Nurturing Arms Daycare - Tobyhanna PA Child Care Center

Noncompliance Area: The emergency contact form on file for child # 1 did not have the address and phone number of the child's physician. The emergency contact from on file for child # 2 did not have the name and phone number of the child's physician.

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

Noncompliance Area: The emergency contact information on file for child # 1 did not have the address and phone number listed for 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: During a renewal inspection on 2/19/20, the certification rep observed snack being served to children in the young preschool room. Prior to snack being served, the children did not wash their hands.

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

Noncompliance Area: The director reported that there are 72 children enrolled at the facility. There is no group supervisor on staff as required for the group of 45 children or for the partial group of 45 children.

Correction Required: In a facility in which more than 45 children are enrolled, a group supervisor is required for the first group of 45 enrolled children and for each group or partial group of 45 additional enrolled children.

Noncompliance Area: The first aid kits in the child care spaces did not have all items; the preschool and infant room first aid kits were missing tweezers, soap, gloves, and scissors, the young toddler first aid kit was missing tweezers, soap, and gloves, the young preschool and school aged first aid kits were missing soap, scissors, tweezers, and gloves.

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: There is a green play mat in the infant room with torn edges. The oven door on the wooden play stove in the preschool room has a door hanging off the hinge.

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: Child # 1 started at the facility on 5/14/18 and there is no Child Service Report on file within 6 months.

Correction Required: 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 in 3270.124(f) (relating to emergency contact information).

Noncompliance Area: The emergency contact forms and financial agreements on file for children # 1 and # 2 were not updated once every six months. The emergency contact forms and financial agreements for child # 1 were reviewed and updated in May, 2018 and then again in December 2018. The emergency contact forms and financial agreements for child # 2 were reviewed and updated in March, 2018 and then December, 2018.

Correction Required: The parent shall update in writing emergency contact information once in a 6-month period or as soon as there is a change in the information. A parent is required to review and update the emergency contact information and the financial agreement at least once in a 6-month period or as soon as there is a change in the information.

Noncompliance Area: The health assessment for Child #1 shows that the child, 4 years old, has not received a flu vaccination. The health assessment for Child #2 shows that the child, 5 years old, has not received a flu vaccination. There is no letter of exemption on file for the flu vaccine for either child.

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: More than 24 months passed between health assessments for staff person # 1. The health assessment on file is dated 8/14/18 and the previous health assessment is dated 4/22/16.

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.

Noncompliance Area: There are no written non family references on file for staff person # 2.

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: There is a crack in the wooden heater cover in the preschool area.

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: On 11/27/18 during a compliant investigation Styrofoam cups were observed in the child care space. The operator admitted to using Styrofoam cups for drinking.

Correction Required: Styrofoam cups and plates may not be used.

Noncompliance Area: On 11/27/18 during a complaint investigation, the cert rep observed staff person # 2 to not be physically present with her group. Staff person # 2 was sitting at a table in the front of the facility working on paperwork and the children in her group were in the back of the facility around a corner where staff could not see, hear, direct, or assess the children in the group.

Correction Required: Each staff person shall be assigned the responsibility for supervision of specific children. The staff person shall know the names and whereabouts of the children in his assigned group. The staff person shall be physically present with the children in his group on the facility premises and on facility excursions off the facility premises.

Noncompliance Area: On 11/27/18, during a complaint investigation, there was no hands free lidded trash can in the diapering area.

Correction Required: If disposable diapers are provided by a parent or by a facility, a soiled diaper shall be discarded by immediately placing the diaper into a plastic-lined, hands-free covered can.