Mercedes M Reyes

Regulation: 3290.123(a)(3)

Description: Services provided

Noncompliance Area: During the completion of the renewal inspection, it was found that the files for Child #1, #2 and #3 did not contain copies of the forms which describe the required child growth and development of the child in the context of the services being provided.

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).

Regulation: 3290.123(a)(6)/3290.182(2)

Description: Admission date/Application, admission, withdrawal dates

Noncompliance Area: During the completion of the renewal inspection, it was found that the file for Child #3 did not include the date of admission into the facility.

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

Regulation: 3290.124(e)/3290.181(c)

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

Noncompliance Area: During the completion of the renewal inspection, it was found that the file for Child #1 included an emergency contact information sheet last reviewed on 4.10.25 and a financial agreement last reviewed on 4.10.25. The file for Child #2 included an emergency contact information sheet last reviewed on 3.30.25 and a financial agreement last reviewed on 3.30.25.

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

Regulation: 3290.131(a)/3290.182(1)

Description: Within 60 days/Initial and subsequent health assessments

Noncompliance Area: During the completion of the renewal inspection, it was found that the file for Child #3 did not contain copies of an initial health assessment [copies of immunizations were present].

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. A child's record must contain initial and subsequent health reports.

Regulation: 3290.131(b)(2)/3290.182(1)

Description: Updated toddler/preschool health report: every 12 months/Initial and subsequent health assessments

Noncompliance Area: During the completion of the renewal inspection, it was found that the file for Child #2 contained a copy of an initial health assessment dated 10.31.23 [expired 10.31.24].

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

Regulation: 3290.192(3)

Description: CPSL information

Noncompliance Area: During the completion of the renewal inspection, it was found that the file for Staff Person #1 did not contain a copy of a signed/witnessed CPSL disclosure document.

Correction Required: 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 childcare position at the facility without this document on file.

Regulation: 3290.192(4)

Description: Required training

Noncompliance Area: During the completion of the renewal inspection, it was found that the file for Staff Person #1 had 6 hours of professional development training on file for the training period AND Staff Person #2 had 8 hours of professional development training on file for the training period.

Correction Required: A facility person's record shall include records of training required by the Department.

Regulation: 3290.151(a)(2)/3290.192(2)

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

Noncompliance Area: Upon inspection of personnel files, it was found that Staff Person #1 last health assessment on record was dated 9.23.22 AND the last health assessment for Staff Person #2 was dated 10.5.22. Both documents were expired at the time of inspection.

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. A facility person's record shall include a written report of initial and subsequent health assessments, including the results of initial and subsequent tuberculin skin tests, x-rays or other medical documentation necessary to confirm freedom from communicable tuberculosis.

Regulation: 3290.18

Description: General Health and Safety

Noncompliance Area: Upon inspection of required documents at the facility, it was found that a written policy pertaining to Shaken Baby Syndrome/Abusive Head trauma was not on file at the time of inspection.

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

Regulation: 3290.31(f)/3290.192(4)

Description: Age and training/Required training

Noncompliance Area: Upon inspection of personnel files, it was found that Staff Person #1 had 7.5 hours of training completed AND Staff Person #2 had 6.5 hours of training completed.

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

Regulation: 3290.75(a)

Description: No peeling paint or plaster

Noncompliance Area: Upon inspection of the physical spaces, it was found that chipping/peeling paint was in evidence at the rear of the facility in the restroom/diaper changing area.

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

Regulation: 3290.95(a)/3290.95(b)

Description: System in compliance/Operator or designated staff responsibility

Noncompliance Area: Upon inspection of the fire detection devices at the facility, it was found that an interconnected fire detection system was not installed at the time of inspection.

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: 3290.123(a)(3)

Description: Services provided

Noncompliance Area: Upon inspection of the children's files onsite, it was found that information to the family about the children's growth and development in the context of the services being provided was not included for child #1 - #4.

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).

Regulation: 3290.124(b)(7)

Description: Name/address/phone release person

Noncompliance Area: Upon inspection of children's files, it was found that the emergency contact information for child #1 - #3 was missing the address[s] of the individual[s] designated by the parent to whom the child may be released.

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.

Regulation: 3290.131(b)(2)

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

Noncompliance Area: Upon inspection of children's files, it was found that child #4 health assessment on file is dated 5.20.22 and would have expired on 5.20.23.

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)

Description: Immunization record/Immunization record

Noncompliance Area: Upon inspection of the children's files, it was found that child #2 and #3 did not have an influenza record or valid exemption on file. Further, it was found that child #4 is missing 1 DTAP vaccination, 1 HIB vaccination and 1 Pneumococcal vaccination.

Correction Required: A health report shall include a review of the child's immunized status according to recommendations of the ACIP. 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.

Regulation: 3290.135(a)(3)

Description: Disposable diapers

Noncompliance Area: Upon inspection of the onsite physical site inspection, it was directly observed that staff person #2 changed a child's diaper and then placed the used diaper in an unlined and unlidded 5-gallon bucket in the bathroom area.

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.

Regulation: 3290.18

Description: General Health and Safety

Noncompliance Area: Upon inspection of the facility emergency plan, it was found that a continuity of operations plan was not developed and included. In addition, it was directly observed that staff person #1 and #2 were caring for children unsupervised without having completed the required 2022 Health and Safety training topics update.

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

Regulation: 3290.181(c)

Description: Emergency info/agreement updated 6 mos

Noncompliance Area: Upon inspection of the children's files, it was found that the financial agreement for child #1 was last reviewed on 10.20.21 and for child #4 on 12.14.21, which exceeded the maximum 6 month review period.

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: 3290.182(5)

Description: Consent for administration of minor first-aid required prior to admission

Noncompliance Area: Upon inspection of the children's files, it was found that signed parental consent for administration of minor first-aid procedures by facility staff was missing for child #3.

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.

Regulation: 3290.24(c)

Description: Training regarding plan

Noncompliance Area: Upon inspection of the facility personnel files, it was found that staff person #1 and #2 did not receive annual emergency plan training within the last one year.

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.

Regulation: 3290.31(f)

Description: Age and training

Noncompliance Area: Staff person #1 has not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): 2022 Health and Safety training topics update. Staff person #2 has not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): 2022 Health and Safety training topics update.

Correction Required: Staff person(s) shall complete professional development in the topics of 3290.31(g) (1-10) within 90 days of hire. Staff person #1 will have until 11.15.23 to complete the required training. Until such time as the required training has been completed, staff person #1 must be supervised, when interacting with children, by an (family childcare home staff person) who has completed the required training related to this citation. If there are no staff available to supervise staff person #1, staff person #1 may not work in a child-care position at the facility. Staff person(s) shall complete professional development in the topics of 3290.31(g) (1-10) within 90 days of hire. Staff person #2 will have until 11.15.23 to complete the required training. Until such time as the required training has been completed, staff person #2 must be supervised, when interacting with children, by an (family childcare home staff person) who has completed the required training related to this citation. If there are no staff available to supervise staff person #2, staff person #2 may not work in a child-care position at the facility.

Regulation: 3290.64(a)

Description: Locked or inaccessible - in original container

Noncompliance Area: Upon completion of the onsite physical site inspection, it was directly observed that a can of insecticide was on the kitchen table, which was accessible to children walking by.

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

Regulation: 3290.75(a)

Description: No peeling paint or plaster

Noncompliance Area: Upon completion of the physical site inspection, it was observed that there was peeling paint on the doorframe between the kitchen and dining room, near the child gate.

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

Regulation: 3290.94(a)(1)

Description: Every 60 days

Noncompliance Area: Upon inspection of the facility fire safety documents, it was observed that drills were conducted on the following dates, which exceeded the maximum of 60 days between drills: 12.13.22 - 2.15.23

Correction Required: The operator or designated staff person who is responsible for compliance with this chapter shall conduct fire drills and ensure that fire drills are conducted at least once every 60 days.

Regulation: 3290.95(a)/3290.95(b)

Description: System in compliance/Operator or designated staff responsibility

Noncompliance Area: Upon inspection of the facility fire safety documents, it was observed that tests were conducted on the followng dates, which exceeded the maximum of 30 days between tests: 1.8.23 -2.18.23; 5.9.23 - 6.13.23; 8.11.23 - 9.12.23

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: 3290.18

Description: General Health and Safety

Noncompliance Area: Upon inspection of the required documents on file at the facility, it was found that a policy and procedure to identify the prevention of shaken baby syndrome, abusive head trauma, and child maltreatment was not developed.

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

Regulation: 3290.24(a)(1)

Description: Emergency plan

Noncompliance Area: Upon inspection of the facility emergency plan, it was found that specific accommodations for shelter of children during an emergency including lock-down AND shelter in place at the facility were not included.

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

Regulation: 3290.24(d)

Description: Emergency plan

Noncompliance Area: Upon inspection of the required documents on file at the facility, it was found that no record was present of an emergency drill being completed in 2021 or 2022 [to date].

Correction Required: Emergency drills shall be conducted annually. Annual emergency drills shall be documented and on file at the facility.

Regulation: 3290.31(g)

Description: Age and training

Noncompliance Area: Staff person #1 has not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): Pre-Service health and Safety trainings. Staff person #2 has not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): Pre-Service health and Safety trainings.

Correction Required: Staff persons shall complete professional development within 90 days of hire as listed in subsections (g)1-10. Staff person(s) shall complete professional development in the topics of 3290.31(g) (1-10) within 90 days of hire. Staff person #1 will have until 10.5.22 to complete the required training. Until such time as the required training has been completed, staff person #1 must be supervised, when interacting with children, by an (family child care home staff person) who has completed the required training related to this citation. If there are no staff available to supervise staff person #1, staff person #1 may not work in a child-care position at the facility. Staff person(s) shall complete professional development in the topics of 3290.31(g) (1-10) within 90 days of hire. Staff person #2 will have until 10.5.22 to complete the required training. Until such time as the required training has been completed, staff person #2 must be supervised, when interacting with children, by an (family child care home staff person) who has completed the required training related to this citation. If there are no staff available to supervise staff person #2, staff person #2 may not work in a child-care position at the facility.

Regulation: 3290.32(a)

Description: Comply with CPSL

Noncompliance Area: The file of facility person #1 does not contain a valid PA child abuse [expired on 6.8.22] , a valid DHS required FBI clearance [expired 6.9.22], or a valid PA criminal clearance [expired 6.2.22]. The file of facility person #2 does not contain a valid PA child abuse [expired on 6.5.22] , a valid DHS required FBI clearance [expired 6.21.22], or a valid PA criminal clearance [expired 6.2.22].

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). Facility person #1 must be removed from a child care position by the close of business [9.20.22]. Facility person #2 must be removed from a child care position by the close of business [9.20.22].

Regulation: 3290.95(a)

Description: System in compliance

Noncompliance Area: Upon inspection of the facility fire safety records on file, it was found that testing was completed on the following dates which exceed the required minimum 30 day testing requirement: 1.8.22, 2.10.22, 3.14.22, 4.28.22, 5.24.22, 6.8.22, 7.8.22, 8.15.22, 9.15.22.

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)).

Regulation: 3290.123(a)

Description: Signed

Noncompliance Area: Upon inspection of the children's files, it was found that the agreement form did not contain the signature of the operator for child #6.

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

Regulation: 3290.123(a)(1)

Description: Amount of fee

Noncompliance Area: Upon inspection of the children's files, it was found that the agreement form did not specify the fee amount charged for child #6-#8.

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

Regulation: 3290.123(a)(4)

Description: Arrival/departure times

Noncompliance Area: Upon inspection of the children's files, it was found that the agreement form did not specify the arrival and departure times for child #6.

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

Regulation: 3290.123(a)(5)

Description: Designated release persons

Noncompliance Area: Upon inspection of the children's files, it was found that the agreement form did not specify the persons designated by a parent to whom the child may be released for child #6.

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

Regulation: 3290.123(b)/3290.182(8)

Description: Parent receives original/Copy of initial and subsequent agreements. Parent receives original.

Noncompliance Area: Upon inspection of the children's files, it was found that the original copy of the agreement form was present in the file for child #1-#3, #5 and #6. It was also found that an initial agreement was entirely missing in the file for child #7 and #8.

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.

Regulation: 3290.124(b)(2)

Description: Physician name, address, phone

Noncompliance Area: Upon inspection of the children's files, it was found that the name of the physician was missing from the emergency contact form for child #3 AND the name, address and telephone number of the child's physician or source of medical care was missing from child #6-#8.

Correction Required: Emergency contact information must include the name, address and telephone number of the child's physician or source of medical care.

Regulation: 3290.124(b)(3)

Description: Parent home/work address, phone

Noncompliance Area: Upon inspection of the children's files, it was found that the telephone numbers of the enrolling parent were missing for child #8.

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

Regulation: 3290.124(b)(4)/3290.182(3)

Description: Written consent/Consent for emergency medical care required prior to admission

Noncompliance Area: Upon inspection of the children's files, it was found that written consent signed by a parent for emergency medical care was not present for child #2, #6-#8.

Correction Required: Emergency contact information must include the written consent signed by a parent for emergency medical care. A child's record must contain signed parental consent for emergency medical care for the child. Written consent is required prior to admission.

Regulation: 3290.124(b)(5)

Description: Information re: disability

Noncompliance Area: Upon inspection of the children's files, it was found that information on the child's special needs was not included for child #3, #7 and #8.

Correction Required: Emergency contact information must include information on the child's special needs, as specified by the child's parent, physician, physician's assistant of CRNP, which is needed in an emergency situation.

Regulation: 3290.124(b)(6)

Description: Insurance coverage information

Noncompliance Area: Upon inspection of the children's files, it was found that health insurance coverage was missing for child #3 AND health insurance coverage and policy number was missing for child #6-#8

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.

Regulation: 3290.124(b)(7)

Description: Name/address/phone release person

Noncompliance Area: Upon inspection of the children's files, it was found that the name for a designated release person was missing for child #8 AND the address and telephone number was missing for the designated release person for child #6-#8.

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.

Regulation: 3290.131(a)

Description: Within 60 days

Noncompliance Area: Upon inspection of the children's files, it was found that an initial health assessment was missing for child #1, #2, #5 and #7.

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.

Regulation: 3290.131(b)(2)

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

Noncompliance Area: Upon inspection of the children's files, it was found that an updated health assessment had last been completed for child #3 [2 years old] on 10.17.19.

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)(1)

Description: Immunization record/Parent written verification from Doctor.

Noncompliance Area: Upon inspection of the children's files, it was found that a review of the child's immunized status according to recommendations of the ACIP was entirely missing from the file of child #5, #6 and #8. In addition, it was found that child #3 was missing vaccinations for influenza, varicella, MMR and Hepatitis A; AND child #7 had no record of an influenza vaccination.

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

Regulation: 3290.176

Description: Transportation First Aid Kit

Noncompliance Area: Upon inspection of the transportation vehicle's first aid kit, it was found to be missing soap.

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.

Regulation: 3290.182(5)

Description: Consent for administration of minor first-aid required prior to admission

Noncompliance Area: Upon inspection of the children's files, it was found that signed parental consent for administration of minor first-aid procedures by facility staff was not present for child #1-#3, #5-#8.

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.

Regulation: 3290.24(a)(1)

Description: Emergency plan

Noncompliance Area: Upon inspection of the facility emergency plan, it was found that accommodations for shelter of children during an emergency including lock-down, shelter in place at the facility had not been developed and/or included.

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

Regulation: 3290.24(a)(5)

Description: Emergency plan

Noncompliance Area: Upon inspection of the facility emergency plan, it was found that accommodations of infants and toddlers, children with disabilities, and children with chronic medical conditions had not been developed and/or included.

Correction Required: The facility shall have an emergency plan that provides for accommodations of infants and toddlers, children with disabilities, and children with chronic medical conditions.

Regulation: 3290.24(b)

Description: Emergency plan

Noncompliance Area: Upon inspection of the facility emergency plan, it was found that the emergency plan had not been reviewed and/or updated with the last year.

Correction Required: The operator shall review the emergency plan at least annually and update the plan as needed. Each review and update of the emergency plan shall be documented in writing and kept on file at the facility.

Regulation: 3290.24(c)

Description: Training regarding plan

Noncompliance Area: Upon inspection of the facility emergency plan, it was found that documentation for each facility person receiving updated emergency plan training was not completed.

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: The file of facility persons #1 and #2 does not contain a completed NSOR verification. The LE does not have an approved waiver to hire provisionally. The file does not contain copies of request(s) for the clearances/verification.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). Facility persons #1 and #2 must be removed from a child care position by the close of business. Effective 12/31/19 provisional hires may not work in a child care position when a waiver approval is not on file

Noncompliance Area: Upon inspection of the children's files, it was found that the agreement for child #2 was not signed by the operator.

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

Noncompliance Area: Upon inspection of the children's files, it was found that the agreement for child #2 did not contain a release person.

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

Noncompliance Area: Upon inspection of the children's files, it was found that the agreement for child #2 did not have a date of admission.

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

Noncompliance Area: Upon inspection of child files, it was found that there was no physician phone number for child #1 AND the name and address for the physician for child #2.

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: Upon inspection of children's files, it was found that the health insurance policy number was missing from child # 1 and #2 AND the Health Insurance Provider for child #2.

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: Upon inspection of the children's files, it was found that the emergency contact information for child #1 and #3 was not updated within the last 6 months AND the financial agreement was not reviewed for child #3 within the last 6 months.

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

Noncompliance Area: Upon inspection of children's files, it was found that there was no written verification of ongoing vaccines for child #2.

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: Upon inspection of the vehicle transportation, it was found that the first aid kit was missing tweezers and scissors.

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: Upon inspection of staff files, it was found that staff person #1 had only 3 documented hours of training over the past two years.

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

Noncompliance Area: Upon visual inspection, Infant Child #1 [approximately 1 month] was observed to be sleeping in a position that is not specifically recommended by the American Academy of Pediatrics.

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

Noncompliance Area: The diapering table and a highchair were visibly dirty. Prior citation 5/10/19. Diapering pad ripped, exposing foam which is a choking hazard for infants and toddlers.

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: Upon arrival, children were observed watching tv and playing videos/utilizing cellphones. No staff directed age appropriate activities to promote development. A child repeated left the childcare space to obtain snack/food without adult supervision. Toddlers were not being provided appropriate stimulation.

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

Noncompliance Area: The parent policy handbook/application did not include transportation policies and private fees.

Correction Required: The operator shall review with the parent, at the time of application, the facility's general daily schedule, hours for which care is provided, fees, responsibilities for meals, clothing, health policies, supervision policies, night care policies, dismissal policies, transportation and pick-up arrangements.

Noncompliance Area: Child service reports were completed but not signed by parents. No copy given to parents. Prior citation 5/10/19.

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).Information in a child's record shall be kept current by the operator.

Noncompliance Area: A child received a snack prior to washing his hands. Prior citation 5/10/19

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

Noncompliance Area: No documentation of annual update of emergency plan sent to EMA.

Correction Required: The operator shall send a copy of the emergency plan and subsequent plan updates to the county emergency management agency.

Noncompliance Area: Bleach solution was not labeled with appropriate contents.

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 childcare room was not set up to provide 6 categories of development with toys and equipment for all ages served.

Correction Required: Play equipment and materials appropriate to the developmental needs, individual interests and ages of the children shall be provided in sufficient amount and variety to preclude long waits for use. Play equipment and materials shall include the items specified at 3290.101(c)(1) - (6).

Noncompliance Area: The diapering table and highchairs were not clean---visible dirt and debris.

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. Toys soiled by secretion or excretion shall be cleaned with soap and water, rinsed and sanitized before being used by a child.

Noncompliance Area: Mats and pack and plays were 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: The daily schedule does not extend to all hours of operation.

Correction Required: A written plan of daily activities and routines, including a time for free play shall be established for each group. The plan shall be flexible to accommodate the needs of individual children and the dynamics of the group.

Noncompliance Area: No handbook/application developed to give to parents at enrollment.

Correction Required: At the time of enrollment, a parent shall receive in writing the facility's general daily schedule, hours for which care is provided, fees, responsibilities for meals, clothing, health policies, supervision policies, night care policies, dismissal policies, transportation and pick-up arrangements.

Noncompliance Area: None of the enrolled children had a child service report completed since 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).Information in a child's record shall be kept current by the operator.

Noncompliance Area: No written plan of transporting a child to the ER at or away from the facility with staffing provisions posted.

Correction Required: A written plan shall be conspicuously posted which identifies the means of transporting a child to emergency care and the facility staffing provisions in the event of an emergency. The plan must accompany a staff person who leaves the facility on an excursion with children.

Noncompliance Area: Child 6 does not have a 1 yr old and 18 mth old physicals on file. Last physical 5/7/18 with no immunization record.

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 3 did not have a 3 yr old physical. Last physical 6/29/18. Child 4 did not have a 2 yr old physical. Last physical 1/29/18. Child 5 did not have 4 yr old physical on file. Last physical 8/2/17.

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.A child's record must contain initial and subsequent health reports.

Noncompliance Area: Children nor staff washed their hands prior to snack.

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

Noncompliance Area: The diapering surface was not cleaned with an acceptable sanitizer.

Correction Required: Diaper changing surfaces shall be cleaned after each use by wiping the surface with a sanitizing solution or by changing a pad or other surface covering.

Noncompliance Area: 2 (two) school aged children are transported but only 1 (one) age appropriate booster seat is available.

Correction Required: A child 7 years of age or younger shall be transported in accordance with the requirements for parents and guardians as stated in 75 Pa.C.S. 4581 (relating to restraint systems).

Noncompliance Area: No 1st aid kit in the transportation vehicle.

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: No annual update/notice of any/no changes to emergency plan sent to EMA. Staff 1 and 2 did not complete annual review of emergency plan.

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. 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: Staff 2 did not have 12 hours biennial training for 6/2015-6/2017 period.

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: Staff 1 and 2 did not have mandated reporter training on file.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). Staff shall complete mandated reporter training as required Sept 2015 and every 5 years thereafter. Staff shall complete mandated reporter training within 90 days of initial employment.

Noncompliance Area: Agreement for child 1 does not specify correct hours child receives care. Agreement for child 3 does not have a parent signature. There is no child services report available for child 3.

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).An agreement shall specify the child's arrival and departure times.

Noncompliance Area: The last health assessment for staff person 1 was 6/11/2015 and is more than 24 months old.

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: Permission for Emergency medical care and minor first aid was not present in file for child 3.

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: Provider does not have copy of Child Abuse clearance on file at the facility, Verified that clearance was mailed to provider. A copy will be sent.

Correction Required: 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 #--- may not work in a child care position at the facility.

Noncompliance Area: Staff 1 has documented 3 hours of training since last renewal. Six hours are required.

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

Noncompliance Area: First aid certification for operator (staff 1) expired on 3/12/18. First aid certification for staff person 2 expired 3/12/2018.

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: Provider is unable to verify conducting 4 fire drills per year. Provider has documented 1 fire drill 3/13/18. No other drills were documented in 2018. There is no documentation of drills occurring in 2017; provider believes there were some, but no longer has the documentation.

Correction Required: Fire evacuation drills shall be conducted at least four times a year.

Noncompliance Area: Agreements for children 1, 2, 3, 4, 5 and 6 did not show date of admission to childcare.

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

Noncompliance Area: Operator did not have individual towels or paper towels available for use after hand washing.

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.Paper towels may be used as towels and washcloths. Paper towels shall be discarded after each use.

Noncompliance Area: Provider has not had any training. 6 hours of training are required.

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

Noncompliance Area: Clearances for operator and HHM are more than 60 months old at the time of renewal inspection. Updated clearances are required. Operator's file does not contain proof of completion of mandated reporter child abuse 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. Updated clearances are required.

Noncompliance Area: Toxic cleaning materials were observed to be accessible to children in 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.