ARMOUR CARE LLC

During the inspection, it was determined that open containers of ready to serve food and concentrated formula was not stored appropriately as noted in number(s) 2 below: 1. The food/formula was not covered;2. The food/formula was not dated;3. The food/formula was not refrigerated according to the manufacturers instructions; 4. The food/formula was not discarded or sent home daily if not used; 5. The food/formula was not refrigerated upon arrival;6. The food/formula was not refrigerated immediately after preparation;7. The food/formula was served beyond the expiration date;8. The food/formula was not prepared prior to the manufacturers instructions;9. The food/formula was not prepared according to the instructions from the infants physician, physicians assistant or certified nurse practitioner;10. 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 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( 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 at least one child care staff member had not completed required health and safety training as noted in number 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

During the inspection, it was determined that outdoor play equipment was unsafe or not used as intended as noted in number(s) 14 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, swingset and teeter toter, 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 for the [ ].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 [ ]. 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 fall zone under and around equipment designated for climbing, swinging, balancing and sliding did not meet the requirements as noted in number 1 below:1. The fall surface material had not been properly distributed or raked as needed to retain proper depth under and around equipment.2. A fall zone hazard was present, in that, the [ ] posed a risk of injury if a child were to fall from a piece of equipment.3. The fall zone was less than 3 feet from the fence for equipment used by children 23 months of age and younger.4. The fall zone was less than 6 feet from the fence for equipment used by children 24 months of age and older.5. There was not a fall zone of 3 feet in all directions from the perimeter of the equipment used by children 23 months of age and younger.6. There was not a fall zone of 6 feet in all directions from the perimeter of the equipment used by children 24 months of age and older.7. The fall zone was less than 4 1/2 feet from each piece of applicable equipment used by children 23 months of age and younger.8. The fall zone was less than 9 feet from each piece of applicable equipment used by children 24 months of age and older. 9. Other [ ]. The program is required to provide adequate fall zones under and around outdoor play equipment at all times. 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

During the inspection, it was determined that handwashing requirements were not followed as listed in number(s) 5 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

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

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 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).10. A working digital thermometer.11. Disposable non-latex gloves.12. A working flashlight.13. An instant cold pack that has not been activated or ice, including a written reference indicating location of the refrigerator/freezer where the ice is stored if an instant cold pack is not part of the first aid kit.14. Sealable leak-proof plastic bags in assorted sizes or double bagged plastic bags that can be securely tied for materials soiled with blood or bodily fluids.15. Pocket mask or face shield, appropriate for all ages of children in care, for cardiopulmonary resuscitation (CPR) administration.16. Soap or waterless sanitizer (field trip or transporting away from the program only).17. Bottled water (field trip or transporting away from the program only).Technical assistance was provided at the time of the inspection, and as discussed, please correct this rule noncompliance. A written response for this rule noncompliance is not required at this time.

Resolution: Compliance Status: Approved – Technical Assistance Provided

During the inspection, it was determined the 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 the staff did not [use a/discard] separation material between each diaper change, as required by the rule, at the diaper changing station. 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 program did not have a copy of the certificate of occupancy or requested statement from the building department available on-site for review. Submit the programs corrective action plan, which includes a copy of the certificate of occupancy or statement of approval from the building department, to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Approved

During the inspection, it was determined that the program was not providing a clean and healthy environment, furniture, materials and equipment as required by Appendix A, as noted in number(s) 3 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. 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 had access and/or were exposed to smoking paraphernalia as noted in number(s) 8 below: 1. Cigarettes.2. Cigars.3. Pipe butts.4. Ashes.5. Chewing or smokeless tobacco.6. Electronic cigarettes.7. Vaporizers.8. Other: marijuana penSubmit 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 13 children were in attendance at one time and the program's usable floor space allowed for 9 children in the class 1 space. 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 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) 34-37, 40, 41, 43 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 procedures for isolating a child due to a suspected communicable disease were not followed for the requirement(s) listed in number(s) 2 below:1. Within sight and hearing of a staff member at all times2. Cared for in another room or portion of a room away from other children3. Provided with a cot or mat4. After use, cot or mat was not properly sanitizedSubmit 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 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 confirmed by multiple staff that upon staff arrival classrooms are out of ratio or classrooms become out of ratio during the day until children can be moved to another classroom. This occurs because of the following 2, 3, 6, 15:1. 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: Staff are not scheduled even though children are expected to comeAdditional 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 the administrator, child care staff, and/or employees of the program did not protect or remove children from a situation and/or person determined to be unsafe or inappropriate as noted in number(s) 4 below:1.Verbal argument involving adults. 2.Staff member(s) allowed child(ren) to do something unsafe.3. Staff member(s) did something unsafe.4. Children were exposed to inappropriate language and conversation by a staff member.5.Other [ ].While the program did not protect the child(ren) from an unsafe or inappropriate situation and/or person, it was determined the situation would not or did not result in a serious incident or injury to a child. All program employees must take actions to protect children in care. Provide staff training. Submit the programs corrective action plan, which includes a statement that training was provided, to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Approved

During the inspection it was determined the program did not ensure all employees were not under the influence of any substance that impairs the Child Care Staff Members ability to supervise children and/or perform duties, as noted in number(s) 2 below: 1. The Child Care Staff Member was under the influence of an illegal substance;2. The Child Care Staff Member was under the influence of a substance that impairs the ability to supervise children;3. The Child Care Staff Member was under the influence of a substance that impairs the ability to perform duties.The Child Care Staff Member was supervising children [at the program, on a trip, on a vehicle]; and this presented a risk to children. Provide staff training. Submit the programs corrective action plan, which includes a statement describing the action taken with the employee and a plan to ensure all employees adhere to these requirements, and a statement that training was provided, to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Approved

During the inspection, it was determined that a child care staff member used a discipline technique to guide or discipline child(ren) that was not developmentally appropriate, consistent, or occurred at the time of the incident (picking children up by the hand, wrist, or arm). Provide staff training. Submit the program's corrective action plan, which includes a statement that training was provided, to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Approved

During the inspection, it was determined that children were left unattended while inside the program as noted in number(s) 3 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 outdoor play equipment was unsafe or not used as intended as noted in number(s) 2 below:1. There was rust exposed.2. There were protruding bolts on the fence. 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 for the [ ].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 [ ]. 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 a medical food or topical product, diaper cream, was within the reach of children in the Little Bears room. 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 open containers of ready to serve food and concentrated formula was not stored appropriately as noted in number(s) 4 below: 1. The food/formula was not covered;2. The food/formula was not dated;3. The food/formula was not refrigerated according to the manufacturers instructions; 4. The food/formula was not discarded within 1 hour if not used; 5. The food/formula was not refrigerated upon arrival;6. The food/formula was not refrigerated immediately after preparation;7. The food/formula was served beyond the expiration date;8. The food/formula was not prepared prior to the manufacturers instructions;9. The food/formula was not prepared according to the instructions from the infants physician, physicians assistant or certified nurse practitioner;10. Other [ ]. Technical assistance was provided at the time of the inspection, and as discussed, please correct this rule noncompliance. A written response for this rule noncompliance is not required at this time.

Resolution: Compliance Status: Approved – Technical Assistance Provided

During the inspection, it was determined that 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 equipment, materials and furnishings provided for indoor and outdoor play did not meet the requirement of the rule as noted in number(s) 1, 2 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 [ ] 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 the program was using space for child care in a manner that was not approved by the Ohio Department of Commerce or local certified building authority as noted in number(s) 6 below: 1. The [ ] room or space was not approved. 2. Children under school age were being cared for in a building only approved for school age. 3. The space had been modified and not yet re-inspected and approved. 4. The [ ] floor, which had not been approved by the building department for child care, was being used. 5. The building limitation had been exceeded. [ ] children were being cared for and the building had been approved for [ ] children. 6. Room 8 (Tiger room) occupancy had been exceeded. 10 children were being cared for in this space that had been approved for 3 children. 7. Care was provided to [ ] children less than two and one-half years of age. This violated the programs building code limitation in that, [ ].Submit the programs corrective action plan, which includes building approval for use of this space, a written statement that the building occupancy limitations are being maintained, or a written statement that it is no longer being used, to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Approved

During the inspection, it was determined that an area was used which was not protected from traffic and other hazards by a continuous fence in good condition, or natural barrier, that ensured children were not able to leave the playground area. The fence or natural barrier was determined to present an immediate risk for a child to be able to leave the playground as noted in number 10 below:1. The fence, natural barrier, or combination of fence and natural barrier was not continuous.2. The fencing had missing slat boards through which children could leave the playground.3. The gate was broken and did not close.4. The latch on the gate was broken.5. The gate had no latch.6. The fencing was broken.7. The latch was easily opened by children on the playground.8. The latch was not engaged to prevent children from opening the gate.9. The portable fencing approved for use by the Department was not being used. 10. Other: there was no fence or barrier on the second outdoor play area. Discontinue use of the playground and provide a space for outdoor play which is well defined by a continuous fence or natural barrier and protected from other hazards. 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 2 child care staff member(s) for 17 children was determined to have occurred for the toddler group when the situation in number(s) 7 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, group size limitations were not maintained for the group of toddlers as it was determined there were 17 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 a meal or snack at the program did not meet the requirements as noted in number(s) 1, 3 below:1. The breakfast served did not include foods from three of the four food groups.2. Snack served did not include foods from two of the four food groups.3. The meal did not provide 1/3 of the recommended daily dietary allowances as specified by the USDA.4. Juice used to meet the fruit or snack component was not 100% undiluted fruit or vegetable juice.5. The meal served did not include an item from the meat or meat alternative group.6. The meal served did not include an item from the bread or grain group.7. The meal served did not include two items from the fruit/vegetable group.8. The meal served did not include a vegetable (two fruits were served).9. The meal served did not include a serving of fluid milk.Submit the programs corrective action plan to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Approved

In review of the staff records, it was determined that background 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, 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 that children were left unattended while inside the program as noted in number(s) 8 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: Staff were unable to keep infants that were sleeping with their sight at all times. 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, a ratio of 1 child care staff member(s) for 7 children, including infants under 12 months, was determined to have occurred for the infant group when the situation in number(s) 15 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 : Too many children, not enough staff in building to cover ratiosAdditional 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 the equipment in number(s) 5 below had been used for sleeping infants and did not allow the infant to sleep on a firm mattress: 1. Mesh cribs;2. Play pens;3. Bassinets;4. Cots;5. Car seats;6. Infant swing;7. The floor;8. Infant seats;9. An infant placed in a car seat in a crib; 10. Other [ ]. Infants must be provided with a crib, which meets requirements specified in this rule, for resting and sleeping. Provide staff training. Submit the programs corrective action plan, which includes a statement that staff 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 outdoor play equipment was unsafe or not used as intended as noted in number(s) 14 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, climber and child slide roller coaster, 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 for the [ ].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 [ ]. 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 potentially hazardous item or toxic substance was used or stored in an unlocked hallway closet where children had access to it, as noted in number(s) 1, 2 below. 1. Bleach. 2. Cleaning agent. 3. Fish tank chemicals. 4. Gasoline. 5. Pesticide. 6. Poison, including insect/rodent poison. 7. Flammable substance. 8. Windshield washer fluid. 9. Aerosol cans. 10. A lawn mower. 11. A weed trimmer. 12. Hedge trimmers. 13. A snow blower. 14. Other potentially hazardous substance, equipment or machinery: [ ].Provide staff training. Submit the programs corrective action plan, which includes a statement that the potentially hazardous substance or item is no longer accessible to children and/or children will not be outside when machinery is in use and a statement that training was provided, to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Approved

In review of 25% of the children's records, 18 files reviewed, 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, 2, 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 25% of the children's records, 18 files reviewed, it was determined that information had not been secured from the parent/guardian on the JFS 01234 Child Enrollment and Health Information For Child Care, as required, for the items in number(s) 4, 6,7,13, 15 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 by submitting a corrective action plan to the department through OCLQS.

Resolution: Compliance Status: Approved

During the inspection, it was determined that the required drills were not completed for item number(s) 1, 3 below:1. Monthly fire drills.2. Monthly weather emergency drills (March through September).3. Emergency/lockdown drills in each quarter of the calendar year.Submit the programs corrective action plan to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Approved

During the inspection, it was determined the program did not meet the requirements for keeping an attendance record as listed in number(s) 2 below:1. No attendance record was being maintained.2. The attendance record was not being consistently completed.3.The record did not include the name of at least one child.4. The record did not include the birth date of at least one child.5.The record did not include the assigned group.6.The record did not include the childs weekly schedule.7.The record did not include the time (hours and minutes) of each childs arrival and departure to the program, including transportation by the program.8. The original attendance record was not kept at the program for a period of one year.Submit the programs corrective action plan to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Approved

During the inspection, a ratio of 1 child care staff member(s) for 13 children was determined to have occurred for the preschool group that included a toddler under 2.5 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 the program had 6 cribs and needed 9. A crib must be provided for all infants in attendance, unless the infant meets the criteria for sleeping on a cot or mat. Technical assistance was provided at the time of the inspection, and as discussed, please correct this rule noncompliance by submitting a corrective action plan to the department.

Resolution: Compliance Status: Approved

During the inspection, it was determined that a child had been placed in a crib with an object that created a potential strangulation or suffocation risk, as indicated in number(s) 2, 4 below: 1. Bib2. Pacifier clip/ribbon3. Teething jewelry4. Blanket for infant under twelve months old5. Pillow6. Boppie7. Bumper pad 8. Clothing stored in the crib9. Diaper bag 10. Object or toy strung over the crib in which a child can pull himself up11. Stuffed animal that is large/soft enough to conform to the shape of the child's face 12. Other [ ] The rule prohibits any item which obstructs child-care staff's visibility or poses a risk of strangulation or suffocation from being placed on or in a crib. Remove the item(s) immediately. Provide staff training. Submit the program's corrective action plan, which includes a statement that training was provided, to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Approved

During the inspection, it was determined that handwashing requirements were not followed as listed in number 5 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

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 1,2,3,5,6 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 the staff did not use a separation material between each diaper change, as required by the rule, at the diaper changing station. 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 3 below:1. There was no method in place;2. The method did not include each child's name;3. The method did not include each child's date of birth;4. The tracking method did not remain with the group at all times;5. The tracking method was not updated throughout the day as children entered or left the group.Submit the program's corrective action plan to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Approved

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 numbers 1, 10 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 [ ] Please correct this rule noncompliance and submit a statement verifying compliance with the 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

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, 3, 5, 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) 2, 3, 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) 13 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 the kitchen floor had been mopped and the door left open14. No platform was provided for the sink or toilet in the [ ] classroom.15. The platform provided for the sink or toilet in the [ ] classroom was not sturdy.16. The platform provided for the sink or toilet in the [ ] classroom posed a safety hazard in that [ ].17. Telephone cords.18. Staff member stepped over a barrier/gate while holding a child.19. Emergency exits were blocked by the following classroom furniture: [ ]. 20. A mercury thermometer was being used to take a childs temperature. 21. Methods of ventilation used did not provide protection from rodents, insects, or other hazards.22. Other [ ].Provide staff training. Submit the programs corrective action plan, which includes a statement that training was provided, to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Approved

During the inspection, it was determined that the program was not providing a clean and healthy environment, furniture, materials and equipment as required by Appendix A, as noted in number(s) 1, 25 below:1. Item(s) soiled with blood or bodily fluids were not cleaned/sanitized immediately- crib sheets2. 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- chair in infant space26. 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 by submitting a corrective action plan in OCLQS.

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, 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 by submitting a corrective action plan in OCLQS.

Resolution: Compliance Status: Approved

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) 10 below:1. The program did not have a first aid kit [onsite, on the vehicle, on a field trip]. 2. One roll of hypoallergenic first-aid tape.3. Individually wrapped sterile gauze squares in assorted sizes.4. Sterile adhesive bandages in assorted sizes.5. Tweezers.6. Gauze rolled bandage.7. Triangular bandage.8. Rounded end scissors.9. Tooth preservation system or fresh chilled liquid milk in which to transport a lost permanent tooth, including a written reference indicating location of the refrigerator/freezer where milk is stored if a tooth preservation system is not part of the first aid kit (for programs serving school age children only).10. A working digital thermometer.11. Disposable non-latex gloves.12. A working flashlight.13. An instant cold pack that has not been activated or ice, including a written reference indicating location of the refrigerator/freezer where the ice is stored if an instant cold pack is not part of the first aid kit.14. Sealable leak-proof plastic bags in assorted sizes or double bagged plastic bags that can be securely tied for materials soiled with blood or bodily fluids.15. Pocket mask or face shield, appropriate for all ages of children in care, for cardiopulmonary resuscitation (CPR) administration.16. Soap or waterless sanitizer (field trip or transporting away from the program only).17. Bottled water (field trip or transporting away from the program only).Technical assistance was provided at the time of the inspection, and as discussed, please correct this rule noncompliance by submitting a corrective action plan in OCLQS.

Resolution: Compliance Status: Approved

During the inspection, group size limitations were not maintained for the group of toddler and preschool as it was determined there were 16 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 the program did not meet the requirements for keeping an attendance record as listed in number(s) 2-6 below:1. No attendance record was being maintained.2. The attendance record was not being consistently completed.3.The record did not include the name of at least one child.4. The record did not include the birth date of at least one child.5.The record did not include the assigned group.6.The record did not include the childs weekly schedule.7.The record did not include the time (hours and minutes) of each childs arrival and departure to the program, including transportation by the program.8. The original attendance record was not kept at the program for a period of one year.Submit the programs corrective action plan to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Approved

During the inspection, it was determined that the method for tracking children in each group did not meet the requirements of the rule as noted in number(s) 4, 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, a ratio of 1 child care staff member(s) for 15 children was determined to have occurred for the toddler/preschool group when the situation in number(s) 1, 2 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 the program's weekly menu did not meet the requirement as noted in number(s) 3 below. 1. The menu was not posted.2. The posted menu was not in a visible place readily accessible to parents.3. The menu was not currently dated.4. The entire menu was substituted.5. At least one item on menu did not match what was served.6. The meal or snack served did not match the posted menu.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

During the inspection, it was determined that a meal or snack at the program did not meet the requirements as noted in number(s) 7 below:1. The breakfast served did not include foods from three of the four food groups.2. Snack served did not include foods from two of the four food groups.3. The meal did not provide 1/3 of the recommended daily dietary allowances as specified by the USDA.4. Juice used to meet the fruit or snack component was not 100% undiluted fruit or vegetable juice.5. The meal served did not include an item from the meat or meat alternative group.6. The meal served did not include an item from the bread or grain group.7. The meal served did not include two items from the fruit/vegetable group.8. The meal served did not include a vegetable (two fruits were served).9. The meal served did not include a serving of 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 television were on during meals and snacks. Technical assistance was provided at the time of the inspection, and as discussed, please correct this rule noncompliance by submitting a corrective action pan in OCLQS.

Resolution: Compliance Status: Approved

In review of the staff records, it was determined that verification of a high school education for the child care staff member(s) listed on the Employee Record Chart, did not meet the requirements as listed in number(s) 1 below: 1. Verification of completion of a high school education was not on file.2. Documentation was incomplete or not on file for a high school junior or senior who is enrolled in a career-technical program.3. Documentation was not on file for a high school junior or senior who is also enrolled in a college credit program in child development or early childhood education.4. Documentation was not on file for a high school junior or senior who is enrolled in a Child Development Associate (CDA) training program.Submit the programs corrective action plan, which includes a copy of the education verification, to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Approved

In review of the staff records, it was determined that child care staff member(s) did not meet the requirements for completing the online orientation training as noted in number(s) 1 below:1. The training was not completed within 30 days of starting employment at the program as a child care staff member.2. Documentation of completing the training after December 31, 2016 was not on file.3. Completion of the training was not verified in the OPR.4. A child care staff member had sole responsibility of children and had not completed the online orientation.Submit the programs corrective action plan to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Approved

During the inspection, required staff/child ratios were not maintained for the same group on multiple occasions, as noted below:The ratio determined for the schoolage group was 0 Child Care Staff Member(s) for 4 children. Additionally, a ratio of 0 Child Care Staff Member(s) for 7 children was determined for the schoolage group. 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 children were left unattended while inside the program as noted in number(s) 2 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

Children in care shall be protected from any items and conditions which threaten their health, safety, and well-being. During the inspection, it was determined that children were not protected from the following item(s) or condition(s) which may threaten their health, safety, or well-being as noted in number(s) 3 below: 1. Open pull cords that are not closed loop. 2. Telephone cords.3. TV Electrical/extension cords attached to an object that would not likely result in a severe injury if pulled. 4. Stacked chairs.5. Employee(s) purse(s). 6. Diaper bags.7. Television not securely anchored.8. Small or lightweight pieces of shelving units are not securely anchored to the wall. 9. Smoke detector needing batteries replaced.10. Staff member stepped over a barrier/gate while holding a child.11. Emergency exits were blocked by the following classroom furniture: [ ]. 12. Other [ ].Provide staff training. Submit the programs corrective action plan, which includes a statement that training was provided, to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Approved

In review of the staff records, it was determined that child care staff member(s) had not completed the online orientation training as noted in number(s) 3 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