FLORA'S LIL FLOWERS

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 the following number(s) 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. Telephone cords.7. Employee(s) purse(s).8. Diaper bags.9. Television not securely anchored.10. Small or lightweight pieces of shelving units are not securely anchored to the wall.11. Staff member stepped over a barrier/gate while holding a child.12. Chipping or peeling paint.13. An area rug did not have a nonskid backing.14. An area rug presented a tripping hazard.15. A floor surface was unsafe in that [ ].16. No platform was provided for the sink or toilet.17. The platform provided for the sink or toilet was not sturdy.18. The platform provided for the sink or toilet posed a safety hazard in that [ ].19. Emergency exits were blocked by the following furniture in that [ ].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: Stacked toy bin on counter accessible to childrenSubmit 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 number(s) 1 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

During the inspection, it was determined that bottles containing juice for a particular infant were not labeled with the childs name and date of preparation. Submit the programs corrective action plan 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(s) 7 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.7: Other: 1% Skim milk was not offered on the menuSubmit the program's corrective action plan to verify compliance with the requirement of the rule.

Resolution: Compliance Status: Approved

In review of 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) 11 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 birth4. Medical(s) were missing the date of the medical examination5. 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 care7. 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 child8. Medical(s) were missing a record of immunizations the child has had specifying month, day and year9. 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 rule10. 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 convictions11. Other: Some child files were missing signatures from caretakersSubmit 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 a child had been place in a crib or playpen with the following number(s) 4 below which could obstruct a provider or child care staff members view of the infant: 1. Busy box or other toy attached to the side of the crib or playpen.2. A blanket hanging over the side of the crib or playpen.3. Stuffed animal that is not large/soft enough that it could conform to the shape of the childs face.4. Other: BlanketCorrect the violation and submit the programs corrective action plan to verify compliance with the requirement of the rule.

Resolution: Compliance Status: Closed - Not Addressed

During the inspection, it was determined that sheets, mattresses and/or mattress covers did not meet the rule requirement as noted in number(s) 1 below:1. At least one crib or playpen did not have a sheet.2.At least one sheet was too large.3.At least one sheet was too small.4.At least one sheet was torn.5.The mattress was not at least one and one-half inches thick.6.The mattress was not firm. 7.There was space between the mattress and the sides and end panels of the crib or playpen which exceeded one and one-half inches. 8.The mattress cover was not waterproof.9.The mattress cover was torn.10. 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 emergency and preparedness and response plan did not meet the requirement for training child care staff members and employees on the plan annually as noted in number(s) 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 written instructions for feeding the infants noted on the Children Record Review form were not on file, as required by this rule. Correct the violation and submit the program's corrective action plan to verify compliance with the requirement of the rule.

Resolution: Compliance Status: Approved

In review 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) 10, 12, & 13 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 [ ] Submit the program's 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 the following number(s) 4 below, were in the restroom:1. There was no liquid soap.2. There was no toilet tissue.3. There were no individually assigned towels or disposable towels.4. The toilet cleaning brush was accessible to the children.5. The plunger was accessible to the children.6. The toilet was 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. Submit the program's corrective action plan to verify compliance with the requirement of the 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 number(s) 16 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 Receptacles 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. Dress up clothes and hats (dramatic play) were not cleaned monthly or when soiled.14. Floors were not cleaned weekly or when soiled.15. The food prep area, including sinks, were not cleaned before and after preparing food (including bottle preparation) or between preparing raw or cooked food.16. Potty chairs were not cleaned after each use, rinsed with water, cleaned and sanitized or contents were not emptied into a toilet.17. Food tables, highchair trays were not cleaned before and after each use.18. Tables used for play were not cleaned when visibly soiled or sanitized daily.19. Toilet bowls were not cleaned when visibly soiled or sanitized weekly.20. Toilet seat(s), handle(s) and hand washing sink(s) were not cleaned when visibly soiled or sanitized daily.21. Mouthed toys were not cleaned and sanitized after each childs use.22. Toys, other than those mouthed by children, were not cleaned monthly or when visibly soiled.23. Washable furniture, including fabrics on infant equipment, were not cleaned weekly or when soiled.24. Upholstered furniture was not steam cleaned when soiled.25. Slip covers were not washed at least every six months or when soiled.26. Wastebaskets/rinse buckets, including lids, were not being emptied daily or cleaned and sanitized when visibly soiled.27. The manufacturers directions for the cleaning product were not followed.28. The solution used for sanitizing was not a commercial product registered by the United States Environmental Protection Agency as a sanitizer.29. Other [ ]. Furniture, materials and equipment must be maintained according to the cleaning and sanitizing schedule in Appendix A to this rule. Submit the programs corrective action plan 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 individuals listed on the Employee Record Chart did not include the required information listed below in number(s) 4 & 5 a,b,c. 1. A medical statement was not on file;2. The medical statement(s) on file were not dated within 12 months of the individual's first day of employment;3. Date of examination was missing;4. Signature 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 individual 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); Submit the programs corrective action plan, which includes a copy of the completed medical statement, to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Approved

During the inspection, it was determined that employment records in the Ohio Professional Registry (OPR) were not created or maintained as noted in number(s) 6 below: 1. The provider had not created or updated their individual profile in the OPR.2. The provider had not created or updated the program's organizational dashboard in the OPR.3. At least one employee, child care staff member, or substitute child care staff member had not created or updated their individual profile in the OPR. 4. At least one employee, child care staff member, or substitute child care staff member had not created an employment record in the OPR for the program on or before the first day of employment, including date of hire.5. At least one employee, child care staff member, or substitute child care staff member had not updated changes to positions or roles in the OPR within five calendar days of the change.6. The program's organizational dashboard in the OPR was not updated within five business days with at least one employee, child care staff member, or substitute child care staff member's scheduled days and hours.7. The program's organizational dashboard in the OPR was not updated within five business days when at least one employee, child care staff member, or substitute child care staff member's group assignments changed, if applicable.8. The program's organizational dashboard in the OPR was not updated with the employment end date within five business days when at least one employee, child care staff member, or substitute child care staff member ended employment.9. At least one resident over the age of eighteen had not created a profile and employment record for the family child care provider within five days of becoming a resident or turning eighteen.10. The program's organizational dashboard in the OPR was not updated within five calendar days of a change in residency for at least one resident over the age of eighteen.11.Other: [] Submit the program's corrective action plan to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Approved

On the day of the inspection, the programs written policies and procedures provided to the parents/guardians and employees was missing item number(s) 4 & 6 below: General Information1. Name, address, email address and telephone number.2. Description of the providers program philosophy.3. Days and hours of operation, scheduled closings and basic daily schedule.4. Staff/child ratios and group size.5. Opportunities for parent involvement in activities.6. Opportunities for parents to meet with the provider regarding their child.7. Payment schedule, overtime charges and registration fees if applicable.8. Programs shall have a policy in place describing supports for onsite breastfeeding or pumping for mothers who wish to do so (if the program serves infants or toddlers). Provider Policies and Procedures9. Enrollment including required enrollment information.10. Care of children without immunizations.11. Attendance including procedures for arrival and departure, the program's absent day policy, releasing child to persons other than the parent, releasing a child according to a custody agreement and follow up when a child scheduled to arrive from another program or activity does not arrive.12. Supervision of children, including a separate supervision policy for school-age children, if applicable.13. Child guidance.14. Suspension and expulsion.15. Ensure compliance with the Americans and Disabilities (ADA) including administering medication to children with disabilities and administering care procedures for children with disabilities.16. Outdoor play, including limitations placed on outdoor play due to weather or safety issues (considerations may include but are not limited to temperature, humidity, wind chill, ozone levels, pollen count, lightning, rain or ice). 17. Food and dietary policy, including information regarding meeting one-third of the child's recommended daily dietary allowance, policy regarding formula, breast milk, meals, and snacks and policy on providing supplemental food. 18. Management of illness including isolation precautions, symptoms for discharge and return, notification of parent of ill child and whether or not the provider will care for sick children.19. Summary of procedures taken in the event of an emergency, serious illness or injury.20. Administration of medication and topical products policy, medical foods, modified diets, and whether school age children are permitted to carry their own medical and ointments.21. Transportation policy for field trips, routine walks, if applicable, and emergencies including if the provider will provide child care services to children whose parents refuse to grant consent for transportation to the source of emergency treatment.22. Water activities/swimming.23. Infant care, if applicable, including feeding, frequency of diaper checks, and information about daily activities.24. Sleeping, napping and resting.25. Evening and overnight care, if applicable.26. Policy on hours of operation, closing due to weather, school delays or closings and any other factors.27. Use of a substitute child care staff member or child care staff member pursuant to 5101:2-13-08 of the Administrative Code for sick days, vacations or other time off.28. Situations that may require disenrollment of a child, if applicable.29. Problem or issue resolution for parents or employees to follow when needing assistance in resolving problems related to the family child care home.30.Formal screenings and assessments conducted on enrolled children and if the program reports child level data to ODJFS pursuant to Chapter 5101:2-17 of the Administrative Code.Correct the violation and submit the program's corrective action plan to verify compliance with the requirement of the rule.

Resolution: Compliance Status: Approved

In review 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) 6, 10, 12, & 14 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 [ ] Submit the program's corrective action plan to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Approved

In review of 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) 6,8 &9 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 birth4. Medical(s) were missing the date of the medical examination5. 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 care7. 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 child8. Medical(s) were missing a record of immunizations the child has had specifying month, day and year9. 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 rule10. 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 convictions11. 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 current version of the prescribed form, JFS 01201 "Dental First Aid" was not posted. Correct the violation and submit the program's corrective action plan to verify compliance with the requirement of the rule.

Resolution: Compliance Status: Approved

During the inspection, it was determined that the Ohio Communicable Disease Chart was not posted as required , as indicated in the number(s) 3 below:1. In a location readily available to provider, child care staff members, employees, and residents;2. The chart was not posted.3. The posted chart was not the current version.4. The posted chart was not displayed in the size available in the ODJFS forms central to be easily read.Submit the programs corrective action plan to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Approved

During the inspection, it was determined the information in number(s) 3 below was not up to date in the Ohio Child Care Licensing and Quality System: 1. Mailing Address; 2. Telephone Number; 3. Email Address; 4. Days and Hours of Operation; 5. Services Offered; 6. Name of Program, If applicable.7. Private pay rates. Submit the program's corrective action plan to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Closed - Not Addressed

The program had not been inspected and approved within 12 months from the date of the last fire approval by the local fire department, as required. Secure and submit an updated fire approval as part of the programs corrective action plan to verify compliance with the requirement of the rule.

Resolution: Compliance Status: Approved

In review of the staff records, it was determined that child care staff member(s) or substitute child care staff member(s) did not meet the requirements for completing the online orientation training as noted in number(s) 1-4 below:1. The training was not completed within 30 days of starting employment at the program as a child care staff member.2. No documentation of completing the training after December 31, 2016.3. 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

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(s) 3 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. Other [ ].Submit the programs corrective action plan to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Approved