Nevaeh'S Nest Enrichment Center

“During the inspection, it was determined that the outdoor play space was not free of trash or foreign objects as noted in number(s) 8 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 outdoor play equipment was unsafe or not used as intended as noted in number(s) 14 below: 1. There was rust exposed. 2. There were protruding bolts. 3. There were cracks. 4. There were holes. 5. There was splintering wood. 6. There were sharp edges or points. 7. There were lead hazards. 8. There were toxic substances. 9. There were tripping hazards. 10. There was chipped and/or peeling paint. 11. The sandbox was not covered when the program was closed or during non-daylight hours. 12. Outdoor equipment, [ ] was not developmentally appropriate. 13. Outdoor equipment, [ ], was placed in the main traffic pattern. 14. Outdoor play equipment was positioned too closely together, posing a risk of injury if a child were to fall from one piece of equipment into another. 15. Outdoor equipment, [ ], was not securely anchored but did not present a risk of imminent danger of the structure collapsing when children are using the equipment 16. Outdoor equipment, [ ], was 30 inches or more from the ground and did not have a protective barrier that would prevent a child from falling off this piece of equipment. 17. The manufacturer's guidelines for assembly and installation were not followed for the [ ]. 18. Functionally linked equipment was used by preschool-age children and the distance between two adjacent pieces of equipment exceeded 12 inches. 19. Functionally linked equipment was used by school-age children and the distance between two adjacent pieces of equipment exceeded 18 inches. 20. Other [ ]. Submit the program’s corrective action plan 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 on multiple occasions, as noted below: The ratio determined for the Infant, Toddler, Preschool/School age group was 1 Child Care Staff Member(s) for 11 children. 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, a ratio of 1 child care staff member(s) for 8 children was determined to have occurred for the Infant/Toddler/Preschool group when the situation in number(s) 1 below occurred: 1. A child care staff member stepped out of the room. 2. A child care staff member had not arrived at work on time. 3. Children were present who were not scheduled to be there. 4. A child care staff member was unable to work. 5. A child was injured in that group. 6. A child arrived in the group before a second staff member was scheduled to arrive with the group. 7. Two groups were combined, and the program did not follow the ratio for the youngest child in the group. 8. A child was transitioning to the next older age group, and the program did not follow the ratio for the youngest child in the group. 9. Ratio was doubled for more than two hours while children were napping. 10. Ratio was doubled while children were napping for a group that included at least one infant. 11. Ratio was doubled while children were napping and there were not enough staff members in the building to meet staff/child ratio. 12. Ratio was doubled in the school age group to allow access to the program, however, the program does not serve only school age children. 13. Both child care staff members did not have a working communication device when one staff member left the group to allow access to the school age only program. 14. The child care staff member did not return to the group after allowing access to the school age only program. 15. Other [ ]. Additional child care staff members must be hired or current child care staff members must be rescheduled to maintain compliance. Provide staff training. Submit the 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 left unattended while inside the program as noted in number(s) 1 below: 1. Child(ren) were left unattended once. 2. Child(ren) were left unattended more than once. 3. Child(ren) left the group and were unattended. 4. Child care staff were using a baby monitor to supervise children. 5. Child care staff were using a walkie talkie to supervise children. 6. Child care staff were using mirrors to view children in another room. 7. Child care staff were using a video camera instead of physically being present in the room. 8. Other [ ]. Children must be supervised and within sight and hearing of a child care staff member at all times. Provide staff training. Submit the 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: 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 being properly supervised as noted in number(s) 1 below: 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 the program did not meet the requirements for keeping an attendance record as listed in number(s) 2 below: 1. No attendance record was being maintained. 2. The attendance record was not being consistently completed. 3. The record did not include the name of at least one child. 4. The record did not include the birth date of at least one child. 5. The record did not include the assigned group. 6. The record did not include the 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, equipment was determined to be unsafe, hazardous to children, or in need of repair as noted in number(s) 17 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 on the [ ]. 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, or 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.”

“During the inspection, it was determined that handwashing requirements were not followed as listed in number(s) 5 below, as required in rule. 1. At least one staff/child did not wash their hands upon arrival for the day. 2. At least one staff/child did not wash their hands prior to departure. 3. At least one staff did not wash their hands upon entry into a classroom. 4, At least one staff/child did not wash their hands after toileting or assisting a child with toileting. 5. At least one staff/child did not wash their hands after each diaper change or pull-up change. 6. At least one staff did not wash their hands after contact with bodily fluids or cleaning up spills or objects contaminated with bodily fluids. 7. At least one child did not wash their hands after contact with bodily fluids. 8. At least one child did not wash their hands after returning inside after outdoor play. 9. At least one staff did not wash their hands after cleaning or sanitizing or using any chemical products. 10. At least one staff/child did not wash their hands after handling pets, pet cages or other pet objects that have come in contact with the pet. 11. At least one staff did not wash their hands before eating, serving or preparing food or bottles or feeding a child. 12. At least one child did not wash their hands before eating or assisting with food preparation. 13. At least one staff did not wash their hands before and after completing a medical procedure or administering medication. 14. At least one child did not wash their hands after water activities. 15. At least one staff/child did not wash their hands when visibly soiled (must use soap and water). 16. Other [ ]. Submit the 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 infant daily care did not meet the requirements of this rule as noted in number(s) 2 below: 1. Infants could not safely and comfortably sit, crawl, toddle, or walk and play according to the infant’s stage of development. 2. Infants were not removed from the crib, swing, infant seat, exercise seat or other equipment throughout the day for individual attention. 3. Each non-crawling infant was not provided the opportunity for tummy time, outside of their crib, each day. A. 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 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.”

“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, 2, 3 below: 1. Child abuse and neglect recognition and prevention training was not completed within sixty days of hire. 2. First aid training was not completed within ninety days of hire. 3. Cardiopulmonary resuscitation (CPR) training was not completed within ninety days of hire. 4. The child abuse and neglect recognition and prevention training was expired. 5. The first aid training was expired. 6. The CPR training was expired. Refer to the Employee Record Chart for the name(s) of the child care staff member(s) who must complete the required health and safety training(s). Submit the 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) 4 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 did not meet the annual professional development requirement as noted in number(s) 1 below: 1. The child care staff member(s) had not completed at least six hours of professional development. 2. Documentation did not demonstrate the person who provided the training met the trainer qualifications as stated in the rule. 3. Training topic did not meet the requirements listed in appendix A of this rule. 4. Documentation of training did not meet the requirements of this rule. 5. The substitute(s) had been used more than ninety days annually between July first and June thirtieth and had not completed at least six hours of professional development 6. Other [ ]. Submit the 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 Preschool/School age where children had access to it, as noted in number(s) 2, 9 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 outdoor play equipment was unsafe or not used as intended as noted in number(s) 5, 20 below: 1. There was rust exposed. 2. There were protruding bolts. 3. There were cracks. 4. There were holes. 5. There was splintering wood. 6. There were sharp edges or points. 7. There were lead hazards. 8. There were toxic substances. 9. There were tripping hazards. 10. There was chipped and/or peeling paint. 11. The sandbox was not covered when the program was closed or during non-daylight hours. 12. Outdoor equipment, [ ] was not developmentally appropriate. 13. Outdoor equipment, [ ], was placed in the main traffic pattern. 14. Outdoor play equipment, [ ], was positioned too closely together, posing a risk of injury if a child were to fall from one piece of equipment into another. 15. Outdoor equipment, [ ], was not securely anchored but did not present a risk of imminent danger of the structure collapsing when children are using the equipment 16. Outdoor equipment, [ ], was 30 inches or more from the ground and did not have a protective barrier that would prevent a child from falling off this piece of equipment. 17. The manufacturer's guidelines for assembly and installation were not followed for the [ ]. 18. Functionally linked equipment was used by preschool-age children and the distance between two adjacent pieces of equipment exceeded 12 inches. 19. Functionally linked equipment was used by school-age children and the distance between two adjacent pieces of equipment exceeded 18 inches. 20. Other- nails protruding from wood. 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 fall zone under and around equipment designated for climbing, swinging, balancing and sliding did not meet the requirements as noted in number(s) 4 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 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 breast milk provided by the parent was not stored appropriately as noted in number(s) 1 below: 1. Not labeled with infant's name, date pumped, and date bottle was prepared; 2. Not immediately refrigerated or frozen; 3. Stored at room temperature longer than eight hours; 4, Stored at the program for more than five days after it was expressed; 5. Stored longer than two weeks in the freezer compartment of the refrigerator; 6. Stored longer than six months in the refrigerator/freezer; 7. Stored longer than twelve months in the deep freezer; 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) 4, 6(a) 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.”

“During the inspection, it was determined a group that included at least one child less than the age of two and one half years of age was not kept separate from groups of older children as noted in number(s) 4 below: 1) The [ ] group, which included children less than two and one half years of age, were cared for in a space where a group of older children were receiving care. 2) A barrier was not used to separate the space being used by the group of children less than two and one half years of age from space being used for groups of children two and one half years and older. 3) The barrier separating the groups was not at least 36 inches in height. 4) The barrier separating the groups was not continuous. 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(s) 2 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 the program’s written disaster plan did not meet the requirement or was missing the information in number(s) 4, 11, 12, 16 below: Procedures: 1. The written disaster plan had not been completed 2. The plan was not provided to all child care staff and employees 3. The plan was not used to respond to an emergency or disaster situation 4. Weather emergencies and natural disasters which earthquakes 5. Emergency outdoor and indoor lockdown or evacuation due to threats of violence which includes active shooter, bioterrorism or terrorism 6. Emergency or disaster evacuations due to hazardous materials and spills, gas leaks or bomb threats. 7. Outbreaks, epidemics or other infectious disease emergencies 8. Loss of power, water, or heat 9. Other threatening situations that may pose a health or safety hazard to the children in the program Details: 10. Shelter in place or evacuation, how the program will care for and account for the children until they can be reunited with the parent 11. A designated safe site where staff and children can safely remain when evacuated. 12. Assisting toddlers 13. Emergency contact information for parents and the program 14. Procedures for notifying and communicating with parents regarding the location of the children if evacuated 15. Procedures for communicating with parents during loss of communications, no phone or internet service available 16. The location of supplies and procedures for gathering necessary supplies for staff and children if required to shelter in place 17. What to do if a disaster occurs during the transport of children or when on a field trip or routine trip 18. Making the plan available to all child care staff members and employees 19. Training of staff or reassignment of staff duties as appropriate 20. Updating the plan on a yearly basis 21. Contact with local emergency management officials Make the necessary revisions to the disaster plan. Submit the program’s corrective action plan, which includes the revised information, to the Department to verify compliance with the requirements of this rule.”

“During the inspection, it was determined the program’s written policies and procedures provided to the parents/guardians and employees was missing item number(s) 4, 8, 15, 17 below: General Information 1. Program name, address, email address and telephone number. 2. Description of the program’s program philosophy. 3. Days and hours of operation, scheduled closings and basic daily schedule. A, Staff/child group size. 5. Opportunities for parent involvement in program activities. 6. Opportunities for parents to meet with teachers regarding their child. 7. Payment schedule, overtime charges and registration fees as applicable. 8. Supports for onsite breastfeeding or pumping for mothers who wish to do so (if the program serves infants or toddlers). Program Policies and Procedures 9. Enrollment including required enrollment information. 10. Care of children without immunizations. 11. Attendance including procedures for arrival and departure, the program’s absent day policy, releasing child to persons other than the parent, releasing a child according to a custody agreement and follow up when a child scheduled to arrive from another program or activity does not arrive. 12. Supervision of children, including a separate supervision policy for school-age children, if applicable. 13. Child guidance. 14. Suspension and expulsion. 15. Compliance with the Americans with Disabilities Act (ADA), including administering medication to children with disabilities and administering care procedures to children with disabilities. 16. Outdoor play, including limitations placed on outdoor play due to weather or safety issues (considerations may include but are not limited to temperature, humidity, wind chill, ozone levels, pollen count, lightning, rain or ice.) 17. Food and dietary policy, including, a policy on providing supplemental food. 18. Management of illness including isolation precautions, symptoms for discharge and return and notification of parent of ill child. 19. Summary of procedures taken in the event of an emergency, serious illness or injury. 20. Administration of medication and topical products including medical foods, modified diets and whether school age children are permitted to carry their own medication and ointments. 21. Transportation for fieldtrips, routine trips (if applicable) and emergencies, including if the center will provide child care services to children whose parents refuse to grant consent for transportation to the source of emergency treatment. 22. Water activities/swimming. 23. Infant care, if applicable, including feeding, frequency of diaper checks and information about daily activities. 24. Sleeping, Napping and Resting. 25. Evening and overnight care, if applicable. 26. Policy on hours of operation including closing due to weather, school delays or closings and any other factors. 27, Situations that may require disenrollment of a child, if applicable. 28. Problem or issue resolution for parents or employees to follow when needing assistance in resolving problems related to the child care program. 29. Formal screenings and assessments on enrolled children and if the program reports child level data to ODJFS pursuant to 5101:2-17-02 of the Administrative Code. Revise the program’s written policies and procedures to include the missing information. Submit the program’s corrective action plan, which includes the revised written policies and procedures, to the Department to verify compliance with the requirements of this rule.”