Brookville Ymca Laugh And Learn Daycare

Regulation: 3270.102(a)

Description: Clean and good repair

Noncompliance Area: In the Outdoor play space, there was a wooden boat that had a broken bench and exposed screws, a broken bubble wand, and multiple screws sticking out of the wooden kitchen, these items posed a cutting hazard to the children in care. The Toddler Turnpike Room had a broken mesh basket that contained stuffed animals that posed 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.

Regulation: 3270.103

Description: Small Toys and Objects

Noncompliance Area: Two ripped rest mats with exposed foam were observed in the Adventure Avenue Room and the Foam Mat in the play space of the Lullaby Lane Room had exposed foam, these items were accessible to the children who are still placing objects in their mouths.

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: 3270.104(a)

Description: Clean, good repair, proper size

Noncompliance Area: One pack n play in the Toddler Turnpike Room was observed to be ripped creating a pinching hazard to the children in care. Two of the bookshelves had peeling felt that was coming off the back of the shelf posing a tripping hazard to the children.

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

Regulation: 3270.106(h)

Description: Soiled bedding cleaned

Noncompliance Area: Three pack n play mats were observed to be soiled in the Toddler Turnpike Room. These pack n plays were used with the children resting directly on the soiled mats.

Correction Required: Soiled bedding shall be cleaned before it is reused.

Regulation: 3270.107

Description: Refrigerator

Noncompliance Area: The refrigerator in the Lobby Room at the facility lacked a thermometer.

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.

Regulation: 3270.124(b)(2)

Description: Physician name, address, phone

Noncompliance Area: The Emergency Contact Form for Child #2 lacked the address and telephone number of the child's physician.

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

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 and Child #4 contained Emergency Contact Forms that were not updated within 6 months of the previous update. The file for Child #3 contained an Emergency Contact Form that had not been updated within the last 6 months.

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

Description: Immunization record/Dismissal policy

Noncompliance Area: The file for Child #1, enrolled for more that 60 days at the facility, did not contain documentation of a 3rd dose of the DTAP vaccination and 3rd dose of the Pneumococcal vaccination as required based on the child's age as per the ACIP recommended schedule.

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 childcare group settings). Child #1 must be dismissed from care by close of business 7/21/26 and may only return to care when the immunization record is updated or when a parent provides a written, signed exemption letter.

Regulation: 3270.133(3)

Description: Name on bottle

Noncompliance Area: In the Toddler Turnpike, there was a bottle of Tylenol that did not identify the name of the child for whom the medication was intended.

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.

Regulation: 3270.151(a)

Description: 12 months prior to service and every 24 months thereafter

Noncompliance Area: The file for Staff #4 contained a Health Assessment at the time of Renewal Inspection, but it was observed that Staff #4 did not obtain a Health Assessment prior to providing childcare.

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.

Regulation: 3270.181(c)

Description: Emergency info/agreement updated 6 mos

Noncompliance Area: The file for Child #1 contained a Financial Agreement Form that was not updated within 6 months of the previous update.

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.

Regulation: 3270.192(5)

Description: Two written references

Noncompliance Area: The file for Staff #3, contained one written, nonfamily reference and one written, family reference from individuals attesting to the 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.

Regulation: 3270.31(e)

Description: Age and Training

Noncompliance Area: The files for Staff #1 and #2, lacked documentation of 8 hours of the required 12 annual clock hours of childcare training.

Correction Required: A staff person shall obtain an annual minimum of 12 clock hours of child care training.

Regulation: 3270.31(f)

Description: Health and Safety Training

Noncompliance Area: The file for Staff #3 contained Health and Safety Basics Part 2 training at the time of the Renewal Inspection, but it was observed that Staff #3 did not obtain Health and Safety Basics Part 2 with 90 days of hire.

Correction Required: Staff persons shall complete professional development within 90 days of hire as listed in subsections (f)1-10.

Regulation: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: The file for Staff #4 contained a National Sex Offender Certificate (NSOR) at the time of Renewal Inspection, but it was observed that Staff #4 did not obtain the NSOR Certificate prior to providing childcare.

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.

Regulation: 3270.76

Description: Building Surfaces

Noncompliance Area: There was a stained ceiling tile observed in the Learning Blvd. Room near the back window. In the Toddler Turnpike Room there was a cracked electrical face plate that posed a shocking hazard to the children in care.

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.

Regulation: 3270.77(a)

Description: No peeling paint or plaster

Noncompliance Area: In the Toddler Turnpike Room on the blue wall next to the play kitchen and the Lullaby Lane Room on the white wall behind the swings there was peeling paint. In the Outdoor play space, there were three wooden Adirondak chairs that 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.

Regulation: 3270.82(h)

Description: Handwashing signs

Noncompliance Area: The sink and diapering area in the Adventure Avenue Room 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.

Regulation: 3270.102(a)

Description: Clean and good repair

Noncompliance Area: It was observed that there were foam building blocks in the preschool Learning Blvd Classroom that had teeth marks with chucks missing from the blocks leaving them in not good repair.

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: 3270.134(a)

Description: Child's hands washed

Noncompliance Area: During a diaper change it was observed that Staff Person #1 did not wash the hands of the young toddler before placing them in their pack and play.

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: 3270.135(a)(3)

Description: Disposable diapers

Noncompliance Area: During a diaper change it was observed that Staff Person #1 discarded the soiled diaper by lifting the lid of the hands-free garbage can with their hand to dispose of the soiled diaper.

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.

Regulation: 3270.27(a)(6)

Description: Emergency plan

Noncompliance Area: The emergency drill log was missing information on if special accommodation were needed for the children in care and if any problems occurred during the emergency drill.

Correction Required: Emergency drills shall be conducted annually. Annual emergency drills shall be documented and on file at the facility.

Regulation: 3270.66(b)

Description: Original container

Noncompliance Area: It was observed that there was a jar of peanut butter and a bag of donuts that were on the same shelf as sunscreen in the Learning Blvd classroom.

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.

Regulation: 3270.76

Description: Building Surfaces

Noncompliance Area: It was observed that the bottom door of the sink in the Learning Blvd. Classroom had a chunk missing on the corner of the door leaving a sharp edge and exposed partial board.

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.

Regulation: 3270.51

Description: Similar Age Level

Noncompliance Area: On 9/9/2024, staff #2 was observed alone in the infant room and caring for 5 infants for approximately one minute.

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: 3270.52

Description: Mixed Age Level

Noncompliance Area: On 9/9/24, staff #1 named six children in her supervisory group. One of the children was of preschool age and five of the children were young toddlers. Ratio: 1:6.

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).

Regulation: 3270.102(a)

Description: Clean and good repair

Noncompliance Area: The refrigerators in the two toddler rooms had sticky substances on the bottoms of the inside of the refrigerators.

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: 3270.123(a)(6)

Description: Admission date

Noncompliance Area: The fee agreements on file for children #1, 2, 3, 4 and 5 lack the date of the child's admission.

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

Regulation: 3270.151(c)(2)(i)

Description: Record on file if positive TB

Noncompliance Area: The file for staff #4, who's medical record is said to demonstrate a positive TB skin test, lacks the TB screening.

Correction Required: If a person's medical record demonstrates a positive tuberculin skin test, that record shall be placed on file at the facility.

Regulation: 3270.27(e)

Description: Letter to parents

Noncompliance Area: The operator did not provide the parents a letter explaining emergency procedures, including shelter of children during an emergency including lock-down, shelter in place at the facility and shelter at locations away from the facility premises, evacuation of children from the facility building and evacuation of children to a location away from the facility premises, evacuation routes and evacuation plans to exit the building may be the same as those required by § 3270.94 (relating to fire drills), a method for facility persons to contact parents as soon as reasonably possible when an emergency situation arises, a method for facility persons to inform parents that the emergency has ended and to provide instruction as to how parents can safely be reunited with their children and acommodations for infants, toddlers, children with disabilities and children with chronic medical conditions.

Correction Required: The operator shall provide to the parent of each enrolled child a letter explaining the emergency procedures. The operator shall also provide to the parent of each enrolled child a letter explaining any subsequent update to the plan.

Regulation: 3270.31(f)

Description: Health and Safety Training

Noncompliance Area: The file for staff #2 lacked Pediatric CPR/FA with approved curriculum and approved PQAS instructor within 90 days of hire. SEE IS CODE SHEET. This is evidenced by the current training on file dated 1/18/24.

Correction Required: Staff persons shall complete professional development within 90 days of hire as listed in subsections (f)1-10.

Regulation: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: The current State Police clearance on file for staff #1 is lacking a dissemination date. The file for staff #3 lacked a disclosure statement at rehire. SEE IS CODE SHEET.

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

Regulation: 3270.102(a)

Description: Clean and good repair

Noncompliance Area: Observed in the infant room the activity bouncer and baby seat with activity tray to be visibly dirty and sticky. Observed on the outdoor play space 2 Radio Flyer tricycles with rusted surfaces and a red tricycle with a sharp metal emblem on the front. Observed parked on the front porch area two 4 passenger baby buggies with fabric seats that were covered with dirt, cobwebs, and black spots resembling mold. Also observed the back wheel axle on one of the buggies to be rusted and cracked.

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: 3270.14/3270.21

Description: Pertinent Laws & Regulations/General Health and Safety

Noncompliance Area: Staff person #3 was observed to be caring for children unsupervised. Staff person #3 has not completed the following pre-service training required prior to caring for children unsupervised: mandated reporter training,

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. Until such time as the required pre-service trainings are completed, staff person #3 must be supervised, when interacting with children, by a director, GS or AGS who has completed the required training related to this citation. If there are no staff person(s) available to supervise staff person #3, staff person #3 may not work in a child-care position at the facility.

Regulation: 3270.31(e)/3270.192(2)(iii)

Description: Age and Training/Exp, educ., training at facility

Noncompliance Area: The file for staff person #1 contains only 3 of the required 12 hours of child care training completed during the year 12/19/2021 to 12/19/2022. Staff #1 has since completed 9 additional training hours.

Correction Required: A staff person shall obtain an annual minimum of 12 clock hours of child care training. A facility person's record shall include verification of child care experience, education and training following the outset of service at the facility.

Regulation: 3270.32(a)

Description: Comply with CPSL

Noncompliance Area: Staff person #3 has not completed an acceptable mandated reporter training within 90 days of their date of hire (see LIS code sheet).

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to Child Protective Services). Staff person #3 will have until 8/27/2023 to complete the mandated reporter training. Until such time as the required training has been completed, staff person #3 must be supervised, when interacting with children, by a director, GS or AGS who has completed the required training related to this citation. If there are no staff person(s) available to supervise staff person #3, staff person #3 may not work in a child-care position at the facility.

Regulation: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: The file for staff person #2 contains a volunteer child abuse clearance which is not accepted for employment in a child care facility. The file for staff person #3 contains a current child abuse clearance that was completed after the start date in the child care facility. The child abuse clearance on file at initial employment is a volunteer clearance which is not accepted for employment in child care. The clearance is now current.

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 a child care position at the facility.

Regulation: 3270.75(c)

Description: Has all items

Noncompliance Area: The first-aid kit in the Common Area is lacking 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.

Regulation: 3270.76

Description: Building Surfaces

Noncompliance Area: The laminate floors throughout the facility are visibly dirty and sticky to the touch. According to staff interview, the floors are mopped daily but have not been stripped or deep cleaned in more than a year.

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.

Regulation: 3270.20(a)(1)/3270.20(b)

Description: Inpatient hospitalization or ER treatment of child/Mail or deliver written report to regional office within 72 hours

Noncompliance Area: The provider did not notify the regional office of an incident that occurred at the facility on 10/4/2022 which required emergency room treatment for child #1.

Correction Required: The operator shall immediately notify a child's parent and shall telephone notice to the appropriate regional office within 24 hours if a child in care at the facility is hospitalized or receives emergency room treatment. The operator shall mail or deliver a written report to the appropriate regional office within 72 hours after hospitalization of a child in care, emergency room treatment of a child in care, death of a child in care, a facility fire requiring the services of a fire department.

Regulation: 3270.182(7)

Description: Reports of accidents, injuries and illnesses. Original report - parent same day Copy - facility accident file. Copy - child's file

Noncompliance Area: An incident report was not completed for an injury occurring to child #1 on 3/6/2023. The operator disclosed that a copy of incident reports is retained in a facility incident file but not retained in the child's 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.

Regulation: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: The file for staff person #1, date of hire (see LIS code sheet) is lacking verification of fingerprinting or a completed clearance prior to the start date as required under CPSL. The file does contain a current 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.

Regulation: 3270.102(g)

Description: Hazardous toys and equipment

Noncompliance Area: Observed a bumbo seat being used for infant care and there was no strap. Bumbo seats were recalled with a requirement to have an adaptive strap if still in use.

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.

Regulation: 3270.104(a)

Description: Clean, good repair, proper size

Noncompliance Area: A tall bookshelf in the common area was not anchored for stability posing a risk of the shelf falling on a child.

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

Regulation: 3270.151(a)/3270.192(3)

Description: 12 months prior to service and every 24 months thereafter/Health assessment, TB test

Noncompliance Area: The files for staff persons #2 and #4 contain current health assessments that were completed greater than 24 months after the previous health assessment. The files are now current. The files for staff persons #3 and #5 contain initial health assessments that were obtained after the individual's start date. The files are now current.

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.A facility person's record shall include a written report of initial and subsequent health assessments, including the results of initial and subsequent tuberculin skin tests, x-rays or other medical documentation necessary to confirm freedom from communicable tuberculosis.

Regulation: 3270.151(c)(2)

Description: Mantoux TB

Noncompliance Area: The files for staff #3 and #5 contain results of TB tests after the start date in a child care position. The files are now current.

Correction Required: 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.

Regulation: 3270.151(c)(3)/3270.151(c)(5)

Description: Exam communicable disease/Physician/CRNP assessment

Noncompliance Area: The file for staff person #6 contains an initial health assessment that is lacking physician statements regarding communicable disease and suitability for working in 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.

Regulation: 3270.166(4)

Description: Bottles labeled

Noncompliance Area: A bottle of infant formula was observed in the refrigerator and was not labeled with the name of the infant.

Correction Required: Disposable nursers and bottles shall be labeled with the child's name.

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

Description: Age and Training

Noncompliance Area: The file for staff person #1 contains a current PFA/PCPR training that was conducted after the previous training had expired. The training is now current. The file for staff person #7 contains expired PFA/PCPR training and does not contain current training.

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: 3270.31(f)

Description: Health and Safety Training

Noncompliance Area: The file for staff person #2, hire date (see IS code sheet) contains current PFA/PCPR training that was received greater than 90 days after hire date. The file is now current.

Correction Required: Staff persons shall complete professional development within 90 days of hire as listed in subsections (f)1-10.

Regulation: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: The file for staff person #6, hire date (see IS code sheet) contains an FBI clearance obtained through the DOE which is not valid for a position in child care under 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. Facility Person #6 may not work in a child care position at the facility.

Regulation: 3270.75(a)

Description: In child care spaces

Noncompliance Area: Observed that a first aid kit was not available on the playground where 20 children ages infant through school age were observed receiving care.

Correction Required: A first-aid kit shall be in a child care space.

Regulation: 3270.76

Description: Building Surfaces

Noncompliance Area: Observed 2 protruding bolts on the gate of the playground outdoor playspace. The bottom of the vanity in the Inventors room bathroom was damaged. The countertop on the sink in the Creators room was damaged.

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.

Regulation: 3270.82(i)

Description: Lidded waste receptacles

Noncompliance Area: The trash container in the common area bathroom was not lidded.

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

Regulation: 3270.113(a)

Description: Supervised at all times

Noncompliance Area: On 3/17/22, at approximately 10:10 AM, observed staff #1 leave the toddler room where 5 children were present and walk thru the middle room and answer the door. This left 1 OT and 4 PS children alone and unsupervised in the toddler room for approximately 1 minute. Additionally, and approximately 2-3 minutes after staff #1 answered the door, observed staff #1 leave the toddler room another time and walk into the middle room to get something out of the closet. This left the 5 children alone and unsupervised in the toddler room for approximately 30 seconds.

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: 3270.113(a)(1)

Description: Staff assigned to specific children

Noncompliance Area: On 3/17/22, at approximately 10:10 AM, observed staff #1 leave the toddler room where 5 children were present and walk thru the middle room and answer the door. This left 5 children alone and unsupervised in the toddler room for approximately 1 minute. Additionally, and approximately 2-3 minutes after staff #1 answered the door, observed staff #1 leave the toddler room another time and walk into the middle room to get something out of the closet. This left the 5 children alone and supervised in the toddler room for approximately 30 seconds.

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.

Regulation: 3270.52

Description: Mixed Age Level

Noncompliance Area: On 3/17/22, at approximately 10:10 AM, observed staff #1 leave the toddler room where 1 OT and 4 PS children were present and walk thru the middle room and answer the door. This left the 5 children alone and unsupervised in the toddler room for approximately 1 minute. Additionally, and approximately 2-3 minutes after staff #1 answered the door, observed staff #1 leave the toddler room another time and walk into the middle room to get something out of the closet. This left the 1 OT and 4 PS age children alone and supervised in the toddler room for approximately 30 seconds. Ratio 0:5.

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).

Regulation: 3270.95(a)/3270.95(b)

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

Noncompliance Area: The facility file did not contain any documentation that manual tests of the fire detection systems have been completed every 30 days.

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. Manual checks of the fire detection system/devices will be checked at least every 30 days and documentation shall be on file.

Regulation: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: The file for staff #1, lacks the FBI clearance required under the CPSL. FBI clearance on file is from PDE and not DHS and the file for staff #2 lacked a State Police clearance on or before initial start date in a child care position. There is now a State Police clearance on file and dated 12/11/19. Previously cited on 7/16/21 under SIN-00190027.

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

Regulation: 3270.95(a)/3270.95(b)

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

Noncompliance Area: The facility file lacked verification of proof of purchase of the facility's interconnected fire detection system.Previously cited on 7/16/21 under SIN-00190027.

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. Child Care Centers shall keep the proof and date of purchase of an interconnected fire detection device or system.

Noncompliance Area: The refrigerator in the Discoverer Room lacked an operating thermometer.

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 Discoverer Room lacked a daily activity schedule.

Correction Required: A written plan of daily activities and routines, including a time for free play shall be established for each group. The plan shall be flexible to accommodate the needs of individual children and the dynamics of the group.

Noncompliance Area: A child service report was not completed every six months for children #1, 3 and 4 and was due in file prior to regulatory suspensions (March 6, 2020.). Child #1 start date is 5/18/2019 and the only child service report on file is dated 6/16/2020. Child #3's start date is 6/4/19 and the only child service report on file is dated 4/2/20. Child #4's start date is 5/28/2019 and the only child service report on file is dated 7/29/2020.

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 fee agreement on file for child #3 lacked an arrival and departure time. The fee agreements on file for children #4 and 5 lack the names of release persons.

Correction Required: An agreement shall specify the child's arrival and departure times.An agreement shall specify the persons designated by a parent to whom the child may be released.

Noncompliance Area: The original fee agreements for children #1, 2, 3 and 4 were not given to the parent as the originals were observed in the children's files.

Correction Required: A parent shall receive the original agreement. The facility shall retain a copy of the agreement.A child's record shall contain a copy of the initial agreement and subsequent written agreements between the parent and the operator. The parent receives the original agreement.

Noncompliance Area: There was more than six months between reviews of the emergency contact and fee agreement information on file for children #1, 3, 4, and 5 and were due in the file prior to regulatory suspensions (March 6, 2020.). Review dates are as follows; Child #1, emergency contact - 6/16/19 and 7/27/10 and fee agreement - 8/12/19 and 7/27/20, Child #3, with start date of 6/4/19- emergency contact - 5/16/19 and 5/16/20 and the only fee agreement on file is dated 8/12/19, Child #4, with start date of 5/28/19 - emergency contact - 5/6/19 and 8/2020 and fee agreement on file is dated 7/29/20, Child #5 with start date of 5/28/2019 and the last review of the emergency contact and fee agreement on file is dated 5/28/2019.

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 informationA 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: The file for child #3, who is of preschool age, lacks a health assessment which was conducted within the past 12 months and was due in the file prior to regulatory suspensions (March 6, 2020.)

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.

Noncompliance Area: The files for children #1 and 2 lack verification of a flu shot within the past year as in accordance with the schedule recommended by 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: In the first aid kits in the Explorer Room and Discoverer Room, observed Ibuprofen, Aspirin, and Burn Gel which lacked the name of the child for whom the medication is intended.

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 files for staff #3, 4, and 5 lacked verification of an initial health assessment 12 months prior to providing initial service in a child care setting. There are now health assessments on file.

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.A facility person's record shall include a written report of initial and subsequent health assessments, including the results of initial and subsequent tuberculin skin tests, x-rays or other medical documentation necessary to confirm freedom from communicable tuberculosis.

Noncompliance Area: The file for staff #3, 4 and 5 lacked verification of a TB test at initial hire. There are now TB tests on fie.

Correction Required: 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.A facility person's record shall include a written report of initial and subsequent health assessments, including the results of initial and subsequent tuberculin skin tests, x-rays or other medical documentation necessary to confirm freedom from communicable tuberculosis.

Noncompliance Area: The facility's COVID-19 Health and Safety Plan lacked a plan which addressed child drop-off and pick-up policies.

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

Noncompliance Area: The file for staff #1 and 2 lack emergency plan training within the past year. Last trainings are dated 5/29/19 for both staff. The initial emergency plan training for staff #3 was not completed within one week of hire. Start date was 8/8/19 and emergency plan training was completed on 8/21/19.

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. A facility person's record shall include verification of child care experience, education and training following the outset of service at the facility.

Noncompliance Area: The files for staff #1 and 6 lacked fire safety training within one year of hire. Hire date for staff #1 was 5/26/19 and fire safety training was completed 7/30/20. Hire date for staff #6 was 5/28/19 and fire safety training was completed 7/20/20.

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.A facility person's record shall include verification of child care experience, education and training following the outset of service at the facility.

Noncompliance Area: The file for staff #1 and 5, lack mandated reporter training within 90 days of hire. Staff #1's mandated reporter training is not an approved training. Staff #5's start date is 9/20/19 and mandated reporter training on file is dated 4/22/20.

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.

Noncompliance Area: The file for staff #3, with provisional hire date of 8/9/19, lacked an application for State Police, Child Abuse and FBI clearances on or before initial date in a child care position. FBI fingerprint date is 8/27/19. No other applications are on file. Clearances are now on file and dated - State Police - 9/9/19, Child Abuse - 10/23/19, FBI - 9/8/19. The file for staff #4, with provisional hire date of 9/20/19 lacked an application for an FBI clearance and a disclosure statement on or before start date in a child care position - FBI fingerprint date is 9/30/19. FBI clearance is on file and dated 10/1/19 and disclosure statement is dated 9/26/19. The file for staff #5, with start date of 9/20/19, lacked a State Police, Child Abuse, FBI and National Sex Offender clearance on or before start date in a child care position. The State Police clearance on file is for volunteer purposes. There are now Child Abuse, FBI, and NSOR clearances on file and dated as such - Child Abuse - 9/23/19, FBI - 9/27/19, and NSOR - 11/13/19.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). Facility Person # -5- 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: There was more than one year between the previous and most current staff evaluations on file for staff #1 and 2. Evaluation dates are as follows: Staff 31 - 5/29/19 and 6/20/20 - Staff #2 - 5/29 /19 and 6/11/20. The file for staff #6 lacked a staff evaluation within one year of hire. Staff #6 hire date is 5/1/19 and staff evaluation was completed on 6/12/20.

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 Creator Room, observed toxic sanitizing solution on top of the paper towel holder and in reach of 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: In the Common Room, observed 3 first-aid kits in an unlocked cabinet and accessible to the children in care.

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

Noncompliance Area: The first aid kits in the Explorer, Creator, Inventor, Discoverer, and Common Rooms lacked soap.

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: In the older toddler room, observed a blue toy bin which had a slight crack on the side causing a pinch point. In the young toddler room, observed a small child's couch which had a denim slip cover. The slip cover had a 4 inch rip on top of one side and a 4 inch rip on the bottom of the other side.

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, observed a pack n play which was not labeled for the use of a specific child.

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: In the infant room, observed Acetaminophen for child #1, which had expired 1/2020.

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

Noncompliance Area: In the infant room, observed a pack n play which had a sheet that was not made for the pack n play and was too large for the mat. Therefore, causing a strangulation hazard. In the older toddler room, observed a television and a computer which were on the top of a shelf. The top shelf was in reach of children and the television and computer could be pulled over by a child causing a threat to the health and safety of the children in care.

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

Noncompliance Area: In the older toddler room, observed a toxic cleaning material containing Suprox-D, which is labeled as, "Keep out of Reach of Children" and sitting on a counter in reach of 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: In the infant, school age, and older toddler room, observed bottles of cleaning liquid. The bottles did not specify the content.

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 infant room, observed child #1 in a crib which was not labeled with the child's name.

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: In the infant room, observed two cribs which 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: Based on staff interviews and facility documentation, on 8-15-2019, child #1 was placed in a high chair with a secured tray for 2-3 minutes as a form of time out by staff #1. On 8-21-2019, child #1 was placed in a high chair with a secured tray for 2-3 minutes as a form of time out by staff #2.

Correction Required: A facility person may not restrain a child by using bonds, ties or straps to restrict a child's movement or by enclosing the child in a confined space, closet or locked room. The prohibition against restraining a child does not apply to the use of adaptive equipment prescribed for a child with special needs.

Noncompliance Area: In the infant room, observed an infant sleeping propped up on a boppy pillow.

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: In the outside play space, in an area used by young toddlers, observed mulch with a diameter of less than an inch by two green slides

Correction Required: Pea gravel and other materials with a diameter of less than 1 inch may not be used in spaces where infants or toddlers receive care.

Noncompliance Area: In the OT room, observed plastic bags in a drawer, and crayons and colored pencils on a shelf. All were accessible to the children in care. There was an infant and young toddler present in the room.. In the outside play space, there is a large telephone pole. The bottom area of the pole is covered with a rubber mat. There are areas on the mat which are being pulled off by the children and were on the ground. They are less than 1 inch in diameter and young children who are still placing object in their mouth play in this area.

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 OT room, all rest equipment was not labeled for the use of a specific child.

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: The fee agreement on file for children #1, #2, #3, #4, and #5, lacked the services to be provided to the family and the child and the names of the persons designated by a parent to whom the child may be released.

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

Noncompliance Area: There was no emergency contact information present in the school age room for all of the children who were 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 immunization record on file for child #1, who is 9 months of age, contains verification of 2 DTAP immunizations. 3 are required. The immunization record on file for child #2 and #4, lacked verification that a flu shot was administered within the past year.

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 file for staff #2 lacks an initial health assessment which was conducted within 12 months prior to providing initial service in a child care setting.

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.A facility person's record shall include a written report of initial and subsequent health assessments, including the results of initial and subsequent tuberculin skin tests, x-rays or other medical documentation necessary to confirm freedom from communicable tuberculosis.

Noncompliance Area: The file for staff #2 lacks a TB test at initial employment.

Correction Required: 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.A facility person's record shall include a written report of initial and subsequent health assessments, including the results of initial and subsequent tuberculin skin tests, x-rays or other medical documentation necessary to confirm freedom from communicable tuberculosis.

Noncompliance Area: The emergency contact information on file for child #1 lacks signed parental consent for emergency medical care and minor first-aid procedures by facility staff.

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.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 #2 lacks two written, nonfamily references.

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