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HomeMy WebLinkAboutEvaluation Form 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: N -a AUX) Address: Date(s) of Follow-up: c1 cxS e r C�� 355 o� Purpose of Visit: Telephone #: Director: Licensee �ahc� `Qa. ��� -'ere -%GL �.vhNvn . � `'� County: \ a\`, ^ ay ❑ Night ubsidy Licensed Capacity: Day Night Days of Operation: Day Night Age Range: Da a— Night Hours of Operation: Day\DaVn- Night _QM X R-N-)A vvl License Number: Code: \� O - Observed by DHR Licensing Representative �- �V�B 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' ch e Deficiencies Noted: Yes ❑ No DHR- e in a esentative: Sections to be completed at the discretion of the DHR icensing Representative. U U REGULATIONS o ca REGULATIONS a o M Q Q Q Q . Q — U U Q U Q Z Z Z Z Facilities (II. C., pages 16-23) a Space for ill or Wed child 1. Indoor area(II. C 4 pages 16-19) f Inns u �byalLchrldihstnfected i �t � y r< n4><4�yi a.r)✓xclustve use of acttvttp areas= - � ±u � Stora e s ace far te_acher's su 7tes� � _ y "', �,+r,#.r.vµ{ - #rykst R'Y - znjjckY 2"�lrnk"s .. �,a� -..ate Xg.,_,5>!.•r`�}.�.p aa?s. - _ tysr. .pp i�d ti? k. .. b' Desi ateds ace for each ou m of childrensf ' � � x x" p P g , h Office space provtded �« c 5liathrooms located on+same level/undeisalme r66 i. Ventilation,lighting,heating(pages 17-18) O 1 one flush toilet for each 15 children 1)�ieatmglatr condctronmg provided _ ( ) g ® (2)F� ertidrahue 68-&Z at'chtldevelx � 2 one handwashin sink for each 15 children (3) One tub(portable plastic acceptable) O (3) Thermometer tti each area used N(4) Factures child size oe adjusted for easyxuse , 4} ThermometeLoutofrxcch of children ?rcY : J 2 d One handwaslung stnlrw�th warm.runntttg'water, r �S)r out9i tndow3 t 18t aCC ppB(led soa a er towels m edch loom here childr 'are ' c x�` kfD` '+x s s 3t.'rCenCtl rc- xg kt 4tril+ g .S -t xa` - _ ,.- c.,...,s..,t„ .f c ,.- -t } >"t �p'1 _Y'..c.r�, _ .i��.e 7 �r1i <.P.. �t,'',X+a,Y�,�a,o- � ✓ y - 1 U U N ill N N REGULATIONS f° v REGULATIONS m M - Q a - U 0 Q V Y Q o Z Z Z Z (6} Outside doorsykeptclosed 3. Swimming and Wading at the Center II. g g ( r C.,6.,pages 20-21) (7)°Lighttng adequate:for activities a. Pools two feet or more in depth(pages 20-21) (8) Lighting adequate at nap/rest rime to allow �l) Lifeguard at poolside at allimes pool children to be seen use - Operational.telephonefor centerbusiness only _- (2) Lifeguard gaining Certificate First�Aid Certificate CPR Certification on file '=z k DFIR notified if tele hone is out of order or if p - _ (3) Lifeguard not counted-m ratios number changes" a ' } I. Hazard prevention(page]8)(Indoor Are (4) Staff-child ratios for children in the pool: (L)-Center free of appaient hazards (a) one staff for each child younger than i r u i xis'- v 6r azardous substances und er lock and key or (b) one stafffor every 4 children ages 2% (2):H combination lock a ` years up to 4 years (3) Containers labeled n (c) one staff for every 6;children ages 4 years t ! ;up to 6 years (4) No fireartris or ammunition kept or"allowed in ,' °(d),one stafffor every 10 children ages center"except law enforcement ryears and older . s (5) Stairways_have hand raihngsm child s'reach �(5) Ratios deterintned by youngest child m the pool (6)'Clear glass doors, arked at child level (6) Personscounted in ratios meet child caret worker qualifications/mhtlie pool+at all times (7) Medicines and drugs kept under lock and key or (7) Staffprovided to supervise children m e, combination lock separate from haimfuI items pool area,but not pro ; (8) Barriers around heaters radiators fans accessible °k (8} IEany part of-a'child's b-dy is tin the water ° to children ' wchild cons►dered in pool (9) Exposed electrical outlets have protective covers n(9) Pool enclosed with fence or sold wall at - - .least 4 feet m height constructed to prevent � �" � t (10)=Consumption of alcohol or use of non accessibility by children prescription narcotic or illegal substances prohibited b. Wading structures less than 2 feet in depth: (11}_Smoking or use of tobacco prohibited on premises (page 21) (12),rBio Contaminants shall be'stored Arid disposed of properly ' '_ m. Center kept clean/Cleaning done daily(pages 18- (1) At(past one staff with CPR&+first 19)- each wading structure _�� �_ (1)-Floors bathtroom fixtures cleaned/disinfected (2) Required ratios met as stated on page 23 ' � _. . c (2) Carpets vacuumed daily "` (3),Atleast two staff at each wading structuie' (3) Cleaning does not interfere with children s (4) Clean water provided each � } - 2. Outdoor area(IL,C.,5.,pages 19-20) (5) Wading structure emptied when notin use See Checklist a' Off street`loadmgluiiloading provided j ` r 4. Away from center activities (II.-,C.,7., x page 21) b"Separate azeasfor children younger than 2'%z(maycbe � � NOTE: The Department of Human Resources achieved by scheduling), does not inspect activities away from the center, including swimming and wading activities. The c^Outdoor an jqAns ores safely accessible + } licensee shall assume full authority and responsibility for away from the center activities. d Outdoor play area free of appazert hazardous conditions 2 U U a) N a) U U M U J C C M REGULATIONS Q ° — Q `—' E E a REGULATIONS Q U U Q O U Q C �-' V r+ O Z p O Z Z Z 5. Furnishings and.equipment (I1.,C.,8., d CPR and first aid pages 21-23) See Checklists present during all hours of operation f_ Child Care Program (II.;.D., pages `k Second staff available when 7 ormore children presenthdoired ratios met 24-37)- 3 1 Required ratios matntatn'ed at all times' r i No staff an duty more than 8 continu ous hours> k,� � onEa regular bests Aa „� a 0 up to 18 months 1 to 5 m Staff free from other duties while working ' {. with the children b -18 months up to 2%years A to . Infan Toddler P�ogram(IL,U., - n 2., pages 26=29) months up to 36 months 1 to 8 i g a. Learning/growtb activities:(page 26) e 2'/years upfa 4 years Lfo 11 r "fa �X (1) Encouraged to play with a variety of toys f 4 years up to school age Ito 18 .' (2) Time outdoors daily,when weather permits g. School age-up'"to 8 years, 1 toFreedom of movement outside cribs daily_ a h 8 years and older, ' 1 to 22 (4) Placed on tummy partof tune while awake ` = v . rt _u and ObSehtred t s`, 2 Children younger than 2'/grouped separately (5) Staff talks to each child and encourages from older children response a Exception for group 24 36 months (6) Cneslsigns of distress investigated ` unmediately t .., . b, ,Exception for individual children s needs li. Diapering7toileting:(pages 26-27) 3 Staff;counted in ratty only when`giving fall 5 (1) CI`ean`dry diapers/clothing provided attention to the children 4. Staff coverage (page 25) (2} tiVet/soiled diaperslclothing changed � x a All children supervised at al] times {3) Changing area cleaned and disinfected t b Staff assigned responsibility for same (4) No child left�unattended while being t infantsltoddlers each daydiapered - a �� c Substitute staff availal le , (5) No clnI diaered' thexfloor , d. Director authonze'd to conduct center businessi n -' (6) Each child s hands,Washed after diapenrig ._ Y e Staff person mcharge=when 3irector is absent (7) Staffuse universal precautions when ; authorized to conduct center business° d diapertiig I5 �.x .,. .. f Staff meach room durrg nappug/�esting + (8) Staff use clean disposable gl0es for P x � 7 � � tfia eying each ehild7for each:iliaper change � `-� �� ! g Staff able to see all the children= -' �' (9) Wet7soiled diapers placed in covered, ily, "a plastic lined contauier and disposed of di g h. Ratio during napping/resting(page 25) (IO)klndividual,disp9sa131e wipes used at each x diaper change disposed ofprop�rly montis l to 5 (11} Forty chairs emptied i7nsed,dts_infeeted r f (2) 18 months'up to 2`lz years 1 to 14 2 `` {12)Diapering area separate rom food service: �� area � Y {3)2'l years and older jq 36 r c. Napping/resting(page 27) 3 m a) a) (D a) m REGULATIONS C .Ca to REGULATIONS Cu a Q M o 0Q o o a U Q z Z o 0 Z Z. (1) Infants allgwed to form awn sleep patterns x� " A * >i Toddlers seated while eating f , k _ (2) Infants placed on back to sleep unless physicians `� s (13) Child encouraged to�ezpenmeriY,with�self � ` �3� statement indicates otherKnse utensils rouided 3 Infants who can east[ turn laced on back but _ ( ) Y p (I4) Di�osable utensils used only wtth close , allowed-to�ado t reerred: osrtionr " )i Ps. P p p su eruiston (4) Noposihoniiig device;used unless specified by (I S) Foods eaten from a dish "*, k r � r" x phySlGlinl i rr= = — (5}-Staff reco tize differing needs of toddlers/all " "to - t (16)Dishes,bottles unbreakable '' .. 1<ollow their own:sleep patterns � ' ,_ �5� A. Cribs,cots,and bedding(pages 27 28) "(17) Drtnktng,tyater offeredo toddlers ; x (1} Two feet between occupied cabs dx �3 i (I8} Child not forced to eat *` � '''� Cots positioned,to allow space for access or t z i°` `� (,19} Food notused as re«ard or punishment f r (3} Ciilislcots cleaned and disinfected and sheets and,` �(20} Child s hands washed before ;,covers washed before usedby another e(itid Hacks,after diapetmg,toiletmg r ��ri a (4) For infants;clean bottom sheets daily or more ;f �(2l} Staffs,hatids`washed_before food often ifneeded slieets fit snugly ' t ° "{ preparation and service after assistingwili=, 'e toileting,after-diapering F Soft mafertal prohibited in infant s�sleepmg `W(22) Individual a er towels for each washin environment no'pillows quilts comforters eto ' and drying P}P g cr" v No infant put to sleep on sofasoft mattress "` - t .. . w 6. Preschool/School-age Progratn fi 1 (II�H pages 77 2) ,p (7) For toddlers clean bottom sheets and top a. L_earning/growth activities(pages 39-30) coverings weekly more often tf needed y e. Feeding(page 28 29) (1) Schedule posted (l) Fvrmulafoo°dSor>tnfants if provided by center (2) Variety of indoor/outdoor activities v planned with parent or ghys�cian -- - (2) If formulaprovided by center ready to feed {n w (3) Time outdoors daily when weather permits °properlysforedandhandled- xt �r ty r a t (3) Meals andspaeks comply with requirements s (4) Staff permit/encourage conversation among y t 5'�yr =x x t sb Kit r kk children s (4) Ifformula provided bypazent,labeled refrigerated ;e (5) Staff give individual'attention to each child aE daily (5) Bottles sent'homc`or contentsJdis`cacded at end of (6) Radio,TV,videos used only to supplement/enhance daily plan 4,ti, 4: ; .7 N t £3 c r""rat i F " .a „+P t z s Small hard candies;nuts not served to ehildren r '' r k (7) Na cliifd required to watch T'V or videos 7 3 40 c r ` (7) Foods that in y cause choking prepared L (13) Vtd_eos previe}ved by stafffor k�` ilr ` appropnately for the child i ;, appropriateness � ' f' ,.$ ♦Y r S'... 4 F e F`r ..<+s2M'4�t.+' 46 .�'�.,.v= (8)Feeding schedule according to child s needs * �° {9) Sexually expltcittviolent„fnghtenmg " Frrater�als prctl�ibtted g hk _ 9 Infants held foc bottle feedm ' g ri T _ b. Napping/resting(page 30) sb _ ,. to -. (10} No bottlespropped " x ' _ U (I) Staff recognize differing needs of ohildren = �.,_<< - (11) When able infantstallowed to sit-in feedm chair (2) Rest period for children in at more than 5 hours I I 4 a) (1) a) a) m m two c c M C.) U REGULATIONS -o REGULATIONS a U U Q U Q +-' V C rr Z Z °Z Z . (3) Rest period at least 45 minutes,not more than " (IS) Children}sealed while eating " > 2`/x hours (4} ff a child;who does not sleepafler 4�minutes „ � t=r�`,.�� Y�'(16}No child`forced to eat , " �., �'' �, � quiet achvtties pet»»tted `' 'S•1 { r k£:y,', t s "t S Cots cleaned aad°clean bottom sheets and o "' x' ' qr O p x S p (17) Children not allowed m kitchen , > sheets/covers ptovtded before usedzby,anothe r (6) Clean sheets/covers provided weekly more often+t (18) Children s hands washed before meals 4'l = �fneeded t (7)s Cots positioned to allow space`forJaccess or s<'' (19) Staff hands washed before fogd e emergency exit° ' says > a =re aratton and service ;attdra8er assts'ttti with t' xsa" .�t � Aa ?. t y` 8w �cytolletmgQlQantaetWlthbodtlj fluid 8 AYleast one staff m resent m`each loom: „ �� sir` ', „t (20) Dtsposabegloves used for dtapenng � (9) Staff able to see all children; ,(21) Indrvtdual paper towels for each washing ,t Z , } z{y MF � z ' ` c. Toileting(Pa e 29) QUtrementS.x� E ls d. d ana« ' �i (1)_According to each child s needs`'eachchtld s _ -e_. Disciplinary Practices(page 32)y (2)•Staffuse Universal Precautions when dtapenng l (1) Discip(me'appropnate'to age ands} ,J y or handling bodily fluids ' developmental leveh of the children w # s x d. Feeding(pages30-31) t fh (2) Nocorparal/physical punishment (1) Children in attendance served breakfast or a.m t u " (3) Noverbalx`abziise t# 'Yi R ' � (2) Meals and snacks comply with USDA guidelines r l (4) No discipline assoctated wtth food",naps dr r�' F x6athraom,procedures, r (3) Fluid milk served'no powdered milk f6r dunkuig ( (5) No physical restraint as punishment P Y child depraved ofineal or'anack 4h (6) No punishment administered by another Child (5) Spectal`dtetary needs`m accordance with wntten f. Staff-Parent Communication-(page33) mstructtons �� � 0 z 'x - {6) Meals,andsnacks�rovtded by the'cetiter # (1) Discipline,behavior problems discussed x with parent r(� Vending machines prphtbtted m areas usedaby`t F` (2) Center open to visits from parents at any children Viz; M .y ,r• ,,,t'F4 r ,r time (8) Stnall hard candies,nuts not Served to children (3) Parents informed of right to visit At r (9) Foods that may cause chol.mg prepared €st , (4) Staff available for communication/ C, appropriately for the child conferences J (10) Portions of food Butted to chrd s needs}second'# 3 T m `�t (5) Parents notified of complaint procedures fro.a�ta.r (11} Jrtbreakable or single use dinnFefw'&eu96d p (6) Parents provided with information on influenza (12}Single use cups or glasses orafdimkmg fountain „ ) g. Health information(pages 33-35) (13}Dnnkutg water offered£�urtr g the days 'x , " {1}rla ill'chtid a lmttted N QY'„ _ UX"' t 4 ',s' E a".y.•$z 4�? f e' Y'$t 3 -x i` $'k, �4 35 rT'i` ,.x`'. --=C C`•'4 z 4y Sf'#✓? `' s } ,5 �l'4t .r 'not directly ontable r � � ` ``6 �_ ,r�3 s crated from oufl brit contlnuousl �� � � `��'�` � j a _ y -z F�y ;.ar4,i�k9 i yPty •ri y+^+r s r ` R. .d• r .��xt� r _�3 - -=,x;._ =�'x'x� tsx 'S6l{perl`tsed�* i.i,a:a ..� '����a - _.,a?�.:5 r,>1��;�•, i U U a) a) N N C C U REGULATIONS Q a REGULATIONS Q (� U Q 0U CL Q c � U �. Z z ° Z Z (3) Parentofill/tn�ured child,nottftedimmediately d* ` , 'Ar _ (e) Children and staff wash hands after hand required to"come for child �,, '' � handling animals s - (4) If pazent cannot be reached or illness/injury , r h `Emergency Preparedness and Response t ` severe emergency medical attentionis obtained Plans a e 3G 37_ See CCteclt)rstl + }, 2 p" (5)°Parents notified of exposure to contagious = Transportation(II.,E , pages 38— diseaselcondmon y 40) x(6) Parents urged to notify center if a child is 1.Transportation provide&by the.Center exposed to a WWIdisease outside centerEE 'p))i fE (pages 38_-40) .£.�F` �9.:`- t�..i,...5 ,it x sra�' ✓„^:iK �i�S y�.v,. _ (7)x"Center reports contagious disease%ondihon to 5v NOTE: The Department of Human Resources does v health`depamnent as re�iired , - k K, not inspect activities away from the center, including swimming and wading activities. The 0-Y Medication/Medical:Procedures-(pages 34-35) licensee shall assume full authority and 10.*1 responsibility for-away from the center activities. Does.the center's staffgiv education/medical- proeedures?` Yes No . (a) Medication administered only wrthfwntten+ :f Ddes the center's staff ovide transportation? � " autlionzation from arent- Yes El No i P (6) No blaiiket authon2ation forms=for medication a Transportation cfiecklists used as iequired }' (c) Medication in'fonginal cogtainer labeled ; b Designated staff complete and sign checklist , s ,(d) Measuring device provided c Driver stgns checklist+indicating he/shehas' ' x (e),Medication admimstered by designated staff a -39 R x d,ChecllistsCept on file for cutrent year£plus°2 Y ra (f) Locked storage provided for medication r additional years t _ s y ; * .(g),+IIedtcation returned to parett or disposediof a Center responsible for picking up'child at "'' +when no longer needed + %° t t r �'`�� �"' designated location and dehvertng''ch4ild to" � +t tf' � _��' x, designatedpers on, x (h� Time and date medication- given is t f. Su eevision in center vehicles a e.-39 documented m wntmg,keptin child s f"ile/Copies ,.� �" �� P (p g ) (9) Hygieric practices(page 34) (1) 'aft-"chrtd ratio met for childrenyouner t 3 F 1 �_ than lawful school age driver not counted ° a Toilet articles labeled and stored se aratel O p Y (2) Children of lawful school age and older z , 22 , (b) Used paper towels wipes tissues aTe disposed (3) For 15 or rnore children of lawful school ' der of)mmedtately foIloiying use a e one staffpittadditto )o dnver or - 1 - £ (+) Toilet paper provided for u'se by children and x d (4,) For 3_0 or more children of lawful sctiool i staff ° 1 ad a age two staff to dttion to dnver { (d)Extra children s clothing available# 5` ka ' " (5)Wo chi dult ` b u R (10) Animals on the premises(pages 35-36) (6) Staff accompany each child tinder 2'/z from r vehffilet0 Care Of de"slgIldted Ij�CISOn�'�� �L�:'`'�,� x r' ��'''�'� �re (a) Aggressive animals not kept in center or on Staffvisually supervise each child 2'/z andxs 3 grounds S older from vehicle to care iif desi ated etson +.w b Animals that could pose a threat to health and r O P (8) Dnver ohecksseabh+seatat each location fog= f safe kept awe from children safety P Y yerify,no child is left on (c) Certificate of rabies vaccination on file for C g. Safety precautions in vehicles(pages 39-40) animals (d) Animals confined,cages kept clean,food and (1) Stationary seating for child,each ohildc i rt + ` �y* water available r(2) Doors locked when{vehieleis mov ng n U U a) N a a) C C M REGULATIONS Q " Qa E Q REGULATIONS C Q U U Q C U Q U � }. Z z O O Z Z y (3)rChildren not transported m front seat of vehicle` ¢ , 2. Records on staff(pages 42=44) with passenger sidsr airbag k��s` -���� �` a r � �" y �f (See Staff Checklist) (4) Dirver and all risen ers secured w-pave hicle is tI ` ' � " - p ga Records on staff kept confldentiat - �� r 0 33 v f r x i � y t (a) Each child under(year or jetghing,pss than ; ;y b Records on file:at time ofem to ent 20 pounds secured m rear facing child restraint, v a- ' installed according tom anufacturersoinkructions s , z ri C. Records on staff maintained at least two years maintained in good conditionjA after person has left b Each child under 5f ears or wet in less than r' " r O 4 Y g d Records filed alphabetically 40,pounds secured 7n fornard facing child restraint 4 w r t �x ' k , installed acco�d�ngito manufacturer s instructions � � � � �"?j'~~-''`'��"� mamt imed in good wnditlon - ` `_ =Inactive files maintained separately#4 y a 'Y� r (cj Each cli�ld underd years secured to abooster= '; (page 45); 3 Health seat installed according to manufacturer s instructions x+ amtamed m cod condition , � � � � �, � g� (� � , � a ):Vledii;al exam and TB 1test on file attime of ,° �; � - � (d) Each child 6 and older,the dnver,and each �: � , ; � b Staffwith symptoms of contagious��- �, k � � ` adult passengersecured iii an individual seat belt, diseaselcondition notm�center t properly�anchored to the vehicle r; ', x a =s z Y= t hs Vehicle safety check done annually signed by 'fix x a Character and Suitability (II. mechanic and dated,filed m center _... .'.A r pages 47-51) G., r S Trans p. ation provided by _ 1 Character and suitabdityreview conducted a rent/ uardian a e..40 reguired ersons ev 5 ears e ' P g. (P g ) s<. 3 a Each child accompanied into and'out of center a Persons with determination of unsuitable t =�C'Itnlnated ;„ x': t. .;4 - 7 r aq c b Each child si r ed m acid si ed;out v b Licensee informs DHR of any ci nal .:� ., . .aconvldtions or cuirent-cliaz es ? R i £ ,. c Any_child who amves by walking or bus signed m -i' e Adinln>lstration_(II , H , -a_ -e_s 52°-56 - ---- d Photo"FID required when releasing child to � x " 1 Applicant/licensee(page- 152) unfamiliar designated person � y � �� �� r = � Staff,(II:,_ F., pages 4.1-46) :a. Licensee assumes full authority and responsibility for meeting and maintaining Minimum Standards 1. Qualifieations(pages 41-42) b.Licensee provides operating funds a. Center director meets qualifications G� _ 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 Child Care woilers/leachers meet requirements for t5 d. Written operating policies established x CCDEatrainuig wrthmr9Q days(if applicable) ..,asF� 'y� �„� _ �� ; e,p c. Aides/assistant teachers not counted in ratio (1) Copy of operating policies provided to S parent at time of child's enrollment S d,Service staff not count d miatio upless they meet i 2 Co of operating ( ) Copy p g policies submitted to qualif cgtions andyare givingvfull attent M to childrenx r DHR e Dever at leastl9 valid dnver's license r, s y� a y (3) Operating policies do not contradict U A � i 1 i ,C �np k s` �., � ` �i Minimum Standards f Substitute Staff meet qualifications of staff.for whoica ?s fRh' (4) Changes in operating policies provided to sub9titutin s fi j 4ic w r., _ parents and to DHR tom . 7 U U ill a) a) U U C C REGULATIONS Q a Q Q E E 'Q REGULATIONS E 'Q C) Q U Q C .' U �. z° ° o z Z 2. Reports to the Department(pages 52- b. Age range of children in care conforms to l+ 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) (1) Change to ownership ji a Children s records and mformatton about children and theirfam�lies kept confidential ,,. (2) Change ui location: b Individual records on eaohchildo rig file on first day of attendance _ (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 s (2)Records filed alphabetically or members of board �sin, {5) Alterations to ter or grounds ' _ Ina(3) c ahv files inamta mewseparately (6),Ivlalor change or extension of hours orprograni S. Center Records (page 55)' 7 Change in addressor telephone number The following records kept on file for the current O -,year plus two additional'years: b. The-followinb reported to DH_R within 24 hours, 'a Daily attendance records on all staff and written report-within 5 days:" �chitdren at (L) Any illness/tndu,'y of child or-staff requiring b Transportation checkiists professional medical"treatment .. Ye (2)`Any illness/ut3ury of child or staff requmng c Vehicle Safety check emergency.medical treatment u (3) Any dea_ pccumng m the center or during away d Sign in(si out sheets Y ` ' from center activities `� � 4);Ma or"damage to facile, ( b „ n. 6. Documents to Ise posted (pag es. 55- {5) Interruption of the center s,electrical"'telephone.`` 56) or gasservice ^ e > - (6)piny litigation involymg the center 3 ' a. Most recent license,permit,or approval `U (7) Any traffic accxdentiinvolvm -d- ent care children .< g cY _ b. Public notice form usinb transportation provided by the.center x.� - (8)'Any arrest of licensee staff employee;;volunteer: g c "M strrecent hcenstn eyaluatlon (9) Final dispAsition of any child abuse/neglect - d Mosi recent def`tctancy report k investigation involving licensee staff employee _ volunteer _ y (10)=Any incident m atuch the hea[th,,welfare or g" Corrective/adverse action notices safety of a child is at nsk x (11)Any disastrous events f_Mast recent fire iii`s ection r ort, 4 P eP c Child abuse/neglect reported as required by law -77 g Most recent health department inspection report and food perrritt or written permtssion for" d Licensee and"all staff employees volunteers li' Menu for meals and snacksldated ' cooperate with DHR on anychdd abuse or neglect t investahon .. i. Name and telephone number for:(page 56) 3. Admission Procedures (pages 53-54) (i) p,redepartment a Total numbe of children m aare rncludm children F r & (2) Law enforcement on the premises children iq transit children on field trips conforms to number specified (3) Medical assistance(ambulance or res4ue) w ' 8 REGULATIONS Cu a •Q Q `�° Cl- REGULATIONS Q U U Q O U C � U < Z Z Z o Z (4) Poison control center r (2)'Required ratios for day time maintained 4 �yhile children are awake(see page 23) (-�)rSubsntute help (3)Ale ast one staff,at least 19 meeting child care worker qualif cations with CPR and 1st aid in Emergency Preparedness and Response Plans center during hours,of operation k Name of directorlstaffperson m'charge ' s (4) All children supervised at all times s (5) Each staff assigned responsibility for same n N><_ghWine Centers (II , L, childrennightly L=` pages 57-58) b (6) At least one staff m each room o_f_sleepmg children Y �,-= z In addition to the regulations set forth for day r„ (7) Staff able to see all the children at all times ,: care centers; centers providing-nigfitt'ne care (after 7 p:rrt.) shall- meet the following regulations or.modifications (8) All staff{awal.e and alert to needs of children x" Does the center provide care_ €t'er 7.00 P.M.? (9) At least two staff m center whenever Yes 0 No [� children are prAesent/ equired-itios met Does'the center provide care r midnight? Yes 0 No .. ;;(10) Lighting maintained so children are visible While"sleepmg 1. Equipment and furnishings \� b. Nightly activity schedule posted (page 58) a In centers operating past mrdiught cribs or cots ° = (1) Outdoor time available during daylight hours fitted a.waterptoof mattress shall be provided foP each child (2) Staff assist each child as needed m dressuig . and grooming ' b In centers operating past midnight there shall be at 1 C. Food (page 58) least one b'athin facility-for every 15 children . ., 1 Child Care-Program.{pages 57-58) (1)`Breakfast served to children going directly`io a: Staffing.(pages 57---58) O g d to.children in 2 Evenm meal se e (1) Staff-child ratio for sleeping children: d: Bathing.(page 58) If any child is bathed: (a) 0 up to 18 months I t, 5 s (1) Clean water provided for each child s (bj 18 months up to 2% 1 to.14 r(2) Each'child bathed separately (c) 2'�z up,to 4 years 1 to]8 (3)r EachJchild supervised while bathing „ W G 4 Individual soa towel and washcloth (d) 4 years and older 1 to 25 O P - rovidedWJ for each child a 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. f� erL Siggnnature of licensee or designated staff Date A Checklist for Infants (0 )indicates compliance observed by DHR Licensing Representative (-I)indicates not in compliance � . (X)indicates not applicable x^ Age Of Children - YXf h n Number�;ofchiIdren - � � �_�'' �` ��'�.• �� � `� ` � �� -�"�" ' � Number,of staff Jam§ , ' art. Mrnrmum„E ua rnent Re ui/'ed or Ench.Grow, q Children Washable soft cnb to s-2` er child 777 - Push and pull tq s-I A device that plays a varietyof age a ro riate music Age a ro ridte books-2 per child Large balls 8+inches-I Nesting and stackin to s-2 sets Washable baby doll-1 Musical toy-1 ` Colorful pictures and posters Activity boxes,such as busy boxes-3 7,T c idrea rtable-plastic a acceptable) Feedift',chars Crrbs/2'feet`ofs"`aee:between occ"up ed crihs -, - " i -iiiterproUiriattress,°sheets.,"z.. ,. b itndoorthercnoineterl,Qut;ofjeach ofchildreny Shelvin'.for. ui e 'riientand'su tieslanchored Funuture.child;s`ize,cleaa oqd eandition - Crtbs m accordanoe with US Consumer Product Safety - - Act�of?008. �.a .. -., ... ,., n: ... ,,.. e# .". .ems:. - fib.i.a r •e. Electrical,outletsebvered Barneia around beaters,<fans ... ?- Hazardous Sub§tanCOS.toeke_d - r� l,,!.?.... .<. _ ,.s., ..n .. -..-'''.✓. °:tea.'` - ,, •` Con4airiers ...- 1n Checklist for Toddlers (age 18 months-V/2 years) (0)indicates compliance observed by DHR Licensing Representative (I) indicates not in compliance (X) indicates not applicable A e:af clx>ildren n- mn < �. .. Ntir►ilier`of cl ddren.w A Nlcnimurre E ui merit Re urged ,or Each.Grou o,Children Lar enon-toxic cra 7aro Pa ervane2. Non-toxic Pla dou h Colorful ictures and osters A device that la s a vane of a riate music Pusli and ulltto s-2 - Lar a cars,trucks,:boats,etc.-2 Sit-on ridin joy-2 A e a ro riate uzzles-2(complete with allpieces) Nestin and stackin toys-2 sets CI Non-wogdep build nj blocks,(a roximatgly 20,non-interlockin ).. Baby dolls 2-com lete wnti al( arts)` rD Doll clothes and blankets Doll bed-1 Toy telephones-2 Pots,pans,buckets,laze plastic spoons Child-size stove Dress-up clothes ;Di eriQ``area, '-; s., x S' -vvamwater,so a er'tawels €,t; ten... ' „ �- �... ,. Plastic-Tined,oove ed contamat.„,,, _' -T� Tub( ortable lastic a acce table) Pti `•`cliaus=cleaned/disinfectedlem tied ° Feedin char s)3oc table atid'atiatrs<Y3 Dribs/cots_ - Etiruiffi&child',size'clean:`ood condtuoti ,1.3: n ,. Electrical outlets covered .= v )earner`s=araiind°heaters�faris. _� �.°v Hazardous'Substances locked .. ColltainetstabdI60- a n Medication locked r i ` .xs as +. t i` r<,k a " Screens on wtnddws which are'o eried �„ tT 3 , 7. li tin` u ade ate ,*,, 3; ;, w 11 Checklist for 24 months up to 36 months (O)indicates compliance observed by DHR Licensing Representative (,l )indicates not in compliance X indicates not applicable A e of children z . f my s ?i§ f k Number of:staff,,F- _ $...€v+'w.�4 # f..I✓zi P,4 ,t- a .,;,3, 2 '� F�' f i, r"; �A s, _ K -:. , •G� Mtax `niun E uc merit Re. wired or Eqch,Group o Children Noii-toxic playdo`ugh Large non-toxic crayons/markers 1/ Paper Non-toxic finger-paints in primary colors Scissors(blunt-tipped) 10 .., 'Books-2 pei•child A device that plays a variety of age appropriate music Rhythm instruments-one for each child in the group ism «. - Baby`dolls'2(compl"ete with a(I paits')- Child-size stove and sink or combination Cooking utensils and dishes Doll bed v Doll clothes and blankets. /�• Dress up clothes Toy telephones—2 7Building•blocks—approximately'�0 non-interlocking" Cars,trucks,boats,etc.—3 Age appropriate puzzles-4(complete with all pieces) - �[ Interlocking manipulative play sets of different types—3 sets D�a erin� :Siiik warmskvatet soa er,to�vels a ;, s xr , I�laSYlC=hned;COVered,COntalneCS- Tables`.;ac e"and�chair:'for each child, a r lieets-and-covers'.:. a Indoorthennometer/,Out=of reach,.f children'' t d3.: Pal � Written daily plan or schedule posted Shelvin`•force u►'ment aiidsu lies/anchored:,, A,7a�,-� -a.�ia.,.w'�,r a fir,•: ..�'iar'.vs *.43����` '-7;' . Designated activity areas Facilities Ekbtrical�OutIeYS-':COYerCds Bamers`aroutiii+heaters,fatiS ; tf a} dr ;S _ z s •,r r Hazardou"s"substances=loeked '= — �-� m'f z :xa, >.sr.�}:` 12 Checklist for Preschool (age 2% years to school age) (O)indicates compliance observed by DHR licensing representative ` ( -1 indicates not in compliance X. indicates not applicable �. Name of teacher/room# ` A'Qe of clitldren' F € �,�.,..'y bK x Number of chdilren_ s r'r t. H+ Number of staff ����s..��r� � poi �° „r�s, r�r'^�„,�. - - 1 1 1 1 1 1 1 i Easel Non-toxic playdough or clay Large non-toxic crayonshvaterc_olor markers Large sheets of paper Nontoxic finger/cold water paints-primary colors Scissors(blunt tip)-2 pr.Per 5 children Non-toxic glue or paste;tape Paint brushes four-1/2 arld 1 inch in width 1 1 1. Large/medium budding blocks-app. 15 norm--interlocking Small building blocks-app. 100 non-interlocking 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) Puppet9-2 „ 1 Child-size stove/sink.(or combo) " Small table and chairs/benches Cooking utensils/dishes(unbreakable) Doll bed or cradle C) 7 Dolls(complete with all parts)-2 Doll clothes and blankets CD Dress-up clothes for boys and girls Storage for dress-up clothes Unbreakable minor-full length Toy telephones-2 _ 1 - Age Appropriafe'children's books-2 perchilil ---- ---- ----- A device that plays a variety of age appropriate music Rhythm instruments,-1 per child-'n group Magnifying glass Magnets Nature collections Measuring and pouring equipment 1 1 1 1 1 1 Tables'ace,ar%dt�ahavforeachchild xtx.:=, ,_ - Cots Sfieets covers for'eachchildk ? �_ j b u Indoorrtliermomater,/,out`.ofreach,r`M z,s Written daily plan or schedule posted w Labeled°stora a=s ace_at;childlevel ;LL= ._ Shelvii`fore`utment andsupplies/anchored`=. Designated,activi _areas Facilities )electrical outletscovered�`� �:���s�,�, „� ,'`ji �` . s,v�z, � c�x�;;�' 4 •�=f ��-� � �' � '•� -� z ��'� 4£�; Barrier"statounil'fieaters;fans t..,.. `f <,` ;s . r." ..a Hazardous;sub"stances'loc7ced/ . .:..; _ a =r , contain'erstlabeled= _ ° •"� ; z ri:�., - '� ,�'�k,.".` j.: ,�� � �t�.�€ .,��r x �r� ��' ��,� Medication locked„ =, Screens`'on windows whic .fie; s Y `_` >,_ , ,.., �.• �:.Xa x Ll tm fade Uate v ` a y ; it p.ta v ,t rig r; Checklist for School-Me (O)indicates compliance observed by DHR Licensing Representative (,I)indicates not in compliance 0 (X)indicates not applicable `� ��Se✓r Name3of teacherlroom "' , Age of children ._ .. x - a} .,.aK., v,r Number orstaff w Minimum E u _merit,Re. aired or Each.Grou. Pf Children Ji -saw uzzle-1. er S 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 ED Brushes Non-toxic crayons Paper(variety) Non-toxic glue or paste,tape Scissors A device that playsayariety of age appropriate music Interlocking manipulative play sets—1 per 5 children- TAbte S ace and chair for.eaeh Child;_ ots/sheetsMovesfor;eachchiIdvvhbna ,,,, _,. Andooruthbrindineter l out of reach`..:-,'` Written daily plan or schedule,posted. Labeteil'astora e,s' a�x. Sheldiri fore U`men°tand su" (ie`s%anohbred r` w ? , Designated Activity areas El'e"ctrical outlets covered xr .,..< . Barrier'saround heaters,fans. - ..,-3,..iw. -. ' _ e, I)BZardOUS SUbStanCeS IOCked1,2 Screens on tvindowawhioh=are ci tined-" ,, ' �_.Y 14 Playmund 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 felwer on the playground �a 1d Location or age group Wheel vehicles to sit on and maneuver-2 Wheel vehicles to pull or push72 Balls-3- Climbing apparatus Crawl-through equipment Digging or sand area Toys for digging Outdoor play azea enclosed by a fence or wall'at least 4feet m h eight x h k } 4 Gates secured Shade and sun azeas provided :', i# ,," w { Outdoor play area free of appazent hazardous condrt�ons n f y " N D- h Concrete/asphalt not+used under eglltpmenf r �b AreawelI drained mpment not designed to be portable,securely anchored` �:Eg w Stairsiste s havejhand rails to child s reach' v ' + _ .u a+p 7-.%� x. 5. ` kg I 15 Emergency Preparedness and Response Plans Checklist ( O) indicates compliance observed by DHR Licensing Representative (,r) indicates not in compliance ( S ) indicates certified by staff in charge(use only for*plan updated yearly,written documentation must be on file) The plan shall tndude 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 eme encies/natural disasters, Current emergency plans and procedures Severe Thunderstorms °ti F z TOliladoas Y f {rFt 71;1 a r 9 ,7 axe "kr Flash flooding �r rr, ti n sP r f [r r + a I Major,snowfall s' k P 4 + r 3• �1r} a :393 r s rr... �.� rk� . r r u Earthquakes" µ z1 L�ockd"own or in-dueto threats ofvtolence �` vocation andise of fire exhnguishers�`k ' Evacuations due to, Documentat,oii'of the"following°quarterly drills,'" Hazardous Spills z, r To t,BQITlb threat$ _ y sr k t r a 1 _, c r r/;"eu , x t ✓ a - O r b Infectious disease emergencies ,_ „ x' Telephones for on site and off site use f , Loss of power;water,or heat " `_ Location of the firstaid and emergency"supply kits ,q Other,�threatenmg s�tuat�ons r,z. The disaster plan shall include details for: 77ie Emergency Preparedness and Response Plans should be: Shelter m place or evaeuat�on. W a h Ava►lable to all staff and employees , Posted m a Cons uuous lace } . Ass�sttng infants and children with special needs,and/or health P k Q t COnditLOnS ny' aw .. - .a....�.x„ All s Reunification with parents m s` _ 4' * Submitted to the Department 4 Supplies needed for shelter m place procedures { ` Copies provided,to all parents/guardians' t z Transportation disaster procedures' F Staff fcalnmg�reassignment as appropriate �x,,,°�v� -` ��' Contact with'local emergency management officals k� s 1.6