JACOBY, PHYLLIS

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) 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

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) 2 below:1. No medical was on file for at least one child 2. Medical(s) on file was not updated every 13 months 3. Medical(s) were missing child's name and date of 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

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 5 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 [ ]. 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 following hazardous conditions existed in the outdoor play area, as noted in number 15 below: 1. There was broken glass.2. There were tall weeds.3. There was poison ivy.4. There were tree branches.5. There was mold visible.6. The sandbox was contaminated.7. There were thistles with prickers.8. There were bird droppings.9. The outdoor area was littered with trash.10. The trash can was missing a lid.11. The trash was not emptied from the day(s) before.12. The trash can was overflowing with trash.13. The trash can was infested with insects.14. The trash can was visibly dirty.15. Other [There was no covering protection from the air conditioning unit ].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, a potentially hazardous item or toxic substance was used or stored where children present had access to it as noted in number 2 below. The potentially hazardous substance or item that posed a risk to children was determined to be accessible to children in child's bathroom . 2. Cleaning agent.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, equipment was determined to be unsafe, hazardous to children, or in need of repair as noted in number 6 below: 6. The equipment had splinters on the raised garden bedsSubmit the programs corrective action plan to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Approved

During the inspection, it was determined that outdoor play equipment was unsafe as noted in the number(s) [ ] below: 2. There were protruding bolts.5. There was splintering wood.6. There were sharp edges or points.Submit the program's corrective action plan to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Approved