Rachel Skipper

Regulation: 3290.123(a)(3)

Description: Services provided

Noncompliance Area: At the time of the inspection, the agreement on file for child #1 did not include the services being provided to the child. There were no child service reports on file for child #1, #4 and #5.

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(a)(6)

Description: Admission date

Noncompliance Area: At the time of the inspection, the agreement for child #1 did not have a date of admisssion.

Correction Required: An agreement shall specify the date of the child's admission.

Regulation: 3290.124(b)(2)/3290.124(b)(3)

Description: Physician name, address, phone/Parent home/work address, phone

Noncompliance Area: At the time of the inspection, the emergency contact form for child #1 and child #4 was missing the name, address and telephone number of the child's physician or source of medical care. The emergency contact form for child #1, #2 and #3 was missing the work addresses and telephone numbers of the enrolling parent.

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 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: At the time of the inspection, the emergency contact form on file for child #1, #2, #3 and #4 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: 3290.124(d)

Description: Written emergency plan posted

Noncompliance Area: At the time of the inspection, a written plan was not posted which identifies the means of transporting a child to emergency care and the facility staffing provisions in the event of an emergency.

Correction Required: A written plan shall be conspicuously posted which identifies the means of transporting a child to emergency care and the facility staffing provisions in the event of an emergency. The plan must accompany a staff person who leaves the facility on an excursion with children.

Regulation: 3290.131(b)(2)/3290.131(d)(7)

Description: Updated toddler/preschool health report: every 12 months/Free from contagious/communicable disease

Noncompliance Area: At the time of the inspection, the health reports for child #1 and child #4 were not updated every 12 months, as required. This is evidenced by the health reports on file dated 1/16/24 and 11/15/24, respectively. Also, these previous health forms did not include a statement that the child is able to participate in child care and appears to be free from contagious or communicable disease.

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 health report shall include a statement that the child is able to participate in child care and appears to be free from contagious or communicable disease.

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

Description: Immunization record/Dismissal policy

Noncompliance Area: At the time of the inspection, child #5 did not have a health assessment or immunization record on file and has been enrolled at the facility for more than 60 days (see LIS code sheet for date of birth and date of admission).

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 child care group settings). ·Child #5 must be dismissed from care by close of business on 2/17/26 and may only return to care when the immunization record is updated or when a parent provides a written, signed exemption letter.

Regulation: 3290.151(a)(2)

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

Noncompliance Area: At the time of the inspection, staff person #1 did not update their health assessment every 24 months, as required. This is evidenced by the health assessment on file dated 1/15/24.

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: 3290.18

Description: General Health and Safety

Noncompliance Area: The emergency plan did not include continuity of operations during and after an emergency that includes continuing daily operations, backing up or retrieving health and other key records/files and managing financial issues such as paying employees and bills during the aftermath of the disaster.

Correction Required: Conditions at the facility may not pose a threat to the health or safety of the children. The OCDEL ANNOUNCEMENT C-22-04 requires facility emergency plans to include continuity of operations during and after an emergency that includes continuing daily operations, backing up or retrieving health and other key records/files and managing financial issues such as paying employees and bills during the aftermath of the disaster.

Regulation: 3290.18

Description: General Health and Safety

Noncompliance Area: At the time of the inspection, the operator did not have a policy and procedure addressing 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. Announcement C-22-03: Updates to Prevention of Shaken Baby Syndrome, Abusive Head Trauma, and Child Maltreatment Requirements states To maintain compliance with 45 CFR 98.41(a)(1)(vi), in addition to the training requirements, child care providers must have a policy and procedure to identify the prevention of shaken baby syndrome, abusive head trauma, and child maltreatment. The policy must include, but is not limited to: · Recognition of potential signs and symptoms of shaken baby syndrome and abusive head trauma; · Strategies for coping with a crying, fussing, or distraught child; and · Address the prevention and identification of child maltreatment.

Regulation: 3290.181(a)

Description: Each child

Noncompliance Area: At the time of the inspection, child #5 did not have a record on file at the facility.

Correction Required: An operator shall establish and maintain an individual record for each child enrolled in the facility.

Regulation: 3290.181(c)

Description: Emergency info/agreement updated 6 mos

Noncompliance Area: At the time of the inspection, the emergency contact form and agreement on file for child #2, child #3 and child #4 was not updated every 6 months, as required. The last update for child #2 and #4 occurred in 2022 and the last update for child #3 occurred on 1/14/25.

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(b)

Description: Emergency plan

Noncompliance Area: At the time of the inspection, the last review of the emergency plan was conducted on 1/3/25 and not annually, as required.

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

Regulation: 3290.24(d)

Description: Emergency plan

Noncompliance Area: At the time of the inspection, the last documented emergency drill on file was done on 2/6/23.

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

Regulation: 3290.24(e)/3290.24(g)

Description: Emergency plan/Emergency plan

Noncompliance Area: At the time of the inspection, the emergency plan for the facility was not posted. There was also no documentation of the emergency plan being sent to the local and county emergency management agencies.

Correction Required: The emergency plan shall be posted in the facility at a conspicuous location. The operator shall send a copy of the emergency plan and subsequent plan updates to the local municipality and to the county emergency management agency.