LITTLE MIRACLES EARLY LEARNING SCHOOL

During the inspection, it was determined that the equipment in number(s) 8 below had been used for sleeping infants and did not allow the infant to sleep on a firm mattress: 1. Mesh cribs;2. Play pens;3. Bassinets;4. Cots;5. Car seats;6. Infant swing;7. The floor;8. Infant seats;9. An infant placed in a car seat in a crib; 10. Other [ ]. Infants must be provided with a crib, which meets requirements specified in this rule, for resting and sleeping. Provide staff training. Submit the programs corrective action plan, which includes a statement that staff 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 the program did not meet the requirements for fire inspection as noted in number(s) 1 below:1. The program did not have documentation on file for a fire inspection without any uncorrected violations within 12 months from the date of the last fire inspection and the request for the new inspection was not made at least 30 days prior to the expiration of the previous fire inspection.2. The documentation for the most recent fire inspection contained violations that had not been corrected. 3. The [ ] space was being used and had not been approved by the fire department or the state fire marshals office for child care.Submit the programs corrective action plan, which includes an updated fire inspection without any uncorrected violations, 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) 10 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.9. The equipment had paint which contains lead or other poisonous materials.10. The equipment had hazardous features (broken toliet seat, broken toliet paper dispenser).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, 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 below: 1. Surge protectors/outlets did not have childproof receptacle covers (girls bathroom).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 [ ].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, it was determined that unsanitary conditions, as noted in number(s) 4 below, were in the 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 an outdoor play area was used which was not protected from traffic and other hazards by a fence in good repair, or other barrier. Although the fence or natural barrier was not meeting the rule requirements, it was determined to not present an immediate risk for a child to be able to leave the playground. The fence or gate was not in good repair and/or being used inappropriately as noted in number 10, 12 below: 1. The fencing had missing slat boards.2. The fencing was broken.3. The fencing was loose.4. The fencing was rotting.5. The gate was broken and did not close.6. The gate was locked.7. The latch on the gate was broken.8. The latch was easily opened by children on the playground.9. The latch was not engaged to prevent children from opening the gate.10. The gate had no latch. 11. There were bolts with more than two threads exposed along a fence line or gate on a playground.12. A section of a gate and fence were broken and unstable.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 children were not protected from item(s) or condition(s) which may threaten their health, safety, or well-being as noted in numbers 4, 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. An area rug was buckled in the preschool room.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: Closed - Not Addressed

During the inspection, equipment was determined to be unsafe, hazardous to children, or in need of repair as noted in number 3 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 changing pad.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: Closed - Not Addressed

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 5 (carpets dirty), 6, 10, 23, 24, 27 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. A written response for this rule noncompliance is not required at this time.

Resolution: Compliance Status: Approved – Technical Assistance Provided

In review of the childrens records, it was determined the program did not meet the requirements for caring for at least one child, indicated on the Children Records Review, with a condition that requires a JFS 01236 "Child Medical/Physical Care Plan" as noted in numbers 20, 32, 33, 44 below: 1. No plan was on file.(Page 1)2. Childs name was missing.3. Name of the condition was missing.4. Indication if medication or medical food is required was missing.5. Signs, symptoms or situations that require staff to take action were missing.6. Activities, foods, environmental conditions to avoid were missing.7. Training instructions for procedures for staff to follow were missing or incomplete.(Page 2)8. Child's name was missing or not attached.9. Child's date of birth was missing or not attached.10. Child's weight was missing or not attached.11. Name of the medication/medical food was missing or not attached.12. Dosage of medication/medical food to be administered was missing or not attached.13. Time for medication/medical food to be administered was missing or not attached.14. Expiration date for medication/medical food was missing or not attached.15. Symptoms that require staff to administer medication/medical food were missing or not attached.16. Specific instructions to administer the medication/medical food were missing or not attached.17. Actions to be taken if the symptoms do not subside were missing or not attached.18. Physician's signature was missing or not attached.19. The date of the physician's signature was missing or not attached.(Page 3)20. Child's name was missing.21. Instructions regarding emergency evacuation, if applicable, were missing.22. Signature of parent granting permission to implement the plan and verifying training was missing.23. Date of parent signature was missing.24. Certified Professional Trainer information was missing.25. Signature of certified professional who trained the program staff was missing, if parent was not the trainer.26. Date of trainer signature was missing.27. Printed name(s)of child care staff member(s) who have received instructions for care and/or have been trained to perform the procedure were missing.28. Signature(s) of child care staff member(s) who have received instructions for care and/or have been trained to perform the procedure were missing.29. Date of staff signature was missing.30. Administrator/Provider signature was missing31. Date of administrator/Provider was missing.(Page 4)32. Child's name was missing.33. Name of medication or medical food was missing.34. Date the medication/medical food was administered was missing.35. Time medication/medical food was administered was missing.36. Dosage of medication/medical food that was administered was missing.37. Signature of person administering medication/medical food was missing.38. The plan was not followed or implemented.39. The plan was not able to be implemented due to conflicting information.40. None of the child care staff members trained in the procedures on the JFS 01236 were onsite when a child requiring the plan was present. 41. Child care staff members trained in the procedures on the JFS 01236 were not scheduled to be present the entire the time the child requiring the plan was onsite. 42. None of the child care staff members trained in the procedures on the JFS 01236 accompanied the child requiring the plan during a trip. 43. A child care staff member who had not been trained in the procedures on the JFS 01236 performed the procedure. 44. Medication listed in the procedures to follow was not onsite available to administer as instructed and alternate instructions for this situation were not included on the plan.Provide staff training. Submit the programs corrective action plan, which includes a copy of the completed JFS 01236, to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Closed - Not Addressed

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 6 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

During the inspection, it was determined the programs written disaster plan did not meet the requirement or was missing the information in number 12 (add toddlers) 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: Closed - Not Addressed

During the inspection, it was determined that the method for tracking children in each group did not meet the requirements of the rule as noted in number 5 below:1. There was no method in place;2. The method did not include each child's name;3. The method did not include each child's date of birth;4. The tracking method did not remain with the group at all times;5. The tracking method was not updated throughout the day as children entered or left the group.Submit the program's 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 written instructions for feeding the infants noted on the Children Record Review were missing information as noted in number 5 below:1. Written instructions were not on file.2. Type of food and/or formula/breast milk was missing.3. Amount of food and/or formula/breast milk was missing.4. Feeding times or frequency of feedings was missing.5. The written instructions on file had not been updated.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 program was not providing a clean and healthy environment, furniture, materials and equipment as required by Appendix A, as noted in numbers 24, 30, 31 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, and cloth chair covers were not cleaned weekly or when soiled. (preschool & Pre-K)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. A cloth chair cover was torn, exposing the foam cushion.31. Walls were not cleaned when visibly soiled.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

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

During the inspection, it was determined that handwashing requirements were not followed as listed in numbers 5 (children & staff), 9 (staff) 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 that unsanitary conditions, as noted in number 5, 9 below, was in the boys 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. Toilets were out of order. (2 in the boys restroom, 1 in girls restroom)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 required drills were not completed and/or documented for item numbers 1 (for November & December), 3 (last quarter of 2023) below:1. Monthly fire drills.2. Monthly weather emergency drills (March through September).3. Emergency/lockdown drills in each quarter of the calendar year.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 cots or mats did not meet the requirements as noted in number(s) 2 below:1. The program did not have enough individually assigned cots and/or mats for each child.2. A child was sleeping at the table. (in the twaddler room, while waiting for lunch)3.Frames were bent/broken.4.Covers were torn.5.Cots were missing bolts.6.Cots were sagging.7.Legs on the cots were broken.8. Cots did not stand at least 3 inches but no more than 18 inches off the floor. 9. Cots were not at least 36 inches in length and as long as the child is tall. 10. Mats were not at least 1 inch thick and as wide and long as the child assigned.11.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

During the inspection, it was determined that the Roli Poli group was served halved chicken sandwiches on buns which [posed a choking hazard/was not appropriate for their age]. 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 breast milk provided by the parent was not stored appropriately as noted in number 1 (date bottle was prepared) below:1. Not labeled with infant's name, date pumped, and date bottle was prepared;2. Not immediately refrigerated or frozen;3. Stored at room temperature longer than eight hours;4. Stored at the program for more than five days after it was expressed;5. Stored longer than two weeks in the freezer compartment of the refrigerator;6. Stored longer than six months in the refrigerator/freezer;7. Stored longer than twelve months in the deep freezer;8. 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 those employees listed on the Employee Record Chart did not include the required information listed below in numbers 2 (doctor signature), 4 (a). 1. Date of examination;2. Signature, business address, and telephone number of the licensed physician, physician assistant, advanced practice nurse, certified midwife, or certified nurse practitioner who completed the examination;3. A statement that verifies that 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);4. Tuberculosis (TB) screening/test 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 4a; 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 while there was adequate fall surface material in the outdoor play space, proper distribution had not been maintained under and around equipment as required. Submit the programs corrective action plan, which includes a statement that fall surface material has been properly redistributed, to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Closed - Not Addressed

During the inspection, a potentially hazardous item or toxic substance stored under an unlocked hand sink in the Early Preschool A classroom and the school age room, where children had access to it, as noted in number 9 (disinfectant spray) 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: [ ].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: Closed - Not Addressed

During the inspection, a potentially hazardous substance, which was determined to not present a serious risk to a child, was accessible to children as noted in numbers 2, 11 below: 1. Cosmetics;2. Disinfecting wipes;3. Fish food;4. Hand lotion;5. Hand sanitizer (for children under 24 months);6. Laundry detergent;7. Powder dish washing soap;8. Paint cans;9. White out;10. Potting Soil;11. Other potentially hazardous substance: Gorilla glue.The potentially hazardous substance was determined to be accessible to children in the following area: Early Preschool A (#2), PreKindergarten (#11)Provide staff training. Submit the programs corrective action plan, which includes a statement that the potentially hazardous substance is no longer accessible to children and a statement that training was provided, to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Approved

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 children were not protected from the following item(s) or condition(s) which may threaten their health, safety, or well-being as noted in number 12 below: 1. Open pull cords that are not closed loop. 2. Telephone cords.3. Electrical/extension cords attached to an object that would not likely result in a severe injury if pulled. 4. Stacked chairs.5. Employee(s) purse(s). 6. Diaper bags.7. Television not securely anchored.8. Small or lightweight pieces of shelving units are not securely anchored to the wall. 9. Smoke detector needing batteries replaced.10. Staff member stepped over a barrier/gate while holding a child.11. Emergency exits were blocked by the following classroom furniture: [ ]. 12. Chipping plaster on the windowsills in several classrooms.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: Closed - Not Addressed

During the inspection, it was determined that the following unsanitary conditions were at the program:- Carpets in classrooms were dirty,- Walls in several classrooms were dirty.- Stepstools in the restrooms and classrooms were dirty.- A section of a baseboard in the girl's restroom was not attached yo the wall, preventing appropriate sanitation. A clean and healthy environment, including furniture, materials and equipment must be provided, and the program shall be cleaned daily. 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 child in the Twaddler group did not wash his or her hands at the time listed in number 3 (after a diaper change) below, as required in rule.1. Upon arrival2. Prior to departure.3. After toileting/diaper change.4. After contact with bodily fluids.5. After returning from outdoor play.6. After handling pets, pet cages, or other pet objects that have come in contact with the pet, before moving on to another activity.7. Before eating or assisting with food preparation.8. After water activities.9. When visibly soiled (must use soap and water)10. 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 number 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: Closed - Not Addressed

A written, signed and dated JFS 01236 Child Medical/Physical Care Plan for Child Care must be on file for any child having health conditions which require monitoring for symptoms, or a medical procedure be performed, or ongoing administration of medication or medical foods at the program. In review of the childrens records, it was determined that the required written information was either not on file, implemented or followed, for at least one child indicated on the Children Records Review, as noted in number 27 below:1. No plan was on file.2. Childs name was missing.3. Childs date of birth was missing.4. Name of the condition was missing.5. Indication if medication is required was missing.6. Symptoms to watch for were missing.7. Directions for when should the medication or medical food be administered were missing.8. Instructions for administration were missing.9. Conditions that trigger the need for medication or medical foods were missing.10. Expected results of the medication or medical food were missing.11. Actions to be taken if the symptoms do not subside were missing.12. Activities, foods, environmental conditions to avoid were missing.13. Training instructions were missing.14. Directions for action to be taken if expected result of medication or medical food does not occur were missing.15. Instructions regarding emergency evacuation, if applicable, were missing.16. Dated signature of parent was missing.17. Dated signature of certified professional who trained the program staff was missing, if parent was not the trainer.18. Printed name(s)/Dated signature(s) of child care staff member(s) trained to perform the procedure were missing.19. Dated signature(s) of administrator was missing.20. Name of any applicable medication was missing.21. Date medication was administered was missing.22. Time medication was administered was missing. 23. Dosage administered was missing.24. Signature of staff member who administered the medication was missing.25. Medication listed in the procedures to follow was not onsite available to administer as instructed and alternate instructions for this situation were not included on the plan.26. The plan was not implemented.27. The plan was not able to be implemented due to conflicting information. Information on the plan did not match the instructions on the pharmaceutical label.28. The plan was not followed.Submit the programs corrective action plan, which includes a copy of the completed JFS 01236, to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Closed - Not Addressed

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 4, 7, 10,15 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

During the inspection, it was determined that children were not being properly supervised as noted in number 5 below: 1.Child(ren) were not within both sight and hearing of a child care staff member during indoor play.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.Children were sleeping with blankets covering their heads, preventing appropriate supervision. 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 medication stored at the center had expired. 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 a topical product, Aquaphor, was at the program which had not been labeled with the child's name. Submit the programs corrective action plan to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Approved