Yia Yias Daycare

Regulation: 3270.124(b)(4)/3270.182(3)

Description: Written consent/Consent for emergency medical care required prior to admission

Noncompliance Area: Certification rep reviewed child #2 record and observed emergency contact form did not contain signed parental consent for emergency medical care for the child.

Correction Required: Emergency contact information must include the written consent signed by a parent for emergency medical care. A child's record shall contain signed parental consent for emergency medical care for the child. Written consent is required prior to admission.

Regulation: 3270.151(c)(2)/3270.192(3)

Description: Mantoux TB/Health assessment, TB test

Noncompliance Area: Certification rep reviewed Staff #1 record and observed Staff #1 adult health assessment in record did not include tuberculosis screening by the Mantoux method at initial employment with legal name.Certification rep reviewed staff #2 record and observed TB test date was not written on physical examination form.

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.

Regulation: 3270.182(5)

Description: Consent for administration of minor first-aid required prior to admission

Noncompliance Area: Certification rep reviewed child #2 record and observed emergency contact form did not contain signed parental consent for administration of minor first-aid procedures by facility staff.

Correction Required: A child's record shall contain signed parental consent for administration of minor first-aid procedures by facility staff. Written consent is required prior to admission.

Regulation: 3270.182(6)

Description: Signed parental consent for transportation, walking excursions, swimming and wading

Noncompliance Area: Certification rep reviewed child #1 record and observed emergency contact did not contain signed parental consent for transportation.

Correction Required: A child's record shall contain signed parental consent for transportation, walking excursions, swimming and wading.

Regulation: 3270.107

Description: Refrigerator

Noncompliance Area: During the renewal inspection certification rep read thermometer in the infant room refrigerator at 49 degrees.

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.

Regulation: 3270.192(2)(iv)

Description: Transcript, diploma and letters

Noncompliance Area: During the renewal inspection certification rep reviewed staff #1, #2, #3, #4, #5, #6, #7, #8, #9 and 10 record and observed verification of experience was not in record.

Correction Required: A facility person's record shall include acceptable verification of experience, education or training is a transcript or a diploma or a letter signed by a representative of the experiential, educational or training entity.

Regulation: 3270.21

Description: General Health and Safety

Noncompliance Area: During the renewal inspection certification rep observed door to the boiler room and storage room unlocked and accessible to children in the preschool room.

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

Regulation: 3270.33(b)

Description: No more than 50% aides

Noncompliance Area: During the renewal inspection certification rep reviewed staff data sheet and observed provider had over 50 percent of staff qualifying as aide qualification level.

Correction Required: At least 50% of the staff persons in a facility shall be individuals qualified and functioning as directors, group supervisors and assistant group supervisors. No more than 50% of the staff persons may be of aide qualification level.

Regulation: 3270.37(c)

Description: Aides supervised all times

Noncompliance Area: During the renewal inspection certification rep observed staff #1, #2, #3, #4, #5, #6, #7, #8 ,#9 and 10 working with children unsupervised by a staff person qualified at minimum as an assistant group supervisor.

Correction Required: An aide or a combination of aides shall be supervised at all times by a staff person qualified at minimum as an assistant group supervisor.

Regulation: 3270.66(a)

Description: Locked or inaccessible

Noncompliance Area: During the renewal inspection certification rep observed bottom cabinet in boy's bathroom unlocked containing Lysol disinfectant wipes and a gallon of Fabulosos cleaning agent.

Correction Required: Cleaning materials and other toxic materials shall be kept in an area or container that is locked or made inaccessible to children.

Regulation: 3270.76

Description: Building Surfaces

Noncompliance Area: During the renewal inspection certification rep observed inner divider wall of girls bathroom had chipped paint.

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.

Regulation: 3270.106(a)

Description: Clean, age appropriate

Noncompliance Area: At the time of renewal inspection, cribs were not labeled in Room #1.

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.

Regulation: 3270.123(a)(6)/3270.182(2)

Description: Admission date/Application, admission, withdrawal dates

Noncompliance Area: At the time of renewal inspection, agreement of child #1, #3, #5, #6, #7, #8, and #9 didn't specify the date of the child's admission.

Correction Required: An agreement shall specify the date of the child's admission. A child's record shall contain the dates of application, admission and withdrawal of the child.

Regulation: 3270.124(b)(3)

Description: Parent home/work address, phone

Noncompliance Area: At the time of renewal inspection, emergency contact form of child #1, #2, and #3 did not include the work address and phone number of the enrolling parent.

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

Regulation: 3270.124(b)(4)/3270.182(3)

Description: Written consent/Consent for emergency medical care required prior to admission

Noncompliance Area: At the time of renewal inspection, emergency contact information of child #2 and #4 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. A child's record shall contain signed parental consent for emergency medical care for the child. Written consent is required prior to admission.

Regulation: 3270.124(b)(5)

Description: Information re: special needs

Noncompliance Area: At the time of renewal inspection, emergency contact information did not include information on the child #1 and #2 special needs, as specified by the child's parent, physician, physician's assistant of CRNP, which is needed in an emergency situation.

Correction Required: Emergency contact information must include information on the child's special needs, as specified by the child's parent, physician, physician's assistant or CRNP, which is needed in an emergency situation.

Regulation: 3270.124(b)(6)

Description: Insurance coverage information

Noncompliance Area: At the time of renewal inspection, emergency contact information of child #6 and #8 did not include health insurance coverage and policy number for a child under a family policy or Medical Assistance benefits, if applicable.

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: 3270.124(b)(7)

Description: Name/address/phone release person

Noncompliance Area: At the time of the inspection, emergency contact information of child #4 did not include the address 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: 3270.14/3270.21

Description: Pertinent Laws & Regulations/General Health and Safety

Noncompliance Area: At the time of renewal inspection, record of staff person #1, #2, #3, #4, #7, #8, #9, #10, #11, and #12 did not include Pennsylvania Health and Safety Update 2022 professional development training.

Correction Required: A facility shall be operated in conformity with applicable Federal and State laws and regulations.State agencies whose regulations may relate to the operation of a facility include the Department of Environmental Resources, the Department of Labor and Industry, the Department of Health, the Department of Education and the Department of Transportation. Conditions at the facility may not pose a threat to the health or safety of the children.

Regulation: 3270.151(a)/3270.151(b)

Description: 12 months prior to service and every 24 months thereafter/Conducted by physician, PA or CRNP

Noncompliance Area: At the time of renewal inspection, a health report of staff person #7 did not include the individual's professional title and there were no date next to the siggnature.

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 health assessment shall be conducted and a report shall be written and signed by a physician, physician's assistant or CRNP. The signature must include the individual's professional title.

Regulation: 3270.151(c)(2)/3270.192(3)

Description: Mantoux TB/Health assessment, TB test

Noncompliance Area: At the time of renewal inspection, health assessment of staff person #13 did not include tuberculosis screening by the Mantoux method at initial employment.

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.

Regulation: 3270.181(e)

Description: Emergency master file updated

Noncompliance Area: At the time of renewal inspection, emergency contact forms were not updated in Room #1, #2, #3, #4, and #5.

Correction Required: If emergency information is updated in a master file, it shall be updated accordingly in other facility records.

Regulation: 3270.182(4)/3270.182(5)

Description: Consent for administration of medications or special dietary needs/Consent for administration of minor first-aid required prior to admission

Noncompliance Area: At the time of renewal inspection, a record of child #2 and #4 didn't contain signed parental consent for administration of medications or special dietary needs and/or for administration of minor first-aid procedures by facility staff. Written consent is required prior to admission.

Correction Required: A child's record shall contain signed parental consent for administration of medications or special dietary needs. A child's record shall contain signed parental consent for administration of minor first-aid procedures by facility staff. Written consent is required prior to admission.

Regulation: 3270.192(5)

Description: Two written references

Noncompliance Area: At the time of renewal inspection, fie of staff person #11 included only one written, nonfamily references from individuals attesting to the person's suitability to serve as a facility person. File of staff person #13 did not include two written, nonfamily references from individuals attesting to the person's suitability to serve as a facility person.

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.

Regulation: 3270.27(a)(6)

Description: Emergency plan

Noncompliance Area: At the time of renewal inspection observed that emergency drill was not conducted annually, written documentation was not available.

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

Regulation: 3270.27(c)

Description: Training regarding plan

Noncompliance Area: At the time of renewal inspection, document that staff person #5, and #6 received training regarding the emergency plan at the time of initial employment was not observed.

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 and kept on file at the facility.

Regulation: 3270.31(e)

Description: Age and Training

Noncompliance Area: At the time of renewal inspection file of staff person #1, #2 did not include verification that staff obtained an annual minimum of 12 clock hours of child care training. Record of staff person #1, #2 included only 11 hours.

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

Regulation: 3270.31(e)(4)(ii)

Description: Fire safety - 1 yr.

Noncompliance Area: At the time of inspection, file for staff person #1, #2 did not include verification that staff participated in fire safety training at least annually. Fire safety training on file of staff person #1 was from 2/6/22, staff person #2 completed fire safety training on 2/11/22.

Correction Required: Staff persons shall participate, at least annually, in firesafety training conducted by a fire protection professional. Staff persons and volunteers shall receive training in maintenance of smoke detectors, the duties of facility persons during a fire drill and during a fire and the use of the facility's fire extinguishers, not including discharge of the fire suppressant agent.

Regulation: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: At the time of renewal inspection, record of staff person #6, #10 did not include complete PA state police clearance. Record of staff person #11 did not include NSOR Certification form, record of staff person #12 did not include PA state police clearance, PA child abuse clearance, FBI clearance. Record of staff person of staff #13 did not include a complete PA State police or FBI clearance required upon hiring. Staff person #6, #10, #11, #12 were not provisional hires.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). LACKING REQUIRED HIRING DOCUMENTS: Staff Person # 13 may not work in a child care position at the facility. 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 Person # 6, #10, #11, #12, #13 must be removed from child care position by close of business. Clearance must be obtained before facility person #6, #10, #11, #12, #13 may resume a child care position.

Regulation: 3270.34(a)(6)

Description: Staff evaluations

Noncompliance Area: At the time of inspection, the files for staff member #3, #4, and #9 did not include an annual staff evaluation.

Correction Required: A director is responsible for written evaluation of staff persons on a regular basis, a minimum of one evaluation every 12 months.

Regulation: 3270.36(b)(5)/3270.192(2)(ii)

Description: HS/GED + 2 yrs/Exp, educ., training prior to facility

Noncompliance Area: At the time of renewal inspection, record of staff person #9 hired for the position of an assistant group supervisor, did not include verification of 2 years child care experience required prior to service at the facility.

Correction Required: An assistant group supervisor shall have a high school diploma or a general educational development certificate and 2 years experience with children. A facility person's record shall include verification of child care experience, education and training prior to service at the facility.

Regulation: 3270.52

Description: Mixed Age Level

Noncompliance Area: At the time of renewal inspection observed 12 children outside ranging in age from older toddler to preschool with only 2 staff persons present. Later on, observed 15 children in Room #5 ranging in age from older toddler to preschool with 2 staff assigned to this group

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 in § 3270.51 (relating to similar age level). Three staff would be required for a group of 13 or 15 children that ranged in age from older toddler to preschool.

Regulation: 3270.131(d)(5)/3270.131(e)(3)

Description: Immunization record/Dismissal policy

Noncompliance Area: At the time of the complaint investigation, heath record of child #1 did not include include influenza immunization recommended by ACIP. Health record of child #2 did not include HIB immunization and 4th dose of PCV immunization. Health record of child #3 did not include 4th doze of PCV immunization. Health record of child #4 did not include immunization record. A letter of exemption was not observed in the file of child #1, #2, and #3.

Correction Required: A health report shall include a review of the child's immunized status according to recommendations of the ACIP. The facility shall implement dismissal policies in accordance with the Department of Health regulation in 28 Pa. Code § 27.77 (relating to immunization requirements for children in child care group settings). Children #1, #2, and #3 must be dismissed from care by close of business 2/13/23 and may only return to care when the immunization record is updated or when a parent provides a written, signed exemption letter.

Regulation: 3270.131(e)(2)(i)/3270.131(e)(2)(ii)

Description: Exemption documentation from parent/guardian/Exemption documentation from health professional

Noncompliance Area: At the time of the complaint investigation, file of child #4 did not include immunization record. An exemption letter from the parent was not dated and was not for religious believes or strong personal objections. The letter included a statement of following the recommended schedule and vaccine damage, but was not written, signed and dated by child's physician, physician's assistant or CRNP.

Correction Required: 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. Exemption from immunization for reasons of medical need must be documented by a written, signed and dated statement from the child's physician, physician's assistant or CRNP. The statement shall be kept in the child's record. Child #4 must be dismissed from care by close of business 2/13/23 and may only return to care when the immunization record is updated or when a parent provides a written, signed exemption letter.

Regulation: 3270.52

Description: Mixed Age Level

Noncompliance Area: At the time of unannounced monitoring inspection observed 13 children ranging in age from young toddlers to preschoolers with staff #1 and #2 on the fenced playground.

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 in § 3270.51 (relating to similar age level). Three staff must be present with 13 children ranging in age from young toddlers to preschoolers.

Regulation: 3270.106(a)

Description: Clean, age appropriate

Noncompliance Area: At the time of renewal inspection observed that the rest equipment in Room #5 was 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.

Regulation: 3270.123(a)(5)/3270.124(b)(7)

Description: Designated release persons/Name/address/phone release person

Noncompliance Area: At the time of renewal inspection an agreement of child #1 did not specify the persons designated by a parent to whom the child may be released. Emergency contact form of child #1 did not include the address of the individual designated by the 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. 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: 3270.151(c)(3)/3270.151(c)(5)

Description: Exam communicable disease/Physician/CRNP assessment

Noncompliance Area: At the time of renewal inspection, a health assessment of staff person #3 and #5 did not include an examination for communicable diseases and the physician's or CRNP's assessment of the person's suitability to provide child care.

Correction Required: An adult health assessment must include an examination for communicable diseases and the results of that examination. An adult health assessment must include the physician's or CRNP's assessment of the person's suitability to provide child care.

Regulation: 3270.182(1)

Description: Initial and subsequent health reports

Noncompliance Area: At the time of renewal inspection, health report of child #2 was not complete.

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

Regulation: 3270.182(3)/3270.182(5)

Description: Consent for emergency medical care required prior to admission/Consent for administration of minor first-aid required prior to admission

Noncompliance Area: At the time of renewal inspection, a record of child #5 didn't contain signed parental consent for emergency medical care for the child and for administration of minor first-aid procedures by facility staff. Both consents are required prior to admission.

Correction Required: A child's record shall contain signed parental consent for emergency medical care for the child. Written consent is required prior to admission.A child's record shall contain signed parental consent for administration of minor first-aid procedures by facility staff. Written consent is required prior to admission.

Regulation: 3270.192(5)

Description: Two written references

Noncompliance Area: At the time of renewal inspection file of staff person #4 included only one written, nonfamily references from individuals attesting to the person's suitability to serve as a facility person.

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

Regulation: 3270.27(c)

Description: Training regarding plan

Noncompliance Area: At the time of renewal inspection the documentation that staff person #4 hired on 12/13/21 and staff person #5 hired on 1/17/22 received emergency plan training at the time of initial employment was not observed.

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 and kept on file at the facility.

Regulation: 3270.31(f)(10)

Description: Health and Safety Training - Pediatric First Aid and CPR

Noncompliance Area: At the time of renewal inspection, file of staff person #3 hired on 10/20/21 did not include verification of completion of pediatric first aid and pediatric cardiopulmonary resuscitation required within 90 days of hire.

Correction Required: Staff persons shall complete professional development in pediatric first aid and pediatric cardiopulmonary resuscitation within 90 days of hire.

Regulation: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: At the time of renewal inspection, file of staff person #2 hired on 10/19/21 did not include FBI clearance required by DHS and mandated reporter training which is required within 90 days of hire. File of staff person #3 hired on 10/20/21 did not include mandated reporter training which is required within 90 days of hire. File of staff person #5 hired on 1/17/22, who is a provisional hire, did not include Disclosure Statement and verification of request for NSOR certificate. Provisional Hire Waiver on file is from 10/25/20.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). LACKING REQUIRED HIRING DOCUMENTS: Facility Person # 1 may not work in a child care position at the facility. 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 must be removed from child care position by close of business.

Regulation: 3270.52

Description: Mixed Age Level

Noncompliance Area: At the time of renewal inspection observed 9 older toddlers and 8 preschoolers with two staff persons present while staff #1 left the 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 in § 3270.51 (relating to similar age level). 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 in § 3270.51 (relating to similar age level). Three staff would be required for a group of 17 children that ranged in age from older toddler to preschool.

Regulation: 3270.76

Description: Building Surfaces

Noncompliance Area: At the time of renewal inspection observed 6 broken vinyl tiles that had missing parts on the floor near the door to Room #6

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.

Regulation: 3270.94(a)(9)

Description: Written record

Noncompliance Area: At the time of renewal inspection observed that a written record of fire drills do not include specific time of day of the drill, the hypothetical location of the fire, the evacuation time, and the number of children who participate in the fire drill.

Correction Required: The Director or designated staff person who is responsible for compliance with this chapter shall conduct fire drills and ensure that a written record is maintained on file at the facility indicating the specific time of day of the drill, the hypothetical location of the fire, the evacuation time, and the names of the facility persons and the number of children who participate in the fire drill.

Regulation: 3270.104(a)

Description: Clean, good repair, proper size

Noncompliance Area: At the time of renewal inspection on 10/4/21 observed two white shelves in Room #5 which were unstable and not secure. These items could fall and pose a hazard to the children in care.

Correction Required: Furniture must be durable, safe, easily cleaned and appropriate for the child's size, age and special needs.

Regulation: 3270.124(e)

Description: Written emergency plan posted

Noncompliance Area: At the time of initial inspection, a written plan identifying the means of transporting a child to emergency care and staffing provisions in the event of emergency was not posted in every child care space.

Correction Required: A written plan identifying the means of transporting a child to emergency care and staffing provisions in the event of an emergency shall be displayed conspicuously in every child care space and shall accompany a staff person who leaves on an excursion with children.

Regulation: 3270.192(3)

Description: Health assessment, TB test

Noncompliance Area: At the time of renewal inspection on 10/04/2021, a written report of initial health assessment of staff person #1 did not include the results of initial tuberculin skin test.

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.

Regulation: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: At the time of initial inspection on 10/4/21, file of staff person #1, who holds the position of the director, included child abuse clearance for volunteer purposes.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). LACKING REQUIRED HIRING DOCUMENTS: Facility Person #1 may not work in a child care position at the facility. 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: 3270.75(c)

Description: Has all items

Noncompliance Area: At the time of initial inspection on 10/4/21, first aid kits in every classroom did not contain 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.

Regulation: 3270.95(b)

Description: Director or designated staff person ensure compliance

Noncompliance Area: At the time of renewal inspection on 10/4/21, provider did not provide documentation of proof of purchase and date of purchase of an interconnected system.

Correction Required: The Director or designated staff person who is responsible for compliance with this chapter shall ensure the requirements under subsection (a) are met.

Noncompliance Area: During renewal inspection on 1/24/20, file of child #2 did not include an initial health report, only immunization record.

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 shall contain initial and subsequent health reports.

Noncompliance Area: During renewal inspection on 1/24/20, file of staff person #1 did not contain a written report of initial health assessment, including the results of initial tuberculin skin tests, x-rays or other medical documentation necessary to confirm freedom from communicable tuberculosis.

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: During renewal inspection on 1/24/20, a health assessment of staff person #2 did not include information on medical problems that might threaten the health of the children or prohibit a staff person from providing adequate care to children.

Correction Required: An adult health assessment must include information on medical problems that might threaten the health of the children or prohibit a staff person from providing adequate care to children.

Noncompliance Area: During renewal inspection on 1/24/20, emergency contact information and the financial agreement of child #1 were not updated at least once in a 6-month period or as soon as there is a change in the information.

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: During renewal inspection on 1/24/20, emergency contact form of child #3 did not include signed parental consent for emergency medical care for the child and for administration of minor first-aid procedures by facility staff. Both written consents are required prior to admission.

Correction Required: A child's record shall contain signed parental consent for emergency medical care for the child. Written consent is required prior to admission.A child's record shall contain signed parental consent for administration of minor first-aid procedures by facility staff. Written consent is required prior to admission.

Noncompliance Area: During renewal inspection on 1/25/19, health assessment form of staff person #1 didn't include information on medical problems that might threaten the health of the children or prohibit a staff person from providing adequate care to children.

Correction Required: An adult health assessment must include information on medical problems that might threaten the health of the children or prohibit a staff person from providing adequate care to children.

Noncompliance Area: During renewal inspection on 1/25/19, file of staff person #2 included child abuse and FBI clearances that were more than 60 months old. Facility Person #2 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. Facility Person #2 may not work in a child care position at the facility.

Noncompliance Area: ON 12/5/17, DIAPER CREAM LABELED 'KEEP OUT OF REACH OF CHILDREN' WAS OBSERVED IN AN UNLOCKED DRAWER ACCESSIBLE TO CHILDREN IN THE OLDER TODDLER ROOM.

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

Noncompliance Area: ON 12/5/17 , THE FILE BELONGING TO STAFF #1 (HIRED 1/12/06) DID NOT CONTAIN A PA CRIMINAL BACKGROUND CLEARANCE.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services).

Noncompliance Area: ON 9/5/17, TWO INFANTS WERE OBSERVED ASLEEP IN PACK N PLAYS THAT WERE NOT AT LEAST 2 FEET APART ON THREE SIDES. THE PACK N PLAYS WERE FLUSH AGAINST ONE ANOTHER WHILE INFANTS WERE SLEEPING.

Correction Required: At least 2 feet of space is required on three sides of a bed, cot, crib or other rest equipment while the equipment is in use.

Noncompliance Area: ON 9/5/17, THE EMERGENCY CONTACT INFORMATION LOCATED IN THE CLASSROOMS WERE NOT UPATED WITHIN A 6 MONTH PERIOD. THE EMERGENCY CONTACT FORMS WERE DATED 1/30/17.

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 informationIf emergency information is updated in a master file, it shall be updated accordingly in other facility records.

Noncompliance Area: ON 9/7/17, AN UPDATED HEALTH ASSESSMENT WAS NOT OBSERVED IN THE FILE BELONGING TO STAFF #1. THE LAST HEALTH ASSESSMENT WAS DATED 9/2/15.

Correction Required: An adult health assessment must include a physical examination.

Noncompliance Area: ON 9/5/17, A BOTTLE OBSERVED IN THE INFANT ROOM REFIGERATOR WAS NOT LABELED WITH THE CHILD'S NAME.

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

Noncompliance Area: ON 9/5/17, AN UNCOVERED ELECTRICAL OUTLET ACCESSIBLE TO CHILDREN WAS LOCATED IN THE HALLWAY BATHROOM USED BY CHILDREN.

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

Noncompliance Area: ON 9/5/17, A CONTAINER OF CLOROX WIPES ACCESSIBLE TO CHILDREN WAS OBSERVED IN THE BATHROOM LOCATED IN THE PK/K CLASSROOM.

Correction Required: Cleaning materials and other toxic materials shall be kept in an area or container that is locked or made inaccessible to children.

Noncompliance Area: ON 2/23/17, THE EMERGENCY CONTACT FORMS LOCATED IN THE CHILD CARE SPACE WERE NOT UPDATED WITHIN A 6 MONTH PERIOD.

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.If emergency information is updated in a master file, it shall be updated accordingly in other facility records.

Noncompliance Area: ON 2/23/17, NO EVIDENCE OF AN UPDATED HEALTH ASSESSMENT NOTING THE PHYSICIAN'S ASSESSMENT OF THE INDIVIDUAL'S SUITABLILITY TO PROVIDE CHILD CARE WAS OBSERVED IN THE HEALTH ASSESSMENT BELONGING TO STAFF #1 DATED ON 7/22/16.

Correction Required: An adult health assessment must include the physician`s or CRNP`s assessment of the person`s suitability to provide child care.

Noncompliance Area: ON 2/23/17, NO EVIDENCE OF THE UPDATED GENERAL LIABILITY WAS ON FILE AT THE FACILITY. THE GENERAL LIABILITY ON FILE EXPIRED ON 8/21/15.

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 2/23/17, NO EVIDENCE OF A COPY OF ACCIDENT/INJURY REPORTS THAT OCCURED AT THE FACILITY WERE OBSERVED IN THE CHILD'S FILE.

Correction Required: A child`s record shall 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.

Noncompliance Area: ON 2/23/17, THE FACILITY'S EMERGENCY PLAN WAS NOT UPDATED ON AN ANNUAL BASIS. THE LAST UPDATE WAS DATED 8/31/15.

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: ON 2/23/17, FIVE DISPENSERS FILLED WITH HAND SANITIZER THAT CONTAINED INSTRUCTIONS "KEEP OUT OF REACH OF CHILDREN" ON THE LABEL WAS OBSERVED ACCESSIBLE TO CHILDREN. ONE DISPENSER WAS LOCATED IN THE PRESCHOOL CLASSROOM AND FOUR DISPENSERS WERE LOCATED IN THE BACK PRE-K/KINDERGARTEN AREA NEAR THE BATHROOMS.

Correction Required: Cleaning materials and other toxic materials containing instructions to keep out of reach of children shall be kept in an area or container that is locked or made inaccessible to children.

Noncompliance Area: ON 2/23/17, LEAVES AND DEBRI WERE OBSERVED ON BOTH THE YOUNG TODDLER AND OLDER TODDLER OUTDOOR PLAY SPACE

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 debri and visible hazards.

Noncompliance Area: ON 2/23/17, HANDWASHING SIGNS WERE NOT OBSERVED AT THE DIAPER CHANGING AREAS LOCATED IN THE INFANT AND OLDER TODDLER ROOM.

Correction Required: A facility person and an able child shall wash his hands after toileting and before eating. A sign on which this requirement is written shall be posted at each toilet, training chair, diapering area and sink in the facility.