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Evaluation Form (6) Revised 9/19 ALABAMA DEPARTMENT OF HUMAN RESOURCES CHILD CARE CENTER LICENSING EVALUATION RENEWAL Health and Safety Guidelines items shaded Name of Center: Date(s) of Evaluation: Address: Date(s) of Follow-up: 131 r� -A- rL 0A . � 5 I kL' 3b5y'S Purpose of Visit: Pry Telephone #: ( I) �(��,_ &C'141 Director: Licensee: County: [ Day ❑ Night ❑ Subsidy Licensed Capacity: Day, ®� Night x Days of Operation: Day Night x Age Range: Day _IS Night Hours of Operati Day Night o :! X 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: X -Not Applicable-Not reviewed with From: To: Licensee/Staff in charge Deficiencies Noted: Yes El icensing Re resentative: Sections to be completed at the discretion of.the DHR LicensigiRepresentative. REGULATIONS m REGULATIONS o a o Q Q — E °- U Q U Q Z Z Z o Z "} r,y ,N }c• J a r k.- ' t�a 5 r3�s t. f r``;, � r�'y T ; Facilities (II. C., pages 16-23) yea,Space for ill or Injured child r 1. Indoor area(II C 4 pages 16-18) f Items used b ill child dlslnfected tj ' ` <x F •7 •7 •! ' a Exclusive use ofactrvlty azeas. �g Storage space for.teacfier s supplies" _f . ....k b kDeslgnated space for`each grouping of children 5, 0. h: Office space provided c `Bathrooms located onaame levellunder same roof i. Ventilation,lighting,heating(pages 17-18) - (1) one flush toilet for each 15 children O '=(1) Heaftng/alr condlhomng provided (2) one handwashing sink for each 15 children t ( )Temperature 68 82 at child level, (3) One tub(portable plastic acceptable) F (3) lhermomete to eacfi area used b'y chill " Y �' (4) Flxtures child size or ad3usted for easy use O � _(4) Thermometeroutrofreacli of children ° ¢ + .-, .t.irir y>s .'�'.'*s,.wx .a.,3 ax l'. d One handwashing sink Huth warm running water w (5) Outside windows that aze opened are soap paper towels m each room,where children are screened z ws 7 ,• „it tdlflnBred 1 U v N REGULATIONS f6 v REGULATIONS m v E o a E o a U Q U Q o O o O Z Z Z Z tside d oors kept closed 3. Swimming and Wading at the Center(IL, } C.,6.,pages 20-21) (7)-Lighting adequate for activities a. Pools two feet or more in depth (8)?Lightingadequate at nap/rest time to allow (])Lifeguard at poolside at alLtimes pool isiin children to be seen ' j. 'Operational telephone,for center business only (2) Lfeguard;Tiatntng Certificate;-.Fast Aids F r y Certificate CPR;Certification on file' y k DHR notified if telephone rs out of order or if (3) Lifeguazd not counted m ratios r 'number changes I. Hazard prevention(page 18)(Indoor Area) (4) Staff-child ratios for children in the pool: h _ (1) Centcr free of appazent hazards (a) one staff for each child younger than 2%s of (2)=Hazardous substances under loci.and key or (b) ane staff for every.4 children ages 2V combmahogloel. " years up, 4 years, ] . u (3)4Contamers labeled O 3 (c)one staff for every 6 children�ages 4 years up to 6 years rx ,:. (4)"N6 fireazms or ammumtton'.kept or all �(d) one'statT-for every l0 children ages 6, ; center except air enforcement yearsrand (� Stairways have hand railings m child s reach { (5) Ratws detetniined byyoungest child m the =t .p001r g.. (6)'Clear glass doors marked at child level {6) Persons counted m ratios meet-child cazd "worler qualifications/mthe pooGat all tunes (7};Medicines and drugs keptunder lock and ley or y, �r (7) Staffprovided to supervise children in ' c77, ombination lock;separate from harmful items pool az but not m pool k. . r } (8)'Bamers:around heaters,radiators,fens accessible' , (8) Ifany part of a child s body urn fire water, ' to children z r " � '- ` child considered in pool (9):Exposed electncal outlets'haveprotective4covers¢ enclosed with fence ors'ohd wall air f, "i ,least 4 feet mthetght,constructed to prevent i (l ll) Consumption of_alcohol or use of,non $accessibility by children i ' prescription narcotic or illegal substances prohibited, ` t ' r b. Wading structures less than 2 feet in depth: Sniokingoruse'oftobacco prohibitedon ' (12} Bio Contaminants shall be stored and disposedt# of properly m. Center kept clean/Cleaning done daily 'n (1) At least one staffwtth CPR&first aid ai '� , leach wading structure y s (1) Floors bathroom fxture sic leaned/di (2) Required ratios met as stated on page 23s (2 yCarpets vacuumed daily g (3) At least two staff at each wading str`uctuie� c Li 5 } (3),Cleaning does not interfere with children s (4)'Cean wate'xprovrded'_each day, 2. Outdoor area(IL,C.,5.,pages 19-20) (5) Wading structure emptied when not`in use r�, . 4 See Checklist A Off street loading/unloading provided r t ' 4. Away from center activities (IL,C.,7., page21) b Separate areas for children younger than 2%:'(maybe NOTE. The Department of Human Resources achieved does not inspect activities away from the center, ` 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 4 Outdoor play area free o,,apparent hazardous condiiii A� 2 U U U U tp tI3 (B (U M REGULATIONS CL ° Q a a a E a REGULATIONS E a U Q U Q o O o 0 Z Z Z Z 5. Furnishings and equipment (II.,C.,8., -.1 St. 'with mfant-child CPR and first and s pages 21-22) See Checklists ® present during all hours of operation 4 O - _ Child Care Program (IL,D., pages �k Second staff available*lien 7 or more children 'presentliequired ratios met *. r 24-37) 1 Required`fa of s maintained of all times f t No staff on duty more than 8 continuous hours , :. on a regular basis a O up to 18 months 1 to 5 + m Staff free from other duties while working `with the children b 18 months up to 2%:years to 7 5. Infant/Toddler Program(H.,D., 2.,pages 26-29) d.24 months ppto 36 inonth5 1,to 8 a. Learning/growth activities:(page 26) e 2!:years up to 4 years r ' a' 1`to 11 (1) Encouraged to play with a variety of toys 1 4'yeais up to school age L1 to 18 yS (2) Time outdoors daily,when weather permits -z s g School age_up to 8 years of movement�outside`cnbs daily , h 8fyears and older 1 to 22 (4)Placed on tummy part of tune white awake jrt4 = � 2 Cht•Idren younger than 2%grouped separately " (5) Staff talks to each child and encourages from older children xi* „t, response R �. a Excepgbq for group 24 36 months r �/ z(6) Cnes/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)f Clean dry diapers/clothmg piovided _ attention to the`chrldren 4. Staff coverage (page 25) ;'`(2) Wethoiled`diapers/olothing cbanged x x ,l ' a All children supervised at all times' (3) Changing area cleaned and disinfected 77 b Staff assigned responsibility for same Norchild left unattended while',bemg infants/toddlers.each day ' = x diapered' , \. c Substitute staff available �+ (5) No child diapered onthe floor« 7 1, Y r _�.: Jc r �E d Director suthonzed to conduct center business 'w " (6) Each child s hands washed after diapering e Staff person m charge when director is absent; (7) Staff use'universal precautions authorized to conduct center business ' diapering 1 f Staff in each room during nappmg/restirig� (8) Staff use clean disposable gloves for s '" S 1 } diapering each child/for each diapercharige J, J £g Staff able to see alf the children - (9) Wet/soiled drapers placed n covered, ;, z , .. ally r ,'`plastic lined container andadisposed t h. Ratio during napping/resting: (10)j Tndivrdual disposable wipes.used at each ' diaper change disposed ofproperly? r Y (lj 0 up�to 18 months t 1 to 5 �/ (11) Potty chairssemptied iinsed disinfected I` ,} I'after each use i (2) 18 months up to 2%years 1 to 14 (12)Diapenngarea separate from food service t area r. (3)2%:years and S older Ito 36 c. Napping/resting(page 27)- 3 a) a) a) a) 0 a) REGULATIONS J2 ca REGULATIONS M C-) A A CL LL aLL E E CL E E 0 0 CL 0 Q- < < 0 0 0 0 z z z z 1 ' Infants 17" a1loWedt6form,bwnsceDDattern s- k "- .(2)-,Infants placed oii.back to sleep unless-ph'v'sici'an"i -tii~Child'ehc�6ui-ag6dto;ekpenment with*self-,-4� stat4ff6t�in�icaic"the rwis 'T-,feeding,1a1idjils;provided (:i4)'--iiisposable-'utensils-tise'd-'dnl.y th b. (3�"Inhints-who,cah easily turn pl aced with close Wlo.vid:to.adopt preferred, 0 q envision '', Tng q 13)-f6ods --,ffl�'No--positio A vice used unless eaten from a physician h 'iciin' j� '0� ,bottles Stiff recognize'difi�1 differing'needs0toddlers/allow 'Dislids, un6r IV` fbll6ii their,own�slee tt p p� ems d Cribs,cots,an d bedding(pages 27-28) "WakrofferedA6 toddle]rs',-, 01, not f&iced-t (l)'Two'eefbetwo6w&cuiiied cribs 0; o eatr . ... .... ... (2);Cots postrioned to allow space for access or (19) Food not used�'reward.of,p6fiishinciit -�t emergency exit -Cribs/cots 61eiinid';' e-. -(20),,Child?9,lfan before hhddisjhfected.and:91 sheets an J,.� q,,4,�, di'v�iisfied- c ore an after covers �sqqc, ..AftetAabering;,,,toi A, "h!ed-sd vaidih (4).'For infants dttdrifsh6ets daily.or.more,'-," 0 °S g,hands, d'.k6l�OT food k often if '1:" preparation with )f, SRMY . after Aoilei dhi after apenng-1---, 0I, paper'. jpf" 1,q g, (22),-IndiViddid towels for:ekhwashing 'env ro entpopillows�'qtq comforters', - an ,-qnvdryingv (6)No mfanf put to sleep on sofa,soft mattress3 ' s, ' 6. Preschool/School-age Program (11.1 D.,3.,pages 29-32) (7):`For toddlers',"616i�i�66ft6M,-sheetsjud a. Learning/growth activities(pages 29-30) coverings weekly more often if needed X, T� e. Feeding(page 28-29) (1) Schedule posted 1 jobil'f6uinfatitsifprovided (2) Variety of indoor/outdoor activities planned with or 'Ai physician (2) If formulafiprovided by center ready to, (3) Time outdoors daily when weather permits d properly stored and c ban I & -V Meals and-snacks 5complyW1 requireifidfit�`q, (4) Staff permitlencourage conversation among children (4) If formula pj�&ide&byp&cm,-hiheled-jefri&iiit�,4�7-`- (5) St 1w 77 aff give individual attention to each child daily (5):Bottles sent home or contents discarded at end of (6) Radio,TV,videos used only to d supplement/enhance daily plan (6) Small hard candies'nuts not -qi Oft ikt&tb,Wat A, our un m ed h!� :&TV'orvi eosl�,��-, d or {7)Foods that may cause choking prepare ie'w--e'd:Wi.,Aiff B e,pare4 (8),;_ nee p Feeding to child frightening schedule di' e* mat prohibited s (9) Infants held for bottle in b6ttle1eid b. Napping/resting(page 30) (10) No bottles needs propped 4"r-l" --%V'��I h A6 sit to feed" 7 djUin' allowed' n oe (2) Rest pe riod for children in attendance more than 5 hours 4 U U U U Q tTS N U N t0 U REGULATIONS Q REGULATIONS C Q U Q U Q U o o U o 0 Z Z Z Z (3) Rest period at least 45 minutes,not more than C (15),Children seated while eating:' 2%:hours J (4) Ifa child who does pqt, cep 0fit 'minutes (16)``No child forced tt%'eat genet activitiis permitted' �� S -(S) Cots cleaned and clean bottom sheets and top. t' ( 7) Children not all w in kitchen sheets/covers'provided:beforeuwd by another child r X (6) Clean sheets/covers provided weekly,more often (18),Childrens hands washed before meals if needed S and snack and after to letuig (7) Cots positioned to allow space for access or ' (19) Staff hands washed before food emergAl ency exit preparation and service and after assisting with ?' to r iletiiigor contact with bodily fluid (8) At least one staff.present in each room r' (20) Disposable gloves.iised for diapering' x (9)`Staff able to see all ehddren 4 r(21) Individual paper towels foreachwashing and drying # � c G Toileting(page 29) + (22) Catered meals and snacks meet ri reJ5 quirements ._ , , (I) According to each child s heeds each child s' e. Disciplinary Practices(page 32) .r hands washed-= Y (2) Staff use Universal Precautions when dtapenng Y (]) I)tsciphne,appropriate to age and ' or handling bodily flmds. E, :developmental level of the ohildren fF}. d. Feeding(pages 30-31) �(2)rNo corporaUphysical punishment } 3 j (1) Children m attendance served breakfast or a:m �`c � Tlo verbal abuse x f snack lunch;p"m snack '�; , � (2)"Meals acid snackscomplywith USDA guidelines (4) IJo discipline associated with food naps or , on pages 29 3g t bathroom procedures s (3)a FIutd milk served no powdered milkfor dunking, (5) No physical restraint as punishment (4)No child depraved ofirieal or snack ` = (6) No punishment administered by another child (5} Specialdietary needs m accordance with written f. Staff-Parent Communication(page 33) instructions n ' (6) Meals and snacks`provided bythe center (1) Discipline,behavior problems discussed with parent (7) Vending machtnes prohibited m areas used by`4 " (2) Center open to visits from parents at any chtldien0, time (8) Small hard candies nuts notFserved to children ~,z (3) Parents informed of right to visit x (9)*Foods that may cause cholung prepared �4"r i 4 (4) Staff available for communication/ happatlyfohdn . s conferences (10) Portions of food'suited to child speeds second l �r3 (5) Parents notified of complaint procedures portions avazlable ,. f ` (l I) Unbreakable or single use.dtnnerwaze used t , ' '£ (6) Parents provided with information on f p `t3 1 a �s"'•4. influenza i (12)Single se-,ups or glasses or ii"king fountain g. Health information(pages 33-35) provided for water 4;_ ' �f s (13)Dnn uigwate.offer d then ^. r r ' (1)�No'ill child'admittedA (1, oo&served on`individual dishes or.nap kit►s (2) If a child bewmes tll!or is m3uied,he/she is _ ,N { not directly on table , F _ separated from group`but continuously t supervised, SK 5 i U U U U C C C C REGULATIONS E E Q REGULATIONS Q U Q O U Q U U 0 0 0 0 z Z Z Zz '(3) Parent of ill/injured;child notified immediately (e) Children and staff wash hands after and required to come for child . handling animals (4) rf parent cannot be reached or illness/injury h. Emergency Preparedness and Response severe,emergency medical attention'is obtained' , ".. _ Plans(page 36-37) See Checklist (5)Parents notified of exposure to contagious Transportation(II.,E., pages 38— disease/condition 40) (6) Parents urged to notify center if a child is 1.Transportation provided by the Center exposed to a contagious disease outside center (pages 38-40) '(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/Medical Procedures(pages 34-35) licensee shall assume full authority and responsibility for away from the center activities. Does the center's staff give medication/m ie procedures? Yes ❑ No (a) Medication administered only with written Does the center's staff provide transportation? authorization from parent Yes ❑ No ❑ (b}.No blanket authorization forms for medication a Transportation checklists used as regwred (c) Medication in original container,labeled b Designated staff complete imd"sign checklist y (d) Measuring device provided c. Driver signs checklist,"indicating he/she has checked,each seat. r(e) Medication administered by designated staff d Checklists'kept on file for current year plus 2 ,(f).Locked siorage provided for medication ,' additional years (g)--Medication returned to parent-or disposed of a Center responsible for pidking up child at ' when:no longer needed designated location and'delivermg child to designated person' (h) Time and date medication is given is documented in writing,kept child s file/copies f. Supervision in center vehicles(page 39) available to parents on request ` (9).Hygienic prachces(page 34} (1) Staff child ratio met,for children younger than lawful school=age driver-not-counted (a) Toiletarticles labeled and stored separately_ (2)'Children of lawful school age and older;; er than I5 transported with bnly,the driver (b) Used`paper towels wipes tissues-are disposed (3) For 15 or more children of lawful school of immediately following use rage one staff m addition to driver ; (c) Toilcfpaper provided for`uie by children and (4) For 30 or more children of lawful schooP staff age,rivo�'staff in addition'to r yer (d) Extra children's clothing available (5) No child left m a vehicle without adult :... .supervision f (10) Animals on the premises(pages 35-36) (6)'Staff accompany each child under 2'/=from ;'vehicle to care of designated,person : (a) Aggressive animals not kept in center or on (7) Staff visuallysupervise each'child grounds .;older front vehicle to care of designated person : (b) Animals that could pose a threat to health and (8) Driver checks each'seat at each locationao 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) boorslocked when vehicle is moving 6 { U U U U M tea m m REGULATIONS E E 'Q REGULATIONS E E Q U Q U Y Q o 0 o O Z Z Z Z (3)`Children not transported in front seaC;of vehicle 2. Records on staff(pages 42-44) with-passenger side air bag (See Staff Checklist) (4) Driver and all passengers secured when vehicle is a Records on staff kept confidential; moving (a) ear or Each child under 1} weighing less than b Records on file at Um m e of eployment 20 pounds secured m rear facing child restraint, Of ,, installed according to manufacturers instructions c. Records on staff maintained at least two years _ maintained m good condition after person has left (b) Each child under S years or weighing less than d Records filed ilphabcticall} 40,pounds secured in forward facing child restraint; 5 Y installed according to manufacturer s uistrii'ctions �;' m e Inactive files rriaintamed sepazately :maintained rn good:coniLtion ' vA s (c) Each'child under 6,years secured�n a booster , 3. Health (page 45) seat installed according o manufacturers instructions maintained m good condition a Medical exatrGand TB test on file'at time of ... t F-� •employment. < (d) Each child 6 and older the driver and each , ' b StafFwith symptoms d of contagious ad'It_passenger secure in an individual seat belt, t: dtseaselcondition not m center properly anct►orcd to the;vehicie t :, r _`- h Vehicle safety check done annually signed by Character and Suitability(II., mechanic and dated filed in center E {,li G., pages 47-51) b 5. Transportation provided by 1 Character and wtability review conducted on parent/guardian(page 40) requiredpersons'(evcrySyears) a EEach child accompanied into and out of center s - i` s z a Persons with determination of unsuitable ' character terminated b a Each child signed m and signed out ' f b Licensee informs DHR of any criminal N -- r convictions'oi ciirrent;bhiii es b A child whoMamves by watkipg or bus signed to Administration (II.,Hy y r Ty pages 52-56 d Photo ID requued when releasing child to ;_ t unfamiliar deli atederson 1. Applicant/licensee(page 52) P !? Staff(II., F.,pages 41-46) 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 c. Licensee designates director and delegates authority and responsibility for operation and b. Child care workers/teachers meet qualifications and management of center to director have 12 hours of training within 30 days of employment `,J ';-Child care workers/teachets meet requtr;Tpp,s§for * y ` d. Written operating policies established CCDF framing, iii 90 days'(�f applicable) x. c. Aides/assistant teachers not counted in ratio (1) Copy of operating policies provided to parent at time of child's enrollment �d Service stiff.not counted m ratio unless they meet` # € r,'a` (2) Copy of operating policies submitted to 0 quah141 ions and are giving full a[tenfion to childreir X, ; DHR e Driver at least 19 y'`d driver s license ' a (3) Operating policies do not contradict Minimum Standards f ft Substitute statTmeet qualifications of staff for whom1 i # (4) Changes in operating policies provided to substituting parents and to DHR 7 U U 0 U U � .t] N U ca U REGULATIONS E E Q REGULATIONS E E Q U Q U Q U o 0 U o 0 z z 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 X a. The following reported to DHR prior to occurrence: 4. Children's Records(pages 54-55) x (I) Change in ownersh_lp a Childen s records and mfornat►on about -chddien and their Wlesk'ept confiilenhal (2)'Change in location b Individual records on each child on file on' first da of attendances, y„., (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 or members of board (S) Alterations to center or grounds {3)Inactive files maintained separately *.. (6); .alor change or eztenston of hours or program, 5. Center Records(page 55) (7) Change m address,or telephoil number The following records kept on file for the current year plus two additional years: b. The following reported to DHR within 24 hours, ja Daily attendance records`on all staff and written report within 5 days: �ch�idren �� � ; t . t, (]),'Any ilingss/injury of child or staffrecjwnng { b Transportation'checkhsts{ professional medtcal treatment . a (2) Any illness/mlury of child or staff requirmg2 a -c Vehrcle safety check x eme�gency medreal treatment ., j•- t. (3) Any death occurring m the center or dunng away d Sign u>>sign out sheets fiortt Centel 660ities (4) Malor damage to facility S r :z s 6. Documents to be posted(pages 55- s 56) (5)' Interruption of the centers electncal telephonic ,' or gas service:t . litigation rvolving the,center a. Most recent license,permit,or approval Y (7)Any trafTic accident involving day care children b. Public notice form using'transportationprovided by tfie center _ l - X'; (8),Any arrest of licensee staff,employee volunteer ` ` c Most recent licensing evaluation (9)_Final.-dnsposntion of any child abuse/neglect d Mostxecent deficiency report ; investigation involving licensee staff employee ram? (I O) Any incident to which the health welfare or: e Correctrve/adverse action notices; } i. a - 2 s c Ctinld abuse/neglect reported as requuedby haw ? S f Most recent fire nnspectnon reportfr d Licensee and all staff employees volunteersr g Most:recent health department mspectwn cooperate wtth'DHR on any child abuse or neglect - report and food permit or ivntten perrntssion for investigation f <cateruig'?food 3. Admission Procedures(pages 53-54) h Menu for meals and sfi&Wdatdd - i. Name and telephone number for: t ,(1) Fire department ; t i a Total number of children to care including children { (2)Maw enforcement O on the premises,children m transit,children on field traps conforms:to number specified x Medical assistance(ambulance or rescue) r` 8 U U U U U U � .S] REGULATIONS `� m .a E .Q REGULATIONS E E Q O U Q O U Q U o 0 U o 0 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),AtIcasi one'staff at least 19,`meeting child care Worker qualifcatiops,with CPR'and Ist aid- j. Emergency Pre'aicdness:and Res onse Plans " center during hours of operation k. Name of directodstaffperson in,charge, (4) All children"supervised at all times Nighttime Centers (IL, 1., (5) Each staff assignedresponsibilityforsame „children nightly'.. ages 57-58) (6) At least one•staffin each room of sleeping i children , �In addition to the regulations set forth for day (7) Staff able to see all the children at all times \/ re centers, centers providing nighttime care (after 7 p.m.) shall meet the following / regulations or modifications (8) All staff awake and aleit to needs of children Does the center provide ca e after 7:00 p.m.? 1. Yes ❑ No (9)At least two staff in center whenever ohildren•are present required ratios iiet fr Does the center provide care a er midnight? Yes ❑ No (10) Lighting maintained so,children aze "visible :while sleeping 1. Equipment and furnishings b. Nightly activity schedule posted (page 58) a.-In centers operating past midnight,cnbs,or cots (1) Outdoor time available during daylight hours fitted with a waterproof mattress shall be provided foi each child- (2)(2) Staff assist each child as needed;m dressing and grooming „.'" b In-centers operating past midnight,there'shall beat C. Food (page 58) least one bathing facility-for every 15 children 2. Child Care Program(pages 57-58) :'. (l) Breakfastserved to children going directly to school a. Staffing(pages 57-58) (2)'Evenmgmeiil served to children,m attendance (1) Staff-child ratio for sleeping children: d. Bathing(page 58) If any child is bathed: (a) 0 up to 18 months 1 to 5 (1) Clean water provided'for each child (b) 18 months up:to 2%: 1 to 14 (2) Eaeh child bathed separately (c) 2'/z pp,to 4 years (3) Each child supervised while bathing (d) 4 years and older 1 tto 25 (4) htdividual soap towel and washcloth •`provided for each child 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 the esponsibili the li ense to operate in compliance with the Minimum Standards. ignature of ensee or de gnated)taff Date 9 Checklist for Infants 0 indicates compliance observed by DHR Licensing Representative -1 indicates not in compliance (X)indicates not applicable Name of teacher/room ,g z Age4,ehil iren Number.ofchildren Number,of staff "A Minimum E ui ment Reauired for Each Group of Children Required Equipment(III.,I., page 66) Washable soft crib toys-2 per child Push and pull toys-I A device that plays a variety of age appropriate music Age appropriate books per child Large balls(8+inches)-1 Nestin.-and stacking toys-2 sets V Washable baby doll-I Musical toy-1 Colorful pictures and posters Activity boxes,such as busy boxes-3 Dia' Xdditional Fur' nishings and Equipment pering. .7 Plastic-lined;covered'con Tub(portable plastic type acceptable) "Feidin"defiiirs 4Cfibg!2_, -dfspace-1 it%i6 'k X - p nIhdivi'dW,Iabe]ed!st6rig6 spice-foieAcfi child ;Furniture c -Qrip$in a6cbidaii6ilvitfi,US;Consumer,Pi6duci Safety-- -Act bt E fheil le6' 6utlki A X Bufi6rs-�idund:hiii 1�4 ­"AW aiarddtigsuhstikces]bck-"ed"' Containers-labeled n = "d* Me ica9- screens;dii.i,,ihd6ws which hie'd'p'e-n'ed T- Li tin} Ad_e'q date J'-.'o`," 10 Checklist for Toddlers (age 18 months-2% vears) 0 indicates compliance observed by DHR Licensing Representative I indicates not in compliance X indicates not applicable Wame� erochildren, �`!" ;Nufiib f mber,of staff Minimum Equipment Required for Each of Children Required Equipment(Ill.,I.,p.66-67) Art/Music Large non-toxic crayons/markers Paper(variety) Non-toxic Playdough Colorful pictures and posters A device that plays a variety of age appropriate music Musical to Active Play Push and pull toys-2 Large cars,trucks,boats,etc:2 Sit-on riding toy-2 Laze soft Quiet Play BooksTper—child Age appropriate puzzles-2(complete with all pieces Nesting and stacking toys-2 sets Oe x Non-wooden buildinQ-blocks farr.Mximate1v 20 non-interlocking)—L--.�-- Hdn�eliving/Dramatic Play Baby dolls-2(complete with all parts) Doll clothes and blankets Doll bed=l To telephones—2 Pots,pans,buckets,large plastic spoons Child-size stove Dress-u clothes —j .-Additional Furnkiiiiiis and Equipment rDia area- 7 Tub(portable plastic type acceptable) 77777T77 -, Potty chgncleari6d/disififeciidlim 7 --Fiidixig'chai6)or table and chWis-%' 4 A. 'Inddoi.theriiometdl Out of reach of children Fiuni tt":6hild si i6,'&an ::66d ccfidifi 6n k- ,IfidW,idiW,,'%b6Icd s6reie ielfdr each WIC Z Facilities JE166 6W-bUtI6tS'C6V&C J'.-Bani6t'ai6tidd heif6s,16 C ffii�aus gabftaifi'eg,lock-O", C a Iabc'i�6rS" 'Ied'- 66t L Medf6iiiofi locked Sd '6fi Wihdo- Checklist for 24 months up to 36 months 0 indicates compliance observed by DHR Licensing Representative -1 indicates not in compliance X indicates not applicable Name 'tei6er roonr* , 77 M u -ber,m of children ren Number,'Uita f Minimum E giement Reguired for Each Group of Children Required Equipment(page 67) Art Non-toxic playdough Large non-toxic crayons/markers Paper Non-toxic finger-paints in primary colors Scissors(blunt-tipped) Literature/Music Books-2 per child N A device that plays a variety of age appropriate music Rhythm instruments-one for each child in the group Homeliving/Dramatic Play Baby dolls—2(complete with all parts) Child-size stove and sink or combination Cooking utensils and dishes Doll bed Doll clothes and blankets Dress up clothes Toy telephones—2 Edticati6nal/Creative Building blocks—approximately 50 non-interlocking Cars,trucks,boats,etc.—3 Age appropriate puzzles-4(complete with all pieces) Interlocking manipulative play sets of different types—3 sets Additional �urnishings and Equipment Sifik,'*krin water,'soapj Ap6r p P Table's ic4iin&bfiaii'fbf' c lnd6o;thcr66 Out' of met&J. Written daily plan or schedule posted Labeled sfo&g6=ipace at child 'Shdvingfbr-Oilirfienf ands` olids/EnC�h'or-ed--.",.,,. Designated activity areas Facilities aroufi atdrs;-ans, Hiiai•d6iis�-siit'siinciis;lo-eked ' Z q Contaihciflab61&-.'_," Li Lln9 ...... 12 CP Checklist for Preschool (Ca)scA2% veaWto school age) 0 indicates compliance observed by DHR licensing representative indicates.not in compliance X indicates not applicable awe of Age of children difib to childre­n ,i., .._ Num ber of staff Required Equipment(Ill., I., p.67-68) Minimunt Equipment Requiredfor Each Group of Children Art Easel V Non-toxic playdough or clay 0 0 1 Large non-toxic crayons/watercolor markers Large sheets of paper 0 Non-toxic finger/cold water paints-primary colors 0 Scissors(blunt tip)-2 pr.Per 5 children 0 Non-toxic glue or paste;tape 0 0 Paint brushes four 1/2 and I inch in width I n I L n I LpA—i Educational and Creative Toys Large/medium building blocks-app. 15 non-interlocking 0 1 L) fo Small building blocks-app. 100 non-interlocking 0 Small cars,trucks,boats,etc.-6 0 0 Age appropriate puzzles-8(complete with all pieces) Q0 Interlocking manipulative play sets,different types-6 0 0 Matching games-6(no more than 2 electronic) Q 0 Puppets-2 Homeliving Area Child-size stove/sink(or combo) 6 Olu Small table and chairs/benches 0 0 Cooking utensils/dishes(unbreakable) 0 Doll bed or cradle 0 Dolls(complete with all parts)-2 In Doll clothes and blankets 1 1 0 Dress-up clothes for boys and girls 0 Storage for dress-up clothes Unbreakable mirror-full length Toy telephones-2 'Literature and Music Age Appropriate children's books-2 per child A device that plays a variety of age appropriate music Rhythm instruments—I per child in group 1, Nature Study and Science Magnifying glass d U Magnets 10 0 Nature collections 0 0 Measuring and pouting equipment Q 0 Additional Furnishings and Equipment 7 T 7 7­17 n 21571 Written daily plan or schedule posted 4C) 7, ,SheMfi 'f6i'646i ifiefii and,siYOOlk 6h6r'ed3`,,I, 9- Facilities Hazardous subsfimd6s`1ocke_d/.',- conta ners; Mcdi6tionI6cke&,'2_" .Screens 6h wihd6ws.ivhichiieooc'n'ed:,!: I? [ V'"'n Ligh tin i4idelfiatd, Ck (V Olk. I(P CAN,26 r q 13 IOT Checklist for School-Age (O )indicates compliance observed by DHR Licensing Representative (I indicates not in compliance (X)indicates not applicable Name of feacheW oom-# E �d. Age."tif children t Nti'mber.of'chtldren r Number-'Of staff Minimum Eaulf2ment Required for Each GroyR of Children Required Equipment(Ill.,I., p. 68- 69) Jig-sawpuzzle-1 per 5 children Games:choose indoor or table games Suited to age of children-1 per 5 children Games:choose outdoor or active games Suited to age of children-1 per 5 children Books suited to age of children-2 per child Non-toxic playdough 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 manipulative play sets—1 per 5 children i -Tattle ace;aiid chaii for each:"child f Cots/sheets/covers'for eaoh'child whom , :. .. ... ;., . = � ., ,. -; , •- . �Iridoor th'eftniometer louf`oficach Written daily Ian or schedule posted Shel'vin"fore ut ment`and su iies/auchored Designated activity areas Facilities Electrical.outlet5`coVered. 4. - rBameri,around heaters fans_ Uf Hazardous'stibstances I cl ed'" r w- ,Confainers'labeled Ivtedication9ocked M Scree is.on windows which are o'ened . x r: 14 Playmund Checklist (O)indicates compliance observed by DHR Licensing Representative (-)indicates not in compliance (X)indicates not applicable Requiredp. 6' Minimum 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 0 Balls-3 Climbing apparatus Crawl-through equipment Digging or sand area (� Toys for digging 10 Facilities Outdoor play area enclosed=by,a fence or wall at least 4 feet to height fFence or wall free of sharp edges Gates secured s{ Shade`and sun areas provided Outdoor play area free of apparent-hazardous conditions Concrete/asphalt iiot used under equipment z Area well drained r Ecju�pmentnot desigried'to be portable securely anghored ` ' = na*: - _, „ 3,. Stairs/steps have handrails m child's 15 Emergency Preparedness and Response Plans Checklist (O)indicates compliance observed by DHR Licensing Representative (-1 indicates not in compliance i The plan shall include procedures that will be used to prepare for The plan should also be inclusive of and respond to the following types of emergency/disaster situations: Current emergency plans,and procedures Weather emergeneieslnatural disasters o t Lookdown or evacuation due to threats of violence Lpicatio., n-and.uk.iffirc extinguishers Evacuations due to ;.' :' ;" $ Docturientation.of the.following quarterly drills Hazardous tnatenals > x Fire Spills O' Tornado fl Gas leaks Loik- (f .Bomb-threats ' ;Relocation �. 16fectious disease emeigenctes °` Telephones foi on stte'and off site use Loss:of owcr=water;or ficat Location oflhe'first art]and errier enc su 1 kits P 0...' g y, Pl?y Other threatening situations 1 • ;The disaster.; larishall rnclude`iiela'ils or '' ,f w Shelter m place"or evacuation ' 4 Asstsiiha infants and children wtth,specral needs andtor healih'conditi6hs y O., a Reunification with parents Shelter m placeproceduri s r N , Transportation disaster piocedures ` 'd i. �. Stafftratning/reassignment }. ,'„. Plan updated yeazly� f „ r Contact with local emergency managemen,,offtcials� 16