Debby Gonzalez Family Child Care Home

Regulation: 3290.123(a)(3)

Description: Services provided

Noncompliance Area: Certification rep reviewed children #1 and #2 record and observed record did not contain a Child Service Report for the children.

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).

Regulation: 3290.124(b)(6)

Description: Insurance coverage information

Noncompliance Area: Certification rep reviewed child #1 record and observed emergency contact information 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: 3290.182(1)

Description: Initial and subsequent health assessments

Noncompliance Area: During the renewal inspection certification rep reviewed child#1 and #2 record and observed Physical Examination in record is expired. Child #1 physical examination in record; 1/26/23 and child #2 physical examination in record: 1/7/23.

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

Regulation: 3290.24(c)

Description: Training regarding plan

Noncompliance Area: During the renewal inspection certification rep reviewed staff #1 record and observed training regarding the emergency plan at the time of initial employment, on an annual basis and at the time of each plan update is not in record.

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)(4)(i)/3290.31(g)(10)

Description: Age and training/Health and Safety Training - Pediatric first aid/CPR

Noncompliance Area: During the renewal inspection certification rep observed current certificate of completion for Adult, Child, First Aid and CPR in record is not from a PQUAS certified trainer.

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. Pediatric first aid and pediatric cardiopulmonary resuscitation.

Regulation: 3290.32(a)/3290.192(3)

Description: Comply with CPSL/CPSL information

Noncompliance Area: During the renewal inspection certification rep reviewed staff #1 record and observed State Police Criminal Clearance in record is expired: date of expiration 6/13/19.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). SAFETY PLAN: The operator is required to submit to the Children and Youth Agency a plan of supervision or alternate arrangement as required by the Child Protective Services Law. LACKING REQUIRED HIRING DOCUMENTS: Facility Person # -- may not work in a child care position at the facility. PROVISIONAL HIRE UNSUPERVISED: A provisional employee may not be permitted to work alone with children and must work within the vicinity of a permanent employee. 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.

Regulation: 3290.95(b)

Description: Operator or designated staff responsibility

Noncompliance Area: During the renewal inspection certification rep reviewed fire drill log and observed operator did not have in record documented fire alarm testing conducted every 30 days.

Correction Required: The operator or designated staff person who is responsible for compliance with this chapter shall ensure the requirements in § 3290.95(a) are met.

Regulation: 3290.117(a)

Description: Pet in good health/friendly

Noncompliance Area: During the renewal inspection, certification rep observed two dogs on the second level of the home and one cat on the changing table area of the childcare space.

Correction Required: A pet or animal present at the facility, indoors or outdoors, shall be in good health and known to be friendly to children.

Regulation: 3290.18/3290.31(f)

Description: General Health and Safety/Age and training

Noncompliance Area: During the renewal inspection certification rep reviewed staff #1 file and observed certificate of completion of the 10-hour Health and Safety and one hour of the Health and Safety Training update was not in record. At the time of renewal Staff #1 did not contain 12 hours of clock hours of childcare training on file.

Correction Required: Conditions at the facility may not pose a threat to the health or safety of the children. A staff person shall obtain an annual minimum of 12 clock hours of child care training.

Regulation: 3290.115(a)(2)

Description: Above-ground pool inaccessible

Noncompliance Area: At the time of renewal inspection a barrier that will make an aboveground swimming pool inaccessible to children according to the swimming pool barrier guidelines of the United States Consumer Product Safety Commission was not observed.

Correction Required: An aboveground swimming pool which is not in use must be made inaccessible to children in accordance with the swimming pool barrier guidelines of the United States Consumer Product Safety Commission.

Regulation: 3290.124(b)(6)/3290.124(b)(7)

Description: Insurance coverage information/Name/address/phone release person

Noncompliance Area: At the time of renewal inspection, emergency contact form of child #1 did not include health insurance policy number for a child under a family policy or Medical Assistance benefits, if applicable. Emergency contact form of child #4 did not include release person's address.

Correction Required: Emergency contact information must include health insurance coverage and policy number for a child under a family policy or Medical Assistance benefits, if applicable. Emergency contact information must include the name, address and telephone number of the individual designated by the parent to whom the child may be released.

Regulation: 3290.124(e)/3290.181(c)

Description: Updated every 6 months/Emergency info/agreement updated 6 mos

Noncompliance Area: At the time of renewal inspection, emergency contact form of child #4 was not updated every 6 months in writing. Last update was on 1/27/22.

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. 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: 3290.131(a)

Description: Within 60 days

Noncompliance Area: At the time of renewal inspection, an initial health report of child #4 was not on file. Child #4 is was enrolled more than 60 days ago.

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: 3290.131(d)(5)/3290.131(e)(2)(i)

Description: Immunization record/Religious belief/strong personal objection

Noncompliance Area: At the time of renewal inspection, immunization record of child #3 did not include influenza immunization recommended by ACIP. Immunization record of child #4 did not include influenza, MMR, Varicella and Hepatitis A immunization recommended by ACIP. A letter of exemption was not observed in the file of child #3 and #4.

Correction Required: A health report shall include a review of the child's immunized status according to recommendations of the ACIP.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.

Regulation: 3290.166(1)

Description: Written statement

Noncompliance Area: At the time of inspection, a written statement giving the formula and feeding schedule for a child #1 was not obtained from the parent.

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

Regulation: 3290.18

Description: General Health and Safety

Noncompliance Area: At the time of renewal inspection, a policy and procedure to identify the prevention of shaken baby syndrome, abusive head trauma and child maltreatment was not observed. In addition, the emergency plan did not contain a statement regarding continuity of operations in the event of an emergency.

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

Regulation: 3290.182(3)/3290.182(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, emergency contact form of child #2 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 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.

Regulation: 3290.24(g)

Description: Emergency plan

Noncompliance Area: At the time of renewal inspection observed that the operator did not send a copy of the emergency plan 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)/3290.192(4)

Description: Age and training/Required training

Noncompliance Area: At the time of renewal inspection, record of staff person #1 did not include 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. A facility person's record shall include records of training required by the Department.

Regulation: 3290.32(a)/3290.192(3)

Description: Comply with CPSL/CPSL information

Noncompliance Area: At the time of renewal inspection, file of staff person #1 included PA child abuse registry clearance from 7/26/17 and mandated reporter training from 7/26/17 that were not renewed every 60 months. File of staff person #1 included Disclosure statement that was not signed by a witness.

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 1 must be removed from child care position by close of business.

Regulation: 3290.94(a)(4)

Description: Hypothetical locations

Noncompliance Area: At the time of renewal inspection observed that hypothetical locations of the fire are not rotated around the facility for each drill.

Correction Required: The operator or designated staff person who is responsible for compliance with this chapter shall conduct fire drills and ensure that the hypothetical locations of the fire are rotated around the facility for each drill such that the hypothetical location is never the same for consecutive drills.

Regulation: 3290.95(b)

Description: Operator or designated staff responsibility

Noncompliance Area: At the time of renewal inspection, a written record of testing fire detection devices at least every thity days were not observed with the facility's fire drill log.

Correction Required: The operator or designated staff person who is responsible for compliance with this chapter shall ensure the requirements in § 3290.95(a) are met.

Regulation: 3290.11(h)(2)/3290.11(h)(2)(i)

Description: Clearances for renewal application/Clearances for individuals residing in home

Noncompliance Area: At the time of renewal inspection, file of household member #1, who attained 18 years of age following the date of the previous application for a certificate of compliance, did not include disclosure statement, Pennsylvania Child Abuse History clearance, National Sex Offender Registry Verification Certificate and FBI clearance required by DHS. Non-compliance continues on 9/14/21.

Correction Required: At renewal, the legal entity shall submit clearances for each individual 18 years of age or older who resides in the child care facility at least 30 days in a calendar year if any of the following apply: The individual attained 18 years of age following the date of the previous application for a certificate of compliance.

Noncompliance Area: During renewal inspection on 9/15/20, file of staff person #1 did not include National Sex Offender Registry Verification Certificate.

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.

Noncompliance Area: During allocated unannounced inspection on 12/9/19 observed a pillow present in the pack 'n play while an infant was sleeping in the pack 'n play.

Correction Required: Toys, bumper pads, or pillows may not be present in a crib while an infant is sleeping in the crib.

Noncompliance Area: During unannounced monitoring inspection on 7/23/19 observed infant sleeping in a portable bassinet/napper located on a 2-shelf bookcase. Provider removed bassinet/napper from the bookcase and attached to the top of the Pack 'n Play were another toddler child was sleeping. After that, provider proceeded to hold a sleeping 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.Infants shall be placed in the sleeping position recommended by the American Academy of Pediatrics unless there is a medical reason an infant should not sleep in this position. The medical reason shall be documented in a statement signed by a physician, physician's assistant or CRNP and placed in the child's record at the facility.

Noncompliance Area: During renewal inspection on 6/20/19, an operating thermometer was not present in the refrigerator.

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 renewal inspection on 6/20/19, files with a veterinarians certificated of current rabies immunization for one dog and 2 cats were not present.

Correction Required: A veterinarian's certificate of current rabies immunization is required for a cat or dog at the facility. The certificate shall be on file when the cat or dog is present.

Noncompliance Area: During renewal inspection on 6/20/19, emergency contact form of child #2 and #3 didn't include health insurance policy number.

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

Noncompliance Area: During renewal inspection on 6/20/19, emergency contact form of child #1, #2, #3 and #4 didn't 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.

Noncompliance Area: During renewal inspection on 6/20/19, emergency contact form of child #1 was last not updated at least every 6 months. Last update was on 9/28/18.

Correction Required: The parent shall update in writing emergency contact information once in a 6-month period or as soon as there is a change in the informationA parent is required to review and update the emergency contact information and the financial agreement at least once in a 6-month period or as soon as there is a change in the information.

Noncompliance Area: During renewal inspection on 6/20/19, the trash can near changing table that was used for dirty diapers was not hands-free. Provider used hands to close the lid.

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: During renewal inspection on 6/20/19, emergency contact form of child #3 didn't include signed parental consent for emergency medical care for the child and for administration of minor first-aid procedures by facility staff health insurance policy number. Both consents are required prior to admission.

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.

Noncompliance Area: During renewal inspection on 6/20/19, peeling paint was observed along the edges of diaper changing table.

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

Noncompliance Area: At the time of the renewal inspection, the file of child #1, who is an infant, had a health assessment dated more than 6 months.

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

Noncompliance Area: At the time of the renewal inspection, it was observed that the trash can next to the changing table was not a hands-free covered can.

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: At the time of the renewal inspection, the emergency plan was not reviewed and documented at least annually.

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 the renewal inspection, the water temperature in the sink in the bathroom downstairs where children wash their hands measured 125 degrees F.

Correction Required: Hot water pipes and other sources of heat exceeding 110 F that are accessible to children shall be equipped with protective guards or shall be insulated to prevent direct contact.

Noncompliance Area: Observed that the provider did not have a written plan of daily activities and routines posted.

Correction Required: A written plan of daily activities and routines, including a time for free play shall be established for each group. The plan shall be flexible to accommodate the needs of individual children and the dynamics of the group.

Noncompliance Area: Observed provider leave child care space leaving children unsupervised.

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). followed at all times e.g., a checklist.

Noncompliance Area: Provider stated she took children in care swimming in the pool in her backyard without a certified lifeguard.

Correction Required: When children are swimming, supervision shall include one person certified in lifeguard training, as described in 3290.31(e)(4)(iii) (relating to age and training).

Noncompliance Area: Provider did not have files for two dogs and cat that she has as pets.

Correction Required: A veterinarian`s certificate of current rabies immunization is required for a cat or dog at the facility. The certificate shall be on file when the cat or dog is present.

Noncompliance Area: Child #2's record does not contain a fee agreement.

Correction Required: At the time of enrollment, a parent shall receive in writing the facility`s general daily schedule, hours for which care is provided, fees, responsibilities for meals, clothing, health policies, supervision policies, night care policies, dismissal policies, transportation and pick-up arrangements.

Noncompliance Area: Child #1's agreement does not specify the date on which the fee is to be paid.

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

Noncompliance Area: Child #1, #2, #3, #4, #5 and #6's records do not contain 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: Child #1, #2, #3, #4, #5 and #6's agreements did not specify the persons designated by a parent to whom the child may be released.

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

Noncompliance Area: Child #1, #2, #3, #4, #5 and #6's agreements did not specify the date of the child's admission.

Correction Required: An agreement shall specify the date of the child`s admission.

Noncompliance Area: Child #1, #2, #3, #4, #5 and #6's agreements did not specify the services which are to be considered as extra.

Correction Required: An agreement shall specify the services which are to be considered as extra.

Noncompliance Area: Child #6 does not have emergency contact information on file.

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

Noncompliance Area: Child #4's emergency contact information did not include name, address and telephone number of the child`s physician or source of medical care.

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

Noncompliance Area: Child #1, #2 and #4's emergency contact information did not include the 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.

Noncompliance Area: Child #4's emergency contact information did not include the written consent signed by a parent for emergency medical care.

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

Noncompliance Area: Child #4's emergency contact information did not include information on the child`s special needs.

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 of CRNP, which is needed in an emergency situation.

Noncompliance Area: Child #2 and #3's emergency contact information did not include the policy number.

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

Noncompliance Area: Child #2 and #4's emergency contact information 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.

Noncompliance Area: Provider did not have a medication log established.

Correction Required: An operator is responsible to establish and maintain a medication log if prescription or nonprescription medication is administered.

Noncompliance Area: Observed Staff person #1 did not wash Child #2's hands after being diapered.

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

Noncompliance Area: Child #2, #5 and #6's emergency contact form was not reviewed in a 6-month period. Child #2's financial agreement was not reviewed in a 6-month period.

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: Child #2's file does not contain a current health report.

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

Noncompliance Area: Child #1, #2, #3, #4, #5 and #6's record did not contain dates of admission.

Correction Required: A child`s record must contain the dates of application, admission and withdrawal of the child.

Noncompliance Area: Child #4 and #6's record did not contain consent for emergency medical care.

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.

Noncompliance Area: Child #1, #4 and #6's record did not contain signed parental consent for administration of medications or special dietary needs.

Correction Required: A child`s record must contain signed parental consent for administration of medications or special dietary needs.

Noncompliance Area: Child #4 and #6's record did not contain signed parental consent for administration of minor first-aid procedures by facility staff.

Correction Required: 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.

Noncompliance Area: Child #4 and #6's record did not contain signed parental consent for transportation, walking excursions, swimming and wading.

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

Noncompliance Area: Staff person #1's file did not include name, address and telephone number.

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

Noncompliance Area: Staff person #1 did not have initial and subsequent health assessments on file.

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: Staff person #1's record did not include trainings required by the Department.

Correction Required: A facility person`s record shall include records of training required by the Department.

Noncompliance Area: Provider does not have 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

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: Observed that the provider did not have an emergency plan in place for shelter in place and shelter at locations away from facility.

Correction Required: The facility shall have an emergency plan that provides for shelter of children during an emergency including shelter in place at the facility and shelter at locations away from the facility premises..

Noncompliance Area: Observed that the provider did not have evacuation routes posted.

Correction Required: The facility shall have an emergency plan that provides 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 (f) and (g) (relating to fire drills).

Noncompliance Area: Staff person #1 did not have education verification on file.

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: Staff person #1's state police and child abuse clearances are expired.

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

Noncompliance Area: Staff person #1 does not have current first-aid training on file.

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: Observed the provider did not have the telephone number of the nearest hospital, police department, fire department, ambulance and poison control center posted by the facility telephone.

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: First-aid kit did not include gauze and 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: Observed that the first-aid kit was not taken outside when children were taken outside to play.

Correction Required: 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).

Noncompliance Area: Provider did not have a fire drill log showing fire evacuation drills conducted.

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