RHYMING THYME INC

Emergency plan (3270.27(a)(6))

The facility was lacking a documented emergency drill within the past year. Requirement: Emergency drills shall be conducted annually. Annual emergency drills shall be documented and on file at the facility. Correction: An emergency drill was conducted, and the drill was fully documented, including date, time, type of drill, participating staff, and any noted improvements. The documentation has been placed in the emergency preparedness binder. Inspection: Renewal. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

Emergency plan (3270.27(a)(5))

The facility's emergency plan was lacking accommodations for infants and toddlers. Requirement: The facility shall have an emergency plan that provides for accommodations for infants, toddlers, children with disabilities, and children with chronic medical conditions. Correction: The emergency plan has been updated to include detailed procedures for safely evacuating and caring for infants and toddlers. Additions include the use of evacuation cribs, infant carriers, toddler walking ropes, designated caregiver assignments, and portable emergency supply kits. The revised plan has been distributed to staff and placed in the emergency binder. Inspection: Renewal. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

Exemption documentation from parent/guardian (3270.131(e)(1))

The file for Child #2 contained an immunization record that was lacking 1 dose of DTAP, 2 doses of HIB, 1 dose of Pneumococcal, 1 dose of MMR, 1 dose of Varicella and 2 doses of Hepatitis A. Requirement: The facility shall require the parent 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 an infant, toddler or preschool child in accordance with the schedule recommended by the ACIP. Correction: The parent/guardian was notified immediately and provided with a written request for an updated immunization record. A current immunization record has now been obtained and placed in the child's file. The file is in full compliance. Inspection: Renewal. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

Toddler/preschool: updated health report every 12 months (3270.131(b)(2))

The file for Child #2 contained a child health report that was obtained more than 12 months ago. Requirement: The operator shall require the parent to provide an updated health report at least every 12 months for an older toddler or preschool child. Correction: A current Child Health Report has been obtained from the child's parent/guardian and placed in the child's file. The file now meets all health documentation requirements. Inspection: Renewal. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

Admission date/Application, admission, withdrawal dates (3270.123(a)(6)/3270.182(2))

The file for Child #1 contained an Agreement form that was lacking the child's admission date. Requirement: An agreement shall specify the date of the child's admission. A child's record shall contain the dates of application, admission and withdrawal of the child. Correction: The Agreement form for Child #1 was updated to include the correct admission date as per original documentation and verification from ELRC3. The completed form has been placed in the child's file. Inspection: Renewal. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

Date fee to be paid (3270.123(a)(2))

The file for Child #1 contained an Agreement form that was lacking that date on which the fee is to be paid. Requirement: An agreement shall specify the date on which the fee is to be paid. Correction: Consulted with enrolling parent and discussed the date in which fees are to be paid weekly, which is on Fridays. Agreement has been updated and copies placed in the child's file. Inspection: Renewal. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

Infant sleep position (3270.119)

Upon arrival in the infant room at approximately 10:15am, a 2-month-old infant was observed sleeping in their crib on their stomach, which is not the sleeping position recommended by the American Academy of Pediatrics. Requirement: Infants shall be placed in the sleeping position recommended by the American Academy of Pediatrics unless there is a medical reason an infant should not sleep in this position. The medical reason shall be documented in a statement signed by a physician, physician's assistant or CRNP and placed in the child's record at the facility. Correction: Classroom staff were reminded that no alternate sleep position may be used without proper documentation. All infant files have been reviewed. Any child requiring an alternate sleep position now has a current, signed medical statement from an approved medical professional placed in their record. · Inspection: Renewal. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

Comply with CPSL (3270.32(a))

The file for Staff #1 contained 2 child abuse clearances that were more than 60 months apart. The file for Staff #3 and #4 both contained 2 state police clearances, 2 child abuse clearances and 2 FBI clearances that were all more than 60 months apart. Requirement: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). Correction: All required clearances for Staff #1, #3, and #4 were immediately updated. Each staff member has now submitted current State Police, Child Abuse, and FBI clearances that meet the 60month requirement. Updated clearances have been placed in each staff file and verified by the director Inspection: Renewal. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

Handwashing signs (3270.82(h))

During observation of two diaper changes in the infant room, the staff member did not wash her hands or the children's hands after each diaper change. Requirement: A facility person and an able child shall wash his hands after toileting and before eating. A sign on which this requirement is written shall be posted at each toilet, training chair, diapering area and sink in the facility. Correction: All staff will wash their hand and change their gloves in between diapering and toileting children. They will also ensure the hands of each child is washed as well. Inspection: Renewal. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

Comply with CPSL (3270.32(a))

The file for Staff #1 contained two state police clearances dated 1.6.20 and 1.13.25, two child abuse clearances dated 1.6.20 and 1.13.25, two FBI clearances dated 1.8.20 and 1.14.25 and two NSOR certificates dated 12.6.19 and 12.16.24 all of these were more then the 60 month requirement of the CPSL. The file for Staff #2 contained two child abuse clearances dated 9.2.19 and 10.29.24 which is more than the 60 month requirement of the CPSL. Requirement: The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). Correction: All staff files are current. Inspection: Renewal. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

Infant: updated health report every 6 months/Initial and subsequent health reports (3270.131(b)(1)/3270.182(1))

The file for Child #3, a young toddler age child, contained a health assessment that was more than 6 months old. Requirement: The operator shall require the parent to provide an updated health report at least every 6 months for an infant or young toddler. A child's record shall contain initial and subsequent health reports. Correction: An updated immunization records has been requested and received. Inspection: Renewal. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

Toddler/preschool: updated health report every 12 months/Initial and subsequent health reports (3270.131(b)(2)/3270.182(1))

The file for Child #1, who is a preschool aged child, contained two health assessments that were more than 12 months apart. The file for Child #2, who is a older toddler aged child, contained two health assessments that were more than 12 months apart. Requirement: 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 child's record shall contain initial and subsequent health reports. Correction: Both files have current Child Health Records Inspection: Renewal. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

Disposable diapers (3270.135(a)(3))

In the infant room, soiled diapers were observed being placed into plastic bags and placed out on a deck. The hands-free garbage can in the infant room was not operable. Requirement: If disposable diapers are provided by a parent or by a facility, a soiled diaper shall be discarded by immediately placing the diaper into a plastic-lined, hands-free covered can. Correction: All soiled diapers will be placed in a lined trash can for disposal. We will no longer us the small individual plastic bags for diapers. All batteries will be replaced immediately in the hands-free trash can. This will ensure we have an operable hands-free trash can at all times. Inspection: Renewal. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

Exemption documentation from parent/guardian (3270.131(e)(1))

The file for Child #3 contained an immunization record that was lacking one dose of HIB and one dose of Pneumococcal vaccines. Requirement: The facility shall require the parent 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 an infant, toddler or preschool child in accordance with the schedule recommended by the ACIP. Correction: We have obtained updated records. However, due to the child's recent physical health condition, the doctor has been unable to complete the 15 month immunizations. Documentation will be sent via email. Inspection: Renewal. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

Availability of certificate of compliance and applicable regulations (3270.25(a))

The facility was lacking information to parents on how to access the regulations electronically. Requirement: The facility's current certificate of compliance shall be posted in a conspicuous location used by parents. The operator shall provide the parent of each child enrolled with information on how to access the regulations in this chapter electronically and with instructions for contacting the appropriate regional child care office. Correction: We have posted the information on all bulletin boards for how parents may access PA Chapter regulations electronically. We have also provide the QR Code to parents via our communication system call Brightwheel. Inspection: Renewal. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).