Elizabeth Greslick Family Child Care Home

Regulation: 3290.124(b)(6)

Description: Insurance coverage information

Noncompliance Area: The emergency contact form on file for Child #1 and child #2 was observed not to have documentation of 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: 3290.131(b)(2)/3290.182(1)

Description: Updated toddler/preschool health report: every 12 months/Initial and subsequent health assessments

Noncompliance Area: The file for Child #2 was observed not to have documentation of an updated health assessment.

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

Regulation: 3290.151(a)(2)/3290.192(2)

Description: 12 months prior to service and every 24 months thereafter/Health assessment, TB test

Noncompliance Area: The most up to date health assessment on file for Staff #1 was observed to be greater than 24 months. This is evidenced by thew the health assessment being dated 1/26/2022 and 2/13/25.

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.

Regulation: 3290.24(d)

Description: Emergency plan

Noncompliance Area: The facility's emergency plan was observed not to have annual emergency drills documentation on file.

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

Regulation: 3290.31(f)(4)(i)/3290.31(g)(10)

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

Noncompliance Area: The most up to date CPR/First Aid training on file for Staff #1 was observed to be greater than 24 months. This is evidenced by training dates being 1/26/22 to 2/13/25.

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 person shall complete professional development in the topic of pediatric first aid and pediatric cardiopulmonary resuscitation.

Regulation: 3290.103

Description: Small Toys and Objects

Noncompliance Area: Plastic bags were observed under the diaper changing table accessible to children.

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.

Regulation: 3290.32(a)/3290.192(3)

Description: Comply with CPSL/CPSL information

Noncompliance Area: The NSOR clearance on file for staff person #1 was observed to be greater than 60 months as evidenced by the date of 2/07/2020.

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

Regulation: 3290.63

Description: Protective Outlet Covers 5 yrs. or less

Noncompliance Area: It was observed a plug protector was not covered on the day of inspection.

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

Regulation: 3290.72

Description: Emergency Numbers Posted

Noncompliance Area: It was observed that emergency telephone numbers were not posted on the day of inspection.

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.

Regulation: 3290.94(a)(5)

Description: Evacuation routes posted

Noncompliance Area: It was observed that evacuation routes were not posted in the upstairs level of the facility.

Correction Required: The operator or designated staff person who is responsible for compliance with this chapter shall conduct fire drills and ensure that evacuation routes are posted in a conspicuous location on each floor of the facility.

Regulation: 3290.124(b)(3)

Description: Parent home/work address, phone

Noncompliance Area: The file of child #1 lacked an emergency contact form with the parents' work phone numbers. The file of child #3 lacked an emergency contact form with the parent's full work address.

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

Regulation: 3290.124(b)(7)

Description: Name/address/phone release person

Noncompliance Area: The file of children #2 and #3 lacked emergency contact forms with the full addresses of the individuals designated by the parents to whom the children may be released.

Correction Required: Emergency contact information must include the name, address and telephone number of the individual designated by the parent to whom the child may be released.

Regulation: 3290.24(a)(1)/3290.24(a)(2)

Description: Emergency plan/Emergency plan

Noncompliance Area: The emergency plan lacked a plan for relocation and maps to get there.

Correction Required: The facility shall have an emergency plan that provides for accommodations for shelter of children during an emergency including lock-down, shelter in place at the facility and shelter at locations away from the facility premises. The facility shall have an emergency plan that provides for accommodations 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 (relating to fire drills).

Regulation: 3290.24(d)

Description: Emergency plan

Noncompliance Area: At the time of the inspection, there was no documentation an emergency plan drill was conducted in 2023. Therefore, emergency plan drills were not held annually.

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

Regulation: 3290.24(g)

Description: Emergency plan

Noncompliance Area: There was no documentation the emergency plan was delivered 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: 3290.32(a)/3290.192(3)

Description: Comply with CPSL/CPSL information

Noncompliance Area: The file of staff #1 had documentation of completing mandated reporter training late due to the fact they were dated 4-14-15 and 8-25-20, more than 60 months apart.

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.

Regulation: 3290.95(a)/3290.95(b)

Description: System in compliance/Operator or designated staff responsibility

Noncompliance Area: The documentation for testing the smoke detector was on a monthly basis, rather than every 30 days.

Correction Required: Fire detection devices or systems must be in compliance with standards established under section 1016(c) of the act (62 P.S. § 1016(c)). 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: 3290.102(c)

Description: Outdoor equip.- protective surfacing

Noncompliance Area: The outdoor embedded play equipment which consists of a rock wall and fort, contained 5 inches and not the required 9 inches of wooden mulch.

Correction Required: Outdoor equipment that requires embedded mounting must be mounted over a loose-fill or unitary playground protective surface covering that meets the recommendations of the United States Consumer Product Safety Commission. The equipment must be anchored firmly and be in good repair.

Regulation: 3290.131(a)(2)/3290.182(1)

Description: Initial health report dated for young toddler < 6 months./Initial and subsequent health assessments

Noncompliance Area: The initial health report on file for child #3, who is a young toddler, was dated more than 6 months prior to the first day of attendance at the facility.

Correction Required: The initial health report for a young toddler must be dated no more than 6 months prior to the first day of attendance at the facility. A child's record must contain initial and subsequent health reports.

Regulation: 3290.131(b)(1)/3290.182(1)

Description: Updated infant health report: every 6 months/Initial and subsequent health assessments

Noncompliance Area: The most current health report on file for child #3, who is a young toddler, was not completed within the past 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.

Regulation: 3290.131(b)(2)/3290.182(1)

Description: Updated toddler/preschool health report: every 12 months/Initial and subsequent health assessments

Noncompliance Area: The most current health report on file for child #4 was not completed within the past 12 moths.

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

Regulation: 3290.131(d)(5)/3290.131(e)(3)

Description: Immunization record/Dismissal policy

Noncompliance Area: The files for children #1 and 2 lack verification of a flu shot within the past year as in accordance with the schedule recommended by the ACIP.

Correction Required: Children #1 and 2 must be dismissed from care by close of business day by 3/7/23 and may only return to care when the immunization record is updated or when a parent provides a written, signed exemption letter. A health report shall include a review of the child's immunized status according to recommendations of the ACIP. The facility shall implement dismissal policies in accordance with the Department of Health regulation in 28 Pa. Code § 27.77 (relating to immunization requirements for children in child care group settings).

Regulation: 3290.131(d)(7)/3290.182(1)

Description: Free from contagious/communicable disease/Initial and subsequent health assessments

Noncompliance Area: The most current health report on file for child #2 lacks a statement that the child 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. A child's record must contain initial and subsequent health reports.

Regulation: 3290.134(b)

Description: Towels labeled and laundered

Noncompliance Area: Observed the children washing their hands in the bathroom and the same purple towel was used by all of the children to dry off their hands. Towels were not labeled with the children's names and were not used by only the named child.

Correction Required: Cloth towels and washcloths shall be labeled with the child's name, used by only the named child and laundered weekly. The operator shall arrange a laundry schedule with the parent.

Regulation: 3290.18

Description: General Health and Safety

Noncompliance Area: The facility's emergency plan lacked a plan for continuity of operations in the aftermath of a disaster.

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

Regulation: 3290.18

Description: General Health and Safety

Noncompliance Area: The required one-hour health and safety update for staff #1 was to be completed by 12/30/22 was not completed until 1/28/23.

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

Regulation: 3290.181(c)

Description: Emergency info/agreement updated 6 mos

Noncompliance Area: There was more than six months between reviews of the fee agreement on file for child #2, Dates are as follows: 7/7/22 and 2/1/23.

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.

Regulation: 3290.182(5)

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

Noncompliance Area: The most current emergency contact information on file for child #2 lacks 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: 3290.22(b)

Description: Availability of certificate of compliance and applicable regulations

Noncompliance Area: The operator did not provide the parent of each child enrolled with information on how to access the regulations in this chapter electronically.

Correction Required: The operator shall provide the parent of each child enrolled in the facility with information on how to access the regulations in this chapter electronically and with instructions for contacting the appropriate regional child care office.

Regulation: 3290.64(a)

Description: Locked or inaccessible - in original container

Noncompliance Area: In the living room, where children were present, observed toxic batteries on the bottom of an end table which were accessible to the children in care.

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: 3290.24(a)(5)

Description: Emergency plan

Noncompliance Area: The Emergency Plan did not have a plan for accommodations of infants and toddlers, children with disabilities, and children with chronic medical conditions.

Correction Required: The facility shall have an emergency plan that provides for accommodations of infants and toddlers, children with disabilities, and children with chronic medical conditions.

Regulation: 3290.24(b)

Description: Emergency plan

Noncompliance Area: At the time of the inspection, there was not documentation of reviewing the emergency plan at least annually.

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.

Noncompliance Area: The file of staff #2 lacked a health assessment with the Tuberculosis screening by the Mantoux.

Correction Required: An adult health assessment shall include Tuberculosis screening by the Mantoux method at initial employment. Subsequent tuberculosis screening is not required unless directed by a physician, CRNP, the Department of Health or a local health department. A facility person's record shall include a written report of initial and subsequent health assessments, including the results of initial and subsequent tuberculin skin tests, x-rays or other medical documentation necessary to confirm freedom from communicable tuberculosis.

Noncompliance Area: The file of staff #1, a household member, had a PA State Police clearance requested for the purpose of volunteer.

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: At 0756 Certification Rep observed 4 school age children standing outside at the end of the driveway not supervised by the provider because the provider was standing inside an enclosed porch. At the same time, there were 4 children; an infant, 1 older toddler, and 2 preschool, in the living room located in the back of the house around the corner and thru 2 thresholds from the enclosed porch. Therefore, the provider was not supervising the children in the living 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 LIS: Children must be supervised at all times. 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. The legal entity must submit documentation in a format approved by DHS proving that the facility procedure for counting children is followed at all times e.g., a checklist. The legal entity will confirm continuing compliance by sending copies of the documentation to the Regional Office of Child Development and Early Learning on a weekly basis for a period of three months after DHS approves the documentation format.

Noncompliance Area: There were no files for the following children #1, #2, #3, and #4. At the time of the inspection, the provider was unable to locate the files of children #5 and #6.

Correction Required: An operator shall establish and maintain an individual record for each child enrolled in the facility.

Noncompliance Area: Due to the fact that household member #1 has regular contact with children in care, household member #1 is required to have a full individual record.

Correction Required: An individual record is required for each facility person.

Noncompliance Area: Household member #1 lacked a Child Abuse, PA State Police clearance, and signed disclosure statement. The file of household member #2 lacked a complete PA State Police clearance. The document on file was proof of request.

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: At 0756, Certification Rep observed 10 children in care. The ages of the children are as follows: 6 School Age, 2 preschool, 1 older toddler, and 1 infant.

Correction Required: The number of children in care may not exceed six children at any one time who are unrelated to the operator.

Noncompliance Area: Staff #1, a household member did not have clearances on file.

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 files of children #1 and #3 lacked financial agreements with 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: The file child #1 lacked an emergency contact form with the full 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: The files of staff #1 and #2 lacked signed disclosure statements.

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

Noncompliance Area: Observed the rest equipment for the children in care not labeled for the use of a specific child.

Correction Required: Individual, clean, age-appropriate rest equipment shall be provided for preschool, toddler and infant children as agreed between the child's parent and the operator. The rest equipment shall be labeled for the use of a specific child and used only by the specified child.

Noncompliance Area: Observed a 4 month old infant sleeping in a car seat which was located in the family room off the kitchen.

Correction Required: 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: The files of children #1, #2, #3, #4, and #5 lacked a copy of the financial agreement; rather the original was in the file.

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

Noncompliance Area: The files of children #1 and #2 lacked an emergency contact form with the work addresses 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: The files of children #3 and #4 lacked emergency contact forms with written consent signed by a parent for emergency medical care and 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.

Noncompliance Area: The files of children #1, #2, and #5 lacked emergency contact forms with 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: 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 posted for parents to see.

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.

Noncompliance Area: Observed the diapering area lacked 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: The files of staff #1 and #2 lacked updated health assessments.

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.

Noncompliance Area: The files of children #3 and #4 lacked emergency contact forms with signed parental consent for administration of minor first-aid procedures by facility staff and signed parental consent for transportation, walking excursions, swimming and wading.

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. A child's record must contain signed parental consent for transportation, walking excursions, swimming and wading.

Noncompliance Area: Observed a lack of fire drills conducted 4 times per year.

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