The Babes & Sucklings Child Care Centers Ltd.

“During the inspection, a ratio of 1 child care staff member for 13 children was determined to have occurred for the preschool group when the situation in number 7 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, equipment was determined to be unsafe, hazardous to children, or in need of repair as noted in number 5 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.”

“In review of the program's records, it was determined that requirements for written permission from the parent/guardian for a field trip or routine trip were not met as listed in numbers 2, 3, 4 below: 1. Written parental permission was not secured for field trips and/or routine trips off the premises. 2. The written permission was missing the child’s name. 3. The written permission was missing the date(s) of the trip(s) (field trips only). 4. The written permission was missing the destination(s) of the trip(s). 5. The written permission was missing the departure and return time(s) of the trip(s) (field trips only). 6. The written permission was missing the signature of the parent. 7. The written permission was missing the date on which the permission was signed. 8. The written permission was missing a statement notifying parents how their child will be transported. 9. Permission forms for routine trips were not being updated annually. 10. Written parental permission forms for field trips and/or routine trips were not being maintained on file for at least one year from the date of the trip. 11. Other: [ ]. 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 information had not been secured from the parent/guardian on the JFS 01234 “Child Enrollment and Health Information For Child Care”, as required, for the items in numbers 4,5, 8 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 numbers 1, 2 below: 1. No medical was on file for at least one child 2. Medical(s) on file was not updated every 13 months 3. Medical(s) were missing child's name and date of birth 4. Medical(s) were missing the date of the medical examination 5. The date of the exam was more than 13 months prior to the date the form was signed. 6. Medical(s) were missing a statement that the child has been examined and is in suitable condition for participation in group care 7. Medical(s) were missing the signature, business address and telephone number of the physician, physician's assistant(PA), advance practice nurse (APN) or certified nurse practitioner (CNP) who examined the child 8. Medical(s) were missing a record of immunizations the child has had specifying month, day and year 9. Medical(s) were missing a statement from the physician, PA, APN, or CNP that the child has been immunized or is in the process of being immunized against the diseases required by division 5104.014 of the Revised Code and found in appendix A to this rule 10. Medical(s) were missing a statement from the child’s parent or guardian that he or she has declined to have the child immunized against the disease for reasons of conscience, including religious convictions 11, Other [ ] Submit the program’s corrective action plan to the Department to verify compliance with the requirements of this rule.”

“During the inspection, it was determined the program’s written disaster plan did not meet the requirement or was missing the information in number 20 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 include severe thunderstorms, tornadoes, flash flooding, major snowfall, blizzards, ice storms or 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 infants, toddlers and children with special needs and/or health conditions 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 3 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 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. 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, it was determined that a quiet space was not provided, as required by this rule, for children who want to rest, nap or sleep. 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 required documentation for substitutions for fluid milk was not on file as noted in number 4 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.”

“In review of the program's records, it was determined that requirements for written permission from the parent/guardian for a field trip or routine trip were not met as listed in numbers 3, 4, 5 below: 1. Written parental permission was not secured for field trips and/or routine trips off the premises. 2. The written permission was missing the child’s name. 3. The written permission was missing the date(s) of the trip(s) (field trips only). 4. The written permission was missing the destination(s) of the trip(s). 5. The written permission was missing the departure and return time(s) of the trip(s) (field trips only). 6. The written permission was missing the signature of the parent. 7. The written permission was missing the date on which the permission was signed. 8. The written permission was missing a statement notifying parents how their child will be transported. 9. Permission forms for routine trips were not being updated annually. 10. Written parental permission forms for field trips and/or routine trips were not being maintained on file for at least one year from the date of the trip. 11, Other: [ ]. 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 the administrator had not completed the required rules review course provided by this Department for program administrators within the time period defined in 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 not required at this time.”

“During the inspection, it was determined that the administrator did not have scheduled hours of availability to meet with parents, or the hours of availability were not posted in a noticeable location. Technical assistance was provided at the time of the inspection, and as discussed, please correct this rule noncompliance. Awritten 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 11 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; date was missing for Dr initials for immunization 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 numbers 4, 8, 14 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 children were not protected from item(s) or condition(s) which may threaten their health, safety, or well-being as noted in number 1, 12 below: 1.One outlet 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- the map rug corner is curled under 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 employment records in the Ohio Professional Registry (OPR) were not created or maintained as noted in number 7 below: 1. At least one administrator, employee or child care staff member (including substitutes) had not created a profile. 2. At least one administrator, employee or child care staff member had not created an employment record for the program on or before their first day of employment. 3. At least one administrator, employee or child care staff member had not updated changes to positions or roles within five calendar days of the change. 4. The administrator had not assigned at least one employee or child care staff member to the program's organization dashboard. 5. At least one individual's schedule was not current. 6. At least one individual's position or role did not include an applicable group assignment. 7. At least one individual's employment had not been end dated. 8. 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 administrator had not completed the required rules review course provided by this Department for program administrators within the time period defined in 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 not required at this time.”

“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 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 numbers 4, 9, 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.”