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HomeMy WebLinkAboutDeficiency Form (13) DHR-DFC-1926 ALABAMA DEPARTMENT OF HUMAN RESOURCES CHILD CARE MINIMUM STANDARDS DEFICIENCY REPORT SECT ON A-,,IDENTIFYING INFORMATION Facility Name: Type of Facility: Home ElDate f Visit: LITTLE PEOPLES NURSERY SCHOOL Day © Group ❑ Night ❑ Center ® / Day/Night ❑ S.A.P ❑ month / day / year Facility Address: Licensee: Telephone#: 509 A'LABAMA STREET LITTLE PEOPLE'S (256)757-4498 KILUEN,AL 35645 NURSERY SCHOOL, INC. Agesl Director (if applicable): Capacity: 5 Weeks through 12 Years GAIL JOHNSON 37 -Day SECTION B =DEFICIENCY INFORMATION Column 1 Column 2 Minimum Standard Date Corrected by Deficiency Licensee rearkr 1� are- lnaul�� 3 a we,, � ���, 1, o � I, � e 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 Q/L�, , as verification that deficient ies have been corrected NOTICP Any misleading or any false statements or reports made to the Department and/or failure to correct the listed deficie q'cies can be the basis for adverse action. None of these requirements are to be interpreted to allow anyone to operate in violatioh 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 inj,,an with Minimum Standards. Signaturg of Facility Representative Dat 2—�3 Signaturl of DHR Licensing Repres Da COPIES O: --� Gii (,�oh�an Page I of i l