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Evaluation Form (4) 02/19 ALABAMA DEPARTMENT OF HUMAN RESOURCES CHILD CARE CENTER LICENSING EVALUATION ANNUAL Health and Safety Guidelines Items Shaded Name of Center: Date(s) of Evaluation: r C. 1 a Address: rl l q 0(An+r.�1 Gly Rrj Date(s) of Follow-up: 414an" 354'10 County: CbW*q Purpose of Visit: AMA l Telephone #: (?OS ) (pia ,.y '-� Director: LC4 /�i l 1S Licensee: Sumiex (o ups ® [X] Day ❑ Night ❑ Subsidy Licensed Capacity: Day 5 Night Days of Operation: Day Night Age Range: D W�af_ Ni t Dht � Hours of Operation: ay Nig ,7.W fig M License Number: L t*o bd a p p g Code: wgoRrl Effective Dates of License: O - Observed by DHR Licensing Representative S -Certified by Licensee/Staff in charge From: p To: D -Discussed with Licensee/Staff in charge 0 ` 2 S-lb %5-20 X-Not Applicable-Not reviewed with Licensee/Staff in charge Deficiencies Noted: [W Yes ❑ No DHR Licensing Representative: e Sections to be completed at the discretion of the DHR Licensing Representative. U U N U U N Z Q N U M U REGULATIONS 5- REGULATIONS Q U Q O U Q U o o U o 0 Z Z Z Z Facilities (II. C., pages 16-22) b. Hazard prevention(page 18)(Indoor area) 1. Indoor area(II.,C.,4.,pages 16-18) �(I) Centerfreegfapp4renthazards a Bathrooms locatep d1ri ` wi a Gsa x ayr s+ "� w � '�Pemx combmah.on tocit/Cuopntaw mdver ersau : k* d F�r m w fabled (1) One flush toilet for each 15 children O � (3) �tdfifirearms or ammunition eKor allowed m� : >• center except law eiiforcetr„rent (2) One hand-washing sink for each 15 children O �4) Stai.,rways°have hand railmgs'in ohild s".reaght 2 # (3) One tub(portable plastic acceptable) `(S) dear glass doors masked a;childev elfi a (4) 5W iqA ixtuies�c ild s zc ar adjusted easy use; {�;F re (6)i ed(panes and drugs ep n kt uder loq)c and eyt a3 � i�, s al td� a gyyws o- lock separate from hamitiil items r�: $�� r '�......, fr,�,<"`"' ' ;` � :t �,_ s,_•�5..ra .._ o- - _'.�- a °. , ? ...d'; -.s"�. to-:^` " ,c�._.,.h`�.. a.R: � �"s 1 U U U U cu U f0 U REGULATIONS a °- Q Q- °- Q E E REGULATIONS E E a U Q U Q U z Z U Z Z (7) �ers arounsleaes, atzrs,fAnsCaeShle91`� _ b. Wading structures less than 2 feet in depth: -tochild . n .4- ...... :. Y. ., v & �, w S n SW4 la x "* w; - ` "r° -7 tMM a 0 v" XpOiedl XeCt 4cal'. tletrS ha(�tOtCCt1 e"CdYeIS _ t (1) 1�1 1PaSC One Sta if 1 �G ltSt al(�$C _ �� k t� yt s"a y' '3 A t u �`a• a p t �' " _As each Wading StrllCtitre �r t nr,:".:"S'' . Jul `« -' io a 'r` ry� § '4"''*gyp" tp"� M IT-JS a�, j'ivr gg gg'"y M"'� .' konsump ion,of awfiw cfr�use ofnon a, " 2) Requtredfrat q�s me�s3siated bn pa e 23 presanption narcotic or illegaisubstaneeS prohibited aaa „µaAaz, a P y �gti s -k - S 4 ` s. � * 'E a "�a 4 ,(f t i 3A��il' 3 (10) Smolnng or use of tobacco pro whited on t r(3) At leastWorstaff a each vvadmg structure s -Li,. , A" .`�._.,.,ix;. alas t<� srdi�� xs.., i`=a. x<"•..+:sar ,q ^�:,. .�`� r'.�r9 xfr lh .-�.8�. '�_"n," :'�t,� 2. Outdoor area(II.,C.,5.,page 19) (4) Clean Yvater provrded each dayl lading ". Mx See Checklist stnnc"emptied when nUt to nSc s a a "''a�Off stieet loadin unloadin rovided b ,Separate arcas for children younger than 2l(may,, ° be�achievedby scheduling �: , 4. Away from center activities (IL, � � C 7 page 21) '� ;c Outdoor area ad�oms or is safely"aecessible ��, :.,..� NOTE: The Department of Human Outdoor play area free of appazent hazardous Resources does not inspect activities away cgadztions {nun mm a", ,ems W .' wadingfrom activities. activiG'es.including Theg licenseeswimmingsha� 3. Swimming and Wading at the Center assume full authority and responsibility for (II.,C.,6.,pages 19-21) away from the center activities a. Pools two feet or more in depth Child Care Program (II., D. (1)}Iafeguartd at poolstde at all tttnes pool is�n user h pages 23-35) a��2 Life ward Trairim Certifeate First�d �M '��r �,: r � '"�:`SIT ..,�Vs O g g li � � 1 r,Rot utred ratios maintained 90i Certificate CPR Certification on filed n r Jt ffi w Boa a R a"_" 9gs da s-r »¢. �- wkw"'-z: .$k". A+?h.'`.. ,a..».:,_ ^?,<,a,+�. -»6 . ,ita (3) Lifeguard notcounted in ratios ' a' 0 up to�18 months , 1 too 5 xt ^; t", .ini. "'a' "t rar xs.aro 3 �s , ,ls. -,i ^� .e v: _x?',5 (4) Staff-child ratios for children in the pool: b 18 montths up to 21 years * x .,a,J, < n (s,y,G 4ad # -a," iaN^" Yip afro (a) one staff for each child younger than 2/z years i „jc. 24 monti�s up to 36 months 1 to!8 Aww (b);66e kafffor every 4 children ages 2"lz years up s d:2%z years up to 4 yearn 1 to 11 r x•tf)4>years r-z w➢ kd ni it v"t�. , ,tF r - c a:: a 91. M111,51"; ' P, + 4 (c) onestafffor every 6 children ages 4years up to 6 e? 4 years up to school age1 to 18 - ;:years ua S x ' a,I, S f r & t: r ,cu J M (d) one's taff_%,%very 10 anddcen ages 6 years ands k f,4School age u)t tor8 YeaFs a _ olc(er e ` $�y Rahos de(ernzined b yggest`shldntthe pool ,and o)der1 to 2L 'i a. V`�.-.ar�a""4';,�� 'a- n'r N.nt', (6)rh'etson§couzited u�ratios meet child care worker � 2 Children younger biu 2%grouped separately did ' t„ , qualtficatiots�mthe,poaiat¢at1'times t� fro�nIderchildreWw n � Stafflirov ded fo superv> @ children mpool'area, ��4 3. Staff coverage(page 23) but not m pb'ol,� � = l ,rk '' )ylfany;palUoON faohtldSQdyalSmtllea$er„child xn a+a.3A.I1'cblld[enSupg 3 dafmull111r1eS tias a €� i Sr a, (bV�� a +sue*' :�" .'� '.� a�-`�,» •r a 9 ,�'F d u+°" ';. M1 (9)1'oolenclosed vijil�fenee or solyd wait at least 4w , * St m each room durmgsnappmgfrestutg� r .rair ..;' 3� a> d ,tin�- pa.+ ^ " s feet m heaght constructed to prevettt accessib�htyby . abildren 'Staffable tosee ��t�ha oluldren g �'s,".Taj» 4 i 2 U a) U a) N f0 U REGULATIONS Q Q -a REGULATIONS E ° n E E a Q- O U Q U Q U Z0 U o 0 Z Z Z d. Ratio during napping/resting: (3} Infants held for:bottle feeding/No:bottles 8 si 4o1mono) 0u Toddlers seated while eating (2) 18 mogths up to 2Z years i 1 to 14j (i (5) Child s bands washed before d afters Pik -sw dFa �i 4:11 A��,�Y t M Sin, Gi .I .' k 'snacks aftentiiaperirigtoilettng;" �r , fi (3)2'/Z years and older 1 to 36 C) f 6 Stafl?s hands washed be ore food ` '� 12, � +r ? � P kn a � 3,. 7 s � •prcparafl0n and SeNiee aftCraSSlStUlga�V}tkl 'ni ., p _ toilehn after dia enn � e ff°.Sta with infant child CPR and first aid present.. during all hours of operation, 4. Infant/Toddler Program(II.,D.,2., if+G� '�� �O Individual paper=towels for eac a h wshing -7 pages 25-28) and=drying °<" `. a. Learning/growth activities:(page 25) 5. Preschool/School-age Program Cries/signs of mm distress investigated iediately (II.,D.,3.,pages 28-31) b. Diapering/toileting:(pages 25-26) a. Learning/growth activities(pages 28-29) (1) Each child s hands washed after=diapering b. Napping/resting(page 29) .»�iN..,;,«,� u�,.,�' �, ..���<p' �,�'i"��e��$n�i..,x,�`��A,g,;�>h,•���3+�'�':�-:+fy�:9.t7Lr�w;x'i tr' ;, am� !;- 'y f(2) Staff wash hands after diapering each child, � `. O)„�Cotsficleaned and cieah^bottonn sheets�add ���, � ��it ; i Ts5 I yak ,t JW S ' �. use -x �r 3. �,R ay^fir,n A a;; t d s top sheets/covers provided before used�by another 3 Staffuse clean dis osable loves for dia erin child P g P g � a eackichild/for each diaper change �y1 ; �,F d s i _ � a;: ,,x n «� (4)Diapering area separate from food°service area,,, Cleansheets/covers provided weekly s �y w1UAl �Y more often if needed c. Napping/resting(page 26) (3) Cots p$sit>oned,Yo allow space for'access fii ' oremergencyexrt ,d �,{ Infants placedon back tosleep unless physicianus� bpi "*° Todetmg:(page29)aceardirig to each,ohild s �� statement indicates otherwise �' w _.m ,needs,each child's handswashed d. Cribs,cots,and bedding(pages 26-27) d. Feeding(pages 29-31) �ifi,.,' „ (1) wo T feet of space betwee' in occupied Dribs �.(lt) Childr'euxm attendance sefVe&breitkfast:or 41 3 dd Co ��.:,g{d (2) tspositioned to allow spacesfor��access�or � � �2) Meals and snacks:complyw�th attgr s�4 Q ,: w ?- ,� r a sas" " i,.„, ,, fN r emergency exit e i7ST)A gmdelines page 29 30 J,I(3) For infants clean bottom sheets daily or more w�' �, �� �„ (3) Small"hard candies nuts not served to * x iP'i� �s ev a Chii ren nnder four .<g�ten rfneeded sheetsfit�snagl� (4} Soft matenal-prohibned in infant-s sleeping (4) Foods that may cause choking prepared envionment no pillows uilts comforters etc �' _ appropriately foe the child =' � �, a,_ . �e,�_.a< �ox:. � Ad {5) For toddlers clean bottom sheets and top w (5} Children not allowed m kitchen coverings weekly more often if needed ia e. Feeding(page 27) + (6) Childien's handslwashed'before meals * and snaok,and aher toiletmg ' #' �, (ft) Mealskai►d snacks complX with requirements,fil �� fi(7} Staff�ilands washed before food ' �� .;, R k w�Ny6-B b`s ` s " sl.fi yr tiP e us huj ldd� �,„ ! c' � preparation°arid service,and after assisting with �' toiletng or contact withbodily fluid (2) Tf forula,provided b7, y parent tabeled, „� _ ,� (&) Sndividuat paper�towels�for each}yashmg � fi �! .�. Kn' *��`t t a'3'P p"xifii f!u, �S .c vt v2 refrigerated a m A �I and dryinglu a GoFDAi Getsj;elr®lef 6(ou l pL"<,$I r-boS Milk, 3 .fl � REGULATIONS m ° C E E Q REGULATIONS E E CL Q U Q U Q o O o O z Z z Z e. Disciplinary Practices(page 31) e. Supervision in center vehicles(page 37) kPv S f. Staff-Parent Communication(page 32) (1) Staff-child rattci met forhtldren youngctao} at ` than lawful'seool age;drtver'.not counted �x d-� "wi,;I'tmi g. Health information(pages 32-35) {2},Chiltlren of lawful snhoo�ge i fewer than l S transported with ohI tha dro ver r `w) No�ill'n kild admitted, °' :(3) For 15 or more children of lawful` drool'" « Y• �� Boa ,. rT w MAgf'o@Staff3trta(IdlttOrltLldrllClMa 3 s�'� s, x. (2)'If a crud becomes tli or t`s tntured"helshe is (4) For 30 or more children oflW� fil,sehool separated from gaup`but conitriuo4�s1a ervised . =rr gage two staff to additon Lo dnyer� F t ,x., ,r ,. ,_•r r v° ? k : ',SSk^. r PwA" "a'"`x x, & kY `5"��''m«°' r $" : 'S"i ^„,"yp' gFi�dr`,` k yatr'„a" wx (3) Parent of tlUtnlured child notified unmedtately (5) hTo ctld left m avehicle without adult , anrre(luired 1;0 Come for crd¢ ' a fi �' ''w a SapeN3510n ' s B. ,� °' ; 'r^ ` s,.e'•. rx kiyxt?'`dx r Ee; `v . iy i� a�"�� ri»A��r � an r. lkkh _ a0 ,'�s e r,N. i,y •r- �Ya �(d) IFparencanndkbeached ar dlriess� d� Al � dc�ompany each crild�under2'z r: • " $, r N a it saiere emergency,"medicatattentton-tsolitamedn < m frogr►,ve4tcleto,careofiestgnatedperson ,WF q (5) Medication/Medical Procedures(page 33) 7) Staffs ��o,ahy supervise each child 2'1a ant I' )l r 1 ='� aai e xx ( ( iaY x� ��z gold r qm vahil to care of designated person bar6� oes the center's staffgive medication f. Safety precautions in vehicles(page 38 wR ".;k" w ,, rir+au:i'; (a)�Medlcation,administered ohly with written :s wY t a4 S(ationary seating for crud,each cht�ld aiithonzatton-frompardnt " kq� 3 seatedwrtlevertcled.}t,s'novtng a : dsrJ`NPt 4 i2L .1.s n�`&.K,.�. n A;"• #" �r!�s� s hi.' «x xt k...�tt •Ir i7", x. „r,s. r*`_:'i� �((�}' okblanleetauthortzafion�forrns for mid c�tdn� � ; - V`' lockedwhen vehicl, s w ovtng � 4 ',(c}ivfedicatton in original containerlabeled/Measuring>a f� (3) Children not transported ii front seat of �. �'�„� ' device pravded ,ry t vehicle wilt pasSen�eraS�desir bag s i F i h. Emergency procedures(page 35) (A) Driver and all:passengers secured ark when rky" 4 "^' r°ere'pLM n' a r"w a - '� .fit kiTuka " (ir (I)' Ian forevacuatton ' i,�� 4 � � (a) aeh cttd rn r yeas or weigtiii)b less p��Gr � , w b 5 u New gyredh a a,,Y i a ,<�G„ ('� _ _ .e .[ .S:?^c`LMPa�, �d 1,'a'T Alan 20 po rids secu to reaz*facing it Transportation (II. E pages 36 — kestsamt installed according to anufaoturers otton,maintained in god�c d lion- � 38 ) ,k, f # m yw raM 4 1.Transportation provided b the Centercriidaunder S ye `o>>welgb' P P Y �r (pages36-38) �les�th 4(}pouadss c c►s�inYfo�dfacmg �a�k w n crild restraint tnstalledaccording to " Does the center's staff provide transportation? manµfaoturer s mstrucgons maintained m good f Yes NOGQ itt0e kr tag gr NOTE: The Department of Human Resources (c) Eachhtld under 6 years secured in a, A 3 does not inspect activities away from the center, booster seat installed according to manufacturers �,r including swimming and wading activities.The a tcucttons a tiuned m good conditaon'. � � '"S licensee shall assume full authority and � 4 ' ��� ` � responsibility for away from the center activities. (d)+Each crild6 and olden therdrrver and w ,. eadh�adult passenger secured m an individual a Transportationkcheckhsts used as required �� ' 9 L a b Designated staff complete and sign checklists s ,gw Ttehtcle safely check done annuallystgned by - a t w rtt xi'�w�"�&.t «_+�.`+ 4 , w "" r,.�,it�ss.0 t`«"•"w"._ .rxI11P.CbafttC�and+`dated.,r10(,In�Center ,,.emu �' ,<'a.c�„ poi a az 2 x s r �.. r; c^:� eckl sts kept on filefor cuientyear plus 2 �r'1�� � ot 5. Transportation provided by addional ye gars 4 '° a' " t parent/guardian(page 38) e y r x: kd rr.,a "* aM� Al r k :k�:.h a k.x".:._ k"k`f d.. entar responsible for plc ingjup child at destg ated v k a Each chile a,Whip ed tnta.and oat ofac�e tez lOCatlOriaand iterVerlllg;child tOdenStggated pe$On, tg i ; ( s' v 4 U U a) a) U N U_ REGULATIONS E E a REGULATIONS E E CL U Q U a Q o O o O Z Z Z Z b aeh child signed in anted signed out �N '(8) Final disposittbh gf�any i s uti abuselneglect nuestigatton 3nuoltng,�tcerlsee aw �h St em la ee Yaltinteer t T "' (W X° '�piul+r , Mr, ,?a � .ups.»;. yip. rI'M C c; yRchcld who }ves by wal_jpd ar bus signed t � � - {�) Any incident in"htch the eaith e faTe> by S a a; iia[ for safety'of a child is it""' .: 114 A.,` .,Photo ID rec urr�ed when rele'asing,child to r Child ahusefneglecftepo Wag gut e�d�by UtifamiliaT designated personwgr�,. law': ;{_ �� , - 0Al0ea a ,;�. ,r, A Staff(II., F., pages 39-44) Drcensee and all staff em layees �+aluntees See Staff Checklist 1y .�- g aoo erate with D }2 a31 ild ," s v me gect rn�estigafis, �r d �, irw »k-r4 �` l° rr ,w ua�s Hw.wn+ wa+w, �e Character and Suitability (II., G, 3. Admission Procedures(pages 51-52) 67 pages 45-49) + $ VIM" rah a �ii baTtA e ran e ofchridren in car+a�"'� " confarms•ta number and get spcifid onhcense � � "w u Administration (II., H., pages 50- 4. Children's Records(pages 52-53) See 54) checwist 5. Center Records(page 53) 1. Applicant/licensee(page 50) The following records kept on file for the current year plus two additional years: 2. Reports to the Department(pages 50-51) t �d �'h a."Daily atte tl ce records an'ai1 staff and �r k, mow. iu�ri6i chi dren � kar r N N hu, a. The following reported to DHR rior to occurrence: h:�W�4' 4'A rri checklists "", w � � check: .� w�V i- .,�Rb'a .rrz3rr r4 rr«}: *;; 9 r5 k -. 4.' fi is- V (2} Change tn:lacation� j '� Sign Tnlstgti out sheets "�o �° �� ��.. TN.,. .o ,,.,. . � ., . T A� �.. ��Q� :. F IPW (3) Change in Director of center 6. Documents to be posted(pages 53-54) (4) Change in chief executive officer of corporation a. Most recent license,permit,or approval or members of board r�:, , tllteration too center of au�iids _ Mgr r b. Public notice form r� .. ( �N 15 lajor,change or extens}on fhpurs or prQrn� + " c. Most recent licensing evaluation M flu.: -. (Z) Cltatige m a i3�ess or telephariei}omber o �- y"d. Most racerit deficie y 1 epait, a`i. _ w-b� "k sip,44NWNAFIVw,_ S?10 ,.' x b. The following reported to DHR within 24 hours, e; Correct<vetadverse a� ,�Uces � written report within 5 days: � � :;. ?.r i MIRRV 31, rh rw. h"" (t) Any lInesslinjuryofchldar taffrequinng f Mostrecent!firetn ectorfre ort Sp_ } P r + w# s ' _9`.,,J"V+ «th"Ni„4GPoa €, x 2 m�xat?^r 4 pr4fSionalror em@Tgency Ined al •tl0atl11Pnt r ids , "�� ia� �y , (2Any dead occurring in the+center or during g osrecent tieaith department inspet n ma g , . awayfroin center activities ro � report and food permit or written permission far+ {4 sG cab er}ng faad_ �i% " him w �rk'i rqi :»..e _ + ��` h� - h�,r4$.il*iil, r ( � Majardamage`,tcacillt � , h Menu far meals 2�SndCdctedr w x �w& + �P KM r did tr g(4 Tnter�uption oche center s elec al telephonei�G n obi,Name and telephonehpinber�for Fire. +, , � - ti Q1raS Service w i 9�tG1 � tl arnnen a snforcemenvMedicatwassiStaneel r i >.. contmlcenter{Substitute help O An 1 ti atioilnVO1V}nthecentet _ v'h,' _` *``4vf w`a +� r 9 y g d #, J ]•NilieTgeflCy plaCeClllr�S „... - un �. t sw r w we.l w, ' w .. (6) Any traffic accident mvplving daycare children` z +lc Name of direetvilstafrpersoh n charge stir �nSin tianS�Olta}an-pTQYdedz.�)y t�le CGIlter� www ,: »;, yw T. 'V m- r err: pry,,K�t,N,ipNWrSk�!.. iF45'N. .,^➢. (7)Any azrest of licensee,staff,employee,volunteerLl 5 U U � C C � fa N N REGULATIONS E E CL Q U Q U = w o 0Z Z Nighttime Centers(II.,L,pages 55-56) In addition to the regulations set forth for day care centers,centers providing nighttime care(after 7 p.m.)shall meet the following regulations or modifications Does the center provide care after 7:00 p.m.? ❑ Yes No Does the center provide care after midnight? ❑ Yes MNo 1. Equipment and furnishings ✓ n ,,cL In center's operating, ast midutght,cabs"or cots -Jffitt6d with a°waterer roof mattress shaliibe provrded for N ,;e4apch.child pk� �- ���✓✓mm � �� a� � s �b ;In centers$peratnig past madmight tl►ere shall,b �at ,°� leas(one bathing faci(itp for every`15 chtldren >'� ��` ' - 2. Child Care Program(pages 55-56) a. Staffing(pages 55-56) (1) Staff-child ratio for sleeping children: �1 $),0 Up tQ 1 g months 1 .';4 t0j�A �is� ;.,," ,,}u s� �i,... .. a rke ws �;xa; 'a 6 e .,'i'�"�� hOk �b) 1 mOntI1S llp$LO 14' TP,kk (c)F Z'fz up to years i to 18^ s G , � (d)�4yeazs�and older lto 25 I � . R l(2) Requtred ratans for day tuie tnamtaied whtte" children are awake(s'ee page, x k 3� e AW ' d ; s- r, �(3�At lust one off at leastmeetmg chtld�aPe woiker gnalificalions°wrth CPR and Lst aid rn cen`ter "A" hours of operaUan r �a All"ohil�dren supervised at all tunes e a 400 11 w -- r y . (5) Each staff assigned responsib�hry fbr same children x y (6At leastfone stall to each room of sleeping children The deficiencies noted have been discussed with me. Failure to correct the deficiencies can be the basis for adverse action. None of these requirements are to be interpreted to allow anyone to operate in violation of the Minimum Standards. A facility licensed/approved by the Department must meet Minimum Standards at all times. It is the responsibility of the licensee to operate in compliance with the Minimum Standards. Signature of Licensee ignated Staff Date 6 Checklist for Infants/Toddlers (O)indicates compliance observed by DHR Licensing Representative (+r)indicates not in compliance (X)indicates not applicable m� sr-I.& al VII Name of feacherlroom E�ge Of°NCIld1 etl Ftti s ' e+ tiw di Number"of childrens . ...n .fit , �. � 5 Number of staff ; t l ti a aR d t ^ �.€ Additional `^.DI erirl"y ea t^' "'fie"' :,R, `a am D. ¢t x .:zx c aaa ar '' rn= �; t , .T' a Siltk,-WarhiNwater,S03 " `a eF.toWe15.':' ." ,r: Plsstic-Imed,COYPtud;contalner €a . .. a_ Tub(portable plastic type acceptable) Feedtn ;CltatrS, � x. .Ve + z+ 'FOR, Cr1bS In aCCOrdanCe WtthU$COriSUmer PrOdUCt Safety ��* A '19 " ;r 6J ;.'Kula` :Gibs/Z`feet.ofs aee•fetWeeii;oecu"ieil'enbs ���� 'Ca - "�`°�' a=,•, �.- � ��E ruof'inattres`s,sheets Lhm"F:Rrff- .6+,+3w'AR`Y r 4 `�&' .. x "`ul k �,, i iP, A 1 tam Ye p.,- Indoor.thermometel,f)ut ofrreacbsof chilYlren .,w . , »� . Shelvin fore ui dient:and,�su 6lieslancliored : Jndlvtdual;IW6kd,,,s e S ace fOr each ChIid ',Gti.z 911 � 1 r ro „r ,a am ' . ., iture child size:`clean,,-`ool,cbndition < ?ottiy chair cteanedJd�su feoted/oinS?taed,(Taddter�o ) �, �a{ n �h F S, ?; ' 0�' Facilities �ICGtt1Cal Atlet3.COveCe � p =` » � °<.. k R > �i s'- 7,j � Barriers-around heater.fans w. av:, Elazardoitsstbst ceslocked,._-F < '` i �ft P `'�" ., �,� .�,a",'i'ry�;•v -;.,vm, t>t1�q"., Y in'. ,.,'< .�. # &v`.. F.a Coritaine`rs labeledy M, r 3. , NtedlcattonloCkel r ..,,' # i. .' 1 SCFCenS On Wlnd0�W5^W111C1181C^,U enCd _X_'a^ �- tea.. ,;��2 .a�I—A ... r._ ,a-� � ��'�''"'si�..ev�' `"`�1➢�r�_. . i till gweodte u:€a���i�^H»r _'. Checklist for 24 months up to 36 months (O)indicates compliance observed by DHR Licensing Representative '(%r)indicates not in compliance X indicates,not applicable Name'of tea'cher7room 'I `'*�� �''��& �. r w :,,", :�t� �� f ro Number of children h s �. � �� ��.�..._'... . i a.�t�..na.. � r,,. �, n""xNa"n�"1s .,�dh��.v iMbR" *k ai i� t+wf ar 6� � _i..ne 14'. �u� ��•u. s � , AdditionalEquipmenta Dta er1A BreSfx a arx >. 8�rs d § ,E i� iG a� erg :: ,.. Strd{e Warlrl WateL'S0d`, a er3toWelS- r s." -., n s �P,Iastic,lu�eilcovered`:contaln_ers ........ .5",��,,��� Table S aCC„and Ch81rIb each'child 'Cots!sheetsand,`oover`s W awe 'a a .�n:bv Indoor.tlieraometer%:Out:°ofreach of.cliildien s. 4 .',fir�f �o �:: ��'� "�� : . Written dailyplan or schedule posted LabeIed��stor71 Wr Slielvrn`fare ui merit antl su"'lies/anchbred?. y _ , Designated activity areas 0 BleCtrlcal 0UtletscoVered. ta` ¢ iN x„ h 4r r ex�. a �m, v,. w , i Bai[LerSNaFOliiid heafeis fans,. `'x � ,.a��Z,.`.,�n <" , „x a ..d. ., �' : "; ma..,.' v M, g �t `. *' x Mnwan ' �Sz M'v w "fit; €aai�xp� ta. .._ Hiiotis substances`iockea __. , - KKu r. :- Containers;labeled ,�� TctoatiDn lfiked r s o � '. z �s s b fit '10 < c.�.„-._... ' t �..k'Sr,x.wtr: a r .mow, ,.s .: u ,0+u,.,,r,.,� Screens.on Windows.wi'llc are`'o ned LJ tSif ade"irate ..<* Aio, �Y Checklist for Preschool/School-Age (O)indicates compliance observed by DHR Licensing Representative (d)indicates not in compliance (X)indicates not applicable NRnle Qf;teaChErlrQQm# wz w a 4 „t9"cam:« ..ate.. �iin.,,?,. c .a -� w,fC ? w A children ' .�.x � e' i�. ge of °e N mber�ofchild " ren j �� k ",e.. x"n.z '"TMao a 'a� chamber of staff N 7 � 1 'r Additional Furiiislihigs and Eq"ipment Cots Sheets;co�eisfor,eaeh,ctilttu� ., ' ,s�- _ ,. xa `I11dO0Ictl1Crn101Y1etC7�%-out.ofieach ,*w.,n>..w'& "s. Sc^as Rz" ,•.,- q ;: r,e,' yr '"yvTu ",`"�a... j. '.,m. Written dail pan or schedule posted °l al7Cl0drstora .S aCat Childbe u u " d'NilaiR a M 9� tl "; Shlvin `foY C Ui rnent>rnyn'SU 1t65/i1tICh0Yed . ;;j, PFI wTV " . wi Designated activity areas Facilities Etectrical'outlefscovered -' ay ` ' - Yr Bacrters�aiotind�heaters,fans,�','„ `�` = k ' Hazardo,WisS bs6nc6i 16clzed°� a� as. 151edtcafionlocked _, `a •SCr4'CC15.O11r;6Y111wd°OWS.Wh1C�laIC"0 bI1Cd��ti:�: '..�"',� t ' t�}°F�" ?�i xx= .��• ru� �4,�,a. �F`' "t r�. Li VII ' m Playground Checklist (O)indicates compliance observed by DHR Licensing Representative indicates not in compliance (X)indicates not applicable Facilities Outdoorsplay area enclosed�by a fence or'*all at least 4 feet in hetght', ww nparasayt wa.': a o s 3 `erICC Or Wal .fnee Of Sharp edgesFm �I y. x u _ 2 rxt x h;` a T �ja �.. Gates secured " ,aa&5r ,r> 3 _xiu', v-,., d... a a,,.>n. a, sue..,F•i:t�"S _ .:�^s.,,.�,,.�„ xs .„w_.-'. ,w m,. v awn , w Shade and suateas provtded � a�.";v Qutdoor playJareit free;of apparent hazardous con"ditions r =• ., , ,;.�, .�. m.,�rg� ��i i v"Yv"M `'>�' °'� a 5et� oncr"dtelasphalt riat usedtnd�equlgment d � � �. u F �n k " � --Area Well-drained .c" e ' Equtpmentnot destge he portables se�curel anchile � ' a ,m..� °a�U Siairs/steps have hand drails rn child s reach , g