Cradle to Krayons

Observed a pack 'n play with a loose sheet in the Infant/Toddler Room creating a potential suffocation hazard.

The file of Staff #1 lacked a DHS FBI Clearance updated every 60 months. The file of Staff #1 contained a DHS FBI Clearance dated 5/27/21 with a previous one dated 4/27/16.

The file of Staff #2 lacked documentation of receiving training regarding the emergency plan on annual basis. The file of Staff #2 contained documentation of emergency plan training on 4/29/24 but no documentation of emergency plan training in 2025.

Observed Germ X Moisturizing Original Hand Sanitizer which indicated "keep out of the reach of children" on the table beside the building in the Outdoor Play Space which was accessible to children.

Observed foam blocks with bite marks in the 2nd storage cabinet in the Outdoor Play Space.

Staff #1 lacked documentation of completing mandated reporter training every 60 months. Staff #1 had documentation of completing mandated reporter training on 6/9/25 with previous training completed on 6/3/20.

Emergency contact information for Child #1 did not include the complete home address of the enrolling parent.

Emergency contact information for Child #2 did not include 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.

Emergency contact information for Child #3 did not include health insurance coverage and policy number for a child under a family policy or Medical Assistance benefits, if applicable.

The file of Staff #6 lacked a State Police Clearance, Child Abuse Clearance, and DHS FBI Clearance updated every 60 months. The file of Staff #6 contained a State Police Clearance dated 11/10/23 with a previous one dated 8/11/18. The file of Staff #6 contained a Child Abuse Clearance dated 11/10/23 with a previous one dated 8/1/18. The file of Staff #6 contained a DHS FBI Clearance dated 11/13/23 with a previous one dated 8/6/18. Staff #7 lacked a valid State Police Clearance. Staff #7 had a State Police Clearance dated 5/10/23 which indicated "results still pending". The file of Staff #8 lacked documentation of application for the State Police Clearance prior to or on the date of initial hire (SEE LIS Code Sheet). The file of Staff #8 contained a State Police Clearance dated 6/14/24. The file of Volunteer #9 lacked a National Sex Offender Registry Certificate and disclosure statement.

The letter to the parent explaining emergency procedures did not address accommodations for infants, toddlers, children with disabilities, and children with chronic medical conditions.

Observed a portable space heater in the office.

Observed approximately a 3 1/2 foot doll house in the Preschool Room which was not anchored creating a potential tipping hazard.

Observed foam blocks and letters with bite marks on a shelf in the Men's Bathroom.

The files of Children #3 and #4 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 9/20/23 and 4/12/24. The file of Child #4 contained health reports dated 7/25/23 and 5/14/24.

The file of Child #4, a 2-year-old, lacked Hepatitis B, DTAP/DTP/TD, Pneumococcal, and Polio immunizations according to the recommendations of the ACIP. Child #4 had documentation of 2 Hepatitis B immunizations, 2 DTAP/DTP/TD immunizations, 2 Pneumococcal immunizations, and 2 Polio immunizations.

The file of Staff #4 lacked an initial health assessment which included tuberculosis screening by Mantoux method at initial employment (SEE LIS Code Sheet). Staff #4 had a Mantoux test read date of 8/17/19.

The facility did not have an emergency plan that provides for accommodations for toddlers and children with chronic medication conditions.

The Director or designated person who is responsible for compliance with this chapter did not ensure that the hypothetical locations of the fire were rotated around the facility for each drill such that the hypothetical location was never the same for consecutive drills.

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 7/3/23, 8/3/23, 9/11/23, 10/11/23, 11/17/23, 12/19/23, 1/18/24, 2/12/24, 3/13/24, 4/9/24, 5/9/24, 6/9/24, and 7/2/24.

The file of Staff #5 lacked documentation of completing the Pennsylvania Health and Safety Update 2022 by December 30, 2022 (SEE LIS Code Sheet). The file of Staff #5 contained documentation of completing the health and safety update on 1/12/23.

The files of Staff #3 and #6 lacked documentation of participating, at least annually, in fire safety training conducted by a fire protection professional. The file of Staff #3 contained documentation of fire safety training completed on 6/10/24 with previous training completed on 5/25/23. The file of staff #6 contained documentation of fire safety training completed on 6/10/24 with previous training completed on 5/30/23.

Staff #3 and Staff #6 lacked documentation of completing mandated reporter training every 60 months. Staff #3 had documentation of mandated reporter training completed on 5/24/23 with previous training completed on 2/16/18. Staff #6 had documentation of mandated reporter training completed on 11/7/23 with previous training completed on 11/2/18.

The file of Staff #6, who was designated as an assistant group supervisor, lacked documentation of 2 years experience with children.

The agreement for Child #2 did not specify the amount of the fee to be charged per day or per week.

The agreement for Child #3 did not specify the child's departure times.

Emergency contact information for Child #2 did not include 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.

Emergency contact information for Child #1 did not include the complete address of the individual designated by the parent to whom the child may be released.

The emergency contact and agreement for Child #3 were not reviewed and updated at least once in a 6-month period. Child #3's emergency contact was signed on 8/25/23 and reviewed on 3/5/24 and 6/24/24. Child #3's agreement was signed on 8/29/23 and reviewed on 3/5/24 and 6/24/24. The emergency contact for Child #4 was not reviewed and updated at least once in a 6-month period. Child #4's emergency contact was signed on 8/21/23 and reviewed on 3/5/24 and 6/25/24.

The file of Volunteer #9 lacked two written, nonfamily references from individuals attesting to the person's suitability to serve as a facility person.

Staff persons #1, #2, #3, #4, #5, #6, and #7 do not have acceptable pediatric first aid/CPR training in an approved curriculum; however, the trainer is PQAS-certified in that training topic.

The file of Staff #4 lacked documentation of completing professional development in pediatric first aid and pediatric cardiopulmonary resuscitation within 90 days of hire (SEE LIS Code Sheet). The file of Staff #4 contained documentation of completing pediatric first aid and pediatric cardiopulmonary resuscitation on 6/15/24.

It was in the outdoor play space on the left side of the exit door, a large blue tote with a cracked lid.

On the day of inspection, the health report on file for child #2 did not contain documentation of an updated health report. This is evidenced by the last health report being dated 7/6/22.

The agreement form on file for Child #1 was observed not to contain the persons designated by a parent to whom the child may be released.

It was observed that the child records were not stored in a locked filing cupboard.

A cracked magnetic block and a broken plastic bin were observed in the preschool room. It was also observed in the outdoor play area peeling table clothes on the picnic tables.