AMANDA'S GARDEN

During the inspection, it was determined that equipment, materials and furnishings provided for indoor and outdoor play did not meet the requirement of the rule as noted in number(s) 3 below.1.Equipment and materials were not varied and adequate to meet the developmental needs of the children.2.Equipment and materials were not provided in a sufficient quantity that each child can be actively involved in an activity.3.Play materials were not readily accessible to the children in the toddler, PK classroom.4. Play materials were not arranged in an orderly manner so that children have opportunities to select, remove and replace play materials with minimal assistance during the day in the [ ] classroom.5. Durable, child-sized or safely adapted furniture was not provided for children in the [ ] classroom. 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 required documentation for substitutions for fluid milk was not on file as noted in number(s) 3, 4 below:1. Written instructions from a licensed physician, physicians assistant, or certified nurse practitioner when infants up to 12 months of age are served anything other than formula or breast milk.2. Written instructions from a licensed physician, physicians assistant, or certified nurse practitioner when infants and toddlers 12 months of age up to 24 months of age are served anything other than unflavored whole homogenized vitamin D fortified cow's milk, breast milk, or non-cow milk substitution that is nutritionally equivalent to milk.3. Written instructions from a licensed physician, physicians assistant, or certified nurse practitioner when toddlers and children 24 months of age and older are served anything other than unflavored one per cent milk that is vitamin A and D fortified, unflavored fat free or skim milk that is vitamin A and D fortified, or non-cow milk substitutions that are nutritionally equivalent to milk.4. Written parental consent for non-cow milk substitutions that are nutritionally equivalent to milk for children 12 months of age and older.5. The program did not have the type of milk on-site to ensure that all children were served age-appropriate fluid milk. 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 policies and procedures provided to the parents/guardians and employees was missing item number(s) 4, 15, 17, 20, 21, 26, 29 below: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 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 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 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) 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, 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) 16, 22 below: 1. Surge protectors/outlets did not have childproof receptacle covers.2. Open pull cords that are not closed loop. 3. Toys or other items small enough to be swallowed were present in the space where infants and/or toddlers were in care.4. Electrical/extension cords attached to an object that would not likely result in a severe injury if pulled. 5. Stacked chairs.6. Employee(s) purse(s). 7. Diaper bags.8. Television not securely anchored.9. Small or lightweight pieces of shelving units are not securely anchored to the wall. 10. Smoke detector needing batteries replaced.11. An area rug did not have a nonskid backing.12. An area rug presented a tripping hazard.13. A floor surface that was unsafe in that [ ].14. No platform was provided for the sink or toilet in the [ ] classroom.15. The platform provided for the sink or toilet in the [ ] classroom was not sturdy.16. The platform provided for the sink or toilet in the restroom posed a safety hazard in that it was not non slip.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 supply closet accessibleProvide 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

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 handwashing requirements were not followed as listed in number(s) 5, 9 below, as required in rule.1. At least one staff/child did not wash their hands upon arrival for the day.2. At least one staff/child did not wash their hands prior to departure.3. At least one staff did not wash their hands upon entry into a classroom.4. At least one staff/child did not wash their hands after toileting or assisting a child with toileting.5. At least one staff/child did not wash their hands after each diaper change or pull-up change.6. At least one staff did not wash their hands after contact with bodily fluids or cleaning up spills or objects contaminated with bodily fluids.7. At least one child did not wash their hands after contact with bodily fluids.8. At least one child did not wash their hands after returning inside after outdoor play.9. At least one staff did not wash their hands after cleaning or sanitizing or using any chemical products.10. At least one staff/child did not wash their hands after handling pets, pet cages or other pet objects that have come in contact with the pet.11. At least one staff did not wash their hands before eating, serving or preparing food or bottles or feeding a child.12. At least one child did not wash their hands before eating or assisting with food preparation.13. At least one staff did not wash their hands before and after completing a medical procedure or administering medication.14. At least one child did not wash their hands after water activities.15. At least one staff/child did not wash their hands when visibly soiled (must use soap and water).16. Other [ ]. Submit the programs corrective action plan to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Approved

During the inspection, it was determined that the program was not providing a clean and healthy environment, furniture, materials and equipment as required by Appendix A, as noted in number(s) 6 below:1. Item(s) soiled with blood or bodily fluids were not cleaned/sanitized immediately. 2. Blankets/sheets were not cleaned weekly, when soiled, or before use by another child. 3. Children's individual blankets and belongings were stored in an unsanitary manner. 4. Bottles, bottle caps, nipples and other equipment used for bottle feeding were not cleaned and sanitized in a dishwasher or by washing, rinsing, and boiling for one minute.5. Carpets were not vacuumed weekly or cleaned when soiled.6. Changing table/pad was not sanitized after each use or cleaned when visibly soiled.7. Reusable cloths were not being washed daily or when visibly soiled.8. Cots/Pads/Mats were not cleaned and sanitized before assigning to a different child, when used by a sick child, when soiled or at least every three months.9. Cribs were not cleaned and sanitized monthly, or when soiled, or before use by another child.10. Diaper Receptables were not cleaned and sanitized daily or more frequently as needed to eliminate odor.11. Dishes/Cups/Silverware were not cleaned and sanitized after each use.12. Water Containers were not labeled with the child's name, or were not cleaned and sanitized before use again on another day.13. Dividers were not cleaned when visibly soiled.14. Dress up clothes and hats (dramatic play) were not cleaned monthly or when soiled.15. Floors were not cleaned weekly or when soiled.16. The food prep area, including sinks, were not cleaned before and after preparing food (including bottle preparation) or between preparing raw or cooked food.17. Potty chairs were not cleaned after each use, rinsed with water, cleaned and sanitized or contents were not emptied into a toilet.18. Food tables, highchair trays were not cleaned before and after each use.19. Tables used for play were not cleaned when visibly soiled or sanitized daily.20. Toilet bowls were not cleaned when visibly soiled or sanitized weekly.21. Toilet seat(s), handle(s) and hand washing sink(s) were not cleaned when visibly soiled or sanitized daily.22. Mouthed toys were not cleaned and sanitized after each childs use.23. Toys, other than those mouthed by children, were not cleaned monthly or when visibly soiled.24. Washable furniture, including fabrics on infant equipment, were not cleaned weekly or when soiled.25. Upholstered furniture was not steam cleaned when soiled.26. Slip covers were not washed at least every six months or when soiled.27. Wastebaskets/rinse buckets, including lids, were not being emptied daily or cleaned and sanitized when visibly soiled.28. The manufacturers directions for the cleaning product were not followed.29. The solution used for sanitizing was not a commercial product registered by the United States Environmental Protection Agency as a sanitizer.30. Other [ ]. Furniture, materials and equipment must be maintained according to the cleaning and sanitizing schedule in Appendix A to this rule. Technical assistance was provided at the time of the inspection, and as discussed, please correct this rule noncompliance. A written response for this rule noncompliance is not required at this time.

Resolution: Compliance Status: Approved – Technical Assistance Provided

In review of the childrens records, it was determined the program did not meet the requirements for caring for at least one child, indicated on the Children Records Review, with a condition that requires a JFS 01236 "Child Medical/Physical Care Plan" as noted in number(s) 1 below: 1. No plan was on file. Blueberry allergy(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 that the dividers used to separate the cribs did not meet the following requirement in number(s) 1 below:1. Did not provide for at least two feet of space on two of the sides or ends of the crib. 2. Constructed so that staff may view children through or around the divider.3. Be unbreakable in normal use situations.4. Be made of a non-porous material that can be easily sanitized.5. Extend up higher than an infant standing in a crib can reach up and shall not impede child care staff members ability to hear the child.Technical assistance was provided at the time of the inspection, and as discussed, please correct this rule noncompliance. A written response for this rule noncompliance is not required at this time.

Resolution: Compliance Status: Approved – Technical Assistance Provided

During the inspection, it was determined that breast milk provided by the parent was not stored appropriately as noted in number(s) 1 below:1. Not labeled with infant's name, date pumped, and date bottle was prepared;2. Not immediately refrigerated or frozen;3. Stored at room temperature longer than eight hours;4. Stored at the program for more than five days after it was expressed;5. Stored longer than two weeks in the freezer compartment of the refrigerator;6. Stored longer than six months in the refrigerator/freezer;7. Stored longer than twelve months in the deep freezer;8. Other [ ]. Submit the programs corrective action plan to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Approved

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 5 below:1.Verbal argument involving adults. 2.Staff members allowed children to do something unsafe.3. Staff members did something unsafe.4. Children were exposed to inappropriate language, conversation, behavior, video, or music.5.Other: Children had sustained minor injuries from a classmate. Incident reports and behavior reports documented eighteen occurrences over the last six months. While the program did not protect the children 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 serious 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 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 the programs written disaster plan did not meet the requirement or was missing the information in number 1 below:Procedures:1. The written disaster plan had not been completed2. The plan was not provided to all child care staff and employees3. The plan was not used to respond to an emergency or disaster situation4. Weather emergencies and natural disasters which include severe thunderstorms, tornadoes, flash flooding, major snowfall, blizzards, ice storms or earthquakes5. Emergency outdoor and indoor lockdown or evacuation due to threats of violence which includes active shooter, bioterrorism or terrorism6. Emergency or disaster evacuations due to hazardous materials and spills, gas leaks or bomb threats.7. Outbreaks, epidemics or other infectious disease emergencies8. Loss of power, water, or heat9. Other threatening situations that may pose a health or safety hazard to the children in the programDetails:10. Shelter in place or evacuation, how the program will care for and account for the children until they can be reunited with the parent11. A designated safe site where staff and children can safely remain when evacuated.12. Assisting infants, toddlers and children with special needs and/or health conditions13. Emergency contact information for parents and the program14. Procedures for notifying and communicating with parents regarding the location of the children if evacuated15. Procedures for communicating with parents during loss of communications, no phone or internet service available16. The location of supplies and procedures for gathering necessary supplies for staff and children if required to shelter in place17. What to do if a disaster occurs during the transport of children or when on a field trip or routine trip18. Making the plan available to all child care staff members and employees19. Training of staff or reassignment of staff duties as appropriate20. Updating the plan on a yearly basis21. Contact with local emergency management officialsMake the necessary revisions to the disaster plan. Submit the programs corrective action plan, which includes the revised information, to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: 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 numbers 6, 7, 13, 22, 23, 27, 29 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 that handwashing requirements were not followed as listed in numbers 5, 8 below, as required in rule.1. At least one staff/child did not wash their hands upon arrival for the day.2. At least one staff/child did not wash their hands prior to departure.3. At least one staff did not wash their hands upon entry into a classroom.4. At least one staff/child did not wash their hands after toileting or assisting a child with toileting.5. At least one staff/child did not wash their hands after each diaper change or pull-up change.6. At least one staff did not wash their hands after contact with bodily fluids or cleaning up spills or objects contaminated with bodily fluids.7. At least one child did not wash their hands after contact with bodily fluids.8. At least one child did not wash their hands after returning inside after outdoor play.9. At least one staff did not wash their hands after cleaning or sanitizing or using any chemical products.10. At least one staff/child did not wash their hands after handling pets, pet cages or other pet objects that have come in contact with the pet.11. At least one staff did not wash their hands before eating, serving or preparing food or bottles or feeding a child.12. At least one child did not wash their hands before eating or assisting with food preparation.13. At least one staff did not wash their hands before and after completing a medical procedure or administering medication.14. At least one child did not wash their hands after water activities.15. At least one staff/child did not wash their hands when visibly soiled (must use soap and water).16. Other.Submit the programs corrective action plan to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Approved

During the inspection, it was determined that children were not protected from item(s) or condition(s) which may threaten their health, safety, or well-being as noted in number 6 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. Employees purses. 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.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.17. Telephone cords.18. Staff member stepped over a barrier/gate while holding a child.19. Emergency exits were blocked by the 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 at least one crib was not labeled with the child's name, 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

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 1 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 background checks did not meet the requirements of the rule for the person(s) listed on the Employee Record Chart as noted in number 1, 3 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 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 1, 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 a Serious Incident was not reported in the Ohio Child Licensing and Quality System (OCLQS), as required, by the program administrator or designee for an incident as listed in number 1 below:1. An incident, injury or illness that required professional medical consultation or treatment. A call was made to 911 on 5/15/2024, and an ambulance was sent to the program for a child who had fallen, hit his head, and was pale. The child was assessed at the program by the emergency medical staff. Transport by ambulance was not required.2. An unusual or unexpected incident which jeopardizes the safety of a child, child care staff member or employee of the program.3. An incident defined as a serious risk non-compliance in appendix A to rule 5101:2-12-03 of the Administrative Code.4. The program did not submit the report in OCLQS by the next business day as required by rule. Submit the programs corrective action plan, which includes a statement that the program administrator or designee has completed the Serious Incident Report in OCLQS, 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 1 below: 1.Children were not within both sight and hearing of a child care staff member during indoor play. This occurred in the infant room while children were being rocked in the rocking chair.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

During the inspection, it was determined that the playground did not have adequate fall surface under and around equipment as noted in number 1 below: 1. No fall surface - Slides placed directly on the grass.2. Adequate fall surface to soften the impact of a fall3. Adequate fall surface to soften the impact of a fall that extended the length of the required fall zone 4. Other.With any equipment designed for climbing, swinging, bouncing, or sliding, resilient material, as specified in Appendix A, needs to be added in order to protect children in the event of a fall. Submit the programs corrective action plan, which includes written verification of the discontinued use of this equipment until corrections are made along with a description of the resilient material added, to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Approved

During the inspection, it was determined that required documentation for substitutions for fluid milk was not on file as noted in numbers 2, 5 below:1. Written instructions from a licensed physician, physicians assistant, or certified nurse practitioner when infants up to 12 months of age are served anything other than formula or breast milk.2. Written instructions from a licensed physician, physicians assistant, or certified nurse practitioner when infants and toddlers 12 months of age up to 24 months of age are served anything other than unflavored whole homogenized vitamin D fortified cow's milk, breast milk, or non-cow milk substitution that is nutritionally equivalent to milk.3. Written instructions from a licensed physician, physicians assistant, or certified nurse practitioner when toddlers and children 24 months of age and older are served anything other than unflavored one per cent milk that is vitamin A and D fortified, unflavored fat free or skim milk that is vitamin A and D fortified, or non-cow milk substitutions that are nutritionally equivalent to milk.4. Written parental consent for non-cow milk substitutions that are nutritionally equivalent to milk for children 12 months of age and older.5. The program did not have the type of milk on-site to ensure that all children were served age-appropriate fluid milk. 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 feeding practices used by a child care staff member were not in accordance with parental preferences, in that a parent preference for an infant to drink from a bottle, not a sippy cup, had not been followed. Submit the programs corrective action plan to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Approved

In review of 25% of the children's records, it was determined that completed medical statements were not on file, as required, for children listed on the JFS Children's Record Review For Child Care as indicated in number 1 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 outdoor play equipment was unsafe or not used as intended as noted in number 20 below:1. There was rust exposed.2. There were protruding bolts. 3. There were cracks.4. There were holes.5. There was splintering wood.6. There were sharp edges or points.7. There were lead hazards.8. There were toxic substances.9. There were tripping hazards.10. There was chipped and/or peeling paint.11. The sandbox was not covered when the program was closed or during non-daylight hours. 12. Outdoor equipment was not developmentally appropriate.13. Outdoor equipment was placed in the main traffic pattern.14. Outdoor play equipment was positioned too closely together, posing a risk of injury if a child were to fall from one piece of equipment into another.15. Outdoor equipment was not securely anchored but did not present a risk of imminent danger of the structure collapsing when children are using the equipment16. Outdoor equipment was 30 inches or more from the ground and did not have a protective barrier that would prevent a child from falling off this piece of equipment.17. The manufacturer's guidelines for assembly and installation were not followed.18. Functionally linked equipment was used by preschool-age children and the distance between two adjacent pieces of equipment exceeded 12 inches.19. Functionally linked equipment was used by school-age children and the distance between two adjacent pieces of equipment exceeded 18 inches.20. Other: The large climber had a piece at the top of the slide that was not securely anchored.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 numbers 2, 3, 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

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 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

During the inspection, it was determined that one administrator had not completed the required rules review course provided by this Department for program administrators within the time period defined in 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 the toddler group was served hot dogs, which pose 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 that required documentation for substitutions for fluid milk was not on file as noted in number(s) 2, 3 below:1. Written instructions from a licensed physician, physicians assistant, or certified nurse practitioner when infants up to 12 months of age are served anything other than formula or breast milk.2. Written instructions from a licensed physician, physicians assistant, or certified nurse practitioner when infants and toddlers 12 months of age up to 24 months of age are served anything other than unflavored whole homogenized vitamin D fortified cow's milk, breast milk, or non-cow milk substitution that is nutritionally equivalent to milk.3. Written instructions from a licensed physician, physicians assistant, or certified nurse practitioner when toddlers and children 24 months of age and older are served anything other than unflavored one per cent milk that is vitamin A and D fortified, unflavored fat free or skim milk that is vitamin A and D fortified, or non-cow milk substitutions that are nutritionally equivalent to milk.4. Written parental consent for non-cow milk substitutions that are nutritionally equivalent to milk for children 12 months of age and older.5. The program did not have the type of milk on-site to ensure that all children were served age-appropriate fluid milk. 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 4 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 that the current JFS 01201 Dental First Aid was not posted in a location readily available to center staff and parents 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, a potentially hazardous substance, which was determined to not present a serious risk to a child, was not used or stored properly as noted in number 12 below: 1. Cosmetics were accessible to children..2. Disinfecting wipes were accessible to children.3. Fish food was accessible to children.4. Hand lotion was accessible to children.5. Hand sanitizer (for children under 24 months) was accessible to children.6. Laundry detergent was accessible to children.7. Powder dish washing soap was accessible to children.8. Paint cans were accessible to children.9. White out was accessible to children.10. Potting Soil was accessible to children.11. Other potentially hazardous substance was accessible to children.12. Cleaning/sanitizing supplies had not been clearly labeled.13. School-age children were using cleaning supplies, agents and/or equipment without adult supervision.14. A spray aerosol was used while children were in attendance. 15. Other.Provide staff training. 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 playground did not have adequate fall surface under and around equipment as noted in number 1 below: 1. No fall surface - toddler climber on the grass.2. Adequate fall surface to soften the impact of a fall3. Adequate fall surface to soften the impact of a fall that extended the length of the required fall zone 4. Other.With any equipment designed for climbing, swinging, bouncing, or sliding, resilient material, as specified in Appendix A, needs to be added in order to protect children in the event of a fall. Submit the programs corrective action plan, which includes written verification of the discontinued use of this equipment until corrections are made along with a description of the resilient material added, to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Approved

During the inspection, an infestation of ants was verified. Multiple staff members stated that there are ants in the kitchen. Ants were observed in the kitchen on the day of the inspection. Documentation was presented to show a pest control company had been to the program. However, the documentation did not include evidence of the recent treatment of ants in the kitchen.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 infants 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 through staff interviews that required staff/child ratios were not maintained for different groups on multiple occasions. Additional 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 Serious Incident was not reported in the Ohio Child Licensing and Quality System (OCLQS), as required, by the program administrator or designee for an incident(s) as listed in number 4 below:1. An incident, injury or illness that required professional medical consultation or treatment.2. An unusual or unexpected incident which jeopardizes the safety of a child, child care staff member or employee of the program.3. An incident defined as a serious risk non-compliance in appendix A to rule 5101:2-12-03 of the Administrative Code.4. The program did not submit the report in OCLQS by the next business day as required by rule. Submit the programs corrective action plan, which includes a statement that the program administrator or designee has completed the Serious Incident Report in OCLQS, to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Approved