Y CHILD DEVELOPMENT CENTER AT FAIR HAVEN

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

Resolution: Compliance Status: Approved

During the inspection, it was determined that quarterly inspections of one or more outdoor play area(s) and equipment had not been completed and documented as required, using the JFS 01281 Child Care Playground Inspection Report form. 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) 19 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 [ ] 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 a van parked next to the building20. 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 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) 16 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 : page 1 missing, page 3 missingTechnical assistance was provided at the time of the inspection, and as discussed, please correct this rule noncompliance. A written response for this rule noncompliance is not required at this time.

Resolution: Compliance Status: Approved – Technical Assistance Provided

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

Resolution: Compliance Status: Approved

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

Resolution: Compliance Status: Approved

During the inspection, a ratio of 1 child care staff member(s) for 13 children was determined to have occurred for the preschool group when the situation in number(s) 4 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, 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(s) 8, 11 below: 1. Cosmetics were accessible to children in the [ ] area.2. Disinfecting wipes were accessible to children in the [ ] area.3. Fish food was accessible to children in the [ ] area.4. Hand lotion was accessible to children in the [ ] area.5. Hand sanitizer (for children under 24 months) was accessible to children in the [ ] area.6. Laundry detergent was accessible to children in the [ ] area.7. Powder dish washing soap was accessible to children in the [ ] area.8. Paint cans were accessible to children in the infant area.9. White out was accessible to children in the [ ] area.10. Potting Soil was accessible to children in the [ ] area.11. Other potentially hazardous substance painting was occurring at the program while children were present in the infant area.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 in the [ ] group 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

In review of the staff records, it was determined that the medical statements for the employees listed on the Employee Record Chart did not meet the requirements as listed in number(s) 6 below. 1. A medical statement was not on file for at least one employee;2. The medical statement(s) on file did not have a date of examination within 12 months of the employees first day of employment;3. Date of examination was missing;4. Signature, business address, or telephone number of the licensed physician, physician assistant, advanced practice nurse, certified midwife, or certified nurse practitioner who completed the examination was missing;5. A statement was missing that verifies the employee is: a. Physically fit for employment in a program caring for children; b. Immunized against Tetanus, Diphtheria, Pertussis (Tdap); c. Immunized against Measles, Mumps, and Rubella (MMR);6. Tuberculosis (TB) screening/test information was missing: a. Documentation of the screening process to determine if the employee resided in a country identified by the world health organization as having a high burden of TB and arrived in the United States within the five years preceding the date of application for employment. b. Results of a TB test for employees meeting both criteria in 6a. c. Results of additional testing for employees with a positive TB test. d. Written statement, signed by a representative of the TB control unit, that the employee's TB is no longer infectious or the individual is receiving a TB treatment regimen for employees with a positive TB test. Submit the programs corrective action plan, which includes a copy of the completed employee medical statement, or TB results/documentation, to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Approved

In review of the staff records, it was determined that at least one child care staff member did not meet the annual professional development requirement as noted in number(s) 1 below: 1. The child care staff member(s) had not completed at least six hours of professional development.2. Documentation did not demonstrate the person who provided the training met the trainer qualifications as stated in the rule. 3. Training topic did not meet the requirements listed in appendix A of this rule. 4. Documentation of training did not meet the requirements of this rule.5. The substitute(s) had been used more than ninety days annually between July first and June thirtieth and had not completed at least six hours of professional development 6. Other [ ].Submit the programs corrective action plan to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Approved

During the inspection, it was determined that medication, medical foods and/or topical products did not meet the requirement(s) for administering medication, medical foods, and/or medical products as noted in number(s) 1 below:1. The medication, medical food, or topical product was no longer needed and had not been removed from the program.2. The medication, medical food, or topical product had expired and had not been removed from the program.3. The prescription label had expired.Submit the program's corrective action plan to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Approved

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, 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(s) 15 below: 1. Cosmetics were accessible to children in the [ ] area.2. Disinfecting wipes were accessible to children in the [ ] area.3. Fish food was accessible to children in the [ ] area.4. Hand lotion was accessible to children in the [ ] area.5. Hand sanitizer (for children under 24 months) was accessible to children in the [ ] area.6. Laundry detergent was accessible to children in the [ ] area.7. Powder dish washing soap was accessible to children in the [ ] area.8. Paint cans were accessible to children in the [ ] area.9. White out was accessible to children in the [ ] area.10. Potting Soil was accessible to children in the [ ] area.11. Other potentially hazardous substance [ ] was accessible to children in the [ ] area.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 in the [ ] group while children were in attendance. 15. Other: Magic Erasers were accessible to children.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

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) 4, 7 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 a copy of the daily program schedule was not posted in the classroom areas as required. Technical assistance was provided at the time of the inspection, and as discussed, please correct this rule noncompliance. A written response for this rule noncompliance is not required at this time.

Resolution: Compliance Status: Approved – Technical Assistance Provided

During the inspection, it was determined that equipment, materials and furnishings provided for indoor and outdoor play did not meet the requirement of the rule as noted in number(s) 2, 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 classrooms.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 a medical food or topical product, ointments and sunscreen, was within the reach of children in the Duckling 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 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 the equipment in number(s) 10 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: infant bouncy seat 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 children were not supervised while outside the program as noted in number(s) 1 below:1.Child(ren) left unattended outside the facility building. 2.Child(ren) left unattended outside the facility building more than once. 3.Child(ren) left unattended off the programs premises. 4.Child(ren) left unattended during a swimming activity.5. Child(ren) left unattended in a vehicle.6. Child(ren) left unattended inside the building and no adults were present in the building. 7.Other [ ]. Children must be supervised and within sight and hearing of a child care staff member at all times. Provide staff training. 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 0 child care staff member(s) for 5 children was determined to have occurred for the infant group when the situation in number(s) 1 below occurred:1. A child care staff member stepped out of the room.2.A child care staff member had not arrived at work on time.3.Children were present who were not scheduled to be there.4.A child care staff member was unable to work.5.A child was injured in that group.6.A child arrived in the group before a second staff member was scheduled to arrive with the group.7.Two groups were combined, and the program did not follow the ratio for the youngest child in the group.8.A child was transitioning to the next older age group, and the program did not follow the ratio for the youngest child in the group.9. Ratio was doubled for more than two hours while children were napping.10. Ratio was doubled while children were napping for a group that included at least one infant.11. Ratio was doubled while children were napping and there were not enough staff members in the building to meet staff/child ratio.12. Ratio was doubled in the school age group to allow access to the program, however, the program does not serve only school age children.13. Both child care staff members did not have a working communication device when one staff member left the group to allow access to the school age only program.14. The child care staff member did not return to the group after allowing access to the school age only program.15.Other [ ].Additional child care staff members must be hired or current child care staff members must be rescheduled to maintain compliance. Provide staff training. Submit the programs corrective action plan, which includes a statement that training was provided, to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Approved

During the inspection, it was determined that the method for tracking children in each group did not meet the requirements of the rule as noted in number(s) 4 below:1. There was no method in place;2. The method did not include each child's name;3. The method did not include each child's date of birth;4. The tracking method did not remain with the group at all times;5. The tracking method was not updated throughout the day as children entered or left the group.Submit the program's corrective action plan to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Approved

During the inspection, it was determined that children were left unattended while inside the program as noted in number(s) 2, 6 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 area around corner. 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

In review of the staff records, it was determined the program did not have at least one child care staff member present/scheduled to be present during all hours of operation with currently valid documentation for the training(s) listed in number(s) 11 below:1. First Aid child care staff members scheduled during the hours of [ ] and [ ] had expired training 2. First Aid child care staff members scheduled during the hours of [ ] and [ ] did not have verification of completion of First Aid 3. First Aid trained child care staff member was not present in each building used by the program.4. CPR child care staff members scheduled during the hours of [ ] and [ ] had expired training 5. CPR child care staff scheduled during the hours of [ ] and [ ] had did not have verification of completion of CPR 6. CPR trained child care staff member was not present in each building used by children7. CPR training taken by staff was not appropriate for all ages and developmental levels of the children in care8. CPR - audiovisual or electronic media training taken by staff did not include an in-person component of the training 9. Communicable Disease child care staff members scheduled during the hours of [ ] and [ ] had expired training 10. Communicable Disease child care staff scheduled during the hours of 5pm and 6pm had not taken Communicable Disease training 11. Communicable Disease trained child care staff member was not present in each building used by the program 12. Child Abuse child care staff members scheduled during the hours of [ ] and [ ] had expired training 13. Child Abuse child care staff scheduled during the hours of [ ] and [ ] had not taken Child Abuse training 14. Child Abuse trained child care staff was not in each building used by the program Refer to the Employee Record Chart for specific details. Submit the programs corrective action plan, which includes verification of complete coverage for any training listed, to the Department to verify compliance with the requirements of this rule.

Resolution: Compliance Status: Approved

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

During the inspection, it was determined that the 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. Submit the programs corrective action plan to the Department to verify compliance with the requirements of this rule. This was corrected at the time of the inspection.

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) 11 below:1. The changing table was not sanitized after each use.2. Reusable cloths were not being cleaned daily or when visibly soiled.3. Dividers were not cleaned when visibly soiled.4. The food prep areas were not being cleaned and sanitized before and after food prep.5. The food prep areas were not being cleaned and sanitized between preparing raw and cooked food.6. Toilet seat(s), handle(s) and toilet bowl(s) were not being cleaned when visibly soiled and sanitized.7. The sinks were not clean.8. Diaper receptacles were not being cleaned and sanitized.9. Potty chairs were not emptied and/or cleaned and sanitized after each use.10. Wastebaskets/trash receptacles/rinse buckets were not being cleaned and sanitized when visibly soiled.11. Other: mat under climbing equipment in infant space was visibly dirty. 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 to the department in OCLQS.

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(s) 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 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 by submitting a corrective action plan in OCLQS.

Resolution: Compliance Status: Approved