Growing Patch Learning Center

The file for Staff #1 lacked a signed disclosure statement.

The file for Staff #3 contained Mandated Reporter Training that was not obtained within 60 months of the previous clearance. The file for Staff #4 contained Mandated Reporter Training that was not obtained within 90 days of hire.

Observed an approximate 2-inch mattress/pillow that was placed on top of the pack n play mattress that was in the crib while an infant was sleeping.

Observed two pairs of sharp teacher scissors that were on the teacher's desk in the Main Room that were accessible to the children in care.

Observed a tube of Clorox wipes labeled "Keep out of reach of children," that were in an unlocked cabinet on a low shelf accessible to the children in care. Observed Tough Plus Cleaner, 2 bottles of Pine Sol, and 1 bottle of Clorox, labeled "Keep out of reach of children," that were underneath the sink in an unlocked cabinet accessible to the children in care.

Observed a piece of metal that was sticking up from underneath the front window approximately 2 feet from the ground that posed a cutting hazard for the children in care.

Observed exposed foam on a changing pad located in the infant area where children are still placing objects on their mouths.

There was no prescription for the Albuterol Inhaler belonging to Child #1.

There was an Albuterol Inhaler that did not identify the name of the child for whom the medication was intended.

Observed the Albuterol Inhaler at the facility for Child #1 lacked written parental consent for administration of the medication.

The file for Staff #2 contained a Health Assessment at the time of inspection, but it was observed they did not have a Health Assessment before their first day working in childcare

The file for Staff #2 contained tuberculosis screening at the time of inspection, but it was observed they did not have tuberculosis screening before their first day working in childcare

Staff person #4 has not completed the following required pre- service training within 90 days of their date of hire (see LIS code sheet): (Health and Safety Basic Training).

The file for Staff #2 did not contain verification of childcare experience, education, and training prior to service at the facility.

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

Staff person #4 has not completed the following required pre- service training within 90 days of their date of hire (see LIS code sheet): (Pediatric First Aid/CPR).

The file for Staff #1 contained a disclosure statement that lacked a witness. The file for Staff #2 contained a disclosure statement that lacked a date. The file or Staff #2 lacked a NSOR Certificate and therefore was incorrectly provisionally hired. The file for Staff #3 contained expired Pennsylvania State Police, Pennsylvania Child Abuse, and FBI Clearances.

The facilities Emergency Plan did not address Continuity of Operations

Observed adult scissors and a box of colored push pins in a low unlocked drawer creating a pinching hazard to the children in care. A stapler posing a pinch hazard was accessible on the desk in the Main Classroom.

The Emergency Plan lacked a method for facility persons to contact parents when an emergency arises.

The facility's emergency plan lacked details regarding communication with parents at the end of an emergency situation.

In the Main Classroom there was a surge protector behind toward the back of the desk that was missing a protective outlet covers. There were also two outlets on the surge protector by the Christmas Tree that were missing protective outlet covers. These outlets were accessible to children 5 years of age and younger.

Observed "Hot Shot" Bug Spray, labeled "Keep out of reach of children", on the ground in the outside play space accessible to the children in care.

The first aid kit located in the Main Room was sitting on the floor making it accessible to children.

The first aid kit located in the Main room lacked scissors.

Observed Pom Pom crafts and glue sticks, labeled, "Small Parts: Not for children under 3," that were on a low child sized table and accessible to the children in care including children who are still placing items in their mouths. Observed fruit loops as part of Christmas Ornaments that were hanging on low on the Christmas Tree and were accessible to the children who are still placing items in their mouths. Two bags of Halls cough drop were in a low basket and labeled, "Not for children under 5 years of age or younger," that were accessible to children who are still placing items in their mouths.

The file for Child #2, a Young Toddler, contained a Health Report that was not updated in the previous 6 months.

The file for Child #1, a preschooler, lacked an updated health report within the last 12 months.

The file for Child #2, enrolled for more that 60 days at the facility, did not contain documentation of a 4th dose of the DTAP vaccination and the 4th dose of Pneumococcal vaccination as required based on the child's age as per the ACIP recommended schedule.

Observed 2 insulin pens, nasal spray, 2 insulin syringes, and 4 separate pills in one container including Ferrous Sulfate, Amlodipine Besgate, Metformin, and Benazepril that were all labeled, "Keep out of reach of children," and were being stored in a basket that was accessible to the children.

The files for Staff #2 and #4 contained a Health Assessment at the time of inspection, but it was observed they did not have a Health Assessment before their first day working in childcare.

The file for Staff #2 did not contain the results of a tuberculin skin test, x-ray or other medical documentation necessary to confirm freedom from communicable tuberculosis. The file for Staff #4 contained the results of a tuberculin skin test, x-ray or other medical documentation necessary to confirm freedom from communicable tuberculosis that was dated over a year prior to date of hire, and therefore not valid.

The facility lacked written statements provided by the parents giving the formula and feeding schedule for the infants in care.

The facility lacked an emergency drill.

Based on conversations with the operator, the operator did not send a copy of the emergency plan to the local or county municipalities.

The file for Staff #1 contained Pediatric First Aid and CPR certification obtained on 11/26/23. Their previous certificate expired on 9/23, creating a lapse in their First Aid and CPR training.

The file for Staff #1, #3, and #5 did not contain documentation of training in fire safety in the last year.

Staff #4 identified as an assistant group supervisor lacked documentation of the qualifications required.

The file for Staff #3 and #5 did not contain an evaluation completed within the previous 12 months.

The Agreements in the file for Child #1 and #3 lacked the operator's signature.

The Agreement in the file for Child #1 did not specify the amount of the fee to be charged per day or per week.

The Agreement in the file for Child #5 did not specify the date on which the fee is to be paid.

The file for Child #5 lacked a child service form that provides information to the family about the child's growth and development in the context of the services being provided.

The file for Child #5 contained an agreement which did not specify the child's departure time.

The Agreements for Child #1 and #5 lacked the persons designated by a parent to whom the child may be released.

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

The Emergency Contact Form for Child #3 lacked the name of the child's physician. The Emergency Contact for Child #5 lacked the telephone number of the child's physician.

The Emergency Contact Form for Child #5 lacked the enrolling parents work address and telephone number.

The Emergency Contact Form for Child #3 lacked the health insurance policy number for the child. The Emergency Contact Form for Child #5 lacked the health insurance coverage for the child.

The file for Child #1 contained an emergency contact form that was not updated within 6 months of the previous update.

The file for Child #5 contained an Agreement form that was not updated within 6 months of the previous update.

The file for Staff # 2 lacked proof of qualifications for education in the form of a diploma, transcript, or letter signed by a representative or the experiential, educational or training entity. The file for Staff #3 contained transcripts in a foreign language and their credentials could not be determined.

The file for Staff #2, contained one written, nonfamily reference and one written, family reference from individuals attesting to the suitability to serve as a facility person.

The files for Staff #1 and #5 lacked documentation of 4 hours of the required 12 annual clock hours of childcare training.

The facility's emergency plan does not include a plan for continuity of operations in an emergency as required by Federal Regulation.

The operator did not have documentation of providing a letter explaining the emergency procedures to the parent of each child enrolled.

Toxins, such as disinfectant spray and Febreze, were observed stored in a cabinet next to and above food.

In the Preschool section of the Main room, the sink to a children's kitchen play set was observed to be cracked with sharp edges and was not in good repair.

Two cribs in the corner of the Infant area in the Main room were not positioned to give at least 2 feet of space while the equipment was in use in which an infant was sleeping.

The file for child #2, older toddler, does not have documentation of an updated health report within the last 12 months. The most recent documentation of a health report is dated 8/22/22. The file for child #4, preschool age, does not have documentation of an updated health report within the last 12 months. The most recent documentation of a health report is dated 8/31/22.

The facility did not have documentation of written statements giving the formula and feeding schedule from the parents of the infants enrolled.

The fire drill log on file at the facility did not include the specific day of the drill and the evacuation times in the months of August through November.

The facility did not have documentation of an annual report from a fire professional that the fire detection system was tested and operable. The most recent documentation on file is dated 10/28/22.

The operator did not have documentation of sending a copy of the emergency plan and subsequent plan updates to the local municipality and to the county emergency management agency.

The file for child #3, who has been enrolled for more than 60 days of attendance, does not include an initial health report.

*SECOND VIOLATION The facility's emergency plan does not include a plan for continuity of operations in an emergency as required by Federal Regulation. Previously cited on SIN-00235469 on 12/1/23.

*SECOND VIOLATION The operator did not have documentation of providing a letter explaining the emergency procedures to the parent of each child enrolled. Previously cited on SIN-00235469 on 12/1/23.

*SECOND VIOLATION The file for child #4, preschool age, does not have documentation of an updated health report within the last 12 months. The most recent documentation of a health report is dated 8/31/22. Previously cited on SIN-00235469 on 12/1/23. The file for child #2 was implemented on 1/26/24.

*SECOND VIOLATION The facility did not have documentation of written statements giving the formula and feeding schedule from the parents of the infants enrolled. Previously cited on SIN-00235469 on 12/1/23.

*SECOND VIOLATION The fire drill log on file at the facility did not include the specific day of the drill and the evacuation times in the months in December and January. Previously cited on SIN-00235469 on 12/1/23.

*SECOND VIOLATION The facility did not have documentation of an annual report from a fire professional that the fire detection system was tested and operable. The most recent documentation on file is dated 10/28/22. Previously cited on SIN-00235469 on 12/1/23.

*SECOND VIOLATION The operator did not have documentation of sending a copy of the emergency plan and subsequent plan updates to the local municipality and to the county emergency management agency. Previously cited on SIN-00235469 on 12/1/23.

*SECOND VIOLATION The files for children #3 and #6, who have been enrolled for more than 60 days of attendance, do not include an initial health report. Previously cited on SIN-00235469 on 12/1/23.

Staff person #1 does not have current pediatric first-aid/CPR training. This is evidenced by the previously documented pediatric first-aid/CPR training expiration date of 10/31/23.

Staff persons #1 and #2 have not had fire safety training within the last 12 months. The most previous documented training on file for staff persons #1 and #2 was dated 11/2/22.

The files for children #1, #2, #3, and #4, all enrolled more than 6 months, did not include a child service report.

The file for child #5 lacked a copy of the written agreement form between the parent and the operator.

The emergency form on file for child #1 lacked the name of the child's physician.

The emergency contact form on file for child #2 lacked the enrolling parent's work telephone number. The emergency contact forms on file for children #3 and #4 lacked the enrolling parent's work address and telephone number.

The emergency contact forms for children #3 and #5 lacked written parental consent for emergency medical care.

The emergency contact forms on file for children #4 and #5 lacked 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.

The emergency contact forms on file for children #3, #4, and #5 lacked information on the health insurance coverage and policy number for the child.

The emergency contact form on file for child #2 lacked the address of the individual designated by the parent to whom the child may be released. The emergency contact form on file for child #4 lacked the address and telephone number of the individual designated by the parent to whom the child may be released.

In the Infant, Toddler and Preschool sections in the Main room, emergency contact information was not present in the child care space where children were observed receiving care.

The emergency contact and agreement forms for children #1, #3 and #4 have not been reviewed or updated in writing by the parent within the last 6 months. The agreement form for child #2 has not been reviewed or updated in writing by the parent within the last 6 months.

The operator did not maintain an individual record for child #6 and #7.

The emergency contact forms for children #3 and #5 lacked written parental consent for administration of minor first-aid procedures by facility staff which is required prior to admission.

*SECOND VIOLATION Staff person #2 has not had fire safety training within the last 12 months. The most previous training on file for staff person #2 was dated 11/2/22. Previously cited on SIN-00235469 on 12/1/23. The file for staff person #1 was implemented on 1/26/24.

The agreement form on file for child #7 did not include the date on which the fee is to be paid.

*SECOND VIOLATION The files for children #1, #2, #3, and #4, all enrolled more than 6 months, did not include a child service report. Previously cited on SIN-00235469.

The agreement form on file for child #7 did not include the child's arrival and departure times.

The parent agreement on file for child #6 lacked the date of the child's admission.

*SECOND VIOLATION The file for child #2 and #5 lacked a copy of the written agreement form between the parent and the operator Previously cited on SIN-00235469 on 12/1/23.

*SECOND VIOLATION The emergency contact forms on file for children #3 and #4 lacked the enrolling parent's work address and telephone number. Previously cited on SIN-00235469 on 12/1/23. The file for child #2 was implemented on 1/26/24.

*SECOND VIOLATION The emergency contact forms for children #4, #5, and #7 lacked written parental consent for emergency medical care. Previously cited on SIN-00235469 on 12/1/23. The file for child #3 was implemented on 1/26/24.

*SECOND VIOLATION The emergency contact form on file for child #5 lacked 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. Previously cited on SIN-00235469 on 12/1/23. The file for child #4 was implemented on 1/26/24.

*SECOND VIOLATION The emergency contact form on file for child #5 lacked information on the health insurance coverage and policy number for the child. Previously cited on SIN-00235469 on 12/1/23. The files for children #3 and #4 were implemented on 1/26/24.

*SECOND VIOLATION The emergency contact form on file for child #2 lacked the address of the individual designated by the parent to whom the child may be released. The emergency contact form on file for child #4 lacked the address and telephone number of the individual designated by the parent to whom the child may be released. Previously cited on SIN-00235469 on 12/1/23.

*SECOND VIOLATION In the Infant, Toddler and Preschool sections in the Main room, emergency contact information was not present in the child care space where children were observed receiving care. Previously cited on SIN-00235469 on 12/1/23.

*SECOND VIOLATION The emergency contact and agreement forms for children #4 and #7 have not been reviewed or updated in writing by the parent within the last 6 months. The agreement form for child #2 has not been reviewed or updated in writing by the parent within the last 6 months. Previously cited on SIN-00235469 on 12/1/23. The files for children #1 and #3 were implemented on 1/26/24.

*SECOND VIOLATION The emergency contact forms for children #4, #5, and #7 lacked written parental consent for administration of minor first-aid procedures by facility staff which is required prior to admission. Previously cited on SIN-00235469 on 12/1/23. The file for child #3 was implemented on 1/26/24.

Based on staff statements and observation, staff person #1 restricted child #1 by placing the child in a pack and play as discipline.

At approximately 9:50 AM in the Infant/Toddler section of the Main Room, child #2 was observed asleep in a car seat and was not in the position recommended by the AAP.

At 9:30 AM, a mixed aged group of 19 children were observed outside on the Front Play Space that has a capacity of 16 children. The group consisted of 9 older toddlers and 10 preschoolers supervised by three staff persons.

The facility did not have documentation of conducting fire drills within the last year on file. Based on the operator's statement, the facility has not conducted a fire drill since January of 2023 at the time of the facility's yearly renewal inspection.

The facility did not have a copy of a written agreement form between the parent and the operator on file for child #2.

The facility did not have emergency contact information on file for child #2.

*SECOND VIOLATION A surge protector in the front area in the Main room was observed to lack three protective receptacle covers. Previously cited on SIN-00216511 on 12/22/22.

*SECOND VIOLATION Staff person #2 has not had a health assessment conducted within the last 24 months. This is evidenced by the previously documented health assessment on file being dated 9/24/20.

*SECOND VIOLATION The operator lacked posting written notification of safe routes in a conspicuous location in the child care facility. Previously cited on SIN-00216511 on 12/22/22.

*SECOND VIOLATION The facility lacked written documentation of notifying the local traffic safety authorities of the location of the facility and the program's use of pedestrian and vehicular routes around the child care facility. Previously cited on SIN-00216511 on 12/22/22.

*SECOND VIOLATION The file for staff person #1 lacked documentation of annual fire safety training. The most current training on file is dated 5/21/21. Previously cited on SIN-00216511 on 12/22/22.

*SECOND VIOLATION The emergency contact form for child #2 lacked emergency contact information on who to be contacted in an emergency. Previously cited on SIN-00216511 on 12/22/22.

*SECOND VIOLATION The emergency contact form on file for children #1, #2, and #4 lacked the address of the individual designated by the parent to whom the child may be released. The emergency contact form on file for child #2 lacked the telephone number of the individual designated by the parent to whom the child may be released. Previously cited on SIN-00216511 on 12/22/22.

*SECOND VIOLATION A written plan identifying the means of transporting a child to emergency care and staffing provisions in the event of an emergency was observed not to be posted in the Main room. Previously cited on SIN-00216511 on 12/22/22.

The facility's emergency plan lacked a method for facility persons to contact parents when an emergency situation arises.

The facility's emergency plan lacked a method for facility persons to inform parents that the emergency has ended and to provide instruction as to how parents can safely be reunited with their children.

The operator lacked reviewing the emergency plan annually and was last updated on 8/4/21.

One outlet cover was observed to be missing below the whiteboard in the PS area in the Main room. which was accessible to children under the age of 5.

An unlabeled spray bottle that the director identified it contained disinfectant spray was observed in a cabinet in the OT area in the Main room.

A red toy car in the PS area in the Main room was observed to be cracked with rough edges and not in good repair.

The rest equipment in the PS area in the Main room was observed to lack labels for each child in care.

The file for child #1 was observed to be lacking an updated health report conducted within 12 months of previous health report.

Staff person #1 and #2 have not had a health assessment conducted within the last 24 months. This is evidenced by the previously documented health assessment on file being dated 6/6/20 for staff person #1 and 9/24/20 for staff person #2.

The operator lacked posting written notification of safe routes in a conspicuous location in the child care facility.

The operator lacked posting evacuation routes in a conspicuous location at the facility.

The facility's emergency plan lacked accommodations for shelter of children during an emergency including lock-down, shelter in place at the facility and shelter at locations away from the faculty's premises.

The facility's emergency plan lacked accommodations for evacuation of children from the facility building and evacuation of children to a location away from the facility premises

The file for child #3 was observed to be lacking an initial health report within 60 days following the first day of attendance at the facility.

The facility lacked written documentation of notifying the local traffic safety authorities of the location of the facility and the program's use of pedestrian and vehicular routes around the child care facility.

The facility's emergency plan did not include requirements for continuity of operations (backing up or retrieving records/files and managing financial issues such as paying employees and bills during the aftermath of the disaster). The facility lacked policies regarding recognition of potential signs and symptoms of shaken baby syndrome and abusive head trauma, strategies for coping with crying, fussing, or distraught children, and prevention and identification of child maltreatment. Staff person #1 has not completed the following pre-service training by December 30, 2022: Pennsylvania Health and Safety Update 2022.

The file for staff person #1 lacked documentation of completing fire safety training annually. The most current training on file was observed to be dated 5/21/21.

The file for staff person #2 was observed to lack a written evaluation by the director within 12 months of hire.

The agreement form on file for child #3 lacked the release persons to whom the child may be released.

The agreement forms on file for children #1, #2, #3, and #4 was observed to be the original agreement forms, in which the parent should receive the original agreement.

The emergency contact form for child #2 lacked emergency contact information on who to be contacted in an emergency.

The emergency contact form on file for child #1 and #4 lacked the enrolling parent's work address and telephone number.

The emergency contact form for child #3 was observed to be lacking written parental consent for emergency medical care.

The emergency form on file for child #2 lacked the health insurance policy number.

The emergency contact form on file for children #1, #2, #3, and #4 lacked the address of the individual designated by the parent to whom the child may be released. The emergency contact form on file for child #2 lacked the telephone number of the individual designated by the parent to whom the child may be released.

A written plan identifying the means of transporting a child to emergency care and staffing provisions in the event of an emergency was observed not to be posted in the Main room.

The emergency form on file for child #3 was observed to be lacking parental consent for administration of minor first-aid procedures by facility staff.

A copy of how to access the DHS regulations electronically was not posted in a conspicuous place.

The file for staff person #1 lacked documentation of an annual minimum of 12 clock hours of child care training.

One outlet cover was observed to be missing on the front wall by the radio in the OT area and two outlet covers were observed to be missing by the sink in the young toddler area which was accessible to children under the age of 5.

An unlabeled spray bottle that staff stated contained disinfectant spray was observed in an unlocked cabinet accessible to children in the OT area.

The facility lacked policies regarding recognition of potential signs and symptoms of shaken baby syndrome and abusive head trauma, strategies for coping with crying, fussing, or distraught children, and prevention and identification of child maltreatment. The emergency plan for the facility did not include requirements for continuity of operations (backing up or retrieving health and other key records/files and managing financial issues such as paying employees and bills during the aftermath of the disaster).

Staff person #1 has not completed mandated reporter training within the last 60 months. This is evidenced by the previously documented mandated reporter training on file being dated 2/19/17.

It was observed that the facility had 2 Bumbo seats in the facility that were previously recalled.

It was observed that the cots were not labeled.

The file for child #1, with a birthday of 11/16/20, had an initial health assessment dated for 5/14/21, with no updated health assessments on file.

The file for child #1, child #3, and child #5 lacked an immunization record in accordance with the ACIP.

Facility staff stated that they did not have a written feeding schedule from the parent for the infant that was enrolled.

The facility began operating on 11/1/21 and conducted the first fire drill on 1/3/22, which is more than 60 days.

Facility lacked the evacuation routes posted.

The file for child #4, with a start date of 11/1/21, lacked an initial health assessment.

The file for staff person #3, with a start date with the legal entity on 5/27/19 lacked fire safety training.

The agreement for child #1 lacked persons designated by a parent to whom the child may be released.

The file for child #2 and child #4 contained the original agreement.

The emergency contact form for child #1 lacked emergency contact information for who shall be contacted in an emergency.

The emergency contact form for child #3 and child #4 lacked the name, address and telephone number of the child's physician or source of medical care.

The emergency contact form for child #2, child #3, and child #4 lacked the enrolling parent's work address and work phone number. The emergency contact form for child #4 lacked the enrolling parent's home address.

The emergency contact form for child #2 lacked signed parental consent for emergency medical care for the child, prior to admission.

The emergency contact form for child #4 lacked the health insurance coverage.

The emergency contact form for child #2, child #4, and child #5 lacked the release person's address. The emergency contact form for child #4 lacked the release person's phone number.

The facility lacked an emergency transportation plan posted.

The emergency contact form for child #1 was signed on 6/9/21 and child #4 was signed on 5/6/21, which is more than 6 months ago.

The emergency contact form for child #1 was signed on 6/9/21 and child #4 was signed on 5/6/21, which is more than 6 months ago. The financial agreement for child #1 was signed on 6/9/21 and child #3 was signed on 3/15/21, which is more than 6 months ago.

The file for child #2 lacked signed parental consent for administration of minor first-aid procedures by facility staff, prior to admission.

The file for staff person #3 contained 1 written reference.

The file for staff person #2 with a start date with the legal entity on 10/1/20 and staff person #3 with a start date with the legal entity on 5/27/19, lacked pediatric first-aid and CPR training.

Staff person #1, staff person #2, and staff person #3 lacked training hours from 12/2020-12/2021.

The file for facility person #1 lacked a signed disclosure statement.

It was observed under the sink in the kitchenette area, there was a bottle of unlabeled cleaner.

The first aid kit lacked tape.

Hand washing signs were missing from above the changing table and sink and the three training toilets in the bathroom.

The glass door in the back of the room on the right side of the desk was blocked with a cabinet.

The space saving highchair lacked the T-strap.

Facility lacked an emergency plan that provides for accommodations for infants and toddlers.

The facility lacked proof of purchase of the inter-connected smoke alarms.

Facility lacked an emergency plan that provides for accommodations for shelter in place at the facility.

Facility lacked an evacuation map to a location away from the facility.

The file for facility person #2, with a hire date of 11/19/19, lacked a written evaluation.

Facility person #2, with a hire date of 11/19/19, lacked pediatric first aid and CPR training.