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 of staff #1 contained documentation of pediatric first aid and pediatric CPR that was updated on 8/14/2024, after the 7/2024 expiration of the prior training.

Corrected Corrected by Sep 13, 2024

Category: ratio. 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, enrolled for more than a year (see coded LIS sheet), contained one child service report to provide information to the family about their child's growth and development which did not have a date making it unable to determine when the form was completed and the most current child service report of child #2 was dated 2/13/2024, more than 6 months ago.

Corrected Corrected by Oct 11, 2024

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.

The file of child #2, identified as an older toddler (see LIS code sheet) contained a health assessment dated 4/11/2023 but did not have documentation of an updated health assessment within 12 months.

Corrected Corrected by Oct 30, 2024

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

3290.131(d)(5)/3290.131(e)(3) · A health report shall include a review of the child's immunized status according to recommendations of the ACIP. The facility shall implement dismissal policies in accordance with the Department of Health regulation in 28 Pa. Code § 27.77 (relating to immunization requirements for children in child care group settings).

The immunization record of child #2 did not have documentation of a Hep A vaccination as recommended by the ACIP or an acceptable exemption on file.

Corrected Corrected by Sep 13, 2024

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

3290.11(h)(3) · Clearances are required for the legal entity and for each individual 18 years of age or older who resides in the facility at least 30 days in a calendar year by the Department if an application for renewal is received following expiration of the current certificate of compliance.

Staff #2, #3, #4 and #5, all identified as household members, do not have completed child abuse clearances, FBI clearances and national sex offender registry verification certificates. Staff #3 and #5 are also lacking documentation of completed PA state police clearances.

Corrected Corrected by Sep 13, 2024

Category: ratio. 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 of the fire detection system exceeded 30 days on the following occasions: 1/5/2024 to 2/7/204, 3/6/2024 to 4/10/2024, 5/9/2024 to 6/10/204, and 8/8/2024 to 9/9/2024.

Corrected Corrected by Sep 13, 2024

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.

The posted certificate of compliance expired 12/16/2023 and the current certificate was not posted.

Corrected Corrected by Sep 27, 2024

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 file of facility person #1, who had taken the required health and safety topics under regulation 3290.31(g)(1-9) online through "Better Kid Care - Penn State Extension" between 9/30/2016 and 10/4/2022, did not contain documentation of completion of the 1 hour "Pennsylvania Health and Safety Update 2022."

Corrected Corrected by Oct 30, 2023

Category: health medication. 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 file of child #1, #2, #3, and #4 contained the original financial agreements.

Corrected Corrected by Oct 26, 2023

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 information of child #1 did not contain the work address of the enrolling parent.

Corrected Corrected by Oct 16, 2023

Category: recordkeeping. 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 of child #1 and #4 did not contain the release addresses of the persons designated by the parent to whom the child may be released.

Corrected Corrected by Oct 27, 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 initial health assessment of child #1 was dated 2/15/2023, which is more than 60 days from the child's start date at the facility (see coded LIS sheet).

Corrected Corrected by Sep 29, 2023

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

3290.131(b)(1) · The operator shall require the parent to provide an updated health report at least every 6 months for an infant or young toddler.

The files of child #1 and #2, both identified as young toddlers, contained consecutive health assessments which exceeded 6 months.

Corrected Corrected by Sep 29, 2023

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

3290.182(3) · A child's record must contain signed parental consent for emergency medical care for the child. Written consent is required prior to admission.

The file of child #2, #3, and #4 did not contain signed parental consent for emergency medical care.

Corrected Corrected by Sep 29, 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 file of child #2, #3, and #4 did not contain signed parental consent for administration of minor first-aid procedures by facility staff.

Corrected Corrected by Sep 29, 2023

Category: ratio. 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 an interconnected fire detection system installed at the time of the inspection. The interconnected system the operator purchased but was waiting to install to see if it was acceptable, was not 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 6, 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 information of child #2 did not include the telephone number of the child's physician.

Corrected Corrected by Sep 20, 2022

Category: health medication. 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 did not have documentation of an annual emergency drill.

Corrected Corrected by Sep 26, 2022

Category: recordkeeping. Marked corrected in the state record.

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

The facility emergency plan does not have a documented contingency plan in the event an emergency or disaster strikes the area.

Corrected Corrected by Sep 30, 2022

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 of child #1 did not contain the work telephone number, and child #2 and 3 did not contain the work address of the enrolling parent.

Corrected Corrected by Sep 20, 2022

Category: recordkeeping. 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 of child #1, 2 and 3 did not contain the addresses of the release persons designated by the parent to whom the child may be released.

Corrected Corrected by Sep 20, 2022

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.

The immunization record of child #2 and #3 did not contain documentation of a current influenza vaccination or an acceptable exemption.

Corrected Corrected by Sep 20, 2022

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

3290.182(3) · A child's record must contain signed parental consent for emergency medical care for the child. Written consent is required prior to admission.

The file of child #2 did not contain signed parental consent for emergency medical care for the child.

Corrected Corrected by Sep 20, 2022

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 file of child #2 did not contain signed parental consent for administration of minor first-aid procedures by facility staff.

Corrected Corrected by Sep 20, 2022

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 the documentation of fire drills, fire drills exceeded 60 days on the following occasions: 12/3/2021 to 2/7/2022, 4/6/2022 to 6/8/2022 to 8/12/2022.

Corrected Corrected by Sep 16, 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.

Based on the documentation of testing the fire detection system, the testing exceeded 30 days on the following occasions: 10/4/2021 to 11/4/2022, 12/3/2021 to 1/4/2022 to 2/7/2022 to 3/10/2022, 5/5/2022 to 6/8/2022, 7/5/2022 to 8/15/2022.

Corrected Corrected by Sep 16, 2022

Category: recordkeeping. 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.

There was a small area of damaged plaster on the wall in the storage area off of the child care room.

Corrected Corrected by Sep 20, 2021

Category: physical safety. 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 on file for child #1 did not include the child's physician's address or phone number.

Corrected Corrected by Sep 23, 2021

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 form on file for child #1 did not include the child's health insurance information.

Corrected Corrected by Sep 23, 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 form on file for child #1 did not include the address and phone number for all release persons.

Corrected Corrected by Sep 23, 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.

The facility's emergency plan did not provide for accommodations of infants and toddlers, children with disabilities, and children with chronic medical conditions.

Corrected Corrected by Sep 23, 2021

Category: physical safety. 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 operator stated the facility's emergency plan has not been sent to the local municipality.

Corrected Corrected by Oct 4, 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.

Fire drills recorded on the facility's fire drill log indicate that fire drills were conducted on 6/2/21 and then again on 9/2/21, more than 60 days later.

Corrected Corrected by Oct 4, 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.

Evacuation routes were posted only on the second floor of the facility, the floor where care is provided. Evacuation routes were not posted in the basement, first floor and 3rd floor of the home.

Corrected Corrected by Sep 23, 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 operable smoke detectors on each floor were not equipped with nonremovable 10 - year lithium ion batteries, as required by Act 62. There was no documentation that smoke detectors were tested at least every 30 days.

Corrected Corrected by Sep 23, 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.

The operator states she did not provide the parent of each child enrolled in the facility with information on how to access the regulations in this chapter electronically.

Corrected Corrected by Sep 21, 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.

The facility's emergency plan did not provide for shelter of children during a lock-down.

Corrected Corrected by Sep 23, 2021

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