Baraka, Beverly A

In review of records, it was determined the CCSM or Substitute CCSM was left alone with children and did not have current valid documentation for training(s) listed in number(s) 12,15 below: 1. First Aid - expired training 2. First Aid - did not have verification of completion of First Aid training 3. First Aid - documentation did not demonstrate the person who provided the training met the trainer qualifications as stated in the rule 4. CPR - expired training 5. CPR - had not taken CPR training 6. CPR - did not have verification of the completion of CPR training 7. CPR - training taken did not include all age groups the program serves and developmental levels of all children in care 8. CPR - documentation did not demonstrate the person who provided the training met the trainer qualifications as stated in the rule 9. CPR - audiovisual or electronic media training taken by staff did not include an in-person component of the training 10. Communicable Disease - expired training 11. Communicable Disease - had not taken CD training 12. Communicable Disease - did not have verification of the completion of the CD training sa i Department of ~ Children & Youth ae 13. Communicable Disease - documentation did not demonstrate the person who provided the training met the trainer qualifications as stated in the rule 14. Child Abuse - expired training 15. Child Abuse - had not taken Child Abuse training 16. Child Abuse - documentation did not demonstrate the person who provided the training met the trainer qualifications as stated in the rule Correct the violation and submit the documentation of current certification with the program's corrective action plan to verify compliance with the requirement of the rule. Corrective Action Plan Due: 02/06/2026

During the inspection, it was determined the provider did not [obtain or maintain the required liability insurance/have a completed JFS 01933 "Liability Insurance Statement for Family Child Care Providers" completed for each child in care]. Correct the violation and submit proof of insurance with the program's corrective action plan to verify compliance with the requirement of the rule. Corrective Action Plan Due: 02/06/2026

In review of the staff records, it was determined that child care staff member(s) or substitute child care staff member(s) did not meet the requirements for completing the online orientation training as noted in number(s) 3 below: 1. The training was not completed within 30 days of starting employment at the program as a child care staff member. 2. No documentation of completing the training after December 31, 2016. 3. Completion of the training was not verified in the OPR. sa i Department of ~ Children & Youth ae 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. Corrective Action Plan Due: 02/06/2026

In review of the staff records, it was determined that the medical statements for those individuals listed on the Employee Record Chart did not include the required information listed below in number(s) 1. 1. A medical statement was not on file; 2. The medical statement(s) on file were not dated within 12 months of the individual'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 individual 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); Submit the program’s corrective action plan, which includes a copy of the completed medical statement, to the Department to verify compliance with the requirements of this rule. Corrective Action Plan Due: 02/06/2026

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 number(s) 1 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: [ ]. Submit the program’s corrective action plan to verify compliance with the requirements of this rule. Corrective Action Plan Due: 02/06/2026

In review of 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) 1, 2 below: 1. No medical was on file for at least one child sa i Department of ~ Children & Youth ae 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. Corrective Action Plan Due: 02/06/2026 Rules In-Compliance/Not Verified PRule Status | Documenting Statement(s), If applicable 5180:2-13-02 Voluntary Temporary Compliant Closure [Rule Status | Documenting Statement(s), If applicable ee a [Rule Status | Documenting Statement(s), If applicable ee a PRue i Status | Documenting Statement(s), If applicable TG i Department of ~ Children & Youth ae ON a | Rule Status | Documenting Statement(s), If applicable a [Rule Status | Documenting Statement(s), If applicable 5180:2-13-03 Inspection Compliant Requirements [Rule Status | Documenting Statement(s), If applicable 5180:2-13-04 Building Requirements Compliant for Type B Homes [Rule Status | Documenting Statement(s), If applicable 5180:2-13-04 Fire Safety for Type B Compliant Homes [Rule Status | Documenting Statement(s), If applicable 5180:2-13-04 Flammable and Compliant Combustible Materials in a Type B Home [Rule Status | Documenting Statement(s), If applicable 5180:2-13-04 Heaters in a Type B Compliant Home [Rule Status | Documenting Statement(s), If applicable ee a | Rule Status | Documenting Statement(s), If applicable 5180:2-13 Written Policies and Compliant Procedures | Rule Status | Documenting Statement(s), If applicable 5180:2-13-07 Type B Provider - Foster | Compliant Parent P Rule Status | Documenting Statement(s), If applicable 5180:2-13-08 Whistle Blower [Compliant TG i Department of ~ Children & Youth ae [Rule sd Status | Documenting Statement(s), If applicable ee a [Rule Status | Documenting Statement(s), If applicable 5180:2-13-10 Professional Compliant Development [Rule Status | Documenting Statement(s), If applicable a a | Rule Status | Documenting Statement(s), If applicable 5180:2-13-11 Outdoor Space Compliant re | Rule Status | Documenting Statement(s), If applicable 5180:2-13-11 Outdoor Equipment Compliant re [Rule i Status | Documenting Statement(s), If applicable a _ ee | Rule i Status | Documenting Statements), If applicable ee a [Rule Status | Documenting Statements), If applicable ee a [Rule Status | Documenting Statement(s), If applicable 5180:2-13-12 Carbon Monoxide Compliant Detectors - Type B Only [Rule Status | Documenting Statement(s), If applicable — a sa i Department of ~ Children & Youth ae PRule Status | Documenting Statement(s), If applicable 5180:2-13-13 Clean environment and | Compliant equipment [Rule Status | Documenting Statement(s), If applicable a a [Rule Status | Documenting Statements), If applicable ee a [Rule sd Status | Documenting Statement(s), If applicable 5180:2-13-13 Toothbrushing Compliant re [Rule Status | Documenting Statement(s), If applicable 5180:2-13-14 Ratio and Supervision Compliant for Field and Routine Trips [Rule Status | Documenting Statement(s), If applicable 5180:2-13-14 Driver Requirements Compliant re [Rule Status | Documenting Statement(s), If applicable ee a [Rule Status | Documenting Statement(s), If applicable — a [Rule Status | Documenting Statement(s), If applicable ee a P Rule Status | Documenting Statement(s), If applicable 5180:2-13-15 Child Records Retention | Compliant and Confidentiality PRule i Status | Documenting Statement(s), If applicable TG i Department of ~ Children & Youth ae 5180:2-13-16 Medical, Dental, and Compliant General Emergency Plan [Rule i Status | Documenting Statement(s), If applicable a a [Rule Status | Documenting Statement(s), If applicable 5180:2-13-16 First Aid Kit/Standard Compliant Precautions [Rule i Status | Documenting Statement(s), If applicable 5180:2-13-16 Communicable Diseases | Compliant re [Rule Status | Documenting Statement(s), If applicable 5180:2-13-16 Incident/Injury Compliant re [Rule Status | Documenting Statements), If applicable 5180:2-13-16 Emergency Compliant Preparedness and Response Plan [Rule i Status | Documenting Statement(s), If applicable ee _ ee [Rule i Status | Documenting Statement(s), If applicable 5180:2-13-17 Materials and Compliant Equipment [Rue Status | Documenting Statement(s), If applicable — a [Rule i Status | Documenting Statement(s), If applicable ee a [Rule i Status | Documenting Statement(s), If applicable TG i Department of ~ Children & Youth ae a [Rule Status | Documenting Statement(s), If applicable — a [Rule Status | Documenting Statement(s), If applicable 5180:2-13-21 Evening and Overnight Compliant Care [Rue i Status | Documenting Statement(s), If applicable 5180:2-13-20 Sleep and Nap Compliant Requirements | Rule Status | Documenting Statement(s), If applicable 5180:2-13-19 Child Guidance Compliant re [Rule Status | Documenting Statement(s), If applicable 5180:2-13-20 Crib and Playpen Compliant Requirements [Rule Cd Status | Documenting Statement(s), If applicable 5180:2-13-21 Sanitary Environment Compliant and Hygiene [Rule Status | Documenting Statement(s), If applicable — a [Rule i Status | Documenting Statement(s), If applicable ee a | Rule Status | Documenting Statement(s), If applicable ee a P Rule Status | Documenting Statement(s), If applicable ee a TG i Department of ~ Children & Youth ae | Rule i Status | Documenting Statement(s), If applicable —e a [Rule Status | Documenting Statement(s), If applicable ee a [Rule Status | Documenting Statement(s), If applicable oe a [Rue i Status | Documenting Statement(s), If applicable 5180:2-13-24 Parent Permission for Compliant Swimming [Rule Status | Documenting Statement(s), If applicable 5180:2-13-25 Medication Compliant Requirements

During the inspection, it was determined that written instructions for feeding the infants noted on the Children Record Review form were [not on file/updated], as required by this rule. Correct the violation and submit the program's corrective action plan to verify compliance with the requirement of the rule. Corrective Action Plan Due: 02/06/2026