West End Day Care

Noncompliance Area: During the in-person inspection on 11/23/20, emergency forms for the children were not located in the front room where 3 children were receiving care.

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

Noncompliance Area: The written plans for emergency transportation for medical care is not posted in each child care space.

Correction Required: A written plan identifying the means of transporting a child to emergency care and staffing provisions in the event of an emergency shall be displayed conspicuously in every child care space and shall accompany a staff person who leaves on an excursion with children.

Noncompliance Area: Child #1 has a start date of 7/16/19 but does not have an initial health report on file. This is greater than 90 days since the child began attending. The director reports that the child is new to the area and the family is trying to find a new physician.

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. Due to the Covid-19 pandemic, the initial health report shall be provided no later than 90 days following the first day of attendance at the facility.

Noncompliance Area: During the electronic file review portion of the renewal inspection, facility person #1 has a health assessment dated 10/19/18 and facility person #3 has a health assessment dated 10/22/20. Both are more than 24 months old.

Correction Required: A facility person providing direct care who comes into contact with the children or who works with food preparation shall have a health assessment conducted within 12 months prior to providing initial service in a child care setting and every 24 months thereafter. A health assessment is valid for 24 months following the date of signature, if the person does not contract a communicable disease or develop a medical problem.

Noncompliance Area: During the electronic file review on 11/2/20 it was observed that Facility person #1 has a child abuse clearance dated 10/30/15. Facility person #2 also has a child abuse clearance dated 10/30/20. Both of these are more than 60 months old and are considered to be expired. Facility person #3 has a PSP clearance dated 10/19/15, which is also expired. Facility person s#2 and #3 also have mandated reporter of abuse training that is dated 10/16/15 and 10/20/15 respectively. These are also more than 60 months old.

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 Persons #1, #2 and #3 may not work in a child care position at the facility.

Noncompliance Area: On 11/7/19, a written plan for transporting a child for emergency care is not posted in the each child care space. When Rep returned to verify corrections, a written plan for transporting a child for emergency care was still not posted or in the excursion bag.

Correction Required: A written plan identifying the means of transporting a child to emergency care and staffing provisions in the event of an emergency shall be displayed conspicuously in every child care space and shall accompany a staff person who leaves on an excursion with children.

Noncompliance Area: On 11/7/19, child #1 is a 2 yr old and has only 1 dose of Hep A vaccine. Child #3 is a 20 month old and had only 3 doses of DTAP and pneumococcal vaccines. The is not in accordance with the ACIP recommended schedule. When Rep returned to verify corrections on 11/25/29, child #1 still did not have a second dose of Hep A documented and Child #3 only has 3 doses of DTAP and pneumococcal vaccines and should have 4 doses of those.

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: Rep observed that sinks in the lunch area have a build up of residue around them.

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: Children #1 & #2 do not have health insurance information on the emergency contact information form.

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: A written plan for transporting a child for emergency care is not posted in the each child care space.

Correction Required: A written plan identifying the means of transporting a child to emergency care and staffing provisions in the event of an emergency shall be displayed conspicuously in every child care space and shall accompany a staff person who leaves on an excursion with children.

Noncompliance Area: Child #1 is a 2 yr old and has only 1 dose of Hep A vaccine. Child #3 is a 20 month old and had only 3 doses of DTAP and pneumococcal vaccines. The is not in accordance with the ACIP recommended schedule.

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: Facility person #1 does not have 6 hours of annual training during the training year 7/18/- 7/19. Required annual hours are complete for current training year.

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

Noncompliance Area: All staff have pediatric first aid/CPR certification that expired on 10/2/18. Evidence of a scheduled first aid/CPR class is on file.

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: Rep observed an uncovered accessible outlet behind the TV in the preschool/napping room.

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

Noncompliance Area: Rep observed a plastic bag on the bottom shelf of the changing table that is accessible to infants & young toddlers.

Correction Required: Toys and objects with a diameter of less than 1 inch, objects with removable parts that have a diameter of less than 1 inch, plastic bags and styrofoam objects may not be accessible to children who are still placing objects in their mouths.

Noncompliance Area: Rep observed a nap mat with a large hole on the corner of the covering.

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: The emergency plan has not been reviewed since 1/2018. Staff last had emergency plan training in 1/2018.

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

Noncompliance Area: Rep observed an area of paneling that was peeling near the window in the back room.

Correction Required: Floors, walls, ceilings and other surfaces, including the facility's outdoor play space surfaces shall be kept clean, in good repair and free from visible hazards.

Noncompliance Area: The embedded equipment in the play yard is not mounted over 9 in. of wood mulch. The wood mulch around the equipment measures 4- 8in. deep.

Correction Required: Outdoor equipment that requires embedded mounting must be mounted over a loose-fill or unitary playground protective surface covering that meets the recommendations of the United States Consumer Product Safety Commission. The equipment must be anchored firmly and be in good repair.

Noncompliance Area: Observed plastic bags in the front and back rooms in various places that are accessible to infants and young toddlers in care. Pushpins on the bulletin board in the front room are accessible to young toddlers and infants who are walking or standing up.

Correction Required: Toys and objects with a diameter of less than 1 inch, objects with removable parts that have a diameter of less than 1 inch, plastic bags and styrofoam objects may not be accessible to children who are still placing objects in their mouths.

Noncompliance Area: Observed an infant sleeping in a pack & play with a pacifier with a stuffed toy on the end. A few other plastic toys were inside the pack & play as well.

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

Noncompliance Area: When Rep arrived at the facility two staff were present with 7 children including 1 infant and one young toddler and 5 preschoolers. When Rep asked staff person to identify her supervision group, she said all of these and motioned to all the children present. The director then said that they supervise all of the children together. Rep explained that children must be assigned to specific staff. Later during the inspection, Rep observed a young toddler leave the back room and walk through the eating area into the front room by herself. Staff did not follow her and seemed unaware that she had left. When a staff came out of bathroom, she asked where child was and director went into front room and got her.

Correction Required: Children on the facility premises and on facility excursions off the premises shall be supervised by a staff person at all times. Outdoor play space used by the facility is considered part of the facility premises. Each staff person shall be assigned the responsibility for supervision of specific children. The staff person shall know the names and whereabouts of the children in his assigned group. The staff person shall be physically present with the children in his group on the facility premises and on facility excursions off the facility premises.

Noncompliance Area: Child #1, date of admission 3/4/18, does not have a child service report on file.

Correction Required: 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 in 3270.124(f) (relating to emergency contact information).

Noncompliance Area: Children #1 and #2 do not have addresses for release person on the emergency information 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: Staff person #1 has a note from a doctor stating that patient had well exam. This does not include a statement that the staff is free from communicable disease and that staff is fit to provide child care.

Correction Required: An adult health assessment must include an examination for communicable diseases and the results of that examination. An adult health assessment must include the physician's or CRNP's assessment of the person's suitability to provide child care.

Noncompliance Area: Observed infant bottles not labeled with child's name.

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

Noncompliance Area: The certificate of compliance that is posted expired on 2/20/17.

Correction Required: The facility's current certificate of compliance and a copy of the applicable regulations under which the facility is certified shall be posted in a conspicuous location used by parents, with instructions for contacting the appropriate regional day care office posted at the same location.

Noncompliance Area: The first aid kit in the back room does not contain gloves.

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

Noncompliance Area: An infant was given a snack and her hands were not washed prior to eating. Also observed a staff person change a child's gloves while changing a child and then carrying the child around without removing the contaminated gloves.

Correction Required: A facility person and an able child shall wash his hands after toileting and before eating. A sign on which this requirement is written shall be posted at each toilet, training chair, diapering area and sink in the facility.

Noncompliance Area: MULCH AROUND THE METAL CLIMBERS AND THE SMALL SWING SET IS MEASURED AT ABOUT 6 INCHES DEEP. THIS EQUIPMENT IS EMBEDDED.

Correction Required: Outdoor equipment that requires embedded mounting must be mounted over a loose-fill or unitary playground protective surface covering that meets the recommendations of the United States Consumer Product Safety Commission. The equipment must be anchored firmly and be in good repair.

Noncompliance Area: OBSERVED PLASTIC BAGS HANGING NEAR THE CHANGING TABLE AND IN THE CUBBIES THAT ARE ACCESSIBLE TO INFANTS AND YOUNG TODDLERS.

Correction Required: Toys and objects with a diameter of less than 1 inch, objects with removable parts that have a diameter of less than 1 inch, plastic bags and styrofoam objects may not be accessible to children who are still placing objects in their mouths.

Noncompliance Area: CHILD #1 DOES NOT HAVE FEE AMOUNT ON THE AGREEMENT.

Correction Required: An agreement shall specify the amount of the fee to be charged per day or per week.

Noncompliance Area: CHILD #2 DOES NOT HAVE ADDRESS FOR RELEASE PERSONS ON EMERGENCY INFORMATION 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: CHILD #3 DOES NOT HAVE WRITTEN PARENTAL CONSENT FOR ADMINISTRATION OF MINOR FIRST AID.

Correction Required: A child's record shall contain signed parental consent for administration of minor first-aid procedures by facility staff. Written consent is required prior to admission.

Noncompliance Area: EMERGENCY NUMBERS ARE NOT POSTED NEAR THE TELEPHONE IN THE ROOM AT THE BA

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.

Noncompliance Area: A FIRST AID KIT IS NOT PRESENT IN THE ROOM AT THE BACK OF THE FACILITY.

Correction Required: A first-aid kit shall be in a child care space.