Cox-Wade, Lisa

During the inspection, it was determined the information in number(s) 4 below was not up to date in the Ohio Child Care Licensing and Quality System: sa i Department of hj Children & Youth 1. Mailing Address; 2. Telephone Number; 3. Email Address; 4. Days and Hours of Operation; 5. Services Offered; 6. Name of Program, If applicable. 7. Private pay rates. Submit the program's corrective action plan to verify compliance with the requirements of this rule. Corrective Action Plan Due: 04/10/2026

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(s) 9 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: 04/10/2026

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) 2 below: 1. No medical was on file for at least one child 2. Medical(s) on file was not updated every 13 months sa i Department of ~ Children & Youth ae 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: 04/10/2026 Rules In-Compliance/Not Verified [Rule Status | Documenting Statement(s), If applicable 5180:2-13-02 Voluntary Temporary Compliant Closure | Rule Cd Status | Documenting Statement(s), If applicable ee a [Rule Status | Documenting Statement(s), If applicable ee a [Rule Status | Documenting Statement(s), If applicable 5180:2-13-02 Provider Medical [Compliant Pd sa i Department of ~ Children & Youth ae [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 5180:2-13-07 Staff Records Compliant re [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 Status | Documenting Statement(s), If applicable TG i Department of ~ Children & Youth ae a [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 Status | Documenting Statements), If applicable Oe a | Rule Status | Documenting Statement(s), If applicable 5180:2-13-10 Professional Compliant Development [Rule Status | Documenting Statement(s), If applicable 5180:2-13-11 Indoor Space Compliant re [Rule Cd Status | Documenting Statement(s), If applicable 5180:2-13-11 Outdoor Space Compliant ee PRule Status | Documenting Statement(s), If applicable — a [Rule Status | Documenting Statements), If applicable ee a | Rule Status | Documenting Statement(s), If applicable ee a P Rule Status | Documenting Statement(s), If applicable