A Peace of Mind INC

The file for staff # 1 contained a current NSOR clearance dated 1/16/24, that was not renewed within 60 months of the prior NSOR clearance dated 1/6/19.

The facility emergency plan was not reviewed annually. The previous review was dated 1/30/24, and the current review was date 2/20/25.

There was an Epipremnum Aureus toxic plant in the Genius room accessible to children.

There was a long deep cracked on the top of the left wall above the window in the giraffe room.

There was damaged plaster on the window frame in the Genius room.

There was a green vinyl circle pillow with two peeling spots in the PS room. There were two damaged mats exposing foam in the gross motor room.

The file for child # 4, a young toddler, contained a current health report dated 2/5/25. The health report was provided more than 6 months after the previous health report, dated 4/16/24.

There was a triple antibiotic with an expiration date of 4/24 and an A&D ointment that were not label with the names of the children whom the medication was intended for in the giraffe room first aid kit. There was a triple antibiotic with an expiration date of 4/24 and an A&D ointment that were not label with the names of the children whom the medication was intended for in the Genius room first aid kit.

The file for staff #1 contained a current health assessment dated 3/4/25. It was not obtained within 24 months of the previous assessment dated 2/24/23.

The file for child # 2 lacked an initial health report.

The file for child #1 lacked the operator's signature on the agreement form.

The files for children #1, and 2 lacked the date of the child's date of admission on the agreement form.

The file for child # 3 lacked the home and work addresses and the home and work telephone number of the enrolling parent on the emergency contact form.

The files for children # 1, and 3 lacked the health insurance policy number on the emergency contact form. The file for child #3 lacked health insurance coverage for a child under a family policy or Medical Assistance benefits, if applicable.

The files for children #1 and 2 lacked the address of the individual designated by the parent to whom the child may be released on the emergency contact form. The file for child #2 lacked the telephone number of the individual designated by the parent to whom the child may be released on the emergency contact form.

The file for child #3 lacked signed parental consent for emergency medical care for the child on the emergency contact form. Written consent is required prior to admission.

The file for child # 3 lacked signed parental consent for administration of minor first-aid procedures by facility staff on the emergency contact form. Written consent is required prior to admission.

The Director ID the driver's license was expired. the expiration date was 11/8/24.

Staff persons # 1,3, and 4 were observed to be caring for children unsupervised. Staff persons #1,3 and 4 do not have current pediatric first-aid/CPR training. This is evidenced by the previously documented pediatric first-aid/CPR training expiration date of 6/2/22 to 6/2/24. Staff person # 2 was observed to be caring for children unsupervised. Staff person #2 do not have current pediatric first-aid/CPR training. This is evidenced by the previously documented pediatric first-aid/CPR training expiration date of 6/14/22 to 6/14/24.

* On 8/29/24 at 9:10 am, staff #4 was observed caring for 1 Young Toddler, 3 Older Toddlers and 3 Preschoolers in the Picasso room. Staff #1, had left the room to go get the children's breakfasts from the upstairs kitchen.

On 8/29/24 at 9:10 am, staff #4 was observed caring for 1 Young Toddler, 3 Older Toddlers and 3 Preschoolers in the Picasso room. Staff #1, had left the room to go get the children's breakfasts from the upstairs kitchen.

The file for staff # 5 lacked a copy of the disclosure statement.

There was a nail on top of the window frame and a bolt on the floor in the gross motor room.

There was a Lysol bottle, a hand sanitizer, a Banana Boat sunscreen and disinfectant wipes on the changing table in the Picasso room labeled " keep out of reach of children" accessible to children. There was a Cocoa Butter Swivel stick in a backpack hanging in a cubby in the Lady Bug room labeled " keep out of reach of children" accessible to children. There was a bottle of Drano Max Gel in the staff bathroom labeled " keep out of reach of children" accessible to children. The bathroom is in the Gross Motor room and the door was open.

There was a clear unlabeled bottle on top of the sink in the Teamwork bathroom.

There was peeling paint on the wall by the cozy corner in the Picasso room. There was damaged plaster on the bottom of the wall by the door in the gross motor room.

There was a large plastic bin on wheels obstructing the stairway.

There was a clear cracked bin in the teamwork room.

The file for staff # 3 lacked the one-hour updated health and safety training course, Pennsylvania Health and Safety Update 2022 by the deadline of 12/30/22.

The file for staff # 1 contained a current FBI clearance dated 7/5/23, that was not renewed within 60 months of the prior FBI clearance dated 5/6/18. The file for staff # 2 contained a current FBI clearance dated 2/16/24, that was not renewed within 60 months of the prior FBI clearance dated 2/15/19.

The facility emergency plan lacks information regarding the strategize on how they will pay for repairs, pay staff and pay bills during the aftermath of the disaster on their Continuity of Operations Plan.

A 1 fl oz bottle of Onnit Instant Melatonin 3mg, Lavender Flavor, Dietary Supplement spray was observed in the medication box located in the Toddler Room. The spray lacked a label identifying the intended child. Based on staff statements, staff would spray the toddler's nap mats with 2 sprays before the children lied down to help them sleep. Staff no longer use the spray because the children are not having trouble sleeping at nap time.

The file for staff # 1 contained a current emergency plan training dated 6/26/23 that was not obtained within a year of the previous emergency plan training dated 3/11/22. The file for staff #2 lacked an emergency plan training.

There was a multiplug with 3 uncovered electrical outlets in the toddler room accessible to children 5 years of age or younger.

There was a Roden Repellent under the teamwork room bathroom sink labeled" Keep out of reach of children".

There was an unlabeled bottle with a blue liquid under the sink in the Teamwork room bathroom.

The water temperature in the toddler room sink was 129.6° F.

There was an orange cracked lid in the Lady Bug room. There were 2 cracked clear bins and 1 lid in the Picasso room. There was a blue plastic bin with a cracked corner,2 cracked clear bins and 1 cracked lid in the Teamwork room.

The operator was not maintaining a medication log for a prescription medication, Nystatin Crean USP for child # 5.

The file for staff # 1 contained a current health assessment dated 2/24/23. It was not obtained within 24 months of the previous assessment dated. 10/7/20.

There were 2 crates with bananas and apples in the kitchen that were not refrigerated.

The facility emergency plan lacked accommodations for infants and children with disabilities.

According to the Fire Detection System Test Log, the tests were greater than 30 days apart from 9/12/23 to 10/18/23.

The file for child # 2 contained a current health report that was provider after 60 days. The child was in care longer than 60 days without initial health report. The file for child # 4 contained a current health report that was provider after 60days. The child was in care longer than 60 days without initial health report.

The files for staff # 1 and 2 contained a current staff evaluation dated 1/14/24 that was conducted more that 12 months from the previous staff evaluation dated 12/19/22.

The files for children # 3 and 4 lacked the work addresses and telephone numbers of the enrolling parent on the emergency contact form.

The files for child # 1 and 3 lacked the information on the child's special needs, as specified by the child's parent, physician, physician's assistant or CRNP, which is needed in an emergency situation, on the Emergency contact form.

The file for child # 4 lacked the address of the individual designated by the parent to whom the child may be released on the emergency contact form.

Second citation previously cited on 03/09/2023. The fire detection system testing log was observed to indicate that testing had not occurred at least once in a 30-day period as evidenced by a test on 4/4/23 and again on 5/8/23, which is a span of 34 days. The schedule which the operator submitted indicates the next text will be on 6/8/23 which is a span of 31 days. On 3/9/23 the log indicated tests on 6/13/22 and not again until 07/14/2022 a span of 31 days, and a test on 07/14/22 and not again until 08/23/22 a span of 40 days.

At 8:55 the giraffe room was observed to have 2 staff and two volunteers. Staff # 4 identified 7 children: 6 PS and 1 OT. Staff #5 identified a 3 YT. Per conversation with staff #4 CR asked who was supervising 2 YT and 1 OT sitting at the table, that neither staff identified. Staff# 4 asked staff #5 why she didn't claim the other children, staff #5 appeared confused. CR told staff #4 that staff #5 was out of ratio since she will then have 5 YT and 1 OT. Staff #4 recognized that she was aware. At 9:15 staff #1 came in and the group was split. Staff #1 took 6 PS to the Picasso room and staff #4 and #5 stayed in the giraffe room with 5YT and 2 OT.

Staff person #4 and #5 were observed to be caring for a group of 13 mixed age level children. Staff person #4, and #5 named 10 of the 13 children, leaving 3 children unassigned to a responsible adult.

The facility was observed to have an emergency plan that lacked a method for facility persons to contact parents as soon as reasonably possible when an emergency situation arises.

The facility was observed to have an emergency plan that lacked a method for facility persons to contact parents to inform them that the emergency has ended and to provide instruction as to how parents can safely be reunited with their children.

The facility was observed to lack documentation that the parent of each enrolled child was provided a letter explaining the emergency procedures.

A tube of Colgate mild bubble fruit toothpaste labeled keep out of reach of children under 6 years of age was observed to be stored in a red duffle bag within reach of children under the age of 6.

A re-usable HDX spray bottle without the contents labeled was observed to be stored on the counter in the kitchen adjacent to packages of Hamburger Buns, and potato chips. A plastic container of disposable disinfecting wipes was observed to be stored on the counter in the kitchen next to packages of Hamburger Buns and potato chips.

The facility was observed to lack a first aid kit in classroom #3.

The facility was observed to possess a tripping hazard on the landing return of the stairs leading to the upstairs classrooms. This is evidenced by the flooring lacking a cap or covering and permits the flooring to catch toe ends. There are 9 boxes being stored on the stairway's landing return leading to the upstairs classrooms and kitchen.

The facility was observed to have damaged or peeling paint on the purple wall in classroom #4, in the doorway from the top of the stairs in classroom #3, on the white wall under the mural in the Ladybug room, and on the white wall near the corner by the play cube in the Giraffe room, the stairway banister handrail, and by the main entry door.

A bin in the Giraffe room that contained shape puzzles was observed to have cracks, and broken edges. A bin in the Ladybug room that contained cookie cutters was observed to have cracks and broken edges. Two bins in classroom #4, one that contained toy binoculars, and one that contained Magna Tiles were observed to have cracks and broken edges.

The facility was observed to have a wooden shelf in the Ladybug room outside the bathroom that was unstable and loose, and a wooden chair that was broken was observed in the gross motor space.

The file for child #3 was observed to contain an immunization record that does not demonstrate the child's immunized status is in accordance with the recommendations of the ACIP.

The files for staff persons #2 and #3 were observed to lack a health assessment conducted within 12 months prior to providing initial service in a child care setting as evidenced by the health assessment for staff person #2 being dated 9/16/22, and the file for staff person #3 does not contain a health assessment.

The facility was observed to have an emergency plan that lacked accommodations for toddlers.

The fire detection system testing log was observed to indicate that testing had not occurred at least once in a 30 day period as evidenced by a test on 6/13/22 and not again until 07/14/2022 a span of 31 days, and a test on 07/14/22 and not again until 08/23/22 a span of 40 days.

The facility was observed to lack documentation that the operator sent a copy of the emergency plan to the local municipality.

The files for children #1, 4 and 5 were observed to lack an initial health report. The file for child #3 was observed to contain a current initial health report that was obtained after 60 days following the first day of attendance at the facility, as evidenced by the child's start date of 9/20/21 and the health report is dated 3/21/22.

The Facility was observed to have an emergency plan that lacked a statement regarding continuity of operations. The facility denied having a Policy regarding Prevention of Shaken Baby Syndrome, Abusive Head Trauma, and Child Maltreatment.

The facility was observed to lack a written plan of daily activities in the Gross Motor Space.

The file for child #2 lacked consent signed by the parent for the emergency medical care on the emergency contact form.

The Files for child #1 and #4 were observed to have an emergency contact form that lacked the insurance policy number.

The file for child #2 was observed to contain an emergency contact form that lacked the address of the individual designated by the parent to whom the child may be released on the emergency contact form.

The files for children # 1, #4, and #5 were observed to have emergency contact forms and financial agreement forms that were not updated at least once in a 6-month period as evidenced by the forms for child #1 being dated 8/15/22, the forms for child #4 are dated 3/7/23, and the forms for child #5 are dated 10/31/21.

The file for child #2 was observed to contain an emergency contact form that lacked consent signed by the parent for the administration of minor first aid procedures by the facility.

The facility was observed to lack documentation that the parent of each child enrolled was provided with information on how to access the regulations in this chapter electronically and with instructions for contacting the appropriate regional child care office.

The fire detection system tests were greater than 30 days apart from 6/12/22-7/14/22.

The file for staff person #3 included a disclosure statement dated after they began working with children. The file for staff person #5 did not include a state police or NSOR clearance or proof of requests for the clearances before they began working with children. The files for facility person #2, #8 and #9 did not include a disclosure statement and included results from the "Dru Sjodin" national sex offender public registry, which is an unacceptable sex offender registry certificate.

Upon entering the facility at approximately 9:30 am, staff person #1 and facility person #2 were observed in the Picasso room with 8 children, a combined group of 4 young toddlers and 4 older toddlers. At the same time, staff person #3 was observed coming into the classroom. When asked who was responsible for the 8 children when staff person #3 wasn't in the room, staff person #1 stated they were responsible for all 8 children. Facility person #2 was a foster grandparent volunteer and could not be in ratio.

Staff person #1 hit child #1 in the forehead, then grabbed the child's hat, pull it down over the child's face and shook the child's head.

Staff person #1 hit child #1 in the forehead, then grabbed the child's hat, pull it down over the child's face and shook the child's head.

There was a pair of adult scissors on a low cubby in the Teamwork room, making them accessible to the preschoolers in care at the time.

The last two emergency plan trainings in the file for #4 were dated more than 12 months apart. There was no emergency plan training in the file for facility person #2, #8 and #9.

There was a large TV mount stand, a bookcase and a table observed in the facility's indoor gross motor space.

In the Teamwork room's bathroom, there was a tube of Crest kid's toothpaste on the sink and two tubes of Crest Kid's toothpaste on the low window sill, making them accessible to the preschoolers in care at the time. In the Ladybug room's bathroom, there were two tubes of Crest Kid's toothpaste on the sink, making them accessible to the preschoolers in care at the time. The toothpaste included instructions to keep out of the reach of children under 6 years old. In the Picasso room, there was a container of disinfecting wipes on the diaper table, making them accessible to some of the toddlers in care at the time. There were alcohol pads in the first-aid kit on the bathroom floor in the Ladybug room, making them accessible to the preschoolers in care at the time. All items included instructions to keep out of the reach of children.

There was an unlabeled plastic spray bottle containing a clear liquid in the Ladybug room.

The first window in the Teamwork room and the first window in the Genius room were able to open more than 6 inches.as both windows were unlocked and their safety latches were not engaged. Both rooms are on the second floor and the windows open directly to the outdoors and are accessible to children.

The list of emergency phone numbers in all child care rooms did not include a number for the ambulance.

There was a first aid kit on the bathroom floor in the Ladybug's room.

There was a long thin crack at the top of the front wall in the Ladybug room, near the ceiling.

The garbage can in the Ladybug bathroom was not lidded.

The small hallway between the Genius and Teamwork room was partially obstructed by 2 stacks of child-sized chairs and plastic play tool bench and a play wooden oven.

The last health report in the file for child #5, a young toddler, was dated more than 6 months ago.

The last health report in the file for child #1, a preschooler, was dated more than 12 months ago.

The last health report in 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.

The file for child #1, a preschooler, and child #2, an older toddler, did not include evidence of a flu shot. The file for child #5, a 20-month old, was missing 1 of 4 DTAP vaccinations. None of the files included a written statement of exemption by a parent.

The 8 children's toothbrushes observed in the Teamwork room's bathroom were unlabeled. Four of them had no names at all and the other four had the child's name on the mounted storage rack but not on the toothbrush. There was one unlabeled toothbrush in the Picasso room's bathroom.

There was a toothbrush in the Picasso room's bathroom that had a plastic cap on it and was in a Ziploc baggie.

The health assessment and the TB screening in the file for staff person #5 was dated more than 12 months before the individual began working with children.

The health assessment and TB screening in the file for staff person #5 was dated more than 12 months before the individual began working with children. The TB screening in the file for staff person #3 was dated more than 12 months before the individual began working with children.

Based on conversation, the facility had not conducted an emergency drill in the last 12 months.

The hypothetical location for the four fire drills conducted between September 2021 and January 2022 was listed as the "Teamwork room."

For all fire drills dated between 4/7/21 and 3/14/22, the participating facility persons were documented as "Director and staff."

There were five times when the facility's fire detection system was tested between 33 and 47 days apart. The last testing date documented was more than 30 days ago.

The initial health report in the file for child #4, a school-ager, was dated beyond the child's first 60 days in attendance.

Based on conversation with the operator, the annual traffic letter had been sent to the local municipality, but a copy was not available at the time of the inspection.

The file for staff person #7 included an online-only FA/CPR training provided by "NewLife CPR." Their previous FA/CPR training expired 1/11/22.

The last fire safety training in the file for staff person #4 and #7 was more than 12 months ago.

The mandated reporter training in the file for facility person #2, #8 and #9 included an unacceptable Mandated Reporter training conducted by the Foster Grandparent Program.

There was not an evaluation in the file for staff person #4, employed more than 12 months. The last evaluation in the file for staff person #1 was more than 12 months ago.

The agreement form in the file for child #4 did not specify the release persons.

The agreement form in the file for child #5 did not include the child's admission date.

The agreement form in the file for child #2, #3 and #5 included highlighting or different colors of ink. Based on conversation with the operator, the forms were the original agreement forms.

The emergency contact information in the file for child #2 did not include a work address and phone number for the child's father. The emergency contact information in the file for child #5 did not include a home or work phone number or a work address for the child's mother.

The last update in writing by a parent on the emergency contact information in the file for child #1, #2 and #3 was more than 6 months ago.

The last update in writing by a parent on the emergency contact information in the file for child #1 was dated more than 6 months ago. The last update in writing by a parent on the emergency contact information and the agreement form in the file for child #2 and #3 was dated more than 6 months ago.

The file for staff person #3 included only one letter of reference. The file for facility person #2, #8 and #9 did not include any reference letters.

The only FA/CPR training in the file for staff person #3 and #6 was an online-only training provided by "NewLife CPR."

The file for staff person #7 included 9.5 hours of childcare training between 12/19/20 and 12/19/21.