Jefferies, Centenial

During the inspection, it was determined pets at the program were not properly housed or cared for or posed a threat to the safety or health of the children as noted in number(s) #6 below: 1. The animal’s cage was dirty with feces. 2. The aquarium was unclean. 3. The litter box was dirty with feces. 4. A pet posed a threat to the safety of a child in that [ ]. 5. A pet requiring a license did not have a current license. 6. Proper inoculation records were not on file at the program for a pet requiring inoculations. 7. Children were exposed to the pet's urine and/or feces. 8. Other [ ]. A pet that poses a threat to the children shall not be at the program. All pets at the program must receive proper care and housing. Submit the program’s corrective action plan to verify compliance with the requirements of this rule. Corrective Action Plan Due: 04/08/2026 Rules In-Compliance/Not Verified [Rule Status | Documenting Statement(s), If applicable 5180:2-13-02 Voluntary Temporary Compliant Closure PRule id Status | Documenting Statement(s), Ifapplicable | TG i Department of ~ Children & Youth ae ee a | Rule Status | Documenting Statement(s), If applicable a [Rule Status | Documenting Statement(s), If applicable —, a [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 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 P Rule Status | Documenting Statement(s), If applicable 5180:2-13-07 Provider Responsibilities | Compliant | TG i Department of ~ Children & Youth ae [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 ——o a | Rule Status | Documenting Statement(s), If applicable 5180:2-13-08 Child Care Staff Compliant Requirements [Rule Status | Documenting Statement(s), If applicable 5180:2-13-08 Whistle Blower Compliant re [Rule Status | Documenting Statement(s), If applicable 5180:2-13-09 Background Checks Compliant ee | Rule i Status | Documenting Statements), If applicable eo a [Rule Status | Documenting Statement(s), If applicable 5180:2-13-10 Professional Compliant Development | Rule Status | Documenting Statement(s), If applicable es a [Rule Status | Documenting Statement(s), If applicable ae 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 ee a [Rue Status | Documenting Statement(s), If applicable Oe a [Rule Cd Status | Documenting Statement(s), If applicable 5180:2-13-12 Safe Environment 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 5180:2-13-13 Clean environment and | Compliant equipment P Rule Status | Documenting Statement(s), If applicable ee a [Rule Status | Documenting Statement(s), If applicable 5180:2-13-15 Child Medical and Compliant Enrollment Records [Rule Status | Documenting Statement(s), If applicable oe a P Rule Status | Documenting Statement(s), If applicable ee a PRule i Status | Documenting Statement(s), If applicable TG i Department of ~ Children & Youth ae 5180:2-13-14 Requirements for Field Compliant and Routine Trips | 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 —s a [Rule i 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 i 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 [Rule Status | Documenting Statement(s), If applicable ee a [Rue Status | Documenting Statement(s), If applicable 5180:2-13-16 First Aid Kit/Standard Compliant Precautions [Rule Status | Documenting Statement(s), If applicable —— a [Rule Status | Documenting Statement(s), If applicable TG i Department of ~ Children & Youth ae a [Rule Status | Documenting Statement(s), If applicable 5180:2-13-16 Emergency Compliant Preparedness and Response Plan [Rule Status | Documenting Statement(s), If applicable —e a [Rule i Status | Documenting Statements), If applicable 5180:2-13-17 Materials and Compliant Equipment | Rule Cd 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 Cd Status | Documenting Statement(s), If applicable a = ee PRule Status | Documenting Statement(s), If applicable —e 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 P Rule Status | Documenting Statement(s), If applicable ee a TG i Department of ~ Children & Youth ae [Rule SCS Status ——SCSCS~S Do curenting Statements), Paplcable 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 ON a | Rule Cd Status | Documenting Statement(s), If applicable 5180:2-13-22 Food Handling Compliant re | Rule Status | Documenting Statement(s), If applicable Oe “™ ee [Rule 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 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 PRule i Status | Documenting Statement(s), If applicable TG i Department of ~ Children & Youth (a 5180:2-13-24 Parent Permission for Compliant Swimming | Rule Status | Documenting Statement(s), If applicable 5180:2-13-25 Medication Compliant Requirements

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) below: Pg.3 (20-31) and Pg.4 (32-44) 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. sa i Department of hj Children & Youth 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: 04/08/2026 TG i Department of ~ Children & Youth PO Low Risk Non-Compliances