GREENE STREET DAY CARE/PRESCHOOL

During the inspection, it was determined the program had administered medication to a child and the written instructions on the JFS 01217 Request for Administration of Medication for Child Care form or attached prescription label were not followed as noted in number(s) 4, 6 below: 1. Medication had been administered to a child at the center at a different time than directed. 2. Medication was administered to a child for a longer or shorter period of time than directed. 3. The dose administered did not match the dosage required by the manufacturers directions. 4. The dose administered did not match the dosage required by the written physicians instructions or the prescription label. 5. A child was administered the wrong medication provided to the program for that child. 6. Other: Medication was on site to be administered and the child did not meet the age and weight requirements by the manufacturer. Provide training to the staff designated to administer medication that the parents and physician's instructions on the prescribed form, as well as instructions on the prescription label, must be followed to avoid over or under medicating a child. 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 the program had not been inspected by the local fire department or local fire safety inspector and secured documentation of a fire inspection without any uncorrected violations within 12 months from the date of the last fire inspection without any uncorrected violations, as required. The program had requested the new inspection at least 30 days prior to the expiration date of the previous fire inspection. Submit the programs corrective action plan, which includes an updated fire inspection without any uncorrected violations, to the Department to verify compliance with the requirements of this rule.

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

Resolution: Compliance Status: 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) 1, 2 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) 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 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 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

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) 4, 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

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 that indoor swings, slides, climbers, and climbing apparatus did not have required shock absorbent protective covering under and around the equipment as noted in number(s) 2 below: 1. A shock absorbent protective covering was not used.2. The mats were not at least one and one-half inches thick for equipment over three feet high.3. The mats were not used according to the manufacturer's guidelines.4. Other [ ]. Submit the programs corrective action plan to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Approved

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

Resolution: Compliance Status: Approved

During the inspection, it was determined that at least one piece of equipment, furnishings, or material at the program was not constructed of materials to facilitate cleaning as noted in number(s) 1 below:1. The material had a tear.2. The material was not washable.3. The material was porous.4. The surface was cracked.5. The surface was repaired, but in a manner that still did not facilitate cleaning. 6. Other [ ]. Equipment, furnishings, and furniture shall be constructed of materials to facilitate cleaning. Technical assistance was provided at the time of the inspection, and as discussed, please correct this rule noncompliance. A written response for this rule noncompliance is not required at this time.

Resolution: Compliance Status: Approved – Technical Assistance Provided

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

Resolution: Compliance Status: Approved

During the inspection, it was determined that a medication, medical food or topical product was at the program which had not been labeled with the child's name. Submit the programs corrective action plan to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Approved

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, 3 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

In review of the children's records, it was determined that the JFS 01236 Child Medical/Physical Care Plan for Child Care did not meet the requirements of the rule as noted in number(s) 1 below:1. The JFS 01236 had not been updated as needed and at least annually.2. A separate JFS 01236 had not been used for each condition.3. The program used an old version of the JFS 01236.Submit the programs corrective action plan to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Approved

During the inspection, it was determined the programs written disaster plan did not meet the requirement for training child care staff members and employees on the plan annually as noted in number(s) 1 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, a ratio of 1 child care staff member(s) for 8 children was determined to have occurred for the toddler group when the situation in number(s) 1 below occurred:1. A child care staff member stepped out of the room.2.A child care staff member had not arrived at work on time.3.Children were present who were not scheduled to be there.4.A child care staff member was unable to work.5.A child was injured in that group.6.A child arrived in the group before a second staff member was scheduled to arrive with the group.7.Two groups were combined, and the program did not follow the ratio for the youngest child in the group.8.A child was transitioning to the next older age group, and the program did not follow the ratio for the youngest child in the group.9. Ratio was doubled for more than two hours while children were napping.10. Ratio was doubled while children were napping for a group that included at least one infant.11. Ratio was doubled while children were napping and there were not enough staff members in the building to meet staff/child ratio.12. Ratio was doubled in the school age group to allow access to the program, however, the program does not serve only school age children.13. Both child care staff members did not have a working communication device when one staff member left the group to allow access to the school age only program.14. The child care staff member did not return to the group after allowing access to the school age only program.15.Other [ ].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 Child Care Staff Member had used the inappropriate techniques in number(s) 14 below when managing unacceptable behavior in children:1. Utilize cruel, harsh, unusual, or extreme techniques; 2. Utilize any form of corporal punishment;3. Delegate children to manage or discipline other children;4. Use physical restraints on a child;5. Restrain a child by prone restraint or any means other than holding children for a short period of time, such as in a protective hug, so that the children may regain control;6. Place children in a locked room or confine children in any enclosed area;7. Confine children to equipment such as cribs or highchairs;8. Humiliate, threaten or frighten children; 9. Subject children to profane language or verbal abuse; 10. Make derogatory or sarcastic remarks about children or their families;11. Punish children for failure to eat or sleep or for toileting accidents;12. Withhold any food (including snacks and treats), rest or toilet use;13. Punish an entire group of children due to the unacceptable behavior of one or a few;14. Isolate and restrict children from all activities for an extended period of time. Child Care Staff Members and other employees must always use appropriate guidance and management methods with 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 a medication, medical food or topical product was at the program which had not been labeled with the child's name. Submit the programs corrective action plan to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Approved

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

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

Resolution: Compliance Status: Closed - Not Addressed

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

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

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) 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

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

Resolution: Compliance Status: Approved

In review of the children's records, it was determined that the JFS 01236 Child Medical/Physical Care Plan for Child Care did not meet the requirements of the rule as noted in number(s) 1 below:1. The JFS 01236 had not been updated as needed and at least annually.2. A separate JFS 01236 had not been used for each condition.3. The program used an old version of the JFS 01236.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, group size limitations were not maintained for the group of toddlers as it was determined there were 15 children grouped together. The group size shall not exceed twice the maximum number of children allowed per Child Care Staff Member. 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 method for tracking children in each group did not meet the requirements of the rule as noted in number(s) 5 below:1. There was no method in place;2. The method did not include each child's name;3. The method did not include each child's date of birth;4. The tracking method did not remain with the group at all times;5. The tracking method was not updated throughout the day as children entered or left the group.Submit the program's corrective action plan to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Approved

During the inspection, it was determined the program had administered medication to a child and the written instructions on the JFS 01217 Request for Administration of Medication for Child Care form or attached prescription label were not followed as noted in number(s) 3, 4 below: 1. Medication had been administered to a child at the center at a different time than directed. 2. Medication was administered to a child for a longer or shorter period of time than directed. 3. The dose administered did not match the dosage required by the manufacturers directions. 4. The dose administered did not match the dosage required by the written physicians instructions or the prescription label. 5. A child was administered the wrong medication provided to the program for that child. 6. Other: [ ].Provide training to the staff designated to administer medication that the parents and physician's instructions on the prescribed form, as well as instructions on the prescription label, must be followed to avoid over or under medicating a child. 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 the program did not meet the requirements for the JFS 01217 ""Request for Administration of Medication for Child Care"" as noted in number(s) 2 below:1. The program used an old version of the JFS 01217.2. The signature date on the JFS 01217 exceeded more than 12 months.3. The time period to administer the medication or medical food on the JFS 01217 was exceeded.4. The JFS 01217 included more than one medication or medical food.5. The JFS 01217 included more than one child's name.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 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

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) 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 at least one child care staff member had not completed required health and safety training as noted in number(s) 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 and the updated form was incomplete.6. The CPR training was expired.Refer to the Employee Record Chart for the name(s) of the child care staff member(s) who must complete the required health and safety training(s). Submit the programs corrective action plan to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Approved

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

Resolution: Compliance Status: Approved – Technical Assistance Provided

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

Resolution: Compliance Status: Approved

During the inspection, it was determined the programs written disaster plan did not meet the requirement for training child care staff members and employees on the plan annually as noted in number(s) 1 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 one surge protectors/outlets did not have childproof receptacle covers. The program must have safety covers on all electrical outlets, including power strips and surge protectors, which are within the reach of the children. Technical assistance was provided at the time of the inspection, and as discussed, please correct this rule noncompliance. A written response for this rule noncompliance is not required at this time.

Resolution: Compliance Status: Approved – Technical Assistance Provided

During the inspection, it was determined that the program had a floor surface that was unsafe, in that, area rugs were not flat on the floor. A walking surface that is not hazardous to children must be maintained at the program. 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 children's individual blankets and belongings were stored in an unsanitary manner. Children's belongings need to be stored in a sanitary manner to prevent the spread of germs. 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 all required items were not taken on a field trip and/or routine trip as determined in that the item number(s) 1 below was missing: 1. Completed copies of the JFS 01234 Child Enrollment and Health Information For Child Care (except routine walks);2. First aid supplies;3. A working cellular phone or other means of immediate communication (not to be used while a vehicle is in motion);4. Written record of children on the trip, including which vehicle each child is being transported in and the cellular phone number of the adult in that vehicle who could be contacted in an emergency. Provide staff training. Submit the programs corrective action plan, which includes a written plan that ensures these safety guidelines will be met when children are transported, and 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) 7, 10, 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 first aid kit(s) at the program 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) 9 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). (exipred)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 that children were left unattended while inside the program as noted in number(s) 1 below: 1.Child(ren) were left unattended once. 2.Child(ren) were left unattended more than once. 3. Child(ren) left the group and were unattended. 4.Child care staff were using a baby monitor to supervise children. 5.Child care staff were using a walkie talkie to supervise children. 6.Child care staff were using mirrors to view children in another room. 7.Child care staff were using a video camera instead of physically being present in the room. 8.Other [ ]. Children must be supervised and within sight and hearing of a child care staff member at all times. Provide staff training. Submit the programs corrective action plan, which includes a statement that training was provided, to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Approved

During the inspection, it was determined that the 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

During the inspection, it was determined the program had not followed the written instructions on the JFS 01217 Request for Administration of Medication for Child Care form or attached prescription label were not followed as noted in number(s) 6 below: 1. Medication had been administered to a child at the center at a different time than directed. 2. Medication was administered to a child for a longer or shorter period of time than directed. 3. The dose administered did not match the dosage required by the manufacturers directions. 4. The dose administered did not match the dosage required by the written physicians instructions or the prescription label. 5. A child was administered the wrong medication provided to the program for that child. 6. Other: Medication was not administered to a child at the times directed by the parent. Provide training to the staff designated to administer medication that the parents and physician's instructions on the prescribed form, as well as instructions on the prescription label, must be followed to avoid over or under medicating a child. 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

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) 19 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: Closed - Not Addressed

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

Resolution: Compliance Status: Approved

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

Resolution: Compliance Status: Approved

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

Resolution: Compliance Status: Approved