Treasured Tots Day Care

Regulation: 3280.131(b)(2)

Description: Toddler/preschool: updated health report every 12 months

Noncompliance Area: It was observed that child #1 did not have an updated health assessment on file. The health assessment was dated 02/2023.

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.

Regulation: 3280.76

Description: Building Surfaces

Noncompliance Area: It was observed that there was peeling paint on the back wall. (Corrected on site.)

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: 3280.123(a)(7)

Description: Services considered extra

Noncompliance Area: The agreements of child #1 through #5 do 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: 3280.124(f)

Description: Updated every 6 months

Noncompliance Area: The emergency contact information of child #1 through child #5 was not updated once in a 6-month period ( most current update 7/6/23, 4/18/24, 11/3/18, 12/12/23, 1/31/24 respectively).

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.

Regulation: 3280.131(d)(5)

Description: Immunization record

Noncompliance Area: Child #2's record did not contain proof of obtaining the required immunizations based upon the child's age (only 8/4/22 for Hep B, Rotavirus, DTAP, HIB, Pneumococcal, and Polio). See Code Sheet

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

Regulation: 3280.32(a)

Description: Comply with CPSL

Noncompliance Area: Staff person #1's time between PA State Police clearances and FBI clearances exceeded the permitted 60 months' timeframe (2/13/19, 1/14/25).

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

Regulation: 3280.67(d)

Description: Contaminated trash in closed plastic-lined receptacle

Noncompliance Area: It was observed that the trashcan in the children's bathroom was not plastic-lined. (corrected during inspection).

Correction Required: Trash that has been contaminated by human secretions or excrement shall be contained in closed, plastic-lined receptacles.

Regulation: 3280.75(c)

Description: Has all items

Noncompliance Area: It was observed that the first aid kit did not contain gloves (corrected during inspection).

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: 3280.77(a)

Description: No peeling paint or plaster

Noncompliance Area: It was observed that there was one 3 inch spot of peeling paint and three 1 inch spots of peeling paint under the mirror mounted on the wall (corrected during inspection).

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

Regulation: 3280.94(a)(5)

Description: Evacuation routes posted

Noncompliance Area: It was observed that evacuation routes were not posted in a conspicuous location on each floor of the facility (corrected during inspection).

Correction Required: The primary staff person 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: 3280.95(b)

Description: Staff responsibility

Noncompliance Area: The time between testing of the fire detection system exceeded the permitted at least every 30 days' timeframe (10/11/24, 11/11/24), (12/11/24, 1/11/25), (1/11/25, 2/11/25).

Correction Required: The primary staff person or designated staff person who is responsible for compliance with this chapter shall ensure the requirements in subsection (a) are met.

Regulation: 3280.151(a)

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

Noncompliance Area: It was observed at the time of inspection staff #1's last health assessment was completed on 4-13-21 and staff #2's health assessment was completed on 4-7-21.

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: 3280.124(b)(7)

Description: Name/address/phone release person

Noncompliance Area: Emergency contact form for child number 1 and number 2 did not contain complete addresses for release persons. Addresses on both Emergency contact forms had the street name and number but did not contain a city, state, or zip code.

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: 3280.131(d)(5)/3280.131(e)(2)(i)

Description: Immunization record/Exemption documentation from parent/guardian

Noncompliance Area: Health report for child number 2 did not contain record of any immunizations. Mother told the operator she is not getting the child immunized, however no immunization exemption form was on file.

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

Regulation: 3280.26(a)(5)

Description: Emergency plan

Noncompliance Area: Emergency Plan on file did not provide any accommodations for infants, toddlers, children with disabilities or children with chronic medical conditions.

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: 3280.32(a)/3280.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: It was observed at the time of inspection that staff #1 and staff #2 did not have their National Sex Offender Registry Clearance on file as required.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). Staff#1 and staff #2 may not work in a child care position until complete clearances are obtained. 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: It was observed that a pack and play was not labeled for the use of a specific child. It was also observed that nap mats were not labeled for the use of a specific child and only used by that specific child. Corrected on site.

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: It was observed that there was not 2 feet of space on three sides of rest equipment during nap time.

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: It was observed and verbalized by a Facility Person that children were not taken out doors daily when weather permits.

Correction Required: Weather permitting, children shall be taken out doors daily.

Noncompliance Area: Parents did not receive the original agreements. Original agreements were in child files.

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

Noncompliance Area: The emergency contact information on file for Child #3 did not include the address 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 emergency contact information for Child #1 did not include the work address or work phone number for the enrolling parent.

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

Noncompliance Area: The emergency contact information for Child #2 did not include a health insurance/MA 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 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.

Noncompliance Area: The health assessment for Child #2 did not include a statement that age-appropriate screenings were conducted since the time of the previous health report.

Correction Required: A health report shall include a statement that age-appropriate screenings recommended by the American Academy of Pediatrics were conducted since the time of the previous health report required by this section.

Noncompliance Area: The files for Child #4 and #5 did not include documentation to support that the child was administered an Influenza immunization within the last year in accordance to the recommendations of ACIP. Child #4 last Influenza immunization was dated 10/21/2016. Child #5 last Influenza immunization was dated 11/9/2018.

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: It was observed that during lunch time children were not served a dairy product. Cheese was served as a protein.

Correction Required: A lunch or dinner prepared at the facility for children of toddler age or older shall include at least one dairy product.

Noncompliance Area: It was observed that food servings were not an adequate portion size suitable for the size and age of children in care. Children were provided one baby carrot and one slice of mandarin orange. Children under the age of 4 were given raw, whole baby carrots which is a choke hazard.

Correction Required: Food servings shall be portioned suitably for the size and age of the children in care. Additional food in reasonable amounts shall be made available to children upon the request of the parent or child.

Noncompliance Area: There was not a full file for related children in care and enrolled at the facility.

Correction Required: An operator shall establish and maintain an individual record for each child enrolled in the facility.

Noncompliance Area: The child files did not include emergency contact information and financial agreements that were updated once in a 6-month period.

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 child files did not contain copies of reports of accidents injuries or illnesses involving the child in care at the facility. The facility also did not retain an accident file of reports of accidents injuries or illnesses involving children in care at the facility.

Correction Required: A child's record must 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: The file for Facility Person #1 and #2 did not have documentation of current first aid training. First aid training expiration date was 8/15/19.

Correction Required: Competence in first-aid is demonstrated by the completion of training by a professional in the field of first-aid. First-aid training shall be renewed on or before expiration of certification or every 3 years, as applicable.One or more facility persons competent in first-aid techniques shall be at the facility when one or more children are in care.

Noncompliance Area: The file for Facility Person #1 did not include a signed disclosure statement.

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

Noncompliance Area: It was observed that there was no protective receptacle cover on an electrical outlet in the Kitchen next to the refrigerator.

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

Noncompliance Area: It was observed that hand sanitizer was accessible to children in the play room and bathroom. It was observed that colognes and other sprays were accessible to children in the bathroom. It was also observed that a spray bottle containing cleaning liquid was unlabeled in the playroom.

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 kept in a locked area or in an area inaccessible to children, and shall be stored away from food, food preparation areas and child care spaces.

Noncompliance Area: It was observed that knives were on a low shelf beside the hand washing sink accessible to children in the kitchen area. It was observed that adult scissors were in a low drawer next to the hand washing sink accessible to children. It was observed that a cord with exposed wires was hanging from the ceiling in the playroom in reach of children. It was also observed that a ceiling tile above the refrigerator was out of place and hanging down, posing a potential hazard.

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 the visit the provider did not allow for the weapons, firearms and ammunition storage requirements to be verified.

Correction Required: If the facility is located in a residence, weapons and firearms shall be contained in a locked cabinet.If the facility is located in a residence, ammunition shall be contained in a locked area separate from weapons and firearms.

Noncompliance Area: Plastic outdoor play equipment was observed weathered and cracked. Pinch points, rough edges observed.

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: Child#4 Did not have a current health assessment on file.

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: Staff person #1(last 4/16) and #2(last 5/16) did not have valid 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.

Noncompliance Area: Toddler area fencing was removed allowing access to the mulched surfaced playground. In addition the toddler play area was being used as storage and stacked with outside play equipment. Play space was not in useable order as intended for playing.

Correction Required: If unsafe areas or conditions are in or near an outdoor play space, fencing or natural barriers are required to restrict children from those unsafe areas or conditions.

Noncompliance Area: Small toy figures small enough to fit into a choke testing tube and is less than one inch in diameter were found among play toys. Toys played by mixed ages of children to include children that may be putting small objects in the mouth.

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: A child's epi-pen was on the refrigerator. There was no label on medication with child's name of who it is intended for (epi-pen) .

Correction Required: A prescription or nonprescription medication may be accepted only in an original container. The medication shall remain in the container in which it was received. 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: Staff person #2 working as substitute staff does not have valid health assessment and TB test on record.

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: Could not verify clearly that staff person #1 had a valid TB test. Writing was unclear on staff health form.

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.

Noncompliance Area: No verification that provider reviewed and document aa annual review of site emergency plan. Staff in facility did not have documented verification of emergency plan training.

Correction Required: The operator shall review the emergency plan at least annually and update the plan as needed. The operator shall document in writing each review and update of the emergency plan and kept on file at the facility. 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.

Noncompliance Area: Staff #1,#2,#3 did not have six hours of annual childcare training on record.

Correction Required: A staff person shall obtain an annual minimum of 6 clock hours of child care training.

Noncompliance Area: Staff person #1 did not have a current FBI clearance in her file.

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.

Noncompliance Area: Provider could not provide the most current records of fire drill. Provider could not find the fire drill log.

Correction Required: A written record shall be kept of the date, the time of day, the hypothetical location of the fire, the evacuation time, the names of facility persons and the number of children participating in the fire drill.

Noncompliance Area: Provider did not have written documention that the site Emergency plan was reviewed on annual basis by provider. To ensure changes and updates are made to plan if needed.

Correction Required: The operator shall review the emergency plan at least annually and update the plan as needed. The operator shall document in writing each review and update of the emergency plan and kept on file at the facility.

Noncompliance Area: Provider staff person #1 had not provided verified documeted training record that staff #2-4 had been provided training on the site emergency plan.

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.

Noncompliance Area: Staff #1-4 in facility did not have valid first aid training on file.

Correction Required: Competence in first-aid is demonstrated by the completion of training by a professional in the field of first-aid. First-aid training shall be renewed on or before expiration of certification or every 3 years, as applicable.

Noncompliance Area: Liquid bleach and bleach cleaning wipes were being stored in location were food was also stored.

Correction Required: Cleaning materials and other toxic materials shall be used in a way that does not contaminate play surfaces, food, food preparation areas and does not constitute a hazard to the children.