Rossenia Liriano

Noncompliance Area: It was observed that there were small craft pieces (googly eyes, pencil top erasers) in a bottom drawer where children who are still placing objects in their mouths have access to them. *CORRECTED ON SITE

Correction Required: Toys and objects with a diameter of less than 1 inch, objects with removable parts that have a diameter of less than 1 inch, plastic bags and styrofoam objects may not be accessible to children who are still placing objects in their mouths.

Noncompliance Area: The file for child #1(enrolled 11/26/18) did not include any updated health assessments. It only included an initial from 7/3/18.

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 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 file for child #2 (enrolled 9/7/20) did not include an initial agreement.

Correction Required: A child's record must contain a copy of the initial agreement and subsequent written agreements between the parent and the operator. The parent receives the original agreement.

Noncompliance Area: The file for staff person #1 did not include mandated reporter training.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services).

Noncompliance Area: Throughout the inspection, the provider left the room, leaving the children without direct supervision. Transitioning to the bathroom and to obtain lunch from the kitchen causes a lapse in 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. STAFF SHALL VIEW THE SUPERVISION VODCAST PROVIDED BY THE DEPARTMENT.

Noncompliance Area: HHM/Staff 2 assists with food preparation for the children and does not have a physical with TB on file.

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 on file at the facility.

Noncompliance Area: Children were given lunch and then placed for nap with no dairy served. Children had no drink at lunch.

Correction Required: A lunch or dinner prepared at the facility for children of toddler age or older shall include at least one dairy product.

Noncompliance Area: Staff 1/HHM will be utilized as a facility person/cook. Staff 1/HHM does not have 2 references on file.

Correction Required: An individual record is required for each facility person.

Noncompliance Area: Child 2 and 3 did not have child service reports completed; child 2 enrolled 5/16 and child 3 enrolled 4/18.

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: The original agreements for all enrolled children were not given to the parents.

Correction Required: A parent shall receive the original agreement. The facility shall retain a copy of the agreement.

Noncompliance Area: Child 3 did not have information on Mother's address/work nor designated release person's info.

Correction Required: Emergency contact information must include the home and work addresses and telephone numbers of the enrolling parent. 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: Child 5 did not have agreement updated from Jan 18 to July 18. Child 3 did not have emergency contact or agreement updated from April 18 to Oct 18.

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 informationA 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: Child 3 did not have 1 yr old or 18 mth old physical on file (1 yr old 5/18/18mth 11/18).

Correction Required: The operator shall require the parent to provide an updated health report at least every 6 months for an infant or young toddlerA child's record must contain initial and subsequent health reports.

Noncompliance Area: Child 4 did not have 2 yr old physical on file.

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: Staff 1 did not have a current physical on file.

Correction Required: 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: Peeling paint/damaged drywall found in Childcare room 2.

Correction Required: Conditions at the facility may not pose a threat to the health or safety of the children.Peeled or damaged paint or damaged plaster is not permitted on indoor or outdoor surfaces in the child care facility.

Noncompliance Area: CHILD 5 DID NOT HAVE A CHILD SERVICE REPORT SIGNED/DATED BY PARENT.

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 1-4 DID NOT HAVE NAME, ADDRESS, TELEPHONE # FOR DESIGNATED 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: STAFF 1 DID NOT HAVE PHYSICAL ON FILE FOR 2015 AND 2017.

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 on file at the facility.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: CHILD 2, 3, 4, AND 5 DID NOT HAVE EMERGENCY CONTACT FORMS AND AGREEMENTS UPDATED IN A 6 MONTH PERIOD.

Correction Required: Information in a child's record shall be kept current by the operator.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: CHILD 2 DID NOT HAVE PARENTAL SIGNATURE FOR CONSENT FOR MINOR FIRST AID AND EMERGENCY CARE.

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.

Noncompliance Area: CHILD 3 DID NOT HAVE ADDRESSES FOR DESIGNATED RELEASE PERSONS.

Correction Required: 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: NOT ENOUGH AGE APPROPRIATE PLAY EQUIPMENT AND MATERIALS FOR THE VARIOUS AGES SERVED.

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: SIPPY CUPS AND BOTTLES WERE USED AND THEN RETURNED TO REFRIG PRIOR TO PROPER CLEANING.

Correction Required: Toys soiled by secretion or excretion shall be cleaned with soap and water, rinsed and sanitized before being used by a child.

Noncompliance Area: SUPERVISION IS CONSTANTLY COMPROMISED: CHILD ASLEEP IN PLAYPEN OUT OF VIEW OF PROVIDER. PROVIDER DID NOT CHECK ON CHILD UNTIL CHILD AWOKE. PROVIDER REPEATEDLY LEFT ROOM, LEAVING CHILDREN WITHOUT DIRECT SUPERVISION. PROVIDER ANSWERED DOOR, LEAVING 2 CHILDREN IN PLAYPEN WITHOUT 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: CHILD OBSERVED IN PLAYPEN, NOT NAPPING. PROVIDER STATES CHILD THERE AS SHE CLIMBS ON CHAIRS.

Correction Required: A facility person may not restrain a child by using bonds, ties or straps to restrict a child's movement or by enclosing the child in a confined space, closet or locked room. The prohibition against restraining a child does not apply to the use of adaptive equipment prescribed for a child with special needs.

Noncompliance Area: PARENT POLICY HANDBOOK DOES NOT INCLUDE FEES, DAILY SCHEDULE TO CLOSING, NIGHTCARE POLICIES. NOT CORRECTED FROM 4/27/17 INSPECTION.

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.

Noncompliance Area: WRITTEN PLAN OF TRANSPORTING CHILD TO ER NOT POSTED IN ROOM 2.

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.

Noncompliance Area: YT HANDS NOT WASHED AFTER DIAPERING.

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: INDIVIDUAL BOTTLES ARE NOT LABELED.

Correction Required: Disposable nursers and bottles shall be labeled with the child`s name.

Noncompliance Area: NOT ENOUGH AGE APPROPRIATE EQUIPMENT/GAMES/ FOR CHILDREN TO HAVE CHOICES OF ACTIVITIES.

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: PACK AND PLAYS WERE NOT 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: NO DAILY SCHEDULE POSTED IN CHILDCARE ROOM 2.

Correction Required: The written plan of daily activities and routines shall be posted in a traffic area used by parents.

Noncompliance Area: PARENT POLICY HANDBOOK DID NOT INCLUDE POLICIES ON SUPERVISION AND NIGHTCARE.

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.

Noncompliance Area: NO CHILD SERVICE REPORT FOR CHILD 1. SCHOOL AGED CHILD ATTENDS CARE 15 HOURS.

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: EMERGENCY CONTACT FORMS LACKED SIGNED PARENTAL CONSENT FOR EMERGENCY CARE AND DESIGNATED RELEASE PERSON (S) NAME ADDRESS AND PHONE NUMBER.

Correction Required: Emergency contact information must include the written consent signed by a parent for emergency medical care. 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: CHILD 3 DID NOT HAVE AN IMMUNIZATION RECORD ON FILE.

Correction Required: The initial health report for a young toddler must be dated no more than 6 months prior to the first day of attendance at the facility.A child`s record must contain initial and subsequent health reports.

Noncompliance Area: CHILD 1 AND 2 DID NOT HAVE COMPLETE PHYSICALS ON FILE WITH IMMUNIZATIONS. CHILD 1 ENROLLED MARCH 2015; CHILD 2 ENROLLED JAN 2016.

Correction Required: 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).A child`s record must contain initial and subsequent health reports.

Noncompliance Area: PRIOR TO RECEIVING A BOTTLE, CHILD NOR STAFF WASHED 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.A facility person shall wash his hands before meals and snacks, and after toileting and after diapering a child.

Noncompliance Area: CHILDREN'S BOTTLES WERE NOT LABELED FOR INDIVIDUAL USE.

Correction Required: Disposable nursers and bottles shall be labeled with the child`s name.

Noncompliance Area: 2 YOUNG TODDLERS WERE PLACED IN PACK AND PLAY TO DRINK BOTTLES.

Correction Required: Neither an infant nor a toddler is permitted to sleep with a bottle in his mouth.

Noncompliance Area: NO OUTLET COVERS IN BATHROOM.

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

Noncompliance Area: BLEACH SOLUTION WAS NOT LABELED WITH CONTENTS. DIAPERING CREAMS AND OTHER ITEMS LABELED KEEP OUT OF REACH OF CHILDREN 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.

Noncompliance Area: NO LIDDED TRASHCAN IN BATHROOM FOR CONTAMINATED TRASH.

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

Noncompliance Area: NO FIRE EVACUATION PLAN OR EMERGENCY PLAN OF TRANSPORTATION TO HOSPITAL POSTED IN CHILDCARE ROOM 2.

Correction Required: Fire evacuation plans shall be developed and posted.A written plan identifying the means of transporting a child to emergency care and staffing provisions in the event of an emergency shall be displayed conspicuously in every child care space and shall accompany a staff person who leaves on an excursion with children.