Tree House Family Day Care

Regulation: 3290.117(c)

Description: Vet's certificate required

Noncompliance Area: During the renewal inspection on 8/10/2026, it was observed that the facility's dog did not have an updated rabies vaccine. The rabies vaccine expired in September of 2025.

Correction Required: A veterinarian's certificate of current rabies immunization is required for a cat or dog at the facility. The certificate shall be on file when the cat or dog is present.

Regulation: 3290.123(a)(3)/3290.124(b)(6)

Description: Services provided/Insurance coverage information

Noncompliance Area: During the renewal inspection on 8/10/2026, children 1 and 3 did not have the name of the health insurance company on the emergency contact form. Child 2 did not have the services provided section filled out on the fee agreement.

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

Regulation: 3290.131(a)

Description: Within 60 days

Noncompliance Area: During the renewal inspection on 8/10/2026, it was observed that children 4, 5 and 6 were at the facility. They are grandchildren of staff 3 and live at the facility. They did not have health assessments on file.

Correction Required: The operator shall require the parent of an enrolled child to provide an initial health report no later than 60 days following the first day of attendance at the facility.

Regulation: 3290.133(4)

Description: Locked

Noncompliance Area: During the renewal inspection on 8/10/2026, it was observed that there were multiple prescription and over the counter medications accessible to the children in an unlocked drawer in the childcare area.

Correction Required: Medication shall be stored in a locked area of the facility or in an area that is out of the reach of children.

Regulation: 3290.182(5)

Description: Consent for administration of minor first-aid required prior to admission

Noncompliance Area: During the renewal inspection on 8/10/2026, child 1 did not have permission for minor first aid on file.

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.

Regulation: 3290.22(a)

Description: Availability of certificate of compliance and applicable regulations

Noncompliance Area: During the renewal inspection on 8/10/2026, the facility did not have the current certificate of compliance posted. The one that was posted expired 11/12/2024.

Correction Required: The facility's current certificate of compliance shall be posted in a conspicuous location used by parents, with instructions for contacting the appropriate regional child care office posted at the same location.

Regulation: 3290.24(b)/3290.24(d)

Description: Emergency plan/Emergency plan

Noncompliance Area: During the renewal inspection on 8/10/2026, the facility's emergency plan was out of date. It was last updated 7/11/2025. The facility also did not have an updated emergency drill on file. The last emergency drill was conducted on 7/30/2025.

Correction Required: The operator shall review the emergency plan at least annually and update the plan as needed. Each review and update of the emergency plan shall be documented in writing and kept on file at the facility. Emergency drills shall be conducted annually. Annual emergency drills shall be documented and on file at the facility.

Regulation: 3290.31(f)

Description: Age and training

Noncompliance Area: During the renewal inspection on 8/10/2026, staff 1 and 2 did not have all 12 hours of annual childcare training on file. Staff 1 still needs 6.5 hours of training and staff 2 needs 11 hours of training. Please see LIS for date of hire.

Correction Required: A staff person shall obtain an annual minimum of 12 clock hours of child care training.

Regulation: 3290.31(f)(4)(i)

Description: Age and training

Noncompliance Area: During the renewal inspection on 8/10/2026, staff person #2 has not completed Pediatric first aid and CPR training on or before expiration of the most current certification. This is evidenced by the previously documented Pediatric first aid and CPR training on file expiring 4/27/2026. Documentation of updated Pediatric first aid and CPR training is not on file.

Correction Required: Competence is the completion of training by a professional in the field of first-aid and CPR. All staff persons shall renew their certification in pediatric first aid and pediatric cardiopulmonary resuscitation (CPR) on or before the expiration of the most current certification. Until such time as the required training has been completed, staff person #2 must be supervised, when interacting with children at a minimum by, a family childcare home staff person who has completed all preservice trainings and has all qualifications to care for children unsupervised. If there are no staff person(s) available to supervise staff person #2, staff person #2 may not work in a child-care position at the facility

Regulation: 3290.31(f)(1)(ii)

Description: Age and training

Noncompliance Area: Staff 1 did not have any annual training hours on file during the renewal inspection on 8/11/20245. During a verification visit on 9/8/2025, staff 1 still did not have the 12 hours of annual training on file.

Correction Required: Training conducted by an entity that is licensed or certified professionally competent in the training topic is acceptable and may count toward the annual requirement for 12 clock hours of child care training.

Regulation: 3290.32(a)

Description: Comply with CPSL

Noncompliance Area: Household member 2 did not have an updated child abuse clearance on file during the renewal inspection on 8/11/2025. It expired on 9/1/2024. During a verification visit on 9/8/2025, the child abuse clearance was still not on file.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). Facility Person #1 may not work in a child care position at the facility. TIERED LIS: 1) Household member 2 shall not be in the facility during childcare hours. This portion of the plan shall have an immediate correction date. 2) Facility person 2 will obtain the child abuse clearance in order to be in the facility during childcare hours.

Regulation: 3290.105(a)

Description: Clean, age appropriate

Noncompliance Area: The pack and play, which is used by a child per staff 3, was not labeled with the child's name.

Correction Required: Individual, clean, age-appropriate rest equipment shall be provided for preschool, toddler and infant children as agreed between the parent and the operator. The rest equipment must be labeled with the child's name and used only by the named child while enrolled in the program.

Regulation: 3290.123(a)(3)

Description: Services provided

Noncompliance Area: Child 3 did not have an updated child service report on file.

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).

Regulation: 3290.173(a)

Description: Age appropriate restraints

Noncompliance Area: As per staff 3, child 2 is transported. It was found that the car seat was forward facing and meant for children at least two years old and/or 35 pounds. As per staff 3, child 2 is 30 pounds. Please see LIS for date of birth.

Correction Required: A child 7 years of age or younger shall be transported in accordance with the requirements for parents and guardians as stated in 75 Pa.C.S. §4581 (relating to restraint systems).

Regulation: 3290.18

Description: General Health and Safety

Noncompliance Area: During the renewal inspection on 8/11/2025, certification representative observed various garbage in the facility's backyard. The garbage included empty beer cans, stacks of wood and tires, a lawnmower and grill. It posed a threat to the health and safety of the children due to the vast amount of garbage.

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

Regulation: 3290.182(3)/3290.182(5)

Description: Consent for emergency medical care required prior to admission/Consent for administration of minor first-aid required prior to admission

Noncompliance Area: Child 2 did not have permission for emergency medical care and minor first aid.

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.

Regulation: 3290.31(f)

Description: Age and training

Noncompliance Area: Staff 1 did not have any annual training hours on file.

Correction Required: A staff person shall obtain an annual minimum of 12 clock hours of child care training.

Regulation: 3290.32(a)/3290.192(3)

Description: Comply with CPSL/CPSL information

Noncompliance Area: Staff 1 had mandated reporter training that expired on 8/6/2025, making it more than 5 years since the last update. Household member 2 did not have an updated child abuse clearance on file. It expired on 9/1/2024.

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. TIERED LIS: 1) Household member 2 shall not be in the facility during childcare hours. This portion of the plan shall have an immediate correction date. Staff 1 shall be supervised at all times until the mandated reporter training is completed. 2) Facility person 2 will obtain the child abuse clearance in order to be in the facility during childcare hours. Staff 1 will obtain a completed mandated reporter training.

Regulation: 3290.95(a)/3290.95(b)

Description: System in compliance/Operator or designated staff responsibility

Noncompliance Area: During the renewal inspection on 8/11/2025, it was observed that the last fire alarm test was on 7/7/2025, making it more than 30 days since the last test.

Correction Required: Fire detection devices or systems must be in compliance with standards established under section 1016(c) of the act (62 P.S. § 1016(c)). The operator or designated staff person who is responsible for compliance with this chapter shall ensure the requirements in § 3290.95(a) are met.

Regulation: 3290.32(a)/3290.192(3)

Description: Comply with CPSL/CPSL information

Noncompliance Area: During the renewal inspection on 8/26/2024, staff 1 did not have updated child abuse and FBI clearances. The child abuse clearance was last updated on 5/10/2019 and the FBI clearance was last updated on 6/15/2019. It was observed during the renewal inspection that he was caring for child 1. On 9/4/2024, certification representative went to the facility and observed that staff 1 still did not have the child abuse and FBI clearance on file. Staff 2 did admit that he was in the facility, upstairs sleeping.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). Facility Person #1 may not work in a child care position at the facility until all clearances are obtained. 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. Facility Person #1 may not work in a child care position at the facility until all clearances are obtained.

Regulation: 3290.105(a)

Description: Clean, age appropriate

Noncompliance Area: The cots that the children nap on were labeled with numbers. However, the cot list was missing.

Correction Required: Individual, clean, age-appropriate rest equipment shall be provided for preschool, toddler and infant children as agreed between the parent and the operator. The rest equipment must be labeled with the child's name and used only by the named child while enrolled in the program.

Regulation: 3290.32(a)/3290.192(3)

Description: Comply with CPSL/CPSL information

Noncompliance Area: During the renewal inspection on 8/26/2024, staff 1 did not have updated child abuse and FBI clearances. The child abuse clearance was last updated on 5/10/2019 and the FBI clearance was last updated on 6/15/2019. It was observed during the renewal inspection that he was caring for child 1.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). Facility Person #1 may not work in a child care position at the facility until all clearances are obtained. 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. Facility Person #1 may not work in a child care position at the facility until all clearances are obtained.

Regulation: 3290.95(a)/3290.95(b)

Description: System in compliance/Operator or designated staff responsibility

Noncompliance Area: During unannounced monitoring conducted on 9/21/2023, facility's OSHA-approved smoke alarms were not interconnected.

Correction Required: Fire detection devices or systems must be in compliance with standards established under section 1016(c) of the act (62 P.S. § 1016(c)). The operator or designated staff person who is responsible for compliance with this chapter shall ensure the requirements in § 3290.95(a) are met. Act 42 of 2022, signed into law July 7, 2022, amended the Fire and Panic Act at 35 P.S. § 1223.6, and requires all certified family child care homes to have interconnected smoke alarms approved, at the time of installation, by a testing laboratory recognized by the Occupational Safety and Health Administration (OSHA) of the United States Department of Labor to test and certify smoke alarms.

Regulation: 3290.105(a)

Description: Clean, age appropriate

Noncompliance Area: During renewal inspection conducted 8/8/2023, facility's rest equipment was labeled with a number and a corresponding list; however, list did not have any children's names on it.

Correction Required: (a) Individual, clean, age-appropriate rest equipment shall be provided for preschool, toddler and infant children as agreed between the parent and the operator. The rest equipment must be labeled with the child's name and used only by the named child while enrolled in the program.

Regulation: 3290.124(b)(3)/3290.124(b)(7)

Description: Parent home/work address, phone/Name/address/phone release person

Noncompliance Area: During renewal inspection conducted 8/8/2023, the following was missing from child #4's emergency contact form: Mother's work information (address and phone number) and release person's address.

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.

Regulation: 3290.151(a)(2)

Description: 12 months prior to service and every 24 months thereafter

Noncompliance Area: During renewal inspection conducted 8/8/2023, last health assessment on file for facility person #3 is dated 7/13/2021.

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.

Regulation: 3290.181(c)

Description: Emergency info/agreement updated 6 mos

Noncompliance Area: During renewal inspection conducted 8/8/2023, the following fee agreement / emergency contact forms have not been updated within the past 6 months: Child #1: fee agreement last updated 8/13/2022. Child #2: fee agreement and emergency contact form last updated 9/21/2022. Child #3: fee agreement and emergency contact form last updated 9/21/2022.

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.

Regulation: 3290.24(c)

Description: Training regarding plan

Noncompliance Area: During renewal inspection conducted 8/8/2023, facility person #3 has not been trained on emergency plan within the past year.

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.

Regulation: 3290.31(g)

Description: Age and training

Noncompliance Area: During renewal inspection conducted 8/8/2023, facility person #1 did not complete the required one-hour 2022 update to the health and safety training by 12/30/2022.

Correction Required: Staff persons shall complete professional development within 90 days of hire as listed in subsections (g)1-10. Facility person #1 shall complete the required one-hour 2022 update to the health and safety training by August 26, 2023.

Regulation: 3290.32(a)/3290.192(3)

Description: Comply with CPSL/CPSL information

Noncompliance Area: During renewal inspection conducted 8/8/2023, facility person #2 did not have child abuse clearance on file.

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. Facility Person #2 may not work in or be present in the facility while child care is occurring until appropriate clearance is in on file.

Regulation: 3290.32(a)/3290.192(3)

Description: Comply with CPSL/CPSL information

Noncompliance Area: During renewal inspection conducted 8/8/2023, facility person #2 did not have child abuse clearance on file.

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.

Regulation: 3290.64(a)

Description: Locked or inaccessible - in original container

Noncompliance Area: During renewal inspection conducted 8/8/2023, cabinet under bathroom sink containing several toxic cleaning materials was not locked. Several items labeled "Keep out of reach of children" were accessible.

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.

Regulation: 3290.117(c)

Description: Vet's certificate required

Noncompliance Area: On renewal inspection conducted 8/16/2022, the file for the dog in the facility reflected that rabies vaccine expired on 3/7/2021.

Correction Required: A veterinarian's certificate of current rabies immunization is required for a cat or dog at the facility. The certificate shall be on file when the cat or dog is present.

Regulation: 3290.124(b)(3)/3290.124(b)(7)

Description: Parent home/work address, phone/Name/address/phone release person

Noncompliance Area: During renewal inspection conducted 8/16/2022, emergency contact information for Child #1 did not include release person's address or parent's work address or phone number.

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.

Regulation: 3290.124(b)(6)

Description: Insurance coverage information

Noncompliance Area: During renewal inspection conducted 8/16/2022, emergency contact information for Child #1 and Child #3 did not include health insurance/MA policy number.

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.

Regulation: 3290.181(c)

Description: Emergency info/agreement updated 6 mos

Noncompliance Area: During renewal inspection conducted 8/16/2022, last update to fee agreement and emergency contact information: Child #1: 1/6/2022 Child #4: 2/3/2022

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.

Regulation: 3290.24(c)

Description: Training regarding plan

Noncompliance Area: During renewal inspection conducted 8/16/2022, file for Staff #1 did not contain documentation that they were trained on the emergency plan within the past year (see LIS code sheet for hire date).

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.

Regulation: 3290.24(d)

Description: Emergency plan

Noncompliance Area: During renewal inspection conducted 8/16/2022, facility had not practiced emergency drill within the past year.

Correction Required: Emergency drills shall be conducted annually. Annual emergency drills shall be documented and on file at the facility.

Regulation: 3290.31(g)

Description: Age and training

Noncompliance Area: Staff person #1 completed the following required pre-service training on 6/7/22, which is more than 90 days after their date of hire (see LIS code sheet): CCDBG Health and Safety training.

Correction Required: Staff persons shall complete professional development within 90 days of hire as listed in subsections (g)1-10.

Regulation: 3290.32(a)/3290.192(3)

Description: Comply with CPSL/CPSL information

Noncompliance Area: On renewal inspection conducted 8/16/2022, Facility person #2, a household member, did not have complete clearance information on file in the facility. No signed/dated disclosure statement on file in the facility. PSP Clearance requested 8/22/2019. No FBI clearance on file in the facility.

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. Facility person #2 will complete disclosure statement and request FBI clearances and will not be present in the facility while child child care is occurring until they are on file.

Regulation: 3290.32(a)/3290.192(3)

Description: Comply with CPSL/CPSL information

Noncompliance Area: On renewal inspection conducted 8/16/2022, Facility person #2 did not have complete clearance information on file in the facility. No signed/dated disclosure statement on file in the facility. PSP Clearance requested 8/22/2019. No FBI clearance on file in the facility.

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. Facility person #2 may not be present on the premises while child care is being provided until FBI and PSP clearances are on file at the facility.

Regulation: 3290.65(d)

Description: Contaminated trash in closed plastic-lined receptacle

Noncompliance Area: On renewal inspection conducted 8/16/2022, trash can in the bathroom of the facility containing a tissue was not contained in a closed receptacle.

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

Regulation: 3290.94(a)(9)

Description: Written record

Noncompliance Area: On renewal inspection conducted 8/16/2022, fire drills were conducted past 60 days: 11/21/21-1/31/21, 2-21/22-7/15/22

Correction Required: The operator or designated staff person who is responsible for compliance with this chapter shall conduct fire drills and ensure that a written record is maintained on file at the facility indicating the specific time of day of the drill, the hypothetical location of the fire, the evacuation time, and the names of the facility persons and the number of children who participate in the fire drill.

Regulation: 3290.95(a)/3290.95(b)

Description: System in compliance/Operator or designated staff responsibility

Noncompliance Area: On renewal inspection conducted 8/16/2022, the following dates were past 30 days on fire detection testing log: 10/10/21-11/21/21, Not tested in December 2021, 2/21/22-3/30/22, 6/18/2022-7/30/22.

Correction Required: Fire detection devices or systems must be in compliance with standards established under section 1016(c) of the act (62 P.S. § 1016(c))The operator or designated staff person who is responsible for compliance with this chapter shall ensure the requirements in § 3290.95(a) are met.

Noncompliance Area: During the annual inspection on 8/17/2020, staff 2 had a health assessment last dated 7/21/2018. As a result, the health assessment was more than 24 months old.

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.

Noncompliance Area: During the annual inspection on 8/17/2020, staff 1 and 2 only had proof of applying for the NSOR on file. The facility was not able to produce the NSOR for staff 1 and 2.

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: Child 1, who is a young toddler, did not have an updated immunization record or health assessment on file. His last health assessment was on 4/25/2019 and he had only one shot of the DTAP, HIB, Pneumococcal and Polio immunizations on file.

Correction Required: The operator shall require the parent to provide an updated health report at least every 6 months for an infant or young toddlerThe 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: Staff 1 did not have proof of applying for the NSOR on file.

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

Noncompliance Area: During the complaint investigation on 4/29/2019, certification representative, upon arrival, observed child 2 sleeping in a bouncer seat. No medical documentation was provided to the certification representative stating that child 1 was medically allowed to sleep in a bouncer seat.

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: During the complaint investigation, it was determined that child 1 was missing one TDAP shot, one HiB shot and one PCV 13 shot.

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

Noncompliance Area: During the course of a complaint investigation, it was admitted by staff 1 that staff 2 did not have a health assessment on file. When at the facility on 4/24/2019, certification representative did not observe a staff health assessment for staff 2. On 4/29/2019, certification representative observed staff 2 at the facility cooking and serving food to the children. Staff 1 was not able to provide a health assessment for staff 2.

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 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: During a complaint investigation, certification representative viewed an inspection summary written by the local municipality, signed by staff 1, stating that she transports infants in a built in car seat. On 5/2/2019, certification representative viewed the built in car seat and it is not approved for infants, as per car seat instructions.

Correction Required: A child 7 years of age or younger shall be transported in accordance with the requirements for parents and guardians as stated in 75 Pa.C.S. 4581 (relating to restraint systems).

Noncompliance Area: During a complaint investigation on 4/29/2019, the facility was observed to be cluttered, which included electrical cords on the floor by the facility's mini fridge. The provider also admitted to the facility being previously cluttered to the point where the facility changing table was not accessible. The electrical cords by the mini fridge also posed a hazard as they could aide in the mini fridge tipping over if pulled on by a child. There was also a book shelf accessible to the children in the child care area that could be easily tipped over. There were multiple items on top of the book shelf that could fall on the children, including two box fans.

Correction Required: Conditions at the facility may not pose a threat to the health or safety of the children. Floors, walls, ceilings and other surfaces, including the facility's outdoor play area, shall be kept clean, in good repair and free from visible hazards. The provider will send a health and safety checklist weekly to the Northeast Regional Office. The health and safety checklist will be approved by DHS before being implemented. The health and safety checklist will be sent over a period of three months.

Noncompliance Area: During the course of the complaint investigation, it was found that staff 2 was working alone with the children without any pediatric first aid/cpr certification. This was further proven by being documented on the local municipalities "child care facility inspection form." and staff 1 signing off on it.

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: During the course of the complaint investigation, it was found that staff 2 was working alone with the children without child abuse, FBI or state police clearances while staff 1 transported children. Staff 2 also did not have mandated reporter training on file. This was further proven by being documented on the local municipalities "child care facility inspection form" which staff 1 was signed off on. Also, on 4/29/2019, certification representative also observed staff 2 at the facility cooking and serving the children in care.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). Staff person 2 may not work in a child care position at the facility until all three clearances are obtained. 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 2 may not work in a child care position at the facility until all three clearances are obtained. Staff 1 will attend an existing provider on 8/28/2019 at the Northeast Regional Office.

Noncompliance Area: During the complaint investigation, provider admitted to cleaning toxics and medication being accessible to the children at the time the complaint was made.

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.Medication shall be stored in a locked area of the facility or in an area that is out of the reach of children. The provider will send a health and safety checklist weekly to the Northeast Regional Office. The health and safety checklist will be approved by DHS before being implemented. The health and safety checklist will be sent over a period of three months.

Noncompliance Area: The mats that are utilized for rest were not labeled with the children's names.

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: Children 1, 2 and 5 were missing the health insurance policy number on their emergency contact forms. Child 4 was missing both the health insurance coverage name and policy number.

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: Child 3 did not have a dated parental signature on the emergency contact form.

Correction Required: 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: Child 1 did not have permission for emergency medical care and minor first aid on his emergency contact form.

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: There was an uncovered outlet in the bathroom that is utilized by the children. The uncovered outlet was to the left of the sink.

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

Noncompliance Area: Under the bathroom sink, there was an unlocked cabinet with cleaner in it. Also, in the downstairs area, there was an unlocked door to the right of the steps which leads to a washer and dryer. There was laundry detergent accessible to the children on a low level shelf. As per provider, the room downstairs is utilized by children if she does need to cook since the stove is down there.

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: The refrigerator utilized for the day care did not have a thermometer in it.

Correction Required: A facility shall have an operable, clean refrigerator used to store potentially hazardous foods. The refrigerator shall be capable of maintaining food at 45 F or below. An operating thermometer shall be placed in the refrigerator.

Noncompliance Area: Certification representative observed an infant sleeping in a car seat.

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 operator did not have the emergency plan posted in a conspicuous location.

Correction Required: The operator shall post the emergency plan in the facility at a conspicuous location.

Noncompliance Area: There was an uncovered electrical outlet in the first room upon entering the facility.

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