Blessing From Above Family Child Care Home

Regulation: 3290.32(a)/3290.192(3)

Description: Comply with CPSL/CPSL information

Noncompliance Area: While reviewing the staff's files I observed that staff 1 the primary staff did not include a current NSOR.

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. Facility Person # 1 may not work in a child care position at the facility.

Regulation: 3290.124(b)(3)

Description: Parent home/work address, phone

Noncompliance Area: While reviewing the child/children's files I observed that child 1, did not contain the home and work addresses and telephone numbers of the enrolling parent.

Correction Required: Emergency contact information must include the home and work addresses and telephone numbers of the enrolling parent.

Regulation: 3290.124(d)

Description: Written emergency plan posted

Noncompliance Area: During the inspection, it was observed that the facility emergency transportation plan was not posted.

Correction Required: A written plan shall be conspicuously posted which identifies the means of transporting a child to emergency care and the facility staffing provisions in the event of an emergency. The plan must accompany a staff person who leaves the facility on an excursion with children.

Regulation: 3290.18

Description: General Health and Safety

Noncompliance Area: During my inspection I observed that the facility did not have the update and required policy changes for shaken baby syndrome. 1. Shaken baby syndrome sign/symptoms 2. Strategies for crying/fussing/distraught children 3. Prevention/identification of maltreatment

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

Regulation: 3290.22(a)

Description: Availability of certificate of compliance and applicable regulations

Noncompliance Area: During the inspection, it was observed that the regional office information was not posted.

Correction Required: 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.

Regulation: 3290.24(a)(1)/3290.24(a)(2)

Description: Emergency plan/Emergency plan

Noncompliance Area: While conducting my inspection I observed that the facility's emergency plan did not include their evacuation nor where they would shelter in place.

Correction Required: 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 shall have an emergency plan that provides for accommodations for evacuation of children from the facility building and evacuation of children to a location away from the facility premises. The evacuation routes and evacuation plans to exit the building may be the same as those required by §  3290.94 (relating to fire drills).

Regulation: 3290.24(b)

Description: Emergency plan

Noncompliance Area: While conducting my inspection I observed that the primary staff had not reviewed their emergency plan in the last year.

Correction Required: 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.

Regulation: 3290.24(c)

Description: Training regarding plan

Noncompliance Area: While reviewing the staff's files I observed that staff 1, did not contain their annual emergency plan training.

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.

Regulation: 3290.31(f)

Description: Age and training

Noncompliance Area: While reviewing the staff's files I observed that staff 1, did not include their 12 clock hours of child care training.

Correction Required: A staff person shall obtain an annual minimum of 12 clock hours of child care training.

Regulation: 3290.31(f)(4)(i)

Description: Age and training

Noncompliance Area: While reviewing the staff's files I observed that staff 1, did not review the first aid and cpr certification.

Correction Required: 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.

Regulation: 3290.63

Description: Protective Outlet Covers 5 yrs. or less

Noncompliance Area: While conducting my inspection I observed that the outlet did not have any protected covers.

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

Regulation: 3290.94(a)(1)

Description: Every 60 days

Noncompliance Area: While conducting my inspection I observed that the facility had not conducted a fire drill in the last 60 days.

Correction Required: Fire drills are conducted at least once every 60 days.

Regulation: 3290.124(b)(6)

Description: Insurance coverage information

Noncompliance Area: While reviewing the child/children's files I observed that child 2, 3, did not include health insurance coverage and policy number for a child under a family policy.

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.

Regulation: 3290.124(b)(7)

Description: Name/address/phone release person

Noncompliance Area: While reviewing the child/children's files I observed that child 1-3, did not include the name, address and telephone number of the individual designated by the parent to whom the child may be released.

Correction Required: 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.

Regulation: 3290.124(d)

Description: Written emergency plan posted

Noncompliance Area: During my inspection I observed that there was no emergency transportation plan posted.

Correction Required: A written plan shall be conspicuously posted which identifies the means of transporting a child to emergency care and the facility staffing provisions in the event of an emergency. The plan must accompany a staff person who leaves the facility on an excursion with children.

Regulation: 3290.18

Description: General Health and Safety

Noncompliance Area: During my inspection I observed that the facility did not have all the update and required policy changes. 1. Shaken baby syndrome sign/symptoms 2. Strategies for crying/fussing/distraught children 3. Prevention/identification of maltreatment

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

Regulation: 3290.24(d)

Description: Emergency plan

Noncompliance Area: During my inspection I observed that the primary had not conducted their annual emergency drill.

Correction Required: Emergency drills shall be conducted annually. Annual emergency drills shall be documented and on file at the facility.

Regulation: 3290.31(f)

Description: Age and training

Noncompliance Area: While reviewing the staff's files I observed that staff 1, did not have their annal 12 hours of child care training.

Correction Required: A staff person shall obtain an annual minimum of 12 clock hours of child care training.

Regulation: 3290.124(b)(6)

Description: Insurance coverage information

Noncompliance Area: While reviewing the children's files I observed that child 1-3, did not have their 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.

Regulation: 3290.124(b)(7)

Description: Name/address/phone release person

Noncompliance Area: While reviewing the children's files I observed that child 1, 2, did not have whom they could be released to on the emergency contact sheet.

Correction Required: 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.

Regulation: 3290.124(d)

Description: Written emergency plan posted

Noncompliance Area: During my inspection I observed that the facility did not have the means of transporting a child to emergency care and the facility staffing provisions in the event of an emergency.

Correction Required: A written plan shall be conspicuously posted which identifies the means of transporting a child to emergency care and the facility staffing provisions in the event of an emergency. The plan must accompany a staff person who leaves the facility on an excursion with children.

Regulation: 3290.14(a)

Description: Building codes

Noncompliance Area: While reviewing the staff's files I observed that staff 1, did not have their 1hr. updated health & safety training.

Correction Required: A certificate of compliance will not be granted by the Department until the legal entity provides a certificate of occupancy as proof of compliance with the applicable requirements in 34 Pa. Code § 403.23 (relating to child day care facilities) and under section 1016(c) of the act (62 P.S. § 1016(c)).

Regulation: 3290.181(c)

Description: Emergency info/agreement updated 6 mos

Noncompliance Area: While reviewing the children's files I observed that child 2, 3, did not have an updated financial agreement form.

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.

Regulation: 3290.24(a)(5)

Description: Emergency plan

Noncompliance Area: During my inspection I observed that the facility's emergency plan did not include accommodations of infants and toddlers, children with disabilities, and children with chronic medical conditions.

Correction Required: The facility shall have an emergency plan that provides for accommodations of infants and toddlers, children with disabilities, and children with chronic medical conditions.

Regulation: 3290.24(d)

Description: Emergency plan

Noncompliance Area: During my inspection I observed that the facility had not conducted or documented any emergency drills.

Correction Required: Emergency drills shall be conducted annually. Annual emergency drills shall be documented and on file at the facility.

Regulation: 3290.24(g)

Description: Emergency plan

Noncompliance Area: During my inspection I observed that a copy of the facility's emergency plan was not sent to the local municipality and to the county emergency management agency.

Correction Required: 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.

Regulation: 3290.31(f)(4)(i)

Description: Age and training

Noncompliance Area: While reviewing the staff's files I observed that staff 1, did not have a current pediatric first aid and pediatric cardiopulmonary resuscitation (CPR) .

Correction Required: 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.

Regulation: 3290.32(d)

Description: Age and training

Noncompliance Area: While reviewing the staff's files I observed that the primary staff did not have pediatric first-aid and pediatric cardiopulmonary resuscitation.

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

Regulation: 3290.94(a)(5)

Description: Evacuation routes posted

Noncompliance Area: During my inspection I observed that the facility did not have their evacuation routes are posted in a conspicuous location on each floor of the facility.

Correction Required: 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.

Regulation: 3290.131(a)/3290.182(1)

Description: Within 60 days/Initial and subsequent health assessments

Noncompliance Area: During renewal inspection dated 10/3/2022, certification representative observed that child #1 did not have a health assessment in file and did not have any immunization records in the file.

Correction Required: 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. A child's record must contain initial and subsequent health reports.

Regulation: 3290.62/3290.91(a)

Description: Outside Walkways/Stairs, exits, etc. unobstructed

Noncompliance Area: During the renewal inspection dated 09/29/2022, certification representative observed that the the front entrance steps at the facility were removed. The steps were being repaired at the time of the inspection. Also, the porch railing was detached from the wall of the home which is a potential safety hazard.

Correction Required: Outside walkways shall be free from ice, snow, leaves, equipment and other hazards. Stairways, hallways, exits from rooms, exits from the facility and other means of egress serving as an exit shall be unobstructed.

Regulation: 3290.64(a)

Description: Locked or inaccessible - in original container

Noncompliance Area: During renewal inspection dated 10/3/2022 certification representative observed that in living room area there was nail polish remover on the floor and hand sanitizer on the table that were accessible to children.

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.

Regulation: 3290.131(a)

Description: Within 60 days

Noncompliance Area: DURING THE RENEWAL INSPECTON ON 11/17/2021, THE FILE OF CHILD # 1 AND CHILD #2 DID NOT CONTAIN AN INITIAL HEALTH ASSESSMENT.

Correction Required: 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.

Regulation: 3290.31(k)

Description: Health and safety

Noncompliance Area: DURING THE RENEWAL INSPECTION ON 11/17/2021, THE FILE OF STAFF PERSON # 1 DID NOT CONTAIN THE HEALTH AND SAFETY PROFESSIONAL DEVELOPMENT TRAINING DOCUMENTATION.

Correction Required: Staff persons shall obtain available ongoing professional development relating to the health and safety topics as specified in § 3290.31(g) prior to obtaining professional development in other topics as permitted in § 3290.31(f)(2).

Noncompliance Area: During renewal inspection on 17 SEPTEMBER 2019, the certification rep. observed that the emergency contact information for children #1-4 had not been updated within the last 6 months.

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: During renewal inspection on 17 SEPTEMBER 2019, the certification rep. observed that the health reports for children #1-4 had not been updated within the last 12 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.

Noncompliance Area: During renewal inspection on 17 SEPTEMBER 2019, the certification rep. observed that the health assessment for staff #1 had not been updated in over 24 months. The last updated health assessment was 9/13/17.

Correction Required: 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.

Noncompliance Area: There were empty plastic bags in reach of children hanging in a plastic bag dispenser 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: The daily schedule was not posted.

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

Noncompliance Area: The file for Child #3 lacked an agreement.

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

Noncompliance Area: The files for Children #3, #4 and #5 lacked child service reports.

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 3290.124(e).

Noncompliance Area: The files for Children #2, #3, #4 and #5 lacked completed health assessments for the children and they have exceeded 60 days in care at the facility. The files for Children #3, #4 and #5 only contained immunizations.

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: There were medications accessible in the living room as follows: a child's Qvar inhaler on a hanging shelving unit in reach of children, a child's inhaler on a low shelf near the entry, allergy medication and ibuprofen on a shelf about the sofa, in reach of children.

Correction Required: Medication shall be stored in a locked area of the facility or in an area that is out of the reach of children.

Noncompliance Area: There is no hands-free plastic lined covered trash can for diaper disposal. The operator states the diapers are placed in individual bags and taken outside.

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 operator states she changes diapers on her lap, rather than a surface that is changed or cleaned after each diaper change.

Correction Required: 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.

Noncompliance Area: There were sharp knives in a block on the counter in the kitchen in reach of children, and one sharp knife in an unlocked kitchen drawer.

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

Noncompliance Area: The files for Children #1, #2, #3, #4 and #5 lacked the initial and subsequent emergency contact forms and financial agreements. Operator reports that she has discarded them once new ones are completed. At this time the Agreements for Children #1 and #4 have exceeded 6 months since their last review and update.

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: The file for Staff Person #1 lacked all of the subsequent health reports between the initial and the current health assessment.

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 regulations under which the facility is certified and the phone number to contact the regional certification office were not posted at the facility.

Correction Required: The facility's current certificate of registration 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: There were two power strips on the floor in the living room with uncovered outlets.

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: Clorox, Windex, MopnGlo, lighter fluid on the floor in the kitchen, Hot Shot insect killer, Clorox, Quick Shine floor cleaner in an unlocked cabinet under the sink in the kitchen, Lysol, glass cleaner on a low shelf in the living room, Lysol wipes on the floor in the living room, cleaner in the shower in the bathroom used by children in care, starch spray, Hot Shot insect killer on the floor in the hallway upstairs. All of the items were labeled "keep out of reach of children."

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 first aid kit did not contain scissors or soap.

Correction Required: A first-aid kit must contain the following: soap, an assortment of adhesive bandages, sterile gauze pads, tweezers, tape, scissors and disposable, nonporous gloves.

Noncompliance Area: The exit from the kitchen was blocked with a (folded) high chair.

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

Noncompliance Area: DURING THE RENEWAL INSPECTION ON 10/24/17, CHILD 3 AND 4 FILE DID NOT HAVE A PHYSICAL IN THERE FILE.

Correction Required: The initial health report for a school-age child must be dated in accordance with the requirements for medical examinations for school attendance in 28 Pa. Code 23.2 (relating to medical examinations).