Milagros Zuleta - Lebanon PA Family Child Care Home

Noncompliance Area: Adult child 18 yr of age/older of provider lists provider's address as his residence. No clearances are on file for this individual over the age of 18.

Correction Required: At renewal, the legal entity shall submit clearances required by the CPSL for each individual 18 years of age or older who resides in the facility at least 30 days in a calendar year if the individual moved into the facility following the date of the previous application for a registration certificate. HHM 1 shall provide proof of address or submit clearances as a household member over the age of 18 yrs.

Noncompliance Area: Children's files reviewed lacked address of designated release person(s) address.

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

Noncompliance Area: Children's files lacked signed parental permission for administration of 1st aid.

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: Child 2 does not have a 6mth old physical 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: Child 1 does not have a current immunization record attached to 2 yr old physical dated 11/27/18.

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

Noncompliance Area: Diapering surface was not sanitized after use. A cloth cover was used on the diapering surface but was not removed and washed/rinsed/sanitized for next diaper change. On site technical assistance given. Cloth cover removed. Bleach solution of 1 tsp bleach to 1 qt water utilized to clean diapering pad after every use. Corrected on site.

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: Staff 4 did not wash hands after diapering and prior to serving infant a bottle. Technical assistance provided on sight regarding when to wash hands with signs placed in the bathroom and at the diapering table. Proper handwashing observed at lunchtime. Corrected on site.

Correction Required: A facility person shall wash his hands before meals and snacks, and after toileting and after diapering a child.

Noncompliance Area: No written infant statements of feeding and formula schedule on file for enrolled infants.

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

Noncompliance Area: Fire evacuation plan not posted in the childcare room.

Correction Required: Fire evacuation plans shall be developed and posted.

Noncompliance Area: NOT ENOUGH PLAY EQUIPMENT AND MATERIALS FOR VARIOUS AGES TO PROMOTE DEVELOPMENT, SOCIAL COMPETENCE, AND SELF ESTEEM. NO PROGRAMMING OR STRUCTURED DAILY ACTIVITES.

Correction Required: Play equipment and materials shall include the items specified at 3290.101(c)(1) - (6).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.

Noncompliance Area: NAP EQUIPMENT WAS NOT PROPERLY SPACED 2 FEET ON 3 SIDES.

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: PROVIDER DOES NOT TRANSITION CHILDREN TO SEE WHEN ANSWERING DOOR, GOING TO ANOTHER FLOOR. PROVIDER DID NOT KNOW THE NUMBER OF CHILDREN IN CARE---WHEN ASKED, PROVIDER STATED 4 CHILDREN WERE PRESENT. FIVE CHILDREN WERE ACTUALLY PRESENT.

Correction Required: Children on the facility premises and on facility excursions off the premises shall be supervised by a staff person at all times. Outdoor play space used by the facility is considered part of the facility premises. The requirement for supervision on and off the facility premises includes compliance with the staff:child ratio requirements in 3290.51-3290.52 (relating to maximum number of children; and staff:child ratio). Children must be supervised at all times.

Noncompliance Area: CHILDRENS HEALTH REPORTS DID NOT INCLUDE CURRENT IMMUNIZATION RECORD.

Correction Required: A health report shall include a review of the child's immunized status according to recommendations of the ACIP.A child's record must contain initial and subsequent health reports.

Noncompliance Area: PROVIDER DID NOT HAVE A DATED PHYSICAL SIGNED BY PHYSICIAN. PHYSICAL EXPIRED FEB 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: 2 (TWO) OLDER TODDLERS WERE GIVEN BOTTLES TO GO TO SLEEP.

Correction Required: Neither an infant nor a toddler is permitted to sleep with a bottle in his mouth.