Kelli Rydboms Kare A Lot 2

Regulation: 3280.123(a)(3)

Description: Services proceeded

Noncompliance Area: The file for child #1, child #2, child #3, child #4, and child #4 were observed not to contain a Child Service report.

Correction Required: An agreement shall specify 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 at § 3280.124(f).

Regulation: 3280.123(a)(5)

Description: Designated release persons

Noncompliance Area: The agreement form on file for child #2 and Child #3 was observed not to 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.

Regulation: 3280.124(b)(5)

Description: Information re: special needs

Noncompliance Area: The emergency contact form on file for child #2 and child #3 was observed not to 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.

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.

Regulation: 3280.131(a)/3280.182(1)

Description: Health Information/Initial and subsequent health assessments

Noncompliance Area: The file for child # 3 was observed not to have a health assessment.

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 must contain initial and subsequent health reports.

Regulation: 3280.119

Description: Infant sleep position

Noncompliance Area: It was observed on the day of inspection, that an infant was sleeping in a bouncy seat.

Correction Required: Infants shall be placed in the sleeping position recommended by the American Academy of Pediatrics unless there is a medical reason an infant should not sleep in this position. The medical reason shall be documented in a statement signed by a physician, physician's assistant or CRNP and placed in the child's record at the facility.

Regulation: 3280.123(a)(6)/3280.182(2)

Description: Admission date/Application, admission, withdrawal dates

Noncompliance Area: The Agreement on file for Child #3 was observed not to contain the date of admission.

Correction Required: An agreement shall specify the date of the child's admission. A child's record must contain the dates of application, admission and withdrawal of the child.

Regulation: 3280.124(b)(5)

Description: Information re: special needs

Noncompliance Area: The emergency contact forms on file for Child #1 and Child #2 were observed not to include information on the child's special need or disability.

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.

Regulation: 3280.124(f)/3280.181(c)

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

Noncompliance Area: The file for Child #3 was observed not to have a review of the emergency contact information or the fee agreement every 6 months.

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: 3280.133(3)

Description: Name on bottle

Noncompliance Area: It was observed that several containers of sunscreen did not identify the name of the child for whom the sunscreen was intended.

Correction Required: The label of a medication container shall identify the name of the medication and the name of the child for whom the medication is intended. Medication shall be administered to only the child whose name appears on the container.

Regulation: 3280.20

Description: General Health and Safety

Noncompliance Area: In the facility bathroom, a razor accessible to the children was left in the shower.

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

Regulation: 3280.66(a)

Description: Locked or inaccessible - in original container

Noncompliance Area: In the facility restroom, several toxics were observed to be accessible to the children in the cupboard.

Correction Required: Cleaning materials and other toxic materials shall be stored in an original labeled container or in a container that specifies the content. Toxics shall be kept in a locked area or in an area inaccessible to children, and shall be stored away from food, food preparation areas and child care spaces.

Regulation: 3280.131(d)(5)/3280.131(e)(3)

Description: Immunization record/Dismissal policy

Noncompliance Area: The file for child #1 lacks a flu shot within the past year as in accordance with the schedule recommended by the ACIP.

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

Regulation: 3280.14/3280.20

Description: Pertinent Laws & Regulations/General Health and Safety

Noncompliance Area: The file for staff #5 lacks the one hour health and safety training that was required by 12/30/22.

Correction Required: A facility shall be operated in conformity with applicable Federal and State laws and regulations. State agencies whose regulations may relate to the operation of a facility include the Department of Environmental Resources, the Department of Labor and Industry, the Department of Health, the Department of Education and the Department of Transportation. Conditions at the facility may not pose a threat to the health or safety of the children.

Regulation: 3280.151(a)/3280.192(3)

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

Noncompliance Area: There was more than 24 months between the previous and most current and updated health assessments on file for staff #1 and 2. The file for staff #4 lacks an initial 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.

Regulation: 3280.151(c)(2)/3280.192(3)

Description: Mantoux TB /Health assessment, TB test

Noncompliance Area: The file for staff #4 lacks a TB screening by the Mantoux method 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. 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: 3280.182(3)/3280.182(5)

Description: Consent for emergency medical care required prior to admission/Consent for administration of minor first-aid required prior to admission

Noncompliance Area: The file for child #1 lacks signed parental consent for emergency medical care for the child and for administration of minor first-aid procedures by facility staff.

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

Regulation: 3280.192(5)

Description: Two written references

Noncompliance Area: The file for staff #4 lacks two written, nonfamily 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.

Regulation: 3280.26(e)

Description: Letter to parents

Noncompliance Area: The operator did not provide the parent of each child enrolled a letter explaining shelter in place and shelter away from the facility, lockdown, evacuation, method to contact parents as soon as reasonably possible when an emergency situation arises and method to inform parents emergency has ended and how they can safely be reunited with their children, accommodations for infants, toddlers, children with disabilities and children with chronic medical conditions.

Correction Required: The operator shall provide to the parent of each enrolled child a letter explaining the emergency procedures. The operator shall also provide to the parent of each enrolled child a letter explaining any subsequent update to the plan.

Regulation: 3280.32(a)/3280.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: There was more than 60 months between Child Abuse clearances on file for staff #3. Dates are as follows: 6/11/18 and 7/18/23. The file for staff #4, who was a provisional hire, lacked verification of DHS FBI fingerprint on or before initial start date in a childcare position. There are no DHS FBI and NSOR clearances on file. SEE IS CODE SHEET.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). LACKING REQUIRED HIRING DOCUMENTS: Facility Person # 4 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.

Regulation: 3280.34(b)(1)/3280.192(2)(ii)

Description: HS/GED + 30 credits/Exp, educ., training prior to facility

Noncompliance Area: The file for staff #4, who holds the title of primary staff person, lacked 30 credit hours from an accredited college or university in early childhood education, child development, special education, elementary education or the human services field.

Correction Required: A primary staff person shall have attained a high school diploma or a general educational development certificate and 30 credit hours from an accredited college or university in early childhood education, child development, special education, elementary education or the human services field. A facility person's record shall include verification of child care experience, education and training prior to service at the facility.

Regulation: 3280.102(a)

Description: Clean and good repair

Noncompliance Area: In the outside play space observed a large play castle. The top of the castle was not secured tight and when the children stand on the castle wall, the top of the castle could come loose causing them to fall, a blue and yellow play car which had 2 cracks in the back of it by the fake gas can, a wooden swing which had a bottom beam coming loose, a red and purple tricycle which had a crack near the front wheel and the back basket and a cream and blue truck with a crack near the back of it.

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: 3280.123(a)(4)/3280.123(a)(5)

Description: Arrival/departure times/Designated release persons

Noncompliance Area: The fee agreement on file for child #1 lacks the arrival and departure times and the persons designated by a parent to whom the child may be released.

Correction Required: An agreement shall specify the child's arrival and departure times.An agreement shall specify the persons designated by a parent to whom the child may be released.

Regulation: 3280.131(b)(2)/3280.182(1)

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

Noncompliance Area: The most current health assessment on file for child #1, who is of preschool age, was not completed within the past 12 months. Health assessment is dated 2/25/21.

Correction Required: The operator shall require the parent to provide an updated health report at least every 12 months for an older toddler or preschool child.A child's record must contain initial and subsequent health reports.

Regulation: 3280.131(e)(1)

Description: Exemption documentation from parent/guardian

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

Correction Required: 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.

Regulation: 3280.14/3280.20

Description: Pertinent Laws & Regulations/General Health and Safety

Noncompliance Area: The emergency plan lacked a plan for how the facility will maintain continuity of care in an emergency.

Correction Required: A facility shall be operated in conformity with applicable Federal and State laws and regulations. State agencies whose regulations may relate to the operation of a facility include the Department of Environmental Resources, the Department of Labor and Industry, the Department of Health, the Department of Education and the Department of Transportation.Conditions at the facility may not pose a threat to the health or safety of the children.

Regulation: 3280.151(a)/3280.192(3)

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

Noncompliance Area: There was more than 24 months between the previous and most current and updated health assessment on file for staff #4.

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.

Regulation: 3280.26(a)(1)/3280.26(a)(5)

Description: Emergency plan/Emergency plan

Noncompliance Area: The facility's emergency plan lacked a plan that provides shelter of children during an emergency including lockdown, shelter in place at the facility and accommodations for infants, toddlers, children with disabilities and children with chronic medical conditions.

Correction Required: The facility shall have an emergency plan that provides for shelter of children during an emergency including lock-down, shelter in place at the facility and shelter at locations away from the facility premises.The facility shall have an emergency plan that provides for accommodations for infants, toddlers, children with disabilities and children with chronic medical conditions.

Regulation: 3280.31(f)

Description: Age and training

Noncompliance Area: Staff person #1,2, 4, 5, 6, and 7--- did not complete the following required pre-service training within the required time frame for all staff who were hired prior to the implementation of the new regulations which were in effect as of 12/19/20. (See LIS CODE SHEET). Health and Safety training was to be completed by 6/17/21 and the six hour training was acceptable from 9/30/16-6/30/18. Current health and safety training is now on file for staff 1, 2, 4, 5, 6 and 7. Staff #1- 5/1/22, Staff #2 took the six hour training on 9/27/16. The ten hour health and safety training is now on file and dated 5/1/22. Staff #4 - 8/2/22, Staff #5 - 8/8/22, Staff #6 - 5/11/22 and Staff #7 - 5/2/22.

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

Regulation: 3280.31(f)

Description: Age and training

Noncompliance Area: Staff persons #1, 2, 3, 4, 5, 6 and 7 have acceptable pediatric first aid/CPR training in an approved curriculum; however, the trainer has not provided documentation that they are PQAS-certified in that training topic.

Correction Required: Staff persons shall complete professional development in the topics of 3270.31(f)(10), 3280.31(f) (10), or 3290.31(g)(10) within 90 days of hire. Staff person #1, 2, 3, 4, 5, 6 and 5 must do one of the following: provide documentation that the trainer has become PQAS-certified or at least is on the waiting list, request the instructor provide documentation, such as their Pediatric First-Aid/CPR Instructor Card from the PQAS-approved organization or the approved curriculum organization, that the instructor is approved to offer Pediatric First-Aid/CPR training on behalf of their organization, or receive pediatric first-aid/CPR training in an approved curriculum by a PQAS-certified trainer.

Regulation: 3280.32(a)/3280.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: There was more than 60 months between the previous State Police and the current State Police clearance on file for staff #3. State Police - 5/23/17 and 6/6/22. The most current Child Abuse clearance on file at the facility for staff #3 was not completed within the past 60 months. Child Abuse - 5/23/17. There is an FBI clearance on file for staff #3 and dated 8/5/21. Previously, it was verified that staff #3 had a prior FBI clearance on file but operator was unable to locate it.

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 at the facility.

Regulation: 3280.52(c)

Description: Mixed age levels

Noncompliance Area: On 8/10/22, observed 12 children in care. Staff #1 named 1 infant, 1 YT, 2 OT and 2 PS age children in her care. Staff #2 named 5 PS age and 1 OT in her care. Staff #1 was out of ratio.

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 at §3280.52(b).

Regulation: 3280.66(a)

Description: Locked or inaccessible - in original container

Noncompliance Area: In the bathroom, observed cleaning materials which were in an unlocked cabinet and accessible to the children .

Correction Required: Cleaning materials and other toxic materials shall be stored in an original labeled container or in a container that specifies the content. Toxics shall be kept in a locked area or in an area inaccessible to children, and shall be stored away from food, food preparation areas and child care spaces.

Regulation: 3280.95(a)/3280.95(b)

Description: FIRE DETECTION/Staff responsibility

Noncompliance Area: Proof of purchase of the facilities fire detection system/devices was not on file at the facility.

Correction Required: Fire detection devices or systems must be in compliance with standards established under section 1016(c) of the act (62 P.S. §  1016(c)). The primary staff person or designated staff person who is responsible for compliance with this chapter shall ensure the requirements in subsection (a) are met. Proof of purchase of the facilities fire detection system/devices shall be on file at the facility.