A+ CHILDCARE & PRESCHOOL

During the inspection, it was determined that medication, medical foods and/or topical products did not meet the requirement(s) for administering medication, medical foods, and/or medical products as noted in number(s) 1 below:1. The medication, medical food, or topical product was no longer needed and had not been removed from the program.2. The medication, medical food, or topical product had expired and had not been removed from the program.3. The prescription label had expired.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 the programs written policies and procedures provided to the parents/guardians and employees was missing item number(s) 8,14,15below:General Information1. Program name, address, email address and telephone number.2. Description of the programs 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 program activities.6. Opportunities for parents to meet with teachers regarding their child.7. Payment schedule, overtime charges and registration fees as applicable.8. Supports for onsite breastfeeding or pumping for mothers who wish to do so (if the program serves infants or toddlers).Program Policies and Procedures9. Enrollment including required enrollment information.10. Care of children without immunizations.11. Attendance including procedures for arrival and departure, the programs 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. Compliance with the Americans with Disabilities Act (ADA), including administering medication to children with disabilities and administering care procedures to 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 a policy on providing supplemental food.18. Management of illness including isolation precautions, symptoms for discharge and return and notification of parent of ill child.19. Summary of procedures taken in the event of an emergency, serious illness or injury.20. Administration of medication and topical products including medical foods, modified diets and whether school age children are permitted to carry their own medication and ointments.21. Transportation for fieldtrips, routine trips (if applicable) and emergencies, including if the center 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 including closing due to weather, school delays or closings and any other factors.27. Situations that may require disenrollment of a child, if applicable.28. Problem or issue resolution for parents or employees to follow when needing assistance in resolving problems related to the child care program.29. Formal screenings and assessments on enrolled children and if the program reports child level data to ODJFS pursuant to 5101:2-17-02 of the Administrative Code.Revise the programs written policies and procedures to include the missing information. Submit the programs corrective action plan, which includes the revised written policies and procedures, to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Approved

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 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: 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 number(s) 4,6 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 number(s) 1 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 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: 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 number(s) 1-5 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 the program was not providing a clean and healthy environment, furniture, materials and equipment as required by Appendix A, as noted in number(s) 16,18,30 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 (Infant).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; microwave used for heating food was visibly soiled ( Preschool).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 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) 6,7,9 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 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

During the inspection, it was determined that children whose diapers were being changed in the restroom, were laid directly on the floor. 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

It was determined through a serious incident/injury report, submitted by the program, that children were not supervised while outside the program as noted in number(s) 1 below:1. Child(ren) left unattended outside the facility building. 2. Child(ren) left unattended outside the facility building more than once. 3. Child(ren) left unattended off the programs premises. 4. Child(ren) left unattended during a swimming activity.5. Child(ren) left unattended in a vehicle.6. Child(ren) left unattended inside the building and no adults were present in the building. 7. Other [ ]. Children must be supervised and within sight and hearing of a child care staff member at all times. Provide staff training. Rule 5180:2-12-03 requires the program to notify parents when a serious risk non-compliance is cited. The notification must inform parents of the serious risk non-compliance and include the Department of Children and Youth website and location of further information regarding the determination. Submit the programs corrective action plan, which includes a statement that training was provided and a copy of the written parent notification, to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Approved

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(s) 3 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: Approved

During the inspection, it was determined the administrator, child care staff, and/or employees of the program did not protect or remove children from a situation and/or person determined to be unsafe or inappropriate as noted in number(s) 5 below:1.Verbal argument involving adults. 2.Staff member(s) allowed child(ren) to do something unsafe.3. Staff member(s) did something unsafe.4. Children were exposed to inappropriate [language; conversation; behavior; video; music; DVD] by a [staff member/child/parent].5.Other: The program provided an outdoor experience for children; however, there was no barrier or fencing to protect the children from entering the road. While the program did not protect the child(ren) from an unsafe or inappropriate situation and/or person, it was determined the situation would not or did not result in a serious incident or injury to a child. All program employees must take actions to protect children in care. 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 a child had been placed in a crib with an object that created a potential strangulation or suffocation risk, as indicated in number(s) 4 below: 1. Bib2. Pacifier clip/ribbon3. Teething jewelry4. Blanket for infant under twelve months old5. Pillow6. Boppie7. Bumper pad 8. Clothing stored in the crib9. Diaper bag 10. Object or toy strung over the crib in which a child can pull himself up11. Stuffed animal that is large/soft enough to conform to the shape of the child's face 12. Other [ ] The rule prohibits any item which obstructs child-care staff's visibility or poses a risk of strangulation or suffocation from being placed on or in a crib. Remove the item(s) immediately. 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

During the inspection, it was determined that the program did not meet the requirements for bottle feeding as noted in number(s) 1 below:1. A bottle was propped for an infant feeding.2. An infant was placed in a crib with a bottle.3. An infant was not held or fed sitting up for bottle feedings.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

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: Approved

During the inspection, it was determined first aid kit(s) at the program (lower level) had missing, or expired, items that are required by appendix A of this rule to be contained in a first aid kit, as noted in number(s) 2,3,4,5,8,9,15 below:1. The program did not have a first aid kit [onsite, on the vehicle, on a field trip]. 2. One roll of hypoallergenic first-aid tape.3. Individually wrapped sterile gauze squares in assorted sizes.4. Sterile adhesive bandages in assorted sizes.5. Tweezers.6. Gauze rolled bandage.7. Triangular bandage.8. Rounded end scissors.9. Tooth preservation system or fresh chilled liquid milk in which to transport a lost permanent tooth, including a written reference indicating location of the refrigerator/freezer where milk is stored if a tooth preservation system is not part of the first aid kit (for programs serving school age children only).10. A working digital thermometer.11. Disposable non-latex gloves.12. A working flashlight.13. An instant cold pack that has not been activated or ice, including a written reference indicating location of the refrigerator/freezer where the ice is stored if an instant cold pack is not part of the first aid kit.14. Sealable leak-proof plastic bags in assorted sizes or double bagged plastic bags that can be securely tied for materials soiled with blood or bodily fluids.15. Pocket mask or face shield, appropriate for all ages of children in care, for cardiopulmonary resuscitation (CPR) administration.16. Soap or waterless sanitizer (field trip or transporting away from the program only).17. Bottled water (field trip or transporting away from the program only).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 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 the program did not have a copy of the certificate of occupancy for the lower level available on-site for review. Submit the programs corrective action plan, which includes a copy of the certificate of occupancy, 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 did not have at least one administrator onsite for 50 percent of the program's operating hours or 40 hours a week, as required by this rule. 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 person designated as the administrator was not responsible for the daily operation of the program and for maintaining compliance. 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 a copy of the daily program schedule was not posted in the Infant 1 area as required. 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 sheets, mattresses and/or mattress covers did not meet the rule requirement as noted in number(s) 2 below:1. At least one crib 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 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

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) 4 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 verification of a high school education for the child care staff member(s) listed on the Employee Record Chart, did not meet the requirements as listed in number(s) 1 below: 1. Verification of completion of a high school education was not on file.2. Documentation was incomplete or not on file for a high school junior or senior who is enrolled in a career-technical program.3. Documentation was not on file for a high school junior or senior who is also enrolled in a college credit program in child development or early childhood education.4. Documentation was not on file for a high school junior or senior who is enrolled in a Child Development Associate (CDA) training program.Submit the programs corrective action plan, which includes a copy of the education verification, 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(s) 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 at least one child care staff member had not completed required health and safety training as noted in number(s) 1 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 cribs were not two feet apart when in use, as required by 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 written instructions for feeding the infants noted on the Children Record Review were missing information as noted in number(s) 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 children were not protected from item(s) or condition(s) which may threaten their health, safety, or well-being as noted in number(s) 1,6,16 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 Toddler 2/Transition Preschool restroom posed a safety hazard in that it was not skid resistant.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: Approved

During the inspection, a potentially hazardous item or toxic substance (toilet bowl cleaner) was used or stored under the sink in the lower-level hall restroom,where children had access to it, as noted in number(s) 2 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: 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 (PreK 1), as noted in number(s) 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 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) 4,6,810,13,14 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 [ ] 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 following information was not posted for item number(s) 1,3 below:1. Fire alert plan, including a diagram indicating evacuation routes.2. Weather alert plan was missing details for [ ].3. Weather alert plan was missing a diagram indicating evacuation routes.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 number(s) 8,9,10 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. 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, a potentially hazardous item or toxic substance was used or stored on a shelf in the PreK classroom where children had access to it, as noted in number(s) 2 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: 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(s) 6 below, in that an employees purse was observed on a shelf in the PreK classroom, accessible to children: 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 [ ].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 being properly supervised as noted in number(s) 1 below, in that a staff member was completing paperwork at a table and could not see children at the other end of the classroom: 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.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

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) 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

During the inspection, it was determined the current licensing rules were not available or available in a noticeable area on the premises; in that the rules did not contain appendixes, procedure and transmittal letters. 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 Child Care Staff Members who were used in the staff/child ratio were engaged in other duties such as noted in number(s) 4 below and, therefore, were unable to provide appropriate care and supervision to the children: 1. Cooking;2. Cleaning that interferes with supervision;3. Paperwork;4. Talking/on the phone for extended time;5. Engaging in a conversation with a parent for an extended period of time;6. 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: 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 number(s) 5c, 6 a-c 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: Closed - Not Addressed

In review of the staff records, it was determined that verification of a high school education for the child care staff member(s) listed on the Employee Record Chart, did not meet the requirements as listed in number(s) 1 below: 1. Verification of completion of a high school education was not on file.2. Documentation was incomplete or not on file for a high school junior or senior who is enrolled in a career-technical program.3. Documentation was not on file for a high school junior or senior who is also enrolled in a college credit program in child development or early childhood education.4. Documentation was not on file for a high school junior or senior who is enrolled in a Child Development Associate (CDA) training program.Submit the programs corrective action plan, which includes a copy of the education verification, 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(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. 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 the program did not have at least one child care staff member present/scheduled to be present during all hours of operation with currently valid documentation for the training(s) listed in number(s) 10 below:1. First Aid child care staff members scheduled during the hours of [ ] and [ ] had expired training 2. First Aid child care staff members scheduled during the hours of [ ] and [ ] did not have verification of completion of First Aid 3. First Aid trained child care staff member was not present in each building used by the program.4. CPR child care staff members scheduled during the hours of [ ] and [ ] had expired training 5. CPR child care staff scheduled during the hours of [ ] and [ ] had did not have verification of completion of CPR 6. CPR trained child care staff member was not present in each building used by children7. CPR training taken by staff was not appropriate for all ages and developmental levels of the children in care8. CPR - audiovisual or electronic media training taken by staff did not include an in-person component of the training 9. Communicable Disease child care staff members scheduled during the hours of [ ] and [ ] had expired training 10. Communicable Disease child care staff scheduled during the hours of 4:45 p.m. and 5:30 p.m. had not taken Communicable Disease training 11. Communicable Disease trained child care staff member was not present in each building used by the program 12. Child Abuse child care staff members scheduled during the hours of [ ] and [ ] had expired training 13. Child Abuse child care staff scheduled during the hours of [ ] and [ ] had not taken Child Abuse training 14. Child Abuse trained child care staff was not in each building used by the program Refer to the Employee Record Chart for specific details. Submit the programs corrective action plan, which includes verification of complete coverage for any training listed, 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(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: 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 number(s) 1,2,3,4,5,6 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: Approved

During the inspection, equipment was determined to be unsafe, hazardous to children, or in need of repair as noted in number(s) 2 below: 1. Manufacturer's guidelines for the [ ] were not followed in that [ ]. 2. The straps were missing on the white infant seats in Infant 2.3. 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

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) 3,16,17,21,24,27,30 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: refrigerator 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

During the inspection, it was determined that unsanitary conditions, as noted in number(s) 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 at least one piece of equipment, furnishings, or material at the program (red chair in PreK 2)was not constructed of materials to facilitate cleaning as noted in number(s) 1 below:1. The material had a tear.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

During the inspection, it was determined that at least one staff member washed his or her hands in a sink that is used for meal preparation or clean-up or is near the food serving area. 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 first aid kit(s) at the program (lower level), had missing, or expired, items that are required by appendix A of this rule to be contained in a first aid kit, as noted in number(s) 5,6,8,9below:1. The program did not have a first aid kit [onsite, on the vehicle, on a field trip]. 2. One roll of hypoallergenic first-aid tape.3. Individually wrapped sterile gauze squares in assorted sizes.4. Sterile adhesive bandages in assorted sizes.5. Tweezers.6. Gauze rolled bandage.7. Triangular bandage.8. Rounded end scissors.9. Tooth preservation system or fresh chilled liquid milk in which to transport a lost permanent tooth, including a written reference indicating location of the refrigerator/freezer where milk is stored if a tooth preservation system is not part of the first aid kit (for programs serving school age children only).10. A working digital thermometer.11. Disposable non-latex gloves.12. A working flashlight.13. An instant cold pack that has not been activated or ice, including a written reference indicating location of the refrigerator/freezer where the ice is stored if an instant cold pack is not part of the first aid kit.14. Sealable leak-proof plastic bags in assorted sizes or double bagged plastic bags that can be securely tied for materials soiled with blood or bodily fluids.,13 15. Pocket mask or face shield, appropriate for all ages of children in care, for cardiopulmonary resuscitation (CPR) administration.16. Soap or waterless sanitizer (field trip or transporting away from the program only).17. Bottled water (field trip or transporting away from the program only).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 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 children were being supervised by an individual who did not meet the requirements of a child care staff member or was not at least two years older than the child(ren). Additional child care staff members must be hired or current child care staff members must be rescheduled 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 a bottle was not prepared appropriately as noted in number(s) 3 below:1. The bottle was heated in the microwave.2. The container of water used to warm bottles was heated to a temperature hotter than 120 degrees Fahrenheit.3. The container used for heating bottles was not emptied and cleaned each day.4. The bottle was not shaken well before feeding.5.The temperature of the bottle was not tested before feeding.6.Frozen breast milk was not thawed under cold running water or in the refrigerator.7.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 written instructions for feeding the infants noted on the Children Record Review were missing information as noted in number(s) 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 the program did not meet the requirements for keeping an attendance record as listed in number(s) 6 below:1. No attendance record was being maintained.2. The attendance record was not being consistently completed.3.The record did not include the name of at least one child.4. The record did not include the birth date of at least one child.5.The record did not include the assigned group.6.The record did not include the childs weekly schedule.7.The record did not include the time (hours and minutes) of each childs arrival and departure to the program, including transportation by the program.8. The original attendance record was not kept at the program for a period of one 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 the administrator did not have scheduled hours of availability to meet with parents, or the hours of availability were not posted in a noticeable location. 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 method for tracking children in each group did not meet the requirements of the rule as noted in number(s) 5 below, in that 9 children were present , but 8 children were marked in on the Preschool attendance: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: Approved

In review of the staff records, it was determined that verification of a high school education was not on file nor verified in the Ohio Professional Registry for Child Care Staff Member(s) listed on the Employee Record Chart, as required. Submit the program's corrective action plan, which includes a copy of the verification of a high school education, 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) had not completed the online orientation training as noted in number(s) 1 below:1. 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.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 check requirements had not been followed, for the individual(s) listed on the Employee Record Chart, as noted in number(s) 3 below:1. The JFS 01176 Program Notification of Background Check Review for Child Care the program received from the Department was not on file and the individual was not left alone with children. 2. The JFS 01177 Individual Notification of Background Check Review for Child Care was on file instead of the JFS 01176.3. The JFS 01176 on file was for a different program.Submit the program's corrective action plan, which includes a statement that the correct form is now on file, to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Approved

During the inspection, it was determined that school-age children engaged in short term activities in another room off the main classroom without meeting number(s) 3 below:1. Were within hearing distance of a Child Care Staff Member;2. In groups of 6 or fewer;3. Checked on at least every 5 minutes (Kindergarten-third grade);4. Checked on at least every 10 minutes (Fourth grade and higher);5. The program has exclusive use of the child care space being used by children.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 cribs were not two feet apart when in use, as required by this rule, in that an infant was observed to be sleeping in a crib that was positioned against two other cribs. 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 number(s) 1,2,3 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 the blue and white stationary climber was positioned such that the fall zone requirement in number(s) 4 below was not met:1. The fall zone was less than 3 feet from the fence for equipment used by children 23 months of age and younger.2. The fall zone was less than 6 feet from the fence for equipment used by children 24 months of age and older.3. 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.4. 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.5. 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.6. The fall zone was less than 9 feet from each piece of applicable equipment used by children 24 months of age and older. 7. Other [ ]. The program is required to provide equipment that is safe with adequate fall zones. 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 not all cleaning/sanitizing supplies had been clearly labeled(pink sanitizer in PreK 1, weed control chemical in container on shelf by playground exit door ). When cleaning or sanitizing supplies are not stored in their original containers, the container must be labeled with the contents. 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, a potentially hazardous substance, which was determined to not present a serious risk to a child, was accessible to children as noted in number(s) 8 below, in that it was stored in an unlocked storage area in the school age room. Children were in the area without supervision for periods of time: 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 [ ].The potentially hazardous substance was determined to be accessible to children in the following area: [ ]. 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

During the inspection, a potentially hazardous item or toxic substance was used or stored on a shelf in the hallway of the exit to the playground, where children had access to it, as noted in number(s) 14 below. The container had a cord /wand that was stored in a manner that children could access it. 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: weed control substance.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: Approved

During the inspection, it was determined that items designed to be placed in a childs mouth were not being washed and sanitized, as required, in that infants were observed placing toys in their mouths and toys were left out for other infants to use. Staff stated toys are cleaned at end of day and they rotate cleaning schedule. 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 following equipment was unclean or soiled during daily use cribs, high chairs in Infant 1; microwave in Infant 1, PreK 1, 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 infant who was 12 months or older was assigned to a mat without written permission from the parent, as required by 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 below, were in the Toddler 1, School age 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

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(s) 1 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.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: Approved

During the inspection, it was determined a child with a condition that required a JFS 01236 "Child Medical/Physical Care Plan" had been present and the program did not meet the requirement(s) noted in number(s) 1 below: 1. None of the child care staff members trained in the procedures on the JFS 01236 were responsible for care of a child, when a child requiring the plan was present. 2. 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. 3. None of the child care staff members trained in the procedures on the JFS 01236 accompanied the child requiring the plan during a trip. 4. A child care staff member who had not been trained in the procedures on the JFS 01236 performed the procedure. 5. 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: 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 number(s) 4,10,11,12,13 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 [ ] 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 first aid kit(s) at the program ( lower level) had missing, or expired, items that are required by appendix A of this rule to be contained in a first aid kit, as noted in number(s) 3,5,6,8,9,13,15 below:1. The program did not have a first aid kit [onsite, on the vehicle, on a field trip]. 2. One roll of hypoallergenic first-aid tape.3. Individually wrapped sterile gauze squares in assorted sizes.4. Sterile adhesive bandages in assorted sizes.5. Tweezers.6. Gauze rolled bandage.7. Triangular bandage.8. Rounded end scissors.9. Tooth preservation system or fresh chilled liquid milk in which to transport a lost permanent tooth, including a written reference indicating location of the refrigerator/freezer where milk is stored if a tooth preservation system is not part of the first aid kit (for programs serving school age children only).10. A working digital thermometer.11. Disposable non-latex gloves.12. A working flashlight.13. An instant cold pack that has not been activated or ice, including a written reference indicating location of the refrigerator/freezer where the ice is stored if an instant cold pack is not part of the first aid kit.14. Sealable leak-proof plastic bags in assorted sizes or double bagged plastic bags that can be securely tied for materials soiled with blood or bodily fluids.15. Pocket mask or face shield, appropriate for all ages of children in care, for cardiopulmonary resuscitation (CPR) administration.16. Soap or waterless sanitizer (field trip or transporting away from the program only).17. Bottled water (field trip or transporting away from the program only).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 observed that a child in the Toddler 2 group was served whole grapes, which posed a choking hazard. 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