Juliet Askew Child Care

Regulation: 3270.113(e)

Description: Restraints prohibited

Noncompliance Area: During the renewal inspection on 10/23/2025, it was observed that child #1, and child #2 were confined in their crib for approximately 20 minutes while staff #1 and staff #2 were feeding the young toddlers.

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.

Regulation: 3270.124(b)(6)

Description: Insurance coverage information

Noncompliance Area: During the renewal inspection on 10/23/2025, the file for child #4 was viewed and the Emergency Contact Form did not include the health insurance coverage and policy number for the child.

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: 3270.124(b)(7)

Description: Name/address/phone release person

Noncompliance Area: During the renewal inspection on 10/23/2025, the file for child # 3 was viewed and the Emergency Contact Form did not include the name, address and telephone number 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.

Regulation: 3270.124(c)

Description: Each child care space

Noncompliance Area: During the renewal inspection on 10/23/2025, it was observed that the childcare spaces did not have Emergency Contact Forms in the 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.

Regulation: 3270.124(f)/3270.181(c)

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

Noncompliance Area: During the renewal inspection on 10/23/2025, the file for child #1 was viewed and the Emergency Contact Form and the Financial Agreement was not updated within a 6-month period. The last date the documents were reviewed was 2/21/2025.

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

Regulation: 3270.182(6)

Description: Signed parental consent for transportation, walking excursions, swimming and wading

Noncompliance Area: During the renewal inspection on 10/23/2025, the file for child #5 was viewed and the Emergency Contact Form did not contain signed parental consent for transportation, walking excursions, swimming and wading.

Correction Required: A child's record shall contain signed parental consent for transportation, walking excursions, swimming and wading.

Regulation: 3270.102(a)

Description: Clean and good repair

Noncompliance Area: During the renewal inspection on 10/10/2024, it was observed that a floor rug under the table was curling at the ends and was a tripping 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.

Regulation: 3270.104(a)

Description: Clean, good repair, proper size

Noncompliance Area: During the renewal inspection on 10/10/2024, it was observed that a bookcase in the front room was not secured to the wall and was a tipping hazard.

Correction Required: Furniture must be durable, safe, easily cleaned and appropriate for the child's size, age and special needs.

Regulation: 3270.131(b)(2)/3270.182(1)

Description: Toddler/preschool: updated health report every 12 months/Initial and subsequent health reports

Noncompliance Area: During the renewal inspection on 10/10/2024, the file for child #2 was reviewed and the most recent health report in the file was dated 12/8/22 which is not within a twelve-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. A child's record shall contain initial and subsequent health reports.

Regulation: 3270.171(a)

Description: Pick-up and drop-off points

Noncompliance Area: During the renewal inspection on 10/10/2024, it was observed that the local traffic safety authorities were not notified annually in writing of the location of the facility and the program's use of pedestrian and vehicular routes around the childcare facility.

Correction Required: An operator shall notify local traffic safety authorities annually in writing of the location of the facility and the program's use of pedestrian and vehicular routes around the childcare facility.

Regulation: 3270.182(5)

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

Noncompliance Area: During the renewal inspection on 10/10/2024, the file for child #1 was reviewed and did not contain signed parental consent for the facility to administer minor first-aid procedures.

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.

Regulation: 3270.27(f)

Description: Emergency plan

Noncompliance Area: During the renewal inspection on 10/10/2024, it was observed that an updated emergency plan was not sent 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: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: During the renewal inspection on 10/10/2024, the file for staff person #1 was reviewed and there was an FBI Clearance dated 10/2/2019 which was not dated within 60 months as required. (See code Sheet for hire date)

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). Staff person #1 must not work in a childcare position until CPSL clearances are obtained.

Regulation: 3270.52

Description: Mixed Age Level

Noncompliance Area: During the renewal inspection on 10/10/2024, it was observed that the room in the back upstairs was not in compliance with required staff/child ratio. The youngest child in the room was 14 months old and there was one staff to 6 children in the room.

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).

Regulation: 3270.77(a)

Description: No peeling paint or plaster

Noncompliance Area: During the renewal inspection on 10/10/2024, it was observed that there was paint chipping on the yellow and blue wall in the front room.

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

Regulation: 3270.106(f)

Description: 2 feet apart

Noncompliance Area: During the renewal inspection dated 10/19/2023, certification representative observed that child #1 was asleep in a crib and there was not 2 feet of space on three sides of the crib.

Correction Required: At least 2 feet of space is required on three sides of a bed, cot, crib or other rest equipment while the equipment is in use.

Regulation: 3270.66(a)

Description: Locked or inaccessible

Noncompliance Area: During the renewal inspection dated 10/19/2023, certification representative observed that in the pre-k room there were toxic substances accessible to the children.

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

Regulation: 3270.75(b)

Description: Inaccessible to children

Noncompliance Area: During the renewal inspection dated 10/19/2023, certification representative observed that a first aid kit was accessible to children in the toddler room.

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

Regulation: 3270.81

Description: Glass

Noncompliance Area: During the renewal inspection dated 10/19/2023, certification representative observed that the windows and glass doors in the pre-K room did not have visual identification on them.

Correction Required: A visual strip or other visual identification shall be placed on glass located in a traffic area, a child care space or a play space.

Regulation: 3270.82(h)

Description: Handwashing signs

Noncompliance Area: During renewal inspection dated 10/19/23, certification representative observed that the hand washing signs throughout the facility did not have the specific wording required in 3270.82(h) regulation.

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.

Regulation: 3270.151(c)(3)

Description: Exam communicable disease

Noncompliance Area: DURING THE RENEWAL INSPECTION ON NOVEMBER 10, 2022, THE HEALTH ASSESSMENT REVIEWED FOR STAFF PERSON #4 DID NOT INCLUDE AN EXAMINATION FOR COMMUNICABLE DISEASES AND THE RESULTS OF THAT EXAMINATION.

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

Regulation: 3270.192(2)(iv)

Description: Transcript, diploma and letters

Noncompliance Area: DURING THE RENEWAL INSPECTION ON NOVEMBER 10, 2022, THE RECORD REVIEWED FOR STAFF PERSON #3 AND STAFF PERSON #4 DID NOT INCLUDE VERIFICATION OF CHILD CARE EXPERIENCE FOR THE POSITION OF CLASSROOM AID.

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.

Regulation: 3270.31(f)

Description: Health and Safety Training

Noncompliance Area: DURING THE RENEWAL INSPECTION ON NOVEMBER 10, 2022, STAFF PERSON #1 AND STAFF PERSON #2 HAS NOT COMPLETED THE FOLLOWING REQUIRED PRE-SERVICE TRAINING WITHIN 90 DAYS OF HIRE (SEE LIS CODE): HEALTH AND SAFETY BASICS TRAINING.

Correction Required: Staff persons shall complete professional development within 90 days of hire as listed in subsections (f)1-10.

Regulation: 3270.32(a)/3270.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: DURING THE RENEWAL INSPECTION ON NOVEMBER 10, 2022, THE RECORD REVIEWED FOR STAFF PERSON #2 CONTAINS FBI CLEARANCES DATED 06.27.17 WHICH IS MORE THAN 60-MONTHS OLD (SEE CODE SHEET). STAFF PERSON #3 HAS NOT COMPLETED MANDATED REPORTER TRAINING WITHIN THE LAST 60 MONTHS. THIS IS EVIDENCED BY THE PREVIOUSLY DOCUMENTED MANDATED REPORTER TRAINING ON FILE BEING DATED 08.09.15.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). LACKING REQUIRED HIRING DOCUMENTS: Facility Person #2 may not work in a childcare 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. Facility Person #2 may not work in a childcare position at the facility. The operator shall comply with the CPSL and with Chapter 3490 (relating to Child Protective Services). Staff person/f #3 will have until 12,02,22 to complete the mandated reporter training. Until such time as the required training has been completed, staff person #3 must be supervised, when interacting with children, by an AGS, primary staff person, who has completed the required training related to this citation. If there are no staff person(s) available to supervise staff person#-3, staff person #3 may not work in a child-care position at the facility.

Regulation: 3270.124(b)(7)

Description: Name/address/phone release person

Noncompliance Area: Release person's address was not present on the Emergency Contact form at the time of the renewal inspection.

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: 3270.192(3)

Description: Health assessment, TB test

Noncompliance Area: Review of files reveal that Staff # 1 did not have a current health assessment as their last health assessment took place in 2019; Staff #2 did not present TB results at the time of the renewal inspection; Staff #4 did not have a health assessment on file to also confirm freedom from communicable diseases; Staff #6 did not have a health form to confirm their physical or TB results at the time of the renewal inspection.

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.

Regulation: 3270.32(a)

Description: Comply with CPSL

Noncompliance Area: Several staff had expired clearances at the time of the renewal inspection. Staff #1 had FBI clearance results that had last taken place on 5/10/16; Staff #2 had mandated reporter training that had taken place on 8/12/15; Staff #3 had a mandated reporter training that had taken place on 8/19/15; Facility person did not have the results for their NSOR, Child Abuse, or State Criminal at the time of the renewal inspection.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). SAFETY PLAN: The operator is required to submit to the Children and Youth Agency a plan of supervision or alternate arrangement as required by the Child Protective Services Law.

Noncompliance Area: DURING THE RENEWAL INSPECTION ON 9/10/19, THE CHANGING PAD IN THE INFANT ROOM WAS TORN WITH FOAM EXPOSED, ACCESSIBLE TO CHILDREN CAUSING A POTENTIAL HAZARD.

Correction Required: Furniture must be durable, safe, easily cleaned and appropriate for the child's size, age and special needs.

Noncompliance Area: DURING THE RENEWAL INSPECTION ON 9/10/19, CHILD 3 EMERGENCY CONTACT FORM DID NOT STATE THE NAME OF THE PHYSICIAN.

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: DURING THE RENEWAL INSPECTION ON 9/10/19, CHILD 3 EMERGENCY CONTACT FORM DID NTO STATE THE MA POLICY NUMBER ON THE FORM.

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: DURING THE RENEWAL INSPECTION ON 9/10/19, CHILD 2 EMERGENCY CONTACT FORM DID NOT STATE THE RELEASE PERSON'S ADDRESS ON THE FORM.

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: DURING THE RENEWAL INSPECTION ON 9/10/19, CHILD 5 FILE DID NOT CONTAIN AN UPDATED HEALTH REPORT. LAST REPORT ON FILE WAS DATED 3/19/18.

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: DURING THE RENEWAL INSPECTION ON 9/10/19, THE FACILITY DID NOT NOTIFY THE LOCAL TRAFFIC SAFETY AUTHORITIES OF THE LOCATION OF THE FACILITY AND THE PROGRAM'S USE OF PEDESTRIAN AND VEHICULAR ROUTES AROUND THE DAY CARE FACILITY.

Correction Required: An operator shall notify local traffic safety authorities annually in writing of the location of the facility and the program's use of pedestrian and vehicular routes around the day care facility.

Noncompliance Area: DURING THE RENEWAL INSPECTION ON 9/10/19, THE EMERGENCY PLAN HAS NOT BEEN UPDATED IN THE LAST YEAR.

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: DURING THE RENEWAL INSPECTION ON 9/10/19, THE EMERGENCY PLAN HAS NOT BEEN SENT TO THE COUNTY EMERENCY MANAGEMENT AGENCY.

Correction Required: The operator shall send a copy of the emergency plan and subsequent plan updates to the county emergency management agency.

Noncompliance Area: DURING THE RENEWAL INSPECTION ON 9/10/19, STAFF 2 AND 4 FILE DID NOT HAVE THE EDUCATION AND EXPERIENCE TO QUALIFY FOR A GROUP SUPERVISOR.

Correction Required: A group supervisor shall have an associate's degree from an accredited college or university, including 30 credit hours in early childhood education, child development, special education, elementary education or the human services field and 3 years of experience with children.A facility person's record shall include verification of child care experience, education and training prior to service at the facility.

Noncompliance Area: DURING THE RENEWAL INSPECTION ON 9/10/19, THE FIRST AID KIT IN THE INFANT ROOM WAS MISSING SCISSORS. THE FIRST AID KIT IN THE TODDLER ROOM WAS MISSING SOAP.

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: DURING THE RENEWAL INSPECTION ON 10/9/18, CHILD 5 AGREMENT FORM WAS NOT SIGNED BY THE PARENT.

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

Noncompliance Area: DURING THE RENEWAL INSPECTION ON 10/9/18, CHILD 1 EMERGENCY CONTACT FORM DID NOT STATE THE PHYSICIAN PHONE NUMBR ON THE FORM.

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: DURING THE RENEWAL INSPECTION ON 10/9/18, CHILD 2 AND 5 EMERGENCY CONTACT FORM WAS MISSING INFORMATION. CHILD 2 FORM WAS MISSING MA POLICY NUMBER, CHILD 5 FORM WAS MISSING MA COVERAGE NAME.

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: DURING THE RENEWAL INSPECTION ON 10/9/18, THE FIRST FLOOR CLASSROOM AND THE INFANT CLASSROOM DID NOT HAVE MEANS OF TRANSPORTING A CHILD TO EMERGENCY CARE AND STAFFING PROVISIONS IN THE EVENT OF AN EMERGENCY POSTED IN THE CHILD CARE SPACE.

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: DURING THE RENEWAL INSPECTION ON 10/9/18, CHILD 5 EMERGENCY CONTACT FORM DID NOT HAVE A CONSENT FOR EMERGENCY MEDICAL CARE ON THE FORM.

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.

Noncompliance Area: DURING THE RENEWAL INSPECTION ON 10/9/18, CHILD 5 EMERGENCY CONTACT FORM DID NOT HAVE A CONSENT FOR ADMINISTRATION OF MINOR FIRST AID ON THE FORM.

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: DURING THE RENEWAL INSPECTION ON 10/9/18, THERE WAS AN ADULT BICYCLE IN THE CHILDCARE SPACE ACCESSIBLE TO CHILDREN CAUSING A POTENTIAL HAZARD IN THE CHILD CARE 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: DURING THE RENEWAL INSPECTION ON 10/9/18, THERE WAS PEELING PAINT IN THE FIRST CLASSROOM UPSTAIRS ON THE LEFT.

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

Noncompliance Area: DURING RENEWAL INSPECTION ON NOVEMBER 6, 2017, THE PACK AND PLAYS USED BY THE INFANTS WERE 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: DURING RENEWAL INSPECTION ON NOVEMBER 6, 2017, THE RECORD OF STAFF #1 DID NOT INCLUDE VERIFICATION OF AGE.

Correction Required: A facility person's record shall include verification of age.

Noncompliance Area: DURING RENEWAL INSPECTION ON NOVEMBER 6, 2017, THE RECORD OF FACILITY PERSON #2 DID NOT INCLUDE TWO WRITTEN, NONFAMILY REFERENCES FROM INDIVIDUALS ATTESTING TO THE PERSON'S SUITABILITY TO SERVE AS A FACILITY PERSON.

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: DURING RENEWAL INSPECTION ON MAY 19, 2017, ALL SERVICE AGREEMENTS REVIEW DID NOT SPECIFY THE SERVICES PROVIDED TO THE FAMILY AND CHILD, OR THE SERVICES WHICH ARE TO BE CONSIDERED AS EXTRA. DURING UNANNOUNCED INSPECTION ON JUNE 26, 2017, ALL SERVICE AGREEMENTS REVIEWED DID NOT SPECIFY THE SERVICES PROVIDED TO THE FAMILY AND CHILD, OR THE SERVICES WHICH ARE TO BE CONSIDERED AS EXTRA. CONTINUED NON-COMPLIANCE.

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).An agreement shall specify the services which are to be considered as extra.

Noncompliance Area: DURING RENEWAL INSPECTION ON MAY 19, 2017, ALL AGREEMENTS REVIEWED DID NOT SPECIFY THE PERSONS DESIGNATED BY A PARENT TO WHOM THE CHILD MAY BE RELEASED. DURING UNANNOUNCED INSPECTION ON JUNE 26, 2017, THE AGREEMENT OF CHILDREN #1, 2, AND 3 DID NOT SPECIFY THE PERSONS DESIGNATED BY A PARENT TO WHOM THE CHILD MAY BE RELEASED. CONTINUED NON-COMPLIANCE.

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

Noncompliance Area: DURING RENEWAL INSPECTION ON MAY 19, 2017, THE EMERGENCY CONTACT INFORMATION OF CHILDREN #1, 3, 4, AND 5 DID NOT CONTAIN THE ENROLLING PARENTS' WORK ADDRESS OR WORK TELEPHONE NUMBER. DURING UNANNOUNCED INSPECTION ON JUNE 26, 2017, THE EMERGENCY CONTACT INFO OF CHILD #1 AND 2 DID NOT CONTAIN THE ENROLLING PARENTS' WORK ADDRESS OR WORK TELEPHONE NUMBER. CONTINUED NON-COMPLIANCE.

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

Noncompliance Area: DURING RENEWAL INSPECTION ON MAY 19, 2017, THE EMERGENCY CONTACT INFORMATION OF CHILDREN #3, 4 AND 5 DID NOT CONTAIN INFORMATION ON THE DISABILITY OF THE CHILD AS SPECIFIED BY THE CHILD'S PARENT, PHYSICIAN, PHYSICIAN'S ASSISTANT, OR CRNP WHICH IS NEEDED IN AN EMERGENCY SITUATION. DURING UNANNOUNCED INSPECTION ON JUNE 26, 2017, THE EMERGENCY CONTACT INFORMATION OF CHILD #1 DID NOT CONTAIN INFORMATION ON THE DISABILITY OF THE CHILD AS SPECIFIED BY THE CHILD'S PARENT, PHYSICIAN, PHYSICIAN'S ASSISTANT, OR CRNP WHICH IS NEEDED IN AN EMERGENCY SITUATION. CONTINUED NON-COMPLIANCE.

Correction Required: Emergency contact information must include information on the child`s special needs, as specified by the child`s parent, physician, physician`s assistant or CRNP, which is needed in an emergency situation.

Noncompliance Area: DURING RENEWAL INSPECTION ON MAY 19, 2017, THE EMERGENCY CONTACT INFORMATION OF CHILDREN #2, 3, 4, AND 6 DID NOT CONTAIN THE HEALTH INSURANCE COVERAGE AND/OR POLICY NUMBER FOR A CHILD UNDER A FAMILY POLICY. DURING UNANNOUNCED INSPECTION ON JUNE 26, 2017, THE EMERGENCY CONTACT INFORMATION OF CHILDREN #1, 4, AND 5 DID NOT CONTAIN THE HEALTH INSURANCE COVERAGE AND/OR POLICY NUMBER FOR A CHILD UNDER A FAMILY POLICY. CONTINUED NON-COMPLIANCE.

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: DURING RENEWAL INSPECTION ON MAY 19, 2017, THE EMERGENCY CONTACT INFORMATION AND FINANCIAL AGREEMENT OF CHILD NUMBER 2 WERE NOT REVIEWED AND UPDATED WITHIN A 6 MONTH TIME FRAME. DURING UNANNOUNCED INSPECTION ON JUNE 26, 2017, THE EMERGENCY CONTACT INFORMATION AND FINANCIAL AGREEMENT OF CHILDREN #1 AND 2 WERE NOT REVIEWED AND UPDATED WITHIN A 6 MONTH TIME FRAME. CONTINUED NON-COMPLIANCE.

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: DURING RENEWAL INSPECTION ON MAY 19, 2017, THE RECORDS OF CHILD #1 (ENROLLED ON 1-4-17), CHILD #2 (ENROLLED 10-24-16) AND CHILD #3 (ENROLLED 1-10-17) DID NOT CONTAIN AN INITIAL HEALTH REPORT NO LATER THAN 60 DAYS FOLLOWING THE FIRST DAY OF ATTENDANCE AT THE FACILITY. DURING UNANNOUNCED INSPECTION ON JUNE 26, 2017, THE RECORDS OF CHILD #2 DID NOT CONTAIN AN INITIAL HEALTH REPORT NO LATER THAN 60 DAYS FOLLOWING THE FIRST DAY OF ATTENDANCE AT THE FACILITY. CONTINUED NON-COMPLIANCE.

Correction Required: The operator shall require the parent of an enrolled child, including a child, a foster child and a relative of an operator or a facility person, to provide an initial health report no later than 60 days following the first day of attendance at the facility.

Noncompliance Area: DURING RENEWAL INSPECTION ON MAY 19, 2017, THE HEALTH ASSESSMENTS OF STAFF #1 AND #4 DID NOT CONTAIN DOCUMENTATION OF TUBERCULOSIS SCREENING AT INITIAL EMPLOYMENT. DURING UNANNOUNCED INSPECTION ON JUNE 26, 2017, THE HEALTH ASSESSMENT OF STAFF #1 STILL DID NOT CONTAIN DOCUMENTATION OF TUBERCULOSIS SCREENING AT INITIAL EMPLOYMENT. CONTINUED NON-COMPLIANCE.

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: DURING RENEWAL INSPECTION ON MAY 19, 2017, THE EMERGENCY CONTACT INFORMATION OF CHILDREN NUMBER 4 AND 6 DID NOT CONTAIN WRITTEN CONSENT SIGNED BY A PARENT FOR EMERGENCY MEDICAL CARE. DURING UNANNOUNCED INSPECTION ON JUNE 26, 2017, THE RECORD OF CHILD #1 AND 2 DID NOT CONTAIN SIGNED PARENTAL CONSENT FOR EMERGENCY MEDICAL CARE FOR THE CHILD. CONTINUED NON-COMPLIANCE.

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.

Noncompliance Area: DURING RENEWAL INSPECTION ON MAY 19, 2017, THE RECORDS OF CHILDREN #4 AND #6 DID NOT CONTAIN SIGNED PARENTAL CONSENT FOR ADMINISTRATION OF MEDICATIONS OR SPECIAL DIETARY NEEDS, TRANSPORTATION, OR WALKING EXCURSIONS. ACCORDING TO STAFF #4, FACILITY DOES NOT PARTICIPATE IN SWIMMING OR WADING ACTIVITIES. DURING UNANNOUNCED INSPECTION ON JUNE 26, 2017, THE RECORDS OF CHILDREN #1 AND 2 DID NOT CONTAIN SIGNED PARENTAL CONSENT FOR ADMINISTRATION OF MEDICATIONS OR SPECIAL DIETARY NEEDS, TRANSPORTATION, OR WALKING EXCURSIONS.

Correction Required: A child`s record shall contain signed parental consent for administration of medications or special dietary needs.A child`s record shall contain signed parental consent for transportation, walking excursions, swimming and wading.

Noncompliance Area: DURING RENEWAL INSPECTION ON MAY 19, 2017, CERTIFICATION REPRESENTATIVE OBSERVED CRACKS IN THE FLOOR AT THE BASE OF THE STEPS LEADING FROM ROOM 1 TO ROOM 2, CRACKS IN THE FLOOR BETWEEN THE BATHROOM AND THE MAIN ROOM 1, DAMAGE TO THE BOTTOM OF RIGHTSIDE WALL IN THE BATHROOM, CRACKED FLOOR AND DAMAGE TO THE BOTTOM OF THE WALL BY THE SINK IN THE MAIN ROOM. THE STEP STOOL IN THE BATHROOM SHOWED VISIBLE DIRT. DURING UNANNOUNCED INSPECTION ON JUNE 26, 2017, THE BOTTOM OF THE WALL BY THE SINK IN THE MAIN ROOM WAS STILL OBSERVED TO BE IN A STATE OF DISREPAIR. CONTINUED NON-COMPLIANCE.

Correction Required: Conditions at the facility may not pose a threat to the health or safety of the children.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: DURING RENEWAL INSPECTION ON MAY 19, 2017, AT APPROXIMATELY 10:00 AM, CERTIFICATION REPRESENTATIVE OBSERVED 16 CHILDREN (6 OLDER TODDLERS AND 10 PRESCHOOL CHILDREN) ALL IN ROOM 1 WITH TWO STAFF. AT LUNCHTIME, THE CERTIFICATION REPRESENTATIVE OBSERVED ALL 20 CHILDREN (1 INFANT, 3 YOUNG TODDLERS, 6 OLDER TODDLERS, AND 10 PRESCHOOL CHILDREN) IN ONE CHILDCARE SPACE WITH THREE STAFF MEMBERS. CHILDREN WERE NOT ADEQUATELY SUPERVISED DUE TO PROPER RATIO NOT BEING MAINTAINED. DURING UNANNOUNCED INSPECTION ON JUNE 26, 2017, CERTIFICATION REPRESENTATIVE OBSERVED 12 CHILDREN AGES 3-10 YEARS OLD WITH ONE STAFF MEMBER IN A ROOM. RATIO AND SUPERVISION SHEETS WERE ONLY COMPLETED FOR THE INFANT CLASSROOM. CONTINUED NON-COMPLIANCE.

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). The required staff:child ratios must be maintained at all times.The legal entity must submit documentation in a format approved by DHS proving that the facility is maintaining the required staff:child ratios at all times. The legal entity will confirm continuing compliance by sending copies of the documentation to the SE Region Office on a weekly basis for a period of three months after DHS approves the documentation format. 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 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: DURING RENEWAL INSPECTION ON MAY 19, 2017, ALL SERVICE AGREEMENTS REVIEW DID NOT SPECIFY THE SERVICES PROVIDED TO THE FAMILY AND CHILD, OR THE SERVICES WHICH ARE TO BE CONSIDERED AS EXTRA.

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).An agreement shall specify the services which are to be considered as extra.

Noncompliance Area: DURING RENEWAL INSPECTION ON MAY 19, 2017, ALL AGREEMENTS REVIEWED DID NOT SPECIFY 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: DURING RENEWAL INSPECTION ON MAY 19, 2017, THE EMERGENCY CONTACTS OF CHILDREN #1, 2, 3 AND 6 DID NOT CONTAIN THE ADDRESS AND/OR PHONE NUMBER OF THE CHILD'S PHYSICIAN OR SOURCE OF MEDICAL CARE.

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: DURING RENEWAL INSPECTION ON MAY 19, 2017, THE EMERGENCY CONTACT INFORMATION OF CHILDREN #1, 3, 4, AND 5 DID NOT CONTAIN THE ENROLLING PARENTS' WORK ADDRESS OR WORK TELEPHONE NUMBER.

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

Noncompliance Area: DURING RENEWAL INSPECTION ON MAY 19, 2017, THE EMERGENCY CONTACT INFORMATION OF CHILDREN NUMBER 4 AND 6 DID NOT CONTAIN WRITTEN CONSENT SIGNED BY A PARENT 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: DURING RENEWAL INSPECTION ON MAY 19, 2017, THE EMERGENCY CONTACT INFORMATION OF CHILDREN #3, 4 AND 5 DID NOT CONTAIN INFORMATION ON THE DISABILITY OF THE CHILD AS SPECIFIED BY THE CHILD'S PARENT, PHYSICIAN, PHYSICIAN'S ASSISTANT, OR CRNP WHICH IS NEEDED IN AN EMERGENCY SITUATION.

Correction Required: Emergency contact information must include information on the child`s special needs, as specified by the child`s parent, physician, physician`s assistant or CRNP, which is needed in an emergency situation.

Noncompliance Area: DURING RENEWAL INSPECTION ON MAY 19, 2017, THE EMERGENCY CONTACT INFORMATION OF CHILDREN #2, 3, 4, AND 6 DID NOT CONTAIN THE HEALTH INSURANCE COVERAGE AND/OR POLICY NUMBER FOR A CHILD UNDER A FAMILY POLICY.

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: DURING RENEWAL INSPECTION ON MAY 19, 2017, THE EMERGENCY CONTACT INFORMATION OF CHILDREN #1, 2, 3 AND 4 DID NOT CONTAIN 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: DURING RENEWAL INSPECTION ON MAY 19, 2017, THE EMERGENCY CONTACT INFORMATION AND FINANCIAL AGREEMENT OF CHILD NUMBER 2 WERE NOT REVIEWED AND UPDATED WITHIN A 6 MONTH TIME FRAME.

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: DURING RENEWAL INSPECTION ON MAY 19, 2017, THE RECORDS OF CHILD #1 (ENROLLED ON 1-4-17), CHILD #2 (ENROLLED 10-24-16) AND CHILD #3 (ENROLLED 1-10-17) DID NOT CONTAIN AN INITIAL HEALTH REPORT NO LATER THAN 60 DAYS FOLLOWING THE FIRST DAY OF ATTENDANCE AT THE FACILITY.

Correction Required: The operator shall require the parent of an enrolled child, including a child, a foster child and a relative of an operator or a facility person, to provide an initial health report no later than 60 days following the first day of attendance at the facility.

Noncompliance Area: DURING RENEWAL INSPECTION ON MAY 19, 2017, THE HEALTH ASSESSMENTS OF STAFF #1 AND #4 DID NOT CONTAIN DOCUMENTATION OF TUBERCULOSIS SCREENING AT INITIAL EMPLOYMENT.

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: DURING RENEWAL INSPECTION ON MAY 19, 2017, A MENU OF MEALS PROVIDED WAS NOT CONSPICUOUSLY POSTED AT LEAST 1 WEEK IN ADVANCE.

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

Noncompliance Area: DURING RENEWAL INSPECTION ON MAY 19, 2017, WRITTEN NOTIFICATION OF SAFE ROUTES WAS NOT POSTED BY THE OPERATOR AT A CONSPICUOUS LOCATION IN THE CHILDCARE FACILITY.

Correction Required: Written notification of safe routes shall be posted by the operator at a conspicuous location in the child care facility.

Noncompliance Area: DURING RENEWAL INSPECTION ON MAY 19, 2017, A CURRENT COPY OF THE LIABILITY INSURANCE POLICY WAS NOT ON FILE AT THE FACILITY.

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: DURING RENEWAL INSPECTION ON MAY 19, 2017, THE RECORDS OF CHILDREN #4 AND #6 DID NOT CONTAIN SIGNED PARENTAL CONSENT FOR ADMINISTRATION OF MEDICATIONS OR SPECIAL DIETARY NEEDS, TRANSPORTATION, OR WALKING EXCURSIONS. ACCORDING TO STAFF #4, FACILITY DOES NOT PARTICIPATE IN SWIMMING OR WADING ACTIVITIES.

Correction Required: A child`s record shall contain signed parental consent for administration of medications or special dietary needs.A child`s record shall contain signed parental consent for transportation, walking excursions, swimming and wading.

Noncompliance Area: DURING RENEWAL INSPECTION ON MAY 19, 2017, CERTIFICATION REPRESENTATIVE OBSERVED CRACKS IN THE FLOOR AT THE BASE OF THE STEPS LEADING FROM ROOM 1 TO ROOM 2, CRACKS IN THE FLOOR BETWEEN THE BATHROOM AND THE MAIN ROOM 1, DAMAGE TO THE BOTTOM OF RIGHTSIDE WALL IN THE BATHROOM, CRACKED FLOOR AND DAMAGE TO THE BOTTOM OF THE WALL BY THE SINK IN THE MAIN ROOM. THE STEP STOOL IN THE BATHROOM SHOWED VISIBLE DIRT.

Correction Required: Conditions at the facility may not pose a threat to the health or safety of the children.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: DURING RENEWAL INSPECTION ON MAY 19, 2017, THE FACILITY'S CURRENT CERTIFICATE OF COMPLIANCE WAS NOT POSTED IN A CONSPICUOUS LOCATION USED BY 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: DURING RENEWAL INSPECTION ON MAY 19, 2017, THE FACILITY WAS UNABLE TO PROVIDE AN EMERGENCY PLAN. PROVIDER EXPRESSED THAT THEY DID HAVE AN EMERGENCY PLAN, BUT WAS UNABLE TO FIND IT AT THE TIME OF INSPECTION.

Correction Required: The facility shall have an emergency plan

Noncompliance Area: DURING RENEWAL INSPECTION ON MAY 19, 2017, THE RECORD OF STAFF #1 DID NOT CONTAIN A COPY OF THE UPDATED DISCLOSURE STATEMENT.

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: DURING RENEWAL INSPECTION ON MAY 19, 2017, AT APPROXIMATELY 10:00 AM, CERTIFICATION REPRESENTATIVE OBSERVED 16 CHILDREN (6 OLDER TODDLERS AND 10 PRESCHOOL CHILDREN) ALL IN ROOM 1 WITH TWO STAFF. AT LUNCHTIME, THE CERTIFICATION REPRESENTATIVE OBSERVED ALL 20 CHILDREN (1 INFANT, 3 YOUNG TODDLERS, 6 OLDER TODDLERS, AND 10 PRESCHOOL CHILDREN) IN ONE CHILDCARE SPACE WITH THREE STAFF MEMBERS. CHILDREN WERE NOT ADEQUATELY SUPERVISED DUE TO PROPER RATIO NOT BEING MAINTAINED.

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). 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. 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.

Noncompliance Area: DURING RENEWAL INSPECTION ON MAY 19, 2017, STAFF #4 WAS OBSERVED TO TAKE 10 CHILDREN ON A WALKING EXCURSION ALONE.

Correction Required: At least two facility persons shall be present when children are on an excursion away from the facility. At a minimum, one of the facility persons shall be a staff person.

Noncompliance Area: DURING RENEWAL INSPECTION ON MAY 19, 2017, HANDWASHING SIGNS WERE NOT POSTED BY THE DIAPERING AREA IN THE INFANT ROOM.

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.