Williams, Taneasha

In review of the staff records, it was determined that background check requirements had not been followed, for the individual(s) listed on the Employee Record Chart, as noted in number(s) 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: 03/01/2026

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) 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. TG i Department of ~ Children & Youth ae Corrective Action Plan Due: 03/01/2026 Rules In-Compliance/Not Verified [Rule i Status | Documenting Statement(s), If applicable 5180:2-13-02 Voluntary Temporary Compliant Closure [Rue Status | Documenting Statement(s), If applicable 5180:2-13-02 License Visible Compliant ee [Rue i Status | Documenting Statement(s), If applicable 5180:2-13-02 Change of Location Compliant re [Rue Status | Documenting Statement(s), If applicable 5180:2-13-02 Information in OCLQS Compliant re [Rule Status | Documenting Statement(s), If applicable — a [Rule i 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 TG i Department of ~ Children & Youth ae a [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 Statements), If applicable ee a | Rule Status | Documenting Statement(s), If applicable 5180:2-13-07 Provider Responsibilities | Compliant re [Rule Status | Documenting Statement(s), If applicable 5180:2-13 Written Policies and Compliant Procedures [Rule Status | Documenting Statement(s), If applicable 5180:2-13-07 Type B Provider - Foster | Compliant Parent [Rule Status | Documenting Statement(s), If applicable ——e a [Rule Status | Documenting Statement(s), If applicable 5180:2-13-08 Child Care Staff Compliant Requirements P Rule Status | Documenting Statement(s), If applicable ee a P Rule Status | Documenting Statement(s), If applicable ee a sa i Department of ~ Children & Youth ae P Rule Status | Documenting Statement(s), If applicable 5180:2-13-10 Professional Compliant Development P Rule Status | Documenting Statement(s), If applicable a a [Rule Status | Documenting Statement(s), If applicable a a [Rule Cd Status | Documenting Statement(s), If applicable 5180:2-13-11 Outdoor Equipment Compliant re [Rule Status | Documenting Statement(s), If applicable ™ ee [Rule Status | Documenting Statement(s), If applicable 5180:2-13-12 Safe Equipment Compliant re P Rule Status | Documenting Statement(s), If applicable ee a [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 P Rule Status | Documenting Statement(s), If applicable 5180:2-13-13 Clean environment and | Compliant equipment PRule i Status | Documenting Statement(s), If applicable TG i Department of ~ Children & Youth ae a a | Rule Status | Documenting Statement(s), If applicable oe a [Rule Status | Documenting Statement(s), If applicable en a [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 Cd 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 ee a [Rule i 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 5180:2-13-16 Medical, Dental, and Compliant General Emergency Plan TG i Department of ~ Children & Youth ae a [Rule Status | Documenting Statement(s), If applicable ——oe a [Rule Status | Documenting Statement(s), If applicable Ne a [Rue i Status | Documenting Statement(s), If applicable 5180:2-13-16 Incident/Injury Compliant re | 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 [Rule Status | Documenting Statement(s), If applicable — a [Rue i Status | Documenting Statement(s), If applicable ee a | Rule Status | Documenting Statement(s), If applicable oo a P Rule Status | Documenting Statement(s), If applicable eee a TG i Department of ~ Children & Youth ae [Rule —~S~S~SSS*dS Status —~SCSS~*dit cmenting Statements), Haplicable 5180:2-13-21 Evening and Overnight Compliant Care [Rule Status | Documenting Statement(s), If applicable 5180:2-13-20 Sleep and Nap Compliant Requirements [Rule Status | Documenting Statement(s), If applicable a a | Rule Cd 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 5180:2-13-22 Meals and Snacks Compliant re [Rule Status | Documenting Statement(s), If applicable — a P Rule Status | Documenting Statements), If applicable ee a | Rule Status | Documenting Statement(s), If applicable es a [Rule Status | Documenting Statement(s), If applicable —oe a P Rule Status | Documenting Statement(s), If applicable 5180:2-13-24 On-site Pools [Compliant TG i Department of ~ Children & Youth (a [Rule Cd Status | Documenting Statement(s), If applicable — a [Rule Status | Documenting Statement(s), If applicable 5180:2-13-24 Parent Permission for Compliant Swimming | Rule sd Status | Documenting Statements), If applicable 5180:2-13-25 Medication Compliant Requirements

During the inspection, it was determined that the program did not have a first aid kit onsite as required, that included all items listed in the appendix A of the rule. The kit(s) were missing the item(s) or the item(s) were not replaced after use and/or expired listed in number(s) 9 below: 1. One roll of first-aid tape; 2. Individually wrapped sterile gauze; squares in assorted sizes; 3. Sterile adhesive bandages in assorted sizes; 4.Tweezers; 5. Gauze rolled bandage; 6. Triangular bandage; 7. Rounded end scissors; 8. Tooth preservation system or fresh chilled liquid milk in which to transport a lost permanent tooth, including a written reference indicating location of the refrigerator/freezer where milk is stored if a tooth preservation system is not part of the first aid kit (for programs serving school age children only); 9. A working digital thermometer; 10. Disposable non-latex gloves; 11. A working flashlight; 12. An instant cold pack that has not been activated or ice, including a written reference indicating location of the refrigerator/freezer where the ice is stored if an instant cold pack is not part of the first aid kit; 13. Sealable leak-proof plastic bags in assorted sizes or double bagged plastic bags that can be securely tied for materials soiled with blood or bodily fluids; 14. Pocket mask or face shield, appropriate; for all ages of children in care, for cardiopulmonary resuscitation (CPR) administration; 15. Soap or waterless sanitizer (field trip or transporting away from the program only); 16. Bottled water (field trip or transporting away from the program only). Correct the violation and submit the program's corrective action plan to verify compliance with the requirements of this rule. Corrective Action Plan Due: 03/01/2026