Time to Succeed Child Care and Early Learning CTR

Staff person #4 was observed to be caring for children unsupervised. Staff person #4 has not completed the following pre- service training required prior to caring for children unsupervised: health and safety training.

Observed rest cots, toys, a filing cabinet, and children's chairs obstructing the door leading outside in the small room between the 1-year-old room and preschool room.

Observed a rest cot in the 1-year-old room with less than 2 feet on three sides when the rest equipment was in use. Observed a rest cot with approximately 2 inches on one side and approximately 1 foot on another side.

The Director or designated staff person who is responsible for compliance with this chapter did not ensure fire drills were conducted at least once every 60 days. The facility provided documentation that fire drills were conducted on 12/16/24, 1/31/25, 2/7/25, 3/6/25, 4/10/25, 5/7/25, and 7/7/25.

The Director or designated staff person who is responsible for compliance with this chapter did not ensure a written record was maintained on file at the facility indicating the hypothetical location of the fire and the names of the facility persons who participated in the fire drill.

Staff #2, #3, and #5 lacked renewal of their certification in pediatric first aid and pediatric cardiopulmonary resuscitation on or before the expiration of the most current certification. Staff #2 completed pediatric first aid and CPR on 1/24/23 with an expiration date of 1/25, and a renewal completed on 5/9/25. Staff #3 completed pediatric first aid and CPR on 9/23/22 with an expiration date of 9/24, and a renewal completed on 10/22/24. Staff #5 completed pediatric first aid and CPR on 7/26/22 with an expiration date of 7/24, and a renewal completed on 8/22/24.

The file of Staff #1 lacked documentation of completing health and safety training within 90 days of hire (SEE LIS Code Sheet). The file of Staff #1 contained documentation of completing health and safety training on 11/6/23.

Staff person #4 has not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): Health and Safety Training. Staff person #4 has documentation of completing Health and Safety Training on 9/11/16.

Based on information obtained during the course of the investigation, it was determined that the young toddler teacher would leave the room and go next door into the older toddler room to obtain needed items which were stored in the older toddler refrigerator.

Observed an infant sleeping in a swing and not in the sleeping position recommended by the American Academy of Pediatrics unless there is a medical reason an infant should not sleep in this position.

Observed mouse droppings and other evidence of mouse infestation (holes chewed into boxes) in the kitchen and kitchen storage area of the facility. In the course of the investigation staff stated the facility has a mouse issue and has been bringing in an exterminator to try to solve the problem.

Observed a hole in the wall beside the entrance door to the infant room. Observed a ceiling vent in the kitchen which needed to be cleaned.

Observed a torn diaper changing pad in the infant and in the young toddler rooms.

Observed a container of pasta and meat sauce was on a cart in the kitchen and had not been refrigerated after it had been served for lunch.

Observed child #1, an infant sleeping in a swing. Therefore, not in the supine position as recommended by the American Academy of Pediatrics.

Observed insufficient lighting for staff #1 to properly supervise the children during nap time in the older toddler room

Staff #1 had children #1 and #2 restrained on their cots during nap time due to the fact the children were covered with a blanket from above their heads, with their faces covered to below their feet. Then the blankets were tucked under each leg of the rest cot thereby restricting children's movements and enclosing the children in a confined space. Therefore, prohibiting the children to freely move their arms and legs.

There was not a copy of consent to transport in the facility vehicle at the time children #1, #2, and #3 were transported to their elementary school.

The facility was observed to be providing a letter to the parent of each enrolled child explaining the emergency procedures, however this letter failed to provide information of the emergency procedures regarding accommodations for infants, toddlers, children with disabilities and children with chronic medical conditions.

An outlet in the infant room by the phone, an outlet in the 1-year-old room reading center, and an extension cord in the big room in the front of the facility were observed to lack protective receptacle covers.

Two 8oz mint green Behr paint samples and a container of Members Mark disinfecting wipes were observed to be being stored in the unlocked and accessible to children counter built over the tub shower in the infant room.

The first-aid kit in the 2015 Toyota Sienna was observed to lack soap.

The facility was observed to have a training "potty" chair in the 2-year-old bathroom that lacked a hand washing sign posted.

A plastic bin used to store magna tiles in the Pre-school room was observed to have a cracked/broken rim, a doll house in the front right room was observed to be broken, and the round Lego table's green piece was observed to be broken.

The file for child #2, a preschool aged child was observed to lack an updated health report at least every 12 months for an older toddler or preschool child. This was evidenced by the only health assessment present in the file is dated 02/28/2023.

A sippy cup that lacked a label with a child's name was observed in the infant room.

The facility was observed to lack documentation of an emergency drill being conducted annually.

The file for children #1 and #2 were observed to lack an updated Department's approved form (Child Service Report) to provide information to the family about the child's growth and development in the context of the services being provided every 6 months. As evidenced by Child Service Reports dated 07/28/2023 and 11/1/2024 present in the file of child #1, and child service reports dated 07/31/2023 and 10/1/2024 present in the file of child #2.

The facility was observed to lack a file for facility person #3 which contained at least current and valid DHS clearances, CPR certification, Health Assessment/TB, mandated reporter training, Emergency Plan training, and 2 written references.

****2nd citation previously cited on 5/10/24. 0n 6/5/2024 Staff persons #1 and #2 were observed caring for 7 infants in the facility's infant room. Staff person #1 identified 4 infants, and staff person #2 identified 2 infants, leaving child #1 unassigned to a staff person for supervision. On 7/1/24 at approximately 11:00 a.m., Staff person #5 unsuccessfully named the children for whom they were responsible due to the fact she named children for whom Staff Person #6 had already identified. Additionally, Staff person #5 identified a female child as Child #2, however, Staff Person #6 stated that was not Child #2, it was Child #3.

****2nd Citation previously cited on 5/10/2024, On 7/1/24 at 10:45 a.m., Staff person #4 was observed in the outdoor play space with 8 children: 3 were young toddlers and 5 were older toddlers. Therefore, staff person #4 was over ratio.

On 5-10-24 at approximately 10:00 a.m., CR arrived at the facility. CR observed staff person Staff #2 in ratio in the front space on the right-hand side from the main entrance. Staff #2 named 7 children in her group: 2 young toddlers, 4 older toddlers, and 1 preschool aged child. Therefore, she as out of ratio from approximately 10:00 to 10:10 until staff #3 returned to the child care space. At 10:06, CR assessed ratio and supervision in the back middle child care space where staff #4 was observed to have 7 children: 1 young toddler, 5 older toddlers, and 1 preschool aged child. Staff #4 was observed to be out of ratio by the CR from 10:06 to 10:08. At 10:06 CR observed the preschool space located in the back right-hand side of the building from the main entrance where staff #5 named 11 children, all preschool aged. Therefore, she was observed out of ratio from 10:06 to 10:15 until staff #7 arrived for her shift.

On 5-10-24 at approximately 10:00 a.m., CR Jessica Mento arrived at the facility. CR observed staff person Staff #2 in ratio in the front space on the right-hand side from the main entrance. Staff #2 named 7 children in her group: 2 young toddlers, 4 older toddlers, and 1 preschool aged child. Therefore, she was out of ratio from approximately 10:00 to 10:10 until staff #3 returned to the child care space. At 10:06, CR assessed ratio and supervision in the back middle child care space where staff #4 was observed to have 7 children: 1 young toddler, 5 older toddlers, and 1 preschool aged child. Staff #4 was observed to be out of ratio by the CR from 10:06 to 10:08. At 10:06 CR observed the preschool space located in the back right-hand side of the building from the main entrance where staff #5 named 11 children, all preschool aged. Therefore, she was observed out of ratio from 10:06 to 10:15 until staff #7 arrived for her shift.

Based on conversation with staff #1, which took place on 5-10-24, they failed to complete an incident report for an incident that occurred the week of April 29, 2024.

Several cleaning materials marked "Keep out of Reach of Children" were observed in the facility preschool, Old Toddler and Young Toddler bathrooms accessible to children.

Tweezers were observed to be missing from the infant room first-aid kit. Tape was observed to be missing from the young toddlers' room first-aid kit.

The bottom of the blue peg board wall in the Older two-year-old room was observed to have peeling paint.

The bathroom light in the Young Toddler Room was observed to not be working.

Toilet bolt covers were observed to be missing from the toilets in the preschool and young toddler rooms.

In the school-age room, a blue cubby and a wooden shelf were observed to be chipped and splintering causing rough edges.

On the day of inspection, the refrigerator in the school-age area was observed to have a faulty thermometer.

The file for Child #3 was observed not to have updated health reports. This is evidenced by the child's DOB:10/2/2022 and enrollment date of 11/28/22. There is only documentation of the initial health report on 11/23/22.

The most up to date health assessment on file for staff person #1 was observed to be greater than 24 months. This is evidenced by the health assessment being dated 5/12/21 and 10/6/23.

The file for Child # 2 was observed not to contain and initial health assessment.

The file for Staff person #2 (DOH) 8/17/23 was observed not to have documentation of Health and Safety training being completed within the staff persons 90 days of hire. This is evidenced by the Health and Safety training being completed on 12/12/2023.

The emergency contact form on file for child # 4 was observed not to contain the address and telephone number of the child's physician.

The emergency contact form on file for child #2 was observed not to contain the work address of the enrolling parent.

The emergency contact form on file for child # 1 was observed not to contain 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 form on file for child #1 and child #2 was observed not to contain the address of the individual designated by the parent to whom the child may be released.

The emergency contact form on file for child #1 was observed not to contain the telephone number of the individual designated by the parent to whom the child may be released.

The emergency contact information for Child #5 was observed not to be present in the child care space in which the child was receiving care.

The emergency contact form on file for child# 1 was observed not to contain written parental consent for administration of medications or special dietary needs.

Staff person #4 was observed to be caring for children unsupervised. Staff person #4 has not completed the following pre-service training required prior to caring for children unsupervised: (Pediatric First Aid/CPR)

It was observed on day of inspection a four-month-old infant sleeping in a bouncy chair with their head tilted into the side of the chair.

It was observed on the date of inspection an infant was placed in a crib that was not labeled for that specific child.

The file for Staff Person #1, and staff person #2 was observed not to have completed Pennsylvania Health and Safety Update 2022 by December 30, 2022.

Staff person #3 has not completed the following required pre-service training Pediatric First Aid/CPR within 90 days of their date of hire 3/9/23 (see LIS code sheet)

Staff person #1 was observed to be caring for children unsupervised. Staff person #1 has not completed the following pre-service training required prior to caring for children unsupervised: Mandated Reporter; Pediatric first-aid/CPR training; CCDBG health and safety professional development,

It was observed in the toddler room a set of cardboard barn stacking blocks that were torn and broken.

It was observed that cribs and sleep cots in the infant and toddler room were not labeled for use of a specific child.

The health report on file for child #3 and child #5 did not contain documentation of an influenza vaccine being administered within the last year in accordance with the recommendations of the ACIP.

It was observed in the facilities vehicle, that the child's passenger restraint systems were expired and not being used as designated by the manufacturer of the system.

The file for child # 6 was observed not to contain documentation of a health report no later than 60 days following the first day of attendance at the facility. This is evidenced by the date of enrollment being 08/23/22.

Staff person #1 has not completed the following required pre-service training within 90 days of hire (See LIS code Sheet); Reporter; Pediatric first-aid/CPR training; CCDBG health and safety professional development,

The file for Child #3 and Child #4 were observed not to contain documentation of an agreement form.

The emergency contact form on file for child #6 was observed not to contain the name, address and telephone number of the child's physician or source of medical care.

The emergency contact form on file for child #2 and child #3 were observed not to contain information on the child's disability.

The emergency contact form on file for child #1 and child #6 was observed not to contain health insurance policy numbers for the children under a family policy or Medical Assistance benefits.

The emergency contact form on file for Child # 6 was observed not to contain health insurance coverage.

The emergency contact form on file for Child # 6 was observed not to contain signed parental consent for emergency medical care for the child.

The emergency contact form on file for Child #6 was observed not to contain signed parental consent for transportation.

It was observed during nap time in the preschool room and the young toddler room that children were placed in areas that made it unable for staff to see, hear, direct, and assess the children.

On 3/23/22 at approximately 10:30 AM Certification Staff observed Child #2, an older toddler, sitting in a highchair while all the other older toddlers were sitting in chairs at the table. When questioned by Certification Staff, Staff #1 indicated Child #2 was placed in the highchair because Child #2 was spitting on the table, and the other children were playing in the saliva.

At approximately 10:15 AM on 3/23/22 Certification Staff observed Child #1 who was an infant sleeping in a bouncer seat which had been placed in the crib.

2nd citation. Previously cited on 12/20/21. Staff #3 lacked a FBI Clearance updated every 60 months. Staff #3 had a FBI Clearance dated 4/6/16.

At approximately 9:10 AM on 2/17/22 Staff #1 and #2 were caring for a group of 14 mixed-aged children which included 12 preschoolers and 2 older toddlers. When asked to name the children in their assigned groups, Staff #1 named 1 older toddler and 8 preschoolers, and Staff #2 named 1 older toddler and 4 preschoolers.

2nd citation. Previously cited on 12/20/21. Observed an electrical outlet which lacked a protective receptacle cover in the play kitchen area in the Infant Room.

2nd citation. Previously cited on 12/20/21. Observed a wobbly bookcase in the health area in the Young Toddler Room.

2nd citation. Previously cited on 12/20/21. Emergency contact information for Child #1 was not present in the van used by staff to transport Child #1 to and from elementary school.

Staff #1, with a start date of 9/13/21 lacked a valid disclosure statement. The disclosure statement on file for Staff #1 was not the one updated in 2020. Staff #1, who was designated as a volunteer, lacked a copy of a FBI Clearance and National Sex Offender Registry Verification Certificate prior to providing initial service in a child care setting. Staff #1, with a start date of 9/13/21, did not have a FBI Clearance and NSOR on file. Staff #3 lacked a State Police Clearance, Child Abuse Clearance, and FBI Clearance updated every 60 months. Staff #3 had a State Police Clearance dated 12/10/21 with a previous one dated 4/12/16. Staff #3 had a Child Abuse Clearance dated 12/7/21 with a previous one dated 4/26/16. Staff #3 had a FBI Clearance dated 4/6/16. Staff #4 lacked a copy of a completed State Police Clearance, Child Abuse Clearance, and FBI Clearance prior to providing initial service in a child care setting. Staff #4 had a start date of 10/15/21 with a State Police Clearance dated 12/14/21 and a Child Abuse Clearance dated 12/14/21. Staff #4 did not have a FBI Clearance on file. Staff #6, with a start date of 9/28/21, lacked a valid disclosure statement. The disclosure…

At approximately 9:05 AM on 12/20/21 Certification Staff observed Child #5 sleeping in a bouncer seat in the Infant Room.

On 12/20/21 observed an electrical outlet which lacked a protective receptacle cover in the play kitchen area in the Infant Room.

On 12/20/21 observed Assured Hand Sanitizer which indicated "keep out of reach of children" on the handwashing sink which was accessible to children in care in the Older Toddler Room. On 12/20/21 observed Mellow Hand Sanitizer which indicated "keep out of reach of children" on the changing table which was accessible to children in care in the Young Toddler Room.

On 12/20/21 observed rust on the fence which runs parallel to the boulevard in the Preschool/School-Age Outdoor Play Space.

On 12/20/21 observed six approximately 1/2 inch holes in the drywall by the cabinet in the Girls Bathroom located in the School-Age Room. On 12/20/21 observed peeling paint around the door frames in the Infant/Toddler Outdoor Play Space.

On 12/20/21 observed a cracked green/yellow Magna Tile in the Older Toddler Room. On 12/20/21 observed a wobbly bookcase in the health area in the Young Toddler Room. On 12/20/21 observed a wobbly table in the dramatic play area in the 2 Year Old Room. On 12/20/21 observed a plastic table with a fake grass top with a loose leg in the School-Age Room. On 12/20/21 observed a wobbly stand containing puzzles in the Preschool Room. On 10/20/21 observed a pink baby carrier with approximately a 4 inch tear in the Preschool Room. On 12/20/21 observed a cracked red plastic basket on the shelf under the copier creating rough edges in the Preschool Room. On 12/20/21 observed 4 screws protruding on the top of the bookcase containing blocks in the Preschool Room.

On 12/20/21 observed 2 foam blocks for the mirror with bite marks in the Older Toddler Room. On 12/20/21 observed foam state puzzle pieces with bite marks in the School-Age Room.

Child #1, a 10 1/2 month old, lacked a current influenza immunization in accordance with the schedule recommended by the ACIP. Child #2, a 17 month old, lacked a current influenza immunization in accordance with the schedule recommended by the ACIP.

The 2 Year Old Room lacked a plastic-lined, hands-free covered can by the changing table.

Staff #5 lacked a health assessment conducted within 12 months prior to providing initial service in a child care setting. Staff #5 did not have a health assessment on file.

On 12/20/21 Certification Staff observed Staff #7 not wash his/her hands after diapering children in the Infant Room.

On 12/20/21 observed bottles not labeled with the child's name in the Infant Room.

The facility did not have an emergency plan that provided for accommodations for toddlers, children with disabilities, and children with chronic medical conditions.

The director or designated staff person did not conduct a fire drill at least every 60 days. On 12/20/21 the most recent fire drill was conducted on 11/1/21 with the previous one conducted on 9/1/21.

Child #2 lacked an initial health report no later than 90 days following the first day of attendance at the facility. Child #2 had a start date of 9/17/21 with no health report on file.

Staff #1 lacked documentation of mandated reporter training completed within 90 days of start. Staff #1 had a start date of 9/13/21 with no documentation of completing mandated reporter training. Staff #2 and #3 lacked documentation of mandated reporter training completed every 60 months. Staff #2 had documentation of mandated reporter training completed on 12/15/21 with previous training completed on 1/5/16. Staff #3 had documentation of mandated reporter training completed on 10/19/16.

Emergency contact information for Child #6 was not present in the Young Toddler Room while Child #6 was receiving care in the space. Emergency contact information for Children #7 and #8 were not present in the Preschool Room when they were receiving care in the space.

Emergency contact information for Child #4 was not present in the van used by staff to transport Child #4 to and from elementary school.

The agreement for Child #3 was not on file at the date of enrollment. Child #3 had an admission date of 8/23/21 with an agreement dated 9/30/21.

Staff #1 lacked two written, nonfamily references from individuals attesting to the person's suitability to serve as a facility person.

On 12/20/21 Staff #2 and #3 lacked documentation of completing an annual minimum of 12 clock hours of child care training.