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Evaluation Form (3) 11/19 ALABAMA DEPARTMENT OF HUMAN RESOURCES CHILD CARE CENTER LICENSING EVALUATION ANNUAL Health and'Safety Guidelines Items Shaded Name of Center: Date(s) of Evaluation: V1 Ae- ��d 'SkArA- Address: gOE5 600� , -e4-- Date(s) of Follow-up: L 3 County: � �' Purpose of Visit: 0n r (_ , \ Telephone #: (756 ) C_*,,(,t- 9 FJ_1. Director: l „ 1i Licensee: C A"I?N ["Day , ❑ Night ❑ Excepted Licensed Capacity: Day Night x Days of Operation: Day�,� Night Day � Nigh Day-7'� M Night Age Range: � Hours of Operation: License Number: USUAC, 610 Code: Effective Dates of License: O - Observed by DHR Licensing Representative S - Certified by Licensee/Staff in charge From: To: D -Discussed with Licensee/Staff in charge X- Not Applicable-Not reviewed with Licensee/Staff in �� I ZZ CJ�Z� change Deficiencies Noted: ❑ Yes No DHR Licensing Represe tative: Sections to be completed at the discretion of the DHR Licensing Rep-re tative. U U N U U a) fB U Rf (B U REGULATIONS Q ° -Q REGULATIONS LL E o CL E o �- U Q O U Q U o o U o 0 Z Z Z Z Facilities (II. C., pages 16-23) b. Hazard prevention(page 18)(Indoor area) 1. Indoor area(II.,C.,4.,pages 16-19) 1� aa � ds �p ?,A dsh F: ta ,'' ✓ a rp �i J K° ��,",. a'J`tV .. ' a Bathrooms Ideated a_n wane leveltunder s�ie ao (2)Hazardous substances uttder laaand key,or ra ,�� ' ;' x � rIN (1) One flush toilet for each 15 children �IaVC a �e�xnS amm}tltna�kepfiota�lgyedaj,� p � ��ezzte�r except I Worlfare�rueaElt r r � ; qm c a I o o s >a� (2) One hand-washing sink for each 15 children (� Ys ave n�railmgs ur gild s retie , x g w O' (3) One tub(portable plastic acceptable) / \J (5) Clear glass doors marked at child level a � r� (4)k,Ftxfure ehald ize or adju ted£ar easy use 'x n G)` vledicmes Arid OUR, and ,filack and k y N, � V,f s �d - kfi s� ti o or eornbtnattan 1aek separate-"frot`M fM rie VIP 5 1 U U a) a) M ca N U REGULATIONS Q Q � Q E E a REGULATIONS E E a U Q U Q U � .,-, o O o O z z z z (7)farriers around hed�t�sliadiators,fans accessible �`'�J�' �,rc s b. Wading structures less than 2 feet in depth: to children M a Gg (page 21) z + ,n'� gar a ; - (8)'Expased eleemeat'outletsliave protective covers (I} :fit(east one stap ff with CPR&first aid atfi " {eacch�Wadtng'�1, ure m ow fib. v, O9 Consurn (ton of alcahaI or use of naa- �>, 0 2 Re uired ratida rnet as statedaan a e23 p a� r �. M� O q P � pr"escriptian narcotic or illegal substances proYiibited .. ..d,e. ,� � �ro � fix. �,K C"'"fit '4,J�yi"ISMha,"-p jaiv - "a r w� (I0) Smoking or use of tobaccoptolutii i an ��� �� ( l�!)Y(east twd staff at each wading structure d = r ?�qr prem esr�s��r�Y`r" ,6P cur � : Vti b s n� "em3 �,�x n ,� P (Id)iBia,icoutammants.shat1 bestored and disposed of (4)- Clean water pro�tded each d61 Wading properly ", y *r i t t ' structure empti6d wheirnot,n use, p ad as s a 2. Outdoor area(II.,C.,5., pages 19-20) See Checklist streetloadingtunloading jiravided b�Separate'arcas far children younger than 2'�'(may d, be achieved by scheduling) "�iwna 4. Away from center activities m , .�r .,.. .. : .. ��F� .' .., C.,7.,page 21) c.Outdoor"9area adjoins or is s'afeIy,acces'sible NOTE. The Department of Human d `O u tdoor play area�free of a(�parent hazardou , Resources does not inspect activities away r f from the center, including swimming and conditions _��;.,r �.. ,� e, „-.,, " wading activities. The licensee shall 3. Swimming and Wading at the Center assume full authority and responsibility for (II.,C.,6., pages 20-21) away from the center activities a. Pools two feet or more in depth(pages 20-21) Child Care Program (II., D., k 1 .x � �w ,Lileguard at polsrtle at all ttme5 pgol is'in use �� pages 24-37) o 2 Life iris Tramin Cernfieate Pirst Aid n �i `� � N � _ �` '�,+ O x „ x� n �� r ton 1 Pequlred=ratios imaintalned at.all Zvi Certificate CPR Certification on�file M r'�a ,'' ;t r -� � �� n nos t>mt's r�1,� vaF.tt,� �`_. 1r. 0- A" a� P ° g"'4 ;M^"k "rit�,r� ? ah �!�x,��uJ' ti t^iik7: a r(3) ISifegug,d not counted in ratios ayiii,(ar tpto pl$pmonths 4 nk d l to 5 " i C d,. F, . (4) Staff-child ratios for children in the pool: T !R�M�11 months up ta2lzyears Ito 7 0 a (a) 2 s ��1 N cFr q2 4��y anthsupto36 mats Ione aff foreach child younger than to t agesa r 8 . . :, �. �*r�x i ' '" r '"'vn�y' :, �ipiitYm4M,�"".!�h.`.` z+"d �^ A �,. (b) onestaff for etiery 4 children ages2 yearns up� �x �'4�u,� �� a w,d 2z years up tad years l tv nd4 (c) one staff for every 6 children ages 4 yearsaup too e 4:years up to sahoal�age l ta�($���� � 3 � ... .. yearS' ... i a u r t� e` �c+auddwii nY N »•r (d) one staff far every I O chi(fti ages 6 years and- , ' t School age up to 8 years Ito 2LV. alder wig"' r " G Jar ' „a M. road id » i, r- i.*.n 9 �,.ih:"d`i�.��,� 8 ✓��S (5);Ronan determm�d-by youngest child in the,pool «�& eats;aml older Ito 22 t �� � a s..m r";�roam 5�M(6)`Persons„counted , ti pC1) i ildrenyounger ha21 separatelyin ratiosmeet child carewker, a �y giialifii ationsl'lp the pool at all`times w "groin alderreb"ildren sM a Mew* , ��. .. (7) SfaffproFrded to supervise ohild erx�inp�oo"hl�area ,°t 3. Staff coverage(page 25) but'iiot in pool 91 „ as 8 ,ff an art of a child s bod"is i the�Vator child �"w'" ` ' yip y_ u a All,abldr a snpervtserl at all trraes 4 2 G 11 P fi C�ansidered inpRol" : .! r t �Y' �4„„ �� r p'ihi2' we '-.."i! .� (9),Pool enclosed with fence ornsolid waU at least 4 �r� r b Staff in each r'ooin duriti¢na in rests g pp N feet u}'heightr constructed to prevent accessibility by ;` o r children a �� AIR c S affinbl6" see ail the children n0 gL AT ; v�.�t>mrswr Vol , .✓.s�(de} �_«z -.ai�4.�r u9s:. 2 U U U U E U REGULATIONS Q °- REGULATIONS ° ° Q E a E a ° ° Q ° c°) Q o ° o ° Z z Z Z d. Ratio during napping/resting:(page 25) '(�}) odd]e1's�se'ted W1lile oa rig N �, rt" ' IT u. ,9""k. �P dXp„ysr swag a�ft,liYA�'.4„WYi,��„�", n aa' '�Cut ,,7t toa r i a 's+ (1) :p up018 months' ,Mir, t to 5*� �g "i ��ti"� r P �'�� (5�Gt hrld's hah8swashed beforeand after_ �t�I;µ' x t t"k „ C ,�'�" u.•a(�nn�i �9 P p w' ; P7idi 4 iSnaGk3;`after dlapeTlllg_toileting vg a a sR¢k 13 a"i g„ayg`ai3ttnw. ra"¢ !`�r .'.�a: +1 .i tPW'tir`' $rt' { ) £3 '^`a ri fiy"r id P, 6. Staffs hands washed efore`food �t (2), Ik months up to 2/z years 1 tc}14' � ;F .. dh ''k'37b,t .✓ X'gr t w .,'ykC °C1 �r e f"Ca t ai �j7Iepatattori an service at�er aS lstlll Wttll 1 " .;k. rP ia"k �3s "s'su wr`atrwl.$,�`rse arq dr 0,14 i"" r y �.�(toilettnt after dla?erYllQy eiPu.7rb`+w�fgp b,wF"ilAi`"yd,w ,.3,k 3 h"�pNkfo6 ind oder'3a 2/ ,y'aa nd ryasdg hamy cdwge s ,_ r+ k h e Staff"w�thinfant child GPR`andgfirst�aldgpresent � � ''7� �g �i� � r �r ` du' gall hiuursZof0 eration 4. Infant/Toddler Program(II.,D.,2., 5. Preschool/School-age Program pages 26-29) (II.,D.,3.,pages 29-32) a. Learning/growth activities:(page 26) a. Learning/growth activities(pages 29-30) {I Gnes/sign4 pf drstressainves xgated immediately b. Diapering/toileting:(pages 26-27) b. Napping/resting(page 30) ,IT ,.'.td A�C fM k 41 .«£" � `µ , (1) Staffuse Ilniversal""Precautions after diapering ai; u % y w s .. (1):Cots Cleaned and ceanbatt©m sheetsnd and contact with buddy fluids M , , •`i N' stop sheets/cover pigvided�befor used by another MW 1�x „i'i' t 3'fi ae«g,'rir,,;w,'g''xsMd ka A, i - + dIT', {2 Staff wash hands after diapering each'child (2) C(ean sheetsicovers;proyide ,i r r7 a r a mOCe Often jfriceded n Mi 10 1 gzsa+;-. s rw vw a J P� r' XirW ,awBC �' h>� w +F4c rx�3��+Staff use clean disposable gloves for diapering -, r + each ChtldfOr each diaper change - a �, (`3) Cots positioned Co a1lOr1'gSpaCefor aCCCSSsC, 9y, Cir1.CX9,ency CXit ',� v . �� +i '�a . �:' O4 is erin area se atate from food service area : _ .a' Z? ' , p a ,P :,p h.r _ �� �P nU aM�� �, . � . c. Napping/resting(page 27) c. Toileting (page 29) ,apn a �1) Infants pte5laced on back to sleep unlessltysician si (4))accoidmg to e chtchild:s needs,each clritd s s�rw r 7 sy till ar r 'sy - a Ctw' sthtement IndiCa otlleCWt$er sF Nip u, ter a hands�VaShed A^ 'I d. Cribs,cots,and bedding(pages 27-28) (2 Staff use�TJmexsal Precautions aer toilet(ng ' u and eolitact with bodily fluids n"IN-, a,'GIHrr (I) o feet."of apace�btvveen occupied cribs °�P d. Feeding(pages 30-31) psw ':a 411 _.', ;`�;. a,`'✓'w'P+ ed realfast r w 1rr�. (2) Cots positioned to allow space for access or .- (1) Children to attendancesery �,Ra i„ ,ru ?; emergepey+eYit a' �g a mSgaeklunch'p m snack a s� „�.` �h,�.tigt�, .x�� rite -_ash, v7 w..Bp ifu,a . - w+ltl�a"vw `Pam P (3) For infants clean bottonrsheets daily,ar more""T, (2) Meals and snaclls ccitnply-051 PT with patterns ,.�M; Often tf nCCdC(1'�sh,et fit,Snuglyt „J6 a i� P Sp = UtdClineS j}a$eS�g? (4) Sl prohibited'm infant's'sleeping age' �'n g� � (3) Small hard'candics,nuts not served Io environment,no pillows quilt oftmaterias{comforters, ra k ,r, IN'' az `�hi" chrldrenFtindet f61YrJ e" ii , (5,)z,Fortoddters clean bottom sheets and-fop t4) I^odds that may causechoking prepared„ vP t�; �p d i; 1 c weeklmoven .�tl. a po ropriately for the Chile{ . e. Feeding(pages 28-29),. (5) Children not allowed to lcitchenr iaT"A .. s i,k1r„ r, aalg .i. Ii1aJ ' k a aia*v gr; P a„ isw",w. is t P 1 rlvleals anrl�snacks comply with re wrernents � + (� Chrldren's hands v asi ed b fore meals a l . x 1 I�" r ixp I s Vl t, m r„ ? ,and snack and aftCr oilehrl +' { Y, x i a+ 's"5^. 'h r g '*..w'gi� `9 (2)FIf formula=provided by parenfz�la6eled„ �F N p t �' (7}:Staff bands washed before food �` + re oration andserviee &'and after assistin with �refi igerated P P + tC}lleting of Contact Wlth bodily fluid + "t� m�� b..... x.tie Tolle d>r 6 a .. 4+' 9,,.7�' +ga y t - a9a o -x au:.rz•^ 'giss s tta Naas "Io a fat (3 Infants held for battle feedrng/N6+bottles prUpped�gF *+ �(8) Individual paper tbVvels for each asbing ➢ w;f dl-x aCgssiti,t��»wiKg . sn+ g4r";.`5ys ti'r` an"C+B r w}g " *'fix anddd> w� g"uw.d�+, ;eta'. Lei Oswg p-w, 21w`iagi F a, r€+o....a . r't-�,� `r i7 t.'"r�',Fk_ C 3 U U U U Z Z REGULATIONS 0 � ` m - E a- REGULATIONSQ E Q 0 o C- 0 o 0- U Q O U Q o O o O Z Z z Z e. Disciplinary Practices(page 32) e. Supervision in center vehicles(page 39) f. Staff-Parent Communication(page 33) (l) Staff child ratio met for children younger 'than lawfulschool age,dr ver'not'counted, g. Health information(pages 33-35) (2) Children of lawfril sehool.ago and older fewerpthan 15 transported,wrth oonly,the driver;; � r 3 For 15 or more children of lawful se ool (1)No ill child admitted, (1) h `r ,. " ge,onestaff m adition.toa 'driver a child becomes ill or ishnJured,he/shefi�s` (4) For 30 nor more children of lawful school separated fromgroup butcontinuousl su cruised age twn staff m audition to;dnver ed Y ,p ,. 3 ,Parent of ill/m ured'ehild notified immediate) (5) No child left m a vehicle without adult;, ( ) J Y ,, and reCluuedto come for child supervision (4)If parent cannot be reached or illnesslinJur ' ' - (6),.Staff accompany each:child under 2%', severe,`emer ene medical.attention i'obtained from veh�cle�to cage of designated person 'i_.g g Y , (5) Medication/Medical Procedures(pages 34-35) (7)w% taft visually supe"wise each�childp2li=and t, s r older from vehicle to care of designated person F DoAl', center's staffgi_ve medication? f. Safe precautions in v Yes tY P vehicles(pages 39-40) ❑.No (a) Iv,cdicahon,admm�stered onl}with written (1) S,tationary seating foz child each child ,] authorization from parent _ `'seatcd'W u e vehicle is moving b} Noblanketnthorization fornis:for me`dication (2)_Doors locked whenVfficleis moving e} Medication in onginal`container;IabbWtI4easunng` (3) Children not transported in front seat of evioe proyided� � ; - x "vehiclo with�passenger is de bag g, ar i� , Emergency Preparedness and°Response Plans (4) Driver and all passengers secured when;w s page 36 37) vehicle is moving ee Cheekl►st,page 9 x n . . ihan 20 p ou` se ure'd in,rear farp Weighing less ; '(a)', year o p g child IL, E., pages 38— restraint,installedaccordingto manufacturers `1 Transportationp g "m"striicfons"maiiainad:iri�'good.coi'dittoii = ta `." O) 1.Transportation provided by the Center (b) Each.child under,5 years or weighing, ; pages 38-40) "less than 4,0 pounds secured in`forward facing child restraint;installed accordingto r oes the center's staff provide tra portation? manufacturers instructions;maintained in good ❑ Yes No condition •,, p" � s• , „ ''"ia OTE: The Department of Human Resources (c)each"child underfi'y'ars secured m ax oes not inspect activities away from the center, boos`t&seat installed according to;manufact"rer's r cluding swimming and wading activities. The ,�mstructions maintained in goad col on censee shall assume full authority and esponsibility for away from the center activities. , (d),Each child,6 and older,"the driver,and each adult passenger secured m an indrvtdual seat Transportati9np-checklists used;as required'_ ` '" belt,properly"anchored to the vehicle . Designated staff complete and sign checklist ! g Vehicle safety check'done annually,signed by mechanic and'dated filed in center` Checklists kept on file for current year.plus 2 5. Transportation provided by a drtional,years parent/guardian(page 40) Center responsible forpickmg up-child at designated a Each�child accompanied into and`out of center ( cation and delivering child to designated pe son yw, „, _ •" 4 U U U U N N N M U REGULATIONS U a ao REGULATIONS a 0 0 a o O o O Z Z Z Z a x f xal, �b Each chtld signed signed m and out r (8)-Final d1spastt� afany thtld x hi v.'r, e abuse/neglel t investigation mvalv�nglydensee; wia2, NAXAW n7 ';Staff em}l0 C8 wlllnteeC §t + }�,y� a A-- 11ei t,e Jupak Yra Pv :,-. 7 x� Pr r 1"' SAY HW p9„A'p aru i4 `' 3ihth heah,� fa`c ychild vho arrives bywah gnedtn ytP F14W � r ,u�yv�,b�@a ti ° SafCty21-� a � �i1t1S bystaf . y� �, •�^� a�K d Photo ID required then releasing child tb� (l0),Any disastrous event, +. aS� -�.. UnfalTilhar,deli nated erS0r1 a;. per s Staff(II. F pages 41-46) c Chtld abuse/rieglectireparred as rcc�ui en ;� See Staff Checklist d���Lttene���5nd`atl staff,empl�6yees volunteers�`m ai ' Character and Suitability (IL, G., taopeaYe with DHIi annthttd muse ar'peg�t 1 � �,� 7 pages 47-51) tnvesnatian 3. Admission Procedures(pages 53-54) Administration IL, H.� pages 52- a a! tftn cr/Age range of e t�ldren to 56) ( p g eonforffiiti number and ages specified on license a R G 4. Children's Records(pages 54-55) See checklist 1. Applicant/licensee(page 52) 5. Center Records(page 55) 2. Reports to the Department(pages 52-53) The following records kept on file for the current year plus two additional years: a. The following reported to DHR prior to occurrence: Dailartegdance retards mall staff and Y Rzhtldren` ,,,� � a (l);hChange in awnershtp ,, y , b Trarisportattan(ehe�("lists , n, .; u,r,u . '. ,�a�a��'=�;. `-..M m ,.( ..m.,i ,• �. _ d✓*y ai.fi5 �' h>✓1 r , �^,,ro �µ e da �a(2 Change>>n�Iacat�onhrcle�safetycheck � --- w" �. . . Piy� `. (3) Change in Director of center dVT Srgn nlstgn ouf sheets (4) Change in chief executive officer of corporation �y 6. Documents to be posted(pages 55-56) or members of board ✓✓ 4(5) Alterations tocenter or,grdFtnds4 ) ,„ ' a. Most recent license,permit,or approval e � a (6} MaJorchang oreXtension of hours,br program e b. Public notice form (3) Change m address nr'teleplone number c. Most recent licensing evaluation .... r _ b. The following reported to DHR within 24 hours, d Most recent e;to ncy repo, written report within 5 days: h' � � rMr iV ,'a � "r a._ ., M+ �J !�w k;.:f al=aa? r. (L Any illnesslmJury of child or staff requ rmg i ,�N „t r e �Gprrective/adverse actao notices;� �+ vs} i,gi a„ Ei �,af t1 YYtl i profess�onaU9r emergency mediCa�freatrrtept � � p F ..��z.�.,„�, u G r�: ' ��� 9 (2) Any death occurring m the center or during ' f Most recent fire mspettioniireport . S. �. 0 4 awa�fromCCnteTaetilFitte6 .,w ala�� � ".. uYr,a, {.. '�i 1 w .., r4a. �a` (3) MaJor damage to�faeiltty 's �: � �' �' i g Masf recent health d'epartment�tnspecttbn „ y .iwx,Y a �afatil� LBds '� a. report 1I1d food permit oryntten peT„I,TA3SIaIY for' � � !ni catering food � ii t,0 . .. i »a� �-",ra „_(4} Interruption of the ceuter s electrical;telephone r �i I',h Menuor��triepls and snacksldated �, A e. OrgaSSCLVIC� _.i 9!Fs.m •"&,�'„o r .z+9tl twXiA iq;K„ x.a m �, Nu a.xnu n k_.- .-„e. FtdVh W (5) Any lretgatton involving the eel,ter �' ��Vg- 7 41, department/Law enforcement!Medical assistanee�r ap .: r�vNaa ro% s* s N� .s,L'o1San dantrdiiceraterl SUbstttute Tel wit MW '. r 9wt,r Boa ,., ,a isa {` x.,: w v �'(6)Any traffic acetdent tnvo)vug day care trldren ,'�"� � J Emergency �reparedness and Response flans using transpo tattp pravrded ft0 by center„ p ? ✓. ,.. r j7 G �- _ ii'B s..,.; k ,rz TAn3y'arrest of he�nsee,staff;emgloyeevalunteer �p �ik„ Name a£direcorl9taffeperson m charges ,c"car.d°>&, d 5 U U a) U C � RI — U REGULATIONS Q O U Q U +, o O z z Nighttime Centers(II.,1., pages 57-58) 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 a r 7:00 p.m.? ❑ Yes No Does the center provide care afte midnight? ❑ Yes rTNo I. Equipment and furnishings a In Centers operatifig past rnidny"ght enlis"or cots g" re" fitted with6a waterproofhmattre'ss shall lie provided fore ` Y r b Inlcenters operating past midnight,there shall be at ,; a j&§f'ohe bathing facilll§�fo eyw5 children , 2. Child Care Program(pages 57-58) a. Staffing(pages 57-58) (1) Staff-child ratio for sleeping children: Quo to I�8 rnontlisr k 1 to 5 2 (b)r,18 months up�to� "� 1 to l4 �.. ,s;w, ( °;2'1 i up to 4 years`':' wl to e) 18 (d)"4 years and older 1 to 25 f s z ° k .rh.vk A (2} Required ratios for day hme Maii>tamed while r , children are awake(see page 23)' r (3) At least one staff,at least I9 xneetmg child care � � �, d WACkEt QtlallfteatlOnS �'th�'GPR and IStatd In CCtlter'�"' a� � ' ` '� r ". i during hours of operation (4) All children supervised at all`times . K($),�Each staff asa�gned fesponsibi3ity for SamC�childien ,+r�P� � �� � nightly � ,. (6),At]east one staff m each room of sleeping children s 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. I is the responsibility of the licensee to operate in compliance with the Minimum Standards. 21 I 1/2020 Signature of Licensee/Designated Staff Date 6 Checklist for Infants/Toddlers, 0)indicates compliance observed by DHR Licensing Representative ( ) indicates not in compliance (X) indicates not applicable of J� "OName" teacher/room,� ch ` , of children" L& H I" timber of c Ildie n : be of'' f,%:� Xd-d'it"ional Furnishi�gs aiiiiquipulent, 77777777 -O,iaperi6g`ir&k' �ink,.waitii'water;sod ppaOei'i6w6ls' P,.Iastic'-Iined,,c6v,ered<,00ntainer,- J Tub(portable plastic type acce iZi;) 7-77-- Feeding,6hairs,'— j C n accordance with US Product ribs-i.`-a666id" Wi Safety Ac 0 ,20 8 OiT Cribs/2,f6et,'&f,806ce�,beiweei6dcupiEd:cribs j lwaterpro'617 mattress,sheets. Indoortherm odnietei.[Oht%6freaeft of children -JA Steely big"fore'quiptn"ent aiidsuppli6s/aridhbred Individual;labeled,,story ge s ace for.,6ach child J U Furfikuic`,chii&sii6,616an,^good c6fidifion,, Potty chairs cleaiiedldisiife6ted/empfied(Toddlers only) :F�clfities )Electrical outld(§covered o j Hazdrdo',u-s substances;,lacked CO11t81Ttel'S labeledV qp A Medication locked`,-' Screens 6n,wiiidows,,whicli aiii-,op erred!".,.d,--d'd�l,,,,�,6,'��-,.",-,' :%")(Z""'� t1ghting ode quai6: V Checklist for 24 months up to 36 months 0) indicates compliance observed by DHR Licensing Representative I)indicates not in compliance (X)indicates not applicable Name of teacher/roorn# Age.of children. Number of children,' 7 betof staff. R MIN MIM"' IMI ring area Plastic-lined covered containers" Tablc sPa6cd'aiid c6irf6i,e"a:cb'child,' Cots/sheets and covers Inddor,tli6nnometei/;Out,ofr6a6h.'6f.ciiildriiii,, j,';,',�,a.,�,,,,�,�4',,,�,_,,,,�,,��, Written daily plan or schedule posted Labeled storages l�ace at child level' Sh6wiig litunt Stid sZlililkg/ cN6f6d`-`- Designated activity areas Vacifities Electrical butletsed've-re'd,, B4Ti&r�ar'66iid hedters;'fhifis',',', V` Jl� Hazardoussubitance§4ocked' 4W2-19, i Oii 0 taffi&isIa6eled--,:' Medication locked,-" Number ..u n Dia e S S. i h k , i, S6r&6fi5'Onwirido' Ws`w ic arq�opem ,Lfghtifig'a&quate,, Checklist for Preschool/School-Au. 6 indicates compliance observed by DHR Licensing Representative I indicates not in compliance X indicates not applicable N ameof teacher/room Y 1 1 Y16", V N!M— R"A '-,5& , -': Additional Furnishings and Equipment r'ITables'ace'a-nd,chair for,each!,cfi.f JC6ti,.'iS*q,ts;,,66v'6is fbi,ea6h-chil&"' IM6"O`r"'tfi'C'M"- Ocr rou:O rea Written daily plan or schedule posted J- 41'Sfi6lyi 'r, W5#iO4" Designated activitv areas Facilities io-vered", ." i)MV garners ar'du-& CD Haikdo6s sukah6esjbck CAt n., V V"MeMf i Playground Checklist 0)indicates compliance observed by DHR Licensing Representative I)indicates not in compliance (X)indicates not applicable >tiFacilities , iOuidGOfP,i` CSei�b ""i'e"n-�c�"e or waIi k. 0',,, ash'� "A'i"'tXWRMWI A V G =4 X4, V d sun,ard'as"' Outdoor play'area'-free,bif" —Ali 6bi�?6o6difi6ii pp�r�n,, S, �Coricretelas halt not '-Z usedunder�,, ipmen -x, A i, i X, 4 "N" 5 W p e io"Aq to be Ch 0 tin-i"IRRI fg/st6 hand r.Wi "'W