Maria E Rosario - Lebanon PA Family Child Care Home

Noncompliance Area: Upon inspection of the childcare space, it was found that there was peeling paint within reach of children.

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

Noncompliance Area: Infant sleeps in a bouncy seat. No doctor note regarding special sleeping arrangements. Bouncy seat is not an age appropriate sleeping/rest equipment.

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: Upon arrival the children were not directly supervised nor engaged in a staff directed activity. Two (2) televisions were playing and the children were running throughout 2 rooms.

Correction Required: Daily activities shall promote the development of skills, social competence and self-esteem. Daily experiences shall recognize the child as an individual and give some choice of activities that respect personal privacy, lifestyle and cultural background.

Noncompliance Area: An infant was in a bouncy seat throughout the inspection. No daily routine noted regarding infant/toddler stimulation.

Correction Required: Infants and toddlers shall be provided stimulation by being held, rocked, talked to, played with and carried.

Noncompliance Area: Upon arrival on the day of the inspection, a visitor to the home answered the door when leaving. Three (3) children including an infant in a bouncy seat were observed in the front room. 3 (three) other children were running from one child care room to the next. Staff 1 and 2 were in the kitchen, not directly supervising the two groups of children.

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: Enrolled infant has feeding issues noted on physical but not included on infant feeding statement.

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

Noncompliance Area: The diapering table was dirty: debris underneath the diapering pad.

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: A pack and play utilized for an infant was not labeled for individual use.

Correction Required: Individual, clean, age-appropriate rest equipment shall be provided for preschool, toddler and infant children as agreed between the child's parent and the operator. The rest equipment shall be labeled for the use of a specific child and used only by the specified child.

Noncompliance Area: Upon arrival at the facility at 10am, children were in 3 (three) separate rooms: 2 (two) children were upstairs; 2 (two) children were in the front room with the provider; and 3 (three) children were in the child care room. On 8/15/18 provider was in the kitchen upon arrival with the children in the childcare room. A visitor to the home had 3 children in the childcare area. The children are not enrolled and the visitor is not an approved staff.

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. Supervision is to see,hear, direct, and assess the children.

Noncompliance Area: Child 1 did not have an updated child service report since 12/14/17.

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

Noncompliance Area: Child 3 were enrolled with no emergency contact form or agreement. Provider was not sure of the children's names as no forms were completed prior to admission.

Correction Required: An agreement shall be signed by the operator and the parent.Emergency contact information is required for each enrolled child. Emergency contact information must reference who shall be contacted in an emergency.

Noncompliance Area: Child 2 did not have a 6 month physical on file. Last physical 1/19/18. child's DOB 11/14/17.

Correction Required: The operator shall require the parent to provide an updated health report at least every 6 months for an infant or young toddlerA child's record must contain initial and subsequent health reports.

Noncompliance Area: Child 2 did not have an infant feeding schedule provided by parent.

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

Noncompliance Area: A diaper bag accessible to the children contained medications, numerous items stating keep out of the reach of children.

Correction Required: Conditions at the facility may not pose a threat to the health or safety of the children.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: Staff 3 did not have documentation of updated emergency disaster plan training.

Correction Required: The operator shall assure that each facility person receives training regarding the emergency plan at the time of initial employment, on an annual basis and at the time of each plan update. The operator shall document the date of each training and the names of all facility persons who received the training. A facility person's record shall include records of training required by the Department.