The Teeter-Totter

The restroom lacked handwashing signs above the toilet and the changing table.

In the infant area, rest equipment lacked a label with the name of a specific child.

The two most recent health report forms for Child #2 are dated 12/15/22 and 5/15/24, more than 12 months apart. (SEE LIS CODE SHEET)

The initial health assessment provided from Staff Person #1 was dated 6/10/22, more than 12 months prior to the date of hire. The initial health assessment for Staff Person #3 was dated 12/4/24, after the date of hire. (SEE LIS CODE SHEET)

The facility lacked written infant feeding schedules from the parent.

The file for Child #1 contained a health report form dated 10/28/24, more than 60 days after the date of enrollment. The file for Child #4, enrolled more than 60 days, did not contain a health report form. (SEE LIS CODE SHEET)

The most recent annual written traffic letter to local safety authorities is dated 12/7/23, more than 12 months prior.

The file for Staff Person #1 and Staff Person #3 did not contain the Pa. Health and Safety Update 2022 which was required to be completed by 12/30/22, as per Announcement C-22-06.

The file for Child #1 did not contain a child service report to document the child's growth and development. The file for Child #2 did not contain a child service report after 12/27/22 to document the child's growth and development.

The emergency contact form for Child #1 and Child #4 lacked a work address and work phone number.

The emergency contact form for Child #3 lacked written parental consent for emergency medical care.

The emergency contact form for Child #1 and Child #4 lacked information regarding the child's special needs.

The file for Child #2 and Child #3 contained an emergency contact form that was not updated within 6 months of the previous update.

The file for Child #2 and Child #3 contained a financial agreement form that was not updated within 6 months of the previous update.

The emergency contact form for Child #3 lacked written parental consent for administration of minor first aid procedures.

The file for Staff Person #2 lacked two written, nonfamily references. The file for Staff Person #3 lacked one written, nonfamily reference.

The file for staff #5 contained a state police clearance which lacked a dissemination date, therefore the clearance was incomplete. The file also lacked an out of state South Carolina clearance from the abuse and neglect registry. The file for staff #6, hired provisionally, did not contain a complete child abuse clearance, a complete state police clearance or a complete FBI clearance. The file for staff #7, hired provisionally, did not contain documentation of applying for the NSOR certificate. The file for staff #8 did not contain a DHS FBI clearance. A copy of the individual's Dept. of Education FBI clearance was on file, but is not acceptable. The file also lacked documentation of applying for the NSOR certificate.

Adult scissors were accessible to children in an unlocked low storage drawer in the toddler area.

The files for staff #1, #2, #3, and #4 contained documentation of completing emergency plan training more than 12 months apart. The trainings were dated 11/02/22 and 12/05/23.

The facility's letter to parents explaining the emergency procedures did not include details regarding accommodations for infants, toddlers, children with disabilities, or children with chronic medical conditions.

Four electrical outlets on a power strip in the toddler area lacked protective covers. The power strip was accessible to children on the floor behind the TV cart.

Liquid White Out, labeled keep out of reach of children, was accessible in an unlocked low storage drawer in the toddler area.

A first aid kit was accessible to children in the PS room. The kit was observed in a toy bin under the window ledge where it is typically stored.

Peeling paint was observed in the PS area on the wall near where the cots are stacked and in the toy storage area near the office.

The toilet's water tank in the rear restroom lacked a lid. The tank opening is currently covered with plastic. The toilet in the restroom where the diapering table is located was not fully secured to the floor and moves when pushed or sat on.

Two plastic storage bins, observed in the children's cubbies, were cracked or broken.

The door on the changing table in the restroom has a disconnected top hinge creating a pinch point. The seat of a blue chair in the infant area was cracked. In the PS area, the top left corner of a shelving unit was no longer secured together creating a pinch point.

The file for staff #6 contained a health assessment and TB screening conducted more than 12 months prior to their first day in a child care position.

The annual test reports for the fire alarm system were dated more than 12 months apart; 8/10/22 and 8/22/23.

The operator did not have documentation of sending a copy of the emergency plan updates to the local municipality and to the county emergency management agency. Changes were made to the plan in 2022.

The file for staff #8, designated as an aide, did not contain documentation of the educational qualifications required for the position.

The file for child #1 lacked a current child service report. The most recent report on file was completed 12/2022.

The agreement for child #2 did not specify the date of the child's admission.

The emergency contact information for child #2 did not include the name of the child's physician or source of medical care.

The files for staff #5, #6, and #8 did not contain written references. The file for staff #7 contained one written reference.

The facility's current certificate of compliance was not posted. The posted certificate expired in 2022.

The file for staff #3 contained a child abuse clearance which was not renewed within 60 months as required. The previous child abuse clearance was obtained on 8/30/17 and was renewed on 12/06/22.

The facility's emergency plan did not include details regarding continuity of business operations.

A first aid kit was accessible children on a small cabinet near the front door.

Peeling paint was observed below the windows in the preschool area.

Cracks, which created pinch points, were observed on a blue plastic storage tub containing books and a white plastic storage bin containing play food and dishes.

Tears were observed in the fabric of a nap cot labeled for child #2. The tears were located where the fabric is secured to the frame of the cot creating the risk of breaking away from the frame under the weight of a child.

A high chair lacking straps was observed near the restrooms. Holes for the straps were present indicating the manufacturer intended for them to be in use with the high chair.

The file for child #1 contained an immunization record which lacked documentation of receiving the influenza vaccine in 2021 or 2022. A written exemption was not on file.

The files for staff #2 and #3 contained health assessments which were not updated within 24 months. The most recent health assessments on file for both staff are now current.

The facility did not provide documentation of conducting an annual emergency drill.

The facility did not have a written policy for the identification and prevention of shaken baby syndrome, abusive head trauma, and maltreatment of children.

The file for staff #4, designated as an aide on the staff data sheet, did not contain verification of the education required for the position they are performing.

The file for staff #4 contained only one written reference.

The file for staff #1 contained 6 hours of training obtained on time and 4 hours of training obtained after 12/19/21. Staff #1 currently lacks 2 hours of annual training for the time period 12/19/20 to 12/19/21. The file for staff #3 contained 6 hours of training obtained on time and 5 hours of training obtained after 12/19/21. Staff #3 currently lacks 1 hour of annual training for the time period 12/19/20 to 12/19/21.

In the young toddler area of the main child care space, an electrical outlet directly below the window was observed to lack two protective coverings.

A cove base located on the lower left hand corner of the wall where parent information is posted was observed to be detached from the wall causing it not to be in good repair.

The staff file for Staff person #1 contained a current health assessment dated 11/16/20 which was not updated within 24 months of the previously dated 4/23/18 health assessment.

The facility's emergency plan lacked accommodations for infants, toddlers, children with disabilities and children with chronic medical conditions.

The facility's emergency plan lacked a lockdown procedure.

The facility lacked a means to provide parents of enrolled children a way to access the regulations in this chapter electronically.