Kiddie Zone

During the inspection, it was determined that children were left unattended and not supervised in that the child came to the door 3 times when HCJFS was knocking on the door and provider did not notice for 10 minutes. Submit the program’s corrective action plan to verify compliance with the requirements of this rule. Corrective Action Plan Due: 12/21/2025 Low Risk Non-Compliances

During the inspection, it was determined an unprotected open flame was used while care was being provided. Correct the violation and submit the program's corrective action plan to verify compliance with the requirement of the rule. Corrective Action Plan Due: 12/21/2025

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 4 & 6 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 [ ] TG i Department of ~ Children & Youth ae Submit the program's corrective action plan to the Department to verify compliance with the requirements of this rule. Corrective Action Plan Due: 12/21/2025 Rules In-Compliance/Not Verified [Rule Status | Documenting Statements), If applicable 5180:2-13-02 Voluntary Temporary Compliant Closure [Rule Status | Documenting Statement(s), If applicable 5180:2-13-02 License Visible Compliant re [Rule Status | Documenting Statement(s), If applicable 5180:2-13-02 Change of Location Compliant re [Rule Status | Documenting Statement(s), If applicable —— a [Rule Status | Documenting Statement(s), If applicable — a [Rule Status | Documenting Statement(s), If applicable 5180:2-13-03 Inspection Compliant Requirements P Rule Status | Documenting Statement(s), If applicable 5180:2-13-04 Building Requirements Compliant for Type B Homes PRue i Status | Documenting Statement(s), If applicable TG i Department of ~ Children & Youth ae 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 a a [Rule i Status | Documenting Statements), If applicable 5180:2-13-07 Provider Responsibilities | Compliant ee | Rule Cd Status | Documenting Statement(s), If applicable 5180:2-13 Written Policies and Compliant Procedures [Rule i Status | Documenting Statement(s), If applicable 5180:2-13-07 Type B Provider - Foster | Compliant Parent [Rule Status | Documenting Statement(s), If applicable 5180:2-13-08 Child Care Staff Compliant Requirements [Rule Status | Documenting Statement(s), If applicable a | Rule Status | Documenting Statement(s), If applicable ee a | Rule Status | Documenting Statement(s), If applicable ee a P Rule Status | Documenting Statement(s), If applicable 5180:2-13-10 Health Training [Compliant TG i Department of ~ Children & Youth ae [Rule Status | Documenting Statement(s), If applicable 5180:2-13-10 Professional Compliant Development [Rule Status | Documenting Statement(s), If applicable —e a [Rule Status | Documenting Statement(s), If applicable ee a | Rule Status | Documenting Statement(s), If applicable 5180:2-13-11 Outdoor Space 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 ee | Rule sd Status | Documenting Statements), If applicable ee a [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 Statement(s), If applicable 5180:2-13-13 Clean environment and | Compliant equipment sa i Department of ~ Children & Youth ae P Rule Status | Documenting Statement(s), If applicable oo a [Rule Status | Documenting Statement(s), If applicable 5180:2-13-14 Requirements for Field Compliant and Routine Trips [Rule Status | Documenting Statement(s), If applicable ee a [Rule Cd Status | Documenting Statement(s), If applicable 5180:2-13-13 Handwashing Compliant re [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 — a | Rule 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 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 Cd Status | Documenting Statement(s), If applicable ——e “™ ee [Rule Status | Documenting Statement(s), If applicable 5180:2-13-17 Materials and Compliant Equipment [Rule Status | Documenting Statement(s), If applicable ee a [Rule i Status | Documenting Statements), If applicable eee a [Rule Status | Documenting Statement(s), If applicable ee a [Rule Status | Documenting Statement(s), If applicable 5180:2-13-21 Sanitary Environment Compliant and Hygiene TG i Department of ~ Children & Youth ae a [Rule Status | Documenting Statement(s), If applicable 5180:2-13-20 Sleep and Nap Compliant Requirements [Rule Status | Documenting Statement(s), If applicable 5180:2-13-20 Crib and Playpen Compliant Requirements [Rule i Status | Documenting Statements), If applicable 5180:2-13-21 Evening and Overnight Compliant Care | Rule i Status | Documenting Statement(s), If applicable ~— “™ ee [Rule Status | Documenting Statement(s), If applicable 5180:2-13-22 Food Handling Compliant re [Rule sd Status | Documenting Statement(s), If applicable 5180:2-13-23 Infant Daily Care Compliant ee [Rule Status | Documenting Statement(s), If applicable 5180:2-13-23 Infant Bottle and Food Compliant Preparation [Rule Status | Documenting Statements), If applicable oe a | Rule Status | Documenting Statement(s), If applicable ee a P Rule Status | Documenting Statement(s), If applicable — a TG i Department of ~ Children & Youth (a | Rule Cd 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 the JFS 01201 "Dental First Aid" was not completed. Correct the violation and submit the program's corrective action plan to verify compliance with the requirement of the rule. Corrective Action Plan Due: 12/21/2025 sa i Department of hj Children & Youth

During the inspection, it was determined the program did not meet the requirements for keeping an attendance record as listed in number 6 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: 12/21/2025

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: 12/21/2025