Johnson, Sherry

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 2 below. The potentially hazardous substance or item that posed a risk to children was determined to be accessible to children in the room where water heater is located. 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: [ ]. sa i Department of hj Children & Youth 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: 05/17/2026

Children in care shall be protected from any items and conditions which threaten their health, safety, and well-being. During the inspection, it was determined the program did not protect children from an unsafe item or condition or equipment due to the following number 6 below: 1. Pull cord(s) on the window blind(s). 2. Extension cord(s); electrical cord(s) attached to an object that could result in a severe injury if pulled. 3. Stacked tables. 4. Folding tables. 5. Matches and/or a lighter. 6. Power tool(s). 7. Live wires. 8. Stove(s) that are either on or able to be turned on by a child. 9. Asbestos. 10. Traffic. 11. A body of water. 12. A well. 13. Environmental hazard(s) confirmed by local authorities having jurisdiction over the hazard. 14. A crockpot used to heat bottles. 15. Immediate access to a knife. 16. Large or heavy pieces of shelving units are not securely anchored to the wall. 17. Marijuana was accessible to children. 18. Other [ ]. Any hazardous equipment must be removed, replaced, or repaired and any hazardous condition must be corrected and must be made inaccessible to children. Provide staff training. Submit the program’s corrective action plan, which includes a statement that the item or condition has been removed and a statement that training was provided, to the Department to verify compliance with the requirements of this rule. Corrective Action Plan Due: 05/17/2026 looms o2satessaniayénvroment TG i Department of ~ Children & Youth ae

During the inspection, it was determined that the Type B Home programs smoke alarm on the main level did not have the battery pushed in on the alarm. A working smoke alarm must be placed, installed, tested, and maintained in accordance with manufacturer's recommendations. Submit the program’s corrective action plan to verify compliance with this rule. Corrective Action Plan Due: 05/17/2026

During the inspection, it was determined the provider did not 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: 05/17/2026

During the inspection, it was determined that the Type B Home carbon monoxide detector on the main level did not have the battery pushed in on the alarm. A working carbon monoxide detector must be placed, installed, tested, and maintained in accordance with manufacturer's recommendations. Submit the program’s corrective action plan to verify compliance with this rule. Corrective Action Plan Due: 05/17/2026 Low Risk Non-Compliances

During the inspection, it was determined the water temperature was 130 degrees in the bathroom. This temperature exceeds the requirement of remaining below 120 degrees Fahrenheit. Correct the violation and submit the program's corrective action plan to verify compliance with the requirement of the rule. Corrective Action Plan Due: 05/17/2026 sa i Department of ~ Children & Youth ae

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 10, 4, 12, 13, 1, 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 TG i Department of ~ Children & Youth ae 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. Child name missing from top of each enrollment page Submit the program's corrective action plan to the Department to verify compliance with the requirements of this rule. Corrective Action Plan Due: 05/17/2026 Rules In-Compliance/Not Verified [Rule Status | Documenting Statement(s), If applicable 5180:2-13-02 Voluntary Temporary Compliant Closure [Rule Status | Documenting Statement(s), If applicable ee i [Rule Status | Documenting Statement(s), If applicable ee a [Rule Status | Documenting Statement(s), If applicable —, a [Rule Status | Documenting Statement(s), If applicable TG i Department of ~ Children & Youth ae Ne 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 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 Cd Status | Documenting Statement(s), If applicable 5180:2-13-07 Staff Records 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 ——— 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 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 ee 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 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 sd Status | Documenting Statements), If applicable ee a [Rule Status | Documenting Statement(s), If applicable ee a | Rule Status | Documenting Statement(s), If applicable _— a [Rule Status | Documenting Statement(s), If applicable 5180:2-13-13 Clean environment and | Compliant equipment 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 [Rule Status | Documenting Statement(s), If applicable a a [Rule Cd Status | Documenting Statement(s), If applicable 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 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 [Rule i Status | Documenting Statements), 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 ee 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 5180:2-13-23 Infant Bottle and Food Compliant Preparation 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 the program's weekly menu did not meet the requirement as noted in number 3 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: 05/17/2026