The Gingerbread House

Regulation: 3270.123(a)(3)

Description: Services proceeded

Noncompliance Area: At the time of the inspection, the file of child #1 did not include a child service report.

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

Regulation: 3270.123(a)(7)

Description: Services considered extra

Noncompliance Area: At the time of the inspection, the financial agreement of child #1-10 did not specify the services which are to be considered as extra.

Correction Required: An agreement shall specify the services which are to be considered as extra.

Regulation: 3270.77(a)

Description: No peeling paint or plaster

Noncompliance Area: At the time of the inspection, peeled paint was observed in rooms 3 (green wall), 5 (window frame and side wall), 4, 10 & 11 (Imagination wall).

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

Regulation: 3270.133(8)

Description: Special diet - parent's instructions

Noncompliance Area: At the time of the inspection, staff #1 confirmed the special diet plan was not followed for child #1. Staff #1 offered a snack that contains milk.

Correction Required: If a special diet is prescribed for a child and if the diet is administered to the child, written instructions and the parent's written consent shall be retained in the child's file.

Regulation: 3270.124(b)(1)

Description: Child's name, birth date

Noncompliance Area: At the time of the inspection, the file of child #1 did not include the birth date on the emergency contact. Non-compliance was corrected on site.

Correction Required: Emergency contact information must include the name and birth date of the child.

Regulation: 3270.124(b)(4)/3270.182(3)

Description: Written consent/Consent for emergency medical care required prior to admission

Noncompliance Area: At the time of the inspection, the file of child #2 did not include written consent signed by parent for emergency medical care.

Correction Required: Emergency contact information must include the written consent signed by a parent for emergency medical care. A child's record shall contain signed parental consent for emergency medical care for the child. Written consent is required prior to admission.

Regulation: 3270.131(b)(2)/3270.182(1)

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

Noncompliance Area: At the time of the inspection, the health assessment of child #2 was dated 5/13/24.

Correction Required: The operator shall require the parent to provide an updated health report at least every 12 months for an older toddler or preschool child. A child's record shall contain initial and subsequent health reports.

Regulation: 3270.182(5)

Description: Consent for administration of minor first-aid required prior to admission

Noncompliance Area: At the time of the inspection, the file of child #2 did not include a signed parental consent for administration of minor first-aid procedures.

Correction Required: 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.

Regulation: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: At the time of the inspection, the file of staff #1 include an NSOR clearance dated 1/22/20, the file of staff #2 included an NSOR clearance dated 1/16/20 and the file of staff #3 included an NSOR clearance dated 1/13/20.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). LACKING REQUIRED HIRING DOCUMENTS: Facility Person #1, #2, and #3 may not work in a child care position at the facility until completed NSOR results are obtained. A facility's person record shall include a copy of the completed clearance information required under CPSL.

Regulation: 3270.65

Description: Protective Outlet Covers 5 yrs. or less

Noncompliance Area: At the time of the inspection, an uncovered electrical outlet was observed in the infant room and room #9. Non-compliance was corrected on site.

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

Regulation: 3270.66(a)

Description: Locked or inaccessible

Noncompliance Area: At the time of the inspection, in room #5 diaper cream was observed in a location accessible to children. Non-compliance was corrected on site.

Correction Required: Cleaning materials and other toxic materials shall be kept in an area or container that is locked or made inaccessible to children.

Regulation: 3270.75(c)

Description: Has all items

Noncompliance Area: At the time of the inspection, the first aid kit in the pavilion did not include a tweezer. Non-compliance was corrected on site.

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: At the time of the inspection, the playground chain linked fence had wires protruding at the bottom. The chain link fence at the corner had a break in the fence line, preventing a continuous, connected structure.

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: 3270.124(a)/3270.124(b)(2)

Description: Each child emergency contact person/Physician name, address, phone

Noncompliance Area: During the renewal inspection conducted on 5/16/24 child # 1 and 2 file did not include individual emergency contact form. The shared emergency contact for did not include physicians' information.

Correction Required: Emergency contact information is required for each enrolled child. Emergency contact information must reference who shall be contacted in an emergency. Emergency contact information must include the name, address and telephone number of the child's physician or source of medical care.

Regulation: 3270.151(c)(2)

Description: Mantoux TB

Noncompliance Area: During the renewal inspection conducted on 5/16/24 staff persons 1 through 3 files did not include verification of TB results.

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: 3270.171(c)

Description: Safe routes posted

Noncompliance Area: During the renewal inspection conducted on 5/16/24 it was observed the facility did not have the required safe routes posted in the main lobby.

Correction Required: Written notification of safe routes shall be posted by the operator at a conspicuous location in the child care facility.

Regulation: 3270.192(5)

Description: Two written references

Noncompliance Area: During the renewal inspection conducted on 5/16/24 staff person#4 file included one reference letter .

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: 3270.94(a)(5)

Description: Evacuation routes posted

Noncompliance Area: During the renewal inspection conducted on 5/16/24 it was observed the facility did not have evacuation routes posted in the main lobby.

Correction Required: The Director or designated staff person who is responsible for compliance with this chapter shall conduct fire drills and ensure that evacuation routes are posted in a conspicuous location on each floor of the facility.

Regulation: 3270.131(a)(3)

Description: Initial health report for older toddler/preschool no more than 1 year

Noncompliance Area: During the renewal inspection on 6/7/23 it was observed that the health record for child #1 was not dated to show when health assessment was completed.

Correction Required: The initial health report for an older toddler or preschool child shall be dated no more than 1 year prior to the first day of attendance at the facility.

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

Description: ACIP recommended immunization record /Dismissal policy

Noncompliance Area: During the renewal inspection on 6/7/23 it was observed that child #1, and child #2 were missing immunizations in accordance with the recommendations of the ACIP. Child #1 missing Hep B and child #2 missing Hep A immunizations.

Correction Required: The facility may not accept or retain an infant 2 months of age or older, a toddler or a preschool child at the facility for more than 60 days following the first day of attendance at the facility unless the parent provides written verification from a physician, physician's assistant, CRNP, the Department of Health or a local health department of the dates (month, day and year) the child was administered immunizations in accordance with the recommendations of the ACIP. The facility shall implement dismissal policies in accordance with the Department of Health regulation in 28 Pa. Code § 27.77 (relating to immunization requirements for children in child care group settings).

Regulation: 3270.113(b)

Description: No physical punishment

Noncompliance Area: During the complaint inspection on 12/6/22, video footage was viewed, and it was observed that staff person #1 grabbed multiple children at different times by the arm, by their clothes, and shook and pushed them in what appeared to be an aggressive manner.

Correction Required: A facility person may not use any form of physical punishment, including spanking a child.

Regulation: 3270.131(e)(2)(i)/3270.131(e)(4)

Description: Exemption documentation from parent/guardian/Annual immunization reporting to DOH

Noncompliance Area: During the renewal inspection on 7/12/22, it was observed that the records of child #1 and child #2 did not include the annual influenza vaccine as recommended by the Department of Health or the exemption from immunization letter.

Correction Required: Exemption from immunization for religious belief or strong personal objection equated to a religious belief shall be documented by a written, signed and dated statement from the child's parent or guardian. The statement shall be kept in the child's record. The facility shall comply with the annual immunization reporting requirements in accordance with the Department of Health regulation in 28 Pa. Code §27.77.

Regulation: 3270.76

Description: Building Surfaces

Noncompliance Area: During the unannounced inspection on 2/10/22 it was observed that the front door was broken.

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: During a review of the records and upon further investigation, it was confirmed by the doctors office that the health assessment included in staff persons #1 records dated 4/20/19 was not completed by said doctors office

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: During the renewal process and upon further investigation it was confirmed by the doctor's office that the Tuberculosis test dated 1/21/18 included in the records of staff person #2 was not completed by said doctors office.

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, 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: During the previous renewal inspection on 9/10/20 the records of staff person #1 did not include a National Sex Offender Registry Certificate and to date has not received said NSOR certificate.

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

Noncompliance Area: During the renewal inspection on 9/10/20 it was observed that the files of staff person #3 did not include the National Sex Offender Registry Certificate as required under CPSL. -The files of staff person #1, #2, and #4 did not include an updated Mandated Reporter training as required under CPSL-mandated Reporter Training certificates presented expired 7/14/20, 5/18/20 and 7/2/2020 respectively

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

Noncompliance Area: During the renewal inspection on 9/10/20 it was observed that the ceiling in Room 10 (in the refrigerator room) was water stained on multiple ceiling tiles.

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: On 7/25/19 at renewal inspection certification representative observed a ripped couch and chair in room # 4 that had exposed stuffing.

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: On 7/25/19 at renewal inspection certification representative observed that the emergency contact form for child # 1 did not contain the child's health insurance policy number.

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

Noncompliance Area: On 7/25/19 at renewal inspection certification representative observed that the immunization record for child # 2 reflected that the child has not had a flu shot since 2014.

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

Noncompliance Area: On 7/25/19 at renewal inspection certification representative observed that the facility did not have written notification to the local traffic authority of the location of the facility and the facility's use of vehicular and pedestrian routes around the facility.

Correction Required: An operator shall notify local traffic safety authorities annually in writing of the location of the facility and the program's use of pedestrian and vehicular routes around the day care facility.

Noncompliance Area: On 7/15/19 at renewal inspection certification representative observed that the file of staff person # 1, hire date 7/1/19, did not contain receipts for a child abuse clearance or verification that person staff person has been fingerprinted. The file of staff person # 2, hire date 6/27/19, did not contain a receipt for a child abuse clearance. The file of staff person # 3, hire date 6/17/19, did not contain verification that staff person has been fingerprinted and did contain a volunteer PA criminal background check and a volunteer child abuse clearance. The file of staff person # 5, 11/15/07, contained a volunteer PA criminal background check. The file of staff person # 5, hire date 5/30/19, contained a PDE fingerprints.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). PROVISIONAL HIRE UNSUPERVISED: A provisional employee may not be permitted to work alone with children and must work within the vicinity of a permanent employee.

Noncompliance Area: On 7/25/19 at renewal inspection certification representative observed unlabeled bleach and water solution bottles in room # 1 and # 2.

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: On 7/25/19 at renewal inspection certification representative observed staff put a child into a high chair for lunch without washing child's hands. A staff person was observed changing a diaper and then putting the child in a high chair wearing the gloves used for diaper changing.

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

Noncompliance Area: Facility person #1 has mistreated or abused clients/children being cared for in the facility or receiving service from the facility.

Correction Required: Facility person #1 cannot have access to children in the facility. The operator may not allow abuse to occur at the facility.

Noncompliance Area: On 8/31/18, staff person #1 repeatedly grabbed child #1 roughly by the arms and roughly forced her to sit in the time out chair. She left red marks on both of the child's arms. This is recorded on classroom video.

Correction Required: A facility person may not use any form of physical punishment, including spanking a child.

Noncompliance Area: On 8/31/18, around 9am, there was an incident involving staff person #1 roughly grabbing child #1 on the arms and leaving marks. The parents were called and notified that morning. When they arrived at the end of the day to watch the video of the incident, no incident report had been written up and none was provided to them same day.

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.

Noncompliance Area: On 8/31/18, staff person #2, discovered red marks on child #1's arms. She watched the classroom video and saw staff person #1 roughly grab the child by the arms repeatedly and force her into a time out chair. Although the facility immediately told the parents and are not trying to deny it happened, they stated that they were unaware of the CPSL mandated reporting requirements. When they were told by Bucks County C&Y to report it, they did an incident report to OCDEL, thinking that is the same as Childline.

Correction Required: An operator or a staff person who has reason to believe that a child enrolled in the facility has been abused is required to report suspected child abuse to ChildLine as mandated by the CPSL.

Noncompliance Area: ON 6/27/18, TWO EPIPENS WERE OBSERVED IN CHILDREN CUBBY'S ACCESSIBLE TO CHILDREN IN ROOM 9. ADDITIONALLY, A PRESCRIPTION WITH THE NAME OF THE CHILD WAS NOT OBSERVED WITH THE EPIPEN BELONGING TO CHILD #1.

Correction Required: A staff person shall administer a prescription medication only if written instructions are provided from the individual who prescribed the medicine. Instructions for administration contained on a prescription label are acceptable. Medication shall be stored in a locked area of the facility or in an area that is out of the reach of children.

Noncompliance Area: ON 6/27/18, CERTIFICATION REPRESENTATIVE OBSERVED A PRE K CHILD LEAVE THE CLASSROOM BATHROOM AFTER TOILETING WITHOUT BEING INSTRUCTED TO WASH HER HANDS.

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: ON 6/27/18, THE INITIAL HEALTH ASSESSMENT OBSERVED IN THE FILE BELONGING TO STAFF #5 DID NOT CONTAIN THE DATE OF THE TB TEST RESULTS.

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.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.

Noncompliance Area: ON 6/27/18, CERTIFICATION REPRESENTATIVE OBSERVED STAFF #4 CHANGE A DIAPER. STAFF #4 DID NOT WASH HER OWN HANDS AFTER DIAPERING THE CHILD.

Correction Required: A facility person shall wash his hands before meals and snacks, and after toileting and after diapering a child.

Noncompliance Area: ON 6/27/18, A MASTER FILE CONTAINING CHILD ACCIDENT/INJURY REPORTS WAS NOT OBSERVED AT THE FACILITY.

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.

Noncompliance Area: ON 6/27/18, ANNUAL FIRE SAFETY TRAINING WAS NOT OBSERVED IN THE FILES BELONGING TO STAFF #1(HIRED 10/12/15) AND STAFF #2 (HIRED 12/5/13)

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: ON 6/27/18, A CHILD ABUSE CLEARANCE WAS NOT OBSERVED IN THE FILE BELONGING TO STAFF #3 (HIRED 3/26/18). ADDITIONALLY, A COPY OF REQUEST MADE FOR CHILD ABUSE CLEARANCE WAS NOT OBSERVED IN THE FILE BELONGING TO STAFF #3.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). LACKING REQUIRED HIRING DOCUMENTS: Facility Person #3 -- 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.

Noncompliance Area: ON 6/27/18, TWO UNLABELED SPRAY BOTTLES CONTAINING BLEACH AND WATER WERE OBSERVED IN ROOM 11. ADDITIONALLY, CLEANING PRODUCTS WERE OBSERVED UNDER THE BATHROOM CABINET SINK LOCATED IN ROOM 9.

Correction Required: Cleaning materials and other toxic materials shall be kept in an area or container that is locked or made inaccessible to children. 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: ON 6/27/18, A LIDDED WASTE RECEPTICLE WAS NOT OBSERVED IN THE TOILET AREA LOCATED IN ROOM 11, ROOM 9 AND IN THE HALLWAY BATHROOM OUTSIDE OF ROOM 7. ADDITIONALLY, A LIDDED WASTE RECEPTACLE WAS NOT OBSERVED AT THE SINK LOCATED IN ROOM 11, AND THE TWO SINKS LOCATED IN THE CAMP ROOM. HANDWASHING SIGN WAS NOT OBSERVED IN THE BATHROOM LOCATED IN THE CAMP ROOM.

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

Noncompliance Area: During the inspection on 8/17/17 the file record for child #1 did not include the 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.

Noncompliance Area: During the inspection on 8/17/17 the file record for staff person #1 did not include 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: As a result of the investigation on 4/20/17, on 4/6/17 staff person #1 drug child #1 across the room to their sleeping bag and hit their head.

Correction Required: A facility person may not use any form of physical punishment, including spanking a child.