Heavenly Hands Early Learning Child Care Academy L

Noncompliance Area: 2ND CITATION; PREVIOUSLY CITED 7/24/2020 : On 8/28/2020 at 2:05 pm staff person #1 was observed in the infant room caring for 4 infants and 1 young toddler. No other staff were present in the classroom.

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). 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: In the preschool room there was a wooden table with a missing bolt causing the table to be unstable and presenting a pinch point .

Correction Required: Toys, play equipment and other indoor and outdoor equipment used by the children shall be clean, in good repair and free from rough edges, sharp corners, pinch and crush points, splinters and exposed bolts.

Noncompliance Area: The files for child #1, in attendance since 9/17/18, child #2 in attendance since 11/30/18 and child #3, in attendance since 6/4/18 did not contain child service reports.

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 files for child #4 and child #5 did not contain complete 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 file for child #4 contains an emergency contact form that is missing the address for the designated emergency release person.

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: Child #3 and child #6 were observed to be receiving care in the preschool room and emergency contact information for them was not available in the child care space.

Correction Required: When children are in the facility, emergency contact information shall be present in a child care space for children receiving care in the space.

Noncompliance Area: The file for child #4, start date of 6/5/18, contains a financial agreement that has not been updated since 6/5/18. The file for child #7, start date 4/5/19, contains emergency contact information that has not been updated since 4/5/19. The file for child #9, start date 11/1/18 contains emergency contact information that has not been updated since 10/26/18.

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 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.

Noncompliance Area: The files for child #4,school age, child #5, young toddler and child #8, school age, do not contain health assessments and all have been in attendance for greater than 60 days.

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

Noncompliance Area: The files for child #2 and child #3, both preschoolers, do not contain updated health reports during the previous 12 month period.

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 files for child #2 and child #3, both preschoolers, do not contain verification of a flu shot received during the previous 12 month period as recommended for children over 6 months by the ACIP immunization schedule.

Correction Required: The facility shall require the parent to provide updated written verification from a physician, physician's assistant, CRNP, the Department of Health or a local health department of ongoing vaccines administered to an infant, toddler or preschool child in accordance with the schedule recommended by the ACIP.

Noncompliance Area: The file for staff person #3 does not contain a health assessment conducted during the previous 24 month period.

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.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 for staff person #2 contains a health assessment form with a box checked stating that the physician did not conduct a physical examination.

Correction Required: An adult health assessment must include a physical examination.

Noncompliance Area: The file for child #8 does not include a financial agreement.

Correction Required: A child's record shall contain a copy of the initial agreement and subsequent written agreements between the parent and the operator. The parent receives the original agreement.

Noncompliance Area: The file for staff person #3, hire date 6/11/18, does not include verification of the NSOR required for all child care staff by 7/1/2020 and cannot work in a child care position until it is obtained. The file for staff person #1 contains a child abuse clearance that expired on 12/24/2019. Staff person #1's current clearance was obtained on 3/23/2020 which is greater than 60 months from the prior clearance. The file for staff person #1 contains mandated reporter training that expired on 3/21/2020 and does not contain current training. The file for staff person #4 does not contain an NSOR prior to 7/1/2020 as required under CPSL. The file does contain a current NSOR.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). A facility person's record shall include a copy of requests for the criminal history record and child abuse registry clearance information, a copy of the disclosure statement and a copy of the completed clearance information required under the CPSL. Facility Person #3 may not work in a child care position at the facility.

Noncompliance Area: On 7/24/2020 at 10:40am Staff person #5 was observed caring for 1 infant, 2 young toddlers and 2 older toddlers in the infant room while staff person #6 left the room to answer the door and obtain supplies.

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). 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: 4th CITATION; PREVIOUSLY CITED 10/23/19, 1/2/20 and 2/19/20. The file for child #7, enrolled greater than 60 days, does not contain a health report.

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

Noncompliance Area: In the young toddler room large vinyl covered foam blocks were observed to be worn through and exposing the interior foam. In the older toddler room a child's black foam covered vinyl couch was worn through and exposing the interior foam. The foam was accessible to children still placing objects in their mouths causing a choking hazard.

Correction Required: Toys, play equipment and other indoor and outdoor equipment used by the children shall be clean, in good repair and free from rough edges, sharp corners, pinch and crush points, splinters and exposed bolts. 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: 3rd CITATION; PREVIOUSLY CITED 10/23/19 AND 1/2/20. The file for child #7, enrolled greater than 60 days, does not contain a health report.

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

Noncompliance Area: 3RD CITATION; PREVIOUSLY CITED 10/23/19 and 1/2/20 The file for staff persons #1 contains only 3 of the required 6 hours of child care training.

Correction Required: A staff person shall obtain an annual minimum of 6 clock hours of child care training.

Noncompliance Area: At 11:00am on 2/19/2020 staff person #2 was observed alone in the infant room supervising 6 infants. The maximum staff : child ratio for a group of infants is 1:4 therefor 2 infants were not in a supervision group.

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. 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: 2nd CITATION; ORIGINALLY CITED 10/23/19. The file for child #1 does not contain a copy of the initial agreement or of any subsequent agreements.

Correction Required: A parent shall receive the original agreement. The facility shall retain a copy of the agreement.A child's record shall contain a copy of the initial agreement and subsequent written agreements between the parent and the operator. The parent receives the original agreement.

Noncompliance Area: 2ND CITATION; ORIGINALLY CITED 10/23/19. The files for child #1, 2, 5, 6, 7 and 8 do not contain emergency contact and financial agreements reviewed and updated by the parents in the previous 6 month period.

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: 2ND CITATION; ORIGINALLY CITED 10/23/19. The files for child #3 and #7, both enrolled greater than 60 days, do not contain a health report.

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

Noncompliance Area: 2nd CITATION; ORIGINALLY CITED 10/23/19. The files for staff persons #1, 2 and 11 do not contain health assessments conducted during the previous 24 month period. A health assessment is not available for facility person #10 serving as the cook.

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: 2ND CITATION; ORIGINALLY CITED 10/23/19. The file for facility person #10 does not contain verification of TB testing and the results.

Correction Required: 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: 2ND CITATION; ORIGINALLY CITED 10/23/19. The file for child #4 does not contain signed parental consent for administration of minor first-aid and emergency medical care.

Correction Required: A child's record shall contain signed parental consent for emergency medical care for the child. Written consent is required prior to admission.A child's record shall contain signed parental consent for administration of minor first-aid procedures by facility staff. Written consent is required prior to admission.

Noncompliance Area: 2ND CITATION; ORIGINALLY CITED 10/23/19. The files for facility persons #1, 2,10,and 11 do not contain current health assessments.

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: 2ND CITATION; ORIGINALLY CITED 10/23/19. Staff person # 5 and facility person #10 did not receive training regarding the facility emergency plan within one week of initial hire and have still not received emergency plan training.

Correction Required: The operator shall assure that each facility person receives training regarding the emergency plan at the time of initial employment, on an annual basis and at the time of each plan update. The operator shall document the date of each training and the names of all facility persons who received the training and kept on file at the facility.

Noncompliance Area: 2ND CITATION; ORIGINALLY CITED 10/23/19 The files for staff persons #1, #2 and #9 contain only 3 of the required 6 hours of child care training.

Correction Required: A staff person shall obtain an annual minimum of 6 clock hours of child care training.

Noncompliance Area: 2ND CITATION; ORIGINALLY CITED 10/23/19 The files for staff persons #2 and #11 do not contain verification of fire safety training during the previous 12 month period.

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: **2ND CITATION; ORIGINALLY CITED 10/23/19 Staff person #6, hire date 2/1/19 and staff person #13, hire date 8/1/18, have not completed mandated reporter training within 90 days of employment as required under CPSL. The file for facility person #10, hire date unknown, serving as the cook and having regular contact with children, does not contain signed disclosure statement, criminal history, child abuse and FBI fingerprinting as required under CPSL. On 1/2/2020 facility person #10 was observed walking in and out of the classrooms where children were receiving care. Facility persons #10 may not work in the facility having contact with children until completed clearances have been received.

Correction Required: **For a period of 2 months all clearances for newly hired facility persons, including all positions where the employee will have contact with children, must be submitted to certification representative for review prior to the person's start date in a child care position.

Noncompliance Area: 2nd CITATION; ORIGINALLY CITED 10/23/19. The fire drill log showed only one fire drill conducted during the previous 12 month period. The date of the logged drill was 10/19/19.

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.

Noncompliance Area: In the Older Toddler room there was a plastic basketball hoop that was cracked at the base posing a sharp edge and a black vinyl couch with cracked vinyl on the armrests. In the School Age room there was a black plastic semi-truck with a cracked plastic door and a cracked plastic box that contained building pieces.

Correction Required: Toys, play equipment and other indoor and outdoor equipment used by the children shall be clean, in good repair and free from rough edges, sharp corners, pinch and crush points, splinters and exposed bolts.

Noncompliance Area: In the Young Toddlers and Older Toddlers rooms the rest mats were numbered but there was no list to identify which child used which mat.

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: In the Young Toddler room there was no schedule of daily activities posted.

Correction Required: The written plan of daily activities shall be posted in the group space.

Noncompliance Area: The file for child #7 contains an agreement that was not signed by the operator.

Correction Required: An agreement shall be signed by the operator and the parent.

Noncompliance Area: The files for child #4,5, and 7 contain agreements that do not specify the date of the child's admission.

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

Noncompliance Area: The file for child #1 does not contain a copy of the initial agreement. The file for child #4 contains the original agreement instead of a copy. The parent shall receive the original.

Correction Required: A parent shall receive the original agreement. The facility shall retain a copy of the agreement.A child's record shall contain a copy of the initial agreement and subsequent written agreements between the parent and the operator. The parent receives the original agreement.

Noncompliance Area: The file for child #1 does not include an emergency contact information form.

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: There was no emergency contact information available in the preschool room for child #1 who was receiving care in the room.

Correction Required: When children are in the facility, emergency contact information shall be present in a child care space for children receiving care in the space.

Noncompliance Area: The files for child #1, 2, 5, 6, 7 and 8 do not contain emergency contact and financial agreements reviewed and updated by the parents in the previous 6 month period.

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: The files for child #3 and #7, both enrolled greater than 60 days, do not contain a health report. The file for child #2 contains an initial health report that was received greater than 60 days after admission. Child #2's health report is current.

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

Noncompliance Area: The files for staff persons #1, 2, 9, 11, 12, and 14 do not contain health assessments conducted during the previous 24 month period. The files for staff persons #4 and 8 do not contain initial health assessments. A health assessment is not available for facility person #10 serving as the cook.

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 files for staff persons #4 and 8 and facility person #10 do not contain verification of TB testing and the results.

Correction Required: 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: In the infant room three infant bottles of formula were observed to be lacking the child's name.

Correction Required: Disposable nursers and bottles shall be labeled with the child's name.

Noncompliance Area: Manufacturers' instructions for use of safety restraints was not kept in the suburban which is used to transport children.

Correction Required: Manufacturers' instructions for use of safety restraints shall be kept in the vehicle at all times.

Noncompliance Area: The files for child #1,4,5 and 7 do not contain the date of the child's admission.

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

Noncompliance Area: The files for child #1 and #4 do not contain signed parental consent for administration of minor first-aid and emergency medical care.

Correction Required: A child's record shall contain signed parental consent for emergency medical care for the child. Written consent is required prior to admission.A child's record shall contain signed parental consent for administration of minor first-aid procedures by facility staff. Written consent is required prior to admission.

Noncompliance Area: A file is not available for facility person #10, serving as the cook,

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

Noncompliance Area: The files for facility persons #1,2,4,8,10,11,13 and 15 do not contain current health assessments.

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: The file for staff person #7 does not contain any written reference letters. The file for staff persons #8 and 13 contain only 1 of the required 2 reference letters.

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

Noncompliance Area: Staff persons #3, 5,6,7,8 and facility person #10 did not receive training regarding the facility emergency plan within one week of initial hire. Staff persons #3,6,7 and 8 have since received training however staff #5 and facility person #10 have still not received emergency plan training.

Correction Required: The operator shall assure that each facility person receives training regarding the emergency plan at the time of initial employment, on an annual basis and at the time of each plan update. The operator shall document the date of each training and the names of all facility persons who received the training and kept on file at the facility.

Noncompliance Area: The files for staff persons #1, #4 and #9 do not contain verification of 6 hours of child care training during the previous 12 month period. The file for staff person #2 contains only 3 of the required 6 hours of child care training.

Correction Required: A staff person shall obtain an annual minimum of 6 clock hours of child care training.

Noncompliance Area: The files for staff persons #2,4,11,12,and13 do not contain verification of fire safety training during the previous 12 month period.

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: Staff person #6, hire date 2/1/19, staff person #11, hire date 5/3/17 and staff person #13, hire date 8/1/18, have not completed mandated reporter training within 90 days of employment as required under CPSL. The file for staff person #7, provisional hire date 10/4/19, does not contain verification of request for criminal history and child abuse clearances and the NSOR prior to employment as required for provisional hire under CPSL. The file for staff person #8, provisional hire date 10/1/19, does not contain verification of application for the NSOR as required for provisional hire. The file for facility person #10, hire date unknown, serving as the cook and having regular contact with children, does not contain request for criminal history, child abuse, FBI fingerprinting and NSOR as required for provisional hire under CPSL. Facility persons #7, 8 and 10 may not work in a child care position until completed clearances and NSOR have been received.

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 #7,8 and 10 may not work in a child care position at the facility.

Noncompliance Area: The files for staff persons #1,2 3 4,9,11,12 and 13 do not contain a staff evaluation completed during the previous 12 month period.

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: The files for staff #7 and #8, both serving as aides, do not contain verification of qualifications to serve as an aide.

Correction Required: An aide shall have attained one of the qualification levels specified in 3270.37(b)(1)-(3).A facility person's record shall include verification of child care experience, education and training prior to service at the facility.

Noncompliance Area: In the hallway by the office door was an electrical power strip missing a protective outlet cover and accessible to children 5 years of age and younger..

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

Noncompliance Area: In the gym there was a maintenance closet containing a 5 gallon bucket of adhesive labeled 'keep out of the reach of children'. The closet door was open allowing the children access.

Correction Required: Cleaning materials and other toxic materials shall be kept in an area or container that is locked or made inaccessible to children.

Noncompliance Area: The first-aid kit in the suburban which is used to transport children, was lacking tweezers and scissors. The first-aid kit in the Young Toddlers room was lacking scissors.

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: On the floor in the gym was coiled electrical wires that could pose a hazard to the children playing in the space.

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: The first stall inside the girl's restroom was lacking a hand washing sign.

Correction Required: A facility person and an able child shall wash his hands after toileting and before eating. A sign on which this requirement is written shall be posted at each toilet, training chair, diapering area and sink in the facility.

Noncompliance Area: The fire drill log showed only one fire drill conducted during the previous 12 month period.

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.

Noncompliance Area: In the Younger Toddler room there were no fire evacuation routes posted.

Correction Required: Evacuation routes shall be posted.

Noncompliance Area: In the toddler room a kitchen play set was observed to have a cracked plastic door posing a sharp edge and pinch point.

Correction Required: Toys, play equipment and other indoor and outdoor equipment used by the children shall be clean, in good repair and free from rough edges, sharp corners, pinch and crush points, splinters and exposed bolts.

Noncompliance Area: In the toddler room the toddlers were observed eating a snack out of individual plastic baggies. Toddler aged children frequently place objects in their mouths as one older toddler was observed putting the plastic bag in his mouth.

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 file for staff person #1 does not contain a health assessment and TB test. Staff person #1 was observed working in the infant room.

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 file for staff person #1 does not contain a health assessment and TB test. Staff person #1 was observed working in the infant room.

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: The file for staff person #1 does not include 2 written non-family references.

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

Noncompliance Area: The file for staff person #1, hire date 5/21/19, does not contain a signed disclosure statement as required under the CPSL and may not work in childcare until a signed disclosure statement is received.

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 #1may not work in a child care position at the facility.

Noncompliance Area: In the young toddler room there was a torn diaper changing mat and vinyl climbing blocks that were worn and tearing and exposing foam.

Correction Required: Toys, play equipment and other indoor and outdoor equipment used by the children shall be clean, in good repair and free from rough edges, sharp corners, pinch and crush points, splinters and exposed bolts.

Noncompliance Area: In the infant room, a young toddler was observed sleeping in a pack and play that was not labeled with her name for individual use.

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: The files for child #1,4,and 5 contained agreements that were lacking the operator's signature.

Correction Required: An agreement shall be signed by the operator and the parent.

Noncompliance Area: The file for child #4 does not contain a child service report completed in the previous 6 month period.

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 files for child #4 and 5 contain agreements that do not include the names of 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 files for child #3,4,and 5 contain the original agreement.

Correction Required: A parent shall receive the original agreement. The facility shall retain a copy of the agreement.A child's record shall contain a copy of the initial agreement and subsequent written agreements between the parent and the operator. The parent receives the original agreement.

Noncompliance Area: The file for child #6 does not contain emergency contact information.

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: The files for child #1 and 2 contain emergency contact information that is missing the physician's phone number.

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

Noncompliance Area: The file for child #4 does not contain signed parental consent for emergency medical care.

Correction Required: Emergency contact information must include the written consent signed by a parent for emergency medical care. A child's record shall contain signed parental consent for emergency medical care for the child. Written consent is required prior to admission.

Noncompliance Area: The file for child #5 does not contain complete 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 files for child #1,2,3,4 and 5 contain emergency contact information that is missing the address for the release persons. The files for child #3 and 5 also do not contain the phone number for the release persons.

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 for child #1,3 and 4 contain emergency contact and financial agreements that have not been updated in the previous 6 month period.

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: The files for child #2,3,and 4, who have been enrolled for greater than 60 days, do not contain a health report.

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

Noncompliance Area: The file for child #6 is lacking statements from the physician that the child is free from communicable disease and able to participate in child care.

Correction Required: A health report shall include a statement that the child is able to participate in child care and appears to be free from contagious or communicable disease.

Noncompliance Area: The files for staff person #4 and #6 and #7 do not contain a health assessment.

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.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 for staff person #10 contains a current health assessment that is missing physician statements regarding communicable disease and suitability to provide child care.

Correction Required: An adult health assessment must include an examination for communicable diseases and the results of that examination. An adult health assessment must include the physician's or CRNP's assessment of the person's suitability to provide child care.

Noncompliance Area: A four month old infant was observed in a bouncy seat with a propped bottle.

Correction Required: An infant 6 months of age or younger shall be held while being bottle fed.

Noncompliance Area: The files for child #4 and 5 do not contain signed parental consent for administration of minor first-aid.

Correction Required: A child's record shall contain signed parental consent for administration of minor first-aid procedures by facility staff. Written consent is required prior to admission.

Noncompliance Area: The file for staff person #4 contains verification of child care experience that is lacking the signature of the representative of the experiential entity and is therefore not acceptable as experience.

Correction Required: A facility person's record shall include acceptable verification of experience, education or training is a transcript or a diploma or a letter signed by a representative of the experiential, educational or training entity.

Noncompliance Area: The files for staff #2 and staff #5 contain only one written reference letter. The file for staff #7 contains no written references.

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

Noncompliance Area: The facility emergency plan has not been updated in the previous 12 month period.

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 and kept on file at the facility.

Noncompliance Area: The operator was lacking documentation of initial training regarding the facility emergency plan for staff persons #1,2,3,4,5,6 and 7 and annual training regarding the facility emergency plan for staff #8,9,11,12, and 14.

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 facility emergency plan was not posted in a conspicuous location.

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

Noncompliance Area: Staff persons #7,8,10,12,and 14 have not received fire safety training in the previous 12 month period.

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: The files for staff persons #7, 8,9,12, 13,and 14 are lacking verification of 6 hours of child care training completed in the previous 12 month period.

Correction Required: A staff person shall obtain an annual minimum of 6 clock hours of child care training.A facility person's record shall include verification of child care experience, education and training following the outset of service at the facility.

Noncompliance Area: The file for staff person #5, hire date 8/1/18, contains a request for state police clearance dated 8/9/18, request for child abuse clearance dated 9/13/18 and FBI fingerprinting dated 9/14/18. These were not completed prior to working in child care as required by CPSL. The file does contain complete clearances. The file for staff person #7, hire date 6/30/17, contains a volunteer state police clearance which is not accepted for employment in child care and the request was completed on 11/1/17, four months after the hire date. The file contains a request for child abuse clearance dated 12/6/17 and FBI clearance dated 10/13/17 both requested after the hire date. The file contains a disclosure statement that is not dated and was not witnessed. Staff person #7 must be removed from a child care position until a state police clearance for the purpose of employment has been received and a valid disclosure statement is completed. The file does contain a complete child abuse and FBI clearance. The file for staff person #7, hire date 6/30/17, does not contain verification of mandated reporter training completed within 90 days of hire as required by CPSL. The file for staff person #8, hire date 6/5/17, contains a state police clearance dated 4/13/17 identifying a record exists but does not include the rap sheet as required for a complete clearance under the CPSL. Staff person #8 has been employed for greater than 90 days and is past the provisional period so must be removed from child care until the complete clearance is obtained. The file for staff person #6, hire date 1/23/18, does not contain mandated reporter training within 90 days of hire as required under the CPSL. The file for staff person #1, hire date 6/30/18, does not contain verification of request for criminal history, child abuse and FBI fingerprinting prior to employment as required under CPSL. The file does contain complete clearances. The file for facility person #3, serving as a volunteer since 9/4/18, does not contain verification of application for child abuse and criminal history clearances prior to service in the facility as required under CPSL. The file does contain complete clearances.

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 Persons #7 and #8 may not work in a child care position at the facility and complete clearances are obtained.

Noncompliance Area: The file for staff person #5, serving as an assistant group supervisor, is lacking a high school diploma or GED. The file for staff person #7, serving as an assistant group supervisor, is lacking verification of experience.

Correction Required: A staff person or a substitute staff person shall meet one of the applicable staff qualifications for the position in which the person is performing.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 verification that a written evaluation had been completed for staff persons #8,9,11,12,and 14 during the previous 12 month period.

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: The first-aid kit in the preschool room was missing soap. The first-aid kit in the infant room was missing tweezers and soap. The first-aid kit in the school age room 208 was missing tape.

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: On the outside play space there was a landscape timber with a metal rod protruding up causing a possible hazard if a child were to fall on it.

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.