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

The facility's Emergency Plan lacked a Continuity of Operations policy.

Corrected Corrected by Dec 4, 2024

Category: ratio. Marked corrected in the state record.

3290.24(a)(3) · The facility shall have an emergency plan that provides for a method for facility persons to contact parents as soon as reasonably possible when an emergency situation arises.

The facility's Emergency Plan lacked a method to contact parents during an emergency.

Corrected Corrected by Dec 4, 2024

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

3290.24(a)(4) · The facility shall have an emergency plan that provides for a method for facility persons to inform parents that the emergency has ended and to provide instruction as to how parents can safely be reunited with their children.

The facility's Emergency Plan lacked a method for the facility to inform parents that the emergency has ended and how to be safely reunited with their children.

Corrected Corrected by Dec 4, 2024

Category: physical safety. 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 container of disinfectant wipes was observed in the downstairs bathroom next to the sink and were accessible to the children in care.

Corrected Corrected by Nov 1, 2024

Category: ratio. Marked corrected in the state record.

3290.69 · Hot water pipes and other sources of heat exceeding 110° F that are accessible to children shall be equipped with protective guards or shall be insulated to prevent direct contact.

In the basement bathroom, the water in the sink was 124 degrees.

Corrected Corrected by Dec 4, 2024

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

3290.123(a)(1) · An agreement shall specify the amount of the fee to be charged per day or per week.

The Financial Agreement form for Child #3 lacked the fee amount for the services provided.

Corrected Corrected by Dec 4, 2024

Category: recordkeeping. 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 file for Child #4 lacked a dated child service report within the last 6 months. The two most recent child service reports on file for Child #5 are dated 10/5/23 & 10/27/24, more than 6 months apart.

Corrected Corrected by Dec 4, 2024

Category: recordkeeping. Marked corrected in the state record.

3290.123(a)(6)/3290.182(2) · An agreement shall specify the date of the child's admission. A child's record must contain the dates of application, admission and withdrawal of the child.

The Financial Agreement forms for Child #1 and Child #4 lacked the date of the child's admission.

Corrected Corrected by Dec 4, 2024

Category: recordkeeping. Marked corrected in the state record.

3290.123(b)/3290.182(8) · A parent shall receive the original agreement. The facility shall retain a copy of the agreement. 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 files for Child #1, Child #2, and Child #3 contained an original copy of the Financial Agreement form, when the parent should receive the original.

Corrected Corrected by Dec 4, 2024

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 two most recent health assessments on file for Child #4 (Younger Toddler at the time) are dated 3/12/24 and 10/15/24, more than 6 months apart.

Corrected Corrected by Nov 5, 2024

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 two most recent health assessments on file for Child #5 (Pre-School Age) are dated 8/18/23 & 9/3/24, more than 12 months apart.

Corrected Corrected by Dec 4, 2024

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

3290.131(d)(7) · A health report shall include a statement that the child is able to participate in child care and appears to be free from contagious or communicable disease.

The most recent health assessment on file for Child #4 (dated 10/15/24) does not indicate if the child is free from contagious disease and may participate in child care.

Corrected Corrected by Dec 4, 2024

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 Financial Agreement form on file for Child #1 lacked a 6-month update from the parent. The two most recent 6-month updates on file for Child #5 are dated 10/5/23 & 10/17/24, more than 6 months apart.

Corrected Corrected by Dec 4, 2024

Category: recordkeeping. Marked corrected in the state record.

3290.24(g) · The operator shall send a copy of the emergency plan and subsequent plan updates to the local municipality and to the county emergency management agency.

The facility lacked documentation that the Emergency Plan and subsequent plan updates have been sent to the local municipality and the county emergency agency.

Corrected Corrected by Dec 4, 2024

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

3290.94(a)(1) · The operator or designated staff person who is responsible for compliance with this chapter shall conduct fire drills and ensure that fire drills are conducted at least once every 60 days.

The fire drill log on file contained fire drills conducted 10/30/23-1/10/24, 1/10/24-3/12/24, and 3/12/24-5/14/24, more than 60 days apart.

Corrected Corrected by Dec 16, 2024

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 alarm 30-day test log includes test dates 12/8/23-1/8/24, 1/8/24-2/9/24, 3/11/24-4/11/24, 4/11/24-5/13/24, 5/13/24-6/13/24, 6/13/24-7/15/24, and 8/9/24-9/9/24, more than 30 days apart.

Corrected Corrected by Dec 16, 2024

Category: recordkeeping. Marked corrected in the state record.

3290.24(f) · The operator shall provide to the parent of each enrolled child a letter explaining the emergency procedures described in subsection (a). The operator shall also provide to the parent of each enrolled child a letter explaining any subsequent update to the plan.

The facility's Emergency Plan contained a parent letter which lacked accommodations for infants, toddlers, children with special needs, and children with chronic medical conditions.

Corrected Corrected by Dec 4, 2024

Category: physical safety. 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 at the FDCH no longer meets the requirements as set forth in Act 42.

Corrected Corrected by Dec 15, 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.

The operator has not completed an emergency drill in the past 12 months.

Corrected Corrected by Dec 14, 2023

Category: recordkeeping. Marked corrected in the state record.

3290.31(f)/3290.192(4) · A staff person shall obtain an annual minimum of 12 clock hours of child care training. A facility person's record shall include records of training required by the Department.

The file for staff #1 contains 4.5 annual training hours for the 12/2021 - 12/2022 time period that were obtained after that time period. The trainings were obtained in 2/2023.

Corrected Corrected by Dec 14, 2023

Category: recordkeeping. Marked corrected in the state record.

3290.31(g) · Staff person(s) shall complete professional development in the topics of 3290.31(g) (1-10) within 90 days of hire or the date designated by the department. Staff person #1 will have until 12/31/23 to complete the required training. Until such time as the required training has been 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 available to supervise staff person #1 staff person #1 may not work in a child-care position at the facility.

Staff person #1 has not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): health and safety one hour update that was due 12/2022.

Corrected Corrected by Nov 22, 2023

Category: supervision. 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.

Child #1 is a toddler, who has been enrolled for more than 60 days. The file for Child #1 contained a health report that lacked the child's updated review of the child's immunized status according to recommendations of the ACIP.

Corrected Corrected by Mar 22, 2023

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

3290.131(e)(3) · 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 child care group settings).

Child #1 is a toddler, who has been enrolled for more than 60 days. The file for Child #1 contained a health report that lacked the child's updated review of the child's immunized status according to recommendations of the ACIP. The facility did not implement a dismissal policy in accordance with the Department of Health's regulation in 28 Pa. Code § 27.77.

Corrected Corrected by Mar 21, 2023

Category: health medication. 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 lacked a shaken baby policy.

Corrected Corrected by Dec 1, 2022

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

3290.73(c) · A first-aid kit must contain the following: soap, an assortment of adhesive bandages, sterile gauze pads, tweezers, tape, scissors and disposable, nonporous gloves.

The first aid kit lacked soap.

Corrected Corrected by Nov 15, 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 file for child #1 lacks an updated health assessment. Child #1 is a YT and the health assessment on file exceeds 6 months.

Corrected Corrected by Dec 15, 2022

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

3290.91(a) · Stairways, hallways, exits from rooms, exits from the facility and other means of egress serving as an exit shall be unobstructed.

At approximately 10:45 am, a large stroller, a vacuum and a large box were observed obstructing the first floor hallway of the facility, as well as, a coatrack in the living room positioned behind the hallway gate. There were also boxes of miscellaneous items at the top of the basement stairs, obstructing the doorway between the steps and the hallway.

Corrected Corrected by Jan 21, 2022

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.

Based on conversation with the operator, evacuation routes were not posted on the 3rd floor.

Corrected Corrected by Dec 17, 2021

Category: recordkeeping. Marked corrected in the state record.

3290.24(a)(5) · The facility shall have an emergency plan that provides for accommodations of infants and toddlers, children with disabilities, and children with chronic medical conditions.

Based on conversation with the operator and on review of the facility's emergency plan, the plan did not include accommodations for infants/toddlers, children with disabilities and chronic medical conditions.

Corrected Corrected by Dec 17, 2021

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

3290.94(a)(1) · The operator or designated staff person who is responsible for compliance with this chapter shall conduct fire drills and ensure that fire drills are conducted at least once every 60 days.

Based on review of the facility's fire drill log, there were two times when drills were conducted more than 60 days apart.

Corrected Corrected by Nov 12, 2021

Category: recordkeeping. 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.

There was a tube of Aquaphor cream on the diapering table, making it accessible to the 2 year-old and 5 year-old in care at the time. The directions included instructions to keep out of the reach of children.

Corrected Corrected by Nov 12, 2021

Category: ratio. Marked corrected in the state record.

3290.113(a)/3290.113(f) · Children on the facility premises and on facility excursions off the premises shall be supervised by a staff person at all times. Outdoor play space used by the facility is considered part of the facility premises. The requirement for supervision on and off the facility premises includes compliance with the staff:child ratio requirements in §§ 3290.51-3290.52 (relating to maximum number of children; and staff:child ratio). When there is only one operator present in the family child care home and the operator is unable to be physically present with the children because the operator is preparing snacks or meals for children in care or the operator is using the restroom, the operator may comply with the supervision requirement in subsection (a) through the use of an electronic monitor, camera, mirror, or other device or method so the operator can see, hear, direct and assess the children in real time at all times.

At approximately 10:15 am, staff person #1, the legal entity and only staff person employed at the facility, answered the front door of the home, which is on the first floor. No children were observed at this time. After walking down the stairs into the basement, child #1, #2 and #3 were observed alone in the back room. At approximately 12:49, staff person #1 left child #1, #2 and #3 sleeping in the main room unsupervised. Based on conversation with staff person #1, they had their monitoring device, however, they were putting dishes away.

Corrected Corrected by Nov 12, 2021

Category: supervision. Marked corrected in the state record.

3290.131(e)(2)(i) · Exemption from immunization for religious belief or strong personal objection equated to a religious belief shall be documented by a written, signed and dated statement from the child's parent or guardian. The statement shall be kept in the child's record.

The list of vaccinations in the file for child #1, a 35-month old, was missing 1 of 3 HIB vaccinations. The last flu shot in the file for child #2, a 5 year old, was in 2018.

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

3290.94(a)(9) · The operator or designated staff person who is responsible for compliance with this chapter shall conduct fire drills and ensure that a written record is maintained on file at the facility indicating the specific time of day of the drill, the hypothetical location of the fire, the evacuation time, and the names of the facility persons and the number of children who participate in the fire drill.

Based on review of the facility's fire drill log, the operator was listing the exits used during the drills, not the hypothetical locations.

Corrected Corrected by Dec 17, 2021

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.

Based on conversation with the operator, they had proof of purchase of their smoke detectors, but couldn't locate it. Based on review of the facility's testing log, there were two times that the testing was conducted more than 30 days apart. The last test documented on the testing log was more than 30 days ago.

Corrected Corrected by Nov 8, 2021

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.

Based on conversation with the operator, they have not provided the parents with information on how to access the regulations electronically.

Corrected Corrected by Dec 17, 2021

Marked corrected in the state record.

3290.24(a)(1) · The facility shall have an emergency plan that provides for accommodations for shelter of children during an emergency including lock-down, shelter in place at the facility and shelter at locations away from the facility premises.

Based on conversation with the operator and on review of the facility's emergency plan, the plan did not include shelter of children during a lock down.

Corrected Corrected by Dec 17, 2021

Category: physical safety. 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.

Based on review of the emergency plan and on conversation with the operator, the last review of the emergency plan was more than 12 months ago.

Corrected Corrected by Dec 17, 2021

Category: recordkeeping. Marked corrected in the state record.