Little Treasures Daycare

Regulation: 3270.14/3270.21

Description: Pertinent Laws & Regulations/General Health and Safety

Noncompliance Area: Staff #1 was observed during the renewal inspection working alone in the Young Toddler Room without having their Pediatric First Aid/CPR certification. Staff #2 was observed during the renewal inspection working alone in the Infant room without having their Pediatric First Aid/CPR certification.

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: 3270.103

Description: Small Toys and Objects

Noncompliance Area: In the preschool room foam dinosaur numbers were observed with bite marks which is a chocking hazard.

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.

Regulation: 3270.123(a)(3)

Description: Services proceeded

Noncompliance Area: The file for Child #4 contains two Child Service Reports dated 9.20.24 and 5.14.24 which is more than the required 6 months.

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(f)/3270.181(c)

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

Noncompliance Area: The file for Child #1 contained an emergency contact form that was lacking a signed 6-month update. The file for Child #4 contained an emergency contact form and financial agreement form that was lacking a signed 6-month update.

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

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

Noncompliance Area: The file for Child #3 who is an infant aged child contained a health report that was more than 6 months old.

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(b)(2)/3270.182(1)

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

Noncompliance Area: The file for Child #2, a Preschool Age Child contained a Health report that is more than 12 months old.

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: 3270.131(d)(5)

Description: Immunization record

Noncompliance Area: The file for Child #3 was lacking the following immunizations: 1 dose Hepatitis B, 1 dose rotavirus, 2 doses DTAP, 2 doses HIB, 2 doses pneumococcal, and 1 dose of Polio.

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

Regulation: 3270.131(e)

Description: ACIP recommended immunization record

Noncompliance Area: The file for Child #4 contained a health report that was obtained more than 60 days after their enrollment date.

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: 3270.31(f)(10)

Description: Health and Safety Training - Pediatric First Aid and CPR

Noncompliance Area: The file for Staff #1 contained a Pediatric First Aid Training dated 10.19.24, which is more than 90 days after the staff's start date.(see LIS code sheet).

Correction Required: Staff persons shall complete professional development in pediatric first aid and pediatric cardiopulmonary resuscitation within 90 days of hire.

Regulation: 3270.32(a)

Description: Comply with CPSL

Noncompliance Area: The file for Staff #1 contained a disclosure statement that was lacking a date.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services).

Regulation: 3270.51

Description: Similar Age Level

Noncompliance Area: At approximately 1:35 pm the certification representative arrived at the facility. Facility person #1, who stated they were on bread at the time, let the certification rep into the facility. Facility person #3 was not at the facility, so when the reason for the visit was shared, facility person #1 and the certification representative walked back to the infant classroom where facility person #2 was caring for children. Upon entering the classroom, it was observed facility person #2 was supervising 5 infants exceeding the staff to child ration of 1:4.

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.

Regulation: 3270.113(a)

Description: Supervised at all times

Noncompliance Area: In the toddler classroom, when asked to identify the children in their respective supervisory groups, facility person #4 identified 5 (older toddlers) and facility person #5 identified 6 (older toddler and preschool) of the 12 children receiving care in the classroom. One child, who was said to have arrived shortly before, was not accounted for by facility person #4.

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.

Regulation: 3270.123(a)(3)

Description: Services proceeded

Noncompliance Area: The files of child #1, #2 and #6 did not contain documentation of the Department's approved form (child service report) to provide information to the family about the child's growth and development in the context of the services being provided being completed in the past year. The files of child #3, #4 and #7 did not contain documentation of a child service report completed within the past 6 months.

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: 3270.123(a)(6)

Description: Admission date

Noncompliance Area: The financial agreement of child #5 did not contain the admission date of the child.

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

Regulation: 3270.124(b)(3)

Description: Parent home/work address, phone

Noncompliance Area: The emergency contact form of child #2 did not include the wok address of the enrolling parent.

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

Regulation: 3270.124(b)(5)

Description: Information re: special needs

Noncompliance Area: The emergency contact form of child #1, #5 and #6 did not 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 or documentation this is not applicable to the child.

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: The emergency contact form of child #6 did not include the insurance policy number for the 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: 3270.124(b)(7)

Description: Name/address/phone release person

Noncompliance Area: The emergency contact form of child #5 and #6 did not contain the address of 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.

Regulation: 3270.131(b)(2)

Description: Toddler/preschool: updated health report every 12 months

Noncompliance Area: The 2 most recent health assessments of child #6 and #7, both identified as preschool age children (see coded LIS sheet), exceeded 12 months.

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.

Regulation: 3270.131(d)(5)/3270.131(e)(3)

Description: Immunization record/Dismissal policy

Noncompliance Area: The health assessment of child #1did not contain documentation of a current influenza vaccination in accordance with the recommendations of the ACIP or documentation of an acceptable exemption.

Correction Required: A health report shall include a review of the child's immunized status according to recommendations of the ACIP. 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: 3270.131(d)(7)

Description: Free from contagious/communicable disease

Noncompliance Area: The health assessment of child #7 did not include a statement the child is able to participate in child care and appears to be free from contagious or communicable disease.

Correction Required: A health report shall include a statement that the child is able to participate in child care and appears to be free from contagious or communicable disease.

Regulation: 3270.131(d)(8)

Description: Age appropriate screenings complete

Noncompliance Area: The health assessment of child #7 did not include a statement that age-appropriate screenings recommended by the American Academy of Pediatrics were conducted since the time of the previous health report required by this section.

Correction Required: A health report shall include a statement that age-appropriate screenings recommended by the American Academy of Pediatrics were conducted since the time of the previous health report required by this section.

Regulation: 3270.151(c)(3)

Description: Exam communicable disease

Noncompliance Area: The health assessment of facility person #3 did not contain the complete results from the examination for communicable disease.

Correction Required: An adult health assessment must include an examination for communicable diseases and the results of that examination.

Regulation: 3270.21

Description: General Health and Safety

Noncompliance Area: A staple remover with 4 sharp "teeth" to remove the stables was accessible to the children in the craft cart drawer.

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

Regulation: 3270.32(a)

Description: Comply with CPSL

Noncompliance Area: The file of facility person #1 and #2, who were working at the facility on the date of the inspection, contained documentation of submission for the NSOR verification certificate but did not contain the completed NSOR within their 45 provisional hire period (see coded LIS sheet) and the disclosure statement of facility person #1 was not dated.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). LACKING REQUIRED HIRING DOCUMENTS: Facility Person #1 and #2 may not work at the facility.

Regulation: 3270.82(h)

Description: Handwashing signs

Noncompliance Area: A handwashing sign was not posted at the changing table in the young toddler classroom.

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: 3270.102(a)

Description: Clean and good repair

Noncompliance Area: In the young toddler room, a container, which held play cars and trucks, was cracked and created an area which children could pinch their fingers.

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.

Regulation: 3270.103

Description: Small Toys and Objects

Noncompliance Area: The children in the young toddler classroom were drawing with small crayons which had a diameter of less than one inch, which is a choking hazard, and one child was observed placing the crayon in their mouth.

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.

Regulation: 3270.124(b)(3)

Description: Parent home/work address, phone

Noncompliance Area: The emergency contact form of child #1 did not contain the work address and work telephone number and the emergency contact form of child #2 and 4 did not contain the work telephone number of the enrolling parent.

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

Regulation: 3270.124(b)(5)

Description: Information re: special needs

Noncompliance Area: The emergency contact form of child #2, 3 and 4 did not contain information on the child's medical needs as specified by the parent, physician, PA or CRNP in the event of an emergency situation or documentation this is not applicable to the child.

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)(7)

Description: Name/address/phone release person

Noncompliance Area: The emergency contact form of child #4 did not contain addresses of the release persons 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)

Description: Updated every 6 months

Noncompliance Area: Documentation of the updates to the emergency contact form of child #3 were dated more than 6 months apart.

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

Regulation: 3270.134(a)

Description: Child's hands washed

Noncompliance Area: In the young toddler room, a child's diaper was changed and hands were cleaned with a baby wipe but not washed at the sink with soap and running water.

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: 3270.14/3270.21

Description: Pertinent Laws & Regulations/General Health and Safety

Noncompliance Area: The facility did not have documentation of a plan for the continuity of services in the event of an emergency. Facility person #2 and #3, who completed the health and safety topics prior to 9/30/2016, were observed to be working alone with children.

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: 3270.21

Description: General Health and Safety

Noncompliance Area: In the preschool play space, the roof of a small (approx. 3.5 - 4 feet tall) plastic storage shed was detached from the side wall. A wasp was observed to be walking on the opening where the roof was to be attached. Upon further inspection, another wasp was observed to be inside the wall of the shed and part of a wasp nest could be seen inside the wall which if disturbed could cause a child to be stung.

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

Regulation: 3270.31(f)

Description: Health and Safety Training

Noncompliance Area: Facility person #2, 3, 4 and 5 has not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): Health and safety topics (all were completed prior to 9/30/2016).

Correction Required: Staff person(s) shall complete professional development in the topics of 3270.31(f)(1 -- 10) within 90 days of hire. Staff person #3, 4 and 5 will have until 10/22/2022 to complete the required training. Until such time as the required training has been completed, staff person #3, 4 and 5 must be supervised, when interacting with children, by an AGS, who has completed the required training related to this citation. If there are no staff available to supervise staff person #3, 4 and 5, staff person #3, 4 and 5 may not work in a child-care position at the facility.

Regulation: 3270.31(f)(10)

Description: Health and Safety Training - Pediatric First Aid and CPR

Noncompliance Area: Documentation of the completion of pediatric first aid and pediatric CPR of facility person #1 was dated 9/27/2022, which was more than 90 days from their start date (see coded LIS sheet).

Correction Required: Staff persons shall complete professional development in pediatric first aid and pediatric cardiopulmonary resuscitation within 90 days of hire.

Regulation: 3270.32(a)

Description: Comply with CPSL

Noncompliance Area: The completed child abuse clearance of facility person #6 was dated 9/22/2022 which was more than 45 days from their start date with children (see coded LIS sheet).

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services).

Regulation: 3270.66(a)

Description: Locked or inaccessible

Noncompliance Area: In the lobby, 2 bottles of hand sanitizer. labeled keep out of the reach of children and 1 spray bottle labeled hand sanitizer, were 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.

Regulation: 3270.75(c)

Description: Has all items

Noncompliance Area: The first aid kit in the pre-k classroom contained only one disposable glove.

Correction Required: A first-aid kit must contain the following: soap, an assortment of adhesive bandages, sterile gauze pads, tweezers, tape, scissors and disposable, nonporous gloves.

Regulation: 3270.95(a)/3270.95(b)

Description: Devices must be compliant/Director or designated staff person ensure compliance

Noncompliance Area: Testing of the fire detection system exceeded 30 days on the following occasions: 12/17/2021 to 2/1/2022 to 3/4/2022 to 4/4/2022, 5/3/2022 to 6/30/2022 to 8/10/2022 to 9/30/2022.

Correction Required: Fire detection devices or systems must be in compliance with standards established under section 1016(c) of the act (62 P.S. §  1016(c)).The Director or designated staff person who is responsible for compliance with this chapter shall ensure the requirements under subsection (a) are met.

Regulation: 3270.124(b)(6)

Description: Insurance coverage information

Noncompliance Area: The file for Child #2 contained an emergency contact form that was lacking the child's health insurance name 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.

Regulation: 3270.131(e)(1)

Description: Exemption documentation from parent/guardian

Noncompliance Area: The file for Child #1 contained an immunization record that was lacking the annual influenza vaccine.

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.

Regulation: 3270.31(e)(4)(i)

Description: Age and Training

Noncompliance Area: The files for Staff #1, #2, #4 and #5 all employed longer than 90 days were all lacking Pediatric First Aid.

Correction Required: Competence is the completion of training by a professional in the field of first-aid and cardiopulmonary resuscitation (CPR). All staff persons shall renew their certification in pediatric first aid and pediatric cardiopulmonary resuscitation (CPR) on or before the expiration of the most current certification.

Regulation: 3270.32(a)

Description: Comply with CPSL

Noncompliance Area: The file Staff #3 contained two FBI clearances that were more than 60 months apart. The file for Staff #4 contained an FBI clearance that was obtained after the staff's date of hire.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services).

Regulation: 3270.32(a)/3270.192(2)(iii)

Description: Comply with CPSL/Exp, educ., training at facility

Noncompliance Area: The File for Staff #2 and #5 both contain Mandated Reporter Training that was completed more than 90 days after hire date.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services).A facility person's record shall include verification of child care experience, education and training following the outset of service at the facility.