Lori Westman Family Home Care

Regulation: 3290.32(a)

Description: Comply with CPSL

Noncompliance Area: The most recent FBI clearance on file for staff #1 was dated 9/28/20, which was more than 60 months ago.

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

Regulation: 3290.134(a)

Description: Child's hands washed

Noncompliance Area: The children's hands were not washed before eating. Child #4 did not wash hands after toileting.

Correction Required: A staff person shall ensure that a child's hands are washed before meals and snacks, after toileting and after being diapered.

Regulation: 3290.181(c)

Description: Emergency info/agreement updated 6 mos

Noncompliance Area: The fee agreement of child #1 was last reviewed 9/30/24. The fee agreement for child #2 was last reviewed 8/26/24. The fee agreement for child #3 was reviewed 7/22/24 and not again until 7/16/25.

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

Regulation: 3290.32(a)/3290.192(3)

Description: Comply with CPSL/CPSL information

Noncompliance Area: There was a gap of greater than 60 months in the NSOR clearances for person #1, #2 and #3 (2/3/20-7/21/25; 2/3/20-7/22/25; 2/3/20-7/22/25 respectively).

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). A facility person's record shall include a copy of requests for the criminal history record and child abuse registry clearance information, a copy of the disclosure statement and a copy of the completed clearance information required under the CPSL.

Regulation: 3290.95(a)/3290.95(b)

Description: System in compliance/Operator or designated staff responsibility

Noncompliance Area: There was a gap of greater than 30 days in the testing of the fire alarm.

Correction Required: Fire detection devices or systems must be in compliance with standards established under section 1016(c) of the act (62 P.S. § 1016(c)). The operator or designated staff person who is responsible for compliance with this chapter shall ensure the requirements in § 3290.95(a) are met.

Regulation: 3290.131(a)/3290.131(b)(2)

Description: Within 60 days/Updated toddler/preschool health report: every 12 months

Noncompliance Area: As of the renewal inspection on 8/21/24, the first health assessment on file for child #1 was dated 7/31/23 (see code sheet for start date). There was no initial within 60 days.

Correction Required: The operator shall require the parent of an enrolled child to provide an initial health report no later than 60 days following the first day of attendance at the facility. The operator shall require the parent to provide an updated health report at least every 12 months for an older toddler or preschool child.

Regulation: 3290.31(f)

Description: Age and training

Noncompliance Area: As of the renewal inspection on 8/21/24, staff #2 did not have 12 hours of training for the time period of 12/19/22 to 12/19/23 as required.

Correction Required: A staff person shall obtain an annual minimum of 12 clock hours of child care training.

Regulation: 3290.32(a)

Description: Comply with CPSL

Noncompliance Area: As of the renewal inspection on 8/21/24, the FBI clearance for person #1 was a Dept of Ed clearance. A DHS FBI clearance is required.

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

Regulation: 3290.131(b)(2)

Description: Updated toddler/preschool health report: every 12 months

Noncompliance Area: File for child #4, see code sheet for enrollment date and date of birth, contained a health assessment dated 7/11/22, but no updated health assessment was observed on completed within the last 12 months as required.

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.

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

Description: Immunization record/Dismissal policy

Noncompliance Area: File for child #4 and #5, see code sheet for enrollment dates and date of birth, did not contain documentation of all immunizations recommended by the ACIP. These children's files did not contain documentation regarding the influenza vaccine.

Correction Required: A health report shall include a review of the child's immunized status according to recommendations of the ACIP. The facility shall implement dismissal policies in accordance with the Department of Health regulation in 28 Pa. Code § 27.77 (relating to immunization requirements for children in child care group settings).

Regulation: 3290.18

Description: General Health and Safety

Noncompliance Area: It was observed that the facility did not have a Continuity of Operations plan created for the facility.

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

Regulation: 3290.181(c)/3290.181(d)

Description: Emergency info/agreement updated 6 mos/Dated signature affixed

Noncompliance Area: Agreement form for child #1 did not contain a dated parental signature attesting to the accuracy of the information provided on the form. Emergency contact forms for child #1-4 did not contain a dated parental signature verifying that these forms were reviewed within the last 6-month period as required.

Correction Required: A parent is required to review and update the emergency contact information and the financial agreement at least once in a 6-month period or as soon as there is a change in the information. Following review, a parent shall attest to the accuracy of information in the emergency contact information and the financial agreement at each review by affixing a dated signature to the record.

Regulation: 3290.32(a)/3290.192(3)

Description: Comply with CPSL/CPSL information

Noncompliance Area: The file for household member #1 contained outdated clearances as follows: PA state police clearance and child abuse clearance both dated 3/15/18 and a FBI clearance dated 3/16/18. No updated clearances completed within the last 60 months were observed on file as required under 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. Household member #1 may not be present when children are in care at the facility.

Regulation: 3290.113(a)

Description: Supervised at all times

Noncompliance Area: It was observed that child #1 was sent inside to retrieve a bookbag while staff person #1 remained outside with the other children in care. This caused child #1 to be left unsupervised.

Correction Required: Children on the facility premises and on facility excursions off the premises shall be supervised by a staff person at all times. Outdoor play space used by the facility is considered part of the facility premises. The requirement for supervision on and off the facility premises includes compliance with the staff:child ratio requirements in §§ 3290.51-3290.52 (relating to maximum number of children; and staff:child ratio).

Regulation: 3290.124(b)(3)

Description: Parent home/work address, phone

Noncompliance Area: Emergency contact form for child #2 and #3 did not contain the enrolling parent's work address.

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

Regulation: 3290.31(f)

Description: Age and training

Noncompliance Area: File for staff person #1 did not contain an annual minimum of 12 clock hours of child care training.

Correction Required: A staff person shall obtain an annual minimum of 12 clock hours of child care training.

Regulation: 3290.74(a)

Description: Requirements

Noncompliance Area: It was observed that a curtain rod, in an area used by children, had pulled away from the wall leaving one side of the curtain rod unsecure and a possible visible hazard.

Correction Required: Floors, walls, ceilings and other surfaces, including the facility's outdoor play area, shall be kept clean, in good repair and free from visible hazards.

Noncompliance Area: When certification representative arrived for the inspection, Child #1 was observed to be napping in a pack and play that was behind a loveseat in the living room. Because of the obstruction of the loveseat, the operator was not able to properly supervise this napping infant by seeing him at all times.

Correction Required: Children on the facility premises and on facility excursions off the premises shall be supervised by a staff person at all times. Outdoor play space used by the facility is considered part of the facility premises. The requirement for supervision on and off the facility premises includes compliance with the staff:child ratio requirements in 3290.51-3290.52 (relating to maximum number of children; and staff:child ratio). Children must be supervised at all times.

Noncompliance Area: The original health assessment on file for the operator is dated 4/30/18, and an updated health assessment was not on file at the facility until 8/27/20, which is beyond the 24-month requirement.

Correction Required: A health assessment is valid for 24 months following the date of signature, if the person does not contract a communicable disease or develop a medical problem.

Noncompliance Area: Child #1, an infant at the facility, did not have a written feeding schedule on file from the parent during the on-site portion of the inspection on 10/1/2020.

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

Noncompliance Area: Staff person #1 did not update the child abuse clearance within the required 60 months, but continued to provide child care during the gap. Dates of old and new child abuse clearances: 7/8/15 and 8/14/20.

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

Noncompliance Area: The required first-aid training on file for the operator expired as of 8/2/2020, and updated first-aid training has not yet been completed, according to the operator. There is noone else present at the facility when children are in care to meet this requirement.

Correction Required: One or more persons competent in first-aid techniques shall be at the facility when day care children are in care.

Noncompliance Area: The refrigerator at the facility was observed to have a layer of food crumbs in the bottom, and is in need of being cleaned.

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: Child #2 has been enrolled at the facility since 6/12/18, but the child's record does not contain proof of 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 3290.124(e).

Noncompliance Area: Child #3, a child who received drop-in care, enrolled at the facility beginning on 10/23/18, but the child's record does not contain a health assessment or immunization record.

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: The files for Child #1 and Child #2 do not contain proof of updated influenza vaccination for the previous year as required by the ACIP schedule. Neither record contains a letter of exemption from the parent.

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 no written documentation on file that the emergency plan for the facility had been reviewed within 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.

Noncompliance Area: A game of Monopoly, with small houses, hotels, game pieces and dice, all less than 1" in diameter, was observed on the dining table in the kitchen, accessible to children still placing objects in their mouths.

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: One outlet cover was observed to be uncovered in the bathroom, accessible to children washing their hands.

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

Noncompliance Area: When the certification representative arrived at the inspection, a heavy drill with a sharp drill bit was observed on top of a cabinet in the kitchen, and the cord was hanging low in reach of children. Multiple chairs in the dining room have vinyl peeling from the seats, accessible to children.

Correction Required: Floors, walls, ceilings and other surfaces, including the facility's outdoor play area, shall be kept clean, in good repair and free from visible hazards.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: A white plastic lawn chair was observed outside the back door in the outdoor play space. This chair had a crack in the seat and sharp plastic was observed.

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: Files for Child #1 and Child #2, who were observed receiving care during the inspection, were reviewed. Neither child's file contained an agreement between the parent and the provider.

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

Noncompliance Area: During an unannounced monitoring inspection on 8/30/18, file for Child #3 was reviewed, and child was observed to be receiving care. This child's emergency contact form and file did not contain health insurance coverage or policy 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: Child #2, who was observed receiving care during the initial inspection on 6/6/18, as well as during this unannounced inspection on 8/30/18. The file for this child was reviewed, and was observed not to contain a health assessment. This child has been enrolled at the facility for more 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.

Noncompliance Area: When the inspector arrived at the facility on 8/30/18, a tube of Boudreaux's Butt Paste and a tube of Up and Up Healing Ointment were observed on the ledge next to the diaper changing area, which were accessible to both children being changed and children playing. Both tubes were labeled "Keep Out of Reach of Children."

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: The fencing that was erected in the backyard to prevent access to an above-ground swimming pool was assessed during the inspection on 8/30/18. This fencing was observed to have two areas where the fencing was removed and open, as well as multiple areas where the fencing was able to be pulled down low enough to be under 48" high. The fencing is no longer sturdy and strong, and no longer provides the required barrier between the yard and the above ground pool.

Correction Required: If unsafe areas or conditions are in or near an outdoor play space, fencing or natural barriers are required to restrict children from those unsafe areas or conditions.An aboveground swimming pool which is not in use must be made inaccessible to children in accordance with the swimming pool barrier guidelines of the United States Consumer Product Safety Commission.

Noncompliance Area: A child lock on the drawer to the left of the stove in the kitchen had a child lock that was observed to be broken, allowing access to the drawer. The drawer is a "catch-all" drawer that contained many small items, sharp items, and items that are labeled and required to be inaccessible to children. This drawer is able to be reached by at least two of the children in the program, and is accessible when using the bathroom, or when children are playing in this space.

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.

Noncompliance Area: A large police ride-in toy was observed outside in the playspace, but it has multiple spots of rust accessible to children.

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: Facility emergency plan has not yet been sent to the county emergency 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: Facility has a swimming pool in the backyard. One side of the pool is lower than 48'' according to the provider, so a new barrier fence was erected to prevent children from having access to the pool. However, the new barrier has poles that extend no higher than 39'' from the ground, allowing the 48'' fencing to be bent over the top of the poles and no longer be 48'' high. Multiple poles in the fencing are also more than 40'' apart. This erected barrier does not meet the requirements for fencing as part of the Safety Barrier Guidelines for Residential Pools from the U.S. Consumer Product Safety Commission.

Correction Required: If unsafe areas or conditions are in or near an outdoor play space, fencing or natural barriers are required to restrict children from those unsafe areas or conditions. An above-ground swimming pool which is not in use must be made inaccessible to children in accordance with the swimming pool barrier guidelines of the United States Consumer Product Safety Commission.

Noncompliance Area: The trash can in the bathroom, which contains contaminated trash, is not a closed receptacle.

Correction Required: Trash that has been contaminated by human secretions or excrement shall be contained in closed, plastic-lined receptacles.

Noncompliance Area: The sink in the bathroom and the sink in the kitchen, both used for handwashing, were measured to have hot water of 118 degrees Fahrenheit. The stove was being used during the inspection at 425 degrees Fahrenheit, but the stove was not equipped with a lock to prevent children from opening it.

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: The first-aid kit 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: Multiple spots of peeling paint and damaged plaster were observed around the edges of the baby gates and on the corner of the walls leading into the front hallway and one of the front rooms.

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