Nunez Family Day Care

Regulation: 3290.105(a)

Description: Clean, age appropriate

Noncompliance Area: During the renewal inspection on 5/27/2026, the pack and play was not labeled with a specific child's name.

Correction Required: Individual, clean, age-appropriate rest equipment shall be provided for preschool, toddler and infant children as agreed between the parent and the operator. The rest equipment must be labeled with the child's name and used only by the named child while enrolled in the program.

Regulation: 3290.117(c)

Description: Vet's certificate required

Noncompliance Area: During the renewal inspection on 5/27/2026, the rabies vaccine for the family dog expired 10/20/2025.

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.

Regulation: 3290.123(a)(6)

Description: Admission date

Noncompliance Area: Child 1 did not have a date of admission on file.

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

Regulation: 3290.131(d)(7)

Description: Free from contagious/communicable disease

Noncompliance Area: Child 1's health assessment did not have a statement on file saying that child 1 is able to participate in childcare and appears to be free from contagious or communicable diseases.

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.

Regulation: 3290.134(a)/3290.135(b)

Description: Child's hands washed/Surfaces cleaned

Noncompliance Area: Staff 1 did not wash the child's hands after diapering or clean the diapering surface with a sanitizing solution.

Correction Required: A staff person shall ensure that a child's hands are washed before meals and snacks, after toileting and after being diapered. 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.

Regulation: 3290.18/3290.104

Description: General Health and Safety/High Chairs

Noncompliance Area: During the renewal inspection on 5/27/2026, it was observed that the highchairs did have a t-strap. However, the t-strap was not in use at the time the children were in the highchairs. There were two children in highchairs where the t-strap was not being utilized.

Correction Required: Conditions at the facility may not pose a threat to the health or safety of the children. High chairs shall have a wide base and a T-shaped safety strap.

Regulation: 3290.24(b)/3290.24(c)

Description: Emergency plan/Training regarding plan

Noncompliance Area: During the renewal inspection on 5/27/2026, it was observed that the emergency plan was last updated on 1/4/2025 making it more than one year since the last renewal inspection. Staff 2 did not have emergency plan training on file.

Correction Required: The operator shall review the emergency plan at least annually and update the plan as needed. Each review and update of the emergency plan shall be documented in writing and kept on file at the facility. 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.

Regulation: 3290.31(f)

Description: Age and training

Noncompliance Area: During the renewal inspection on 5/27/2026, it was observed that staff 2 did not have 12 hours of annual training. Staff 2 had 4.5 hours of annual training on file. Please see LIS for DOH.

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

Regulation: 3290.32(a)/3290.192(3)

Description: Comply with CPSL/CPSL information

Noncompliance Area: During the renewal inspection on 5/27/2026, staff 1 did not have updated clearances on file. The state police clearance expired 1/20/2026. The FBI clearance expired 1/26/2026. The child abuse clearance expired 1/25/2026. The NSOR clearance expired 4/5/2026. As a result, they were not updated within the last 60 months.

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. Staff 1 may not work in a childcare position at the facility until all clearances are obtained.

Regulation: 3290.73(c)

Description: Has all items

Noncompliance Area: During the renewal inspection on 5/27/2026, the first aid kit was missing medical 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.

Regulation: 3290.94(a)(5)

Description: Evacuation routes posted

Noncompliance Area: During the renewal inspection on 5/27/2026, the fourth floor of the facility did not have an evacuation map.

Correction Required: Evacuation routes are posted in a conspicuous location on each floor of the facility.

Regulation: 3290.181(a)

Description: Each child

Noncompliance Area: Children #1-#3 did not have a file on site during the inspection on 4/16/2026.

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

Regulation: 3290.32(a)/3290.192(3)

Description: Comply with CPSL/CPSL information

Noncompliance Area: During an inspection on 4/16/2026, it was found that household member #1 did not have any clearances on file.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). Household member #1 may not be in the childcare area of the facility until all clearances are obtained. A household members record shall include a copy of requests for the criminal history record and child abuse registry clearance information and a copy of the completed clearance information required under the CPSL. Facility Person #1 may not work in a child care position at the facility.

Regulation: 3290.105(a)

Description: Clean, age appropriate

Noncompliance Area: As per provider, the pack n' play in the childcare area is utilized by a child to sleep. The pack n' play was not labeled with a child's name.

Correction Required: Individual, clean, age-appropriate rest equipment shall be provided for preschool, toddler and infant children as agreed between the parent and the operator. The rest equipment must be labeled with the child's name and used only by the named child while enrolled in the program.

Regulation: 3290.131(e)

Description: Immunization record

Noncompliance Area: During the renewal inspection, it was observed that child 1 did not have updated immunizations on file. It was observed that three DTaP shots were on file. According to the ACIP, four DTaP shots should be on file for child 1's age. Please see LIS for date of birth and date of admission.

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.

Regulation: 3290.31(f)

Description: Age and training

Noncompliance Area: Staff 1 did not have 12 hours of annual training on file.

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

Regulation: 3290.75(a)

Description: No peeling paint or plaster

Noncompliance Area: There was peeling paint on the upstairs bathroom cabinet.

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

Regulation: 3290.95(a)/3290.95(b)

Description: System in compliance/Operator or designated staff responsibility

Noncompliance Area: During the renewal inspection on 5/12/2025, it was observed that the facility had operable smoke detectors in the basement, 1st floor, 2nd floor and 3rd floor. However, the smoke detectors were not interconnected.

Correction Required: Fire detection devices or systems must be in compliance with standards established under section 1016(c) of the act (62 P.S. § 1016(c)). The operator or designated staff person who is responsible for compliance with this chapter shall ensure the requirements in § 3290.95(a) are met.

Regulation: 3290.64(a)

Description: Locked or inaccessible - in original container

Noncompliance Area: Toxics were observed to be accessible to children in the upstairs bathroom which is utilized by children. Cleaning materials were observed to be accessible under the sink in an unlocked cabinet. Perfume and hair supplies were also accessible to children on a stand next to the toilet.

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.

Regulation: 3290.124(b)(7)

Description: Name/address/phone release person

Noncompliance Area: During renewal inspection conducted on 8/12/2024, release person's address was missing on child #2's 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.

Regulation: 3290.131(d)(5)/3290.131(e)(3)

Description: Immunization record/Dismissal policy

Noncompliance Area: During renewal inspection conducted 8/12/2024, immunization record for child #1 indicated that child had 3 of 4 doses of HIB vaccine and had not received Hep A vaccine. There was no exemption on file. Child #1 is a young toddler (see LIS code sheet for date of birth).

Correction Required: A health report shall include a review of the child's immunized status according to recommendations of the ACIP. The facility shall implement dismissal policies in accordance with the Department of Health regulation in 28 Pa. Code § 27.77 (relating to immunization requirements for children in child care group settings). Child #1 must be dismissed from care by close of business 8/12/2024 and may only return to care when the immunization record is updated or when a parent provides a written, signed exemption letter.

Regulation: 3290.95(a)/3290.95(b)

Description: System in compliance/Operator or designated staff responsibility

Noncompliance Area: During renewal inspection conducted 8/12/2024, smoke alarm in the facility's basement was not interconnected.

Correction Required: Fire detection devices or systems must be in compliance with standards established under section 1016(c) of the act (62 P.S. § 1016(c)). The operator or designated staff person who is responsible for compliance with this chapter shall ensure the requirements in § 3290.95(a) are met.

Regulation: 3290.22(a)

Description: Availability of certificate of compliance and applicable regulations

Noncompliance Area: During unannounced monitoring conducted 7/8/2024, certificate of compliance posted on the facility's board expired on 9/30/2023.

Correction Required: The facility's current certificate of compliance shall be posted in a conspicuous location used by parents, with instructions for contacting the appropriate regional child care office posted at the same location.

Regulation: 3290.65(c)

Description: No insects or rodents

Noncompliance Area: During complaint investigation, it was verified that facility was infested with mice. Operator reported that an exterminator has been hired to take care of the issue.

Correction Required: Evidence of infestation of insects or rodents in the facility is not permitted.

Regulation: 3290.123(a)(3)

Description: Services provided

Noncompliance Area: During renewal inspection conducted 2/27/2024, the Child Service Reports (CSRs) on file for child #2 and child #4 were not filled out. Children have both been attending the facility for over 6 months (see LIS code sheet for dates of enrollment). An acceptable plan of correction was received with a correction date of 3/11/2024. When certification representative returned for unannounced monitoring on 4/18/2024, the Child Service Reports (CSRs) on file for child #2 and child #4 were not filled out. Children have both been attending the facility for over 6 months (see LIS code sheet for dates of enrollment).

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).

Regulation: 3290.124(b)(2)/3290.124(b)(3)

Description: Physician name, address, phone/Parent home/work address, phone

Noncompliance Area: During renewal inspection conducted 2/27/2024, the following information was missing from children's emergency contact forms: Child #1: Mother's work address and work telephone number. Child #3: Father's work address. Mother's telephone number. Child's doctor's telephone number. Child #5: Mother's home telephone number. An acceptable plan of correction was received with a correction date of 2/27/2024. When certification representative returned for unannounced monitoring on 4/18/2024, operator reported that child #1 and child #5 are unenrolled from the facility. The following information was missing from children's emergency contact forms: Child #3: Father's work address. Mother's telephone number. Child's doctor's telephone number.

Correction Required: Emergency contact information must include the name, address and telephone number of the child's physician or source of medical care. Emergency contact information must include the home and work addresses and telephone numbers of the enrolling parent.

Regulation: 3290.181(c)

Description: Emergency info/agreement updated 6 mos

Noncompliance Area: During renewal inspection conducted 2/27/2024, the following forms were not updated within 6 months: Child #2: Emergency contact form and fee agreement last updated 5/24/2023. Child #4: Emergency contact form and fee agreement last updated 4/24/2023. An acceptable plan of correction was received with a correction date of 3/11/2024. When certification representative returned for unannounced monitoring on 4/18/2024, the following forms were not updated within 6 months: Child #2: Emergency contact form and fee agreement last updated 5/24/2023. Child #3: Emergency contact form and fee agreement last updated 9/20/2023. Child #4: Emergency contact form and fee agreement last updated 4/24/2023.

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.

Regulation: 3290.182(3)/3290.182(5)

Description: Consent for emergency medical care required prior to admission/Consent for administration of minor first-aid required prior to admission

Noncompliance Area: During renewal inspection conducted 2/27/2024, emergency contact form for child #3 did not contain signed parental consent for emergency medical care or minor first-aid. An acceptable plan of correction was received with a correction date of 3/1/2024. When certification representative returned for unannounced monitoring on 4/18/2024, emergency contact form for child #3 did not contain signed parental consent for emergency medical care or minor first-aid.

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. 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.

Regulation: 3290.182(3)/3290.182(5)

Description: Consent for emergency medical care required prior to admission/Consent for administration of minor first-aid required prior to admission

Noncompliance Area: During renewal inspection conducted 2/27/2024, emergency contact form for child #3 did not contain signed parental consent for emergency medical care or minor first-aid. An acceptable plan of correction was received with a correction date of 3/1/2024. When certification representative returned for unannounced monitoring on 4/18/2024, emergency contact form for child #3 did not contain signed parental consent for emergency medical care or minor first-aid.

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. 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. The legal entity will submit a complete emergency contact form and a complete fee agreement form for any new child being enrolled at the facility to the NE Regional Office for approval prior to the child receiving care at the facility. The completed forms for all new enrollments must be submitted to the NE Regional Office for a period of three (3) months from the date the office receives acceptable plans of correction.

Regulation: 3290.94(a)(4)

Description: Hypothetical locations

Noncompliance Area: During renewal inspection conducted 2/27/2024, facility's fire drill log did not list hypothetical location for fire drills conducted in the past. An acceptable plan of correction was received with a correction date of 2/27/2024. When certification representative returned for unannounced monitoring on 4/18/2024, facility's fire drill log did not list hypothetical location for fire drill conducted on 3/8/2024.

Correction Required: The operator or designated staff person who is responsible for compliance with this chapter shall conduct fire drills and ensure that the hypothetical locations of the fire are rotated around the facility for each drill such that the hypothetical location is never the same for consecutive drills.

Regulation: 3290.95(a)/3290.95(b)

Description: System in compliance/Operator or designated staff responsibility

Noncompliance Area: During renewal inspection conducted 2/27/2024, smoke alarms were tested past 30 days 11/22/2023-12/30/2023. An acceptable plan of correction was received with a correction date of 2/27/2024. When certification representative returned for unannounced monitoring on 4/18/2024, fire drill detection testing log reflected that smoke alarms were last tested on 3/8/2024, which is over 30 days ago.

Correction Required: Fire detection devices or systems must be in compliance with standards established under section 1016(c) of the act (62 P.S. § 1016(c)). The operator or designated staff person who is responsible for compliance with this chapter shall ensure the requirements in § 3290.95(a) are met.

Regulation: 3290.95(a)/3290.95(b)

Description: System in compliance/Operator or designated staff responsibility

Noncompliance Area: During renewal inspection conducted 2/27/2024, smoke alarms were tested past 30 days 11/22/2023-12/30/2023. An acceptable plan of correction was received with a correction date of 2/27/2024. When certification representative returned for unannounced monitoring on 4/18/2024, fire drill detection testing log reflected that smoke alarms were last tested on 3/8/2024, which is over 30 days ago.

Correction Required: Fire detection devices or systems must be in compliance with standards established under section 1016(c) of the act (62 P.S. § 1016(c)). The operator or designated staff person who is responsible for compliance with this chapter shall ensure the requirements in § 3290.95(a) are met. Operator shall create a schedule for smoke detector testing for the next twelve (12) months and submit it to the Northeast Regional Office.

Regulation: 3290.121(a)

Description: Review policies and procedures

Noncompliance Area: During renewal inspection conducted 2/27/2024, facility's parent handbook did not include general daily schedule, hours, supervision policy, night care policy, dismissal policy, or pick-up arrangements.

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.

Regulation: 3290.123(a)(3)

Description: Services provided

Noncompliance Area: During renewal inspection conducted 2/27/2024, the Child Service Reports (CSRs) on file for child #2 and child #4 were not filled out. Children have both been attending the facility for over 6 months (see LIS code sheet for dates of enrollment).

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).

Regulation: 3290.123(a)/3290.123(a)(2)

Description: Signed /Date fee to be paid

Noncompliance Area: During renewal inspection conducted 2/27/2024, operator signature and date payment is to be made was missing from child #5's fee agreement.

Correction Required: An agreement shall be signed by the operator and the parent. An agreement shall specify the date on which the fee is to be paid.

Regulation: 3290.124(b)(2)/3290.124(b)(3)

Description: Physician name, address, phone/Parent home/work address, phone

Noncompliance Area: During renewal inspection conducted 2/27/2024, the following information was missing from children's emergency contact forms: Child #1: Mother's work address and work telephone number. Child #3: Father's work address. Mother's telephone number. Child's doctor's telephone number. Child #5: Mother's home telephone number.

Correction Required: Emergency contact information must include the name, address and telephone number of the child's physician or source of medical care. Emergency contact information must include the home and work addresses and telephone numbers of the enrolling parent.

Regulation: 3290.131(a)

Description: Within 60 days

Noncompliance Area: During renewal inspection conducted 2/27/2024, there was no initial health assessment on file for child #4 or child #5. Child #4 and child #5 have been attending the facility for over 60 days (see LIS code sheet for date of enrollment).

Correction Required: The operator shall require the parent of an enrolled child to provide an initial health report no later than 60 days following the first day of attendance at the facility.

Regulation: 3290.131(b)(1)

Description: Updated infant health report: every 6 months

Noncompliance Area: During renewal inspection conducted on 2/27/2024, last health assessment on file for child #2 is dated 3/14/2023. Child #2 is a young toddler (see LIS code sheet for date of birth).

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.

Regulation: 3290.131(d)(5)/3290.131(e)(3)

Description: Immunization record/Dismissal policy

Noncompliance Area: During renewal inspection conducted 2/27/2024, the following children were not immunized according to the recommendations of the ACIP: Child #2: 1 of 2 doses of Hepatitis A vaccine; last dose received on 6/27/2023. There is no exemption on file. Child #2 is a young toddler (see LIS code sheet for date of birth). Child #3: 1 of 2 doses of Hepatitis A vaccine; last dose received on 3/9/2023. There is no exemption on file. Child #3 is an older toddler (see LIS code sheet for date of birth). Child #4: 1 of 2 doses of Hepatitis A vaccine; last dose received on 4/18/2023. There is no exemption on file. Child #4 is a young toddler (see LIS code sheet for date of birth).

Correction Required: A health report shall include a review of the child's immunized status according to recommendations of the ACIP. The facility shall implement dismissal policies in accordance with the Department of Health regulation in 28 Pa. Code § 27.77 (relating to immunization requirements for children in child care group settings). Child #2, child #3, and child #4 must be dismissed from care by close of business 2/27/2024 and may only return to care when the immunization record is updated or when a parent provides a written, signed exemption letter.

Regulation: 3290.131(d)(7)

Description: Free from contagious/communicable disease

Noncompliance Area: During renewal inspection conducted 2/27/2024, the health assessment on file for child #3 does 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.

Regulation: 3290.131(e)

Description: Immunization record

Noncompliance Area: During renewal inspection conducted 2/27/2024, there was no immunization summary on file for child #5. Child #5 has been attending the facility for over 60 days (see LIS code sheet for date of enrollment).

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.

Regulation: 3290.181(c)

Description: Emergency info/agreement updated 6 mos

Noncompliance Area: During renewal inspection conducted 2/27/2024, the following forms were not updated within 6 months: Child #2: Emergency contact form and fee agreement last updated 5/24/2023. Child #4: Emergency contact form and fee agreement last updated 4/24/2023.

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.

Regulation: 3290.182(3)/3290.182(5)

Description: Consent for emergency medical care required prior to admission/Consent for administration of minor first-aid required prior to admission

Noncompliance Area: During renewal inspection conducted 2/27/2024, emergency contact form for child #3 did not contain signed parental consent for emergency medical care or minor first-aid.

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. 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.

Regulation: 3290.94(a)(4)

Description: Hypothetical locations

Noncompliance Area: During renewal inspection conducted 2/27/2024, facility's fire drill log did not list hypothetical location for fire drills conducted in the past.

Correction Required: The operator or designated staff person who is responsible for compliance with this chapter shall conduct fire drills and ensure that the hypothetical locations of the fire are rotated around the facility for each drill such that the hypothetical location is never the same for consecutive drills.

Regulation: 3290.95(a)/3290.95(b)

Description: System in compliance/Operator or designated staff responsibility

Noncompliance Area: During renewal inspection conducted 2/27/2024, smoke alarms were tested past 30 days 11/22/2023-12/30/2023.

Correction Required: Fire detection devices or systems must be in compliance with standards established under section 1016(c) of the act (62 P.S. § 1016(c)). The operator or designated staff person who is responsible for compliance with this chapter shall ensure the requirements in § 3290.95(a) are met.

Regulation: 3290.95(a)/3290.95(b)

Description: System in compliance/Operator or designated staff responsibility

Noncompliance Area: During renewal inspection conducted 2/27/2024, facility purchased OSHA-approved alarms; however, could not demonstrate that they were functioning in an interconnected fashion.

Correction Required: Fire detection devices or systems must be in compliance with standards established under section 1016(c) of the act (62 P.S. § 1016(c)). The operator or designated staff person who is responsible for compliance with this chapter shall ensure the requirements in § 3290.95(a) are met. Act 42 of 2022, signed into law July 7, 2022, amended the Fire and Panic Act at 35 P.S. § 1223.6, and requires all certified family child care homes to have interconnected smoke alarms approved, at the time of installation, by a testing laboratory recognized by the Occupational Safety and Health Administration (OSHA) of the United States Department of Labor to test and certify smoke alarms.

Regulation: 3290.113(a)

Description: Supervised at all times

Noncompliance Area: Complaint investigation conducted in September 2023 verified that a young school-aged child scratched an infant child on the face without cause. Staff person #1 reports that they did not see the incident as they were helping another child. Staff #1 noticed that the infant was scratched after the infant began crying. When certification representative returned to facility in October 2023, complaint investigation verified that staff person #1 and staff person #2 were leaving the room in which the children were in. Staff person #1 and staff person #2 were not able to see, hear, direct, or assess the children in the other room.

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). The Legal Entity will establish a supervision policy. The policy will include how the facility will demonstrate their knowledge and ability to adequately supervise children at all times. The policy must focus on ensuring that each child is seen, heard, assessed and able to be directed at all times. The policy must include how the facility will ensure appropriate supervision at all times including nap/overnight care and short periods of time when a staff may have to use the bathroom. The legal entity must submit the policy to regional office for approval. Once approved, all existing staff and new hires must be trained on the policy and sign an acknowledgment that must be kept on file.

Regulation: 3290.113(a)

Description: Supervised at all times

Noncompliance Area: Complaint investigation conducted in September 2023 verified that a young school-aged child scratched an infant child on the face without cause. Staff person #1 reports that they did not see the incident as they were helping another child. Staff #1 noticed that the infant was scratched after the infant began crying. When certification representative returned to facility in October 2023, complaint investigation verified that staff person #1 and staff person #2 were leaving the room in which the children were in. Staff person #1 and staff person #2 were not able to see, hear, direct, or assess the children in the other room.

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). The operator shall demonstrate the ability to maintain compliance with the regulation during all unannounced inspections conducted by the Department over the next three (3) months.

Regulation: 3290.113(a)

Description: Supervised at all times

Noncompliance Area: Complaint investigation conducted in September 2023 verified that a young school-aged child scratched an infant child on the face without cause. Staff person #1 reports that they did not see the incident as they were helping another child. Staff #1 noticed that the infant was scratched after the infant began crying. When certification representative returned to facility in October 2023, complaint investigation verified that staff person #1 and staff person #2 were leaving the room in which the children were in. Staff person #1 and staff person #2 were not able to see, hear, direct, or assess the children in the other room.

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).

Regulation: 3290.52(3)

Description: Two infants, three toddlers

Noncompliance Area: Complaint inspection verified that operator provided care for 6 related and unrelated infants and toddlers at one time. The operator identified 2 of the children as infants and the other 4 children as being 2-year-olds. The operator reported that none are related to her.

Correction Required: The operator may provide care to no more than five related and unrelated infants and toddlers at any one time. No more than two related and unrelated infants may receive care at any one time. If two infants are in care, three toddlers are permitted.

Regulation: 3290.95(a)/3290.95(b)

Description: System in compliance/Operator or designated staff responsibility

Noncompliance Area: During unannounced monitoring conducted 9/5/2023, facility did not have OSHA-approved interconnected smoke alarms. An acceptable plan of correction was received with a correction date of 9/12/2023. When certification representative returned for unannounced monitoring on 10/18/2023, facility purchased OSHA-approved alarms; however, could not demonstrate that they were functioning in an interconnected fashion.

Correction Required: Fire detection devices or systems must be in compliance with standards established under section 1016(c) of the act (62 P.S. § 1016(c)). The operator or designated staff person who is responsible for compliance with this chapter shall ensure the requirements in § 3290.95(a) are met.

Regulation: 3290.113(a)

Description: Supervised at all times

Noncompliance Area: Complaint investigation verified that a young school-aged child scratched an infant child on the face without cause. Staff person #1 reports that they did not see the incident as they were helping another child. Staff #1 noticed that the infant was scratched after the infant began crying.

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). The operator will arrange for all staff to receive a minimum of 3 hours of PQAS approved, live training regarding supervision and ratio. It does not matter if the PQAS approved, live training is done through the ELRC. The operator will receive DHS approval of training content prior to scheduling the training. The training will not be conducted while children are in care.

Regulation: 3290.113(a)

Description: Supervised at all times

Noncompliance Area: Complaint investigation verified that a young school-aged child scratched an infant child on the face without cause. Staff person #1 reports that they did not see the incident as they were helping another child. Staff #1 noticed that the infant was scratched after the infant began crying.

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).

Regulation: 3290.118

Description: Infant sleep position

Noncompliance Area: During unannounced monitoring conducted 8/16/2023, an infant was asleep in an infant seat with a raised back for approximately 10 minutes before being moved to a pack-n-play. An acceptable plan of correction was received with a correction date of 8/16/2023. When certification representative returned to facility for unannounced monitoring on 9/5/2023, a sleeping infant was observed in a bassinet with a pillow and a toy. Bassinet had a suffocation hazard tag advising to "use only the mattress and sheets" provided by the bassinet company.

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. The operator will arrange for all staff to receive a minimum of 2 hours of PQAS approved, live training regarding Health & Safety - Infant/Toddler Safe Sleep. It does not matter if the PQAS approved, live training is done through the ELRC. The operator will receive DHS approval of training content prior to scheduling the training. The training will not be conducted while children are in care.

Regulation: 3290.118

Description: Infant sleep position

Noncompliance Area: During unannounced monitoring conducted 8/16/2023, an infant was asleep in an infant seat with a raised back for approximately 10 minutes before being moved to a pack-n-play. An acceptable plan of correction was received with a correction date of 8/16/2023. When certification representative returned to facility for unannounced monitoring on 9/5/2023, a sleeping infant was observed in a bassinet with a pillow and a toy. Bassinet had a suffocation hazard tag advising to "use only the mattress and sheets" provided by the bassinet company.

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.

Regulation: 3290.18

Description: General Health and Safety

Noncompliance Area: During renewal inspection conducted 6/20/2023-6/27/2023, facility's emergency plan did not address practice drills or continuity of operations. An acceptable plan of correction was received with a correction date of 7/10/2023. When certification representative returned to facility for unannounced monitoring on 8/16/2023, facility's emergency plan did not address practice drills or continuity of operations. An acceptable plan of correction was received with a correction date of 8/18/2023. When certification representative returned to facility for unannounced monitoring on 9/5/2023, facility's emergency plan did not address practice drills or continuity of operations.

Correction Required: Conditions at the facility may not pose a threat to the health or safety of the children. The operator shall update the sections of their emergency plans that must address practice drills and continuity of operations.

Regulation: 3290.182(7)

Description: Reports of accidents, injuries and illnesses. Original report - parent same day Copy - facility accident file. Copy - child's file

Noncompliance Area: Complaint investigation verified that staff person #1 was aware that child #1 was injured in the facility. Staff person #1 admitted that they did not complete an injury report following the incident.

Correction Required: A child's record must 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.

Regulation: 3290.24(g)

Description: Emergency plan

Noncompliance Area: During unannounced monitoring conducted 8/16/2023, operator did not have documentation that emergency plan was sent to local municipality and to the county emergency management agency. Allentown EMA and Lehigh County EMA provide acknowledgements when they receive emergency plans; however, provider cannot produce them. An acceptable plan of correction was received with a correction date of 8/18/2023. When certification representative returned to facility for unannounced monitoring on 9/5/2023, operator provided documentation that emergency plan was sent to county emergency management agency; however, admitted that emergency plan was not sent to local municipality.

Correction Required: The operator shall send a copy of the emergency plan and subsequent plan updates to the local municipality and to the county emergency management agency.

Regulation: 3290.95(a)/3290.95(b)

Description: System in compliance/Operator or designated staff responsibility

Noncompliance Area: During unannounced monitoring conducted 9/5/2023, facility did not have OSHA-approved interconnected smoke alarms.

Correction Required: Fire detection devices or systems must be in compliance with standards established under section 1016(c) of the act (62 P.S. § 1016(c)). The operator or designated staff person who is responsible for compliance with this chapter shall ensure the requirements in § 3290.95(a) are met. Act 42 of 2022, signed into law July 7, 2022, amended the Fire and Panic Act at 35 P.S. § 1223.6, and requires all certified family child care homes to have interconnected smoke alarms approved, at the time of installation, by a testing laboratory recognized by the Occupational Safety and Health Administration (OSHA) of the United States Department of Labor to test and certify smoke alarms.

Regulation: 3290.118

Description: Infant sleep position

Noncompliance Area: During unannounced monitoring conducted 8/16/2023, an infant was asleep in an infant seat with a raised back for approximately 10 minutes before being moved to a pack-n-play.

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.

Regulation: 3290.124(a)/3290.181(a)

Description: Each child emergency contact person/Each child

Noncompliance Area: During unannounced monitoring conduct4ed 8/16/2023, child #1 did not have emergency contact form or fee agreement on file. Operator reports that this is child's first day.

Correction Required: Emergency contact information is required for each enrolled child. Emergency contact information must reference who shall be contacted in an emergency. An operator shall establish and maintain an individual record for each child enrolled in the facility.

Regulation: 3290.18

Description: General Health and Safety

Noncompliance Area: During renewal inspection conducted 6/20/2023-6/27/2023, facility's emergency plan did not address practice drills or continuity of operations. An acceptable plan of correction was received with a correction date of 7/10/2023. When certification representative returned to facility for unannounced monitoring on 8/16/2023, facility's emergency plan did not address practice drills or continuity of operations.

Correction Required: Conditions at the facility may not pose a threat to the health or safety of the children. The operator shall update the sections of their emergency plans that must address practice drills and continuity of operations.

Regulation: 3290.24(c)

Description: Training regarding plan

Noncompliance Area: During unannounced monitoring conducted 8/16/2023, facility person #1, who works in the facility, has not been trained on the 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.

Regulation: 3290.24(g)

Description: Emergency plan

Noncompliance Area: During unannounced monitoring conducted 8/16/2023, operator did not have documentation that emergency plan was sent to local municipality and to the county emergency management agency. Allentown EMA and Lehigh County EMA provide acknowledgements when they receive emergency plans; however, provider cannot produce them.

Correction Required: The operator shall send a copy of the emergency plan and subsequent plan updates to the local municipality and to the county emergency management agency.

Regulation: 3290.64(a)

Description: Locked or inaccessible - in original container

Noncompliance Area: During renewal inspection conducted 6/20/2023--6/27/2023, operator reported that they are currently using the upstairs bathroom for children as there is something broken in the one downstairs. There were several items labeled "keep out of reach of children" underneath the sink and on a stand in the bathroom. Items were accessible to children. An acceptable plan of correction was received with a correction date of 6/30/2023. When certification representative returned for unannounced monitoring on 8/16/2023, there were several items labeled "keep out of reach of children" underneath the sink in the bathroom used by children. Items 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.

Regulation: 3290.69

Description: Heat Source

Noncompliance Area: During unannounced monitoring conducted 8/16/2023, a 2-year-old child was observed to open the baby gate between the living area and kitchen several times. Child went into the kitchen several times. Operator had a pot cooking on the stove and child was tall enough to reach it. Stove was not equipped with a protective guard and pot and stovetop were accessible to child.

Correction Required: Hot water pipes and other sources of heat exceeding 110° F that are accessible to children shall be equipped with protective guards or shall be insulated to prevent direct contact.

Regulation: 3290.105(a)

Description: Clean, age appropriate

Noncompliance Area: During renewal inspection conducted 6/20/2023--6/27/2023, rest equipment was not labeled. Certification representative observe a child sleeping in an unlabeled pack-n-play.

Correction Required: (a) Individual, clean, age-appropriate rest equipment shall be provided for preschool, toddler and infant children as agreed between the parent and the operator. The rest equipment must be labeled with the child's name and used only by the named child while enrolled in the program.

Regulation: 3290.123(a)(1)/3290.123(a)(5)

Description: Amount of fee/Designated release persons

Noncompliance Area: During renewal inspection conducted 6/20/2023-6/27/2023, the following was missing from children's fee agreements: Child #1: Release person(s). Child #2: Fee amount. Release person(s).

Correction Required: An agreement shall specify the amount of the fee to be charged per day or per week. An agreement shall specify the persons designated by a parent to whom the child may be released.

Regulation: 3290.124(a)

Description: Each child emergency contact person

Noncompliance Area: During renewal inspection conducted 6/20/2023-6/27/2023, the facility did not have emergency contact form on file for Child #4.

Correction Required: Emergency contact information is required for each enrolled child. Emergency contact information must reference who shall be contacted in an emergency.

Regulation: 3290.124(b)(2)/3290.124(b)(6)

Description: Physician name, address, phone/Insurance coverage information

Noncompliance Area: During renewal inspection conducted 6/20/2023-6/27/2023, the following was missing from children's emergency contact forms: Child #1: Health insurance coverage and policy number. Child #2: Name, address, and phone number of child's physician. Health insurance coverage and policy number.

Correction Required: Emergency contact information must include the name, address and telephone number of the child's physician or source of medical care. Emergency contact information must include health insurance coverage and policy number for a child under a family policy or Medical Assistance benefits, if applicable.

Regulation: 3290.124(b)(3)

Description: Parent home/work address, phone

Noncompliance Area: During renewal inspection conducted 6/20/2023-6/27/2023, the following was missing from children's emergency contact forms: Child #1: parents' work address and phone number and father's phone number. Child #2: parents' work address and phone number. Child #3: Father's work address and work phone number. Both parents' addresses.

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

Regulation: 3290.124(d)

Description: Written emergency plan posted

Noncompliance Area: During renewal inspection conducted 6/20/2023--6/27/2023, facility did not have emergency transportation plan posted.

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.

Regulation: 3290.131(a)

Description: Within 60 days

Noncompliance Area: During renewal inspection conducted 6/20/2023-6/27/2023, Child #1 did not have initial health assessment on file. Child #1 has been enrolled at the facility for over 60 days (see LIS code sheet).

Correction Required: The operator shall require the parent of an enrolled child to provide an initial health report no later than 60 days following the first day of attendance at the facility.

Regulation: 3290.131(d)(5)/3290.131(e)(3)

Description: Immunization record/Dismissal policy

Noncompliance Area: During renewal inspection conducted 6/20/2023-6/27/2023, Child #4 received 3 of 4 doses of DTAP and HIB vaccines. Child #4 did not receive any doses of Hepatitis A vaccine. Child #4 is a young toddler (see LIS code sheet).

Correction Required: A health report shall include a review of the child's immunized status according to recommendations of the ACIP. The facility shall implement dismissal policies in accordance with the Department of Health regulation in 28 Pa. Code § 27.77 (relating to immunization requirements for children in child care group settings). Child #4 will be dismissed from care by close of business 6/27/2023 until either the immunization record is updated, or a parent provides a written, signed exemption letter.

Regulation: 3290.135(b)

Description: Surfaces cleaned

Noncompliance Area: During renewal inspection conducted 6/20/2023--6/27/2023, diapering pad was ripped, exposing the foam inside and rendering it unable to be properly sanitized after each use.

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.

Regulation: 3290.18

Description: General Health and Safety

Noncompliance Area: During renewal inspection conducted 6/20/2023-6/27/2023, facility's emergency plan did not address practice drills or continuity of operations.

Correction Required: Conditions at the facility may not pose a threat to the health or safety of the children. The operator shall update the sections of their emergency plans that must address practice drills and continuity of operations.

Regulation: 3290.182(3)/3290.182(5)

Description: Consent for emergency medical care required prior to admission/Consent for administration of minor first-aid required prior to admission

Noncompliance Area: During renewal inspection conducted 6/20/2023-6/27/2023, the following was missing from children's emergency contact forms: Child #1: consent for emergency medical care and consent for minor first-aid. Child #2: consent for emergency medical care and consent for minor first-aid. Child #3: consent for emergency medical care and consent for minor first-aid.

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. 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.

Regulation: 3290.63

Description: Protective Outlet Covers 5 yrs. or less

Noncompliance Area: During renewal inspection conducted 6/20/2023--6/27/2023, an uncovered electrical outlet was observed by the built-in bookcase. Electrical outlet was accessible to children 5 years of age and younger.

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

Regulation: 3290.64(a)

Description: Locked or inaccessible - in original container

Noncompliance Area: During renewal inspection conducted 6/20/2023--6/27/2023, operator reported that they are currently using the upstairs bathroom for children as there is something broken in the one downstairs. There were several items labeled "keep out of reach of children" underneath the sink and on a stand in the bathroom. Items 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.

Regulation: 3290.102(a)

Description: Clean and good repair

Noncompliance Area: During initial inspection conducted 1/11/2023, there were several nails poking out of a garden area in the backyard.

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.

Regulation: 3290.18

Description: General Health and Safety

Noncompliance Area: During initial inspection conducted 1/11/2023, facility did not develop a policy to identify the prevention of shaken baby syndrome, abusive head trauma, and child maltreatment.

Correction Required: Conditions at the facility may not pose a threat to the health or safety of the children. Beginning April 29, 2022, all child care facilities must have a policy to identify the prevention of shaken baby syndrome, abusive head trauma, and child maltreatment. The policy must include, but is not limited to: · Recognition of potential signs and symptoms of shaken baby syndrome and abusive head trauma; · Strategies for coping with a crying, fussing, or distraught child; and · Address the prevention and identification of child maltreatment.

Regulation: 3290.192(2)

Description: Health assessment, TB test

Noncompliance Area: During initial inspection conducted 1/11/2023, Facility Person #2 did not have initial health assessment on file with results of TB skin tests. Operator reports that Facility Person #2 will be a staff member in the facility.

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.

Regulation: 3290.31(g)

Description: Age and training

Noncompliance Area: During initial inspection conducted 1/11/2023, Facility Person #1 did not complete the required one-hour 2022 update to the health and safety training by 12/30/2022.

Correction Required: Staff persons shall complete professional development within 90 days of hire as listed in subsections (g)1-10. Facility Person #1 shall complete the required one-hour 2022 update to the health and safety training by 1/28/2023.

Regulation: 3290.32(a)/3290.192(3)

Description: Comply with CPSL/CPSL information

Noncompliance Area: During initial inspection conducted 1/11/2023, Facility Person #1 and Facility Person #2 informed Certification Representative that they moved to Pennsylvania two (2) years ago. Prior to that they resided in Bronx, NY. Facility Person #1 and Facility Person #2 do not have proper out-of-state clearances on file at the facility.

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 Person #1 and Facility Person #2 may not work in a child care position at the facility until appropriate out-of-state clearances are on file in the facility.

Regulation: 3290.70(d)

Description: Above ground window opening restricted to 6"

Noncompliance Area: During the initial inspection conducted 1/11/2023, windows on the second and third floors of the facility were not modified or adapted to limit the opening to 6 or fewer inches.

Correction Required: Windows or doors above the ground floor that open directly to the outdoors and are accessible to children shall be constructed, modified or adapted to limit the opening to 6 or fewer inches.

Regulation: 3290.73(c)

Description: Has all items

Noncompliance Area: During initial inspection conducted 1/11/2023, facility's first-aid kit did not contain soap.

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.

Regulation: 3290.95(a)/3290.95(b)

Description: System in compliance/Operator or designated staff responsibility

Noncompliance Area: During initial inspection conducted January 11, 2023, facility did not have proof of purchase on file for 10-year lithium-ion battery-operated smoke detectors.

Correction Required: Fire detection devices or systems must be in compliance with standards established under section 1016(c) of the act (62 P.S. § 1016(c)). The operator or designated staff person who is responsible for compliance with this chapter shall ensure the requirements in § 3290.95(a) are met.