Liberty Extended Day Program

The disclosure statement in the file for Staff #1 lacked a date. Although the file for Staff #2 contained a National Sex Offender Certificate at the time of inspection, it was observed that Staff #2 did not obtain the certificate within 45 days of hire and therefore was incorrectly provisionally hired. The file for Staff #3 lacked a PA State Police Clearance or request for the Clearance. The file for Staff #3 who has lived outside of Pennsylvania in the last five years lacked Maryland's clearances or request for the clearances.

Trash that has been contaminated by human secretions or excrement was observed in a non-lidded, open trash receptacle in the two bathrooms and in the cafeteria space.

The file for Staff #4 did not contain documentation of receiving training regarding the emergency plan within the past 12 months. The file for Staff #5 contained Emergency Plan trainings that were dated more than 12 months apart.

The Epi Pen observed at the facility for Child #2 was expired.

Observed the medication at the facility for Child #1 and Child #2 lacked written parental consent for administration of the medication.

The file for Staff #3 lacked a Health Assessment. The last two health assessments in the file for Staff #5 were dated more than 24 months apart.

The file for Staff #3 lacked tuberculosis screening by the Mantoux method.

The facility's emergency plan lacked accommodations for infants, toddlers, children with disabilities, and children with chronic medical conditions.

Based on conversations with the operator, the operator did not send a copy of the emergency plan to the local or county municipalities.

The facility's written Shaken Baby Policy did not address the 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 addressing the prevention and identification of child maltreatment.

The files for Staff #4 and #5 did not contain documentation of training in fire safety in the last year.

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

Although the file for Staff #2 contained Pediatric First Aid/CPR at the time of inspection, it was observed that the file for Staff #2 did not contain Pediatric First Aid/CPR within 90 days of hire.

Although Staff #5 had current Mandated reporter Training at the time of the Renewal Inspection, it was observed that Staff #5 updated Mandated Reporter Training in an interval greater than 60 months.

The file for Staff 4 did not contain an evaluation completed within the previous 12 months

The Agreement in the file for Child #1 lacked the operator's signature.

The Agreement for Child #1 lacked the date of the child's admission.

The file for Staff #3 lacked two written, nonfamily references from individuals attesting to the person's suitability to serve as a facility person.

The file for Staff #4 and #5, lacked documentation of the annual 12 clock hours of childcare training for the 12/22-12/23 training year.

Staff person #1 and #3 were observed to be caring for children unsupervised. Staff person #1 has not completed the following pre-service training required prior to caring for children unsupervised: Health and safety training. Staff person #3 has not completed the following pre-service training required prior to caring for children unsupervised: Health and safety training and First-aid/CPR training.

The file for staff person #1, hired provisionally on (SEE LIS CODE DATE) and past their 45-day provisional period, did not include an NSOR clearance. The file for staff person #3, hired provisionally on (SEE LIS CODE SHEET), did not include clearances for North Carolina. Based on review of the file, they had a driver's license from North Carolina issued in 2021 and reference letters regarding experience in North Carolina in 2023. When the operator was asked when the individual moved to Pennsylvania, they stated it was within the last year. At approximately 4:40 pm, staff person #1 and #3 were the only staff outside with a group of children.

The following medications were observed as accessible to children, as they were stored on the steps of the facility's storage area next to the girls' bathroom: an epi-pen, albuterol and OTC allergy medications. The door to the storage area was unlocked at the time.

The albuterol for child #7 was expired. The box containing the medication listed 5/31/24 as the expiration date, however, the actual canister listed the expiration date of July 2023.

There was no written parental consent for albuterol belonging to child #6.

The health assessment in the file for staff person #1, #2 and #3 was dated after the individual began working with children. The last health assessment in the file for staff person #4, #5 and #7 was dated more than 24 months ago.

The TB screening in the file for staff person #1 was dated after the staff person began working with children.

Based on review of the facility's fire drill log, there was one time when fire drills were conducted more than 60 days apart: 11/3/22 and 1/11/23. The drill listed on 12/1/22 was a tornado emergency drill.

Based on review of the facility's fire drill log, the hypothetical location of the fire for consecutive drills on 2/6/23 and 3/8/23 was the cafeteria.

Based on review of the facility's fire drill log, there was not an evacuation time listed for drills on 1/11/23 and 2/6/23.

Based on conversation with the operator, there was not proof that the most recent updates to the facility's emergency plan were sent to the local and county emergency management agencies.

The health and safety training and the First-aid/CPR training in the file for staff person #6 were dated beyond their first 90 days working with children.

The mandated reporter in the file for staff person #6 was dated beyond their first 90 days working with children.

The file for staff person #2, holding the title of group supervisor, did not include evidence of a bachelor's degree in a related field.

The file for staff person #1 and #6, both holding the title of assistant group supervisor, included a high school diploma, but did not include evidence of 2500 hours of experience.

The agreement forms in the file for child #1 through #5 were not signed by the operator.

The agreement forms in the file for child #1 through #5 did not specify the child's date of admission.

The emergency contact information in the file for child #4 did not include the addresses for all 4 release persons.

Based on conversation with the operator and review of the files for child #3 and #4, a third copy of all injury/illness reports were not being retained in the children's files.

The updated health report for child #1, which included a statement that the child is able to participate in child care and appears to be free from communicable disease, did not include a name, title or written or electronic signature of the individual who completed the form.

2nd citation: The health assessment for staff person #7 did not include an examination for communicable diseases and the results of that examination or the physician's or CRNP's assessment of the person's suitability to provide childcare. Previously cited on 12/16/22.

The hypothetical location was listed as "cafe" for consecutive drills on 1/11/23 and 2/6/23.

2nd citation: The facility's emergency plan was updated with a statement that they had a plan for continuity of operations, but the actual plan was not addressed. The facility's shaken baby sydrome policy did not address the signs/symptoms of shaken baby, how to cope with a crying/distarught child and the identification and prevention of child maltreatment. Previously cited on 12/16/22.

On 11/29/22, staff person #2 and #4 were observed to be caring for children unsupervised. Staff person #2 and #4 has not completed the following pre-service training required prior to caring for children unsupervised: Mandated reporter.

The last state police clearance and FBI clearance for staff person #2, who who was observed caring for children, were dated 9/13/17 and 9/18/17 respectively. The file for staff person #5, hired provisionally and beyond their 45-day provisional period, did not include a signed disclosure statement or state police clearance and based on conversation with the operator, was caring for children. The file for staff person #6, who was hired provisionally and beyond their 45-day provisional period, lived out of state in the previous 5 years and did not include the child abuse or sex offender registry for that state or a signed disclosure statement. The file for staff person #7, whose date of hire was 10/7/21 and was not listed on the previous year's staff sheet, did not include a signed disclosure statement.

At approximately 5:05 pm, an older schoolager was observed leaving the cafeteria unsupervised. When asked where the child was going, staff stated that the child was walking to the gym, which is at the other end of the first floor hallway.

At approximately 5:05 pm, an older schoolager was observed leaving the cafeteria unsupervised. When asked where the child was going, staff stated that the child was walking to the gym, which is at the other end of the first floor hallway.

At approximately 4 pm, staff person #2 and #4 were observed in the cafeteria with 22 schoolagers. When asked to identify for whom they were responsible, staff person #2 identified 8 children and staff person #4 identified 11 children, leaving 3 children unidentified. Staff were not able to identify which 3 children were missed. The staff were asked to identify their groups again and the children's names were read back to them for clarification. 3 children were still unidentified and staff were not able to identify which 3 children were missed. This certification representative pointed to each child in the cafeteria and asked their names and at that time, the certification representative was able to identify the 3 children who were not identified. At approximately 5:05 pm, an older schoolager was observed leaving the cafeteria unsupervised. When asked where the child was going, staff stated that the child was walking to the gym, which is at the other end of the first floor hallway.

The last documented review of the emergency plan was more than 12 months ago.

The last emergency plan training in the file for staff person #2 and #3 was 9/15/21. The last emergency plan training in the file for staff person #4 was 9/16/19. There was no emergency plan training in the file for staff person #5, #6 and #7, all working with children more than 90 days.

The health report in the file for child #1 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.

There was no written instructions or prescription for the epi-pen belonging to child #3.

The epi-pen belonging to child #2 was expired.

There was no written parental consent for the epi-pen belonging to child #2 and #3.

The health assessment for staff person #7 did not include an examination for communicable diseases and the results of that examination.

The file for staff person #7 did not include the physician's or CRNP's assessment of the person's suitability to provide child care.

The fire drills documented on the log since 12/16/21 did not specify the time of day or the hypothetical location of the fire.

The facility's emergency plan did not include information regarding continuity of operations. The facility did not have a shaken baby sydrome policy.

The liability insurance on file at the facility at the time of the inspection expired 8/21/22.

The last two fire safety trainings in the file for staff person #1, #2, #3, #4 and #6 were dated 10/21/21 and 12/14/22. The only fire safety training in the file for staff person #7, hired 10/7/21, was dated 11/17/22.

Staff person #3 has not completed the following required pre-service training within 90 days of their date of hire: First-aid/CPR. Staff person #5 has not completed the following required pre-service training within 90 days of their date of hire: First-aid/CPR and Health and safety training.

Staff person #2 and #4 has not completed mandated reporter training within the last 60 months. This is evidenced by the previously documented mandated reporter training on file being dated 9/20/17 for staff person #2 and 11/4/16 for staff person #4.

The last evaluation in the file for staff person #2 was dated 9/20/21. The last evaluation in the file for staff person #3 was dated 9/15/21. The last evaluation in the file for staff person #4 was dated 10/26/21. There was no evaluation on file for staff person #7, employed more than 12 months.

Based on conversation with the operator, staff person #7, holding the title of group supervisor, has a bachelor's degree in Sociology, but there no proof of the degree on file.

The agreement in the file for child #1 did not specify the amount of the fee to be charged per day or per week.

The agreement in the file for child #1 did not specify the date on which the fee is to be paid.

The file for child #2 did not include the written consent signed by a parent for emergency medical care.

The file for child #2 did not include the written consent signed by a parent for minor first-aid.

The file for staff person #2 included 10 hours of child care training between 12/19/20 and 12/19/21.

The file for staff #1 contained an FBI clearance which indicated there was a record, however the attachment was not present in the file therefore the clearance is invalid. The file for staff #2 contained out of state clearances which were obtained after their first day in a child care position for this program year. The program year started on 9/03/21 and the Florida Department of Children and Families clearance was not obtained until 10/21/21. The Florida Department of Law Enforcement clearance was obtained on 9/14/21. The file for staff #3, with a start date of 10/13/17, contained an NSOR certificate obtained after their first day in a child care position for this program year after being closed due to covid 19. The program year started on 9/03/21 and the NSOR for staff #3 was dated 11/02/21.

Based on documentation at the facility, staff have not received emergency plan training on an annual basis or prior to returning to their child care positions after the program was closed due to covid-19. Previous training documentation was not on file. The files for staff #3 and staff #5 lack current emergency plan training. All other staff now have current training on file.

The files for staff #1, #2, and #3 contained health assessments which were not updated within 24 months as required. The most recent health assessments on file for all 3 staff are now current.

The files for children #3 and #5, both enrolled over the 90 days allowed due to the Covid 19 related regulation suspension, did not contain health reports. The file for child #2 contained a health report which lacked a date therefore compliance could not be determined.

Based on documentation on file, staff #1, #2, #3, #5, and #6 did not renew certification in pediatric CPR and first aid on or before the expiration of their previous certification or prior to returning to child care positions when the program reopened after being closed due to Covid-19. The files for staff #1, #2, #5 and #6 now contain current certification. The file for staff #3 lacks documentation of current certification in pediatric CPR and pediatric first aid.

Based on documentation at the facility, staff did not receive fire safety training on an annual basis or prior to returning to child care positions when the program reopened after being closed due to Covid-19.The files for staff #1, 2, 3, 5, and 6 now contain current fire safety training documentation.

The file for staff #4, with a start date of 9/09/21, did not contain documentation of Pediatric first aid and pediatric cardiopulmonary resuscitation.

Based on documentation, staff have not received written evaluations on an annual basis or upon returning to child care positions when the program reopened after being closed due to covid-19. The files for staff #2, #5, and #6 now contain current evaluations. The files for staff #1 and #3 do not contain current written evaluations.

The file for staff #2, designated as a co-director, did not contain verification of 1 year of experience with children.

The file for staff #1, designated as a co-director, did not contain verification of 2 years experience with children.

The file for child #1 contained an agreement which was not signed by the operator.

The file for child #4 contained an agreement which did not specify the amount of the fee.

The files or children 1-5 contained agreements which did not specify the date on which the fee is to be paid.

The files for children 1-4 contained agreements which did not specify the child's arrival and departure times.

The file for child #1 contained an agreement which did not specify the date of the child's admission.

The files for children #3 and #5 contained emergency contact information which did not include the work addresses and telephone numbers of the enrolling parent.

The file for child #4 contained emergency contact information and an agreement which have not been reviewed and updated since 5/11/2017.

The facility lacked means of providing parents with information on how to access the regulations in this chapter electronically.