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Regulation: 3270.32(a)

Description: Comply with CPSL

Noncompliance Area: In reviewing of the staff files, staff person #2's file contained updated Mandated Reporter Training (previous 5/18/18; updated 6/7/23) that was late in obtaining.

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

Regulation: 3270.32(a)

Description: Comply with CPSL

Noncompliance Area: In reviewing of the staff files, staff person #1's file contained an updated PA State Police clearance (previous 2/5/18; updated 6/6/23) and an updated Child Abuse clearance (previous 2/13/18; updated 6/10/23) that were late in obtaining.

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

Regulation: 3270.31(f)

Description: Health and Safety Training

Noncompliance Area: Staff person #1 and staff person #3 have not completed the following required pre-service training within 90 days of their hire: 3270.31(f)(1-9). (Staff person #1 and staff person #3 had completed Health and Safety Basics: Requirements for Certification prior but not within the training date perimeters. Both staff person #1 and staff person #3 completed this training prior to 9/30/16.)

Correction Required: Staff persons shall complete professional development in the topics of 3270.31(f)(1-9) within 90 days of hire. Staff person #1 and staff person #3 will have until 10/8/22 to complete the required training. Until such time as the required training has been completed, staff person #1 and staff person #3 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 #1 and staff person #3, staff person #1 and staff person #3 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: Staff person #2 has not completed the following required pre-service training within 90 days of their date of hire: Pediatric First Aid and CPR/3270.31(f)(10).

Correction Required: Staff persons shall complete professional development in pediatric first aid and pediatric cardiopulmonary resuscitation within 90 days of hire. Staff person #2 will have until 10/8/22 to complete the required training. Until such time as the required training has been completed, staff person #2 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 #2, staff person #2 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: Staff person #4 has not completed the following required pre-service training within the 90 days of their hire: Pediatric First Aid and CPR/3270.31(f)(10). (Staff person #4 did have verification of completion of previous First Aid and CPR in her file but it was not a PQAs approved curriculum or trainer.)

Correction Required: Staff persons shall complete professional development in pediatric first aid and pediatric cardiopulmonary resuscitation within 90 days of hire. Staff person #4 will have until 10/8/22 to complete the required training. Until such time as the required training has been completed, staff person #4 must be supervised by an AGS who has completed the required training related to this citation. If there are no staff available to supervise staff person #4, staff person #4 may not work in a child care position at the facility.

Noncompliance Area: During the renewal inspection, the NSOR verification certificate, for Staff #1, #2, #3 and #4, was received on 7/24/20 which was after the 7/1/20 deadline required under the CPSL; the FBI Clearance for Staff #4 was for PDE and not the required DHS FBI Clearance.

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: During the renewal inspection, the first aid kit in the Pre-K room did not contain scissors and tweezers.

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.

Noncompliance Area: During the inspection, the water temperature was 120 F and 135 F at the sinks in the Rabbit Room and boys bathroom.

Correction Required: Hot water temperature, in areas accessible to children, may not exceed 110 F.

Noncompliance Area: During the inspection, the file for staff #1 contained only one non-family references from individuals attesting to the person's suitability to serve as a facility person

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: During the inspection, the hot water in the children's bathroom sink was at 140 F.

Correction Required: Hot water temperature, in areas accessible to children, may not exceed 110 F.

Noncompliance Area: It was observed in the school age room lid on the jump rope container was cracked posing a pinching hazard, in the older toddler room the lid on the farm animals was cracked and broken posing a pinching hazard, and in the Pooh Bear 4-5 year old room the ball and stick toy bin was cracked and broken with a rough edge all accessible to children.

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: It was observed that the refrigerator, in the room across from the kitchen, was storing cheese but did not contain an operating thermometer to monitor temperature.

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: It was observed in the Christopher Robin school age room individual staff were not assigned a specific primary care group.

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: Emergency contact form for child #3 did not contain 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: Emergency contact form for child #1, #3, #4, #5, #6, and #8 did not contain release person's address.

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: Child #10 is of preschool age and most recent health report on file is dated June 2017, therefore child health report has not been updated within last 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.

Noncompliance Area: Health report on file for child #5 was not signed by a physician, physician's assistant or a CRNP.

Correction Required: A health report must be written and signed by a physician, physician's assistant or a CRNP. The signature must include the individual's professional title.

Noncompliance Area: Health assessment on file for staff person #1 and staff person #2 did not contain a signature by a physician, physician's assistant or CRNP.

Correction Required: A health assessment shall be conducted and a report shall be written and signed by a physician, physician's assistant or CRNP. The signature must include the individual's professional title.

Noncompliance Area: Financial agreement for child #2 was updated in July 2018, but previous 6 month update was not found on file at facility. Financial agreement for child #6 has not been updated within last 6 months. Emergency contact form for child #9 was updated in April 2018, but the previous 6 month update was not found on file at facility.

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: It was observed that a copy of the applicable regulations with the instructions for contacting the appropriate regional day care office was not posted in a conspicuous location used by parents at the facility.

Correction Required: The facility's current certificate of compliance and a copy of the applicable regulations under which the facility is certified shall be posted in a conspicuous location used by parents, with instructions for contacting the appropriate regional day care office posted at the same location.

Noncompliance Area: It was observed that the emergency plan was not posted in a conspicuous location used by parents in the facility.

Correction Required: The operator shall post the emergency plan in the facility at a conspicuous location.

Noncompliance Area: Staff person #3 is currently being used as an assistant group supervisor but acceptable verification of experience, education or training, such as a transcript or diploma, or a letter signed by a representative of the experiential, educational or training to show staff person can be used as an assistant group supervisor is not on file at facility.

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

Noncompliance Area: It was observed in the cafeteria, during afternoon snack, that 3 staff members came downstairs to cafeteria with 24 older and younger school aged children. During snack preparation, two staff persons left the room leaving one staff person in the cafeteria with a total of 24 younger and older school age children for approximately 2 minutes. When children are grouped in similar age levels, the following maximum child group sizes and ratios of staff persons apply: 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.

Correction Required: When children are grouped in mixed age levels, the age of the youngest child in the group determines the staff:child ratio and maximum group size in accordance with the requirements in 3270.51 (relating to similar age level).

Noncompliance Area: It was observed that 8 children from the Pooh Bear 4-5 year old room were playing in the art room which was measured for a capacity of 5.

Correction Required: The capacity established for an indoor space may not be exceeded.

Noncompliance Area: It was observed that cafeteria schedule did not indicate when capacity of space was exceeded while children were eating.

Correction Required: When the capacity of a space is exceeded while children are eating, the meal time shall be designated on the facility's schedule of daily activities.

Noncompliance Area: The room designated as a cafeteria has a measured maximum capacity of 9. It was observed that each classroom: Tiggers 3-4 year olds, Pooh Bears 4-5 year olds, and Christopher Robins school age rooms each had their own separate designated lunch period. It was observed that the Christopher Robins school-age room had a total of 23 children eating lunch during their lunch period in the cafeteria and the Pooh Bear 4-5 year old room had 20 children eating lunch during their lunch period in cafeteria, therefore exceeding the room's capacity by more than double during each lunch period.

Correction Required: When the capacity of a space is exceeded while children are eating, the number of children present in the space may not be more than twice the measured capacity of the space.

Noncompliance Area: It was observed in the Christopher Robins school age room sunscreen was stored in cabinet under changing table and in purse behind desk, disinfectant spray, Spic N Span, and 2 Lysol aerosol sprays were stored in drawer behind desk; in the Tigger 3-4 year old room small container of sunscreen was stored in the blue and white plastic drawers; and outside an unlocked shed located in the outdoor play space was used to store pool chemicals all 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: It was observed that teachers were placing band aids in their emergency contact binders and did not have a complete first-aid kit available when using the outdoor play space where children receive care. It was observed the Pooh Bear 4-5 year old room was missing gloves from their first-aid kit.

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

Noncompliance Area: It was observed that the Christopher Robins school age room went on an excursion to the library and did not have with them a complete first-aid kit, only band aids accompanied staff and children.

Correction Required: One first-aid kit per child care group must accompany children and facility persons on excursions from the facility. Each first aid kit taken on an excursion must contain a bottle of water in addition to the items specified at 3270.75(c).

Noncompliance Area: It was observed in the cafeteria there was a large chip in the paint on the wall next to the kitchen.

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

Noncompliance Area: During the inspection it was observed that cleaning supplies were stored above diapers in the bathroom on the 2nd floor.

Correction Required: Cleaning materials and other toxic materials shall be stored in an original labeled container or in a container that specifies the content. Toxics shall be stored away from food, food preparation areas and child care spaces.