Joshua Group

The file for staff person #1 contained a pediatric first Aid and CPR certification with an expiration date of 3/8/2024 and an update certificate on 6/13/2024. The file for staff person # 6 contained a pediatric first aid & CPR certificate with an expiration date of 1/3/24 and an update certificate on 6/13/2024.

The agreement form on file for child # 1, Child #2, child #3, child #4, and child #5 did not contain the child's admission date.

The agreement form on file for child #1, Child #2, Child #3, child #4, and child#5 did not include information related to services which are to be considered extra.

The health assessments on file for staff person # 3 contained a subsequent health assessment that was beyond 24-month timeframe. The health assessments on file were dated 8.20.24 and again on 7.29.22.

The file for staff person #1 did not contain a NSOR clearance report and a DHS approved FBI clearance on file within 45 days of hire.

The file for child #1, and Child #4, and child #5 included a record of the child's immunization status which lacked an influenza immunization. The file for child # 2 included a record of the child's immunization status which lacked the most current influenza immunization. The last recorded influenza immunization was dated 2/10/2020.

The facility's parent emergency letter did not include language related to accommodations for infants, toddlers, children with disabilities, and children with chronic medical conditions.

Staff person #1 and staff person #3 were observed in the Preschool -3 classroom to be caring for children without having completed pre-service training. Staff person #1 and #3 have not completed the following pre-service training that is required prior to caring for children unsupervised: Get Started with Center-Based Care: Building Blocks for Quality. The facility's current Prevention of Shaken Baby Syndrome, Abusive Head Trauma, and Child Maltreatment policy did not include strategies for coping with a crying, fussing, or distraught child and did not include the prevention and identification of child maltreatment. The facility's emergency plan did not address the programs continuity of operations.

The agreement form on file for child # 2 did not include the release persons as designated by the parent.

The file for staff person # 4 did not include verification of education or experience prior to service at the facility. The file for staff person # 1 did not include verification of experience prior to service at the facility.

The file for Staff person #4 does not contain an initial physical prior to working with children. The file for Staff person # 3 did not have an initial physical completed within 1 year of working in a childcare position. The physical for staff #3 on file was dated 8.21.2023.

It was observed that staff person #1s mandated reporter training was completed on 6/5/17 with an update on 8/15/22, more than 60 months renewal timeframe as required. The file for Facility person # 3 did not include NSOR results within the 45 days of provisional hire timeframe.

It was observed that the facility's emergency plan did not contain a method for facility persons to inform parents that the emergency has ended and to provide instruction as to how parents can safely be reunited with their children.

It was observed that metal studs were exposed and need to be recovered and repaired.

It was observed in the Preschool 1 room that rest mats were not labeled for the use of a specific child.

The facility did not require the parent of Child #2, Child#3, and Child#4 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 a toddler or preschool child in accordance with the schedule recommended by the ACIP nor did the facility require the parent to provide an exemption from immunization statement for religious belief or strong personal objection equated to a religious belief. Child #2 has documentation of last receiving the influenza vaccination on 1/2/2019 which is not in accordance with the schedule recommended by the ACIP. Child # 3 has documentation of last receiving the influenza vaccination on 2/17/2019 which is not in accordance with the schedule recommended by the ACIP. Child # 4 has documentation of last receiving the influenza vaccination on 12/2018 which is not in accordance with the schedule recommended by the ACIP.

It was observed that the emergency plan on file did not include accommodations for infants, toddler, children with disabilities and children with chronic conditions.

The files for facility person #1, facility #2, facility person #5, and facility #6 included documentation of a written evaluation dated 8/25/20 with no annual update.

It was observed that that parents did not receive the original agreements. Original agreements were in files for child #1, child #2, child #3, child #4, and child #5.

It was observed that the emergency contact for child #5 did not contain signed parent consent for the administration of minor first aid procedures.

The file for Facility Person #3 hired 9/7/2021 does not contain a completed Child Abuse clearance, FBI clearance or NSOR verification. The LE does not have an approved waiver to hire provisionally. The file contains a copy of the request for the NSOR verification dated 8/25/2021 but no other copies of the requests for clearances/verification. The file for Facility Person #4 hired 9/7/2021 does not contain the results of the NSOR verification. The file contains a copy of the request for the NSOR verification dated 8/25/2021. The LE does not have an approved waiver to hire provisionally.

The health report for Child #5 is not signed by a physician, physician's assistant or a CRNP.

The adult health assessment for Staff Person #1 does not include an examination for communicable disease and the results of that examination.

The provider does not have proof of purchase of the interconnected, fire detection system that is installed at the facility and is therefore, not in compliance with the standards established under section 1016(c) of the act (62 P.S. § 1016(c)).

All staff members and facility persons last completed fire safety training on 10/14/2020, which is beyond the annual requirement.

The agreement for Child #1, #3, #4, and #5 does not specify the persons designated by a parent to whom the child may be released.

Emergency contact information for Child # 3 and #4 does not include the telephone number of the child's physician or source of medical care.

Emergency contact information for Child #1 does not include the home telephone number of the enrolling parent. Emergency contact information for Child #2, #3 and #4 does not include the work address and telephone number of the enrolling parent.

Emergency contact information for Child #2, #3 and #4 does not include the policy number for a child under a family policy or Medical Assistance benefits.

Emergency contact information for Child #2 does not include the address of the individual designated by the parent to whom the child may be released. Emergency contact information for Child #3 does not include the telephone number of the individual designated by the parent to whom the child may be released.