Mushatt, Angela

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: 11/27/2025

During the inspection, it was determined the current licensing rules were not available on the premises. Correct the violation and submit the program's corrective action plan to verify compliance with the requirement of the rule. Corrective Action Plan Due: 11/27/2025

In review of the staff records, it was determined that background check requirements had not been followed, for the individual listed on the Employee Record Chart, as noted in number 2 below: 1. The JFS 01176 “Program Notification of Background Check Review for Child Care” the program received from the Department was not on file and the individual was not left alone with children. 2. The JFS 01177 “Individual Notification of Background Check Review for Child Care” was on file instead of the JFS 01176. 3. The JFS 01176 on file was for a different program. Submit the program’s corrective action plan, which includes a statement that the correct form is now on file, to verify compliance with the requirements of this rule. Corrective Action Plan Due: 11/27/2025

During the inspection, it was determined the gate used was not safe as noted in number 1 below: 1. Anchored; 2. Mounted; 3. Free of Entrapment; 4. The Approved Style; 5. Other [ ]. Correct the violation and submit the program's corrective action plan to verify compliance with the requirement of the rule." Corrective Action Plan Due: 11/27/2025

During the inspection, it was determined several toothbrushes were not labeled with the child's name. Submit the program’s corrective action plan to verify compliance with the requirements of this rule. sa i Department of ~ Children & Youth ae | Corrective Action Plan Due: 11/27/2025 |

During the inspection, it was determined that the program was not providing a clean and healthy environment, furniture, materials and equipment as required by Appendix A, as noted in numbers 22 & 29 below: 1. Item(s) soiled with blood or bodily fluids were not cleaned/sanitized immediately. 2. Blankets/sheets were not cleaned weekly, when soiled, or before use by another child. 3. Children's individual blankets and belongings were stored in an unsanitary manner. 4. Bottles, bottle caps, nipples and other equipment used for bottle feeding were not cleaned and sanitized ina dishwasher or by washing, rinsing, and boiling for one minute. 5. Carpets were not vacuumed weekly or cleaned when soiled. 6. Changing table/pad was not sanitized after each use or cleaned when visibly soiled. 7. Reusable cloths were not being washed daily or when visibly soiled. 8. Cots/Pads/Mats were not cleaned and sanitized before assigning to a different child, when used by a sick child, when soiled or at least every three months. 9. Cribs were not cleaned and sanitized monthly, or when soiled, or before use by another child. 10. Diaper Receptacles were not cleaned and sanitized daily or more frequently as needed to eliminate odor. 11. Dishes/Cups/Silverware were not cleaned and sanitized after each use. sa i Department of hj Children & Youth 12. Water Containers were not labeled with the child's name, or were not cleaned and sanitized before use again on another day. 13. Dress up clothes and hats (dramatic play) were not cleaned monthly or when soiled. 14. Floors were not cleaned weekly or when soiled. 15. The food prep area, including sinks, were not cleaned before and after preparing food (including bottle preparation) or between preparing raw or cooked food. 16. Potty chairs were not cleaned after each use, rinsed with water, cleaned and sanitized or contents were not emptied into a toilet. 17. Food tables, highchair trays were not cleaned before and after each use. 18. Tables used for play were not cleaned when visibly soiled or sanitized daily. 19. Toilet bowls were not cleaned when visibly soiled or sanitized weekly. 20. Toilet seat(s), handle(s) and hand washing sink(s) were not cleaned when visibly soiled or sanitized daily. 21. Mouthed toys were not cleaned and sanitized after each child’s use. 22. Toys, other than those mouthed by children, were not cleaned monthly or when visibly soiled. 23. Washable furniture, including fabrics on infant equipment, were not cleaned weekly or when soiled. 24. Upholstered furniture was not steam cleaned when soiled. 25. Slip covers were not washed at least every six months or when soiled. 26. Wastebaskets/rinse buckets, including lids, were not being emptied daily or cleaned and sanitized when visibly soiled. 27. The manufacturer’s directions for the cleaning product were not followed. 28. The solution used for sanitizing was not a commercial product registered by the United States Environmental Protection Agency as a sanitizer. 29. Other: Floor mat not cleaned when visibly soiled. Furniture, materials and equipment must be maintained according to the cleaning and sanitizing schedule in Appendix A to this rule. Submit the program’s corrective action plan to verify compliance with the requirements of this rule. Corrective Action Plan Due: 11/27/2025

In review of the program's records, it was determined that requirements for written permission from the parent/guardian for a field trip or routine trip were not met as listed in number(s) 4, 6, & 9 below: 1. Written parental permission was not secured for field trips and/or routine trips off the premises. 2. The written permission was missing the child’s name. 3. The written permission was missing the date(s) of the trip(s) (field trips only). 4. The written permission was missing the destination(s) of the trip(s). 5. The written permission was missing the departure and return time(s) of the trip(s) (field trips only). 6. The written permission was missing the signature of the parent. 7. The written permission was missing the date on which the permission was signed. 8. The written permission was missing a statement notifying parents how their child will be transported. 9. Permission forms for routine trips were not being updated annually. 10. Written parental permission forms for field trips and/or routine trips were not being maintained on file for at least one year from the date of the trip. 11. Other: [ ]. Submit the program’s corrective action plan to verify compliance with the requirements of this rule. Corrective Action Plan Due: 11/27/2025 sa i Department of ~ Children & Youth ae

In review of of the children's records, it was determined that completed medical statements were not on file, as required, for children listed on the JFS Children's Record Review For Child Care as indicated in number(s) 2, 9, & 11 below: 1. No medical was on file for at least one child 2. Medical(s) on file was not updated every 13 months 3. Medical(s) were missing child's name and date of birth 4. Medical(s) were missing the date of the medical examination 5. The date of the exam was more than 13 months prior to the date the form was signed 6. Medical(s) were missing a statement that the child has been examined and is in suitable condition for participation in group care 7. Medical(s) were missing the signature, business address and telephone number of the physician, physician's assistant(PA), advance practice nurse (APN) or certified nurse practitioner (CNP) who examined the child 8. Medical(s) were missing a record of immunizations the child has had specifying month, day and year sa i Department of hj Children & Youth 9. Medical(s) were missing a statement from the physician, PA, APN, or CNP that the child has been immunized or is in the process of being immunized against the diseases required by division 5104.014 of the Revised Code and found in appendix A to this rule 10. Medical(s) were missing a statement from the child’s parent or guardian that he or she has declined to have the child immunized against the disease for reasons of conscience, including religious convictions 11. Other: Section B not completed by the physician, physician's assistant(PA), advance practice nurse (APN) or certified nurse practitioner (CNP) who examined the child. Submit the program’s corrective action plan to the Department to verify compliance with the requirements of this rule. Corrective Action Plan Due: 11/27/2025

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 number(s) 4, 6, 8, & 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 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: 11/27/2025 TG i Department of ~ Children & Youth Po Rules In-Compliance/Not Verified [Rule i Status | Documenting Statement(s), If applicable 5180:2-13-02 Voluntary Temporary Compliant Closure [Rule Status | Documenting Statements), If applicable 5180:2-13-02 License Visible Compliant re [Rule sd Status | Documenting Statement(s), If applicable 5180:2-13-02 Information in OCLQS Compliant re [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 i 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 PRule i Status | Documenting Statement(s), If applicable TG i Department of ~ Children & Youth ae 5180:2-13-04 Heaters in a Type B Compliant Home | Rule Status | Documenting Statement(s), If applicable a a [Rule Status | Documenting Statement(s), If applicable 5180:2-13 Written Policies and Compliant Procedures [Rule Status | Documenting Statement(s), If applicable 5180:2-13-08 Employee Requirements | Compliant re [Rule Status | Documenting Statement(s), If applicable 5180:2-13-08 Child Care Staff Compliant Requirements [Rule i Status | Documenting Statement(s), If applicable 5180:2-13-08 Whistle Blower Compliant re [Rule Status | Documenting Statement(s), If applicable 5180:2-13-10 Health Training Compliant re [Rule Status | Documenting Statement(s), If applicable 5180:2-13-10 Professional Compliant Development [Rule i Status | Documenting Statements), If applicable ee a [Rule Status | Documenting Statement(s), If applicable ae a [Rule Status | Documenting Statement(s), If applicable TG i Department of ~ Children & Youth ae a [Rule Status | Documenting Statement(s), If applicable a a [Rule Status | Documenting Statement(s), If applicable ee a [Rule i Status | Documenting Statements), If applicable 5180:2-13-12 Carbon Monoxide Compliant Detectors - 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During the inspection, it was determined that sheets, mattresses and/or mattress covers did not meet the rule requirement as noted in number 2 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. 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: 11/27/2025