3290.106 · 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.

The refrigerator temperature was 46 degrees Fahrenheit.

Corrected Corrected by Oct 7, 2024

Category: nutrition. 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.

Based on documentation, pediatric first aid and pediatric CPR of staff #1 was updated on 10/6/2024 after the 11/2023 expiration date of the previous training.

Corrected Corrected by Oct 30, 2024

Category: ratio. Marked corrected in the state record.

3290.32(a)/3290.192(4) · The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services).

The file of household member #2 did not contain documentation of a DHS FBI clearance.

Corrected Corrected by Nov 30, 2024

Category: background checks. 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.

In the bathroom, a bottle of hand sanitizer labeled "keep out of the reach of children" was stored in the unlocked vanity accessible to children.

Corrected Corrected by Oct 29, 2024

Category: ratio. Marked corrected in the state record.

3290.117(c) · A veterinarian's certificate of current rabies immunization is required for a cat or dog at the facility. The certificate shall be on file when the cat or dog is present.

The facility did not have documentation of a current rabies immunization for the dog which resides at the home.

Corrected Corrected by Nov 30, 2024

Category: health medication. 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.

The emergency contact information of child #1 did not contain the name of the child's health insurance policy.

Corrected Corrected by Nov 30, 2024

Category: health medication. 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.

The file of child #1 did not contain a current health report with the last being dated 10/28/2020, when the child was an older toddler (see LIS code sheet).

Corrected Corrected by Nov 6, 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.

Documentation of a review and/or update of the financial agreement and emergency contact form of child #1 exceeded 6 months with the forms being dated 12/19/2022 and updated 10/1/2024.

Corrected Corrected by Nov 1, 2024

Category: recordkeeping. Marked corrected in the state record.

3290.182(5) · 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 emergency contact form of child #1 did not contain signed parental permission for administration of minor first aid procedures by staff.

Corrected Corrected by Nov 1, 2024

Category: ratio. 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 documentation, fire drills exceeded 60 days on the following occasions: 11/2/2023 to 1/2/2024, 3/2/2024 to 5/2/2024 and 7/2/2024 to 9/2/2024.

Corrected Corrected by Oct 30, 2024

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.

Evacuation routes were not posted on the lower level, first, second or third floor of the home.

Corrected Corrected by Oct 30, 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.

Based on documentation, the manual testing of the fire detection system exceeded 30 days on the following occasions: 12/2/2023 to 1/2/2024 to 2/2/2024, 3/2/2024 to 4/2/2024, 5/2/2024 to 6/2/2024 and 7/2/2024 to 8/2/2024 to 9/2/2024.

Corrected Corrected by Oct 30, 2024

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 facility was not able to provide documentation of an emergency drill conducted within the last 12 months.

Corrected Corrected by Oct 30, 2024

Category: recordkeeping. 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 file of staff #1 did not contain documentation of any training hours in their training year between 12/19/2022 and 12/19/2023, but contained 6 hours of training dated 9/17/2024, 4 hours dated 9/25/2024 and 3 hours dated 9/26/2024 and is now in compliance.

Corrected Corrected by Nov 30, 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 financial agreement of child #3 did not specify the services to be provided to the parent and child.

Corrected Corrected by Nov 17, 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 financial agreement of child #2 did not contain the persons designated by the parent to whom the child may be released.

Corrected Corrected by Nov 17, 2023

Category: recordkeeping. Marked corrected in the state record.

3290.123(b) · A parent shall receive the original agreement. The facility shall retain a copy of the agreement.

The files of child #1, #2 and #3 contain the original financial agreement.

Corrected Corrected by Nov 17, 2023

Category: recordkeeping. Marked corrected in the state record.

3290.124(b)(2) · Emergency contact information must include the name, address and telephone number of the child's physician or source of medical care.

The emergency contact form of child #2 did not include the address of the child's physician and the form of child #3 did not include the telephone number of the child's physician.

Corrected Corrected by Nov 17, 2023

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

3290.124(b)(3) · Emergency contact information must include the home and work addresses and telephone numbers of the enrolling parent.

The emergency contact form of child #2 does not include the work address or telephone number of the enrolling parent.

Corrected Corrected by Nov 17, 2023

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.

The emergency contact form of child #2 does not contain their health insurance policy number.

Corrected Corrected by Nov 17, 2023

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

3290.124(b)(7) · 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.

The emergency contact form of child #3 did not contain the addresses and telephone numbers for all of the persons designated by the parent to whom the child may be released.

Corrected Corrected by Nov 17, 2023

Category: recordkeeping. Marked corrected in the state record.

3290.131(a) · 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 health assessment of child #1 contained an initial health assessment which was signed on 9/28/2023 and child #3's health assessment was dated 10/2/2023, both of which are more than 60 days from each child's start date at the facility (see coded LIS sheet).

Corrected Corrected by Nov 17, 2023

Category: health medication. 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 did not have documentation the emergency plan was sent to the county emergency management agency.

Corrected Corrected by Nov 30, 2023

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

3290.94(a)(4) · The operator or designated staff person who is responsible for compliance with this chapter shall conduct fire drills and ensure that the hypothetical locations of the fire are rotated around the facility for each drill such that the hypothetical location is never the same for consecutive drills.

The fire drill log did not contain documentation of the hypothetical location of the fire.

Corrected Corrected by Nov 17, 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.

Documentation of testing the current fire detection system exceeded 30 days: 12/21/2022 to 1/21/2023 to 2/21/2023, 3/21/2023 to 4/22/2023, 5/21/2023 to 6/21/2023, 7/21/2023 to 8/31/2023 to 9/21/2023.

Corrected Corrected by Nov 17, 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.

At the time the inspection, the smoke alarms in the family child care home were not able to be verified they were approved by a testing laboratory recognized by OSHA to test and certify smoke alarms. 35 P.S.§ 1223.6(f.1)(1.1)(ii).

Corrected Corrected by Nov 30, 2023

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.

The facility did not have a plan for the continuity of operations planning an include, backing up or retrieving health and other key records/files and managing financial issues such as paying employees and bills during the aftermath of the disaster. The facility did not have a policy and procedure to identify the prevention of shaken baby syndrome, abusive head trauma, and child maltreatment.

Corrected Corrected by Dec 23, 2022

Category: ratio. Marked corrected in the state record.

3290.32(a) · The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services).

The PA state police clearance of facility person #1 was updated more than 60 months from the prior clearance (11/1/2016 and updated on 5/9/2022) exceeding 60 months. The child abuse clearance of household member #2, as identified on the renewal application, expired on 11/28/2022 and was not renewed.

Corrected Corrected by Dec 5, 2022

Category: background checks. 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 of child #1 and 3 did not contain documentation of 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 in the past 6 months.

Corrected Corrected by Dec 23, 2022

Category: recordkeeping. Marked corrected in the state record.

3290.124(b)(5) · Emergency contact information must include 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 of child #1 did not contain information on the child's special needs in an emergency situation as specified by the child's parent, physician, PA or CRNP or documentation this does not apply to the child.

Corrected Corrected by Dec 23, 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 most current health assessment on file for child #1 was dated 10/28/2020 and child #3 was dated 6/21/2021 both lacking updated health assessments within the last 12 months as required for a preschool age child.

Corrected Corrected by Jan 3, 2023

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

3290.131(e)(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.

The immunization record of child #1 and 3 did not contain documentation of a current annual influenza vaccination and child #3 was also lacking a Hep A vaccination based on the recommendations of the ACIP.

Corrected Corrected by Jan 3, 2023

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

3290.151(a)(2)/3290.192(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. 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.

The file of facility person #1 contained documentation of a health assessment dated 1/6/2020 but did not contain an updated health assessment within 24 months.

Corrected Corrected by Dec 2, 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 emergency contact and financial agreements of child #1, 2 and 3 did not contain documentation of being updated withing the past 6 months. Documentation of the last review/updated was 9/21/2021 for child #1, 2 and 3.

Corrected Corrected by Dec 23, 2022

Category: recordkeeping. Marked corrected in the state record.

3290.31(h) · Completion of professional development shall be documented by the signature and title of a representative of the professional development entity and include the date the professional development was completed. Documentation of the completion of the professional development under subsection (g) taken from September 30, 2016, forward satisfies this requirement.

Documentation of the required health and safety topics of facility person #1 was dated 9/5/2016 which was prior to 9/30/2016, not satisfying the requirement. The updated training was taken on 11/3/2022 and facility person #1 is now compliant.

Corrected Corrected by Dec 5, 2022

Category: health medication. 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.

Documentation of fire drills exceeded 60 days on the following occasions: 3/1/2022 to 5/4/2022, 7/1/2022 to 9/1/2022 to 11/1/2022.

Corrected Corrected by Dec 5, 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 facility did not have documentation of the proof of purchase of the fire detection system. Documentation showed the last testing of the fire detection system occurred on 12/5/2021 and the next was at the physical site inspection on 11/21/2022, exceeding 30 days.

Corrected Corrected by Dec 5, 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 did not have information to provide the parent of each enrolled child on how to access the regulations electronically.

Corrected Corrected by Dec 6, 2022

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 file of facility person #1 did not have documentation of 12 annual training hours between 12/19/2020 and 12/19/2021 but did have 12 hours dated 11/3/2022 (10 & 2) and is now compliant.

Corrected Corrected by Dec 5, 2022

Category: recordkeeping. Marked corrected in the state record.

3290.123(a) · An agreement shall be signed by the operator and the parent.

The agreement in the file for child #2 was not signed by the operator.

Corrected Corrected by Oct 14, 2021

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 agreement form in the file for child #2 did not include the child's date of admission.

Corrected Corrected by Oct 14, 2021

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 first-aid/CPR training in the file for staff person #1 and #2, both employed before 12/19/20 and the only two staff employed at the facility had expired 8/31/21.

Corrected Corrected by Nov 30, 2021

Category: ratio. Marked corrected in the state record.

3290.32(d) · One or more facility persons competent in pediatric first-aid and pediatric cardiopulmonary resuscitation techniques shall be at the facility when one or more children are in care.

The first-aid/CPR training in the file for staff person #1 and #2, both employed before 12/19/20 and the only two staff employed at the facility had expired 8/31/21.

Corrected Corrected by Nov 30, 2021

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

3290.106 · 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.

The facility's refrigerator included a built-in digital thermometer that read 46 degrees Fahrenheit.

Corrected Corrected by Nov 30, 2021

Category: nutrition. Marked corrected in the state record.

3290.124(b)(2) · Emergency contact information must include the name, address and telephone number of the child's physician or source of medical care.

The emergency contact information in the file for child #2 did not include any information for the child's medical provider.

Corrected Corrected by Nov 30, 2021

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

3290.124(b)(3) · Emergency contact information must include the home and work addresses and telephone numbers of the enrolling parent.

The emergency contact information in the file for child #3 did not include either a city or zip code for the mother's place of work.

Corrected Corrected by Nov 30, 2021

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.

The emergency contact information in the file for child #2 did not include any information for the child's health insurance.

Corrected Corrected by Nov 30, 2021

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

3290.124(b)(7) · 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.

The emergency contact information in the file for child #1 and #3 did not include either a city or zip code for the release persons. The emergency contact information in the file for child #2 did not include addresses for the 6 release persons listed.

Corrected Corrected by Nov 30, 2021

Category: recordkeeping. 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 #2, a 15 month old, did not include a flu shot. There was not a written statement of exemption by a parent.

Corrected Corrected by Nov 30, 2021

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

3290.31(h) · Completion of professional development shall be documented by the signature and title of a representative of the professional development entity and include the date the professional development was completed. Documentation of the completion of the professional development under subsection (g) taken from September 30, 2016, forward satisfies this requirement.

The file for staff person #1, employed before 12/19/20, did not include evidence of training in health and safety topics #1 through #9 as required by regulation 31f.

Corrected Corrected by Nov 30, 2021

Category: health medication. 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 fire drill log and on conversation with the operator, the three fire drills conducted in 2021were all dated more than 60 days apart. The last fire drill documented on the log was conducted more than 60 days ago.

Corrected Corrected by Nov 30, 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.

There were no evacuation routes posted on the 1st, 2nd and 3rd floors of the facility.

Corrected Corrected by Oct 14, 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 documentation of the 30 day testing of the facility's fire detection system, there were 4 times when testing was done 31 days apart. The last test was conducted more than 30 days ago.

Corrected Corrected by Oct 14, 2021

Category: recordkeeping. Marked corrected in the state record.