Shannon Shields Gdch

Noncompliance Area: The child file for Child #1, who is a preschool age child, contained a copy of their immunization status which lacked an annual influenza vaccination as recommended by the ACIP. The child file for Child #2, who is a young toddler, contained a copy of their immunization status which lacked an annual influenza vaccination as recommended by the ACIP.

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 staff file for Staff person #1 contained an updated health assessment dated 10/9/20 which was conducted more than 24 months from the previously dated 3/5/18 health assessment. The staff file for Staff person #2 contained an updated health assessment dated 10/7/20 which was conducted more than 24 months from the previously dated 3/13/18 health assessment. The staff file for Staff person #3 lacked a valid health assessment; the health assessment on file dated 7/13/18 is more than 24 months old.

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: The staff file for Staff person #3 contained current mandated reporter training dated 9/29/20 which was not renewed every five years from the previous mandated reporter training that was completed on 3/17/15.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). A facility person's record shall include verification of child care experience, education and training following the outset of service at the facility.

Noncompliance Area: Emergency contact information for Child #2 lacked the addresses of the individuals designated by the parent to whom the child may be released.

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: The last two updates of the Agreement and Emergency Contact Forms for Child #3 were dated more than six months apart.

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 last two child health reports for Child #1, a preschooler, were dated more than 12 months apart.

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 health report for Child #1 lacks an influenza vaccine. Although the file contains a form stating they choose not to immunize, the file lacks an acceptable written, signed and dated statement from the parents regarding a religious or strong personal objection.

Correction Required: Exemption from immunization for religious belief or strong personal objection equated to a religious belief shall be documented by a written, signed and dated statement from the child's parent or guardian. The statement shall be kept in the child's record.

Noncompliance Area: The TB test results indicated on Staff #2's health assessment was deemed unacceptable because the results appeared to be photocopied onto the form prior to the doctor completing the rest of the form.

Correction Required: An adult health assessment must include tuberculosis screening by the Mantoux method at initial employment. Subsequent tuberculosis screening is not required unless directed by a physician, physician's assistant, CRNP, the Department of Health or a local health department.

Noncompliance Area: One infant was being bottle fed by the operator with a bottle that lacked a label with the child's name.

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

Noncompliance Area: The documentation for first-aid training was deemed unacceptable due to the operator writing the documentation letters as well as lack of proof of the trainer's qualifications to deliver the training.

Correction Required: A facility person's record shall include acceptable verification of experience, education or training is a transcript or a diploma or a letter signed by a representative of the experiential, educational or training entity.

Noncompliance Area: Staff #1 obtained only 3 hours of annual training hours during the anniversary dates of 2/22/18- 2/22/19.

Correction Required: A staff person shall obtain an annual minimum of 6 clock hours of child care training.

Noncompliance Area: The facility first-aid kit lacked tweezers.

Correction Required: A first-aid kit must contain the following: soap, an assortment of adhesive bandages, sterile gauze pads, tweezers, tape, scissors and disposable, nonporous gloves.

Noncompliance Area: Agreements for Child #1, 2, 3 & 4 lacked a specific date/ day when child care fees are due.

Correction Required: An agreement shall specify the date on which the fee is to be paid.

Noncompliance Area: The most recent Child Service Reports in the files for Child #2 & 4 were dated more than 6 months ago.

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 3280.124(f).

Noncompliance Area: The initial health report in the file for Child #4 was dated more than 60 days from the enrollment date.

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.

Noncompliance Area: Two bottles of Melatonin, one bottle of liquid children's Tylenol and one jar of Mentholatum were observed in a locked storage closet in the facility and lacked the names of the individuals for whom they are intended. (It was stated that they were for the operator's granddaughter, who previously resided in the home.)

Correction Required: The label of a medication container shall identify the name of the medication and the name of the child for whom the medication is intended. Medication shall be administered to only the child whose name appears on the container.

Noncompliance Area: One unlabeled bottle of liquid Tylenol was observed to have an expiration date of 6/2018.

Correction Required: Medication shall be stored in accordance with the manufacturer's or health professional's instructions on the original label.

Noncompliance Area: Staff #2 served a snack prior to having the children wash 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.

Noncompliance Area: The most current reviews of Agreements and Emergency Contact Forms for Child #1, 2, & 4 were dated more than 6 months ago.

Correction Required: 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: First-aid training for Staff #1 expired in 8/2018. Staff #1, 2, & 3 completed an online first-aid/ CPR training to meet the first-aid requirement, which DHS deems invalid. Therefore, no one at the facility currently has obtained first-aid training.

Correction Required: Competence in first-aid is demonstrated by the completion of training by a professional in the field of first-aid. First-aid training shall be renewed on or before expiration of certification or every 3 years, as applicable. One or more facility persons competent in first-aid techniques shall be at the facility when one or more children are in care.

Noncompliance Area: The training certification of completion for a valid Mandated Reporter training for Staff #2 is deemed invalid due to the name and completion date are hand-written onto the certificate. Therefore, it cannot be verified that Staff #2 has received Mandated Reporter Training within the first 90 days of employment.

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

Noncompliance Area: Peeling paint and plaster debris were observed along the bottom of a corner of a Green painted wall in the child care space (closest to the office).

Correction Required: Peeled or damaged paint or damaged plaster is not permitted on indoor or outdoor surfaces in the child care facility.

Noncompliance Area: In the outside play area intended for use by infants and toddlers, two uncapped, protruding and rusted screws were observed on the Little Tikes- style play structure with slide. In the outside play area intended for use by the older toddlers and children, one uncapped and protruding rusted screw was observed on a Little Tikes-style sliding board.

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: The Emergency Contact Form in the file for Child #1 lacked signed, written parental consent for both emergency medical care as well as administration of minor first-aid procedures by facility staff. It was determined that even though this child was related to the operator, the operator stated that the child is considered to be enrolled in 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. 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: The Certificate of Compliance that was centrally posted was observed to be from a previous compliance year.

Correction Required: The facility's current certificate of compliance 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: Above the laundry machines, a tub of powdered cleaner was observed to be stored inside of a re-used Enfamil container. When asked, the provider stated that the contents was powdered laundry detergent.

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: Observed an unstable table used by children in the main child care space.

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: Observed accessible crafting stickers labeled "not for use with children under 3" on the table in the main child care room.

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: Observed a tube of diaper cream which expired in 12/2016.

Correction Required: Medication shall be stored in accordance with the manufacturer's or health professional's instructions on the original label.

Noncompliance Area: Observed several containers of expired baby food.

Correction Required: Food stored, prepared or served shall be clean, wholesome, free from spoilage, free from adulteration and safe for human consumption.