Careytown Preschool & Child Care

“During the inspection, it was determined that children were not supervised while outside the program as noted in number 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 program’s 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 [ ]. was Children must be supervised and within sight and hearing of a child care staff member at all times. Provide staff training. Rule 5180:2-12-03 requires the program to notify parents when a serious risk non-compliance is cited. The notification must inform parents of the serious risk non-compliance and include the Department of Children and Youth website and location of further information regarding the determination. Submit the program’s corrective action plan, which includes a statement that training was provided and a copy of the written parent notification, to the Department to verify compliance with the requirements of this rule.”

“During the inspection, it was determined that children were not supervised while outside the program as noted in number 1 below: 1. Child(ren) left unattended outside the facility building (Playground). 2. Child(ren) left unattended outside the facility building more than once. 3. Child(ren) left unattended off the program’s 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 [ J. Children must be supervised and within sight and hearing of a child care staff member at all times. Provide staff training. Rule 5180:2-12-03 requires the program to notify parents when a serious risk non-compliance is cited. The notification must inform parents of the serious risk non-compliance and include the Department of Children and Youth website and location of further information regarding the determination. Submit the program’s corrective action plan, which includes a statement that training was provided and a copy of the written parent notification, to the Department to verify compliance with the requirements of this rule.”

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

“In review of the records, it was determined the program did not meet the requirements for completing a JFS 01299 “\ncident/Injury Report” as noted in number 4 below: 1. The JFS 01299 was not completed when a child became ill or received an injury which required first aid treatment. 2.The JFS 01299 was not completed when a child was transported to a source for emergency assistance. 3. The JFS 01299 was not completed when a child received a bump or blow to the head. 4. The JFS 01299 was not completed when an unusual or unexpected incident which jeopardized the safety of a child or employee of a program. 5. The parent or a person picking up the child did not receive the JFS 01299 on the day of the incident. 6. The program information (program name, number, address) was incomplete on the JFS 01299. 7. Child’s name was incomplete on the JFS 01299. 8. Child’s birthdate was incomplete on the JFS 01299. 9. Name of person(s) responsible for the child at the time of the incident was incomplete on the JFS 01299. 10. Number of children present in the group at the time of the incident was incomplete on the JFS 01299. 11. Date and/or time of the incident was incomplete on the JFS 01299. 12. Whether or not parents were contacted was incomplete on the JFS 01299. 13. Complete summary of the incident was incomplete on the JFS 01299. 14. Accurate summary of the incident was incomplete on the JFS 01299. 15. Name and/or signature of the person completing the form was incomplete on the JFS 01299. 16. The JFS 01299 was not kept on file at the program for at least one year. 17. 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 a Serious Incident was not reported in the Ohio Child Licensing and Quality System (OCLQS), as required, by the program administrator or designee for an incident(s) as listed in number 4 below: 1. An incident, injury or illness that required professional medical consultation or treatment. 2. An unusual or unexpected incident which jeopardizes the safety of a child, child care staff member or employee of the program. 3. An incident defined as a serious risk non-compliance in appendix A to rule 5101:2-12-03 of the Administrative Code. 4. The program did not submit the report in OCLQS by the next business day as required by rule. Submit the program’s corrective action plan, which includes a statement that the program administrator or designee has completed the Serious Incident Report in OCLQS, to the Department to verify compliance with the requirements of this rule.”

“During the inspection, it was determined that a Child Care Staff Member had used the inappropriate techniques in number 7 below when managing unacceptable behavior in children: 1. Utilize cruel, harsh, unusual, or extreme techniques; 2. Utilize any form of corporal punishment; 3. Delegate children to manage or discipline other children; 4. Use physical restraints on a child; 5. Restrain a child by prone restraint or any means other than holding children for a short period of time, such as 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 the program did not meet the requirements for keeping an attendance record as listed in number 2 below: 1. No attendance record was being maintained. 2. The attendance record was not being consistently completed (Room 3 & 4). 3. The record did not include the name of at least one child. 4. The record did not include the birth date of at least one child. 5. The record did not include the assigned group. 6. The record did not include the child’s weekly schedule. 7. The record did not include the time (hours and minutes) of each child’s arrival and departure to the program, including transportation by the program. 8. The original attendance record was not kept at the program for a period of one year. Submit the program’s corrective action plan 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 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 (Room 5). 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, 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 2 below: 1, Cosmetics were accessible to children in the [ ] area. 2. Disinfecting wipes were accessible to children (Clorox Wipes). 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: [ ]. Provide staff training. 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 unsanitary conditions, as noted in numbers 5 & 6 below, were in Room 4 and School age restroom: 1. There was no liquid soap. 2. There was no toilet paper. 3. There were no paper towels. 4. The toilet cleaning brush was accessible to the children. 5. The plunger was accessible to the children. 6. The toilet(s) were not flushed. 7. The trash was not emptied from the day before. 8. There was a strong urine odor. 9. Other [ ]. The restroom(s) must be kept sanitary at all times. 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 indoor swings, slides, climbers, and climbing apparatus did not have required shock absorbent protective covering under and around the equipment as noted in number 2 and 4 below: 1. A shock absorbent protective covering was not used. 2. The mats were not at least one and one-half inches thick for equipment over three feet high. 3. The mats were not used according to the manufacturer's guidelines. 4. Other (Mat not large enough). Submit the program’s corrective action plan to the Department to verify compliance with the requirements of this rule.”

“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 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(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.”

“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 numbers 1, 5b & 5c 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; A, 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 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.”

“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.”

“During the inspection, it was determined the program’s written disaster plan did not meet the requirement for training child care staff members and employees on the plan annually as noted in number 1 below: 1. Child care staff members and employees were not trained annually. 2. Written documentation of the training was not kept on file. Submit the program’s corrective action plan to the Department to verify compliance with the requirements of this rule.”

“During the inspection, it was determined that a Child Care Staff Member had used the inappropriate techniques in number 1 below when managing unacceptable behavior in children: 1. Utilize cruel, harsh, unusual, or extreme techniques; (A child care staff member hit a child in the mouth). 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 the program was not kept clean to prevent an infestation by insects or rodents. 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.”

“In review of the staff records, it was determined that background checks did not meet the requirements of the rule for the person(s) listed on the Employee Record Chart as noted in number 4 below: 1. The request for a background check for child care was not submitted in the OPR. 2. The fingerprints were not submitted electronically according to the process established by BCI. 3. The individual(s) had engaged in assigned duties or were near children and preliminary approval from ODJFS was not on file. 4. Background checks were not updated every five years. Submit the program’s corrective action plan, which includes a copy of the JFS 01176, or a copy of the preliminary approval or a statement that the individual(s) are no longer engaged in assigned duties and are not near children until the preliminary approval has been received, to the Department to verify compliance with the requirements of this rule.”

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

“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 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 numbers 1 & 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 unsanitary conditions, as noted in number 5 below, were in the School age restrooms: 1. There was no liquid soap. 2. There was no toilet paper. 3. There were no paper towels. 4. The toilet cleaning brush was accessible to the children. 5. The plunger was accessible to the children. 6. The toilet(s) were not flushed. 7. The trash was not emptied from the day before. 8. There was a strong urine odor. 9. Other [ ]. The restroom(s) must be kept sanitary at all times. 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 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 (Quarter 2 & 3). 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 outdoor play space was not free of trash or foreign objects as noted in number 12 below: 1. The outdoor area was littered with trash. 2. The trash can was missing a lid. 3. The trash can was not emptied from the day(s) before. 4. The trash can was overflowing with trash. 5. The trash can was infested with insects. 6. The trash can was visibly dirty. 7. There was broken glass. 8. There were tall weeds. 9. There was poison ivy. 10. There were tree branches. 11. There was mold visible. 12. There were thistles with prickers. 13. There were bird droppings. 14. The sandbox was contaminated. 15. 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 1 & 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 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); 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 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.”

“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 numbers 32 and 33 below: 1. No plan was on file. (Page 1) 2. Child’s 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 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. 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 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.”

“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 program’s corrective action plan 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 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 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 unsanitary conditions, as noted in number 6 below, were in Room 1 restroom: 1. There was no liquid soap. 2. There was no toilet paper. 3. There were no paper towels. 4. The toilet cleaning brush was accessible to the children. 5. The plunger was accessible to the children. 6. The toilet(s) were not flushed. 7. The trash was not emptied from the day before. 8. There was a strong urine odor. 9. Other [ ]. The restroom(s) must be kept sanitary at all times. 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 an outdoor play area was used which was not protected from traffic and other hazards by a fence in good repair, or other barrier. Although the fence or natural barrier was not meeting the rule requirements, it was determined to not present an immediate risk for a child to be able to leave the playground. The fence or gate was not in good repair and/or being used inappropriately as noted in number 1 below: 1. The fencing had missing slat boards. 2. The fencing was broken. 3. The fencing was loose. 4. The fencing was rotting. 5. The gate was broken and did not close. 6. The gate was locked. 7. The latch on the gate was broken. 8. The latch was easily opened by children on the playground. 9. The latch was not engaged to prevent children from opening the gate. 10. The gate had no latch. 11. There were bolts with more than two threads exposed along a fence line or gate on a playground. 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 outdoor play space was not free of trash or foreign objects as noted in number 1 below: 1. The outdoor area was littered with trash. 2. The trash can was missing a lid. 3. The trash can was not emptied from the day(s) before. 4. The trash can was overflowing with trash. 5. The trash can was infested with insects. 6. The trash can was visibly dirty. 7. There was broken glass. 8. There were tall weeds. 9. There was poison ivy. 10. There were tree branches. 11. There was mold visible. 12. There were thistles with prickers. 13. There were bird droppings. 14. The sandbox was contaminated. 15. 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 written instructions for feeding the infants noted on the Children Record Review were missing information as noted in number 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.”

“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 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 the medical statements for the employees listed on the Employee Record Chart did not meet the requirements as listed in numbers 6a 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); 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 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 13 below. 1. No enrollment form was completed for at least one child 2. The current JFS 01234 was not completed for at least one child 3. Complete child information 4. Complete parent information 5. Complete emergency contact information 6. Complete physician information 7. Information regarding the parent list 8. Health information 9. Additional information for all boxes checked “yes” 10. Emergency transportation information 11. Parent/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 the program’s written disaster plan did not meet the requirement for training child care staff members and employees on the plan annually as noted in number 1 below: 1. Child care staff members and employees were not trained annually. 2. Written documentation of the training was not kept on file. Submit the program’s corrective action plan to the Department to verify compliance with the requirements of this rule.”