Safe Haven Child Care

In review of records, it was determined the CCSM or Substitute CCSM was left alone with children and did not have current valid documentation for training(s) listed in number(s) 2, 5, 11, 15 below: 1. First Aid - expired training 2. First Aid - did not have verification of completion of First Aid training 3. First Aid - documentation did not demonstrate the person who provided the training met the trainer qualifications as stated in the rule 4. CPR - expired training 5. CPR - had not taken CPR training 6. CPR - did not have verification of the completion of CPR training 7. CPR - training taken did not include all age groups the program serves and developmental levels of all children in care 8. CPR - documentation did not demonstrate the person who provided the training met the trainer qualifications as stated in the rule se ier Department of “ale Children & Youth 9. CPR - audiovisual or electronic media training taken by staff did not include an in-person component of the training 10. Communicable Disease - expired training 11. Communicable Disease - had not taken CD training 12. Communicable Disease - did not have verification of the completion of the CD training 13. Communicable Disease - documentation did not demonstrate the person who provided the training met the trainer qualifications as stated in the rule 14. Child Abuse - expired training 15. Child Abuse - had not taken Child Abuse training 16. Child Abuse - documentation did not demonstrate the person who provided the training met the trainer qualifications as stated in the rule Correct the violation and submit the documentation of current certification with the program's corrective action plan to verify compliance with the requirement of the rule. Corrective Action Plan Due: 09/24/2025

The program had not been inspected and approved within 12 months from the date of the last fire approval by the local fire department, as required. Secure and submit an updated fire approval as part of the program's corrective action plan to verify compliance with the requirement of the rule. Corrective Action Plan Due: 09/24/2025

During the inspection, it was determined that the following hazardous conditions existed in the outdoor play area, as noted in number(s) 15 below: 1. There was broken glass. 2. There were tall weeds. 3. There was poison ivy. 4. There were tree branches. 5. There was mold visible. 6. The sandbox was contaminated. 7. There were thistles with prickers. 8. There were bird droppings. 9. The outdoor area was littered with trash. 10. The trash can was missing a lid. 11. The trash was not emptied from the day(s) before. 12. The trash can was overflowing with trash. 13. The trash can was infested with insects. 14. The trash can was visibly dirty. 15. Other: 2 screwdrivers, pile of sticks and limbs behind play area, splintered wood around play area, broom accessible on front porch. se ier Department of ~ Children & Youth Sor ig Correct the violation and submit the program's corrective action plan to verify compliance with the requirement of the rule. Corrective Action Plan Due: 09/24/2025

During the inspection, it was determined the fall zone under and around equipment designated for climbing, swinging, balancing and sliding did not meet the requirements as noted in number(s) 1 below: 1. The fall surface material had not been properly distributed, turned over or raked as needed. 2. The fall surface material was not being used according to manufacturer's guidelines for its use as a fall surface. 3. Other []. The program is required to provide adequate fall zones under and around outdoor play equipment at all times. Submit the program’s corrective action plan to the Department to verify compliance with the requirements of this rule. Corrective Action Plan Due: 09/24/2025

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) 5 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. se ier Department of “ale Children & Youth 10. Child's weight was missing or not attached. 11. Name of the medication/medical food was missing or not attached. 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: 09/24/2025 se ier Department of = Children & Youth a 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) 13 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. se ier Department of ~ Children & Youth Sor ig Corrective Action Plan Due: 09/24/2025 Rules In-Compliance/Not Verified | Rule i 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 re | Rule Status | Documenting Statement(s), If applicable 5180:2-13-02 Change of Location Compliant re [Rule Status | Documenting Statement(s), If applicable 5180:2-13-02 Information in OCLQS Compliant ee [Rule i Status | Documenting Statements), If applicable ee a PRule Status | Documenting Statementi(s), If applicable ee a | 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 Inspections for | Compliant Type A Homes se ier Department of ~ Children & Youth nl PRule Status | Documenting Statement(s), If applicable a PRule Status | Documenting Statement(s), If applicable a a [Rue i Status | Documenting Statement(s), If applicable 5180:2-13-05 Denial, Revocation, and | Compliant Suspension [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 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 i Status | Documenting Statement(s), If applicable ee a [Rule Status | Documenting Statement(s), If applicable 5180:2-13-10 Professional Compliant Development P Rule Status | Documenting Statement(s), If applicable ee a PRue Cd Status | Documenting Statement(s), If applicable se ier Department of ~ Children & Youth nl a a | Rule Cd Status | Documenting Statement(s), If applicable ee a [Rule Status | Documenting Statement(s), If applicable ~~ a [Rule Status | Documenting Statement(s), If applicable oe a P Rule Status | Documenting Statement(s), If applicable 5180:2-13-13 Clean environment and | Compliant equipment [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 Driver Requirements Compliant re [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 5180:2-13-14 Ratio and Supervision Compliant for Field and Routine Trips [Rule Status | Documenting Statement(s), If applicable ae a [Rule Status | Documenting Statement(s), If applicable se ier Department of ~ Children & Youth nl a [Rule Cd Status | Documenting Statement(s), If applicable a a [Rule Status | Documenting Statement(s), If applicable 5180:2-13-15 Child Records Retention | Compliant and Confidentiality [Rue Status | Documenting Statement(s), If applicable 5180:2-13-16 Medical, Dental, and Compliant General Emergency Plan | Rule sd Status | Documenting Statement(s), If applicable 5180:2-13-16 Emergency Drills Compliant re [Rule Status | Documenting Statement(s), If applicable 5180:2-13-16 First Aid Kit/Standard Compliant Precautions [Rule Status | Documenting Statement(s), If applicable 5180:2-13-16 Communicable Diseases | Compliant ee [Rule Status | Documenting Statement(s), If applicable ee a [Rue i Status | Documenting Statement(s), If applicable 5180:2-13-16 Emergency Compliant Preparedness and Response Plan | Rule Status | Documenting Statement(s), If applicable —e a [Rule Status | Documenting Statement(s), If applicable 5180:2-13-17 Materials and Compliant Equipment se ier Department of ~ Children & Youth nl [Rule —~S~S~S~SSSCSCSC*S Status ——~SCSCSCS~*dié cmenting Statements), applicable Se a [Rule Cd Status | Documenting Statement(s), If applicable ee a [Rule Status | Documenting Statement(s), If applicable oo a | Rule Cd Status | Documenting Statement(s), If applicable 5180:2-13-19 School Age Supervision | Compliant re | Rule Status | Documenting Statement(s), If applicable 5180:2-13-19 Child Guidance Compliant re [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 Status | Documenting Statement(s), If applicable 5180:2-13-21 Evening and Overnight Compliant Care | Rule Status | Documenting Statement(s), If applicable 5180:2-13-21 Sanitary Environment Compliant and Hygiene P Rule Status | Documenting Statement(s), If applicable — a PRule Status | Documenting Statement(s), If applicable 5180:2-13-23 Infant Daily Care [Compliant se ier Department of ~ Children & Youth nl [Rule Status | Documenting Statement(s), If applicable a a [Rule Status | Documenting Statement(s), If applicable ee a [Rule Status | Documenting Statement(s), If applicable 5180:2-13-23 Infant Bottle and Food Compliant Preparation | Rule Status | Documenting Statement(s), If applicable “™ ee | Rule Cd Status | Documenting Statement(s), If applicable 5180:2-13-25 Medication Compliant Requirements [Rule Status | Documenting Statement(s), If applicable 5180:2-13-11 Indoor Space Compliant ee | Rule i Status | Documenting Statements), If applicable Se a [Rule Status | Documenting Statement(s), If applicable oe a [Rule Status | Documenting Statement(s), If applicable 5180:2-13-24 Parent Permission for Compliant Swimming [Rule Status | Documenting Statement(s), If applicable 5101:2-13-08 Review Policies and Compliant Procedures se ier Department of = Children & Youth