ITS ALL ABOUT KIDS

Written instructions (3270.133(2))

An albuterol canister located within a prescription box in the preschool classroom had a different expiration date (11/2026) than the date listed on its accompanying box (11/2025), confirming the albuterol was not the item originally dispensed in that specific box which contained the prescriber's instructions for administration. Requirement: A staff person shall administer a prescription medication only if written instructions are provided from the individual who prescribed the medicine. Instructions for administration contained on a prescription label are acceptable. Correction: The parent was notified that the prescription on the child's albuterol was past the expiration date. The prescribed medicine was not past parent was given the medicine and the container until the situation can be corrected. At this time they are in consult with their pharmacist has to how to rectify the situation as they do not have any non expired boxes to hold the unexpired medication. We will accept the new medication once a new script box is received. Inspection: Renewal. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

Original container (3270.66(b))

In a cabinet in the kitchen, a spray bottle of liquid was not labeled with its contents. When asked, staff #3 identified the contents as a mixture of bleach and water. Requirement: Cleaning materials and other toxic materials shall be stored in an original labeled container or in a container that specifies the content. Toxics shall be stored away from food, food preparation areas and child care spaces. Correction: The bottle containing the bleach and water solution was immediately labeled by the staff person in charge of filling the bottles each morning. Inspection: Renewal. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

Glass (3270.81)

The bottom area of the glass wall in the blue toddler classroom did not contain visual strips. Requirement: A visual strip or other visual identification shall be placed on glass located in a traffic area, a child care space or a play space. Correction: Stocking were hung on the glass so that they created a visual strip to keep children from walking into the glass. Inspection: Renewal. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

Handwashing signs (3270.82(h))

In the preschool classroom, child #1 did not wash their hands after using the toilet. Requirement: A facility person and an able child shall wash his hands after toileting and before eating. A sign on which this requirement is written shall be posted at each toilet, training chair, diapering area and sink in the facility. Correction: Children in the upstairs classrooms are always told to wash their hands after using the bathroom. During the inspection one of the supervisors must have noticed a child not washing their hands in the bathroom. Time had passed before the caregiver was notified and she did not notice at the time. The child had washed her hands since using the bathroom when getting ready for lunch. Inspection: Renewal. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

Small Toys and Objects (3270.103)

Th protective foam on the cabinet located next to the changing table in the purple toddler classroom was observed to be exposed and peeling, and accessible to children still placing objects in their mouths. Requirement: Toys and objects with a diameter of less than 1 inch, objects with removable parts that have a diameter of less than 1 inch, plastic bags and styrofoam objects may not be accessible to children who are still placing objects in their mouths. Correction: The piece of bumper that is referred to in the violation was removed and/or repaired on the day of the inspection. Since that time the foam bumpers on all of the shelves have been inspected and repaired or replaced. Inspection: Renewal. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

2 feet apart (3270.106(f))

At approximately 9:45 am in the purple toddler classroom, a child was observed to be sleeping in a pack and play which was against the wall and against another pack and play. At about 11:00 am, in the same classroom, a child was sleeping in a pack and play which was against the wall and approximately 11 inches from another pack and play. The rest equipment did not have at least 2 feet on 3 sides while in use. Requirement: At least 2 feet of space is required on three sides of a bed, cot, crib or other rest equipment while the equipment is in use. Correction: The room containing the pack and plays had plenty of space for the sleeping children's bedding to have 3 sides with two feet. The pack and play was moved when it was called to the staff's attention. Inspection: Renewal. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

Arrival/departure times (3270.123(a)(4))

The financial agreement of child #3 did not contain the arrive and departure times of the child. Requirement: An agreement shall specify the child's arrival and departure times. Correction: The child's departure time and arrival time was added to the agreement. Inspection: Renewal. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

Name/address/phone release person (3270.124(b)(7))

The emergency contact information of child #3 and #5 did not contain the addresses of the release persons designated by the child's parent. Requirement: Emergency contact information must include the name, address and telephone number of the individual designated by the parent to whom the child may be released. Correction: Addresses were added to the existing emergency contacts for both children. Inspection: Renewal. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

Toddler/preschool: updated health report every 12 months/Initial and subsequent health reports (3270.131(b)(2)/3270.182(1))

The file of child #4, identified as a preschool age child (see LIS code sheet), contained consecutive health assessments dated more than 12 months apart (4/25/2024 and 5/5/2025). Requirement: The operator shall require the parent to provide an updated health report at least every 12 months for an older toddler or preschool child. A child's record shall contain initial and subsequent health reports. Correction: Parents are required to submit children's health report at least every 12 months for an older toddler or preschooler. Inspection: Renewal. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

Original label (3270.133(5))

In the kitchen, Tylenol labeled for child #6 had an expiration date of 9/2025. Requirement: Medication shall be stored in accordance with the manufacturer's or health professional's instructions on the original label. Correction: The Tylenol was returned to the parent at pick up. No new medication has been received. Inspection: Renewal. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

12 months prior to service and every 24 months thereafter (3270.151(a))

The health assessment of staff #4 was dated 1/4/2024, more than 12 months prior to their start date at the facility. Requirement: A facility person providing direct care who comes into contact with the children or who works with food preparation shall have a health assessment conducted within 12 months prior to providing initial service in a child care setting and every 24 months thereafter. A health assessment is valid for 24 months following the date of signature, if the person does not contract a communicable disease or develop a medical problem. Correction: Staff member #4 provided an updated health assessment as soon as her provider was able to accommodate her. Inspection: Renewal. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

Locked or inaccessible (3270.66(a))

In the unlocked closet in the preschool classroom, 2 bottles of Swiffer Jet cleaning solution were on the floor by the door, and an additional bottle was in the mop, all accessible to children in care. Requirement: Cleaning materials and other toxic materials shall be kept in an area or container that is locked or made inaccessible to children. Correction: The lock on the closet was immediately locked. Inspection: Renewal. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

Mixed Age Level (3270.52)

At approximately 9:40 am, 8 children were observed in the purple toddler classroom. When asked to identify the group of children in their respective supervisory group, staff #1 identified 3 young toddlers and 2 infants while staff #2 identified 2 young toddlers. Requirement: When children are grouped in mixed age levels, the age of the youngest child in the group determines the staff:child ratio and maximum group size in accordance with the requirements in § 3270.51 (relating to similar age level). Correction: Although both staff members in the above mentioned group were both aware of how many infants and how many toddlers were in the group they did not respond correctly when asked to identify their children. They identified the children on their part of the room rather than the children in their group. This concept was explained to them. They both understand that in the future each will identify the children they are actually responsible for instead of how many children are in their area of the room. At no point were the children out of ratio or unsupervised by the caregivers in charge of that room at that time. Inspection: Renewal. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

Comply with CPSL/CPSL information (3270.32(a)/3270.192(4))

The file of staff #4 contained the "Record Check Details" for the PA criminal history check but lacked an official certificate with a "Pennsylvania State Police" seal, making it an incomplete clearance. Consecutive mandated reporter trainings of staff #5 were dated more than 60 months apart (10/22/2020 and 11/17/2025). Requirement: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). A facility person's record shall include a copy of requests for the criminal history record and child abuse registry clearance information, a copy of the disclosure statement and a copy of the completed clearance information required under the CPSL. Facility Person #4 may not work in a child care position at the facility. Correction: The file of staff member #4 was corrected on the date of the inspection. Since the old clearance was not able to be produced from the state a new state police clearance was applied for and received and placed in the file. Inspection: Renewal. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

General Health and Safety (3270.21)

In an unlocked drawer in the preschool classroom, a screwdriver and 2 staple removers with sharp "teeth" were accessible to children in care. Requirement: Conditions at the facility may not pose a threat to the health or safety of the children. Correction: The screwdriver and the staple removers were immediately removed from the drawer. Inspection: Renewal. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

12 months prior to service and every 24 months thereafter/Health assessment, TB test (3270.151(a)/3270.192(3))

The file of staff #6 did not contain a completed health assessment prior to working with children at the facility (see LIS code sheet). Requirement: A facility person providing direct care who comes into contact with the children or who works with food preparation shall have a health assessment conducted within 12 months prior to providing initial service in a child care setting and every 24 months thereafter. A health assessment is valid for 24 months following the date of signature, if the person does not contract a communicable disease or develop a medical problem. A facility person's record shall include a written report of initial and subsequent health assessments, including the results of initial and subsequent tuberculin skin tests, x-rays or other medical documentation necessary to confirm freedom from communicable tuberculosis. Correction: The staff member #6 had a health assessment on her second day of work (the day of the inspection). She did not have it done prior to work. She did not return to work with the children until her assessment was completed and a copy in her file. Inspection: Renewal. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

Health and Safety Training (3270.31(f))

Staff person #3 has not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): pediatric first aid and pediatric CPR Requirement: Staff person(s) shall complete professional development in the topics of 3270.31(f)(1 -- 10) within 90 days of hire. Staff person #3 will have until 1/7/2025 to complete the required training. Until such time as the required training has been completed, staff person #3 must be supervised, when interacting with children, by an AGS who has completed the required training related to this citation. If there are no staff available to supervise staff person #3, staff persons #3 may not work in a child-care position at the facility. Correction: Staff member #3 was retrained by a certified First Aid and Cpr instructor on 12/18/24. The new card has the word pediatric in the title of the certificate. Inspection: Renewal. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

Refrigerator (3270.107)

The thermometer in the preschool classroom refrigerator displayed a temperature of 70 degrees Fahrenheit. Requirement: A facility shall have an operable, clean refrigerator used to store potentially hazardous foods. The refrigerator shall be capable of maintaining food at 45° F or below. An operating thermometer shall be placed in the refrigerator. Correction: A thermometer was purchased to replace the broken thermometer. Inspection: Renewal. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

Has all items (3270.75(c))

The first aid kit in the toddler classroom (with the windowed wall) did not contain soap. Requirement: A first-aid kit must contain the following: soap, an assortment of adhesive bandages, sterile gauze pads, tweezers, tape, scissors and disposable, nonporous gloves. Correction: Soap was purchased and put into the first aid container the next day. Inspection: Renewal. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

Original container (3270.66(b))

A container of disinfecting wipes, which did not have its original label, was not labeled with its contents. Requirement: Cleaning materials and other toxic materials shall be stored in an original labeled container or in a container that specifies the content. Toxics shall be stored away from food, food preparation areas and child care spaces. Correction: The cleaning material was clearly marked at the inspection. Inspection: Renewal. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

Each staff person meets quals/Exp, educ., training prior to facility (3270.33(a)/3270.192(2)(ii))

The file of staff # 5, identified as an assistant group supervisor, did not have documentation to support their qualifications for the position. Requirement: A staff person or a substitute staff person shall meet one of the applicable staff qualifications for the position in which the person is performing. A facility person's record shall include verification of child care experience, education and training prior to service at the facility. Correction: Staff #5 was demoted to an aid rather than assuming her former position of an assistant group supervisor. She will remain an aide until she can produce the additional hours. She worked for us in the past but her file has been misplaced. Inspection: Renewal. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

Comply with CPSL/CPSL information (3270.32(a)/3270.192(4))

The file of staff #3 contained a volunteer child abuse clearance and a disclosure statement which was dated 8/27/2024, after their start date at the facility (see LIS code sheet). The file of staff #6 contained a disclosure statement which was not dated. Requirement: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). A facility person's record shall include a copy of requests for the criminal history record and child abuse registry clearance information, a copy of the disclosure statement and a copy of the completed clearance information required under the CPSL. Facility Person #3 may not work in a child care position at the facility. Correction: Staff member emailed me the correct child abuse clearance. She had both clearances in her file at home. She brought a physical copy with her when she began her shift at 3:00 the day of the inspection. Inspection: Renewal. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

Mantoux TB/Health assessment, TB test (3270.151(c)(2)/3270.192(3))

The file of staff #6 did not contain a completed tuberculosis screening prior to working with children at the facility (see LIS code sheet). Requirement: An adult health assessment must include tuberculosis screening by the Mantoux method at initial employment. Subsequent tuberculosis screening is not required unless directed by a physician, physician's assistant, CRNP, the Department of Health or a local health department. A facility person's record shall include a written report of initial and subsequent health assessments, including the results of initial and subsequent tuberculin skin tests, x-rays or other medical documentation necessary to confirm freedom from communicable tuberculosis. Correction: Staff member #6 did have the blood drawn for her TB test and the results were recorded on 12/23/24. Because of her birthplace she needed to have a different form of TB test done. The results took longer than the typical 48-72 hours. The information is in her file. Inspection: Renewal. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

Training regarding plan (3270.27(c))

Documentation of the recent consecutive emergency plan trainings for staff #1 and #2 exceeded 12 months. Requirement: The operator shall assure that each facility person receives training regarding the emergency plan at the time of initial employment, on an annual basis and at the time of each plan update. The operator shall document the date of each training and the names of all facility persons who received the training and kept on file at the facility. Correction: Existing staff will be trained within every 12 month period Inspection: Renewal. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).