Little Buckeye Learning Center-Avon Lake

“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 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. 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 program was not providing a clean and healthy environment, furniture, materials and equipment as required by Appendix A, as noted in number(s) 6 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 [ ]. 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 an outdoor play area was used which was not protected from traffic and other hazards by a fence in good repair, or other barrier. Although the fence or natural barrier was not meeting the rule requirements, it was determined to not present an immediate risk for a child to be able to leave the playground. The fence or gate was not in good repair and/or being used inappropriately as noted in number(s) 12 below: 1. The fencing had missing slat boards. 2. The fencing was broken. 3. The fencing was loose. 4. The fencing was rotting. 5. The gate was broken and did not close. 6. The gate was locked. 7. The latch on the gate was broken. 8. The latch was easily opened by children on the playground. 9. The latch was not engaged to prevent children from opening the gate. 10. The gate had no latch. 11. There were bolts with more than two threads exposed along a fence line or gate on a playground. 12. Other- Wood fencing was rotting preventing the gate latch from latching. Submit the program’s corrective action plan to the Department to verify compliance with the requirements of this rule.”

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

“In review of the staff records, it was determined that at least one child care staff member had not completed required health and safety training as noted in number(s) 7 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. 7. Other- At least one additional staff must have CPR training for coverage. 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.”