (Older Infant), 101 (Young Toddler), and 102 (Young Toddler) did not have platforms or steps to be easily approached.

Correction Required: Toilets and sinks shall be at proper heights for children using them or shall be easily approached by means of platforms or steps.

Regulation: 3270.113(e)

Description: Restraints prohibited

Noncompliance Area: *Based on video footage and staff interviews, Staff #1 and #2 placed Child #1 in a highchair for 7 minutes before then placing Child #1 in a car seat for 46 minutes.

Correction Required: *A facility person may not restrain a child by using bonds, ties or straps to restrict a child's movement or by enclosing the child in a confined space, closet or locked room. The prohibition against restraining a child does not apply to the use of adaptive equipment prescribed for a child with special needs.

Regulation: 3270.113(e)

Description: Restraints prohibited

Noncompliance Area: **Based on video footage and staff interviews, Staff #1 and #2 placed Child #1 in a highchair for 7 minutes before then placing Child #1 in a car seat for 46 minutes.

Correction Required: **The Legal entity will arrange for all staff to attend a live virtual or in person training with ELRC 6 staff regarding effective and age-appropriate handling of children with challenging behaviors

Regulation: 3270.113(e)

Description: Restraints prohibited

Noncompliance Area: ***Based on video footage and staff interviews, Staff #1 and #2 placed Child #1 in a highchair for 7 minutes before then placing Child #1 in a car seat for 46 minutes.

Correction Required: ***The operator will contact ELRC 6 to arrange for Start Up TA to come to the facility to conduct a minimum of 4 classroom observations over the period of 4 months and will follow recommendations of ELRC 6 staff.

Regulation: 3270.14/3270.21

Description: Pertinent Laws & Regulations/General Health and Safety

Noncompliance Area: The file of Staff #1 lacked documentation of completing the Pennsylvania Health and Safety Update by December 30, 2022 (SEE LIS Code Sheet). The file of Staff #1 contained documentation of completing the health and safety update on 6/13/23. Staff person #2 was observed to be caring for children unsupervised. Staff person #2 has not completed the following pre-service training required prior to caring for children unsupervised: mandated reporter training, health and safety training, and pediatric first aid/CPR from a PQAS approved trainer and a PQAS approved curriculum.

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. Until such time as the required pre-service trainings are completed, staff person #2 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 #2, staff person #2 may not work in a child-care position at the facility.

Regulation: 3270.162(c)

Description: Not withheld as discipline

Noncompliance Area: Based on interviews, Child #1 was denied a popsicle at afternoon snack for not napping.

Correction Required: Food may not be withheld from a child for purposes of discipline.

Regulation: 3270.133

Description: Child Medication and Special Diets

Noncompliance Area: Based on documentation and interviews, staff did not follow a special diet that is prescribed by a physician, physician's assistant or CRNP as treatment related to the child's special needs.

Correction Required: The operator shall make reasonable accommodation in accordance with applicable federal and state laws to facilitate administration of medication or a special diet that is prescribed by a physician, physician's assistant or CRNP as treatment related to the child's special needs. Facility persons are not required to administer medication or special diets which are requested or required by a parent, a physician, a physician's assistant or a CRNP but are not treatment related to the child's special needs.

Regulation: 3270.14/3270.21

Description: Pertinent Laws & Regulations/General Health and Safety

Noncompliance Area: The file of Staff #1 lacked documentation of completing the Pennsylvania Health and Safety Update 2022 by December 30, 2022 (SEE LIS Code Sheet). The file of Staff #1 contained documentation of completing the Pennsylvania Health and Safety Update 2022 on 3/20/23.

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.

Regulation: 3270.31(f)(10)

Description: Health and Safety Training - Pediatric First Aid and CPR

Noncompliance Area: The file of Staff #2 lacked documentation of completing professional development in pediatric first aid and pediatric cardiopulmonary resuscitation within 90 days of hire (SEE LIS Code Sheet). The file of Staff #2 contained documentation of completing pediatric first aid and pediatric cardiopulmonary resuscitation on 12/28/22.

Correction Required: Staff persons shall complete professional development in pediatric first aid and pediatric cardiopulmonary resuscitation within 90 days of hire.

Regulation: 3270.113(a)(1)

Description: Staff assigned to specific children

Noncompliance Area: At approximately 10:20 AM Staff #1 and #2 were caring for a group of 12 mixed age children which included 11 older toddlers and 1 preschooler. Staff #1 and #2 indicated they were sharing responsibility of the children. When asked to name the children, Staff #1 was able to name all of them, but Staff #2 was only able to name 10 of them.

Correction Required: 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: 3270.14/3270.21

Description: Pertinent Laws & Regulations/General Health and Safety

Noncompliance Area: Staff person #3 was observed to be caring for children unsupervised. Staff person #3 has not completed the following pre-service training required prior to caring for children unsupervised: mandated reporter training, pediatric first aid and CPR training, and 10-hour health and safety training.

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. Until such time as the required pre-service trainings are 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 person(s) available to supervise staff person #3, staff person #3 may not work in a child-care position at the facility.

Regulation: 3270.32(a)

Description: Comply with CPSL

Noncompliance Area: At approximately 10:45 AM Certification Staff observed Staff #3, a provisional hire, working alone in the 3-Year-Old Classroom (Room 302) and not in the vicinity of a permanent employee.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). PROVISIONAL HIRE UNSUPERVISED: A provisional employee may not be permitted to work alone with children and must work within the vicinity of a permanent employee.

Regulation: 3270.124(b)(2)

Description: Physician name, address, phone

Noncompliance Area: 2nd citation. Previously cited on10/24/22. The file of Child #1 lacked the complete address of the child's physician or source of medical care on the emergency contact form.

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

Regulation: 3270.131(a)

Description: Health information

Noncompliance Area: 2nd citation. Previously cited on 10/24/22. The file of Child #2 lacked an initial health report no later than 60 days following the first day of attendance at the facility. The file of Child #2 contained 2 health reports which are not dated, and one of them is not signed by a physician, physician's assistant, or a CRNP.

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(e)(1)

Description: Exemption documentation from parent/guardian

Noncompliance Area: 2nd citation. Previously cited on 10/24/22. The file of Child #1, an 11-month-old, lacked a current influenza immunization in accordance with the schedule recommended by the ACIP. The file of Child #3, a 10-month-old, lacked a current influenza immunization in accordance with the schedule recommended by the ACIP.

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.

Regulation: 3270.133(1)

Description: Original container

Noncompliance Area: 2nd citation. Previously cited on 10/17/22. Observed the prescription medication for Child #4 was not in the original container in Room 101.

Correction Required: A prescription or nonprescription medication may be accepted only in an original container. The medication shall remain in the container in which it was received.

Regulation: 3270.133(7)

Description: Medication log

Noncompliance Area: 2nd citation. Previously cited on 10/17/22. The operator did not establish a medication log for prescription medication for Child #5.

Correction Required: An operator is responsible to establish and maintain a medication log if prescription or nonprescription medication is administered.

Regulation: 3270.135(a)(3)

Description: Disposable diapers

Noncompliance Area: 2nd citation. Previously cited on 10/17/22. The diapering area in the Toddlers Classroom lacked a plastic-lined, hands-free covered can.

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: 3270.192(5)

Description: Two written references

Noncompliance Area: 2nd citation. Previously cited on 10/24/22. The file of Staff #7 lacked two written, nonfamily references from individuals attesting to the person's suitability to serve as a facility person.

Correction Required: A facility person's record shall include two written, nonfamily references from individuals attesting to the person's suitability to serve as a facility person.

Regulation: 3270.27(c)

Description: Training regarding plan

Noncompliance Area: 2nd citation. Previously cited on 10/24/22. The files of Staff #3, #4, #5, and #6 lacked documentation of receiving training regarding the emergency plan at the time of initial employment (SEE LIS Code Sheet). The files of Staff #3, #4, #5, and #6 do not contain documentation of any emergency plan training.

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: 3270.36(b)(3)

Description: HS/GED, 15 credits + 1 yr

Noncompliance Area: 2nd citation. Previously cited on 10/24/22. The files of Staff #7 and #8, who were designated as assistant group supervisors, lacked documentation of 1 year of experience with children.

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: 3270.36(b)(5)

Description: HS/GED + 2 yrs

Noncompliance Area: 2nd citation. Previously cited on 10/24/22. The file of Staff, #1, who was designated as an assistant group supervisor, lacked documentation of 2 years' experience with children.

Correction Required: An assistant group supervisor shall have a high school diploma or a general educational development certificate and 2 years experience with children.

Regulation: 3270.52

Description: Mixed Age Level

Noncompliance Area: At approximately 1:15 PM Staff #1 and Staff #2 were caring for a group of 9 mixed-age children which included 5 infants and 4 young toddlers. When asked to name the children in their assigned groups, Staff #1 named 1 infant and 4 young toddlers, and Staff #2 named 4 infants.

Correction Required: When children are grouped in mixed age levels, the age of the youngest child in the group determines the staff:child ratio and maximum group size in accordance with the requirements in § 3270.51 (relating to similar age level).

Regulation: 3270.66(a)

Description: Locked or inaccessible

Noncompliance Area: 2nd citation. Previously cited on 10/17/22. Observed Purell Hand Sanitizer and Xtra Hand Sanitizer which indicated "keep out of the reach of children" at the handwashing sink in Room 102 which were accessible to children. Observed Purell Hand Sanitizer and Xtra Hand Sanitizer which indicated "keep out of the reach of children" at the handwashing sink in Room 103 which were accessible to children.

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

Regulation: 3270.82(j)

Description: Running water - diapering

Noncompliance Area: 2nd citation. Previously cited on 10/17/22. Observed the diapering area in the Toddler Classroom lacked a source of running water for handwashing. Staff open and close a gate to get to the sink located in the Infant side of the classroom.

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.

Regulation: 3270.31(f)

Description: Health and Safety Training

Noncompliance Area: 2nd citation. Previously cited on 10/24/22. Staff persons #1 and #2 have not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): pediatric first aid and CPR.

Correction Required: Staff person(s) shall complete professional development in the topics of 3270.31(f)(10) within 90 days of hire. Staff person #1 and #2 will have until December 8, 2022 to complete the required training. Until such time as the required training has been completed, staff person #1 and #2 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 persons #1 and #2, staff persons #1 and #2 may not work in a child-care position at the facility.

Regulation: 3270.102(a)

Description: Clean and good repair

Noncompliance Area: On 10/17/22 observed a Nerf football with pieces missing in the outdoor play space. On 10/17/22 observed a cracked bin containing mobile animals in the 4 Year Old Classroom.

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: 3270.103

Description: Small Toys and Objects

Noncompliance Area: On 10/17/22 observed foam blocks with bite marks in 3 Year Old Classroom. On 10/17/22 observed foam shapes with bite marks in the School-Age Classroom.

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.

Regulation: 3270.106(a)

Description: Clean, age appropriate

Noncompliance Area: On 10/17/22 observed rest equipment not labeled for the use of a specific child in the following classrooms: Older Toddler, 3 Year Old Classroom, and 4 Year Old Classroom.

Correction Required: Individual, clean, age-appropriate rest equipment shall be provided for preschool, toddler and infant children as agreed between the child's parent and the operator. The rest equipment shall be labeled for the use of a specific child and used only by the specified child.

Regulation: 3270.113(a)

Description: Supervised at all times

Noncompliance Area: At approximately 1:45 PM on 10/17/22 Certification Staff entered the 3 Year Old Classroom to assess supervision and ratio at naptime. Certification Staff observed child care staff sitting on one side of the classroom. When Certification Staff went to speak to child care staff, Certification Staff was unable to see 4 children on the other side of the classroom because it was too dark.

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.

Regulation: 3270.123(a)(3)

Description: Services proceeded

Noncompliance Area: The files of Children #1, #2, #3, #4, #5, #6, #7, #8, #9, and #10 lacked the services to be provided to the family and child on the agreement.

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).

Regulation: 3270.124(b)(2)

Description: Physician name, address, phone

Noncompliance Area: The file of Child #8 lacked the complete address of the child's physician or source of medical care on the emergency contact form.

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