Rocio Escobar Berdugo - Lebanon PA Family Child Care Home

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.