Faith Builders Day Care

The file for staff person #3 was observed to lack documentation of a high school diploma or a general educational development certificate

The file for child #1 was observed to contain an emergency contact form that lack a parent's signature giving consent for emergency medical care.

The files for children #1 and #2 were observed to contain emergency contact forms the lacked the address of the individual designated by the parent to whom the child may be released.

The file for child #1 was observed to contain an emergency contact form that lack a parent's signature giving consent for minor first-aid procedures by facility staff.

The file for Staff person #1 was observed to lack two written, nonfamily references from individuals attesting to the person's suitability to serve as a facility person. This was evidenced by only one written reference present in the file.

Staff person #1 admitted to and was observed on camera striking a child's hand in response to the child touching under another child's clothing.

Based on video footage and interviews, Child #1 exited the indoor play space unnoticed by Staff #1 and Staff #2. Video footage showed Child #1 climbing into a stroller located on the other side of the door from which Child #1 exited. Video footage showed Child #1's mother coming through the entrance door and going down the stairs at the entrance. Video footage then showed Child #1's mother coming up the stairs on the opposite side of the entrance and getting Child #1 out of the stroller. During the interview process, Staff #1 and Staff #2 indicated Child #1's mother came to the door of the play space to tell them she had Child #1. Based on video footage, Child #1 was alone in the lobby for approximately 1 minute.

Based on video footage and interviews, Child #1 exited the indoor play space unnoticed by Staff #1 and Staff #2. Video footage showed Child #1 climbing into a stroller located on the other side of the door from which Child #1 exited. Video footage showed Child #1's mother coming through the entrance door and going down the stairs at the entrance. Video footage then showed Child #1's mother coming up the stairs on the opposite side of the entrance and getting Child #1 out of the stroller. During the interview process, Staff #1 and Staff #2 indicated Child #1's mother came to the door of the play space to tell them she had Child #1. Based on video footage, Child #1 was alone in the lobby for approximately 1 minute.

Observed 2 strollers obstructing the middle doors of the indoor play space.

The Director or designated staff person who is responsible for compliance with this chapter did not ensure that fire drills were conducted at least once every 60 days. The facility provided documentation of fire drills being conducted on 3/26/24, 5/24/24, 7/23/24, 9/20/24, and 11/20/24.

Staff person #2 has completed the health and safety course titled Get Started with Center-Based Care: Building Blocks for Quality but has not completed the required health and safety update course titled Pennsylvania Health and Safety Update 2022 (1 hour) training.

Staff #1 lacked renewal of their certification in pediatric first-aid and pediatric cardiopulmonary resuscitation on or before the expiration of the most current certification. Staff #1 had documentation of completing pediatric first-aid and cardiopulmonary resuscitation training on 7/2/24 with a previous one completed on 5/25/22.

The facility was observed to be providing the parent of each enrolled child a letter explaining the emergency procedures, however this letter failed to include the accommodations for infants, toddlers, children with disabilities and children with chronic medical conditions.

A clear spray bottle that contained a clear liquid and no written identification of the contents was observed sitting on the cubbies in the infant room.

A first-aid kit was observed to be accessible to children in the facility's 3-year-old room.

A first-aid kit that contained the following: soap, an assortment of adhesive bandages, sterile gauze pads, tape, scissors and disposable, nonporous gloves, but did not contain, tweezers was observed in the facilities 4-year-old Classroom.

A container of Vicks medication labeled "keep out of the reach of children" was observed stored in a child's cubby and therefore within the reach of children.

The facility was observed to have a written consent for administration of Diazepam gel medication for child #11 that lacked the enrolling parent's signature.

The facility was observed to have a medication log for child #12 that failed to include special notes, if any related to problems of administration.

The facility was observed to lack a written policy addressing Shaken Baby Syndrome and Abusive Head Trauma.

The files for children #1 and #6 were observed to contain financial agreements that failed to specify the date of the child's admission.

The files for children #1, #2, #3, #4, #5, #6, #7, #8 and #10 were observed to contain an agreement that failed to specify the services which are to be considered as extra.

The file for child #1 was observed to contain an original agreement.

The file for child #9 was observed to contain an emergency contact form that failed to include the work addresses and telephone numbers of the enrolling parent.

The file for child #9 was observed to contain an emergency contact information that failed to include information (if any) on the child's special needs, as specified by the child's parent, physician, physician's assistant or CRNP.

The Director or designated staff person who is responsible for compliance with this chapter did not ensure fire drills were conducted at least once every 60 days. The facility provided documentation of fire drills being conducted on 9/29/23 and 3/26/24.

2nd citation. Previously cited on 10/18/23. Observed an electrical outlet between the windows on the orange wall in Room 104 which lacked protective receptacle covers.

2nd citation. Previously cited on 10/18/23. Observed Boudreaux's Butt Paste which indicated "keep out of the reach of children" in a plastic bin on the floor beside the changing table in the Women's Bathroom on the 2nd floor which was accessible to children.

2nd citation. Previously cited on 10/18/23. Observed hard corn kernels in the outdoor play space by the Step 2 Playhouse which were accessible to children.

2nd citation. Previously cited on 10/30/23. The file of Staff #1, who was designated as a group supervisor, lacked documentation of meeting one of the applicable staff qualifications for the position in which the person is performing.

2nd citation. Previously cited on 10/30/23. The files of Children #1, #2, #3, and #4 lacked child service reports completed at least every 6 months. The file of Child #1, who had an admission date of 8/23/21, did not contain a child service report. The file of Child #2, who had an admission date of August 2022, did not contain a child service report. The file of Child #3, who had an admission date of 8/23/21, did not contain a child service report. The file of Child #4, who had an admission date of 2/27/23, did not contain a child service report.

On 10/18/23 Staff person #2 was observed to be caring for children unsupervised. Staff person #2 has not completed the following pre-service training required prior to caring for children unsupervised: pediatric first aid and CPR training and 10-hour health and safety training.

On 10/18/23 Certification Staff observed Staff #2, a provisional hire, taking children from the 3-Year-Old Classroom (Room 302) to the bathroom alone and not in the vicinity of a permanent employee.

The file of Staff #1, a provisional hire, lacked documentation of application for the National Sex Offender Registry Certificate and FBI fingerprint receipt dated prior to or on the date of initial hire (SEE LIS Code Sheet). The file of Staff #1 contained an FBI Clearance dated 5/24/22 and contained no NSOR. Staff #1 was not suspended after 45 days. The file of Staff #3, a provisional hire, lacked the results of the Child Abuse Clearance prior to employment (SEE LIS Code Sheet). The file of Staff #3 contained a Child Abuse Clearance dated 9/7/23. The file of Staff #5 lacked a valid FBI Clearance because it did not contain a disposition for charges. The files of Staff #8 and #9 lacked a disclosure statement signed at the time of initial employment (SEE LIS Code Sheet). The file of Staff #8 contained a disclosure statement dated 8/31/21. The file of Staff #9 contained a disclosure statement dated 8/26/21.

On 10/18/23 observed a pair of adult scissors in the drawer under the microwave and above the cabinet door labeled "bleach" in the kitchen which were accessible to children.

The files of Staff #8 and #9 lacked documentation of training regarding the emergency plan on annual basis. The file of Staff #8 contained documentation of emergency plan training completed on 12/22/22 with previous training completed on 9/3/21. The file of Staff #9 contained documentation of emergency plan training completed on 10/26/22 with previous training completed on 9/2/21.

On 10/18/23 observed an electrical outlet between the windows on the orange wall in Room 104 which lacked protective receptacle covers. On 10/18/23 observed electrical outlets on the power strip on the microwave which lacked protective receptacle covers in the 3-year-old Room. On 10/18/23 observed an electrical outlet which lacked a protective receptacle cover by the black cabinet in Room 303. On 10/18/23 observed an electrical outlet which lacked a protective receptacle cover to the left of the closet in Room 303.

On 10/18/23 observed Equate Sunscreen and Coppertone Pure and Simple 100 Mineral Sun Protection which indicated "keep out of the reach of children" in a plastic bin on the 2nd shelf from the bottom which were accessible to children in Room 103. On 10/18/23 observed Johnson Baby Lotion which indicated "keep out of the reach of children" in a plastic bin on the floor beside the changing table in the Women's Bathroom on the 2nd floor which was accessible to children.

On 10/18/23 observed a first-aid kit on a hook approximately 2 1/2 feet from the floor in Room 104 which was accessible to children.

On 10/18/23 observed the end cap of the baseboard heater was loose by the Lego table in Room 303.

On 10/18/23 observed peeling paint on the baseboard heater under numbers and the alphabet in Room 303. On 10/18/23 observed peeling paint in the left bottom corner of the bathroom stall closest to the window in the Women's Bathroom on the 2nd floor.

On 10/18/23 the counter height sinks in Rooms 201 (Older Infant), 101 (Young Toddler), and 102 (Young Toddler) did not have platforms or steps to be easily approached.

On 10/18/23 observed plastic grocery bags and ziploc bags on the 2nd shelf from the bottom on the bookcase beside the entrance in Room 102 which were accessible to children. On 10/18/23 observed hard corn kernels in the outdoor play space by the Step 2 Playhouse which were accessible to children.

On 10/18/23 observed a microwave on top of a mini fridge in Room 102 which was not anchored creating a potential tipping hazard. On 10/18/23 observed a microwave on top of a mini fridge in the 3-year-old Room which was not anchored creating a potential tipping hazard. On 10/18/23 observed a microwave on top of a mini fridge in Room 104 which was not anchored creating a potential tipping hazard.

On 10/18/23 observed rest equipment not labeled for the use of a specific child in Room 103.

On 10/18/23 the refrigerator in Room 104 lacked an operating thermometer.

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 1/28/22, 4/29/22, and 2/3/23.

The file of Child #1 lacked an updated health report at least every 12 months for an older toddler or preschool child. The file of Child #1 contained a current health report dated 5/11/23 with a previous one dated 4/22/22.

Child #6, a 16-month-old, lacked Pneumococcal immunizations according to the recommendations of the ACIP. Child #6 had documentation of 3 Pneumococcal immunizations.

The files of Staff #3 and #6 contained health assessments which did not include an examination for communicable diseases and the results of that examination.

The files of Staff #3 and #6 contained health assessments which did not include the physician's or CRNP's assessment of the person's suitability to provide child care.

On 10/18/23 the operator lacked documentation of sending a copy of the emergency plan updates to the local municipality and to the county emergency management agency.

The file of Staff #10 lacked documentation of completing the Pennsylvania Health and Safety Update 2022 by December 30, 2022 (SEE LIS Code Sheet). The file of Staff #10 contained documentation of completing the health and safety update on 6/12/23.

The file of Staff #10 lacked documentation of participating, at least annually, in fire safety training conducted by a fire protection professional. The file of Staff #10 contained documentation of fire safety training completed on 8/22/23 with previous training completed on 5/18/22.

The files of Staff #4 and #7, who were designated as group supervisors, lacked documentation of meeting one of the applicable staff qualifications for the position in which the person is performing.

The file of Staff #3, who was designated as an assistant group supervisor, lacked documentation of a high school diploma or general educational development certificate. The file of Staff #9, who was designated as an assistant group supervisor, lacked documentation of 2 years' experience with children.

On 10/18/23 the written plan of daily activities was not posted in Room 303.

The files of Children #1, #2, #3, #5, and #6 lacked child service reports completed at least every 6 months. The file of Child #1, who had an admission date of 8/23/21, did not contain a child service report but contained Ages and Stages. The file of Child #2, who had an admission date of August 2022, did not contain a child service report but contained Ages and Stages. The file of Child #3, who had an admission date of 8/23/21, did not contain a child service report but contained Ages and Stages. The file of Child #5, who had an admission date of 2/27/23, did not contain a child service report but contained Ages and Stages. The file of Child #6, who had an admission date of 9/21/22, did not contain a child service report but contained Ages and Stages.

The agreements for Children #1, #2, #3, #4, #5, and #6 lacked the date of the child's admission.

The emergency contact for Child #1 did not include written consent signed by a parent for emergency medical care.

The emergency contacts for Children #1 and #6 were not reviewed and updated at least once in a 6-month period. Child #1's emergency contact was reviewed on 9/14/22, 1/17/23, and 10/9/23. Child #6's emergency contact was signed on 9/20/22 and reviewed on 1/17/23.

The file of Child #1 did not contain signed parental consent for administration of minor first-aid procedures by facility staff on the emergency contact form.

*Based on video footage and staff interviews, Staff #1 and #2 placed Child #1 in a highchair for 7 minutes before then placing Child #1 in a car seat for 46 minutes.

**Based on video footage and staff interviews, Staff #1 and #2 placed Child #1 in a highchair for 7 minutes before then placing Child #1 in a car seat for 46 minutes.

***Based on video footage and staff interviews, Staff #1 and #2 placed Child #1 in a highchair for 7 minutes before then placing Child #1 in a car seat for 46 minutes.

The file of Staff #1 lacked documentation of completing the Pennsylvania Health and Safety Update by December 30, 2022 (SEE LIS Code Sheet). The file of Staff #1 contained documentation of completing the health and safety update on 6/13/23. Staff person #2 was observed to be caring for children unsupervised. Staff person #2 has not completed the following pre-service training required prior to caring for children unsupervised: mandated reporter training, health and safety training, and pediatric first aid/CPR from a PQAS approved trainer and a PQAS approved curriculum.

Based on interviews, Child #1 was denied a popsicle at afternoon snack for not napping.

Based on documentation and interviews, staff did not follow a special diet that is prescribed by a physician, physician's assistant or CRNP as treatment related to the child's special needs.

The file of Staff #1 lacked documentation of completing the Pennsylvania Health and Safety Update 2022 by December 30, 2022 (SEE LIS Code Sheet). The file of Staff #1 contained documentation of completing the Pennsylvania Health and Safety Update 2022 on 3/20/23.

The file of Staff #2 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 #2 contained documentation of completing pediatric first aid and pediatric cardiopulmonary resuscitation on 12/28/22.

Staff person #3 was observed to be caring for children unsupervised. Staff person #3 has not completed the following pre-service training required prior to caring for children unsupervised: mandated reporter training, pediatric first aid and CPR training, and 10-hour health and safety training.

At approximately 10:45 AM Certification Staff observed Staff #3, a provisional hire, working alone in the 3-Year-Old Classroom (Room 302) and not in the vicinity of a permanent employee.

At approximately 10:20 AM Staff #1 and #2 were caring for a group of 12 mixed age children which included 11 older toddlers and 1 preschooler. Staff #1 and #2 indicated they were sharing responsibility of the children. When asked to name the children, Staff #1 was able to name all of them, but Staff #2 was only able to name 10 of them.

At approximately 1:15 PM Staff #1 and Staff #2 were caring for a group of 9 mixed-age children which included 5 infants and 4 young toddlers. When asked to name the children in their assigned groups, Staff #1 named 1 infant and 4 young toddlers, and Staff #2 named 4 infants.

2nd citation. Previously cited on 10/24/22. The files of Staff #3, #4, #5, and #6 lacked documentation of receiving training regarding the emergency plan at the time of initial employment (SEE LIS Code Sheet). The files of Staff #3, #4, #5, and #6 do not contain documentation of any emergency plan training.

2nd citation. Previously cited on 10/17/22. Observed Purell Hand Sanitizer and Xtra Hand Sanitizer which indicated "keep out of the reach of children" at the handwashing sink in Room 102 which were accessible to children. Observed Purell Hand Sanitizer and Xtra Hand Sanitizer which indicated "keep out of the reach of children" at the handwashing sink in Room 103 which were accessible to children.

2nd citation. Previously cited on 10/17/22. Observed the diapering area in the Toddler Classroom lacked a source of running water for handwashing. Staff open and close a gate to get to the sink located in the Infant side of the classroom.

2nd citation. Previously cited on 10/24/22. The file of Child #1, an 11-month-old, lacked a current influenza immunization in accordance with the schedule recommended by the ACIP. The file of Child #3, a 10-month-old, lacked a current influenza immunization in accordance with the schedule recommended by the ACIP.

2nd citation. Previously cited on 10/17/22. Observed the prescription medication for Child #4 was not in the original container in Room 101.

2nd citation. Previously cited on 10/17/22. The operator did not establish a medication log for prescription medication for Child #5.

2nd citation. Previously cited on 10/17/22. The diapering area in the Toddlers Classroom lacked a plastic-lined, hands-free covered can.

2nd citation. Previously cited on 10/24/22. The file of Child #2 lacked an initial health report no later than 60 days following the first day of attendance at the facility. The file of Child #2 contained 2 health reports which are not dated, and one of them is not signed by a physician, physician's assistant, or a CRNP.

2nd citation. Previously cited on 10/24/22. The files of Staff #7 and #8, who were designated as assistant group supervisors, lacked documentation of 1 year of experience with children.

2nd citation. Previously cited on 10/24/22. The file of Staff, #1, who was designated as an assistant group supervisor, lacked documentation of 2 years' experience with children.

2nd citation. Previously cited on10/24/22. The file of Child #1 lacked the complete address of the child's physician or source of medical care on the emergency contact form.

2nd citation. Previously cited on 10/24/22. The file of Staff #7 lacked two written, nonfamily references from individuals attesting to the person's suitability to serve as a facility person.

2nd citation. Previously cited on 10/24/22. 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): pediatric first aid and CPR.

The files of Staff #3, #4, #9, #11, and #15 lacked a signed disclosure statement dated at the time of providing initial care (SEE LIS Code Sheet). The file of Staff #3 contained a disclosure statement dated 2/9/21. The file of Staff #4 contained a disclosure statement dated 12/12/21. The file of Staff #9 contained a disclosure statement dated 8/31/21. The file of Staff #11 contained a disclosure statement dated 1/1/22. The file of Staff #15 contained a disclosure statement dated 7/5/22. The file of Staff #4 lacked a completed copy of the State Child Abuse and Neglect Registry Check and Sex Offender Registry Check from the State(s) in which Staff #4 resided in the last 5 years prior to providing initial service in child care (SEE LIS Code Sheet). The file of Staff #4 did not contain a Child Abuse and Registry Check and Sex Offender Registry Check from the State(s) in which Staff #4 resided. The file of Staff #6, a provisional hire, lacked documentation of application for the State Child Abuse and Neglect Registry Check from the State(s) in which Staff #6 resided in the last 5 years prior to or on the date of initial hire (SEE LIS Code Sheet). The file of Staff #6 did not contain a…

At approximately 1:45 PM on 10/17/22 Certification Staff entered the 3 Year Old Classroom to assess supervision and ratio at naptime. Certification Staff observed child care staff sitting on one side of the classroom. When Certification Staff went to speak to child care staff, Certification Staff was unable to see 4 children on the other side of the classroom because it was too dark.

On 10/17/22 observed adult scissors on the table along the wall at the entrance to the School-Age Classroom which were accessible to children. On 10/17/22 observed adult scissor in the drawer under the phone in the kitchen which were accessible to children. On 10/17/22 observed pairing knives in the drawer to the right of the single sink in the kitchen which were accessible to children.

The files of Staff #1, #3, #7, #10, #11, #12, #15, #18, and #22 lacked documentation of receiving training regarding the emergency plan at the time of initial employment (SEE LIS Code Sheet). The files of Staff #1, #3, #7, #10, #11, #12, #15, #18, and #22 do not contain documentation of any emergency plan training. The file of Staff #9, #13, #20, and #21 lacked documentation of training regarding the emergency plan on an annual basis. The file of Staff #9 contained documentation of emergency plan training on 8/19/21 but no documentation for 2022. The file of Staff #13 contained documentation of emergency plan training on 8/23/21 but no documentation for 2022. The file of Staff #20 contained documentation of emergency plan training on 10/8/21 but no documentation for 2022. The file of Staff #21 contained documentation of emergency plan training on 9/2/21 but no documentation for 2022.

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

On 10/17/22 observed hand sanitizer spray and Berkley Jensen Disinfecting wipes which both indicated "keep out of the reach of children" on the hand washing sink which were accessible to children located in the Young Toddler Classroom (Room 102). On 10/17/22 observed Boogie Diaper Rash Spray and Aquaphor which indicated "keep out of the reach of children" in a bin which was accessible to children between the sink and changing table in the Older Toddler Classroom. On 10/17/22 observed Boogie Diaper Rash Spray, Caldesene medicated protecting power, and Aquaphor which indicated "keep out of the reach of children" under the changing table which were accessible to children in the Older Toddler Classroom. On 10/17/22 observed Lysol Disinfecting Wipes which indicated "keep out of the reach of children" on the book caddy in the School-Age Classroom which were accessible to children. On 10/17/22 observed Eczema Care and Desitin which both indicated "keep out of the reach of children" in bins beside the changing table in the Girls Bathroom located on the 2nd floor which were accessible to children. On 10/17/22 observed Lysol Disinfecting Wipes which indicated "keep out of the reach of…

The telephone number of the nearest hospital was not posted by the telephone in the following classrooms: Young Infant, Toddlers (1-2), Young Toddler (Room 101), Young Toddler (Room 102), Older Toddler, Older Toddlers (Room 104), 3 Year Old Classroom, 4 Year Old Classroom, and School-Age Classroom.

On 10/17/22 observed a first-aid kit on a hook in a cubby in the 4 Year Old Classroom which was accessible to children. On 10/17/22 observed a first-aid kit on the table to the right of the entrance of the School-Age Classroom which was accessible to children.

The first-aid kit in the Older Toddlers Classroom (Room 104) lacked the following: adhesive bandages, sterile gauze pads, tweezers, and tape.

On 10/17/22 observed the gate used to block off the mini-split heating/cooling system located in the outdoor play space was not secured to the building.

On 10/17/22 the sink in the Young Infant Classroom lacked a clean, lidded waste receptacle. On 10/17/22 observed the sinks in the Boys and Girls Bathrooms on the 2nd floor lacked clean, lidded waste receptacles. On 10/17/22 the sink in the Women's Bathroom located by the Young Toddler Classrooms lacked a clean, lidded waste receptacle.

On 10/17/24 observed the diapering area in the Young Infant and Toddlers Classrooms lacked a source of running water for handwashing. The diapering area is located on the Toddler side of the classroom, and the handwashing sink is located on the Infant side of the classroom. Staff open and close a gate to get from the diapering area to the handwashing sink.

On 10/17/22 observed a Nerf football with pieces missing in the outdoor play space. On 10/17/22 observed a cracked bin containing mobile animals in the 4 Year Old Classroom.

On 10/17/22 observed foam blocks with bite marks in 3 Year Old Classroom. On 10/17/22 observed foam shapes with bite marks in the School-Age Classroom.

On 10/17/22 observed rest equipment not labeled for the use of a specific child in the following classrooms: Older Toddler, 3 Year Old Classroom, and 4 Year Old Classroom.

The file of Child #6 contained a health report dated 8/8/22 which lacked a review of the child's immunized status according to the recommendations of the ACIP.

The file of Child #1, a 16 month old, lacked Hepatis A immunizations in accordance with the schedule recommended by the ACIP. The file of Child #1 did not contain documentation of Hepatitis A immunizations. The file of Child #5, a 3 year old, lacked a current influenza immunization in accordance with the schedule recommended by the ACIP. The file of Child #8, an 11 month old, lacked a current influenza immunization in accordance with the schedule recommended by the ACIP. The file of Child #10, a 10 month old, lacked a current influenza immunization in accordance with the schedule recommended by the ACIP.

On 10/17/22 observed prescription medication for Child #12 which was not in the original container in the Young Toddler Classroom (Room 101).

On 10/17/22 observed an Epipen on a shelf by the refrigerator in the 3 Year Old Classroom which was accessible to children. On 10/17/22 observed an Epipen in a bag hung in a cubby in the 4 Year Old Classroom which was accessible to children.

The operator did not establish a medication log for prescription medication for Children #12, #13, and #14.

On 10/17/22 the diapering area in the Toddlers Classroom lacked a plastic-lined, hands-free covered can. On 10/17/22 the diapering area in the Girls Bathroom located on the 2nd floor lacked a plastic-lined, hands-free covered can.

The files of Staff #1 and #20 lacked an initial health assessment which included tuberculosis screening by the Mantoux method at initial employment (SEE LIS Code Sheet). Staff #1 had a health assessment dated 12/5/21 but a Mantoux test read date of 12/11/21. Staff #20 had a health assessment dated 6/18/21 but a Mantoux test read date of 2/14/20.

The file of Staff #9 contained a health assessment which included an examination for communicable diseases and the results of that examination but did not describe the conditions and the risk it might pose to others exposed to this individual. The file of Staff #23 contained a health assessment which did not include an examination for communicable diseases and the results of that examination.

The Director or designated staff person did not ensure that fire drills were conducted at least once every 60 days. The facility provided documentation of fire drills being conducted on 10/13/21, 12/22/21, 2/22/22, 4/25/22, 6/28/22, and 8/29/22.

The facility was unable to provide written documentation that the fire detection system was manually tested at least every 30 days or inspected by a fire safety professional annually. The facility provided a written record that the fire detection system was manually tested on 9/24/21, 10/26/21, 11/23/21, 12/22/21, 1/11/22, 2/22/22, 3/22/22, 5/31/22 and 7/27/22. The facility provided documentation the the fire detection system was inspected by a fire protection professional on 9/26/22 but did not have documentation for 2021.

The file of Child #5 lacked an initial health report no later than 60 days following the first day of attendance at the facility. The file of Child #5 contained 2 health reports which are not dated, and one of them is not signed by a physician, physician's assistant, or a CRNP.

The operator did not notify local traffic safety 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 letters addressed to local traffic safety authorities dated 8/1/21 and on 9/14/22.

Staff persons #2, #5, and #22 were observed to be caring for children unsupervised. Staff person #2 has not completed the following pre-service training required prior to caring for children unsupervised: Pediatric first-aid and CPR and health and safety training. Staff person #5 and #22 have not completed the following pre-service training required prior to caring for children unsupervised: Pediatric first-aid and CPR. 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.

Staff persons #1, #4, #5, #8, #14, #16, #17, #18, and #20 have acceptable pediatric first aid/CPR training in an approved curriculum; however, the trainer has not provided documentation that they are PQAS-certified in that training topic.

Staff person #19 has acceptable pediatric first aid/CPR training in an approved curriculum; however, the trainer has not provided documentation that they are PQAS-certified in that training topic

Staff persons #13 and #22 have not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): pediatric first-aid and CPR.

The files of Staff #9 and #21 lacked a written evaluation on a regular basis, a minimum of one evaluation every 12 months (SEE LIS Code Sheet). The files of Staff #9 and #21 contained no written evaluation.

The file of Staff #13, who was designated as the director, lacked documentation of 1 year of experience with children.

The file of Staff #15, who was designated as a group supervisor, lacked documentation of 3 years of experience with children.

The files of Staff #2 and #16, who were designated as an assistant group supervisor, lacked documentation of 1 year of experience with children.

The files of Staff #9, #10, #21, and #23, who were designated as an assistant group supervisor, lacked documentation of 2 years experience with children.

The files of Staff #4 and #6, who were designated as an aide, lacked documentation of a high school diploma or general educational development certificate.

The files of Children #1, #2, #3, #4, #5, #6, #7, #8, #9, and #10 lacked the services to be provided to the family and child on the agreement.

The file of Child #8 lacked the complete address of the child's physician or source of medical care on the emergency contact form.

Emergency contact information was not present for Child #11 when Child #11 was in the outdoor play space.

The agreements for Children #5 and #6 were not reviewed and updated once every 6 months with the reinstating of this regulation on 1/6/22. The agreement for Child #5 was signed on 9/2/21 and reviewed on 9/7/22. The agreement for Child #6 was signed on 10/27/21 and then reviewed on 6/2/22 and 8/29/22.

It was observed that the agreement was not on file at the date of enrollment for Children #3, #4, and #8. Child #3 had an admission date of 8/16/22 with an agreement dated on 8/24/22. Child #4 had an admission date of 8/29/22 with an agreement dated on 9/8/22. Child #8 had an admission date of 8/15/22 with an agreement dated on 9/6/22.

The file of Staff #2 lacked two written, nonfamily references from individuals attesting to the person's suitability to serve as a facility person.

An incident occurred on 12/21/21 in which an ambulance was called and emergency room treatment services were administered to a child from the facility. The regional office was not notified until 12/27/21, exceeding 48 hours after the incident occurred.

Staff #2 was observed having a provisional hire date of 11/1/21 but lacked application for a Pennsylvania State Police (PSP) and Pennsylvania Child Abuse clearance or the clerances on file. Staff #5 was observed having a provisional hire date of 9/28/21 but lacked application for a PSP, Pennsylvania Child Abuse clearance, and National Sex Offender Registry (NSOR) certificate ordered prior to employment or on file. Staff #6 was observed having a provisional hire date of 10/1/21 but lacked documentation of a PSP, Pennsylvania Child Abuse clearance, and NSOR certificate ordered prior to employment or on file. A current FBI clearance was observed for staff #6, who had a provisional hire date of 10/1/21 but ordered incorrectly as a provisional hire on 10/15/21, after initial employment. Staff #7 was employed at the facility on 8/19/21 and observed having a volunteer Pennsylvania Child Abuse clearance. Staff #9 is utilized as a volunteer but lacked a PSP, FBI clearance or NSOR certificate on file.

Staff #3 was employed on 8/19/21 and observed having an initial health assessment dated 10/09/21, not at initial employment. Staff #4 was employed on 8/25/21 and observed having an initial health assessment dated 9/29/21, not at initial employment. Staff #8 was employed on 8/30/21 and observed having an initial health assessment dated 9/14/21, not at initial employment.

Staff #1 was employed on 8/23/21 and observed having a tuberculosis screening by the Mantoux method dated 9/17/21, not at initial employment. Staff #3 was employed on 8/19/21 and observed having a tuberculosis screening by the Mantoux method dated 10/09/21, not at initial employment. Staff #4 was employed on 8/25/21 and observed having a tuberculosis screening by the Mantoux method dated 10/1/21, not at initial employment. Staff #8 was employed on 8/30/21 and observed having a tuberculosis screening by the Mantoux method dated 9/16/21, not at initial employment.

The agreements for children #1, #2, #3, #4, and #5 lacked the persons designated by a parent to whom the child may be released.

The agreements for children #1, #2, #3, #4, and #5 lacked the date of the child's admission.

The agreements for children #1, #2, #3, #4, and #5 lacked the services which are to be considered as extra.

10 preschool children were observed in the indoor gross motor space and the supervising staff lacked the children's emergency contact information.

All child care spaces lacked a written plans identifying the means of transporting a child to emergency care and staffing provisions in the event of an emergency.

The file for staff #2 lacked an educational record on file at the facility.

The file for staff #2 lacked two written, nonfamily references from individuals attesting to the person's suitability to serve as a facility person. The file for staff #6 lacked two written, nonfamily references from individuals attesting to the person's suitability to serve as a facility person.