Kathy Serrano

Regulation: 3290.124(b)(2)

Description: Physician name, address, phone

Noncompliance Area: The Emergency Contact Form for Child #2 did not include the phone number 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)(3)

Description: Parent home/work address, phone

Noncompliance Area: There were no work phone numbers for the enrolling parents of Child #1 or Child #4 on their Emergency Contact Forms.

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

Regulation: 3290.124(b)(5)

Description: Information re: disability

Noncompliance Area: The Emergency Contact Form for Child #1 did not include information on the child's allergies/disabilities. These areas were left blank on the form.

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)(7)

Description: Name/address/phone release person

Noncompliance Area: The Emergency Contact Forms for Child #2 and Child #3 did not include addresses for the people 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(a)(3)/3290.131(e)

Description: Initial health report dated older toddler/preschool < 1 year./Immunization record

Noncompliance Area: Child #1 did not have an initial health report and immunizations on file within 60 days of the child's first day of attendance. The only health report/immunizations was dated 3/18/22, over 12 months prior to enrollment and the Rotavirus, Pneumococcal and Hepatitis A vaccines were not documented as having been administered according to the ACIP schedule. Child #1 was still attending the facility and had not been excluded from care after 60 days.

Correction Required: The initial health report for an older toddler or preschool child shall be dated no more than 1 year prior to the first day of attendance at the facility. 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.

Regulation: 3290.131(b)(2)

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

Noncompliance Area: There were no updated health reports on file for Child #1 or Child #5 that were completed within 12 months of the last ones. The last health report for Child #1 was dated 3/18/22 and the last one for Child #5 was dated 3/13/24.

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(e)(1)

Description: Parent written verification from Doctor.

Noncompliance Area: The file for Child #4 did not include documentation of current vaccines in accordance with the ACIP schedule. The Hep A vaccine (Dose 1 and 2) has not been administered and there was no exemption statement for the vaccine on file.

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: 3290.131(e)(3)

Description: Dismissal policy

Noncompliance Area: Child #1 and Child #4 did not have documentation of all current vaccines according to the ACIP schedule and they were not dismissed from care at the time of the inspection.

Correction Required: 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 file for Staff Person #1 did not include an updated health assessment within 24 months from the prior one, which was dated 8/21/23.

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.

Regulation: 3290.31(f)

Description: Age and training

Noncompliance Area: The file for Staff Person #1 did not include documentation of annual 12 hours of childcare training. There was documentation of 8 hours of childcare training.

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

Regulation: 3290.131(a)

Description: Within 60 days

Noncompliance Area: The file for Child #1 did not contain an initial health report within 60 days of enrollment. There was only a list of immunizations in the file.

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

Regulation: 3290.131(a)(2)

Description: Initial health report dated for young toddler < 6 months.

Noncompliance Area: The file for Child #2 contained an initial health report dated 8/4/23, which was more than 6 months prior to the first day of attendance (see code sheet).

Correction Required: The initial health report for a young toddler must be dated no more than 6 months prior to the first day of attendance at the facility.

Regulation: 3290.131(b)(1)

Description: Updated infant health report: every 6 months

Noncompliance Area: The files for Children #1, #2 and #3 did not include updated health reports that were dated 6 months from the last ones in the files. The last dated health reports for each child were as follows: Child #1: no initial health report in the file and no updated ones Child #2: 8/1/23 Child #3: 3/22/24

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: 3290.131(e)/3290.131(e)(3)

Description: Immunization record/Dismissal policy

Noncompliance Area: The file for Child #2 contained the initial list of immunizations administered, that were missing the required Rotavirus and Pneumococcal vaccines. Child #2 was still attending without an initial health report and complete immunizations, beyond 60 days of enrollment.

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. 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 childcare group settings).

Regulation: 3290.24(d)

Description: Emergency plan

Noncompliance Area: There was no documentation of an Emergency Drill having been conducted annually.

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

Regulation: 3290.105(a)

Description: Clean, age appropriate

Noncompliance Area: Rest equipment (mats and pack-n-play used for sleeping) was not labeled with the children's names and used only by the named children.

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

Regulation: 3290.123(a)(3)

Description: Services provided

Noncompliance Area: There were no completed Child Service Reports for Children #1, #2 and #3 and they have all been enrolled 6 months or more.

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: 3290.131(a)/3290.182(1)

Description: Within 60 days/Initial and subsequent health assessments

Noncompliance Area: There were no initial health reports/physicals in the files of Children #1, #2 and #3.

Correction Required: The operator shall require the parent of an enrolled child to provide an initial health report no later than 60 days following the first day of attendance at the facility. A child's record must contain initial and subsequent health reports.

Regulation: 3290.165

Description: Menus

Noncompliance Area: There is no menu shared with the parents.

Correction Required: The operator shall discuss the general menu plan with the parent so that the daily nutritional needs of the child can be met.

Regulation: 3290.166(1)

Description: Written statement

Noncompliance Area: There was no written statement from the parent giving the formula and feeding schedule for Child #4.

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

Regulation: 3290.18

Description: General Health and Safety

Noncompliance Area: There was no written policy to address shaken baby/abusive head trauma/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 agreements and emergency contact forms for Children #1, #2 and #3 were not updated by the parents within 6 months of the children's start date.

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: 3290.64(a)

Description: Locked or inaccessible - in original container

Noncompliance Area: A spray bottle containing bleach and water used for sanitizing, was not labelled with the ratio of bleach to water.

Correction Required: Cleaning materials and other toxic materials shall be stored in an original labeled container or in a container that specifies the content. Toxics shall be kept in a locked area or in an area inaccessible to children, and shall be stored away from food, food preparation areas and child care spaces.

Regulation: 3290.94(a)(1)

Description: Every 60 days

Noncompliance Area: Fire drills have not been conducted and documented every 60 days. Fire drills were documented as having been conducted on 10/10/23 and then on 12/15/23 and there were none documented since.

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: 3290.94(a)(5)

Description: Evacuation routes posted

Noncompliance Area: Evacuation Routes were not posted on the first (main) 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.

Noncompliance Area: Children's files reviewed did not include the designated release person(s) address.

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: Children's agreements were not updated in a 6 month period.

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: After diaper change, staff nor child washed 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.A facility person shall wash his hands before meals and snacks, and after toileting and after diapering a child.

Noncompliance Area: Diaper was changed on the stairway landing and not sanitized.

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: Three (3) school aged children being transported did not have the age appropriate safety restraint required booster seats.

Correction Required: A child 7 years of age or younger shall be transported in accordance with the requirements for parents and guardians as stated in 75 Pa.C.S. 4581 (relating to restraint systems). Manufacturers' instructions for use of safety restraints shall be kept in the vehicle at all times.

Noncompliance Area: Child 1, 2, and 3 did not have child service reports completed 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: Child 4 did not have designated release persons address and phone number listed on 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: Child 1-5 did not have updated agreements in a 6 mth period.

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 1 did not have updated physical on file. Last physical 5/17.

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: Enrolled infant did not have feeding/formula written statement from parent and bottles were not labeled for individual use.

Correction Required: A written statement giving the formula and feeding schedule for an infant shall be obtained from the parent.Disposable nursers and bottles shall be labeled with the child's name.

Noncompliance Area: Children 7 yrs and younger do not have proper safety seats when transported.

Correction Required: A child 7 years of age or younger shall be transported in accordance with the requirements for parents and guardians as stated in 75 Pa.C.S. 4581 (relating to restraint systems). Safety restraints installed in the vehicle at the time of manufacturing shall be used by all occupants.

Noncompliance Area: Child 4 and 5 did not have signed parental permission for emergency medical care and minor 1st aid.

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

Noncompliance Area: CHILD 1, 2, 3 DID NOT HAVE UPDATE ON EMERGENCY CONTACT FORM AND AGREEMENT WITHIN 6 MONTHS.

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 2 AND 3 DID NOT HAVE SIGNED PARENTAL PERMISSION FOR EMERGENCY MEDICAL CARE AND MINOR FIRST AID.

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

Noncompliance Area: YOUNG TODDLER ASLEEP IN CARSEAT PER PARENT'S INSTRUCTIONS.

Correction Required: Individual, clean, age-appropriate rest equipment shall be provided for preschool, toddler and infant children as agreed between the child`s parent and the operator. The rest equipment shall be labeled for the use of a specific child and used only by the specified child.

Noncompliance Area: CHILDREN'S CHILD SERVICE REPORTS WERE NOT COMPLETED/UPDATED/SIGNED BY PARENT EVERY 6 MONTHS. CHILD 1 AND 2 DID NOT HAVE UP TO DATE CHILD SERVICE REPORTS.

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).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: EMERGENCY CONTACTS AND AGREEMENTS WERE NOT UPDATED EVERY 6 MONTHS.

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 3 DID NOT HAVE CURRENT PHYSICAL 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.