Growing Hope Child Care Center

Noncompliance Area: During the verification inspection on 7/10/2020, the staff person designated in charge could not provide the certification representative immediate access to the facility's files and records.

Correction Required: A staff person shall provide to agents of the Department immediate access to the facility, the children and the files and records

Noncompliance Area: The agreements on file for Child #1, #2, #4, #5 did not include or specify the persons designated by a parent to whom the child may be released. Continued deficiency; on 7/13/2020 it was observed that agreements on file for Child #1, #2, #4, #5 still did not include or specify the persons designated by a parent to whom the child may be released

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

Noncompliance Area: The files for Child #1, #2 and #5 contained original agreements. Continued deficiency; on 7/13/2020 it was observed that files for Child #1, #2 and #5 still contained original agreements

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

Noncompliance Area: The emergency contact information on file for Child #1 and #3 did not include the enrolling parents work address. Continued deficiency; on 7/13/2020 it was observed that the emergency contact information on file for Child #1 and #3 still did not include the enrolling parents work address

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

Noncompliance Area: It was observed that emergency contact information was not present in each childcare space for the children receiving care in the space. Continued deficiency; on 7/13/2020 it was observed that emergency contact information was still not present in each childcare space for the children receiving care in the space.

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: It was observed that a written plan identifying the means of transporting a child to emergency care and staffing provisions in the event of an emergency was not displayed conspicuously in every child care space. Continued deficiency; on 7/13/2020 it was observed that a written plan identifying the means of transporting a child to emergency care and staffing provisions in the event of an emergency was still not displayed conspicuously in every child care space.

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 file for Child #4, enrolled 10/29/2019 did not include a health assessment. Continued deficiency; on 7/13/2020 it was observed that the file for Child #4, enrolled 10/29/2019 still did not include a health assessment

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 files for Child #1 and Child #4 did not include a review of the child's immunization status. Continued deficiency; on 7/13/2020 it was observed that the files for Child #1 and Child #4 still did not include a review of the child's immunization status.

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

Noncompliance Area: The health report on file for Child #1 and #3 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. Continued deficiency; on 7/13/2020 it was observed that the health report on file for Child #1 and #3 still 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 file for Child #2, #5 did not include documentation to verify that they received an Influenza vaccination in accordance with the recommendations of the ACIP. Continued deficiency; on 7/13/2020 it was observed that the file for Child #2, #5 still did not include documentation to verify that they received an Influenza vaccination in accordance with the recommendations of the ACIP.

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: The files for Child #1, #2, #4 did not contain emergency contact or financial agreement information that was updated at least once in a 6-month period. Continued deficiency; on 7/13/2020 it was observed that the files for Child #1, #2, #4 still did not contain emergency contact or financial agreement information that was updated at least once in a 6-month 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.

Noncompliance Area: The file for Facility Person #5 did not include acceptable verification of experience, education or training. Continued deficiency; on 7/13/2020 it was observed that file for Facility Person #5 still did not include acceptable verification of experience, education or training.

Correction Required: A facility person's record shall include acceptable verification of experience, education or training is a transcript or a diploma or a letter signed by a representative of the experiential, educational or training entity.

Noncompliance Area: The files for Facility Persons #4 and #5 did not include a written report of 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 at initial employment. Continued deficiency; on 7/13/2020 it was observed that the files for Facility Persons #4 and #5 still did not include a written report of 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 at initial employment.

Correction Required: 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 Facility Person #1 did not include two written non-family references attesting to the person's suitability to serve as a facility person. Continued deficiency; on 7/13/2020 it was observed that file for Facility Person #1 still did not include two written non-family references attesting to the person's suitability to serve as a facility person.

Correction Required: A facility person's record shall include two written, nonfamily references from individuals attesting to the person's suitability to serve as a facility person

Noncompliance Area: It was observed that the facility emergency plan did not include a method to inform parents that the emergency has ended and to provide instructions as to how parents can safely be reunited with their children. Continued deficiency; on 7/13/2020 it was observed that the emergency plan still did not include a method to inform parents that the emergency has ended and to provide instructions as to how parents can safely be reunited with their children.

Correction Required: The facility shall have an emergency plan that provides for a method for facility persons to inform parents that the emergency has ended and to provide instruction as to how parents can safely be reunited with their children.

Noncompliance Area: The files for Facility Persons #1, #2, #3, #4, #5 did not include documentation to support that each facility person received training regarding the emergency plan at time of initial employment. Continued Deficiency; on 7/13/2020 it was observed that the files for Facility Persons #1, #2, #3, #4, #5 did not include documentation to support that each facility person received training regarding the emergency plan at time of initial employment.

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 and kept on file at the facility.

Noncompliance Area: It was observed that all windows in the facility were missing screens. Facility persons stated that windows are opened and used for ventilation. Continued deficiency; on 7/13/2020 it was observed that all the windows in the facility were still missing screens.

Correction Required: Windows or doors used for ventilation shall be screened when open.

Noncompliance Area: It was observed that the telephone number of the nearest hospital, police department, fire department, ambulance and poison control center were not posted by each telephone in the facility. Continued deficiency; on 7/13/2020 it was observed that the telephone number of the nearest hospital, police department, fire department, ambulance and poison control center were still not posted by each telephone in the facility

Correction Required: The telephone number of the nearest hospital, police department, fire department, ambulance and poison control center shall be posted by each telephone in the facility.

Noncompliance Area: It was observed that a sufficient amount and variety of play equipment and materials were not available to children in the infant and young toddler classrooms.

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.

Noncompliance Area: It was observed that dramatic play equipment and materials for role playing were missing from each of the classrooms.

Correction Required: Play equipment and materials shall include materials for dramatic role playing.

Noncompliance Area: It was observed that a toy refrigerator in the play space area was dirty with a sticky substance.

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: It was observed that a red chair in the older toddler classroom was missing a metal 'floor glide' piece on the front left chair leg, making it unsafe (not sturdy) for children.

Correction Required: Furniture must be durable, safe, easily cleaned and appropriate for the child's size, age and special needs.

Noncompliance Area: It was observed that the rest equipment for all children was not labeled for the use of a specific child and used only by the specified child.

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: It was observed that the daily activity and routine schedule did not include an established free play time for each group.

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: The agreements on file for Child #1, #2, #3, #4, #5 did not include or specify the persons designated by a parent to whom the child may be released

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

Noncompliance Area: The files for Child #1, #2 and #5 contained original agreements.

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

Noncompliance Area: The emergency contact information on file for Child #1 and #3 did not include the enrolling parents work address.

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

Noncompliance Area: It was observed that emergency contact information was not present in each childcare space for the children receiving care in the space.

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: It was observed that a written plan identifying the means of transporting a child to emergency care and staffing provisions in the event of an emergency was not displayed conspicuously in every child care space

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 file for Child #4, enrolled 10/29/2019 did not include a health assessment.

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 health report for Child #3 did not include a signature of a physician, physician's assistant or a CRNP.

Correction Required: A health report must be written and signed by a physician, physician's assistant or a CRNP. The signature must include the individual's professional title.

Noncompliance Area: The files for Child #1 and Child #4 did not include a review of the child's immunization status.

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

Noncompliance Area: The health report on file for Child #1 and #3 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 file for Child #2, #3, #5 did not include documentation to verify that they received an Influenza vaccination in accordance with the recommendations of the ACIP.

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: It was observed that there were multiple tubes of diaper creams that were not labeled for the use of each individual child in the infant room.

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: It was observed that written notification of safe routes into the facility was not posted by the operator at a conspicuous location in the child care facility

Correction Required: Written notification of safe routes shall be posted by the operator at a conspicuous location in the child care facility.

Noncompliance Area: The files for Child #1, #2, #3, #4, #5 did not contain emergency contact or financial agreement information that was updated at least once in a 6-month 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.

Noncompliance Area: It was observed that an incident report dated 12/3/2019 was in the infant classroom and was not given to the parent on the day of the incident. It was also observed that a copy of incident reports were not retained at the facility in the child's files or in an accident file.

Correction Required: A child's record shall contain reports of accidents, injuries and illnesses involving a child in care at the facility. The original report shall be given to the parent on the day of the incident. The second copy of the report shall be retained at the facility in an accident file. The third copy of the report shall be retained at the facility in the child's file.

Noncompliance Area: It was observed that child files were not stored in a locked cabinet.

Correction Required: Child records are confidential and shall be stored in a locked cabinet.

Noncompliance Area: The file for Facility Person #5 did not include acceptable verification of experience, education or training.

Correction Required: A facility person's record shall include acceptable verification of experience, education or training is a transcript or a diploma or a letter signed by a representative of the experiential, educational or training entity.

Noncompliance Area: The files for Facility Persons #4 and #5 did not include a written report of 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 at initial employment.

Correction Required: 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 files for Facility Person #1 did not include two written non-family references attesting to the person's suitability to serve as a facility person.

Correction Required: A facility person's record shall include two written, nonfamily references from individuals attesting to the person's suitability to serve as a facility person

Noncompliance Area: It was observed that the facility emergency plan did not include a method to inform parents that the emergency has ended and to provide instructions as to how parents can safely be reunited with their children.

Correction Required: The facility shall have an emergency plan that provides for a method for facility persons to inform parents that the emergency has ended and to provide instruction as to how parents can safely be reunited with their children.

Noncompliance Area: The files for Facility Persons #1, #2, #3, #4, #5 did not include documentation to support that each facility person received training regarding the emergency plan at time of initial employment.

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 and kept on file at the facility.

Noncompliance Area: The file for Facility Person #1, hired on 10/28/2019, did not include an NSOR verification .The file for Facility Person #4 , hired 2/24/2020, did not include a Child Abuse clearance or NSOR verification. The LE does not have an approved waiver to hire provisionally. Furthermore, on 3/3/2020, Facility Person #4 was observed in a preschool room working alone with children and was not supervised by a permanent employee.

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. Facility Persons #1 and # 4 must be removed from a child care position by the close of business. Provisional hires may not work in a child care position when a waiver approval is not on file. Furthermore, provisional hires may not work unsupervised.

Noncompliance Area: It was observed in the large main child care space that there were 16 children ages infant through preschool napping. The children were supervised by only 3 facility persons. Ratios could not be doubled because infants were observed napping in the space.

Correction Required: The staff:child ratio while toddlers and preschoolers are napping is one staff person to 10 young toddlers, one staff person to 12 older toddlers, one staff person to 20 preschool children

Noncompliance Area: It was observed during nap time that there were not enough facility persons on duty remaining in the child care portion of the facility premises. There were only 3 facility persons on duty during nap time.

Correction Required: Staff persons who are on duty but are not providing child care during naptime shall remain in the child care portion of the facility premises.

Noncompliance Area: It was observed that a boudreaux butt paste-diaper cream was stored in a low bin, accessible to children in the preschool bathroom. It was also observed that desitin and aquaphor were in a child's bag in the hallway, accessible to children.

Correction Required: Cleaning materials and other toxic materials shall be kept in an area or container that is locked or made inaccessible to children.

Noncompliance Area: It was observed that all windows in the facility were missing screens. Facility persons stated that windows are opened and used for ventilation.

Correction Required: Windows or doors used for ventilation shall be screened when open.

Noncompliance Area: It was observed and verified through a test call that the facility did not have an operable telephone connected to the published number.

Correction Required: A facility shall have an operable telephone and a published telephone number.

Noncompliance Area: It was observed that the telephone number of the nearest hospital, police department, fire department, ambulance and poison control center were not posted by each telephone in the facility.

Correction Required: The telephone number of the nearest hospital, police department, fire department, ambulance and poison control center shall be posted by each telephone in the facility.

Noncompliance Area: It was observed that a first-aid kit was accessible to children in the preschool classroom. Corrected on site.

Correction Required: A first-aid kit must be inaccessible to children.

Noncompliance Area: It was observed in the Preschool classroom that there was a hanging cord, broken face-plate and large carpet wrinkles causing a tripping hazard. It was observed in the older toddler classroom that there were hanging cords and exposed wires from a power supply box accessible to children. It was observed in the preschool bathroom that the left knob on the cabinet, below the sink was broken and there was significant residue build up on the hot water knobs. It was observed in the play space room that the ceiling light covers were broken, the 'flashing' was loose and peeling from the bottom of the pole and there was an exposed, working light bulb on the wall. It was also observed in the Kitchen that the wall vent cover beside the food prep area was very dusty.

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: It was observed that there were holes in plaster and peeling paint on the wall, in the preschool classroom.

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

Noncompliance Area: It was observed that the sink area in the toddler classroom was not equipped with a lidded waste receptacle.

Correction Required: A toilet area, training chair area, diapering area and sink area shall be equipped with a clean, lidded waste receptacle.

Noncompliance Area: It was observed that the names of facility persons whom participated in the fire drill were missing from the fire drill log.

Correction Required: A written record shall be kept of the date, the time of day, the hypothetical location of the fire, the evacuation time, the names of facility persons and the number of children participating in the fire drill.

Noncompliance Area: Facility person #1 has a health assessment with the results of tuberculin skin tests dated 1/6/2018 which is longer than 12 months ago and is no longer valid for initial employment. Facility person #2 has a health assessment with the results of tuberculin skin tests dated 2/7/2018 which is longer than 12 months ago and is no longer valid for initial employment.

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 liability insurance claim report does not include the address and telephone number of the facility.

Correction Required: A liability insurance claim report shall include the name, address and telephone number of the facility.

Noncompliance Area: On October 2, 2019 the provider did not provide documentation that the fire detection system has been inspected annually.

Correction Required: Conditions at the facility may not pose a threat to the health or safety of the children. The agent of the Department will file a complaint with the appropriate municipal office to request an additional fire safety inspection by the appropriate agency to verify compliance with 34 Pa. Code 403.23 and per Chapter 20.35(c)

Noncompliance Area: All five (5) first-aid kits did not contain 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: It was observed on a pole in the corner of the indoor play area there was an area of peeling paint. (CORRECTED ON SITE)

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