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

The agreement for child #4 did not specify the date on which the fee is to be paid.

Corrected Corrected by May 8, 2025

Category: recordkeeping. Marked corrected in the state record.

3290.123(a)(3) · An agreement shall specify the services to be provided to the family and the child, including the Department's approved form to provide information to the family about the child's growth and development in the context of the services being provided. the operator shall complete and update the form and provide a copy to the family in accordance with the updates regarding emergency contact information at § 3290.124(e).

The file for child #2 contained consecutive child service reports dated more than 6 months apart. The reports were dated 1/18/24 and 1/28/25. A current report is now on file.

Corrected Corrected by May 8, 2025

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 agreement for child #3 did not specify the persons designated by a parent to whom the child may be released.

Corrected Corrected by May 8, 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 forms for children #1 and #3 did not include the address and telephone number of the child's physician or source of medical care.

Corrected Corrected by May 8, 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 forms for children #1 and #3 did not include the work address and telephone number of the enrolling parent.

Corrected Corrected by May 8, 2025

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 forms for children #2 and #3 did not include the addresses of the individuals designated by the parent to whom the child may be released.

Corrected Corrected by May 8, 2025

Category: recordkeeping. 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 emergency contact form for child #1 did not include signed parental consent for emergency medical care. The boxes were initialed.

Corrected Corrected by May 8, 2025

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 for child #1 did not include signed parental consent for minor first-aid procedures by facility staff. The boxes were initialed.

Corrected Corrected by May 8, 2025

Category: ratio. Marked corrected in the state record.

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

The facility's letter to parents explaining the emergency procedures did not include details regarding the accomodations made for infants, toddlers, children with disabilities or children with chronic medical conditions. Additionally, the letter lacked a specific location of where the children will evacuate to in the case of an emergency which requires them to leave the facility.

Corrected Corrected by May 8, 2025

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

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

The file for staff #1 contained 3 hours of training completed on time between 12/31/23 and 12/31/24. An additional 9 hours of training was completed late after 12/31/24. The file is now current and contains documentation of all 12 hours of training.

Corrected Corrected by May 8, 2025

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 on site does not include provisions regarding the facility's continuity of operations, required as of 7/1/22, as per Announcement C-22-04. In the bathroom, a wax warmer on the handwashing sink was observed to be hot and accessible to children.

Corrected Corrected by May 17, 2024

Category: ratio. Marked corrected in the state record.

3290.64(a) · Toxics shall be kept in a locked area or in an area inaccessible to children, and shall be stored away from food, food preparation areas and child care spaces.

A bottle of Gillette shaving cream, labeled 'Keep Out of the Reach of Children', was observed in the bathroom cabinet above the sink which was accessible to children

Corrected Corrected by May 17, 2024

Category: ratio. 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.

The second floor hallway window was observed to be unlocked and not modified to limit the opening to 6 inches or fewer.

Corrected Corrected by May 17, 2024

Category: physical safety. 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.

An exposed nail was observed on a wood pallet in the outdoor driveway, which was accessible to children.

Corrected Corrected by May 17, 2024

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

3290.102(a) · Toys, play equipment and other indoor and outdoor equipment used by the children shall be clean, in good repair and free from rough edges, sharp corners, pinch and crush points, splinters and exposed bolts.

In the living room, a child-sized blue wooden chair was observed to be broken and cracked which created a pinch point and was not in good repair. A pack and play was observed with tears in the mesh lining and not in good repair.

Corrected Corrected by May 17, 2024

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.

In the living room, small plastic french fries 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 May 17, 2024

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 two most recent health assessments on file for Child #1 (PSA) are dated 2/21/23 and 3/7/24, more than 12 months apart.

Corrected Corrected by May 17, 2024

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

3290.135(b) · Diaper changing surfaces shall be cleaned after each use by wiping the surface with a sanitizing solution or by changing a pad or other surface covering.

Between diaper changes, it was observed that the staff person did not clean or sanitize the diaper changing surface.

Corrected Corrected by May 17, 2024

Category: health medication. 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 facility's emergency plan's most recent review and update was 4/23/23, more than 12 months prior.

Corrected Corrected by May 6, 2024

Category: recordkeeping. Marked corrected in the state record.

3290.113(a) · **The legal entity must create a written active supervision policy statement that includes the following regulations: 3290.4 (definition of supervision), 3290.113 (Supervision of children). The policy must be approved by DHS. Each staff must review and sign the supervision policy and a copy of the signed policy shall be posted on the parent board and given to the parents of each child enrolled at the facility.

**Upon entry at the facility on 6/16/23 at 11:15 AM, the Certification Representative (CR) knocked on the screen door. The CR could hear children's voices and proceeded to open the screen door and called for staff #1 by name. There was no staff response and the staff did not answer the door. Child #1, called out to the CR using the CR's first name. CR stepped into the foyer and could see 3 children in the living room with no adult present. CR asked the children about staff #1. Child #1 responded that staff #1 was sleeping, then proceeded to call out to staff #1 through the doorway gate to an adjoining bedroom. Staff #1 came from the bedroom area of the home and proceeded to the living room where the children were in care. Staff #1 stated that she was not sleeping, but had been in the other room putting something away.

Corrected Corrected by Jul 21, 2023

Category: supervision. 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). Children must be supervised at all times.

*Upon entry at the facility on 6/16/23 at 11:15 AM, the Certification Representative (CR) knocked on the screen door. The CR could hear children's voices and proceeded to open the screen door and called for staff #1 by name. There was no staff response and the staff did not answer the door. Child #1, called out to the CR using the CR's first name. CR stepped into the foyer and could see 3 children in the living room with no adult present. CR asked the children about staff #1. Child #1 responded that staff #1 was sleeping, then proceeded to call out to staff #1 through the doorway gate to an adjoining bedroom. Staff #1 came from the bedroom area of the home and proceeded to the living room where the children were in care. Staff #1 stated that she was not sleeping, but had been in the other room putting something away.

Corrected Corrected by Jul 1, 2023

Category: supervision. Marked corrected in the state record.

3290.113(a) · *** The legal entity must arrange for all facility staff to complete the "Mixed Age Groups: Safety, Supervision, and Design of Your Family Child Care Program" training available on the PD Registry or a comparable, minimum of two hours, training regarding supervision of children, that is preapproved by DHS. Verification of completion of the supervision training will be submitted to DHS. The training may count towards the staff annual minimum of 12 clock hours of child care training.

***Upon entry at the facility on 6/16/23 at 11:15 AM, the Certification Representative (CR) knocked on the screen door. The CR could hear children's voices and proceeded to open the screen door and called for staff #1 by name. There was no staff response and the staff did not answer the door. Child #1, called out to the CR using the CR's first name. CR stepped into the foyer and could see 3 children in the living room with no adult present. CR asked the children about staff #1. Child #1 responded that staff #1 was sleeping, then proceeded to call out to staff #1 through the doorway gate to an adjoining bedroom. Staff #1 came from the bedroom area of the home and proceeded to the living room where the children were in care. Staff #1 stated that she was not sleeping, but had been in the other room putting something away.

Corrected Corrected by Jul 31, 2023

Category: supervision. 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.

Child file #2 lacked the health insurance coverage and policy number on the emergency contact form.

Corrected Corrected by Jul 1, 2023

Category: health medication. 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.

Child file #1 contained an agreement form that lacked the date of the child's admission to the childcare.

Corrected Corrected by May 21, 2023

Category: recordkeeping. Marked corrected in the state record.

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

The operator had documentation of fire drills completed that exceeded the 60 days as required.

Corrected Corrected by May 21, 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 operator had documentation of testing the fire detection system that exceeded 30 days as required by Act 62.

Corrected Corrected by May 21, 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.

Staff person #1 had 10 hours of documented child care trainings completed between 12/19/21 and 12/19/22, 2 hours of child care training was borrowed from 2023 trainings completed.

Corrected Corrected by May 21, 2023

Category: recordkeeping. 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). Children must be supervised at all times.

Based on investigative findings and operator statements, it was determined that staff were not supervising children in care at the time when a child was bitten by another child and scratched by a stray cat.

Corrected Corrected by Feb 16, 2023

Category: supervision. Marked corrected in the state record.

3290.117(a) · A pet or animal present at the facility, indoors or outdoors, shall be in good health and known to be friendly to children.

A stray cat who was not known to be friendly had access to the facility and the children in care.

Corrected Corrected by Feb 16, 2023

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

3290.117(b) · Contact with pets by the children is permitted only when a staff person is physically present.

A stray cat was with the children in care when the staff person was not physically present with the children.

Corrected Corrected by Feb 16, 2023

Category: recordkeeping. 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 lacked documentation for current rabies immunizations for a stray cat who had access to the facility and the children in care.

Corrected Corrected by Feb 16, 2023

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

3290.182(7) · A child's record must contain reports of accidents, injuries and illnesses involving a child in care at the facility. The original report shall be given to the parent on the day of the incident. The second copy of the report shall be retained at the facility in an accident file. The third copy of the report shall be retained at the facility in the child's file.

The operator did not complete an incident or injury report for incidents involving a child being bitten by another child or scratched by a cat while in care at the facility on the dates the incidents occurred.

Corrected Corrected by Feb 16, 2023

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.

Child file #2 lacked the health insurance coverage and policy number on the emergency contact form.

Corrected Corrected by May 5, 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 lacked documentation of conducting the emergency drill annually.

Corrected Corrected by May 5, 2022

Category: recordkeeping. Marked corrected in the state record.

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

Staff file #1 lacked documentation of completion of 12 hours of child care training annually. (See LIS CODE SHEET)

Corrected Corrected by May 6, 2022

Category: recordkeeping. 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.

Household member #3 lacked documentation of NSOR Verification in the file. (See LIS CODE SHEET)

Corrected Corrected by Jun 10, 2022

Category: background checks. Marked corrected in the state record.

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

The exit door that opens on the driveway side of the home was obstructed preventing use of the door as a means of egress from the facility.

Corrected Corrected by May 6, 2022

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.

The children in care were observed sleeping on the rug on the floor and not on age appropriate rest equipment that was labeled for the child's use.

Corrected Corrected by May 5, 2022

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

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

Child file #2 lacked an agreement form in the child's file with operator and parent signatures.

Corrected Corrected by May 4, 2022

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.

Child files #1 and #4 lacked the designated persons for whom the child may be released listed on the agreement form.

Corrected Corrected by May 4, 2022

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.

Child files #1 and #2 lacked the name, address and phone number of the child's physician on the emergency contact forms.

Corrected Corrected by May 4, 2022

Category: health medication. 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.

Child file #1 lacked written consent from a parent for emergency medical care on the emergency contact form.

Corrected Corrected by May 4, 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.

Child file #1 lacked the name, address and phone number of the persons to whom the child may be released on the emergency contact form.

Corrected Corrected by May 4, 2022

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.

Child file #2 lacked documentation of an initial health report within 60 days of admission into the facility.

Corrected Corrected by May 4, 2022

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.

Child file #3 and #4 lacked updated health reports every 12 months as required for an older toddler and a preschool child.

Corrected Corrected by May 4, 2022

Category: health medication. 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.

Child files #1, #3, #4 lacked an updated immunization of influenza vaccination as recommended by the ACIP or an exemption statment in the file.

Corrected Corrected by May 5, 2022

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

3290.134(a) · A staff person shall ensure that a child's hands are washed before meals and snacks, after toileting and after being diapered.

The staff person did not wash the child's hands after diapering the child.

Corrected Corrected by May 4, 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.

Child file #1 lacked signed consent for parent for administration of minor first aid by the staff persons while at the facility.

Corrected Corrected by May 4, 2022

Category: ratio. 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 lacked a method to provide each enrolled child's parent information on how to access the regulations electronically.

Corrected Corrected by May 4, 2022

Marked corrected in the state record.