Eagles Nest Child Care Center

Noncompliance Area: ***On 08/10/2020, at approximately 9:30 am, staff person #1 was walking a group of 4 older toddlers and 1 preschool age child back to the classroom from the young toddler playground, child #1 was left outside the classroom unsupervised. Staff person #1 was not aware one of the children was missing from the group.

Correction Required: ***The facility director will use the supervision observation checklist approved by the ELRC Region 6 staff, daily in each classroom. Completed checklists will be maintained on file by the facility director and be made available electronically to the Department Representative and ELRC Region 6 Staff when requested. This will be done for a period of 4 months and 2 weeks from the date this Plan of Correction is accepted by the Regional Office of Child Development and Early Learning.

Noncompliance Area: **On 08/10/2020, at approximately 9:30 am, staff person #1 was walking a group of 4 older toddlers and 1 preschool age child back to the classroom from the playground, child #1 was left outside the classroom unsupervised. Staff person #1 was not aware one of the children was missing from the group.

Correction Required: **The operator will convene monthly staff meetings for at least 4 months from the date this Plan of Correction is accepted by the Regional Office of Child Development and Early Learning. At each staff meeting, time will be set aside to review and discuss the facility's previous regulatory non-compliance items documented on inspection summaries issued in the last 6 months, as well as the Department of Human Services' definitions and regulations related to staff:child ratios and supervision of children. An agenda will be prepared for each staff meeting and a log identifying the date and time, and a sign-in sheet for persons attending each meeting will be maintained. The staff meeting agendas, logs and sign-in sheets will be made available to OCDEL-DHS representatives upon request.

Noncompliance Area: It was reported by the operator that on 06/29/2020 at 5:35 am, staff person #1 and #2 were working together in classroom #11 with 1 preschooler and 3 school-age children. Staff person #2 left the classroom to pick up sign-in sheets. While staff person #2 was in the office, staff person #1 entered the office, leaving the 4 children alone in the classroom unsupervised until staff person #2 was able to return 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.

Noncompliance Area: The file for staff person #1 lacked updated clearances within 60 months. The file contained a PA Criminal History clearance dated 04/10/2015, a Child Abuse clearance dated 04/19/2015 and an FBI clearance dated 04/13/2015 with no current clearances on file. The file for staff person #1 did not contain an NSOR certificate.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). A facility person's record shall include a copy of requests for the criminal history record and child abuse registry clearance information, a copy of the disclosure statement and a copy of the completed clearance information required under the CPSL. Facility Person #1 may not work in a child care position at the facility.

Noncompliance Area: It was reported by the operator that on 06/29/2020 at 5:35 am, staff person #1 (an Aide) and #2 (an Assistant Group Supervisor) were working together in classroom #11 with 1 preschooler and 3 school-age children. Staff person #2 left the classroom to pick up sign-in sheets in the office leaving staff person #1 unsupervised in the classroom with the children.

Correction Required: 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.

Noncompliance Area: Observed a table in room #7 with loose legs causing the table to wobble.

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

Noncompliance Area: At 11:00 AM, observed 12 older toddlers in the Little Cafeteria (room #13); emergency contact information was not present in the child care space while the children were receiving care.

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

Noncompliance Area: The gate and outside door leading out of the courtyard of the facility is left open for bus drop off daily from approximately 2:20 pm when the first bus arrives until approximately 4:00/4:15 pm when the last 3 buses arrive. The open gate and outside door leads to a sidewalk directly next to the parking lot and leads to the street. In September 2019, Child #1 ran out of the courtyard through the open gate and open door to the end of the sidewalk near the road before staff person #1 was able to reach him.

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

Noncompliance Area: Observed the door to the Laundry room unlocked; a shelf with insect sprays, paint cans and Clorox toilet bowl cleaner is located to the left of the door which were accessible to children. A table located next to the washer and dryer contained a bottle of laundry detergent 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.

Noncompliance Area: On 02/18/2020, observed ceiling tiles missing in Big Cafeteria.

Correction Required: Floors, walls, ceilings and other surfaces, including the facility's outdoor play space surfaces shall be kept clean, in good repair and free from visible hazards.

Noncompliance Area: On 02/18/2020, observed peeling paint on the posts supporting the roof over the sidewalk where preschool and school-age children stand to wait for the bus.

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

Noncompliance Area: SECOND CITATION: Observed rest equipment in room #4 (young and older toddlers) and room #6 (preschoolers) with less than 2 feet of space on three sides while the cots were in use. PREVIOUSLY CITED ON 01/10/2020.

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.

Noncompliance Area: THIRD CITATION: The file for child #1 (enrollment date 06/10/2013) only contained an initial health report dated 08/07/2013; the file did not contain any subsequent health reports. PREVIOUSLY CITED ON 01/10/2020 and 11/20/2019.

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

Noncompliance Area: The operator lacked documentation of training regarding the emergency plan for staff person #2 (rehire date 12/02/2019) at the time of rehire.

Correction Required: The operator shall assure that each facility person receives training regarding the emergency plan at the time of initial employment, on an annual basis and at the time of each plan update. The operator shall document the date of each training and the names of all facility persons who received the training and kept on file at the facility.

Noncompliance Area: The file for staff person #1, with a hire date of 01/20/2020 contained a volunteer criminal history clearance at the time of initial hire. The file lacked documentation of a request for the criminal history clearance for the purpose of child care employment. The file for staff person #2, with a rehire date of 12/02/2019, lacked documentation of fingerprinting for the FBI clearance prior to working in a child care position at the facility. The file contained a receipt for fingerprinting dated 01/15/2020 with results dated 01/16/2020.

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. A facility person's record shall include a copy of requests for the criminal history record and child abuse registry clearance information, a copy of the disclosure statement and a copy of the completed clearance information required under the CPSL.

Noncompliance Area: Observed rest equipment in room #6 (preschoolers) and room #12 (older toddlers) with less than 2 feet of space on three sides while the cots were in use.

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.

Noncompliance Area: SECOND CITATION: The file for child #1 (enrollment date 06/10/2013) only contained an initial health report dated 08/07/2013; the file did not contain any subsequent health reports. PREVIOUSLY CITED ON 11/20/2019.

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

Noncompliance Area: At the time of initial hire, the disclosure statement for staff person #1 (date of hire 12/03/2019) lacked the date the disclosure statement was signed and witnessed.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). A facility person's record shall include a copy of requests for the criminal history record and child abuse registry clearance information, a copy of the disclosure statement and a copy of the completed clearance information required under the CPSL.

Noncompliance Area: Observed in the older baby room a blue chair which had loose support screws. Observed 2 red chairs in the pre k room which had loose support screws and a wooden chair with a loose back creating a pinch point. Observed in room 7 a broken top to a plastic blue chair. Observed loose legs on the lego tables in room 7 and room 8. Observed a blue chair with exposed foam in room 10. Observed 2 small rips in the diaper changing pad in room 11. Observed a blue chair with a torn cover and exposed foam in the school age room. Observed multiple pieces of broken plastic inside and outside of the fence for the school age play area. Observed a cracked plastic cup and frisbee in the school age play area. Observed some broken plastic pieces/toy in the preschool sandbox and a missing support screw on the plastic castle creating a pinch point.

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: Observed in room 10, a pink Bumbo seat which did not have the CPSC recall required safety strap.

Correction Required: Children's toys and equipment, including furniture and rest equipment, described as hazardous by the United States Consumer Product Safety Commission may not be used by children at the facility and may not be on the premises at the facility. At the time of inspection, the operator shall submit to the Department written affirmation on a form provided by the Department stating that the facility is in compliance with this requirement.

Noncompliance Area: Observed in the young infant room diaper changing area, had a side board which had multiple small strands of fiber which were accessible to infants. Observed multiple spots of peeling contact paper on low shelves in room 12 which is occupied by older toddlers.

Correction Required: Toys and objects with a diameter of less than 1 inch, objects with removable parts that have a diameter of less than 1 inch, plastic bags and styrofoam objects may not be accessible to children who are still placing objects in their mouths.

Noncompliance Area: Observed in the young toddler room, multiple chairs stacked on a low counter which were accessible to children and could be pulled over. Observed in the young toddler room, a refrigerator on a low counter with a microwave on top and accessible to children, was not securely anchored and could be pulled or knocked over. Observed in the little cafeteria, a refrigerator on a low counter and accessible to children, was not securely anchored and could be pulled or knocked over.

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

Noncompliance Area: Observed during nap time in the older baby room, an infant sleeping in a Pack N Play which did not have 2 feet of space on three sides. Observed during the morning in the young infant room, 2 infants sleeping in their rest equipment and did not have 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.

Noncompliance Area: Observed there was no thermometer in the large refrigerator in the big cafeteria. Observed the thermometer in the refrigerator in the little cafeteria was reading 50 degrees.

Correction Required: A facility shall have an operable, clean refrigerator used to store potentially hazardous foods. The refrigerator shall be capable of maintaining food at 45 F or below. An operating thermometer shall be placed in the refrigerator.

Noncompliance Area: The files for children #1, #3, #4, #7 and #9 lacked a child service report with information about the child's growth and development at least once every 6 months. The files for children #1 (admission date 03/25/2019), #4 (admission date 12/12/2018) and #9 (admission date 05/15/2018) did not contain any completed child service reports. The file for child #3 (admission date 01/23/2018) contained a child service report dated 05/22/2019 with no previous reports on file. The file for child #7 (admission date 08/04/2015) contained child service reports dated 07/14/2016 and 06/21/2017 with no subsequent reports on file.

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

Noncompliance Area: The original agreement was not provided to the parent; the facility maintains the original and the parent receives a copy if requested. The files for children #8, #9 and #10 contained the original agreement.

Correction Required: A parent shall receive the original agreement. The facility shall retain a copy of the agreement.

Noncompliance Area: The emergency contact information for child #2 lacked the complete address of the child's physician or source of medical care.

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

Noncompliance Area: The emergency contact information for child #10 lacked the complete work address of the enrolling parent.

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

Noncompliance Area: The emergency contact information for child #7 lacked the health insurance coverage and policy number

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

Noncompliance Area: The emergency contact information for children #7 and #9 lacked the complete address of the individuals designated by the parent to whom the child may be released. The emergency contact information for child #2 lacked the telephone number for one 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.

Noncompliance Area: Observed the preschool room excursion bag, which is taken with the group when they take walks, did not contain a copy of the emergency transportation plan.

Correction Required: A written plan identifying the means of transporting a child to emergency care and staffing provisions in the event of an emergency shall be displayed conspicuously in every child care space and shall accompany a staff person who leaves on an excursion with children.

Noncompliance Area: The file for child #1 (enrollment date 03/25/2019) lacked a completed health report within 60 days following the first day of attendance; the initial health report on file was dated 07/11/2019.

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.

Noncompliance Area: The file for child #1, an 8-month-old, included a record of the child's immunization status which lacked a 3rd dose of DTap and a 3rd dose of PCV13. The file for child #4, a 22 month old, included a record of the child's immunization status which lacked a 4th dose of PCV13, a Hep A and an influenza immunization. The file for child #5, a 3 year old, included a record of the child's immunization status which lacked a Hep A immunization. The file for child #7, a 4 year old, included a record of the child's immunization status which lacked an influenza immunization. The file for child #9, a 5 year old, included a record of the child's immunization status which lacked a current influenza immunization.

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

Noncompliance Area: Observed a bottle of expired infant Tylenol in the medication box in the young infant room.

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

Noncompliance Area: Observed Children's Motrin for child #6 which lacked a medication log with the parent's written consent for administration of medication.

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

Noncompliance Area: The files for staff persons #2 and #6 lacked an updated health assessment at least once every 24 months; the most recent health assessment on file for staff person #6 was dated 07/26/2017. The file for staff person #2 contains a current health assessment dated 02/20/2019 with the previous health report dated 08/04/2016.

Correction Required: A facility person providing direct care who comes into contact with the children or who works with food preparation shall have a health assessment conducted within 12 months prior to providing initial service in a child care setting and every 24 months thereafter. A health assessment is valid for 24 months following the date of signature, if the person does not contract a communicable disease or develop a medical problem.

Noncompliance Area: Observed a sippy cup of milk, brought from a child's home, was sitting on top of the cubbies.

Correction Required: Potentially hazardous food brought from the child's home or provided by the facility shall be refrigerated.

Noncompliance Area: Observed in the young infant room, that one infant in care did not have an infant feeding schedule.

Correction Required: A written statement giving the formula and feeding schedule for an infant shall be obtained from the parent.

Noncompliance Area: The file for child #10 (enrollment date 06/10/2013) only contained an initial health report dated 08/07/2013; the file did not contain any subsequent health reports.

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

Noncompliance Area: On 11/20/19, it was observed that there was not an operable fire detection system in room 9. A beeping noise was coming from the smoke alarm and when staff went to test the alarm it did not sound. It was observed that there was not an operable fire detection system in room 11. The base of a smoke detector was on the wall but there was no smoke detector present.

Correction Required: Conditions at the facility may not pose a threat to the health or safety of the children. Demonstration of Compliance with 34 Pa. Code 403.23 is required.

Noncompliance Area: The operator lacked documentation of annual training regarding the emergency plan for staff person #5 annually; the most recent training documented was on 07/10/2018.

Correction Required: The operator shall assure that each facility person receives training regarding the emergency plan at the time of initial employment, on an annual basis and at the time of each plan update. The operator shall document the date of each training and the names of all facility persons who received the training and kept on file at the facility.

Noncompliance Area: The files for staff person #3 (date of hire 02/29/2016) and #4 (date of hire 02/29/2016) lacked an annual minimum of 6 clock hours of child care training. The files for staff person #3 & #4 contained 3 hours of training between 02/2018 - 02/2019.

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

Noncompliance Area: The files for staff persons #1 and #4 contained CPSL clearances which were not updated within 60 months. The file for staff person #1 contained a current state police clearance dated 09/04/2019 with the previous dated 08/05/2014, a current child abuse clearance dated 09/04/2019 with the previous dated 07/31/2014, and a current FBI clearance dated 12/15/15. The file for staff person #4 contained a current state police clearance dated 11/20/2019 with the previous dated 08/13/2014, a current child abuse clearance dated 11/20/2019 with the previous dated 08/22/2014, and a current FBI clearance dated 08/05/2019 with the previous dated 07/29/2014.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services).A facility person's record shall include a copy of requests for the criminal history record and child abuse registry clearance information, a copy of the disclosure statement and a copy of the completed clearance information required under the CPSL.

Noncompliance Area: The files for staff persons #2, #3 and #5 lacked documentation of a written evaluation at least once every 12 months. The most recent written evaluation for staff person #2 was dated 08/02/2017. There weren't any evaluations present in the file for staff person #3. The most recent written evaluation for staff person #5 was dated 06/29/2018.

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

Noncompliance Area: Observed in the big cafeteria, electrical outlets which did not have protective receptacle covers in the bathroom and by the wooden box. Observed an electrical power strip in the entrance foyer which did not have protective receptacle covers. Observed an electrical outlet which did not have a protective receptacle cover by the cabinet in room 9.

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

Noncompliance Area: Observed in the older baby room, diaper creams labeled keep out of the reach of children, accessible to children in diaper bags on low shelves. Observed a bottle of sunscreen labeled keep out of the reach of children, accessible to children in a bag hanging on a low hook. Observed water conditioner, labeled keep out of the reach of children, on a low windowsill in the PreK 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.

Noncompliance Area: Observed in the young toddler room and room 9, Dab O Ink markers which were labeled keep out of the reach of children, accessible to children in the arts and craft areas.

Correction Required: Arts and crafts materials shall be nontoxic.

Noncompliance Area: Observed a hot glue gun accessible to children on a low shelf in the preschool room and another on a low wooden cabinet in the pre k room. Observed a tart burner which was not in use on a low windowsill in room 12.

Correction Required: Hot water pipes and other sources of heat exceeding 110 F that are accessible to children shall be equipped with protective guards or shall be insulated to prevent direct contact.

Noncompliance Area: Observed the cabinet under the sink in the big cafeteria, room 7, and room 10 were dirty with deteriorating counter top particles. Observed in room 7, a piece of detached floor trim, a broken electrical cover plate, and exposed telephone jacks. Observed a detached light support cover and an exposed metal cabinet door hinge by the counter in room 9. Observed the light outside of room 9 did not work. Observed a large piece of detached plastic outside of room 11. Observed in room 10, a spot on the damaged wooden door with splintering edges. Observed in the little cafeteria, a detached ceiling tile with exposed insulation and a broken ceiling tile. Observed a detached ceiling tile and a missing electrical outlet cover plate in the school age room. Observed a cracked fence post/tarp support which had rough edges.

Correction Required: Floors, walls, ceilings and other surfaces, including the facility's outdoor play space surfaces shall be kept clean, in good repair and free from visible hazards.

Noncompliance Area: Observed 2 spots of damaged/peeling paint in the housekeeping area and under the colors poster in room 12. Observed a spot of peeling paint on the green metal building post to the left and to the right of the toddler play area.

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

Noncompliance Area: Observed the toilet and sink in room 7 need to be cleaned. Observed the sink in room 8, 9, and 10 did not work. Observed the toilet in the school age room was leaking from the tank.

Correction Required: Toilet areas and fixtures shall be cleaned daily and be in good repair.

Noncompliance Area: Observed the trash can by the bathroom in room 8 did not have a lid.

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

Noncompliance Area: The files for staff person #1 and #2 lacked verification of child care experience to qualify as an aid prior to service at the facility.

Correction Required: A facility person's record shall include verification of child care experience, education and training prior to service at the facility.

Noncompliance Area: The file for staff person #2, with a rehire date of 10/29/2019, lacked documentation of a request for the NSOR clearance prior to working with children. A request form was completed by staff person #2 on 10/28/2019, however, the NSOR clearance was not submitted as of 11/01/2019.

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.

Noncompliance Area: 3rd CITATION: Observed an orange chair in the "Big Cafeteria" with a bent leg. PREVIOUSLY CITED ON 06/06/2019 & 07/24/2019.

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

Noncompliance Area: 4th CITATION: The "Big" Cafeteria lacked emergency contact information for children #1, #2, #3, #3, #5, #6, #7, #8 and #9 while receiving care in the child care space. PREVIOUSLY CITED on 05/06/2019, 07/24/2019 & 08/06/2019.

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

Noncompliance Area: 3rd CITATION: Observed an electrical outlet in the "Big" Cafeteria which lacked protective receptacle covers. PREVIOUSLY CITED ON 05/06/2019 & 07/24/2019.

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

Noncompliance Area: 3rd CITATION: Observed a cabinet along the counter under the windows with a loose hinge in Room #6. Observed ceiling tile and insulation pieces on the floor and next to the door in Room #10. Observed an exposed bolt on the side gate leading into the preschool playground from the sidewalk near the cafeteria. Observed exposed bolts on the bottom of the fence near the corner of the preschool playground. PREVIOUSLY CITED ON 06/07/2019 & 07/24/2019.

Correction Required: Floors, walls, ceilings and other surfaces, including the facility's outdoor play space surfaces shall be kept clean, in good repair and free from visible hazards.

Noncompliance Area: Observed a toilet in the bathroom located in classroom #10 which lacked a lid on the toilet tank. Observed trash and a visibly dirty seat on a toilet located in classroom #10.

Correction Required: Toilet areas and fixtures shall be cleaned daily and be in good repair.

Noncompliance Area: The sinks and toilets in classroom #10 lacked hand washing signs.

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

Noncompliance Area: 3rd CITATION: Classroom #1 lacked emergency contact information for child #2 while receiving care in the child care space. PREVIOUSLY CITED ON 05/06/2019 & 07/24/2019.

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

Noncompliance Area: 2nd CITATION: On 08/06/2019, observed staff person #1 send child #1 (an older toddler) to play immediately after changing the child's diaper without washing the child hands. PREVIOUSLY CITED ON 05/06/2019.

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

Noncompliance Area: On 08/06/2019, observed staff person #1 changing an older toddlers diaper, staff person #1 did not wash her hands after diapering the child.

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

Noncompliance Area: 2nd CITATION: The file for staff person #2, with a hire date of 06/26/2019, lacked documentation of training regarding the emergency plan at the time of initial employment; emergency plan training was documented on 07/26/2019. PREVIOUSLY CITED ON 05/09/2019.

Correction Required: The operator shall assure that each facility person receives training regarding the emergency plan at the time of initial employment, on an annual basis and at the time of each plan update. The operator shall document the date of each training and the names of all facility persons who received the training and kept on file at the facility.

Noncompliance Area: 2nd CITATION: The file for staff person #2, with a hire date of 06/24/2019, lacked a signed disclosure statement at the time of initial hire; the file contained a disclosure statement signed on 06/26/2019. The file for staff person #3, with a hire date of 05/13/2019, lacked a signed disclosure statement at the time of initial hire; the file did not contain a disclosure statement. PREVIOUSLY CITED ON 05/09/2019.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). A facility person's record shall include a copy of requests for the criminal history record and child abuse registry clearance information, a copy of the disclosure statement and a copy of the completed clearance information required under the CPSL.

Noncompliance Area: 2nd CITATION: Observed an orange chair in the "Big" Cafeteria with a bent leg. Observed a teacher desk with loose legs located in classroom #9. PREVIOUSLY CITED ON 05/06/2019.

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

Noncompliance Area: 2nd CITATION: The "Little" Cafeteria lacked emergency contact information for child #1 while receiving care in the child care space. PREVIOUSLY CITED ON 05/06/2019.

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

Noncompliance Area: 2nd CITATION: The file for child #2, a two year old, included a record of the child's immunization status which lacked a 4th does of PCV13. PREVIOUSLY CITED ON 05/07/2019.

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

Noncompliance Area: 2nd CITATION: Observed electrical outlets in classrooms #3, #13 and #14 which lacked protective receptacle covers. PREVIOUSLY CITED ON 05/06/2019.

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

Noncompliance Area: 2nd CITATION: Observed cabinet doors with broken hinges under the sink in the "Big" Cafeteria. Observed a cabinet along the counter under the windows with a loose hinge in Room #8. Observed bolts protruding toward the outside walkway located at the bottom of the fencing near the sandboxes. Observed a bolt on the side gate leading into the preschool playground from the sidewalk near the cafeteria. Observed the bottom fence rail detached from the bracket, located next to the sidewalk between the PreK and school age playground on the kitchen side of the courtyard. Observed a broken ceiling tile and insulation lying on the floor located in classroom #10. Observed the door in classroom #5 is not closing properly due to a broken closing mechanism at the top of the door. PREVIOUSLY CITED ON 05/07/2019.

Correction Required: Floors, walls, ceilings and other surfaces, including the facility's outdoor play space surfaces shall be kept clean, in good repair and free from visible hazards.

Noncompliance Area: *On 06/11/2019 at approximately 9:00/9:30 am, child #1 a young toddler, left the classroom and was found outside the room on the sidewalk by individual #2. Staff members #1 and #2 were unaware how or when the child left the classroom.

Correction Required: *The facility is required to maintain its hands-free method for identifying the specific children for which each staff person is responsible. It will include, minimally, the name and a picture of the child and staff will utilize the identification method appropriately at all times while on duty at the facility. When a new child enrolls at the facility, a supervision card will be present at the facility before the child's first day of attendance.

Noncompliance Area: On 06/12/2019 at 12:35 pm, There were 25 school age children in the cafeteria finishing lunch with 3 staff. Staff person #3 identified 1 child in her group. Staff person #1 stated she had 12 children in her group but initially only identified 10 children, when prompted she was able to identify all 12 of the children the second time. Staff person #4 was leaving for her break and staff person #2 was stepping in to supervise the remaining 12 children. Staff person #2 was unable to easily identify the children in her group. Initially, she was unable to identify the children in her group. Cert Rep prompted her to utilize the name tags; the tags were all in a plastic baggie and staff person #3 had to help find the names of the children in her group. When the tags were sorted, staff person #2 still had a difficult time identifying the children in her group. The entire process took approximately 10 minutes.

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.

Noncompliance Area: According to staff person #4, child #1 was injured in her classroom on 06/11/2019. Staff person #4 stated a Boo-Boo report was completed at the time of the accident but the parent did not receive the report on the day of the incident. A copy of the incident was not in the child's file or in the facility accident file.

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.

Noncompliance Area: Observed diaper cream labeled "keep out of reach of children" in a plastic tote on a counter below the windows located in classroom #4 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.

Noncompliance Area: Observed a play mat located in classroom #2 which was torn. PLAYGROUND: Observed a yellow and blue plastic ride-on toy on the younger toddler playground with a broken horn creating rough edges and sharp points. Observed a free standing basketball net with a broken backboard located on the school-age playground. Observed a cracked dome window in the large playground equipment located on the preschool playground creating a pinch hazard. Observed a green "worm" ride on toy on the older toddler playground with cracks in the accordion plastic below the seats creating a pinch hazard.

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: Observed foam padding falling off of the bottom of the shelves located in Room #3. Observed chairs located in the "Big" cafeteria with missing feet on the metal legs. Observed a plastic storage cabinet located on the older toddler playground with a cracked door creating a pinch hazard.

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

Noncompliance Area: The files for child #1 (enrollment date 01/07/2018), child #4 (enrollment date11/21/2017), child #6 (enrollment date 07/24/2017), child #7 (enrollment date 06/18/2018) and child #9 (enrollment date 01/23/2018) lacked completed child service reports with information about the child's growth and development at least once every 6 months; each file has no record of any completed child service reports. The file for child #5 (enrollment date 08/11/2017), lacked an updated child service report at least once every 6 months; the file contains a child service report dated 06/29/2018 with no record of previous or current child service reports on file.

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

Noncompliance Area: The files for children #1, #2, #4, #6, #8, #9 and #10 lacked the date of the child's admission on the agreement form.

Correction Required: An agreement shall specify the date of the child's admission.

Noncompliance Area: The file for child #1 lacked the name, address and telephone number of the child's physician or source of medical care on the emergency contact form. The file for child #4 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.

Noncompliance Area: The file for child #1 lacked the complete home and work address of the enrolling parent on the emergency contact form. The file for child #4 lacked the complete work address of the enrolling parent on the emergency contact form. The files for children #5 and #10 lacked the complete work address and telephone number of the enrolling parent on the emergency contact form.

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

Noncompliance Area: The file for child #7 lacked the health insurance policy number for the child on the emergency contact form.

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

Noncompliance Area: The file for child #1 lacked the names and addresses of the individuals designated by the parent to whom the child may be released on the emergency contact form; the release information was listed as "shelter staff" with a phone number and no additional information provided. The files for child #4 and #5 lacked the complete address of the individuals designated by the parent to whom the child may be released on the emergency contact form.

Correction Required: Emergency contact information must include the name, address and telephone number of the individual designated by the parent to whom the child may be released.

Noncompliance Area: Classroom #3 lacked emergency contact information for child #11 while receiving care in the space. Classroom #12 lacked emergency contact information for child #12 while receiving care in the space.

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

Noncompliance Area: The "Big" Cafeteria lacked a posting of the emergency transportation plan, identifying the means of transporting a child to emergency care and staffing provisions in the event of an emergency, in a conspicuous location.

Correction Required: A written plan identifying the means of transporting a child to emergency care and staffing provisions in the event of an emergency shall be displayed conspicuously in every child care space and shall accompany a staff person who leaves on an excursion with children.

Noncompliance Area: The file for child #1, with an enrollment date of 01/17/2018, lacked an initial health report within 60 days of attendance; there are no health reports or immunization records in the child's file. The file for child #8, with an enrollment date of 11/13/2018, lacked an initial health report within 60 days of attendance, the initial health report on file is dated 03/14/2019 with an immunization record dated 11/26/2018.

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.

Noncompliance Area: The file for child #4, lacked an updated health report at least once every 6 months for a young toddler; the file contains an initial health report dated 01/12/2018 with a subsequent health report dated 10/16/2018 and no additional health reports on file. The file for child #9, lacked an updated health report at least once every 6 months for a young toddler, the file contains a current health report dated 04/09/2019 with a previous health report dated 09/12/2018 and an initial health repot dated 01/05/2018.

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

Noncompliance Area: The file for child #4, 18 months old, included a record of the child's immunization status which lacked a 3rd dose of HIb. The file for child #6, a 4 year old, included a record of the child's immunization status which lacked an influenza immunization. The file for child #8, a two year old, included a record of the child's immunization status which lacked a 4th does of PCV13 The file for child #10, 6 months old, included a record of the child's immunization status which lacked a 2nd dose of DTaP, a 2nd dose of Rotavirus, a 2nd dose of Hib, a 2nd does of PVC13 and a 2nd dose of Polio immunization.

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

Noncompliance Area: On 05/06/2019, observed staff person #8 change a young toddler's diaper without washing the child's hands after being diapered.

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

Noncompliance Area: The diaper changing station in Room #3, a young toddler classroom, lacked a 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.

Noncompliance Area: The files for children #1, #2, #3, #4, and #6 lacked a review of the emergency contact information and the financial agreement by a parent at least once every 6 months.

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

Noncompliance Area: Observed emergency contact forms in the school-age classroom with incomplete emergency information. The information was not updated when the master file was updated.

Correction Required: If emergency information is updated in a master file, it shall be updated accordingly in other facility records.

Noncompliance Area: The file for child #2, with an enrollment date of 02/23/2015, lacked an initial and subsequent health reports; the most recent health report on file was dated 07/20/2017 with no previous health reports on file. The file for child #3, with an enrollment date of 06/10/2013, contains a health report dated 08/28/2014 with no subsequent health reports. The file for child #6, with an enrollment date of 07/24/2017, contains a current health report dated 11/07/2018 with no previous health reports on file.

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

Noncompliance Area: The file for child #1 lacked signed parental consent for emergency medical care prior to admission.

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.

Noncompliance Area: The files for children #1 and #7 lacked signed parental consent for administration of minor first-aid procedures prior to admission.

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.

Noncompliance Area: The file for staff person #3 (with a hire date of 04/11/2019) lacked documentation of training regarding the emergency plan at the time of initial employment. The files for staff persons #4, #5 and #7 lacked documentation of training regarding the emergency plan on an annual basis; staff persons #4, #5 and #7 have documentation of current training dated 02/05/2019 with previous training dated 07/07/2017.

Correction Required: The operator shall assure that each facility person receives training regarding the emergency plan at the time of initial employment, on an annual basis and at the time of each plan update. The operator shall document the date of each training and the names of all facility persons who received the training and kept on file at the facility.

Noncompliance Area: The file for staff person #7 (with a hire date of 02/29/2016) lacked an annual minimum of 6 clock hours of child care training; the file contains documentation of 3 hours of training between 02/2018 - 02/2019.

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

Noncompliance Area: The file for staff person #1 with an initial hire date of 12/26/2018, lacked the results of the FBI clearance.. The file for staff person #1 contained a disclosure statement dated 12/26/2018, an FBI receipt for fingerprinting dated 12/12/2018, a PA state police clearance dated 12/11/2018 and a child abuse clearance dated 12/11/2018. The file for staff person #6 with a hire date of 04/16/2018, lacked documentation of Mandated Reporter Training within the first 90 days of hire.

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.A facility person's record shall include a copy of requests for the criminal history record and child abuse registry clearance information, a copy of the disclosure statement and a copy of the completed clearance information required under the CPSL.

Noncompliance Area: The file for staff person #4, lacked a written evaluation by the director at least once every 12 months; the most recent written evaluation was dated 11/07/2017. The files for staff persons #5 (initial date of hire 05/22/2017,), #6 (initial date of hire 04/16/2018), and #7 (initial date of hire 02/29/2016 lacked written evaluations by the director at least once every 12 months.

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

Noncompliance Area: Observed an electrical outlet in Room #13, the toddler cafeteria, which lacked a protective receptacle cover.

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

Noncompliance Area: Observed the first-aid kit located in Room #5 hanging on a hook in the cubbies which were accessible to the preschool age children in care. Observed the first-aid kit located in Room #9 on a table which was accessible to the preschool age children in care.

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