The Caring Heart Child Care Center

Regulation: 3270.151(a)

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

Noncompliance Area: At the time of the renewal inspection the certification representative observed that staff #1 had a health assessment that was more than 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.

Regulation: 3270.26

Description: Compliance/Nondiscrimination

Noncompliance Area: At the time of the renewal inspection the certification representative observed that the facility did not complete the civil rights compliance questionnaire.

Correction Required: A legal entity must comply with The Pennsylvania Human Relations Act (43 P. S. §§951-962.2), the Age Discrimination Act of 1975 (42 U.S.C.A. §§6101-6107), Title VI of the Civil Rights Act of 1964 (42 U.S.C.A. §§2000d-2000d-4a). Title VII of the Civil Rights Act of 1964 (42 U.S.C.A. §§2000e-2000e-5), Section 504 of the Rehabilitation Act of 1973 (29 U.S.C.A. §794), the Americans with Disabilities Act of 1990 (42 U.S.C.A. §§12101-12514).

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

Description: Age and Training

Noncompliance Area: At the time of the renewal inspection the certification representative observed that the file for staff #3 did not have documentation for the completion of updated pediatric first aid and pediatric cardiopulmonary resuscitation (CPR).

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

Regulation: 3270.32(a)

Description: Comply with CPSL

Noncompliance Area: At the time of the renewal inspection the certification representative observed that staff #1 had a Pa state police clearance, child abuse clearance, and NSOR that was more than 60 months old and staff #2 had a PA state police and child abuse clearance that are more than 60 months old.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). SAFETY PLAN: The operator is required to submit to the Children and Youth Agency a plan of supervision or alternate arrangement as required by the Child Protective Services Law. LACKING REQUIRED HIRING DOCUMENTS: Facility Person # -- may not work in a child care position at the facility.

Regulation: 3270.106(f)

Description: 2 feet apart

Noncompliance Area: At the time of the renewal inspection the certification representative observed 3 children asleep in the cribs while they were butted up against each other.

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.

Regulation: 3270.124(b)(2)

Description: Physician name, address, phone

Noncompliance Area: At the time of the renewal inspection the certification representative observed that the emergency contact information for child #3 did not include the name, address and telephone number of the child's physician or source of medical care.

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(b)(6)

Description: Insurance coverage information

Noncompliance Area: At the time of the renewal inspection the certification representative observed that the emergency contact information for child #3 did not include the health insurance coverage and policy number for a child under a family policy or Medical Assistance benefits.

Correction Required: Emergency contact information must include health insurance coverage and policy number for a child under a family policy or Medical Assistance benefits, if applicable.

Regulation: 3270.124(b)(7)

Description: Name/address/phone release person

Noncompliance Area: At the time of the renewal inspection the certification representative observed that the emergency contact information for child #3 did not include the address of the individual designated by the parent to whom the child may be released.

Correction Required: Emergency contact information must include the name, address and telephone number of the individual designated by the parent to whom the child may be released.

Regulation: 3270.151(c)(4)/3270.151(c)(5)

Description: Information re: medical problems/Physician/CRNP assessment

Noncompliance Area: At the time of the renewal inspection the certification representative observed that the health report for staff #3 did not have the answers to the questions on the DHS health form included in their health report.

Correction Required: An adult health assessment must include information on medical problems that might threaten the health of the children or prohibit a staff person from providing adequate care to children. An adult health assessment must include the physician's or CRNP's assessment of the person's suitability to provide child care.

Regulation: 3270.31(f)(10)

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

Noncompliance Area: At the time of the renewal inspection the certification representative observed that the file for staff #2 and #3 did not have documentation for the completion of PQAS approved pediatric first aid and pediatric cardiopulmonary resuscitation (CPR).

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

Regulation: 3270.32(a)

Description: Comply with CPSL

Noncompliance Area: At the time of the renewal inspection the certification representative observed that staff #1 had a DHS FBI clearance that was more than 60 months old. Staff #3 did not have a DHS FBI clearance and out of state clearances for Louisiana and Kansas are required and not on file.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). SAFETY PLAN: The operator is required to submit to the Children and Youth Agency a plan of supervision or alternate arrangement as required by the Child Protective Services Law. LACKING REQUIRED HIRING DOCUMENTS: Facility Person # -- may not work in a child care position at the facility.

Regulation: 3270.52

Description: Mixed Age Level

Noncompliance Area: At the time of the renewal inspection the certification representative observed that room number 2 was over the maximum group size of 8 due to an infant being part of the ratio.

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: 3270.65

Description: Protective Outlet Covers 5 yrs. or less

Noncompliance Area: At the time of the renewal inspection the certification representative observed that the power strip in room #1 did not have receptacle covers in each electrical outlet.

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

Regulation: 3270.74

Description: Emergency Numbers Posted

Noncompliance Area: At the time of the renewal inspection the certification representative observed that the facility did not have emergency telephone numbers posted near each telephone in the facility.

Correction Required: The telephone number of the nearest hospital, police department, fire department, ambulance and poison control center shall be posted by each telephone in the facility.

Regulation: 3270.123(a)

Description: Signed

Noncompliance Area: At the time of the renewal inspection the certification representative observed that the agreement for child #1 and #5 did not have a signature of a parent.

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

Regulation: 3270.123(a)(3)

Description: Services proceeded

Noncompliance Area: At the time of the renewal inspection the certification representative observed that there was no child service report, in the last 6 months, on file for child # 2, 4, and 5.

Correction Required: The services to be provided to the family and the child, including the Department's approved form to provide information to the family about the child's growth and development in the context of the services being provided. The operator shall complete and update the form and provide a copy to the family in accordance with the updates regarding emergency contact information in § 3270.124(f) (relating to emergency contact information).

Regulation: 3270.131(a)/3270.131(d)(5)

Description: Health information/Immunization record

Noncompliance Area: At the time of the renewal inspection the certification representative observed that child #5, admitted on 10/2/23, did not have a health report on file at the facility.

Correction Required: The operator shall require the parent of an enrolled child, including a child, a foster child and a relative of an operator or a facility person, to provide an initial health report no later than 60 days following the first day of attendance at the facility. A health report shall include a review of the child's immunized status according to recommendations of the ACIP.

Regulation: 3270.14/3270.21

Description: Pertinent Laws & Regulations/General Health and Safety

Noncompliance Area: At the time of the renewal inspection the certification representative observed that the facility had an emergency plan that did not include the facility's plan for continuity of operation during and in the aftermath of an emergency/disaster. Also, the facility had a written policy and procedure to identify the prevention of shaken baby syndrome, abusive head trauma, and child maltreatment but it did not address the strategies for coping with a crying, fussing, or distraught child and the prevention and identification of child maltreatment.

Correction Required: A facility shall be operated in conformity with applicable Federal and State laws and regulations.State agencies whose regulations may relate to the operation of a facility include the Department of Environmental Resources, the Department of Labor and Industry, the Department of Health, the Department of Education and the Department of Transportation. Conditions at the facility may not pose a threat to the health or safety of the children.

Regulation: 3270.171(b)/3270.171(c)

Description: Safe pick-up and drop-off in writing/Safe routes posted

Noncompliance Area: At the time of the renewal inspection the certification representative observed that the operator did not have a written and posted policy identifying safe pedestrian crossways, pick-up and drop-off points and bike routes in the vicinity of the facility.

Correction Required: Safe pedestrian crossways, pick-up and drop-off points and bike routes shall be appropriately determined in the vicinity of the facility and communicated to the children and parents in writing. Written notification of safe routes shall be posted by the operator at a conspicuous location in the child care facility.

Regulation: 3270.27(a)(3)

Description: Contact when arises

Noncompliance Area: At the time of the renewal inspection the certification representative observed that the emergency plan for the facility did not specify a method for facility persons to contact parents as soon as reasonably possible when an emergency situation arises.

Correction Required: The facility shall have an emergency plan that provides for a method for facility persons to contact parents as soon as reasonably possible when an emergency situation arises.

Regulation: 3270.27(a)(4)

Description: Contact when ended

Noncompliance Area: At the time of the renewal inspection the certification representative observed that the emergency plan for the facility did not specify 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. .

Correction Required: The facility shall have an emergency plan that provides for 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.

Regulation: 3270.27(a)(5)

Description: Emergency plan

Noncompliance Area: At the time of the renewal inspection the certification representative observed that the emergency plan for the facility did not include accommodations for infants and toddlers that are in care.

Correction Required: The facility shall have an emergency plan that provides for accommodations for infants, toddlers, children with disabilities, and children with chronic medical conditions.

Regulation: 3270.27(d)

Description: Plan posted

Noncompliance Area: At the time of the renewal inspection the certification representative observed that the facility did not have the emergency plan posted in a conspicuous location.

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

Regulation: 3270.27(e)

Description: Letter to parents

Noncompliance Area: At the time of the renewal inspection the certification representative observed that the parents of the facility were not provided with a letter explaining the emergency plan.

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: 3270.32(a)

Description: Comply with CPSL

Noncompliance Area: At the time of the renewal inspection the certification representative observed that staff #1 had a child abuse clearance, dated 9/28/18 and mandated reporter training, dated 11/2018; that were more than 60 months old. The DHS FBI clearance was not in the staff file for staff #2.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). SAFETY PLAN: The operator is required to submit to the Children and Youth Agency a plan of supervision or alternate arrangement as required by the Child Protective Services Law. LACKING REQUIRED HIRING DOCUMENTS: Facility Person # -- may not work in a child care position at the facility.

Regulation: 3270.82(h)

Description: Handwashing signs

Noncompliance Area: At the time of the renewal inspection the certification representative observed that the bathrooms and classroom sinks did not have a handwashing sign that stated, "A facility person and an able child shall wash his hands after toileting and before eating."

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: 3270.113(c)/3270.113(d)

Description: No ridicule or threaten harm/No harsh language

Noncompliance Area: As a result of complaint investigation conducted on 1/26/23, it was verified by DHS- Cert Rep that staff person #1 use harsh demeaning language towards the children in care. In addition, staff person #1 while yelling at the child called him a "simpleton".

Correction Required: A facility person may not single out the child for ridicule, threaten harm to the child or the child's family and may not specifically aim to degrade the child or the child's family. A facility person may not use harsh, demeaning or abusive language in the presence of children.

Noncompliance Area: AN UNANNOUNCED INSPECTION WAS CONDUCTED, THE FOLLOWING WAS OBSERVED: THE INFANT/ TODDLER ROOM WAS VERY DARK. AND ALTHOUGH IT WAS NAPTIME, THE LACK OF LIGHTING PREVENTED THE ABILITY TO SEE THE CHILDREN WHOM WERE SCATTERED AROUND THE ENTIRE CLASSROOM FLOOR. A YOUNG TODDLER CHILD WAS ASLEEP IN A CORNER WITH HIS BLANKET WRAPPED AROUND HIS FACE AND NECK. DURING THIS TIME STAFF PERSON #1 WAS ASLEEP (LOUDLY SNORING ) NEXT TO THE CHILD. IN ADDITION, STAFF IN THE ROOM WERE UNABLE TO PROVIDE SPECIFIC CHILDREN THAT THEY WERE RESPONSIBLE FOR WHEN ASKED.

Correction Required: ALL CHILDREN ON THE PREMISES MUST BE SUPERVISED AT ALL TIMES. 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: AN UNANNOUNCED INSPECTION WAS CONDUCTED, THE FOLLOWING WAS OBSERVED: THE INFANT/ TODDLER ROOM WAS VERY DARK. AND ALTHOUGH IT WAS NAPTIME, THE LACK OF LIGHTING PREVENTED THE ABILITY TO SEE THE CHILDREN WHOM WERE SCATTERED AROUND THE ENTIRE CLASSROOM FLOOR. A YOUNG TODDLER CHILD WAS ASLEEP IN A CORNER WITH HIS BLANKET WRAPPED AROUND HIS FACE AND NECK. DURING THIS TIME STAFF PERSON #1 WAS ASLEEP (LOUDLY SNORING ) NEXT TO THE CHILD. IN ADDITION, STAFF IN THE ROOM WERE UNABLE TO PROVIDE SPECIFIC CHILDREN THAT THEY WERE RESPONSIBLE FOR WHEN ASKED. THESE CONDITIONS POSED 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: DURING AN UNANNOUNCED INSPECTION THE LIGHTING IN THE INFANT/ TODDLER ROOM AND THE PRESCHOOL ROOM LACKED SUFFICIENT LIGHTING TO SEE THE CHILDREN IN ALL AREAS OF THE ROOM WHILE NAPPING.

Correction Required: Rooms, hallways, stairways, outside steps, porches and ramps shall be lighted by artificial or natural light.

Noncompliance Area: ON 12/14/18 RENEWAL INSPECTION, NEWLY HIRED (11/2018) STAFF PERSONS #1, AND #2 DID NOT HAVE A HEALTH ASSESSMENT PRIOR TO PROVIDING DIRECT CARE TO CHILDREN.

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: OF THE 10 STAFF FILES REVIEWED, 6 STAFF QUALIFIED AS AIDES AND PROVISIONAL HIRES. STAFF WERE LACKING IN THE QUALIFICATIONS FOR THE POSITION FOR WHICH THEY WERE HIRED/ AND OR PERFORMING. EDUCATION AND EXPERIENCE FOR NEW HIRES WERE NOT VERIFIED BY THE OPERATOR.

Correction Required: 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: ON 12/14/18 RENEWAL INSPECTION, OF THE 10 STAFF FILES, 6 STAFF QUALIFIED AS AIDES/ PROVISIONAL HIRES. STAFF WERE LACKING IN THE QUALIFICATIONS FOR THE POSITION FOR WHICH THEY WERE HIRED/ AND OR PERFORMING. EDUCATION AND EXPERIENCE FOR NEW HIRES WERE NOT VERIFIED BY THE OPERATOR/ PROVIDER.

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. At least 50% of the staff persons in a facility shall be individuals qualified and functioning as directors, group supervisors and assistant group supervisors. No more than 50% of the staff persons may be of aide qualification level.

Noncompliance Area: ON 12/14/18 RENEWAL INSPECTION THE CARPET, TILE FLOORING AND AREA RUGS THROUGHOUT THE FACILITY WAS IN DISREPAIR AND VERY DIRTY. THE TILE FLOORING AND BASEBOARDS IN THE BASEMENT BATHROOMS WERE DAMAGED. A DIAPERING PAD WAS IN DISREPAIR. THE P/S KITCHEN AREA CONTAINED LEFT OVER FOOD AND CRUMBS, DRIED UP STAINS FROM FOOD AND DRINKS WERE SPLATTERED ON APPLIANCES, COUNTER AND FLOOR SURFACES.

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

Noncompliance Area: At the time of the inspection (approximately 10:15 AM) child #1 had been diapered by staff #1. The child's hands were not washed.

Correction Required: A staff person shall ensure that a child's hands are washed before meals and snacks, after toileting and after being diapered.

Noncompliance Area: At the time of the inspection the record of staff member #2 was lacking in the two written, nonfamily 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: At the time of the inspection the records of staff members 1, 2, 3, 4 and 5 Were lacking in the qualifications for the position they hold. Education was not verified nor was Child care experience verified by the provider.

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: At the time of the inspection the total number of staff was 9 and 5 of which are identified as aides/provisional hires.

Correction Required: At least 50% of the staff persons in a facility shall be individuals qualified and functioning as directors, group supervisors and assistant group supervisors. No more than 50% of the staff persons may be of aide qualification level.

Noncompliance Area: At the time of the inspection from approximately 8:15 to 8:35 AM there were a total of 23 children in care with 3 staff members providing care. The group included one infant (child #1) and at least 3 younger toddlers.

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).