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

Staff #1 Did not complete the 1 hour Health and Safety Training Update as required by 12/30/2022. Completed day of inspection 09/05/2023

Corrected Corrected by Sep 5, 2023

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

3290.123(a)(6) · An agreement shall specify the date of the child's admission.

Files for children #2 and #3 - fee agreements were observed to not contain an admission date. However, under .182(2) the date was found elsewhere in the file.

Corrected Corrected by Oct 20, 2023

Category: recordkeeping. Marked corrected in the state record.

3290.131(b)(2) · The operator shall require the parent to provide an updated health report at least every 12 months for an older toddler or preschool child.

Record for Child #3 did not contain a current health record, the last on file being dated 04/08/2022.

Corrected Corrected by Oct 20, 2023

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

3290.124(e) · The parent shall update in writing emergency contact information once in a 6-month period or as soon as there is a change in the information

Files for Children #1 and #2 were observed to have not been updated since 08/2021.

Corrected Corrected by Oct 15, 2022

Category: recordkeeping. Marked corrected in the state record.

3290.124(b)(6) · Emergency contact information must include health insurance coverage and policy number for a child under a family policy or Medical Assistance benefits, if applicable.

Emergency Contact Form for Child #2 did not contain medical insurance carrier or policy number, For Child #3 did not contain the policy number.

Corrected Corrected by Oct 15, 2022

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

3290.131(d)(5) · A health report shall include a review of the child's immunized status according to recommendations of the ACIP.

Records for Children #1 and #3 did not contain an influenza immunization for last year and no parental exemption was found on file. Record for Child #2 contained no record of any influenza immunization and no parental exemption was found on file.

Corrected Corrected by Oct 15, 2022

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

3290.182(8) · A child's record must contain a copy of the initial agreement and subsequent written agreements between the parent and the operator. The parent receives the original agreement.

Files for children #2 and #3 did not contain a fee agreement that could be located at time of inspection,

Corrected Corrected by Oct 15, 2022

Category: recordkeeping. 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 last health assessment on file for facility person #1 was dated 8/22/18.

Corrected Corrected by Oct 21, 2021

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

3290.32(a)/3290.192(3) · 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.

The only NSOR verification certificate on file of facility person #1 was dated 9/3/21, and was therefore not on file by July 1, 2020, as required. The file of facility person #1 contained mandated reporter training dated 1/15/16. An updated training dated within the past 60 months was not on file, as required under the CPSL.

Corrected Corrected by Nov 5, 2021

Category: background checks. Marked corrected in the state record.

3290.131(a)/3290.131(e) · 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. 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.

The file of child #3, a preschool child enrolled since 10/15/18, did not contain a health assessment or immunization record. The file of child #5, an older toddler enrolled since 10/28/19, did not contain a health assessment.

Corrected Corrected by Nov 5, 2021

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

3290.135(a)(3) · If disposable diapers are provided by a parent or by a facility, a soiled diaper shall be discarded by immediately placing the diaper into a plastic-lined, hands-free covered can.

A used diaper was observed on the ground outside, on the walkway to the outdoor play area. Additional diapers were observed in uncovered trashcans outside of the facility.

Corrected Corrected by Nov 5, 2021

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

3290.182(3)/3290.182(5) · A child's record must contain signed parental consent for emergency medical care for the child. Written consent is required prior to admission. A child's record must contain signed parental consent for administration of minor first-aid procedures by facility staff. Written consent is required prior to admission.

The files of children #1, 2, 3, 4, and 5 did not include signed parental consent for emergency medical care or administration of minor first-aid procedures by facility staff.

Corrected Corrected by Nov 2, 2021

Category: ratio. Marked corrected in the state record.

3290.182(8) · A child's record must contain a copy of the initial agreement and subsequent written agreements between the parent and the operator. The parent receives the original agreement.

The file of child #1 did not contain a fee agreement.

Corrected Corrected by Oct 29, 2021

Category: recordkeeping. 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 evacuation routes were observed not to be posted in the facility.

Corrected Corrected by Nov 5, 2021

Category: recordkeeping. Marked corrected in the state record.

3290.95(a) · Fire detection devices or systems must be in compliance with standards established under section 1016(c) of the act (62 P.S. § 1016(c)). An acceptable fire alarm system must be installed. Smoke detectors must include enclosed, 10 year minimum lithium ion batteries and meet Underwriters Laboratories standards.

The interconnected fire alarm system in the facility was operated by removable batteries. The fire alarm system does not meet the requirements of Act 62.

Corrected Corrected by Nov 5, 2021

Category: physical safety. Marked corrected in the state record.

3290.31(g)/3290.31(i) · All staff persons shall complete the professional development under subsection (g). Documentation of the completion of training shall be kept in the facility person's file or maintained in an electronic system as designated by the Department. Staff persons shall complete professional development in the following topics within 90 days of the date of hire: (1) Prevention and control of infectious diseases (including immunization) and the establishment of a grace period that allows homeless children and children in foster care to receive services under this subchapter while their families (including foster families) are taking necessary action to comply with immunization and other health and safety requirements. (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) within the meaning of those terms under section 602(a)(1) of the Robert T. Stafford Disaster Relief and Emergency Assistance Act (42 U.S.C.A. § 5195a(a)(1)). (8) Handling and storage of hazardous materials and appropriate disposal of biocontaminants. (9) Precautions when transporting children. (10) Pediatric first aid and pediatric cardiopulmonary resuscitation.

There was not documentation on file that facility person #1 had completed the professional development topics required under 3290.31(g)(1) - 3290.31(g)(9).

Corrected Corrected by Nov 2, 2021

Category: ratio. Marked corrected in the state record.