Rocio Escobar Berdugo

Noncompliance Area: Child 2 and 3 did not have a complete immunization summary attached to the initial enrolling physical.

Correction Required: A health report shall include a review of the child's immunized status according to recommendations of the ACIP.A child's record must contain initial and subsequent health reports.

Noncompliance Area: Staff 1 did not complete 12 hours biennial training for June 2017-2019.

Correction Required: A staff person shall obtain an biennial minimum of 12 clock hours of child care training.A facility person's record shall include records of training required by the Department.

Noncompliance Area: Crayons were small/broken, not age appropriate for infants/toddlers.

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: Broken crayons for PS/SA, plastic bags, and small toy pieces less than 1 inch were accessible to toddler present.

Correction Required: Pea gravel and other materials with a diameter of less than 1 inch may not be used in spaces where infants or toddlers receive care.

Noncompliance Area: Child 4 attend 15 hrs/week. Child 4 did not have a child service report that was due Nov 2018.

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).

Noncompliance Area: Child 1 did not have a current physical with immunization record within 60 days of enrollment Nov 2018.

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.The initial health report for an older toddler or preschool child shall be dated no more than 1 year prior to the first day of attendance at the facility.

Noncompliance Area: Child 3 did not have initial enrollment physical with immunizations within 60 days of enrollment. Enrolled july 2018.

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.The initial health report for a school-age child must be dated in accordance with the requirements for medical examinations for school attendance in 28 Pa. Code 23.2 (relating to medical examinations).

Noncompliance Area: Child 2 did not have an update physical for 5 yr old. Last physical 11/27/17.

Correction Required: The operator shall require the parent to provide an updated health report at least every 12 months for an older toddler or preschool child.A child's record must contain initial and subsequent health reports.

Noncompliance Area: Child 1 and 2 did not have information on parents work address and telephone number.

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

Noncompliance Area: Provider transports school agers to and from school. Child 1 and 2 did not have signed parental permission for transportation.

Correction Required: The operator shall obtain written consent from the parent for transportation by the facility staff.A child's record must contain signed parental consent for transportation, walking excursions, swimming and wading.

Noncompliance Area: Provider did not have manufacturer's instructions for use of safety restraints in the vehicle.

Correction Required: Manufacturers' instructions for use of safety restraints shall be kept in the vehicle at all times.

Noncompliance Area: Child 1 and 2 did not have signed parental permission for emergency medical care and minor 1st 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.

Noncompliance Area: Upon arrival, all 5 (five) children were asleep, not engaged in any activity at 10am. This was not naptime as noted on daily schedule. The children ranged in ages from preschool to schoolage. Previous citation of no activities cited 12/7/17. Provider did not follow POC/POM of engaging children in age appropriate activites as per daily schedule.

Correction Required: Daily activities shall promote the development of skills, social competence and self-esteem. Daily experiences shall recognize the child as an individual and give some choice of activities that respect personal privacy, lifestyle and cultural background.

Noncompliance Area: Child 1 fell off a piece of equipment while climbing. Staff 2 was in the room and did not stop child from climbing.

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). Children must be supervised at all times.

Noncompliance Area: Upon arrival at 10am, staff #1 came out of the rear door to answer the doorbell. The children were left alone in the front childcare room without direct staff supervision.

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). Children must be supervised at all times.

Noncompliance Area: Bathroom cabinets containing toxics such as hair spray and cleaning products was not locked/inaccessible 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.

Noncompliance Area: Contaminated trash in the bathroom did not have a lid.

Correction Required: Trash that has been contaminated by human secretions or excrement shall be contained in closed, plastic-lined receptacles.

Noncompliance Area: PLAY EQUIPMENT AND MATERIALS DO NOT MEET THE DEVELOPMENTAL NEEDS/INTERESTS AND AGES FOR THE CHILDREN SERVED. NO AGE APPROPRIATE ITEMS FOR INFANTS AND TODDLERS; EQUIPMENT AND MATERIALS ARE APPROPRIATE FOR PRESCHOOLERS. PROVIDER SERVES INFS TO SCHOOLAGERS.

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. Play equipment and materials shall include the items specified at 3290.101(c)(1) - (6).

Noncompliance Area: REST EQUIPMENT IS LABELED FOR INDIVIDUAL USE.

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: UPON ARRIVAL 12/7/17 PRESCHOOL CHILD IN CARE WAS NOT ENGAGED IN ANY STAFF DIRECTED DAILY ACTIVITY. CHILD WAS WATCHING TV WITH PROVIDER LAYING ON MATS. NO DAILY PROGRAMMING TO PROMOTE DEVELOPMENT.

Correction Required: Daily activities shall promote the development of skills, social competence and self-esteem. Daily experiences shall recognize the child as an individual and give some choice of activities that respect personal privacy, lifestyle and cultural background.

Noncompliance Area: AGREEMENTS WERE NOT SIGNED BY BOTH THE PARENT AND THE PROVIDER.

Correction Required: An agreement shall be signed by the operator and the parent.

Noncompliance Area: CHILDREN'S EMERGENY CONTACT FORMS WERE NOT COMPLETE---INFORMATION MISSING FROM MANY BOXES INCLUDING ADDRESS OF PARENT (FATHER), ALLERGIES/SPECIAL NEEDS, DESIGNATED RELEASE PERSON(S) ADDRESSES.

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

Noncompliance Area: CHILD 1 AND 2 DID NOT HAVE INITIAL PHYSICAL WITH IMMUNIZATIONS ON FILE. BOTH CHILDREN ENROLLED MORE THAN 60 DAYS.

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.The initial health report for an older toddler or preschool child shall be dated no more than 1 year prior to the first day of attendance at the facility.

Noncompliance Area: PROVIDER TRANSPORTS CHILDREN IN PERSONAL VEHICLE WITH THE PROPER INSURANCE AS REQUIRED UNDER PA VEHICLE CODE TITLE 75.

Correction Required: A vehicle shall be insured in accordance with the requirements of 75 Pa.C.S. 1701-1799.7 (relating to the Motor Vehicle Financial Responsibility Law).

Noncompliance Area: NO PARENTAL SIGNATURE FOR EMERGENCY MEDICAL CARE AND MINOR 1ST AID ON EMERGENCY CONTACT FORM.

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.

Noncompliance Area: NO COPY OF 2008 REGULATIONS AVAILABLE ON SITE.

Correction Required: The facility's current certificate of registration and a copy of the applicable regulations under which the facility is certified shall be posted in a conspicuous location used by parents, with instructions for contacting the appropriate regional day care office posted at the same location

Noncompliance Area: EMERGENCY DISASTER PLAN DID NOT INCLUDE METHOD TO CONTACT PARENTS WHEN EMERGENCY ARISES NOR HOW TO NOTIFY TO REUNITE WITH CHILD AFTER EMERGENCY ENDS.

Correction Required: The facility shall have an emergency plan that provides for a method for facility persons to contact parents as soon as reasonably possible when an emergency situation arises. 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: PROVIDERS HAS 7 CHILDREN IN CARE FROM 5AM - 8AM MONDAY-FRIDAY.

Correction Required: The number of children in care may not exceed six children at any one time who are unrelated to the operator.

Noncompliance Area: NO OUTLET COVERS IN BATHROOM AND CHILDCARE ROOM WHERE CHILDREN ARE 5 YRS OLD AND YOUNGER.

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

Noncompliance Area: DIAPERS ARE CHANGED; DIAPERING PAD IS SANITIZED ABOVE SHELF CONTAINING TOYS THAT THE CHILDREN UTILIZE CAUSING CROSS CONTAMINATION.

Correction Required: Cleaning materials and other toxic materials shall be used in a way that does not contaminate play surfaces, food, food preparation areas and does not constitute a hazard to the children.