HART 2 HEART CHILDCARE

Noncompliance Area: There was an indoor climber with an attached slide in the new indoor play room that was not being used over a protective surface covering.

Correction Required: Indoor play equipment for climbing shall be installed or used over a protective surface covering which does not interfere with the stability of the equipment.

Noncompliance Area: Child #1 had a previous health assessment dated 12-3-18 and a current health assessment dated 2-5-20. Child #2 had a previous health assessment dated 10-2-18 and a current health assessment dated 12-3-19.

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: Staff person #3 lacked initial training in the emergency plan.

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: Staff person #2 had a most recent fire safety training dated 5-5-19.

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 #1, with a documented start date with children of 12-15-19, had an NSOR verification dated 2-26-20; which was obtained after the required time frame as designated by the CPSL.

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: Staff person #3, functioning as an Assistant Group Supervisor, lacked proof of childcare 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: The facility was using the back room that had been measured for indoor play space as childcare space. The facility designated another room in the facility as indoor play space and was using the room before it had been inspected and measured as play space.

Correction Required: Indoor child care space is measured within permanent stationary partitions or walls. The allowable number of children in a space is determined by dividing the total square feet in a space by 40. Outdoor or indoor play space shall be measured at 65 square feet per child

Noncompliance Area: There were 2 uncovered outlets on the wall in the new indoor play room.

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

Noncompliance Area: There were several bottles of cleaners being stored on top of the refrigerator next to a box of fruit cups.

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 stored away from food, food preparation areas and child care spaces.

Noncompliance Area: The first aid kit in the new indoor play room lacked 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: There were 2 small holes in the wall to the left of the play kitchen set in the back room.

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: Child #1 was released to a person who was not listed on the child's emergency contact form or agreement as being a person designated by the parent to whom the child may be released. There was no written consent from the child's parent for the child to be released to the person to whom the facility released the child.

Correction Required: A child shall be released only to the child's parent or to an individual designated in writing by the enrolling parent. A child shall be released to either parent unless a court order on file at the facility states otherwise.An agreement shall specify the persons designated by a parent to whom the child may be released.

Noncompliance Area: At 1:20pm it was observed that there was 1 staff person in the nap room with 6 children. All of the lights in the room were off and the staff person could not see the children in the room to properly supervise them.

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.

Noncompliance Area: 2ND CITATION: Staff person #4 had only 4 hours of annual childcare training. PREVIOUSLY CITED ON 3-20-19

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

Noncompliance Area: The refrigerator in the middle room lacked a thermometer.

Correction Required: A facility shall have an operable, clean refrigerator used to store potentially hazardous foods. The refrigerator shall be capable of maintaining food at 45 F or below. An operating thermometer shall be placed in the refrigerator.

Noncompliance Area: It was observed that child in the middle room were being restrained in high chairs and bouncy seats during circle time. The children's movement during that time was being restricted with the seat belts on the high chair and the bouncy chairs.

Correction Required: A facility person may not restrain a child by using bonds, ties or straps to restrict a child's movement or by enclosing the child in a confined space, closet or locked room. The prohibition against restraining a child does not apply to the use of adaptive equipment prescribed for a child with special needs.

Noncompliance Area: Child #4 had an agreement that lacked the persons designated by the parent to whom the child may be released.

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

Noncompliance Area: Child #2 and Child #3 had agreements that lacked the child's date of admission.

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

Noncompliance Area: Child #1, Child #2, Child #3, Child #4 had records that contained the original agreements.

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

Noncompliance Area: Child #4, enrolled as a young toddler on 7-5-18, had an initial health assessment dated 12-22-17. Child #4 had a subsequent health assessment dated 2-11-19.

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.

Noncompliance Area: Child #1 had an immunization record that did not document an annual influenza vaccination as recommended by the ACIP.

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: There was medication lip balm on the sink accessible to children in the middle room and on the television stand accessible to children in the front room.

Correction Required: Medication shall be stored in a locked area of the facility or in an area that is out of the reach of children.

Noncompliance Area: There were apples and oranges reportedly purchased the previous Sunday (3 days prior to the inspection) that were being stored on a shelving unit in the cafeteria room and were not being refrigerated.

Correction Required: Fresh fruits and vegetables that are not used on the day of purchase shall be refrigerated.

Noncompliance Area: The facility's menu was not posted one week in advance in a conspicuous location.

Correction Required: An operator shall conspicuously post the menu at least 1 week in advance or provide a menu to each family.

Noncompliance Area: There were no written feeding instructions for the two infants enrolled at the facility.

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

Noncompliance Area: Staff person #2's record contained only 1 written non-family reference.

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 person #3 and staff person #4 lacked 6 hours of annual childcare training.

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

Noncompliance Area: Staff person #1, with a documented start date of 2-4-19, had an FBI clearance dated 2-19-19 and proof that the staff person was not fingerprinted until 2-13-19. Staff person #2, a provisional hire, was observed to be working alone in the middle room with a group of children.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). A provisional employee may not be permitted to work alone with children and must work within the vicinity of a permanent employee.

Noncompliance Area: Staff person #2, classified and functioning as an Assistant Group Supervisor, lacked 2500 hours of children 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.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: At approximately 1:15pm it was observed that Staff person #5 was alone in the nap room with 1 infant, 1 young toddler, 3 older toddlers, and 2 preschoolers.

Correction Required: The staff:child ratio while toddlers and preschoolers are napping is one staff person to 10 young toddlers, one staff person to 12 older toddlers, one staff person to 20 preschool children

Noncompliance Area: There was a spray bottle with cleaner in a cupboard above the sink in the cafeteria room that was not labeled with its contents.

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 stored away from food, food preparation areas and child care spaces.

Noncompliance Area: There was a working lamp accessible to children next to the fish tank in the front room whose bulb measured 132.6 degrees F.

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

Noncompliance Area: There was an exposed bolt on the drawer of the sink unit in the middle room where the drawer's knob was missing. There was climbing equipment and other play equipment stacked on top of other play equipment in the indoor gross motor room that posed a hazard of toppling over if bumped into.

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: It was observed there were 4 children sitting in the bucket chairs suspended from the table in the kitchenette room who were not buckled in with the attached safety straps. There were two other chairs suspended from the table that were not in use but also lacked the required safety straps.

Correction Required: High chairs shall have a wide base and a T-shaped safety strap.

Noncompliance Area: The daily schedule was not posted in the middle room.

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

Noncompliance Area: Child #1 and child #2 lacked a child service report.

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: There was no medical emergency procedure posted in the middle room or in the back room.

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: Child #1 had a most recent health assessment dated 3-2-16. Child #2 had a most recent health assessment dated 1-3-17. Child #4 had a most recent health assessment dated 1-11-17.

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: Child #3 lacked a record of immunization and also lacked proof of exemption from immunization.

Correction Required: Exemption from immunization for religious belief or strong personal objection equated to a religious belief shall be documented by a written, signed and dated statement from the child's parent or guardian. The statement shall be kept in the child's record.

Noncompliance Area: The facility had general liability insurance that covered the Group Child Care and was restricted to only 12 children. The maximum capacity of the facility as a childcare center is 27 children.

Correction Required: The legal entity shall have comprehensive general liability insurance to cover the persons who are on the premises. A current copy of the insurance policy shall be on file at the facility.

Noncompliance Area: There were standing fans in the front room and in the middle room that lacked a protective screen over the fan cover thereby allowing access for the children to put their fingers through the cover and touch the blades.

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

Noncompliance Area: Staff person #1, functioning as an Assistant Group Supervisor, lacked documentation of childcare 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.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 a first aid kit inside of a backpack accessible to children hanging on a low hook in the front room near the facility's entrance.

Correction Required: A first-aid kit must be inaccessible to children.

Noncompliance Area: On 2/13/2018, an individual record was observed not to be available at the child care facility for staff person #1.

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

Noncompliance Area: Upon review of staff person #1's file on 2/15/2018, it was observed that the file did not contain documentation of two 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: Upon review of staff person #1's file on 2/15/2018, it was observed that documentation of application for child abuse clearance was not submitted prior to staff person #1's date of hire, nor was there documentation on file of complete application for an FBI clearance for staff person #1. This is evidenced by there only being documentation on file that staff person #1 registered for an FBI clearance on 2/13/2018, but had not yet been fingerprinted as of 2/14/2018. Also, staff person #1 did not sign a disclosure statement prior to date of hire.

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

Noncompliance Area: Upon review of staff person #1's file on 2/15/2018, it was observed that the file did not contain documentation of education and experience obtained prior to the onset of employment at the child care facility to qualify staff person #1 to work as a primary staff person.

Correction Required: A primary shall have attained one of the following qualification levels specified at 3280.34(b)(1) - (5).A facility person's record shall include verification of child care experience, education and training prior to service at the facility.

Noncompliance Area: The rest equipment and linens used by the children in care were observed not to be labeled for the individual children whom they are intended for.

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 agreement on file for child #1 and child #3 were observed not to specify the persons designated by the parent whom the child may be released to.

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

Noncompliance Area: The emergency contact form on file for child #2 was observed not to contain complete work information for 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 emergency contact form on file for child #2 was observed not to 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 emergency contact form on file for children #1 and #3 were observed not to contain complete emergency contact information for the person's whom children #1 and #3 are authorized to be released to.

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: Emergency contact forms were observed not to be present in each child care space where children are receiving care.

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: In the front child care space a kitchen area was observed to be put together at the one end of the child care space. The following items in this area were observed to be accessible to the children in care; a hot plate, toaster oven, and a George Foreman grill. These items when in use exceed 110 degrees and expose a risk to the children's general health and safety.

Correction Required: Conditions at the facility may not pose a threat to the health or safety of the children.Hot water pipes and other sources of heat exceeding 110 F that are accessible to children shall be equipped with protective guards or shall be insulated to prevent direct contact.

Noncompliance Area: The regulation under which the facility is certified were observed not to be posted in a conspicuos location used by the parents.

Correction Required: The facility's current certificate of compliance and a copy of the applicable regulations under which the facility is certified shall be posted in a conspicuous location used by parents, with instructions for contacting the appropriate regional day care office posted at the same location.

Noncompliance Area: The file for staff person #1 was observed not to contain documentation of training in the facility's emergency plan at the time of hire.

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.

Noncompliance Area: The telephone number for the nearest fire and ambulance department were observed not to be posted in the facility. 911 was posted in their place.

Correction Required: The telephone number of the nearest hospital, police department, fire department, ambulance and poison control center shall be posted by each telephone in the facility.

Noncompliance Area: A fire drill was observed not to have been conducted within the last 60 days.

Correction Required: A fire drill shall be held at least every 60 days. Staff persons, volunteers and children in attendance shall participate in the fire drill and shall exit the facility, weather permitting.