Rossenia Liriano - Lebanon PA Family Child Care Home

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.