Little Strength Christian Learning Center

“During the inspection, a ratio of 1 child care staff member(s) for 10 children was determined to have occurred for the combined Toddler & Woddler groups with 1 child under 18 months. 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.”

“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. The following was observed: Health and safety trainings were not completed by all required staff. 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 at least one child care staff member did not meet the annual professional development requirement. The following was observed: At least one child care staff member did not meet the annual professional development requirement. 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 child care staff member(s) did not meet the requirements for completing the online orientation training as noted in number(s) 1 below: 1. The training was not completed within 30 days of starting employment at the program as a child care staff member. 2. Documentation of completing the training after December 31, 2016 was not on file. 3. Completion of the training was not verified in the OPR. 4. A child care staff member had sole responsibility of children and had not completed the online orientation. Submit the program’s corrective action plan to the Department to verify compliance with the requirements of this rule.”

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

“In review of the staff records, it was determined the program did not have at least one child care staff member present/scheduled to be present during all hours of operation with currently valid documentation for the training(s) listed in number(s) 2, 5 below: 1. First Aid — child care staff members scheduled during the hours of [ ] and [ ] had expired training 2. First Aid — child care staff members scheduled during the hours of 6am-8:30am (Monday) and 4:15pm-5:30pm (Monday) did not have verification of completion of First Aid 3. First Aid — trained child care staff member was not present in each building used by the program. 4. CPR — child care staff members scheduled during the hours of [ ] and [ ] had expired training 5. CPR — child care staff scheduled during the hours of 6am-8:30am (Monday) and 4:15pm - 5:30pm (Monday) had did not have verification of completion of CPR 6. CPR - trained child care staff member was not present in each building used by children 7. CPR — training taken by staff was not appropriate for all ages and developmental levels of the children in care 8. CPR - audiovisual or electronic media training taken by staff did not include an in-person component of the training 9. Communicable Disease — child care staff members scheduled during the hours of [ ] and [ ] had expired training 10. Communicable Disease — child care staff scheduled during the hours of 6am and 7am had not taken Communicable Disease training (Monday, Thursday, Friday) 11. Communicable Disease — trained child care staff member was not present in each building used by the program 12. Child Abuse — child care staff members scheduled during the hours of [ ] and [ ] had expired training 13. Child Abuse — child care staff scheduled during the hours of [ ] and [ ] had not taken Child Abuse training 14. Child Abuse — trained child care staff was not in each building used by the program Refer to the Employee Record Chart for specific details. Submit the program’s corrective action plan, which includes verification of complete coverage for any training listed, to the Department to verify compliance with the requirements of this rule.”

“During the inspection, required staff/child ratios were not maintained for [the same group/different groups] on multiple occasions, as noted below: The ratio determined for the Toddler group was 1 Child Care Staff Member(s) for 8 children, the group included 2 children under the age of 2 1/2 years of age. Additionally, a ratio of 1 Child Care Staff Member(s) for 18 children was determined for the School Age group that included 1 preschool aged child waiting for the bus. Additional staff members must be hired or current Child Care Staff Members must be rescheduled to maintain compliance. Provide staff training. Submit the program’s corrective action plan, which includes a statement that training was provided, to the Department to verify compliance with the requirements of this rule.”

“During the inspection, it was determined the program did not meet the requirement(s) for administering a medication or medical food or a prescription topical product to a child as noted in number(s)7 & 8 below: 1. The JFS 01217 “Request for Administration of Medication for Child Care” was not on file for a medication, medical food, or prescription topical product that was not required by a JFS 1236 ""Child Medical/Physical Care Plan for Child Care"". 2. The child’s name was missing on the JFS 01217. 3. The child’s date of birth was missing on the JFS 01217 and was needed to determine the correct dosage. 4. The child’s weight was missing on the JFS 01217 and was needed to determine the correct dosage. 5. The name of the medication was missing on the JFS 01217. 6. The exact dose was missing on the JFS 01217. 7. The time to administer was missing on the JFS 01217. 8. The time period to administer was missing on the JFS 01217. 9. The medication's expiration date was missing on the JFS 01217. 10. The Parent/Guardian’s dated signature was missing on the JFS 01217. 11. Physician instructions were missing on the JFS 01217. 12. Possible side effects were missing on the JFS 01217. 13. Physician’s dated signature was missing on the JFS 01217. 14. Physician’s phone number was missing on the JFS 01217. 15. Date medication was administered was missing on the JFS 01217. 16. Time medication was administered was missing on the JFS 01217. 17. Dosage administered was missing on the JFS 01217. 18. Staff member's signature was missing on the JFS 01217. 19. A prescription label was not attached to the prescription medication. 20. The medication or product, [ ], was not brought to the program in its original container, 21. Parent instructions conflict with either the manufacturer or physician instructions. Submit the program’s corrective action plan, which includes the completed JFS 01217 for each child needed, verification that the prescription label is now attached, and/or verification that the medication or product is now in its original container, and a statement that training was provided, 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) 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 child care staff member(s) did not meet the requirements for completing the online orientation training as noted in number(s) 4 below: 1. The training was not completed within 30 days of starting employment at the program as a child care staff member. 2. Documentation of completing the training after December 31, 2016 was not on file. 3. Completion of the training was not verified in the OPR. 4. A child care staff member had sole responsibility of children and had not completed the online orientation. Submit the program’s corrective action plan to the Department to verify compliance with the requirements of this rule.”

“In review of the staff records, it was determined that at least one child care staff member 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.”

“In review of 25% of the children's records, it was determined that information had not been secured from the parent/guardian on the JFS 01234 “Child Enrollment and Health Information For Child Care”, as required, for the items in number(s)4,12 & 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.”

“In review of 25% 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(s) 9 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 program’s written policies and procedures provided to the parents/guardians and employees was missing item number(s) 4, 14 & 27below: 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 ratios and 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. (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, information regarding meeting one-third of the child's recommended daily dietary allowance, policy regarding formula, breast milk, meals and snacks, and 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.”

“During the inspection, required staff/child ratios were not maintained for [the same group/different groups] on multiple occasions, as noted below: The ratio determined for the Toddler group was 1 Child Care Staff Member(s) for 9 children. Additionally, a ratio of 1 Child Care Staff Member(s) for 16 children was determined for the Preschool/School Age group. Additional staff members must be hired or current Child Care Staff Members must be rescheduled to maintain compliance. Provide staff training. Submit the program’s corrective action plan, which includes a statement that training was provided, to the Department to verify compliance with the requirements of this rule,”

“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(s) 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.”

“In review of the children’s records, it was determined the program did not meet the requirements for caring for at least one child, indicated on the Children Records Review, with a condition that requires a JFS 01236 "Child Medical/Physical Care Plan" as noted in number(s) 1,7, 22 & 23 below: 1. No plan was on file. (Page 1) 2. Child’s name was missing. 3. Name of the condition was missing. A. Indication if medication or medical food is required was missing. 5. Signs, symptoms or situations that require staff to take action were missing. 6. Activities, foods, environmental conditions to avoid were missing. 7. Training instructions for procedures for staff to follow were missing or incomplete. (Page 2) 8. Child's name was missing or not attached. 9. Child's date of birth was missing or not attached. 10. Child's weight was missing or not attached. 11. Name of the medication/medical food was missing or not attached. 12. Dosage of medication/medical food to be administered was missing or not attached. 13. Time for medication/medical food to be administered was missing or not attached. 14. Expiration date for medication/medical food was missing or not attached. 15. Symptoms that require staff to administer medication/medical food were missing or not attached. 16. Specific instructions to administer the medication/medical food were missing or not attached. 17. Actions to be taken if the symptoms do not subside were missing or not attached. 18. Physician's signature was missing or not attached. 19. The date of the physician's signature was missing or not attached. (Page 3) 20. Child's name was missing. 21. Instructions regarding emergency evacuation, if applicable, were missing. 22. Signature of parent granting permission to implement the plan and verifying training was missing. 23. Date of parent signature was missing. 24. Certified Professional Trainer information was missing. 25. Signature of certified professional who trained the program staff was missing, if parent was not the trainer. 26. Date of trainer signature was missing. 27. Printed name(s)of child care staff member(s) who have received instructions for care and/or have been trained to perform the procedure were missing. 28. Signature(s) of child care staff member(s) who have received instructions for care and/or have been trained to perform the procedure were missing. 29. Date of staff signature was missing. 30. Administrator/Provider signature was missing 31. Date of administrator/Provider was missing. (Page 4) 32. Child's name was missing. 33. Name of medication or medical food was missing. 34. Date the medication/medical food was administered was missing. 35. Time medication/medical food was administered was missing. 36. Dosage of medication/medical food that was administered was missing. 37. Signature of person administering medication/medical food was missing. 38. The plan was not followed or implemented, 39. The plan was not able to be implemented due to conflicting information. 40. None of the child care staff members trained in the procedures on the JFS 01236 were onsite when a child requiring the plan was present. 41. Child care staff members trained in the procedures on the JFS 01236 were not scheduled to be present the entire the time the child requiring the plan was onsite. 42. None of the child care staff members trained in the procedures on the JFS 01236 accompanied the child requiring the plan during a trip. 43. 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, 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 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.”

“In review of the staff records, it was determined that background check requirements had not been followed, for the individual(s) listed on the Employee Record Chart, as noted in number(s) 2 below: 1. The JFS 01177 "Individual Notification of Background Check Review for Child Care" was on file instead of the JFS 01176. 2. The JFS 01176 on file was for a different program. Submit the program's corrective action plan, which includes a statement that the correct form is now on file, to the Department to verify compliance with the requirements of this rule.”

“During the inspection, it was determined that medication, medical foods and/or topical products did not meet the requirement(s) for administering medication, medical foods, and/or medical products as noted in number(s) 2 & 3 below: 1. The medication, medical food, or topical product was no longer needed and had not been removed from the program. 2. The medication, medical food, or topical product had expired and had not been removed from the program. 3. The prescription label had expired. Submit the program's corrective action plan to the Department to verify compliance with the requirements of this rule.”

“In review of 25% of the children's records, it was determined that information had not been secured from the parent/guardian on the JFS 01234 “Child Enrollment and Health Information For Child Care”, as required, for the items in number(s) 4,6 & 9 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.”