Homewood-Brushton YWCA

The file for Staff Person #2 contained a DHS FBI Clearance dated 10/28/24 obtained after their date of hire (See LIS Code Sheet).

The parent letter explaining the emergency procedures lacked the following: lockdown information; accommodations for infants, toddlers, children with disabilities, and children with chronic medical conditions; method on how to communicate with parents at the beginning and end of an emergency situation, including how to reunite with their children.

There was a multiplug with 3 uncovered electrical outlets in Room 122, the older toddler room; there were 7 uncovered outlets in Room 225, the middle preschool room; and there were 2 uncovered electrical outlets in the gym accessible to children 5 years of age or younger.

Room 225, the middle preschool room, lacked a first aid kit.

In Room 116, the younger toddler room, the first aid kit lacked scissors.

In Room 120, the infant room, the bottom of the wooden cabinet under the sink was covered in large round water stains. The stains were black and there was a musty odor under the sink. In the second floor restroom, there was a plastic bin, approximately 2 ft long, 1 ft wide and 1 ft deep, under the sink with approximately 1 inch of standing water. Black spots that appeared to be mold were floating in the water. The bin and water were accessible to children using the second floor restroom.

Peeling paint was observed on the wall behind the toilet in the first stall of the second floor restroom; and in Room 225, the middle preschool room, on the wall next to the dramatic play area, the wall above the light table, and the wall near the door.

The larger stall in the bathroom on the second floor lacked a hand washing sign above the toilet.

In Room 116, the younger toddler room, foam blocks were observed with teeth and bite marks on them. Pieces of foam were missing from the areas where they had been bitten.

The file for child #3 lacked an updated health report. The previous health report was dated 11/3/22. The child was a young toddler at the time of the previous health report (See LIS Code Sheet). The file for Child #4, a young toddler, (See LIS Code Sheet) lacks an updated health report. The previous health report is dated 1/26/24.

The file for Child #3 lacked a current health report. The most recent health report on file for Child #3, a preschooler, is dated 11/3/22.

The file for child #3 lacked an updated verification of vaccines.

The file for staff person #1 contained a current health assessment dated 8/8/24. The health assessment was obtained greater than 24 months from the previous health assessment dated 3/14/22.

The facility's emergency plan lacked accommodations for infants and toddlers.

According to the fire alarm test log, the system was tested on 6/14/24 and 7/18/24, as well as 8/16/24 and 9/16/24 which was more than 30 days apart.

The facility lacked written notification to the local traffic authority of the location of the facility and about the program's use of pedestrian and vehicular routes around the child care center.

The file for Child #2 lacked a current Child Service Report, 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 most recent Child Service Report for Child #2 contained in the file was dated 1/31/24, greater than 6 months ago.

The agreement form for Child #4 lacked arrival and departure times.

The agreement form for Child #1 lacked the persons designated by the parent to whom the child may be released.

The files for Child #1 and Child #5 contained the original agreement forms.

The emergency contact form for Child #4 lacked the parent's work address.

The emergency contact form and fee agreement on file for Child #2 were not reviewed or updated at least every 6 months. The current review/update was dated 9/11/24 more than 6 months after the previous review dated 11/2/23.

The file for Staff Person #3 lacked documentation of education and experience prior to working at the facility.

The file for Staff Person #4 contained pediatric first aid and CPR by a PQAS certified instructor dated 9/28/24 more than 90 days after date of hire (See LIS Code Sheet). The previous documentation for FA/CPR training for Staff Person #4 included in the file was dated 10/16/22 and was not PQAS certified.

In the younger toddler room, the bottom shelf of the refrigerator was unclean from what appeared to be the result of a spill.

Facility Person #2 lived in another state in the previous 5 years. There was no documentation of a criminal history clearance for this state on file for Facility Person #2. There was no NSOR clearance or signed disclosure statement on file for Facility Person #3. The most recent completed criminal history clearance on file for Facility Person #4 was completed more than 60 months prior. The current mandated reporter training documentation on file for Facility Person #4 indicates the training was completed more than 60 months after the prior training documented and on file. There was an FBI clearance on file for Facility Person #6, still within their 45 day provisional hiring period, but there no criminal history clearance or current proof of application for a criminal history clearance on file for Facility Person #6.

At approximately 10:45 AM, Facility Persons #5 and #6 were supervising 4 older toddlers and 3 young toddlers in the Toddler Room. When asked to identify the children they were supervising, Facility Person #5 identified each of the young toddlers. Facility Person #6 first said they were not responsible for any children, when asked again, they stated they were responsible for the older toddlers. Facility Person #6 then stated it was their first day and they didn't know the names of the children in their group.

There were sharp adult scissors on the desk in Pre-K Room, accessible to children.

Documentation of initial emergency plan training on file for Facility Persons # 2 and #5 indicate the training was completed more than 90 days after their start dates.

The letter to the parents explaining the emergency plan did not include information regarding the lockdown plan, accommodations, or the annual emergency drill.

There was an uncovered outlet on the wall in the older toddler room near a desk area.

The first aid kits in the PreK 1 & 2 rooms did not contain soap.

There was a detached floor tile in the gym, creating a tripping hazard.

Peeling paint was observed in the following areas: -in the toddler room behind a diaper disposal can in the restroom area; near the door to the infant room, on a wall behind table & chairs; on a wall in the dramatic play area behind furniture -in the older toddler room on a wall near the entrance to the room, and on the wall below the hallway observation window -in the gym on walls on two sides of the room, lower, near the floor

There were no handwashing signs at 2 toilets in the preschool restroom an at a toilet in the toddler room.

There were small tears in the mat on the changing table in the toddler room, exposing foam. In the gym near a detached floor tile there were small pieces (with a diameter less than one inch) of the tile on the floor.

There was no thermometer in the refrigerator in the infant room.

The most recent health assessments on file for children #2 (a young toddler) and #5 (an infant) were not completed within the previous 6 months.

The immunization record on file for child #5 did not indicate the child had the appropriate doses of the DTAP, Hib, pneumococcal and polio vaccines as recommend by the ACIP based on the age of the child.

There were sample packets of medication (aspirin, ointment, first aid cream) in the first aid kits in the infant and Pre-K 2 rooms, not labeled for use by a specific child.

The trash can used for diaper disposal in the infant room was not hands-free.

The health assessment and TB test on file for Facility Person #1 were completed more than 12 months prior to their start in a child care position at the facility. The TB test on file for Facility Person #6 was completed more than 12 months prior to their start in a child care position at the facility.

The facility's emergency plan did not include accommodations for infants and toddlers in the event of an emergency.

The current emergency plan was dated 2/4/22.

There was no documentation the emergency plan was sent to the local municipality and to the county emergency management agency.

There was no traffic safety letter sent within the last 12 months.

Facility Person #2 was classified as an assistant group supervisor, but did not meet the educational and/or experiential requirements for the classification.

The daily activity schedule was not posted in the PreK 1 Room.

There was no child service report form completed and a copy given to the parent on file for child #2, enrolled at the facility more than 6 months.

The agreement on file for child #4 did not specify the child's arrival and departure time.

The agreement on file for child #3 did not specify the child's date of admission.

The emergency contact form on file for child #3 did not include the enrolling parents work contact information.

The emergency contact form on file for child #1 did not include the addresses of all release persons.

The agreements on file for children #1-#4 were the originals.

There was not an emergency contact in the gym for one of the children receiving care in that space.

The emergency contact forms and agreements on file for children #1 and #5 were not reviewed and updated by a parent in writing in the previous 6 months.

There were no written nonfamily references on file for Facility Person #3.

Per a facility self-reported incident and staff statements, on 10/5/23 child #1, an older toddler, hit child #2, an older toddler, in the face. Staff #1, instructed child #2 to hit child #1 back, in order to stop child #1 from hitting other children.

Per a facility self-reported incident and staff statements, on 10/5/23 child #1, an older toddler, hit child #2, an older toddler, in the face. Staff #1, instructed child #2 to hit child #1 back, in order to stop child #1 from hitting other children.

Per a facility self-reported incident and staff statements, on 10/5/23 child #1, an older toddler, hit child #2, an older toddler, in the face. Staff #1, instructed child #2 to hit child #1 back, in order to stop child #1 from hitting other children.

The files for staff # 1 and 2 lacked the one-hour updated health and safety training course, Pennsylvania Health and Safety Update 2022 by the deadline of 12/30/22.

The file for staff # 1 lacked an updated First - Aid and CPR training. The previous training certificate expired on 4/9/23. The file for staff # 3 lacked an updated First - Aid and CPR training. The previous training certificate expired on 8/23/23.

The file for staff #2 contained a State Police Clearance date of 5-24-2017 and 10-31-2022 which exceeded the mandatory 60 months to receive the clearance. The file for staff #2 contained a Child Abuse Clearance date of 6-1-2017 and 10-31-2022 which exceeded the mandatory 60 months to receive the clearance.

In Room 122, the first aid kit was observed on a white and green colored table which was located to the left of the entrance to the room and was accessible to children in care.

In Room 224, there was no thermometer in the refrigerator to determine the temperature of the refrigerator.

The file for child #1 contained an Influenza Vaccine date of 11-22-2022 which exceeded the mandatory 60 days to receive the vaccine.

The file for staff #5 (See IS Code Sheet) contained a health assessment date of 1-27-2022 which exceeded the mandatory date to receive the health assessment. The file for staff #6 (See IS Code Sheet) contained a health assessment date of 11-21-2022 which exceeded the mandatory date to receive the health assessment. The file for staff #7(See IS Code Sheet) contained a health assessment date of 5-20-2022 which exceeded the mandatory date to receive the health assessment.

The file for staff #5(See IS Code Sheet) contained a tuberculosis screening test date of 1-27-2022 which exceeded the mandatory date to receive the tuberculosis testing. The file for staff #7(See IS Code Sheet) contained a Tuberculosis test date of 5-23-2022 which exceeded the mandatory date to receive the tuberculosis test. The file for staff #6 (See IS Code Sheet) contained a tuberculosis screening test date of 11-18-2022 which exceeded the mandatory date to receive the tuberculosis testing.

Based on conversations with the operator, there was not an initial emergency drill conducted by the required date of 12-19-2021.

The file for staff #3 contained a fire safety training date of 2-5-2021 and 2-11-2022 which exceeded the mandatory date of 2-5-2022 to receive the training. The file for staff #4 contained a fire safety training date of 2-5-2021 and 11-7-2022 which exceeded the mandatory date of 2-5-2022 to receive the training.

The file for staff #6 (See IS Code Sheet) contained a Health and Safety training date of 11-23-2022 which exceeded the mandatory 90 days to receive the training. The file for staff #5 (See IS Code Sheet) contained a Pediatric First Aid/CPR training date of 8-21-2022 which exceeded the mandatory 90 days to receive the training. The file for staff #7 (See IS Code Sheet) contained a Health and Safety Training date of 10-3-2022 which exceeded the mandatory 90 days to receive the training.

Staff person #-6 has not completed the following required pre-service training within 90 days of their date of hire: Pediatric First Aid/CPR Training from an approved curriculum and completed with a PQAS instructor.

The file for staff #5 contained a Mandated Reporter Training date of 5-31-2017 and 11-17-2022 which exceeded the mandatory 60 months to renew the training. The file for staff #6 (See IS Code Sheet) contained a Mandated reporter Training date of 11-3-2022 which exceeded the mandatory 90 days to receive the training.

The file for child #3 did not contain a child service report which was due by the mandatory date of 10-31-2022.

The file for child #2 contained a fee agreement which did not specify the child's date of admission.

The file for child #3 contained an emergency contact form and financial agreement form date of 7-23-2021 and 7-25-2022 which exceeded the mandatory date of 1-23-2022 to update the emergency contact and financial agreement information.

The file for child #1 contained an Influenza Vaccine date of 11-22-2022 which exceeded the mandatory 60 days to receive the vaccine.

Documentation of the original incident report that was completed for an injured child on 9-20-22 was observed at the facility, resulting in the parent not receiving the original incident report. Staff stated that a copy of the incident report was provided to the parent of the injured child.

Facility last conducted a fire drill on 11/10/21.

Facility lacked a 30-day testing log or current letter of operability.

The file for staff person #11 included a disclosure statement that was not signed by a witness or dated. The individual was hired through a substitute agency.

3rd citation: Based on conversation with the operator, staff person #2 through #9 have not completed the 2 supervision trainings on Better Kid Care. Previously cited on 8/19/21 and 11/29/21.

At approximately 9:50 am in the infant room, staff person #10, a substitute staff person, was observed manually bouncing child #1 up and down gently in a bouncy seat and the child appeared to be sound asleep.

2nd citation. The file for facility person #1 did not include evidence of emergency plan training. Based on conversation with the operator, the individual received the training in October 2021, but it was not documented. Previously cited 11/29/21.

At approximately 9:50 am in the infant room, staff person #10, a substitute staff person, was observed manually bouncing child #1, an 8 month-old, up and down gently in a bouncy seat and the child appeared to be sound asleep.

2nd citation: The last health assessment in the file for staff person #3 was dated more than 24 months ago. Previously cited on 11/29/21.

2nd citation: Based on conversation with the director, the legal entity did not have the proof of purchase for the facility's fire detection system. When the system was tested during the inspection, the system was interconnected. Previously cited on 11/29/21.

2nd citation: The file for facility person #1, observed working at the front desk on 2/8/22, did not include two letters of reference. Previously cited on 11/29/21.

2nd citation: There was no training on health and safety topics #1 through #9, as required by regulation 31f, in the file for staff person #2 through #9. Previously cited on 11/29/21.

The NSOR certificate in the file for staff person #2 was dated after the individual began working with children. The last two state police clearances in the file for staff person #9 were dated more than 60 months apart. The last state police clearance and child abuse clearance in the file for facility person #10 was more than 60 months old. Based on conversation with the operator, the staff persons continued to work without the proper clearances. Based on conversation with the operator, individual #11 and #12, who were both observed working at the facility's front desk at the time of the inspection, did not have any clearances.

2nd citation: At approximately 10:00 am, upon walking into the infant room, staff person #3 was observed standing inside the doorway between the young toddler room and the infant room, leaving 4 young toddlers with an individual who was not a staff person, but a therapist for one of the children in the classroom. Staff person #3 could not see, hear, direct or assess the 4 children who were in the young toddler room as they were on the other side of the classroom. Previously cited on 8/19/21.

*2nd citation: At approximately 10:00 am, upon walking into the infant room, staff person #3 was observed standing inside the doorway between the young toddler room and the infant room, leaving 4 young toddlers with an individual who was not a staff person, but a therapist for one of the children. Staff person #3 could not see, direct or assess the 4 children who were in the young toddler room as they were on the other side of the classroom. Previously cited on 8/19/21.

**2nd citation: At approximately 10:00 am, upon walking into the infant room, staff person #3 was observed standing inside the doorway between the young toddler room and the infant room, leaving 4 young toddlers with an individual who was not a staff person, but a therapist for one of the children. Staff person #3 could not see, direct or assess the 4 children who were in the young toddler room as they were on the other side of the classroom. Previously cited on 8/19/21.

2nd citation: At approximately 10:00 am, upon walking into the infant room, staff person #3 was observed standing inside the doorway between the young toddler room and the infant room, leaving 4 young toddlers with an individual who was not a staff person, but a therapist for one of the children in the room. Staff person #3 was not physically present with the children in their group and could not see, hear, direct or assess the 4 children who were in the young toddler room as they were on the other side of the classroom. Previously cited on 8/19/21.

Based on review of documentation at the time of the inspection, the plan had not been updated since October 2020.

Based on conversation with the operator, individual #11 and #12, who were both observed working at the facility's front desk at the time of the inspection, did not have training in the emergency plan. The last two emergency plan trainings in the file for staff person #3, #4, #9 were dated more than 12 months apart. The last emergency plan training in the file for facility person #10 was dated more than 12 months ago.

There were several children's tables and chairs set up in the gymnasium, which is the facility's indoor gross motor space. Based on conversation with the director, the tables are used daily during morning drop-off and afternoon pick up for their PreK Counts classrooms.

The file for child #1, a 4 year-old, was missing the following vaccinations: 1 of 4 HIB and 1 of 2 HEP A. The file for child #2, a 33 month old, was missing the following vaccinations: I of 4 pneumococcal, 1 of 4 HIB and 1 of 2 Hep A. The file for child #3, a 20 month old, was missing the following vaccinations: 2 of 4 DTAP, 2 of 4 HIB, 2 of 4 pneumococcal and 1 of 3 polio. The file for child #4, a 7 month old, was missing the following vaccinations: 2 of 3 DTAP, 2 of 3 HIB, 2 of 3 pneumococcal, 1 of 2 polio and 2 of 3 rotavirus. None of the files contained a written statement of exemption by a parent.

The initial health assessment and TB test in the file for staff person #2 and #6 were both dated after the individual started working with children. The last health assessment in the file for staff person #8 and facility person #10, the facility's cook, were dated more than 24 months ago.

Based on review of the facility's emergency plan at the time of the inspection, the plan did not provide accommodations for infants and toddlers.

Based on conversation with the director, the legal entity did not have the proof of purchase for the facility's fire detection system. When the system was tested during the inspection, the system was interconnected.

Based on review of the facility's emergency plan at the time of the inspection, the plan did not provide accommodations for shelter of children during a lock down.

The copy of the facility's liability insurance presented at the time of inspection did not include the building's address.

The last 2 fire safety trainings in the file for staff person #3 were more than 12 months apart. There was no fire safety in the file for staff person #4, employed more than 12 months. The last fire safety in the file for staff person #8 and #9 was dated more than 12 months ago.

The last two Mandated Reporter trainings in the file for staff person #1 were dated more than 60 months apart.

The emergency contact information in the file for child #1 did not include an address or phone number for the child's physician. The emergency contact information in the file for child #2 did not include a phone number for the child's physician.

The emergency contact information in the file for child #4 did not include a work address for the child's mother.

The emergency contact information in the file for child #1 did not include the name of the child's health insurance.

Based on conversation with the operator, the facility did not have a file for individual #11 and #12, who were both observed working at the facility's front desk at the time of the inspection.

Based on conversation with the operator, individual #11 and #12, who were both observed working at the facility's front desk at the time of the inspection, did not have a record that includes their name, address and telephone number.

Based on conversation with the operator, individual #11 and #12, who were both observed working at the facility's front desk at the time of the inspection, did not have a record that included verification of age.

Based on conversation with the operator, individual #11 and #12, who were both observed working at the facility's front desk at the time of the inspection, did not have two letters of reference.

There was no training on health and safety topics #1 through #9, as required by regulation 31f, in the file for staff person #1, #4, and #8. All were hired before 12/19/20 and the training was due by 6/17/21. There was no training on health and safety topics #1 through #9, as required by regulation 31f, in the file for staff person #2, #6 and #7, all hired after 12/19/20 and employed more than 90 days.

The link to the center regulations was not posted at the facility, Based on conversation with the director, parents of enrolled children have not been provided information on how to access the regulations electronically.