The Learning Tree Schools

Noncompliance Area: The front and rear classrooms lacked posted written plans of daily activities that address the needs of the children receiving care in those rooms. The schedules currently posted are not intended for the age groups receiving care in the rooms on the day of the inspection.

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. The written plan of daily activities shall be posted in the group space.

Noncompliance Area: The file for child #2 contained an agreement which was not signed by the operator or the parent.

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

Noncompliance Area: The file for child #2 contained an agreement which did not specify the child's arrival and departure times.

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

Noncompliance Area: The files for child #1 and child #2 contained original agreements.

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

Noncompliance Area: The file for child #1 contained emergency contact information which 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.

Noncompliance Area: The files for child #2 and #4 contained emergency contact information that did not include the name, address and telephone number 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.

Noncompliance Area: The file for child#2, enrolled for more than 60 days, did not contain a health report. The health report was due prior to the suspension of the regulation due to COVID 19.

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.

Noncompliance Area: Expired medication was observed in the older toddler room. A Ventolin inhaler intended for child #3 expired 4/2020. Motrin intended for child #5 expired 2/2020.

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

Noncompliance Area: The following medication, intended for child #3, was observed in the older toddler room and lacked written parental consent; Motrin, liquid allergy medicine, and a Ventolin inhaler.

Correction Required: A parent shall provide written consent for administration of medication or a special diet.

Noncompliance Area: The file for staff #5 contained a health assessment that has not been updated in over 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.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: Based on documentation at the facility, staff #2 and #5 did not update their mandated reporter training within 60 months as required. Both staff completed the training on 4-23-15 and updated it on 8-25-20.

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 #1, with a start date of 1-28-20, contained an NSOR certificate obtained on 2-12-20. The file for staff #2 contained a state police clearance that was not updated within 60 months as required. The clearance was previously obtained on 2-26-15 and updated on 8-25-20.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). A facility person's record shall include a copy of requests for the criminal history record and child abuse registry clearance information, a copy of the disclosure statement and a copy of the completed clearance information required under the CPSL.

Noncompliance Area: The files for staff #2, #3, #5, and #6 did not contain evaluations completed within the past 12 months. The last evaluations were completed on 6-19-19.

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: The file for staff #4, designated as an assistant group supervisor, did not contain valid verification of 2 years of experience with children.

Correction Required: An assistant group supervisor shall have a high school diploma or a general educational development certificate and 2 years experience with children.A facility person's record shall include verification of child care experience, education and training prior to service at the facility.

Noncompliance Area: Staff #3, designated as an aide, was observed alone in the infant room caring for 2 children.

Correction Required: An aide or a combination of aides shall be supervised at all times by a staff person qualified at minimum as an assistant group supervisor.

Noncompliance Area: Multiple toxics were observed to be accessible to children on the day of the inspection; multiple cans of paint in an unlocked supply closet in the gross motor space; Comet cleaner, Softscrub, paint and other cleaning materials in an unlocked storage closet in the hall between the office and rear classroom; Spackle and Water Stop Cement in an unlocked storage room in the hall near the restrooms; hand sanitizer on the teacher's desk in the front classroom and on a low shelf in the rear classroom.

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: A cracked plastic swimming pool used for toy storage and a cracked plastic bin storing musical instruments were observed in the older toddler room. Both cracked bins had sharp edges and pinch points.

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: Cracked and splintered wood was observed under the seat of a rocking chair in the infant room.

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

Noncompliance Area: The file for child #1, enrolled on 7/5/18, contained a child service report that was not completed and shared with the parent within 6 months after their first day. The report was dated 2/21/19 and is now current.

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 file for child #3, a preschooler, contained a health report which has not been updated for over 12 months.

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

Noncompliance Area: The file for child #2 contained an immunization record which lacked documentation of receiving the influenza vaccine within the last 12 months. The file for child #3, a 3 yr old, contained an immunization record which lacked documentation of receiving the 4th dose of DTAP, the influenza vaccine within the last 12 months, the MMR vaccine, the varicella vaccine, and the hepatitis A vaccine.

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 #1 contained clearances which were not updated within the required 60 month period. Staff person #1 worked in a child care position at the facility without valid and current clearances. The initial state police clearance for staff #1 was obtained on 6/2/14 and renewed on 6/10/19. The initial child abuse clearance for staff #1 was obtained on 5/28/19 and renewed on 6/19/19.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). A facility person's record shall include a copy of requests for the criminal history record and child abuse registry clearance information, a copy of the disclosure statement and a copy of the completed clearance information required under the CPSL.

Noncompliance Area: Allergy relief medicine, which expired in 4/19, was observed in the older toddler room. The medicine was labeled for child #1.

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

Noncompliance Area: Motrin, which lacked written parental consent for administration, was observed in the older toddler room. The medicine was labeled for child #2.

Correction Required: A parent shall provide written consent for administration of medication or a special diet.

Noncompliance Area: The file for child #1 contained child service reports which were not completed at least once in a 6 month period. The reports were completed on 1-26-17 and again on 6-28-18. The most recent report on file for child #1 is current. The file for child #4 contains a child service report completed on 12-12-17. No other reports were on file for child #4.

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 file for child #3 contains emergency contact information which does not include a 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: The file for child #3 contained an initial health report that was conducted more than 60 days after the first day of attendance at the facility. The most recent health report on file for child #3 is current.

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 child's record shall contain initial and subsequent health reports.

Noncompliance Area: Based on statements made by staff, able bodied young toddlers are using hand sanitizer or baby wipes in place of hand washing after being diapered.

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: In the older toddler room, the hands-free can is not functioning. In the young toddler room, diapers are being thrown away in a trash can that is not hands-free.

Correction Required: If disposable diapers are provided by a parent or by a facility, a soiled diaper shall be discarded by immediately placing the diaper into a plastic-lined, hands-free covered can.

Noncompliance Area: The diaper changing pad used in the younger toddler room had absorbent cloth sides, approximately 4 inches wide on each side, with a plastic portion down the center. Based on statements made by staff, only the plastic center is sanitized after diaper changes. The cover is not removed or replaced after diaper changes.

Correction Required: Diaper changing surfaces shall be cleaned after each use by wiping the surface with a sanitizing solution or by changing a pad or other surface covering.

Noncompliance Area: Based on statements made by staff, staff in the young toddler room are using hand sanitizer after diapering in place of washing hands.

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

Noncompliance Area: Mold was observed on bagels stored in the bottom right drawer of the refrigerator in the kitchen.

Correction Required: Food stored, prepared or served shall be clean, wholesome, free from spoilage, free from adulteration and safe for human consumption.

Noncompliance Area: The file for child #2 contained emergency contact information and an agreement which were not reviewed and updated at least once in a 6 month period. The emergency contact information was reviewed on 3-27-17 and again on 3-13-18. The financial agreement was reviewed on 4-30-17, 1-11-18, and again on 3-13-18. Updates to the information for child #2 are now current.

Correction Required: A parent is required to review and update the emergency contact information and the financial agreement at least once in a 6-month period or as soon as there is a change in the information.

Noncompliance Area: The file for staff #1, designated as an aide, lacked documentation of obtaining a high school diploma.

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

Noncompliance Area: At the time of the inspection, the facility's indoor play space was being used for storage and did not provide space for running, jumping, climbing, or riding.

Correction Required: A facility shall provide outdoor or indoor play space to be used for large muscle activity which includes running, jumping, climbing and riding.

Noncompliance Area: Cleaning material which lacked a label specifying the contents was observed in the older toddler room, in the cabinet above the sink.

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

Noncompliance Area: The school-age room lacked a means of designating the use of rest equipment for specific children.

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 files for children #1-3, who have been enrolled for more than 6 months, lack child service reports completed using a form approved by the Department.

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 file for child #1, a young toddler at the time of the last exam, contains a health report that has not been updated within the last 12 months.

Correction Required: The operator shall require the parent to provide an updated health report at least every 6 months for an infant or young toddler

Noncompliance Area: Children's Benadryl, which was labeled with the names of two children, was observed in the preschool room. Sunscreen lacking the name of the child for whom it was intended was observed in the preschool room.

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: A prescription Ventolin inhaler which lacked written parental permission for its use was observed in the preschool room.

Correction Required: A parent shall provide written consent for administration of medication or a special diet.

Noncompliance Area: Entries in the medication log maintained in the young toddler room did not include the time of administration or initials of the staff person who administered the medication.

Correction Required: A medication log shall include the time of administration. A medication log shall include the initials of the staff person who administered the medication.

Noncompliance Area: At approximately 3:15 PM, staff #1 was observed changing a child's diaper. Staff did not ensure the child washed hands after the diaper change or before sitting down and beginning to eat. Staff #1 did not wash hands after changing the child's diaper or prior to initiating the diaper change of another child in care.

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

Noncompliance Area: Expired Gerber Oatmeal Cereal was observed in the infant room.

Correction Required: Food stored, prepared or served shall be clean, wholesome, free from spoilage, free from adulteration and safe for human consumption.