5101:2-13-03 Compliance inspection and complaint investigation of a licensed family child care provider.  

  • Text Box: ACTION: Revised Text Box: DATE: 09/20/2016 2:23 PM

     

     

     

    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

    Agency Mailing Address (Plus Zip)                                       Phone                     Fax

    Michael.Lynch@jfs.ohio.gov

    Email

    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 It replaces rescinded rules 5101:2-13-07, 5101:2-13-08 and 5101:2-14-03.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

    Text Box: ACTION: Revised                                                                                                                                              Text Box: DATE: 09/20/2016 2:23 PM

    Ohio Department of Job and Family Services

    STATEMENT OF NONCONVICTION FOR CHILD CARE

    Text Box: This statement must be signed annually by every:  individual owner, administrator, licensed family child care provider, child care staff member, employee, all persons 18 years of age and older who reside in a family child care home, substitute, and certified in-home aide.

    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

    Text Box: ACTION: Revised                                                                                                                                              Text Box: DATE: 09/20/2016 2:23 PM

    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)

    Text Box: ACTION: Revised                                                                                                                                              Text Box: DATE: 09/20/2016 2:23 PM

    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

    Text Box: ACTION: Revised                                                                                                                                              Text Box: DATE: 09/20/2016 2:23 PM

    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)

    Text Box: ACTION: Revised                                                                                                                                              Text Box: DATE: 09/20/2016 2:23 PM

    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

    Text Box: Comments - Provider

    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

     
    DATE:O0h9io/D2e0p/a2rt0m1en6t o2f :J2ob3aPndMFamily Services

    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

     
    DATE: 09/O2h0io/D2e0pa1rt6me2nt:o2f3JobPaMnd Family Services

    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)

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

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    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