The Growing Patch Child Care Center LLC - Brookville PA Child Care Center

Noncompliance Area: The most current and updated health assessment on file for child #1, who is a young toddler, was not completed within the past six months and was due prior to 3/6/2020 (regulatory suspensions.) Previously cited on 8/26/2020 under SIN -00174589.

Correction Required: 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 shall contain initial and subsequent health reports.

Noncompliance Area: The file for child #1 lacks verification of ongoing vaccinations as in accordance with the schedule recommended by the ACIP. Previously cited on 8/26/2020 under SIN - 00174589.

Correction Required: 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.

Noncompliance Area: The file for staff #1 lacks an initial health assessment which was conducted 12 months on or before initial start date in a child care position. Previously cited on 8/26/2020 under SIN-00174589.

Correction Required: A facility person providing direct care who comes into contact with the children or who works with food preparation shall have a health assessment conducted within 12 months prior to providing initial service in a child care setting and every 24 months thereafter. A health assessment is valid for 24 months following the date of signature, if the person does not contract a communicable disease or develop a medical problem.A facility person's record shall include a written report of initial and subsequent health assessments, including the results of initial and subsequent tuberculin skin tests, x-rays or other medical documentation necessary to confirm freedom from communicable tuberculosis.

Noncompliance Area: The file for staff #1 lacks an initial TB screening by the Mantoux method. Previously cited on 8/26/2020 under SIN -00174589.

Correction Required: An adult health assessment must include tuberculosis screening by the Mantoux method at initial employment. Subsequent tuberculosis screening is not required unless directed by a physician, physician's assistant, CRNP, the Department of Health or a local health department.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.

Noncompliance Area: Based on a conversation with staff and review of the menu, the children had pancakes, sausage, applesauce and juice for lunch. A dairy product was not served at lunch. Based on the review of the two week menu, 9 of the 10 lunches posted did not contain a dairy product.

Correction Required: A lunch or dinner prepared at the facility for children of toddler age or older shall include at least one dairy product.

Noncompliance Area: The last review of the fee agreement on file for child #2 was not completed within the past six months and is dated 4/10/2019. This were due prior to 3/6/2020 (regulatory suspensions.) Previously cited on 8/26/2020 under SIN -00174589.

Correction Required: 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.

Noncompliance Area: In the Toddler Room, observed a toy plane and two toy trucks which were dirty.

Correction Required: 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.

Noncompliance Area: In the older children's outdoor play space, observed that the wooden mulch around the embedded swing set and embedded climbing apparatus with slide, was approximately 5-6 inches deep and not the 9 inches recommended by the CPSC.

Correction Required: Outdoor equipment that requires embedded mounting must be mounted over a loose-fill or unitary playground protective surface covering that meets the recommendations of the United States Consumer Product Safety Commission. The equipment must be anchored firmly and be in good repair.

Noncompliance Area: In the Toddler Room, observed that all of the blue cots lacked a label with the child's name.

Correction Required: Individual, clean, age-appropriate rest equipment shall be provided for preschool, toddler and infant children as agreed between the child's parent and the operator. The rest equipment shall be labeled for the use of a specific child and used only by the specified child.

Noncompliance Area: The files for children #2, 4 and 5 lack verification of child service reports within the past six months and were due in the file prior to 3/6/2020 (regulatory suspensions.) There are no child service reports on file for children #2 and 4. The last child service report on file for child #5 is dated 7/31/19.

Correction Required: 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 in 3270.124(f) (relating to emergency contact information).

Noncompliance Area: The parent did not receive the original fee agreements for children #1, 2, 3, 4 and 5 as the originals were observed in the files.

Correction Required: A parent shall receive the original agreement. The facility shall retain a copy of the agreement.A child's record shall contain a copy of the initial agreement and subsequent written agreements between the parent and the operator. The parent receives the original agreement.

Noncompliance Area: The most current emergency contact information on file for child #1 lacks a health insurance name and policy number. The most current emergency contact information on file for children #3 and 4 lack the address of all release persons.

Correction Required: Emergency contact information must include health insurance coverage and policy number for a child under a family policy or Medical Assistance benefits, if applicable. 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.

Noncompliance Area: The last review of the emergency contact information and fee agreement on file for child #2 was not completed within the past six months and is dated 8/12/2019. This was due prior to 3/6/2020 (regulatory suspensions.) There was more than six months between reviews of the emergency contact information on file for child #4. Reviews were completed on 4/10/2019 and then 2/3/2020. The last review of the fee agreement on file for child #4 was not completed within the past six months and is dated 4/10/2019. These were due prior to 3/6/2020 (regulatory suspensions.)

Correction Required: 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 informationA 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.

Noncompliance Area: The most current and updated health assessments on file for children #2 and 5, who are young toddlers, were not completed within the past six months and were due prior to 3/6/2020 (regulatory suspensions.) The most current health assessment for child #5, who was a young toddler at the time the assessment was due, was not completed within the past six months and was due prior to 3/6/2020 (regulatory suspensions.)

Correction Required: The operator shall require the parent to provide an updated health report at least every 6 months for an infant or young toddlerA child's record shall contain initial and subsequent health reports.

Noncompliance Area: The files for children #1, 4 and 5 lack verification of ongoing vaccinations as in accordance with the schedule recommended by the ACIP.

Correction Required: 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.