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HomeMy WebLinkAboutDeficiency Form DHR-DFC-1927 ALABAMA DEPARTMENT OF HUMAN RESOURCES . • IHILD CARE MINIMUM STANDARDS DEFICIENCY REPORT(Additional Page) LITTLE PEOPLES NURSERY SCHOOL �,'. rz Facility Name: Date of Visi . SECTION B -DEFICIENCY INFORMATION(Continued) Column 1 Column 2 Minimum Standard Date Corrected by Deficiency Licensee 4 (nl 1 t b I II 1 � a &/7 40( 1" -fie n b(-1716e A J 4-vvta- Chat 649'ne.- INSTRUCTIONS TO LICENSEE: Column 2,Date Corrected by Licensee, is to be completed by the facility representative after each def ciency is corrected The facility representative must put the date of ection and his/her initials in Column 2. This form mJst be returned to the Department of Human Resources on or before 1A 10 202V , as verification that deficienlies 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 violatio�of Minimum Standards. A facility licensed by the Department must meet Minimum Standards applicable to that facility at all timesi It is the responsibility of the licensee to operate in compliance with Minimum Standards. Signature of Facility Representative Date Signatur of DHR Licensing Represe v Date O— —2v COPIES TO: Page 2'of