Pat Mcfaddin Day Care Center

Noncompliance Area: The outdoor play little tykes boat had two long cracks along the top of the boat posing pinch points to the children in care.

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: The facility had Mylicon, Albuterol and ointment for use with child in care that were past their expiration date as indicated on the medications.

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

Noncompliance Area: The back infant room lacked a hands free diapering can for use at the diaper changing table. The toddler room contained an inoperable hands free diaper changing can by the diaper changing table.

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: Staff file #2, DOH 10/25/00, contained valid health assessments dated 2/16/17 and 3/5/19 which exceeded the 24 months for valid health assessments. Staff file #3, DOH 8/31/16, contained valid health assessments dated 8/27/18 and 8/28/20 which exceeded the 24 months for valid health assessments.

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: On the date of inspection, it was observed that there was a fire detection system that was not operable because the alarm did not sound when activated for the system that was hard wired to electricity. The facility did have operable battery operated smoke detectors. This condition at the facility poses a threat to the health or safety of children.

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. The agent of the Department will file a complaint with the appropriate municipal office to request an additional fire safety inspection by the appropriate agency to verify compliance with 34 Pa. Code 403.23 and per Chapter 20.35(c). the provider will contact the local building code official to determine what system is needed for the building and demonstrate an operable fire detection system to an agent of the department.

Noncompliance Area: All staff files contained NSOR verifications dated on 8/1/2020 or later which was after the required date of 7/1/2020 per CPSL. Staff file #4, DOH 6/15/20, was incorrect provisional hire, staff file contained a request for NSOR dated 8/1/20 and a valid NSOR verification dated 8/27/20, which was requested after hire. The facility did not have approved DHS Provisional Hire Waiver to hire staff provisionally.

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 first aid kit located in the back infant room was accessible to the children in care.

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

Noncompliance Area: Outside in the play area, it was observed that the wooden picnic table was splintering. The disney princess scooter had a crack on the basket attached to the front and little tikes boat had a crack on the bottom, causing 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: In the infant room, the stair mats were torn on numerous corners, causing the foam to be exposed. The children could then pull it apart causing 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.

Noncompliance Area: In the back room, it was observed that a high chair did not have a T-strap safety strap.

Correction Required: High chairs shall have a wide base and a T-shaped safety strap.

Noncompliance Area: Upon entering the facility is was observed that four children were sleeping with toys and other children beside each other, lacking the 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: Upon entry into the facility it was observed that an infant was sleeping in a swing, which is not recommended by the American Academy of pediatrics.

Correction Required: Infants shall be placed in the sleeping position recommended by the American Academy of Pediatrics unless there is a medical reason an infant should not sleep in this position. The medical reason shall be documented in a statement signed by a physician, physician's assistant or CRNP and placed in the child's record at the facility.

Noncompliance Area: The agreement for child for child #2 lacked an arrival and departure times.

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

Noncompliance Area: The files for child #1, #4, and #5 contained an original agreement.

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

Noncompliance Area: The file for child #3 and #5 lacked an immunization record in accordance with the ACIP.

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: The health assessment for staff person #1 lacked answering the question "free from communicable diseases." The file for staff person # 2 contained a health assessment conducted on 8-31-17. A health assessment needs to be completed every 24 months.

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: The file for staff person # 4 lacked a signed disclosure statement.

Correction Required: 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 #--- may not work in a child care position at the facility.

Noncompliance Area: The file for staff person #4, with a start date of 8/13/19, lacked emergency plan training at time of hire.

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 # 4 lacked a signed disclosure statement and contained an education FBI clearance.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). LACKING REQUIRED HIRING DOCUMENTS: Facility Person #4 -- may not work in a child care position at the facility.

Noncompliance Area: The files for staff person #1 and #3 last had an evaluation done in August of 2018. An evaluation needs to be completed 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: In the back room, it was observed that there was a unlabeled bottle of cleaner under the sink.

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.

Noncompliance Area: In the outside play area, the yellow mats were buckling up in some areas, causing a tripping hazard.

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: In the back room, it was observer that the paint was peeling on the back wall. Outside in the play area, the two metal picnic tables legs had peeling paint.

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

Noncompliance Area: A black storage bin located in the infant/toddler area had bolts exposed on the lid to children in care. The mats in the outdoor play space were pulled up in multiple places posing a tripping hazard to the children in care.

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: The facility had 2 Butt Paste, A&D Ointment and triple antibiotic ointment labeled daycare for use on the children in care, and not designated for use with a specific child in care.

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

Noncompliance Area: The facility had Cephalexin on site that was not in a locked container in the refrigerator and lacked a medication log for administration of the medication to the child that the prescription was intended.

Correction Required: Medication shall be stored in a locked area of the facility or in an area that is out of the reach of children. An operator is responsible to establish and maintain a medication log if prescription or nonprescription medication is administered.

Noncompliance Area: The emergency plan posted in the facility lacked designated shelter in place and evacuation location and the route to evacuation site.

Correction Required: The facility shall have an emergency plan that provides for shelter of children during an emergency including shelter in place at the facility and shelter at locations away from the facility premises.The facility shall have an emergency plan that provides for evacuation of children from the facility building and evacuation of children to a location away from the facility premises. The evacuation routes and evacuation plans to exit the building may be the same as those required by 3270.94 (f) and (g) (relating to fire drills).

Noncompliance Area: Staff file #1, DOH 3/4/18, contained a disclosure statement dated 7/2/18 which was not completed at initial hire.

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: Staff file #2 lacked copies of verification of child care experience prior to working at the facility to meet staff qualifications of an assistant group supervisor, the position in which staff #2 was performing.

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 verification of child care experience, education and training prior to service at the facility.

Noncompliance Area: Staff #1 and Staff #2, both aides, were not being supervised by a staff person qualified at a minimum of an assistant group supervisor.

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: An older toddler was not served lunch at same time as all other children due to lack of high chairs available for use by the younger children.

Correction Required: Play equipment and materials appropriate to the developmental needs, individual interests and ages of the children shall be provided in sufficient amount and variety to preclude long waits for use. Daily activities shall promote the development of skills, social competence and self-esteem. Daily experiences shall recognize the child as an individual and give some choice of activities that respect personal privacy, lifestyle and cultural background.

Noncompliance Area: Toys soiled with excretion were not cleaned between use by multiple children in care.

Correction Required: Toys soiled by secretion or excretion shall be cleaned with soap and water, rinsed and sanitized before being used by a child.

Noncompliance Area: Two children in care were observed sharing the same pack n play for sleeping during the inspection. Staff statements revealed that pack n plays are to be cleaned at staff shift change not between children use.

Correction Required: Individual, clean, age-appropriate rest equipment shall be provided for preschool, toddler and infant children as agreed between the child's parent and the operator. The rest equipment shall be labeled for the use of a specific child and used only by the specified child.

Noncompliance Area: Upon arrival, at approximately 12 noon, staff #3 was not in the facility, she returned from the adjacent house. There were 2 staff and 13 children of mixed ages in the facility. Staff #3 returned within 5 minutes of my arrival. Upon staff #3 return to the facility, she identified 3 children including 2 infants and 1 young toddler in her group.

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. Children must be supervised at all times.

Noncompliance Area: Some children were not offered all items available for lunch during the inspection.

Correction Required: Food servings shall be portioned suitably for the size and age of the children in care. Additional food in reasonable amounts shall be made available to children upon the request of the parent or child.

Noncompliance Area: Staff file #1 lacked two written, nonfamily references from individuals attesting to the person's suitability to serve as a facility person in the 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: Staff file #1 lacked documentation of prior education or child care experience in the file to qualify staff as aide at the facility.

Correction Required: An aide shall have a high school diploma or a general educational development certificate.A facility person's record shall include verification of child care experience, education and training prior to service at the facility.

Noncompliance Area: Upon arrival at the facility, at approximately 12 noon, Staff #1 identified 2 infants, 2 young toddlers and 1 older toddler in her group; Staff #2 identified 1 older toddler and 4 preschool children in her group; Staff #3 who was not in the facility upon my arrival, returned to the facility, identified 2 infants and 1 older toddler in her group.

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). The required staff:child ratios must be maintained at all times.

Noncompliance Area: There were Lysol cleaning wipes accessible to the children in the bathroom on the sink.

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: The window in the front of the facility was opened and lacked a screen.

Correction Required: Windows or doors used for ventilation shall be screened when open.

Noncompliance Area: Graco high chair in the infant space lacked a T safety strap.

Correction Required: High chairs shall have a wide base and a T-shaped safety strap.

Noncompliance Area: Child file #1 lacked operator signature and admission date on the agreement form.

Correction Required: An agreement shall be signed by the operator and the parent.An agreement shall specify the date of the child`s admission.

Noncompliance Area: Child file #2 lacked an updated health report every 12 months as required for a preschool child.

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: The facility had an expired Epi Pen for a use with a child currently in care.

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

Noncompliance Area: The crib sheets were loose and posed a suffocation hazard for sleeping infants in care.

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

Noncompliance Area: Staff file #3 lacked documentation of emergency plan training at initial employment.

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: Staff file #2 lacked documentation of completion of fire safety training annually.

Correction Required: Staff persons shall participate, at least annually, in firesafety training conducted by a fire protection professional. Staff persons and volunteers shall receive training in maintenance of smoke detectors, the duties of facility persons during a fire drill and during a fire and the use of the facility`s fire extinguishers, not including discharge of the fire suppressant agent.

Noncompliance Area: Staff file #2 lacked copy of written evaluation completed every 12 months in the file.

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: Staff file #1 lacked copies of verification of education qualifications and experience for group supervisor in the file.

Correction Required: A group supervisor shall have attained one of the qualification levels specified at 3270.35(b)(1)-(4). A facility person`s record shall include verification of child care experience, education and training prior to service at the facility.

Noncompliance Area: Staff file #2 and #3 lacked copies of education and experience verification for Aide in the file.

Correction Required: An aide shall have a high school diploma or a general educational development certificate.A facility person`s record shall include verification of child care experience, education and training prior to service at the facility.

Noncompliance Area: Outlet located in the childcare space, next to the kitchen area lacked a protective outlet cover.

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