MILESTONES LEARNING CENTER OF ASHLAND

During the inspection, it was determined the information in number(s) 7 below was not up to date in the Ohio Child Licensing and Quality System (OCLQS): 1. Mailing address2. Telephone number3. Email address4. Days and hours of operation5. Services offered6. Name of program7. Private pay ratesTechnical assistance was provided, and as discussed, log on to OCLQS and update the information, as required.

Resolution: Compliance Status: Approved – Technical Assistance Provided

During the inspection, it was determined employment records in the Ohio Professional Registry (OPR) were not created or maintained as noted in number(s) 5,6,7 below: 1. At least one administrator, employee or child care staff member (including substitutes) had not created a profile.2. At least one administrator, employee or child care staff member had not created an employment record for the program on or before their first day of employment. 3. At least one administrator, employee or child care staff member had not updated changes to positions or roles within five calendar days of the change.4. The administrator had not assigned at least one employee or child care staff member to the program's organization dashboard. 5. At least one individual's schedule was not current.6. At least one individual's position or role did not include an applicable group assignment.7. At least one individual's employment had not been end dated.8. Other: [ ]Submit the program's corrective action plan to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Submitted

In review of the staff records, it was determined that child care staff member(s) did not meet the requirements for completing the online orientation training as noted in number(s) 2 below:1. The training was not completed within 30 days of starting employment at the program as a child care staff member.2. Documentation of completing the training after December 31, 2016 was not on file.3. Completion of the training was not verified in the OPR.4. A child care staff member had sole responsibility of children and had not completed the online orientation.Submit the programs corrective action plan to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Submitted

In review of the staff records, it was determined that the medical statements for the employees listed on the Employee Record Chart did not meet the requirements as listed in number(s) 5b, 6a below. 1. A medical statement was not on file for at least one employee;2. The medical statement(s) on file did not have a date of examination within 12 months of the employees first day of employment;3. Date of examination was missing;4. Signature, business address, or telephone number of the licensed physician, physician assistant, advanced practice nurse, certified midwife, or certified nurse practitioner who completed the examination was missing;5. A statement was missing that verifies the employee is: a. Physically fit for employment in a program caring for children; b. Immunized against Tetanus, Diphtheria, Pertussis (Tdap); c. Immunized against Measles, Mumps, and Rubella (MMR);6. Tuberculosis (TB) screening/test information was missing: a. Documentation of the screening process to determine if the employee resided in a country identified by the world health organization as having a high burden of TB and arrived in the United States within the five years preceding the date of application for employment. b. Results of a TB test for employees meeting both criteria in 6a. c. Results of additional testing for employees with a positive TB test. d. Written statement, signed by a representative of the TB control unit, that the employee's TB is no longer infectious or the individual is receiving a TB treatment regimen for employees with a positive TB test. Submit the programs corrective action plan, which includes a copy of the completed employee medical statement, or TB results/documentation, to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Submitted

In review of the staff records, it was determined that at least one child care staff member did not meet the annual professional development requirement as noted in number(s) 1 below: 1. The child care staff member(s) had not completed at least six hours of professional development.2. Documentation did not demonstrate the person who provided the training met the trainer qualifications as stated in the rule. 3. Training topic did not meet the requirements listed in appendix A of this rule. 4. Documentation of training did not meet the requirements of this rule.5. The substitute(s) had been used more than ninety days annually between July first and June thirtieth and had not completed at least six hours of professional development 6. Other [ ].Submit the programs corrective action plan to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Submitted

In review of the staff records, it was determined that at least one child care staff member had not completed required health and safety training as noted in number(s) 1, 2, 3, 5, 6 below:1. Child abuse and neglect recognition and prevention training was not completed within sixty days of hire.2. First aid training was not completed within ninety days of hire.3. Cardiopulmonary resuscitation (CPR) training was not completed within ninety days of hire.4. The child abuse and neglect recognition and prevention training was expired.5. The first aid training was expired.6. The CPR training was expired.Refer to the Employee Record Chart for the name(s) of the child care staff member(s) who must complete the required health and safety training(s). Submit the programs corrective action plan to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Submitted

During the inspection, it was determined that the playground did not have adequate fall surface under and around equipment as noted in number(s) 2 below: 1. No fall surface2. Adequate fall surface to soften the impact of a fall3. Adequate fall surface to soften the impact of a fall that extended the length of the required fall zone 4. Other [ ] With any equipment designed for climbing, swinging, bouncing, or sliding, resilient material, as specified in Appendix A, needs to be added in order to protect children in the event of a fall. Submit the programs corrective action plan, which includes written verification of the discontinued use of this equipment until corrections are made along with a description of the resilient material added, to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Submitted

During the inspection, it was determined that outdoor play equipment was unsafe or not used as intended as noted in number(s) 1, 2, 3, 5, 6, 9, 10, 14 below:1. There was rust exposed: adult and children chairs, bikes, stroller, red metal truck.2. There were protruding bolts: pole on climber, umbrella poles. 3. There were cracks: storage bin with broken lid.4. There were holes.5. There was splintering wood: climber, wood planks around playground equipment.6. There were sharp edges or points: pole on climber, umbrella poles. 7. There were lead hazards.8. There were toxic substances.9. There were tripping hazards: toys, screens.10. There was chipped and/or peeling paint: on swing set, water table.11. The sandbox was not covered when the program was closed or during non-daylight hours. 12. Outdoor equipment, [ ] was not developmentally appropriate.13. Outdoor equipment, [ ], was placed in the main traffic pattern.14. Outdoor play equipment, brown climber and slides on toddler playground, was positioned too closely together, posing a risk of injury if a child were to fall from one piece of equipment into another.15. Outdoor equipment, [ ], was not securely anchored but did not present a risk of imminent danger of the structure collapsing when children are using the equipment16. Outdoor equipment, [ ], was 30 inches or more from the ground and did not have a protective barrier that would prevent a child from falling off this piece of equipment.17. The manufacturer's guidelines for assembly and installation were not followed for the [ ].18. Functionally linked equipment was used by preschool-age children and the distance between two adjacent pieces of equipment exceeded 12 inches.19. Functionally linked equipment was used by school-age children and the distance between two adjacent pieces of equipment exceeded 18 inches.20. Other [ ]. Submit the programs corrective action plan to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Submitted

During the inspection, it was determined that the outdoor play space was not free of trash or foreign objects as noted in number(s) 1, 15 below:1. The outdoor area was littered with trash.2. The trash can was missing a lid. 3. The trash can was not emptied from the day(s) before. 4. The trash can was overflowing with trash.5. The trash can was infested with insects.6. The trash can was visibly dirty.7. There was broken glass. 8. There were tall weeds. 9. There was poison ivy. 10. There were tree branches. 11. There was mold visible. 12. There were thistles with prickers. 13. There were bird droppings. 14. The sandbox was contaminated.15. Other: soaked blankets and towels on ground and dirty toys on infant playground. Submit the programs corrective action plan to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Submitted

Children in care shall be protected from any items and conditions which threaten their health, safety, and well-being. During the inspection, it was determined that at least one area of the program or at least one piece of equipment had chipping or peeling paint. Submit the programs corrective action plan to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Submitted

During the inspection, a potentially hazardous item or toxic substance was used or stored in the staff room where children had access to it, as noted in number(s) 2, 5, 14 below. 1. Bleach. 2. Cleaning agent. 3. Fish tank chemicals. 4. Gasoline. 5. Pesticide. 6. Poison, including insect/rodent poison. 7. Flammable substance. 8. Windshield washer fluid. 9. Aerosol cans. 10. A lawn mower. 11. A weed trimmer. 12. Hedge trimmers. 13. A snow blower. 14. Other potentially hazardous substance, equipment or machinery: drill/tools.Provide staff training. Submit the programs corrective action plan, which includes a statement that the potentially hazardous substance or item is no longer accessible to children and/or children will not be outside when machinery is in use and a statement that training was provided, to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Submitted

During the inspection, it was determined that children were not protected from item(s) or condition(s) which may threaten their health, safety, or well-being as noted in number(s) 1, 4, 5, 6 below: 1. Surge protectors/outlets did not have childproof receptacle covers and had too many plugs in one outlet in school age.2. Open pull cords that are not closed loop. 3. Toys or other items small enough to be swallowed were present in the space where infants and/or toddlers were in care.4. Electrical/extension cords attached to an object that would not likely result in a severe injury if pulled in school age and preschool 1. 5. Stacked chairs in school age.6. Employee(s) purse(s) in preschool 1 . 7. Diaper bags.8. Television not securely anchored.9. Small or lightweight pieces of shelving units are not securely anchored to the wall. 10. Smoke detector needing batteries replaced.11. An area rug did not have a nonskid backing.12. An area rug presented a tripping hazard.13. A floor surface that was unsafe in that [ ].14. No platform was provided for the sink or toilet in the [ ] classroom.15. The platform provided for the sink or toilet in the school age classroom was not sturdy as it was cracked.16. The platform provided for the sink or toilet in the [ ] classroom posed a safety hazard in that [ ].17. Telephone cords.18. Staff member stepped over a barrier/gate while holding a child.19. Emergency exits were blocked by the following classroom furniture: [ ]. 20. A mercury thermometer was being used to take a childs temperature. 21. Methods of ventilation used did not provide protection from rodents, insects, or other hazards.22. Other [ ].Provide staff training. Submit the programs corrective action plan, which includes a statement that training was provided, to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Submitted

During the inspection, equipment was determined to be unsafe, hazardous to children, or in need of repair as noted in number(s) 8 below: 1. Manufacturer's guidelines for the [ ] were not followed in that [ ]. 2. The straps were missing on the [ ].3. The straps were attached, but were not used on the [ ]. 4. The straps were attached and were used, but were not used in a safe manner.5. The equipment had sharp points or corners.6. The equipment had splinters.7. The equipment had protruding nails.8. The equipment had loose or rusty parts; file cabinet in preschool 1.9. The equipment had paint which contains lead or other poisonous materials.10. The equipment had hazardous features.11. A fan was unstable and could easily tip over. 12. A fan had openings a finger could enter.13. The pipes from the heat pump felt hot to the touch14. A space heater felt hot to the touch15. The position of a space heater was a tripping hazard16. The air conditioning unit was not enclosed and was accessible to children on the playground. 17. A ball pit, trampoline, inflatable bounce house, inflatable slide, or inflatable equipment used for climbing and bouncing was used. 18. Other [ ].Submit the programs corrective action plan to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Submitted

During the inspection, a potentially hazardous substance, which was determined to not present a serious risk to a child, was not used or stored properly as noted in number(s) 11 below: 1. Cosmetics were accessible to children in the [ ] area.2. Disinfecting wipes were accessible to children in the [ ] area.3. Fish food was accessible to children in the [ ] area.4. Hand lotion was accessible to children in the [ ] area.5. Hand sanitizer (for children under 24 months) was accessible to children in the [ ] area.6. Laundry detergent was accessible to children in the [ ] area.7. Powder dish washing soap was accessible to children in the [ ] area.8. Paint cans were accessible to children in the [ ] area.9. White out was accessible to children in the [ ] area.10. Potting Soil was accessible to children in the [ ] area.11. Other potentially hazardous substance shaving cream was accessible to children in the preschool 1 area.12. Cleaning/sanitizing supplies had not been clearly labeled.13. School-age children were using cleaning supplies, agents and/or equipment without adult supervision.14. A spray aerosol was used in the [ ] group while children were in attendance. 15. Other: [ ].Provide staff training. Submit the programs corrective action plan to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Submitted

During the inspection, it was determined that the program was not providing a clean and healthy environment, furniture, materials and equipment as required by Appendix A, as noted in number(s) 3, 8, 27, 30 below:1. Item(s) soiled with blood or bodily fluids were not cleaned/sanitized immediately. 2. Blankets/sheets were not cleaned weekly, when soiled, or before use by another child. 3. Children's individual blankets and belongings were stored in an unsanitary manner. 4. Bottles, bottle caps, nipples and other equipment used for bottle feeding were not cleaned and sanitized in a dishwasher or by washing, rinsing, and boiling for one minute.5. Carpets were not vacuumed weekly or cleaned when soiled.6. Changing table/pad was not sanitized after each use or cleaned when visibly soiled.7. Reusable cloths were not being washed daily or when visibly soiled.8. Cots/Pads/Mats were not cleaned and sanitized before assigning to a different child, when used by a sick child, when soiled or at least every three months.9. Cribs were not cleaned and sanitized monthly, or when soiled, or before use by another child.10. Diaper Receptables were not cleaned and sanitized daily or more frequently as needed to eliminate odor.11. Dishes/Cups/Silverware were not cleaned and sanitized after each use.12. Water Containers were not labeled with the child's name, or were not cleaned and sanitized before use again on another day.13. Dividers were not cleaned when visibly soiled.14. Dress up clothes and hats (dramatic play) were not cleaned monthly or when soiled.15. Floors were not cleaned weekly or when soiled.16. The food prep area, including sinks, were not cleaned before and after preparing food (including bottle preparation) or between preparing raw or cooked food.17. Potty chairs were not cleaned after each use, rinsed with water, cleaned and sanitized or contents were not emptied into a toilet.18. Food tables, highchair trays were not cleaned before and after each use.19. Tables used for play were not cleaned when visibly soiled or sanitized daily.20. Toilet bowls were not cleaned when visibly soiled or sanitized weekly.21. Toilet seat(s), handle(s) and hand washing sink(s) were not cleaned when visibly soiled or sanitized daily.22. Mouthed toys were not cleaned and sanitized after each childs use.23. Toys, other than those mouthed by children, were not cleaned monthly or when visibly soiled.24. Washable furniture, including fabrics on infant equipment, were not cleaned weekly or when soiled.25. Upholstered furniture was not steam cleaned when soiled.26. Slip covers were not washed at least every six months or when soiled.27. Wastebaskets/rinse buckets, including lids, were not being emptied daily or cleaned and sanitized when visibly soiled.28. The manufacturers directions for the cleaning product were not followed.29. The solution used for sanitizing was not a commercial product registered by the United States Environmental Protection Agency as a sanitizer.30. Other: sinks, stools in restrooms and doors were not cleaned when visibly soiled; mirror in infant room. Furniture, materials and equipment must be maintained according to the cleaning and sanitizing schedule in Appendix A to this rule. Technical assistance was provided at the time of the inspection, and as discussed, please correct this rule noncompliance. A written response for this rule noncompliance is not required at this time.

Resolution: Compliance Status: Approved – Technical Assistance Provided

During the inspection, it was determined that unsanitary conditions, as noted in number(s) 4, 5, 7 below, were in the preschool 1, school age and staff room restroom:1. There was no liquid soap.2. There was no toilet paper.3. There were no paper towels.4. The toilet cleaning brush was accessible to the children.5. The plunger was accessible to the children.6. The toilet(s) were not flushed.7. The trash was not emptied from the day before.8. There was a strong urine odor.9. Other [ ]. The restroom(s) must be kept sanitary at all times. Technical assistance was provided at the time of the inspection, and as discussed, please correct this rule noncompliance. A written response for this rule noncompliance is not required at this time.

Resolution: Compliance Status: Approved – Technical Assistance Provided

During the inspection, it was determined that accumulated trash or garbage was stored in an area approved for child care. Technical assistance was provided at the time of the inspection, and as discussed, please correct this rule noncompliance. A written response for this rule noncompliance is not required at this time.

Resolution: Compliance Status: Approved – Technical Assistance Provided

During the inspection, it was determined that at least one piece of equipment, furnishings, or material at the program was not constructed of materials to facilitate cleaning as noted in number(s) 1 below:1. The material had a tear: teacher chair in preschool 1; climbing mats in toddler 1.2. The material was not washable.3. The material was porous.4. The surface was cracked.5. The surface was repaired, but in a manner that still did not facilitate cleaning. 6. Other [ ]. Equipment, furnishings, and furniture shall be constructed of materials to facilitate cleaning. Technical assistance was provided at the time of the inspection, and as discussed, please correct this rule noncompliance. A written response for this rule noncompliance is not required at this time.

Resolution: Compliance Status: Approved – Technical Assistance Provided

In review of 25% of the children's records, it was determined that information had not been secured from the parent/guardian on the JFS 01234 Child Enrollment and Health Information For Child Care, as required, for the items in number(s) 2, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15 below. 1. No enrollment form was completed for at least one child 2. The current JFS 01234 was not completed for at least one child 3. Complete child information 4. Complete parent information 5. Complete emergency contact information 6. Complete physician information 7. Information regarding the parent list 8. Health information 9. Additional information for all boxes checked yes 10. Emergency transportation information 11. Parent/guardians signature 12. Diapering Statement 13. Acknowledgement of Policies and Procedures 14. Enrollment form for at least one child was not updated by either the parent or the administrator 15. Enrollment form for at least one child was not signed by the administrator 16. Other [ ] Technical assistance was provided at the time of the inspection, and as discussed, please correct this rule noncompliance. A written response for this rule noncompliance is not required at this time.

Resolution: Compliance Status: Approved – Technical Assistance Provided

In review of 25% of the children's records, it was determined that completed medical statements were not on file, as required, for children listed on the JFS Children's Record Review For Child Care as indicated in number(s) 1, 2, 8 below: 1. No medical was on file for at least one child 2. Medical(s) on file was not updated every 13 months 3. Medical(s) were missing child's name and date of birth 4. Medical(s) were missing the date of the medical examination 5. The date of the exam was more than 13 months prior to the date the form was signed. 6. Medical(s) were missing a statement that the child has been examined and is in suitable condition for participation in group care 7. Medical(s) were missing the signature, business address and telephone number of the physician, physician's assistant(PA), advance practice nurse (APN) or certified nurse practitioner (CNP) who examined the child 8. Medical(s) were missing a record of immunizations the child has had specifying month, day and year 9. Medical(s) were missing a statement from the physician, PA, APN, or CNP that the child has been immunized or is in the process of being immunized against the diseases required by division 5104.014 of the Revised Code and found in appendix A to this rule 10. Medical(s) were missing a statement from the childs parent or guardian that he or she has declined to have the child immunized against the disease for reasons of conscience, including religious convictions 11. Other [ ] Submit the programs corrective action plan to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Submitted

In review of the staff records, it was determined that at least one child care staff member had not completed required health and safety training as noted in numbers 2, 3 & 4 below:1. Child abuse and neglect recognition and prevention training was not completed within sixty days of hire.2. First aid training was not completed within ninety days of hire.3. Cardiopulmonary resuscitation (CPR) training was not completed within ninety days of hire.4. The child abuse and neglect recognition and prevention training was expired.5. The first aid training was expired.6. The CPR training was expired.Refer to the Employee Record Chart for the name(s) of the child care staff member(s) who must complete the required health and safety training(s). Submit the programs corrective action plan to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Approved

During the inspection, it was determined the fall zone under and around equipment designated for climbing, swinging, balancing and sliding did not meet the requirements as noted in number 1 below:1. The fall surface material had not been properly distributed or raked as needed to retain proper depth under and around equipment.2. A fall zone hazard was present, in that, the [ ] posed a risk of injury if a child were to fall from a piece of equipment.3. The fall zone was less than 3 feet from the fence for equipment used by children 23 months of age and younger.4. The fall zone was less than 6 feet from the fence for equipment used by children 24 months of age and older.5. There was not a fall zone of 3 feet in all directions from the perimeter of the equipment used by children 23 months of age and younger.6. There was not a fall zone of 6 feet in all directions from the perimeter of the equipment used by children 24 months of age and older.7. The fall zone was less than 4 1/2 feet from each piece of applicable equipment used by children 23 months of age and younger.8. The fall zone was less than 9 feet from each piece of applicable equipment used by children 24 months of age and older. 9. Other [ ]. The program is required to provide adequate fall zones under and around outdoor play equipment at all times. Submit the programs corrective action plan to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Approved

In review of the staff records, it was determined that the medical statements for the employees listed on the Employee Record Chart did not meet the requirements as listed in numbers 3, 4, 5 & 6 below. 1. A medical statement was not on file for at least one employee;2. The medical statement(s) on file did not have a date of examination within 12 months of the employees first day of employment;3. Date of examination was missing;4. Signature, business address, or telephone number of the licensed physician, physician assistant, advanced practice nurse, certified midwife, or certified nurse practitioner who completed the examination was missing;5. A statement was missing that verifies the employee is: a. Physically fit for employment in a program caring for children; b. Immunized against Tetanus, Diphtheria, Pertussis (Tdap); c. Immunized against Measles, Mumps, and Rubella (MMR);6. Tuberculosis (TB) screening/test information was missing: a. Documentation of the screening process to determine if the employee resided in a country identified by the world health organization as having a high burden of TB and arrived in the United States within the five years preceding the date of application for employment. b. Results of a TB test for employees meeting both criteria in 6a. c. Results of additional testing for employees with a positive TB test. d. Written statement, signed by a representative of the TB control unit, that the employee's TB is no longer infectious or the individual is receiving a TB treatment regimen for employees with a positive TB test. Submit the programs corrective action plan, which includes a copy of the completed employee medical statement, or TB results/documentation, to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Approved

During the inspection, it was determined that unsanitary conditions, as noted in number 6 below, were in the toddler restroom:1. There was no liquid soap.2. There was no toilet paper.3. There were no paper towels.4. The toilet cleaning brush was accessible to the children.5. The plunger was accessible to the children.6. The toilet(s) were not flushed.7. The trash was not emptied from the day before.8. There was a strong urine odor.9. Other [ ]. The restroom(s) must be kept sanitary at all times. Technical assistance was provided at the time of the inspection, and as discussed, please correct this rule noncompliance. A written response for this rule noncompliance is not required at this time.

Resolution: Compliance Status: Approved – Technical Assistance Provided

During the inspection, it was determined that the playground did not have adequate fall surface under and around equipment as noted in number 2 below: 1. No fall surface2. Adequate fall surface to soften the impact of a fall3. Adequate fall surface to soften the impact of a fall that extended the length of the required fall zone 4. Other [ ] With any equipment designed for climbing, swinging, bouncing, or sliding, resilient material, as specified in Appendix A, needs to be added in order to protect children in the event of a fall. Submit the programs corrective action plan, which includes written verification of the discontinued use of this equipment until corrections are made along with a description of the resilient material added, to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Approved

During the inspection, a potentially hazardous substance, which was determined to not present a serious risk to a child, was not used or stored properly as noted in number 12 below: 1. Cosmetics were accessible to children in the [ ] area.2. Disinfecting wipes were accessible to children in the [ ] area.3. Fish food was accessible to children in the [ ] area.4. Hand lotion was accessible to children in the [ ] area.5. Hand sanitizer (for children under 24 months) was accessible to children in the [ ] area.6. Laundry detergent was accessible to children in the [ ] area.7. Powder dish washing soap was accessible to children in the [ ] area.8. Paint cans were accessible to children in the [ ] area.9. White out was accessible to children in the [ ] area.10. Potting Soil was accessible to children in the [ ] area.11. Other potentially hazardous substance [ ] was accessible to children in the [ ] area.12. Cleaning/sanitizing supplies had not been clearly labeled.13. School-age children were using cleaning supplies, agents and/or equipment without adult supervision.14. A spray aerosol was used in the [ ] group while children were in attendance. 15. Other: [ ].Provide staff training. Submit the programs corrective action plan to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Approved

In review of the staff records, it was determined that the medical statements for the employees listed on the Employee Record Chart did not meet the requirements as listed in numbers 1 & 5 below. 1. A medical statement was not on file for at least one employee;2. The medical statement(s) on file did not have a date of examination within 12 months of the employees first day of employment;3. Date of examination was missing;4. Signature, business address, or telephone number of the licensed physician, physician assistant, advanced practice nurse, certified midwife, or certified nurse practitioner who completed the examination was missing;5. A statement was missing that verifies the employee is: a. Physically fit for employment in a program caring for children; b. Immunized against Tetanus, Diphtheria, Pertussis (Tdap); c. Immunized against Measles, Mumps, and Rubella (MMR);6. Tuberculosis (TB) screening/test information was missing: a. Documentation of the screening process to determine if the employee resided in a country identified by the world health organization as having a high burden of TB and arrived in the United States within the five years preceding the date of application for employment. b. Results of a TB test for employees meeting both criteria in 6a. c. Results of additional testing for employees with a positive TB test. d. Written statement, signed by a representative of the TB control unit, that the employee's TB is no longer infectious or the individual is receiving a TB treatment regimen for employees with a positive TB test. Submit the programs corrective action plan, which includes a copy of the completed employee medical statement, or TB results/documentation, to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Approved

In review of the staff records, it was determined that child care staff member(s) did not meet the requirements for completing the online orientation training as noted in number 4 below:1. The training was not completed within 30 days of starting employment at the program as a child care staff member.2. Documentation of completing the training after December 31, 2016 was not on file.3. Completion of the training was not verified in the OPR.4. A child care staff member had sole responsibility of children and had not completed the online orientation.Submit the programs corrective action plan to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Approved

In review of the staff records, it was determined that background checks did not meet the requirements of the rule for the person(s) listed on the Employee Record Chart as noted in numbers 1 & 2 below:1. The request for a background check for child care was not submitted in the OPR.2. The fingerprints were not submitted electronically according to the process established by BCI.3. The individual(s) had engaged in assigned duties or were near children and preliminary approval from ODJFS was not on file.4. Background checks were not updated every five years. Submit the programs corrective action plan, which includes a copy of the JFS 01176, or a copy of the preliminary approval or a statement that the individual(s) are no longer engaged in assigned duties and are not near children until the preliminary approval has been received, to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Approved

In review of the staff records, it was determined that at least one child care staff member had not completed required health and safety training as noted in numbers 2 & 3 below:1. Child abuse and neglect recognition and prevention training was not completed within sixty days of hire.2. First aid training was not completed within ninety days of hire.3. Cardiopulmonary resuscitation (CPR) training was not completed within ninety days of hire.4. The child abuse and neglect recognition and prevention training was expired.5. The first aid training was expired.6. The CPR training was expired.Refer to the Employee Record Chart for the name(s) of the child care staff member(s) who must complete the required health and safety training(s). Submit the programs corrective action plan to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Approved

In review of the staff records, it was determined that at least one child care staff member did not meet the annual professional development requirement as noted in number 1 below: 1. The child care staff member(s) had not completed at least six hours of professional development.2. Documentation did not demonstrate the person who provided the training met the trainer qualifications as stated in the rule. 3. Training topic did not meet the requirements listed in appendix A of this rule. 4. Documentation of training did not meet the requirements of this rule.5. The substitute(s) had been used more than ninety days annually between July first and June thirtieth and had not completed at least six hours of professional development 6. Other [ ].Submit the programs corrective action plan to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Approved

During the inspection, it was determined that the outdoor play space was not free of trash or foreign objects as noted in numbers 8 & 12 below:1. The outdoor area was littered with trash.2. The trash can was missing a lid. 3. The trash can was not emptied from the day(s) before. 4. The trash can was overflowing with trash.5. The trash can was infested with insects.6. The trash can was visibly dirty.7. There was broken glass. 8. There were tall weeds. 9. There was poison ivy. 10. There were tree branches. 11. There was mold visible. 12. There were thistles with prickers. 13. There were bird droppings. 14. The sandbox was contaminated.15. Other [ ]. Submit the programs corrective action plan to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Approved

During the inspection, it was determined that handwashing requirements were not followed as listed in number 4 below, as required in rule.1. At least one staff/child did not wash their hands upon arrival for the day.2. At least one staff/child did not wash their hands prior to departure.3. At least one staff did not wash their hands upon entry into a classroom.4. At least one staff/child did not wash their hands after toileting or assisting a child with toileting.5. At least one staff/child did not wash their hands after each diaper change or pull-up change.6. At least one staff did not wash their hands after contact with bodily fluids or cleaning up spills or objects contaminated with bodily fluids.7. At least one child did not wash their hands after contact with bodily fluids.8. At least one child did not wash their hands after returning inside after outdoor play.9. At least one staff did not wash their hands after cleaning or sanitizing or using any chemical products.10. At least one staff/child did not wash their hands after handling pets, pet cages or other pet objects that have come in contact with the pet.11. At least one staff did not wash their hands before eating, serving or preparing food or bottles or feeding a child.12. At least one child did not wash their hands before eating or assisting with food preparation.13. At least one staff did not wash their hands before and after completing a medical procedure or administering medication.14. At least one child did not wash their hands after water activities.15. At least one staff/child did not wash their hands when visibly soiled (must use soap and water).16. Other [ ]. Submit the programs corrective action plan to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Approved

During the inspection, it was determined the programs written disaster plan did not meet the requirement or was missing the information in numbers 4, 5, 6, 7, 8, 10, 12, 15, 16 & 20 below:Procedures:1. The written disaster plan had not been completed2. The plan was not provided to all child care staff and employees3. The plan was not used to respond to an emergency or disaster situation4. Weather emergencies and natural disasters which include severe thunderstorms, tornadoes, flash flooding, major snowfall, blizzards, ice storms or earthquakes5. Emergency outdoor and indoor lockdown or evacuation due to threats of violence which includes active shooter, bioterrorism or terrorism6. Emergency or disaster evacuations due to hazardous materials and spills, gas leaks or bomb threats.7. Outbreaks, epidemics or other infectious disease emergencies8. Loss of power, water, or heat9. Other threatening situations that may pose a health or safety hazard to the children in the programDetails:10. Shelter in place or evacuation, how the program will care for and account for the children until they can be reunited with the parent11. A designated safe site where staff and children can safely remain when evacuated.12. Assisting infants, toddlers and children with special needs and/or health conditions13. Emergency contact information for parents and the program14. Procedures for notifying and communicating with parents regarding the location of the children if evacuated15. Procedures for communicating with parents during loss of communications, no phone or internet service available16. The location of supplies and procedures for gathering necessary supplies for staff and children if required to shelter in place17. What to do if a disaster occurs during the transport of children or when on a field trip or routine trip18. Making the plan available to all child care staff members and employees19. Training of staff or reassignment of staff duties as appropriate20. Updating the plan on a yearly basis21. Contact with local emergency management officialsMake the necessary revisions to the disaster plan. Submit the programs corrective action plan, which includes the revised information, to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Approved

During the inspection, it was determined the programs written disaster plan did not meet the requirement for training child care staff members and employees on the plan annually as noted in number 2 below:1. Child care staff members and employees were not trained annually.2. Written documentation of the training was not kept on file. Submit the programs corrective action plan to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Approved

During the inspection, it was determined that equipment, materials and furnishings provided for indoor and outdoor play did not meet the requirement of the rule as noted in number 3 below.1.Equipment and materials were not varied and adequate to meet the developmental needs of the children.2.Equipment and materials were not provided in a sufficient quantity that each child can be actively involved in an activity.3.Play materials were not readily accessible to the children in the toddler classroom.4. Play materials were not arranged in an orderly manner so that children have opportunities to select, remove and replace play materials with minimal assistance during the day in the [ ] classroom.5. Durable, child-sized or safely adapted furniture was not provided for children in the [ ] classroom. Technical assistance was provided at the time of the inspection, and as discussed, please correct this rule noncompliance. A written response for this rule noncompliance is not required at this time.

Resolution: Compliance Status: Approved – Technical Assistance Provided

During the inspection, it was determined that equipment and materials in the following categories were not provided in sufficient quantities for children in the toddler classrooms, as required: 3, 6, 7 & 10.1. Art supplies (excludes infants)2. Manipulative materials and equipment3. Blocks4. Science-nature equipment (excludes infants)5. Language arts and auditory materials and equipment6. Pretend or dramatic play materials7. Music equipment8. Transportation materials and equipment9. Gross motor equipment10. Sensory motor equipment11. School age children were not provided sufficient equipment and materials in at least five of the first nine categories above.Technical assistance was provided at the time of the inspection, and as discussed, please correct this rule noncompliance. A written response for this rule noncompliance is not required at this time.

Resolution: Compliance Status: Approved – Technical Assistance Provided

During the inspection, it was determined that at least one piece of equipment, furnishings, or material at the program was not constructed of materials to facilitate cleaning as noted in numbers 1 & 6 below:1. The material on the small potty seats had tears.2. The material was not washable.3. The material was porous.4. The surface was cracked.5. The surface was repaired, but in a manner that still did not facilitate cleaning. 6. Other: the changing pad had stains that were not removed from cleaning.Equipment, furnishings, and furniture shall be constructed of materials to facilitate cleaning. Technical assistance was provided at the time of the inspection, and as discussed, please correct this rule noncompliance. Provide staff training. A written response for this rule noncompliance is required at this time.

Resolution: Compliance Status: Approved

During the inspection, required staff/child ratios were not maintained for different groups, as noted below:The ratio determined for the Nursery/Tiny Tots group (younger and older infants combined outside) was 1 Child Care Staff Member for 6 children. Additionally, a ratio of 2 Child Care Staff Members for 15 children was determined for the Twos/Toddlers group (younger and older toddlers combined outside). Additional staff members must be hired, current Child Care Staff Members must be rescheduled, or current staff need to better understand the rule requirements to maintain compliance. Provide staff training. Submit the programs corrective action plan, which includes a statement that training was provided, to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Approved

During the inspection, it was determined that the program was not providing a clean and healthy environment, furniture, materials and equipment as required by Appendix A, as noted in numbers 15, 20 & 21 below:1. Item(s) soiled with blood or bodily fluids were not cleaned/sanitized immediately. 2. Blankets/sheets were not cleaned weekly, when soiled, or before use by another child. 3. Children's individual blankets and belongings were stored in an unsanitary manner. 4. Bottles, bottle caps, nipples and other equipment used for bottle feeding were not cleaned and sanitized in a dishwasher or by washing, rinsing, and boiling for one minute.5. Carpets were not vacuumed weekly or cleaned when soiled.6. Changing table/pad was not sanitized after each use or cleaned when visibly soiled.7. Reusable cloths were not being washed daily or when visibly soiled.8. Cots/Pads/Mats were not cleaned and sanitized before assigning to a different child, when used by a sick child, when soiled or at least every three months.9. Cribs were not cleaned and sanitized monthly, or when soiled, or before use by another child.10. Diaper Receptables were not cleaned and sanitized daily or more frequently as needed to eliminate odor.11. Dishes/Cups/Silverware were not cleaned and sanitized after each use.12. Water Containers were not labeled with the child's name, or were not cleaned and sanitized before use again on another day.13. Dividers were not cleaned when visibly soiled.14. Dress up clothes and hats (dramatic play) were not cleaned monthly or when soiled.15. Floors were not cleaned weekly or when soiled.16. The food prep area, including sinks, were not cleaned before and after preparing food (including bottle preparation) or between preparing raw or cooked food.17. Potty chairs were not cleaned after each use, rinsed with water, cleaned and sanitized or contents were not emptied into a toilet.18. Food tables, highchair trays were not cleaned before and after each use.19. Tables used for play were not cleaned when visibly soiled or sanitized daily.20. Toilet bowls were not cleaned when visibly soiled or sanitized weekly.21. Toilet seat(s), handle(s) and hand washing sink(s) were not cleaned when visibly soiled or sanitized daily.22. Mouthed toys were not cleaned and sanitized after each childs use.23. Toys, other than those mouthed by children, were not cleaned monthly or when visibly soiled.24. Washable furniture, including fabrics on infant equipment, were not cleaned weekly or when soiled.25. Upholstered furniture was not steam cleaned when soiled.26. Slip covers were not washed at least every six months or when soiled.27. Wastebaskets/rinse buckets, including lids, were not being emptied daily or cleaned and sanitized when visibly soiled.28. The manufacturers directions for the cleaning product were not followed.29. The solution used for sanitizing was not a commercial product registered by the United States Environmental Protection Agency as a sanitizer.30. Other [ ]. Furniture, materials and equipment must be maintained according to the cleaning and sanitizing schedule in Appendix A to this rule. Technical assistance was provided at the time of the inspection, and as discussed, please correct this rule noncompliance. Provide staff training. A written response for this rule noncompliance is required at this time.

Resolution: Compliance Status: Approved

During the inspection, it was determined that unsanitary conditions, as noted in numbers 4, 5 & 9 below, were in the restrooms:1. There was no liquid soap.2. There was no toilet paper.3. There were no paper towels.4. The toilet cleaning brush was accessible to the children.5. The plungers were accessible to the children.6. The toilet(s) were not flushed.7. The trash was not emptied from the day before.8. There was a strong urine odor.9. Other: clothing items, used toilet paper and potty seats were observed directly on the restroom floorsThe restroom(s) must be kept sanitary at all times. Technical assistance was provided at the time of the inspection, and as discussed, please correct this rule noncompliance. Provide staff training. A written response for this rule noncompliance is required at this time.

Resolution: Compliance Status: Approved

During the inspection, it was determined the program had not responded to the non-compliances addressed in the inspection report dated 8/8/23. The rule requires the program to complete and submit a corrective action plan in OCLQS to address non-compliances detailed in written inspection reports within the timeframe outlined in the report. Submit the programs corrective action plan, which includes a statement that current and future corrective action plans will be submitted timely, to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Approved

During the inspection, it was determined that children were not being properly supervised as noted in number 1 below: 1.Child(ren) were not within both sight and hearing of a child care staff member during nap time in the Preschool 1 room.2.Child(ren) were not within both sight and hearing of a child care staff member during outdoor play.3.Child(ren) were not within both sight and hearing of a child care staff member more than once. 4. Staff were not physically present in the space and near enough to respond and reach the child(ren) immediately. 5.Other: [ ]. Children must be supervised according to rule and within both sight and hearing of a child care staff member at all times. Provide staff training. Submit the programs corrective action plan, which includes a statement that training was provided, to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Approved

During the inspection, it was determined that children were not protected from item(s) or condition(s) which may threaten their health, safety, or well-being as noted in number 22 below: 1. Surge protectors/outlets did not have childproof receptacle covers.2. Open pull cords that are not closed loop. 3. Toys or other items small enough to be swallowed were present in the space where infants and/or toddlers were in care.4. Electrical/extension cords attached to an object that would not likely result in a severe injury if pulled. 5. Stacked chairs.6. Employee(s) purse(s). 7. Diaper bags.8. Television not securely anchored.9. Small or lightweight pieces of shelving units are not securely anchored to the wall. 10. Smoke detector needing batteries replaced.11. An area rug did not have a nonskid backing.12. An area rug presented a tripping hazard.13. A floor surface that was unsafe in that [ ].14. No platform was provided for the sink or toilet in the [ ] classroom.15. The platform provided for the sink or toilet in the [ ] classroom was not sturdy.16. The platform provided for the sink or toilet in the [ ] classroom posed a safety hazard in that [ ].17. Telephone cords.18. Staff member stepped over a barrier/gate while holding a child.19. Emergency exits were blocked by the following classroom furniture: [ ]. 20. A mercury thermometer was being used to take a childs temperature. 21. Methods of ventilation used did not provide protection from rodents, insects, or other hazards.22. Other: the window blinds were broken in the Preschool 1 classroom.Submit the programs corrective action plan to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Approved

During the inspection, it was determined that outdoor play equipment was unsafe or not used as intended as noted in numbers 1, 3, 6 & 10 below:1. There was rust exposed.2. There were protruding bolts. 3. There were cracks.4. There were holes.5. There was splintering wood.6. There were sharp edges or points.7. There were lead hazards.8. There were toxic substances.9. There were tripping hazards.10. There was chipped and/or peeling paint.11. The sandbox was not covered when the program was closed or during non-daylight hours. 12. Outdoor equipment, [ ] was not developmentally appropriate.13. Outdoor equipment, [ ], was placed in the main traffic pattern.14. Outdoor play equipment, [ ], was positioned too closely together, posing a risk of injury if a child were to fall from one piece of equipment into another.15. Outdoor equipment, [ ], was not securely anchored but did not present a risk of imminent danger of the structure collapsing when children are using the equipment16. Outdoor equipment, [ ], was 30 inches or more from the ground and did not have a protective barrier that would prevent a child from falling off this piece of equipment.17. The manufacturer's guidelines for assembly and installation were not followed for the [ ].18. Functionally linked equipment was used by preschool-age children and the distance between two adjacent pieces of equipment exceeded 12 inches.19. Functionally linked equipment was used by school-age children and the distance between two adjacent pieces of equipment exceeded 18 inches.20. Other [ ]. Submit the programs corrective action plan to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Approved

In review of the records, it was determined the program did not meet the requirements for completing a JFS 01299 Incident/Injury Report as noted in numbers 1, 3, 5 & 17 below: 1. The JFS 01299 was not completed when a child became ill or received an injury which required first aid treatment.2.The JFS 01299 was not completed when a child was transported to a source for emergency assistance.3. The JFS 01299 was not completed when a child received a bump or blow to the head.4. The JFS 01299 was not completed when an unusual or unexpected incident which jeopardized the safety of a child or employee of a program.5. The parent or a person picking up the child did not receive the JFS 01299 on the day of the incident.6. The program information (program name, number, address) was incomplete on the JFS 01299.7. Childs name was incomplete on the JFS 01299.8. Childs birthdate was incomplete on the JFS 01299.9. Name of person(s) responsible for the child at the time of the incident was incomplete on the JFS 01299.10. Number of children present in the group at the time of the incident was incomplete on the JFS 01299.11. Date and/or time of the incident was incomplete on the JFS 01299.12. Whether or not parents were contacted was incomplete on the JFS 01299.13. Complete summary of the incident was incomplete on the JFS 01299.14. Accurate summary of the incident was incomplete on the JFS 01299.15. Name and/or signature of the person completing the form was incomplete on the JFS 01299.16. The JFS 01299 was not kept on file at the program for at least one year.17. The current version of the JFS 01299 was not used. An on-site investigation was conducted including classroom observations. The complainant, administrative, current and former child care staff members were interviewed. Incident reports and written messages between staff and parents were reviewed. Follow-up calls were made to the program for additional information. After a thorough investigation and review of all available evidence, the allegation is substantiated. Evidence was able to be verified indicating the program was not compliant with the licensing rule referenced in the allegation. Technical assistance was provided at the time of the investigation, and as discussed, please correct this rule noncompliance. A written response for this rule noncompliance is required at this time.

Resolution: Compliance Status: Approved

During the inspection, it was determined that the program was not providing a clean and healthy environment, furniture, materials and equipment as required by Appendix A, as noted in numbers 6 & 28 below:1. Item(s) soiled with blood or bodily fluids were not cleaned/sanitized immediately. 2. Blankets/sheets were not cleaned weekly, when soiled, or before use by another child. 3. Children's individual blankets and belongings were stored in an unsanitary manner. 4. Bottles, bottle caps, nipples and other equipment used for bottle feeding were not cleaned and sanitized in a dishwasher or by washing, rinsing, and boiling for one minute.5. Carpets were not vacuumed weekly or cleaned when soiled.6. Changing table/pad was not sanitized after each use or cleaned when visibly soiled.7. Reusable cloths were not being washed daily or when visibly soiled.8. Cots/Pads/Mats were not cleaned and sanitized before assigning to a different child, when used by a sick child, when soiled or at least every three months.9. Cribs were not cleaned and sanitized monthly, or when soiled, or before use by another child.10. Diaper Receptables were not cleaned and sanitized daily or more frequently as needed to eliminate odor.11. Dishes/Cups/Silverware were not cleaned and sanitized after each use.12. Water Containers were not labeled with the child's name, or were not cleaned and sanitized before use again on another day.13. Dividers were not cleaned when visibly soiled.14. Dress up clothes and hats (dramatic play) were not cleaned monthly or when soiled.15. Floors were not cleaned weekly or when soiled.16. The food prep area, including sinks, were not cleaned before and after preparing food (including bottle preparation) or between preparing raw or cooked food.17. Potty chairs were not cleaned after each use, rinsed with water, cleaned and sanitized or contents were not emptied into a toilet.18. Food tables, highchair trays were not cleaned before and after each use.19. Tables used for play were not cleaned when visibly soiled or sanitized daily.20. Toilet bowls were not cleaned when visibly soiled or sanitized weekly.21. Toilet seat(s), handle(s) and hand washing sink(s) were not cleaned when visibly soiled or sanitized daily.22. Mouthed toys were not cleaned and sanitized after each childs use.23. Toys, other than those mouthed by children, were not cleaned monthly or when visibly soiled.24. Washable furniture, including fabrics on infant equipment, were not cleaned weekly or when soiled.25. Upholstered furniture was not steam cleaned when soiled.26. Slip covers were not washed at least every six months or when soiled.27. Wastebaskets/rinse buckets, including lids, were not being emptied daily or cleaned and sanitized when visibly soiled.28. The manufacturers directions for the cleaning/sanitizing product were not followed.29. The solution used for sanitizing was not a commercial product registered by the United States Environmental Protection Agency as a sanitizer.30. Other [ ]. Furniture, materials and equipment must be maintained according to the cleaning and sanitizing schedule in Appendix A to this rule. Technical assistance was provided at the time of the inspection, and as discussed, please correct this rule noncompliance. A written response for this rule noncompliance is not required at this time.

Resolution: Compliance Status: Approved – Technical Assistance Provided

During the inspection, it was determined that the posted food service license had expired. A current food service license must be obtained. Submit the programs corrective action plan, which includes a copy of the updated food service license, to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Approved

During the inspection, it was determined that the outdoor play space was not free of trash or foreign objects as noted in numbers 8 & 12 below:1. The outdoor area was littered with trash.2. The trash can was missing a lid. 3. The trash can was not emptied from the day(s) before. 4. The trash can was overflowing with trash.5. The trash can was infested with insects.6. The trash can was visibly dirty.7. There was broken glass. 8. There were tall weeds. 9. There was poison ivy. 10. There were tree branches. 11. There was mold visible. 12. There were thistles with prickers. 13. There were bird droppings. 14. The sandbox was contaminated.15. Other [ ]. Submit the programs corrective action plan to the Department to verify compliance with the requirements of this rule."

Resolution: Compliance Status: Approved

During the inspection, equipment was determined to be unsafe, hazardous to children, or in need of repair as noted in number 1 below: 1. Manufacturer's guidelines for the blinds on the windows were not followed in that they were broken in several classrooms2. The straps were missing on the [ ].3. The straps were attached, but were not used on the [ ]. 4. The straps were attached and were used, but were not used in a safe manner.5. The equipment had sharp points or corners.6. The equipment had splinters.7. The equipment had protruding nails.8. The equipment had loose or rusty parts.9. The equipment had paint which contains lead or other poisonous materials.10. The equipment had hazardous features.11. A fan was unstable and could easily tip over. 12. A fan had openings a finger could enter.13. The pipes from the heat pump felt hot to the touch14. A space heater felt hot to the touch15. The position of a space heater was a tripping hazard16. The air conditioning unit was not enclosed and was accessible to children on the playground. 17. A ball pit, trampoline, inflatable bounce house, inflatable slide, or inflatable equipment used for climbing and bouncing was used. 18. Other [ ].Submit the programs corrective action plan to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Approved

In review of 25% of the children's records, it was determined that completed medical statements were not on file, as required, for children listed on the JFS Children's Record Review For Child Care as indicated in numbers 1 & 2 below: 1. No medical was on file for at least one child 2. Medical(s) on file was not updated every 13 months 3. Medical(s) were missing child's name and date of birth 4. Medical(s) were missing the date of the medical examination 5. The date of the exam was more than 13 months prior to the date the form was signed. 6. Medical(s) were missing a statement that the child has been examined and is in suitable condition for participation in group care 7. Medical(s) were missing the signature, business address and telephone number of the physician, physician's assistant(PA), advance practice nurse (APN) or certified nurse practitioner (CNP) who examined the child 8. Medical(s) were missing a record of immunizations the child has had specifying month, day and year 9. Medical(s) were missing a statement from the physician, PA, APN, or CNP that the child has been immunized or is in the process of being immunized against the diseases required by division 5104.014 of the Revised Code and found in appendix A to this rule 10. Medical(s) were missing a statement from the childs parent or guardian that he or she has declined to have the child immunized against the disease for reasons of conscience, including religious convictions 11. Other [ ] Submit the programs corrective action plan to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Approved

In review of the staff records, it was determined that the medical statements for the employees listed on the Employee Record Chart did not meet the requirements as listed in numbers 2, 5 & 6 below. 1. A medical statement was not on file for at least one employee;2. The medical statement(s) on file did not have a date of examination within 12 months of the employees first day of employment;3. Date of examination was missing;4. Signature, business address, or telephone number of the licensed physician, physician assistant, advanced practice nurse, certified midwife, or certified nurse practitioner who completed the examination was missing;5. A statement was missing that verifies the employee is: a. Physically fit for employment in a program caring for children; b. Immunized against Tetanus, Diphtheria, Pertussis (Tdap); c. Immunized against Measles, Mumps, and Rubella (MMR);6. Tuberculosis (TB) screening/test information was missing: a. Documentation of the screening process to determine if the employee resided in a country identified by the world health organization as having a high burden of TB and arrived in the United States within the five years preceding the date of application for employment. b. Results of a TB test for employees meeting both criteria in 6a. c. Results of additional testing for employees with a positive TB test. d. Written statement, signed by a representative of the TB control unit, that the employee's TB is no longer infectious or the individual is receiving a TB treatment regimen for employees with a positive TB test. Submit the programs corrective action plan, which includes a copy of the completed employee medical statement, or TB results/documentation, to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Approved

In review of the staff records, it was determined that child care staff member(s) did not meet the requirements for completing the online orientation training as noted in numbers 2 & 3 below:1. The training was not completed within 30 days of starting employment at the program as a child care staff member.2. Documentation of completing the training after December 31, 2016 was not on file.3. Completion of the training was not verified in the OPR.4. A child care staff member had sole responsibility of children and had not completed the online orientation.Submit the programs corrective action plan to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Approved

In review of the staff records, it was determined that background checks did not meet the requirements of the rule for the person(s) listed on the Employee Record Chart as noted in numbers 1 & 4 below:1. The request for a background check for child care was not submitted in the OPR.2. The fingerprints were not submitted electronically according to the process established by BCI.3. The individual(s) had engaged in assigned duties or were near children and preliminary approval from ODJFS was not on file.4. Background checks were not updated every five years. Submit the programs corrective action plan, which includes a copy of the JFS 01176, or a copy of the preliminary approval or a statement that the individual(s) are no longer engaged in assigned duties and are not near children until the preliminary approval has been received, to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Approved

In review of the staff records, it was determined that at least one child care staff member did not meet the annual professional development requirement as noted in number 1 below: 1. The child care staff member(s) had not completed at least six hours of professional development.2. Documentation did not demonstrate the person who provided the training met the trainer qualifications as stated in the rule. 3. Training topic did not meet the requirements listed in appendix A of this rule. 4. Documentation of training did not meet the requirements of this rule.5. The substitute(s) had been used more than ninety days annually between July first and June thirtieth and had not completed at least six hours of professional development 6. Other [ ].Submit the programs corrective action plan to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Approved

In review of the staff records, it was determined that at least one child care staff member had not completed required health and safety training as noted in numbers 2, 3, 4, 5 & 6 below:1. Child abuse and neglect recognition and prevention training was not completed within sixty days of hire.2. First aid training was not completed within ninety days of hire.3. Cardiopulmonary resuscitation (CPR) training was not completed within ninety days of hire.4. The child abuse and neglect recognition and prevention training was expired.5. The first aid training was expired.6. The CPR training was expired.Refer to the Employee Record Chart for the name(s) of the child care staff member(s) who must complete the required health and safety training(s). Submit the programs corrective action plan to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Closed - Not Addressed

During the inspection, it was determined that outdoor play equipment was unsafe or not used as intended as noted in numbers 3, 10, 14 & 17 below:1. There was rust exposed.2. There were protruding bolts. 3. There were cracks in the plastic on a storage box, bike seats and interlocking pieces.4. There were holes.5. There was splintering wood.6. There were sharp edges or points.7. There were lead hazards.8. There were toxic substances.9. There were tripping hazards.10. There was chipped and/or peeling paint/stain on the wooden climber.11. The sandbox was not covered when the program was closed or during non-daylight hours. 12. Outdoor equipment, [ ] was not developmentally appropriate.13. Outdoor equipment, [ ], was placed in the main traffic pattern.14. Outdoor play equipment on the toddler playground, was positioned too closely together, posing a risk of injury if a child were to fall from one piece of equipment into another.15. Outdoor equipment, [ ], was not securely anchored but did not present a risk of imminent danger of the structure collapsing when children are using the equipment16. Outdoor equipment, [ ], was 30 inches or more from the ground and did not have a protective barrier that would prevent a child from falling off this piece of equipment.17. The manufacturer's guidelines were not followed for the bikes that had missing pedals18. Functionally linked equipment was used by preschool-age children and the distance between two adjacent pieces of equipment exceeded 12 inches.19. Functionally linked equipment was used by school-age children and the distance between two adjacent pieces of equipment exceeded 18 inches.20. Other [ ]. Submit the programs corrective action plan to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Approved

During the inspection, it was determined the program did not meet the requirement(s) for administering a medication or medical food that is not required by a JFS 01236 "Child Medical/Physical Care Plan for Child Care" or a prescription topical product to a child as noted in numbers 15, 16, 17, 18 & 21 below:1. No JFS 01217 Request for Administration of Medication for Child Care was on file.2. The childs name was missing on the JFS 01217.3. The childs date of birth was missing on the JFS 01217 and was needed to determine the correct dosage.4. The childs weight was missing on the JFS 01217 and was needed to determine the correct dosage.5. The name of the medication was missing on the JFS 01217.6. The exact dose was missing on the JFS 01217.7. The time to administer was missing on the JFS 01217.8. The time period to administer was missing on the JFS 01217.9. The medication's expiration date was missing on the JFS 01217.10. The Parent/Guardians dated signature was missing on the JFS 01217.11. Physician instructions were missing on the JFS 01217.12. Possible side effects were missing on the JFS 01217.13. Physicians dated signature was missing on the JFS 01217.14. Physicians phone number was missing on the JFS 01217.15. Date medication was administered was missing on the JFS 01217.16. Time medication was administered was missing on the JFS 01217.17. Dosage administered was missing on the JFS 01217.18. Staff members signature was missing on the JFS 01217.19. A prescription label was not attached to the prescription medication.20. The medication or product, [ ], was not brought to the program in its original container.21. Parent instructions conflict with either the manufacturer or physician instructions.Submit the programs corrective action plan, which includes the completed JFS 01217 for each child needed, verification that the prescription label is now attached, and/or verification that the medication or product is now in its original container, and a statement that training was provided, to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Approved

During the inspection, it was determined that the program's weekly menu did not meet the requirement as noted in number 6 below. 1. The menu was not posted.2. The posted menu was not in a visible place readily accessible to parents.3. The menu was not currently dated.4. The entire menu was substituted.5. At least one item on menu did not match what was served.6. The meal or snack served did not match the posted menu.Technical assistance was provided at the time of the inspection, and as discussed, please correct this rule noncompliance. A written response for this rule noncompliance is not required at this time.

Resolution: Compliance Status: Approved – Technical Assistance Provided

During the inspection, it was determined that children's records/information had not been kept confidential in that a no pick-up list was posted in the classrooms. Provide staff training. Submit the program's corrective action plan, which includes a statement that training was provided, to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Approved

In review of 25% of the children's records, it was determined that information had not been secured from the parent/guardian on the JFS 01234 Child Enrollment and Health Information For Child Care, as required, for the items in numbers 2, 12, 13, 14 & 15 below. 1. No enrollment form was completed for at least one child 2. The current JFS 01234 was not completed for at least one child 3. Complete child information 4. Complete parent information 5. Complete emergency contact information 6. Complete physician information 7. Information regarding the parent list 8. Health information 9. Additional information for all boxes checked yes 10. Emergency transportation information 11. Parent/guardians signature 12. Diapering Statement 13. Acknowledgement of Policies and Procedures 14. Enrollment form for at least one child was not updated by either the parent or the administrator 15. Enrollment form for at least one child was not signed by the administrator 16. Other [ ] Technical assistance was provided at the time of the inspection, and as discussed, please correct this rule noncompliance. A written response for this rule noncompliance is not required at this time.

Resolution: Compliance Status: Approved – Technical Assistance Provided