Keystone Smiles Community Child Care CTR

The file for staff person #4 lacked an NSOR verification certificate at their start date and requires a current NSOR verification certificate. (See LIS CODE SHEET)

At approximately 9:55 a.m., a speech therapist was observed with 2 preschoolers in the mindfulness room without a staff person present in the room to supervise the children resulting in a 0:2 staff to child ratio.

At approximately 9:55 a.m., a speech therapist was observed with 2 preschoolers in the mindfulness room without a staff person present in the room to supervise the children.

At approximately 9:55 a.m., a speech therapist was observed with 2 preschoolers in the mindfulness room without a staff person present in the room to supervise the children.

The file for staff person #3 lacked current emergency plan training completed within the last year.

The first-aid kit in the pre-k room was located in a backpack in a cubby near the door and was accessible to children.

In the pre-k room, there were a few damaged ceiling tiles that were observed.

In the lunchroom, there were a few areas of peeling paint on the front right wall near the baseboard.

There was a portable space heater observed in the office.

The file for child #1 had a health assessment that lacked a statement that the child is able to participate in child care and appears to be free from contagious or communicable disease.

The file for child #1 had a health assessment that lacked a statement that age-appropriate screenings recommended by the American Academy of Pediatrics were conducted since the time of the previous health assessment.

The file for staff person #2 had a health assessment that exceeded 24 months between assessments.

The file for child #2 lacked an initial health assessment within 60 days of the child's first day of attendance at the facility and requires a current health assessment.

The file for staff person #1 had current pediatric first-aid/CPR training with a completion date of 1-23-25 that was after the October 2024 expiration of the prior training.

The file for staff person #4, functioning as an aide, lacked verification of education to qualify as an aide.

The files for child #1 and #3 had an emergency contact form that lacked the address of the individual designated by the parent to whom the child may be released.

The file for staff person #4 lacked two written, nonfamily references.

The letter to the parents regarding the facility's emergency plan did not include the facility's accommodations in the event of an emergency or the facility's plans for annual emergency drills.

The following toxics were accessible to children receiving care in the lunchroom. There was a hand sanitizer labeled "keep out of reach of children" on a table in reach of children. There were bottles of cleaning supplies including bleach on the floor in the kitchen, adjacent to the lunchroom. The door to the kitchen was open as children received care in the lunchroom.

There was a small area of peeling paint on the wall in the upstairs Pre-K Counts room, near the floor, in the back of the room in a reading/ book area.

There were no handwashing signs posted at one toilet in restroom off of the Pre-K Counts room or at two toilets in the restroom off of the preschool/Pre-K Counts room.

There was insect sting relief medication in the first aid kid, not labeled with the name of a particular child for their use.

The current health assessment on file for Facility Person #1 was completed more than 24 months after previous health assessment on file for Facility Person #1.

The number of children participating in each fire drill was not documented on the facility's fire drill log.

The documentation of smoke detector testing on file indicates that smoke detectors were tested on 3/1/23 and then again on 4/16/23, more than 30 days between testing.

There was no documentation, as required, to indicate the facility's emergency plan was sent to the local municipality and the county emergency management agency.

The medical emergency transportation plan was not posted in the mindfulness room or the gross motor room.

Facility Persons #1 and #4 were observed to be caring for children unsupervised. Facility Persons #1 and #4 have not completed the following pre-service training required prior to caring for children unsupervised: health and safety training.

There was no plan for continuity of operations included the facility's emergency plan, as required by federal mandate.

There were sharp knives in an open kitchen drawer near the entrance to the kitchen, accessible to children receiving care in the adjacent lunchroom as the door to the kitchen was open and/or unlocked.

There was no documentation of emergency plan training on file for Facility Person #1, employed at the facility more than 90 days.

There were toxics, including cleaning supplies, on the floor in the kitchen near the entrance under the sink, accessible to children receiving care in the adjacent lunchroom as the door to the kitchen was open and/or unlocked.

The trash can by the sink in the lunchroom used for handwashing was not lidded.

There was no documentation of a current influenza vaccine (recommended annually by the ACIP) on file for child #2.

The most recent health assessment on file for Facility Person #1 was completed more than 24 months prior. The current/initial health assessment, including a TB test, on file for Faciity Person #4 was completed after their start date in a child care position at the facility.

The most recent emergency drill documented and on file was conducted on 2/18/22, more than 12 months prior.

The documentation of dates the facility's fire alarm system was tested indicates testing was done on 12/2/22, then again on 1/5/23. Test dates were also recorded as 4/12/22 and then on 5/20/22. In both instances, more than 30 days passed between test dates. Act 62 requires smoke detectors are tested at least every 30 days.

The initial health assessment on file for child #1 was completed more than 60 days after the child's first day of attendance at the facility.

There was no documentation that Faciity Person #1 had completed the required health and safety training update. The health and safety training update completed by Faciity Person #3 (dated 2/15/23) and Facility Person #4 (dated 1/30/23) were completed after the required completion date of 12/30/22.

There was no documentation of annual firesafety training on file for Facility Person #1, employed at the facility more than 12 months.

There was no documentation of completion of the required pre-service health and safety training on file for Facility Persons #1 and #4. The documentation of completion of the required pre-service health and safety training on file for Facility Person #2 (9/11/6) and Facility Person #3 (9/22/16) indicate the training was completed prior to 9/30/16. Facility Persons #1, #2, #3 and #4 have been employed at the facility for at least 90 days. (See IS Code Sheet.)

There were no annual staff evaluations on file for Facility Person #1, employed at the facility more than 12 months.

Facility Person #4 was classified as an assistant group supervisor. There was documentation of high school graduation on file for Facility Person #4, but no documentation of child care experience.

The current pediatric first aid and CPR training documented and on file for Facility Person #1, employed at the facility for more than 90 days, was not acceptable as the training was conducted by a PQAS approved trainer.

There was no documentation on file of any child care training hours completed during the most recent review year (12/19/21-12/19/22) on file for Facility Person #1.

The file for facility person #2, lacked verification of a disclosure statement and a current DHS FBI clearance. There is a DHS State Police on file- 2/16/18, Child Abuse - 2/27/18 and NSOR 11/26/19.

The facility's refrigerator lacked an operating thermometer.

The current health report on file for child #1 lacked a signature by a physician, physician's assistant or CRNP. and lacked a statement that the child is able to participate in child care and appears to be free from contagious or communicable disease.

The current immunization records on file for children #1, 2, 3, 4 and 5 lack verification of a flu shot within the past year as in accordance with the schedule recommended by the ACIP. The immunization record on file for child #4 lacks documentation of 2 Hep A immunizations and 1 Varicella immunization as in accordance with the schedule recommended by the ACIP.

The facility file lacked documentation that an emergency drill was conducted within the past year.

The file for child #2, with start date of 8/25/21, lacks an initial health assessment.

The pediatric first aid and pediatric CPR training on file for staff #1 was not renewed on or before expiration date. Training expired 2/2021 and then new training was completed 4/8/21.

There was more than 1 year between fire safety trainings for staff #1. Training was completed on 1/22/21 and then on 2/3/22.

The file for facility person #2, with start date of 8/8/15, lacks verification of current mandated reporter training which was completed within the past 60 months.