5101:2-13-03 Compliance inspection and complaint investigation of a licensed family child care provider.
Rule Summary and Fiscal Analysis (Part A)
Department of Job and Family Services
Agency Name
Division of Social Services Michael Lynch
Division Contact
OFC- 4200 E. 5th Ave., 2nd fl. J6-02 P.O. Box 183204 Columbus OH 43218-3204
614-466-4605 614-752-8298
5101:2-13-03
Rule Number
NEW
TYPE of rule filing
Rule Title/Tag Line Compliance inspection and complaint investigation of a licensed family child care provider.
RULE SUMMARY
1. Is the rule being filed for five year review (FYR)? No
2. Are you proposing this rule as a result of recent legislation? No
3. Statute prescribing the procedure in accordance with the agency is required to adopt the rule: 119.03
4. Statute(s) authorizing agency to adopt the rule: 5104.017, 5104.018
5. Statute(s) the rule, as filed, amplifies or implements: 5104.03, 5104.04, 5104.017, 5104.02, 5104.018
6. State the reason(s) for proposing (i.e., why are you filing,) this rule:
This rule is being adopted as a result of the five year review and to improve the clarity of the regulations and the organization of the chapter. It replaces rescinded rules 5101:2-13-07, 5101:2-13-08 and 5101:2-14-03.
7. If the rule is an AMENDMENT, then summarize the changes and the content
Page 2 Rule Number: 5101:2-13-03
of the proposed rule; If the rule type is RESCISSION, NEW or NO CHANGE, then summarize the content of the rule:
This rule outlines guidelines and timeframes for inspection and investigations of the family child care home.
8. If the rule incorporates a text or other material by reference and the agency claims the incorporation by reference is exempt from compliance with sections
121.71 to 121.74 of the Revised Code because the text or other material is generally available to persons who reasonably can be expected to be affected by the rule, provide an explanation of how the text or other material is generally available to those persons:
This rule incorporates one or more references to another rule or rules of the Ohio Administrative Code. This question is not applicable to any incorporation by reference to another OAC rule because such reference is exempt from compliance with RC 121.71 to 121.74 pursuant to RC 121.76(A)(3).
This rule incorporates one or more dated references to an ODJFS form or forms. Each cited ODJFS form is dated and is generally available to persons affected by this rule via the inner-web at http://innerapp.odjfs.state.oh.us/forms/inner.asp or on the inter-net at http://www.odjfs.state.oh.us/forms/inter.asp in accordance with RC 121.75(E).
9. If the rule incorporates a text or other material by reference, and it was infeasible for the agency to file the text or other material electronically, provide an explanation of why filing the text or other material electronically was infeasible:
Not Applicable.
10. If the rule is being rescinded and incorporates a text or other material by reference, and it was infeasible for the agency to file the text or other material, provide an explanation of why filing the text or other material was infeasible:
Not Applicable.
11. If revising or refiling this rule, identify changes made from the previously filed version of this rule; if none, please state so. If applicable, indicate each specific paragraph of the rule that has been modified:
Paragraph (G)(5)(b) changed "violation" to "noncompliance"
Page 3 Rule Number: 5101:2-13-03
Appendix A:
Changed language in rule 5101:2-13-11 to say "equipment and/or ropes not securely anchored"
Added language in rule 5101:2-13-12 to say "children not protected from unsafe items, conditions or situations" and "illegal drugs on premises or alcohol in area used for child care."
12. Five Year Review (FYR) Date:
(If the rule is not exempt and you answered NO to question No. 1, provide the scheduled review date. If you answered YES to No. 1, the review date for this rule is the filing date.)
NOTE: If the rule is not exempt at the time of final filing, two dates are required: the current review date plus a date not to exceed 5 years from the effective date for Amended rules or a date not to exceed 5 years from the review date for No Change rules.
FISCAL ANALYSIS
13. Estimate the total amount by which this proposed rule would increase / decrease either revenues / expenditures for the agency during the current biennium (in dollars): Explain the net impact of the proposed changes to the budget of your agency/department.
This will have no impact on revenues or expenditures. 0
The proposed rule will not have an impact on the agency's projected budget during the current biennium.
14. Identify the appropriation (by line item etc.) that authorizes each expenditure necessitated by the proposed rule:
Not Applicable.
15. Provide a summary of the estimated cost of compliance with the rule to all directly affected persons. When appropriate, please include the source for your information/estimated costs, e.g. industry, CFR, internal/agency:
There are no anticipated new costs of compliance as a result of this new rule.
Page 4 Rule Number: 5101:2-13-03
16. Does this rule have a fiscal effect on school districts, counties, townships, or municipal corporations? No
17. Does this rule deal with environmental protection or contain a component dealing with environmental protection as defined in R. C. 121.39? No
S.B. 2 (129th General Assembly) Questions
18. Has this rule been filed with the Common Sense Initiative Office pursuant to
R.C. 121.82? Yes
19. Specific to this rule, answer the following:
A.) Does this rule require a license, permit, or any other prior authorization to engage in or operate a line of business? Yes
Type A home providers must be licensed because they serve seven or more children. Type B home providers must be licensed if they want to serve children who are publicly funded or they can voluntarily be regulated.
B.) Does this rule impose a criminal penalty, a civil penalty, or another sanction, or create a cause of action, for failure to comply with its terms? Yes
Failure to comply may result in revocation of a license.
C.) Does this rule require specific expenditures or the report of information as a condition of compliance? No
Ohio Department of Job and Family Services
STATEMENT OF NONCONVICTION FOR CHILD CARE
SECTION I:
Name (please print or type)
I hereby attest that I have never been convicted of or pleaded guilty to crimes set forth in divisions (A)(4) or (A)(5) of section 109.572 of the Revised Code and that no child has been removed from my home as described in section 2151.353 of the Revised Code.
I have been convicted of a crime included in divisions (A)(4) or (A)(5) of section 109.572 of the Revised Code.
I have had a child removed from my home as described in section 2151.353 of the Revised Code.
Signature of Person Completing Form
Date
Street Address
City
State
Zip Code
Telephone Number
The licensee of a family child care home shall sign the following statement on his or her own form only: I hereby attest that no one who resides in my home and who is under eighteen years of age has been adjudicated a delinquent child for committing a violation of any offense listed in divisions (A)(8) or (A)(9) of section 109.572 of the Revised Code.
Signature
Date
Note: Anyone who withholds information from, or falsifies information on this statement is guilty of falsification, a misdemeanor of the first degree. If the offender is an owner of a center, a licensee of a family child care home, or an in-home aide, the conviction constitutes grounds for denial, revocation or refusal to renew a child care license application or child care license. If the offender is a child care staff member of a center or family child care home, or is a person eighteen years of age or older who resides in a family child care home or is a substitute, and if the owner or licensee had knowledge of, and acquiesced in the commission of the offense, the conviction constitutes grounds for denial, revocation or refusal to renew a child care license.
SECTION II: (required for new hires and new residents only) Date BCI/FBI Requested
First Day of Employment/Residence
JFS 01328 (Rev. 12/2016) Page 1 of 2
Homicide
Prohibitive Offenses found in division (A)(5) of section 109.572 of the Revised Code
R.C. 2913.21 - Misuse of credit cards
R.C. 2903.01 - Aggravated murder
R.C. 2903.02 - Murder
R.C. 2903.03 - Voluntary manslaughter
R.C. 2903.04 - Involuntary manslaughter
Assault
R.C. 2903.11 - Felonious assault
R.C. 2903.12 - Aggravated assault
R.C. 2903.13 - Assault
R.C. 2903.16 - Failing to provide for a functionally impaired person
Menacing
R.C. 2903.15 - Permitting child abuse
R.C. 2903.21 - Aggravated menacing
R.C. 2903.211- Menacing by stalking
R.C. 2903.22 - Menacing
Patient abuse and neglect
R.C. 2903.34 - Patient abuse, neglect
Kidnapping and related issues
R.C. 2905.01 - Kidnapping
R.C. 2905.02 - Abduction
R.C. 2905.04 - Child stealing (as this law existed prior to July 1, 1996)
R.C. 2905.05 - Criminal child enticement
R.C. 2905.32 - Trafficking in persons
Sex offenses
R.C. 2907.02 - Rape
R.C. 2907.03 - Sexual battery
R.C. 2907.04 - Corruption of a minor
R.C. 2907.05 - Gross sexual imposition
R.C. 2907.06 - Sexual imposition
R.C. 2907.07 - Importuning
R.C. 2907.08 - Voyeurism
R.C. 2907.09 - Public indecency
R.C. 2907.12 - Felonious sexual penetration (as this former section of law existed)
R.C. 2907.19 - Commercial sexual exploitation of a minor
R.C. 2907.21 - Compelling prostitution
R.C. 2907.22 - Promoting prostitution
R.C. 2907.23 - Procuring
R.C. 2907.24 - Soliciting - after positive HIV test driver's license suspension
R.C. 2907.25 - Prostitution
R.C. 2907.31 - Disseminating matter harmful to juveniles
R.C. 2907.32 - Pandering obscenity
R.C. 2907.321 - Pandering obscenity involving a minor
R.C. 2907.322 - Pandering sexually oriented matter involving a minor
R.C. 2907.323 - Illegal use of a minor in nudity-oriented material or performance
Arson
R.C. 2909.02 - Aggravated arson
R.C. 2909.22 - Soliciting or providing support for act of terrorism
R.C. 2909.23 - Making terroristic threat
R.C. 2909.24 - Terrorism
R.C. 2909.03 - Arson
Robbery and Burglary
R.C. 2911.01 - Aggravated robbery
R.C. 2911.02 - Robbery
R.C. 2911.11 - Aggravated burglary
R.C. 2911.12 - Burglary
Theft and Fraud
R.C. 2913.02 - Theft; aggravated theft
R.C. 2913.03 - Unauthorized use of a vehicle
R.C. 2913.04 - Unauthorized use of property, computer, cable, or telecommunication property or service
R.C. 2923.02 - Attempt
R.C. 2913.041 - Possession or sale of unauthorized cable television device
R.C. 2913.33 - Making or using slugs
R.C. 2913.05 - Telecommunications fraud
R.C. 2913.06 - Unlawful use of telecommunications
R.C. 2913.11 - Passing bad checks
R.C. 2913.31 - Forgery; identification card
R.C. 2913.32 - Criminal simulation
R.C. 2913.40 - Medicaid fraud
R.C. 2913.41 - Prima facie evidence of purpose to defraud
R.C. 2913.42 - Tampering with records
R.C. 2913.43 - Securing writings by deception
R.C. 2913.44 - Personating an officer
R.C. 2913.441- Law Enforcement emblem display
R.C. 2913.45 - Defrauding creditors
R.C. 2913.46 - Illegal use of food stamps or WIC program benefits
R.C. 2913.47 - Insurance fraud
R.C. 2913.48 - Worker's compensation fraud
R.C. 2913.49 - Identity fraud
Offenses against the family
R.C. 2919.12 - Unlawful abortion
R.C. 2919.22 - Endangering children
R.C. 2919.23 - Interference with custody
R.C. 2919.24 - Contributing to unruliness or delinquency of a child
R.C. 2919.25 - Domestic violence
R.C. 2919.224 - Misrepresentation relating to provision of child care
R.C. 2919.225- Disclosure and notice regarding death or injury of child in facility
Offenses against justice and public administration
R.C. 2921.11 - Perjury
R.C. 2921.13 - Falsification
R.C. 2921.14 - Making or causing false report of child abuse or Neglect
Weapons control
R.C. 2923.12 - Carrying a concealed weapon
R.C. 2923.13 - Having a weapon while under disability
R.C. 2923.161 - Improperly discharging a firearm at or into a habitation or school
R.C. 2923.01 - Conspiracy
R.C. 2923.02 - Attempt, that relates to a crime specified in division
109.572 (A)(5)
R.C. 2923.03 - Complicity, that relates to a crime specified in division
109.572 (A)(5)
Drug offenses
R.C. 2925.02 - Corrupting another with drugs
R.C. 2925.03 - Trafficking in drugs
R.C. 2925.04 - Illegal manufacture of drugs or cultivation of marijuana
R.C. 2925.05 - Funding of drug or marijuana trafficking
R.C. 2925.06 - Illegal administration or distribution of anabolic steroids
R.C. 2925.11- Possession of drugs or marijuana that is not a minor drug possession offense in section R.C. 2925.01
Other
R.C. 959.13 - Cruelty to animals
R.C. 2151.421- Reporting child abuse or neglect
R.C. 2905.11 - Extortion
R.C. 3716.11 - Placing harmful objects in food or confection
R.C. 2909.04 - Disrupting public services
R.C. 2909.05 - Vandalism
R.C. 2917.01 - Inciting to violence
R.C. 2917.02 - Aggravated riot
R.C. 2917.03 - Riot
R.C. 2917.31 - Inducing panic
R.C. 2921.03 - Intimidation
R.C. 2921.34 - Escape
R.C. 2921.35 - Aiding escape or resistance to authority
R.C. 2927.12 - Ethnic intimidation
R.C. 4511.19 - Operating vehicle under the influence of alcohol or drugs- OVI. (A second violation within five years of the date of application for licensure or employment).
*Or an existing or former offense of any municipal corporation, this state, or any other state, or the United States that is substantially equivalent to any of these offenses.
JFS 01328 (Rev. 12/2016) Page 2 of 2
Ohio Department of Job and Family Services
COMPLAINT INVESTIGATION RECEIPT FOR CHILD CARE
Provider Name
Provider License Number
Summary of Complaint Allegation
Date of Visit
Time In
Time Out
Individuals Present
Relationship to the Provider
Items Discussed/Observed
Provider Signature
Date
County Agency Signature
Date
Provider's signature indicates he/she has received a copy of this document.
JFS 01526 (Rev. 12/2016)
Ohio Department of Job and Family Services CHILD MEDICAL/PHYSICAL CARE PLAN FOR CHILD CARE
Child's Name Date of Birth
Special Health Conditions
Symptoms to watch for and emergency action to be taken if the following symptoms occur
Activities/foods/environmental conditions to avoid, if applicable
Medical procedures to be followed and expected benefit of treatment, if applicable
Are any medications required? c Yes c No (If yes, complete JFS 01217 "Request for Administration of Medication")
If yes, what medications?
In an emergency does this child require additional assistance (more than other children of the same age or in the same group) to evacuate? c Yes c No
In the event that the child care program must be evacuated, are there medications or supplies that must be taken with this child? c Yes c No
Training Instructions (Trainer must be a parent or certified professional)
Signature of Trainer Date
Signature of trained providers, substitutes or child care staff members who have been made aware of the condition.
(There must always be a trained caregiver present when the child is present.)
Signature Date I have been
Informed
Signature Date I have been
Informed
Signature Date I have been
Informed
Signature Date I have been
Informed
I have been
Trained I have been
Trained
I have been
Trained I have been
Trained
(Only trained providers, substitutes or child care staff members shall be permitted to perform medical procedures listed above.)
Additional services (educational/therapeutic) child is receiving
Who provides the above services?
Name Phone Number May we contact? Yes No
Name Phone Number May we contact? Yes No
I give my permission for the staff listed above to perform the procedures in my child's Medical/Physical Care Plan.
Parent Signature
Date
Administrator/Provider Signature
Date
Note: A separate plan must be written for each condition that requires different actions to be taken
Ohio Department of Job and Family Services
REQUEST FOR REVIEW FOR LICENSING AND STEP UP TO QUALITY
Program Information
Program Name
License Number
Administrator Name
Phone Number
Program Address
City, State, Zip Code
E-Mail Address
Detailed description of the requested findings included in this request, indicate rule citation, noncompliance/decision, date of noncompliance/decision and what is being requested for review by the program.
Name of Person Making Request
Title
Signature of Person Making Request
Date of Signature
Return completed request with applicable documentation to support the request. This form is to be e-mailed or mailed to your licensing specialist within seven business days from the receipt of the findings. E-mailing this form will time stamp the application for review.
JFS 01155 (12/2016)
Ohio Department of Job and Family Services
INSPECTION REPORT FOR FAMILY CHILD CARE
Provider Name
License Number
Telephone Number
Address
County
Hours of Operation
City
Zip Code
Date(s) of Inspection
Time of Inspection
Purpose of Inspection Pre-Licensing Provisional Complaint Compliance
Monitoring/Follow-up
Name of County Agency Staff
Arrive
AM/PM
Announced Unannounced
Depart
AM/PM
Compliance Status Key Code: I = In Compliance
O = Out of Compliance P/V = Previously Verified
N/V = Compliance Not Verified N/A = Not Applicable
Please Note: Each rule must have a status using this key code and all noncompliances shall be summarized on page 8-9
Compliance Item
Status
Comments
5101:2-13-02
Application Requirements
Application completed Provider Medical Statement
JFS 01328 "Statement of Nonconviction for Child Care"
BCI and FBI criminal records check completed for provider and all adults in home
JFS 01302 "Request for Child Abuse and Neglect Report
Information for Child Care"
High school diploma or GED verified for providers licensed or certified on or after April 1, 2003
JFS 01250 "Plan of Operation for Child Care"
5101:2-13-02
Issuance of License
JFS 08087 "Communicable Disease Chart" given to provider License posted
5101:2-13-04
Building Approval
Type A Homes Only:
Building department inspection report on file
5101:2-13-04
Fire Approval/Fire Safety
Type A Homes Only:
Fire department inspection report on file
Type B Homes Only:
Primary and secondary escape routes
No space higher than the second floor of building used for child care Window openings 5.7 sq. ft.
No space accessible only by ladder, folding stairs or trapdoor is used All stairs, hallways and passages to exit are adequately lighted Doorways, corridors, stairways are clear of obstructions
Written evacuation plan
Proper storage of flammable/combustible materials
One working UL or FM smoke detector on each level of the home At least one UL or FM portable fire extinguisher; one in kitchen (minimum rating of 1A:10BC)
Nonflammable guards on heaters, no unprotected flames
Electrical connections in properly covered junction boxes
JFS 01926 (Rev. 12/2016) Page 1 of 9
5101:2-13-07
Provider Qualifications
At least 18 years of age/Date of birth: Resides in the home
No child removed
Provides safe and healthy environment
Not employed elsewhere during operating hours Scheduled hours of availability posted
On-site 75% of operating hours
5101:2-13-07
Provider On-Going Responsibilities
JFS 01302 "Request for Child Abuse and Neglect Report Information for Child Care" annually
Polices/Procedures manual/handbook Foster parent
5101:2-13-08
Child Care Staff Members and Substitutes
JFS 01328 "Statement of Nonconviction for Child Care"
At least 18 years of age
JFS 01302 "Request for Child Abuse and Neglect Report Information for Child Care" annually
5101:2-13-09
Criminal Records
BCI and FBI checks current for provider and all adults in the home BCI and FBI checks current for child care staff members and Substitutes
Current JFS 01328 "Statement of Nonconviction for Child Care" on file for each individual
JFS 01206 "Rehabilitation Criteria for Child Care" on file for each rehabilitative offense
5101:2-13-10
Training Requirements Professional Development
Provider:
Currently trained in First Aid Currently trained in CPR
Currently trained in of Communicable disease
Currently trained in Child Abuse and Neglect Recognition Annual 6 hours of professional development
Child Care Staff Member: Currently trained in First Aid Currently trained in CPR
Currently trained in Management of Communicable disease Currently trained in Child Abuse and Neglect Recognition - 1 hour course
Annual 6 hours of professional development
Substitute:
Currently trained in First Aid Currently trained in CPR
5101:2-13-11
Indoor Space
Indoor square footage available for child care
5101:2-13-11
Outdoor Space
Outdoor square footage available for child care Equipment:
Out of traffic pattern
Anchored or stable
Ropes attached at both ends (< 5" diameter loop or less) "S" hooks closed
Free of rust, cracks, holes splinters, sharp points or edges. No
JFS 01926 (Rev. 12/2016) Page 2 of 9
chipped/peeling paint or toxic substances. No protruding bolts or tripping hazards
Protective barriers on platforms over 30" Assembled/Installed according to manufacturer's guidelines Sandboxes covered when not in use
Shade available
Free of trash, foreign objects, garbage, hazards
Fall zone of protective resilient material under and around equipment
5101:2-13-12
Safe Equipment
No broken or unsafe equipment No toys small enough to swallow
Protective covering under indoor gross motor Equipment straps used properly
Safe use of equipment
No trampolines or bounce houses permitted
5101:2-13-12
Safe Environment
Firearms, weapons and ammunition onsite locked and out of sight Temperature 65-85 degrees indoor
Hot and cold water, Hot water temperature Free of lead
One working UL or FM carbon monoxide detector on each level of home
No hazardous conditions
Cleaning supplies stored appropriately and labeled Pets inoculated, licensed and properly cared for Electrical outlet covers
Fans and air conditioners used safely Blind cords, electrical cords secure
Toilet and sink height suitable or platform Sink, refrigerator, stove available
Proper ventilation
Handles of pots facing inward on stove No spray aerosols
No mercury thermometers
"No Weapons" sign posted [per ORC 2923.1212(A)(8)]
Consumer Product Safety Commission (CPSC) guidelines followed
5101:2-13-13
Sanitary Equipment and Environment
Toilet tissue, liquid soap, toweling available for handwashing Toilets flushed after each use
Home and equipment clean and in good repair Food/drink servings discarded if not used
Cups/dishes/silverware cleaned and sanitized after use or sent home Bottles labeled and sanitized
Water supply is safe and sanitary, Non-public water supply (Public water complies with EPA)
Trash not accessible
Cleaning according to schedule No insects or rodents present
Diaper changing surface cleaned if visibly soiled Surface sanitized after each diaper changed
5101:2-13-13
Handwashing
At required times
5101:2-13-13
Smoke Free Environment
No smoking in home or attached buildings Person smoking cannot be seen by children Area removed so that smoke not inhaled
JFS 01926 (Rev. 12/2016) Page 3 of 9
Written notice provided to caretakers if smoking permitted in home after child care hours
No smoking in vehicles while children are being transported
"No Smoking" sign posted
No ashes or butts
5101:2-13-14
Transportation Vehicle Requirements
Written permission for routine trips or field trips
JFS 01234 "Child Enrollment and Health Information for Child
Care"
JFS 01236 "Child Medical/Physical Care Plan for Child Care"
First aid supplies
Working cell phone or other means of immediate communication Driver has valid driver's license
Approved child restraint systems used
No children under 12 years old in the front seat Contact information shall be attached to the child Driver is 18
Driver trained/ODJFS training Children not unattended Additional adult
Weekly inspection of vehicle
5101:2-13-14
Field Trips/Routine Trips
Child's name
Destination (and date for field trips) Parent's signature and date
Notification if children will have access to bodies of water eighteen inches or more in depth
How child is transported
5101:2-13-15
Child Records
JFS 01234 "Child Enrollment and Health Information for Child Care" complete for every child in care
JFS 01234 "Child Enrollment and Health Information for Child Care" updated annually and as needed by caretaker
Child's Medical Statement on file within 30 days of attendance for every child (not yet attending school) in care
Medical exam completed every 13 months Records are kept confidential
Records can be easily/quickly accessed and removed in an emergency
5101:2-13-15
Care of Child with Special Needs or Health Conditions
JFS 01236 "Child Medical/Physical Care Plan for Child Care" on file for children with special needs or health conditions
Plan updated at least annually and as needed
Provider, Child Care Staff Member and Substitute have received training as needed
Modified meal plan on file
5101:2-13-16
Medical and Dental Plan Emergency Plan
Disaster plan on file Required drills conducted
JFS 01242 "Medical, Dental and General Emergency Plan for Child Care
JFS 01201 "Dental First Aid"
5101:2-13-16
Incident/Injury Report
JFS 01299 "Incident/Injury Report for Child Care" appropriately completed and filed
OCLQS notified as required for serious incidents/injuries or death
JFS 01926 (Rev. 12/2016) Page 4 of 9
5101:2-13-16
First Aid Supplies and Procedures
Supplies:
Tweezers
Rounded end scissors Digital thermometer Assorted adhesive bandages Assorted gauze squares First Aid tape
Rolled gauze bandage Instant cold pack or ice Disposable non-latex gloves
Pocket mask or face shield for CPR Working flashlight
Sealable plastic bags, assorted sizes
Tooth preservation system or fresh chilled milk (providers serving S/A only)
A current guide to emergency first aid Soap (fieldtrips/routine trips only)
Bottled water (fieldtrips/routine trips only) Hand sanitizer, if applicable
Procedures:
Kit taken on field trips and routine trips
Supplies in a closed, unlocked first aid container that is readily available, but out of reach of children
5101:2-13-16
Management of Communicable Disease
Provider observes children for signs of communicable illness upon arrival each day
Ill children isolated away from other children Current Communicable Disease Chart posted
Parents notified when child has been exposed to a communicable Illness
5101:2-13-17
Programming
Balanced program of activities/quiet and active play Copy of daily program posted and being followed
Program designed to promote children's physical, social-emotional, cognitive and language development
Daily outdoor or indoor gross motor activities Opportunities for child initiated activities
5101:2-13-17
Equipment
Equipment available for all appropriate age categories Sufficient quantities of equipment
Furniture durable and child sized Play materials accessible and orderly
Equipment accessible to children, able to select, remove, replace Store personal belongings
5101:2-13-18
Group Size
No more than six children (Type B home provider) No more than 12 children (Type A home provider) Number of children under 2
Number of children under 6 included
Number of children 6-14 years, not related to provider
Number of children 6-15 years, related to provider and care provided are included
Number of children 15-17 years, not related to provider and private or publicly funded, are included
JFS 01926 (Rev. 12/2016) Page 5 of 9
Number of Provider/Staff Daily attendance record
5101:2-13-19
Supervision
Children supervised at all times (within sight or hearing)
Provider not under any influence that impairs their ability to perform duties
Outdoor supervision requirements met (within sight and hearing) Notifies PCSA if suspects abuse or neglect
Provider/Staff have access to phone
5101:2-13-19
Child Guidance
Separation from situations developmentally appropriate and not used with infants
Does not use a prohibited discipline technique
5101:2-13-20
Sleeping/Napping
Individual bed, cot, sofa, pad or mat for each resting child No children directly on floor
Mats or pads/floor carpeted, clean, warm, dry, draft free and 1.5" thick
Areas lighted to allow for visual supervision
Non-napping children provided with quiet activities Cots, etc. assigned to children
Cots, etc. sanitized in between children
Linen changed at least weekly and between children for beds, cribs, pack and plays and couch
Evacuation routes not blocked
Written permission on file for infant (12 months or older) to sleep on mat or cot
5101:2-13-20
Crib/Playpen Requirements
Cribs have COC on file or documented manufacture date after 6/28/11
Closely spaced bars (2 3/8")
No more than 1 ½ inches between mattress and sides
Firm mattress at least 1 ½ inches thick, playpen no more than 1" thick
Safe, waterproof mattress cover that can be sanitized Properly fitting sheets
Bumper pads not in use
Items not hung over the side of the crib or playpen Cribs/playpens sanitized between children
Infants not placed in crib with bibs or other strangulation or suffocation hazards
Cribs or playpens not used for storage of toys or other materials Infants on back to sleep
No blankets in crib
No sleeping in anything other than crib or playpen
Cribs with corner posts do not exceed 1/16 of an inch above the top of end panel
Playpens have mesh openings less than ¼ inch Supports in lowest setting
No stacked cribs
Written permission for infants over 12 months to sleep on cot/mat, if applicable
5101:2-13-21
Evening and Overnight Care
Individual crib, cot mattress or bed and blankets for each child Children under five years, sleep on same level as provider Safe and sanitary and private area for washing and changing Provider assists children as needed with washing and changing Each child provided with washcloth, towel and toothbrush
JFS 01926 (Rev. 12/2016) Page 6 of 9
Provider (or Child Care Staff Member) remains awake until all children are asleep
Monitoring device to ensure sight or hearing Bedtime routines and activities
Children sleeping four hours or more have clean, comfortable sleeping garments
Outdoor walkways, bathrooms, hallways, sleeping rooms and entrances adequately lighted
Approved sleeping areas Tubs sanitized
Access to soap, water and toothpaste
5101:2-13-22
Meal Preparation Nutritional Requirements
Breakfast Served - Fluid milk, + two food groups Meals Served - Fluid milk, meat/meat alternative, two fruit/vegetable, one grain/bread
Snack Served - Two foods from two food groups Follows USDA portion recommendations
Meals and snacks are varied, nutritious and appropriately timed Children are fed required meals
Food is prepared, served and stored in a clean and safe manner Refrigerator Temp (40 degrees or lower)
Current weekly menu is posted Non-choking foods
Written instructions for medical diet No screens on during meals
Whole milk 12-24 months Skim milk/1% over 24 months
Form on file/Breast milk over 12 months
5101:2-13-23
Infant Care
Infants allowed to safely and comfortably sit, crawl, toddle, walk and play
Parents provided with written daily record which includes: food intake, sleep, diapers changes and daily activities
Tummy time
No bottles propped
Bottles labeled with name and date of preparation
Bottles refrigerated upon arrival (unless commercially prepared) Formula and food labeled w/name and when prepared, discarded according to manufacturer's instructions
Formula/food expiration dates verified
No solid foods under 4 months of age without physician note Breast milk: labeled w/date expressed and date of receipt.
Breast milk stored appropriately:
Storage Temperature (at or below) Storage Time Room temp (78F) 6-8 hours
Refrigerator (39F) 5 days (expressed)
Freezer w/in refrigerator (5F) 2 weeks Freezer/refrigerator w/separate door (0)F 3-6 months Deep freeze (-4F) 6-12 months
5101:2-13-23
Diaper Care
Children not left unattended on changing table Provider washes all soiled areas of child Disposable separation material used
Soiled clothing bagged and sent home
Covered, plastic lined, receptacle that prevents hand contamination and is not accessible to children
Wipes/washcloths discarded, or properly sanitized and laundered Ensure that each child has a clean supply of diapers and a change of clothes
JFS 01926 (Rev. 12/2016) Page 7 of 9
5101:2-13-24
Swimming and Water Safety
Onsite swimming pools inaccessible to children by fence or barrier Saunas, hot tubs, spas inaccessible to children and not used by children
Wading pools 18" or less filtered or emptied and sanitized daily Provider supervises at all time with a clear view of all parts of pool and surrounding areas where children are playing
Approved off-site swim sites meet all state/local guidelines for health
Activities in water eighteen inches or more in depth supervised by lifeguard or Water Safety Instructor
No swimming activities in lakes, rivers, ponds, creeks or similar bodies
Written permission from parent before swimming or infants/toddlers in wading pools
5101:2-13-25
Administration of Medication
Provider uses the JFS 01217 "Request for Administration of Medication for Child Care" for all medications, topical ointments and food supplements
Medications properly labeled
Medications are safely and properly stored
Provider ensures that child has had medication prior to the provider administering
Medication in refrigerator stored in a separate container Medications no longer needed or expired, sent home or disposed
Additional Comments/Noncompliances - County Agency Staff
JFS 01926 (Rev. 12/2016) Page 8 of 9
The inspection documented on this form was conducted by county agency staff to determine compliance with family child care rules. All statements on this report are true and accurate documentation of compliance items on the date of the inspection.
Signature of County Agency Staff
Date
The provider's signature below indicates acknowledgement of receipt of the report, not necessarily agreement with findings.
Signature of Provider
Date
JFS 01926 (Rev. 12/2016) Page 9 of 9
ACTION: Revised
CHILDREN'S RECORD REVIEW FOR CHILD CARE
Name of Program
License Number
Date of Inspection
Total Number of Files Reviewed
Signature of Licensing Specialist Completing Review
Name of Child
Child Med.
JFS 01234
Routine/ Swim/ Fieldtrip
JFS 01236
JFS 01217
Notes
JFS 01215 (Rev. 12/2016)
ACTION: Revised
EMPLOYEE RECORD CHART FOR CHILD CARE
Program Name
Key Code:
I or a - In Compliance N/A - Not Applicable
O - Out of Compliance P/V - Previously Verified N/V - Not Verified
Hours of Operation
From: To:
From: To:
Days of Operation
License Number
Date of Onsite
Months of Operation
From: To:
ITEMS TO BE COMPLETED BY APPLICANT/ADMINISTRATOR
TO BE COMPLETED BY CHILD CARE LICENSING SPECIALIST (see more information on back)
Name
(List all persons at the center/home)
Date of Hire
Position
(CCSM, driver, cook, volunteer, janitor, etc)
Hours (start and end times)
and Days
Educ Verif
Med.
Staff Orient
Exp. Date of NCS
(X) Sent or Date to Exp.
FCC 1302
Exp Date DVT
Exp. Date of Training
Professional Development
Hours (6) (# of hours)
M
T
W
R
F
S
S
BCI
FBI
Driver's Lic
FA
CPR
MCD
CA/N
(6 or 3)
CA/N (1)
!
Administrator (CDA exp date or promoted from within qualifications due, if applicable)
Date Administrator Training Due/Completed
Administrator #2 (CDA exp date or promoted from within qualifications due, if applicable)
Date Administrator Training Due/Completed
Administrator #3 (CDA exp date or promoted from within qualifications due, if applicable)
Date Administrator Training Due/Completed
The information I am providing on this form is true and accurate to the best of my knowledge.
Provider/Administrator or Designee Signature
Date
Child Care Licensing Specialist/Reviewer Signature
Date
AJTFTASCH01p3(1059673(9R) epva(.3013240/24)0d1(665)4549) ra(505145) print date: 09/20/2016 8:00 PM
Page 1 of 2
Directions:
1. The Provider or Administrator/designee please fill the section within the bold black box on page one. Including the name of any person who has assigned hours or responsibilities at the center or home. This would include any child care staff members, employees, janitors, vehicle drivers, second adults, students, volunteers or additional residents of the type A home.
2. Fill-in the date that each person began working in the center or home.
3. List the positions that each person holds, for child care staff members include the age group or classroom name of the group for which they provide care.
4. List the hours and days that each person is scheduled at the center or home, or working/volunteering for the program.
5. Sign at the bottom of page one.
Educ Verif.
Verification of completion of high school education or higher degree
Med
Employee medical statements are required at the time of employment. (JFS 01296 may be used)
Staff Orient.
All CCSMs must complete the Staff Orientation Training, using the curriculum provider by the department.
NCS
The nonconviction statement must be signed annually and on file for every person at the center or home. (JFS 01328 shall be used)
BCI
A criminal records check is required to be processed through the Bureau of Criminal Investigation (BCI) and the Federal Bureau of Investigation (FBI).
FCC 1302
A JFS 01302 is required for all type B providers, residents and staff members.
DVT
Driver Vehicle Training must be completed by all drivers, using the curriculum prescribed by the Ohio Department of Education.
Driver's Lic.
Drivers must hold a currently valid driver's license that is required by Ohio law for the type of vehicle being driven.
Professional Development
All CCSM's must complete at least 6 hours of inservice training annually.
FA
First Aid
CPR
Cardiopulmonary Resuscitation
MCD
Management of Communicable Disease
CA/N
Child Abuse and Neglect Recognition and Prevention
Total
The total inservice training hours completed and on file.
JFS 01306 (Rev. 12/2016) Page 2 of 2
Document Information
- File Date:
- 2016-09-20
- CSI:
- Yes
- Rule File:
- 5101$2-13-03_PH_RV_N_RU_20160920_1423.pdf
- RSFA File:
- 5101$2-13-03_PH_RV_N_RS_20160920_1423.pdf
- Related Chapter/Rule NO.: (1)
- Ill. Adm. Code 5101:2-13-03. License capacity for licensed type A homes