Mercedes M Reyes - Lancaster PA Family Child Care Home

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.