Pamela Butlers Babies

At approximately 9:30am, 2 Staff Persons were observed supervising 12 children in the Main room. Staff Person #1 identified 5 children (1 infant, 3 young toddlers, and 1 older toddler) in their assigned group of children to supervise. Staff Person #2 identified 3 children (3 young school-age) in their assigned group. As a result, 4 children (2 older toddlers, 2 preschoolers) were not identified.

At approximately 9:30am, 2 Staff Persons were observed supervising 12 children in the Main room. Staff Person #1 identified 5 children (1 infant, 3 young toddlers, and 1 older toddler) in their assigned group of children to supervise. Staff Person #2 identified 3 children (3 young school-age) in their assigned group. As a result, 4 children (2 older toddlers, 2 preschoolers) were not identified.

A sharp kitchen knife was observed on the counter in the kitchen area accessible to children in care.

The file for Staff Person #4 did not contain documentation of emergency plan training at the time of initial employment.

The hot water temperature in the bathroom sink read 120° F.

A yellow bin containing children's toys was observed to be cracked with sharp edges and was not in good repair.

The two most recent health reports in the files for children #4 and #5, who are preschool aged, are dated more than 12 months apart.

The financial agreement in the files for children #1 and #2 lacked the amount of the fee to be charged per day or per week.

The financial agreement in the file for child #2 lacked the date on which the fee is to be paid.

The financial agreement in the file for child #2 lacked the persons designated by a parent to whom the child may be released.

The file for child #3 contained documentation that the parent reviewed and updated the emergency contact form on 4/14/24 and 5/26/25, which is more than 6 months apart. The file for child #4 contained documentation that the parent reviewed and updated the financial agreement on 2/8/24 and 2/3/25, which is more than 6 months apart.

The files for Staff Persons #1, #2, and #3 lacked 6 of their 12 hours of child care training in their respective training year.

The emergency plan on file at the facility did not include a plan for continuity of operations in an emergency.

The medication box In the bathroom contained a child's Albuterol Inhaler that expired in 07/2024.

The hypothetical location for the three most recent fire drills conducted (11/8/24, 12/6/24, and 1/3/25) were the same and were not rotated around the facility for each drill.

The operator did not have documentation on file of testing the fire detection system within the last 30 days. The most recent testing on file at the time of inspection was dated 1/6/25.

*SECOND VIOLATION The files for staff persons #6 and #7, who were identified as aides, lacked documentation of education prior to service at the facility. Previously cited on SIN-00246960.

The file for staff person #5 lacked documentation of PA State Police and NSOR clearance results prior date of hire (See LIS Code Sheet). The PA State Police Clearance in the file for staff person #7 lacked the disseminated date making the clearance not complete. The file for staff person #7 lacked FBI clearance results prior to date of hire (See LIS Code Sheet).

The facility's emergency plan has not been reviewed within the last 12 months. The most recent update was observed to be dated 7/1/22.

Staff persons #1, #2, #3, and #4 have not had emergency plan training within the last 12 months. The most recent documentation of training in the files for staff persons #1, #2, #3, and #4 are dated 6.23.23.

In the outside play space, peeling/chipping paint was observed around the door frame where children enter and exit the facility.

The two most recent health assessments on file for staff person #1 are dated more than 24 months apart: 5/1/22 and 6/26/24. The two most recent health assessments on file for staff person #2 are dated more than 24 months apart: 12/30/21 and 1/9/24. The file for staff person #7 lacked documentation of a health assessment at initial employment.

The file for staff person #7 lacked documentation of a TB screening and the results of the screening at initial employment.

The facility did not have documentation of conducting an emergency drill within the last 12 months.

The facility's documentation of testing the fire detection system exceeded 30 days from 10/1/23 to 11/1/23, 11/1/23 to 12/30/23, 2/1/24 to 3/5/24, and 3/5/24 to 4/11/24.

The facility 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 operator did not have documentation of notifying local traffic safety authorities in writing of the location of the facility and the program's use of pedestrian and vehicular routes around the child care facility.

The files for staff persons #1 and #3 had documentation of pediatric first aid/CPR training was not renewed before the expiration date of the most current certification. Staff person #1: 3/26/22 and 5/25/24. Staff person #3: 3/26/22 and 5/25/24. Staff persons #2 and #4 do not have current pediatric first-aid/CPR training. This is evidenced by the previously documented pediatric first aid/CPR training expiration date of 3/31/24.

The file for staff person #5, who was identified as an AGS, lacked documentation of education prior to service at the facility.

The files for staff persons #6 and #7, who were identified as aides, lacked documentation of education prior to service at the facility.

The emergency contact form in the file for child #1 has not been reviewed or updated by the parent within the last 6 months. The most recent update was documented on 11/21/23.

The file for staff person #5 lacked one written, nonfamily reference from an individual attesting to the person's suitability to serve as a facility person. The file for staff person #7 lacked two written, nonfamily references from individuals attesting to the person's suitability to serve as a facility person.

The file for Staff #1 lacked a current Child Abuse clearance. The file for Staff #1 contained State Police Clearances that that were updated in an interval greater than 60 months. The file for Staff #3 contained a disclosure statement that had no witness signature.

Located on the half wall in the middle of the Main Classroom were two containers of disinfecting wipes, labeled "keep out of reach of children." Both of these containers were accessible to the children in care.

Observed trash scattered throughout the play space and multiple weeds coming through the fence, both creating a tripping hazard to the children in care.

Located in the unlocked bathroom cabinet, accessible to the children in care were Diaper Genie refills, labeled "Warning: To avoid danger of suffocation, keep away from babies and children."

The file for Child #3, a preschooler, lacked an updated health report within the last 12 months.

The file for Child #1, #3, #4, and 5, enrolled more than 60 days at the facility, did not contain documentation of an influenzas vaccination within the past year, as required per the ACIP recommended schedule.

The Health Report for Child #3 lacked a statement indicating the child is able to participate in child care and appears to be free from contagious or communicable disease.

The Emergency Plan Delivery documentation that was submitted during the renewal inspection lacked information on the county municipality that the emergency plan was shared.

The file for Staff #2 lacked the Pennsylvania Health and Safety Update training that was required by the compliance date of 12/30/22 as set forth in Announcement C-22-06.

The files for Staff #1, #2, #4, and #5 did not contain documentation of training in fire safety in the last year.

Staff person #2 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 (2/2/18).

The two most recent staff evaluations for Staff #1 and #2 were completed more than one year apart.

The Agreement for Child #1 lacked the amount of the fee to be charged.

The files for Child #1 and #5 lacked a child service form that provide information to the family about the child's growth and development in the context of the services being provided.

The Agreement for Child #4 and #5 lacked the persons designated by a parent to whom the child may be released.

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

The Emergency Contact Form for Child #1 lacked the address of the individual designated by the parent to whom the child may be released.

The files for Child #1, #3, #4, and #5 contained Emergency Contact Forms that had not been updated within the last 6 months.

The files for Child #1, #3, #4, and #5 contained Agreement Forms that had not been updated within the last 6 months.

The file for Staff #3, contained one written, nonfamily reference and one written, family reference from individuals attesting to the suitability to serve as a facility person.

The file for Staff #1 and #3 contained a NSOR certificate obtained after the required date of 7/1/20. The files for Staff #1, #2, #3, and #4 lacked a disclosure statement. The file for Staff#5 lacked a FBI clearance and contained an incomplete disclosure statement without a date. (See LIS Code Sheet)

At approximately 12:25 PM Staff #3 and #5 left the main classroom to enter the back kitchen and office area, leaving Staff #1 and #2 alone in the main classroom with 14 children; 1 infant, 3 young toddlers, 4 older toddlers, 4 preschoolers, and 2 school aged children.

Located in an unlocked cabinet in the main classroom were push pins and a stapler that were accessible to the children in care and creating a puncture hazard.

Staff #1, #2, #3, #4, and #5 had current emergency plan training at the time of renewal inspection, they did not have training within their 90 days of hire.

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

Located in the Outdoor Play Space was a large hole next to the steps when entering the facility and overgrown weeds located all along the fence creating a tripping hazard.

The bathroom lacked a hand washing sign posted at the toilet.

Observed the side exit door from the kitchen was blocked due to a deep freezer being in front of the door.

Located in the Main Classroom was a toy bench that had a loose hitch on the top section creating a pinching hazard for the children in care.

Child #6, an infant, lacked labeled individual rest equipment.

The file for Staff #4 contained a health assessment that had not been updated within the last two years. The file for Staff #5 contained a health assessment that lacked that statement that the individual was suitable for childcare.

The file for Child #6, an infant, lacked a written formula and feeding schedule obtained from the parent.

A bottle which was not labeled with the infant child's name was observed in the main room.

Observed the facility did not have written notification of safe routes shall be posted by the operator at a conspicuous location in the child care facility.

The facility contained documentation of conducting an annual emergency drill after the required date of 12/19/21.

The facility lacked a smoke detection system testing log.

Staff person #3 had not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): Health and Safety

The Agreement for Child #4 lacked the amount of the fee to be charged.

The file for Child #1 and # 3 contained Agreements which did not specify the child's arrival or departure times.

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

The Agreement for Child #5 lacked the date of the child's admission.

The emergency contact for Child #3, #4, ad #5 lacked the health insurance coverage policy number for the child.

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

The main room lacked a file containing emergency contact information for Child #6 while they were present and receiving care in the space.

The Emergency Contact form for Child #4 lacked signed parental consent for administration of minor first-aid procedures by facility staff.

The file for Staff #1 and #3 lacked documentation of the annual 12 clock hours of child care training.