Monica E Atkinson Group Child Care Home

Noncompliance Area: Observed a crack, which created a possible pinch hazard, in the blue toy bin in the Little Big Shots Room.

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 Fee Agreement in the file for Child #1 did not include 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 Emergency Contact Form in the file for Child #3 did not include 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: The file for Child #2, a Preschool Child, did not include an updated health report conducted within the past 12 months.

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: The initial health assessment in the file for Staff Person #1 did not include documentation of a tuberculosis screening.

Correction Required: An adult health assessment must include tuberculosis screening by the Mantoux method at initial employment. Subsequent tuberculosis screening is not required unless directed by a physician, physician's assistant, CRNP, the Department of Health or a local health department. 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 file for Staff Person #1, with a start date of 6/15/19, did not include documentation of initial training in the facility's Emergency Plan.

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. A facility person's record shall include verification of child care experience, education and training following the outset of service at the facility.

Noncompliance Area: On the morning of the inspection, Staff Person #1 left the child care area to answer the door for the certification representative. This resulted in Staff Person #2 supervising a group of seven children of mixed age levels. The youngest child in the group was an Older Toddler.

Correction Required: When children are grouped in mixed age levels, the age of the youngest child in the group determines the staff:child ratio and maximum group size in accordance with the requirements at 3280.52(b).

Noncompliance Area: The basketball set in the outdoor play space was not secured. This presents a potential toppling 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 file for Staff Person #1, who has been working in a child care position at the facility for more than 90 days (2/25/19), did not include documentation of 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 verification of child care experience, education and training following the outset of service at the facility.

Noncompliance Area: A strip of aluminum siding was leaning against the wooden fence in the outdoor play space.

Correction Required: Floors, walls, ceilings and other surfaces, including the facility's outdoor play space surfaces shall be kept clean, in good repair and free from visible hazards.

Noncompliance Area: Observed peeling/flaking paint along the bottom of the garage and the bottom of the shed in the outdoor play space.

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

Noncompliance Area: In the back learning room, observed tears in rest mats, which exposed the inner foam. This created a potential choking hazard for children who are still placing objects in their mouths.

Correction Required: Toys and objects with a diameter of less than 1 inch, objects with removable parts that have a diameter of less than 1 inch, plastic bags and styrofoam objects may not be accessible to children who are still placing objects in their mouths.

Noncompliance Area: On January 8th, 2019, at 1:00 PM, Staff Person #2 answered the door to let certification representative into facility. Staff Person #2 had two children with her and was the only facility person on the premises at this time. In order to answer the door, Staff Person #2 left Child #4, who was napping upstairs, unsupervised.

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.

Noncompliance Area: The Emergency Contact Form in the file for Child #2 did not include 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: The most recent health report in the file for Child #1 did not include a review of the child's immunization records.

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: The most recent health reports in the file for Staff Person #2 exceeded 24 months between reports. The most recent health report in the file for Staff Person #2 is current.

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 conducted within 12 months prior to providing initial service in a child care setting and every 24 months thereafter. 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: The file for Staff Person #1 did not have a tuberculosis screening conducted within one year of the staff member's start date. The tuberculosis screening in the file for Staff Person #1 is not valid.

Correction Required: An adult health assessment must include tuberculosis screening by the Mantoux method at initial employment. Subsequent tuberculosis screening is not required unless directed by a physician, physician's assistant, CRNP, the Department of Health or a local health department. 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 parental updates for the Emergency Contact Form and Fee Agreement in the file for Child #4 were conducted more than six months after the child's enrollment date: Enrollment: 4/24/18 Update: 11/13/18. The most recent updates are current.

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: The Emergency Contact Form in the file for Child #3 did not include signed parental consent for emergency medical care for the child.

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: There was a plastic toy bin in the preschool room with a crack, creating a sharp edge/potential pinch point.

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: A child was resting in a packnplay in the middle (toddler) room without 2 feet of space on 3 sides of the rest equipment.

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 agreement on file for child #3 did not specify the services 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 3280.124(f).

Noncompliance Area: The agreement on file for child #4 did not specify the release persons.

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

Noncompliance Area: The agreement on file for child #4 did not specify the child's admission date.

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

Noncompliance Area: The agreements on file for children #1-#5 were the originals.

Correction Required: A parent shall receive the original agreement. The facility shall retain a copy of the agreement.

Noncompliance Area: There were no emergency contact forms in the preschool room for the children receiving care in that room.

Correction Required: When children are in the facility, emergency contact information shall be present in a child care space for children receiving care in the space.

Noncompliance Area: There was no medical emergency transportation plan posted in the preschool room.

Correction Required: A written plan identifying the means of transporting a child to emergency care and staffing provisions in the event of an emergency shall be displayed conspicuously in every child care space and shall accompany a staff person who leaves on an excursion with children.

Noncompliance Area: The health assessment on file for child #2 did not include 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 TB test read date was not documented on the health assessment on file for Facility Person # 3.

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 conducted within 12 months prior to providing initial service in a child care setting and every 24 months thereafter. 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.An adult health assessment must include tuberculosis screening by the Mantoux method at initial employment. Subsequent tuberculosis screening is not required unless directed by a physician, physician's assistant, CRNP, the Department of Health or a local health department.

Noncompliance Area: The health assessment on file for Facility Person #1 did not include an exam for communicable disease and the results of that examination.

Correction Required: An adult health assessment must include an examination for communicable diseases and the results of that examination.

Noncompliance Area: The health assessment on file for Facility Person #1 did not include the physician's or CRNP's 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: There was no documentation of emergency plan training on file for Facility Person #4.

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: All clearances on file for Facility Person #2 were completed after her first day of employment. There was no proof of application on file for any clearance for Facility Person #2. The FBI clearance on file for Facility Person #2 was not completed by an acceptable agency. The FBI clearance on file for Facility Person #3 was incomplete.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). Facility Persons #2 and #3 may not work in a child care position without the completed clearances.

Noncompliance Area: There were small areas of peeling pant on walls in the preschool and back rooms.

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

Noncompliance Area: A child was resting in a packnplay located in front of a door, blocking an exit from the toddler room.

Correction Required: Stairways, hallways, exits from rooms, exits from the facility and other means of egress serving as an exit shall be unobstructed.

Noncompliance Area: Fire drills were held more than 60 days apart on 5/26/17, 8/24/17, and 12/21/17, with no fire drills in between these dates.

Correction Required: A fire drill shall be held at least every 60 days. Staff persons, volunteers and children in attendance shall participate in the fire drill and shall exit the facility, weather permitting.