Growing Together Learning Center

Regulation: 3270.106(a)

Description: Clean, age appropriate

Noncompliance Area: During the unannounced visit cert rep observed when walking into the infant classroom 3 infants were sleep in a car seats and baby chairs.

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: 3270.106(f)

Description: 2 feet apart

Noncompliance Area: During the unannounced visit cert rep observed in classroom #2, 3, 6 and 9 rest equipment was not 2 feet of space on three sides during nap time.

Correction Required: At least 2 feet of space is required on three sides of a bed, cot, crib or other rest equipment while the equipment is in use.

Regulation: 3270.51

Description: Similar Age Level

Noncompliance Area: During the unannounced visit cert rep observed the infant room with 8 infants and two staff persons. One staff person left out of the infant room leaving one staff person with 8 infants.

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.

Regulation: 3270.27(a)(5)

Description: Emergency plan

Noncompliance Area: The facility's emergency plan did not provide for accommodations for infants, toddlers, children with disabilities, and children with chronic medical conditions.

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. Amend the facility emergency plan to include accommodations for infants, toddlers, children with disabilities, and children with chronic medical conditions. Submit a written copy of the amended emergency plan.

Regulation: 3270.14/3270.21

Description: Pertinent Laws & Regulations/General Health and Safety

Noncompliance Area: Several staff persons records did not contain verification of completed required CCDBG training (Pa Update) (#1 -#8).

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 persons cannot work unsupervised with children until the PA Update has been completed. Submit written verification of the required CCDBG training (PA Update).

Regulation: 3270.20(a)(1)/3270.20(b)

Description: Inpatient hospitalization or ER treatment of child/Mail or deliver written report to regional office within 72 hours

Noncompliance Area: On 8/22/23, a child received emergency room treatment subsequent to sustaining an injury at the facility when the child left the facility alone and unsupervised by a staff person. Operator failed to notify the regional office within 24 hours of the emergency room treatment and mail a written report within 72 hours after the occurrence. (Child #1)

Correction Required: The operator shall immediately notify a child's parent and shall telephone notice to the appropriate regional office within 24 hours if a child in care at the facility is hospitalized or receives emergency room treatment. The operator shall mail or deliver a written report to the appropriate regional office within 72 hours after hospitalization of a child in care, emergency room treatment of a child in care, death of a child in care, a facility fire requiring the services of a fire department. Complete and submit the incident report. Ensure that incident reporting is completed as specified. Revise and submit written policies and procedures regarding incident reporting and notification in relation to emergency room treatment for children in care.

Regulation: 3270.21/3270.113(a)

Description: General Health and Safety/Supervised at all times

Noncompliance Area: On 8/22/23 at approximately 5:30pm, a child exited the facility when the staff person left the classroom to answer the main door. The staff person assigned responsibility for the supervision of a child had no knowledge of the child's whereabouts until returned to the facilty by a stranger.

Correction Required: Conditions at the facility may not pose a threat to the health or safety of the children. 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. The legal entity must arrange for all facility staff to receive training in proper supervision of children, including the requirement that staff know the whereabouts of the children in his assigned group and that staff 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 ensure that the training is DHS approved hands-on training. Submit written verification of the completed training for all facility staff persons. Develop and submit a written protocol regarding the supervision of children during times of transition, school-age arrivals, parent pick up and other administrative needs. Notify all facility staff of this protocol. Submit a copy of written the notification that includes each staff person's signature.

Regulation: 3270.21/3270.113(a)

Description: General Health and Safety/Supervised at all times

Noncompliance Area: On 8/22/23 at approximately 5:30-pm, a child exited the facility when the staff person left the classroom to answer the main door. The staff person assigned responsibility for the supervision of a child had no knowledge of the child's whereabouts until returned to the facilty by a stranger.

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

Regulation: 3270.151(a)

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

Noncompliance Area: Two staff person's records did not contain a health assessment completed in accordance with these regulations. (#1 and #2)

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. Obtain and submit a current up-to-date health assessment in accordance with these regulations for the identified staff persons. Ensure that staff have the required health assessments in accordance with these regulations.

Regulation: 3270.182(7)

Description: Reports of accidents, injuries and illnesses. Original report - parent same day Copy - facility accident file. Copy - child's file

Noncompliance Area: On 7/5/22, an injury was observed on a child while in care at the facility and the operator did not provide the parent the original report on the date of the incident. ( #1)

Correction Required: A child's record shall contain reports of accidents, injuries and illnesses involving a child in care at the facility. The original report shall be given to the parent on the day of the incident. The second copy of the report shall be retained at the facility in an accident file. The third copy of the report shall be retained at the facility in the child's file. Provide the parent an incident and submit a copy for verification. Ensure that parents are provided the original report on the day of the incident involving an injury, accident or illness. Revise and submit written policies and procedures to ensure that parents are provided the original incident report on the date of the incident.

Regulation: 3270.36(b)(5)

Description: HS/GED + 2 yrs

Noncompliance Area: Several staff person's record did not contain written verification of education for their assistant group supervisor position. (#1, #2 and #3)

Correction Required: An assistant group supervisor shall have a high school diploma or a general educational development certificate and 2 years experience with children. Obtain and submit written verification of education for the identified staff person.. Ensure that all staff records have written verification of education and experience for their positions.

Noncompliance Area: Staff person acknowledged tapping a child's hand because he was playing with pencil and not focusing on his work. (staff #1) (child #1)

Correction Required: A facility person may not use any form of physical punishment, including spanking a child.The legal entity must arrange for all staff persons to receive training in handling active children and developmentally appropriate programming for preschool age children. The training must be DHS approved. Submit written verification of the completed training.

Noncompliance Area: On 9/11/29, a child received emergency room treatment subsequent to sustaining an injury at the facility and the operator failed to notify the regional office within 24 hours of the emergency room treatment and mail a written report within 72 hours after the occurrence.

Correction Required: The operator shall immediately notify a child's parent and shall telephone notice to the appropriate regional office within 24 hours if a child in care at the facility is hospitalized or receives emergency room treatment. The operator shall mail or deliver a written report to the appropriate regional office within 72 hours after hospitalization of a child in care, emergency room treatment of a child in care, death of a child in care, a facility fire requiring the services of a fire department. Ensure that incident reporting is completed as specified. Revise and submit written policies and procedures regarding incident reporting and notification in relation to emergency room treatment for children in care.

Noncompliance Area: On 4/26/19, a staff person responsible for supervising an older toddler was not able to direct or assess the activity of the child when the child fell out of a crib and staff person did not realize the child sustained severe injury to both arms.

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. The legal entity must arrange for all facility staff persons to receive at least 2 hours of in-person DHS approved training regarding supervision of children, including the requirement that staff persons must be physically present and be able to see, hear and assess and direct the activity of the children and training in managing biting behavior in child care settings. The legal entity must receive DHS approval of the training content prior to scheduling the training. Submit written verification of the training content and completed training for all facility staff persons. The legal entity must arrange for all facility staff persons to receive at least 2 hours of DHS approved training regarding supervision of children, including the requirement that staff persons must be physically present and be able to see, hear and assess and direct the activity of the children. The legal entity must receive DHS approval of the training content prior to scheduling the training. Submit written verification of the training content and completed training for all facility staff persons.

Noncompliance Area: On the date of this follow up inspection, for the purposes of verifying the correction from previous violation: Provider was unable to provide access to the files requested, no staff on the facility was able to comply with the request. This violation marks a continuous non compliance in this particular area.

Correction Required: A staff person shall provide to agents of the Department immediate access to the facility, the children and the files and records

Noncompliance Area: One classroom lacked a sufficient amount and variety play equipment and materials appropriate to the developmental needs, individual interests and ages of the children

Correction Required: Play equipment and materials appropriate to the developmental needs, individual interests and ages of the children shall be provided in sufficient amount and variety to preclude long waits for use. Obtain and submit written verification of additional variety and amount of play equipment and materials as specified.

Noncompliance Area: Two children's records did not contain signed parental consent for emergency medical care and for administration of minor first-aid procedures by facility staff. (#1 and #2)

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. Obtain and submit written verification of signed parental consents for the identified children as specified in the regulation. Ensure that all children's records contain the required parental consents prior to admission. Revise and submit written policies and procedures to ensure that all children's records contain the required parental consents prior to admission.

Noncompliance Area: Carpets in two classrooms were in need of cleaning. (#2-older toddler room) (#3-preschool room)

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. Clean, replace or remove the carpets. Ensure that surfaces in the facility remain clean.

Noncompliance Area: At the time of the inspection the 3 year old room on the second floor was staffed with one adult staff person who was providing care for 12 children from 7:45 AM until 8:00 AM.

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).

Noncompliance Area: While on an investigation of a complaint access to the files was requested and no staff on the facility was able to comply with the request.

Correction Required: A staff person shall provide to agents of the Department immediate access to the facility, the children and the files and records

Noncompliance Area: The facility lacked a sufficient amount of materials for dramatic role playing in room #3 and room #5.

Correction Required: Play equipment and materials appropriate to the developmental needs, individual interests and ages of the children shall be provided in sufficient amount and variety to preclude long waits for use. Play equipment and materials shall include materials for dramatic role playing. Obtain additional materials for dramatic role playing in a sufficient amount to preclude long waits. Submit written documentation of purchase receipts for verification of compliance.

Noncompliance Area: The facility lacked a sufficient amount of art materials for tactile development in room #4.

Correction Required: Play equipment and materials appropriate to the developmental needs, individual interests and ages of the children shall be provided in sufficient amount and variety to preclude long waits for use. Play equipment and materials shall include toys to handle and manipulate and art materials for tactile development. Obtain additional art materials for tactile development in a sufficient amount to preclude long waits. Submit written documentation of purchase receipts for verification of compliance.

Noncompliance Area: It could not be determined when child service reports were completed for three children as the reports did not contain the date when they were completed. (#1, #2 and #5)

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). Complete and submit a current up-to-date child service report for the indicated children. Provide child service report training for all facility staff that includes the proper completion of the form. Ensure that all child service reports are completed every 6 months in accordance with this regulation. Submit a copy of the completed training for all facility staff persons.

Noncompliance Area: Menus were not conspicuously posted one week in advance in the facility.

Correction Required: An operator shall conspicuously post the menu at least 1 week in advance or provide a menu to each family. Ensure that menus are conspicuously posted in the facility at least 1 week in advance as specified.

Noncompliance Area: Several childrens records did not contain emergency contact and/or financial agreement information that had been reviewed and updated within the past 6 months. (#1, #3 and 4)

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. Obtain and submit written verification of the updated emergency contact and financial agreement information for the identified children. Revise and submit written policies and procedures to ensure that childrens emergency contact information is updated at least every 6 months or as soon as the information changes.

Noncompliance Area: One child's record did not contain signed parental consent for emergency medical care and for administration of minor first-aid procedures by facility staff. (#5)

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. Obtain and submit written verification of signed parental consents for the identified child as specified in the regulation. Ensure that all children's records contain the required parental consents prior to admission.

Noncompliance Area: The emergency plan was not posted at a conspicuous location in the facility.

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. Post the emergency plan at a conspicuous location in the facility.