Hale, Kishia D

“During the inspection, it was determined that information was not up to date in the Ohio statewide licensing system. The following information was not current: • Days and hours of operation 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 emergency preparedness and response plan did not meet the requirement or was missing the information. The following was observed missing: ¢ Procedures for medical or dental emergencies, including emergency transportation. • Contact with local emergency management officials. Submit the program’s corrective action plan, which includes the missing information, if applicable, 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 did not meet the annual professional development requirement. The following was observed: ¢ The Provider had not completed at least six hours of professional development in the fiscal year of 2025-2026 due date. Submit the program’s corrective action plan to the Department to verify compliance with the requirements of this rule.”

“In review of of the children's records, it was determined that immunization records were not on file, as required. The following was observed: ¢ Immunization records were not updated no more than every thirteen months. 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 information in number 4 below was not up to date in the Ohio Child Care Licensing and Quality System: Chir Department of i eg Children & Yout! 1. Mailing Address; 2. Telephone Number; 3. Email Address; 4. Days and Hours of Operation; 5. Services Offered; 6. Name of Program, If applicable. 7. Private pay rates. Submit the program's corrective action plan 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.”

“During the inspection, cleaning and sanitizing equipment and supplies were not stored properly as noted in numbers 11 & 15 below: 1. Cosmetics were accessible to children in the [ ] area. 2. Disinfecting wipes were accessible to children in the [ ] area. 3. Fish food was accessible to children in the [ ] area. 4. Hand lotion was accessible to children in the [ ] area. 5. Hand sanitizer (for children under 24 months) was accessible to children in the [ ] area. 6. Laundry detergent was accessible to children in the [ ] area. 7. Powder dish washing soap was accessible to children in the [ ] area. 8. Paint cans were accessible to children in the [ ] area. 9. White out was accessible to children in the [ ] area. 10. Potting Soil was accessible to children in the [ ] area. 11. Other potentially hazardous substance prescription meds & vitamins were accessible to children in unlocked kitchen cabinet 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: lighters in unlocked kitchen drawer. Provide staff training. Submit the program’s corrective action plan, which includes a statement that the potentially hazardous substance is no longer accessible to children 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 the program did not have a first aid kit onsite as required, that included all items listed in the appendix A of the rule. The kit was missing the item listed in number 1 below: 1. One roll of first-aid tape; 2. Individually wrapped sterile gauze; squares in assorted sizes; 3. Sterile adhesive bandages in assorted sizes; 4.Tweezers; 5. Gauze rolled bandage; 6. Triangular bandage; 7. Rounded end scissors; 8. Tooth preservation system or fresh chilled liquid milk in which to transport a lost permanent tooth, including a written reference indicating location of the refrigerator/freezer where milk is stored if a tooth preservation system is not part of the first aid kit (for programs serving school age children only); 9. A working digital thermometer; 10. Disposable non-latex gloves; 11. A working flashlight; 12. An instant cold pack that has not been activated or ice, including a written reference indicating location of the refrigerator/freezer where the ice is stored if an instant cold pack is not part of the first aid kit; 13. Sealable leak-proof plastic bags in assorted sizes or double bagged plastic bags that can be securely tied for materials soiled with blood or bodily fluids; 14, Pocket mask or face shield, appropriate; for all ages of children in care, for cardiopulmonary resuscitation (CPR) administration; 15. Soap or waterless sanitizer (field trip or transporting away from the program only); 16. Bottled water (field trip or transporting away from the program only). Correct the violation and submit the program's corrective action plan to verify compliance with the requirements of this rule.”

“In review of records, it was determined the provider did not have current valid documentation for trainings listed in numbers 1 & 4 below: 1. First Aid - expired training 2. First Aid - did not have verification of the completion of First Aid training 3. First Aid - documentation did not demonstrate the person who provided the training met the trainer qualifications as stated in the rule 4. CPR - expired training 5. CPR - had not taken CPR training 6. CPR - did not have verification of the completion of CPR training Chir Department of i eg Children & Yout 7. CPR - training taken did not include all age groups and developmental levels of all children in care 8. CPR - documentation did not demonstrate the person who provided the training met the trainer qualifications as stated in the rule 9. CPR- audiovisual or electronic media training taken did not include an in-person component of the training 10. Communicable Disease - expired training 11. Communicable Disease - had not taken CD training 12. Communicable Disease - did not have verification of the completion of CD training 13. Communicable Disease - documentation did not demonstrate the person who provided the training met the trainer qualifications as stated in the rule 14. Child Abuse - expired training 15. Child Abuse - had not taken Child Abuse training 16. Child Abuse - documentation did not demonstrate the person who provided the training met the trainer qualifications as stated in the rule Correct the violation and submit the documentation of current certification with the program's corrective action plan to verify compliance with the requirement of the rule.”

“In review of the children's records, it was determined that information had not been secured from the parent/guardian on the JFS 01234 “Child Enrollment and Health Information For Child Care”, as required, for the items in numbers 4, 10, 12, 14, & 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 [ ] Chir Department of i eg Children & Yout 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 that completed medical statements were not on file, as required, for children listed on the JFS Children's Record Review For Child Care as indicated in number 2 below: 1. No medical was on file for at least one child 2. Medical(s) on file was not updated every 13 months 3. Medical(s) were missing child's name and date of birth 4. Medical(s) were missing the date of the medical examination 5. The date of the exam was more than 13 months prior to the date the form was signed 6. Medical(s) were missing a statement that the child has been examined and is in suitable condition for participation in group care 7. Medical(s) were missing the signature, business address and telephone number of the physician, physician's assistant(PA), advance practice nurse (APN) or certified nurse practitioner (CNP) who examined the child 8. Medical(s) were missing a record of immunizations the child has had specifying month, day and year 9. Medical(s) were missing a statement from the physician, PA, APN, or CNP that the child has been immunized or is in the process of being immunized against the diseases required by division 5104.014 of the Revised Code and found in appendix A to this rule 10. Medical(s) were missing a statement from the child’s parent or guardian that he or she has declined to have the child immunized against the disease for reasons of conscience, including religious convictions 11. Other [ ] Submit the program’s corrective action plan to the Department to verify compliance with the requirements of this rule.”

“During the inspection, it was determined the written policies and procedures were not given to parents as required. A copy must be made available onsite for review. Submit the program’s corrective action plan to verify compliance with this rule.”

“During the inspection, it was determined the program had not responded to the non-compliances addressed in the inspection report dated 2/21/25. The rule requires the program complete and submit a Chir Department of i Le Children & Yout! corrective action plan in OCLQS to address non-compliances detailed in written inspection reports within the timeframe outlined in the report. Submit the program’s corrective action plan, which includes a statement that current and future corrective action plans will be submitted timely, to the Department to verify compliance with the requirements of this rule.”

“During the inspection, cleaning and sanitizing equipment and supplies were not stored properly as noted in numbers 2, 4, 11, & 15 below: 1. Cosmetics were accessible to children in the [ ] area. 2. Disinfecting wipes were accessible to children in the program area. 3. Fish food was accessible to children in the [ ] area. 4. Hand lotion was accessible to children in the program bathroom 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 gorilla glue was accessible to children in an unlocked cabinet in the kitchen 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: prescriptions and vitamins were accessible in the kitchen area. Provide staff training. Submit the program’s corrective action plan, which includes a statement that the potentially hazardous substance is no longer accessible to children and a statement that training was provided, 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 children were not protected from the following item or condition which may threaten their health, safety, or well being as noted in the following number 4 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. Telephone cords, 7. Employee(s) purse(s). 8. Diaper bags. 9. Television not securely anchored. 10. Small or lightweight pieces of shelving units are not securely anchored to the wall. 11. Staff member stepped over a barrier/gate while holding a child. 12. Chipping or peeling paint. 13. An area rug did not have a nonskid backing. 14. An area rug presented a tripping hazard. 15. A floor surface was unsafe in that [ ]. 16. No platform was provided for the sink or toilet. 17. The platform provided for the sink or toilet was not sturdy. 18. The platform provided for the sink or toilet posed a safety hazard in that [ ]. 19. Emergency exits were blocked by the following furniture in that [ ]. 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 [ ]. 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 was not providing a clean and healthy environment, furniture, materials and equipment as required by Appendix A, as noted in number 17 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. Chir Department of i Le Children & Yout! 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 Receptacles 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. Dress up clothes and hats (dramatic play) were not cleaned monthly or when soiled. 14. Floors were not cleaned weekly or when soiled. 15. The food prep area, including sinks, were not cleaned before and after preparing food (including bottle preparation) or between preparing raw or cooked food. 16. Potty chairs were not cleaned after each use, rinsed with water, cleaned and sanitized or contents were not emptied into a toilet. 17. Food tables, highchair trays were not cleaned before and after each use. 18. Tables used for play were not cleaned when visibly soiled or sanitized daily. 19. Toilet bowls were not cleaned when visibly soiled or sanitized weekly. 20. Toilet seat(s), handle(s) and hand washing sink(s) were not cleaned when visibly soiled or sanitized daily. 21. Mouthed toys were not cleaned and sanitized after each child’s use. 22. Toys, other than those mouthed by children, were not cleaned monthly or when visibly soiled. 23. Washable furniture, including fabrics on infant equipment, were not cleaned weekly or when soiled. 24, Upholstered furniture was not steam cleaned when soiled. 25. Slip covers were not washed at least every six months or when soiled. 26. Wastebaskets/rinse buckets, including lids, were not being emptied daily or cleaned and sanitized when visibly soiled. 27, The manufacturer’s directions for the cleaning product were not followed. 28. The solution used for sanitizing was not a commercial product registered by the United States Environmental Protection Agency as a sanitizer. 29. Other [ ]. Furniture, materials and equipment must be maintained according to the cleaning and sanitizing schedule in Appendix A to this rule. Submit the program’s corrective action plan to verify compliance with the requirements of this rule.”

“During the inspection, it was determined the handwashing requirements were not being followed by the provider or a child in that the children were placed in a high chair for a snack with out handwashing. Submit the program’s corrective action plan to verify compliance with the requirements of this rule.”

“During the inspection, equipment was determined to be unsafe, hazardous to children as noted in number 16 below: 1. Manufacturer's guidelines for the [ ] were not followed in that [ ]. 2. The straps were missing on the [ ]. 3. The straps were attached, but were not used onthe [ ]. 4. The straps were attached and were used, but were not used in a safe manner. 5. The equipment had sharp points or corners. 6. The equipment had splinters. 7. The equipment had protruding nails. 8. The equipment had loose or rusty parts. 9. The equipment had paint which contains lead or other poisonous materials. 10. The equipment had hazardous features. 11. A fan was unstable and could easily tip over. 12. A fan had openings a finger could enter. 13. The pipes from the heat pump felt hot to the touch 14. A space heater felt hot to the touch 15. The position of a space heater was a tripping hazard 16. The air conditioning unit was not enclosed and was accessible to children on the playground. 17. A ball pit, trampoline, inflatable bounce house, inflatable slide, inflatable equipment used for climbing and bouncing was used. 18. Other [ ]. Submit the program’s corrective action plan to the Department to verify compliance with the requirements of this rule.”

“In review of the program's records, it was determined that requirements for written permission from the parent/guardian for a field trip or routine trip were not met as listed in number 1 below: 1. Written parental permission was not secured for routine trips off the premises. 2. The written permission was missing the child’s name. 3. The written permission was missing the date(s) of the trip(s) (field trips only). 4. The written permission was missing the destination(s) of the trip(s). 5. The written permission was missing the departure and return time(s) of the trip(s) (field trips only). 6. The written permission was missing the signature of the parent. 7. The written permission was missing the date on which the permission was signed. 8. The written permission was missing a statement notifying parents how their child will be transported. 9. Permission forms for routine trips were not being updated annually. 10. Written parental permission forms for field trips and/or routine trips were not being maintained on file for at least one year from the date of the trip. 11. Other: [ ]. Submit the program’s corrective action plan to verify compliance with the requirements of this rule.”

“In review of the children's records, it was determined that information had not been secured from the parent/guardian on the JFS 01234 “Child Enrollment and Health Information For Child Care”, as required, for the items in numbers 4, 8, 10, & 11 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 Chir Department of i Le Children & Yout! 15. Enrollment form for at least one child was not signed by the administrator 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 children's records, it was determined that completed medical statements were not on file, as required, for children listed on the JFS Children's Record Review For Child Care as indicated in number 2 below: 1. No medical was on file for at least one child 2. Medical(s) on file was not updated every 13 months 3. Medical(s) were missing child's name and date of birth 4. Medical(s) were missing the date of the medical examination 5. The date of the exam was more than 13 months prior to the date the form was signed 6. Medical(s) were missing a statement that the child has been examined and is in suitable condition for participation in group care 7. Medical(s) were missing the signature, business address and telephone number of the physician, physician's assistant(PA), advance practice nurse (APN) or certified nurse practitioner (CNP) who examined the child 8. Medical(s) were missing a record of immunizations the child has had specifying month, day and year 9. Medical(s) were missing a statement from the physician, PA, APN, or CNP that the child has been immunized or is in the process of being immunized against the diseases required by division 5104.014 of the Revised Code and found in appendix A to this rule 10. Medical(s) were missing a statement from the child’s parent or guardian that he or she has declined to have the child immunized against the disease for reasons of conscience, including religious convictions 11. Other [ ] Submit the 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 Ohio Communicable Disease Chart was not posted as required, as indicated in the number 3 below: Chir Department of i Le Children & Yout! 1. Ina location readily available to provider, child care staff members, employees, and residents; 2. The chart was not posted. 3. The posted chart was not the current version and the Child Care Manual Procedural Letter No. 159 was not posted next to the chart. 4. The posted chart was not displayed in the size available in the ODJFS forms central to be easily read. Submit the program’s corrective action plan to verify compliance with the requirements of this rule.”

“In review 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 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. no annual update. Submit the program's corrective action plan to the Department to verify compliance with the requirements of this rule.”

“In review of of the children's records, it was determined that completed medical statements were not on file, as required, for child listed on the JFS Children's Record Review For Child Care as indicated in number 8 below: 1. No medical was on file for at least one child 2. Medical(s) on file was not updated every 13 months 3. Medical(s) were missing child's name and date of birth 4. Medical(s) were missing the date of the medical examination 5. The date of the exam was more than 13 months prior to the date the form was signed 6. Medical(s) were missing a statement that the child has been examined and is in suitable condition for participation in group care 7. Medical(s) were missing the signature, business address and telephone number of the physician, physician's assistant(PA), advance practice nurse (APN) or certified nurse practitioner (CNP) who examined the child 8. Medical were missing a record of immunizations the child has had specifying month, day and year 9. Medical(s) were missing a statement from the physician, PA, APN, or CNP that the child has been immunized or is in the process of being immunized against the diseases required by division 5104.014 of the Revised Code and found in appendix A to this rule 10. Medical(s) were missing a statement from the child’s parent or guardian that he or she has declined to have the child immunized against the disease for reasons of conscience, including religious convictions 11. Other [ ] Submit the 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 emergency preparedness and response plan did not meet the requirement or was missing the information in number 10 below: Procedures: 1. The written emergency and preparedness and response plan had not been completed 2. The plan was not provided to all child care staff and employees 3. Weather emergencies and natural disasters which include severe thunderstorms, tornadoes, flash flooding, major snowfall, blizzards, ice storms or earthquakes 4. Emergency outdoor and indoor lockdown or evacuation due to threats of violence which includes active shooter, bioterrorism or terrorism including a designated safe site where staff and children can safely remain when evacuated 5. Emergency or disaster evacuations due to hazardous materials and spills, gas leaks or bomb threats including a designated safe site where staff and children can safely remain when evacuated 6. Outbreaks, epidemics or other infectious disease emergencies 7. Loss of power, water, or heat 8. Other threatening situations that may pose a health or safety hazard to the children in the program Details: 9. Shelter in place or evacuation, how the program will care for and account for the children until they can be reunited with the parent 10. Assisting infants, toddlers and children with special needs and/or health conditions 11. Emergency contact information for parents and the program 12. Procedures for notifying and communicating with parents regarding the location of the children if evacuated 13. Procedures for communicating with parents during loss of communications, no phone or internet service available 14. The location of supplies and procedures for gathering necessary supplies for staff and children if required to shelter in place 15. What to do if a disaster occurs during the transport of children or when ona field trip or routine trip 16. Making the plan available to all child care staff members and employees 17. Training of staff or reassignment of staff duties as appropriate 18. Updating the plan on a yearly basis 19. Contact with local emergency management officials 20. The plan was unable to be implemented in that, [ ]. Submit the program’s corrective action plan, which includes the missing information, if applicable, to verify compliance with the requirements of this rule.”

“In review of the children's records, it was determined that information had not been secured from the parent/guardian on the JFS 01234 “Child Enrollment and Health Information For Child Care”, as required, for the items in numbers 14 and 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 [ ] Submit the program's corrective action plan to the Department to verify compliance with the requirements of this rule.”

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

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