Autumns Wonderland

The facility's outdoor fenced in play yard was observed to have large fist sized holes, a pile of Rabbit feces, and two paper wasp nests in the garage window.

The facility was observed to have their highchairs folded and placed together in a row and the seat cushions especially the creases were observed to be soiled with food ruminants on 3 of the highchairs.

The thermometer inside the refrigerator in Room #1 was checked twice and was observed to read 50° F both times.

The file for child #4 was observed to contain a health report that lacked a review of the child's immunized status according to recommendations of the ACIP.

The file for child #1 was observed to contain a health report that 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 facility was observed to have a bottle in the infant space that was identified as belonging to child #4 but was not labeled with child #4's name.

The facility was observed to lack documentation on file of an emergency drill conducted annually. As evidenced by documentation of a drill occurring on 7/19/2024 and no documentation of a drill in 2025.

The file for staff person #3 was observed to lack a minimum of one written evaluation every 12 months. This was evidenced by the most recent written evaluation in the file was dated 01/02/2024.

The file for child #2 was observed to lack an agreement signed by the operator and the parent

The file for child #4 was observed to contain an emergency contact form that lacked the work addresses and telephone numbers of the enrolling parent.

The file for staff person #2 was observed to lack documentation of obtaining an annual minimum of 12 clock hours of child care training.

The file of staff #1, and AGS had PA State Police clearance for the purpose of volunteer rather than employment.

On 9-10-24, at the time of inspecting a vehicle (Kia) used to transport school-age children daily to and from school, the vehicle had an expired registration dated 8-31-24.

Observed staff #2 not wash their hands after diapering an infant. In addition, there was not a source of running water in the space in which staff #2 diapered the infant due to the fact they were on the floor of the preschool room rather than at the diaper changing table in the infant space.

The file of staff #1 lacked a health assessment. The file of staff #2 had a late health assessment due to the fact they were dated: 3-10-22 and 7-31-24; more than 24 months apart.

The file of child #2 lacked an emergency contact form with the work address and telephone number of the enrolling parent.

The file of child #1 lacked an emergency contact form with the written consent signed by a parent for emergency medical care.

The file of child #1 lacked an emergency contact form with the signed parental consent for administration of minor first-aid procedures by facility staff and signed parental consent for transportation, walking excursions, swimming and wading; or NA if not applicable.

The file of staff #1 lacked two written, nonfamily references from individuals attesting to the person's suitability to serve as a facility person.

2nd citation. Previously cited on 6/13/24. At approximately 11 AM on 8/21/24, Staff #1 left the Preschool Room to answer the door located in another room leaving Staff #2 with 3 older toddlers and 4 preschoolers. After opening the door Staff #1 took Child #1 who had entered the entrance area alone from outside back to the outside play space where Staff #3 was present. Before returning to the Room with Staff #2, Staff #1 also used the restroom. While Staff #1 was using the restroom, Child #1 again entered the entrance alone, so Staff #2 told the child to return to the play space with Staff #3. Staff #3 then was observed to be caring for 6 preschoolers including Child #1 and 4 young school-age children.

2nd citation. Previously cited on 6/13/24. At approximately 11 AM on 8/21/24, Staff #1 left the Preschool Room to answer the door located in another room leaving Staff #2 with 3 older toddlers and 4 preschoolers. After opening the door Staff #1 took Child #1 who had entered the entrance area alone from outside back to the outside play space where Staff #3 was present. Before returning to the Room with Staff #2, Staff #1 also used the restroom. While Staff #1 was using the restroom, Child #1 again entered the entrance alone, so Staff #2 told the child to return to the play space with Staff #3. Staff #3 then was observed to be caring for 6 preschoolers including Child #1 and 4 young school-age children.

Staff person #1 was observed to be caring for children unsupervised. Staff person #1 has not completed the following pre-service training required prior to caring for children unsupervised: pediatric first aid/CPR from a PQAS approved trainer and a PQAS approved curriculum

Child #1 received an injury on 4/12/24. The injury received resulted in the child being seen in the emergency room. The operator was notified on 4/12/24 of the emergency room visit. As of the time of investigation, the operator had not yet reported to the department either verbally or in writing.

Child #1 received an injury on 4/12/24. The injury received resulted in the child being seen in the emergency room. The operator was notified on 4/12/24 of the emergency room visit. As of the time of investigation, the operator had not yet reported to the department either verbally or in writing.

Child #1 who was an infant received an injury from a Step 2 Kitchen set which is not recommended for children under the age of 2

The facility was unable to provide documentation that the fire detection system was manually tested at least every 30 days. The facility provided documentation that the fire detection system was manually tested on 11/7/23, 12/4/23, 1/2/24, 1/29/23, 2/19/24, 3/1/24, 4/2/24, 5/2/24, 5/31/24, and 6/5/24.

On 6/13/24 when certification representative asked to see the facility's accident file, Staff #2 indicated parents are given the original report and a copy is placed in a child's file, but a copy is not retained at the facility in an accident file. Staff #2 indicated the facility does not have an accident file.

At approximately 9:15 AM on 6/13/24, Staff #1 left the Preschool Room to answer the door located in another room leaving Staff #2 with 5 Preschoolers and 4 Older Toddlers. At approximately 9:25 AM Staff #1 left the Preschool Room again to relieve Staff #3 who working in the Infant Room leaving Staff #2 with 5 Preschoolers and 4 Older Toddlers.

At approximately 9:15 AM on 6/13/24, Staff #1 left the Preschool Room to answer the door located in another room leaving Staff #2 with 5 Preschoolers and 4 Older Toddlers. At approximately 9:25 AM Staff #1 left the Preschool Room again to relieve Staff #3 who working in the Infant Room leaving Staff #2 with 5 Preschoolers and 4 Older Toddlers. At approximately 9:20 on 6/13/24 Staff #1 and #2 were caring for a group of 9 mixed-age children which included 4 older toddlers and 5 preschoolers. When asked to name the children in their assigned groups, Staff #1 named all 5 preschoolers, but Staff #2 named only 2 of the 4 older toddlers. At approximately 9:25 AM Staff #3 was caring for 2 infants and 2 young toddlers but could not name 1 of the young toddlers.

On 4/25/24 Certification Staff observed the indoor temperature to be 62 degrees F.

On 4/25/24 Certification Staff observed a Child Service Report for Child #1 which referenced the child as a she when the child is a male. On 6/13/24 Certification Staff observed Child Service Reports dated 1/19/24 with identical information for Children #2 and #3.

2nd citation. Previously cited on 9/18/23. Observed 1 exposed nail on the left side of the porch railing upon entering the outdoor play space.

2nd citation. Previously cited on 9/18/23. The facility did not have written parental consent to transport Child #1.

2nd citation. Previously cited on 9/18/23. The facility was unable to provide a written record that the fire detection system was manually tested at least every 30 days. The facility provided a written record that the fire detection system was manually tested on 11/17/22, 12/5/22, 1/3/23, 1/29/23, 2/1/23, 2/17/23, 3/2/23, 3/18/23, 4/4/23, 5/15/23, 6/12/23, 7/10/23, 8/9/23, and 9/5/23, and 10/2/23.

Observed 2 pair of adult scissors located in a pink plastic bin on top of the microwave in Room #1 which were accessible to children.

Observed 2 exposed nails on the left side of the porch railing upon entering the outdoor play space. Observed approximately a 1-inch piece missing from the heat vent which was also rusty in the infant section of Room #2.

Observed peeling paint to the right of the door upon entering the outdoor play space. Observed approximately two 1/2-inch holes in the drywall by the toilet paper holder in the 2nd bathroom.

The toilet in each bathroom lacked a handwashing sign.

The file of Child #3 lacked an updated health report at least every 6 months for an infant or young toddler. The file of Child #3 contained health reports dated 8/31/22, 11/30/22, and 7/18/23.

Staff #3 lacked a health assessment conducted every 24 months. Staff #3 had a current health assessment dated 5/19/23 with a previous one dated 2/9/21.

The facility did not have written parental consent to transport Children #5, #6, #7, and #8.

All manufacturer's instructions for use of safety restraints were not kept in the Kia Sorento.

The Kia Sorento and Honda Odyssey did not contain documentation of being insured in accordance with the requirements of 75 Pa.C.S. § § 1701-1799.7 (relating to the Motor Vehicle Financial Responsibility Law).

The facility was unable to provide a written record that the fire detection system was manually tested at least every 30 days. The facility provided a written record that the fire detection system was manually tested on 11/17/22, 12/5/22, 1/3/23, 1/29/23, 2/1/23, 2/17/23, 3/2/23, 3/18/23, 4/4/23, 5/15/23, 6/12/23, 7/10/23, 8/9/23, and 9/5/23.

The operator did not notify local traffic authorities annually in writing of the location of the facility and the program's use of pedestrian and vehicular routes around the child care facility. The operator provided documentation of notifying local traffic authorities in February 2022.

The files of Staff #2 and #3 lacked documentation of completing the Pennsylvania Health and Safety Update 2022 by December 30, 2022. The file of Staff #2 contained documentation of completing the health and safety update on 2/13/23. The file of Staff #3 contained documentation of completing the health and safety update on 8/11/23.

The file of Staff #1, who was designated as the director, lacked documentation of 3 years of experience with children.

The file of Staff #3, who was designated as an assistant group supervisor, lacked documentation of 2 years experience with children.

The agreement for Child #4 did not specify the amount of the fee to be charged per day or per week.

The agreements for Children #3 and #4 did not specify the date on which the fee is to be paid.

The agreement for Child #3 did not include the services provided to the family and child.

The agreements for Children #1 and #3 did not specify the persons designated by a parent to whom the child may be released.

Emergency contact information for Child #2 lacked the complete address and telephone number of the child's physician or source of medical care.

Emergency contact information for Children #2 and #3 lacked the complete work address of the enrolling parent.

The files of Staff #1 and #3 lacked documentation of training regarding the emergency plan on an annual basis. The files of Staff #1 and #3 contained documentation of emergency plan training on 10/6/22 with previous training on 1/12/21. The file of Staff #4 lacked documentation of receiving training regarding the emergency plan at the time of initial employment (SEE LIS Code Sheet). The file of Staff #4 contained documentation of emergency plan training on 10/6/22.

The operator did not post the emergency plan in the facility at a conspicuous location.

Observed Parents Choice Diaper Rash Ointment which indicated "keep out of the reach of children" in a pink bin on the table in the Right Front Room which was accessible to children.

Observed 2 boards with splintering wood at the top of the stairs on the porch in the Outdoor Play Space.

Observed foam puzzle pieces with bite marks in the Left Front Room where young toddlers were located.

Observed rest equipment not labeled for the use of a specific child in the following classrooms: Multipurpose Room, Right Front Room, and Left Front Room.

The file of Child #2 lacked an updated health report at least every 6 months for an infant or young toddler. The file of Child #2 contained a current health report dated 6/1/22 with a previous one dated 8/24/21.

The files of Children #3 and #4 lacked an updated health report at least every 12 months for an older toddler or preschool child. The file of Child #3 contained a current health report dated 8/11/22 with a previous one dated 5/17/21. The file of Child #4 contained a current health report dated 9/29/22 with a previous one dated 3/10/21.

The file of Child #1 contained a health report which 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.

Staff #2 in the Left Front Room did not ensure that a child's hands were washed after being diapered.

Staff #2 in the Left Front Room did not wash his/her hands after diapering a child. Staff #2 used hand sanitizer.

The facility did not have a policy that addressed the recognition of potential signs and symptoms of shaken baby syndrome and abusive head trauma, strategies for coping with a crying, fussing, and distraught child, and the prevention and identification of child maltreatment.

The file of Staff #3 lacked documentation of renewing their certification in pediatric first aid and pediatric cardiopulmonary resuscitation on or before the expiration of the most current certification. The file of Staff #3 contained documentation of pediatric first aid and pediatric cardiopulmonary resuscitation completed on 6/1/22 with a previous one completed on 5/6/20.

The file of Staff #4, who was designated as an assistant group supervisor, lacked documentation of 2 years' experience with children.

The files of Children #2 and #4 lacked the date of the child's admission on the agreement.

The files of Children #1, #2, #3, #4, and #5 contained the original copies of the agreement. The facility did not make a copy for the files and give the original to the parent.

The file of Child #5 lacked the complete address and telephone number of the individual designated by the parent to whom the child may be released on the emergency contact form.

The emergency contact and agreement for Child #3 were not reviewed and updated at least once every 6 months with the reinstating of this regulation on 1/6/22. Child #3's emergency contact was reviewed on 8/21, 3/15/22, and 8/15/22. Child #3's agreement was reviewed on 8/21, 3/15/22, 5/26/22, and 8/15/22.

The file of Staff #4 lacked two written, nonfamily references from individuals attesting to the person's suitability to serve as a facility person.

2nd citation. Previously cited on 4/21/22. A first-aid kit was not present in the vehicle used to transport children.

The emergency contact forms for Children #1 and #2 lacked signed parental consent for transportation. Staff indicated the facility transports Children #1 and #2 to school.

At approximately 12:30 PM Certification Staff observed children resting on only blankets.

2nd citation. Previously cited on 4/21/22. The file of Child #1 lacked a current influenza immunization in accordance with the schedule recommended by the ACIP.

2nd citation. Previously cited on 4/21/22. The facility was unable to provide a written record that the fire detection system was manually tested at least every 30 days. The facility provided a written record that the fire detection system was manually tested on 6/2/21, 7/2/21, 8/2/21, 9/2/21, 10/4/21, 11/2/21, 12/2/21, 1/20/22, 2/28/22, 3/17/22, 4/19/22, 5/18/22, 6/10/22, and 7/5/22.

The file of Staff #3 lacked documentation of application for the State Police Clearance, Child Abuse Clearance, and FBI fingerprint submitted receipt dated prior to or on the date of initial hire (SEE LIS Code Sheet). The file of Staff #3 contained a State Police Clearance dated 4/3/18, a Child Abuse Clearance dated 4/11/18, and a FBI Clearance dated 4/3/18. The file of Staff #4 lacked documentation of application for the Child Abuse Clearance dated prior to or on the date of initial hire. The file of Staff #4 contained a Child Abuse Clearance dated 2/5/18. The file of Staff #5 lacked a State Police Clearance updated every 60 months. The file of Staff #5 contained a State Police Clearance dated 7/28/20 with a previous one dated 4/24/15.

At approximately 12:00 PM on 5/4/22 when Staff #4 was asked who was in his/her assigned group, Staff #4 identified 1 infant and 4 older toddlers.

*On 5/4/22 observed a child sleeping in a play house with the doors and windows covered by a blanket in the Infant/Toddler Room. On 5/4/22 Certification Staff observed Staff #2 who was unable to provide critical oversight of 2 children in which the supervisor could see, hear, direct, and assess the activity of the supervisee because Staff #2 was sitting on one side of the 1/2 wall while the 2 children were on the other side of the 1/2 wall.

**On 5/4/22 observed a child sleeping in a play house with the doors and windows covered by a blanket in the Infant/Toddler Room. On 5/4/22 Certification Staff observed Staff #2 who was unable to provide critical oversight of 2 children in which the supervisor could see, hear, direct, and assess the activity of the supervisee because Staff #2 was sitting on one side of the 1/2 wall while the 2 children were on the other side of the 1/2 wall.

At approximately 12:00 PM on 5/4/22 when Staff #5 was asked who was in his/her assigned group, Staff #5 identified 4 preschoolers in the space where he/she was physically present and 6 preschoolers in the adjacent classroom.

***On 4/21/22 and 5/4/22 observed preschool-aged children placed in highchairs to eat and pack and plays to nap. When Certification Staff asked why, Staff #5 indicated children are placed in highchairs because they will not sit at the table to eat, and children are placed in pack and plays because they will not stay on their mats to nap.

*On 4/21/22 and 5/4/22 observed preschool-aged children placed in highchairs to eat and pack and plays to nap. When Certification Staff asked why, Staff #5 indicated children are placed in highchairs because they will not sit at the table to eat, and children are placed in pack and plays because they will not stay on their mats to nap.

**On 4/21/22 and 5/4/22 observed preschool-aged children placed in highchairs to eat and pack and plays to nap. When Certification Staff asked why, Staff #5 indicated children are placed in highchairs because they will not sit at the table to eat, and children are placed in pack and plays because they will not stay on their mats to nap.

On 4/21/22 observed Child #5 who is a preschooler sitting in a high chair and rocking it so only 2 legs were on the floor creating a potential fall hazard. On 5/4/22 observed Child #3, an older toddler, and Child #9, a preschooler, attempt to crawl out of their pack and plays creating a potential fall hazard.

On 4/21/22 observed an electrical power strip on the 1/2 wall between the multi-purpose room and infant/toddler room which lacked protective receptacle covers.

On 4/21/22 observed splintering wood and an exposed screw on the cover for the heat pump in the outdoor play space. On 4/21/22 observed three approximately 4 inch holes in the siding located at the bottom of the garage in the outdoor play space. On 4/21/22 observed loose siding at the bottom of the garage in the outdoor play space.

On 4/21/22 observed peeling paint on the frame and building to the left of the heat pump. On 4/21/22 observed peeling paint on 2 window frames of the garage in the outdoor play space.

On 4/21/22 observed a broken handle on toy pliers in the multi-purpose room.

On 4/21/22 observed a Cosco high chair and an Ingenuity high chair missing T-shaped safety straps in the preschool room.

The health report for Child #3 was not updated at least every 6 months for an infant or young toddler with the reinstating of this regulation on 1/6/22. The file of Child #3 contained a current health report dated 3/30/22 with a previous one dated 8/26/21.

The health report for Child #1 was not updated at least every 12 months for an older toddler or preschool child with the reinstating of this regulation on 1/6/22. The file of Child #1 contained a current health report dated 3/17/22 with a previous one dated 9/2/20.

The files of Children #2 and #4 lacked a current influenza immunization in accordance with the schedule recommended by the ACIP.

On 4/21/22 Staff #4 did not ensure that a child's hands were washed after being diapered.

On 4/21/22 observed Staff #4 did not discard a soiled diaper by immediately placing the diaper into a plastic-lined, hands-free covered can. Staff #4 placed the diaper in a plastic grocery bag and then used her hand to open the small hands-free covered can.

On 4/21/22 the file of Staff #2 lacked documentation of a health assessment conducted every 24 months. The file of Staff #2 contained health assessments dated 4/18/18 and 4/20/20. The file of Staff #4 lacked documentation of a health assessment conducted every 24 months. The file of Staff #4 contained a current health assessment dated 3/7/22 with a previous one dated 4/3/18.

The file of Staff #3 lacked a health assessment which included tuberculosis screening by the Mantoux method at initial employment (SEE LIS CODE SHEET). The file of Staff #3 had tuberculosis read date of 4/2/18.

On 4/21/22 observed bottles which were not labeled with the child's name in the infant/toddler room.

Manufacturer's instructions for use of safety restraints were not kept in the vehicle.

The first-aid kit in the minivan lacked tape.

The facility did not conduct an emergency drill

The facility was unable to provide a written record that the fire detection system was manually tested at least every 30 days. The facility provided a written record that the fire detection system was manually tested on 6/2/21, 7/2/21, 8/2/21, 9/2/21, 10/4/21, 11/2/21, 12/2/21, 1/20/22, 2/28/22, 3/17/22, and 4/19/22.

The facility did not have an emergency plan that provides for accommodations for evacuation of children from the facility building and evacuation of children to a location away from the facility premises. The emergency plan did not contain evacuation routes and evacuation plans or written directions to exit the building.

The file of Staff #1 lacked documentation of completion of preservice training within 90 days of hire.

Staff #5 lacked documentation of mandated reporter training completed every 60 months. Staff #5 had documentation of mandated reporter training completed on 4/15/20 with previous training completed on 12/10/14.

The files of Staff #2, #3, and #4 lacked documentation of an associate's degree from an accredited college or university, including 30 credit hours in early childhood education, child development, special education, elementary education or the human services field.

The file of Child #2 lacked the arrival and departure times on the agreement.

The file of Child #1 lacked the date of the child's admission on the agreement.

The file of Child #3 lacked the complete address of the individual designated by the parent to whom the child may be released on the emergency contact form.

Emergency contact information was not present for any child receiving care in either the multi-purpose room or infant/toddler room.

Emergency contact information for Children #5, #6, #7, and #8 were not present in the van used by staff to transport them.

The agreement and emergency contact form for Child #1 were not reviewed and updated at least once every 6 months with the reinstating of this regulation on 1/6/22. Child #1's agreement and emergency contact form were reviewed on 8/21 and then on 3/15/22.

Health and safety training on file for Staff #2 and #5 was observed not to be valid due to the fact that the trainings were completed prior to September 30, 2016.

The operator did not provide instructions for contacting the appropriate regional child care office.

The files of Staff #2, #3, and #4 lacked documentation of an annual minimum of 12 clock hours of child care training.