Early Connections-john E Horan Garden Apt Ccc

Noncompliance Area: The current child service report on file for child #2 was completed more than 6 months after the prior child service report on file.

Correction Required: 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 in 3270.124(f) (relating to emergency contact information).

Noncompliance Area: The emergency contact form on file for child #3 did not include the health insurance information.

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: The initial health assessment on file for child #1 was completed more than 60 days after the child's first day of attendance at the facility.

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: The current health assessment on file for child #2, a preschooler, was completed more than 12 months after the prior health assessment on file for the child. Health assessments were dated 2/28/18 and 10/17/19.

Correction Required: The operator shall require the parent to provide an updated health report at least every 12 months for an older toddler or preschool child.

Noncompliance Area: The health assessment/ TB test on file for Facility Person #5, a volunteer, were completed more than 12 months prior to her start date.

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.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.

Noncompliance Area: The health assessment on file for Facility Person #5, a volunteer, did not include an examination for communicable diseases and the results of that examination.

Correction Required: An adult health assessment must include an examination for communicable diseases and the results of that examination.

Noncompliance Area: There were no written nonfamily references on file for Facility Person #5, a volunteer.

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. We will obtain two written nonfamily references for Facility Person #5.

Noncompliance Area: There was no documentation of initial emergency plan training on file for Facility Persons # 1, # 3, #4 and #5.

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.

Noncompliance Area: The child abuse clearance on file for Facility Person #4 was completed after her start date in a child care position. There was no proof of application for a child abuse clearance on file for Facility Person #4.

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: The current staff evaluation on file for Facility Person #2 was completed more than 12 months after the prior 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.

Noncompliance Area: There was no documentation of child care experience on file for Facility Person #1, classified as and serving as the facility's director. Only documentation of the required education was present in the file.

Correction Required: A director shall have attained a bachelor's degree from an accredited college or university in early childhood education, child development, special education, elementary education or the human services field and 1 year of experience with children.A facility person's record shall include verification of child care experience, education and training prior to service at the facility.

Noncompliance Area: There was no documentation of child care experience on file for Facility Person #3, classified as a group supervisor. The only qualification documented and on file for Facility Person #3 was an associate's degree in early childhood education.

Correction Required: A group supervisor shall have an associate's degree from an accredited college or university in early childhood education, child development, special education, elementary education or the human services field and 2 years of experience with children.A facility person's record shall include verification of child care experience, education and training prior to service at the facility.

Noncompliance Area: There was no documentation of child care experience on file for Facility Person #4, classified as an assistant group supervisor. The only qualification documented and on file for Facility Person #4 was a high school diploma.

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.

Noncompliance Area: There were no fire drills recorded between 1/20/19 -9/12/19.

Correction Required: A fire drill shall be held at least every 60 days. Facility persons and children in attendance shall participate in the fire drill. Facility persons and children shall exit the building, weather permitting. A written record shall be kept of the date, the time of day, the hypothetical location of the fire, the evacuation time, the names of facility persons and the number of children participating in the fire drill.

Noncompliance Area: The fee agreements on file for children. #1, #2, and #3 did not specify the fee amounts.

Correction Required: An agreement shall specify the amount of the fee to be charged per day or per week.

Noncompliance Area: The only child service report on file for child #2 was completed more than 6 months prior to the inspection date.

Correction Required: 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 in 3270.124(f) (relating to emergency contact information).

Noncompliance Area: All five children's files reviewed (children #1-#5) included the original agreements.

Correction Required: A parent shall receive the original agreement. The facility shall retain a copy of the agreement.

Noncompliance Area: The health insurance policy number was not included on the emergency contact form on file for child # 4.

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: There was no health assessment on file for child #3, in attendance at the facility for more than 60 days. The health assessment on file for child #4 was completed more than 60 days after her first day of attendance.

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: In the toddler area, the table used for food service for children, and a counter used for some food preparation were located in the same area as the changing table and the sink used for handwashing after diapering.

Correction Required: The diapering area may not be used for food preparation or food service.

Noncompliance Area: The health assessment on file for Facility Person #1 completed more than 24 months after the prior staff health assessment on file.

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.

Noncompliance Area: The current agreement on file for child #5 was reviewed and updated by a parent in writing more than 6 months after the prior review.

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

Noncompliance Area: The children's files were stored in a cabinet that was not locked.

Correction Required: Child records are confidential and shall be stored in a locked cabinet.

Noncompliance Area: The facility persons' records were stored in a cabinet that was not locked.

Correction Required: Facility persons' records are confidential and shall be stored in a locked cabinet.

Noncompliance Area: There was no documentation of emergency plan training on file for Facility Person #2.

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.

Noncompliance Area: There was no documentation of any firesafety training completed by Facility Person #1, employed in a child care position for more than one year.

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.

Noncompliance Area: There was no documentation of mandated reporter training completed and on file for Facility Person #2, employed in a child care position more than 90 days.

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

Noncompliance Area: The documentation of child care experience on file for Facility Person #1, classified as an assistant group supervisor based on high school and 2 years (2500 hours) of child care experience, did not specify the number of hours of child care experience.

Correction Required: An assistant group supervisor shall have a high school diploma or a general educational development certificate and 2 years experience with children.

Noncompliance Area: There were empty plastic bags accessible in an unlocked cabinet under the changing table in the older toddler area, where toddlers were receiving care. There was a large foam cover wrapped around a pole in the outdoor playspace. There was no covering over the foam to prevent access to children still placing objects in their mouths.

Correction Required: Toys and objects with a diameter of less than 1 inch, objects with removable parts that have a diameter of less than 1 inch, plastic bags and styrofoam objects may not be accessible to children who are still placing objects in their mouths.

Noncompliance Area: There were empty plastic bags in a low drawer in reach of children in the kitchen area, where staff state toddlers receive care at times.

Correction Required: Toys and objects with a diameter of less than 1 inch, objects with removable parts that have a diameter of less than 1 inch, plastic bags and styrofoam objects may not be accessible to children who are still placing objects in their mouths.

Noncompliance Area: The agreement on file for child #1 did not specify the arrival and departure times.

Correction Required: An agreement shall specify the child's arrival and departure times.

Noncompliance Area: The medical emergency transportation plan was not posted in the gym.

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.

Noncompliance Area: The eating area in the infant child care space was located between the changing table and the sink used for handwashing after diapering.

Correction Required: The diapering area may not be used for food preparation or food service.

Noncompliance Area: The current health assessments on file for Facility Persons #1 and #4 were completed more than 24 months after the prior health assessments.

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.

Noncompliance Area: The current health assessment on file for Facility Person #4 included a positive response to the presence of a communicable disease, but did not provide the supporting information.

Correction Required: An adult health assessment must include an examination for communicable diseases and the results of that examination.

Noncompliance Area: According to the documentation on file, the initial emergency plan training conducted with Facility Person #2, who began employment in a child care position on 1/22/18, was completed on 2/16/18.

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.

Noncompliance Area: The first aid training documentation on file for all staff in the facility was issued by the legal entity rather than the training entity, and did not include the signature of a representative of the training entity.

Correction Required: Completion of training shall be documented by the signature and title of a representative of the training entity and shall include the date training was completed. Documentation shall be retained in the facility person's file.One or more facility persons competent in first-aid techniques shall be at the facility when one or more children are in care.

Noncompliance Area: There was no documentation of mandated reporter training on file for Facility Person #3, who began employment on 10/26/17. The CPSL requires mandated reporter training to be completed within 90 days of the first day of employment.

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

Noncompliance Area: Facility Person #3 was classified as a group supervisor. Although there was a bachelor's degree on file for Facility Person #3, there was no documentation of the field of study in which the bachelor's degree was completed.

Correction Required: A group supervisor shall have a bachelor's degree from an accredited college or university in early childhood education, child development, special education, elementary education or the human services field.A facility person's record shall include verification of child care experience, education and training prior to service at the facility.

Noncompliance Area: ***According to staff and witness statements, on 9/22/17 at approximately 11:00 AM, Facility Persons #1 and #2 were supervising 7 older toddlers in the outdoor playspace when Child #1 walked back into the building through a door that was propped open, unknown to the staff supervising him. An employee of another agency found the child in an unoccupied preschool classroom operated by that agency and located in the same building, across the hall from the child care space. He returned the child immediately. It is estimated the child was returned to the group approximately less than one minute after he was last seen by staff and as staff were searching for him on the playground,

Correction Required: The legal entity shall conduct monthly staff meetings for a minimum period of four months, with all facility staff in attendance at each meeting. Meetings shall include discussion of supervision policy and supervision concerns, specifically noncompliance within the previous 12 months relating to supervision and staff:child ratio regulations. Meeting agendas and documentation of the meeting date and staff in attendance for each meeting shall be kept on file at the facility for review upon request by certification staff.

Noncompliance Area: According to staff and witness statements, on 9/22/17 at approximately 11:00 AM, Facility Persons #1 and #2 were supervising 7 older toddlers in the outdoor playspace when Child #1 walked back into the building through a door that was propped open, unknown to the staff supervising him. An employee of another agency found the child in an unoccupied preschool classroom operated by that agency and located in the same building, across the hall from the child care space. He returned the child immediately. It is estimated the child was returned to the group approximately less than one minute after he was last seen by staff and as staff were searching for him on the playground,

Correction Required: When children are grouped in similar age levels, the following maximum child group sizes and ratios of staff persons apply: Infants 1:4 with a maximum group size of 8; Young toddlers 1:5 with a maximum group size of 10; Older toddlers 1:6 with a maximum group size of 12; Preschool children 1:10 with a maximum group size of 20; Young school-age children 1:12 with a maximum group size of 24; Older school-age children 1:15 with a maximum group size of 30.

Noncompliance Area: The agreements on file for children #1-#5 were the originals.

Correction Required: A parent shall receive the original agreement. The facility shall retain a copy of the agreement.

Noncompliance Area: The only health assessment on file for child #1, enrolled on 11/7/16, was completed on 8/17/17.

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: The health assessments on file for child #4 (an older toddler) and child #5 (a preschooler) were completed more than 12 months after their health assessments on file.

Correction Required: The operator shall require the parent to provide an updated health report at least every 12 months for an older toddler or preschool child.

Noncompliance Area: There was no documentation of the TB test date on file for Facility Person #1.

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.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.

Noncompliance Area: There was no documentation on file of emergency plan training conducted with Facility Persons # 1 & #2 at initial hire (within 7 days of hire date)

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.

Noncompliance Area: Facility Person #1 was classified as an aide based on completion of a GED; however, the GED documentation on file indicates the GED status for Facility Person #1 as "non-passed."

Correction Required: An aide shall have a high school diploma or a general educational development certificate.

Noncompliance Area: There was a crack in the plastic shed door in the outdoor playspace, creating a sharper edge/potential pinch point.

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.

Noncompliance Area: There was a small spot of damaged plaster on the wall in the hallway/storage area between the child care space and the outdoor playspace.

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

Noncompliance Area: ****According to the statements of staff, on 2/28/17, at approximately 11:10 AM, Facility Person #1 was assigned responsibility for supervising nine preschoolers, including child #1, who left the restroom and walked out of the facility. Neither Facility Person #1 nor any of the three other staff persons in the child care space (Facility Persons #2, #3, and #4) were aware the child left the facility until an employee of another agency in the building, who found the child standing outside of the door to the child care facility, returned him. Staff estimate the child was outside, unsupervised by any staff person, for approximately 5-10 minutes.

Correction Required: The legal entity shall arrange for all facility staff to complete a training through the Regional Key regarding the supervision of children. Documentation that every staff person has completed the supervision training shall be retained on file at the facility.

Noncompliance Area: On 3/6/17, at approximately 3:30 PM, Facility Person #1 was supervising 10 preschoolers and 2 young schoolagers in the preschool area of the main child care space. She stated she knew the names of three of the children in her care, but said she did not know the names of the other nine children as it was her first day. She stated she could read the names on the labels on the cots of the five children still resting, in order to identify those particular children. On 7/25/17, at approximately 11:15 AM, Facility Person #2 was supervising 1 young schoolager and 8 preschoolers in the outdoor playspace. Child #1 was observed leaving the playspace and walking through a small storage area/hallway, unsupervised, and into the preschool area of the child care space where Facility Person #1 was caring for one preschooler. According to the statements of staff, Child #1 needed to use the restroom, so she was sent in to the preschool space where Facility Person #1 could supervise her. There was no communication observed between the staff regarding the change in supervision assignment from Facility Person #2 to Facility Person #1 for Child #1.

Correction Required: Each staff person shall be assigned the responsibility for supervision of specific children. The staff person shall know the names and whereabouts of the children in his assigned group. The staff person shall be physically present with the children in his group on the facility premises and on facility excursions off the facility premises.

Noncompliance Area: According to the statements of staff, on 2/28/17, at approximately 11:10 AM, Facility Person #1 was assigned responsibility for supervising nine preschoolers, including child #1, who left the restroom and walked out of the faciilty. Neither Facility Person #1 nor any of the three other staff persons in the child care space (Facility Persons #2, #3, and #4) were aware the child left the facility until an employee of another agency in the buiding, who found the child standing outside of the door to the child care facility, returned him. Staff estimate the child was outside, unsupervised by any staff person, for approximately 5-10 minutes. On 7/25/17, at approximately 11:15 AM, Facility Person #5 was supervising 1 young schoolager and 8 preschoolers in the outdoor playspace. Child #2 was observed leaving the playspace and walking through a small storage area/hallway, unsupervised, and into the preschool area of the child care space where Facility Person #6 was caring for one preschooler. According to the statements of staff, Child #2 needed to use the restroom, so she was sent in to the preschool space where Facility Person #6 could supervise her.

Correction Required: When children are grouped in similar age levels, the following maximum child group sizes and ratios of staff persons apply: Infants 1:4 with a maximum group size of 8; Young toddlers 1:5 with a maximum group size of 10; Older toddlers 1:6 with a maximum group size of 12; Preschool children 1:10 with a maximum group size of 20; Young school-age children 1:12 with a maximum group size of 24; Older school-age children 1:15 with a maximum group size of 30.

Noncompliance Area: At approximately 3:30 PM, Facility Person #1 was supervising 10 preschoolers and 2 young schoolagers in the preschool area of the main child care space.

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).