Tiny Tots Academy Llc - Pittsburgh PA Family Child Care

Noncompliance Area: The file of facility person #1, with a start date of 1/14/2020, contained an FBI clearance which did not contain a disposition and a completed NSOR verification certificate. The file of facility person #2, with a start date of 11/20/2019, contained documentation of the request for the NSOR verification after their start date with children. The file of facility person #3, with a start date of 9/17/2019, contained an FBI and PA state police clearance which did not contain dispositions.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). LACKING REQUIRED HIRING DOCUMENTS: Facility Person # 1 and 2 may not work in a child care position at the facility. 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. Facility Person #--- may not work in a child care position at the facility.

Noncompliance Area: The financial agreement of child #1 did not contain the date on which the fee is to be paid.

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

Noncompliance Area: The financial agreement of child #3 did not contain the persons designated by the parent 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 health assessments of child #1, 2 and 4 contained immunization records which were not according to the recommendations of the ACIP.

Correction Required: A health report shall include a review of the child's immunized status according to recommendations of the ACIP.

Noncompliance Area: The first-aid kit in Classroom 4 contained hand cleansing wipes and antibiotic cream which were not labeled with the name of whom they were intended.

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 facility did not have written consent for administration of Motrin Infant Drops for a child in Classroom 4.

Correction Required: A parent shall provide written consent for administration of medication or a special diet.

Noncompliance Area: The health assessment of facility person #1, with a start date of 1/14/2020, is dated 12/13/2018, which is more than 12 months prior to initial service in a child care setting. The health assessment of facility person #2, with a start date of 11/20/2019, is dated 12/3/2019, which is after their start date with children. Facility person #2 now has a current health assessment.

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: Documentation of tuberculosis screening of facility person #1, with a start date of 1/14/2020, is dated 4/6/2018, which is more than 12 months prior to initial service in a child care setting.

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: The health assessment of facility person #4 did not contain documentation of an examination for communicable diseases and the results of that examination.

Correction Required: An adult health assessment must include an examination for communicable diseases and the results of that examination.

Noncompliance Area: The file of facility person #1 did not contain 2 written nonfamily references which attest tot he person's suitability per 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: At approximately 2:12 pm, there were 17 children in the facility. 13 of the children were unrelated to the operators or the facility persons.

Correction Required: No more than 12 children unrelated to the operator may simultaneously receive care except in a facility serving older school-age children. In a facility serving only older school-age children, a certificate of compliance may be issued for up to 15 children unrelated to the operator.

Noncompliance Area: At approximately 2:12 pm, facility person #1 was in Room 3 alone, supervising 15 sleeping children between the ages of 1 year and 4 years old.

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: Two children were observed resting on bed linens on the floor in Room 3.

Correction Required: Bed linens may not be used alone as age-appropriate rest equipment.

Noncompliance Area: ***3RD CITATION PREVIOUSLY CITED ON 9/16/2019 AND 10/24/2019 - I arrived at the facility at approximately 2:05 pm on 11/18/2019. I knocked on the door to Room 1 as stated on the note on the door since it was nap time. When nobody answered, I called the cell phones of facility person #1 and 4 with no answer. At approximately 2:12, facility person #3 came up the stairs to the hallway and knocked on the door of Room 3. Facility person #1 was alone in Room 3 with 15 children between the ages of 1 year to 4 years old. When asked, facility person #1 stated they were responsible for 5 children in Room 3 with the youngest being 1 year old. Facility person #2 stated they were supervising the 2 infants in Room 2 and 2 children in Room 3. Facility person #3 stated they were responsible for 5 children in Room 3 with the youngest being 1 year old. When asked who was responsible for the 3 children not identified by a facility person, facility person #1 stated nobody, they were unaccounted for because they were the responsibility of facility person #4, who was not present at the facility.

Correction Required: The legal entity will work with the ELRC and a Quality Coach to be retrained on proper supervision of children including how to make group assignments to ensure all children are accounted for in a supervisory group and being physically present with the children in their group on the facility premises and on facility excursions off the facility premises.

Noncompliance Area: **PREVIOUSLY CITED ON 9/16/2019 - In room 3, facility person #1 identified 4 children in their group, stating the youngest child in their group was 1 year old. Facility person #2 identified 5 children in their group stating one was in the restroom, but that child was not in care that day. Then facility person #2 identified 4 children in their group, all 1 and 2 years old. Child #1 was omitted from a supervisory group.

Correction Required: The Legal Entity will arrange for all facility persons to take a minimum of 3 hours training on supervision by an approved training organization. The training will be submitted to the regional office prior to completion for approval. Proof of training for each facility person will be submitted upon completion.