Heavens Angels

Regulation: 3270.131(b)(2)/3270.182(1)

Description: Toddler/preschool: updated health report every 12 months/Initial and subsequent health reports

Noncompliance Area: At the time of the inspection the record of child #1 was lacking a current valid health assesment.

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. A child's record shall contain initial and subsequent health reports.

Regulation: 3270.134(a)

Description: Child's hands washed

Noncompliance Area: At the time of the inspection the children in the toddler room were served breakfast and they did not wash their hands prior to eating.

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

Regulation: 3270.151(a)/3270.192(3)

Description: 12 months prior to service and every 24 months thereafter/Health assessment, TB test

Noncompliance Area: At the time of the inspection the record of staff person #3 was lacking a current valid health assessment.

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. A facility person's record shall include a written report of initial and subsequent health assessments, including the results of initial and subsequent tuberculin skin tests, x-rays or other medical documentation necessary to confirm freedom from communicable tuberculosis.

Regulation: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: At the time of the inspection facility person #2 was observed caring for a child. The record of facility person #2 was lacking a FBI fingerprint clearance.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). A provisional employee may not be permitted to work alone with children and must work within the vicinity of a permanent employee. 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 #- 2 may not work in a child care position at the facility.

Regulation: 3270.66(a)

Description: Locked or inaccessible

Noncompliance Area: At the time of the inspection there was a can of Lysol on the changing table in the infant room.

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(a)/3270.124(c)

Description: In child care spaces/Each child care space

Noncompliance Area: At the time of the inspection the children were gathered in the cafeteria and neither emergency contact forms nor a first aid kit were in the room.

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

Regulation: 3270.106(f)

Description: 2 feet apart

Noncompliance Area: At the time of the inspection, the cots in the toddler and preschool rooms during nap time did not have at least 2 feet of space on three sides.

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: 3270.119

Description: Infant sleep position

Noncompliance Area: At the time of the inspection, child #5 was observed asleep in the rocker.

Correction Required: Infants shall be placed in the sleeping position recommended by the American Academy of Pediatrics unless there is a medical reason an infant should not sleep in this position. The medical reason shall be documented in a statement signed by a physician, physician's assistant or CRNP and placed in the child's record at the facility.

Regulation: 3270.123(a)(3)

Description: Services proceeded

Noncompliance Area: At the time of the inspection, the file of child #1, #2, and #3 did not include 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: 3270.124(b)(7)

Description: Name/address/phone release person

Noncompliance Area: At the time of the inspection, the emergency contact of child #4 did not include 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: 3270.124(f)/3270.181(c)

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

Noncompliance Area: At the time of the inspection, the emergency contact and the financial agreement for child #3 did not include once in a 6-month review.

Correction Required: The parent shall update in writing emergency contact information once in a 6-month period or as soon as there is a change in the information. A parent is required to review and update the emergency contact information and the financial agreement at least once in a 6-month period or as soon as there is a change in the information.

Regulation: 3270.34(a)(6)

Description: Staff evaluations

Noncompliance Area: At the time of the inspection, the file of staff person #1 and #2 did not include a staff evaluation.

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

Regulation: 3270.77(a)

Description: No peeling paint or plaster

Noncompliance Area: At the time of the inspection, peeled paint was observed in the school age program room near the white board.

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(h)

Description: Handwashing signs

Noncompliance Area: At the time of the inspection, a handwashing sign was not observed in the boys bathroom. Non-compliance was corrected on site.

Correction Required: A facility person and an able child shall wash his hands after toileting and before eating. A sign on which this requirement is written shall be posted at each toilet, training chair, diapering area and sink in the facility.

Regulation: 3270.52

Description: Mixed Age Level

Noncompliance Area: At the time of the inspection, 4 infants and 9 toddlers with 3 staff persons was observed in the toddler room.

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: 3270.124(b)(6)

Description: Insurance coverage information

Noncompliance Area: At the time of the inspection the emergency contact information of child #1 was lacking health insurance coverage and policy number for that child.

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

Regulation: 3270.151(a)/3270.192(3)

Description: 12 months prior to service and every 24 months thereafter/Health assessment, TB test

Noncompliance Area: At the time of the inspection the record of staff person #3 was lacking a current valid health assessment.

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. A facility person's record shall include a written report of initial and subsequent health assessments, including the results of initial and subsequent tuberculin skin tests, x-rays or other medical documentation necessary to confirm freedom from communicable tuberculosis.

Regulation: 3270.31(e)/3270.192(2)(iii)

Description: Age and Training/Exp, educ., training at facility

Noncompliance Area: At the time of the inspection the record of staff person #1, having over one year of providing care for children at the facility, was lacking in the proof of an annual minimum of 12 clock hours of child care training.

Correction Required: A staff person shall obtain an annual minimum of 12 clock hours of child care training. A facility person's record shall include verification of child care experience, education and training following the outset of service at the facility.

Regulation: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: At the time of the inspection the record of staff person #2, having served the facility in a child care position for over 45 days, was lacking a completed National Sex Offender Clearance Letter.

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. 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.

Regulation: 3270.75(a)/3270.124(c)

Description: In child care spaces/Each child care space

Noncompliance Area: At the time of the inspection the children were being cared for in the cafeteria and there was no first aid kit in the room, nor was there emergency contact information for children receiving care in the space.

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

Regulation: 3270.82(i)

Description: Lidded waste receptacles

Noncompliance Area: At the time of the inspection the toilet area in the rear of the building was not equipped with a lidded waste receptacle.

Correction Required: A toilet area, training chair area, diapering area and sink area shall be equipped with a clean, lidded waste receptacle.

Regulation: 3270.107

Description: Refrigerator

Noncompliance Area: On 4/20/23, at time of inspection, a thermometer was not observed in the refrigerator located in the infant room.

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: 3270.131(b)(1)/3270.182(1)

Description: Infant: updated health report every 6 months/Initial and subsequent health reports

Noncompliance Area: On 4/20/23, at time of inspection, Child #2 (YT) file did not contain an updated health report at least every 6 months.

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. A child's record shall contain initial and subsequent health reports.

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

Description: Immunization record/ACIP recommended immunization record

Noncompliance Area: On 4/20/23, at time of inspection, Child #1 and Child #2 have been enrolled at the facility for more than 60 days. An updated immunization record was not on file for Child #1. Additionally, Child #1 and Child #2 files did not contain documentation of an annual influenza vaccine as recommended by the ACIP.

Correction Required: A health report shall include a review of the child's immunized status according to recommendations of the ACIP. The facility 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.

Regulation: 3270.151(a)/3270.192(3)

Description: 12 months prior to service and every 24 months thereafter/Health assessment, TB test

Noncompliance Area: On 4/20/23, at time of inspection, Staff #2 file did not contain an initial health assessment including results of tuberculosis testing. Staff #1 and Staff #3 file did not contain initial health assessments (only results of tb tests were on file for Staff #1 and #3).

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. A facility person's record shall include a written report of initial and subsequent health assessments, including the results of initial and subsequent tuberculin skin tests, x-rays or other medical documentation necessary to confirm freedom from communicable tuberculosis.

Regulation: 3270.166(4)

Description: Bottles labeled

Noncompliance Area: On 4/20/23, at time of inspection, there were two unlabeled bottles in the refrigerator located in the infant room.

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

Regulation: 3270.192(5)

Description: Two written references

Noncompliance Area: On 4/20/23, at time of inspection, Staff #2 and Staff #4 files did not contain 2 letters of written references.

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)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: On 4/20/23, at time of inspection, Staff #2 file did not contain completed Child Abuse clearance, PA Criminal Clearance or FBI clearance as required by CPSL.

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

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

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

Noncompliance Area: On 4/20/23, at time of inspection, Staff #2 was observed working as an aide in the Infant/Toddler Room. Staff #2 file did not contain verification of education/experience.

Correction Required: A staff person or a substitute staff person shall meet one of the applicable staff qualifications for the position in which the person is performing. A facility person's record shall include acceptable verification of experience, education or training is a transcript or a diploma or a letter signed by a representative of the experiential, educational or training entity.

Regulation: 3270.51/3270.113(a)(1)

Description: Similar Age Level/Staff assigned to specific children

Noncompliance Area: On 4/20/23, at approximately 10:45am, Staff #1 was observed out of ratio with 12 children (ages 3-5) while Staff #3 left the room to answer the door.

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. The required staff:child ratios must be maintained at all times. Each staff person shall be assigned the responsibility for supervision of specific children. The staff person shall know the names and whereabouts of the children in his assigned group. The staff person shall be physically present with the children in his group on the facility premises and on facility excursions off the facility premises.

Regulation: 3270.124(b)(6)

Description: Insurance coverage information

Noncompliance Area: On 6/8/22, Child #1, Child #2 and Child #3 file did not include the health 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.

Regulation: 3270.124(b)(7)

Description: Name/address/phone release person

Noncompliance Area: On 6/8/22, Child #2 and Child #4 emergency contact information did not contain the address of the individuals 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: On 5/8/22, the facility did not have a policy to address shaken baby syndrome, abusive head trauma, and child maltreatment as required by 45 CFR 98.41(a)(1)(vi)

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: 3270.181(c)/3270.181(e)

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

Noncompliance Area: On 6/8/22, the emergency contact information located in the child care space and in the facility van used to transport children was not updated at least once in a 6 month period. Emergency contact information was updated in the child's master file.

Correction Required: A parent is required to review and update the emergency contact information and the financial agreement at least once in a 6-month period or as soon as there is a change in the information. If emergency information is updated in a master file, it shall be updated accordingly in other facility records.

Regulation: 3270.182(5)

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

Noncompliance Area: On 6/8/22, Child #1 file did not contain signed parental consent for administration of 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: On 6/8/22, two letters of reference were not observed in the file belonging to Staff #2 (the file contained one letter).

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(a)(6)

Description: Emergency plan

Noncompliance Area: On 6/8/22, the facility did not conduct an annual emergency drill.

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

Regulation: 3270.32(a)

Description: Comply with CPSL

Noncompliance Area: On 6/8/22, Staff #1 file did not contain a completed NSOR clearance required by CPSL.

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.

Regulation: 3270.72(d)

Description: Above ground window opening restricted to 6"

Noncompliance Area: On 6/8/22, the safety feature on the second floor window located in the Toddler Room was not engaged, enabling the window to open more than 6".

Correction Required: Windows or doors above the ground floor that open directly to the outdoors and are accessible to children shall be constructed, modified or adapted to limit the opening to 6 or fewer inches.

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

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

Noncompliance Area: On 11/12/21, during unannounced inspection, at approximately 1:15pm, Staff #2 left 6 sleeping PS age children in the second floor PS room unsupervised and unattended for approx. 2 minutes while answering the front door. The front door is located on the first floor.

Correction Required: Children on the facility premises and on facility excursions off the premises shall be supervised by a staff person at all times. Outdoor play space used by the facility is considered part of the facility premises. Children must be supervised at all times. Each staff person shall be assigned the responsibility for supervision of specific children. The staff person shall know the names and whereabouts of the children in his assigned group. The staff person shall be physically present with the children in his group on the facility premises and on facility excursions off the facility premises.

Regulation: 3270.119

Description: Infant sleep position

Noncompliance Area: On 11/12/21, during unannounced inspection, Child #1 (infant) was not observed in a sleeping position recommended by the AAP. Child #1 was observed asleep in an upright position in a bouncy seat. No evidence of medical reason signed by a physician instructing other sleeping position was on file at the facility)

Correction Required: Infants shall be placed in the sleeping position recommended by the American Academy of Pediatrics unless there is a medical reason an infant should not sleep in this position. The medical reason shall be documented in a statement signed by a physician, physician's assistant or CRNP and placed in the child's record at the facility.

Regulation: 3270.32(a)

Description: Comply with CPSL

Noncompliance Area: On 11/12/21, during unannounced inspection, Staff #1 was provisionally hired on 10/4/21. At approximately 1:20pm, Staff #1 was observed in the infant/toddler room working alone with children and was 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). SAFETY PLAN: The operator is required to submit to the Children and Youth Agency a plan of supervision or alternate arrangement as required by the Child Protective Services Law. 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: 3270.134(a)/3270.152

Description: Child's hands washed/Adult Hygiene

Noncompliance Area: On 8/11/21, during complaint investigation at 12:40pm (nap time), certification rep asked Staff #3 (infant/toddler staff) to describe all the steps of diaper changing procedure in detail. Staff #3 stated that after the diaper is changed, the child returns to class activity. Staff #3 stated that gloves are removed at end of diaper changing. Adult and child handwashing after diapering was not included in the diaper changing procedures described by Staff #3.

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

Regulation: 3270.33(a)/3270.37(c)

Description: Each staff person meets quals/Aides supervised all times

Noncompliance Area: On 8/11/21, during complaint investigation, Staff #1 acknowledged that on 6/16/21 Staff #2 transported 5 school age students in the facility van to and from a field trip, unsupervised by a staff person qualified at minimum as an assistant group supervisor. Staff 2 is qualified as an aide.

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.An aide or a combination of aides shall be supervised at all times by a staff person qualified at minimum as an assistant group supervisor.