Judith E Wells Family Day Care

Noncompliance Area: The most current immunization record on file for child #4 lacks 1 Flu shot within the past 12 months as in accordance with the schedule recommended by the ACIP. Previously cited on 12/19/2019 under SIN-00167646.

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 file for household member #2, an FBI Clearance. Previously cited on 12/19/ 2019 under SIN - 00167646.

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 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.

Noncompliance Area: In the main child care space, observed a drawer with crayons, a drawer with colored pencils, and a drawer with markers which had a diameter of less than 1 inch and were in reach of a young toddler, who is still placing objects in his/her mouth.

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 a young toddler being placed in a pack n play. The pack n play was not labeled with that child's name.

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 fee agreement on file for child #2 lacks the fee amount and the date on which 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.

Noncompliance Area: The file for child #4, lacks a child service report within the past six 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 fee agreements on file for children #1, 2, 3, 4 and 5 were the originals and not copies.

Correction Required: A parent shall receive the original agreement. The facility shall retain a copy of the agreement.

Noncompliance Area: The emergency contact information on file for child #1 lacks the address of all release persons.

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: There was more than six months in between reviews of the fee agreement and emergency contact information on file for child #1. Fee agreement and emergency contact were reviewed on 2-29-29 and then on 12-17-19. The last review of the fee agreement and emergency contact information on file for child #2 was completed more than six months ago. Child's #2's reviews were completed on 8-18-18. The last review of the emergency contact information on file for child #4 was completed more than six months ago. Child #3's emergency contact information was reviewed on 11-16-18.

Correction Required: The parent shall update in writing emergency contact information once in a 6-month period or as soon as there is a change in the informationA parent is required to review and update the emergency contact information and the financial agreement at least once in a 6-month period or as soon as there is a change in the information.

Noncompliance Area: The most current health assessment on file for child #4, who is a young toddler, was not completed within the past six months.

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. A child's record must contain initial and subsequent health reports.

Noncompliance Area: The most current immunization record on file for child #4 lacks 1 Hep B, 1 DTAP, 2 HIB, 1 MMR, 1 Varicella, 1 Hep and 1 Flu shot within the past 12 months as in accordance with the schedule recommended by 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.

Noncompliance Area: There was more than 24 months in between the previous health assessment and the most current and updated health assessment on file for staff #1.

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.

Noncompliance Area: The file for child #4 lacks a fee agreement.

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 file for household member #2, who is 18 years of age, lacks a State Police, Child Abuse, and FBI Clearance and an NSOR Certificate.

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: Observed that the facility's excursion first-aid kit lacked a bottle of water.

Correction Required: One first-aid kit per child care group must accompany children and facility persons on excursions from the facility. Each first aid kit taken on an excursion must contain a bottle of water in addition to the items specified at 3290.73(c).

Noncompliance Area: Based on a conversation with the operator, the children were wading in the small children's wading pool yesterday, 7-16-2019. The facility file for staff #1 lacked verification of water safety instruction.

Correction Required: A facility person who is counted in the staff-child swimming ratio shall annually complete water safety instruction.

Noncompliance Area: In the outside play space on the ground and accessible to the children, observed toxic Clorox cleaner which was labeled, "Keep out of reach of children."

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 window at the childcare facility, which was accessible to children who are in the outside play space, which was broken with pieces of sharp glass attached. Observed a large rusty nail which was protruding from the outside shed, which is located in the outside play space and which was accessible to the children in care. Observed two nails protruding from the outside play space wooden fence.

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 the outside wooden play set, observed peeling paint on the ledge at the top of the steps, on the area of the small bridge floor and ledge, and on the floor at the top of the yellow slide.

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

Noncompliance Area: The file for staff #1 lacked a State Police and Child Abuse Clearance. During the last renewal inspection on 12-14-2017, observed that there was a State Police Clearance on file which was dated 03-20-2015 and Child Abuse Clearance on file which was dated 04-29-2015. The file for household member #2 lacked a Child Abuse Clearance. During last renewal inspection on 12-14-2017, observed that there was a Child Abuse Clearance on file which was dated 03-26-2015. Previously cited under SIN- 00147066.

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: Observed a large plastic toy bin with a green lid. This lid had a large crack in the middle of it exposing pinch and crush points.

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: In the bathroom, used by all children in care, observed a plastic bag in the corner near the toilet and a drawer under the diaper changing table which was filled with plastic bags. There was an infant in care.

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 sitting in a high chair which lacked a T-shaped safety strap.

Correction Required: High chairs shall have a wide base and a T-shaped safety strap.

Noncompliance Area: Observed a pack-n-play which lacked a label 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 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 facility lacked a written plan of daily activities.

Correction Required: A written plan of daily activities and routines, including a time for free play shall be established for each group. The plan shall be flexible to accommodate the needs of individual children and the dynamics of the group.

Noncompliance Area: The emergency contact information on file for child #3 lacked written consent signed by a parent for emergency medical care and administration of minor first-aid procedures by facility staff.

Correction Required: Emergency contact information must include the written consent signed by a parent for emergency medical care. 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: The emergency contact information on file for child #3 lacked the name of the health insurance and a 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: The files for children #1, #2, and #4 lack a review/update by the parent of the emergency contact information and fee agreement within the past 6 months. The most current reviews are as follows: Child #1 - emergency contact information was last updated on 12-15-2017 and fee agreement on 01-09-2018. Child #2 - emergency contact information was last updated on 08-17-2017 and fee agreement on 07-18-2017. Child #4 - emergency contact information was last updated on 11-17-2017 and fee agreement on 07-18-2017.

Correction Required: The parent shall update in writing emergency contact information once in a 6-month period or as soon as there is a change in the informationA parent is required to review and update the emergency contact information and the financial agreement at least once in a 6-month period or as soon as there is a change in the information.

Noncompliance Area: Child #5, an infant, lacked a written statement from the parent giving the formula and feeding schedule.

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

Noncompliance Area: Observed an infant bottle which lacked a label with the child's name.

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

Noncompliance Area: The last review of the emergency plan was dated 03-17-2017.

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: The file for staff #1 lacked a State Police and Child Abuse Clearance. During the last renewal inspection on 12-14-2017, observed that there was a State Police Clearance on file which was dated 03-20-2015 and Child Abuse Clearance on file which was dated 04-29-2015. The file for household member #2 lacked a Child Abuse Clearance. During last renewal inspection on 12-14-2017, observed that there was a Child Abuse Clearance on file which was dated 03-26-2015.

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: Observed a cabinet under the kitchen sink which contained toxic Flexseal, insect repellent, and Orange Glow Cleaner. This cabinet had a failed lock and was 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: The first aid kit, which was located in the excursion bag, lacked tweezers.

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.One first-aid kit per child care group must accompany children and facility persons on excursions from the facility. Each first aid kit taken on an excursion must contain a bottle of water in addition to the items specified at 3290.73(c).

Noncompliance Area: In the main child care space, observed a child size plastic blue couch which is used by the children. The blue couch had multiple rips.

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: There was no verification on file of a current rabies immunization for Sabrina, the cat.

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.

Noncompliance Area: There is a child service report on file for child #2 dated 11-17-2017. There was no verification or signature from the parent that the child service report was viewed that would verify that a copy was provided to the parent. There is a child service report on file for child #4 dated 7-17-2017. There was no verification or signature from the parent that the child service report was viewed and that would verify that a copy was provided to the parent.

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 #4, who has been enrolled since 11-28-2014, lacked verification of all emergency contact information. There is no form on file.

Correction Required: Emergency contact information is required for each enrolled child. Emergency contact information must reference who shall be contacted in an emergency.Information in a child's record shall be kept current by the operator.

Noncompliance Area: The emergency contact information on file for child #2 lacked the address of the child's physician. The emergency contact information on file for child #1, #2, and #3 lacked the health insurance policy number. The emergency contact information on file for child #2 lacked the name of the health insurance.

Correction Required: Emergency contact information must include the name, address and telephone number of the child's physician or source of medical care.Emergency contact information must include health insurance coverage and policy number for a child under a family policy or Medical Assistance benefits, if applicable.

Noncompliance Area: The emergency contact information on file for child #1, #2, and #3 lacked the address of all 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: Facility person #1 walks child #4 to school every morning. There was no emergency contact information on file at the facility for child #4 and none available to be taken on the walking excursion.

Correction Required: When children leave the facility on walking and riding excursions, emergency contact information specific to each child on the excursion shall accompany a staff person on the excursion.

Noncompliance Area: The file for child #4 who is of school age and who has been enrolled for longer than sixty days, lacks a copy of the health report required upon entrance into school.

Correction Required: The initial health report for a school-age child must be dated in accordance with the requirements for medical examinations for school attendance in 28 Pa. Code 23.2 (relating to medical examinations).A child's record must contain initial and subsequent health reports.

Noncompliance Area: The file for child #2, who is of preschool age, lacked verification of a current updated health report within the last 12 months.

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: The current updated health assessment on file for staff #1 lacked an examination for communicable diseases and the results of that examination and an assessment of the person's suitability 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: The file for child #2, with enrollment date of 12-6-2016 lacks a review/update of the emergency contact information and the financial agreement within the last 6 months. The last date review/update of the emergency contact information and fee agreement was dated 12-06-2016.

Correction Required: A parent is required to review and update the emergency contact information and the financial agreement at least once in a 6-month period or as soon as there is a change in the information.

Noncompliance Area: The file for staff #2 is lacking 3 of the 12 biennial clock hours of child care training.

Correction Required: A staff person shall obtain an biennial minimum of 12 clock hours of child care training.A facility person's record shall include records of training required by the Department.

Noncompliance Area: The file for staff #/1, with employment date of 04-01-2003, lacked verification that mandated reporter training was completed by 07/01/2015. There is mandated reporter training on file for staff #1 and completed on 01-29-2017. The file for staff #2, with employment date of 04-01-2013, lacks verification of mandated reporter training by 07-01-2015. There is no mandated reporter training on file for staff #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 records of training required by the Department.

Noncompliance Area: On 12-14-2017, at 09:30 AM, Certification Representative observed staff #1 and staff #2 caring for 8 unrelated children. There was 1 young toddler, 1 older toddler, 2 preschool, and 4 school age children in care.

Correction Required: The number of children in care may not exceed six children at any one time who are unrelated to the operator.

Noncompliance Area: In the main childcare space and behind the green chair, an electrical outlet without a protective receptacle cover was observed and accessible to children 5 years of age or younger.

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

Noncompliance Area: Observed Clorox cleaning spray on the diaper changing table and accessible to the younger children when getting their diapers changed and accessible to the older children when using the bathroom. Observed White Out by the microwave and 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: In the outdoor play space, the children's playhouse had four steps leading to the top play area. A handrail was not present on the steps and created a visible 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 outdoor playhouse, which requires embedded mounting, lacked the nine inches of loose fill (mulch) recommended by the United States Consumer Product Safety Commission.

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.