Four Mile Childcare Center/midland

Noncompliance Area: The health assessment for child #1 was last updated on 12/8/18, which is more than 12 months ago.

Correction Required: The operator shall require the parent to provide an updated health report at least every 12 months for an older toddler or preschool child.

Noncompliance Area: The immunization record for child #1 lacked influenza vaccination and child #2 lacked HIB, Pneumococcal, MMR, and Varicella in accordance with the ACIP.

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

Noncompliance Area: The file for staff person #3 had a physical conducted on 8/16/17 and 2/27/20, which is more than 24 months apart. Staff person #4, with a hire date 9/16/19, had an initial health assessment dated for 2/28/20, which is not at initial employment or 12 months prior. Staff person #6 last had a physical conducted on 6/1/18, which is more than 24 months ago.

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: Staff person #6 lacked documentation of National Sex Offender Registry and the request.

Correction Required: 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 #6--- may not work in a child care position at the facility.

Noncompliance Area: The emergency plan was last reviewed and signed off on 6/28/19 and 7/20/20, which is not annually.

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

Noncompliance Area: Staff person #1 had State Police clearance dated 8/22/14 and 11/5/19, Child Abuse clearance 9/5/14 and 11/13/19, and FBI clearance 8/28/14 and 9/7/19, all clearances listed more than 60 months passed before new ones were obtained, all were current during the inspection. Staff person #2 with a hire date of 8/24/15, had Nation Sex Offender Registry dated for 7/2/20, which was needed to be on file by 7/1/20. Staff person #3, with a hire date of 12/16/19, obtained the Nation Sex Offender Registry on 3/2/20. Staff person #5 had State police clearance dated for 1/22/15 and 2/2420, which is more than 60 months apart. Staff person #6, with a hire date of 6/4/18,completed mandated reporter training on 6/19/20 and lacked the National Sex offender registry.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). LACKING REQUIRED HIRING DOCUMENTS: Facility Person # 6-- may not work in a child care position at the facility.

Noncompliance Area: In the Grasshopper and Fireflies classroom the sink lacked a handwashing sign.

Correction Required: A facility person and an able child shall wash his hands after toileting and before eating. A sign on which this requirement is written shall be posted at each toilet, training chair, diapering area and sink in the facility.

Noncompliance Area: Observed in the outdoor play area: dirt and debris in the red flower pot of the playhouse. Dirty surfaces of the two plastic play shopping carts.

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: On 3/21/19, at approximately 9:45 AM in the Bumblebee (Preschool) Room, Certification Representative asked Staff Persons #7, #8 and #9 to identify the children in their supervisory groups. Staff Persons #7 and #9 identified four children each. Staff Person #8 identified three children. The certification representative pointed out that he counted 12 children in the room. A second time, each staff person identified the same children. The staff pointed out that, of the twelve names listed on the white board, one of the children was absent. Child #6, who was present in the room, but not listed on the white board, was not identified by name by any of the three staff members.

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: The parental updates for the emergency contact forms and the fee agreements in the files for Child #1, 2, 3, 4 and 5 exceeded six months in between updates: March, 2018 and October, 2018. The parental updates in the files for all five children are current: March, 2019.

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 most recent health assessments in the file for Child #2, a young toddler, exceeded six months between assessments. The most recent health assessment in the file for Child #2 is current.

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. A child's record shall contain initial and subsequent health reports.

Noncompliance Area: The most recent immunization reports in the files for Child #3 and Child #6, did not include documentation of a flu shot for the past 12 months.

Correction Required: The facility shall require the parent to provide updated written verification from a physician, physician's assistant, CRNP, the Department of Health or a local health department of ongoing vaccines administered to an infant, toddler or preschool child in accordance with the schedule recommended by the ACIP.

Noncompliance Area: The most recent health assessments in the files for Staff Persons #1, #3, #4, and #5 exceeded 24 months between assessments. The most recent health assessments in the files for all four staff members are current.

Correction Required: A facility person providing direct care who comes into contact with the children or who works with food preparation shall have a health assessment conducted within 12 months prior to providing initial service in a child care setting and every 24 months thereafter. A health assessment is valid for 24 months following the date of signature, if the person does not contract a communicable disease or develop a medical problem. A facility person's record shall include a written report of initial and subsequent health assessments, including the results of initial and subsequent tuberculin skin tests, x-rays or other medical documentation necessary to confirm freedom from communicable tuberculosis.

Noncompliance Area: The most recent health assessment in the file for Staff Person #7 did not include the physician's or CRNP's assessment of the person's suitability to provide child care.

Correction Required: An adult health assessment must include the physician's or CRNP's assessment of the person's suitability to provide child care.

Noncompliance Area: Documentation of initial training in the emergency plan in the file for Staff Person #2 was dated after the staff person's initial day providing care for children. First day in childcare: 9/10/18. Initial training in emergency plan: 10/30/18. The most recent training in the emergency plan is current. Documentations of the most recent annual trainings regarding the emergency plan exceeded twelve months in between training: 1/29/18-2/26/19. The most recent training regarding the plan for all staff is current.

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