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Evaluation Form Revised 3/2020 ALABAMA DEPARTMENT OF HUMAN RESOURCES CHILD CARE CENTER LICENSING EVALUATION RENEWAL Health and Safety Guidelines items marked with an asterisk* Name of Center: . Date(s) of Evaluation: 3W&r Cogt t`-_ ©P ► , Inc C i r Read Sftwf ,12-20 Address: 187 Co6v OrpAKttj Date(s) of Follow-up: grnelie,AL 35159 Purpose-of Visit: R,fQ Telephone #:-(2,p5 ) 1,55.ag19 Director: Licensee: ;�uvs�q f w�- �Qo ii Inc Doris Ofle County: 5 ® Day ❑ Night ❑ Subsidy Licensed Capacity: Dayy0 Night Days of Operation: Day- Night Age Range: DayM 5 Nigh -Hours of Operation: Day Ni. ht `omit-�:aoP License Number: Code: O. - Observed by DHR Licensing Representative S Certified by Licensee/Staff in charge D '- Discussed with Licensee/Staff in charge Effective.Dates of License:From: q: X -Not Applicable-Not reviewed with 0 To: r�..20.2,t) Licensee/Staff in charge Deficiencies Noted: ❑ Yes [ ] No DHR Licensing Representative: Sections to be completed at the discretion of the DHR Licensing Representative. U U � REGULATIONS c c .fl to tg REGULATIONS m M U O Q 0 0 t1 L) U y Q Z Z ° o Z Z Facilities (II. C., Pabes t6-23) *e. Space for ill or injured child O 1: Indoor area(II.,C.,4.,pages 16-19) *f. Items used by ill child disinfected C I ! *a. Exclusive use of activity areas *g. Storage space for teacher's supplies110I 1 *b. Designated space for each grouping of children *h. Office space provided O *c. Bathrooms located on same level/under same roof o i. Ventilation,lighting,heating(pages 17-!8) (1) one flush toilet for each 15 children * (1) Heating/air conditioning provided (2) one handwashing sink for each 15 children 0 * (2) Temperature 68-82 at child level 10 (3) One tub(portable plastic acceptable) * (3) Thermometer in each area used by children * 10 (4) Fixtures child size or adjusted for easy use * (4) Thermometer out of reach of children *d. One handwashing sink with warm running water, * (5) Outside windows that are opened are soap,paper towels in each room where children are O screened diapered I U U U U REGULATIONS catoREGULATIONS v Q a _ Q Q — E a E E CL a U Q U Q Z Z Z Z * (6) Outside doors kept closed 3. Swimming and Wading at the Center(II., 0 C.,6.,pages 20-21) * (7) Lighting adequate for activities 0 a. Pools two feet or more in depth(pages 20-21) * (8) Lighting adequate at nap/rest time to allow * (1) Lifeguard at poolside at all times pool is children to be seen 0 in use *j. Operational telephone for center business only * (2) Lifeguard Training Certificate,First Aid 10 Certificate,CPR Certification on file *k. DHR notified if telephone is out of order or if * (3) Lifeguard not counted in ratios number changes 1511 1 _1 L.Hazard prevention(page 18j(indoor-Area) (4) Staff-child ratios for children in the pool: * (I)-Center free of apparent hazards * (a) one staff for each child younger than 2'/2 l years of age d( * (2) Hazardous substances under lock and key or * (b) one staff for every 4 children ages 2'h I/ combination lock 0 years up to 4 years J� * (3) Containers labeled * (c) one staff for every 6 children ages 4 ID years up to 6 years * (4) No firearms or ammunition kept or allowed in * (d) one staff for every 10 children ages 6 center except law enforcement years and older. * (5) Stairways have hand railings in child's reach ^ * (5) Ratios determined by youngest child in (/ v the pool [> * (6) Clear glass doors marked at child level * (6) Persons counted in ratios meet child care worker qualifications/in the pool at all times J� * (7) Medicines and drugs kept under lock and key or * (7) Staff provided to supervise children in combination lock,separate from harmful items pool area,but not in pool * (8) Barriers around heaters,radiators,fans * (8) If any part of a child's body is in the accessible to children water,child considered in pool K * (9) Exposed electrical outlets have protective covers V * (9) Pool enclosed with fence or solid wall at least 4 feet in height,constructed to prevent p * (10) Consumption of alcohol or use of non- accessibility by children prescription narcotic or illegal substances prohibited * (11) Smoking or use of tobacco prohibited on b. Wading structures less than 2 feet in depth: premises (page 21) * (12) Bio Contaminants shall be stored and disposed 10 of properly m. Center kept clean/Cleaning done daily(pages 18- * (1) At least one staff with CPR&first aid at ,I 19) each wading structure x * (1) Floors,bathroom fixtures cleaned/disinfected * (2) Required ratios met as stated on page 24 * (2) Carpets vacuumed daily * (3) At least two staff at each wading structure * (3) Cleaning does not interfere with children's * (4) Clean water provided each day activities 2. Outdoor area(ll.,C.,5.,pages 19-20) * (5) Wading structure emptied when not in use See Checklist *a. Off-street loading/unloading provided 4. Away from center activities (II., page 21) *b. Separate areas for children younger than 2%(may NOTE., The Department of Human Resources be achieved by scheduling) x does not inspect activities away from the center, 4 including swimming and wading activities. The *c. Outdoor area adjoins or is safely accessible licensee shall assume full authority and responsibility for away from the center activities. *d. Outdoor play area free of apparent hazardous } conditions U U a U U N ZC t= � C C Z REGULATIONS Q CL U E E a REGULATIONS E E a o °- U U Q U c°� Q c � — 0 0 0 0 Z Z Z Z 5. Furnishings and equipment (II.,C.,8., *j. Staff with infant-child CPR and first aid pages 21-23) See Checklists present during all hours of operation Child Care Program (II., M,;pages *k• Second staff available when 7 or more children present/required ratios met 24-37) - *1. Required ratios maintained at all times C *I. No staff on duty more than.8 continuous V hours on a regular basis * a. 0 up to 18 months 1 to 5 *m. Staff free from other duties while working j� with the children * b. 18 months up to 2'/a years I to 7 5 Infant/Toddler Program 2., pages 26-29) * d. 24 months up to 36 months I to 8 a. Learning/growth activities:(page 26) * e. 2%years up to 4 years 1 to 11 (1) Encouraged to play with a variety of toys * f. 4 years up to school age 1 to 18 (2) Time outdoors daily,when weather permits * g. School age up to 8 years 1 to 21 * (3) Freedom of movement outside cribs daily * h. 8 years and older 1 to 22 y * (4) Placed on tummy part of time while awake ,O and observed J` *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) Cries/signs of distress investigated immediately * b. Exception for individual children's needs b. Diapering/toileting:(pages 26-27) *3. Staff counted in ratio only when giving full * (1) Clean,dry diapers/clothing provided attention to the children 4. Staff coverage (page 25) * (2) Wet/soiled diapers/clothing changed promptly * a. All children supervised at all times * (3) Changing area cleaned and disinfected * b. Staff assigned responsibility for same * (4) No child left unattended while being infants/toddlers each day diapered * c. Substitute staff available * (5) No child diapered on the floor * d. Director authorized to conduct center business ® * (6) Each child's hands washed after diapering * e. Staff person in charge when director is absent, * (7) Staff use universal precautions when authorized to conduct center business ® diapering * f. Staff in each room during napping/resting * (8) Staff use clean disposable gloves for diapering each child/for each diaper change * g. Staff able to see all the children * (9) Wet/soiled diapers placed in covered, plastic-lined container and disposed of daily * h. Ratio during napping/resting(page 25) * (10) Individual,disposable wipes used at each i diaper change,disposed of properly (1) 0 up to 18 months 1 to 5 * (11) Potty chairs emptied,rinsed,disinfected after each use * (2) 18 months up to 2%z years I to 14 * * (12)Diapering area separate from food service area i * (3) 2%years and older 1 to 36 c. Napping/resting(page 27) I i 0 N U U a)REGULATIONS = _ -Q m c_a REGULATIONS m ccaa 0 o Q o2 1 o a C.) Q Z Z ° O Z Z * (1) Infants allowed to form own sleep patterns * (12) Toddlers seated while eating * (2) Infants placed on back to sleep unless physician's (13) Child encouraged to experiment with statement indicates otherwise (` self-feeding,utensils provided * (3) Infants who can easily turn placed on back but * (14) Disposable utensils used only with close allowed to adopt preferred position .supervision * (4) No positionin;device used unless specified by * (15) Foods eaten from a dish physician * (5) Staff recognize differing needs of toddlers/allow * (16) Dishes,bottles unbreakable to follow their own sleep patterns d. Cribs,cots,and,bedding(pages 27-28) * (17) Drinking water offered to toddlers * (1) Two feet between occupied cribs * (18) Child not forced to eat * (2) Cots positioned to allow space for access or * (19) Food not used as reward or punishment emergency exit * (3) Cribs/cots cleaned and disinfected and sheets and * (20) Child's hands washed before and after covers washed before used by another child snacks,after diapering,toileting * (4) For infants,clean bottom sheets daily or more * (2 1) Staffs hands washed before food often if needed,sheets fit snugly preparation and service,after assisting with toileting,after diapering J� * (5) Soft material prohibited in infant's sleeping * (22) Individual paper towels for each washing environment,no pillows,quilts,comforters,etc. K and drying * (6).No infant put to sleep on sofa,soft mattress 6. Preschool/School=age ProA29-30) x (II.,D.,3.,pages 29-33) * (7) For toddlers,clean bottom sheets and top a: Learning/growth activities(pag coverings weekly,more often if needed e. Feeding(page 28-29) (1) Schedule posted * (1) Formula,food for infants if provided by center, (2) Variety of indoor/outdoor activities planned with parent or physician * (2) If formula provided by center,ready to feed, (3) Time outdoors daily when weather permits r y properly stored and handled J1 * (3) Meals and snacks comply with requirements (4) Staff permit/encourage conversation among C children J * (4) If formula provided by parent,labeled, (5) Staff give individual attention to each child refrigerated daily * (5) Bottles sent home or contents discarded at end of (6) Radio,TV,videos used only to [� day supplement/enhance daily plan J 4 * (6) Small hard candies,nuts not served to children � * (7) No child required to watch TV or videos under four * (7) Foods that may cause choking prepared * (8) Videos previewed by staff for appropriately for the child appropriatenesso * (8) Feeding schedule according to child's needs * (9) Sexually explicit,violent,frightening C materials prohibited J j * (9) Infants held for bottle feeding b. Napping/resting(page 30) k i (10) No bottles propped * (1) Staff recognize differing needs of children (11) When able,infants allowed to sit in feeding chair (2) Rest period for children in attendance more j than 5 hours 1 I L Irw►0�I W a' I i U U .0 U U C C U t4 t0 U REGULATIONS E E a REGULATIONS Q CL a o a E E U � Q �j 0 Q o c �- Z Z o Z Z (3) Rest period at least 45 minutes,not more than * (15) Children seated while eating 2'/z hoursS, a * (4) If a child who does not sleep after 45 minutes, * (16) No child forced to eat v quiet activities permitted * (5) Cots cleaned and clean bottom sheets and top * (17) Children not allowed in kitchen }� sheets/covers provided before used by another child 5 * (6) Clean sheets/covers provided weekly,more often * (18) Children's hands washed before meals if needed and snack and after toileting _ * (7) Cots,positioned to allow space for access or * (19) Staff hands washed before food emergency exit preparation and service,and after assisting with D toileting or contact with bodily fluid * (8) At least one staff present in each room * (20) Disposable gloves used for diapering * (9) Staff able to see all children * (2 1) Individual paper towels for each washing. and drying c. Toileting(page 30) * (22) Catered meals and snacks meet requirements J� * (1) According to each child's needs,each child's 0 e. Disciplinary Practices(page.32) I ` hands washed * (2) Staff use Universal Precautions when diapering O * (I) Discipline appropriate to age and or handling bodily fluids developmental level of the children d. Feeding(pages 30-32) * (2) No corporal/physical punishment * (1) Children in attendance served breakfast or a.m. L * (3) No verbal,abuse snack,lunch,p.m.snack D * (2) Meals and snacks comply with USDA guidelines T * (4) No discipline associated with food,naps, on pages 29-30 or bathroom procedures * (3) Fluid milk served,no powdered milk for drinking 'f (5) No physical restraint as punishment * (4) No child deprived of meal or snack ^ (6) No punishment administered by another J child * (5) Special dietary needs in accordance with written f. Staff-Parent Communication(page 33) instructions * (6) Meals and snacks provided by the center (1) Discipline,behavior problems discussed with parent * (7) Vending machines prohibited in areas used by (2) Center open to visits from parents at any children time * (8) Small hard candies,nuts not served to children (3) Parents informed of right to visit j under four * (9) Foods that may cause choking prepared (4) Staff available for communication appropriately for the child conferences v * (10) Portions of food suited to child's needs,second (5) Parents notified of complaint procedures portions available b * Ile) (11) Unbreakable or single-use dinnerware used (6) Parents provided with information on ainfluenza f f * (12)Single-use cups or glasses or a drinking fountain � g. Health information(pages 33-36) provided for water i '(13) Drinking water offered during the day * (1) No ill child admitted * (14) Food served on individual dishes or napkins, ^ * (2) If child becomes ill or is injured,he/she not directly on table (V� is separated from group,but continuously supervised, U U O U U N C C C C Z REGULATIONS a REGULATIONS E Q Em Eto Q U U Q O U Q C U C O p O Z Z Z Z * (3) Parent of ill/injured child notified immediately (e) Children and staff wash hands after and required to come for child handling animals * (4) If parent cannot be reached or illness/injury *h. Emergency Preparedness and Response severe,emergency.medical attention is obtained Plans(page 36-37) See Checklist o * (5) Parents notified of exposure to contagious Transportation (I'I.,E.,_pages 38— disease/condition 40) * (6) Parents urged to notify center if a child is ('� 1.Transportation provided-by'ttie Center exposed to a contagious disease outside center. `J (pages 3$-40) * (7) Center reports contagious disease/condition to NOTE. The Department of Human Resources does health department as required not inspect activities away from the center, ` including swimming and,wading activities. The (8) Medication/ivledical Procedures(pages 34-35) licensee shall assume full °authority and responsibility for away from the center activities. Does the cen(er's staff ve m�dic.ation/medical. procedures? Fes \o_ * (a) Medication administered only with written Does tqJ center's sta9f provide trarisportation? authorization from parent S— Yes, No 611 * (b) No blanket authorization forms for medication *a. Transportation checklists used as required * (c) Medication in original container,labeled *b. Designated staff complete and sign checklist * (d)'Measuring device provided *c. Driver signs checklist,indicating he/she has checked each seat ¢� * (e) Medication administered by designated staff 4J *d. Checklists kept on file for current year plus 2 * (fJ Locked storage provided for medication additional years * (g) Medication returned to parent or disposed of *e. Center responsible for picking up child at when no longer needed designated location and delivering child to designated person * (h) Time and date medication is given is documented in writing,kept in child's file/copies f. Supervision in center vehicles(page 39) available to parents on request (9) Hygienic practices(page 35) * (1) Staff-child ratio met for children younger ('► than lawful school-age,driver not counted J * (a) Toilet articles labeled and stored separately * (2) Children of lawful school age and older, fewer than 15 transported with only the driver * (b) Used paper towels,wipes,tissues are disposed /� * (3) For 15 or more children of lawful school [V of immediately following use 00 age,one staff in addition to driver J ) * (c) Toilet paper provided for use by children and * (4) For 30 or more children of lawful school staff 11 age,two staff in addition to driver * (d) Extra children's clothing available * (5) No child left in a vehicle without adult supervision (10) Animals on the premises(pages 35-36) * (6) Staff accompany each child under 2'/2 from vehicle to care of designated person (a) Aggressive animals not kept in center or on * (7) Staff visually supervise each child 2%:and grounds older from vehicle to care of designated person (b) Animals that could pose a threat to health and * (8) Driver checks each seat at each location to safety kept away from children verify no child is left on the vehicle. (c) Certificate of rabies vaccination on file for g. Safety precautions in vehicles(pages 39-40) animals (d) Animals confined,cages kept clean,food and * (1) Stationary seating for child,each child water available seated while vehicle is moving * (2) Doors locked when vehicle is moving U U U U C C � C C [[REGULATIONS o Q REGULATIONS E C a U U Q O 0 Q C Q Z Z Z Z * (3) Children not transported in front seat of vehicle with passenger side air bag 2. Records on staff(pages 42-44) (See Staff Checklist) * (4) Driver and all passengers secured when vehicle *a.Records on staff kept confidential is moving * (a) Each child under 1 year or weighing less than *b. Records on file at time of employment C� 20 pounds secured in rear facing child restraint, / J installed according to manufacturers instructions, /XO maintained in good condition c. Records on staff maintained at least two years after person has left * (b) Each child under 5 years or weighing less than *d. Records filed alphabetically 40 pounds secured in forward facing child restraint, installed according to manufacturer's instructions, maintained in good condition. *e.' Inactive files maintained separately * (c) Each child under 6 years secured in a booster 3. Health (page--4,) seat installed accordins to manufacturer's instructions, maintained in good condition. *a. Medical exam and TB test on file at time of employment * (d) Each child 6 and older,the driver,and each *b. Staff with symptoms of contagious adult passenger secured in an individual seat belt, disease/condition not in center properly anchored to the vehicle. *h. Vehicle safety check done annually,signed by mechanic and dated,filed in center Character and Suitability (IL, G., pages 47-51-) 5. Transportation providedby *1. Character and suitability review conducted parent/guardian(page 40) on required persons(every 5 years) O *a. Each child accompanied into and out of center *a. Persons with determination of unsuitable character terminated *b. Each child signed in and signed out *b. Licensee informs DHR of any criminal convictions or current charges *c. Any child who arrives by walking or bus,signed in Ad-ministration (II , II., by staff 52-56 = *d. Photo ID required when releasing child to unfamiliar,designated person L Applicant/licensee(page 52) Staff(IL, F., pages.4`1:-46} a. Licensee assumes full authority and responsibility for meeting and maintaining Minimum Standards 1. Qualifications(pages 41-42) b.Licensee provides operating funds a. Center director meets qualifications 0 c. Licensee designates director and delegates b. Child care workers/teachers meet qualifications and authority and responsibility for operation and have 12 hours of training within 30 days of employment management of center to director * Child care workers/teachers meet requirements for d. Written operating policies established CCDF training within 90 days(if applicable) c. Aides/assistant teachers not counted in ratio (1) Copy of operating policies provided to parent at time of child's enrollment *d. Service staff not counted in ratio unless they meet * (2) Copy of operating policies submitted to qualifications and are giving full attention to children U DHR I *e. Driver at least 19,valid driver's license (3) Operating policies do not contradict Minimum Standards *f. Substitute staff meet qualifications of staff for (4) Changes in operating policies provided to whom substituting parents and to DHR S U U U U tII M tt7 U REGULATIONS Q REGULATIONS Q o °- U 0 Q U Q Z Z o 0 z z 2. Reports to the Department(pages 52- b. Age range of children in care conforms to 53) ages specified c. Requirements for drop-in care met a. The following- p reported to DHR r lor.to occurrence: 4. Children's Records(pages 54-55) (See Children's Checklist) * (1) Change in ownership *a. Children's records and information about S children and their families kept confidential . S * (2) Change in location *b. Individual records on each child on 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 * (2) Records filed alphabetically .per or members of board �J * (5) Alterations to center or grounds * (3)Inactive files maintained separately S * (6) Major change or extension of hours or program 5. Center Records (page 55) * (7) Change in address or telephone number The following records kept on file for the current year plus two additional years: b. The following reported to DHR within 24 hours, *a. Daily attendance records on all staff and written report within 5 days: children * (1) Any illness/injury of child or staff requiring *b. Transportation checklists professional medical treatment * (2) Any illness/injury of child or staff requiring *c. Vehicle safety check emergency medical treatment * (3) Any death occurring in the center or during *d. Sign in/sign out sheets away from center activities * (4) Major damage to facility 6: Documents to be.posted..(pages 55- * (5) Interruption of the center's electrical,telephone 56) or gas service * (6).Any litigation involving the center a. Most recent license,permit,or approval * (7) Any traffic accident involving day care children b. Public notice form using transportation provided by the center * (8)Any arrest of licensee,staff,employee,volunteer ` *c. Most recent licensing evaluation * (9) Final disposition of any child abuse/neglect *d. Most recent deficiency report investigation involving licensee,staff,employee, volunteer * (10) Any incident in which the health,welfare,or *e. Corrective/adverse action notices safety of a child is at risk * (11)Any disastrous events *f. Most recent fire inspection report 0 *c. Child abuse/neglect reported as required by law *g. Most recent health department inspection report and food permit or written permission for catering food i *d. Licensee and all staff,employees,volunteers *h. Menu for meals and snacks/dated cooperate with DHR on any child abuse or neglect investigation i. Name and telephone number for:(page 56) 3. Admission Procedures(pages 53-54) * (1) Fire department i *a. Total number of children in care,including children * (2) Law enforcement on the premises,children in transit,children on field trips conforms to number specified * (3) Medical assistance(ambulance or rescue) 1 I U U O O lll U U REGULATIONS 'a 'a .L `� f° 2 Q REGULATIONS C Q U U Q O U C O O U C O Z Z Z Z * (4) Poison control center * (2) Required ratios for day time maintained while children are awake(see page 23) * (5) Substitute help ® * (3) At least one staff,at least 19,meeting child care worker qualifications,with CPR and lst aid in I/ *j. Emergency Preparedness and Response Plans center.during hours of operation J� *k. Name of director/staff person in charge ® * (4) All children supervised at all times X Nlb,httime Centers ( L, Ip� * (5) Each staff assigned responsibility for same children nightly pages.57-58) (6) At least one staff in each room of sleeping children x In addition to the regulations set forth for day * (7) Staff able to see all the children at all times care centers, centers providing,nighttime care (after 7 p.m.) shall- meet- the following regulations or modifications * (8) All staff awake and alert to needs of children Does the center provide car after 7:00 p.m.? * (9) At least two staff in center whenever V Yes Q No children are present/required ratios met Does the-center provide ca PafCet midnight? Yes 0 No [ * (10) Lighting maintained so children are K visible while sleeping 1. Equipment and furnishings b. Nightly activity schedule posted VV (page 58) n *a. In centers operating past midnight,cribs or cots, (1) Outdoor time available during daylight hours fitted with a waterproof mattress shall be provided for .each child riand 2) Staff assist each child as needed,in dressing g grooming *b. In centers operating past midnight,there shall be at e. Food(page 58) least one bathing facility for every 15 children 2: Ghild"Gate Program(pages"57=58) * (1) Breakfast served to children going directly to school a. Staffing.(pages 57-58-)- ' (2) Evening meal served to children in attendance (1) Staff-child ratio for sleeping childreh: 'd Bathing(page 58)- If any child is bathed: * (a) 0 up to 18 months It 5 I( * (1) Clean water provided for each child * (b) 18 months up to 2% I to 14 * (2) Each child bathed separately * (c) 2%-up to 4 years I to 18 * (3) Each child supervised while bathing * (d) 4 years and older I to 25 * (4) Individual soap,towel and washcloth provided for each child i 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 t responsibility of the licensee to operate in compliance with the Minimum Standards. - J11WIle Signature of licensee or designated staff Date i i Emergency Preparedness and Response Plans Checklist ( O) indicates compliance observed by DHR Licensing Representative (I indicates not in compliance ( S )-indicates certified by staff in charge(use only for#plan updated yearly,written documentation must be on file) law The plan shall include procedures tliat will be used to prepare for The plan should also be inclasive of. and respond to the following types of emergency/disaster situations: *Weather emergencies/natural disasters; *Current emergency plans and procedures * Severe Thunderstorms * Tornadoes * Flash flooding * Major snowfall * Blizzards * Ice storms * Earthquakes *Lockdown or evacuation due to threats of violence *Location and use of fire extinguishers Q *Evacuations due to; *#Documentation of the following quarterly drills; (7 * Hazardous materials * Fire * Spills * Tornado * Gas leaks * Lockdown * Bomb threats * Relocation * Fire *Infectious disease emergencies *Telephones for on-site and off-site use ,p *Loss of power,water,or heat *Location of the first aid and emergency supply kits 0 *Other threatening situations The disaster plan shall include details for. The Emergency.Preparedness and Response Plans should be: *Shelter in place or evacuation *Available to all staff and employees *Assisting.infants and children with special needs and/or *Posted in a Conspicuous place health conditions 0 *Reunification with parents *Submitted to the Department *Supplies needed-for shelter in place procedures .*Copies provided to all parents/guardians *Transportation disaster procedures *Staff training/reassignment as appropriate *#Plan updated yearly *Contact with local emergency management officials f I t i I Checklist for Infants (0)indicates compliance observed by DHR Licensing Representative (,r)indicates not in compliance (X.)indicates not applicable *Name of teacher/room# *Age of children 1( *Number of children �( *Number of staff Minimum,E rri ment:Re,wired or_Eaeh Orq 41P of Ch Washable sotfcnb to s=2 er'chi`Id Push and pull toys-1 A device that plays a variety of age appropriate music Age appropriate books-2 per child Large balls 8+inches)-I Nesting and stacking to s-2 sets Washable baby doll-I Musical toy-1 Colorful pictures and posters Activity boxes,such as busy boxes-3 I.�I }f f: f . .. - .. _ *r erind-area k,warm water,soa , a er towels tic-lined,covered container V. Tub("ortable plastic type acce table) *Feeding chairs *Cribs/2 feet of space between occupied cribs *Waterproof mattress,sheets *Indoor thermometer/Out of reach of children *Shelving forequipment and supplies/anchored *Individual,labeled storalge space for each child *Furniture child size,clean,good condition *Cribs in accordance with US Consumer Product Safety Act of 2008 K *Electrical`ou'ticts'covered` *Barriers around heaters,fans *Hazardous substances locked *Containers labeled Y. *Medication locked *Screens on windows which are opened *Lighting adequate ;I i f i j I i j i ( i i I Checklist for Toddlers (ate 18 months-21/2 years) (0)indicates compliance observed by I)HR Licensing Representative (1)indicates not in compliance (X-)indicates not applicable *Name of teacher/room# *Age of children *Number of children *Number of staff 11lrn j#z«m E ui ment Re uired or,T4iq&Grou o, Children , w Laree non toxic cravonsYmaikers' Pa ei(variety) Non-toxic Plavdou h Colorful pictures and posters A device that plays,a variety of age appropriate music Mt!sical tovs-2. , , Mecars, ftov's-2 rucks,boats,etc.-? toy-2 Books-2 er child A e appropriate puzzles-2(complete with allpieces) Nesting and stacking toys-2 sets Non-wooden,buildin.'e blocks.(approximatelv2Q,non-i.nterlockine) - Baby dolls 2'(can leie with all O arii) Doll clothes and blankets Doll bed-1 Toy telephones-2 Pots, ans,buckets,large plastic spoons Child-size stove Dress-up clothes 7TPotty rm water,soa , a er towels ined,covered container able lastic a acce table) airs cleaned/disinfected/emptied !Feeding chaii(s)or table and chairs *Cribs/cots *Waterproof mattress(es),sh6ets,coverin s *Indoor thermometer/Out of reach of children *SM-ving forequipment and supplies/anchored *Furniture child size,clean,good condition *Individual,labeled storage space for each child t " .,, . *Electrical outlets t:overed ' " "` � --- - •' *Barriers around heaters,fans *Hazardous substances locked *Containers labeled *Medication locked *Screens on windows which are open d *Lighting adequate -Checklist for 24 months up to 36 months O)indicates compliance observed by DHR Licensing Representative (1)indicates not in compliance - X indicates not applicable *Name of teacher/room# *Age of children *Number of children *Number of staff Minimum,E ui_meet,Re ,uired or Each Group of Children Non-toxic playdough .,• ., v _.:,....- . .. ,-. ". .,:, _ ,. Large nontoxic crayons/markers Paper Non-toxic finger-paints in primary colors v Scissors(blunt-tipped) v: s 13ook 2 per child A device that plays a variety of age appropriate music Rhythm instruments-one for each child in the group Baby dolls-2(complete with all parts) Child-size stove and sink or combination K Cooking.utensils and dishes Doll bed V Doll clothes and blankets A Dress up clothes Toy telephones—2 Building' =blocl approxiriiatefy 50 non-interlocking Cars,trucks,boats,etc.—3 Age appropriate puzzles-4(complete with all pieces) j, Interlocking manipulative play sets of different types—3 sets *Dra :erina area *Sink,warm water,soap,paper towels Y. *Plastic-lined covered containers *Tablets ace and chair for each child" *Cots/sheets and covers *Indoor thermometer/Out of reach of children Written daily Ian or schedule posted *Labeled.storage space at child level *Shelving forequipment and supplies/anchored i Designated activity areas *Electrical outlets-,covered' *Barriers around heaters,fans j *Hazardous substances locked *Containers labeled 3 *Medication locked X 777 *Screens-on windows which are opened I *Lighting adequate i i I .1 teacher/room *Age of children *Number ofchiIdren I♦tequ�redll e�n�pment(IIL,i.,p 6Z��) �y` �nrmr�>n�Egrre�ment R u�t°ed ar Ea Group of Children A. t.. y�r.�j1 �.r'> ; dr')�5 s-ti5*.t" -" ..y w��s ?` nric,.t tf..c .ZZt '7P` �,s ,i �. ?... _ ... .... .1. ..,-.r-,-.:r1., s-c�.;��r�i:��..-3 - .�...��c riaz7': `.fie"...F: .. S 1 r clay L.ar. •non-toxic 1 crayons/watercolor. •• • --�n�--_� brushesEarge sheets of paper Scissors(blunt tip)-2 pr.Per 5 children Non-toxic glue or paste;tape 1 . I inch in width . nlat1o11•���.aDl�: f�te71,@;'(a�fS .er g't�'+' { i' '�r.'ia^',.� �....:;rtn ''T3;`r'^'t7�?.,3°_;, ,+t4f sr ??:saas�r'1�a,':� ,t, -X;� ' m:<'• ,: 3 Small c s-1 trucks,boats,etc.-6 Age appropriate puzzles-8(complete with all�iiec Interlocking manipulative play sets,different types-6 .. .1- 9■a ��b���l •4'A�ea�,_ii.}i '"� n+�5`• 4e, y f-};;'K""3t �v.. .ye- - 1 1 1 •• -. - .. Cooking utensils/.ishes(unbreakable bollsDoll bed or cradle with allparts)-2 1 clothesll • 1 .. 1lankets Dress-uthes 1 boys . girls --_�--__- Storage for-dresswupclothes mirror-fullUnbreakable --_�- Toy telep qries-2_. � kpp��,, aa�l��a$�d"^i y5'•; i, 3 ; �,. .,,x f '[ �' 4 3'iR`7 rzc�7 "K, ,dx5,q `•'t r>'�x, v-�.r s �is. t:t �.t.AJ-s• $.: fiYxS ,,s 50-{�Tr F f,d x .7. kxgt ,�Trht; z ar a,u n ` y`t�` •,..h rAX ..J. :.',*.si f.' t., lufi'..• y,1•k, ?4,.7ttrr-crt s, „y �$sF T-nZ,9-s.1,r(+�t.7�'.'w P"rY.?a" 1t�. '�i '3 }.�`i n� •�:: - ., Nature collections Additioi�al'�urnis6iugs-an��Qoipment a?�kn, ':r`,,'r�" 'l;� ,a"'.�h® •�®,`�= t> =,a ®� •*Indoor thermometer/out of reach dailyWritten plan or -1 -posted *Shelving for equipment an1 supplies/anchored Designated activity,Areas *Barriers*Hazardous around heaters, 1 1 .stances bstances locked *C• - ..- -1 --- ---�- *Medication locked ��--- ----- adequate Checklist for School-Age (0)indicates compliance observed by DHR Licensing Representative (d)indicates not in compliance (X)indicates not applicable *Name of teacher/room# X *Age of children *Number of children �( *Number of staff MiniMgm E td ment:,R,e hired _or Each Groat of Children MOM jig-saw uzzle=l er ch"ildren Games:choose indoor or table games Suited to ase of children-1 er 5 children Games:choose outdoor or active-games Suited to age of children-1 er 5 children -Books suited to age of children72 per child X Non-toxic playclough'or modeling clay. Non-toxic tempera paint Brushes Non-toxic crayons Paper(variety) Non-toxic glue or paste,tape Scissors A device that plays a variety of age appropriate music Interlocking mani ulative. la sets—t per 5 children Emma „ - *Table's ace arid chair foi eact child - Cots/sheets/covers for each child who nap *Indoor thermometer/out of reach Written daily plan or schedule posted *Labeled storage space at child level *Shelving forequipment and supplies/Anchored Designated activity areas _.. ._ *Elecfncal ou[lets.covered - • - '- -" " *Barriers around heaters,fans *Hazardous substances locked *Containers labeled *Medication locked *Screens on windows which are opened *Lighting adequate i I I k I t PlayLground Checklist (0)indicates compliance observed by DHR Licensing Representative (+r)indicates not in compliance , (X)indicates not applicable 7mi" nimuin Equipment Required for groups of twenty-five children or fewer on the playground Location or age group Wheel vehicles to sit on.and maneuver-2 Wheel vehicles to pull or push-2 Q Balls-3 Climbing apparatus Crawl-through equipment O Digging or sand area Toys for digging D *Outdoor play area enclosed.by a fence or wall at least 4 feet in height o *Fence or wall free of sharp edges *Gates secured *Shade and sun areas provided *Outdoor play area free of apparent hazardous conditions Q * Concrete/asphalt not used under equipment * Area well-drained * Equipment notdesigned to be portable,securely anchored O *Stairs/steps have hand rails in child's reach O i