River Ferns Maineville

“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, 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 30 below: 1. Item(s) soiled with blood or bodily fluids were not cleaned/sanitized immediately. 2. Blankets/sheets were not cleaned weekly, when soiled, or before use by another child. 3. Children's individual blankets and belongings were stored in an unsanitary manner. 4. Bottles, bottle caps, nipples and other equipment used for bottle feeding were not cleaned and sanitized in a dishwasher or by washing, rinsing, and boiling for one minute. 5. Carpets were not vacuumed weekly or cleaned when soiled. 6. Changing table/pad was not sanitized after each use or cleaned when visibly soiled. 7. Reusable cloths were not being washed daily or when visibly soiled. 8. Cots/Pads/Mats were not cleaned and sanitized before assigning to a different child, when used by a sick child, when soiled or at least every three months. 9. Cribs were not cleaned and sanitized monthly, or when soiled, or before use by another child. 10. Diaper Receptables were not cleaned and sanitized daily or more frequently as needed to eliminate odor. 11. Dishes/Cups/Silverware were not cleaned and sanitized after each use. 12. Water Containers were not labeled with the child's name, or were not cleaned and sanitized before use again on another day. 13. Dividers were not cleaned when visibly soiled. 14. Dress up clothes and hats (dramatic play) were not cleaned monthly or when soiled. 15. Floors were not cleaned weekly or when soiled. 16. The food prep area, including sinks, were not cleaned before and after preparing food (including bottle preparation) or between preparing raw or cooked food. 17. Potty chairs were not cleaned after each use, rinsed with water, cleaned and sanitized or contents were not emptied into a toilet. 18. Food tables, highchair trays were not cleaned before and after each use. 19. Tables used for play were not cleaned when visibly soiled or sanitized daily. 20. Toilet bowls were not cleaned when visibly soiled or sanitized weekly. 21. Toilet seat(s), handle(s) and hand washing sink(s) were not cleaned when visibly soiled or sanitized daily. 22. Mouthed toys were not cleaned and sanitized after each child’s use. 23. Toys, other than those mouthed by children, were not cleaned monthly or when visibly soiled. 24, Washable furniture, including fabrics on infant equipment, were not cleaned weekly or when soiled. 25. Upholstered furniture was not steam cleaned when soiled. 26. Slip covers were not washed at least every six months or when soiled. 27. Wastebaskets/rinse buckets, including lids, were not being emptied daily or cleaned and sanitized when visibly soiled. 28. The manufacturer’s directions for the cleaning product were not followed. 29. The solution used for sanitizing was not a commercial product registered by the United States Environmental Protection Agency as a sanitizer. 30. Other: Trashcans, the front doors on cabinets, walls, windows and mirrors had visible dirt. Furniture, materials and equipment must be maintained according to the cleaning and sanitizing schedule in Appendix A to this rule. Technical assistance was provided at the time of the inspection, and as discussed, please correct this rule noncompliance. A written response for this rule noncompliance is required at this time.”

“During the inspection, it was determined that the program had not performed and/or documented some monthly drills or weekly inspections of vehicles used for transporting children. The weekly inspection needs to include the following: 1. A visual inspection of the tires for wear and tire pressure 2. A visual inspection of headlights, taillights, signals, mirrors, wiper blades, and dash gauges 3. An inspection for properly functioning child and driver restraints 4. An inspection for properly functioning doors and windows 5. An inspection for, and cleaning of, debris from inside the vehicle Submit the program’s corrective action plan, which includes a copy of the documented weekly inspection of vehicles, to the Department to verify compliance with the requirements of this rule.”

“During the inspection, it was determined that written instructions for feeding infants were missing information as noted in number 1 and 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 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 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 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 4 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 required at this time.”

“In review of the children’s records, it was determined the program did not meet the requirements for caring for at least one child, indicated on the Children Records Review, with a condition that requires a JFS 01236 "Child Medical/Physical Care Plan" as noted in number 1 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.”

“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 12 below: 1. Cosmetics were accessible to children in the [ ] area. 2. Disinfecting wipes were accessible to children in the [ ] area. 3. Fish food was accessible to children in the [ ] area. 4. Hand lotion was accessible to children in the [ ] area. 5. Hand sanitizer (for children under 24 months) was accessible to children in the [ ] area. 6. Laundry detergent was accessible to children in the [ ] area. 7, Powder dish washing soap was accessible to children in the [ ] area. 8. Paint cans were accessible to children in the [ ] area. 9. White out was accessible to children in the [ ] area. 10. Potting Soil was accessible to children in the [ ] area. 11. Other potentially hazardous substance [ ] was accessible to children in the [ ] area. 12. Cleaning/sanitizing supplies had not been clearly labeled. 13. School-age children were using cleaning supplies, agents and/or equipment without adult supervision. 14. A spray aerosol was used in the [ ] group while children were in attendance. 15. Other: [ ]. 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 the program was not providing a clean and healthy environment, furniture, materials and equipment as required by Appendix A, as noted in numbers 3 and 30 below: 1. Item(s) soiled with blood or bodily fluids were not cleaned/sanitized immediately. 2. Blankets/sheets were not cleaned weekly, when soiled, or before use by another child. 3. Children's individual blankets and belongings were stored in an unsanitary manner. 4. Bottles, bottle caps, nipples and other equipment used for bottle feeding were not cleaned and sanitized ina dishwasher or by washing, rinsing, and boiling for one minute. 5. Carpets were not vacuumed weekly or cleaned when soiled. 6. Changing table/pad was not sanitized after each use or cleaned when visibly soiled. 7. Reusable cloths were not being washed daily or when visibly soiled. 8. Cots/Pads/Mats were not cleaned and sanitized before assigning to a different child, when used by a sick child, when soiled or at least every three months. 9. Cribs were not cleaned and sanitized monthly, or when soiled, or before use by another child. 10. Diaper Receptables were not cleaned and sanitized daily or more frequently as needed to eliminate odor. 11. Dishes/Cups/Silverware were not cleaned and sanitized after each use. 12. Water Containers were not labeled with the child's name, or were not cleaned and sanitized before use again on another day. 13. Dividers were not cleaned when visibly soiled. 14. Dress up clothes and hats (dramatic play) were not cleaned monthly or when soiled. 15. Floors were not cleaned weekly or when soiled. 16. The food prep area, including sinks, were not cleaned before and after preparing food (including bottle preparation) or between preparing raw or cooked food. 17. Potty chairs were not cleaned after each use, rinsed with water, cleaned and sanitized or contents were not emptied into a toilet. 18. Food tables, highchair trays were not cleaned before and after each use. 19. Tables used for play were not cleaned when visibly soiled or sanitized daily. 20. Toilet bowls were not cleaned when visibly soiled or sanitized weekly. 21. Toilet seat(s), handle(s) and hand washing sink(s) were not cleaned when visibly soiled or sanitized daily. 22. Mouthed toys were not cleaned and sanitized after each child’s use. 23. Toys, other than those mouthed by children, were not cleaned monthly or when visibly soiled. 24. Washable furniture, including fabrics on infant equipment, were not cleaned weekly or when soiled. 25. Upholstered furniture was not steam cleaned when soiled. 26. Slip covers were not washed at least every six months or when soiled. 27. Wastebaskets/rinse buckets, including lids, were not being emptied daily or cleaned and sanitized when visibly soiled. 28. The manufacturer’s directions for the cleaning product were not followed. 29. The solution used for sanitizing was not a commercial product registered by the United States Environmental Protection Agency as a sanitizer. 30. Other: Cupboard doors, windows, trashcans and area rugs were visibly dirty. Furniture, materials and equipment must be maintained according to the cleaning and sanitizing schedule in Appendix A to this rule. Technical assistance was provided at the time of the inspection, and as discussed, please correct this rule noncompliance. A written response for this rule noncompliance is required at this time.”

“During the inspection, it was determined that handwashing requirements were not followed as listed in numbers 1 and 2 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 required documentation for substitutions for fluid milk was not on file as noted in number 5 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 required at this time.”

“During the inspection, it was determined that a diaper cream was at the program which had not been labeled with the child's name. 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 equipment in number 7 below had been used for sleeping infants and did not allow the infant to sleep on a firm mattress: 1. Mesh cribs; 2. Play pens; 3. Bassinets; 4. Cots; 5. Car seats; 6. Infant swing; 7. The floor; 8. Infant seats; 9, An infant placed in a car seat in a crib; 10. Other [ ]. Infants must be provided with a crib, which meets requirements specified in this rule, for resting and sleeping. Provide staff training. Submit the program’s corrective action plan, which includes a statement that staff training was provided, to the Department to verify compliance with the requirements of this rule.”