Cooper, Twila

During the inspection, a potentially hazardous item or toxic substance was used or stored where children present had access to it as noted in number 14 below. The potentially hazardous substance or item that posed a risk to children was determined to be accessible to children, hydro-peroxide in the bathroom. 1. Bleach. 2. Cleaning agent. 3. Fish tank chemicals. 4. Gasoline. 5. Pesticide. 6. Poison, including insect/rodent poison. 7. Flammable substance. 8. Windshield washer fluid. 9. Aerosol cans. 10. A lawn mower. 11. A weed trimmer. 12. Hedge trimmers. 13. A snow blower. 14. Other potentially hazardous substance, equipment or machinery: A toxic chemical, hydro-peroxide was located in the bathroom, on top of the toilet lid, and was accessible to children that were present in the home while at my visit. sa i Department of ~ Children & Youth ae Provide staff training. Submit the program’s corrective action plan, which includes a statement that the potentially hazardous substance or item is no longer accessible to children and/or children will not be outside when machinery is in use and a statement that training was provided, to the Department to verify compliance with the requirements of this rule. Corrective Action Plan Due: 03/21/2026

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 1 & 7 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. sa i Department of hj Children & Youth 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: 03/08/2026

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 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. sa i Department of hj Children & Youth 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. A child 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. Corrective Action Plan Due: 03/08/2026 sa i Department of ~ Children & Youth Low Risk Non-Compliances

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 number 4, 6, 7, 8, 12, 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 [ ] Submit the program's corrective action plan to the Department to verify compliance with the requirements of this rule. Corrective Action Plan Due: 03/08/2026 sa i Department of ~ Children & Youth ae Rules In-Compliance/Not Verified P Rule Status | Documenting Statement(s), If applicable 5180:2-13-02 Voluntary Temporary Compliant Closure [Rule i Status | Documenting Statement(s), If applicable ee a [Rule Status | Documenting Statements), If applicable 5180:2-13-02 Change of Location Compliant re [Rule Status | Documenting Statement(s), If applicable 5180:2-13-02 Informationin OCLQS —_| Compliant re [Rule Status | Documenting Statement(s), If applicable 5180:2-13-02 Provider Medical Compliant re [Rule Status | Documenting Statement(s), If applicable 5180:2-13-03 Inspection Compliant Requirements [Rule Status | Documenting Statementi(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 PRue i Status Documenting Statement(s), If applicable TG i Department of ~ Children & Youth ae 5180:2-13-04 Heaters in a Type B Compliant Home | Rule Status | Documenting Statement(s), If applicable a a [Rule Status | Documenting Statement(s), If applicable — 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 [Rule sd Status | Documenting Statement(s), If applicable 5180:2-13-08 Employee Requirements | Compliant re [Rule Status | Documenting Statement(s), If applicable 5180:2-13-08 Child Care Staff Compliant Requirements [Rule Status | Documenting Statement(s), If applicable ee a [Rule i Status | Documenting Statements), If applicable ee a [Rule Status | Documenting Statement(s), If applicable ee a [Rule Status | Documenting Statement(s), If applicable 5180:2-13-10 Professional Compliant Development TG i Department of ~ Children & Youth ae a [Rule Status | Documenting Statement(s), If applicable ee a [Rule Status | Documenting Statement(s), If applicable ee a [Rule i Status | Documenting Statement(s), If applicable 5180:2-13-11 Outdoor Equipment Compliant re | Rule Status | Documenting Statement(s), If applicable ee “™ ee [Rule Status | Documenting Statement(s), If applicable 5180:2-13-12 Safe Equipment Compliant re [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 [Rule Status | Documenting Statements), If applicable 5180:2-13-13 Clean environment and | Compliant equipment | Rule Status | Documenting Statement(s), If applicable ee a P Rule Status | Documenting Statement(s), If applicable —e a TG i Department of ~ Children & Youth ae [Rule SCS Status SCS Documenting Statements), Paplicable en a [Rule i 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 ee a | Rule Status | Documenting Statement(s), If applicable 5180:2-13-14 Vehicle Inspections Compliant re | Rule Status | Documenting Statement(s), If applicable 5180:2-13-14 Vehicle Requirements Compliant re [Rule Status | Documenting Statement(s), If applicable 5180:2-13-15 Child Records Retention | Compliant and Confidentiality [Rule Status | Documenting Statement(s), If applicable 5180:2-13-16 Medical, Dental, and Compliant General Emergency Plan [Rue i Status | Documenting Statement(s), If applicable — a | Rule Status | Documenting Statement(s), If applicable 5180:2-13-16 First Aid Kit/Standard Compliant Precautions P Rule Status | Documenting Statement(s), If applicable ee a P Rule Status | Documenting Statement(s), If applicable 5180:2-13-16 Incident/Injury [Compliant TG i Department of ~ Children & Youth ae [Rule Status | Documenting Statement(s), If applicable 5180:2-13-16 Emergency Compliant Preparedness and Response Plan [Rule Status | Documenting Statement(s), If applicable “oe a [Rule Status | Documenting Statement(s), If applicable 5180:2-13-17 Materials and Compliant Equipment | Rule Status | Documenting Statement(s), If applicable 5180:2-13-18 Group Size and Ratios Compliant re | Rule Status | Documenting Statement(s), If applicable 5180:2-13-18 Attendance Compliant re [Rule i Status | Documenting Statement(s), If applicable oo _ ee | Rule i Status | Documenting Statements), If applicable eee a [Rule Status | Documenting Statements), 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 Status | Documenting Statement(s), If applicable ee a TG i Department of ~ Children & Youth ae P Rule Status | Documenting Statement(s), If applicable 5180:2-13-21 Sanitary Environment Compliant and Hygiene P Rule Status | Documenting Statement(s), If applicable ee a [Rule Status | Documenting Statement(s), If applicable a a [Rule sd Status | Documenting Statement(s), If applicable 5180:2-13-23 Infant Daily Care Compliant re [Rule Status | Documenting Statement(s), If applicable 5180:2-13-23 Infant Bottle and Food Compliant Preparation [Rule Status | Documenting Statement(s), If applicable ™ ee P Rule Status | Documenting Statement(s), If applicable ee a [Rule i Status | Documenting Statement(s), If applicable —~ a [Rule Status | Documenting Statement(s), If applicable 5180:2-13-24 Parent Permission for Compliant Swimming PRule Status | Documenting Statement(s), If applicable 5180:2-13-25 Medication Compliant Requirements 4 i Department of ~ Children & Youth

During the inspection, it was determined that an infant was placed in a crib with the following suffocation or strangulation hazard. | viewed a child sleeping in a crib with an large oversized pillow while, | was in the home during my inspection. Correct the violation and submit the program's corrective action plan to verify compliance with the requirement of the rule. Corrective Action Plan Due: 03/21/2026

During the inspection, it was determined that the program's weekly menu did not meet the requirement as noted in number 4 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. Submit the program's corrective action plan to verify compliance with the requirement of the rule. Corrective Action Plan Due: 03/08/2026