Gethsemane United Methodist Church W Branch Area

The emergency contact form on file for Child #2 and Child #4 were observed not to have documentation of health insurance coverage and policy number for a child under a family policy or Medical Assistance benefits, if applicable.

The emergency contact on file for Child #1 was observed not to have the address for the individual designated by the parent to whom the child may be released. The file for Child #4 was observed not to have the release person's name or the address of the individual designated by the parent to whom the child may be released.

In the outdoor play area benches and picnic tables were observed to have splintering areas.

The outdoor embedded play equipment was observed not to have loose-fill to meet recommendations of US Consumer Product Safety Commission.

It was observed that there was an infant sleeping in the swing on day of investigation.

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.

Loose crib sheets were observed in 2 of the cribs in the infant room.

The file for Facility person #4 was observed not to have documentation of a State Police clearance.

It was observed on the day of inspection a 5-month-old infant was sleeping in a swing.

It was observed on the day of inspection that the bottom banquet hall was being used by children. This space is not on the license for use by children in care.

The first-aid kit in the monkey room was observed not to contain soap.

In the Giraffe room, it was observed that allergy medication, Tylenol and Ibuprofen did not identify the name of the child for whom the medication is intended.

An expired bottle of Tylenol was observed in the Giraffe room on day of inspection.

The most up to date health assessment on file for staff person #2 was observed to be greater than 24 months. This is evidenced by the health assessment being dated 10/13/21 to 5/28/24.

It was observed that the staff in the Koala Room did not wash their hands after diapering a child.

A bottle was observed in the crib of a 9-month-old infant while they were sleeping.

The facility's fire drill log showed that the facility did not conduct fire drills every 60 days. This is evidenced by there being a gap of more than 60 days from 1/3/24 to 3/5/24.

The facility fire drill log showed that the facility has not been testing the fire detection system every 30 days. This is evidenced by testing done 1/3/24 to 2/5/24. The facility did not have a fire detection system on the lower level of the building located next to the kitchen.

The file for Staff #3 was observed not to have documentation of a Health and Safety update that was due by 12/30/23.

Staff file #3 lacked a completed PA State Criminal Clearance with disseminated date and a valid NSOR certificate. Staff #3 resided in the state of California within the previous 5 years and lacked California State Criminal Clearance, the Child Abuse Clearance and the Sex Registry Clearance in the file. (See LIS CODE SHEET)

At naptime during the renewal inspection, it was observed that there was not sufficient natural or artificial light in the Giraffe room (Rm 46); the Turtle room (Overflow) and the Infant Room (Rm 42, 43) for the staff to see the children as they were napping.

The outlet behind the chair in the Monkey room (Rm 53) lacked an outlet cover.

The janitors closet in the hallway where toxics and cleaning materials are stored was not locked and was accessible to the children in care. There were Clorox disinfectant wipes and hand sanitizer on the shelving unit in the Music room that were accessible to the children in care.

The temperature in the girl's bathroom in the hallway measured at 112° F and was accessible to the children in care. The temperature in the bathroom's in the gym measured at 123° F and was accessible to the children in care.

The first aid kit in the Turtle (Overflow) Rm lacked sterile gauze pads. The first aid kit in the Preschool (Rm25, 26) room lacked soap.

The toilet bowl in the Monkey Room (Rm 53) was dirty and had black water in it.

The toilets in the Fox Room (Rm 50) lacked a hand washing sign. The diapering areas in the Giraffe Room (Rm 46), the Infant Room and the Turtle Room (Overflow) lacked hand washing signs at each diapering area.

The diapering areas in the Fox Room (Rm 50,) Giraffe Room (Rm 46), Monkey Room (Rm 53) and the Turtle Room (Overflow) lacked a source of running water for hand washing at each diapering area.

The exit to Grace Hall foyer area which is an emergency exit was obstructed with cots lining the sides of the hall.

The facility had a portable space heater located in the Music Room.

There was a cracked bin containing toys for the children in the Fox Room (Rm 50) that had sharp corners.

The thermometer in the refrigerator in the Preschool Room was not operable.

Child file #4 contained a health report dated 8/16/22 and lacked an updated health report including updated immunizations in accordance to the recommendations of the ACIP. (See LIS CODE SHEET)

The facility had Tylenol for Child #5 that lacked a medication log with parental written consent for administration of the medication to the child while in care.

Staff were observed using wipes and not washing the toddler's hands after diapering the young and older toddlers who were able to wash their hands at the sink.

Staff were observed disposing of soiled diapers in a lidded trash can that was not hands free in the Monkey Room (Rm 53) and Turtle Room (Overflow) for disposal of soiled diapers.

The sink in the Infant Room and the Turtle Room (Overflow) was observed to be used for bottle prep, washing bottles and dishes used by the children and handwashing after diapering.

Staff were observed not washing their hands immediately after diapering the young and older toddlers.

The infant bottles were not labeled with the child's name on them.

Child file #1 contained a health report dated 2/8/23 which was more than 60 days after the child's first day of attendance at the facility. (See LIS CODE SHEET)

Staff #1 lacked documentation of completion of the Pennsylvania Health and Safety Update 2022 within the prescribed timeframe required by OCDEL to complete the training, which was by December 30, 2022, as per Announcement C-22-06.

Staff file #1 contained copies of staff evaluations completed on 1/21/22 and 3/2/23, which exceeded the 12 months as required.

Child file #3 lacked the child's date of admission on the agreement form.

Child files #1, #2, and #3 lacked the child's health insurance coverage and policy number on the emergency contact forms.

Staff file #3 lacked verification of their child care experience and education prior to service at the facility.

Staff file #3 contained only one of the two required written, nonfamily references from individuals attesting to the person's suitability to serve as a facility person.

At the time of the inspection on 8/29/23, Staff #4, the director, presented on a PA Driver's License that expired on 8/26/23.

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: CPR/FA

Staff person #3 lacked a disclosure and NSOR on or before initial date in a child care position (See LIS CODE SHEEET). There is now a disclosure and NSOR on file and dated: Disclosure 4/22/22 and NSOR - 5/3/22. The file for staff #4 lacks a current Child Abuse clearance within the past 60 months. Child Abuse on file is dated 8/27/17.

The facility file lacked documentation of a plan for continuity of operations during the aftermath of a disaster.

In Room 25/27, observed that the telephone in the room lacked the telephone number of the nearest hospital, police department, fire department, ambulance and poison control center posted by the telephone.

In the outside play space, all bolts on the fence and gates are facing the inside of the play space and are exposed. On the outside play space climbing apparatus which is colored teal, purple and blue, observed a crack on the third stair in the right corner causing a pinch and crush point and the top stair is starting to wear away. causing a tripping hazard to the children in care.

In Room 46, observed latex gloves in an unlocked drawer and accessible to children who are still placing objects in their mouths.

The refrigerator in room 46 lacks an operable thermometer.

Observed that there were styrofoam cups in the School Age room and these cups are used by the school age children in care.

There was more than six months between the previous and most current and updated health assessment on file for child #4, who is a young toddler.

The immunization record on file for child #3 lacks verification of a flu shot within the past year as in accordance with the schedule recommended by the ACIP.

Observed an Epi Pen which expired 7/2022. Observed Infant Tylenol which expired 4/22. Observed A and D ointment which lacked the name of the child for whom it was intended.

In Room 53, observed Infant Motrin, Infant Tylenol and Saline Spray for child #6 which lacked parent's written consent for administration.

There was more than 24 months between the previous and most current updated health assessments on file for #1 and #5. The file for staff #2 lacks a health assessment which was completed in the past 24 months. The file for staff #3 lacked an initial health assessment within 12 months prior to providing service in a child care setting. There is now a current health assessment on file.

The facility provides breakfast, lunch and snack. The menu was not posted nor provided to each family at least one week in advance.

In the infant room, observed a five month old sitting in a bouncer and being bottle fed by a staff.

The facility file lacked documentation of an emergency plan drill and within the past year.

On the fire drill log, observed that the hypothetical location of the fire was the same for consecutive drills.

Observed that the facility did not check the fire detection devices every 30 days.

The initial health assessment on file for child #2, (SEE LIS CODE SHEET) was not provided within 90 days of start date (suspended regulations allowing 90 days). There is now a current health assessment on file and dated 12/16/21. The initial health assessment on file for child #5, (SEE LIS CODE SHEET) was not provided within 60 days of start date. There is now a current health assessment on file and dated 8/11/22.

The file for staff #2 lacks documentation that fire safety training has been completed within the past year.

Staff person # 3 has not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): CPR/FA from an approved curriculum and PQUA approved instructor.

The file for staff #1, who holds the title of group supervisor, lacks documentation of the qualifications required for a group supervisor.

The fee agreement on file for child #4 lacks the date of the child's admission.

The emergency contact information on file for child #1 lacks the health insurance and policy number. The emergency contact information on file for child #3 lacks addresses of all persons designated by the parent to whom the child may be released.

Based on written information and information obtained in interviews, it was determined on several occasions a young school age child was picked up and physically moved from one area and to another area to be put down in a time out spot.

Based on information obtained during interviews, it was determined that while a child was acting out, a staff person used their arms and legs to restrict the child's movement until the child was calm and was then released.