Willow Child Development Center

Regulation: 3270.102(a)

Description: Clean and good repair

Noncompliance Area: There were 4 foam blocks in the Crayfish room that had teeth marks and pieces of foam missing

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.

Regulation: 3270.107

Description: Refrigerator

Noncompliance Area: The thermometer in the refrigerator in the Crayfish room where milk is stored, measured 55° F at the time of the inspection.

Correction Required: A facility shall have an operable, clean refrigerator used to store potentially hazardous foods. The refrigerator shall be capable of maintaining food at 45° F or below. An operating thermometer shall be placed in the refrigerator.

Regulation: 3270.124(b)(7)

Description: Name/address/phone release person

Noncompliance Area: The emergency contact form on file for Child #2 does not include a complete address for all listed release persons.

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: 3270.124(c)

Description: Each child care space

Noncompliance Area: Nine children were observed receiving care in the Crayfish without their emergency contact forms being in the classroom.

Correction Required: When children are in the facility, emergency contact information shall be present in a child care space for children receiving care in the space.

Regulation: 3270.131(d)(7)

Description: Free from contagious/communicable disease

Noncompliance Area: The health assessment on file for Child #1 does not indicate if the child is free from contagious disease and is able to participate in child care.

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.

Regulation: 3270.131(d)(8)

Description: Age appropriate screenings complete

Noncompliance Area: The health assessment on file for Child #1 does not 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.

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.

Regulation: 3270.82(h)

Description: Handwashing signs

Noncompliance Area: There were no handwashing signs at the sinks in Room 108 which the provider has converted from a classroom to a gross motor space.

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: 3270.111(a)

Description: Written plan

Noncompliance Area: There was no written daily activity schedule in Room 101.

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.

Regulation: 3270.123(a)(3)

Description: Services proceeded

Noncompliance Area: The file for Child #2, includes Child Service reports. dated 11.3.23 and 6.6.24, more than 6 months apart.

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: 3270.124(b)(6)

Description: Insurance coverage information

Noncompliance Area: The emergency contact form on file for Child #1 and #3 does not include the policy number for the child's health care 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: 3270.131(a)

Description: Health information

Noncompliance Area: The file for Child #1, with an enrollment date of 8/26/24, which is more than 60 days ago, does not include an initial health report.

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.

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

Description: Immunization record/Dismissal policy

Noncompliance Area: The immunization record on file for Child #1, who is 3 years old, included 1 of 4 HIB vaccines recommended by the ACIP for a child this age; 2 of 4 Pneumococcal vaccines recommended by the ACIP for a child this age; and 1 of 2 Hepatitis A vaccines recommended by the ACIP for a child this age.

Correction Required: ·Child #1 must be dismissed from care by close of business on 2.12.25 and may only return to care when the immunization record is updated or when a parent provides a written, signed exemption letter.

Regulation: 3270.151(a)/3270.192(3)

Description: 12 months prior to service and every 24 months thereafter/Health assessment, TB test

Noncompliance Area: The 2 most recent health assessments on file for Staff person #1 were dated 5.26.22 and 9.30.24, more than 24 months apart.

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.

Regulation: 3270.25(a)

Description: Availability of certificate of compliance and applicable regulations

Noncompliance Area: The Certificate of Compliance posted at the facility was expired as of 7.10.24; the current certificate was not posted.

Correction Required: The facility's current certificate of compliance shall be posted in a conspicuous location used by parents. The operator shall provide the parent of each child enrolled with information on how to access the regulations in this chapter electronically and with instructions for contacting the appropriate regional child care office.

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

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

Noncompliance Area: The most recent training regarding the emergency plan on file for Staff person #1 is dated 5.4.23, more than 1 year ago.

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: 3270.76

Description: Building Surfaces

Noncompliance Area: There was a quarter-sized area on the wall to the left of the closet that had damaged paint and drywall.

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: 3270.77(a)

Description: No peeling paint or plaster

Noncompliance Area: There was chipped, peeling paint on the blue cinderblock wall in Room 101 above the table; on the wall to the right of the classroom door; and on the wall to the right of the closet.

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

Regulation: 3270.95(a)/3270.95(b)

Description: Devices must be compliant/Director or designated staff person ensure compliance

Noncompliance Area: The fire alarm 30-day test log includes test dates 11.12.24-12.13.24, more than 30 days apart.

Correction Required: Fire detection devices or systems must be in compliance with standards established under section 1016(c) of the act (62 P.S. §  1016(c)). The Director or designated staff person who is responsible for compliance with this chapter shall ensure the requirements under subsection (a) are met.

Regulation: 3270.31(f)/3270.31(g)

Description: Health and Safety Training/Professional development certificate

Noncompliance Area: Staff persons #1 and #2 have not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): Health & Safety topics #1-#9 completed after 9/30/2016. Staff #1 and #2 completed Health & Safety Basics prior to 9/30/2016 which is not acceptable.

Correction Required: Staff persons shall complete professional development within 90 days of hire as listed in subsections (f)1-10. Staff person #1 and #2 will have until 5/1/2023 to complete the required training. Until such time as the required training has been completed, staff persons #1 and 2 must be supervised, when interacting with children, by an AGS, GS or director who has completed the required training related to this citation. If there are no staff available to supervise staff person #1 and 2, staff persons #1 and 2 may not work in a child-care position at the facility. Completion of professional development shall be documented by the signature and title of a representative of the professional development entity and include the date professional development was completed. Documentation shall be retained in the facility person's file or maintained in an electronic system as designated by the Department. Documentation of the completion of the professional development under subsection (f) taken from September 30, 2016, forward satisfies this requirement.

Regulation: 3270.124(c)

Description: Each child care space

Noncompliance Area: Emergency contact information was not available for child #2 in the Ducks classroom where child #2 was observed receiving care.

Correction Required: When children are in the facility, emergency contact information shall be present in a child care space for children receiving care in the space.

Regulation: 3270.131(a)/3270.182(1)

Description: Health information/Initial and subsequent health reports

Noncompliance Area: The file for child #1, young toddler, is lacking an initial health report within 90 days of the first day of attendance in the child care facility as required under the covid-19 suspended regulation.

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(b)(1)

Description: Infant: updated health report every 6 months

Noncompliance Area: The file for child #1, young toddler, is lacking a health report completed in the previous 6 month period.

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

Regulation: 3270.133(3)

Description: Name on bottle

Noncompliance Area: Observed in a medication box in the office a container of Children's Tylenol and a container of Children's Motrin both lacking the name of the child for whom they were intended.

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: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: The file for staff person #1, start date in a child care position (see code sheet), is lacking verification of FBI clearance prior to start date. The file does contain a current FBI clearance. Also, staff person #1 has lived in the state of Maryland within the previous 5 years and is lacking complete Maryland state clearances.

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 #1 may not work in a child care facility.

Regulation: 3270.95(a)/3270.95(b)

Description: Devices must be compliant/Director or designated staff person ensure compliance

Noncompliance Area: The director does not have a fire detection system test log that documents and verifies that the alarm system is tested at least every 30 days.

Correction Required: Fire detection devices or systems must be in compliance with standards established under section 1016(c) of the act (62 P.S. §  1016(c)).The Director or designated staff person who is responsible for compliance with this chapter shall ensure the requirements under subsection (a) are met.

Regulation: 3270.136(d)

Description: Communicate report to DOH

Noncompliance Area: Facility failed to promptly notify OCDEL of a positive COVID exposure and test result that occurred on 9/25/21 at their child care; OCDEL did not receive notification of the positive COVID exposure and test result until Monday, 9/27/21 which was more than 24 hours.

Correction Required: A facility person who knows of a communicable disease for which 28 Pa. Code Chapter 27 (relating to communicable and noncommunicable diseases) requires reporting, or who knows of a group expression of an illness which may be of public concern, whether or not it is known to be of a communicable nature, shall report it promptly to the appropriate division of the Department of Health as specified in Chapter 27, or to a local department of health.

Noncompliance Area: The staff file for Staff person #1 contained emergency plan training that was not completed on an annual basis; the dates of the two most recent trainings were 9/10/18 and 8/5/20. The staff file for Staff person #2, who has a start date working with children of 2/17/20 lacked emergency plan training at time of initial employment; Staff person #2 received emergency plan training on 3/11/20. The staff file for Staff person #3, who has a start date working with children of 3/11/20, lacked emergency plan training at time of initial employment; Staff person #3 received emergency plan training on 6/29/20. The staff file for Staff person #5, who has a start date working with children of 8/20/19 lacked emergency plan training at time of initial employment; Staff person #5 received emergency plan training on 3/11/20. The staff file for Staff person #6, who has a start date working with children of 2/13/20 lacked emergency plan training at time of initial employment; Staff person #6 received emergency plan training on 3/11/20.

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.

Noncompliance Area: The staff file for Staff person #2, who has a start date working with children of 2/17/20 and considered a provisional hire, lacked documentation of having applied for the National Sex Offender Registry (NSOR) verification certificate prior to working with children as required by the Child Protective Service Law (CPSL); Staff person #2 had a valid NSOR verification certificate on file dated 3/6/20. The staff file for Staff person #3, who has a start date working with children of 3/11/20 and considered a provisional hire, lacked documentation of having applied for the National Sex Offender Registry (NSOR) verification certificate prior to working with children as required by the Child Protective Service Law (CPSL); Staff person #3 had a valid NSOR verification certificate on file dated 7/15/20 which was not obtained prior to 7/1/20 as required by the CPSL. The staff file for Staff person #4, who has a start date working with children of 9/24/18, contained a valid NSOR verification certificate on file dated 7/9/20 which was not obtained prior to 7/1/20 as required by CPSL. The staff file for Staff person #6 and Staff person #7, who both have a start date working with children of 2/13/20 and considered a provisional hire, lacked documentation of having applied for the National Sex Offender Registry (NSOR) verification certificate prior to working with children as required by the Child Protective Service Law (CPSL); Staff person #6 and Staff person #7 have a valid NSOR verification certificate on file dated 3/6/20.

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: In the Sunfish Room the thermometer being used inside the refrigerator was observed to be broken.

Correction Required: A facility shall have an operable, clean refrigerator used to store potentially hazardous foods. The refrigerator shall be capable of maintaining food at 45 F or below. An operating thermometer shall be placed in the refrigerator.

Noncompliance Area: The child file for child #1, who has an enrollment date of 2/26/19, lacked a valid health assessment; the initial health assessment on file was not dated. The child file for child #3, who has an enrollment date of 8/29/18, contained an initial health assessment dated 11/7/18 which was more than 60 days following the first day of attendance 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.

Noncompliance Area: The child file for child #1, who is an older toddler, contained a copy of their immunization status which lacked an annual influenza vaccination as recommended by the ACIP; child #1 was last vaccinated on 1/29/18. The child file for child #2, who is an older toddler, contained a copy of their immunization status which lacked the following immunizations as recommended by the ACIP: Haemophilus influenza type b (Hib), Pneumococcal conjugate (PCV13), Measles, mumps, and rubella (MMR), and Varicella (VAR). The child file for child #3, who is a preschool aged child, contained a copy of their immunization status which lacked an annual influenza vaccination as recommended by the ACIP; child #3 was last vaccinated in 2016.

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: Child #4 had a Tylenol on site at the facility and the medication log on file was filled out however permission to give consent to administer medication to child was not signed by the parent.

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

Noncompliance Area: The staff file for staff person #1 contained a current health assessment that was conducted on 9/13/18 which was more than 24 months from the previously dated 8/15/16 health assessment on file. The staff file for staff person #2 contained a current health assessment that was conducted on 9/13/18 which was more than 24 months from the previously dated 8/25/16 health assessment 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: The staff file for staff person #1 lacked annual fire safety training; the last documented fire safety training on file is dated 4/11/18.

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: During a complaint investigation, conducted on 10/2/18, it was verified that there is an infestation of bees inside the facility as evidence by the observance of over 65 dead bees inside the ceiling light fixtures and on the window sills in Perch/Room 7, Trout/Room 6, and Sunfish/Room 8.

Correction Required: Evidence of infestation of insects or rodents in the facility is not permitted.

Noncompliance Area: In the Walleye Room resting cots were observed to lack the names of specific children for whom they are to be used by.

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: At approximately 1:20pm, during naptime in the Perch Room, Staff person #2 was observed to be standing near the cabinet fixtures and Staff person #3 was observed to be sitting down at a table. A shelving unit, about knee height, was observed to be obstructing Staff person #2 and Staff person #3's view of a child who was sleeping on the opposite side of the shelving unit. Given where the staff were positioned at the time, they were not able to properly see, direct, and assess that child.

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: Staff person #1 self reported that the children have not been going outdoors daily due to the lack of fencing in the outdoor space which would allow for the children to be outside safely.

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

Noncompliance Area: In the Blue Gill room, at approximately 9:53am, an infant was observed to be asleep on a boppy pillow. The infant remained asleep on the boppy pillow until approximately 10:00am once it was brought to Staff person #4's attention. There is no medical reason documented on file by a pediatrician that indicates the child should not be placed in the recommended sleeping position by the American Academy of Pediatrics.

Correction Required: Infants shall be placed in the sleeping position recommended by the American Academy of Pediatrics unless there is a medical reason an infant should not sleep in this position. The medical reason shall be documented in a statement signed by a physician, physician's assistant or CRNP and placed in the child's record at the facility.

Noncompliance Area: The child file for child #1, who has an enrollment date of 3/20/18, lacked an initial health report within 60 days of the first day of attendance.

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: In the Perch room an unlabeled jar that contained diaper crme from a child's home was observed.

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.

Noncompliance Area: In the Perch room an expired diaper crme was observed.

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

Noncompliance Area: The staff file for staff person #1 contained a health report dated 5/14/18 which was not updated within 24 months of the previously dated health report of 5/12/16.

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: In the Blue Gill room a bottle was observed to not be labeled with the child's name.

Correction Required: Disposable nursers and bottles shall be labeled with the child's name.

Noncompliance Area: In the hallway, 8 ceiling tiles located to the right of the Family Engagement Room, were observed to have water damage causing them not to be in good repair.

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: The Sunfish Room, Blue Gill Room, Perch Room and Trout Room were observed to lack play equipment and materials appropriate for the developmental needs, individual interest and ages of the children whom will be utilizing that room.

Correction Required: Play equipment and materials appropriate to the developmental needs, individual interests and ages of the children shall be provided in sufficient amount and variety to preclude long waits for use.

Noncompliance Area: The staff file for staff person #1 lacked documentation verifying 1 year experience with children.

Correction Required: A director shall have attained a bachelor's degree from an accredited college or university in early childhood education, child development, special education, elementary education or the human services field and 1 year of experience with children. A facility person's record shall include verification of child care experience, education and training following the outset of service at the facility.