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Deficiency Form (5) DHR-DFC-1926 ALABAMA DEPARTMENT OF HUMAN RESOURCES CHILD CARE MINIMUM STANDARDS DEFICIENCY REPORT SECTION A-IDENTIFYING INFORMATION Facility Name: Type of Facility: Home ❑ Date of Visit: BABY LOVES Day © Group ® Night ❑ Center ❑ Jfvtr�J Day/Night ❑ S.A.P ❑ month / day / year Facility Address: Licensee: Telephone#: 160 COUNTY RD 3 MORGAN WALLS (251)593-9114 URIAH,AL 36480 Ages: Director(if a cable): Capacity: 0 Weeks through 5 Years 12 -Day SECTION B-DEFICIENCY INFORMATION Column 1 Column 2 Minimum Standard Date Corrected by Deficiency Licensee enTe-e, neel 26 Aou-r� 6 ( train,I�V on a- c tA r- n�a+ (4�vqlnse, 10,h INSTRUCTIONS TO LICENSEE: Column 2,Date Corrected by Licensee, is to be completed by the facility representative after each deficiency is corrected The facility representative must.put the date of ec ton and /fir i Column 2. This form must be returned to the Department of Human Resources on or before 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 compliance with Minimum Standards. Signature of Facility Representative , nAk Dat Signature of DHR Licensing Representative �; ate `- d'V COPIES TO: Page l—of—3 DHR-DFC-1927 ALABAMA DEPARTMENT OF HUMAN RESOURCES CHILD CARE MINIMUM STANDARDS DEFICIENCY REPORT (Additional Page)/,, l Facility Name: BABY LOVES Date of Visit:l% SECTION B -DEFICIENCY INFORMATION(Continued) Column 1 Column 2 Minimum Standard Date Corrected by Deficiency Licensee Y) n e-6 Y-0 verl, 8a�, 1 e Lk0-a-+1 V1 , One a ► l d �m cv) �Niqi,tee n ee-d an .,tp IWO � ► 1 c � '1�c� INSTRUCTIONS TO LICENSEE: Column 2,Date Corrected by Licensee, is to be completed by the facility representative after each deficiency is corrected. The facility representative must put the date o ecWon an� i lter 'nit' is�inn- I m olun 2. This form must be returned to the Department of Human Resources on or before c-,- v erification 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 compliance with Minimum Standards. Signature of Facility RepresentativeIr _ Date Signature of DHR Licensing Representative COPIES TO: Page Of DHR-DFC-1927 ALABAMA DEPARTMENT OF HUMAN RESOURCES CHILD CARE MINIMUM STANDARDS DEFICIENCY REPORT (Additional Page) ®� Facility Name: BABY LOVES Date of Visit: SECTION B -DEFICIENCY INFORMATION(Continued) Column 1 Column 2 Minimum Standard Date Corrected by Deficiency Licensee Pr&J Oq 1'� i n o) 0111� 11 � i d S' bonk a 1a-5 e s i x�-G a i�1 Yl INSTRUCTIONS TO LICENSEE: Column 2,Date Corrected by Licensee, is to be completed by the facility representative after each deficiency is corrected. The facility representative must put the date o rection and 's er initials in Column 2. This form must be returned to the Department of Human Resources on or befo s 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 ail times. It is the responsibility of the"licensee to operate in compliance with Minimum Standards. Signature of Facility Representative Date Signature of DHR Licensing Representative Date COPIES TO: Page�of