Sheffields Family Childcare Home

Regulation: 3280.124(c)

Description: Each child care space

Noncompliance Area: In the front room, the emergency contact forms were not present in the room for the 6 children receiving care in the room.

Correction Required: When children are in the facility, emergency contact information shall be present in a child care space for children receiving care in the space.

Regulation: 3280.135(a)(3)

Description: Disposable diapers

Noncompliance Area: In the infant room, there was a hands-free covered can next to the changing table that is used for discarding diapers with a lid that was not operating correctly and closing to function as a hands-free covered can.

Correction Required: If disposable diapers are provided by a parent or by a facility, a soiled diaper shall be discarded by immediately placing the diaper into a plastic-lined, hands-free covered can.

Regulation: 3280.171(a)

Description: Pick up and drop off points

Noncompliance Area: The operator lacked documentation of notifying local traffic safety authorities in writing of the location of the facility and about the program's use of pedestrian and vehicular routes around the group child care facility.

Correction Required: The operator shall notify local traffic safety authorities in writing of the location of the facility and about the program's use of pedestrian and vehicular routes around the group child care facility.

Regulation: 3280.26(f)

Description: Emergency plan

Noncompliance Area: The operator lacked verification of sending a copy of the emergency plan to the county emergency management agency.

Correction Required: The operator shall send a copy of the emergency plan and subsequent plan updates to the local municipality and to the county emergency management agency.

Regulation: 3280.32(a)/3280.192(4)

Description: Comply with CPSL/CPSL information

Noncompliance Area: The file for staff person #1 lacked a child abuse clearance at their start date & requires a current child abuse clearance.

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. Staff Person #1 may not work in a child care position at the facility.

Regulation: 3280.33(a)/3280.192(2)(ii)

Description: Each staff person meets quals/Exp, educ., training prior to facility

Noncompliance Area: The file for staff person #2, functioning as a primary staff person, lacked verification of experience to qualify as a primary staff person.

Correction Required: A staff person or a substitute staff person shall meet one of the applicable staff qualifications for the position in which the person is performing. A facility person's record shall include verification of child care experience, education and training prior to service at the facility.

Regulation: 3280.14/3280.20

Description: Pertinent Laws & Regulations/General Health and Safety

Noncompliance Area: The emergency plan lacked the requirement for continuity of operations according to federal requirements at 45 CFR § 98.41(a)(1)(vii).

Correction Required: A facility shall be operated in conformity with applicable Federal and State laws and regulations. State agencies whose regulations may relate to the operation of a facility include the Department of Environmental Resources, the Department of Labor and Industry, the Department of Health, the Department of Education and the Department of Transportation. Conditions at the facility may not pose a threat to the health or safety of the children.

Regulation: 3280.17

Description: Liability Insurance

Noncompliance Area: A current copy of the insurance policy was not on file at the facility.

Correction Required: The legal entity shall have comprehensive general liability insurance to cover all persons who are on the premises. A current copy of the insurance policy shall be on file at the facility.

Regulation: 3280.192(5)

Description: Two written references

Noncompliance Area: The file for staff person #1 lacked two written, nonfamily references.

Correction Required: A facility person's record shall include two written, nonfamily references from individuals attesting to the person's suitability to serve as a facility person.

Regulation: 3280.20

Description: General Health and Safety

Noncompliance Area: In the kitchen, there was an unlocked drawer that contained multiple sharp knives that was accessible to children.

Correction Required: Conditions at the facility may not pose a threat to the health or safety of the children.

Regulation: 3280.26(e)

Description: Letter to parents

Noncompliance Area: The operator's letter provided to the parent of each enrolled child explaining the emergency procedures lacked a method for facility persons to contact parents as soon as reasonably possible when an emergency situation arises and 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.

Correction Required: The operator shall provide to the parent of each enrolled child a letter explaining the emergency procedures. The operator shall also provide to the parent of each enrolled child a letter explaining any subsequent update to the plan.

Regulation: 3280.75(c)

Description: Has all items

Noncompliance Area: The facility's first-aid kit lacked soap.

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: The cabinet in the kitchen that holds cleaning supplies such as tide pods, Ajax, Febreeze and Chlorox Wo[es/

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: At approximately 8am on 5/14/19, Staff #1 was at the facility alone with 1 infant, 2 young toddlers and 4 preschool age children. While waiting for Staff #2 to come in another infant and older toddler arrived at the facility. Staff #2 arrived at 8:21am. At 8:28am an older toddler and preschool aged children arrived at the facility putting the facility over ratio again with 2 staff and 2 infants, 2 young toddlers, 2 older toddlers and 5 preschool age children. While waiting for Staff #3 to come in another older toddler arrived. Staff #3 arrived at 9:15am. Staff #1 admitted to being out of ratio at the time of the complaint due to a staff call-off.

Correction Required: When children are grouped in similar age levels, the following maximum child group sizes and ratios of staff persons apply: Infants 1:4 with a maximum group size of 12; Young toddlers 1:5 with a maximum group size of 12; Older toddlers 1:6 with a maximum group size of 12; Preschool children 1:10 with a maximum group size of 12; Young school-age children 1:12 with a maximum group size of 12; Older school-age children 1:15 with a maximum group size of 15. IF USING TIERED LIS: The required staff:child ratios must be maintained at all times. The legal entity must submit documentation in a format approved by DHS proving that the facility is maintaining the required staff:child ratios at all times. The legal entity will confirm continuing compliance by sending copies of the documentation to the -------- Region Office on a weekly basis for a period of three months after DHS approves the documentation format.

Noncompliance Area: The sleeping equipment in the facility(mats, pack-n-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: An infant was observed sleeping with a bib on and a pacifier hook.

Correction Required: Toys, bumper pads, or pillows may not be present in a crib while an infant is sleeping in the crib.

Noncompliance Area: The file for Child #2 and 4 contained a financial agreements that was lacking the parent's signature.

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

Noncompliance Area: The file for Child #4 contained a child service report dated 4/2018, more than 6 months old.

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 files for Child #4 and 5 contained financial agreements that were lacking the children's arrival and departure times.

Correction Required: An agreement shall specify the child's arrival and departure times.

Noncompliance Area: The file for Child #4 and 5 contained financial agreements that were lacking the persons to whom the child may be released.

Correction Required: An agreement shall specify the persons designated by a parent to whom the child may be released.

Noncompliance Area: The files for Child #1, 2, 3, 4, and 5 all contained the original copy of the financial agreement.

Correction Required: A parent shall receive the original agreement. The facility shall retain a copy of the agreement.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 files for Child #2 and 3 contained emergency contact forms that were lacking the phone number of the child's physician.

Correction Required: Emergency contact information must include the name, address and telephone number of the child's physician or source of medical care.

Noncompliance Area: The file for Child #4 contained an emergency contact form that was lacking the addresses of the persons 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 file for Child #4 contained emergency contact forms and financial agreements that were last updated 4/2018, which is more than 6 months ago.

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: The file for Child #4 contains a health assessment that was lacking a date written on it.

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: The file for Chidl #5(18 month old child) contained two health assessments that were more than 6 months apart.

Correction Required: The operator shall require the parent to provide an updated health report at least every 6 months for an infant or young toddler

Noncompliance Area: The file for Child #4 contained a health assessment that was lacking the physicians signature.

Correction Required: A health report must be written and signed by a physician, physician's assistant or a CRNP. The signature must include the individual's professional title.

Noncompliance Area: The file for Child #5(18 months old) was lacking one dose of the rotovirus immunization. The file for Child #1, 3 and 4 were all lacking the annual influenza vaccination.

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 first aid kit contained medication that was not labeled with whom it was intended for.

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: The file for Staff #2 and 3 contained staff health assessments that were more than 24 months old. The file for Staff #4 was lacking an initial health assessment prior to starting at the facility.

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 file for Staff #1 was lacking documentation of the staffs qualifications.

Correction Required: A facility person's record shall include verification of child care experience, education and training prior to service at the facility.

Noncompliance Area: The emergency plan at the facility was lacking documentation of annual reviews of the emergency plan.

Correction Required: The operator shall review the emergency plan at least annually and update the plan as needed. The operator shall document in writing each review and update of the emergency plan and kept on file at the facility.

Noncompliance Area: The file for Staff #2, 3 and 4 were lacking documentation of initial and annual emergency plan training.

Correction Required: The operator shall assure that each facility person receives training regarding the emergency plan at the time of initial employment, on an annual basis and at the time of each plan update. The operator shall document the date of each training and the names of all facility persons who received the training.

Noncompliance Area: The first aid kit in the facility was lacking gauze pads.

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: I entered the facility at 9:30am and two infants were in their carseats. One was taken out and fed while the other still stayed in their carseat, that child was in the carseat until 10:10 when he was taken out to change their diaper. Carseats are not considered developmentally appropriate play spaces to stay in and can also be a safety hazard to the children.

Correction Required: Infants and toddlers shall be provided stimulation by being held, rocked, talked to, played with and carried.

Noncompliance Area: The files for Child #2, #3 and #4 all contained Financial Agreements that are lacking the parent's signature.

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

Noncompliance Area: The file for Child #2 was lacking an Emergency Contact form.

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

Noncompliance Area: The file for Child #1, #2 #3 and #4 all contained Emergency Contact forms and Financial Agreements that were lacking 6 month parental updates.

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: The file for Staff #1 showed an expired First Aid card. Staff #1 stated that there are times when numbers are low especially in the evening when she is in the facility alone with the children. This would make it required for her to be current in First Aid.

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.

Noncompliance Area: The gate in the kitchen next to the dryer does not go across the entire opening leaving an opening where children could get thru and have access to the toxics such as bleach, laundry detergent, turpentine, etc.

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: One large green toy bin was observed to be cracked along the edges and the easel located in the child care space was observed to have a one inch screw protruding from the side of the easel at the children's eye level. These conditions exposed the children in care to rough edges, sharp corners, pinch and crush points, and exposed screws.

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 rest equipment located in the child care facility was observed not to be labeled for the children whom they are intended for.

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: Child #1 an infant aged child in care was observed to be napping on his stomach. The doctor's note on file did not state a medical reason giving permission to nap on his stomach.

Correction Required: Infants shall be placed in the sleeping position recommended by the American Academy of Pediatrics unless there is a medical reason an infant should not sleep in this position. The medical reason shall be documented in a statement signed by a physician, physician's assistant or CRNP and placed in the child's record at the facility.

Noncompliance Area: The agreement form on file for child #3 was observed not to have specified the persons designated by the child's parent whom the child may be released to.

Correction Required: An agreement shall specify the persons designated by a parent to whom the child may be released.

Noncompliance Area: The emergency contact form on file for children #2 and #5 were observed not to have documented the children's date of birth.

Correction Required: Emergency contact information must include the name and birth date of the child.

Noncompliance Area: The emergency contact form on file for children #2, #3, and #4 were observed not to have complete contact information for the enrolling parent.

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

Noncompliance Area: The emergency contact form on file for children #2 and #5 were observed not to have documented complete health insurance policy information.

Correction Required: Emergency contact information must include health insurance coverage and policy number for a child under a family policy or Medical Assistance benefits, if applicable.

Noncompliance Area: The emergency contact form on file for children #2 and #5 were observed not to contain complete contact information for the person's whom the children are authorized to be released to.

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 file for child #5 was observed not to contain an initial health report.

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: The file for child #3 a younger aged toddler in care was observed not to have a health report completed within the last 6 months. This is evidenced by the most recent health report on file being dated 5/12/2016.

Correction Required: The operator shall require the parent to provide an updated health report at least every 6 months for an infant or young toddler

Noncompliance Area: It was observed that the operator did not have a written statement from the parent of the infant aged children giving a formula and feeding schedule.

Correction Required: A written statement giving the formula and feeding schedule for an infant shall be obtained from the parent.

Noncompliance Area: The bottles being used for the infant aged children in care were observed not to be labeled with the child's name.

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

Noncompliance Area: The emergency contact form on file for child #3 was observed not to have been reviewed by the child's parent and documented with a dated signature within the last 6 months. This is evidenced by the most recent dated signature on file being dated 5/10/2016.

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. Following review, a parent shall attest to the accuracy of information in the emergency contact information and the financial agreement at each review by affixing a dated signature to the record.

Noncompliance Area: From approximately 10:15 am to 10:30 am staff person #1 was observed caring for a group of 5 children consisting of 2 preschool aged children, 1 older toddler aged child and 2 infant aged children. At approximately 10:30 one infant aged child was picked up by the child's parent. At approximately 10:40 another staff person arrived at the child care facility.

Correction Required: When children are grouped in mixed age levels, the age of the youngest child in the group determines the staff:child ratio and maximum group size in accordance with the requirements at 3280.52(b). The required staff:child ratios must be maintained at all times.

Noncompliance Area: It was observed that the operator had not conducted a fire drill since November 16.

Correction Required: A fire drill shall be held at least every 60 days. Staff persons, volunteers and children in attendance shall participate in the fire drill and shall exit the facility, weather permitting.

Noncompliance Area: The file for staff person #1 was observed not to have a health assessment on file dated prior to staff person #1's date of hire. Also, the file for staff person #2 was observed not to have on file documentation of a health assessment being conducted within the last 12 months.

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 file for staff person's #1 and #2 were observed not to contain 2 written, nonfamily references from individuals attesting to the person's suitability to serve as a facility person.

Correction Required: A facility person`s record shall include two written, nonfamily references from individuals attesting to the person`s suitability to serve as a facility person

Noncompliance Area: On 4/4/2017, staff person's #1 and #2 were observed to be the only staff person's present at the group child care home caring for a group of 7 children consisting of 3 infant aged children, 1 younger toddler aged child, 2 older toddler aged children, and 1 preschool aged child. Upon review of the files for staff person's #1 and #2 it was observed that they have not been trained in the facility's emergency plan.

Correction Required: The operator shall assure that each facility person receives training regarding the emergency plan at the time of initial employment, on an annual basis and at the time of each plan update. The operator shall document the date of each training and the names of all facility persons who received the training.

Noncompliance Area: On 4/4/2017, staff person's #1 and #2 were observed to be the only staff person's present at the group child care home caring for a group of 7 children consisting of 3 infant aged children, 1 younger toddler aged child, 2 older toddler aged children, and 1 preschool aged child. Upon review of the file for staff person's #1 and #2 it was observed that neither staff had documentation of completion of first aid training by a professional in the field of first aid.

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: On 4/4/2017, staff person's #1 and #2 were observed to be the only staff person's present at the group child care home caring for a group of 7 children consisting of 3 infant aged children, 1 younger toddler aged child, 2 older toddler aged children, and 1 preschool aged child. Upon review of the file for staff person #1 it was observed that she did not have on file documentation of a valid Pennsylvania State Police criminal history clearance. This is evidenced by the clearance she had on file being for volunteer purposes. Also, the file for staff person #2 was found not to contain documentation of application for a child abuse or Pennsylvania State Police criminal history clearance prior to the onset of employment. Nor was their documentation of staff person #2 being fingerprinted for the application of an FBI criminal history clearance. Both of these employees were provisionally hired employees at the time of inspection and were working unsupervised.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). Staff Person's #1 and #2 may not work in a child care position at the facility. A provisional employee may not be permitted to work alone with children and must work within the vicinity of a permanent employee. 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. Staff Person's #1 and #2 may not work in a child care position at the facility.

Noncompliance Area: The file for staff person #2 was observed not to contain documentation of education or experience obtained prior to the onset of employment at the child care facility to work as a primary staff person.

Correction Required: A primary staff person shall have attained a high school diploma or a general educational development certificate and 2 years of experience with childrenA facility person`s record shall include verification of child care experience, education and training prior to service at the facility.