ADALUS FAMILY DAYCARE LLC

Clean and good repair (3290.102(a))

Cert Rep observed 38 exposed bolts in the outdoor play space. Requirement: Toys, play equipment and other indoor and outdoor equipment used by the children shall be clean, in good repair and free from rough edges, sharp corners, pinch and crush points, splinters and exposed bolts. Correction: A complete inspection of the outdoor play area was carried out and all the exposed bolts were covered using protective rubber covers on exposed bolts. Inspection: Renewal. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

Parent receives original/Copy of initial and subsequent agreements. Parent receives original. (3290.123(b)/3290.182(8))

Child #1, 2, 3 & 4 do not have a financial agreement on file. Requirement: A parent shall receive the original agreement. The facility shall retain a copy of the agreement. A child's record must contain a copy of the initial agreement and subsequent written agreements between the parent and the operator. The parent receives the original agreement. Correction: The parent/guardian of the child will be contacted to complete and sign the3 facility's financial agreement form immediately. A review of all current files will also be conducted to ensure all children have financial agreements on file. Inspection: Allocated Unannounced Monitoring. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

Physician name, address, phone (3290.124(b)(2))

Child #1 is missing the name, address and telephone number of the child's physician. Requirement: Emergency contact information must include the name, address and telephone number of the child's physician or source of medical care. Correction: The parent/guardian will be asked to provide the required physician information. The enrollment packet will be reviewed and updated to ensure this section is clearly marked as required. Inspection: Allocated Unannounced Monitoring. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

Parent home/work address, phone (3290.124(b)(3))

Child #1 & 3 are missing the work addresses and telephone numbers of the enrolling parent. Requirement: Emergency contact information must include the home and work addresses and telephone numbers of the enrolling parent. Correction: The parent/guardian will be contacted to provide their current work address and telephone number. All enrollment forms will be updated to include this section as a required field. Inspection: Allocated Unannounced Monitoring. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

Written consent/Consent for emergency medical care required prior to admission (3290.124(b)(4)/3290.182(3))

Child #1, 2, 3 & 4 are missing signed written consent by a parent for emergency medical care. Requirement: Emergency contact information must include the written consent signed by a parent for emergency medical care. A child's record must contain signed parental consent for emergency medical care for the child. Written consent is required prior to admission. Correction: A new emergency medical care consent form will be provided to the parent/guardian for immediate signature. Staff will verify that all child files contain signed consents. Inspection: Allocated Unannounced Monitoring. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

Insurance coverage information (3290.124(b)(6))

Child #1 & 3 are missing health insurance coverage and policy number. Requirement: Emergency contact information must include health insurance coverage and policy number for a child under a family policy or Medical Assistance benefits, if applicable. Correction: Parent/guardian will be asked to submit current health insurance information. The form will be re3vised to emphasize the importance of this section. Inspection: Allocated Unannounced Monitoring. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

Name/address/phone release person (3290.124(b)(7))

Child #1 & 2 are missing the name, address and telephone number of the individual designated by the parent to whom the child may be released. Requirement: Emergency contact information must include the name, address and telephone number of the individual designated by the parent to whom the child may be released. Correction: The parent/guardian will complete the designated release section of the emergency contact form. All files will be reviewed for this information and updated accordingly. Inspection: Allocated Unannounced Monitoring. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

Excursions/Signed parental consent for transportation, walking excursions, swimming and wading (3290.124(c)/3290.182(6))

Child #1, 2, 3 & 4 are missing signed written consent for walking excursions. Requirement: When children leave the facility on walking and riding excursions, emergency contact information specific to each child on the excursion shall accompany a staff person on the excursion. A child's record must contain signed parental consent for transportation, walking excursions, swimming and wading. Correction: The parent/guardian will be asked to sign the walking excursion consent form. A consent checklist will be created to ensure completeness during enrollment. Inspection: Allocated Unannounced Monitoring. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).

Consent for administration of minor first-aid required prior to admission (3290.182(5))

Child #1, 2, 3 & 4 are missing signed parental consent for administration of minor first-aid. Requirement: A child's record must contain signed parental consent for administration of minor first-aid procedures by facility staff. Written consent is required prior to admission. Correction: Parent/guardian will be asked to sign a minor first aid consent form. This consent will be make part of the standard enrollment process. Inspection: Allocated Unannounced Monitoring. Source: PA DHS COMPASS provider search (compass.dhs.pa.gov).