Lindsey's Child Care

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 14 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 IHA. 15. Enrollment form for at least one child was not signed by the IHA. 16. Other [ ]. Submit a corrective action plan to verify compliance with the requirements of this rule. Corrective Action Plan Due: 06/21/2025 ir Compliance Not Verified Sd [Rule i Status | Documenting Statement(s), If applicable 5180:2-14-02 In-Home Aide Compliant Qualifications [Rule i Status | Documenting Statement(s), If applicable 5180:2-14-02 In-Home Aide Compliant Responsibilities [Rule i Status | Documenting Statement(s), If applicable 5180:2-14-03 Health Trainings and Compliant Professional Development Requirements [Rule sd Status | Documenting Statement(s), If applicable 5180:2-14-04 Background Checks _| Compliant Pe Page 3 of 5 sor ier Department of ~ Children & Youth |Rule sd Status | Documenting Statement(s), If applicable 5180:2-14-05 Safe and Sanitary Compliant Environment [Rule Status | Documenting Statement(s), If applicable 5180:2-14-05 Handwashing [Compliant Pt [Rule sd Status | Documenting Statement(s), If applicable 5180:2-14-05 Communicable Compliant Diseases [Rule Status | Documenting Statement(s), If applicable 5180:2-14-05 First Aid Kit/Standard Compliant Precautions [Rule Status | Documenting Statement(s), If applicable 5180:2-14-05 Swimming and Water Compliant Safety [Rule sd Status | Documenting Statement(s), If applicable 5180:2-14-05 Swimming Permission _ | Compliant Po [Rule Cd Status | Documenting Statement(s), If applicable 5180:2-14-05 Pets Compliant PO [Rule i Status | Documenting Statements), If applicable 5180:2-14-06 Health Conditions Compliant | [Rule sd Status | Documenting Statement(s), If applicable 5180:2-14-06 Child Record Retention | Compliant and Confidentiality [Rule sd Status | Documenting Statement(s), If applicable 5180:2-14-08 Child Guidance [Compliant | [Rule Status | Documenting Statement(s), If applicable 5180:2-14-07 Medical, Dental, and Compliant General Emergency Requirements/Drills [Rule i Status | Documenting Statement(s), If applicable 5180:2-14-07 Incident/Injury [Compliant | [Rule Status | Documenting Statement(s), If applicable 5180:2-14-08 Supervision [Compliant | [Rule Cd Status | Documenting Statement(s), If applicable 5180:2-14-08 Ratio and Group Sze [Compliant ——<d| SS SCSCS*” [Rule Cd Status | Documenting Statement(s), If applicable Page 4of 5 sor ier Department of ~ Children & Youth 5180:2-14-08 Child Abuse and Compliant Neglect Reporting [Rule Status | Documenting Statement(s), Ifapplicable | 5180:2-14-09 Requirements for Field | Compliant Trip Safety [Rule sd Status | Documenting Statement(s), If applicable 5180:2-14-09 Vehicle Inspections [Compliant —sd|SSSSCS~* [Rule Cd Status | Documenting Statement(s), If applicable 5180:2-14-10 Crib and Playpen Compliant Requirements [Rule Cd Status | Documenting Statement(s), If applicable 5180:2-14-10 Sleeping and Napping Compliant Requirements [Rule sd Status | Documenting Statement(s), If applicable 5180:2-14-10 Evening and Overnight | Compliant Care [Rule sd Status | Documenting Statement(s), If applicable 5180:2-14-11 Meals and Snacks [Compliant Pt [Rule i Status | Documenting Statement(s), If applicable 5180:2-14-12 Medication Compliant Requirements [Rule Status | Documenting Statement(s), If applicable 5180:2-14-13 Infant Daily Care [Compliant [Rule sd Status | Documenting Statement(s), If applicable 5180:2-14-13 Infant Bottle and Food =| Compliant Preparation [Rule sd Status | Documenting Statement(s), If applicable 5180:2-14-13 Diapering [Compliant Page 5of 5

During the inspection, it was determined the IHA's written emergency preparedness and response plan did not meet the requirement or was missing the information in number 3 below: Procedures: 1. The written emergency preparedness and response plan had not been completed. 2. The plan was not dated. 3. The plan was not reviewed with the parent at least annually. Procedures: 4, Weather emergencies and natural disasters which include severe thunderstorms, tornadoes, flash flooding, major snowfall, blizzards, ice storms or earthquakes 5. Emergency evacuations due to hazardous materials and spills, gas leaks or bomb threats including a designated safe site where children can safely remain when evacuated. 6. Outbreaks, epidemics or other infectious disease emergencies. 7. Loss of power, water or heat 8. Emergencies or disasters that occur during the transport of children or when on a field trip or routine trip. 9. Other threatening situations that may pose a health or safety hazard to the children. 10. Shelter in place, disasters or evacuation. 11. Emergency contact information for parents and the IHA. 12. Plan to contact and work with local emergency management officials. 13. The location of supplies. 14. Procedures for gathering necessary supplies for children. 15. Procedures for communicating with parents during loss of communication including loss of phone or internet service. 16. Procedures for assisting infants, toddlers, and children with special needs and/or health conditions. Add the missing information to the emergency preparedness and response plan. Submit a corrective action plan, which includes the missing information, to verify compliance with the requirements of this rule. Corrective Action Plan Due: 06/21/2025

During the inspection, it was determined that the IHA did not have documentation of completion of the prescribed driver training on file. Submit a corrective action plan to verify compliance with the requirements of this rule. Corrective Action Plan Due: 06/21/2025 Page 2 of 5 i or ier Department of ~ Children & Youth