The Growing Tree · Salix

Staff persons #2 and #3 were observed to be caring for children unsupervised. Staff person #2 has not completed the following pre-service training required prior to caring for children unsupervised: mandated reporter training, pediatric first aid/CPR from a PQAS approved trainer and a PQAS approved curriculum, and health and safety training. Staff person #3 has not completed the following pre-service training required prior to caring for children unsupervised: pediatric first aid/CPR from a PQAS approved trainer and a PQAS approved curriculum and health and safety training.

The files of Staff #2, #3, #7, and #8 lacked a valid disclosure statement (See LIS Code Sheet). The disclosure statement on file for Staff #2, #3, #7, and #8 was not the one updated in 2020. The file of Staff #2 lacked a valid FBI Clearance. The file of Staff #2 contained an FBI Clearance dated 5/14/24 from the Department of Education. The file of Staff #3 lacked a valid Child Abuse Clearance prior to providing initial service in a child care setting (See LIS Code Sheet). The file of Staff #3 contained a Child Abuse Clearance for employment dated 11/4/24 and a Child Abuse Clearance for a volunteer dated 7/14/23. The files of Staff #6, #7, and #8 lacked a disclosure statement signed at the time of initial service in a child care setting (See LIS Code Sheet). The file of Staff #6 contained a disclosure statement dated 10/25/19. The file of Staff #7 contained a disclosure statement dated 9/24/24. The file of Staff #8 contained a disclosure statement dated 9/24/24. The file of Staff #6 lacked a Child Abuse Clearance and FBI Clearance updated every 60 months. The file of Staff #6 contained a Child Abuse Clearance dated 11/5/24 with a previous one dated 10/10/19. The file of Staff #6…

At approximately 12:32 PM observed Staff #5 send a preschool child to the Toddler Room to use the bathroom and observed Staff #5 stand in the threshold of the door between the Preschool and Toddler Rooms to supervise the child in the bathroom and to supervise 9 preschool age children in the Preschool Room.

The letter provided to the parent explaining emergency procedures did not address accommodations for infants, toddlers, children with disabilities, and children with chronic medical conditions.

Observed Bic Wite-Out which indicated "keep out of the reach of children" in the bin labeled "fine tip sharpies" by the refrigerator in the Preschool Room which was accessible to children.

The sinks in the Toddler Room and Infant Room lacked platforms or steps to be easily approached by children using them.

Observed a cracked Magna Tile in the Preschool Room.

Observed foam letters with bite marks in the Toddler Room. Observed small foam cubes with bite marks in the Preschool Room. Observed foam bases and foam pieces with numbers with bite marks in the Outdoor Play Space.

The file of Child #2 lacked an updated health report at least every 6 months for an infant or young toddler. The file of Child #2 contained health reports dated 8/11/23, 3/7/24, and 8/26/24.

The file of Child #3 contained a health report which did not include a list of the child's current medication and the reason for the medication and if a special diet is prescribed for a child.

Observed staff placing soiled diapers in a lidded waste receptacle instead of a plastic-lined, hands-free covered can in the Toddler Room.

The files of Staff #3, #6, #7, and #9 lacked a health assessment conducted within 12 months prior to providing initial service in a child care setting (See LIS Code Sheet). The file of Staff #3 contained a health assessment dated 10/25/24. The file of Staff #6 contained a health assessment dated 8/10/23. The file of Staff #7 contained a health assessment dated 11/19/24. The file of Staff #9 did not contain a health assessment.

The files of Staff #3, #6, #7, and #8 lacked an initial health assessment which included tuberculosis screening by Mantoux method at initial employment (See LIS Code Sheet). The file of Staff #3 had a Mantoux test read date of 10/25/24. The file of Staff #6 had a Mantoux test read date of 8/23/21. The file of Staff #7 had a Mantoux test read date of 11/21/24. The file of Staff #8 had a Mantoux test read date of 11/4/24.

The facility was unable to provide documentation that the fire detection system was manually tested at least every 30 days. The facility provided documentation that the fire detection system was manually tested on 12/1/23, 1/3/24, 2/2/24, 2/7/24, 3/7/24, 4/5/24, 5/3/24, 6/3/24, 7/3/24, 8/5/24, 9/4/24, 10/4/24, 11/1/24, and 11/29/24.

The file of Staff #7 lacked documentation of completing the Pennsylvania Health and Safety Update within 90 days of hire (See LIS Code Sheet).

Staff #1 and #4 lacked renewal of their certification in pediatric first aid and pediatric cardiopulmonary resuscitation on or before the expiration of the most current certification. The file of Staff #1 contained documentation of pediatric first aid and pediatric cardiopulmonary resuscitation completed on 10/4/24 with a previous one completed on 8/6/22. The file of Staff #4 contained documentation of pediatric first aid and pediatric cardiopulmonary resuscitation completed on 10/3/24 with a previous one completed on 7/16/22.

Staff person #6 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 from a PQAS approved trainer and a PQAS approved curriculum.

Staff person #6 has not completed the mandated reporter training within 90 days of their date of hire (see LIS code sheet). Staff person #6 has documentation of completing mandated reporter training on 8/17/21, but it is not an approved course.

The file of Staff #3 lacked documentation of meeting one of the applicable staff qualifications for the position in which the person was performing.

The file of Staff #6 lacked a written evaluation on a regular basis, a minimum of one evaluation every 12 months (See LIS Code Sheet). The file of Staff #6 contained a written evaluation dated 12/23/22 but did not contain one for 2023 or 2024.

The files of Staff #2, #5 and #7, who were designated as assistant group supervisors, lacked documentation of 2 years' experience with children. The file of Staff #8, who was designated as an assistant group supervisor, lacked documentation of a high school diploma or a general educational development certificate.

The agreement for Child #5 did not specify the amount of the fee to be charged per day or per week.

The agreement for Children #1, #2, #4, and #5 did not specify the date on which the fee is to be paid.

The files of Children #1, #2, #3, #4, and #5 contained the original agreement. The facility did not make a copy for the file and give the original to the parent.

Emergency contact information for Child #5 did not include the telephone number of the child's physician or source of medical care.

Emergency contact information for Child #4 did not include the work address of the enrolling parent.

The files of Children #1 and #3 lacked written consent signed by a parent for emergency medical care prior to admission.

Emergency contact information for Child #1 did not include 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 for Child #4 was not reviewed and updated at least once in a 6-month period. Child #4's emergency contact was signed on 8/22/23 and reviewed on 2/22/24.

The files of Children #1 and #3 lacked signed parental consent for administration of minor first-aid procedures by facility staff prior to admission.

The file of Staff #3 lacked two written, nonfamily references from individuals attesting to the person's suitability to serve as a facility person.

The file of Staff #5 lacked documentation of completing professional development in pediatric first aid and pediatric cardiopulmonary resuscitation within 90 days of hire (See LIS Code Sheet). The file of Staff #5 contained documentation of completing pediatric first aid and pediatric cardiopulmonary resuscitation on 10/3/24.

The file of Staff #6 lacked documentation of obtaining an annual minimum of 12 clock hours of child care training.

The file of staff #3 had documentation of receipt and the complete clearance for PA State Police after their date of hire (see LIS code sheet).

At the time of reviewing documentation, the emergency plan lacked a continuity of operations.

The files of staff #1 and #2 lacked health assessments. The file of staff #4 had a late health assessment due to the fact the ones on file were dated 1-15-20 an 10-11-22.

At the time of reviewing documentation, the emergency plan lacked addressing accommodations to children with chronic medical conditions.

At the time of reviewing documentation, the emergency plan lacked documentation of conducting a drill.

At the time of reviewing documentation of fire drills, they were not conducted every 60 days on the following dates: 1-4-23 to 3-22-23 = 77 days, 3-22-23 to 6-7-23 = 77 days, and 6-7-23 to 9-1-23 = 86 days.

At the time of reviewing documentation of testing the smoke detection system, the system was not tested every 30 days due to the fact the dates listed were 5-1-23 to 6-5-23 = 35 days and 7-5-23 to 8-7-23 = 33 days.

The file of child #1 lacked an emergency contact form with the work address and telephone number of the enrolling parent.

The file of child #1 lacked an emergency contact form with the full address of the individual designated by the parent to whom the child may be released.

The file of staff #13 lacked documentation of a valid PA State Police clearance due to the fact the document on file was for a volunteer.

The file of staff #14, a facility person lacked documentation of completing emergency plan training at the time of hire.

The emergency plan was not posted in the facility at a conspicuous location.

The files of children #1 and #2 lacked the flu immunization.

Based on documentation on the fire drill log, fire drills were not conducted every 60 days due to the fact 9-1-22 to 11-1-22 is 61 days and 11-1-22 to 1-4-23 is 64 days.

Staff persons #1, #2, #3, #4, #5, #6, #7, #8, #9, #10, #11, #12, and #14 have not completed the following required pre-service training within 90 days of their start dates (see LIS code sheet): Pennsylvania Health and Safety Update 2022.

Staff person #3 has not completed the following required pre-service training within 90 days of their start date (see LIS code sheet): Pediatric First Aid and CPR.

The files of staff #9 and #11, both an AGS lacked documentation to support the positions due to the fact there was not proof of education.

The file of staff #14, a facility person lacked two written, nonfamily references.

The certificate of compliance and information on how to access the regulations in this chapter electronically, with instructions for contacting the appropriate regional child care office were not posted in a conspicuous location used by parents.

The files of staff #10 and #12 lacked documentation of completing an annual minimum of 12 clock hours of child care training.

Observed a trash can in the preschool room with dirty tissues. The trash can lacked a lid.

Observed in the infant room a Graco brand and Fisher Price brand high chair lacking shoulder straps in the plastic mold cutouts. Therefore, the chairs were not used according to the manufacturer's guidelines.

Observed an Epi Pen not labeled for the use of a specific child in the first aid kit in the preschool room.

At the time of the inspection, there was not a policy for shaken baby syndrome, abusive head trauma, and child maltreatment.

The file for child #1 lacked an agreement with an enrollment date.

At the time of the inspection, emergency transportation plans were not posted in each child care space.

The file of staff #1 lacked documentation of completing the annual requirement for 12 clock hours of child care training in 2021.