Little Bombers Llc

Regulation: 3270.124(b)(5)

Description: Information re: special needs

Noncompliance Area: Per inspection on 5/1/23 children # 2-3-1 have incomplete emergency contact information.

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

Regulation: 3270.124(b)(6)

Description: Insurance coverage information

Noncompliance Area: Per inspection on 5/1/23 record review revealed that child #-4 does not have a record of the health insurance coverage.

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: 3270.131(d)(5)/3270.131(e)(1)

Description: Immunization record/Exemption documentation from parent/guardian

Noncompliance Area: Per inspection on 5/1/23, Child number 1does not have a record of Hepatitis A immunization per the guidelines of 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 shall require the parent to provide updated written verification from a physician, physician's assistant, CRNP, the Department of Health or a local health department of ongoing vaccines administered to an infant, toddler or preschool child in accordance with the schedule recommended by the ACIP.

Regulation: 3270.131(e)

Description: ACIP recommended immunization record

Noncompliance Area: Per inspection on 5/1/23, Child number 1does not have a record of Hepatitis A immunization per the guidelines of the ACIP.

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.

Regulation: 3270.131(e)(2)(ii)

Description: Exemption documentation from health professional

Noncompliance Area: Child #2 does not have a valid record of an exemption for an immunization.

Correction Required: Exemption from immunization for reasons of medical need must be documented by a written, signed and dated statement from the child's physician, physician's assistant or CRNP. The statement shall be kept in the child's record.

Regulation: 3270.131(e)(3)

Description: Dismissal policy

Noncompliance Area: Per inspection on 5/1/23, Child number 1does not have a record of Hepatitis A immunization per the guidelines of the ACIP.

Correction Required: The facility shall implement dismissal policies in accordance with the Department of Health regulation in 28 Pa. Code § 27.77 (relating to immunization requirements for children in child care group settings).

Regulation: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: During inspection on 5/1/23 observed staff # 1 working as a permanent staff, staff #1 does not have a record of a valid State Police clearance as required under the CPSL.

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. Staff Person #-1- may not work in a childcare position at the facility.

Noncompliance Area: On 7/7/20, the written plan for transporting a child for emergency medical treatment and staff provision is not posted in each child care space.

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: On 7/7/20, Rep observed children's lunches brought from home on a cart in child care space. At least 2 of the lunches contained perishable food, cheese.

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

Noncompliance Area: Facility person #1 began working in child care on 11/19/19 and has a disclosure statement dated 11/19/19, a PSP clearance dated 11/15/19, a child abuse clearance dated 8/23/19, an FBI clearance dated 8/25/19 and a request for NSOR certification dated 1/21/20. Facility person #1 was hired provisionally with out an NSOR request on file. Facility person #2 began working in child care on 2/21/20 and has a disclosure statement dated 2/20/20, a PSP clearance dated 7/23/19, a child abuse clearance dated 7/23/19, a PDE FBI clearance dated 7/30/19 and an NSOR request dated 2/20/20 and certification dated 2/24/20. DHS does not accept PDE FBI clearances.

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 #2 may not work in child care.

Noncompliance Area: On 7/7/20, Rep observed a board on the outdoor ramp where the ramp meets the pavement is loose and sticking up creating a tripping hazard.

Correction Required: Outside walkways shall be free from ice, snow, leaves, equipment and other hazards.

Noncompliance Area: A fire drill was conducted on 12/2/19 and again on 2/3/20 which is a span of 62 days.

Correction Required: A fire drill shall be held at least every 60 days. Facility persons and children in attendance shall participate in the fire drill. Facility persons and children shall exit the building, weather permitting.

Noncompliance Area: An infant was given another child's breast milk by mistake. The milk and bottles were labeled with names but the staff person did not check name on the bag of milk.

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

Noncompliance Area: Emergency contact information forms for infants were not present in the infant room.

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: Child #1, DOB 9/20/17, has only 2 doses of HepB vaccine. ACIP recommendations call for 3 doses by 18 months.

Correction Required: The facility shall require the parent to provide updated written verification from a physician, physician's assistant, CRNP, the Department of Health or a local health department of ongoing vaccines administered to an infant, toddler or preschool child in accordance with the schedule recommended by the ACIP.

Noncompliance Area: Facility person #1 has an initial health assessment that does not contain results of an exam for communicable diseases or a statement of suitability to provide child care.

Correction Required: An adult health assessment must include an examination for communicable diseases and the results of that examination. An adult health assessment must include the physician's or CRNP's assessment of the person's suitability to provide child care.

Noncompliance Area: Facility person #2 has evaluations dated 5/5/17 and 1/26/19, a span of more than 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: A first aid kit in the main room was on to of an accessible shelf in child care space.

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

Noncompliance Area: Observed exposed bolts on the front gate of the outdoor play yard.

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: Children #1 & #2 do not have addresses for release persons on the emergency information 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: Facility person #2, DOH 9/6/17, has an initial health assessment dated 3/2/16 and an initial TB screening dated 12/11/7 which is after she began working in child care. Facility person #3, DOH 3/31/17, has an initial health assessment and TB screening dated 4/3/17 which is after the date she began working in child care. Facility person #1, DOH 11/3/17, has an initial TB screening dated 7/11/16 which was more than 12 months old at initial service.

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.An adult health assessment must include tuberculosis screening by the Mantoux method at initial employment. Subsequent tuberculosis screening is not required unless directed by a physician, physician's assistant, CRNP, the Department of Health or a local health department.

Noncompliance Area: Facility person #1, DOH 11/3/17, signed the disclosure statement on 11/3/17 and has a PSP clearance dated 11/28/17, a child abuse clearance dated 12/6/17 and an FBI clearance dated 7/5/16. Facility person #2, DOH 9/6/17, signed the disclosure statement on 9/6/17, and has a PSP clearance requested & dated 10/18/17, a child abuse clearance dated 8/14/17, and an FBI clearance dated 8/28/17. Both facility persons were hired provisionally. Facility person #2 also has a mandated reporter of abuse training dated 4/24/18 which is past the 90 day provisional period.

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: Facility person #1 is employed as an AGS and has proof of 18 credits but does not have 1250 hours of experience documented or a high school diploma on file. Facility person #3 is employed as an AGS and has a high school diploma and proof of 18 credits on file but does not have 1250 hours of experience with children documented. Facility person #4 is employed as an AGS but her transcript does not show the credit hours for each class taken. She also does not have 1250 hours of experience with children documented..

Correction Required: An assistant group supervisor shall have a high school diploma or a general educational development certificate, 15 credit hours from an accredited college or university in early childhood education, child development, special education, elementary education or the human services field and 1 year of experience with children.

Noncompliance Area: Child #1 was injured at the facility and received first aid but her parent was not told of the injury until she called the facility later to say that the child was favoring her arm and was going to seek medical treatment,

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: The closet door in the children's bathroom on the right was opened and cleaning supplies are accessible to the 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: There is peeling paint on the wall near the diapering area in the Toddler Room.

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

Noncompliance Area: The agreement for Child #3 is not signed by the operator or the parent.

Correction Required: An agreement shall be signed by the operator and the parent.

Noncompliance Area: Child #3 is missing services to be provided to the family and the child. Child #1 is missing an updated 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).

Noncompliance Area: Child #2 is missing arrival and departure times.

Correction Required: An agreement shall specify the child`s arrival and departure times.

Noncompliance Area: Child #2 is missing specific persons designated by a parent to whom the child may be released.

Correction Required: An agreement shall specify the persons designated by a parent to whom the child may be released.

Noncompliance Area: Child #3 is missing the date of the child's admission.

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

Noncompliance Area: Child #1 does not have an agreement on file.

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

Noncompliance Area: Facility person #2 does not have an initial health assessment or TB screening on file. Date of hire 1/17. Facility person #3 does not have an initial health assessment or TB screening on file. Date of hire 6/16.

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.An adult health assessment must include tuberculosis screening by the Mantoux method at initial employment. Subsequent tuberculosis screening is not required unless directed by a physician, physician's assistant, CRNP, the Department of Health or a local health department.

Noncompliance Area: Child #1 does not have an updated emergency contact.

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: Facility person #3 does not have an individual file. Date of hire 6/16.

Correction Required: An individual record is required for each facility person.

Noncompliance Area: Facility person's #2 & 3 do not have proof of education or prior experience.

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: Facility person's #2 & 3 do not have two written nonfamily references on file.

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

Noncompliance Area: Facility person's #2, 3 & 4 do not have proof of initial emergency plan training.

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

Noncompliance Area: At the time of the unannounced visit Facility person #3 was working in the young toddler room along with another staff. Facility person #3 does not have a signed disclosure statement, or Child Abuse and FBI clearances on file. Facility person #3 does not have proof of mandated reporter training. Date of hire 6/16.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). Legal Entity must attend the existing provider training on May 17, 2017 at the Scranton Regional Office.

Noncompliance Area: At the time of the unannounced visit Facility person #1 was responsible for 13 preschool children, this group requires an additional staff member. Facility person #2 was responsible for 8 young toddlers, this group requires an additional staff member.

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.