3290.18 · A facility shall be operated in conformity with applicable Federal and State laws and regulations. State agencies whose regulations may relate to the operation of a facility include the Department of Environmental Resources, the Department of Labor and Industry, the Department of Health, the Department of Education and the Department of Transportation. Conditions at the facility may not pose a threat to the health or safety of the children. Until such time as the required pre-service trainings are completed, staff person #1 must be supervised, when interacting with children, by a family child care home staff person who has completed the required training related to this citation. If there are no staff person(s) available to supervise staff person #1, staff person #1 may not work in a child-care position at the facility.

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: health and safety training topics including pediatric first aid and CPR

Corrected Corrected by Apr 8, 2024

Category: supervision. Marked corrected in the state record.

3290.18 · Conditions at the facility may not pose a threat to the health or safety of the children.

The facility had not developed a handwritten policy and procedure identifying the prevention of shaken baby syndrome, abusive head trauma, and child maltreatment by 4/29/22 per announcement C-22-03.

Corrected Corrected by Jun 21, 2023

Category: health medication. Marked corrected in the state record.

3290.123(a)(3) · An agreement shall specify the services to be provided to the family and the child, including the Department's approved form to provide information to the family about the child's growth and development in the context of the services being provided. the operator shall complete and update the form and provide a copy to the family in accordance with the updates regarding emergency contact information at § 3290.124(e).

The child file for Child #1 lacked a child service report every 6 months; the most current child service report on file is dated 5/27/22. The child file for Child #3 lacked a child service report every 6 months; the most current child service report on file is dated 5/1/22. The child file for Child #4 contained a current child service report dated 2/1/23 which was completed more than 6 months from the previously dated 3/12/21 child service report on file.

Corrected Corrected by Jun 21, 2023

Category: recordkeeping. Marked corrected in the state record.

3290.131(b)(1)/3290.182(1) · The operator shall require the parent to provide an updated health report at least every 6 months for an infant or young toddler. A child's record must contain initial and subsequent health reports.

The child file for Child #1, who was a young toddler at the time (See IS CODE SHEET), lacked an updated health report every 6 months; the last documented health report on file is dated 5/10/22. The child file for Child #4, who was a young toddler at the time (See IS CODE SHEET), lacked an updated health report at least every 6 months; the two most recent health reports on file are dated 3/27/23 and 6/2/21

Corrected Corrected by Jun 23, 2023

Category: health medication. Marked corrected in the state record.

3290.131(b)(2)/3290.182(1) · 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 must contain initial and subsequent health reports.

The child file for Child #2, who is an older toddler (See IS CODE SHEET), lacked an updated health report; the most recent health report on file is dated 5/23/22 which is more than 12 months old. The child file for Child #3, who is an older toddler (See IS CODE SHEET), lacked an updated health report; the most recent health report on file is dated 5/20/22 which is more than 12 months old.

Corrected Corrected by Jun 23, 2023

Category: health medication. Marked corrected in the state record.

3290.131(d)(5)/3290.131(e)(3) · A health report shall include a review of the child's immunized status according to recommendations of the ACIP. The facility shall implement dismissal policies in accordance with the Department of Health regulation in 28 Pa. Code § 27.77 (relating to immunization requirements for children in childcare group settings). Child #1, Child #3, and Child #4 must be dismissed from care by close of business 2/21/23 and may only return to care when the immunization record is updated or when a parent provides a written, signed exemption letter.

The child file for Child #2, Child #3, and Child #4 lacked a flu shot for 2022.

Corrected Corrected by Jun 23, 2023

Category: health medication. Marked corrected in the state record.

3290.94(a)(5) · The operator or designated staff person who is responsible for compliance with this chapter shall conduct fire drills and ensure that evacuation routes are posted in a conspicuous location on each floor of the facility.

The facility lacked an evacuation route posting on the second floor of the facility.

Corrected Corrected by Jun 21, 2023

Category: recordkeeping. Marked corrected in the state record.

3290.95(a)/3290.95(b) · Fire detection devices or systems must be in compliance with standards established under section 1016(c) of the act (62 P.S. § 1016(c)). The operator or designated staff person who is responsible for compliance with this chapter shall ensure the requirements in § 3290.95(a) are met.

Upon review of the facility's 30-day fire testing documentation, the following tests were observed to have been conducted more than 30 days apart: 4/1/23 - 5/3/23 (32 days).

Corrected Corrected by Jun 22, 2023

Category: recordkeeping. Marked corrected in the state record.

3290.24(b) · The operator shall review the emergency plan at least annually and update the plan as needed. Each review and update of the emergency plan shall be documented in writing and kept on file at the facility.

Staff person #1 disclosed that the emergency plan is reviewed annually however there was no documentation in writing and kept on file at the facility.

Corrected Corrected by Jun 22, 2023

Category: recordkeeping. Marked corrected in the state record.

3290.24(d) · Emergency drills shall be conducted annually. Annual emergency drills shall be documented and on file at the facility.

Staff person #1 disclosed that an annually emergency drill was conducted on 6/13/23 however it was not documented in writing.

Corrected Corrected by Jun 21, 2023

Category: recordkeeping. Marked corrected in the state record.

3290.123(a)(5) · An agreement shall specify the persons designated by a parent to whom the child may be released.

The child file for Child #2 contained a financial agreement form that lacked the name(s) of the person(s) designated by the parent to whom the child may be released to.

Corrected Corrected by Jun 3, 2022

Category: recordkeeping. Marked corrected in the state record.

3290.18 · Conditions at the facility may not pose a threat to the health or safety of the children.

A lighter was observed to be located in an unlocked kitchen drawer and considered accessible to children in care; the kitchen has two child lock gates however both gates were not locked at time of inspection.

Corrected Corrected by Jun 2, 2022

Category: health medication. Marked corrected in the state record.

3290.24(c) · 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.

The staff file for Staff person #2 lacked documentation of having received training on the facility emergency plan on an annual basis.

Corrected Corrected by Jun 9, 2022

Category: recordkeeping. Marked corrected in the state record.

3290.31(f)(4)(i) · Competence is the completion of training by a professional in the field of first-aid and CPR. All staff persons shall renew their certification in pediatric first aid and pediatric cardiopulmonary resuscitation (CPR) on or before the expiration of the most current certification.

The staff file for Staff person #2 lacked current Pediatric First Aid/CPR; the previous training certificate on file is dated 1/6/2020 and has expired.

Corrected Corrected by Jun 5, 2022

Category: ratio. Marked corrected in the state record.

3290.64(a) · 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 kept in a locked area or in an area inaccessible to children, and shall be stored away from food, food preparation areas and child care spaces.

A spray bottle of Formula 409 and Windex cleaner both labeled 'Keep Out of Reach of Children' were observed on top of the kitchen counter accessible to children in care; the kitchen has two child lock gates however both gates were not locked at time of inspection.

Corrected Corrected by Jun 2, 2022

Category: ratio. Marked corrected in the state record.

3290.31(f) · A staff person shall obtain an annual minimum of 12 clock hours of child care training.

The staff file for Staff person #2 lacked 12 clock hours of childcare training for 12/19/20 - 12/19/21.

Corrected Corrected by Jun 15, 2022

Category: recordkeeping. Marked corrected in the state record.

3290.131(a)/3290.182(1) · The operator shall require the parent of an enrolled child to provide an initial health report no later than 60 days following the first day of attendance at the facility.A child's record must contain initial and subsequent health reports.

The child file for Child #2, was observed to not contain documentation of an initial health report within 60 days of enrollment (See IS CODE SHEET). An initial health report dated 5/25/22 is on file.

Corrected Corrected by Jun 21, 2022

Category: health medication. Marked corrected in the state record.

3290.131(b)(1)/3290.182(1) · The operator shall require the parent to provide an updated health report at least every 6 months for an infant or young toddler. A child's record must contain initial and subsequent health reports.

The child file for Child #1, who is a young toddler, was observed to contain an updated health report dated 5/10/22 which was conducted more than 6 months from the previously dated 4/7/21 health report on file. The child file for Child #4, who is a young toddler, was observed to contain an updated health report dated 5/12/22 which was conducted more than 6 months from the previously dated 2/15/21 health report on file.

Corrected Corrected by Jun 3, 2022

Category: health medication. Marked corrected in the state record.

3290.131(b)(2)/3290.182(1) · 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 must contain initial and subsequent health reports.

The child file for Child #3, who is an older toddler, was observed to contain an updated health report dated 5/20/22 which was conducted more than 12 months from the previously dated 2/24/21 health report on file.

Corrected Corrected by Jun 3, 2022

Category: health medication. Marked corrected in the state record.

3290.131(e)/3290.182(1) · The facility may not accept or retain an infant 2 months of age or older, a toddler or a preschool child at the facility for more than 60 days following the first day of attendance at the facility unless the parent provides written verification from a physician, physician's assistant, CRNP, the Department of Health or a local health department of the dates (month, day and year) the child was administered immunizations in accordance with the recommendations of the ACIP.A child's record must contain initial and subsequent health reports.

The child file for Child #2 lacked a copy of immunization records within 60 days of first day of attendance (See IS CODE SHEET).

Corrected Corrected by Jun 23, 2022

Category: health medication. Marked corrected in the state record.

3290.131(e)(1)/3290.182(1) · The facility shall require the parent to provide updated written verification from a physician, physician's assistant, CRNP, the Department of Health or a local health department of ongoing vaccines administered to an infant, toddler or preschool child in accordance with the schedule recommended by the ACIP.A child's record must contain initial and subsequent health reports.

The child file for Child #3 lacked a flu shot for 2021.

Corrected Corrected by Jun 10, 2022

Category: health medication. Marked corrected in the state record.

3290.151(a)(2) · 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.

The staff file for Staff person #2, contained a current health assessment dated 4/13/22 which was conducted more than 24 months from the previously dated 1/3/20 health assessment on file.

Corrected Corrected by Jun 10, 2022

Category: health medication. Marked corrected in the state record.

3290.151(c)(3)/3290.151(c)(5) · An adult health assessment must include an examination for communicable diseases and the results of that examination. An adult health assessment must include the physician's or CRNP's assessment of the person's suitability to provide child care.

The staff file for Staff person #1 and Staff person #2 contained updated health assessments that lacked examination for communicable diseases and the results as well as a physician's or CRNP's assessment of their suitability to provide child care.

Corrected Corrected by Jun 17, 2022

Category: health medication. Marked corrected in the state record.

3290.181(c) · A parent is required to review and update the emergency contact information and the financial agreement at least once in a 6-month period or as soon as there is a change in the information.

The child file for Child #1 contained a financial agreement and an emergency contact information form that were not reviewed and updated by the parent at least once in a 6-month period; the dates of the two most recent reviews were 10/27/21 and 5/27/22 for both the financial agreement and the emergency contact information form. The child file for Child #3 contained a financial agreement and an emergency contact information form that were not reviewed and updated by the parent at least once in a 6-month period; the dates of the two most recent reviews were 10/15/21 and 5/1/22 for both the financial agreement and the emergency contact information form. The child file for Child #4 contained a financial agreement and an emergency contact information form that were not reviewed and updated by the parent at least once in a 6-month period; the dates of the two most recent reviews were 2/8/21 and 5/23/22 for both the financial agreement and the emergency contact information form.

Corrected Corrected by Jun 10, 2022

Category: recordkeeping. Marked corrected in the state record.

3290.95(a)/3290.95(b) · Fire detection devices or systems must be in compliance with standards established under section 1016(c) of the act (62 P.S. § 1016(c))The operator or designated staff person who is responsible for compliance with this chapter shall ensure the requirements in § 3290.95(a) are met.

The fire detection system within the facility was neither interconnected nor 10yr. nonreplaceable lithium ion operated as required by Act 62. Staff person #1 self reported that the fire detection system is tested every 30 days however the tests have not been documented in writing and kept on file at the facility.

Corrected Corrected by Jun 2, 2022

Category: recordkeeping. Marked corrected in the state record.

3290.22(b) · The operator shall provide the parent of each child enrolled in the facility with information on how to access the regulations in this chapter electronically and with instructions for contacting the appropriate regional child care office.

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

Corrected Corrected by Jun 2, 2022

Marked corrected in the state record.

3290.24(d) · Emergency drills shall be conducted annually. Annual emergency drills shall be documented and on file at the facility.

Staff person #1 self reported that an emergency drill was conducted however it was not documented in writing and on file at time of inspection.

Corrected Corrected by Jun 9, 2022

Category: recordkeeping. Marked corrected in the state record.

3290.31(g) · Staff persons shall complete professional development in the following topics within 90 days of hire: (1) Prevention and control of infectious diseases (including immunization); (2) Prevention of Sudden Infant Death Syndrome and use of safe sleep practices; (3) Administration of medication, consistent with standards for parental consent; (4) Prevention of and response to emergencies due to food and allergic reactions; (5) Building and physical premises safety, including identification of and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, and vehicular traffic; (6) Prevention of shaken baby syndrome and abusive head trauma; (7) Emergency preparedness and response planning for emergencies resulting from a natural disaster or a man-caused event (such as violence at a child care facility); (8) Handling and storage of hazardous materials and appropriate disposal of bio contaminants; (9) Precautions when transporting children.

The staff file for Staff person #1 lacked valid health and safety training; the health and safety training on file dated 7/10/16 was completed prior to 9/30/16 and is no longer considered an acceptable training.

Corrected Corrected by Jun 7, 2022

Category: ratio. Marked corrected in the state record.