3290.32(a)/3290.192(4) · The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). Household member #1 cannot be in the vicinity of the facility.

The file for facility person #1, household member, did not contain documentation of PA State Police and Child Abuse clearance results. The PA State Police and Child Abuse clearances on file are for Volunteer purposes.

Corrected Corrected by Mar 14, 2025

Category: background checks. 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 in the files for children #1, #3, and #4 did not include the date of the child's admission.

Corrected Corrected by Feb 28, 2025

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 in the file for child #1 did not include the name of the child's physician. The emergency contact form in the file for child #4 did not include the telephone number of the child's physician.

Corrected Corrected by Feb 24, 2025

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 in the file for child #1 did not include the enrolling parent's work address and telephone number.

Corrected Corrected by Feb 24, 2025

Category: recordkeeping. Marked corrected in the state record.

3290.124(b)(4)/3290.182(3) · Emergency contact information must include the written consent signed by a parent for emergency medical care. A child's record must contain signed parental consent for emergency medical care for the child. Written consent is required prior to admission.

The emergency contact form in the file for child #4 did not include parental consent for emergency medical care for the child.

Corrected Corrected by Feb 28, 2025

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 in the file for child #4 did not include the policy number for the child's health insurance.

Corrected Corrected by Feb 28, 2025

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

3290.124(e)/3290.181(c) · 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. 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 agreement form in the file for child #2 were reviewed and updated by the parent on 1/14/24 and 1/8/25, which is more than 6 months apart. The emergency contact and financial agreement form in the files for children #3 and #4 have not been reviewed or updated by the parent within the last 6 months.

Corrected Corrected by Feb 28, 2025

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 files for children #3 and #4 did not include documentation of health reports.

Corrected Corrected by Feb 28, 2025

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.

The diapering area was observed to have a plastic-lined covered can but was not hands-free.

Corrected Corrected by Feb 24, 2025

Category: health medication. 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 in the file for child #4 did not include parental consent for administration of minor first-aid procedures by facility staff.

Corrected Corrected by Feb 28, 2025

Category: ratio. 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.

2nd CITATION: The facilities Emergency Plan did not address Continuity of Operations. Previously cited, 1/11/24.

Corrected Corrected by Apr 8, 2024

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 file for Staff #1, lacked documentation of 11 hours of the required 12 annual clock hours of childcare training.

Corrected Corrected by Jan 18, 2024

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.

In an unlocked kitchen drawer where the children were receiving care there were multiple sharp knives that were accessible to the children in care and created a cutting hazard.

Corrected Corrected by Jan 11, 2024

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

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 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 does not have current pediatric first-aid/CPR training. This is evidenced by the previously documented pediatric first-aid/CPR training expiration date of (11/20/23).

Corrected Corrected by Jan 12, 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 facilities Emergency Plan did not address Continuity of Operations.

Corrected Corrected by Feb 16, 2024

Category: ratio. 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.

The last documented update of the emergency plan occurred on 3/15/22.

Corrected Corrected by Feb 16, 2024

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 file for Staff #1 contained expired Pediatric First Aid and CPR.

Corrected Corrected by Jan 12, 2024

Category: ratio. 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 file for Staff #2, Household Member, lacked a State Police Clearance, Child Abuse Clearance, FBI Clearance, NSOR Certificate and a Disclosure Statement.

Corrected Corrected by Feb 23, 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 upstairs bedroom which is used for childcare space there was air wick outlet plug that was accessible to the children in care. Located in the unlocked dresser drawer in the upstairs bedroom was nail glue. Both of these items were labeled keep out of reach of children and were observed to be accessible to the children in care. In an unlocked kitchen drawer where the children were receiving care there was white out labeled keep out of reach of children that was accessible to the children.

Corrected Corrected by Jan 11, 2024

Category: ratio. Marked corrected in the state record.

3290.74(a) · Floors, walls, ceilings and other surfaces, including the facility's outdoor play area, shall be kept clean, in good repair and free from visible hazards.

In the upstairs bathroom of the facility there was peeling wallpaper that exposed a crack in the wall creating a cutting hazard to the children in care.

Corrected Corrected by Jan 11, 2024

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

3290.124(e)/3290.181(c) · 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. 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 files for Child #1, #2, and #3 contained an emergency contact forms that had not been updated within the last 6 months.

Corrected Corrected by Jan 27, 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 file for Child #3, a young toddler, lacked an updated health report within the last year.

Corrected Corrected by Jan 16, 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 file for Child #2, a preschooler, lacked an updated health report within the last year.

Corrected Corrected by Jan 25, 2024

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

3290.131(d)(5)/3290.131(e)(1) · 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 child care group settings). Child #2 and Child #3 must be dismissed from care by close of business 1/11/24 and may only return to care when the immunization record is updated or when a parent provides a written, signed exemption letter.

The file for Child #3, enrolled for more that 60 days at the facility, did not contain documentation of a 2nd and 3rd dose of DTAP, 4th dose of Pneumococcal, 3rd dose of Polio, MMR, Varicella, and Hepatitis A as required based on the child's age as per the ACIP recommended schedule.

Corrected Corrected by Jan 16, 2024

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

3290.133(4) · Medication shall be stored in a locked area of the facility or in an area that is out of the reach of children.

In an unlocked dresser drawer in the upstairs bedroom, that is childcare space, there was a prescription bottle of Ferosal. This medication was accessible to the children in care.

Corrected Corrected by Jan 11, 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 files for Child #1, #2, and #3 contained Agreements that had not been updated within the last 6 months.

Corrected Corrected by Jan 27, 2024

Category: recordkeeping. 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 hypothetical locations of the fire that were listed for all of the fire drills held in 2023 used of the same hypothetical location.

Corrected Corrected by Feb 1, 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 facility lacked smoke detectors in the family childcare home that were interconnected, via hardwire, Bluetooth connectivity or any other means that allow for communication between smoke alarms. The facility lacked a smoke detector log.

Corrected Corrected by Feb 23, 2024

Category: recordkeeping. 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.

*THIRD CITATION: The health reports for the following children lacked verification of ongoing vaccines in accordance with the schedule recommended by the ACIP. The report for Child #2 lacked an 3rd dose of the DTAP vaccination. The report for Child #3 and #5 lacked an influenza vaccination. Previously cited on 1/24/23 and 3/07/23.

Corrected Corrected by Apr 7, 2023

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.

*THIRD CITATION: The files for Child #1, #3, #4, and #5 contained a financial agreement form that had not updated within the last 6 months. Previously cited on 1/24/23 and 3/07/23.

Corrected Corrected by Apr 7, 2023

Category: recordkeeping. Marked corrected in the state record.

3290.124(e)/3290.181(c) · 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. 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.

*SECOND CITATION: The files for Child #1, #3, #4, and #5 contained an Emergency Contact Form that had not updated within the last 6 months. Previously cited on 1/24/23.

Corrected Corrected by Mar 10, 2023

Category: recordkeeping. 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.

*SECOND CITATION: The file for Child #3, a preschooler, lacked a health report within the last 12 months. Previously cited on 1/24/23.

Corrected Corrected by Mar 17, 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.

*SECOND CITATION: The health reports for the following children lacked verification of ongoing vaccines in accordance with the schedule recommended by the ACIP. The report for Child #2 lacked an 3rd dose of the DTAP vaccination. The report for Child #3 and #5 lacked an influenza vaccination. Previously cited on 1/24/23.

Corrected Corrected by Mar 17, 2023

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.

*SECOND CITATION: The files for Child #1, #3, #4, and #5 contained a financial agreement form that had not updated within the last 6 months. Previously cited on 1/24/23.

Corrected Corrected by Mar 10, 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.

*SECOND CITATION The facility lacked documentation of conducting an annual emergency drill. Previously cited on 1/24/23.

Corrected Corrected by Mar 10, 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.

Staff person #1 lacked the Pennsylvania Health and Safety Update 2022 by the compliance date of December 31, 2022. Observed a pair of sharp scissors on a towel rack in the facility bathroom and accessible to the children in care. Observed a fan that was on a low shelf and accessible to the reach of the children in care posing a cutting hazard.

Corrected Corrected by Jan 24, 2023

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

3290.63 · Protective receptacle covers shall be placed in electrical outlets accessible to children 5 years of age or younger.

In the Upstairs Bedroom there were four outlets on a surge protector next to the shelf that were missing protective outlet overs. In the Living Room there were three outlets on a surge protector that were missing protective outlet covers. These outlets were accessible to children 5 years of age and younger.

Corrected Corrected by Jan 24, 2023

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.

Observed Array Citrus spray, Anti-bacterial wipes, Disinfecting wipes, and Clorox spray in the facility bathroom. The Citrus Spray and Clorox Spray were sitting along the edge of the bathtub and were accessible to the children in care. The anti-bacterial wipes and disinfecting wipes were sitting on the back of the toilet seat and accessible to the children in care.

Corrected Corrected by Jan 24, 2023

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.

Located in the Kitchen on the stove were knobs that were accessible to the children in care. The stove had four knobs and two of the knobs did not have protective guards.

Corrected Corrected by Feb 28, 2023

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

3290.70(d) · Windows or doors above the ground floor that open directly to the outdoors and are accessible to children shall be constructed, modified or adapted to limit the opening to 6 or fewer inches.

Observed two windows in the bedroom and one window in the bathroom all on the second floor that were accessible to children and were not modified to limit the opening to 6 inches or fewer.

Corrected Corrected by Feb 28, 2023

Category: physical safety. 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 facilities first aid kit lacked tweezers and nonporous gloves.

Corrected Corrected by Jan 24, 2023

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

3290.113(a) · 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). TIERED LIS: Children must be supervised at all times. The legal entity must arrange for all facility staff to receive a minimum of two hours of training regarding supervision of children. The legal entity must receive DHS approval of the training content prior to scheduling the training. The legal entity must submit documentation in a format approved by DHS proving that the facility procedure for counting children is followed at all times e.g., a checklist. The legal entity will confirm continuing compliance by sending copies of the documentation to the Regional Office of Child Development and Early Learning on a weekly basis for a period of three months after DHS approves the documentation format.

At approximately 11:00 AM, operator answered the door, leaving one child upstairs in the bedroom and one child downstairs in the kitchen. At approximately 12:00 PM, the door rang, and the operator left both children in the kitchen to answer the door. Therefore, the child were not supervised by a staff person at all times.

Corrected Corrected by Jan 24, 2023

Category: supervision. 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 Agreement for Child #4 lacked the persons designated by a parent to whom the child may be released.

Corrected Corrected by Feb 7, 2023

Category: recordkeeping. Marked corrected in the state record.

3290.124(b)(4)/3290.182(3) · Emergency contact information must include the written consent signed by a parent for emergency medical care. A child's record must contain signed parental consent for emergency medical care for the child. Written consent is required prior to admission.

The Emergency Contact Forms in the file for Child #4 lacked written consent signed by a parent for emergency medical care.

Corrected Corrected by Feb 7, 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 for Child #2, #4, and #5 lacked the health insurance coverage policy number for the child.

Corrected Corrected by Feb 7, 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 for child #2 lacked the name, address and telephone number of the individual designated by the parent to whom the child may be released.

Corrected Corrected by Feb 7, 2023

Category: recordkeeping. Marked corrected in the state record.

3290.124(e)/3290.181(c) · 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. 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 files for Child #1, #3, #4, and #5 contained an Emergency Contact Form that had not updated within the last 6 months.

Corrected Corrected by Feb 7, 2023

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.

Although at the time of inspection, the files for Child #1 and #2 contained a current health report it was observed that the files for Child #1 and #2 lacked an initial health report within 60 days of attendance. The files for Child #4 and #5 lacked an initial health report.

Corrected Corrected by Feb 14, 2023

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

3290.131(b)(2)/3290.181(c) · 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 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 file for Child #3, a preschooler, lacked a health report within the last 12 months.

Corrected Corrected by Feb 14, 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 health reports for the following children lacked verification of ongoing vaccines in accordance with the schedule recommended by the ACIP. The report for Child #2 lacked an 3rd dose of the DTAP vaccination. The report for Child #3 and #5 lacked an influenza vaccination.

Corrected Corrected by Feb 14, 2023

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 files for Child #1, #3, #4, and #5 contained a financial agreement form that had not updated within the last 6 months.

Corrected Corrected by Feb 7, 2023

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 in the files for Child #4 and #5 lacked signed parental consent for administration of minor first-aid procedures by facility staff.

Corrected Corrected by Feb 7, 2023

Category: ratio. Marked corrected in the state record.

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.

The facility lacked documentation of fire drills being held at least every 60 days.

Corrected Corrected by Jan 31, 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.

The facility lacked documentation of Smoke Detection Testing being tested at least every 30 days. The fire extinguishers in the facility was last serviced in December 2021.

Corrected Corrected by Feb 28, 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 facility lacked documentation of conducting an annual emergency drill.

Corrected Corrected by Jan 31, 2023

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 for Staff #1 lacked 12 clock hours of child care training.

Corrected Corrected by Feb 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 Fee Agreement Form for Child File #1 lacked the Release Person's Name.

Corrected Corrected by Apr 11, 2022

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.

In the bathroom it was observed on the shelf above the toilet labeled "Keep out of the Reach of Children" a container of Wipe Out -- Antibacterial Wipes; a spray bottle of TB Quat Disinfectant Ready-to-Use Cleaner; and a spray bottle of Clorox, Scentiva Disinfecting Multi-Surface Cleaner was accessible to children.

Corrected Corrected by Mar 28, 2022

Category: ratio. Marked corrected in the state record.

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

The Fee Agreement Form for Child File #3 lacked the Operator's Signature.

Corrected Corrected by Mar 28, 2022

Category: recordkeeping. Marked corrected in the state record.

3290.123(a)(2) · An agreement shall specify the date on which the fee is to be paid.

The Fee Agreement Form for Child File #1 lacked the Date Fee to be Paid.

Corrected Corrected by Mar 28, 2022

Category: recordkeeping. 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 for Child #1 lacked the Enrolling Parent's Work Number.

Corrected Corrected by Apr 11, 2022

Category: recordkeeping. Marked corrected in the state record.

3290.124(b)(4)/3290.182(3) · Emergency contact information must include the written consent signed by a parent for emergency medical care. A child's record must contain signed parental consent for emergency medical care for the child. Written consent is required prior to admission.

The Emergency Contact Form for Child #1 #2 and #3 lacked a signature for Obtaining Emergency Medical Care.

Corrected Corrected by Apr 11, 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.

The Emergency Contact Form for Child #1 lacked the Health Insurance/MA Policy Number and Child #3 lacked the Health Insurance/MA Coverage and Health Insurance/MA Policy Number.

Corrected Corrected by Mar 28, 2022

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

3290.131(e)/3290.131(e)(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.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 file for Child #3 who was enrolled for at least 60 days, lacked written verification of immunizations.

Corrected Corrected by Apr 11, 2022

Category: health medication. 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 for Child #1, #2 and #3 lacked a signature for Consent for Minor First Aid.

Corrected Corrected by Apr 11, 2022

Category: ratio. Marked corrected in the state record.

3290.182(6) · A child's record must contain signed parental consent for transportation, walking excursions, swimming and wading.

The Emergency Contact Form for Child #1, #2 lacked a parental signature for Consent for Walking, as the provider states they walk around the building.

Corrected Corrected by Apr 11, 2022

Category: transportation. Marked corrected in the state record.

3290.31(f)(4)(i)/3290.31(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. 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.

2nd Citation: The file for Staff #1 lacked updated Pediatric First Aid and Pediatric CPR Training. Previously Cited: 10/21/2021

Corrected Corrected by Jan 21, 2022

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.

2nd Citation: The facility lacked a competent person in pediatric first-aid and pediatric CPR when one or more children are in care. Previously Cited: 10/21/2021

Corrected Corrected by Jan 21, 2022

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

3290.151(c)(1)/3290.192(2) · An adult health assessment must include a physical examination. 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.

2nd Citation: The file for staff person #1 contained a health assessment that was older than 24 months. Previously cited: 10/21/2021

Corrected Corrected by Jan 14, 2022

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

3290.31(i)/3290.192(4) · 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. A facility person's record shall include records of training required by the Department.

2nd Citation: Staff #1 lacked training in the 10 required health and safety topics. Previously Cited: 10/21/2021

Corrected Corrected by Jan 18, 2022

Category: health medication. 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.

2nd Citation: Through conversation with the operator, the operator disclosed she does not provide parent of each enrolled child a letter explaining the emergency procedures. Previously Cited: 10/21/2021

Corrected Corrected by Jan 14, 2022

Category: physical safety. 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.

In the kitchen, in an unlocked, child-height drawer were a pair of adult scissors and pliers accessible to children. On the second room on the left upstairs, a television was observed to be unanchored which poses a toppling risk. The operator disclosed that children sometimes use the room.

Corrected Corrected by Nov 17, 2021

Category: health medication. 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 file for Staff #1 lacked updated Pediatric First Aid and Pediatric CPR Training.

Corrected Corrected by Dec 30, 2021

Category: ratio. 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).

Staff File # 1 lacked Disclosure Statement.

Corrected Corrected by Dec 16, 2021

Category: recordkeeping. 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 facility lacked a competent person in pediatric first-aid and pediatric CPR when one or more children are in care.

Corrected Corrected by Dec 30, 2021

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

3290.72 · The telephone number of the nearest hospital, police department, fire department, ambulance and poison control center shall be posted by each telephone in the facility.

A copy of the facility's Emergency Telephone Numbers were not posted by each telephone in the facility.

Corrected Corrected by Nov 17, 2021

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

3290.75(a) · Peeled or damaged paint or damaged plaster is not permitted on indoor or outdoor surfaces in the child care facility.

In the kitchen, peeling paint was observed to the left of the stove.

Corrected Corrected by Nov 17, 2021

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

3290.103 · 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.

On the kitchen refrigerator, magnetic, plastic letters were observed to be less than 1 inch in diameter and accessible to children who are still placing objects in their mouths.

Corrected Corrected by Nov 17, 2021

Marked corrected in the state record.

3290.181(a) · An operator shall establish and maintain an individual record for each child enrolled in the facility.

The operator lacked an individual child record for each unrelated child enrolled in the facility.

Corrected Corrected by Dec 30, 2021

Category: recordkeeping. Marked corrected in the state record.

3290.105(a) · (a) Individual, clean, age-appropriate rest equipment shall be provided for preschool, toddler and infant children as agreed between the parent and the operator. The rest equipment must be labeled with the child's name and used only by the named child while enrolled in the program.

A young toddler was observed to be sleeping atop an adult sized bed and when the operator was asked if age appropriate rest equipment was available the operator disclosed there was none.

Corrected Corrected by Dec 30, 2021

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

3290.111(a) · A written plan of daily activities and routines, including a time for free play shall be established for each group. The plan shall be flexible to accommodate the needs of individual children and the dynamics of the group.

The facility lacked a posting of the written plan of daily activities.

Corrected Corrected by Nov 17, 2021

Marked corrected in the state record.

3290.121(b) · At the time of enrollment, a parent shall receive in writing the facility's general daily schedule, hours for which care is provided, fees, responsibilities for meals, clothing, health policies, supervision policies, night care policies, dismissal policies, transportation and pick-up arrangements.

Through conversation with operator, the operator disclosed she did not provide general daily schedule, hours for which care is provided, fees, responsibilities for meals, clothing, health policies, supervision policies, night care policies, dismissal policies, transportation and pick-up arrangements in writing.

Corrected Corrected by Nov 17, 2021

Category: supervision. Marked corrected in the state record.

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

Child File #1 lacked a signed agreement form by the operator and parent.

Corrected Corrected by Dec 30, 2021

Category: recordkeeping. Marked corrected in the state record.

3290.124(a) · Emergency contact information is required for each enrolled child. Emergency contact information must reference who shall be contacted in an emergency.

Child File #1 lacked the required emergency contact information for the child receiving care in the space.

Corrected Corrected by Dec 30, 2021

Category: recordkeeping. 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.

The operator answered the door with a soiled diaper in hand; therefore she did not discard the diaper immediately. It was also observed the garbage can did not operate in a hands-free manner.

Corrected Corrected by Dec 30, 2021

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

3290.151(c)(1)/3290.192(2) · An adult health assessment must include a physical examination. 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 for staff person #1 contained a health assessment that was older than 24 months.

Corrected Corrected by Dec 30, 2021

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

3290.31(i)/3290.192(4) · 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. A facility person's record shall include records of training required by the Department.

Staff #1 lacked training in the 10 required health and safety topics.

Corrected Corrected by Dec 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.

No Fire drills were documented prior to 10/29/2021.

Corrected Corrected by Nov 17, 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 facility lacked evacuation route postings in a conspicuous location on each floor of the facility.

Corrected Corrected by Dec 30, 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.

The facility's, kitchen fire extinguisher was expired. The facility lacked documentation of monthly manual testing or any annual test conducted by a fire safety professional.

Corrected Corrected by Dec 30, 2021

Category: recordkeeping. Marked corrected in the state record.

3290.22(a) · The facility's current certificate of compliance shall be posted in a conspicuous location used by parents, with instructions for contacting the appropriate regional child care office posted at the same location.

A copy of the facility's current Certificate of Compliance was not posted in a conspicuous place. A copy of instructions for contacting the appropriate regional child care office was not posted in a conspicuous place.

Corrected Corrected by Nov 17, 2021

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 operator has not provided the parent with information on how to access the DHS regulations electronically.

Corrected Corrected by Nov 17, 2021

Marked corrected in the state record.

3290.24(a)(2) · The facility shall have an emergency plan that provides for accommodations for evacuation of children from the facility building and evacuation of children to a location away from the facility premises. The evacuation routes and evacuation plans to exit the building may be the same as those required by §  3290.94 (relating to fire drills).

The Emergency Plan has not been updated to include: Evacuation of children from the facility and to a location away from the facility.

Corrected Corrected by Nov 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.

The operator lacked annual, written documentation of the emergency plan being updated.

Corrected Corrected by Nov 17, 2021

Category: recordkeeping. Marked corrected in the state record.

3290.24(e) · The emergency plan shall be posted in the facility at a conspicuous location.

A copy of the facility's current Emergency Plan was not posted in a conspicuous place.

Corrected Corrected by Nov 17, 2021

Category: physical safety. 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.

Through conversation with the operator, the operator disclosed she does not provide parent of each enrolled child a letter explaining the emergency procedures.

Corrected Corrected by Dec 30, 2021

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