A Place To Grow Daycare - Blandon PA Child Care Center

Noncompliance Area: Diaper rash relief cream was observed in the Toddler classroom, signed in for use on a child in the classroom, but had an expiration date of 01/2019. Cortisone 10 cream was observed in the Preschool classroom, signed in for use on a child in the Pre-K classroom, but had an expiration date of 03/2020.

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

Noncompliance Area: Two small hand sanitizers, both labeled "Keep out of reach of children" were observed hanging from backpacks in the Pre-K room, accessible to all children in the classroom.

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

Noncompliance Area: Three bolts around the gate and inside fencing on the small playground to the side of the building were observed uncovered during the inspection.

Correction Required: Toys, play equipment and other indoor and outdoor equipment used by the children shall be clean, in good repair and free from rough edges, sharp corners, pinch and crush points, splinters and exposed bolts.

Noncompliance Area: During an unannounced appeals monitoring inspection on 1/27/2020, DG Baby Diaper Rash Paste, labeled for Child #1, was observed to have an expiration date of 6/2019. An epi-pen, labeled for Child #2, was observed to have an expiration date of Oct. 2019. These two medications were observed in the toddler medication box. Infants' Tylenol was observed in the Preschool classroom for Child #3, but the medication was observed to have an expiration date of 12/2019. A plan of correction was received from the facility stating that on 1/29/2020, "All medicine was given back to parents on January 27, 2020 and explained that when/if new medicine was brought in that they needed a new medication form. The new epipen was received on January 29 2020. In the future, teachers will use a written checklist to check medicine containers weekly to check for name of child and expiration date. They will aso check that medicine has a written permission paper on file and it is updated when needed." An unannounced appeals monitoring visit was conducted on 2/24/2020. During this inspection, Infants' Tylenol, labeled for use for two children in the Toddlers classroom, was observed to have expired in 1/2020.

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

Noncompliance Area: The diaper changing pad in the infants' classroom was observed to have multiple tears in the covering on both sides of the pad, exposing the inner foam, making it unable to be fully sanitized between each diaper change.

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

Noncompliance Area: During an inspection conducted on 1/27/2020, a box of baking soda labeled "Keep out of reach of children" was observed in an unlocked cabinet in the Pre-K classroom in an unlocked cabinet accessible to children in the classroom. A roll of plastic garbage bags was observed in the toddler section of the facility in an unlocked cabinet in the kitchenette area, accessible to children who are still placing objects in their mouths. A plan of correction was received from the facility that on 1/27/2020, "The item was put out of reach of the children. In the future, we will have daily written checks to look inside unlocked cabinets for any items that would put a child in danger. This includes toys and objects with a diameter of lesss than one inch, objects with removeable parts that have a diameter of less than 1 inch, plastic bags, styrofoam or any cleaning or toxic material." An unannounced appeals monitoring visit was conducted on 2/24/2020. During this inspection, a cabinet lock in the Toddlers classroom, on the second cabinet in on the island, was broken, allowing children access to plastic grocery bags, trash bags, and a large bottle of hand sanitizer labeled "keep out of reach of children." Swiffer Wet Jets, with the solution bottles attached, were observed in the Toddlers and Preschool classroom, accessible to children. The cleaning solution is labeled "Keep Out of Reach of Children." Pledge spray and Febreeze spray, both labeled "keep out of reach of children," were observed in an unlocked drawer in the entranceway of the Preschool classroom, accessible to children. A PowerStick deodorant, labeled "keep out of reach of children," was observed in an unlocked cabinet under the sink in the Pre-K classroom.

Correction Required: Cleaning materials and other toxic materials shall be kept in an area or container that is locked or made inaccessible to children. Toys and objects with a diameter of less than 1 inch, objects with removable parts that have a diameter of less than 1 inch, plastic bags and styrofoam objects may not be accessible to children who are still placing objects in their mouths.

Noncompliance Area: A bottle of Motrin Infants' drops was observed in the medication box in the toddlers classroom, but the bottle was not labeled with the name of the child for whom the medication is intended. Staff were unsure to whom the medication belonged.

Correction Required: The label of a medication container shall identify the name of the medication and the name of the child for whom the medication is intended. Medication shall be administered to only the child whose name appears on the container.

Noncompliance Area: DG Baby Diaper Rash Paste, labeled for Child #1, was observed to have an expiration date of 6/2019. An epi-pen, labeled for Child #2, was observed to have an expiration date of Oct. 2019. These two medications were observed in the toddler medication box. Infants' Tylenol was observed in the Preschool classroom for Child #3, but the medication was observed to have an expiration date of 12/2019.

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

Noncompliance Area: There was no written permission on file at the facility for the DG Baby Diaper Rash Cream labeled for Child #1.

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

Noncompliance Area: A box of baking soda labeled "Keep out of reach of children" was observed in an unlocked cabinet in the Pre-K classroom in an unlocked cabinet accessible to children in the classroom. A roll of plastic garbage bags was observed in the toddler section of the facility in an unlocked cabinet in the kitchenette area, accessible to children who are still placing objects in their mouths.

Correction Required: Cleaning materials and other toxic materials shall be kept in an area or container that is locked or made inaccessible to children. Toys and objects with a diameter of less than 1 inch, objects with removable parts that have a diameter of less than 1 inch, plastic bags and styrofoam objects may not be accessible to children who are still placing objects in their mouths.

Noncompliance Area: A section of teal peeling paint was observed in the toddler classroom, near the gate by the back door, accessible to children.

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

Noncompliance Area: On 8.30.19 a complaint investigation was conducted. During the investigation, staff 1 showed cert rep footage on his person cell phone from 8.29.19.This footage was later transferred to a jump drive for rep. On 9.4.19, cert rep received and reviewed the jump drive. In the video, inspector observed staff 2 grabbing child 1, pushing child 1's face to the floor, flinging child 1 to the floor, holding child 1 down on the floor and restraining child 1. Inspector observed staff 1, 3 and 4 in the room with staff 2 while staff 2 was tussling on the floor with child 1. None of the staff attempted to intervene, nor did they call childline to report what they saw occurring between staff 2 and child 1.

Correction Required: A facility person may not use any form of physical punishment, including spanking a child. 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. Staff 2 must attend existing provider orientation on November 12, 2019 at the NE Regional office. Staff 2 is required to call the NE Regional office to register to attend the existing provider orientation.

Noncompliance Area: On 8.30.19, a complaint investigation was conducted. Staff 1 admitted he cursed at child 1's mom in front of child care children that were in care on 8.29.19.

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

Noncompliance Area: On 8.30.19 a complaint investigation was conducted. During the investigation, staff 1 showed cert rep footage on his person cell phone from 8.29.19.This footage was later transferred to a jump drive for rep. On 9.4.19, cert rep received and reviewed the jump drive. In the video, inspector observed staff 2 grabbing child 1, pushing child 1's face to the floor, flinging child 1 to the floor, holding child 1 down on the floor and restraining child 1. Inspector observed staff 1, 3 and 4 in the room with staff 2 while staff 2 was tussling on the floor with child 1. None of the staff attempted to intervene, nor did they call childline to report what they saw occurring between staff 2 and child 1.

Correction Required: An operator or a staff person who has reason to believe that a child enrolled in the facility has been abused is required to report suspected child abuse to ChildLine as mandated by the CPSL.

Noncompliance Area: On 8.30.19 a complaint inspection was conducted. Inspector walked through the infant room. The curtains were drawn not allowing any natural light into the room. The room was dark and inspector was unable to see the baby's sleeping in the cribs. Inspector had to lean into the cribs of the babies sleeping in order to see the baby's face and if the baby was breathing. Inspector observed staff person 5 in the kitchen making a bottle and was unable to assess the children in the cribs from the kitchen in the dark. Staff person 5 was approximately 20-25 feet away from the farthest baby in the crib sleeping. Staff person 6 was sitting closer to the closed curtains in a rocking chair approximately10-15 feet away from the cribs feeding a baby. Inspector provided technical assistance to the owners husband on supervision.

Correction Required: Rooms, hallways, stairways, outside steps, porches and ramps shall be lighted by artificial or natural light.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. The legal entity must arrange for all facility staff to receive three hours of PQAS approved in-person training regarding supervision of children. It does not matter if the PQAS approved training is through the ELRC. The legal entity must receive DHS approval of the training content prior to scheduling the training.