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Evaluation Form (3) Revised 11/19 ALABAMA DEPARTMENT OF HUMAN RESOURCES CHILD CARE CENTER LICENSING EVALUATION RENEWAL Health and Safety Guidelines items shaded Name of Center: Date(s) of Evaluation: C\'\d InP-0 e)o9w%ev 'c Ceh�ver Address:�(�'� '�, - Q�,e , Cj .E, Date(s) of Follow-up: Purpose of Visit:141nQ-00, �n Telephone #: 005)0`b-�-1(:\C)B Director: Licensee: �`"C G �\c� '0'�v�`o�rn� Co Y►�`� ����� C�v.�r S�•G County: a � � 2"Day ❑ Night Subsidy Licensed Capacity: Da� Night Days of Operation: Day Night v Age Range: Day") Night Hours of Operation: Day\ga`N'` Night \-C)` License Number: Code: O - Observed by DHR Licensing Representative ooac)o S - Certified by Licensee/Staff in charge D - Discussed with Licensee/Staff in charge Effective Dates of License: X Not Applicable-Not reviewed with From: To: Licensee/Staff in charge oe Deficiencies Noted: ❑ Yes No DH i !Vns presentative: Sections to be completed at the discretion of the DH R Licensing Representative. U U U a) a)REGULATIONS m REGULATIONS m m E E Q E E Q U Q U Q U o 0 U o 0 z Z z z -.. zr a u io" vt5 Facilities (II. C., pages 16-23) eSpace£or ill or injured childAl 1. Indoor area(II.,C.,4.,pages 16-19) f.=Items used by ill chtlddtstnfected aXCUS1Ye USe q�acttVy aieas , x6 IW �P��G x9 ",gStorage;space£Or tCaGl erS SUpT116Sw x ,mwu.R1rf r„ uLa;,'x r � h I)esrgnated space foreach grouping of children , rF, hc'O ce spacerovtded � r c Bathrooms located on"saine leveUunder same roof' i. Ventilation,lighting,heating(pages 17-18) (1) one flush toilet for each 15 children �` (I� I3eatinglatr condiitontn$provtdeij6� ' � (2) one handwashing sink for each 15 children Ms(�2} 1emeratu 6$S at c)nldevcl''� y �� � il su Rn 3 One tub(portable plastic acceptable) O (p p p ) (3),Themometer to each area used$y chtldren f ` `. P a 'r` f"+s, g a r is (4) ?txtures child stze`or adjusted£or easy use _ (4) thermometer out of reach of chtldren 14111a ,�z,;.., tg.. irk d Qe h�hdwashing sank wit ,warm running vfater, ��i � i .. {5r C1G std .,,ir�fydo�s that arebbpe ed area rr ,,r��rr" , SD2�5i IaJICt tbW81S In e C UOTTY W lerO Cha101en arP� , y° 5,ere4ned k a;; �,p rr^ ' t.,4r��µ sired P'iv Port d '..I 3k�' , Or , ,„}`'',".l`K t L drapered � irdag a ,m,r a Fa rdA 1 U U U U REGULATIONS f° REGULATIONSCL m U Q 0 0O Q 00 t1 0 ¢ 0 L) a 0 0 0 0 z z z z (6) Outside doors kept closedi a P i�R , , ,d�, 3. Swimming and Wading at the Center(IL, P C.,6.,pages 20-21) (7) Lightingadequate'for activities a. Pools two feet or more in depth(pages 20-21) (8)'Lighting adt" uate�at nap/rest time to allow (1} Lifeguard at'poolside at all times'pool.is mn . children`to be seen-, use (S erational"fete hone for centec,busmess:onl � 2 rife aril Tramin Certtf[cate;First�A id s "" �tifpx p*a a tad r,y y kq °h ( *pdN ate,,CPI'i Cerh'ficati6n on file° k. DIII2 notified if telephone is out of order,or if (3) Lifeguard not counted in ratios number�changes- r I. Hazard prevention(page 18)(Indoor Area) (4) Staff-child ratios for children in the pool: (1);Centerifree of apparent hazards (a) one staff for each child younger than,"% R ycarsofage 2 t`Hazardous bsta n ces under lock and'ke Yor ° m" O77 (li) one staff for every 4 children su ages,2l cointination-lock years up to 4 years: r` (3}`Containers labeled (c} ane stafffor every.6 children ages 4 years u to 6 ears * ; r il tt"; '-cen,(4te)r exce p t=IffW enatf o"a r�c""e!mn ie,� a.i9„ ds 7t, yeasr,usr.�arnn�du„iry qa]�nd{e'IC�h @Y- OhdIe,�. * e 6 ept! "nt o firearms oranmunztionkgoe in grV a 9al ri A i {5) Stairways have hand railings m child's reach ", (5)"Ratios determined by youngest child i the pool . (6),Clear glass doors marked at child level' ,",' ' " " i (6) Persons counted in ratios meet child care rs i�vi b 7(i s ilk ` "" 71 a a x aira b �r" s p x u rK" l. . .,WOr]Cei QUa�1ICat10nS�In t11e p001"at al�tlzlle3 q� N p i ,.¢¢;- z" au>ir �i"i a�1i i!.ws ', q .:'�a ra s r (7 )vledicznes anddrugs kept-under lock;andce} or (7} Staff provided to supervzsc children combination lock,separate from harmful items " pool area,but not'm pool (8) Barriers around heaters radiators fans accessible (8) if any part of"4"(,hild s body is,"m the water, i to children a �,childcansidered in To , Sx a " (9}"Exposed'electtical outlets have protective cgyers ".Pgot enctged"wztl) 6nceot sglzd wall'itt m nos (. a a G".* * :aa wx' Past,4 feet in hei tit ao nstruc ed to revent"a �� �(10) Consumption ofalcohol"or use ofnoni ° rr accessibility by children prese"ription narcotic-or:iilegal sub stances'prohibited- ; (11) Smoking or use of tobacco prohibited on b. Wading structures less than 2 feet in depth: (page 21) premisesMZv (12) ,3 Contaminants shall be stored and disposedu „ of properly "" * " " 'tv aid,at Center kept clean/Cleaning done daily(pages 18 (1) Atleast one staff with CPR&-first 19) each wading structure k (1) Floorsi bathroom fixtures cleanedldisinfected ;(D-Re, ired'ratios met as stated on page 23 (2)°Carpet swacuamed"�daily ,,$ sa iRa' i (3}�P�t least fwo staff ateach warding strucitue (3);Cleaning does not interfere with children s (4) Clean water provided each day activities a 2. Outdoor area(II.,C.,5.,pages 19-20) d (5) Wading structure emptied'when noti n use See Checklist a ,ray y IVUK a .Ostreet,loadinglunit]ading"pr"ovided ��„;! p , ;� 4. Away from center activities (II.,C.,7., page 21) b Separate areas for children younger than 2'!z(may"be NOTE. The Department of Human Resources achieve y scheduling} does not inspect activities away from the center, including swimming and wading activities. The *c Outdoor area adloZns or zs safely accessible licensee shall assume full authority and dry ` responsibility for awayfrom the activities. 6N e center d outdoor play area free�of apparent hazardous conditions '"'e 2 U U U U C C (Q IO U t0 U REGULATIONS E E Q REGULATIONS E E CL Q U V Q U Q 0 0 0 0 Z z z Z 5. Furnishings and equipment (II.,C.,8., ;Staffw,tli infant child i✓PR and first and s" pages 21-23) See Checklists presentunng allours ofoperatron ^�". CLI.) Child Care Program (II., D., pages Second sfa ayarlable when?ocmore :presentlrequired ratios met 24-37) 'd'tv "d"�zCr4 ""d �� 1 Required ratios mainWnedfat all times � �' 1 No st7aff on dory more than S�contlnuaus hoots i a ��_y -on aregulaz basts ;a°3� � •�°� x' a U,u PtQ�� ��AM 110nths l'to � p � xSr T da "99 u #7n t�,,a' P x a#' Stffree froth otter dukts«vhlle workm (�i� �y ; �'�, G, iirrcs a r a „7d. ru a the; t�h �htldren �° b�l8 months up to 2Y�years° u �I to 7 5. Infant/Toddler Program(II.,D., IR 2.,pages 26-29) d 2A months up to 36 months lxo 8" a. Learning/growth activities:(page 26) Ri '" , s t 9 `sF 4 e a yews iipfio 4 years s (1) Encouraged to play with a variety of toys f 4 years up to�scl�ool age ' lto l8 s �h" (2) Time outdoors daily,when weather permits 3 .E f .!: .°'"' s `*,v ';.a ydH �° ,i" ? s mi i, WW a i{ -�.�.n_t'� M!�` ya, g SghnilbagetpEtd 8°ears Xrto 24 rFa � _ (3) eedommovementoutstdeartbsat� h 8 years"androlder 1 to 22on%tummy partoftune while wake " ,�avad4rr dr�d��N� sK F +:w sartd obd,� x .>J wn,.,, 9i,A '� ,<,�, `, � ,�. 2'Children"younger than 2%grouped separately £ (5) Staff talks to each child and encourages fromolder childdren i , response ' - 1 +' i' § 'r&'sdr a -z""IN! u. u 1 G Clef b �..�, - 'r�+diA� }aq i' �`P .�a '� �� •.`"3 a� xceptronoroup46kmonths , x {h},�Ceslstgns of dtatre�mv$Strgated ° ,. � N R 11 k'C� 4 trumu lately b�Xoepi on for rttdtvrc(naI attaldzen's�1eec( b. Diapering/toiletin (pages 26-27 :�A, 'r .o-' zf g•(p g ) 4"p •a IAi p,�N�z a lW" c: -x..sff b1j;.a'' aq,4e; 3 StaffScounted m'ratio only when grving fnit kri F ' {I) Clean dry drapers/clothing provided " attClLtlOn�tO the Children e". °Ga, G,+. € af4r a a xp a eds=P� �: a%t-M m a� 4. Staff coverage (page 25) ;i (2) WVogl et/svredd�aeis/olotiing changed N„� M Sr , p:+_ a Allchldrensupervsed at all tunes min a Mai rs, t a ) C hangCig areaicleanec�and��,itttected ) ,:ts, ,w,8� b Staff assigned responsibrlrty for same *" r (4) No child left unattended whdebeing Infatits�toditlels each day dl$pered & t, ;° _<s. s`�-,.. ��s a`4 z a .�., ':;�h' rf"`'fir dr'drcd � rbr am§* ,�✓rd��a "r itl ur' l t .e= t6r^ u1 rf. � r.voS 7a +�aµF y v �` UaP c Sfibstrtu� ff$avadable " Q, (5) Io child chapered oritYewflob e.,72" d Drectorrauthonzed tq conduct,eentec business qd'``r fi, r{6) tch`child's hands washed afte dtapering x " aOW, a �+,.�,a ., <,exs, .§0 ,h '����*� �� >e Staff person m charge when di>ec r is,absent s t r M, i ��� �(�t Staff�us iuuversal precautions `hens" "�_'�x� aUtOfiZed t0 COr1dUCt C01ItCL business diaperrag rs�. Staffslnr�eae�rTOIn during�lalp.IllreStlilg` �ua� r ��aY „.";gym,�"y p1SpoSb1Q Lr c r b ,< dapertrtg each eln#dtfor each draper change wsk ,6.�_-� .bat`. ..:��. g Saffable fo see all the"children ; (9) Wet/soileddtapers placed m covered, ear sr d e h�% �" >•i s ,!¢A ,; <k dr Fd firs :+ a 4+ s4e rk"ibr "`s3G°� s r•xi s54 di k,S«7adfrss` ! � .. astiGlItedCQptamer d'dtssedFof�tl aiy�� ", ... pl p h. Ratio duringnapping/restinga e 25 r " (page ) ���� (lb) hldrvrdual drsposa6le wrpes used at e�ch� ��x'� ' draperchange drsposed ofpmperly aaffi �,z 5 .d k"«„ r .2Pe'^', (l)� up to�$months. 1 to 5 � x (1 IJi�ttchaus emptred rtnsed,.dvsrnfecfe , 2 � r - s r s';ti• �d�,rrrs r db d F d s ; ,d r i`� 2 18 months�upato 2'1 ears ° tra)4« x x �?°`" '" - r{121iaperiag asapazate from��Noad�serviCe 9 ern-�,tifed¢a.�..A } (3)-2'/x years and older `I to 3b ` c. Napping/restinga .4 a (page 27) 3 REGULATIONS c_`o REGULATIONS m cc Q Q — Q Q . — E o a E o a U Q U a Q 0 z Z z z (i)Iifants allowed to fQrrri awn sleeprpatterns , Nw; rdir � � (ll2oddlers seatedwhTe�ating 7 � (2},Infants placed on back to sleep unless physician s , x a (i3) Chtld encouraged'to"expenment with self statement indicates otheranse s fdeding,utensils rovided „ ° (3j Infants who can easily turn placed ion backbut � � i �(14),-Disposable uiensl swused only with close " �114WBL1 tOaaOpTtir�erXed, oSftt011 wjtd a „ �,Av.`Q. »eSt3pFtYlSland a�Vm su,�p' i,.k. �Y x MIt ^Y,� k�, 4^+ , Ff :: .y&. 12,.pf'"d'IP�Pl"x%ll. �:� '" +,N,d" .�4,.OrN�Od" W". } (4).lo jiosltionmg deice usedEnnless sgecified bye ^4 s , � (15 'F'oods7egten',from a is r x� a a <4. e'n'es` ,fl�`" Y& zt X s e` ggz e wy� k x t�, zr,i°" phy51CIa11 F. ,rt✓rt ,r".r �mm. ., yak*' r `s4 r� SX x'"9tfs Ya.a1 a: ,va., •r �. °" (5) Staff recognize differing needs oftoddlers/allow�to f (16) Dishes bottles unbreakable as r ss S x` ° follow,their own slee art ins r� F r i �" , pp , h far �.s a b, �,}. � k f:4, „E :CW "rr fief zp arn� " pia d. Cribs,cots,and bedding(pages 27-28) f�(I? rinkingwateroft�d t "toddlers of pt ems... d* tk;&izt v>- as z 7 s n r "a`"ro s a Z WO feet��leLWeCh,Oi Cti led,Gnb3 " �a (I8) child not(orced��eat C ) p1 `� r ile � z (2) Cats positioned to allow space for access of fl (7 9t}Food not"used as rewar&&punisbi" a eiiirrrgency exit ". °r ' � (3) ribs1cots1cleaned and disinfected and�skets �� � (20)xChlld�shandsxwashed before'and afcerr " COvgr3'Washed befOfC U d 17}a40t11era Child x, ..a roa is 0711 r apksftenr dta�, ringua �� �� a,, s `„ i dmr6 . ASd tiTk �" ✓A �s+�ki W „�,��" F � r �==i , {4 -1 or infant's clean bottom sheets�dalty or iriore , X; of r (2tf) ta s handsxwashed before°food' ) °x ; Often ifneeded Sheets fiY Snugly �� ; �`' 4kax v tt` ., " �preparatt„On�d SONice;,after .. 3 3 t"1et1, after diapeIIrlg (5)"Softinatenal prohibited m infant s sleeping Ufa„a� � �� ,, ;< (22) Indivlduaipaper towels for each washing e `y ,enviranznent qno irl]a)vs,i udts,con forters,etc �,k g.m,x = and dry gut , wh r� , 'N' �m g, �, t 14,. °�O o infant ut to sle io isot` sofa t#resi � � "� 6. Preschool/School-age Program w (H.,D.,3.,pages 29-32) (?} For toddlers cican.bbttom.sfieets and top a. Learning/growth activities(pages 29-30) ,: covenn s weekl ,more oftenfif needed e. Feeding(page 28-29) (1) Schedule posted O d( �1oxmula food for infants if provided by center (2) Variety ofindoor/outdoor activities P�lanited with parent or physician , " t xi.f (2} If formula jrovided by center,ready'Yo feed, # ;r (3) Time outdoors daily when weather permits praperlystored and handled k z 3) Meals apnd snacks comply with requiremeiits� + k h (4) Staff permit/encourage conversation among °i�a'pfm' M?� .� , xb'r :"4 ivA 6C� children P" " sk a81z nx+°"�W`y d (4) Tfformula.proyided by parent;labeled r , (5) Staff give individual attention to each child daily V P (S} Bottles senYhome or cantents:diseazdediatend ofA „ E (6) Radio,TV,videos used only to da �� ` r ? supplcment/enhance daily plan t O rsm�l2hi{CdkCilIlClieS lltt IlijSCiVd t`Gl7il# n dd a "(7O�ChI�te, 11l�dkLayt 11 ^�at��ldt OS � yj e 'w" A �d"erfanr W": IMP- ;, '(?) Foods that,may cause cholang preparedf! f (8)aVideos previewed by stafffor appropiaately for the child� appropriat =,. enness . ,IM a r . (8) 1 eedirig schedule according tochild s needs r (9),` a wally explicit violent frightening� t r ay r materi� rRbibyted � N r r ,c`(» _"W�°(t iii",n.;v�",., .�w."rfr4 s xfi�; ,,�^; E'�f` 75 � xx.9r" ..,...« _ (9fTnits held far hattle feCding �nNi , µr 'b. Napping/resting(page 30) } c `"#rs" Y.- k (10):No bottles propped x apt (1) affreeognize differing needs of childten s.w .,. {l l) When aloe infants allowed to s1Y m feedmg chair '�� � (2) Rest period for children in attendance more P, than 5 hours r .�.e.�a� �. f •, d 4 S ac.J�Qe cr� U U U U (0 U M M U REGULATIONS ,Q REGULATIONS Q U Q O U Q U Z 0 U o 0 Z Z (3) Rest period at least 45 minutes,not more than `(15} Chrldrert seatedwltl€ eing. 2'/2 hours ai it fj * D ^ w x wu (id� a Vfi�"ini`e y :# a�tId;fvcedtneat r45 nmates .�i{4)Tfituild> �oe notsleepafevg ci � ..... w (intatdatiS�tteS armlttad�g ;�� a� > �� MM � �a' f , . k�"i `rn..-_v. 'A F ix hr '�usr xg. ,°°p . -- v Ali.�� �4��. ots cleaned anal clean bottom sizeetand�top; f (17) Children natial�gwed a krtehen sheetstcovers pravtded4before,usedNby atiisther ahtld re, mi,a �'+rp T�.µWt ;Gj„r�" xs,..r„tii. . ?,w�""'' � 6) Clean"sheetslaque,"is,�pr „ued weekty,'mare often, . � 6iChltfatthands washed beore gals w� i a(' NOW— f needad i 111� �.11 - >= w `m'anc s as d after t rEatittg u�. > ���� > �. WN ittoned to allow space for aecess'crr n � 19} Staff hands vyashewbefa(e� CmeYgenC aCXI k " `� w� �8t� �I :pr �dtatlpbJl al�d$e i and artera4sd 1sjp' tQlletlri or,eorl�� th�b dtl �Itttd. � � (8) At least onegs.....went each room �2{1 -.T�as a ab egg fives"tsed foi d aparang w10 n_ ilA�, ( taable to see all aluldren> t r� (2� ]iYdtvtd apex,towels for each washing ' and�dr���ngy c. Toileting(page 29) � �Cater eats and snacks meet a' m �. (I}According f0aot��eh��ls�ne�ds xdh a lids _ � e. Disciplinary Practices(page 32) hands Was ed iN�b +u w � #"' r�x �,. . . a . Staff use llnrversat Precautions when dta enn11 e*I�, (1) Disaiphne:apopfiat otaged N p � is r Lle �w m111at�k �Qf t e f tt t or h film h d �Aurds� , ��" ao „ � Ia. t _ �. . fl OWN d. Feeding(pages 30-31) (2�Np aorporailp }91ertt��` m '� �i �1 �00 Gas d �O Chaldreu in attendanae served bYeakfast or a m 0 r al M "Aft a rise:,, 4 s aak;Iunc .m 3 �. . ,"�7�91.' "Jv:" v`0rv�,r�'"-` ��> .." ;k";.., �,�,y"ry d..? i, GG, SM.:.; iPaw `Gi Iw awl "pzi lY>eals:and snacks comply-_with USDA gurdehnes�it sr 5 I�io seiphne associated with food,nap s °z,�,� n pages 29=30prcicedutes , wu'16 milk served,no powdered milk for drinking was ": (5) No physical restraint as punishment at� o cttildpnved"ofineal oilsnack, WE (6) No punishment administered by another NO child �i y(S) pecral dietary needs m accordance wzth wrote f. Staff Parent Communication(page 33) instructions { -Meals and snacks provided by fate center ` � i w f (1) Discipline,behavior problems discussed with parent Qr ( -Vending maelnnes grohrbrfed m are, used by � y�� (2) Center open to visits from parents at any chtidren .�� .. time 1 I aPa. $�Smaliw and candies ottse ed4a children `r (3) Parents informed of right to visit s aa,x ,y�r ripL4r xµd �,'rda�`>�io�,r^"`"�y�„ NO�,"'a _ (9)Vd6dsithat'inay�eaUs ahoktrlg pi a �d dR�� �s (4) Staff available for communication/ appropriately"fottheehilck. � �� . � conferences QA) Portions of food suited to child s needs,seco�ar q �I; (5) Parents notified of complaint procedures M polanS'avalla�Je �su.§."m, "*e. ,#>... ✓x„s�.N&r ',r>'s�t".ram„. &a�ttt`x'at,i:ix,�r,... ^°�` (il) Unbreakablea;single usedmnertvare used �i' tt r (6) Parents provided with information on �,w'��� influenza SD (12)Single u�e enpsogasses or�a� nttrnggfpupt in � � g. Health information(pages 33-35) �provi�ad qx�w-ter,� �� `,,�"9wN0^ �p AZ"' �1 ) Drtnktrrgwater Qffered ditiing the day�� � {h) ta ill cht)d a tnttted`` r �� x>sia,r<£ d�, , ;+ ,e �_., ->%�oa»�.rrxw. cv. .�. a,��.,.r ,'�,�'�"v f;n�'".. irr�+�a"w - 4 Food seined on tndrvrduadtshas-otia kids F (2 a,ahrid beaomes r11:or rs tnlredhel��te rs z - �a,n € 5 U U U a) REGULATIONS Q REGULATIONS Ea a U Q 0 Q o O o 0 Z Z Z Z (3Ak�)a�Parent of illlin�urei child notified unmedtate (e) Children and staff wash hands after and;require d'to come for.child„ handling animals 'flhn s a t 2pN( a �� 4{ to� u _ (4)off parent cannot be reacbed,or illness/mJgry �h Emergency Preparedneks and Response severe emergency me'dical.atkention is obtai Plans a e;3p6=37 rt See"Checklist„ "Si ) (h g ) (5)i Parents njot,fied of exposure ioicontagious o i - E ��„ "i Transportation (II.,E.,pages 38— disedse/condition 40) 6 .Pare is u +�(��r P rged to notify center,fa child is r � � ��9�.'! �� , �� 1.Transportation provided by the Center exposed to a contagious disease outside center (pages 38-40) SD (7) Center reports contagious diseaselcoltdirion to NOTE. The Department of Human Resources does h6 th'deparhnent as requiretl, not inspect activities away from the center, a{r ,including swimming and wading activities. The (8) Medication/Medical Procedures(pages 34-35) licensee shall assume full authority and responsibility for away from the center activities. Does the center's staff giv edication/medical procedures? Yes No ❑ (a) lvfedieation.adm istered'only with written Does the center's staff rovide transportation? authorization from parent Yes ❑ No (b) 'No°lilanketauthorization�forms"foimcdicarion °a Transportation checklists used as required (c) Medieafion m of igutal container labeled 'b Designated staff complete and sigh checklist Measuring device provided �" c DrNersigns checklist,indicating be/she has (e) Medic_ation adrhimstered�by designated staff 77777" £:pd�'CbCC ISSS kept On`file fqY current YeaC ,(f)Lacked storage provided for medication additional years d > .s»ti (g) Medication returned to parent or disposed of � `e Center`<responsible for picking up,,child at. whenho longer neededu� � ; a * designa�fei loca68f and delivering child to t .designated person (h) Tune and date medication is given;is docthtented m writing kept in child 9@file"!eopwies r "'�� f. Supervision in center vehicles(page 39) available to parentspon rcquest w (9) Hygienic practices(page 34) (l Staff child ratio met for children younger ,.: than lawful school-age driver not counted G(a) Torletarticles.labeled and'stored separately¢ �{ ��� , , (2) Cliidren"oflawEu[scliiolage and older fewer than 15 transported with only the drive(° + +. (b) Used paper towels wipes tissues are disposed (3} For 15,or mare children of lawful school 'a of iniiiiediately following use '� age one!staff m addition to driver (c) £oiler paper prc�ided for use by children and ar c;{ ai (� )or 30 or mere chi�dretl'of 1 wfnl school�, ' staff age two staff in aildttion to driver " "�W (d) Extra children s1.clothing,!vatlable, (S) Nochild left in a vehicle without adult, �a4�, ,yr� �: NUP =g,r n I" m e 5tlperVlS10 "I"I,ro al f A Ana (10) Animals on the premises(pages 35-36) (6) Staff accompany each: "child under 2%:from vehicle to,care ofdsignated person (a) Aggressive animals not kept in center or on (7) Staff visually supervise each c!>?ld 2'/z anda grounds older from vehicle fo Dare of designated personm'�u �• b Animals that could pose a threat to health and �' 'O p (8) Driver checks each seat at each location to safety kept away from children wetfy no child is le�on the vehicle pia (c) Certificate of rabies vaccination on file for g. Safety precautions in vehicles(pages 39-40) animals (d) Animals confined,cages kept clean,food and (1) Stavonary seating for child each ehildMl water available seated while vehicle is movwg v� , (2) Doors loeked,when vehicle is anovmg ° > 6 U U ill U U N (a U N U REGULATIONS E E Q REGULATIONS E E CL U Q U CL Q U c U o 0 rZ o 0 Z Z' Z Z {3} Q �� reottranrtedmfranea��ov�ehcll �i r 2. Records on staff(pages 42-44) �'4vtth passenger stde air bag� � 'If � I,���x��� �i (See Staff Checklist) i � �t ,,.3•., 4),Driver and all passengers secured whon vehicle ryts� Zecoi�s on staff kept confidential mOYltlg r w,x, ,z, s Er %rn "AP al al ,r.,as �TT rag (a) Each child under 1 year ctrwetghittg Tess thane Uu mI � �� ,o ilw( 1�� Reovrds ofi file at time cif employment, (g ' k 2o:p"crunds Secured in teat faGiIlg Guild YeStramt, v ea u M installed according to manufacturers instructions, g maintained in good condition a c. Records on staff maintained at least two years after person has left * x ghM;;r,^w.,l ''»r �i r u f' v (fs)r ach childhun'd%'St ears or eighth Ids rth t '� k xd Recerds filed atp�bdttcall m wed!" 4o pghndssecuredm�lfai�ardatring child res t��,� , ,' � �.„. �� yet a%,h 1 a rat o get .i w MMMPV 111_11h i@ =; mstled aCGozdtg tO[natIU7GtUer$a1>aStttlGtiQ� _" s8 a[G a Tli1 # It main dtned in oad condition �i � ,FL c) ach clildaitnde`" years secui ed in a liooie 3. Health (page 45 i, s .-, �a nD w+$ih^ r�t f " raa 11��IVo (P g ) seat all`dj"b"' fdtngwto��anufacttir�'a ns up�tons �"`i+ P,«�7 '"hi tlz. ':� %s' ii;°�r'�V" ',. u�Hl�'�� _ i''r r`u h apt' .a„i aC4' Nd R �.:... atntatned tn:good condition (d} aGh child 6 and older the driver,and each y b� to ymptos oco tad loos, �� adult dssenger- ecured' d�yidu'1' e(belt, ' easelGCSndttton noun center � a ptape ly auchoted to the'vehicl[.�. , . "NA ,ab h 4ic e safe check done annuall si ned b y g yg Character and Suitability(II. mecll lZt acid dated filedri,, 0 ter I ��I��r . Ins ... � �M G., pages 47-51) 5. Transportation provided by Char�ei and suttabthty review Gonduetedon G parent/guardian(page 40) �equiredpesons(ecrery 5 years) t gp ce rii' �" �fla W'�WN - -_.tti`xz aaCl Ghtld accomp ie into and qutofcettter "� h Gt �S�tdte�rSil�lrtdT011�fnilraSUttdbe � �r ., I 'y amyl SFr G .06h»�.. �61m �GharacteF terminated ,. r, � Ip.°,, ' G c,F Z^ v w,hlhh'i k ar,r� �� p o t ��j'^ rr ""°�,YGeiFr G n fOtffl$u14R a$rS Grtk n}l r .. b Each child Signed m and signed tlt� kn� � x» q u ea �� G4nYlGttpns'Or current Char'es ' , - tiy chtl� v b'arnve� wail ng or bus;signed iri Administration (II. H. pages 52 56 c1,q,,to ID qu fed when ele stngich t � 1. Applicant/licensee(page 52) J tinfamihar,designated person A , Staff(II., F., pages 41-46) a. Licensee assumes full authority and responsibility for meeting and maintaining Minimum Standards 1. Qualifications(pages 41-42) b.Licensee provides operating funds S a. Center director meets qualifications c. Licensee designates director and delegates authority and responsibility for operation and b. Child care workers/teachers meet qualifications and management of center to director have 12 hours of training within 30 days of employment � uld acre or ers/tearfiers meetrecptitaert � r G, d. Written operating policies established hieRtnttgitliin9l�t�iliay (ifapplicable) *a4, IF O c. Aides/assistant teachers not counted in ratio (1) Copy of operating policies provided to parent at time of child's enrollment r- d SerYtce staffnoi Gouged m raft unless the meef a , (2) Copy of operating policies submitted to gtalificntolta[tdpre gtvng�full nttontobht�drest DHR 1)rzver at least l9 va s�hcense �lid driver (3) Operating policies do not contradict 4t ��ai Minimum Standards �f ttl srituYe staffineet quaitfieahons of staff for whom ' (4) Changes in operating policies provided to s�ituting parents and to DHR U U U a) Z Q REGULATIONS 0 'Q REGULATIONS Q U 0 Q 0 Q 0 0 0 0 z z z z 2. Reports to the Department(pages 52- b. Age range of children in care conforms to 53) ages specified c. Requirements for drop-in care met a. The following reported to DHR prior to occurrence: 4. Children's Records(pages 54-55) (See Children's Checklist) "ki. ' `::�` ` _. zi a"" "`i +.'• ;ti. ^-' �r�u: P' p j. ''�th� .z„qn » { °' a re'",! ' .^"..�'d';';wa�r {',"" t� '`yz'' ( Change in ownership , ,"" z a {�f rC31�?CC0rd ;3t i 1TlftlrtIlat1011 a Ottf k _, artz s kd� A�Mr re s r �. �m ehlldTCl13i#Idthetrfdf111It03kCIftC0n (1e11�ttalz (2)r Change m location R= b ndivddual records"'on each child on file on n, � td fa cetr 31rS ay:0 ttCndSn .,..:.e z' uata_.•._-,.'"..�i __:. ai .z. �: .....sJ ' (3) Change in Director of center (1) Children's records maintained 2 years after child has left the center (4) Change in chief executive officer of corporation (2) Records�iled al habettcnlly or members of boards ��_ �'� r £.s� $ 2 1 (5) Alterattgps to center or grounds (3)1;tacrive files matntained separately �. w ..,..e ( ° vlalornc�iangeoctens�on�ohoursrorp ograt , viz �aa 5. Center Records(page 55) NIT r � The followin records kept on file for the current (?)Change m address or telephone number k� A g P 1, 7year plus two additional years: b. The following reported to DHR within 24 hours, a Darly attendance reco��ds ou all staff and written report within 5 days: eluldren r °; �w7� �z" a a»."' s rid„ a ' L)„ n �illnesslmaury°ochtldorstaf£requtrtngi �� ,..: „ �Pti b ransporta nchec zst � G� � if �' fi (2) Anj,illness/injury of child or staff regmnng M Vehr©le Safety check emer enc 95, medteal treatment �� �� �' �_ � � 7. ".. � : � J „S`d -. i '.,' Z£ `• T + Y � �t£ g:ha pa rn., (3) Any death occumng to the center Ovid g away, d Stgn nlstgn out sheets �> :� �Y z jotadamage twoaattrysel i� 6. Documents to be posted(Pages 55_ , "„��r(5) Interruption of thecenter's electricnt�teb e ��g�B 56) or gas servtce " rti r EV: a { rAy�htigatton tnvglvtng the°center ��, �� a. Most recent license,permit,or approval (7)any traffio accident rnvodvmg day care childrefi i �� b. Public notice form usmranspptation�prp�iled byatfie center , (8}Any ar>est of Iice nSee,,stafF,'employee volunteex c Most xecentehcenstng eyaluatidii (~ a'i.cr ° „-s> (9) Final d�spositton of any child abuselneglect s as '� d Most°recent defictency report ` n mveshgatton mvolvmg licensee,staff employee, YOtuntee[ w �k°. , � o-g,.-,..t. .:. ' ..Rnt.eivx v,+ x .<. 4..,"65.. ,-iAn.o aew .✓^ _, _,,,.. .t; „ao s<.,S !„ .:. ..n�rd,.a,1.a 4+�'%'.^'tl`'U n'-0w.4�aM+"�h 0J &.,r«+° ..'2+., ^ $-d L,^reff w: ,K"•`��"' NPt ", € {''- :.N4w�� ,"< x . '` lQ Any ihcrdent�t��wWcWthe,heafth,welfare o CotrecftveCadverse actron nottces;' t s iu safety o€ child is at nsk a�£0s � � � ��1 � )4 �� dt ao.� R, a � w pa �' *4E��� fa "'°" x t °r t �`�t�r."9",%^,x earn ,`Y,u "'a 9 k� Gl )la An dtsastrous events f Most recent fire'ina ectibn re ort Y . , a... .,.: ... r . f p. p< ,r x ) d c Child abuse/neglect reported as=required by laws g Most'recent health department inspection ' �; o- 4z r Y B �•; d,jeport and food perm[[or x�ntten permission fdr catering food a z',,, u x r a s� +,�' d Liaeitsee and all staff,=emplpyeeS;val>imeers Menu for meal did snaeks�dated aw dig a 1. �d 11 _ �a, �.. : _ �`"cooperate with DHR onganp,child abuse or neglects" � ,'� ��n ����rt nvesfgahon r<= �� x � �i�r� i. Name and telephone number for:(page 56) � , 3. Admission Procedures(pages 53-54) (i) Eire department �Y ,' �, a s'+ems„ '�� Pry41 ,' - a Total number of children in care includin children a (2j I aw enorce�nent g � m v �" �'�� -§ t7-xi ��r�the premi$e�,Childreitl2i�tralLStta Childfez 'bn ftBlCr;*�I�� fi ;„, day 9 g���' ,i e�uF �� �� ass au�I,p�z�;�{ i s a 3 Meflical as [stance ambnlanep,oY resew r trs ct5tifoms to°numbesper8ed �a � f ) r, .z�" �{ n 8 U U a) (a)j U REGULATIONS E E Q REGULATIONS E E Q o Q U V Q U Q U o O o 0 z Z Z Z b. "GG' a04) Eorson e`ontrol eetYer x x O Required rattosiffir day time maintained 6r� 'while children'areawake,(seepage23) G'� (5)`Substitute help-, (3)-At least one`staff at least 19,meeting-child J emergency=Preparedness and Response°Plans care worker quahicahons with CPR and 1st aid m centef"ducmg hours of operation vv aw .'94 W b � r k Name of dvector/staffpersan in charge - ry �A) All chtldrerlsupervtsed at all tinnes �� Nighttime Centers (Il.y L, (5) Edchstaffassignedresponstbbilityforsame ��hildren nightly ` „ pages 57-58) (6) At least one"staff in-each room of sleeping In addition to the regulations set forth for day �, (7) Stffcable�to„sea'all�tlie�children'attiallttmes x � '` care centers, centers providing nighttime care fi+: TM.i ts e A e:S (after 7 p.m.) shall meet the following regulations or modifications (8) All staff awkl e and aterf toneeds of children t. Does the center provide care offer 7:00 p.m.? (9) At least two staff m center ,whegever Yes No [✓� children are present redutred ratios met,,, a . Does the center provide care ter midnight? Yes ❑ No (10)iLightmg maintained so ehildr�n are vtsc_ble '"whtle sleeping 1. Equipment and furnishings b. Nightly activity schedule posted V (page 58) n 1 Outdoor time available during daylight hours a m�centers operatininp past midnight orLbs"pr eo�s�,� = E , „� O g ;fitted with a wa`terproaf mattress shalbbe provided fbrs �' ui f each;child (2) staff assist each child"as needed m dressing sand grooming, . .R b .1n centers"operating past„midn ght there,shall.be at e. Food(page 58) `least one bathing facthty'for,every'15 ohiIdren 2. Child Care Program(pages 57-58) (1) Breakfast served to children going d,tectly to ' school a. Staffing(pages 57-58) (2)'Evening meal se eid"to children to :attendance (1) Staff-child ratio for sleeping children: d. Bathing(page 58) If any child is bathed: O p " (i�) Clean water, rovtded fpr each child a 0 u to l8 months I't7�5 e p (b) 18 months„up,to 2%2 I to,14 xX 71 (2)'Each child(lathed separately years* ( ) Each child supervtaed while bathing r .,�g',�ii,p �r rang rah`` rG9iadoi ,,�q: f6 r-rg�a ry„< - s n, _ e rv,,,. ' (4) Individual soap,towel`and washcloth (d) 4 yFi6 and older 1 to 35 ,provided"for each.child 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 Pi must meet Minimum Standards at all times. It is the sonsibili� of the licensee to operate in compliance with the Minimum Standards. Signature of licensee or designated staff Date 9 Emergency Preparedness and Response Plans Checklist ( O )indicates compliance observed by DHR Licensing Representative (I indicates not in compliance (S ) indicates certified by staff in charge(use only for*plan updated yearly,written documentation must be on file) Procedures Documentation, The plan shall include procedures that will be used to prepare for The plan should also be inclusive of and respond to the following types of emergency/disaster situations: Weather enier encies/natural'd►sasters Gurrent emergency plans and procedures Seivere ThundelstormS fk ea �. ep t s M < a�'T(}121adQL'$ aV^ LAQ�dl(��y A &,'1) � "i EaM1; �� a�OT'SIIO Wfall ¢ � k �r " �� s IC@StOIM's n ..>.,' `.� 6rt.=S �8 i r 'k kiwi Lo;� wnmor�evacuaton clue-to threats�o ¢v olehce� � � s� Tocatto�nanduse.of dire eX�(tit ushers � u'� �'� �,,,� r, t ." �' ". x, nt" �����v ��lfl�u✓" Jg � Evacuations dueDocumentatidit, the�followmg uai erly dri ls, °w M Hazardous materialsTiX Spzlls� Tornado u {Ta$leaks ✓ s �� ' ,•G�N � f-ry�s�'�hP,�`I�ackdown.� OITl thTC2tS �Ja ark, , s ¢qJ w ) (ir�y x, E z 4i 2 gL�Cat101Y it4 a ur, dy�,p p Og 5V� 91 Ipi� d �i.. w:. YCkkG �`'��.,' Mgt�h /:, k ��"'H� 7p s1ri tP' i k l.r`"^-�.... r `� infeefOus disease a"finer encies„ ;Y-- g auk,,. �, Telephones for on site and off site use s Loss`of power,water;or heat';` r Location of,the f rst aid and'emergency supply k�tsr „E a Other'thr'eatenmgsituat�ons`' � ,, ,:: Details The disaster plan shall include details for: The Emergency Preparedness and Response Plans should be: Shelter m.place or evacuation Available'to all staff and employees Ass�ai n: iiaa,nts and children':with special needs and/or,health` " osted m a Conspicuous place �� ' i , 9 xr n #^' CpndTf10i1S RaF a m ,� ..f`<Bai��uirp .�.... -�, A,A.0 .u'� ..a .. ,rqax �'° a V OX� -Afq 's irh x rig � � Submitted tothe eprt7nent Rennifieat10t1st ith parents, i. H Supplies needed for shelter m plaee i ocednres Copies�prov�7ed�to�a11 parents/guardians k P_ - �. trllSpOrtatlOA dlSaBtCC proCedUrCS Staffframmg/reass�gnment as appraptn� y' r i ; r. *Plan'updatecl�yearly gr Contact with local'emerg enc ,`maneg ement officials 16 Checklist for Infants (O )indicates compliance observed by DHR Licensing Representative (-1)indicates not in compliance (X)indicates not applicable V Name o9teacherlroQm# -ak k 1 p ' Age of children N,uiSiber of children p xa �a r� Nuinbeb ofstaff a � ' �� � �.a `' Minimum E ui ment Re wired for Each Grou of Children Required Washable soft crib toys-2 per child Push and pull toys-1 A device that plays a variety of age appropriate music Age appropriate books-2 per child Large balls 8+inches-I Nesting and stacking toys-2 sets Washable baby doll-1 Musical toy-I Colorful pictures and posters Activity boxes,such as busy boxes-3 Additional1 .,a.�, .49<:° ,� N —11 Smk;,warm.Water,fsoa ert. wets. MCx 2yr ,. .45 P�;a W;' ,P Mastic-lined`covered:contamer .`.: ''" n „_ r "- Tub(portable plastic type acceptable) r .Indoortliermotiicterl0ut'ofreacli`ofchiliiie M ,Iniliviclual�iabeled'stora i s ace fot•.eacti child ,. ,�� "`+p4' E; k _�� "^� ., �.� ,a, xe;�,,a����,. :; �, >F'u'tnii to child<size`acle'""' ood b&dition ' '"4M- Gribsn accordance wtth[IS Consumer Product S fete s r U Act of2.b08 Facilities ttectli6lret lets'G6Vered`^ w r 3ya y a �� Haiarrloussulistances:l`o""eked- '.,, ., z ;a , x ° Contaiiers-lalieledr r Medicaiton'`locked s .. . rNOw ` S.eriiiiohvitida�vs=whirl►are,`o en'ed 1 ! ,,.v. ,.'�a .•_v,ro .. ,-w.;-�-:.a«C,.', _.,��i, -a b i �tI71` 'ad U3t �, r m s s y 10 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 teacher/coon 4M,`T @ F y + +b a �,'�" der A esOf`Cluld'rell� E ,° ,„z ,l P ., Number of children;• Y, b `v { Nluiberof:slaff Minimum E ui meat Re uired for Each Groui o Children Required Equipment(page 67) Art Non-toxic playdough Large non-toxic crayons/markers Paper Non-toxic finger-paints in primary colors Scissors(blunt-tipped) Books-2 per child A device that plays a variety of age appropriate music Rhythm instruments-one for each child in the group Homeliving/Dramatic Play Baby dolls—2(complete with all parts) Child-size stove and sink or combination Cooking utensils and dishes Doll bed Doll clothes and blankets. Dress up clothes Toy telephones—2 Building blocks—approximately 50 non-interlocking Cars,trucks,boats,etc.—3 Age appropriate puzzles-4(complete with all pieces) Interlocking manipulative play sets of different types—3 sets Additional Furnishings and Equipment .Sink wa=,WatCr.soa�, BI,6wel$ l?lastly-lmedicovered"COntalners Table"s ace`and'chaii=for`�each;chill Ta° ,.'' �`^" "�""�� ' xa� err` Indoor::then hometer/:.'04 ofiedbff hildien E. �€ y,`% „y '_, � k iiu ,, r x�G�a r Written daily Ian or schedule posted I;abeted,sioia`"e s aceafehild:level' '� ,��r: `x� "�` ^�' g .S,hCIV:1t] fOri°8 Ul mC17tE�a�ItdsSt'I I1CSIai1CIl0I8d .„. '• "'`�'rf:? � "' K,'v� a' `` v `�a a ��,z'"�' ,",i0:. � ' Designated activity areas ru-ti- ,p °4" - 1"r n rG� i i�a rw a ,.4,„ ,� "` s .* ,. 7!EIeC#tcal.oufletc,OVered. r ,s ..., ,fit F. Barriera,aroiind=heaters`°fans Hazardbils iubsianb6si'k cked - Con(ane""rs labeled ., c`, u., d t .,;;3 v a ">,- »fl, a a� fin°„ z ,;r r�' i.z x d' WdiM lOClked z s._. `z, y o* tar ry b Seieens on:winilows which are.:o'erred a. F ,,v t " " F ' z z LI Imn `adequate., .#. .: ,a u , # F r ti„ ..fia d r: $*I t 12 Checklist for Toddlers (age 18 months-21/2 years) (0)indicates compliance observed by DHR Licensing Representative (,r)indicates not in compliance (X)indicates not applicable �, Naztiie of teacherlroom ,. �4.<. � ,.:.: w .m ;r m aA �olrchilcijr,pi w , r , r * ' ' twayri"s�a�} Num!ber�of�children' r 9.`« ta< . 1�Tumber;of�staff Minimum E ui ment Required for Each Group of Children Required Equipment (III., I., p. 66-67) Large non-toxic crayons/markers Paper(variety) Non-toxic Pla dou h Colorful pictures and posters A device that plays a variety of age appropriate music Musical toys—2 Active Play Push and pull toys-2 Large cars,trucks,boats etc.-2 Sit-on riding toy-2 Large soft balls-2 Play Books-2 er child Age appro riatepuzzles-2(complete with allpieces) Nesting and stacking toys-2 sets Non-wooden buildin•blocks a roximatel 20 non-interlockin 1 Baby dolls-2(complete with all arts Doll clothes and blankets Doll bed-1 Toy telephones—2 Pots pans,buckets,large plastic spoons Child-size stove Dress-up clothes Additional1 Equipment ri ;"r.✓a3Yv� ';, Sink-.avarm4waters3a a ertow�I51 .,„. ;. ,q£ , iyal� ,Iastic-�lirte co a ed'container ,, j a d,` J '^.ry 9 ,a} ,'",' ., <„ ,,. ,.. Tub( ortable plastic a acce table -N ch airs cleaiied/disirifectedterrl tied a a" ` jsmt x "Fee "ahal s)oitalile�and�chatrs e _��. .� ��, Wafe `oofmattiess es'=sheets coveriri's z0 rdata a c s ax a a Ltdaorahrmometeia�Qu4oExeach,ofclnldren. ,, ?q. 1..,*.. . ., 'ShC1Yln fore tii"'erit.aildsu lieC11Ore`d:t� w .,OiIP° �� �� ca .�` �� .„rye', iP'urmtuze"cliild'size,cle' "oodcondition , i,Itidividial•lab6ledstora° ""'ace,foreacli,child+ , .,a c. v, �1 a ., ? s� t, "' .<. . Facilities EIeCtCtcal„OLlt1e1S„COVelBd'^r a x, 't wv BaCCteFs,d[OUII(111eatets`'f3115 `r.<45w, .,r n>".», a „6` c<: e .` '� +bi ,° 97flC(1(ItIS"Subst> ices«Iacf[ed w � IMg r 4 r va CotttitlileTsdtabeled k , �ltE, d r. k� a*, 1 i, v. �INo- r o-Pk SciCenson,�Wind'owslWliicll,aze:o erred , `F9r,;,�.;r,:, ra... '• ' ;,,,,,,�;, +�`.,t "'n;'",�,°;aFA.F. ]'..1 tltl-ade 113te ' � �- #<..os,• i""6 s x�: �- w8,"w eta� .��" �'s��. .A>:P:���,.°,�* a.'. �°�, �;>�?r `� rid ,s�s,>pr�.x 11 Checklist for Preschool (age 2Y2 years to school age) 0)indicates compliance observed by DHR licensing representative I)indicates not in compliance C ,�Y\.C-) X)indicates not applicable 'ame o,',( 0 her r ff, AgB:of Children ` I -A Number p,"ren Nuucber of staffA Qm Required Equipment(Ill., I., p. 67-68) Minimunt EquipmentRequiredfor Each Group of Children Art Easel CID Non-toxic playdough or clay Large non-toxic crayons/watercolor markers Large sheets of paper Non-toxic finger/cold water paints-primary colors Scissors(blunt tip)-2 pr.Per 5 children Non-toxic glue or paste;tape 0 Paint brushes four 1/2 and I inch in width Educational and Creative Toys Large/medium building blocks-app. 15 non-interlocking- Small building blocks-app. 100 non-interlocking V) Small cars,trucks,boats,etc.-6 Age appropriate puzzles-8(complete with all pieces) Interlocking manipulative play sets,different types-6 Matching games-6(no more than 2 electronic) FPuppets-2 Horneliving Area Child-size stove/sink(or combo) Small table and chairs/benches C Cooking utensils/dishes(unbreakable) Doll bed or cradle Dolls(complete with all parts)-2 Doll clothes and blankets n Dress-up clothes for boys and girls F Storage for dress-up clothes Unbreakable mirror-full length Toy telephones-2 Literature and Music Age Appropriate children's books-2 per child A device that plays a variety of age appropriate music Rhythm instruments—I per child in group Nature Study and Science Magnifying glass Magnets Nature collections Measuring and pouring equipment Additional Furnishings and Equipment C Sh��804M ila� S �%w ,h� R -w Written daily plan or schedule posted 4"'A ,Sbclvinj� .6r,equip ax t Facilities V P0, X N A '46aters t� ans� 7 coritainers"labeled 1Vledicatiori kickedZ" t Scr="nF<s,o5n,,w`ffi"d6wi,(vvbicfi,are 7 i 13 Checklist for School-Age 0)indicates compliance observed by DHR Licensing Representative f be VIM )indicates not in compliance �Se X)indicates not applicable C3C, %I- NO 'ARE,Name of teacher/room# 45 � z T MAV2ti,T�,-T_, """'y"n" C, 6Y Xad ,5 Prot: X K,w'r il� ""V U" , V'1111111, n6 NumberOStaf '4 J , Minimum Egui ment Re wired or Each Group of Children Required Equipment (Ill., I., p. 68- 69) Jig-saw puzzle-] per 5 children Games:choose indoor or table games Suited to age of children-1 per 5 children Games:choose outdoor or active games Suited to age of children-1 per 5 children Books suited to age of children-2 per child Non-toxic playdough or modeling clay Non-toxic tempera paint n Brushes Non-toxic crayons Paper(variety) Non-toxic glue or paste,tape Scissors A device that plays a variety of age appropriate music Interlocking manipulative play sets—I per 5 children Additional Furnishings and Equipment �C 6igU68 i' 0,.dach chifd4hb na M ;]]h_do"6r' ihcffiiidfdetei,Y6' f 0'3 Written daily plan or schedule posted 1pifiefif.and Wlijili&s/ Designated activity areas Facilities A ektrkal 777777 -Barriers- ilazardo -,us e V w U at 'A C ers,) 7�7�—q,,7, M 011,,�,�,��,M�7 5T 0 E M10f, WOW&M4, 7.7 k" I tin 14 Playground Checklist (0)indicates compliance observed by DHR Licensing Representative (I)indicates not in compliance (X)indicates not applicable Minimum Equipment Required for groups of twenty-five children or fewer on the playground Ali Location or age group Wheel vehicles to sit on and maneuver-2 Wheel vehicles to pull or push-2 Balls-3 Climbing apparatus Crawl-through equipment Digging or sand area n Toys for digging Facilities budoor play area enclased by a fence or wall at least4 feetm herght a �' ,r ehce Or Wall free o£Sharp edges a � ; l t ro a ? a a qr r �GWp1� � tiwl .. a,.d ., ".. .. ,. ., GateStSeCured } xx n s "a diz6 "3 r,l iNyg . 5 81hade7and SUn"'areas provided j >,az a t IV s cur P z k wail Outdoor play area free o£apparent hazardous condthons con' .,^?.,mMM 22 Concretelasphatt now used underEegmpent DR �1'ea well dr$lned h� 7 Q' p " °'i p, ,-,: -', s• P k 'rx - l h �t ors"( ra'° 'Li sB ut went nbt dest ed fo beirtable securel arihedr �� Sta1rS�StepS haY6ha¢d Cd1iS in C}l7idh:S reclCl7 "'n�1 �+- � �lii i 5 irzii �. a » ztr} �i� ika,rr „, z ,i J 1 15