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HomeMy WebLinkAboutDeficiency Form (5) DHR-DFC-1926 ALABAMA DEPARTMENT OF HUMAN RESOURCES CHILD CARE MINIMUM STANDARDS DEFICIENCY REPORT SECT-ION A-,IDENTIFYING INFORMATION i Facility Name: Type of Facility: Home ❑ Date f Visit: LITTLE PEOPLES NURSERY SCHOOL Day © Group El � � W Night ❑ Center ® / � Day/Night ❑ S.A.P ❑ month / day / year Facility Address: Licensee: Telephone#: 509 ALABAMA STREET LITTLE PEOPLE'S (256)757-4498 KIL N, AL 35645 NURSERY SCHOOL, INC. Ages Director (if applicable): Capacity: 5 Weeks through 12 Years GAIL JOHNSON 37 -Day SECT�ON B-DEFICIENCY INFORMATION Column 1 Column 2 Minimum Standard Date Corrected by Deficiency Licensee • ®►i c 4o.4 rea rA,,r ate., i aco ie,&. Arn¢, chi d�u are l Sit �h ld��-�, �eco r& 1 �,a°za�eJ 3, an, 4 rne, I; rrJRJ o n LW\e, j INSTRUCTIONS TO LICENSEE: Column 2,Date Corrected by Licensee,Ys to be completed by the facility representative after each deficiency is corrected The facility representative must put the date of c r ection and his/her initials in Column 2. This form must be returned to the Department of Human Resources on or before Ql4 , , as verification that deficiencies have been corrected NOTICE: Any misleading or any false statements or reports made to the Department and/or failure to correct the listed deficiencies can be the basis for adverse action. None of these requirements are to be interpreted to allow anyone to operate in violation'of Minimum Standards. A facility licensed by the Department must meet Minimum Standards applicable to that facility at all times) It is the responsibility of the licensee to operate in co liance with Minimum Standards. Signatures of Facility Representative ° Dat '2✓-3 67— D Signature,of DHR Licensing Repres � A— Da COPIES TO:�� Page I of