Salem Crossroads Day Care INC

The updates to the State Police, Child Abuse and FBI clearances on file for Staff Person #2 exceeded 60 months between update. This was evidenced by State Police clearances dated 11.27.18 and 1.8.24, Child Abuse clearances dated 11.28.18 and 1.9.24, and FBI clearances dated 11.29.18 and 1.5.24. The updates to the Mandated Reporter training for Staff Person #2 also exceeded 60 months between 4.23.19 and 12.16.24. The updates to the Child Abuse clearances on file for Staff Person #4 exceeded 60 months between clearances dated 10.8.18 and 1.4.24. The updates to the NSOR Certificates on file for Staff Person #6 exceeded 60 months between NSOR certificates dated 11.6.19 and 1.22.25. The updates to the FBI clearances on file for Staff Person #7 exceeded 60 months between clearances dated 8.1.19 and 1.2.25.

A portable space heater was observed in the staff office at the facility.

In Classroom 5, four mats were observed to be in disrepair causing the inside foam to be exposed. In Classroom 6, two mats were observed to be in disrepair causing the inside foam to be exposed.

The file for Child #3, an older toddler, lacked a current health report. The most recent health report was dated 10.9.23. The file for Child #4, a preschooler, exceeded 12 months between health reports completed on 1.11.22 and 7.31.24.

The file for Child #5 lacked an immunization record for the child and they have exceeded 60 days since their first day of attendance at the facility (refer to LIS code sheet). A completed immunization record was not on file until 146 days in care. The file for Child #3 lacked verification that the child had received their 15--18-month DTAP vaccination. A written exemption was not on file at the time of the inspection.

One expired Ibuprofen was observed in the medication box in Classroom 5. One expired Motrin and one expired Ibuprofen were observed in the medication box in Classroom 6.

In Classroom 3, written consent from the parent was missing for a prescription Nayzilam intended for a child in care in the event of an emergency medical situation. In Classroom #5, written consent from the parent was missing for an opened Ibuprofen intended for a child in care.

The files for Staff Person's #1 and #5 lacked a current health assessment. The most recent health assessment on file for Staff Person #1 was dated 3.17.22 and the most recent health assessment on file for Staff Person #5 was dated 2.4.22.

The current health assessment on file for Staff Person #3 lacked information that an examination for communicable diseases had been completed and the results of that examination.

The facility has exceeded 60 days since their most recent fire drill was completed on 11.6.24.

The file for Child #8, a school-ager, lacked an initial health report and the child has exceeded 60 days since their first day of attendance on 8.10.20.

The written plan of daily activities was not posted in Classroom 3 (School Age).

The agreements on file for Children #1 and #2 lacked an Operator signature.

The agreement for Child #1 lacked a fee amount.

The agreement on file for Child #7 lacked the arrival and departure times.

The current agreement on file for Child #6 lacked the designated release persons.

The agreements on file for Children #1 and #5 lacked a date of admission.

The emergency contact form on file for Child #2 lacked the addresses and telephone numbers for two of the release persons listed.

An emergency contact form was missing for one child receiving care in Classroom #2 and one child receiving care in Classroom #4.

The emergency contact form for Child #5 lacked signed parental consent for obtaining emergency medical care and administration of minor first aid by facility staff.

Based on consistent interviews with staff, it has been determined that Staff Person #1 has used harsh language towards children receiving care at the facility. This included behaviors described as "yelling" and "screaming" at the children.

At approximately 10:05am, 19 preschool age children were observed to be receiving care in Classroom #4. The classroom has a measured capacity of 17 children.

The file for Staff Person #1 lacked a completed PA State Police Clearance and they have exceeded 45 days in a child care taking position. A completed PA State Police Clearance was not on file until 408 days after starting.

Adult scissors were observed on desks accessible to the children receiving care in Classrooms #3 and #4.

The file for Staff Person #1 lacked verification that they have received updated emergency plan training within the last 12 months. The last documented emergency plan training was on 6.12.23.

In Classroom #3, a bottle of hand sanitizer was observed on the desk in the classroom. The desk was accessible to school age children receiving care in the space. In Classroom #6, diapering ointments were observed in the open cubes at the changing table. The cubes would be accessible to toddler children being diapered in the space. Diapering ointments were observed in an unlocked cabinet in the restroom. The diapering ointments would be accessible to children using the restroom. All items were labeled Keep Out of Reach of Children.

In Classrooms #3 and #5 unlidded trash cans containing used plates, utensils and food that had been served to children were observed.

Exposed bolts were observed on the fencing in the outdoor toddler play space. The exposed bolts posted a visible hazard to children.

In Classroom #2, one expired acetaminophen was observed in the medication bin.

The facility lacked verification that they had participated in an annual emergency drill within the last 12 months. The last documented emergency drill was completed on 4.12.23.

The facility was unable to locate the fire drill log at the time of the unannounced inspection. This did not allow for assessment that fire drills are being completed as required.

Staff person #1 did not complete the following required pre-service training within 90 days of their date of hire (see LIS code sheet): 10-hour health and safety training and mandated reporter training. The 10-hour health and safety training was completed 211 days after starting at the facility. The mandated reporter training was completed 212 days after starting at the facility.

The file for Staff Person #1 lacked a written staff evaluation. Staff Person #1 has exceeded 12 months as a staff person at the facility.

A copy of the facility's current Certificate of Compliance was not posted in a conspicuous location.

At approximately 10:00am, Staff Person #2 was observed in the doorway of Classroom #6 talking with Operator. Upon entering Classroom #4 Staff Person #1 was observed with 13 preschool age children. Staff Person #2 entered the classroom behind Cert Rep and reported they had just stepped out to inform Operator of something. Staff Person #2 leaving had placed Staff Person #1 out of required staff:child ratio of 1:10 for preschool age children.

SECOND CITATION Young Toddlers receiving care in Classroom #2 were observed to be seated in the feeding table without the safety straps being engaged. FACILITY PREVIOUSLY CITED ON 1.18.2024.

The file for Staff Person #1 lacked a completed State Police Clearance within 45 days of starting at the facility. The State Police Clearance on file at the time of the inspection was under review. The disclosure statement on file for Staff Person #1 also lacked a date of signature. A completed state police clearance and dated disclosure statement were not on file until 233 days after starting at the facility. The mandated reporter training on file for Staff Person #1 was not completed within 90 days of starting at the facility. The mandated reporter training was completed 211 days after starting at the facility. The mandated reporter trainings on file for Staff Person #10 exceeded 60 months between trainings completed on 10.9.17 and 1.22.23. The mandated reporter trainings on file for Staff Person #11 exceeded 60 months between trainings completed on 10.10.18 and 10.19.23.

A Staff Person in Classroom #6 was observed to change a child's diaper and did not ensure that the child's hands were washed following the change. The child was observed to return to play with other children in the classroom. A hand washing sign was missing from one of the toilets and the changing table in the 2nd floor restroom.

An exit leading from Classroom #2 was observed to be blocked with a pack and play.

Torn rest mats, causing foam to be exposed, were observed in Classroom #6.

The high chair seats in Classroom #2 were observed to be missing safety straps from 5 of the seats.

The rest mats in Classroom #2 were not labeled to identify which mat belonged to which child.

The updates to the health assessments for Child #5, an older toddler, exceeded 12 months between examinations on 3.17.22 and 9.28.23.

The Physician instructions were missing for a Diazepam medication intended for a child receiving care in Classroom #5.

The garbage can in place at the changing table in Classroom #2 and in the restroom on the 2nd floor was not hands free. This did not allow for appropriate disposal of soiled diapers.

The health assessments on file for Staff Person #3 exceeded 24 months between examinations on 6.10.21 and 1.2.24. The health assessments on file for Staff Person #4 exceeded 24 months between examinations on 7.7.21 and 12.6.23.The health assessments on file for Staff Person #5 exceeded 24 months between examinations on 12.30.20 and 1.5.23. The health assessments on file for Staff Person #7 exceeded 24 months between examinations on 8.24.21 and 1.18.24. The health assessments on file for Staff Person #8 exceeded 24 months between examinations on 6.9.21 and 1.9.24. The health assessments on file for Staff Person #9 exceeded 24 months between examinations on 12.29.21 and 1.18.23.

At approximately 9:10am 18 preschool children were observed to be receiving care in Classroom #4. The classroom has a measured capacity of 17 children.

The file for Staff Person #1 lacked completion of their Pediatric First Aid and CPR training and the required Health and Safety training within 90 days of starting at the facility. The Pediatric First Aid and CPR training was completed 94 days after starting and the Health and Safety training was completed 197 days after starting.

A daily plan of activities was not posted in Classroom #3 (School Age Classroom).

The agreement on file for Child #2 lacked the fee amount to be paid.

The agreement form for Children #7 and #10 lacked the arrival and departure times.

The agreement form for Child #8 lacked the admission date.

The files for Children #1, #2, #3, #4, #6, #7, #8, #9 and #10 were observed to contain the original agreements.

The emergency contact form for Child #2 lacked the telephone number of the child's physician.

The emergency contact form for Children #4, #5 and #6 lacked the addresses for the release persons listed. The emergency contact form for Child #5 also lacked the telephone number for one of the release persons listed.

Emergency contact forms were missing for two children receiving care in Classroom #4.

The written emergency transportation plan was not posted in Classroom #4.

The updates to the emergency contact form and financial agreement for Child #5 exceeded 6 months between updates on 12.28.22 and 10.4.23.

The file for Staff Person #6 lacked verification of education. The file for Staff Person #7 lacked verification of experience.

The file for Staff Person #5 lacked one of their two written, nonfamily references.

The file for Staff Person #2 lacked 11 of their 12 hours of child care training during their respective training year. The file for Staff Person #8 lacked 1 of their 12 hours of child care training during their respective training year.

The updates to the State Police, Child Abuse and FBI clearances on file for Staff Person #1 exceeded 60 months. The State Police Clearances on file were dated 7.27.17 and 12.30.22. The FBI clearances were dated 7.27.17 and 1.3.23. The file lacked a current Child Abuse Clearance. The Child Abuse Clearance on file was dated 7.31.17. The files for Staff Person #4 and #6 lacked completion of mandated reporter training within 90 days of starting at the facility. The mandated reporter training on file for Staff Person #4 was completed 285 days after starting at the facility. The mandated reporter training on file for Staff Person #6 was completed 223 days after starting at the facility. The file for Staff Person #11 exceeded 60 months between update to their mandated reporter trainings occurring on 11.2.16 and 1.23.22. The file lacked verification that Staff person #7 has completed the mandated reporter training within 90 days of their date of hire (see LIS code sheet). The file for Staff Person #5 lacked an FBI clearance that had been completed for DHS purposes. The FBI clearance on file was completed through the Department of Education and is not acceptable for employment in a child…

The file for Facility Person #3 lacked their prior State Police and Child Abuse clearances. Facility Person #3 does have current clearances on file at this time.

The updates to the emergency plan training exceeded 12 months between 6.9.21 and 1.5.23 for Staff Person's #1, #3, #8, #9, #11, #12, #14, #15, #16, #17, #18 The updates to the emergency plan exceeded 12 months between 10.18.21 and 1.5.23 for Staff Person #21 and 10.19.21 and 1.5.23 for Staff Person's #7, 10 and #22. The file for Staff Person #13 lacked current emergency plan training. The last training was dated 10.19.21. The file for Staff Person #6 lacked initial emergency plan training within 90 days of starting at the facility. The training on file was dated 218 days after starting at the facility.

The lock under the sink in Classroom #6 was in disrepair allowing the cabinet to open without restriction. Bottles of Bissell Floor Cleaner, labeled Keep out of Children, were observed under the sink. A bottle of hand sanitizer was observed in an unlocked desk drawer accessible to the children receiving care in Classroom #3. The hand sanitizer was labeled Keep out of Children.

The hot water in Classroom #5 was observed to measure at 115.9° F. The hot water in Classroom #6 was measured at 117.2° F.

The portable electric sink in the changing area in Classroom #5 was observed to be unplugged which did not allow for a source of running water to be present in the diapering area.

The rest equipment in Classrooms #2, #3 and #5 were not all labeled for use of a specific child.

The health assessments on file for Child #2, a young toddler, exceeded 6 months between examinations occurring on 11.24.21 and 8.8.22.

The updates to the health assessments on file for Child #4, an older toddler, exceeded 12 months between examinations on 8.2.21 and 11.1.22. The updates to the health assessments on file for Child #7, an older toddler, exceeded 12 months between examinations on 5.5.21 and 2.9.21. The file for Child #8, an older toddler, lacked a current health assessment. The last health assessment was dated 6.19.21.

The files for Children #1, #2, #3, #6, #7, #8 and #9 lacked verification that the children had received an annual influenza vaccination in 2022 as recommended by the ACIP. The file for Child #2 also lacked verification that the child had received their 15-18 month DTAP vaccination. Written exemptions for the missing immunizations were not on file for the children at the time of the inspection.

Written physician instructions were missing for an Auvi Q medication in classroom #7. Written physician instructions were missing for an Epipen in classroom #6

A container of Healing Ointment was observed in on the bottom area of a cubby in Classroom #6.

An expired Epipen was observed in the medication box in Classroom #4.

Written parental consent was missing for an Epipen observed in the medication box in Classroom #6.

The file for Facility Person #1, #3, #7 and #13 lacked a current health assessment that had been completed within the last 24 months. The health assessment on file for Facility Person #1 was dated 1.6.20. The health assessment on file for Facility Person #3 was dated 6.19.19. The health assessment on file for Facility Person #7 was dated 2.13.20. The health assessment on file for Facility Person #13 was dated 3.12.20. The health assessments on file for Facility Person's #10 and #12 exceeded 24 months between examination. The health assessments on file for Facility Person # 10 were dated 8.5.20 and 1.4.23. The health assessments on file for Facility Person #12 were dated 10.31.20 and 12.15.22. The file for Facility Person #2 and #6 lacked an initial health assessment that had been completed within 12 months prior to starting at the facility. The health assessment on file for Facility Person #2 was completed 13 days after starting at the facility. The health assessment on file for Facility Person #6 was completed 1 day after starting at the facility.

The health assessment on file for Facility Person #5 lacked information related to an examination for communicable diseases and the physician's assessment of their suitability to provide child care.

A written statement from the parent giving the formula and feeding schedule for an Infant in care was missing at the time of the inspection.

Documentation that the facility had participated in an annual emergency drill was not available at the time of the inspection.

Documentation that the facility has submitted their annual notification to the local traffic authority was not on file at the time of the inspection.

The files for Staff Person's #8 and #9 lacked completion of the required health and safety update by 12.30.22. The updated health and safety training was completed on 1.2.23 for both Staff.

The file for Facility Person #5 lacked written verification from a representative of the training institution that they are currently enrolled in an approved training curriculum and that they had completed the required classroom training.

The file for Facility Person #3 lacked verification that they had completed annual fire safety training.

Staff person #15 has not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): 31(f)(1-9). The training on file was the 6-hour health and safety training and it was not completed in the approved time frame. Staff Person #15 needed to complete the 10-hour health and safety training at the time they completed the 6-hour training.

Pediatric First Aid and CPR trainings were not on file for Staff Person's #1, #3, #7, #8, #9, #10, #11, #12, #13, #14, #15, #16, #17, #18, and #19 with a PQAS approved instructor in an approved curriculum by 4.29.22. The prior trainings on file were completed through an online service provider, which was not acceptable. Staff have all completed Pediatric First Aid and CPR with a PQAS instructor at this time. The files for Staff Person #4, #20 and #21 lacked completion of their Pediatric First Aid and CPR within 90 days of starting at the facility. The training for Staff Person #4 was completed 215 days after starting at the facility. The training on file for Staff Person #20 was completed 422 days after starting at the facility. The training on file for Staff Person #21 was completed 369 days after starting at the facility. The file for Staff Person #6 lacked completion of their required health and safety training within 90 days of starting at the facility. The training was completed 229 days after starting at the facility. The files for Staff Person's #8 and #9 lacked completion of the required health and safety training update by 12.30.22. The updated health and safety training…

The staff evaluations on file for Facility Person's #3, #7, #14, #16, #17 and #21 exceeded 12 months between evaluations. This was evidenced from the information provided by the Operator on the Staff Worksheet.

The agreement form for Child #5 lacked the admission date.

The emergency contact form for Children #5 and #9 lacked the complete address information for the release persons listed.

Emergency contact forms were missing for children receiving care in Classrooms #4 and #6

The written emergency transportation plan was not posted in Classroom #1, #2, #3, #4, #5, #6 and #7.

The updates to the emergency contact form and financial agreement for Child #4 exceeded 6 months between updates occurring on 3.8.22 and 11.1.22.

The files for Facility Person's #4 and #10, who were identified as Assistant Group Supervisors, lacked verification of 2500 hours to qualify them for the position. The file for Facility Person #4 did not have any hours verified and the file for Facility Person #10 had 1550.4 hours verified.

The file for Facility Person's #3, #4 and #5 lacked two written, nonfamily references.

The file for Staff Person #1 lacked 9 hours of childcare training in their respective training year (12.19.21-12.18.22). The file for Staff Person #7 lacked 3 hours of childcare training in their respective training year (12.19.21-12.18.22). The file for Staff Person #10 lacked 1 hour of childcare training in their respective training year (12.19.21-12.18.22).

The file for staff person #6, whom was hired as an assistant group supervisor on 9/30/16, lacked state police, child abuse, and FBI clearances that were competed 60 months from the previous clearances. The state police clearances in the file are dated 9/16/16 and 10/27/21. The child abuse clearances in the file are dated 9/16/16 and 10/28/21. The FBI clearances in the file are dated 9/25/16 and 10/28/21. The file for staff person #12, whom was hired as an assistant group supervisor on 11/1/21, lacked a state police clearance and NSOR verification certificate within 45 days from the hire date. The state police clearance in the file is dated 1/18/22. The NSOR verification certificate in the file is dated 1/11/22. The file for staff person #15, whom was hired as an aide on 8/26/21, lacked a disclosure statement that was signed and dated prior to start date. The disclosure statement in the file is dated 10/15/21. The file for staff person #19, whom was hired as an assistant group supervisor on 10/18/21, lacked an NSOR verification certificate within 45 days from the hire date. The NSOR verification certificate in the file is dated 2/8/22. The file for staff person #20, whom was hired…

The outlets behind the portable sink in the school-age room were observed to be missing protective receptacle covers accessible to children 5 years of age or younger.

The first-aid kit in the school-age room was observed to be missing scissors and tweezers.

Two nails were observed protruding out of wooden playground equipment in the outdoor playspace causing a visible hazard. The heater furthest from the door on the floor in Preschool #1 was observed to have an opening with sharp edges causing a visible hazard.

Two bottles of Tylenol each labeled for a specific child lacked written parent consent for administration of the medication.

The file for staff person #1 lacked a health assessment that was completed 24 months from the previous health assessment. The health assessment in the file is dated 12/19/19. The file for staff person #6 lacked a health assessment that was completed 24 months from the previous health assessment. The health assessments in the file are dated 2/27/19 and 6/10/21. The file for staff person #14 lacked a health assessment that was completed in the last 24 months. The health assessment in the file is dated 9/18/19. The file for staff person #17 lacked a health assessment that was completed 24 months from the previous health assessment. The health assessments in the file are dated 2/26/19 and 12/20/21.

The files for staff persons #1, #2, #3, #4, #5, #6, #8, #9, #10, #11, #13, #14, #16, #17, and #18 lacked firesafety training that was completed 12 months from the previous training. The training in the files was dated 11/10/20 and 1/11/22.

The file for staff person #1, whom was hired on 12/27/19, lacked mandated reporter training that was completed within 90 days from the hire date. The mandated reporter training in the file is dated 1/11/22. The file for staff person #2, whom was hired on 2/24/20, lacked mandated reporter training that was completed within 90 days from the hire date. The file for staff person #6 lacked mandated reporter training that was completed 60 months from the previous training. The mandated reporter trainings in the file are dated 11/28/16 and 1/23/22. The file for staff person #9 lacked mandated reporter training that was completed 60 months from the previous training. The mandated reporter trainings in the file are dated 1/6/17 and 1/19/22. The file for staff person #19, whom was hired on 10/18/21 lacked mandated reporter training that was completed within 90 days from the hire date.

The file for staff person #1 lacked 2 years experience with children. The file for staff person #12 lacked a high school diploma and 2 years experience with children.

The file for child #2 lacked emergency contact information that included the address of the child's physician.

The file for child #2 lacked emergency contact information that included the work addresses and work telephone numbers of the enrolling parent. The file for child #3 lacked emergency contact information that included the work telephone number of the enrolling parent.

The file for child #3 lacked emergency contact information that included 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 files for children #2 and #3 lacked emergency contact information that included the addresses of the individuals designated by the parent to whom the child may be released.

In the young toddler room upstairs it was observed that the written plan identifying the means of transporting a child to emergency care and staffing provisions in the event of an emergency to not be displayed conspicuously.

The file for child #1 lacked emergency contact information that contained signed parental consent for administration of minor first-aid procedures by facility staff prior to admission.

The files for staff persons #12, #15, and #17 lacked 1 written, nonfamily reference from an individual attesting to the person's suitability to serve as a facility person

The files for staff persons #12 and #15 lacked health and safety training.

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