Boiner, Jessica

In review 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 8 and 16 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. Missing start date at program. Submit the program's corrective action plan to the Department to verify compliance with the requirements of this rule. TG i Department of ~ Children & Youth ae Corrective Action Plan Due: 05/15/2026 Rules In-Compliance/Not Verified [Rule i Status | Documenting Statement(s), If applicable 5180:2-13-02 Voluntary Temporary Compliant Closure [Rue Status | Documenting Statement(s), If applicable 5180:2-13-02 License Visible Compliant ee [Rue i Status | Documenting Statement(s), If applicable 5180:2-13-02 Change of Location Compliant re [Rue Status | Documenting Statement(s), If applicable 5180:2-13-02 Information in OCLQS Compliant re [Rule Status | Documenting Statement(s), If applicable — a [Rule i 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 i Status | Documenting Statement(s), If applicable 5180:2-13-04 Fire Safety for Type B Compliant Homes TG i Department of ~ Children & Youth ae a [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 Statements), If applicable ee a | Rule Status | Documenting Statement(s), If applicable 5180:2-13-07 Provider Responsibilities | Compliant re [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 [Rule Status | Documenting Statement(s), If applicable ——e a [Rule Status | Documenting Statement(s), If applicable 5180:2-13-08 Child Care Staff Compliant Requirements P Rule Status | Documenting Statement(s), If applicable ee a P Rule Status | Documenting Statement(s), If applicable ee a sa i Department of ~ Children & Youth ae PRule Status | Documenting Statement(s), If applicable ee a P Rule Status | Documenting Statement(s), If applicable 5180:2-13-10 Professional Compliant Development [Rule Status | Documenting Statement(s), If applicable a a [Rule Cd 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 ee [Rule Status | Documenting Statement(s), If applicable ee ™ ee P Rule Status | Documenting Statement(s), If applicable ee a [Rule i Status | Documenting Statement(s), If applicable ee a [Rule Status | Documenting Statement(s), If applicable 5180:2-13-12 Carbon Monoxide Compliant Detectors - Type B Only PRule Status | Documenting Statement(s), If applicable _— a PRule i Status | Documenting Statement(s), If applicable TG i Department of ~ Children & Youth ae 5180:2-13-13 Clean environment and | Compliant equipment | Rule Status | Documenting Statement(s), If applicable ee a [Rule Status | Documenting Statement(s), If applicable —e a [Rule Status | Documenting Statement(s), If applicable 5180:2-13-13 Toothbrushing Compliant re [Rule Status | Documenting Statement(s), If applicable 5180:2-13-14 Requirements for Field | Compliant and Routine Trips [Rule Cd 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 eo a [Rule Status | Documenting Statements), If applicable ee a [Rule Status | Documenting Statement(s), If applicable ee a [Rule Status | Documenting Statement(s), If applicable 5180:2-13-15 Child Records Retention | Compliant and Confidentiality TG i Department of ~ Children & Youth ae a [Rule i Status | Documenting Statement(s), If applicable 5180:2-13-16 Medical, Dental, and Compliant General Emergency Plan [Rule i Status | Documenting Statement(s), If applicable Ne a [Rue i Status | Documenting Statement(s), If applicable 5180:2-13-16 First Aid Kit/Standard Compliant Precautions [Rule Status | Documenting Statement(s), If applicable 5180:2-13-16 Communicable Diseases | Compliant re [Rule Status | Documenting Statements), If applicable 5180:2-13-16 Incident/Injury Compliant re [Rule Status | Documenting Statement(s), If applicable 5180:2-13-16 Emergency Compliant Preparedness and Response Plan [Rule Status | Documenting Statement(s), If applicable _— a [Rule i Status | Documenting Statement(s), If applicable 5180:2-13-17 Materials and Compliant Equipment [Rule Status | Documenting Statements), If applicable —e a [Rule Status | Documenting Statement(s), If applicable oo a TG i Department of ~ Children & Youth ae [Rule ——S~S~S~SSSSSC*SdS Status —~SS~*dit cmenting Statements), applicable ee a [Rule Status | Documenting Statement(s), If applicable 5180:2-13-21 Evening and Overnight Compliant Care [Rule Status | Documenting Statement(s), If applicable 5180:2-13-20 Sleep and Nap Compliant Requirements | Rule Cd 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 Status | Documenting Statement(s), If applicable 5180:2-13-21 Sanitary Environment Compliant and Hygiene [Rule Status | Documenting Statement(s), If applicable — a P Rule Status | Documenting Statements), If applicable oe a | Rule Status | Documenting Statement(s), If applicable ee a [Rule Status | Documenting Statement(s), If applicable a a PRule i Status | Documenting Statement(s), If applicable TG i Department of ~ Children & Youth (a 5180:2-13-23 Infant Bottle and Food Compliant Preparation | Rule Status | Documenting Statement(s), If applicable oo a [Rule Status | Documenting Statement(s), If applicable a a [Rule i Status | Documenting Statements), If applicable 5180:2-13-24 Swimming Sites Compliant ee [Rule i Status | Documenting Statements), If applicable 5180:2-13-24 Parent Permission for Compliant Swimming [Rule Cd Status | Documenting Statement(s), If applicable 5180:2-13-25 Medication Compliant Requirements

During the inspection, it was determined the program did not meet the requirements for keeping an attendance record as listed in number 2 below: 1. No attendance record was being maintained. 2. The attendance record was not being consistently completed. 3. The record did not include the name of at least one child. 4. The record did not include the birth date of at least one child. 5. The record did not include the assigned group. 6. The record did not include the child’s weekly schedule. 7. The record did not include the time (hours and minutes) of each child’s arrival and departure to the program, including transportation by the program. 8. The original attendance record was not kept at the program for a period of one year. Submit the program’s corrective action plan to the Department to verify compliance with the requirements of this rule. Corrective Action Plan Due: 05/15/2026