Trena A Wilson Family Child Care Home

Regulation: 3290.121(b)

Description: Given parents in writing

Noncompliance Area: Parents did not receive in writing the facility's policy regarding supervision during the transfer of care between the child care facility and school.

Correction Required: At the time of enrollment, a parent shall receive in writing the facility's general daily schedule, hours for which care is provided, fees, responsibilities for meals, clothing, health policies, supervision policies, night care policies, dismissal policies, transportation and pick-up arrangements.

Regulation: 3290.123(b)/3290.182(8)

Description: Parent receives original/Copy of initial and subsequent agreements. Parent receives original.

Noncompliance Area: The files of Children #2, #3, #4, and #5 contained the original agreement. The facility did not make a copy for the files and give the original to the parent.

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.

Regulation: 3290.124(b)(3)

Description: Parent home/work address, phone

Noncompliance Area: Emergency contact information for Child #1 did not include the work telephone number of the enrolling parent. Emergency contact information for Child #5 did not include the work address and work telephone number of the enrolling parent.

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

Regulation: 3290.124(b)(6)

Description: Insurance coverage information

Noncompliance Area: Emergency contact information for Child #3 did not include the health insurance coverage and policy number for a child under a family policy or Medical Assistance benefits, if applicable.

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: 3290.131(b)(1)

Description: Updated infant health report: every 6 months

Noncompliance Area: The files of Children #2 and #3 lacked an updated health report at least every 6 months for an infant or young toddler. The file of Child #2 contained health reports dated 10/22/24, 12/31/24, and 2/10/26. The file of Child #3 contained health reports dated 10/23/23, 5/12/25, and 11/17/25.

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.

Regulation: 3290.131(b)(2)

Description: Updated toddler/preschool health report: every 12 months

Noncompliance Area: The file of Child #5 lacked an updated health report at least every 12 months for an older toddler or preschool child. The file of Child #5 contained a health report dated 7/2/25 with a previous one dated 3/7/24.

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.

Regulation: 3290.131(d)(5)/3290.131(e)(3)

Description: Immunization record/Dismissal policy

Noncompliance Area: Child #2, a young toddler, lacked DTAP/DTP/TD and Pneumococcal immunizations according to the recommendations of the ACIP. Child #2 had documentation of 3 DTAP/DTP/TD immunizations and 3 Pneumococcal immunizations.

Correction Required: A health report shall include a review of the child's immunized status according to recommendations of the ACIP. The facility shall implement dismissal policies in accordance with the Department of Health regulation in 28 Pa. Code § 27.77 (relating to immunization requirements for children in child care group settings).

Regulation: 3290.134(a)

Description: Child's hands washed

Noncompliance Area: Staff did not ensure that a child's hands were washed after being diapered. Staff used a wipe to wash the mobile child's 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.

Regulation: 3290.135(a)(3)

Description: Disposable diapers

Noncompliance Area: Observed a soiled diaper being placed in a plastic bag instead of being discarded immediately by placing it into a plastic-lined, 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: 3290.151(a)(2)/3290.192(2)

Description: 12 months prior to service and every 24 months thereafter/Health assessment, TB test

Noncompliance Area: The file of Staff #1 lacked a health assessment conducted every 24 months. The file of Staff #1 contained a current health assessment dated 2/6/26 with a previous one dated 7/6/23.

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.

Regulation: 3290.18

Description: General Health and Safety

Noncompliance Area: Observed boards with exposed nails beside the picnic table in the outdoor play space. Observed a garden rake in the outdoor play space. Observed an extension cord lying in the grass in the outdoor play space which was not secured creating a potential tripping and/or strangulation hazard.

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

Regulation: 3290.18

Description: General Health and Safety

Noncompliance Area: Staff person #1 was observed to be caring for children unsupervised. Staff person #1 has not completed mandated reporter training within the last 60 months. This is evidenced by the previously documented mandated reporter training on file being dated 2/18/21.

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. Until such time as the required pre- service trainings are completed, staff person #1 must be supervised, when interacting with children, at a minimum by, a family child care 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 #1, staff person #1 may not work in a child-care position at the facility.

Regulation: 3290.24(c)

Description: Training regarding plan

Noncompliance Area: The file of Staff #1 lacked documentation of emergency plan training on an annual basis. The file of Staff #1 contained documentation of emergency plan training completed on 2/4/26 with previous training completed on 1/30/25.

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: Emergency drills were not conducted annually. The facility provided documentation of emergency drills being conducted on 4/16/24 and 8/8/24.

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

Regulation: 3290.24(f)

Description: Emergency plan

Noncompliance Area: At the time of the inspection the operator was unable to provide documentation of the letter provided to the parent explaining emergency procedures that addressed shelter and lockdown, evacuation, method to contact parents, method to inform parents the emergency has ended and instructions for how to safely be reunited with their children, and accommodations for infants, toddlers, children with disabilities, and children with chronic medical conditions.

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

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

Description: Age and training

Noncompliance Area: Staff #1 lacked renewal of their certification in pediatric first aid and pediatric cardiopulmonary resuscitation (CPR) on or before the expiration of the most current certification. Staff #1 had documentation of first aid and CPR training completed on 5/7/25 with a previous training completed on 4/11/23 with an expiration of 4/25.

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.

Regulation: 3290.32(a)

Description: Comply with CPSL

Noncompliance Area: Staff person #1 has not completed mandated reporter training within the last 60 months. This is evidenced by the previously documented mandated reporter training on file being dated 2/18/21.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to Child Protective Services). Until such time as the required training has been completed, staff person #1 must be supervised, when interacting with children at a minimum by, a family child care 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 #1, staff person #1 may not work in a child-care position at the facility.

Regulation: 3290.32(a)/3290.192(3)

Description: Comply with CPSL/CPSL information

Noncompliance Area: The file of Staff #1 lacked a State Police Clearance, Child Abuse Clearance, and DHS FBI Clearance updated every 60 months. The file of Staff #1 contained a State Police Clearance dated 2/4/26 with a previous one dated 10/1/20. The file of Staff #1 contained a Child Abuse Clearance dated 2/10/26 with a previous one dated 10/13/20. The file of Staff #1 contained a DHS FBI Clearance dated 2/5/26 with a previous one dated 10/10/20.

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: 3290.63

Description: Protective Outlet Covers 5 yrs. or less

Noncompliance Area: Observed an electrical outlet which lacked a protective receptacle cover behind the recliner located beside the kitchen entrance.

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

Regulation: 3290.94(a)(1)

Description: Every 60 days

Noncompliance Area: The operator did not ensure that fire drills were conducted at least once every 60 days. The facility provided documentation of fire drills being conducted on 2/5/25, 4/4/25, 6/3/25, 8/30/25, 10/29/25, 12/19/25, and 2/17/26.

Correction Required: Fire drills are conducted at least once every 60 days.

Regulation: 3290.94(a)(5)

Description: Evacuation routes posted

Noncompliance Area: An evacuation route was not posted in a conspicuous location in the attic of the facility.

Correction Required: Evacuation routes are posted in a conspicuous location on each floor of the facility.

Regulation: 3290.95(a)/3290.95(b)

Description: System in compliance/Operator or designated staff responsibility

Noncompliance Area: The facility was unable to provide documentation that the fire detection system was manually tested at least every 30 days. The facility provided documentation that the fire detection system was manually tested on 3/5/25, 4/4/25, 5/2/25, 6/2/25, 7/2/25, 8/1/25, 9/1/25, 10/1/25, 10/31/25, 11/30/25, 12/30/25, 1/29/26, and 2/28/26.

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 subsection (a) are met.

Regulation: 3290.134(a)

Description: Child's hands washed

Noncompliance Area: Observed a staff person who did not ensure that a child's hands were washed after being diapered.

Correction Required: A staff person shall ensure that a child's hands are washed before meals and snacks, after toileting and after being diapered.

Regulation: 3290.152

Description: Adult Hygiene

Noncompliance Area: Observed a staff person who did not wash her hands after diapering a child.

Correction Required: A facility person shall wash his hands before meals and snacks, and after toileting and after diapering a child.

Regulation: 3290.94(a)(1)

Description: Every 60 days

Noncompliance Area: 2nd citation. Previously cited on 3/10/25. The operator or designated staff person who is responsible for compliance with this chapter did not ensure that fire drills were conducted at least once every 60 days. The operator provided documentation that fire drills were conducted on 2/12/24, 4/12/24, 6/18/24, 8/19/24, 10/18/24, 12/18/24, and 2/5/25.

Correction Required: The operator or designated staff person who is responsible for compliance with this chapter shall conduct fire drills and ensure that fire drills are conducted at least once every 60 days.

Regulation: 3290.95(a)/3290.95(b)

Description: System in compliance/Operator or designated staff responsibility

Noncompliance Area: 2nd citation. Previously cited on 3/10/25. The facility was unable to provide written documentation that the fire detection system was manually tested at least every 30 days. The facility provided a written record that the fire detection system was manually tested on 3/12/24, 4/12/24, 5/12/24, 6/12/24, 7/12/24, 8/12/24, 9/12/24, 10/12/24, 11/12/24, 12/12/24, 1/10/25, and 2/7/25.

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: 3290.102(f)

Description: No hazardous toys/equipment

Noncompliance Area: Observed a Bumbo Seat which lacked a strap to secure infants in the seat.

Correction Required: Children's toys and equipment, including furniture and rest equipment, described as hazardous by the United States Consumer Product Safety Commission may not be used by children at the facility.

Regulation: 3290.123(a)(3)

Description: Services provided

Noncompliance Area: The file of Child #1 lacked child service reports completed at least every 6 months. Child #1, with an admission date of 8/19/24, contained a child service report dated 8/28/24.

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: 3290.123(b)/3290.182(8)

Description: Parent receives original/Copy of initial and subsequent agreements. Parent receives original.

Noncompliance Area: The files of Children #1, #4, and #5 contained the original agreement. The facility did not make a copy for the files and give the original to the parent.

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.

Regulation: 3290.124(b)(2)

Description: Physician name, address, phone

Noncompliance Area: Emergency contact information for Child #2 did not include the complete address of the child's physician or source of medical care.

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

Regulation: 3290.124(b)(3)

Description: Parent home/work address, phone

Noncompliance Area: Emergency contact information for Child #2 did not include the complete work address of the enrolling parent. Emergency contact information for Child #5 did not include the work address of the enrolling parent.

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

Regulation: 3290.124(b)(7)

Description: Name/address/phone release person

Noncompliance Area: Emergency contact information for Child #5 did not include the address of the individual 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.

Regulation: 3290.131(b)(1)

Description: Updated infant health report: every 6 months

Noncompliance Area: The file of Child #4 lacked an updated health report at least every 6 months for an infant or young toddler. The file of Child #4 contained health reports dated 8/1/23, 3/6/24, and 10/22/24.

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.

Regulation: 3290.18

Description: General Health and Safety

Noncompliance Area: The file of Staff #1 lacked documentation of completing the Pennsylvania Health and Safety Update 2022 by December 30, 2022 (SEE LIS Code Sheet). The file of Staff #1 contained documentation of completing the health and safety update on 2/22/23. The facility had a policy that addressed the recognition of potential signs and symptoms of shaken baby syndrome and abusive head trauma and strategies for coping with a crying, fussing, and distraught child, but the policy did not address the prevention and identification of child maltreatment

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

Regulation: 3290.181(c)

Description: Emergency info/agreement updated 6 mos

Noncompliance Area: The financial agreement for Child #3 was not reviewed and updated at least once in a 6-month period. Child #3's agreement was reviewed on 2/22/24 and 8/22/24.

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(a)(2)

Description: Emergency plan

Noncompliance Area: The facility did not have an emergency plan that provides for accommodations for evacuation of children from the facility building and evacuation of children to a location away from the facility premises. The evacuation routes and evacuation plans to exit the building may be the same as those required by §  3290.94 (relating to fire drills).

Correction Required: The facility shall have an emergency plan that provides for accommodations for evacuation of children from the facility building and evacuation of children to a location away from the facility premises. The evacuation routes and evacuation plans to exit the building may be the same as those required by §  3290.94 (relating to fire drills).

Regulation: 3290.32(a)/3290.192(3)

Description: Comply with CPSL/CPSL information

Noncompliance Area: The file of Staff #1 lacked a Child Abuse Clearance updated every 60 months. The file of Staff #1 contained a Child Abuse Clearance dated 10/13/20 with a previous one dated 10/7/15.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). A facility person's record shall include 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: 3290.32(a)/3290.192(4)

Description: Comply with CPSL/Required training

Noncompliance Area: Staff #1 lacked documentation of completing mandated reporter training every 60 months (SEE LIS Code Sheet). Staff #1 had documentation of mandated reporter training completed on 2/18/21.

Correction Required: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). A facility person's record shall include records of training required by the Department.

Regulation: 3290.72

Description: Emergency Numbers Posted

Noncompliance Area: The telephone number of the nearest hospital was not posted by each telephone in the facility.

Correction Required: The telephone number of the nearest hospital, police department, fire department, ambulance and poison control center shall be posted by each telephone in the facility.

Regulation: 3290.74(a)

Description: Requirements

Noncompliance Area: Observed approximately a 4-inch by 6-inch hole in the siding along the sidewalk in the outdoor play space. Observed approximately a 1-inch by 1-inch hole in the siding above the 4-inch by 6 -inch hole along the sidewalk in the outdoor play space. Observed approximately a 1-inch by 1-inch hole in the siding under the faucet in the outdoor play space. Observed 3 protruding screws to the right of the faucet in the outdoor play space.

Correction Required: 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.

Regulation: 3290.94(a)(1)

Description: Every 60 days

Noncompliance Area: The operator or designated staff person who is responsible for compliance with this chapter did not ensure that fire drills were conducted at least once every 60 days. The operator provided documentation that fire drills were conducted on 2/12/24, 4/12/24, 6/18/24, 8/19/24, 10/18/24, 12/18/24, and 2/5/25.

Correction Required: The operator or designated staff person who is responsible for compliance with this chapter shall conduct fire drills and ensure that fire drills are conducted at least once every 60 days.

Regulation: 3290.95(a)/3290.95(b)

Description: System in compliance/Operator or designated staff responsibility

Noncompliance Area: The facility lacked an interconnected smoke alarm system on each level of the residence. The facility had smoke detectors powered by a non-replaceable lithium battery on each floor and in the basement. The facility was unable to provide written documentation that the fire detection system was manually tested at least every 30 days. The facility provided a written record that the fire detection system was manually tested on 3/12/24, 4/12/24, 5/12/24, 6/12/24, 7/12/24, 8/12/24, 9/12/24, 10/12/24, 11/12/24, 12/12/24, 1/10/25, and 2/7/25.

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: 3290.123(a)(4)

Description: Arrival/departure times

Noncompliance Area: The agreement on file for Child #1 was observed not to contain the child's arrival and departure times.

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

Regulation: 3290.123(a)(5)

Description: Designated release persons

Noncompliance Area: The agreement on file for Child #1 was observed not to specify the persons designated by a 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.

Regulation: 3290.123(a)(7)

Description: Services considered extra

Noncompliance Area: The agreement on file for Child #1 was observed not to specify the services which are to be considered as extra.

Correction Required: An agreement shall specify the services which are to be considered as extra.

Regulation: 3290.18

Description: General Health and Safety

Noncompliance Area: It was observed that the hand railing on the stairs to enter the facility were unstable and not attached to the main posts causing a falling hazard. The facility's emergency plan did not contain a plan to address the continuity of operations and specify the role of a volunteer, if applicable. A toilet bowl bolt was observed to be exposed and not covered.

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

Regulation: 3290.75(a)

Description: No peeling paint or plaster

Noncompliance Area: It was observed peeling drywall/paint located on the hallway wall going to the upstairs bathroom.

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

Regulation: 3290.94(a)(1)

Description: Every 60 days

Noncompliance Area: The facility's fire drill was observed not to have conducted fire drills at least once every 60 days. This is evidenced by 4/7/23 to 6/8/23 and 8/8/23 to 10/9/23 12/1/24 to 2/23/24.

Correction Required: The operator or designated staff person who is responsible for compliance with this chapter shall conduct fire drills and ensure that fire drills are conducted at least once every 60 days.

Regulation: 3290.95(a)/3290.95(b)

Description: System in compliance/Operator or designated staff responsibility

Noncompliance Area: The facility's fire drill was observed not to have documentation of testing the smoke detectors every 30 days.

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: 3290.123(a)(1)/3290.123(a)(2)

Description: Amount of fee/Date fee to be paid

Noncompliance Area: The agreement form on file for Child #3 was observed not to contain the fee amount nor the date that the fee is to be paid.

Correction Required: An agreement shall specify the amount of the fee to be charged per day or per week. An agreement shall specify the date on which the fee is to be paid.

Regulation: 3290.124(b)(2)

Description: Physician name, address, phone

Noncompliance Area: The emergency contact form on file for Child #1 was observed not to contain the address 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.

Regulation: 3290.124(b)(5)

Description: Information re: disability

Noncompliance Area: The emergency contact form on file for Child #1 was observed not to contain information on the child's special needs, as specified by the child's parent, physician, or physicians assistant or CRNP, which is needed in an emergency situation.

Correction Required: Emergency contact information must include information on the child's special needs, as specified by the child's parent, physician, physician's assistant of CRNP, which is needed in an emergency situation.

Regulation: 3290.124(b)(6)

Description: Insurance coverage information

Noncompliance Area: The emergency contact form on file for child #3 was observed not to contain health insurance coverage and policy number for a child under a family policy or Medical Assistance benefits, if applicable.

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: 3290.131(d)(5)/3290.131(e)(3)

Description: Immunization record/Dismissal policy

Noncompliance Area: The health report on file for children #1, #2, and #3 were observed not to contain documentation of an influenza vaccine being administered within the last year in accordance with 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. The facility shall implement dismissal policies in accordance with the Department of Health regulation in 28 Pa. Code § 27.77 (relating to immunization requirements for children in child care group settings).

Regulation: 3290.151(a)(2)

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

Noncompliance Area: The most up to date health assessment on file for staff person #1 was observed to be greater than 24 months. This is evidenced by the last health assessment being dated 6/23/20.

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: 3290.95(a)/3290.95(b)

Description: System in compliance/Operator or designated staff responsibility

Noncompliance Area: The facility fire drill log showed that the facility has not been regularly testing the facility's fire drill system every 30 days since 2/23/22.

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.

Regulation: 3290.131(e)(1)

Description: Parent written verification from Doctor.

Noncompliance Area: The health report on file for children #1, #2 and #3 did not contain documentation of an influenza shot being administered with in the last year in accordance with the recommendations of 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.

Regulation: 3290.94(a)(5)

Description: Evacuation routes posted

Noncompliance Area: It was observed that the facility did not have evacuation routes posted in a conspicuous location on each floor of the facility.

Correction Required: The operator or designated staff person who is responsible for compliance with this chapter shall conduct fire drills and ensure that evacuation routes are posted in a conspicuous location on each floor of the facility.

Regulation: 3290.94(a)(9)

Description: Written record

Noncompliance Area: The facility fire drill log showed that the facility did not conduct fire drills every 60 days. This is evidenced by there being a gap of more than 60 days from 2/21/21 to 6/10/21 and 6/10/21 to 10/13/21.

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: The fire drill log showed that the facility has not been regularly testing the facility's fire detection system every 30 days since 2/17/2021.

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: The agreement form for child #3 lacked the arrival and departure times.

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

Noncompliance Area: The emergency contact information for child #1 lacked the complete address of the child's physician or source of medical care.

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 emergency contact information for child #1 lacked the complete work address of 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 information for child #1 lacked the complete address 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 file for child #1, enrollment date 11/01/2019, lacked an initial health report within 60 days of enrollment; the initial health report on file was dated 01/28/2020

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 #1, a 2-year-old, included a record of the child's immunization status which lacked an influenza immunization. The file for child #2, a 2-year-old, included a record of the child's immunization status which lacked a current influenza immunization.

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 emergency contact information and the financial agreement for children #2 and #4 lacked a review by a parent at least once every 6 months. The forms for child #2 has a recent review dated 01/01/2020 with the previous review on 03/08/2019. The forms for child #4 has a recent review dated 03/02/2020 with the previous review on 03/18/2019.

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: Observed a window in the second floor bathroom which was able to be opened greater than 6 inches.

Correction Required: Windows or doors above the ground floor that open directly to the outdoors and are accessible to children shall be constructed, modified or adapted to limit the opening to 6 or fewer inches.

Noncompliance Area: Observed bolts securing the gate to the post next to the back door in which the sharp point on the end protruded through the wood creating a sharp point. Observed a loose handrail on the right side at bottom of the steps and on the left side in the middle of the steps leading up to the front entrance.

Correction Required: 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.

Noncompliance Area: Observed 2 children sleeping on rest mats in the front playroom with less than 2 feet of space on three sides during naptime.

Correction Required: At least 2 feet of space is required on three sides of a bed, cot, crib or other rest equipment while the equipment is in use.

Noncompliance Area: The files for children #1, #3 and #4 lacked child service reports with information about the child's growth and development at least once every 6 months. The file for child #1, with an initial enrollment date of 01/20/2015, contained a current child service report completed on 12/06/2018 with no additional child service reports on file. The file for child #3, with an initial enrollment date of 08/17/2017, contained a current child service report dated 12/06/2018 and a previous child service report dated 04/06/2018 with no additional child service reports on file. The file for child #4, with an initial enrollment date of 08/14/2017, contains a current child service report dated 12/06/2018 and a previous child service report dated with no additional child service reports 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).

Noncompliance Area: The files for children #1, #2, #3 and #4 lacked a review by a parent of the emergency contact and financial agreement form at least once every 6 months. The file for child #1 has documentation of a recent review on 01/17/2019 and previous reviews dated 12/04/2017 and 02/02/2017 with no additional reviews documented. The file for child #2 has documentation of a recent review on 03/08/2019 with a previous review documented on 05/23/2018.with no additional reviews documented. The file for child #3 has documentation of a recent review on 03/07/2019 with previous reviews documented on 03/07/2018.with no additional reviews documented. The file for child #4 has documentation of a recent review on 03/08/2019 with a previous review dated 05/23/2018 with no additional reviews documented.

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 file for child #1 lacked an updated health report for an older toddler or preschool child at least once every 12 months. The file for child #1 contains a current health report dated 01/30/2019 and a previous health report dated 01/23/2017.

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 file for child #4, a 2 year old, included a record of the child's immunization status which lacked a second does of Hep A and an influenza immunization. The file for child #1, 4 year old, included a record of the child's immunization status which lacked a current influenza immunization.

Correction Required: The facility may not accept or retain an infant 2 months of age or older, a toddler or a preschool child at the facility for more than 60 days following the first day of attendance at the facility unless the parent provides written verification from a physician, physician's assistant, CRNP, the Department of Health or a local health department of the dates (month, day and year) the child was administered immunizations in accordance with the recommendations of the ACIP.

Noncompliance Area: Observed prescription medication for child #3 with an expiration date of 12/2018.

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

Noncompliance Area: The diaper changing area at the facility lacked a hands-free covered can for the immediate disposal of soiled diapers.

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.

Noncompliance Area: Observed staff person #1 use a diaper wipe in lieu of a sanitizing solution to wipe the changing pad following a diaper change.

Correction Required: Diaper changing surfaces shall be cleaned after each use by wiping the surface with a sanitizing solution or by changing a pad or other surface covering.

Noncompliance Area: The file for staff person #1 lacked an updated health assessment a least once every 24 months; the most recent health assessment was completed on 02/15/2017.

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: Observed an electrical outlet in the upstairs hallway which lacked a protective receptacle cover.

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

Noncompliance Area: Observed sharp knives and adult scissors in an unlocked drawer in the kitchen. The kitchen is accessible to preschool and school-age children in care.

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

Noncompliance Area: Observed an electrical outlet in the living room next to the sofa and the recliner which lacked protective receptacle covers which were accessible to toddlers and preschoolers in care.

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

Noncompliance Area: On 09/26/2018, observed antibacterial gel, shampoo and lotion on the edge of the kitchen counter next to the door leading to the living room which were accessible to preschool children in care. Observed baby powder on the floor in the living room which were accessible to toddlers and preschool children in care. Observed hairspray and deodorant on the bathroom counter in the bathroom used by the preschool children in care. The door leading from the bathroom into the laundry room was unlocked; observed laundry detergent in the room which were accessible to the preschool children in care. Observed shampoo, conditioner and body soap on the ledge of the bathtub which were accessible to the preschool children in care. On 11/07/2018, observed the laundry room door unlocked and open, laundry detergent was accessible on the lower 2 shelves which were accessible to the children in care. Lotions and creams were observed on the kitchen counters which were accessible to the children in care.

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 a missing ceiling tile in the kitchen and broken ceiling tiles in the kitchen which were loose.

Correction Required: 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.

Noncompliance Area: On 09/26/2018, observed peeling paint on the floor of the front porch next to the entry door used by children to enter the home. On 11/07/2018, observed peeling paint on the floor of the front porch next to the entry door used by children to enter the home.

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

Noncompliance Area: Observed a Little Tykes toy box with visible dirt on the front of the toy box located in the playroom. Observed a crack in a Little Tykes toy shopping cart located in the playroom which created a pinch hazard.

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 files for children #1 (enrollment date 08/14/2017), #3 (enrollment date 08/17/2017), #4 (enrollment date 08/14/2018) and #5 (enrollment date 10/16/2015) lacked completed child service reports with information about the child's growth and development at least once every 6 months.

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 file for child #3 lacked the complete address of the child's physician or source of medical care on the emergency contact form.

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 #3 lacked the complete work address of the enrolling parent on the emergency contact form.

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

Noncompliance Area: The files for children #2 and #5 lacked the addresses of the individuals designated by the parent to whom the child may be released on the emergency contact form.

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 files for children #1, #2, #3, #4 and #5 lacked a review of the emergency contact and financial agreement form by a parent at least once every 6 months. The emergency contact form for child #1 was reviewed on 03/17/2018 with the original signature dated 08/13/2017; the agreement form was dated 08/13/2017 with no additional reviews documented. The emergency contact form for child #2 was reviewed on 05/23/2018 with the original signature dated 08/14/2017; the agreement form was dated 08/14/2017 with no additional reviews documented. The emergency contact and agreement forms for child #3 were reviewed on 05/25/2018 with the original signature dated 08/15/2017. The emergency contact and agreement forms for child #4 were reviewed on 05/23/2018 with the original signature dated 08/14/2018. The emergency contact and agreement forms for child #5, with an enrollment date of 10/16/2015, were updated on 05/23/2018 with no additional documentation of reviews on file.

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 file for child #1 lacked an updated health report at least once every 6 months for an infant; the file contains an initial health report dated 11/06/2017 with no additional health reports on file. The file for child #4 lacked an updated health report at least once every 6 months for a young toddler; an initial heath report dated 10/26/2017 and an immunization record dated 01/25/2018 were 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 toddler

Noncompliance Area: The file for child #5 lacked an updated health report at least once every 12 months for a preschool child. The file contained a current health report dated 05/24/2018 and a previous health report dated 11/07/2018 with no additional health reports 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: Observed medications on the top of the stove which were accessible to preschool and school-age children in care. Observed an Epi-pen for child #6 in an unlocked drawer next to the sofa in the living room which was accessible to children.

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.

Noncompliance Area: Observed an Epi-pen for child #6 which lacked a medication log with written consent by a parent for administration

Correction Required: A parent shall provide written consent for administration of medication or a special diet. An operator is responsible to establish and maintain a medication log if prescription or nonprescription medication is administered.

Noncompliance Area: The file for child #5, with an enrollment date of 10/16/2015, lacked copies of the initial and subsequent agreements between the parent and the operator. The file contains a current agreement form dated 05/23/2018 with no additional agreements on file.

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 facility lacked a copy of the current certificate of compliance posted in a conspicuous location used by parents; a copy of the certificate of compliance which expired on 03/18/2018 was posted in the kitchen.

Correction Required: The facility's current certificate of registration 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: The operator lacked documentation in writing of an annual review of the emergency plan in the previous 12 months; the previous review was documented on 02/01/2017.

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.

Noncompliance Area: Observed 2 tubes of toothpaste labeled keep of out of reach of children in an unlocked drawer located at the sink in the bathroom used by children. Observed a variety of deodorants on the shelf next to the sink in the bathroom used by children which were accessible to the preschool and school-age children in care.

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 ant baits at the following locations in the kitchen: on the kitchen table, on the trash bin, on the floor beside the refrigerator and on the floor under the table which were accessible to the preschool and school-age children eating lunch at the kitchen table.

Correction Required: Cleaning materials and other toxic materials shall be used in a way that does not contaminate play surfaces, food, food preparation areas and does not constitute a hazard to the children.

Noncompliance Area: Observed a window in the bathroom located on the second story of the home which was open approximately 12 inches. The window was next to the toilet used by the children in care.

Correction Required: Windows or doors above the ground floor that open directly to the outdoors and are accessible to children shall be constructed, modified or adapted to limit the opening to 6 or fewer inches.