Martin, Oceola

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 8, 15 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: 03/26/2026 Rules In-Compliance/Not Verified TG i Department of ~ Children & Youth ae | Rule Status | Documenting Statement(s), If applicable 5180:2-13-02 Voluntary Temporary Compliant Closure [Rule Status | Documenting Statement(s), If applicable — a [Rule Status | Documenting Statement(s), If applicable ee a [Rule i Status | Documenting Statements), If applicable 5180:2-13-02 Informationin OCLQS —_| Compliant re P 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 sa i Department of ~ Children & Youth ae P Rule Status | Documenting Statement(s), If applicable ee a [Rule Status | Documenting Statement(s), If applicable a [Rule Status | Documenting Statements), If applicable 5180:2-13 Written Policies and Compliant Procedures [Rule Cd 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 Employee Requirements | Compliant ee [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 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 Professional Compliant Development PRule i Status | Documenting Statement(s), If applicable TG i Department of ~ Children & Youth ae ae a | Rule Status | Documenting Statement(s), If applicable en a [Rule Status | Documenting Statement(s), If applicable — a [Rule Status | Documenting Statement(s), If applicable ee ~™ ee [Rule Status | Documenting Statement(s), If applicable 5180:2-13-12 Safe Equipment Compliant re [Rule i Status | Documenting Statement(s), If applicable 5180:2-13-12 Safe Environment Compliant re [Rule i 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 Statements), If applicable 5180:2-13-13 Clean environment and | Compliant equipment [Rule Status | Documenting Statement(s), If applicable ee a [Rule Status | Documenting Statement(s), If applicable TG i Department of ~ Children & Youth ae a [Rule Status | Documenting Statement(s), If applicable ee a [Rule Status | Documenting Statement(s), If applicable 5180:2-13-14 Requirements for Field Compliant and Routine Trips [Rule i Status | Documenting Statements), 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 5180:2-13-14 Vehicle Inspections Compliant re [Rule Status | Documenting Statement(s), If applicable 5180:2-13-14 Vehicle Requirements Compliant ee [Rule Status | Documenting Statement(s), If applicable ee a [Rule Status | Documenting Statements), 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 P Rule Status | Documenting Statement(s), If applicable ——oe a TG i Department of ~ Children & Youth ae [Rule SCS Status SD curenting Statements), applicable —— a [Rule Status | Documenting Statement(s), If applicable — a [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 5180:2-13-18 Group Size and Ratios Compliant re [Rule Status | Documenting Statement(s), If applicable oo a P Rule Status | Documenting Statements), If applicable ee a | Rule Status | Documenting Statement(s), If applicable 5180:2-13-21 Evening and Overnight Compliant Care PRule Status | Documenting Statement(s), If applicable 5180:2-13-20 Sleep and Nap Compliant Requirements P Rule Status | Documenting Statement(s), If applicable 5180:2-13-19 Child Guidance [Compliant TG i Department of ~ Children & Youth ae [Rule Status | Documenting Statement(s), If applicable 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 a | Rule Status | Documenting Statement(s), If applicable 5180:2-13-22 Food Handling Compliant re [Rule i Status | Documenting Statement(s), If applicable — _ ee [Rule Status | Documenting Statement(s), If applicable 5180:2-13-23 Infant Daily Care Compliant ee | Rule i Status | Documenting Statements), If applicable 5180:2-13-23 Infant Bottle and Food Compliant Preparation [Rule Status | Documenting Statement(s), If applicable oe a | Rule Status | Documenting Statement(s), If applicable a a [Rule Status | Documenting Statement(s), If applicable —~ a TG i Department of ~ Children & Youth (a PRule Status | Documenting Statement(s), If applicable 5180:2-13-24 Parent Permission for Compliant Swimming [Rule i Status | Documenting Statements), If applicable 5180:2-13-25 Medication Compliant Requirements

During the inspection, it was determined the program did not meet the requirements for keeping an attendance record as listed in number 2 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: 03/26/2026