Learn, Laugh & Love Too! Llc

“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 18 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. A highchair had a dirty trash can lid sitting on the food tray. 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 child’s 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 manufacturer's 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 required at this time.”

“During the inspection, it was determined that accumulated trash or garbage was stored in an area approved for child care in that the school age trash can was dirty and overflowing with trash. 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 required at this time.”

“During the inspection, a potentially hazardous item or toxic substance was used or stored in the toddler restroom ona shelf where children had access to from a step stool, as noted in number 14 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. Goo Gone and Clorox wipes were accessible in the toddler restroom. Provide staff training. Submit the program's 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.”

“During the inspection, it was determined that cots or mats did not meet the requirements as noted in number 2 below: 1. The program did not have enough individually assigned cots and/or mats for each child. 2. Children were sleeping on the floor in the school age room and in the toddler room. 3. Frames were bent/broken. 4. Covers were torn. 5. Cots were missing bolts. 6. Cots were sagging. 7. Legs on the cots were broken. 8. Cots did not stand at least 3 inches but no more than 18 inches off the floor. 9. Cots were not at least 36 inches in length and as long as the child is tall. 10. Mats were not at least 1 inch thick and as wide and long as the child assigned. 11. 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 required at this time.”

“During the inspection, it was determined a child with a condition that required a JFS 01236 "Child Medical/Physical Care Plan" had been present and the program did not ensure there was at least one child care staff member caring for the child at all times who had signed the JFS 01236 on the child's condition (needing insulin). 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.”

“During the inspection, a potentially hazardous item or toxic substance was used or stored on the floor in the unlocked kitchen with access from the main hallway where children had access to it, as noted in number 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 program’s 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.”

“During the inspection, it was determined that handwashing requirements were not followed as listed in number 1 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 program’s corrective action plan to the Department to verify compliance with the requirements of this rule.”

“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 of the child care staff member who must complete the required health and safety training. Submit the program’s corrective action plan to the Department to verify compliance with the requirements of this rule.”

“During the inspection, a ratio of 1 child care staff member(s) for 16 children was determined to have occurred for the PS group when the situation in number(s) 1 below occurred: 1. A child care staff member stepped out of the room. PS 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 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.”

“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 child’s 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 manufacturer's 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.”

“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(s) 1, 6, 8 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 program’s corrective action plan to the Department to verify compliance with the requirements of this rule.”

“During the inspection, it was determined that the barrier between the play and sleeping space did not meet the requirements as noted in number(s) 2 below: 1. No barrier had been provided 2. The barrier did not prevent the infants from entering the sleeping area. 3. The barrier was not safe. 4. The barrier was not sturdy. 5. The barrier impaired staff's ability to see and hear all sleeping infants in their cribs. 6. The barrier was inadequate. 7. 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.”

“During the inspection, it was determined that bottles containing [breast milk/formula] for a particular infant were not labeled with the child’s name and date of preparation. 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.”

“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 program’s corrective action plan to the Department to verify compliance with the requirements of this rule.”

“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) 1 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 program’s corrective action plan to the Department to verify compliance with the requirements of this rule.”

“During the inspection, it was determined that the playground did not have adequate fall surface under and around equipment as noted in number(s) 1 below: 1. No fall surface under slides 2. Adequate fall surface to soften the impact of a fall 3. Adequate fall surface to soften the impact of a fall that extended the length of the required fall zone 4. Other [ ] With any equipment designed for climbing, swinging, bouncing, or sliding, resilient material, as specified in Appendix A, needs to be added in order to protect children in the event of a fall. Submit the program’s corrective action plan, which includes written verification of the discontinued use of this equipment until corrections are made along with a description of the resilient material added, to the Department to verify compliance with the requirements of this rule.”

“In review of the children’s records, it was determined the program did not meet the requirements for caring for at least one child, indicated on the Children Records Review, with a condition that requires a JFS 01236 "Child Medical/Physical Care Plan" as noted in number(s) 1 below: 1. No plan was on file. (Page 1) 2. Child’s name was missing. 3. Name of the condition was missing. A, 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 missing 31. 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. Achild 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 program’s corrective action plan, which includes a copy of the completed JFS 01236, to the Department to verify compliance with the requirements of this rule.”

“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) 8 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 the following classroom furniture: [ ]. 20. A mercury thermometer was being used to take a child’s temperature. 21. Methods of ventilation used did not provide protection from rodents, insects, or other hazards. 22. Other [ ]. 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.”

“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) 4 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 ina 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 child’s 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 manufacturer’s 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.”

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

“During the inspection, it was determined that at least one staff member washed his or her hands in a sink that is used for meal preparation or clean-up or is near the food serving area. Submit the program's corrective action plan to the Department to verify compliance with the requirements of this rule.”

“During the inspection, it was determined that equipment and materials in the following categories were not provided in sufficient quantities for children in the PS classroom, as required: 4, 7. 1. Art supplies (excludes infants) 2. Manipulative materials and equipment 3. Blocks 4. Science-nature equipment (excludes infants) 5. Language arts and auditory materials and equipment 6. Pretend or dramatic play materials 7, Music equipment 8. Transportation materials and equipment 9. Gross motor equipment 10. Sensory motor equipment 11. School age children were not provided sufficient equipment and materials in at least five of the first nine categories above. 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.”

“During the inspection, it was determined that equipment, materials and furnishings provided for indoor and outdoor play did not meet the requirement of the rule as noted in number(s) 3 below. 1. Equipment and materials were not varied and adequate to meet the developmental needs of the children. 2. Equipment and materials were not provided in a sufficient quantity that each child can be actively involved in an activity. 3. Play materials were not readily accessible to the children in the toddler and PS 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.”

“During the inspection, it was determined that required documentation for substitutions for fluid milk was not on file as noted in number(s) 3 below: 1. Written instructions from a licensed physician, physician’s assistant, or certified nurse practitioner when infants up to 12 months of age are served anything other than formula or breast milk. 2. Written instructions from a licensed physician, physician’s assistant, or certified nurse practitioner when infants and toddlers 12 months of age up to 24 months of age are served anything other than unflavored whole homogenized vitamin D fortified cow's milk, breast milk, or non-cow milk substitution that is nutritionally equivalent to milk. 3. Written instructions from a licensed physician, physician’s assistant, or certified nurse practitioner when toddlers and children 24 months of age and older are served anything other than unflavored one per cent milk that is vitamin A and D fortified, unflavored fat free or skim milk that is vitamin A and D fortified, or non-cow milk substitutions that are nutritionally equivalent to milk. 4. Written parental consent for non-cow milk substitutions that are nutritionally equivalent to milk for children 12 months of age and older. 5. The program did not have the type of milk on-site to ensure that all children were served age-appropriate fluid milk. Technical assistance was provided at the time of the inspection, and as discussed, please correct this rule noncompliance. A written response for this rule noncompliance is not required at this time.”

“During the inspection, it was determined that the dividers used to separate the cribs did not meet the following requirement in number(s) 1 below: 1. Did not provide for at least two feet of space on two of the sides or ends of the crib. 2. Constructed so that staff may view children through or around the divider. 3. Be unbreakable in normal use situations. 4. Be made of a non-porous material that can be easily sanitized. 5. Extend up higher than an infant standing in a crib can reach up and shall not impede child care staff member's ability to hear the child. Technical assistance was provided at the time of the inspection, and as discussed, please correct this rule noncompliance. A written response for this rule noncompliance is not required at this time.”

“During the inspection, it was determined that a crib, assigned to a child, was used for storage. Technical assistance was provided at the time of the inspection, and as discussed, please correct this rule noncompliance. Awritten response for this rule noncompliance is not required at this time.”

“In review of the staff records, it was determined that at least one child care staff member had not completed required health and safety training as noted in number(s) 4 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 program’s corrective action plan to the Department to verify compliance with the requirements of this rule.”

“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.”

“During the inspection, a ratio of 2 child care staff member(s) for 14 children was determined to have occurred for the infant 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 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.”

“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) 5 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 child’s 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 manufacturer's 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.”

“During the inspection, required staff/child ratios were not maintained for different groups on multiple occasions, as noted below: The ratio determined for the Preschool/PreK/School age combined group was 1 Child Care Staff Member(s) for 17 children, when a staff member left the room to answer door. Additionally, a ratio of 1 Child Care Staff Member(s) for 8 children was determined for the Toddler group, when a staff member was in the restroom. Additional staff members must be hired or current Child Care Staff Members must be rescheduled to maintain compliance. 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.”

“During the inspection, required staff/child ratios were not maintained for [the same group/different groups] on multiple occasions, as noted below: The ratio determined for the combined infant/toddler group was 1 Child Care Staff Member(s) for 9 children. Additionally, a ratio of 1 Child Care Staff Member(s) for 8 children was determined for the combined infant/toddler group. Additional staff members must be hired or current Child Care Staff Members must be rescheduled to maintain compliance. 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.”

“During the inspection, it was determined through interviews, that a Child Care Staff Member had used the inappropriate techniques in number(s) 1 below when managing unacceptable behavior in children, in that a staff member yelled at infant/toddler children and shoved a child down: 1. Utilize cruel, harsh, unusual, or extreme techniques; 2. Utilize any form of corporal punishment; 3. Delegate children to manage or discipline other children; 4, Use physical restraints on a child; 5. Restrain a child by prone restraint or any means other than holding children for a short period of time, such as ina protective hug, so that the children may regain control; 6. Place children in a locked room or confine children in any enclosed area; 7. Confine children to equipment such as cribs or highchairs; 8. Humiliate, threaten or frighten children; 9. Subject children to profane language or verbal abuse; 10. Make derogatory or sarcastic remarks about children or their families; 11. Punish children for failure to eat or sleep or for toileting accidents; 12. Withhold any food (including snacks and treats), rest or toilet use; 13. Punish an entire group of children due to the unacceptable behavior of one or a few; 14. Isolate and restrict children from all activities for an extended period of time. Child Care Staff Members and other employees must always use appropriate guidance and management methods with children. Provide staff training. Submit the 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.”

“During the inspection, it was determined that children were not being properly supervised as noted in number(s) 1 below, in that staff member was observed in the restroom with a child and was unable to see all children in the classroom: 1. Child(ren) were not within both sight and hearing of a child care staff member during indoor play. 2. Child(ren) were not within both sight and hearing of a child care staff member during outdoor play. 3. Child(ren) were not within both sight and hearing of a child care staff member more than once. 4, Staff were not physically present in the space and near enough to respond and reach the child(ren) immediately. 5. Other: [ ]. Children must be supervised according to rule and within both sight and hearing of a child care staff member at all times. Provide staff training. Submit the 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.”

“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) 6 below: 1. Surge protectors/outlets did not have childproof receptacle covers. 2. Open pull cords that are not closed loop. 3. Toys or other items small enough to be swallowed were present in the space where infants and/or toddlers were in care. 4. Electrical/extension cords attached to an object that would not likely result in a severe injury if pulled. 5. Stacked chairs. 6. 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 the following classroom furniture: [ ]. 20. A mercury thermometer was being used to take a child’s temperature. 21, Methods of ventilation used did not provide protection from rodents, insects, or other hazards. 22. Other [ ]. 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.”

“During the inspection, it was determined that the staff did not use separation material between each diaper change, as required by the rule, at the diaper changing station. The staff member changed a child on the carpeted floor in the Toddler room and did not use separation material. Submit the program’s corrective action plan to the Department to verify compliance with the requirements of this rule.”

“During the inspection, a potentially hazardous item or toxic substance was used or stored in the laundry room where children had access to it, as noted in number(s) 2,9 below, in that a staff member was observed doing laundry with a mobile infant who was on the floor. Spray paint cans and a cleaning agent were observed on the bottom of a shelving unit and the floor, accessible to the infant. 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 program’s 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.”

“During the inspection, it was determined the information in number(s) 4 below was not up to date in the Ohio Child Licensing and Quality System (OCLQS): 1. Mailing address 2. Telephone number 3. Email address 4. Days and hours of operation 5. Services offered 6. Name of program 7. Private pay rates Technical assistance was provided, and as discussed, log on to OCLQS and update the information, as required.”

“During the inspection, it was determined the program was not abiding by stipulations or limitations set forth in the written documentation by the state fire marshal or local fire safety inspector, in that the program was using a space heater in the office and the current fire inspection did not have approval for space heaters. Submit the program’s corrective action plan to the Department to verify compliance with the requirements of this rule.”

“During the inspection, it was determined that children were not being properly supervised as noted in number(s) 1 below, in that a staff member was in the kitchen and left an infant in the hallway. The infant wandered into the preschool room: 1. Child(ren) were not within both sight and hearing of a child care staff member during indoor play. 2. Child(ren) were not within both sight and hearing of a child care staff member during outdoor play. 3. Child(ren) were not within both sight and hearing of a child care staff member more than once. 4. Staff were not physically present in the space and near enough to respond and reach the child(ren) immediately. 5. Other: [ ]. Children must be supervised according to rule and within both sight and hearing of a child care staff member at alltimes. 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.”

“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, in that all children were combined in the school age classroom and a staff person was observed bringing an attendance roster for infants to the school age classroom: 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.”

“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) 3 below, in that all age groups were combined in the school age room: 1. Surge protectors/outlets did not have childproof receptacle covers. BOLD, 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 the following classroom furniture: [ ]. 20. A mercury thermometer was being used to take a child’s temperature. 21. Methods of ventilation used did not provide protection from rodents, insects, or other hazards. 22. Other [ ]. 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.”

“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) 4,5,6,16,17,18,27 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 ina 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 child’s 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 manufacturer's 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.”

“During the inspection, it was determined that handwashing requirements were not followed as listed in number(s) 1 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 program’s corrective action plan to the Department to verify compliance with the requirements of this rule.”

“During the inspection, it was determined that the program's weekly menu did not meet the requirement as noted in number(s) 2,6 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.”

“During the inspection, it was determined that a bottle was not prepared appropriately as noted in number(s) 3 below: 1. The bottle was heated in the microwave. 2. The container of water used to warm bottles was heated to a temperature hotter than 120 degrees Fahrenheit. 3. The container used for heating bottles was not emptied and cleaned each day. 4. The bottle was not shaken well before feeding. 5. The temperature of the bottle was not tested before feeding. 6. Frozen breast milk was not thawed under cold running water or in the refrigerator. 7. 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.”

“During the inspection, it was determined that written instructions for feeding the infants noted on the Children Record Review were missing information as noted in number(s) 5 below: 1. Written instructions were not on file. 2. Type of food and/or formula/breast milk was missing. 3. Amount of food and/or formula/breast milk was missing. 4. Feeding times or frequency of feedings was missing. 5. The written instructions on file had not been updated. 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.”

“During the inspection, it was determined the mattress support was not maintained at the lowest position for all cribs when in use, as required. Except when infants are being placed in cribs, removed from cribs, or being soothed, the sides should remain in the highest position. 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.”

“During the inspection, it was determined that a crib, assigned to a child, was used for storage. Technical assistance was provided at the time of the inspection, and as discussed, please correct this rule noncompliance. Awritten response for this rule noncompliance is not required at this time.”

“During the inspection, it was determined employment records in the Ohio Professional Registry (OPR) were not created or maintained as noted in number(s) 5,6 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.”

“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) 5 b,c 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 employee’s 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); BOLD, 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 program’s 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.”

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

“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, in that a sunscreen was observed in a classroom, and staff stated child is no longer attending: 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.”

“During the inspection, it was determined the program did not obtain signed written permission from the parent prior to administering topical products and lotions, other than hand sanitizer to be used by children older than twenty-four months and lip balm. Submit the program’s corrective action plan to the Department to verify compliance with the requirements of this rule.”

“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) 4,10,1,15 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/guardian’s 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.”

“During the inspection, it was determined that children's records had not been kept confidential in that incident reports were posted on children's cubbies. 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.”