Massie L Grissett Family Child Care Home

Noncompliance Area: 2nd CITATION: The child file for Child #1, who is a school aged child, contained a copy of their immunization status which lacked an annual influenza vaccination as recommended by the ACIP; the child was last vaccinated for influenza on 11/14/18. PREVIOUSLY CITED ON 2/18/20.

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 child file for child #1 contained a financial agreement form that lacked the fee amount.

Correction Required: An agreement shall specify the amount of the fee to be charged per day or per week.

Noncompliance Area: The child file for child #2 lacked an updated child service report; two child service reports were on file: one was dated 8/10/18 and the second one lacked a date thus making it difficult to determine if it was done timely.

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 child file for child #1 contained a financial agreement form that lacked the arrival and departure times.

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

Noncompliance Area: The child file for child #1 contained a financial agreement form that lacked the name(s) of the person(s) designated by the parent to whom the child may be released to.

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

Noncompliance Area: The child file for child #1 contained an emergency contact information form that lacked the health insurance 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 child file for child #1, who has an enrollment date of 9/27/19, contained an initial health report dated 1/23/20 which was more than 60 days from the first date of attendance.

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 child file for child #2, who is a young toddler, lacked an updated health report; the most recent health report on file is dated 2/28/19.

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 child file for child #1 contained a health report dated 1/23/20 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 child file for Child #1, who is a school aged child, contained a copy of their immunization status which lacked an annual influenza vaccination as recommended by the ACIP; the child was last vaccinated for influenza on 11/14/18.

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 staff file for staff person #1 contained a current health assessment dated 2/25/19 which was obtained more than 24 months from the previously dated health assessment 2/21/17.

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 child file for child #2 contained a financial agreement and emergency contact information form that were not updated at least once in a 6-month period, or as needed; the financial agreement and emergency contact information forms were last reviewed by the parent on 2/3/19.

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.

Noncompliance Area: Operator reported that the emergency plan was reviewed annually however the review was not documented in writing; the last documented review was dated 3/27/18.

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: The staff file for staff person #1 contained current first-aid training completed on 10/14/19 which was not renewed on or before the expiration of previous first-aid training certification which expired on 9/27/19.

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: In the main child care space, utilized by children 5 years of age or younger, an electrical outlet located to the left of the entry way was observed to be missing one protective cover and accessible to children in care. In the little room which children 5 years of age or younger have access to, the following electrical outlets were observed to be accessible to children and missing one or more protective covers: a 6 outlet power strip located underneath the TV table was observed to be missing two protective covers and another 6 outlet power strip underneath the computer desk was observed to be missing one protective cover.

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

Noncompliance Area: In the main child care space the back cushion of a red folding chair was observed to be coming off of the chair causing it not to be in good repair.

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: In the main child care space a crib was observed to not be labeled for the use of a specific child.

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

Noncompliance Area: The child file for child #1 contained a financial agreement form that lacked the operators signature.

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

Noncompliance Area: The child file for child #1, who has been enrolled in care since 8/15/18, lacked a child service report on file.

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 child file for child #1, who has been enrolled in care since 8/5/18, lacked an initial 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: Staff person #1 self reported that soiled diapers are put into a plastic bag first before being discarding into a plastic-lined, hands-free covered can that is kept on the porch.

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: The file for staff person #1 contained an updated health assessment that lacked an assessment of the person's suitability to provide child care.

Correction Required: An adult health assessment must include the physician's or CRNP's assessment of the person's suitability to provide child care.

Noncompliance Area: The child file for child #1 lacked a written statement giving the formula and feeding schedule from the parent.

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

Noncompliance Area: The child file for child #1 contained an emergency contact information form that lacked signed parental consent for emergency medical care.

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.

Noncompliance Area: The child file for child #1 contained an emergency contact information form that lacked signed parental consent for administration of minor first-aid procedures by facility staff.

Correction Required: 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: In the main child care space utilized by the children three ceiling tiles located above the window were observed to have visible water marks causing the ceiling tiles not to be in good repair. In the living room multiple electrical cords were observed along the floor accessible to the children in care causing a potential safety 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: The child file for child #1 contained an initial health report that lacked a statement that the child is able to participate in child care and is free of 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: Facility person #1 self-reported that facility person #2 has been responsible to care for the day care children on Mondays and Fridays in the afternoon while facility person #1 left to go to work. The file for facility person #2 lacked documentation of a health assessment and results of a tuberculin skin test.

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 last documented review and update of the facility emergency plan was dated 3/1/16.

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: Facility person #1 self-reported that facility person #2 has been responsible to care for the day care children on Mondays and Fridays in the afternoon while facility person #1 left to go to work. The file for facility person #2 lacked documentation of having received training of the facility emergency plan prior to caring for children.

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: Facility person #1 self-reported that facility person #2 has been responsible to care for the day care children on Mondays and Fridays in the afternoon while facility person #1 left to go to work. The file for facility person #2 lacked documentation of a valid child abuse clearance as well as documentation of having completed mandated 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. Facility Person #2--- may not work in a child care position at the facility.

Noncompliance Area: In the living room utilized by the children five ceiling tiles located to the left of the window were observed to have visible water marks caused from a leak in the upstairs bathroom which has since been repaired.

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 file for Child #2 contained an agreement that lacked the times of care and the release persons.

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.

Noncompliance Area: The file for Child #2 contained an agreement that lacked the enrollment date.

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

Noncompliance Area: The facility lacked an emergency contact form for Child #3.

Correction Required: Emergency contact information is required for each enrolled child. Emergency contact information must reference who shall be contacted in an emergency.

Noncompliance Area: The file for Child #1 contained an emergency contact form that lacked the contact information for the child's medical provider, the child's health insurance policy name and the child's health insurance policy number.

Correction Required: Emergency contact information must include the name, address and telephone number of the child`s physician or source of medical care. 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 files for Children #1 and #2 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 Children #1 and #2 contained emergency contact forms that lacked the addresses of the 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: According to operator report, emergency contact forms are not being taken in the vehicle when transporting children.

Correction Required: When children leave the facility on walking and riding excursions, emergency contact information specific to each child on the excursion shall accompany a staff person on the excursion.

Noncompliance Area: The file for Child #1 lacked a health 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. A child`s record must contain initial and subsequent health reports.

Noncompliance Area: An unlabeled petroleum jelly was observed to be accessible to children in the first-aid kit, located on the desk in the second floor room. An unlabeled toothpaste marked keep out of reach of children was accessbile to children in the medicine cabinet in the bathroom.

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. 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 file for Staff Person #1 contained consecutive health assessments that were dated more than 24 months apart.

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 file for Staff Person #1 contained documentation of a chest x-ray completed but an evaluation of the x-ray was not present in the file.

Correction Required: A record of a person with a positive tuberculin skin test shall include the results of a chest x-ray and evaluation for chemoprophylaxis.

Noncompliance Area: The file for Staff Person #1 contained a health assessment that lacked results of an examination for communicable diseases and any information on medical problems that might threaten the health of the children or prohibit a staff person from providing adequate care to children.

Correction Required: An adult health assessment must include an examination for communicable diseases and the results of that examination. An adult health assessment must include information on medical problems that might threaten the health of the children or prohibit a staff person from providing adequate care to children.

Noncompliance Area: The vehicle used to transport children lacked a first-aid kit.

Correction Required: A first-aid kit, including the contents as specified in 3290.73 (relating to first-aid kit) shall be in the vehicle when children are being transported.

Noncompliance Area: Child #3 lacked a record in the facility.

Correction Required: An operator shall establish and maintain an individual record for each child enrolled in the facility.

Noncompliance Area: The file for Child #1 contained an emergency contact form that lacked parental signatures to consent for emergency care and 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 Family Child Care Home regulations were not posted in a conspicuous location used by parents.

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 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 lacked documentation of current first-aid training.

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. A facility person`s record shall include records of training required by the Department.

Noncompliance Area: Toxic cleaners were observed to be accessible to children under the sink in the kitchen. A Glade toxic was observed to be accessible to children on a shelf in the bathroom.

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 working stove in the kitchen was observed to be accessible to children.

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 two windows in the second floor room, which are above ground level, were observed to open more than 6 inches.

Correction Required: Windows or doors above the ground floor that open directly to the outdoors and are accessible to children shall be constructed, modified or adapted to limit the opening to 6 or fewer inches.

Noncompliance Area: The first-aid kit was observed to be accessible to children on a desk in the second floor room.

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

Noncompliance Area: A TV was observed to not be secured to the stand on which it was setting in the second floor room. A razor and a lighter were observed in the medicine cabinet in the bathroom, accessible to children. Sharp knives were observed to be accessible to children in the top drawer in the kitchen.

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: Peeling paint was observed on the railing of the deck, by the bookshelf in the second floor room and by the desk in the second floor room.

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