Ms C's Kindercare Childcare

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: 04/05/2026

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) #1 below: 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: 04/05/2026 sa i Department of ~ Children & Youth Pe Low Risk Non-Compliances

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(s) #2 and #4 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 TG i Department of ~ Children & Youth ae 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: 04/05/2026 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 5180:2-13-02 License Visible Compliant ee [Rule Status | Documenting Statements), If applicable 5180:2-13-02 Change of Location Compliant re [Rule Status | Documenting Statements), If applicable —,, a [Rule i Status | Documenting Statement(s), If applicable ee 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 TG i Department of ~ Children & Youth ae P 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 5180:2-13-07 Staff Records Compliant re [Rule i Status | Documenting Statement(s), If applicable 5180:2-13 Written Policies and Compliant Procedures [Rule Status | Documenting Statements), If applicable 5180:2-13-07 Type B Provider - Foster | Compliant Parent [Rule Status | Documenting Statements), If applicable 5180:2-13-08 Employee Requirements | Compliant re [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 PRule Status | Documenting Statement(s), If applicable ee a TG i Department of ~ Children & Youth ae [Rule SSCS Status SCS Documenting Statements), Papal ee a [Rule Status | Documenting Statement(s), If applicable 5180:2-13-10 Professional Compliant Development [Rule Status | Documenting Statement(s), If applicable ae a | 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 re [Rule Status | Documenting Statement(s), If applicable ee ~™ ee [Rule Status | Documenting Statement(s), If applicable ee a P Rule 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 PRule i Status | Documenting Statement(s), If applicable TG i Department of ~ Children & Youth ae 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 —e a [Rule Status | Documenting Statement(s), If applicable 5180:2-13-13 Toothbrushing Compliant re [Rule Status | Documenting Statement(s), If applicable 5180:2-13-14 Requirements for Field | Compliant and Routine Trips [Rule Cd 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 eo a [Rule Status | Documenting Statements), If applicable ee a [Rule Status | Documenting Statement(s), If applicable 5180:2-13-15 Child Records Retention | Compliant and Confidentiality [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 First Aid Kit/Standard Compliant Precautions [Rule Status | Documenting Statement(s), If applicable Ne a [Rule i Status | Documenting Statements), If applicable ee 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 “em ™ ee [Rule sd Status | Documenting Statement(s), If applicable 5180:2-13-17 Materials and Compliant Equipment PRule Status | Documenting Statement(s), If applicable — a [Rule Status | Documenting Statements), If applicable oe a | Rule Status | Documenting Statement(s), If applicable eee a P Rule Status | Documenting Statement(s), If applicable oo a Care TG i Department of ~ Children & Youth ae [Rule SCS Status ——~SCS~S Do curenting Statements), applicable 5180:2-13-20 Sleep and Nap Compliant Requirements [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 | Rule Status | Documenting Statement(s), If applicable 5180:2-13-22 Meals and Snacks Compliant re | Rule Status | Documenting Statement(s), If applicable 5180:2-13-22 Food Handling Compliant re [Rule Status | Documenting Statement(s), If applicable ee ~™ ee [Rule Status | Documenting Statement(s), If applicable — a P Rule Status | Documenting Statements), If applicable 5180:2-13-23 Infant Bottle and Food Compliant Preparation | Rule Status | Documenting Statement(s), If applicable —e a [Rule Status | Documenting Statement(s), If applicable ee a P Rule Status | Documenting Statement(s), If applicable 5180:2-13-24 Swimming Sites [Compliant TG i Department of ~ Children & Youth (a [Rule sd 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 requirements for the JFS 01242 "Medical, Dental and General Emergency Plan" were not followed as noted in number(s) #7below: 1. The plan was not posted on each level of the home used for child care. 2. The name, address and telephone number of the program were not complete. 3. The location of the first aid kit, fire extinguisher and fire alarm system, fire alarm pull stations and electrical circuit box were not complete. sa i Department of ~ Children & Youth ae 4. The telephone number for emergency squad, fire department hospital, poison control program, public children services agency, local health department, local emergency management agency and police department were not complete. 5. Location of children's records was not complete. 6. Emergency information including any medications or supplies needed i the event of an evacuation was not complete. 7. The current version of the prescribed form was not used. 8. The plan was not implemented when necessary in that [ ]. Submit the program’s corrective action plan to the Department to verify compliance with the requirements of this rule. Corrective Action Plan Due: 04/05/2026

During the inspection, it was determined the JFS 01201 "Dental First Aid" was not completed/posted. Correct the violation and submit the program's corrective action plan to verify compliance with the requirement of the rule. Corrective Action Plan Due: 04/05/2026

During the inspection, it was determined the program did not meet the requirements for keeping an attendance record as listed in number(s) #6 and #7 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: 04/05/2026

During the inspection, it was determined that sheets, mattresses and/or mattress covers did not meet the rule requirement as noted in number(s) #3 below: 1. At least one crib or playpen did not have a sheet. 2. At least one sheet was too large. 3. At least one sheet was too small. 4. At least one sheet was torn. 5. The mattress was not at least one and one-half inches thick. 6. The mattress was not firm. 7. There was space between the mattress and the sides and end panels of the crib or playpen which exceeded one and one-half inches. 8. The mattress cover was not waterproof. 9. The mattress cover was torn. TG i Department of ~ Children & Youth ae 10. Other: [ ]. Submit the program’s corrective action plan to the Department to verify compliance with the requirements of this rule. Corrective Action Plan Due: 04/05/2026