Nimani Kids

5180:2-13-16 Communicable Diseases

“During the inspection, it was determined that the DCY 08087 Communicable Disease Chart was not posted as required.The following was observed: A current communicable disease chart was not posted. Submit the programs corrective action plan to verify compliance with the requirements of this rule..”

5180:2-13-15 Child Enrollment Records

“In review of the children's records, it was determined that information had not been secured from the parent/guardian on the DCY 01234 Child Enrollment and Health Information For Child Care or equivalent as required.The following was observed as missing: Enrollment form for at least one child was not updated by either the parent or the administrator.Submit the program's corrective action plan to the Department to verify compliance with the requirements of this rule.”

5180:2-13-14 Requirements for Field and Routine Trips

“In review of the program's records, it was determined that requirements for written permission from the parent/guardian for a routine trip were not met.The following was observed: Permission forms for routine trips were not being updated annually.Submit the programs corrective action plan to verify compliance with the requirements of this rule.”

5180:2-13-12 Pets

“During the inspection, it was determined that regulations for having pets were not followed.The following was observed: All local and state ordinances governing the keeping of an animal were not followed. Submit the program's corrective action plan to the Department to verify compliance with the requirement of this rule.”

5180:2-13-20 Crib and Playpen Requirements

“During the inspection, it was determined that a child had been place in a crib or playpen with the following number 1 below which could obstruct a provider or child care staff members view of the infant: 1. Busy box or other toy attached to the side of the crib or playpen.2. A blanket hanging over the side of the crib or playpen.3. Stuffed animal that is not large/soft enough that it could conform to the shape of the childs face. 4. Other [ ]Correct the violation and submit the programs corrective action plan to verify compliance with the requirement of the rule.”

5180:2-13-16 Emergency Preparedness and Response Plan

“During the inspection, it was determined the programs written emergency and preparedness and response plan did not meet the requirement for training child care staff members and employees on the plan annually as noted in numbers 1 and 2 below:1. Child care staff members and employees were not trained annually.2. Written documentation of the training was not kept on file.Submit the programs corrective action plan to the Department to verify compliance with the requirements of this rule.”

5180:2-13-15 Child Medical and Enrollment Records

“In review of of the children's records, it was determined that completed medical statements were not on file, as required, for children listed on the JFS Children's Record Review For Child Care as indicated in numbers 1 and 8mbelow:1. No medical was on file for at least one child 2. Medical(s) on file was not updated every 13 months 3. Medical(s) were missing child's name and date of birth4. Medical(s) were missing the date of the medical examination5. The date of the exam was more than 13 months prior to the date the form was signed 6. Medical(s) were missing a statement that the child has been examined and is in suitable condition for participation in group care7. Medical(s) were missing the signature, business address and telephone number of the physician, physician's assistant(PA), advance practice nurse (APN) or certified nurse practitioner (CNP) who examined the child8. Medicals were missing a record of immunizations the child has had specifying month, day and year9. Medical(s) were missing a statement from the physician, PA, APN, or CNP that the child has been immunized or is in the process of being immunized against the diseases required by division 5104.014 of the Revised Code and found in appendix A to this rule10. Medical(s) were missing a statement from the childs parent or guardian that he or she has declined to have the child immunized against the disease for reasons of conscience, including religious convictions11. Other [ ] Submit the programs corrective action plan to the Department to verify compliance with the requirements of this rule. .”

5180:2-13-12 Safe Environment

“During the inspection, it was determined the gate used were not safe as noted in number 2 below:1. Anchored;2. Mounted; on the access of the upstairs steps.3. Free of Entrapment;4. The Approved Style;5. Other [ ].Correct the violation and submit the program's corrective action plan to verify compliance with the requirement of the rule.\"”

5180:2-13-12 Safe Environment

“During the inspection it was determined the item noted in number 4 below were not in working condition:1. Kitchen Sink;2. Refrigerator;3. Stove or Microwave Oven;4. Other: Mounted TV stand with accessible fire pace on. Correct the violation and submit the program's corrective action plan to verify compliance with the requirement of the rule.\"”

5180:2-13 Written Policies and Procedures

“On the day of the inspection, the programs written policies and procedures provided to the parents/guardians and employees was missing item numbers 3, 20, 21, 23, 24 an d 25 below: General Information1. Name, address, email address and telephone number.2. Description of the providers program philosophy.3. Days and hours of operation, scheduled closings and basic daily schedule.4. Staff/child ratios and group size.5. Opportunities for parent involvement in activities.6. Opportunities for parents to meet with the provider regarding their child.7. Payment schedule, overtime charges and registration fees if applicable.8. Programs shall have a policy in place describing supports for onsite breastfeeding or pumping for mothers who wish to do so (if the program serves infants or toddlers). Provider Policies and Procedures9. Enrollment including required enrollment information.10. Care of children without immunizations.11. Attendance including procedures for arrival and departure, the program's absent day policy, releasing child to persons other than the parent, releasing a child according to a custody agreement and follow up when a child scheduled to arrive from another program or activity does not arrive.12. Supervision of children, including a separate supervision policy for school-age children, if applicable.13. Child guidance.14. Suspension and expulsion.15. Ensure compliance with the Americans and Disabilities (ADA) including administering medication to children with disabilities and administering care procedures for children with disabilities.16. Outdoor play, including limitations placed on outdoor play due to weather or safety issues (considerations may include but are not limited to temperature, humidity, wind chill, ozone levels, pollen count, lightning, rain or ice). 17. Food and dietary policy, including information regarding meeting one-third of the child's recommended daily dietary allowance, policy regarding formula, breast milk, meals, and snacks and policy on providing supplemental food. 18. Management of illness including isolation precautions, symptoms for discharge and return, notification of parent of ill child and whether or not the provider will care for sick children.19. Summary of procedures taken in the event of an emergency, serious illness or injury.20. Administration of medication and topical products policy, medical foods, modified diets, and whether school age children are permitted to carry their own medical and ointments.21. Transportation policy for field trips, routine walks, if applicable, and emergencies including if the provider will provide child care services to children whose parents refuse to grant consent for transportation to the source of emergency treatment.22. Water activities/swimming.23. Infant care, if applicable, including feeding, frequency of diaper checks, and information about daily activities.24. Sleeping, napping and resting.25. Evening and overnight care, if applicable.26. Policy on hours of operation, closing due to weather, school delays or closings and any other factors.27. Use of a substitute child care staff member or child care staff member pursuant to 5101:2-13-08 of the Administrative Code for sick days, vacations or other time off.28. Situations that may require disenrollment of a child, if applicable.29. Problem or issue resolution for parents or employees to follow when needing assistance in resolving problems related to the family child care home.30.Formal screenings and assessments conducted on enrolled children and if the program reports child level data to ODJFS pursuant to Chapter 5101:2-17 of the Administrative Code.Correct the violation and submit the program's corrective action plan to verify compliance with the requirement of the rule.”

5180:2-13-16 Emergency Preparedness and Response Plan

“During the inspection, it was determined the programs written emergency preparedness and response plan did not meet the requirement or was missing the information in numbers 10, 11, 16, 17, 18 and 19 below:Procedures:1. The written emergency and preparedness and response plan had not been completed2. The plan was not provided to all child care staff and employees3. Weather emergencies and natural disasters which include severe thunderstorms, tornadoes, flash flooding, major snowfall, blizzards, ice storms or earthquakes4. Emergency outdoor and indoor lockdown or evacuation due to threats of violence which includes active shooter, bioterrorism or terrorism including a designated safe site where staff and children can safely remain when evacuated5. Emergency or disaster evacuations due to hazardous materials and spills, gas leaks or bomb threats including a designated safe site where staff and children can safely remain when evacuated6. Outbreaks, epidemics or other infectious disease emergencies7. Loss of power, water, or heat8. Other threatening situations that may pose a health or safety hazard to the children in the programDetails:9. Shelter in place or evacuation, how the program will care for and account for the children until they can be reunited with the parent10. Assisting infants, toddlers and children with special needs and/or health conditions11. Emergency contact information for parents and the program12. Procedures for notifying and communicating with parents regarding the location of the children if evacuated13. Procedures for communicating with parents during loss of communications, no phone or internet service available14. The location of supplies and procedures for gathering necessary supplies for staff and children if required to shelter in place15. What to do if a disaster occurs during the transport of children or when on a field trip or routine trip16. Making the plan available to all child care staff members and employees17. Training of staff or reassignment of staff duties as appropriate18. Updating the plan on a yearly basis19. Contact with local emergency management officials20. The plan was unable to be implemented in that, [ ].Submit the programs corrective action plan, which includes the missing information, if applicable, to verify compliance with the requirements of this rule.”

5180:2-13-16 Emergency Preparedness and Response Plan

“During the inspection, it was determined the programs written emergency and preparedness and response plan did not meet the requirement for training child care staff members and employees on the plan annually as noted in numbers 1 and 2 below:1. Child care staff members and employees were not trained annually.2. Written documentation of the training was not kept on file.Submit the programs corrective action plan to the Department to verify compliance with the requirements of this rule.”

5180:2-13-09 Background Checks

“In review of the staff records, it was determined that background checks did not meet the requirements of the rule for the person listed on the Employee Record Chart as noted in number 1 below:1. The request for a background check for child care was not submitted in the OPR.2. The fingerprints were not submitted electronically according to the process established by BCI.3. The individual(s) had engaged in assigned duties or were near children and preliminary approval from ODJFS was not on file.4. Background checks were not updated every five years. Submit the programs corrective action plan, which includes a copy of the JFS 01176, or a copy of the preliminary approval or a statement that the individual(s) are no longer engaged in assigned duties and are not near children until the preliminary approval has been received, to the Department to verify compliance with the requirements of this rule.”

5180:2-13-08 Child Care Staff Requirements

“In review of the staff records, it was determined that substitute child care staff member did not meet the requirements for completing the online orientation training as noted in number 1 below:1. The training was not completed within 30 days of starting employment at the program as a child care staff member.2. No documentation of completing the training after December 31, 2016.3. Completion of the training was not verified in the OPR.4. A child care staff member had sole responsibility of children and had not completed the online orientation.Submit the programs corrective action plan to the Department to verify compliance with the requirements of this rule.”

5180:2-13-22 Meals and Snacks

“During the inspection, it was determined that the program's weekly menu did not meet the requirement as noted in number 1 below. 1. The menu was not posted.2. The posted menu was not in a visible place readily accessible to parents.3. The menu was not currently dated.4. The entire menu was substituted.5. At least one item on menu did not match what was served.6. The meal or snack served did not match the posted menu.Submit the program's corrective action plan to verify compliance with the requirement of the rule.”

5180:2-13-18 Attendance

“During the inspection, it was determined the program did not meet the requirements for keeping an attendance record as listed in number 2 below:1. No attendance record was being maintained.2. The attendance record was not being consistently completed.3.The record did not include the name of at least one child.4. The record did not include the birth date of at least one child.5.The record did not include the assigned group.6.The record did not include the childs weekly schedule.7.The record did not include the time (hours and minutes) of each childs arrival and departure to the program, including transportation by the program.8. The original attendance record was not kept at the program for a period of one year.Submit the programs corrective action plan to the Department to verify compliance with the requirements of this rule.”

5180:2-13-16 Emergency Preparedness and Response Plan

“During the inspection, it was determined the programs written emergency preparedness and response plan did not meet the requirement or was missing the information in numbers 3, 6, 7, 10, 14 and 15 below:Procedures:1. The written emergency and preparedness and response plan had not been completed2. The plan was not provided to all child care staff and employees3. Weather emergencies and natural disasters which include severe thunderstorms, tornadoes, flash flooding, major snowfall, blizzards, ice storms or earthquakes4. Emergency outdoor and indoor lockdown or evacuation due to threats of violence which includes active shooter, bioterrorism or terrorism including a designated safe site where staff and children can safely remain when evacuated5. Emergency or disaster evacuations due to hazardous materials and spills, gas leaks or bomb threats including a designated safe site where staff and children can safely remain when evacuated6. Outbreaks, epidemics or other infectious disease emergencies7. Loss of power, water, or heat8. Other threatening situations that may pose a health or safety hazard to the children in the programDetails:9. Shelter in place or evacuation, how the program will care for and account for the children until they can be reunited with the parent10. Assisting infants, toddlers and children with special needs and/or health conditions11. Emergency contact information for parents and the program12. Procedures for notifying and communicating with parents regarding the location of the children if evacuated13. Procedures for communicating with parents during loss of communications, no phone or internet service available14. The location of supplies and procedures for gathering necessary supplies for staff and children if required to shelter in place15. What to do if a disaster occurs during the transport of children or when on a field trip or routine trip16. Making the plan available to all child care staff members and employees17. Training of staff or reassignment of staff duties as appropriate18. Updating the plan on a yearly basis19. Contact with local emergency management officials20. The plan was unable to be implemented in that, [ ].Submit the programs corrective action plan, which includes the missing information, if applicable, to verify compliance with the requirements of this rule.”

5180:2-13-12 Safe Environment

“Children in care shall be protected from any items and conditions which threaten their health, safety, and well being. During the inspection, it was determined that children were not protected from the following items and condition which may threaten their health, safety, or well being as noted in the following numbers 1 and 22 below:1. Surge protectors/outlets did not have childproof receptacle covers on the hallway wall going into the kitchen.2. Open pull cords that are not closed loop.3. Toys or other items small enough to be swallowed were present in the space where infants and/or toddlers were in care.4. Electrical/extension cords attached to an object that would not likely result in a severe injury if pulled.5. Stacked chairs.6. Telephone cords.7. Employee(s) purse(s).8. Diaper bags.9. Television not securely anchored.10. Small or lightweight pieces of shelving units are not securely anchored to the wall.11. Staff member stepped over a barrier/gate while holding a child.12. Chipping or peeling paint.13. An area rug did not have a nonskid backing.14. An area rug presented a tripping hazard.15. A floor surface was unsafe in that [ ].16. No platform was provided for the sink or toilet.17. The platform provided for the sink or toilet was not sturdy.18. The platform provided for the sink or toilet posed a safety hazard in that [ ].19. Emergency exits were blocked by the following furniture in that [ ].20. A mercury thermometer was being used to take a childs temperature. 21. Methods of ventilation used did not provide protection from rodents, insects, or other hazards.22. Batteries in the TV stand, in a drawer in the kitchen and in a drawer under the desk in the main program space.Submit the programs corrective action plan to the Department to verify compliance with the requirements of this rule.”

5180:2-13-12 Safe Environment

“During the inspection, it was determined the water temperature was 124 in the following room, bathroom. This temperature exceeds the requirement of remaining below 120 degrees Fahrenheit. Correct the violation and submit the program's corrective action plan to verify compliance with the requirement of the rule.”

5180:2-13-12 Safe Environment

“Children in care shall be protected from any items and conditions which threaten their health, safety, and well-being. During the inspection, it was determined the program did not protect children from an unsafe item due to the following number 15 below: 1. Pull cord(s) on the window blind(s). 2. Extension cord(s); electrical cord(s) attached to an object that could result in a severe injury if pulled.3. Stacked tables. 4. Folding tables. 5. Matches and/or a lighter. 6. Power tool(s). 7. Live wires. 8. Stove(s) that are either on or able to be turned on by a child. 9. Asbestos. 10. Traffic. 11. A body of water. 12. A well. 13. Environmental hazard(s) confirmed by local authorities having jurisdiction over the hazard.14. A crockpot used to heat bottles. 15. Immediate access to a knife. 16. Large or heavy pieces of shelving units are not securely anchored to the wall. 17. Marijuana was accessible to children.18. Other [ ]. Any hazardous equipment must be removed, replaced, or repaired and any hazardous condition must be corrected and must be made inaccessible to children.Provide staff training. Submit the programs corrective action plan, which includes a statement that the item or condition has been removed and a statement that training was provided, to the Department to verify compliance with the requirements of this rule.”

5101:2-13-15 Child Medical and Enrollment Records

“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 numbers 2 and 16 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/guardians 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. Missing names at the top of pages 2 and 3 of enrollment form.Submit the program's corrective action plan to the Department to verify compliance with the requirements of this rule.”

5101:2-13-15 Child Medical and Enrollment Records

“In review of of the children's records, it was determined that completed medical statements were not on file, as required, for children listed on the JFS Children's Record Review For Child Care as indicated in number 2 below:1. No medical was on file for at least one child 2. Medical on file was not updated every 13 months 3. Medical(s) were missing child's name and date of birth4. Medical(s) were missing the date of the medical examination5. The date of the exam was more than 13 months prior to the date the form was signed 6. Medical(s) were missing a statement that the child has been examined and is in suitable condition for participation in group care7. Medical(s) were missing the signature, business address and telephone number of the physician, physician's assistant(PA), advance practice nurse (APN) or certified nurse practitioner (CNP) who examined the child8. Medical(s) were missing a record of immunizations the child has had specifying month, day and year9. Medical(s) were missing a statement from the physician, PA, APN, or CNP that the child has been immunized or is in the process of being immunized against the diseases required by division 5104.014 of the Revised Code and found in appendix A to this rule10. Medical(s) were missing a statement from the childs parent or guardian that he or she has declined to have the child immunized against the disease for reasons of conscience, including religious convictions11. Other [ ] Submit the programs corrective action plan to the Department to verify compliance with the requirements of this rule. .”

5101:2-13-12 Safe Environment

“During the inspection, it was determined the water temperature was 140 degrees in the following room, kitchen. This temperature exceeds the requirement of remaining below 120 degrees Fahrenheit. Correct the violation and submit the program's corrective action plan to verify compliance with the requirement of the rule.”

5101:2-13-12 Safe Environment

“Children in care shall be protected from any items and conditions which threaten their health, safety, and well being. During the inspection, it was determined that children were not protected from the following items which may threaten their health, safety, or well being as noted in the following numbers 4 and 22 below:1. Surge protectors/outlets did not have childproof receptacle covers.2. Open pull cords that are not closed loop.3. Toys or other items small enough to be swallowed were present in the space where infants and/or toddlers were in care.4. Electrical cords attached to an object that would not likely result in a severe injury if pulled.5. Stacked chairs.6. Telephone cords.7. Employee(s) purse(s).8. Diaper bags.9. Television not securely anchored.10. Small or lightweight pieces of shelving units are not securely anchored to the wall.11. Staff member stepped over a barrier/gate while holding a child.12. Chipping or peeling paint.13. An area rug did not have a nonskid backing.14. An area rug presented a tripping hazard.15. A floor surface was unsafe in that [ ].16. No platform was provided for the sink or toilet.17. The platform provided for the sink or toilet was not sturdy.18. The platform provided for the sink or toilet posed a safety hazard in that [ ].19. Emergency exits were blocked by the following furniture in that [ ].20. A mercury thermometer was being used to take a childs temperature. 21. Methods of ventilation used did not provide protection from rodents, insects, or other hazards.22. Toothpaste and shampoo out in reach of children.Submit the programs corrective action plan to the Department to verify compliance with the requirements of this rule.”

5101:2-13-11 Outdoor Space

“During the inspection, it was determined that the following hazardous conditions existed in the outdoor play area, as noted in number 15 below: 1. There was broken glass.2. There were tall weeds.3. There was poison ivy.4. There were tree branches.5. There was mold visible.6. The sandbox was contaminated.7. There were thistles with prickers.8. There were bird droppings.9. The outdoor area was littered with trash.10. The trash can was missing a lid.11. The trash was not emptied from the day(s) before.12. The trash can was overflowing with trash.13. The trash can was infested with insects.14. The trash can was visibly dirty.15. Wood slats with screws sticking out, they are sticking out from under the stairs that lead to the backyard.Correct the violation and submit the program's corrective action plan to verify compliance with the requirement of the rule.”

5101:2-13-10 Health Training

“In review of records, it was determined the provider did not have current valid documentation for training listed in number 14 below:1. First Aid - expired training2. First Aid - did not have verification of the completion of First Aid training3. First Aid - documentation did not demonstrate the person who provided the training met the trainer qualifications as stated in the rule4. CPR - expired training5. CPR - had not taken CPR training6. CPR - did not have verification of the completion of CPR training7. CPR - training taken did not include all age groups and developmental levels of all children in care8. CPR - documentation did not demonstrate the person who provided the training met the trainer qualifications as stated in the rule9. CPR- audiovisual or electronic media training taken did not include an in-person component of the training10. Communicable Disease - expired training11. Communicable Disease - had not taken CD training12. Communicable Disease - did not have verification of the completion of CD training13. Communicable Disease - documentation did not demonstrate the person who provided the training met the trainer qualifications as stated in the rule 14. Child Abuse - expired training15. Child Abuse - had not taken Child Abuse training16. Child Abuse - documentation did not demonstrate the person who provided the training met the trainer qualifications as stated in the ruleCorrect the violation and submit the documentation of current certification with the program's corrective action plan to verify compliance with the requirement of the rule.”

5101:2-13 Written Policies and Procedures

“On the day of the inspection, the programs written policies and procedures provided to the parents/guardians and employees was missing item numbers 9, 15, 20 and 23 below: General Information1. Name, address, email address and telephone number.2. Description of the providers program philosophy.3. Days and hours of operation, scheduled closings and basic daily schedule.4. Staff/child ratios and group size.5. Opportunities for parent involvement in activities.6. Opportunities for parents to meet with the provider regarding their child.7. Payment schedule, overtime charges and registration fees if applicable.8. Programs shall have a policy in place describing supports for onsite breastfeeding or pumping for mothers who wish to do so (if the program serves infants or toddlers). Provider Policies and Procedures9. Enrollment including required enrollment information.10. Care of children without immunizations.11. Attendance including procedures for arrival and departure, the program's absent day policy, releasing child to persons other than the parent, releasing a child according to a custody agreement and follow up when a child scheduled to arrive from another program or activity does not arrive.12. Supervision of children, including a separate supervision policy for school-age children, if applicable.13. Child guidance.14. Suspension and expulsion.15. Ensure compliance with the Americans and Disabilities (ADA) including administering medication to children with disabilities and administering care procedures for children with disabilities.16. Outdoor play, including limitations placed on outdoor play due to weather or safety issues (considerations may include but are not limited to temperature, humidity, wind chill, ozone levels, pollen count, lightning, rain or ice). 17. Food and dietary policy, including information regarding meeting one-third of the child's recommended daily dietary allowance, policy regarding formula, breast milk, meals, and snacks and policy on providing supplemental food. 18. Management of illness including isolation precautions, symptoms for discharge and return, notification of parent of ill child and whether or not the provider will care for sick children.19. Summary of procedures taken in the event of an emergency, serious illness or injury.20. Administration of medication and topical products policy, medical foods, modified diets, and whether school age children are permitted to carry their own medical and ointments.21. Transportation policy for field trips, routine walks, if applicable, and emergencies including if the provider will provide child care services to children whose parents refuse to grant consent for transportation to the source of emergency treatment.22. Water activities/swimming.23. Infant care, if applicable, including feeding, frequency of diaper checks, and information about daily activities.24. Sleeping, napping and resting.25. Evening and overnight care, if applicable.26. Policy on hours of operation, closing due to weather, school delays or closings and any other factors.27. Use of a substitute child care staff member or child care staff member pursuant to 5101:2-13-08 of the Administrative Code for sick days, vacations or other time off.28. Situations that may require disenrollment of a child, if applicable.29. Problem or issue resolution for parents or employees to follow when needing assistance in resolving problems related to the family child care home.30.Formal screenings and assessments conducted on enrolled children and if the program reports child level data to ODJFS pursuant to Chapter 5101:2-17 of the Administrative Code.Correct the violation and submit the program's corrective action plan to verify compliance with the requirement of the rule.”

5101:2-13-15 Child Medical and Enrollment Records

“In review of the children's records, it was determined that completed medical statements were not on file, as required, for children listed on the JFS Children's Record Review For Child Care as indicated in number 2 below:1. No medical was on file for at least one child 2. Medical(s) on file was not updated every 13 months 3. Medical(s) were missing child's name and date of birth4. Medical(s) were missing the date of the medical examination5. The date of the exam was more than 13 months prior to the date the form was signed 6. Medical(s) were missing a statement that the child has been examined and is in suitable condition for participation in group care7. Medical(s) were missing the signature, business address and telephone number of the physician, physician's assistant(PA), advance practice nurse (APN) or certified nurse practitioner (CNP) who examined the child8. Medical(s) were missing a record of immunizations the child has had specifying month, day and year9. Medical(s) were missing a statement from the physician, PA, APN, or CNP that the child has been immunized or is in the process of being immunized against the diseases required by division 5104.014 of the Revised Code and found in appendix A to this rule10. Medical(s) were missing a statement from the childs parent or guardian that he or she has declined to have the child immunized against the disease for reasons of conscience, including religious convictions11. Other [ ] Submit the programs corrective action plan to the Department to verify compliance with the requirements of this rule. .”