Hart to Hart Childcare Center LLC

A first-aid kit in the Blue Room did not contain soap.

Staff persons #1-#12 exceeded 12 months in the completion of annual fire safety training.

Facility person #5 was observed to be caring for children unsupervised. Facility person #5 has not completed the following pre-service training required prior to caring for children unsupervised: Pediatric first aid and pediatric CPR.

The file of facility person #2 contained documentation of submission and completion of a PA state police clearance dated 12/6/2022, and a child abuse clearance dated 12/7/2022, both after their start date with children (see coded LIS sheet). The signed disclosure statement completed for facility person #3 was not the form dated 11/2015 and not the current form.

The doors of the diaper changing table in the Gray Room were not locked, which make diaper creams labeled "keep out of the reach of children" accessible to the children in the classroom.

The unlocked closet in the Gray Room contained an unlocked filing cabinet containing plastic backs accessible to children in the classroom still placing objects in their mouths.

The health assessment of child #2, identified as a young toddler (see coded LIS sheet), contained health assessments dated 8/24/2022 and 6/14/2023, exceeding 6 months.

The immunization record of child #3 did not contain all dosages of the ACIP recommended DTAP vaccinations for their age (see coded LIS sheet), an annual influenza vaccination or acceptable documentation of exemption.

The file of facility person #2 does not have an initial health assessment (see coded LIS sheet). The health assessments of facility person #7 (3/26/2021 and 4/10/2023), #8 (1/11/2021 and 1/18/2023), #10 (3/21/2021 and 6/9/2023) and #11 (10/13/2020 and 12/19/2022) exceeded 24 months.

The file of facility person #11 had taken the required health and safety topics under regulation 3270.31(f)(1-9) on the "Better Kid Care - Penn State Extension" between 9/30/2016 and 10/4/2022, contained documentation of completion of the 1 hour "Pennsylvania Health and Safety Update 2022" dated 9/6/2023, which was after the requirement of completion on or before 12/30/2022.

Documentation of annual fire safety training for facility person #6 exceeded 12 months (6/17/2022 and 6/23/2023).

The documentation of completion of the health and safety topics listed in subsections (f)1-9 was dated more than 90 days from their start date at the facility (see coded LIS sheet) for facility person #1 (dated 4/27/2023).

The review and/or update of the emergency contact form and financial agreement of child #1 exceeded 6 months and the forms of child #2 were dated 12/27/2022, lacking documentation of a review and/or update within 6 months.

The file of facility person #4, identified as an assistant group supervisor, did not contain documentation of education and facility person #5, also identified as an assistant group supervisor, did not contain documentation of at least 2 years (2500 hours) of experience working with children to qualify as an assistant group supervisor.

The file of facility person #3 did not contain 2 written, non-family references attesting to the person's suitability to serve as a facility person.

The documentation of completion of acceptable pediatric first aid and pediatric CPR was dated more than 90 days from their start date at the facility (see coded LIS sheet) for facility person #1 (dated 3/29/2023).

The current certificate of compliance was not posted in a conspicuous location used by parents.

In the infant area of the library, 3 staff and 12 infants were observed. When asked the children in their respective supervisory groups, staff person #1 identified all 12 infants as did facility persons #2 and #3 exceeding the maximum group size of 8 infants with 2 staff.

The play space in the back of the facility was removed and new play spaces were added to the side of the building and were being used prior to being measured and added to the certificate.

The play space toward the back contained a plastic playhouse which was cracked on the right side of the porch exposing children to an area where fingers could become pinched.

Then written plan of daily activities was not posted in the Pre-K-Early Pre-K classroom.

Documentation of the request for the NSOR verification certificate for facility person #1 was dated 6/28/2022, which was after their start date with children (see coded LIS sheet) and the completed NSOR was dated 7/5/2022.

At rest time, facility person #1 and 5 identified 8 infants and toddlers in their group. Due to the lighting in the classroom and other pack and plays, at least 1 of the children sleeping on the other side of the infant space where facility persons #1 and 5 were standing, were unable to be seen (facility person #1 walked to the farthest row of pack and plays to identify the child). Facility person #4 identified 9 young and older toddlers. Two of the toddlers were on the infant side of the classroom with facility person #1 and 5 and were unable to be seen by facility person #4. Another older toddler facility person #4 was supervising was sleeping behind the changing table, making them unable to be seen based on the position of facility person #4.

A bottle labeled bleach/sanitizing and disinfectant was located on a shelf next to Gerber Puffs and Gerber infant cereal in the infant area of the classroom.

In the infant/toddler classroom, a bottle labeled bleach/sanitizing and disinfectant was located above bottles in the infant area and a second bottle labeled with the same solution was located on a shelf directly above diapers both of which would constitute a hazard if the bottle leaks.

In the infant/toddler classroom, the certification rep was having a discussion with facility staff at rest time when a drop of water came down landing on the certification rep. After a minute or so, a second drop did the same. There was no noticeable leaking on the ceiling tiles, but after the operator investigated further, it was determined the water was coming through by the light. In the toddler classroom, a ceiling tile was not inside the frame allowing part of the ceiling tile to bow downward which could cause a hazard it if would fall from the frame.

In the preschool classroom, the sink did not have a posted handwashing sign.

The 2 restrooms in the preschool classroom did not contain lidded trash cans.

The file of child #1, identified as an infant, contained an initial health assessment dated 2/25/2022, but did not contain an updated health assessment within the last 6 months.

The immunization records of child #1, 2 and 3 were not in accordance with the schedule recommended by the ACIP and did not have letters of exemption. The record of child #1 contained 2 of 3 DTAP and 2 of 3 Pneumococcal vaccinations, child #2 did not have documentation of a current influenza vaccination and child #3 had an immunization record documenting 1 of 2 Hepatitis A vaccinations.

The health assessment of facility person #3 did not include documentation of an examination for communicable diseases and the results of that examination.

The financial agreement of child #3 did not contain the signature of the operator.

The financial agreement of child #3 did not have the amount of their fee.

The emergency contact information of child #4 did not have telephone number of the child's physician.

The emergency contact information of child #4 did not have the work address of the enrolling parent.

The emergency contact information of child #4 did not contain information on any special needs, as specified by the child's parent, physician, physician's assistant or CRNP, which is needed in an emergency situation or documentation this is not applicable to the child.

Documentation of experience for facility person #2 was completed by an immediate family member who documented all of the accumulated hours facility person #2 provided care for various families over time.

The emergency plan did not provide for accommodations for infants and toddlers.

The facility did not have documentation of the proof of purchase of the buildings interconnected fire detection system.

The emergency plan did not include evacuation routes to the off-site location from the facility premises in the event of an emergency.

The facility did not have a policy on the recognition of potential signs of shaken baby syndrome and abuse head trauma, strategies for coping with a crying, fussing or distraught child, and addressing the prevention and identification of child maltreatment.

The facility did not have information to provide to parents on how to access the regulations, Chapter 3270. Child Care Centers, electronically.