Carlow University Early LRG Center

In the Young Toddler Room, at approximately 10:00am, three staff and ten young toddlers were observed. After conducting a first supervision/ ratio check including all 3 staff, the director stated that one of the staff were new and were not serving as part of the child: staff ratio. A second supervision/ ratio check was conducted. Staff person #2 identified and named 6 young toddlers as part of her supervision group and Staff person #1 identified and named all 10 young toddlers as part of her supervision group. Therefore, Staff #1 exceeded the child: staff ratio by one child and Staff #2 exceeded the child: staff ratio by 4 children.

In the Young Toddler Room, a bottle of children's Zyrtec was observed to not be labeled with the child's name for whom the medication is intended for.

At approximately 10:15am in the Young Toddler Room, during a diaper change, Staff was observed to not immediately discard the soiled diaper into a plastic-lined, hands-free covered can until completing the diaper change.

The staff file for Staff person #1, contained a current health assessment dated 3/5/24 which was conducted more than 24 months from the previously dated 2/25/22 health assessment on file.

The staff file for Staff person #4 was observed to contain a tuberculosis screening test results dated 7/12/23 which was conducted more than 12 months prior to providing initial service in a childcare setting.

The staff file for Staff person #3, contained a current health assessment dated 9/10/24 was observed to lack an examination for communicable diseases and the results of that examination.

The staff file for Staff person #3, contained a current health assessment dated 9/10/24 was observed to lack the physician's or CRNP's assessment of the person's suitability to provide childcare.

The staff file for Staff person #1 contained current staff evaluation dated 3/4/24 which was not completed at least one every 12 months from the previous staff evaluation on file dated 2/6/23. The staff file for Staff person #2 contained current staff evaluation dated 3/1/24 which was not completed at least one every 12 months from the previous staff evaluation on file dated 2/6/23.

The child file for Child #1 was observed to contain a current emergency contact information form that lacked the health insurance policy number.

At approximately 2:00 pm in the infant room, staff person #1, #2 and #3 were in the infant room with 3 infants. Staff person #2 was in the crib area, sitting in a rocking chair holding an infant, with the chair facing the back wall. Staff person #1 and #3 were in the other half of the room, outside the crib area. Upon approaching staff person #2, it was observed that their eyes were closed and remained closed for a few seconds, before opening them. The 4 month old infant they were holding appeared to be asleep, as the child's eyes were closed and remained closed. In addition, there was an infant sleeping behind staff person #2 and because the child's face was behind a wall, none of the 3 staff could see the child's face.

At approximately 2:00 pm in the infant room, staff person #1, #2 and #3 were in the infant room with 3 infants. Staff person #2 was in the crib area, sitting in a rocking chair holding an infant, with the chair facing the back wall. Staff person #1 and #3 were in the other half of the room, outside the crib area. Upon approaching staff person #2, it was observed that their eyes were closed and remained closed for a few seconds, before opening them. The 4 month-old infant they were holding appeared to be asleep, as the child's eyes were closed and remained closed.

At approximately 2:00 pm in the infant room, staff person #1, #2 and #3 were in the infant room with 3 infants. Staff person #2 was in the crib area, sitting in a rocking chair holding an infant, with the chair facing the back wall. Staff person #1 and #3 were in the other half of the room, outside the crib area. Upon approaching staff person #2, it was observed that their eyes were closed and remained closed for a few seconds, before opening them. The 4 month old infant they were holding appeared to be asleep, as the child's eyes were closed and remained closed.

The last two professional testing reports for the facility's fire detection system was dated 8/19/22 and 10/18/23.

The health and safety training update in the file for staff person #3, hired before 10/4/22, was dated 2/1/23.

The most recent agreement in the file for child #1 and #2 did not specify the child's date of admission.

Staff person #1 through #13 were caring for children unsupervised. Staff person #1 through #13 have not completed the following pre-service training required prior to caring for children unsupervised: FA/CPR training.

The file for facility person #13, who lived out of state in the 5 years previous to volunteering at the facility, did not contain the child abuse clearance and sex offender clearance for that state.

Upon entering the infant room at approximately 10:16 am, an infant was observed sleeping in a bouncy seat. When the child was still sleeping in the seat at 10:26 am, staff were told that the child could not sleep in the seat.

Upon entering the infant room at approximately 10:16 am, staff person #4 and #11, as well as, facility person #12, were observed in the infant room with 6 children, a combined group of 4 infants and 2 young toddlers. At that time, an infant was observed sleeping in a bouncy seat. When the child was still sleeping in the seat at 10:26 am, staff were asked to remove the child from the seat.

The last two health reports in the file for child #2, a young toddler, were dated 8/11/21 and 7/11/22.

The last two health assessments in the file for staff person #3 were dated 7/14/20 and 7/19/22. The last two health assessments in the file for staff person #9 were dated 9/28/20 and 10/8/22. The last two health assessments in the file for staff person #11 were dated 3/8/20 and 10/21/22. There was no health assessment in the file for facility person #12 and #13.

There was no TB screening in the file for facility person #12 and #13. Based on observation and conversation with the operator, the individuals assist in the classrooms.

The last two emergency drills on file at the facility were dated 8/23/21 and 9/15/22

The fire testing report dated 8/19/22 included deficiencies at the time of the inspection. Based on conversation with the operator, the deficiencies were corrected, but there was no documentation of the corrections at the time of the inspection.

Staff person #1 through #12 have not completed the following required pre-service training within 90 days of their date of hire: FA/CPR training.

The last two fire safety trainings in the file for staff person #1 though #11 were dated 10/8/21 and 10/21/22.

The file for staff person #4 included a health and safety training dated 11/2/22, which was beyond their first 90 days of employment.

The most recent emergency contact information in the file for child #1 did not contain signed parental consent for minor first-aid.

The file for facility person #12 and #13 did not include 2 letters of reference. Based on observation and conversation with the operator, the individuals assist in the classrooms.

The PA Child Abuse clearance on file for Staff person #4, with a hire date of 3/31/21, was obtained for volunteer purposes.

The NSOR on file for Staff person #4, with a hire date of 3/31/21, is dated 11/2/21, more than 45 days after hire, 5/15/21.

The immunization record on file for Child #1 includes 2/3 Rotavirus vaccinations, 2/3 DTAP vaccinations, 2/3 Pneumococcal vaccinations, and 2/3 Polio vaccinations as recommended by the ACIP for a child this age.

The 2 most recent health assessments on file for Staff person #1 are dated 2/20/19 and 4/23/21, more than 24 months apart. The 2 most recent health assessments on file for Staff person #3 are dated 8/21/19 and 11/1/21, more than 24 months apart.

According to the fire drill log on file at the facility, the two most recent fire drills, dated 9/10/21 and 10/20/21 used the same hypothetical location.

The facility does not have verification of proof of purchase for the interconnected fire detection system, as required by current regulation.

The pediatric first aid/CPR certification on file for Staff person #2, with a hire date of 6/21/21, is dated 10/8/21, more than 90 days after hire, 9/19/21, as required following the implementation of the current regulations. The pediatric first aid/CPR certification on file for Staff person #4, with a hire date of 3/31/21, is dated 7/24/21, more than 90 days after hire, 6/29/21, as required following the implementation of the current regulations

The verification of completed health and safety training on file for Staff person #2, with a hire date of 6/21/21, is dated 10/28/21, more than 90 days after hire, 9/19/21, as required following the implementation of the current regulations. The file for Staff person #4, with a hire date of 6/21/21, does not include verification of completed health and safety training, which was to be completed within 90 days after hire, 6/29/21, as required following the implementation of the current regulations.