Mary E Smith Family Child Care Home

Noncompliance Area: The toys and rest equipment stored in the outdoor play space were observed to be dirty.

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: The agreement in the file for Child #1 did not contain the date of admission.

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

Noncompliance Area: The files for Child(ren) #1 and #2 contained original, signed agreements.

Correction Required: A parent shall receive the original agreement. The facility shall retain a copy of the agreement. A child's record must contain a copy of the initial agreement and subsequent written agreements between the parent and the operator. The parent receives the original agreement.

Noncompliance Area: The emergency contact form in the file for Child #1 did not contain the address for the child's 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: The emergency contact form in the file for Child #1 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.

Noncompliance Area: The emergency contact forms in the files for Child(ren) #1 and #5 lacked health insurance coverage information and the policy number.

Correction Required: Emergency contact information must include health insurance coverage and policy number for a child under a family policy or Medical Assistance benefits, if applicable.

Noncompliance Area: The emergency contact forms in the files for Child(ren) #1 and #4 lacked addresses and phone numbers for the designated release persons.

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: The files for Child(ren) #1, #2, #4, and #5 lacked documentation that the emergency contact forms and agreements have been reviewed in the last six 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 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: The file for Child #2, start date 08/03/2016, contained an initial health assessment dated 06/19/2017. The file for Child #3, start date 10/2012, contained an initial health assessment dated 08/14/2013. The file for Child #4, start date 08/03/2016, contained an initial health assessment dated 07/19/2017. The file for Child #5, start date 08/01/2016, contained an initial health assessment dated 01/05/2017. All files lacked initial health assessments dated within 60 days following the first date 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: The file for Child #5, a preschooler, lacked a health assessment within the last 12 months.

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.

Noncompliance Area: A cloth towel was observed in the bathroom that was not labeled for individual use by a child; no paper towels or other methods of hand-drying were observed.

Correction Required: Cloth towels and washcloths shall be labeled with the child's name, used by only the named child and laundered weekly. The operator shall arrange a laundry schedule with the parent.

Noncompliance Area: The trash can used for diaper disposal was not hands-free.

Correction Required: If disposable diapers are provided by a parent or by a facility, a soiled diaper shall be discarded by immediately placing the diaper into a plastic-lined, hands-free covered can.

Noncompliance Area: Staff reported diapers are checked at 6:00am, 10:00am, and every two hours thereafter; more than two hours pass between diaper checks in the morning.

Correction Required: A staff person shall check a child's diaper at least every 2 hours and whenever the child indicates discomfort or exhibits behavior that suggests a soiled diaper. A staff person shall change a child's diaper when the diaper is soiled.

Noncompliance Area: Staff reported diapers are checked at 6:00am, 10:00am, and every two hours thereafter; more than two hours pass between diaper checks in the morning.

Correction Required: A staff person shall check a child's diaper at least every 2 hours and whenever the child indicates discomfort or exhibits behavior that suggests a soiled diaper. A staff person shall change a child's diaper when the diaper is soiled.

Noncompliance Area: At the time of inspection, there was no operable smoke detector in the basement of the home.

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

Noncompliance Area: The emergency plan for the facility lacked evacuation routes and evacuation plans for evacuation of children to a location away from the facility premises.

Correction Required: The facility shall have an emergency plan that provides for evacuation of children from the facility building and evacuation of children to a location away from the facility premises. The evacuation routes and evacuation plans to exit the building may be the same as those required by 3290.94 (f) and (g) (relating to fire drills).

Noncompliance Area: The file for Facility Person #1 contained a FBI Clearance dated 06/25/2015, lacking documentation of a FBI Clearance within the last five years. The file for Facility Person #2 contained Mandated Reporter training dated 12/30/2014, lacking documentation of Mandated Reporter training within the last five years.

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 #1 may not work in a child care position at the facility.

Noncompliance Area: The outdoor play space in the front of the home was observed to be unsafe. Toys were scattered around the play space, obstructing the walkways. Gardening equipment was observed in the outdoor space, accessible to children. The play space is a grass hill and a sidewalk bordering a residential street with no fencing or natural barrier restricting children from accessing the street.

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.

Noncompliance Area: The outdoor play space in the front of the home was observed to be unsafe. Toys were scattered around the play space, obstructing the walkways. Gardening equipment was observed in the outdoor space, accessible to children. The play space is a grass hill and a sidewalk bordering a residential street with no fencing or natural barrier restricting children from accessing the street.

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.

Noncompliance Area: The first aid kit was placed in an unlocked cabinet in the main child care space, accessible to children.

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

Noncompliance Area: The outdoor play space in the front of the home was observed to be unsafe. Toys were scattered around the play space, obstructing the walkways. Gardening equipment was observed in the outdoor space, accessible to children. The play space is a grass hill and a sidewalk bordering a residential street with no fencing or natural barrier restricting children from accessing the street.

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: The door from the kitchen to the back yard of the home was unable to be opened by the operator without assistance. The stairs from the main level to the basement were obstructed by a roll of flooring, and the wood steps had cracks making it unsafe to access; an exit from the basement to the outside of the home serves as an egress from the home.

Correction Required: Stairways, hallways, exits from rooms, exits from the facility and other means of egress serving as an exit shall be unobstructed.

Noncompliance Area: The operator was notified on 8/15/2019 that child #1 received emergency room treatment as a result of an injury that occurred while receiving care at the family child care home on 8/14/2019. On 8/16/2019, the operator stated to the department representative that she had not yet notified the appropriate regional office and did not know that she had to.

Correction Required: The operator shall immediately notify a child's parent and shall telephone notice to the appropriate regional office within 24 hours if a child in care at the facility is hospitalized or receives emergency room treatment.

Noncompliance Area: On 8/16/2019, the exit at the rear of the family child care home was observed not to be able to be opened. This is evidenced by staff person #1 not being able to open the door due to their not being a door knob on the door. Also, when staff person attempted to putt the door the entire exterior wall of the facility was observed to be moving. These conditions pose a threat to the health and safety of the children.

Correction Required: Conditions at the facility may not pose a threat to the health or safety of the children.Stairways, hallways, exits from rooms, exits from the facility and other means of egress serving as an exit shall be unobstructed.

Noncompliance Area: 2nd Citation - Previously cited on 5/10/2019. On 6/19/2019 the emergency contact form on file for child #1 was observed not to contain documentation of the address and telephone number for the person's whom child #1 is authorized to be released to.

Correction Required: Emergency contact information must include the name, address and telephone number of the individual designated by the parent to whom the child may be released.

Noncompliance Area: 2nd citation - Previously cited on May 10, 2019. On 6/19/2019, the file for child #2 was observed not to contain documentation of an initial health report on file. This is evidenced by there only being documentation of an immunization record on file for child #2.

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: 2nd Citation - Previously cited on 5/10/2019. The immunization record on file for children #1 and #3 were observed not to contain documentation of the children receiving an influenza vaccination within the last 12 months as recommended by the ACIP.

Correction Required: The facility shall require the parent to provide updated written verification from a physician, physician's assistant, CRNP, the Department of Health or a local health department of ongoing vaccines administered to an infant, toddler or preschool child in accordance with the schedule recommended by the ACIP.

Noncompliance Area: 2nd citation - Previously cited on 5/10/2019. The emergency contact form and agreement form on file for children #1, #2 and #3 were observed not to have been reviewed by the child's parent and documented with a dated signature within the last 6 months.

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.

Noncompliance Area: The lid to a toy bin located along the front walkway of the child care facility was observed to be cracked. Also, multiple ceramic and plastic lawn ornaments were observed to be broken and cracked in the facility's yard where children play, this exposes the children to rough edges, sharp corners and pinch and crush points.

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: Multiple ceramic and plastic lawn ornaments located in the facility's yard where the infant and toddler children have access were observed to be cracked and broken. Small pieces less than 1 inch in diameter are accessible to the children in care.

Correction Required: Pea gravel and other materials with a diameter of less than 1 inch may not be used in spaces where infants or toddlers receive care.

Noncompliance Area: The file for children #2 and #3 were observed not to contain documentation of a child service report being completed within the last 6 months.

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: The agreement form on file for child #3 was observed not to contain documentation of the child's arrival and departure time.

Correction Required: An agreement shall specify the child's arrival and departure times.

Noncompliance Area: The agreement form on file for child #3 was observed not to contain documentation of the child's date of admission.

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

Noncompliance Area: The emergency contact form on file for children #3 and #4 were observed not to contain complete contact information including work address and telephone number for the enrolling parent.

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

Noncompliance Area: The emergency contact form on file for child #3 was observed not to contain documentation of the address and telephone number for the person's whom child #3 is authorized to be released to.

Correction Required: Emergency contact information must include the name, address and telephone number of the individual designated by the parent to whom the child may be released.

Noncompliance Area: The file for child #4 was observed not to contain documentation of an initial health report on file. This is evidenced by there only being documentation of an immunization record on file for child #4.

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 most recent health report on file for child #2 a preschool aged child in care was observed not to contain documentation of a health report being completed within the last 12 months. This is evidenced by the most recently dated health report on file for child #2 being dated 6/19/17.

Correction Required: The operator shall require the parent to provide an updated health report at least every 12 months for an older toddler or preschool child.

Noncompliance Area: The immunization record on file for children #2 and #3 were observed not to contain documentation of the children receiving an influenza vaccination within the last 12 months as recommended by the ACIP.

Correction Required: The facility shall require the parent to provide updated written verification from a physician, physician's assistant, CRNP, the Department of Health or a local health department of ongoing vaccines administered to an infant, toddler or preschool child in accordance with the schedule recommended by the ACIP.

Noncompliance Area: The file for staff person #3 was observed not to contain documentation of a health assessment being completed within the last 24 months.

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: The yard located to the right of the family child care home was observed to be accessible to the children in care. In this area there were multiple visible hazards accessible to the children in care that may pose a threat to the health and safety of the children in care. These visible hazards include but are not limited to an antennae line hanging from the roof more than 20 feet high to the ground and a television cable hanging from the roof as well more than 20 feet high to the ground. These two cords create a strangulation hazard to the children in care.

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

Noncompliance Area: The emergency contact form and or agreement form on file for children #1 - #5 were observed not to have been reviewed by the child's parent and documented with a dated signature within the last 6 months.

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.

Noncompliance Area: Upon review of the files for staff person #1-#3 it was observed that there was no documentation on file stating that the staff have reviewed the facility's emergency plan on an annual basis.

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

Noncompliance Area: Upon review of the files for staff person's #1 - #3 they were observed not to contain documentation of any of the 3 staff persons to have a valid first aid certification. This is evidenced by the first aid training on file for each of the 3 staff having expired in March of 2019.

Correction Required: Competence in first-aid is demonstrated by the completion of training by a professional in the field of first-aid. First-aid training shall be renewed on or before expiration of certification or every 3 years, as applicable.

Noncompliance Area: The file for staff person #1 was observed not to contain documentation of a valid Pennsylvania State Police Criminal History clearance.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). Staff Person #1 may not work in a child care position at the facility. A facility person's record shall include a copy of requests for the criminal history record and child abuse registry clearance information, a copy of the disclosure statement and a copy of the completed clearance information required under the CPSL. Staff Person #1 may not work in a child care position at the facility.

Noncompliance Area: Staff person's #1 and #2 were observed caring for a group of four children on 5/10/2019. Upon review of the files for staff person's #1 and #2 it was discovered that neither staff person had a valid First Aid certification.

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 railing along the outdoor walkway was observed to have the end of a nail protruding from the railing, also, the front left post of the porch was observed to have the end of the nail protruding from it. These conditions expose the children in care to visible hazards.

Correction Required: Outside walkways shall be free from ice, snow, leaves, equipment and other hazards.

Noncompliance Area: Peeling paint was observed to be accessible to the children in care at the top of the beams on the facility's porch where children play.

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

Noncompliance Area: On 10/31/2018, a bumbo seat which has been describe as hazardous by the United States Consumer Product Safety Commission was observed being used at the child care facility. This is evidenced by the disclosure of the operator that the seat was being used by an infant aged child in care.

Correction Required: Children's toys and equipment, including furniture and rest equipment, described as hazardous by the United States Consumer Product Safety Commission may not be used by children at the facility.

Noncompliance Area: On 10/31/2018, at approximately 10 am, child #1 an older toddler aged child was observed to be napping on the floor without individual, clean, age-appropriate 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: On 10/31/2018, multiple toys on the front porch of the facility were to be cracked or broken exposing the children in care to rough edges, sharp corners, pinch and crush points.

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: One lid to a toy bin was observed to be cracked along the top surface exposing the children in care to rough edges, sharp corners, pinch and crush points.

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: The facility refrigerator was observed not to be fully operable. This is evidenced by the door not being functional as evidenced by a large sealed bucket needing to be placed in front of the door to keep the door closed. Also, the thermometer located in the refrigerator was observed to read 65 degrees.

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: The file for children #1, #2, and #4 were observed not to contain documentation of a child service report completed within the last 6 months.

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: The agreement on file for child #3 and #4 were observed not to specify the child's arrival and departure time.

Correction Required: An agreement shall specify the child's arrival and departure times.

Noncompliance Area: The emergency contact form on file for child #2 was observed not to contain complete work information for the enrolling parent.

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

Noncompliance Area: The emergency contact form on file for child #2 was observed not to contain complete health insurance information.

Correction Required: Emergency contact information must include health insurance coverage and policy number for a child under a family policy or Medical Assistance benefits, if applicable.

Noncompliance Area: The emergency contact form on file for children #2-#4 were observed not to contain complete contact information for the person's whom children #2-#4 are authorized to be released to.

Correction Required: Emergency contact information must include the name, address and telephone number of the individual designated by the parent to whom the child may be released.

Noncompliance Area: The file for children #1, #2, and #4 were observed not to contain documentation of a health report on file.

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 file for staff person #1 was observed not to contain a health assessment on file completed within the last 24 months.

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 on file at the facility.

Noncompliance Area: Five large bookshelf's located in the dining room area of the family child care home were observed not to be attached to the walls. Each bookshelf had multiple items stacked on top of them in excess of approximately 6 feet in height. This creates a falling hazard and poses as threat to the health and safety of the children in care if the shelves were to fall.

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

Noncompliance Area: The emergency contact form on file for child #1 was observed not to contain signed written consent for emergency medical care or administration of minor first aid. This is evidenced by there only being parent initials for consent.

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.

Noncompliance Area: The file for staff person #1 was observed not to contain documentation of a valid child abuse clearance or FBI clearance completed within the last 5 years. This is evidenced by the most recent child abuse clearance on file being dated 2/4/2013. There was no documented FBI clearance on file for staff person #1. The file for household member #2 was observed not to contain documentation of a Pennsylvania State Police Clearance.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). Staff Person #1 may not work in a child care position at the facility.A facility person's record shall include a copy of requests for the criminal history record and child abuse registry clearance information, a copy of the disclosure statement and a copy of the completed clearance information required under the CPSL. Staff Person #1 may not work in a child care position at the facility.

Noncompliance Area: The utility closet containing hygiene products, cleaning materials and other toxics marked keep out of reach of children was observed not to be locked. This is evidenced by the lock being placed on the door, but the lock not being closed. This closet is accessible to the children in care as they head up the steps to use the restroom.

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: The railing located on the right side of the step going on to the porch of the facility was observed to be loose and not securely attached. This exposed the children in care to screws, pinch and crush points and created a falling hazard to the children as they enter the child care facility.

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: SIN-00115500, which had not yet been verified corrected, was not posted in a conspicuous location used by parents at the verification visit on 8/7/17.

Correction Required: The operator shall post a copy of each inspection summary issued by the Department next to the facility's certificate of registration in a conspicuous location used by parents. The inspection summary shall remain posted until an agent of the Department verifies that each noncompliance item noted on the inspection summary has been corrected.

Noncompliance Area: At the renewal inspection on 5/31/17, and again at the verification visit on 8/7/17, the file for Staff Person #1 (Household Member) contained an FBI clearance that lacked a complete disposition. At the renewal inspection on 5/31/17 and again at the verification visit on 8/7/17, the file for Staff Person #2 lacked an FBI clearance.

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 #2--- may not work in a child care position at the facility. Facility Person #1 (Household Member) may not be present in the child care space while children are in care.

Noncompliance Area: A cracked white bin with a sharp edge was observed on the shelf in the front room. A cracked green toy drawer with a sharp edge was observed in the dining room.

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: Beads with a diameter of less than 1 inch were observed in an unlocked drawer of a toy bin in the front room, accessible to children who may still be 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: Blankets and sheets were being used alone as rest equipment for the children.

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.Bed linens may not be used alone as age-appropriate rest equipment.

Noncompliance Area: The file for Child #1 contained an agreement that lacked the fee to be charged and the date the fee is due.

Correction Required: An agreement shall specify the amount of the fee to be charged per day or per week. An agreement shall specify the date on which the fee is to be paid.

Noncompliance Area: The files for Child #1, #3, #4 and #5 contained child service reports that were not completed within 6 months of enrollment.

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: The file for Child #1 contained an agreement that lacked the times of care.

Correction Required: An agreement shall specify the child`s arrival and departure times.

Noncompliance Area: The files for Child #1 and #2 contained agreements that lacked release persons.

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

Noncompliance Area: The files for Child #1, #3 and #4 contained emergency contact forms that lacked the work addresses and telephone numbers of the enrolling parents.

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

Noncompliance Area: The files for Child #3 and #4 contained emergency contact forms that lacked the children's health insurance policy numbers.

Correction Required: Emergency contact information must include health insurance coverage and policy number for a child under a family policy or Medical Assistance benefits, if applicable.

Noncompliance Area: The file for Child #4 contained an emergency contact form that lacked the name, address and telephone number of release persons.

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: The file for Child #5 contained a health report dated more than 6 months ago.

Correction Required: The operator shall require the parent to provide an updated health report at least every 6 months for an infant or young toddler

Noncompliance Area: The file for Child #3 contained a health report dated more than 12 months ago.

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: The file for Child #4 contained a health report that lacked a statement that the child is able to participate in child care and appears to be free from contagious or communicable disease.

Correction Required: A health report shall include a statement that the child is able to participate in child care and appears to be free from contagious or communicable disease.

Noncompliance Area: The file for Child #1 contained a health report dated more than 60 days following the first day of care.

Correction Required: The facility may not accept or retain an infant 2 months of age or older, a toddler or a preschool child at the facility for more than 60 days following the first day of attendance at the facility unless the parent provides written verification from a physician, physician's assistant, CRNP, the Department of Health or a local health department of the dates (month, day and year) the child was administered immunizations in accordance with the recommendations of the ACIP.

Noncompliance Area: The file for Staff Person #4 lacked a 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 on file at the facility.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.

Noncompliance Area: The file for Staff Person #4 lacked documentation of a tuberculosis screening.

Correction Required: An adult health assessment shall include Tuberculosis screening by the Mantoux method at initial employment. Subsequent tuberculosis screening is not required unless directed by a physician, 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.

Noncompliance Area: The files for Child #2, #3 and #5 contained agreements that have not been updated at least once in the past 6-month period. The file for Child #1 contained an agreement that had consecutive updates more than 6 months apart.

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.

Noncompliance Area: The files for Child #1 and #2 contained emergency contact forms that lacked parental signatures to consent for emergency medical care and the administration of first-aid.

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.

Noncompliance Area: The certificate posted in the facility was not current.

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

Noncompliance Area: The files for Staff Person #2 and #4 lacked documentation of current emergency 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.

Noncompliance Area: The emergency plan was not posted in the facility.

Correction Required: The operator shall post the emergency plan in the facility at a conspicuous location.

Noncompliance Area: The file for Staff Person #1 contained documentation of 3 of the 12 biennial hours of child care training. The file for Staff Person #2 lacked dcoumentation of the 12 biennial hours of child care training.

Correction Required: A staff person shall obtain an biennial minimum of 12 clock hours of child care training.A facility person`s record shall include records of training required by the Department.

Noncompliance Area: The files for Staff Person #2 and #4 lacked documentation of mandated child abuse reporter training.

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: Two unlabeled bottles containing unknown liquids were observed in the toxic closet.

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: Sharp nails were observed in a bin on the porch, accessible to children. Electrical cords and a sharp tool were observed in an unlocked bottom file drawer in the dining room, accessible to children. The floors in the front room and dining room were observed to be soiled. A broken plexiglass window covering with a sharp edge was observed in the bathroom.

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.