Beth Shalom Early Childhood Dept

A handwashing sign was not posted near one sink and one toilet in the restroom between Room 101 and Room 103.

The resting mats in Room 104 and Room 203 were observed to be ripping on the edges exposing foam the interior and were not in good repair.

The file for staff person #3 has a current health assessment on file dated 1/16/25, but the previous health assessment on file dated 8/2/23 did not include a physical examination.

The health assessment on file for staff person #4 did not include an examination for communicable diseases and the results of that examination. The health assessment on file for staff person #6 included an examination for communicable diseases but did not include the results of the examination.

The facilities documentation of testing the fire detection system exceeded 30 days between multiple testings since 5/17/24.

Staff person #1 has not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): Health and Safety.

The file for staff person #2, identified as an assistant group supervisor, lacked qualification documents at the time of inspection.

A written plan of daily activities was not posted in Room 208.

The financial agreement form in the file for child #2 did not include the persons designated by the parent to whom the child may be released.

The financial agreement form in the file for child #2 did not include the date of the child's admission.

The emergency contact form in the file for child #1 lacked the enrolling parent's work address and telephone number.

The facility's emergency plan did not include requirements for volunteer emergency preparedness training, practice drills and continuity of 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) to maintain compliance with 45 CFR § 98.41(a)(1)(vii)

The file for Staff Person #1 did not include documentation of training in the facility's Emergency Plan conducted within the past 12 months. The files for Staff Person #6, 7 and 8, who have been working at the facility for more than 90 days, did not include documentation of initial training in the facility's Emergency Plan (See LIS Code Sheet).

Observed discolored ceiling tiles from water damage in the following areas: Corner of Room #102 (Infant Nap Room), Room #103 in the middle of ceiling near sprinkler, Room #104 above diaper table, and gym restroom. The gate in the infant room was wobbly, which creates a potential toppling hazard. The closet doors under the stage in the gym were not secured, which creates a potential pinch hazard.

Observed in the Infant Room #101: peeling paint at the bottom of the gate on the left side of the room. Flaking plaster at the bottom of the wall near the entrance gate.

Observed dirt and debris under the mats of the diaper changing tables in the infant and toddler rooms.

The most recent updated health reports in the file for Child #5, a Preschool Child, exceeded 12 months between reports.

Observed in the medicine box in the toddler room, a bottle of eye drops, which were not labeled with the name of Child #2, for whom the medication was intended.

The TB Screening in the file for Staff Person #2 was conducted more than 12 months prior to the staff person's start date and is not valid (See LIS Code Sheet).

The fire drill log documented three times when fire drills exceeded 60 days: 2/1/23-4/20/23, 4/20/23-6/27/23, and 6/27/23-8/29/23.

Based on review of the fire drill/fire system check log, the fire detection/alarm system has not been tested every 30 days.

The Health and Safety Trainings in the files for Staff Person #1 and #2 were conducted more than 90 days after the staff persons' first day working in child care. The Pediatric First Aid/CPR Trainings in the files for Staff Person #3 and #5 were conducted more than 90 days after the staff persons' first day working in child care (See LIS Code Sheet).

Staff person #4 has not completed the following required pre-service training within 90 days of their date of hire: Health and Safety Training (see LIS code sheet).

The file for Staff Person #9, an aide, did not include documentation of a high school diploma.

The fee agreements in the child files which were reviewed were the original documents.

The Emergency Contact forms in the files for Child #1 and #4 did not include health insurance coverage and policy numbers.

The Emergency Contact forms in the files for Child #1 and #3 did not include the release persons addresses.

The Emergency Contact Forms and Fee Agreements in the files for Child #4 and #6 have not been updated by the parents in the past six months.

The Emergency Contact Form in the file for Child #4 did not include signed parental consent for emergency medical care for the child signed parental consent for administration of minor first-aid procedures by facility staff.

While having breakfast, child #1 ingested a dairy product which based on written parental instructions, the child is not permitted to have due to an allergy.

Staff person #1 and 2 have not completed the following required pre-service training within 90 days of their date of hire (see LIS code sheet): pediatric first aid and pediatric CPR

Documentation of completion of the training on the health and safety topics listed in subsections (f)1-10 was completed on 3/14/2023 by facility person #2, which was more than 90 days from their start date at the facility (see coded LIS sheet).

The file for staff person #3 lacked emergency plan training that was completed 12 months from the previous emergency plan training. The emergency plan training in the file is dated 8/26/21 and 10/22/22.

On the left hand side wall on the second mat a hole was observed creating a visible hazard.

The file for child #3 lacked a health report that included a review of the child's health history.

The file for child #3 lacked a health report that included a statement that the child is able to participate in child care and appears to be free from contagious or communicable disease.

In Room 206 and Room 208 two albuterol inhalers (one in each room) were observed to not be in the original container labeled with the name of the medication and the name of the child for whom the medication is intended.

The file for staff person #4 lacked a health assessment that was completed 12 months from the previous health assessment. The health assessments in the file are dated 1/14/20 and 2/7/22.

The file for staff person #1 lacked firesafety training that was completed 12 months from the previous firesafety training. The firesafety training in the file is dated 1/3/22 and 1/6/23. The file for staff person #3 lacked firesafety training that was completed 12 months from the previous firesafety training. The firesafety training in the file is dated 1/4/21 and 9/7/22. The file for staff person #4 lacked firesafety training that was completed 12 months from the previous firesafety training. The firesafety training in the file is dated 1/3/22 and 1/9/23. The file for staff person #5 lacked firesafety training that was completed 12 months from the previous firesafety training. The firesafety training in the file is dated 1/3/22 and 1/6/23. The file for staff person #7 lacked firesafety training that was completed 12 months from the previous firesafety training. The firesafety training in the file is dated 1/3/22 and 1/10/23. The file for staff person #9 lacked firesafety training that was completed 12 months from the previous firesafety training. The firesafety training in the file is dated 1/3/22 and 1/7/23.

The file for staff person #1 lacked a staff evaluation that was completed 12 months from the previous evaluation. The staff evaluations in the file are dated 12/9/21 and 1/4/23. The file for staff person #2 lacked a staff evaluation that was completed 12 months from the previous evaluation. The staff evaluations in the file are dated 12/16/21 and 1/3/23.

The file for child #1 lacked emergency contact information that included information on the child's special needs, as specified by the child's parent, physician, physician's assistant or CRNP, which is needed in an emergency situation.

The file for child #2 lacked emergency contact information that included signed parental consent for administration of minor first-aid procedures by facility staff prior to admission.

The file for staff person #6 lacked 12 clock hours of child care training between 12/19/21 and 12/19/22. There were 9 hours of child care training in the file between 12/19/21 and 12/19/22. The file for staff person #8 lacked 12 clock hours of child care training. There were 9 hours of child care training in the file.

The NSOR certificate on file for Staff person #2, a provisional hire, with a hire date of 8/30/21, is dated 10/21/21, more than 45 days after hire. The disclosure statement on file for Staff person #5, with a hire date of 11/19/21, is dated 1/19/22, after hire. The signed disclosure statement on file for Staff person #6 is not dated.

The file for Staff person #4, with a hire date of 8/30/21, has a PA Child Abuse clearance, dated 7/21/20, that was obtained for volunteer purposes. The file for Staff person #6, with a hire date of 11/15/21, and who requires out of state clearances from Delaware, where she resided in the previous 5 years, does not include a Delaware Child Abuse and Neglect clearance or Delaware Sex Offender registry check. The file for Staff person #8, with a hire date of 10/6/21, and who requires out of state clearances from Virginia, where she resided in the previous 5 years, does not include a Virginia Child Abuse and Neglect clearance.

During the renewal inspection on 2/16/22, at approximately 10:00 AM, a staff person, who is classified as an aide, was observed to be unsupervised in the infant nap room with 4 infants on several brief occasions over a 3-5 minute period while infants were being transferred from the infant room to the infant nap room by another staff person, through the diaper changing room which is approximately 7 foot long room and separates the infant room and nap room.

The file for Staff person #3, with a hire date of 8/30/21, does not include verification of emergency plan training at hire. The most recent emergency plan training on file for Staff person #9, dated 10/6/21, more than 1 year after the previous training, dated 8/19/19. The file for Staff person #12, with a hire date of 11/1/21, includes verification of emergency plan training completed 1/27/22, not at hire.

There was an outlet under the chalkboard, which is accessible to children in Room 201 that did not have outlet covers. There was an extension cord in use in Room 201 which is accessible to children that had an unused plug that did not have an outlet cover.

There was a hole in the wall, with exposed drywall, in Room 201, next to the "Sight words" wall hanging. There were five holes in the padding on the wall in the gym, with exposed foam filling.

The benches in the outdoor playground had several areas of peeling paint.

The dramatic play area in Room 203 had a toy dishwasher that included a plastic bin which had a broken piece on the corner.

The current immunization record on file for Child #1 does not include an influenza vaccination administered in the last calendar year. The current immunization record on file for Child #3, who is 6 months old, includes 1 of 2 Hepatitis B vaccinations, 1 of 2 Rotavirus vaccinations, 1 of 2 DTAP vaccinations, 1 of 2 Pneumococcal vaccinations, and 1 of 2 Polio vaccinations that are recommended for a child this age.

The initial immunization record on file for Child #1, with an enrollment date of 8/30/21, is dated 11/3/21, more than 60 days after enrollment.

There was a bottle of children's Tylenol in Room 206 labeled for use by a child which had expired 1/2022.

There was a bottler of Zyrtec in Room 103 labeled for use by a child which did not have written parental consent to administer. There was a bottler of Tylenol in Room 104 labeled for use by a child which did not have written parental consent to administer.

The 2 most recent health assessments on file for Staff person #9 are dated 8/6/19 and 9/7/21, more than 24 months apart. The 2 most recent health assessments on file for Staff person #10 are dated 1/3/20 and 1/24/22, more than 24 months apart. The 2 most recent health assessments on file for Staff person #11 are dated 2/21/19 and 2/22/21, more than 24 months apart.

The current health assessment on file for Staff person #13, states the physician or health care professional did not complete a physical examination.

The initial Tuberculosis screening on file for Staff person #4, with a hire date of 8/30/21, is dated 8/19/20, more than 1 year prior to hire in a child care position.

The fire drill log included fire drills dated 1/6/21-3/10/21; 3/10/21-5/11/21; 5/11/21-7/29/21; 7/29/21-10/7/21-1/3/22, which are all more than 60 days apart.

The 30 day test log for the fire alarm testing are dated 2/1/21-3/10/21; 3/10/21-4/15/21; 6/7/21-7/29/21; 9/6/21-10/7/21; and 10/7/21-11/8/21, which are all more than 30 days apart. The facility does not have proof of purchase of the fire alarm detection system, as required by L&I and Act 62.

The file for Staff person #1, with a hire date of 3/8/21, has verification of completed mandated reporter training dated 6/9/21, more than 90 days after hire.

The 2 most recent staff evaluations on file for Staff person #9 are dated 1/12/20 and 1/26/22, more than 1 year apart.

The emergency contact form on file for Child #1 does not include a complete address for the child's physician/health care provider.

The emergency contact form on file for Child #1 does not include a complete address or telephone number for where the enrolling parent works.

The file for Child #2 does not include written parental consent for the facility to obtain emergency medical care.

The emergency contact form on file for Child #2 does not indicate if the child has any special medical needs or disabilities, as required in event of an emergency.

The emergency contact form on file for Child #1 does not include the health insurance coverage and policy number for the child's health insurance coverage.

The emergency contact form on file for Child #1 does not include a complete address for all listed release persons.

There was a child receiving care in the Infant room (101) and nap room (102) without her emergency contact form being in the room.

The file for Child #2 does not include written parental consent for the facility to administer minor first aid procedures.

The file for Staff person #6, with a hire date of 11/15/21, lacked documentation of current certification in pediatric first-aid and CPR, which was due 90 days (2/13/22) following the hire date. The file for Staff person #7, with a hire date of 9/3/21, lacked documentation of current certification in pediatric first-aid and CPR, which was due 90 days (12/2/21) following the hire date. The file for Staff person #8, with a hire date of 10/6/21, lacked documentation of current certification in pediatric first-aid and CPR, which was due 90 days (1/4/22) following the hire date. The files for Staff #13, an existing staff member, lacked documentation of current certification in pediatric first-aid and CPR, which was due180 days following the implementation of the current regulations.

The facility did not have verification of notifying parents of enrolled children on how to access the regulations in this chapter electronically.

The file for Staff person #9, who was hired prior to 12/19/20, does not include 12 hours of annual training between 12/19/20-12/19/21, as required by Announcement C-21-09. The file for Staff person #11, who was hired prior to 12/19/20, does not include 12 hours of annual training between 12/19/20-12/19/21, as required by Announcement C-21-09. The file for Staff person #13, who was hired prior to 12/19/20, does not include 12 hours of annual training between 12/19/20-12/19/21, as required by Announcement C-21-09.