Tiny Tot Child Development Center

Regulation: 3270.131(a)/3270.182(1)

Description: Health information/Initial and subsequent health reports

Noncompliance Area: The child file for Child #2, who is a preschool age child, was observed to not contain documentation of an initial health report within 60 days of enrollment (See IS CODE SHEET). An initial health report dated 9/2/22 is on file.

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.

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

Description: Immunization record/Dismissal policy

Noncompliance Area: The file for Child #1, who is an older toddler, was observed to contain an immunization record that lacked the second required dose of Hep A in accordance with the schedule recommended by the ACIP.

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 child care group settings). Child #1 must be dismissed from care by close of business 3/1/23 and may only return to care when the immunization record is updated or when a parent provides a written, signed exemption letter.

Regulation: 3270.131(e)(1)/3270.182(1)

Description: Exemption documentation from parent/guardian/Initial and subsequent health reports

Noncompliance Area: The file for Child #1, who is an older toddler, was observed to contain an immunization record that lacked the second required dose of Hep A in accordance with the schedule recommended by the ACIP. The file for Child #2, who is a preschool age child, was observed to contain an immunization record that lacked the two-dose vaccination of Hep A 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. A child's record shall contain initial and subsequent health reports.

Regulation: 3270.133(3)

Description: Name on bottle

Noncompliance Area: In the Koalas Room, an Equate Childrens Cetirizine bottle was observed to lack the name of the child for whom the medication is intended for.

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: 3270.14/3270.21

Description: Pertinent Laws & Regulations/General Health and Safety

Noncompliance Area: The facility emergency plan lacked information regarding volunteer emergency preparedness.

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: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: The file for Staff person #1 was observed to lack documentation of having applied for and received a State sex offender check and State criminal background check, and the State child abuse and neglect registry from the States in which they resided in within the previous five years as required by the Child Protective Service Law (CPSL). The file for Staff person #2 was observed not to contain documentation of application of a State Police clearance prior to date of hire required for provisional hiring under the CPSL; A State Police clearance dated 2/18/22 is on file. (See IS CODE SHEET)

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. Staff Person #1 may not work in a childcare position at the facility.

Regulation: 3270.27(c)/3270.192(2)(iii)

Description: Training regarding plan/Exp, educ., training at facility

Noncompliance Area: The file for staff #1 and staff #2 had an emergency plan training date of 7-7-2020 and 7-9-2021 which exceeded the mandatory training date of 7-7-2021.

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.

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

Description: Age and Training

Noncompliance Area: The file for staff #3 contained a Pediatric First Aid/CPR training date of 10-7-2019 and 12-11-2021 which exceeded the mandatory training date of 10-7-2021.

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.

Noncompliance Area: It was observed that Staff person #3 and staff person #4 were escorting children between classroom 4 and the bathroom. After escorting 3 children in the hallway and transitioning them to Staff person #4, who entered the bathroom with the children, Staff person #3 went into classroom 4. It was then observed that a preschool aged child exited classroom 4 and was unsupervised in the hallway as the child walked from the classroom to the bathroom.

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.

Noncompliance Area: Child #1, child #2, and child #3 had immunization records that lacked a current influenza vaccination as 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: Staff person #1, with a documented start date with children of 11-26-19, had an FBI clearance dated 12-5-19 and no proof of having applied for the clearance prior to working with children as a provisional hire. Staff person #2, with a documented start date with children of 11-20-19, had a NSOR verification that was dated 11-21-19 and no proof of having applied for the verification prior to working with children as a provisional hire.

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

Noncompliance Area: A large gym mat that was attached to the wall with Velcro adhesive was coming detached from the wall causing there to be damaged paint on the wall in the gross motor room.

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

Noncompliance Area: The toilet seat in Room 2 was not installed properly causing there to be a gap between the toilet seat and the toilet bowl.

Correction Required: Toilet areas and fixtures shall be cleaned daily and be in good repair.

Noncompliance Area: There was a standing fan with spinning blades on which there was no protective screen covering the plastic grate cover thereby allowing access to the spinning blades.

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

Noncompliance Area: The garbage can by the diapering table in the infant room was 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 hot water temperature in the sink in the infant room measured 139.4 degrees F.

Correction Required: Hot water temperature, in areas accessible to children, may not exceed 110 F.

Noncompliance Area: Child #1 had a previous health assessment dated 11-16-17 and a current health assessment dated 1-7-19.

Correction Required: The operator shall require the parent to provide an updated health report at least every 12 months for an older toddler or preschool child.

Noncompliance Area: There was no hand washing sign by the sink in the kitchen.

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.

Noncompliance Area: There was a wooden stool in Room 5 that had loose screws causing the stool to be unstable.

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

Noncompliance Area: There was cheese and yogurt in a child's lunch box in the cubby area in Room 5 that was not being refrigerated.

Correction Required: Potentially hazardous food brought from the child's home or provided by the facility shall be refrigerated.

Noncompliance Area: One of the two doors in Room 5 was obstructed with toys, materials, and a large closet.

Correction Required: Stairways, hallways, exits from rooms, exits from the facility and other means of egress serving as an exit shall be unobstructed.

Noncompliance Area: There was a shape sorter in Room 2 on which there was a foam top that had bite marks and a small chunk breaking off of it. There was a foam tube taped to the bottom of the outdoor fence on which pieces of foam were breaking off and were accessible to children on the ground.

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: There were 2 wooden child sized chairs in Room 4 on which the legs and sides were wobbly and unstable,

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

Noncompliance Area: There was a diaper cream in Room 2 that was not labeled with the intended user's name.

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: There was a container of diaper cream in a child's back pack accessible to children in the cubby area of Room 3.

Correction Required: Medication shall be stored in a locked area of the facility or in an area that is out of the reach of children.

Noncompliance Area: There were expired diaper creams in Room 3 and in Room 2.

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

Noncompliance Area: Staff person #1, with a documented start date with children of 1-30-17, had a state police clearance dated 1-31-17 and proof that the clearance was not applied for until 1-31-17 which was after the staff person's start date.

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

Noncompliance Area: There were uncovered outlets accessible to children on a power strip on a ledge near the sink in the rear of Room 3.

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

Noncompliance Area: There was plastic lattice covering an air conditioning unit on the outdoor playground on which there was a crack causing the lattice to pull away from the frame and allowing pinch points to be accessible to the children.

Correction Required: Floors, walls, ceilings and other surfaces, including the facility`s outdoor play space surfaces shall be kept clean, in good repair and free from visible hazards.

Noncompliance Area: In Room #3A, a sleep mat was observed in the child care area. Staff members acknowledged that the mat was being used for any child who wanted to rest when it was not nap time. They also acknowledged that the mat was not sanitized after individual children had used it.

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 file for child #3 did not include the work address of the enrolling parent on the emergency contact form.

Correction Required: Emergency contact information must include the home and work addresses and telephone numbers of the enrolling parent.

Noncompliance Area: The file for child #2 did not include the address for a release person on the emergency contact form.

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 #1 did not include a statement that the child is able to participate in child care and appears to be free from contagious or communicable disease.

Correction Required: A health report shall include a statement that the child is able to participate in child care and appears to be free from contagious or communicable disease.

Noncompliance Area: In the stairwell, on route to the upstairs napping area, there were aluminum framing borders which were protruding into the walkway which could cut children as they walk by. In the stairwell, on route to the upstairs napping area, there were two long 2x4's which were propped up against the wall which could tip over and fall n the children as they walk by.

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

Noncompliance Area: In the stairwell on route to the upstairs napping area, there were cans of paint and stain, mortar, and caulking available to children. In Room #3B, a bag of Miracle Grow was observed on a window ledge that was accessible to 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.