Sylvania Ymca Child Development Center

“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. The following was observed: The request for a background check for child care was not submitted in the OPR. Submit the program’s corrective action plan, which includes a copy of the DCY 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's Records Review, with a condition that requires a DCY 01236 ""Health Care Plan Documentation & Permission to Administer Medication" or equivalent form. The following was observed: Signs, symptoms or situations that require staff to take action were missing, training instructions for procedures for staff to follow were missing or incomplete. Symptoms that require staff to administer medication/medical food were missing or not attached. Specific instructions to administer the medication/medical food were missing or not attached. The form had not been updated as needed and at least annually. Printed name(s) of child care staff member(s) who received instructions or were trained to perform the procedure were missing. Signature(s) of child care staff member(s) who received instructions or were trained to perform the procedure were missing. Provide staff training. Submit the program’s corrective action plan, which includes a copy of the completed DCY 01236 or equivalent form, 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. The following was observed: The record did not include the full name of at least one child. The record did not include the birth date of at least one child. 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 individual bottles of water were not labeled with each 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 a child with a condition that required a DCY 01236 "Health Care Plan Documentation & Permission to Administer Medication" or equivalent form had been present and the program did not ensure there was at least one child care staff member caring for the child at all times who had signed the form on the child's condition. 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 medication, medical foods and/or topical products did not meet the requirement(s) for administering medication, medical foods, and/or medical products. The following was observed: The prescription label had expired. Submit the program's corrective action plan to the Department to verify compliance with the requirements of this rule.”

“During the inspection, it was determined that a medical food or topical product, diaper cream, was within the reach of children in the toddler room. Submit the program’s corrective action plan to the Department to verify compliance with the requirements of this rule.”

“During the inspection, it was determined that a Child Care Staff Member had used the inappropriate techniques in numbers 2, 4, & 5 below when managing unacceptable behavior in children: 1. Utilize cruel, harsh, unusual, or extreme techniques; 2. Utilize any form of corporal punishment; 3. Delegate children to manage or discipline other children; 4, Use physical restraints on a child; 5. Restrain a child by prone restraint or any means other than holding children for a short period of time, such as ina protective hug, so that the children may regain control; 6. Place children in a locked room or confine children in any enclosed area; 7. Confine children to equipment such as cribs or highchairs; 8. Humiliate, threaten or frighten children; 9. Subject children to profane language or verbal abuse; 10. Make derogatory or sarcastic remarks about children or their families; 11. Punish children for failure to eat or sleep or for toileting accidents; 12. Withhold any food (including snacks and treats), rest or toilet use; 13. Punish an entire group of children due to the unacceptable behavior of one or a few; 14. Isolate and restrict children from all activities for an extended period of time. Child Care Staff Members and other employees must always use appropriate guidance and management methods with children. Provide staff training. Submit the program’s corrective action plan, which includes a statement that training was provided, to the Department to verify compliance with the requirements of this rule.”

“During the inspection, it was determined through staff interviews that ratio was out of compliance for the toddler and preschool groups when the situation in number 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 through staff interviews that drinking water was not made available to children throughout the day, as required by the rule. Technical assistance was provided at the time of the inspection, and as discussed, please correct this rule noncompliance. Please submit a written statement verifying compliance.”

“In the review of the program’s records, it was determined that the written parental permission requirement for swimming/water activities was not met as noted in number 8 below: 1. The child’s name and date of birth was missing. 2. Statement indicating whether the child is a non-swimmer or capable of swimming was missing. 3. Location of the water activities or swimming site by water of eighteen or more inches in depth was missing. 4. Astatement of whether or not the program is providing additional adults or child care staff members above the licensing ratio requirements for this activity was missing. 5. Asignature and date from the parent indicating permission for the activity was missing. 6. Written permission was not obtained when water was directly accessible to children. 7. Written permission was not obtained prior to a child swimming or playing in water eighteen inches or more in depth. 8. Written permission was not obtained prior to a child participating in activities in or on water eighteen inches or more in depth. 9. Written permission was not obtained prior to infants and toddlers using wading pools. 10. Written permission was not updated annually for on-going activities. Technical assistance was provided at the time of the inspection, and as discussed, please correct this rule noncompliance. Please submit a written statement verifying complaince.”

“In review of 25% of the children's records, it was determined through staff interviews 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 1 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. Please submit a written statement verifying compliance.”

“During the inspection, it was determined that children were not protected from item(s) or condition(s) which may threaten their health, safety, or well-being as noted in numbers 11 & 12 below: 1. Surge protectors/outlets did not have childproof receptacle covers. 2. Open pull cords that are not closed loop. 3. Toys or other items small enough to be swallowed were present in the space where infants and/or toddlers were in care. 4, Electrical/extension cords attached to an object that would not likely result in a severe injury if pulled. 5. Stacked chairs. 6. Employee(s) purse(s). 7. Diaper bags. 8. Television not securely anchored. 9. Small or lightweight pieces of shelving units are not securely anchored to the wall. 10. Smoke detector needing batteries replaced. 11. An area rug did not have a nonskid backing. 12. An area rug presented a tripping hazard. 13. A floor surface that was unsafe in that [ ]. 14. No platform was provided for the sink or toilet in the [ ] classroom. 15. The platform provided for the sink or toilet in the [ ] classroom was not sturdy. 16. The platform provided for the sink or toilet in the [ ] classroom posed a safety hazard in that [ ]. 17. Telephone cords. 18. Staff member stepped over a barrier/gate while holding a child. 19. Emergency exits were blocked by the following classroom furniture: [ ]. 20. A mercury thermometer was being used to take a child’s temperature. 21. Methods of ventilation used did not provide protection from rodents, insects, or other hazards. 22. Other [ ]. Provide staff training. Submit the program’s corrective action plan, which includes a statement that training was provided, to the Department to verify compliance with the requirements of this rule.”

“During the inspection, it was determined the fall zone under and around equipment designated for climbing, swinging, balancing and sliding did not meet the requirements as noted in number 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 the program's weekly menu did not meet the requirement as noted in number 5 below. 1. The menu was not posted. 2. The posted menu was not in a visible place readily accessible to parents. 3. The menu was not currently dated. 4. The entire menu was substituted. 5. At least one item on menu did not match what was served. 6. The meal or snack served did not match the posted menu. 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 numbers 1 - 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 that the medical statements for the employees listed on the Employee Record Chart did not meet the requirements as listed in numbers 1 & 5 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 children's records, it was determined that the JFS 01236 “Child Medical/Physical Care Plan for Child Care” did not meet the requirements of the rule as noted in number 2 below: 1. The JFS 01236 had not been updated as needed and at least annually. 2. A separate JFS 01236 had not been used for each condition. 3. The program used an old version of the JFS 01236. Submit the program’s corrective action plan to the Department to verify compliance with the requirements of this rule.”

“During the inspection, it was determined that a medical food or topical product, diaper cream, was within the reach of children in the preschool bathroom room. 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 children’s records, it was determined the program did not meet the requirements for caring for at least one child, indicated on the Children Records Review, with a condition that requires a JFS 01236 "Child Medical/Physical Care Plan" as noted in numbers 11, 12, 13, 14, 27, 28, 42 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. AO. 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. Achild 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 the method for tracking children in each group did not meet the requirements of the rule as noted in number 5 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 handwashing requirements were not followed as listed in number 1 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.”

“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 5 below. 1. A medical statement was not on file for at least one employee; 2. The medical statement(s) on file did not have a date of examination within 12 months of the employee’s first day of employment; 3. Date of examination was missing; 4. Signature, business address, or telephone number of the licensed physician, physician assistant, advanced practice nurse, certified midwife, or certified nurse practitioner who completed the examination was missing; 5. A statement was missing that verifies the employee is: a. Physically fit for employment in a program caring for children; b. Immunized against Tetanus, Diphtheria, Pertussis (Tdap); c. Immunized against Measles, Mumps, and Rubella (MMR); 6. Tuberculosis (TB) screening/test information was missing: a. Documentation of the screening process to determine if the employee resided in a country identified by the world health organization as having a high burden of TB and arrived in the United States within the five years preceding the date of application for employment. b. Results of a TB test for employees meeting both criteria in 6a. c. Results of additional testing for employees with a positive TB test. d. Written statement, signed by a representative of the TB control unit, that the employee's TB is no longer infectious or the individual is receiving a TB treatment regimen for employees with a positive TB test. Submit the program’s corrective action plan, which includes a copy of the completed employee medical statement, or TB results/documentation, to the Department to verify compliance with the requirements of this rule.”

“In review of 25% of the children's records, it was determined that information had not been secured from the parent/guardian on the JFS 01234 “Child Enrollment and Health Information For Child Care”, as required, for the items in numbers 6, 8, & 13 below. 1. No enrollment form was completed for at least one child 2. The current JFS 01234 was not completed for at least one child 3. Complete child information 4. Complete parent information 5. Complete emergency contact information 6. Complete physician information 7. Information regarding the parent list 8. Health information 9, Additional information for all boxes checked “yes” 10. Emergency transportation information 11. Parent/guardian’s signature 12. Diapering Statement 13. Acknowledgement of Policies and Procedures 14. Enrollment form for at least one child was not updated by either the parent or the administrator 15. Enrollment form for at least one child was not signed by the administrator 16. Other [ ] Technical assistance was provided at the time of the inspection, and as discussed, please correct this rule noncompliance. A written response for this rule noncompliance is not required at this time.”

“During the inspection, it was determined that a medication, medical food or topical product 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 a medical food or topical product, diaper creams, was within the reach of children in the toddler room. 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 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 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.”