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 had documentation of renewing the CPR certificate after the expiration of the previous certificate due to the fact they were dated: expires 3-2024 and 4-6-24.

Corrected Corrected by Nov 26, 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). SAFETY PLAN: The operator is required to submit to the Children and Youth Agency a plan of supervision or alternate arrangement as required by the Child Protective Services Law. 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 files of staff #1 and #2 lacked disclosure statements.

Corrected Corrected by Nov 26, 2024

Category: supervision. 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 file of child #2 lacked an emergency contact form with the complete address of the child's physician or source of medical care.

Corrected Corrected by Nov 26, 2024

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 file of child #2 lacked an emergency contact form with the complete work address of the enrolling parent.

Corrected Corrected by Nov 26, 2024

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 of CRNP, which is needed in an emergency situation.

The file of child #1 lacked an emergency contact form with the information on the child's special needs, or "NA" if not applicable.

Corrected Corrected by Nov 26, 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 file of child #1 lacked an emergency contact form with the health insurance coverage and policy number for a child under a family policy or Medical Assistance benefits, if applicable.

Corrected Corrected by Nov 26, 2024

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 file of child #2 lacked an emergency contact form with the complete address of the individual designated by the parent to whom the child may be released.

Corrected Corrected by Nov 26, 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.

Observed the facility did not have documentation of the operators shaken baby, abusive head trauma, and child maltreatment policy.

Corrected Corrected by Nov 15, 2023

Category: health medication. 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).

Observed child file #3 contained a child service report which was completed more than 6 months after the child's first day of attendance at the facility.

Corrected Corrected by Nov 15, 2023

Category: recordkeeping. 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).

Observed child file #1 and #2 did not contain written verification of ongoing flu vaccines administered in accordance with the schedule recommended by the ACIP.

Corrected Corrected by Nov 16, 2023

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

3290.133(3) · The label of a medication container shall identify the name of the medication and the name of the child for whom the medication is intended. Medication shall be administered to only the child whose name appears on the container.

Observed the first aid kit contained triple antibiotic ointment which was not labeled with the name of the person for whom it was intended.

Corrected Corrected by Nov 15, 2023

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

3290.151(a)(2) · A health assessment is valid for 24 months following the date of signature, if the person does not contract a communicable disease or develop a medical problem.

Observed staff file #1 contained an updated health assessment which was dated more than 26 months after the previous valid health assessment.

Corrected Corrected by Nov 15, 2023

Category: health medication. 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.

Observed the fire alarm testing log revealed that one time in the previous 12 months the fire alarms were tested more than 30 days apart. The testing dates were 6/16/23-7/21/23.

Corrected Corrected by Nov 15, 2023

Category: recordkeeping. 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.

Observed the facility did not have documentation of an annual review of the emergency plan.

Corrected Corrected by Nov 15, 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 emergency plan did not contain a continuity of care section which was due by the mandatory date of 7-1-2022

Corrected Corrected by Dec 2, 2022

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

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

The facility did not have a policy and procedure to share with families that would recognize the potential signs of shaken baby syndrome and abusive head trauma, strategies for coping with a crying, fussing, or distraught child, and addressing the prevention and identification of child mistreatment.

Corrected Corrected by Dec 2, 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 file for child #1 who is a preschool aged child contained a health assessment and a review of the vaccinations date of 4-22-2021 and 8-16-2022 which exceeded the mandatory 12 months to receive an updated health assessment and vaccinations. The file for child #2 who is a preschool aged child contained a health assessment and a review of the vaccinations date of 9-21-2021 and 10-31-2022 which exceeded the mandatory 12 months to receive an updated health assessment and vaccinations.

Corrected Corrected by Dec 2, 2022

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

3290.131(e)(1)/3290.182(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. A child's record must contain initial and subsequent health reports.

The file for child #1 contained an Influenza Vaccine date of 11-2-2020 and has not received an updated Influenza Vaccine.

Corrected Corrected by Nov 30, 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.

Based on conversations with the operator, there was not an initial emergency drill conducted by the required date of 12-19-2021. The first documented facility emergency drill was conducted on 1-30-2022.

Corrected Corrected by Dec 2, 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.

Observed toothpaste, labeled keep out of the reach of children, accessible to children on the sink counter in the bathroom used by the children.

Corrected Corrected by Nov 9, 2021

Category: ratio. 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.

Observed child file #1, 2, 3, and 4 did not contain the complete address of the individual designated by the parent to whom the child may be released.

Corrected Corrected by Nov 30, 2021

Category: recordkeeping. Marked corrected in the state record.

3290.151(a) · A facility person providing direct care who comes into contact with the children or who works with food preparation shall have a health assessment on file at the facility.

Observed staff file #1 contained an update health assessment which was dated more than 24 months after the previous valid health assessment.

Corrected Corrected by Nov 9, 2021

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.

Observed the facilities documented fire drill log revealed that one time, 12/4/20-4/16/21, that the fire drills were conducted more than 60 days apart.

Corrected Corrected by Nov 9, 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.

Observed the facility did not have documentation of testing the fire alarms at least every 30 days. Observed the facility did not have documentation of the purchase date/receipts for the 10 year lithium battery smoke alarms.

Corrected Corrected by Nov 30, 2021

Category: recordkeeping. Marked corrected in the state record.