Carmen Reaves Family Child Care Home

Regulation: 3290.73(a)/3290.73(d)

Description: In facility/On excursions

Noncompliance Area: On 8/7/24 during the renewal inspection, the operator was providing care upstairs at the time of inspection. The operator did not have her first aid kit upstairs. It was located in the lower level of the facility in the classroom area.

Correction Required: A first-aid kit shall be in the facility. One first-aid kit per child care group must accompany children and facility persons on excursions from the facility. Each first aid kit taken on an excursion must contain a bottle of water in addition to the items specified at §3290.73(c).

Regulation: 3290.105(a)

Description: Clean, age appropriate

Noncompliance Area: ON 9/23/22, DURING THE RENEWAL INSPECTION, CERTIFICATION REP. OBSERVED THAT THE PACK AND PLAY WAS NOT LABELED WITH CHILDS NAME.

Correction Required: (a) Individual, clean, age-appropriate rest equipment shall be provided for preschool, toddler and infant children as agreed between the parent and the operator. The rest equipment must be labeled with the child's name and used only by the named child while enrolled in the program.

Regulation: 3290.124(b)(2)

Description: Physician name, address, phone

Noncompliance Area: ON 9/23/22, DURING THE RENEWAL INSPECTION, CHILD #2 AND CHILD #3 WAS MISSING THE PHYSICIAN NAME, ADDRESS, AND TELEPHONE NUMBER ON THE EMERGENCY CONTACT FORM

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

Regulation: 3290.124(b)(7)

Description: Name/address/phone release person

Noncompliance Area: ON 9/23/22, DURING THE RENEWAL INSPECTION, CHILD #1 DID NOT HAVE THE ADDRESS OF THE INDIVIDUAL DESIGNATED BY THE PARENT TO WHOM THE CHILD MAY BE RELEASED TO ON THE EMERGENCY CONTACT FORM.

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: 3290.22(a)

Description: Availability of certificate of compliance and applicable regulations

Noncompliance Area: ON 9/23/22, DURING THE RENEWAL INSPECTION, CERTIFICATION REP. OBSERVED THAT THE CURRENT CERTIFICATE OF COMPLIANCE WAS NOT POSTED IN THE FACILITY.

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.

Noncompliance Area: DURING THE RENEWAL INSPECTION THE CHILD CUBBIES LOCATED IN THE BASEMENT PLAY ROOM AREA WAS UNSTABLE. THERE WAS A TOY BOOK SHELF LYING ON ITS SIDE.

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: DURING THE RENEWAL INSPECTION THE REST EQUIPMENT WAS NOT LABELED FOR 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: DURING THE RENEWAL INSPECTION THE THERMOMENTER IN THE REFRIGERATOR WAS NOT OPERATING.

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: DURING THE RENEWAL INSPECTION THE FILE OF CHILD 1 (ENROLLED 2/2017), CHILD 2 (ENROLLED 9/2015), CHILD 3 (ENROLLED 11/2018), CHILD 4 (ENROLLED 3/2017) AND CHILD 5 (ENROLLED 8/2015) DID NOT INCLUDE A CHILD SERVICE REPORT IN THE LIST OF SERVICES TO BE PROVIDED. THE FILE OF CHILD 3 AND CHILD 4 DID NOT INCLUDE A CHILD SERVICE REPORT.

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: DURING THE RENEWAL INSPECTION THE EMERGENCY CONTACT INFORMATION FOR CHILD 3 DID NOT INCLUDE THE PHYSICIAN'S PHONE NUMBER.

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: DURING THE RENEWAL INSPECTION THE EMERGENCY CONTACT INFORMATION FOR CHILD 1 DID NOT INCLUDED THE PARENTS, HOME PHONE NUMBER, WORK PHONE NUMBER, OR WORK ADDRESS. THE EMERGENCY CONTACT INFORMATION FOR CHILD 4 DID NOT INCLUDE THE PARENT'S WORK PHONE NUMBER.

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

Noncompliance Area: DURING THE RENEWAL INSPECTION THE EMERGENCY CONTACT INFORMATIO FOR CHILD 1, CHILD 2 AND CHILD 3 DID NOT INCLUDE THE RELEASE PERSON'S ADDRESS.

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.

Noncompliance Area: DURING THE RENEWAL INSPECTION THE FILE OF CHILD 2 (ENROLLED 9/2015) DID NOT INCLUDE A CURRENT, UP-TO-DATE HEALTH REPORT. THIS IS CONTINUED NON-COMPLIANCE.

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: DURING THE RENEWAL INSPECTION THE HEALTH REPORT FOR CHILD 2, CHILD 4 AND CHILD 5 DID NOT INCLUDE A SIGNATURE AND PROFESSIONAL TITLE.

Correction Required: A health report must be written and signed by a physician, physician's assistant or a CRNP. The signature must include the individual's professional title.

Noncompliance Area: DURING THE RENEWAL INSPECTION THE HEALTH REPORT FOR CHILD 2, CHILD 3, CHILD 4 AND CHILD 5 DID NOT INCLUDE A STATEMENT THAT THE CHIDL 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: DURING THE RENEWAL INSPECTION THE HEALTH REPORT FOR CHILD 5 (DOB 7/22/15) DID NOT PROVIDE WRITTEN VERIFICATION THAT THE CHILD RECEIVED THE 4 RECOMMENDED DOSES OF PNEUMOCOCCAL. THE CHILD WAS MISSING ONE DOSE.

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

Noncompliance Area: DURING THE RENEWAL INSPECTION THE TWO FIRE EXTINGUISHERS LOCATED IN THE KITCHEN AND BASEMENT WERE EXPIRED AND DATED FOR FEB 2018 AND MARCH 2018. THE REAR EMERGENCY EXIT THROUGH THE BASEMENT WAS OBSCURED BY A METAL GATE THAT WAS NOT IN GOOD REPAIR AND DID NOT HAVE AN OPENING.

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

Noncompliance Area: DURING THE RENEWAL INSPECTION THE OPERATOR DID NOT HAVE PARENT PARTICIPATION FILE DOCUMENTING ANNOUNCEMENTS TO PROMOTE PARENT PARTICIPATION.

Correction Required: A parent of a child in care shall be permitted free access, without prior notice, throughout the center whenever children are in care, unless a court of competent jurisdiction has limited the parental right of access to the child and a copy of the order is on file at the facility. Opportunity shall be provided for parents to participate in the facility's program. The operator shall maintain a yearly file which documents general announcements to promote parent participation. The file shall be updated annually.

Noncompliance Area: DURING THE RENEWAL INSPECTION THE POSTED CERTIFICATE OF COMPLIANCE EXPIRED ON 4/11/18.

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: DURING THE RENEWAL INSPECTION THE INSPECTION SUMMARY ISSUED BY THE DEPARTMENT WAS NOT POSTED.

Correction Required: The operator shall post a copy of each inspection summary issued by the Department next to the facility's certificate of registration in a conspicuous location used by parents. The inspection summary shall remain posted until an agent of the Department verifies that each noncompliance item noted on the inspection summary has been corrected.

Noncompliance Area: DURING THE RENEWAL INSPECTION THE FILE OF STAFF 1 AND STAFF 2 DID NOT INCLUDE WRITTEN VERIFICATION OF ANNUAL EMERGENCY PLAN TRAINING. THIS IS CONTINUED NON-COMPLIANCE.

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: DURING THE RENEWAL INSPECTION THE FILE OF STAFF 1 DID NOT INCLUDE PROOF OF A HIGH SCHOOL DIPLOMA OR A GENERAL EDUCATIONAL DEVELOPMENT CERTIFICATE. THIS IS CONTINUED NON-COMPLIANCE.

Correction Required: The operator shall have a high school diploma or a general educational development certificate and submit proof to the appropriate regional office of the Department at the time of registration renewal.

Noncompliance Area: DURING THE RENEWAL INSPECTION THE FILE OF STAFF 2 DID NOT INCLUDE DOCUMENTATION OF THE BIENNIAL MINIMUM OF 12 CLOCK HOURS OF TRAINING.

Correction Required: A staff person shall obtain an biennial minimum of 12 clock hours of child care training. A facility person's record shall include records of training required by the Department.

Noncompliance Area: DURING THE RENEWAL INSPECTION STAFF 3 HAD AN INCOMPLETE STATE POLICE CLEARANCE AND DID NOT HAVE A COPY OF THE RAP SHEET. STAFF 1, STAFF 2 AND STAFF3 DID NOT HAVE A DISCLOSURE FORM. THIS IS CONTINUED NON-COMPLIANCE.

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 3 may not be in the facility when children are in care until the required clearances are obtained and reviewed by DRA.

Noncompliance Area: DURING THE RENEWAL INSPECTION STAFF 2 WAS ALONE IN THE FACILITY WITH 3 CHILDREN. THE FILE OF STAFF 2 DOES NOT INCLUDE VERIFICATION OF TRAINING IN FIRST-AID TECHNIQUES OR PEDIATRIC CPR.

Correction Required: One or more persons competent in first-aid techniques shall be at the facility when day care children are in care. A facility person's record shall include records of training required by the Department.

Noncompliance Area: DURING THE RENEWAL INSPECTION THE BACKYARD AND OUTSIDE WALKWAY CONTAINED EXCESSIVE FOLIAGE AND DEBRIS. THE GATE WAS ALSO RUSTED WITH PEELING PAINT. THERE WAS ANIMAL FECES OUTSIDE OF THE DOOR AND THERE WERE HANGING CABLE WIRES THAT WERE BLOCKING THE OPENING OF THE DOOR.

Correction Required: Outside walkways shall be free from ice, snow, leaves, equipment and other hazards.

Noncompliance Area: DURING THE RENEWAL INSPECTION THERE WERE MULTIPLE ELECTRICAL OUTLETS THAT WERE ACCESSIBLE TO CHILDREN THAT DID NOT CONTAIN PROTECTIVE COVERS. THERE WAS ONE OUTLET IN THE BATHROOM. THERE WERE 3 OUTLETS LOCATED IN THE BASEMENT PLAY ROOM AREA NEAR THE FRONT OF THE FACILITY.

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

Noncompliance Area: DURING THE RENEWAL INSPECTION THERE WAS A RODENT GLUE TRAP BY THE REAR EXIT DOOR. THERE WAS SPRAY FOAM INSULATION AROUND THE REAR EXIT DOOR FRAME AND IN THE CABINET UNDER THE SINK.

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: DURING THE RENEWAL INSPECTION THE FOLLOWING ITEMS WERE OBSERVED: - THE CEILING BY THE REAR EMERGENCY EXIT CONTAINED A HOLE AND WAS DAMAGED AND IN DISREPAIR. THE LINOLEUM STABLED TO THE CEILING WAS DETACHED AND PEELING. THERE WERE EXPOSED WIRES BY THE EXIT DOOR. - THE CURTAIN IN THE BATHROOM WAS STAINED AND TORN. - THE DOOR TO THE STORAGE AREA UNDER THE STAIRS WAS HANGING DUE TO A BROKEN HINGE. THE WOODEN WALL PANEL NEAR THE BOTTOM OF THE STAIRS WAS CHIPPED AND BROKEN. THE CLOSET WHERE THE GAS FURNACE WAS STORED WAS NOT LOCKED AND WAS ACCESSIBLE TO CHILDREN. THERE WERE MULTIPLE CLOSET OR ROOM DOORS IN THE BASEMENT THAT WERE CHIPPED AND BROKEN. -IN THE BASEMENT PLAY ROOM AREA THERE WAS A SHUTTER DOOR WITH MISSING PIECES EXPOSING THE WATER METER AND WATER SHUT OFF VALVE. THERE WERE CABLE WIRES HANGING FROM THE CEILING OVER THE DOOR DOWN TO THE FLOOR. THERE WAS AN ELECTRICAL OUTLET WITH SPACE AROUND IT ALLOWING ROOM FOR A CHILD'S FINGER. THERE WAS A HOLE IN THE WALL NEAR THE OUTLET.

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

Noncompliance Area: DURING THE RENEWAL INSPECTION DAMAGED PAINT OR PLASTER WAS OBSERVED IN THE FOLLOWING AREAS: THERE WAS PEELING PAINT AROUND THE DOOR FRAME TO THE REAR EMERGENCY EXIT. THERE WAS DAMAGED PAINT ON THE WALLS IN THE BASEMENT PLAY ROOM AREA. THERE WAS DAMAGED PLASTER AROUND THE WINDOW.

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

Noncompliance Area: DURING THE RENEWAL INSPECTION THE EMERGENCY EXIT WAS OBSTRUCTED BY MISCELLANEOUS ITEMS STORED IN THE REAR ROOM. THE BACKYARD EXIT WAS OBSTRUCTED BY A FENCE THAT DID NOT HAVE AN OPENING. THIS IS CONTINUED NON-COMPLIANCE.

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 THE POSTED FIRE EVACUATION PLAN DID NOT ADDRESS REMOVAL OF ALL PERSONS FROM THE FACILITY IN A SINGLE TRIP.

Correction Required: Fire evacuation plans shall be developed and posted. Evacuation plans shall provide for removal of all persons from the facility in a single trip.

Noncompliance Area: DURING THE RENEWAL INSPECTION THERE WAS NO FIRE DRILL LOG. PROVIDER ACKNOWLEDGE THAT SHE WAS NOT CURRENT WITH FIRE DRILLS.

Correction Required: Fire evacuation drills shall be conducted at least four times a year.

Noncompliance Area: On 4/11/19, at approximately 2:30pm, a child was observed alone and unattended in a rear room in the basement child care space with no staff supervision. CONTINUING NON-COMPLIANCE

Correction Required: Children on the facility premises and on facility excursions off the premises shall be supervised by a staff person at all times. Outdoor play space used by the facility is considered part of the facility premises. The requirement for supervision on and off the facility premises includes compliance with the staff:child ratio requirements in 3290.51-3290.52 (relating to maximum number of children; and staff:child ratio). The legal entity must arrange for all facility staff persons to receive at least 2 hours of DHS approved training regarding supervision of children, including the requirement that staff persons must be physically present and be able to see, hear and assess and direct the activity of the children. Submit written verification of the completed training for all facility staff persons.

Noncompliance Area: Several children have been enrolled for more than 60 days and their records did not contain a current, up-to-date health report. (#1, #2, #3 and #4). CONTINUING NON-COMPLIANCE

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. Obtain and submit a current up-to-date health report for the indicated children. Ensure that all children's records include a current, up-to-date health report within 60 days of enrollment. Revise and submit written policies and procedures to ensure that children's health reports are completed and submitted as specified in this regulation.

Noncompliance Area: Two facility person's records did not contain a health assessment completed within the past 24 months. (#1 and #2) CONTINUING NON-COMPLIANCE

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 on file at the facility.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. Obtain and submit a current up-to-date health assessment for the identified staff persons. Ensure that health assessments are completed within the required timeframes.

Noncompliance Area: Two enrolled children lacked and individual record. (#4 and #5). CONTINUING NON-COMPLIANCE

Correction Required: An operator shall establish and maintain an individual record for each child enrolled in the facility. Obtain and submit a copy of the record for the identified children and ensure that all children have an individual record as specified in this regulation.

Noncompliance Area: Three children's records did not contain emergency contact information that had been updated within the past 6-months. (#1, #2 and #3) Emergency contact information in one child's record was not being updated every 6 months. (#3). CONTINUING NON-COMPLIANCE.

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. . Revise and submit written policies and procedures to ensure that children's emergency contact and financial agreement information is updated at least every 6 months or as soon as the information changes. Obtain and submit a written copy of the current up-to date emergency contact and financial agreement information for the identified children.

Noncompliance Area: Several children's records did not contain signed parental consent for emergency medical care and for administration of minor first-aid procedures by facility staff. (#4 and #5) CONTINUING NON-COMPLIANCE

Correction Required: A child's record must contain signed parental consent for emergency medical care for the child. Written consent is required prior to admission.A child's record must contain signed parental consent for administration of minor first-aid procedures by facility staff. Written consent is required prior to admission. Obtain and submit written verification of signed parental consents for the identified children as specified in the regulation. Ensure that all children's records contain the required parental consents prior to admission

Noncompliance Area: One facility person did not have an individual record that was presented at the time of the inspection. (#2) CONTINUING NON-COMPLIANCE

Correction Required: An individual record is required for each facility person. Obtain and submit a copy of the completed file for the identified facility person. Ensure that each facility person has a completed individual record.

Noncompliance Area: Two staff person's records did not include written verification of annual emergency plan training. (#1 and #2) CONTINUING NON-COMPLIANCE

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. Provide and submit written verification of the completed training for all identified facility persons.

Noncompliance Area: The operator did not submit written verification of a high school diploma or a general educational development certificate to the appropriate regional office of the Department at the time of registration renewal. (#1) CONTINUING NON-COMPLIANCE

Correction Required: The operator shall have a high school diploma or a general educational development certificate and submit proof to the appropriate regional office of the Department at the time of registration renewal. Obtain and submit written verification of a high school diploma or a general educational development certificate.

Noncompliance Area: The facility was not in compliance with the CPSL and with Chapter 3490 (relating to protective services): Several facility person's records did not contain the required CPSL hiring documents. (#1-lacked completed STATE POLICE-invoice only) (#3-household member- lacked completed STATE POLICE-invoice only, lacked completed CHILD ABUSE). CONTINUING NON-COMPLIANCE

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). LACKING REQUIRED HIRING DOCUMENTS: 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 until the required clearances have been completed and submitted. Household member #3 cannot be in the facility when children are in care until the required clearances have been completed and submitted. Obtain and submit a copy of the completed CPSL clearances as specified for the identified staff and household members.

Noncompliance Area: On 4/11/2019, at approximately 2:30pm, a group of 10 older toddler/preschool/ school age children were observed being cared for in the basement child care space and the number of children in care may not exceed six children at any one time who are unrelated to the operator. CONTINUING NON-COMPLIANCE

Correction Required: The number of children in care may not exceed six children at any one time who are unrelated to the operator. Develop and submit a written plan to ensure compliance with the maximum number of children as specified in these regulations.

Noncompliance Area: The basement rear exit was obstructed by toys, a fan and other items. CONTINUING NON-COMPLIANCE

Correction Required: Stairways, hallways, exits from rooms, exits from the facility and other means of egress serving as an exit shall be unobstructed. Remove the items and ensure that all stairways, hallways, exits from rooms, exits from the facility and other means of egress serving as an exit remain unobstructed. Notify staff of this requirement and submit written verification of staff notification.

Noncompliance Area: On 4/11/19, at approximately 2:30pm, a child was observed alone and unattended in a rear room in the basement child care space with no staff supervision.

Correction Required: Children on the facility premises and on facility excursions off the premises shall be supervised by a staff person at all times. Outdoor play space used by the facility is considered part of the facility premises. The requirement for supervision on and off the facility premises includes compliance with the staff:child ratio requirements in 3290.51-3290.52 (relating to maximum number of children; and staff:child ratio). Ensure that children are insured at all times.

Noncompliance Area: The facility lacked a written plan identifying the means of transporting a child to emergency care and staffing provisions in the event of an emergency in accordance with this regulation.

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. Develop a written plan identifying the means of transporting a child to emergency care and staffing provisions in the event of an emergency. Post the plan in each child care space and ensure that it accompanies staff persons who leave on excursions with children.

Noncompliance Area: Several children have been enrolled for more than 60 days and their records did not contain a current, up-to-date health report. (#1, #2, #3 and #4). Documentation reviewed on 7/5/19 did not include a current, up-to-date health report for the indicated children and written policies and procedures to ensure that children's health reports are completed and submitted as specified in this regulation.

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. Obtain and submit a current up-to-date health report for the indicated children. Ensure that all children's records include a current, up-to-date health report within 60 days of enrollment. Revise and submit written policies and procedures to ensure that children's health reports are completed and submitted as specified in this regulation.

Noncompliance Area: Two facility person's records did not contain a health assessment completed within the past 24 months. (#1 and #2) Documentation reviewed on 7/5/19 did not include a current up-to-date health assessment for the identified staff persons.

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 on file at the facility.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. Obtain and submit a current up-to-date health assessment for the identified staff persons. Ensure that health assessments are completed within the required timeframes.

Noncompliance Area: Two enrolled children lacked and individual record. (#4 and #5). Documentation reviewed on 7/5/19 did not include a copy of the record for the identified children.

Correction Required: An operator shall establish and maintain an individual record for each child enrolled in the facility. Obtain and submit a copy of the record for the identified children and ensure that all children have an individual record as specified in this regulation.

Noncompliance Area: Three children's records did not contain emergency contact information that had been updated within the past 6-months. (#1, #2 and #3) Emergency contact information in one child's record was not being updated every 6 months. (#3). Documentation reviewed on 7/5/19 did not include a written copy of the current up-to date emergency contact and financial agreement information for the identified children and written policies and procedures to ensure that children's emergency contact and financial agreement information is updated at least every 6 months or as soon as the information changes.

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. Revise and submit written policies and procedures to ensure that children's emergency contact and financial agreement information is updated at least every 6 months or as soon as the information changes. Obtain and submit a written copy of the current up-to date emergency contact and financial agreement information for the identified children.

Noncompliance Area: Several children's records did not contain signed parental consent for emergency medical care and for administration of minor first-aid procedures by facility staff. (#4 and #5) Documentation reviewed on 7/5/19 did not include written verification of signed parental consents for the identified children.

Correction Required: A child's record must contain signed parental consent for emergency medical care for the child. Written consent is required prior to admission.A child's record must contain signed parental consent for administration of minor first-aid procedures by facility staff. Written consent is required prior to admission.Obtain and submit written verification of signed parental consents for the identified children as specified in the regulation. Ensure that all children's records contain the required parental consents prior to admission

Noncompliance Area: One facility person did not have an individual record that was presented at the time of the inspection. (#2) Documentation reviewed on 7/5/19 did not include a copy of the completed file for the identified facility person.

Correction Required: An individual record is required for each facility person. Obtain and submit a copy of the completed file for the identified facility person. Ensure that each facility person has a completed individual record.

Noncompliance Area: Two staff person's records did not include written verification of annual emergency plan training. (#1 and #2). Documentation reviewed on 7/5/19 did not include written verification of 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. Provide and submit written verification of the completed training for all identified facility persons.

Noncompliance Area: The operator did not submit written verification of a high school diploma or a general educational development certificate to the appropriate regional office of the Department at the time of registration renewal. (#1) Documentation reviewed on 7/5/19 did not include written verification of a high school diploma or a general educational development certificate.

Correction Required: The operator shall have a high school diploma or a general educational development certificate and submit proof to the appropriate regional office of the Department at the time of registration renewal. Obtain and submit written verification of a high school diploma or a general educational development certificate.

Noncompliance Area: The facility was not in compliance with the CPSL and with Chapter 3490 (relating to protective services): Several facility person's records did not contain the required CPSL hiring documents. (#1-lacked completed STATE POLICE-invoice only)(#2-lacked completed STATE POLICE, FBI and CHILD ABUSE and mandated reporter training)(#3-household member- lacked completed STATE POLICE-invoice only, lacked completed CHILD ABUSE). Documentation submitted on 4/23/19 did not include completed CPSL documents for facility persons #1 and #2.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). LACKING REQUIRED HIRING DOCUMENTS: 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 and #2 may not work in a child care position at the facility until the required clearances have been completed and submitted. Household member #3 cannot be in the facility when children are in care until the required clearances have been completed and submitted. Obtain and submit a copy of the completed CPSL clearances as specified for the identified staff and household members.

Noncompliance Area: On 4/11/2019, at approximately 2:30pm, a group of 10 older toddler/preschool/ school age children were observed being cared for in the basement child care space and the number of children in care may not exceed six children at any one time who are unrelated to the operator.

Correction Required: The number of children in care may not exceed six children at any one time who are unrelated to the operator. Reduce the number of unrelated children in care to no more than six children. Ensure that the number of children in care does not exceed six children at any one time who are unrelated to the operator in accordance with 55 PA Code 3290 regulations.

Noncompliance Area: The basement rear exit was obstructed by toys, a fan and other items. Documentation reviewed on 7/5/19 did not include written verification of staff notification.

Correction Required: Stairways, hallways, exits from rooms, exits from the facility and other means of egress serving as an exit shall be unobstructed. Remove the items and ensure that all stairways, hallways, exits from rooms, exits from the facility and other means of egress serving as an exit remain unobstructed. Notify staff of this requirement and submit written verification of staff notification.

Noncompliance Area: At the time of inspection, rest equipment observed at nap time was not labeled for the use of a specific child and used only by the specified 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: At the time of inspection, child service reports dated within the last 6 months were missing for the following children #1, #2 and #3.

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: At the time of inspection, the emergency contact forms for child #1 and #2 were missing release persons addresses.

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.

Noncompliance Area: At the time of inspection, the file for child #1 and #2 did not include completed health history reports. The documents observed in both files were shot records only.

Correction Required: A health report shall include a review of the child's health history.A child's record must contain initial and subsequent health reports.

Noncompliance Area: At the time of inspection, the file for staff member #1 was missing initial and subsequent health assessment. The staff member did not have a current health assessment dated less than 24 months old.

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.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: At the time of inspection, the operator had not documented in writing the annual review of the facility's emergency plan.

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.

Noncompliance Area: At the time of inspection, the operator did not have a letter to provide to parents of enrolled children explaining the emergency procedure for the facility.

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: At the time of inspection, no one on staff had verification of completion of training by a professional in the field of first-aid.

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.

Noncompliance Area: At the time of inspection, a water stained ceiling tile was observed in the child care area.

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

Noncompliance Area: At the time of inspection, the operator did not have documentation of fire drills conducted at least four time a year.

Correction Required: Fire evacuation drills shall be conducted at least four times a year.

Noncompliance Area: CERTIFICATION REPRESENTATIVE OBSERVED REFRIGERATORS IN THE BASEMENT AND MAIN KITCHEN WERE MISSING AN 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: FILE RECORD FOR CHILD #2 WAS MISSING THE BIRTHDATE ON THE EMERGENCY CONTACT FORM

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

Noncompliance Area: FILE RECORD FOR CHILD #4 DID NOT INCLUDE HEALTH INSURANCE POLICY NUMBER OR MEDICAL ASSISTANCE BENEFITS

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: FILE RECORDS FOR CHILD #2,#3,AND #4 WERE MISSING RELEASE PERSON NAME ADDRESS AND TELEPHONE NUMBER

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.

Noncompliance Area: FILE RECORD WAS MISSING AN UPDATE OF EMERGENCY CONTACT INFORMATION ONCE IN A SIX MONTH PERIOD FOR CHILD #1, CHILD #2, CHILD#3, AND CHILD #4

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: FILE RECORD REVIEW FOR STAFF #1 DID NOT INCLUDE AN INITIAL OR SUBSEQUENT 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: FILE RECORD FOR STAFF #1 WAS MISSING STATE POLICE CLEARANCE AND MANDATED REPORTER TRAINING

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

Noncompliance Area: FACILITY WAS MISSING A DEVELOPED AND POSTED EMERGENCY PLAN

Correction Required: The facility shall have an emergency plan.The operator shall post the emergency plan in the facility at a conspicuous location.

Noncompliance Area: IN REVIEW OF FILE RECORD OF STAFF PERSON #1 IT DID NOT INCLUDE 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.

Noncompliance Area: THE FILE RECORD FOR STAFF #1 DID NOT INCLUDE CURRENT TRAINING IN FIRST AID TECHNIQUES;LAST COMPLETED ON 8/2/14 AND VALID UNTIL 8/2/16

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

Noncompliance Area: CERTIFICATION REPRESENTATIVE OBSERVED PROTECTIVE OUTLET COVERS MISSING IN THE FACILITY

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

Noncompliance Area: CERTIFICATION REPRESENTATIVE OBSERVED THAT EMERGENCY PHONE NUMBERS WERE MISSING FROM THE FACILITY

Correction Required: The telephone number of the nearest hospital, police department, fire department, ambulance and poison control center shall be posted by each telephone in the facility.

Noncompliance Area: CERTIFICATION REPRESENTATIVE OBSERVED FIRE EVACUATUION PALNS WERE MISSING FROM THE FACILITY

Correction Required: Fire evacuation plans shall be developed and posted.