Michele L Rupert Family Daycare

Noncompliance Area: On 08/28/2020, the rabies immunization for Clifton (a dog) did not have a current rabies immunization; the vet record stated an updated rabies booster was due 08/11/2020. The vet record for Forrest (a dog) did not include documentation of a current rabies immunization. Observed a cat at the facility that did not belong to the operator, when requested, the operator was unable provide a veterinarian's certificate of a current rabies immunization; the cat was observed in the child care space interacting with the children in care.

Correction Required: A veterinarian's certificate of current rabies immunization is required for a cat or dog at the facility. The certificate shall be on file when the cat or dog is present.

Noncompliance Area: On 09/09/2020, the file for child #1 lacked an updated health report at least once every 12 months for a preschool child. The most recent health report on file was dated 09/06/2018; an updated health report was due 09/06/2019; and was due prior to the COVID suspended regulations.

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: On 09/09/2020, the file for child #1, 4 years old, included a record of the child's immunization status which lacked a current influenza immunization.

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: Observed 2 shelves located in the indoor child care space which lacked an anchor to prevent a tip hazard.

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 embedded outdoor play equipment lacked a minimum of 9 inches of mulch; there was approximately 4-7 inches of mulch under the swings and around the slide/climbing areas.

Correction Required: Outdoor equipment that requires embedded mounting must be mounted over a loose-fill or unitary playground protective surface covering that meets the recommendations of the United States Consumer Product Safety Commission. The equipment must be anchored firmly and be in good repair.

Noncompliance Area: The sleeping bags used by the children for naptime lacked a label with the name of the child for whom the sleeping bag is intended.

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 file for child #3 lacked the signature of the operator on the agreement form.

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

Noncompliance Area: The file for child #3 lacked the services to be provided to the family and the child on the agreement form. The file for child #5 lacked a completed child service report (CSR) providing information to the family about the child's growth and development at least once every 6 months; the file contains a current CSR completed on 04/20/2019 with the previous CSR completed on 08/17/2018.

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 #5 lacked the health insurance policy number on the emergency contact form.

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 #1 lacked an updated health report at least once every 6 months for a young toddler; the file contains a current health report dated 08/07/2109 with the previous health report dated 09/18/2018 and no additional health report In between. The file for child #2 lacked an updated health report at least once every 6 months for an infant; the file contains an initial health report dated 08/24/2018 and a current health report dated 08/06/2019 and no additional health report in between.

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 lacked an updated health report at least once every 12 months for a preschool child; the file contains a current health report dated 08/08/2019 with the previous health report dated 04/11/2018. The file for child #4 lacked an updated health report at least once every 12 months for a preschool child; the file contains a current health report dated 08/07/2019 with the previous health report dated 10/16/2017.

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, a 3 year old, included a record of the child's immunization status which lacked a Hep A immunization.

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: Observed staff person #1 change a toddler's diaper without washing the child's hands after being diapered.

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: Observed staff person #1 change a toddler's diaper without immediately discarding the diaper into a plastic-lined, hands-free covered can. Staff person #1, changed the diaper and took the wrapped diaper to an outdoor trash can which required opening a gate and the front door to dispose of the diaper.

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 lacked documentation of an annual minimum of 6 clock hours of child care training between 11/2017 - 11/2018.

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

Noncompliance Area: Observed an electrical outlet on the wall next to the front door which lacked protective receptacle covers and was accessible to children 5 years of age or younger.

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

Noncompliance Area: The first-aid kit in the child care space lacked tape.

Correction Required: A first-aid kit must contain the following: soap, an assortment of adhesive bandages, sterile gauze pads, tweezers, tape, scissors and disposable, nonporous gloves.

Noncompliance Area: Observed a loose board and a splintering board on the benches of the wooden picnic table located in the outdoor play space. Observed an exposed, rusty nail on the gate of the toddler outdoor play space. Observed a splintering board on the top of the steps (top rung) leading to the top of the wooden play structure in the outdoor play space used by preschoolers. Observed dog feces in the grassy areas of the outdoor play area.

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 #1, with an enrollment date of 08/30/2017 lacked a child service report providing information about the child's growth and development at least once every 6 months. The file contains a current child service report dated 04/17/2018 with no additional child service reports 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 file for child #2 lacked the persons designated by the parent to whom the child may be released on the agreement form.

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

Noncompliance Area: The file for child #4 lacked information for health insurance coverage with the policy number on the emergency contact form. The file for child #1 lacked the health insurance policy number on the emergency contact form.

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 files for children #2 and #4 lacked the address of the individuals designated by the parent to whom the child may be released on the emergency contact form.

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 #1 lacked a timely review of the emergency contact and agreement forms at least once in a 6-month period. The most recent review of the forms were dated 04/17/2018 with the initial document signed and dated on 08/30/2017.

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: The file for child #2, with an enrollment date of 02/28/2018, lacked an initial health report no later than 60 days following the first day of attendance; the most recent health report on file was dated 08/24/2018 with no additional health reports 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 child #1 lacked an updated health report at least every 6 months for a young toddler; the most recent health report on file was dated 10/10/2017 with no additional health reports on file.

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 lacked an updated health report at least once every 12 months for an older toddler; the most recent health report on file is dated 02/07/2017 with no additional health reports on file.

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 staff person #1 lacked an updated health assessment at least every 24 months; the most recent health assessment on file is dated 11/19/2015.

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.

Noncompliance Area: At approximately 12:00 pm, observed French toast sticks with syrup and a cup of juice being served to the children for lunch with no additional items served.

Correction Required: A lunch or dinner prepared at the facility for children of toddler age or older shall include at least one dairy product. A lunch or dinner prepared at the facility for children of toddler age or older shall include at least one protein.

Noncompliance Area: The file for child #2 lacked a written statement from the parent giving the formula and feeding schedule for an infant.

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

Noncompliance Area: The file for child #4, with an enrollment date of 02/29/2016 lacked initial and subsequent health reports; the file contained a current health report dated 11/08/2017 with no additional health reports on file.

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

Noncompliance Area: The operator lacked documentation of a review of the emergency plan at least annually, the most recent review of the emergency plan was dated 06/20/2017.

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: Observed an electrical outlet on the wall next to the door in the bathroom used by children which lacked a protective receptacle cover.

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

Noncompliance Area: Observed shampoo and body wash on the ledge of the shower located in the bathroom used by the children in care which were accessible to children.

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: Observed wood chips with a diameter of less than 1 inch on the outdoor play area used by toddlers.

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: Observed child #1 and child #2 resting on a shared comforter on the floor during naptime. Observed child #3 and child #4, who are siblings, resting on a shared comforter on the floor during naptime. Comforter may not be used alone as age-appropriate rest equipment. Individual, age-appropriate rest equipment is not provided for the children in care.

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: Observed 2 comforters being used as rest equipment that lacked 2 feet of space on three sides during naptime.

Correction Required: At least 2 feet of space is required on three sides of a bed, cot, crib or other rest equipment while the equipment is in use.

Noncompliance Area: The file for child #6 lacked the date of the child's admission on the agreement form.

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

Noncompliance Area: The files for children #3, #4 and #5 lacked the complete address of the child's physician or source of medical care on the emergency contact form.

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 files for children #1 and #6 lacked the work address and telephone number of the enrolling parent on the emergency contact form. The files for children #3, #4 and #5 lacked the complete work address of the enrolling parent on the emergency contact form.

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 #3, #4, #5 and #6 lacked written consent signed by a parent for emergency medical care prior to admission.

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.

Noncompliance Area: The file for child #5 lacked the name, address and telephone number of the individuals designated by the parent to whom the child may be released on the emergency contact form. The file for child #6 lacked the address of the individuals designated by the parent to whom the child may be released on the emergency contact form. The file for child #1 lacked the complete address of the individuals designated by the parent to whom the child may be released on the emergency contact form.

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 facility lacked a written plan identifying the means of transporting a child to emergency care and staffing provisions in the event of an emergency.

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: The file for child #1, with an admission date of 03/13/2017, lacked an initial health report no later than 60 days following the first day of attendance at the facility. The file contained a copy of immunization records dated 08/21/2017. The file for child #6, lacked a copy of initial and subsequent health reports; the file contained a copy of immunization records dated 08/21/2017.

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: The file for child #4 lacked a updated health report at least every 6 months for a young toddler; the most recent health report on file is dated 12/03/2015. The file for child #3 lacked an updated health report at least every 12 months for a preschool child; the most recent health report on file is dated 12/03/2015.

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. 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 files for children #1 and #6 lacked a statement that the child is able to participate in child care and appears to be free from contagious or communicable disease on the health report.

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: Observed non-prescription medication for child #5 which lacked a label identifying the name of the child for whom the medication was intended.

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.

Noncompliance Area: Observed staff person #1 change children's diapers without washing the children's hands after being diapered. Staff person #1 did not wash their hands between each child being diapered or after the last child was diapered.

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: Observed a child's pull-up lying on the bathroom floor. The child went into the restroom after naptime to change their pull-up and the pull-up was not properly disposed of in a plastic-lined, hands-free covered can.

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 child #6 lacked a written statement from the parent giving the formula and feeding schedule.

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

Noncompliance Area: The files established and maintained for children #2 and #6, who are siblings, are shared files and lacked an individual record for each child. The files established and maintained for children #3 and #4, who are siblings, are shared files and lacked an individual record for each child.

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

Noncompliance Area: The files for children #3, #4, #5 and #6 lacked signed parent consent for administration of minor first-aid procedures by facility staff prior to admission.

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: The facility lacked a posted copy of the applicable regulations under which the facility is certified with instructions for contacting the appropriate regional day care office 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 facility lacked a posting of the emergency plan in a conspicuous location.

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

Noncompliance Area: Observed body wash on the ledge of the shower located in the bathroom used by children in care which were accessible. Observed scrubbing bubbles toilet tabs in an unlocked cabinet which were accessible to children. Observed Lysol soap labeled "Keep out of reach of children" on the bathroom counter which was accessible to children in care. Observed gasoline in containers next to the shed in the outdoor play space which was accessible to children.

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 first-aid kit at the facility lacked soap and scissors.

Correction Required: A first-aid kit must contain the following: soap, an assortment of adhesive bandages, sterile gauze pads, tweezers, tape, scissors and disposable, nonporous gloves.

Noncompliance Area: Observed an unlocked shed in the outdoor play space which was accessible to children; the shed contained a gas can, a variety of gardening equipment and a variety of tools. Observed a wheel barrel leaning against the side of the shed in the outdoor play space creating a fall hazard. Observed an uncovered gas grill on the deck which was accessible to children. Observed a broken steering wheel on the outdoor play equipment, the steering wheel was broken off exposing the bolt used to hold the steering wheel in place.

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.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 sliding glass door leading onto the patio from the indoor child care space lacked a visual strip or other visual identification.

Correction Required: A visual strip or other visual identification shall be placed on glass located in a traffic area, a child care space or a play space.