Donna M Hartman

Regulation: 3290.123(a)(3)

Description: Services provided

Noncompliance Area: During the inspection, the Child Service Reports on file for Child #1, #2, #3, #4, and #5 had not been updated at least once in a 6-month period in accordance with the updates regarding emergency contact information.

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: 3290.24(b)

Description: Emergency plan

Noncompliance Area: During the inspection, the emergency plan was last updated 1/24/25.

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

Regulation: 3290.64(a)

Description: Locked or inaccessible - in original container

Noncompliance Area: During the inspection, window cleaner, air freshener spray and other toxic materials were accessible to children in an unlocked cabinet under the bathroom 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.

Regulation: 3290.94(a)(1)

Description: Every 60 days

Noncompliance Area: During the inspection, fire drills were not consistently being conducted at least once every 60 days.

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

Regulation: 3290.95(b)

Description: Operator or designated staff responsibility

Noncompliance Area: During the inspection, fire alarm testing was not consistently being conducted at least once every 30 days.

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

Regulation: 3290.105(f)

Description: 2 feet apart

Noncompliance Area: During the inspection, cots for 10 children were observed on the lower level with none of the cots having at least 2 feet of space on three sides.

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.

Regulation: 3290.21(a)

Description: Immediate access

Noncompliance Area: During the inspection, upon arrival the operator asked the Certification Representative and Certification Supervisor to wait outside for six minutes thereby not providing immediate access to the facility.

Correction Required: A staff person shall provide to agents of the Department immediate access to the facility, the children and the files and records.

Regulation: 3290.113(a)

Description: Supervised at all times

Noncompliance Area: During the inspection, Staff #1 left Child #1 alone and unsupervised in the bathroom in order to attend to a child who was crying in another room.

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). TIERED IS: 1. Children must be supervised at all times. 2. The legal entity must arrange for all facility staff to receive a minimum of two hours of training regarding supervision of children. The legal entity must receive DHS approval of the training content prior to scheduling the training.

Regulation: 3290.52(2)

Description: One infant, four toddlers

Noncompliance Area: During the inspection, Staff #1 was alone providing childcare for 19 children, including one infant, 8 toddlers and 10 preschoolers. Twelve were unrelated and 7 were related.

Correction Required: TIERED IS: 1. The operator may provide care to no more than five related and unrelated infants and toddlers at any one time. No more than two related and unrelated infants may receive care at any one time. If one infant is in care, four toddlers are permitted. 2. The legal entity must submit documentation in a format approved by DHS proving that the facility is maintaining the required staff:child ratios at all times. The legal entity will confirm continuing compliance by sending copies of the documentation to the Central Region Office on a weekly basis for a period of three months after DHS approves the documentation format.

Regulation: 3290.51

Description: Maximum Number of Children

Noncompliance Area: During the investigation, Staff #1 was alone providing childcare for 19 children, including one infant, 8 toddlers and 10 preschoolers. Twelve children were unrelated and seven were related.

Correction Required: The number of children in care may not exceed six children at any one time who are unrelated to either the legal entity or the staff person. At any one time, the related children of either the legal entity or the staff person, but not both, may be excluded in determining compliance with this section.

Regulation: 3290.131(d)(5)

Description: Immunization record

Noncompliance Area: During the inspection, an immunization for Child #1 was not up to date per the recommendations of the ACIP.

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

Regulation: 3290.151(a)(2)

Description: 12 months prior to service and every 24 months thereafter

Noncompliance Area: During the inspection, the most recent health assessment for Staff #1, dated 11/29/23, was no longer valid and there was not an updated health assessment on file.

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.

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

Description: Age and training

Noncompliance Area: During the inspection, the file for Staff #1 contained first aid and CRP training that was not pediatric, was not provided by a PQAS certified instructor and was not in an approved curriculum.

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. Staff #1 will have until 2/18/26 to complete the required training. Staff #1 must receive pediatric first aid/CPR in an approved curriculum by a PQAS-certified trainer. Until such time as the correction is implemented, Staff #1 must be supervised. when interacting with children by a family childcare home staff person who has completed the required training related to the citation. If there are no staff available to supervise Staff #1, Staff #1 may not work in a child-care position at the facility.

Regulation: 3290.32(a)

Description: Comply with CPSL

Noncompliance Area: During the inspection, the mandated reporter training for Staff #1 was dated 9/18/20 and had not been updated within 60 months as required under the CPSL.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). Staff #1 may not work in a childcare position at the facility.

Regulation: 3290.123(a)(3)

Description: Services provided

Noncompliance Area: During the renewal inspection, the file for Child #1, #2, #3, #4 and #5 did not contain an updated form within 6 months to provide information to the family about the child's growth and development. The last form on file for Child #1, #2, #3, #4 and #5 was dated 5/28/24.

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(e)/3290.181(c)

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

Noncompliance Area: During the renewal inspection, the emergency contact and financial agreement was not updated at least once in a 6-month period for Child #1, #2, #3, #4 and #5. The last updates were 11/28/23, 12/1/23, 11/4/23, 5/29/24 & 12/5/23 and 2/7/23 & 12/1/23 respectively.

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)/3290.182(1)

Description: Within 60 days/Initial and subsequent health assessments

Noncompliance Area: During the renewal inspection, the file for Child #5 did not contain an initial or subsequent health report.

Correction Required: The operator shall require the parent of an enrolled child to provide an initial health report no later than 60 days following the first day of attendance at the facility. A child's record must contain initial and subsequent health reports.

Regulation: 3290.18

Description: General Health and Safety

Noncompliance Area: During the renewal inspection, the emergency plan did not include continuity of operations.

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

Regulation: 3290.131(e)(2)(i)

Description: Religious belief/strong personal objection

Noncompliance Area: During the renewal inspection, the immunization record did not include the influenza vaccine for Child #1, Child #2, Child #3 and Child #4. The file for Child #1, Child #2, Child #3 and Child #4 did not include a statement of exemption from immunization written, signed and dated from the child's parent or guardian.

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.

Regulation: 3290.24(b)

Description: Emergency plan

Noncompliance Area: During the renewal inspection, the emergency plan had not been updated annually. The last documented update was 11/10/21.

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

Regulation: 3290.123(a)(3)

Description: Services provided

Noncompliance Area: During the renewal inspection, the file for Child #1, #2, #3 and #4 did not contain any Department approved forms to provide information to the family about the child's growth and development.

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)(4)/3290.182(3)

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

Noncompliance Area: During the renewal inspection, the file for Child #1 and Child #2 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 must contain signed parental consent for emergency medical care for the child. Written consent is required prior to admission.

Regulation: 3290.182(5)

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

Noncompliance Area: During the renewal inspection, the file for Child #1 and Child #2 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.

Regulation: 3290.131(e)/3290.131(e)(2)(i)

Description: Immunization record/Religious belief/strong personal objection

Noncompliance Area: During the renewal inspection, the immunization record did not include the influenza vaccine for Child #1. The file for Child #1did not include a statement of exemption from immunization written, signed and dated from the child's parent or guardian.

Correction Required: The facility may not accept or retain an infant 2 months of age or older, a toddler or a preschool child at the facility for more than 60 days following the first day of attendance at the facility unless the parent provides written verification from a physician, physician's assistant, CRNP, the Department of Health or a local health department of the dates (month, day and year) the child was administered immunizations in accordance with the 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.