A Place Like Home Child Care

Noncompliance Area: A block of packing Styrofoam was observed in the upstairs child care space. An empty plastic bag was accessible to children on the oven door handle in the kitchen.

Correction Required: 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.

Noncompliance Area: A written plan of daily activities and routines was not established and was not posted in an area used by parents.

Correction Required: 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 written plan of daily activities and routines shall be posted in a traffic area used by parents.

Noncompliance Area: The files for children #1, #2, and #3, enrolled for over 90 days, did not contain health reports.

Correction Required: The operator shall require the parent of an enrolled child, including a child, a foster child and a relative of an operator or a facility person, 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.

Noncompliance Area: Based on documentation at the facility, there was a lapse in insurance coverage between 8/13/20 and 10/10/20. The facility now has current liability insurance.

Correction Required: The legal entity shall have comprehensive general liability insurance to cover the persons who are on the premises. A current copy of the insurance policy shall be on file at the facility.

Noncompliance Area: On the date of inspection, the interconnected smoke detectors did not function properly. Smoke detectors were present, but only functioned independently and did not relay the alarm to the other detectors. This condition poses a threat to the health or safety of children.

Correction Required: Conditions at the facility may not pose a threat to the health or safety of the children. Demonstration of compliance with 34 Pa. Code 403.23 is required. The agent of the department will file a complaint with the appropriate municipal office to request an additional fire safety inspection by the appropriate agency. The provider will demonstrate fully functional interconnected smoke detectors to an agent of the department. The provider obtain a class B extinguisher with a full gauge an current tag.

Noncompliance Area: The file for staff #1 did not contain documentation of 6 hours of annual training as required.

Correction Required: A staff person shall obtain an annual minimum of 6 clock hours of child care training. A facility person's record shall include verification of child care experience, education and training following the outset of service at the facility.

Noncompliance Area: The file for staff #1 did not contain an NSOR certificate as required. Staff #1 may not work in a child care position at the facility.

Correction Required: 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. Staff #1 may not work in a child care position at the facility.

Noncompliance Area: At the time of the inspection, the stove in the facility was accessible to children in the kitchen where the children eat. No means of preventing access were in use.

Correction Required: 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.

Noncompliance Area: A protruding paneling nail was observed near the door where the children's coats are hung.

Correction Required: Floors, walls, ceilings and other surfaces, including the facility's outdoor play space surfaces shall be kept clean, in good repair and free from visible hazards.

Noncompliance Area: The written record of fire drills did not include the hypothetical location of the fire.

Correction Required: A written record shall be kept of the date, the time of day, the hypothetical location of the fire, the evacuation time, the names of facility persons and the number of children participating in the fire drill.

Noncompliance Area: Evacuation routes were not posted at the facility.

Correction Required: Evacuation routes shall be posted.

Noncompliance Area: The file for staff #1 contained a child abuse clearance which was not updated within the required 60 month time frame. The initial clearance was obtained 9-9-14 and was updated on 10-7-19. The file for staff #1 also contained an expired state police clearance dated 9-4-19 and an expired FBI clearance dated 8-25-14.

Correction Required: 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. Staff #1 may not work in a child care position at the facility. The facility has no other staff. Children may not be in care until completed clearances for staff #1 are on file.

Noncompliance Area: Based on statements made by staff, two facility persons have not been present on reoccurring excursions with preschool age children.

Correction Required: At least two facility persons shall accompany any number of children on an excursion away from a facility

Noncompliance Area: A Little Tikes climber in the outdoor play space was missing a leg making it unstable.

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: Plastic bags were observed on the floor of the kitchen, on the door knob of the backdoor in the kitchen, and at the base of the open cellar stairs which are accessible to children from the outdoor play space. Tacks, small crafting items, and an empty plastic document sleeve were observed in the main room on 7/22/19.

Correction Required: 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.

Noncompliance Area: The refrigerator at the facility lacked a thermometer.

Correction Required: A facility shall have an operable, clean refrigerator used to store potentially hazardous foods. The refrigerator shall be capable of maintaining food at 45 F or below. An operating thermometer shall be placed in the refrigerator.

Noncompliance Area: The files for children #1 and #5 included agreements which did not specify the amount of the fee to be charged per day or per week.

Correction Required: An agreement shall specify the amount of the fee to be charged per day or per week.

Noncompliance Area: The files for children #1, #3, and #5 included agreements which did not specify the date on which the fee is to be paid.

Correction Required: An agreement shall specify the date on which the fee is to be paid.

Noncompliance Area: The files for children 1-5 contained original agreements.

Correction Required: A parent shall receive the original agreement. The facility shall retain a copy of the agreement.

Noncompliance Area: The file for child #2 contained emergency contact information which did not include the birth date of the child.

Correction Required: Emergency contact information must include the name and birth date of the child.

Noncompliance Area: The file for child #2 contained emergency contact information which did not include the name, address and telephone number of the child's physician or source of medical care.

Correction Required: Emergency contact information must include the name, address and telephone number of the child's physician or source of medical care.

Noncompliance Area: The file for child #1 contained emergency contact information which did not include the written consent signed by a parent for emergency medical care.

Correction Required: Emergency contact information must include the written consent signed by a parent for emergency medical care.

Noncompliance Area: The files for children #3 and #4 contained emergency contact information which did not include information regarding health insurance coverage and policy numbers.

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.

Noncompliance Area: The file for child #5, enrolled for longer than 60 days, did not contain a health report.

Correction Required: The operator shall require the parent of an enrolled child, including a child, a foster child and a relative of an operator or a facility person, to provide an initial health report no later than 60 days following the first day of attendance at the facility.

Noncompliance Area: The files for children #3 and #4 contained health assessments which did not include statements that the child is able to participate in child care and appears to be free from contagious or communicable disease.

Correction Required: A health report shall include a statement that the child is able to participate in child care and appears to be free from contagious or communicable disease.

Noncompliance Area: The file for child #2 contained an immunization record which lacked documentation of having received the influenza vaccine within the last 12 months.

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 contained a health assessment which has not been updated in 29 months.

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 legal entity did not have documentation of general liability insurance. The last documented insurance policy expired on 8/31/2018.

Correction Required: The legal entity shall have comprehensive general liability insurance to cover the persons who are on the premises. A current copy of the insurance policy shall be on file at the facility.

Noncompliance Area: Enrolled children #6 - #13 lacked individual records.

Correction Required: An operator shall establish and maintain an individual record for each child enrolled in the facility.

Noncompliance Area: The file for child #5 contained emergency contact information that did not include a dated parental signature attesting to the review.

Correction Required: Following review, a parent shall attest to the accuracy of information in the emergency contact information and the financial agreement at each review by affixing a dated signature to the record.

Noncompliance Area: Knives were observed in a container on the edge of the kitchen counter, accessible to children. Two window blind cords, knotted at the bottom, were accessible in the main care space on the front windows.

Correction Required: Conditions at the facility may not pose a threat to the health or safety of the children.

Noncompliance Area: The facility's current certificate of compliance was not posted at the facility.

Correction Required: The facility's current certificate of compliance and a copy of the applicable regulations under which the facility is certified shall be posted in a conspicuous location used by parents, with instructions for contacting the appropriate regional day care office posted at the same location.

Noncompliance Area: The file for staff #1 lacked documentation of completing first-aid training. Based on statements made by the operator, staff #1 is the only facility person present with children in care.

Correction Required: Competence in first-aid is demonstrated by the completion of training by a professional in the field of first-aid. First-aid training shall be renewed on or before expiration of certification or every 3 years, as applicable.One or more facility persons competent in first-aid techniques shall be at the facility when one or more children are in care.

Noncompliance Area: The file for staff #1 lacked documentation of completing an annual minimum of 6 clock hours of child care training.

Correction Required: A staff person shall obtain an annual minimum of 6 clock hours of child care training.A facility person's record shall include verification of child care experience, education and training following the outset of service at the facility.

Noncompliance Area: The branches of several thorny bushes were observed extending into the path used by children to access the outdoor play space.

Correction Required: If unsafe areas or conditions are in or near an outdoor play space, fencing or natural barriers are required to restrict children from those unsafe areas or conditions.

Noncompliance Area: Electrical outlets on a power strip in the main care space, accessible to children 5 years of age or younger, lacked protective covers.

Correction Required: Protective receptacle covers shall be placed in electrical outlets accessible to children 5 years of age or younger.

Noncompliance Area: The following toxics accessible to children were observed on 7/15/19 in the locations indicated; In the kitchen; Woolite and Murphy's Oil Soap under the sink in an unlocked cabinet, sealer and granite cleaner on the edge of the counter. In the downstairs main care space; Resinol medicated ointment in an unlocked drawer of a storage unit, a pack of batteries on a shelf near the TV, 5 bottles of liquid fabric dye in an unlocked storage unit at the base of the stairs, and 1 box of RIT clothing dye on a shelf near the front door. In the upstairs care space; a bottle of woodglue on the floor; scented oil plugs ins on a shelf. In the restroom used by children in care; Lysol wipes on a shelf behind the toilet and all purpose cleaners on a shelf near the window. On the front porch used to enter and exit the facility when accessing the outdoor play space; an open bag of Terro Ant Killer, 6 or more cans of spray paint, and a large bottle of Ortho Home Defense. Through the entrance to the cellar, which lacks functioning doors, off the outdoor play space; 1 bottle of charcoal lighter fluid near the base of the steps, 1 bottle of bleach inside the door on top of a clothes washer, and loose detergent pods on top of the washer. In a storage room under the rear porch, along the path the children use to access the outdoor play space; 1 five gallon gas can without a lid which contained gas.

Correction Required: 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.

Noncompliance Area: The following hazards were observed on the facility surfaces on 7/15/19 in the areas indicated; several broken ceramic tiles with sharp edges on the kitchen floor, 2 protruding screws on a yellow shelving unit in the main care space downstairs, 8 protruding nail heads around the door frame to a small storage room under the rear deck. This area is accessible to children on the route they use to access the outdoor play space. 2 protruding nails on a wooden beam supporting the rear deck. This area is accessible to children from the outdoor play space. The metal handle on the front door of the facility was broken with sharp edges and sharp metal protrusions around the holes of the missing screws. The railing on the front porch steps was not secured at the base making it unstable. A hole was observed in the outdoor play space creating a tripping hazard.

Correction Required: Floors, walls, ceilings and other surfaces, including the facility's outdoor play space surfaces shall be kept clean, in good repair and free from visible hazards.

Noncompliance Area: Peeled paint was observed along the baseboard in the main care space, near the rear right hand windows.

Correction Required: Peeled or damaged paint or damaged plaster is not permitted on indoor or outdoor surfaces in the child care facility.

Noncompliance Area: The door to the cellar, which opens directly into a stairwell with no landing, was missing 1 of the 2 doors required to fully secure the stairs. This area is accessible to children in the outdoor play space.

Correction Required: If a door or doorway opens or exits directly into a stairwell and if there is no landing beyond the door or doorway, the door shall be restricted from opening or shall be removed and a secure barrier to prevent access to the stairwell shall be erected.

Noncompliance Area: Based on documentation at the facility, fire drills are not being held at least every 60 days. The last documented fire drill took place on 2/14/19.

Correction Required: A fire drill shall be held at least every 60 days. Staff persons, volunteers and children in attendance shall participate in the fire drill and shall exit the facility, weather permitting.

Noncompliance Area: A toy high chair was broken and missing a leg. A toy jeep was missing a wheel. A hole approximately 2x2 inches was observed in the netting of a pack and play used by children in care in the dining room.

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: Plastic bags were accessible to children on the floor in the restroom, in an unlocked cabinet in the restroom, and on a shelf in the living room care space.

Correction Required: 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.

Noncompliance Area: The crib in the upstairs care space and two cribs in the dining room care space were not labeled for use by specific children.

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 refrigerator lacked a operating thermometer.

Correction Required: A facility shall have an operable, clean refrigerator used to store potentially hazardous foods. The refrigerator shall be capable of maintaining food at 45 F or below. An operating thermometer shall be placed in the refrigerator.

Noncompliance Area: The file for child #4, with an enrollment date of 8-21-18, did not contain a financial agreement.

Correction Required: An agreement shall be signed by the operator and the parent.

Noncompliance Area: The file for child #2 contained a child service report which has not been updated since 2-15-18.

Correction Required: 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 3280.124(f).

Noncompliance Area: The file for child #5 contained an agreement which did not specify the persons designated by a parent to whom the child may be released.

Correction Required: An agreement shall specify the persons designated by a parent to whom the child may be released.

Noncompliance Area: The files for child #2 and child #3 contain original agreements.

Correction Required: A parent shall receive the original agreement. The facility shall retain a copy of the agreement.

Noncompliance Area: The file for child #5 contained emergency contact information which did not include the name, address and telephone number of the child's physician or source of medical care.

Correction Required: Emergency contact information must include the name, address and telephone number of the child's physician or source of medical care.

Noncompliance Area: The file for child #1 and child #3 contained emergency contact information which did not include information regarding health insurance coverage and policy number.

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.

Noncompliance Area: Emergency contact information for child #4 was not present at the facility on the day of the inspection. The child was receiving care on that day.

Correction Required: When children are in the facility, emergency contact information shall be present in a child care space for children receiving care in the space.

Noncompliance Area: The file for child #5, enrolled for longer than 60 days, did not contain a health report.

Correction Required: The operator shall require the parent of an enrolled child, including a child, a foster child and a relative of an operator or a facility person, 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.

Noncompliance Area: The file for child #2, a preschooler, contained a health assessment which has not been updated in the past 23 months.

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 must contain initial and subsequent health reports.

Noncompliance Area: The file for staff #2 contained a health assessment which lacked the address, phone number, and title of the person who conducted the exam. The information could not be verified and therefore the health assessment was determined to be invalid.

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: A written statement giving the formula and feeding schedule for child #5, an infant, was not obtained from the parent

Correction Required: A written statement giving the formula and feeding schedule for an infant shall be obtained from the parent.

Noncompliance Area: A bottle intended for an infant in care was not labeled with the child's name.

Correction Required: Disposable nursers and bottles shall be labeled with the child's name.

Noncompliance Area: The file for child #1 contained emergency contact information and a financial agreement which have not been updated since 1-10-18. The file for child #2 contained emergency contact information and a financial agreement which have not been updated since 9-29-16.

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: A looped HDMI cable was observed hanging from a wall mounted TV in the living room care space. The loop was accessible to children in care and created a choking hazard. A bucket, 1/2 full of soapy water, was observed in the tub in the restroom used by children in care.

Correction Required: Conditions at the facility may not pose a threat to the health or safety of the children.

Noncompliance Area: The file for staff #1 contained documentation of completing initial emergency plan training on 7-2-18, 16 days after their start date on 6-16-18. The file for staff #2 contained documentation of completing initial emergency plan training on 7-13-18, 17 days after their start date on 6-16-18.

Correction Required: The operator shall assure that each facility person receives training regarding the emergency plan at the time of initial employment, on an annual basis and at the time of each plan update. The operator shall document the date of each training and the names of all facility persons who received the training.

Noncompliance Area: The operator lacked a letter or other means of providing information regarding the emergency procedures to parents of enrolled children.

Correction Required: The operator shall provide to the parent of each enrolled child a letter explaining the emergency procedures. The operator shall also provide to the parent of each enrolled child a letter explaining any subsequent update to the plan.

Noncompliance Area: The file for staff #3 lacked documentation of completing the required 6 hours of annual training.

Correction Required: A staff person shall obtain an annual minimum of 6 clock hours of child care training.

Noncompliance Area: Based on statements made by staff, there has not always been a facility person competent in first-aid at the facility. Only 1 staff person currently employed at the facility has documentation of first-aid training on file.

Correction Required: One or more facility persons competent in first-aid techniques shall be at the facility when one or more children are in care.

Noncompliance Area: The following electrical outlets, accessible to children 5 years of age or younger, lacked receptacle covers; the power strip on the floor near the cubbies, the green extension cord near the TV, 1 outlet under the window in the living room, and 1 outlet in the upstairs care space.

Correction Required: Protective receptacle covers shall be placed in electrical outlets accessible to children 5 years of age or younger.

Noncompliance Area: Lysol wipes were accessible to children in an unlocked drawer in the kitchen where the children eat meals. A bucket 1/2 full of water and cleaning solution was observed in the tub of the restroom used by the children in care. Sun block labeled keep out of reach of children was accessible to children in an unlocked drawer near the diaper changing station.

Correction Required: 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.

Noncompliance Area: A protruding nail was observed on the bookshelf in the living room. The nail was accessible to children.

Correction Required: Floors, walls, ceilings and other surfaces, including the facility's outdoor play space surfaces shall be kept clean, in good repair and free from visible hazards.

Noncompliance Area: A portable space heater was observed in the restroom used by children in care. The operator did not have documentation that the space heater is allowed by local ordinance. The space heater was not equipped with protective guards. Based on statements made by the operator, the space heater has been in use during child care hours.

Correction Required: Portable space heaters, if allowed by local ordinance, may be used while children are in care, if the units are used in accordance with the manufacturer's operating instructions.Fixed and portable space heaters shall be insulated or equipped with protective guards.

Noncompliance Area: Evacuation routes were not posted at the facility.

Correction Required: Evacuation routes shall be posted.

Noncompliance Area: Broken plastic clips with sharp edges were observed on the front of the outdoor play house in the back yard play area.

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: Broken crayon pieces were observed on the floor of the dining room where infants and toddlers were receiving care. Plastic bags were observed to be accessible to children in unlocked cabinets in the bathroom and kitchen where the children eat meals.

Correction Required: 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.

Noncompliance Area: Two pack and plays used by children in care were not labeled for the use of a specific child.

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: An infant was observed sleeping in a detachable napper secured on top of a pack n play. The infant was sleeping on a top of a loose blanket which presents a suffocation hazard.

Correction Required: Infants shall be placed in the sleeping position recommended by the American Academy of Pediatrics unless there is a medical reason an infant should not sleep in this position. The medical reason shall be documented in a statement signed by a physician, physician's assistant or CRNP and placed in the child's record at the facility.

Noncompliance Area: The files for child #1 and child #2 contained agreements that were not signed by the operator.

Correction Required: An agreement shall be signed by the operator and the parent.

Noncompliance Area: The file for child #3 contained an agreement which did not specify the amount of the fee to be charged per day or per week.

Correction Required: An agreement shall specify the amount of the fee to be charged per day or per week.

Noncompliance Area: The file for child #3 contained an agreement which did not specify the date on which the fee is to be paid.

Correction Required: An agreement shall specify the date on which the fee is to be paid.

Noncompliance Area: The files for children #3, #4, and #5 contained agreements which did not specify the services to be provided to the family and the child. The files for children #1 and #2, both enrolled longer than 6 months, lack an approved form to provide information to the family about the child's growth and development in the context of the services being provided. The files for children #1 and #2 contained agreements which have not been updated since 04-07-2017 which exceeds the allowable 6-month period. The files for children #4 and #5 contained agreements which were updated on 06-13-2017 and then again on 01-10-2018. This exceeds the allowable 6-month period.

Correction Required: 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 3280.124(f).

Noncompliance Area: The file for children #1 and #2 contained agreements which did not specify the persons designated by a parent to whom the children may be released.

Correction Required: An agreement shall specify the persons designated by a parent to whom the child may be released.

Noncompliance Area: The files for children #1, #2, and #4 contained original agreements.

Correction Required: A parent shall receive the original agreement. The facility shall retain a copy of the agreement.

Noncompliance Area: The files for children #4 and #5 lack emergency contact information.

Correction Required: Emergency contact information is required for each enrolled child. Emergency contact information shall reference who shall be contacted in an emergency.

Noncompliance Area: The files for children #1 and #2 contained emergency contact information last updated on 04-7-2017.

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 information

Noncompliance Area: The file for child #2, a young toddler, contained a health assessment that has not been updated for 11 months.

Correction Required: The operator shall require the parent to provide an updated health report at least every 6 months for an infant or young toddler

Noncompliance Area: Children were observed eating snack without washing hands.

Correction Required: A staff person shall ensure that a child's hands are washed before meals and snacks, after toileting and after being diapered.

Noncompliance Area: The facility lacked a functioning hands free can for diaper disposal.

Correction Required: 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.

Noncompliance Area: The file for staff #2 contained a health assessment that was conducted after their first day providing service in a child care position. The health assessment on file for staff #2 is now current. The file for staff #3 lacked a health assessment.

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: Staff #1 was observed completing a diaper change without washing hands afterward. Based on statements made by staff, they have been using gloves in place of washing hands.

Correction Required: A facility person shall wash his hands before meals and snacks, and after toileting and after diapering a child.

Noncompliance Area: The files for staff #3 and #4 did not include the address and telephone number of the facility person.

Correction Required: A facility person's record shall include the name, address and telephone number of the facility person.

Noncompliance Area: The files for staff #3 and #4 did not include verification of age.

Correction Required: A facility person's record shall include verification of age.

Noncompliance Area: The files for staff #1 and #2 lacked copies of initial health assessments. The most recent health assessments on file are current.

Correction Required: 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 files for staff #1 and staff #2 contained only 1 written reference. The file for staff #3 did not contain any written references.

Correction Required: A facility person's record shall include two written, nonfamily references from individuals attesting to the person's suitability to serve as a facility person

Noncompliance Area: Knives were observed to be accessible to children in a container on the kitchen counter. A 5 gallon bucket 3/4 full of water was observed on the floor on the kitchen when children were present in the room.

Correction Required: Conditions at the facility may not pose a threat to the health or safety of the children.

Noncompliance Area: The facility's current certificate of compliance was not posted. The posted certificate expired on 04-16-2017.

Correction Required: The facility's current certificate of compliance and a copy of the applicable regulations under which the facility is certified shall be posted in a conspicuous location used by parents, with instructions for contacting the appropriate regional day care office posted at the same location.

Noncompliance Area: The facility lacked documentation of reviewing the emergency plan on an annual basis.

Correction Required: The operator shall review the emergency plan at least annually and update the plan as needed. The operator shall document in writing each review and update of the emergency plan and kept on file at the facility.

Noncompliance Area: The file for staff #3, provisionally hired on 01-18-2018, lacked proof of applying for the child abuse, state police, and FBI clearance prior to starting in a child care position. No completed clearances were on file for staff #3. Staff #3 was observed working alone with children on 01-19-2018 at approximately 10:20 AM and 10:35 AM. The file for staff #3 also contained a disclosure statement that was not dated. The file for staff #2, provisionally hired on 08-30-2016, contained a disclosure statement that was not dated and lacked proof of applying for the FBI clearance prior to their first day in a child care position. The completed FBI clearance is dated 11-12-2016. The file for staff #4 contained a disclosure which lacked a witness signature and was not dated.

Correction Required: *The operator shall submit to the department proof of application for all required clearances, or completed clearances, and a completed disclosure statement prior to the first day in a child care position for all new staff hired for a period of 3 months following the approval of this plan.

Noncompliance Area: Upon arrival at approximately 10:20 AM, the certification representative observed staff #1, designated as primary staff, exit the facility leaving staff #3 alone inside with 4 children in care. At approximately 10:35 AM, staff #1 again left staff #3 alone with the children in care while upstairs with the certification representative. The file for staff #3 lacks proof of qualifications for either primary or secondary staff.

Correction Required: A primary staff person shall supervise the performance of a secondary staff person

Noncompliance Area: Staff #3 was observed leaving a preschooler and an older toddler alone in the kitchen. Staff #3 left the room to retrieve a sippy cup from the next room.

Correction Required: When children are grouped in mixed age levels, the age of the youngest child in the group determines the staff:child ratio and maximum group size in accordance with the requirements at 3280.52(b).The required staff:child ratios must be maintained at all times. 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. Children must be supervised at all times.

Noncompliance Area: In the back yard play area, a tree stump with large sharp pieces of wood still attached to the top was observed. The tree was cut down late last year.

Correction Required: If unsafe areas or conditions are in or near an outdoor play space, fencing or natural barriers are required to restrict children from those unsafe areas or conditions.

Noncompliance Area: Electrical outlets accessible to children 5 years of age or younger on the wall under the TV and on a power strip in the living room lacked protective covers.

Correction Required: Protective receptacle covers shall be placed in electrical outlets accessible to children 5 years of age or younger.

Noncompliance Area: The following toxics were accessible to children; Lysol and other cleaning solutions on a low shelf in the bathroom, diaper creams labeled keep out of reach of children in low unlocked drawers in the dining room, disinfectant spray on a low shelf in the dining room, wood glue under the sink in an unlocked cabinet in the kitchen, and liquid adhesive in a low unlocked drawer in the living room. Diamond Krystal Winter Melt salt labeled keep out of reach of children was observed in an open bag on the porch. The children use the porch to enter and exit the facility while going to the outdoor play space.

Correction Required: 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.

Noncompliance Area: Several broken ceramic tiles with sharp edges were observed in the kitchen where the children eat meals. Three nails were observed protruding from the wall in the living room near the couch.

Correction Required: Floors, walls, ceilings and other surfaces, including the facility's outdoor play space surfaces shall be kept clean, in good repair and free from visible hazards.

Noncompliance Area: The exit door in the kitchen was blocked by a folded high chair and a bucket of soapy water.

Correction Required: Stairways, hallways, exits from rooms, exits from the facility and other means of egress serving as an exit shall be unobstructed.