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Some Pennsylvania Family Child Day Care Centers Did Not Always Comply With State Health and Safety Requirements

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The Pennsylvania Department of Human Services (State agency) conducted the required inspections at all three of the providers that we reviewed and ensured that all three providers complied with the administrative and background check requirements. However, this onsite monitoring did not ensure that the providers complied with all State licensing requirements related to the health and safety of children. Specifically, we found that all three providers did not comply with requirements related to the physical conditions of their child day care centers.

The State agency lacked a sufficient number of inspectors to identify all areas of noncompliance. At the time of our review, the State agency's average ratio of inspectors to providers was 1:143, which far exceeds the 1:50 ratio recommended by Child Care Aware of America. Reducing the inspectors' caseload would enable the State agency to ensure more frequent and thorough onsite monitoring of childcare providers.

We recommended that the State agency (1) correct the specific health and safety issues with the providers noted in this report and (2) ensure more thorough onsite monitoring of providers' compliance with health and safety requirements by reducing licensing inspectors' caseloads. The State agency concurred with our findings and provided information on actions it had taken and planned to take to address our recommendations.

Filed under: Center for Medicare and Medicaid Services