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Evaluation Form ROisc"d 3/2420: ALABAMA.KPARTMENT OF HUMAN RESOURCES CHILD CARE CENTER LY'ENSING`EVALUATION 7zIJNEVWAL Health and,Safety Guidelines.items marked with an asterisk* NAh*of;Center%. Date(s) of Evaluation: .Address: �q, ����r o '; Date(s).of Follow-up RL -3(oq Q l Purpose,of Visit: Telephone #: ( `} j �}Q Director: _Lcensee. y�a `Th rrl tt s iCounty 5 ®.'PAY El Night ❑ Subti, +ar_r�i a! Licensed.Capacity: Day' H ht?, :Days-of OperatioA.- ngy �ht Day Ni ht � Day Night: ;Age Range: Hours of Operati'0 MM MAL;- , Code: License, Nu> ber 0 Oliserved',by DHR Licensing Representative S - Certifiied'by Licensee/Staff in-charge. � ,D - DiT§cussed with_Lice'nsee/Staff in:charge, Effective Dates o'f License: TO X =Nor Applicable-Not reviewed with :From; 4-- -1I Licensee/staff in charge D& idieneies Noted: ❑ Yes ( No DHR Licensing Representative 6 E rSections:to be.completed at.the discretion of the DHR Licensing Representative. dy B `REGULATIONS` '. a RE"GULATIONSM a U E —n E ¢ c� Q U c° Q 41 0 0 0 0' Z Z Z Z; Fat iltties (II.,C'.,pages 16-23) c:`Space.foi ill or injured child F t.: Indo'or'3rea(t[,C.,,4.1 pages 1649) `f. Items used by ill child disinfected 0 ra.;Exclusive use of aelivity.ateas k Storage=space for. cactier'Ssupplics •b: I)esignatc'd space fgr cach,broupiiig of children p' *l, Office space provided 'c.;Bathrooms locatcd;on s'antelevcUundcrsamc,roof is Ventilation,lighting,hca ing(pages 11=18) 1 ode flush toilet fqr each 1 a children O (L) Hcatind/airconditioningiprovided: (2);one ht adwashin sink.fordAclt 15 children •(2) Ten?peraturc 6&92 at child level (3) One ttiti(poaable plastic acceptable). ° {3) Thc[moihetc,in each area used by;:children .(4) Fixtures.child size'or adjusted fdretisy user -(n) 7'lictmontet6r out al'reach.of children •d 'One handwttshtng'§ink-"with warm running%atcr,' (5) Outside windows'that arc.opened arc soap papertgwels to cash roost where children,are screened t diapered t l REGULATIONS? �' ro 0 REGULA'I`IONS n. ' ro it°i o. Q Q o' Q ° ° Q 5� U 0 a U o 0 Z> Z; Z. ,buWde doors kept closed 3: Swlinmmg and•Yfadhig nt the-Center 20 *' ;(T Ltghiinb adequatc�for,aetivitics '. a. Pools twa fcelor,more in depth(pages 20 21); * (8) Lighting adegaatefat nap/zest time to allow (1) Lifeguard At poolside at all times poet is:n., children,"fo Eicseen_ V use. Y , *j.`06.cratfoiral telephone for cenlcrbusiness only ' * (2) Lifeguard Triunitig Certificate,First Aid Certific tp CPR Certification on ftle *k: DIiR notified iftelephonc is,outafordcr or if, " Q)z L l'e6uard%not counted in ratios: n m;qr changes ;i. HQard'p"reyenticiti(p'iige I o)(Indaor Area) (4) Stamehild tatios'forchildren in'tha paoli' (,1) Center free.of apparent hazards tJ ' (a).onestaff for each child younger tham2% ycarsof age, * (2) Hazardous substances under lock and key or " (b) one,slaiT"for every h'children iges'2% 'conbinationaoCk }carsup;to 4 years (3)"t6ntainersIabeled � c one siaff for every.6 children�ges 4. eas: t!p tti G,years * (4) No firearms arainnitniiurin l ept,ar`'alloived ri * (d),;one-stafflgrevery'10 cliildnn`ajes 6 cei fi.r cxcepf-law forocm eiient years and older. , * (�) Stairways have hand railings in child's reach *" (5}Ratios determined by youngest child m;the pool.` J *' ;(6),Clcii<gias"dors`maiked`at child level * (6)-licrscuu counted iii ratios'mcct childtiirc yvorker quahfieations/in the pool at all times * (7) Yledicines and drugs kept.under loc k;and key,or * (9) Staff provided to super larch ldren in combination lock,separate ho►n.harniful items pool area itiut:not iiipool ". (fi) 13arricrs arauiid healers,r diators�fiins "* (8y Ifany.pvi of a child's body is'iii the accessible to cin'l, water„child considered in pool Exposed electrical outtcts have protective covers Pool enclosed with fence or solid wall at {cas(4 fi et m height;constricted to prevcnl * (10) Consumption of'alcohol or use:ofnon accessibility by children pr cnpttort narcohe or,illegal sutiatances prolribitcd (11) Smok ng:or use.of tobacco prohibited on b. Wading striietu i s less than 2 feet in depth: emises [ (page 21) pr i * (12) Rio:Contaminants'shall.6e stored and disposc`d of;properly, im.`Cemer kept.clean%Mining,donc daily(pages 18-19) " (1) At:least,brie staff with EPR&first aid at } each wading stri.ctu.re z " OY F cted * (2).Required ratios met as fated on page 24 (2) Car'cts vacuumed"daily p * (3) Avlcast two,stafl'at cacti wadingstructure * (3) Cke ling`does not interfere with children's * (4).Clean water provided cacti day. aotivilies a 2 Outdoor area(IL,C;5.,pages 19-20) _ * (S) Wading structure ernplicd when'noit in`,uk Sec:Chechtist P *a Oti street`loadriigJtioload'ing,providcd D 4. Away°from center activities page2h *b, 'Sep'tratc,areas forcGildren younger,than 2'/2(may NOTE: The Department of`.Human Resources be achieved by scheduling) does-not`lnspect acrlvkles away from the center, i including sWi0m(ng and wading'actAddfes. ,The s *c., Outdo, adjoins or is safely accessible licensee, shall assume, full .authorlty ,and; responalbrJlty Ior away from theycenter activFtfes +d: Out 0,11 iyz area free of apparcirt fiazarddtts i cotidiiions r t 2 i tv ct Cal Ca Ca m REGUI - L CLA REGULATIONS E U a c Q Q. a Z o Z` z° Z. 5 Furntstings and equipment.(11„C.,8�; !j: Staft with mfaiit-childCf'Rxtnd first aid pages 21 23) See Cheel.hsts v presetirdurutg all hours of operation Child Care Program (IL,D , pages. "k• Second staff available wlicn 7 or rnore. cftildrempresent/rcquired ratios met 2.4 7) l.. Required'ratios mauttained at alI`tunes "I. No staffon duly nroris than 8 continuous, ours, �. : on a regular basis * a;:.:OuP'lo I8:months A toI5 .'m Stafffree,•from.other dutics-while'working. twh the clirldren. j li.. 18mortthsOn01/,:years Ito7 5. infant/Toddler Rrogram pages ntontiis up l0 36 montlis 1108 a. Learning/t;rowth 5ctivitics:(page-26) ' e 2%years up to.4 years Ito'l 1 S (I) Encouraged to play with a variety of toys15 years up,to school'age I 10,18 (2) 7'inte outdoors daily,.,.tiylicn weather permits, *'g. School'ageupto 8.ycars` l'to2i " (3y Freedom of movement outside cribs daily °-h>syuus:aiidolAer Ato22 * (4)i Placed.omlurnrny part:oftimc.whileawake and observed, *2 Chtldrert'yomig;cr.than Wgrouped,separately (5) Staffialks to each child and.cncourages from older cliililren responac. Exceptiori,forgroup 24736 months * (Gj Cries/signsnl'distress investigated :immediately' b::;:Caception-for individual children's'needs L Diapering/loiletiiig:(pages'26-27) *3 Staffcounicd ln.ratio,only when giving full • (1) Clcmi,dry,diapers/clothing provided attention to the,childmn 4.,Saatff coverage:(pagcZ$) " (2) Wet/soiled.diapers/clothing changed prorn`plly a: Allohildren supcnised al all times. • (3) Cliatlg'iitg area cleaned and disinfected: + b. Staff-.assigned-responsibility for-same ' (4) No child left unattended while being infants/toddlers�each day diapered ' c: Subsdiutcstafl°available O (5) Nn;;child,diapered on the,floor �- ' rd: Nreclorauthotizcd`to conduct'ccaterbusiness * (6) Gacli:child"s hands wtrshed'aflcr diapering: " e- Staff person ut charge when director.is absent, * (7) Stafl'use';universal.prccdo ions Mien authorized loeonduct ecnter business diapering • tafTin';cach roon>;during'napping/resting , (8) Stafruse clean disposn6lcglovcs'for diapering,each childlfor each diaper change i " .g, Stalf'ablc to sec all the children ' (9) Wet/soiled Angers'placed in'covered,, ,5 plastic-lined container and disposed of daily ' h: IiaUoduring nappiaglresfing'(page;25) * (10).individual,,disposable-wipes used at each diaper change.disposed of properly (I) 0 up to.l8'tnonlhs 1'to 3 ! (11) Potty chairs'empt ed,rinsed,disinfected _l .. uftercach use • (2) 18 montlrs1up,'to1%yg*s 1,to;14 • (12)Diapering.aica,scparale from food service Sarea 2 `aind older :1 to 36` c. Napping. %yearsrestin pageV). 3 I REGULATIONS; CU. m REGU.LAfiIO1NS C C � O Q _ U: CL E E �. E CL O 0 CL U U Q O � Z Z Z Z lntanls lidwedlo fomt c wn slccp pattenis< (I2) 'fo dle seated whilc..cating * (2).infants placid on"back to sleep unless physician's *' {13) Child enc6ti' ged to experirnei lvitli statt meat mdiontes olh t noise self fi.edmg utensils provided * ( ),lnfants"who c an"casjly'tum placed on back but *- {14) Disposable utensils used only yltli cl'oscA allowed to adopt pr6ferred':positioit supervision * (4)`14posidoning device used unless spcci tied'b� * (15) Foods:eatcn from a dish v physician ,< * (5}",.Staff recognuc;differingneeds oftoddlers/allow * (16),[)isles,battles unbreakable to'"follow thcir�own sk,ep patterns d. Cribs,cots,and beddii g(pagq:27-28) (19) Drinkirt :water oRerc(totoddlcrs feev.bcntcctroccupied cribs " 48) Child not forced to cat; Cots positioned to allow space for access or *' (19) Food not used as roward or punishmen{ emergency t ait * (3),Cabs/cats ciciuted an( disinfected and`shects and'' *: {20} Child's hands;washed before and after y +�. covers.avashed before used`b anothct,child ✓ s»acks,after diapering,todcting * (4)For utfants„Clcall bottom sh cts daily or more' * (21) Stairs hands washed before food often if needed;"sleets fit snugly preparation and service,after assisting with toileting;after diapering * (5} Soli material prohibited m infant's sleeping. * (22) Individual paper towels for each washing environment no,ptllotvs;guilts,corn orters,,eto nt!drying * '(6) Ho infan'ptit io sleep on sofa;-soft mattress 6. ,Pt escl>ool/School-age`Pro rate: * (7) For toddlers clean bottom"sltecfs anflob a. Learning/growth;lctivitieti(pngcs:39-30}-, coverings wecklyi.,more ohcn if needed ` c. Feeding{pagc28_Z�) (1) Schedule posted * (1} formula,-,food for`nfants if.ptovided by,center, (2) V,tricty"of indoor/optdooractivities planned with parent orphysician * (x):it fonnuIaprovidcday center; Cady to=feed,. (3) Tiine outdoors'dally when weather permits, properly storcd'and handled (3)'Meals.and'saacks comply with requhcizrents, children Staff rage,convcrsalion aniaiig ld pr^, nfrt t ra,Ifonnulir'provided�by parent;'labcledr (5) Slafr tolgivc individual attention cash"child'' * g' led daily s * (5} Settles sent home orcontents discarded -avoid of (6) Radio,'fV;videos uscd:on`ly`to �. day' supplemetiOcnhance daily"phis * (6) Sipall hard:candies;nuts'not"scrved`to:children *• '(7) No childrequired to watch TV or videos utttler`faur ' * (7) roods that may cause choking{prepared ' "'(8) Vidcns'previewed by stall for. { appropriately for the child appropriateness J 1 * (8) i?eeding'scliedWe acc6rding tosliiltl's needs *` :{9} Sexualh explicit, tellingviolent.,frigh rh 11criais lirghifiitcd aifauts liild for bottle feeding �S b. Napping/resting( age 3Q) (10) No bottics.propped: " (I).Slaffrccogntzc differing needsol'etiildnn ' i (1I) Vhereable;infants allowed to sit'in fecdiitg'chair (2) Rest period for children in attendance more than5 hours 4 tv a) a) --- c c Z REGULATIONS a - Q REGULATIONS CL C :Q U c? Q ° Q 0 0 U ° Z Z (3) Rest Period,at least 45 minutes,not more than 2Ys * (I S} Ghiidren seated"whlc-eating a, hours r * (4) if a cliild who does notsleep,after45,minutes, * (16):No ctiild:farccd o car quiet, ilk * (Si Cots cleaned and clean"baftom sheets'and top sl ° (17) Children,dpt.allowed in kitchen sheetcovers,'provided before used;by anotherchild lr * (f> Clean,sliecis/co>xrs prpvidcd wcekly,;more oft if needed. - * (1 ) Childreo's hands washcd before meals: "and snack and aftcrrlodenng: positioned to alloiv space"for access or * (19) Staff hands washed before food emergency exit: . nreparation'and service said after assisting with toileting or contact with bodily fluid (i3) AGleastoncstaiff.ptesent:in each room * (20) Disposable;gloves used for diapering 5hiffalile to'sec"fall children (21) Individual paperlowels'for cacti%va ltiiig, arid drying c• Toileting(page 3Q) (22)"Cacreii meals,aud snacks meet : rgquirml-e is- * (1) Accoriting;to each child's needs each child's: , e Diseipliiia'ry Yrsictic%s"(pti"fie 32) hands washed` * '(2)Staffusc Unner`sal_precautions whcn'diapering. ' (1) Discipline,appmpriate to;age:aiid or handling bodily tlwds' deyclopnicnia)Jevel of tlic children § d: t:ceding(palges30.32) Nu corpprtillphysicalpunishment * (l) Children;in'attendance sccVcd bre akfrist or;a:nt. " {3) No verbal ul use: : snack;111' h;p,iet sn;ich ^=-M ` * (2j Meals and snacks comply with,'USDAguidelines * (4) No dis6ioline associated}vrth food,,naps,: on;pges:29-30 �' ortbathroom procedures * (3)'.'ltad milk served;n6,0oivdc:rcd,ittilk for drinking O`No,phystcal restraint as punishrnent * (4)""No child deprived ofineat.or°snack O No puuwliheritadministered by-another cliild * (5);Special,diefx"ry;necds inaccordancesvith written f. Stafff-I'aecnt"Con municniton.,(pnge33} instructions * (b)"'Meals,andsnacksgravidedbythe.center (1} Disci)iliac,,beliaaiorprghlemsdiscusscd l t` with parcpt z * :(7} Veriding nachin'cs prohibited in areas used by000r (2) Center opcn'to,visits'from;parciits at.an i Children ` time * (8) Sruall hard candies,nuts notscrvcd to Children r" . underoyF (3) 1 greats"infonnr 3 of righHowisit S .. (9)Foods that may cause choking prepared 5 (4) Staf]'avail able'for communication / appri ueiy for,lhe child Pro . corif6rcnccs" * 00) porlioits,of food suited to child's needs;sectinsi_ (S) Parents notified of complaint procedures ` portto(savailabl;e, *';(I 1} Unbreakable.or:§ingle.uso`dnnerware used (G) 1'aicrtls pro"vide;l cvithinormation•on influenza * (12,Sin le us@ capsor gl•rsses or a Jrinkin' fountain g. llcalth'irifarmatiga{pages 33-3f) }, gg provided far wafer * ,(13}D inking,waterblTered dui tig;the day ! (t) Will admitted ,7 5, P * (14)"Food ser,e d on"itt2lividual dishes or napkins,not• Ifa Child becomes ill or ifi`mjured,he/she" dtwayontahler is,sepaiaied from group;.butcontinuausly. supervised. J 5 C C Q. �°chi -CL 'REGULATIONS REGULATIONSE V a Q U CL Q o o z z z 0 * {3} !'ar�nf;oFtll/utjared child notifieQ mniedilitel� Children atidstaffwash harids'afle`r m?d,:rcqutredtocomefoYchild dandling-aiirrals * O If goat cannot Tie reached or tllnecslinjury ['la,ns:(pgg encyll) P paredncss and Rcspotise severe emcrgencyntidicat attention rs obtained Scc`Checklist. Parents notifed oF��pos ire to con / tagious> Tratls(lortatiotl(11, Pages 3$— dQ) diseasecon�lifitin. Y _ � ` (G) Parents urocdt0 nolfy center if child is l Transportation provided by the Center exposed to ucontagious-tsease�outside canter' (Rages 3840) * (7) Center reports contagious diseaselcondition to NOTE.' The:Department of Human Resources=does' health department as required NOTE.' inspect actwfiles away from the center 'lncluding swimming and wading actrgibes The. (ff) ItifedreatranJi4Fedcal,Prdcedures(pages 3#=35) Ilcensee' shall assume full authoirty and Docsthccenter'sstaffliv tttCdicu"tion/medical r Aonslbilily.1 awayfmm Me,cenler.'aCt(Yltles. ptacedurea3 Yes' Ntwo * (a) tvtedreatton'a-minister,"cd;only with Written Does th Centers staff Provide transportation?" i authprtzatiorrfrom parent Yes' \o, * (b);No tilankel autlranra, forms formedicauiin *.a. Transporiation,checklisls escd as required * (c) ltcd cation n origin l container;labeled G. 17csign ted stafTcoinplcte.nndslgn checklist *_ (tl) Measuring devacc.providcd` *c. Drivcrsgps checklist,indicating he/site dais . Checked.eaci:celt (c).Mcdication administered by designated Six S '*d, Checklists kept on file for current year plus 2 (t) Cocked stbrage;provided'for medcatipn additional,years ' (g} dedication returned to parent ar disposed of *e; Centcuresponsible for.picl ing up.child at ,whgnsita longerncede� designated location`and delivering chili)to designated person (h) 7 tme?atid,date,lnedreation is given is docutnented m;wnUng keptin child's file/copies f..Supervision irteenter vehicles(page 39) available to,parents on rgq`uesi, i; l; ,(9)`1{ygienid practices;(pagc 35j ! (1} Staff=child ratio met for children ynung4r than lawful school-dgeAriver not counted w r ca) Totict flnicics lalicicd andstoredseparalely " {27 Children of lawtidschool age and older; ri"'e.than 15�tronsporlcd with only the driver * {b} Used paper towels types,assucs ate:dispose- * (3) For 15 or more children oGla�yful school of itnaudrately Tallowtng tse, age,nac staffil addrtioii to dnyet_ * (e) T a_ct paper provided,for use by children and * ,(4) For 30 br mare children`oflawful school staff10, age,:hvostalfin addition to driver, (d) L•xtra:chlidren'sclothingavailablc * (S) No child Ictt iir a'vehicic withouradtilt supcwisiait (I,1)) Animals;un[he prs nises.(pages 35.36), (¢) Staffacvompany"each child tmder2%idiom vehicleA,a care ofr designate d person � (a) Aggressive muinals not kepl'in wnte'o'r.ai *- (9)-Staff visually supervise each chdJ 2lx.and . . . grounds older from vchicl-to cart,of designated person (b) Ammalsthat c ouid pose;a tltrcat'to.heatth'and: *. (8) Driver checks caehseat at�each loon'tinn to safcty,kept away,from children veil na chi Ich-on thevelticie., {c}`Certiticale of rabies.vaccination an frlcfnr ' amntals >;> safety precautinns in vehides,(pnges=3940): (U). gnmials':con�ned cages:kept clean,food,and J * (L) Stationary sentiizg foi diild;each elrlii 1 water available }" seated while vehicle ismovmg se m ' (2j t3oprs lie�ed cvhep,vchicl¢is moviig k l.. 6 t,. Y, 2 C n C•" �. T .0 2 v :REGULATIONS Va REGULATIONS '6 E CL o a p O C :r Z; Z o .Z, Z 1) Children nortraiisponed ii frc it'seat of vchieie 2. R`ecordS oti taff(p;tges'42-4rS) With passenger side air bag (See Staff Checklist) ' (4) briver and all passengers"sccitred wl cn vehicle *a.Records omstaffkepI confidential is moving. * (a) Efibhxhild under t ye at ar wughurg Ecss than *b. Records on'fl'c at time cif'cmployment 20,00unds secured m rear facutg°chl)d restraint installed' spud condito anufacturcrs•,pstntcttons,.irraintaincd in e; Records on staff muinlained'at Icast two ears g i Y. ` afkr person.hus let' (b)"B"acli child under 5 years or,6+eighing less than *d. Records filed alphabetically 40 pounds secured in fornvard facie;child reslrtinl installed aec,orgdm w manufacturer s instructions, g Mamtamed lit pod eonditicn. " maintained separately- - e. inactive filcsut scat i c) Each eluld under 6 years'sccured in�'a booster I Health (page 45), nstalled according i�mantifacturcr's,instructions . mti ntamed to good condition. ! *a. Medical exam and TB"testcn the at tinic.of empioyMenc M 'kh child G and oldcr;,fhc driver„rind each *b StafT with.symptoms of.conlagious adult;passenge rsecured lit tut and vidualseat belt, disease/condition not in center properly anchored to,ihe vehicle, h. •Vehicle safety check done annually,signed by mechantcanddated ftled'in,centei' Character and.Suitability(YI., G., pages 47-51') 5 Transportation„provided by' *>I Character and suitibdity review conducted"cn; parent%guardian(page 40f requiter!persons(every>years) t h. *a.:Each child accoln lii d into;and out ol7cepicr `"�, !a Pcrsoiis wuh"dcienninatign of unsuitable �.1 character terminated ` *b,"`}aclt child stgned"in and signed,out. b l icensc4 informs:DIIR"of any criminal e convictions or current.char2es *c My,,childtivho arrives by walking or bus,.st ncii ii7 '" g Ad-m�nl<strat>lon. "//IL,.H by staff. l a, es 52-56 E• *d :PhotoID"rcquged".uhenreleasingchilli.to' unfamthar desgriatedperson' 1`.0, .ApplcanUlicensec.(Page 52)" i� Staff(ITi, `F., pageS 4.1-4G)` a,, 1 tct nscc;assumes full authority and' res onsibtli p ly�formec'tin and�maintainutg g� tt✓) MuumumSt�ndards �„ 1. QUaIiClea`tions(pages 41-42); b.,l iccnscc provides olicating fiords 7 Center director meets gtrllifioations c._Licensee dtsignates,directorand delegates b Childcare,tvorl.c rs/teucltcis meet qualifict Lions and atithanty tnd.responsibility'fpr operutioti and have`IZ hours oftraining ealhin 30 days,pf t mploymc�ttt management of center 10 director * Child care,workers/teatchers meet requirements for d.,:written,operating:policies-established CCDI training wtihin 90 days(ifapplicablc) c Atcs/assistitttcacfiers riot"cotnteil in ratio, (1) Copy of operating policies provided to Parent at of child's enrollment *d Service staiTnot counted in ratio unless they meet 4 quahficaharis and•try giving lull attention t6 children' f)1-fR) Copp.ofojerating policies submitted to *e: Driveratlea3t19,valddnver's,hccrise: (3) Operatingpoliciesdcnot`contradict �fiaimitm Standard *f Sii6ahtute staff meet qualification Orstiff`for (4) Changes in operating policies prnVidciiAto etihom IsubstituUng ; parents andto DHR;_ 7 i 3 i U V r REGULATIONS Q a REGULATIONS n `—' U ". Q ° O Q 0 0: o. Z 'Z Z Z. 2. Reports,to the Department(pages`52- b..Agc r.;nge of cliildren.in cure conforms to ages 53) snecired (11 P. Requirement's fordrop,in;cari"mel a:.ThCfollowing,reported to-D1•1k mini.to recurrence:: ( Children s Records;_(ptiges,+65) (See Children's Checkhst) ' (1;) Chang@'in ownership *a Children s rccords and information about children and their families kcptconfidcntial "(2)Change in,location *b Individual rccords on each child on file on first day of attendance S (3) Change;;in Dit:ctorofcenter (1) Children's records.rtutintained2,years,after child has left-Ihc center S (a) Change in chief cxcc__ut ye office.1..1 oration (2)Records me'd alphahctically or members o f board * (5) Alterations to'ccriter orgrounds (3)Inaictive,files maintained°separately (4,Major,changc;or cxtulsion of hours or program s 5. Center Records(page 55) (7} Cl augcin address or t I cpdione number The foll6 nl rccords kept of file`forthe cur'reni ycarplus qvo additional years: b The following rcportc8 to l)l1R,within 24 hours, sn.Dailyattcndancerrc ords,oii all slri(r:and. written reportIvithin 5 days: children l i ' (1.) Any iUncss/injurry ofchild or staff requiring C *h; Transportation checklists ' professional nlcdtcal:treatment. �,l c ` (2) Any Illness/mjtiry.ofchildorstaffrequiring. em Vic. Vchicls safety check ,c �rgcncy m cal edi treatment * (3) Any death otWf ing.in'the cchidrordurin�.,ilva V i o ) "d. 5ign in/sign out;shcetsi from center acfivnies: - * (a) Mujof:daniageto fain ty: 6. Documents.to:be posted(pages 55- p SG) * (S) Interruption of the center's electrical,teie drone orr gas€service. • (6) Any;lftigation involvingdte center a. Most rcccnt license,permit,or approval' * :(7)'_Ajik tiatrc accident involving day-care children b;.l'ublic:notice.farru using'tratisportation provid d by,the center S * (8).And direst of liccn$ce,`st lfl>4nlployee,voluntccr *c. Mast recent liccrunS.evaluation ° (9),Final disposition of any'childafiuseUneglecl *d, Most recent deficichcy report mvcstigation involving licensee,stair,employee, volunteer * (It)) Am ineiduit in witichi he hcaltlilvclfare or *e. Correctiveladydrse actioil notices safety;of a child=is a(risk- * (l E:}.Any diristrous cvcuts *'f.;Most recent fire iilspcc(oii report }/ "c. Child abuse/neglccCreported;a_s)r_equired by law' *92 Most recent health department inspection' caport cring Food d"pemrit or writttin;pc.nn,ission for ,F L:in,y�*'tig` Licensce andAl stait employees,volunteers `*h; Menu for.il Gals andsnacks/dated perate wiIb;DHR on'aily gW.10buse orner-i6a alwn i, Name tuld`ac(cphone:nuuibcf-lbr:(page 56) t- (p g ) (1)'Firedepartment 3 .Admission,,ProcCdures A es53-54. Total•number:of children m care;includingchildren * 42) Law enforcement oit the premiscs,children'iii trausrt,children:on field trtpsSon fiorms lomunlber specified � * (3) Medical assistance(ambulance or rescue) �. i 8_ , ai c c =c REGULATIONS -CLE E' n. REGULATIONS .Q Q n 'E U v. Q. o E Q` ° 0. Q c +� C) O . C. 0 z Z Z; poison.control`'ccnter Q)'Itequired'ratios for day time maintained whilc.children are awake(see page 23) (j) Substitt klielp (3) At[cast one staff,atIcast 19 uieeting child carrworket'Q1 lfficatiom,with CPR'And I t:aid•in *j. �inergency preparedness and Rvsponse,Plans ((� center`during hours ofaperal'ion *k Nantc'ot,directbriitaffperson-in charge + 0j,All childrensupm6ed•at all times Nighttime;Centerm Oh., L�, " W) F,actt stafPassignc ,responsibility forsami; children nightly pages 57-M) ` (G) At least one-staff in cach.room of sleeping, children In addition to t1mreg61ations set.forf6 for tis,y care centet s centers pi ttvi'ding•nigfiftime care. *'(7) Staff able to see all the children at all times (after 7 pm.)" shall rheef 'alie following regulations or modifications * '(8) All stiff awake and alert to needs of children Does the,center provide care sifter 7:00 pin:? NO, ❑ iIo tT1 (9) At[cast two;staffua ednter whenever Does this center provide ca ftermidnight ' c}iildreii:an'pra enU rcquared ratios met k Yes: �o: � "`„(10) Liglatingmaintaincd so children"tire visirlc 1 a�•liilcsleeping I`. Equipncntapd furnishings-b. Nightly activity schedule:-posted (page 58) *a, In centgrs operatiing,past midi ight,'cribs or colts, (I) Outdoor time avaiNble during daylight,hours fitted tivtll►,a.waferproofmat tress shall bcprovidcd:for each child * (2) Staff:i ssist each child as needed,iirdressing. i and grooming *b In center s,operating past miciniglit,therc,sliall beat' ood-(Page 58) (cast one 'atiting:facility'foreveryI5 children I ' i 2. -,Child Care'Progratn (pages S7-58) *'•(1) Breakfast served to children going directly to schopl a. ;Staffing(Pages 57-58)' * (2j Evening Hied[served to children in attendance (tj?St.fl-child mtiaforslceiiing children d:.:oathitig(Page 58), If.any,c!>Ild is'.batlied: Q) 0 up to;l8;months 1 to°$ � ` (I) Cleuii"watcr:providcd for'each child ti niaiitlasup lo`2Y- I to 14 (2) Each child bathed separately- l (c) 7 2Yz-up•to.4,years l•to18 ' (3),Each'chitdsiaperviscdwhilebathino i ' (dj j ycaWand,older I to 25 * (4) lndiviilunl soap;',foivcl and wsaslicloth provided foreacla child The deficiencies noted-have been discussed fvith mc. Failure to correct the deficiencies can be,the basis for adverse lictidne None of these requirements a"re to be.,interpreted to allow anyone.:to, operate m v>Iol -ion of,the Minimum Standards A facility licensed/appro by the Department: must meet;,M><nimun► Standards at aIl•,tm`es. It is thc';es ansibil' • of; censee to op'crate in complianeemith tho' mihimuin Standards: g u're:of licensee or �ignatcd; t:tff Date 9 F a. Emer.2ency. Preparedness and Response Plans Checklist (O;)indicate's compliance observed by DHR Liccnsing Representative (I)_ikdica'tes not incompliance (S') indicatest6ri tifted by staff in charge.(use only for#plan updated yearly,written documentation trust be on file)" Tlte:plau slrtil!`Inelurle-prncedurc�t/tnJ w!l!`hc rrsed.t�r prepare fot The j la�i tilioirlrl.rilso be h clmiive of an�1 respgn to 1hC:. INwiltg types ojci�terge�ic�/�Ir�asreraitiritlinits: *Weather emergencieslnatural disasters;; *Current•emergency plans and procedures; Severe Thunderstorms * Tamadocs: Flash'.Ilooding 'Major snowfall ;Bli77Ard`s I sloittis- * -Farthgta}es *Lockdown or,evacuation dueato twrea'ts of vtoiciice *Locatipn,anal use of fi'rc extinguishcrs *Evacuations due'to; *#D"ocumentat on:'ofihe-following quarterly dMis; * I azardous,matcrials ripe Spills * Cas leaks T6rnado #f * B6mh;tJ4eats * f,ockdownAIL Relocation' *.Infectious>ili erise;emer. encies g *Telephones;for�on-site and off-Ate. Loss:ofpowcr,water,'or heat; *Ucatiori.of'tlie first_aid and emergency-supplyki s *Other threatening situations: s Tire:rlisirsler plan,shiill:Incltnlc.flgNih fgr:, The Ehiegi dhey.Preprire lriessaud RGspnnse PMns shbuli!'be., i *.Shelter to phtcc or evacuation *Available to:all st:iff'and employees *Assisting nfints,and`children.witWspecial`needs'and/or *Posted in-1 Conspicuous"place health-conditgons *Ret nrficati'oii ivith'Ohe6fits *Submitted to tife'D'epn tinei t f` *Su ;Iies needed forshelter in lace; rocedures ` p P parents/ uardians ( -Pn p p Co tes: rovided to--All g *Transportation disaster.;proccilures *Staff training/reassignment ns;apprapriate ' �#Plan uptislted yeiirly *Confact:ivithaocal emergeircy management'gfficials: 1 d t.. i I P Y jt< 7 1,l� i �E I Checklist for Infa<nts (;O<")mdtcu es compliance.observed by.DHR:Licensing Represctttative (;r)indicates"not;in compliance. (X)'itidicates not uppticabte, Ram-6-of:te'a`cher%room;# *Agc of�chiltlren i *Number.of children *Plumbcr�of staff Mnrmut:rE rri`n:erit Re ttirerl or.Errs t Ghqup of.,Gullrc�ri 71ro ib io"s-2 Or child aims vs-C` s a variety of.age appropriate music' book§F2 er child Gar'uballs 8+inc hes=1 7-5-7 :Nestin?andstackitin'tovsa2 sets v 3 , MmNble bab :doll=l i7 Ntu'§icahto`-1 +.Colorful ictures and posters =Acfivit''biixe"s;'such.as,bus;-boxes=3 ; 'f r i k r rOEM mum *Dfii aitfg area p, "Sink wauti a' tet, io lia cr towels { '!Plastic-lined eovercd'container Tub "ortatile"'liistic' ' c acci ta61e "Feednt <clinir's Crib! et ofs acc'between occ-- ied cribs. .Water roof'ntattresS,sheets 'indoor thennotneter%Out ofreach.of children `Shelvtn fore'to 'iien[and 5u lies/anchored" 'Individual,'labetcdslora c's ace fot':each child ' :*Furnntikcliildstzc�olcan, `ood.conditioit Tiicri it US Consuliicr Prod c Safety Act of:2l'68' -Elcctri ca!°oinlets;covar`ed tBarricrs around hcaters,:;fans. "Il.izardoas'§ubstaitces!locked 'Gontatnersaab'"elect. *N(cdicatdori_locked: !Screens on;%Vindows:which aie"o eni d *Li titiii adc tiatc - k' Y. �r H. Checklist for Toddlers (age .18 months-21/ years) (0)mdlctites comphance:.observed by DHRLkensing Representative (,r)"mdlcafes not.n com�lialt;ce (X)`indica"tes riti Pplica.. e *N'ame.oC; ea¢herlrooin>#. of_chil'dren *Number of,children ��" *Number-of staff tYliniriiiui:E"ui ent Re uire t; or.Eadt.Grott a.,Children, Lar+c`ion•tozic'cra"ons!mitikers � ; Non•tortc ugh - !, Coloit'a1 ictures�and. stcrs; A.device that. f`s a vaii¢N of�e a i tro riatrniusio Mtisic5l loVs=fi Pdsli`and ullanvs-2. ... Lar c cnrs.1;Tmks,bD'Iii;'01e.=3i Sit-otrridin .toy-2 La e.'soli balls-2r-._,. B66kss2 ear.abild � A e ro tria uzsles-2 earn"lets with all, iems) Nestin*and stackin•do s-2 sets': � „;, Non-wooden lioitdin blocks( "roxitnatcl'20 iioir-inteilockln' t x Aabvdolls-2 com late with all 'ails Doltclothes'and,blankers, Doll,15ed=1 To'.telc lions 2>: Pois� aiis;buckets;lar a plasticls cons Child=sire-s"to4c� £ Dres's=u clothes •Dta'inn aica !Sink•avannwatcr'soa, a er.towels 'Plastic-linbil,:co4eted`coniaincr Tub('otia6le )astic t e'acec fable): !Potty;c)taitsscTeatted+'di§infectcdletn tied 'Fecdin g,chair(s).oraable atid.chairs •Cribslcols: Waif`ioof mattress`(as),ilia is,:coyerin s •litdaor."therntonictcr/Out orreach'orchildred "Shchil Cote"ui lnent.unilsii Eteslaiichored !Eurnitbre'thild size;tidal) good):condition "Siidividitilrlabeled slom a ace roreach child t !Elcctiical:ouiiets;covcred. "F3arricrs around fieatets<fans i; •Hazardous substances locked !Containes'labeled •iviedication locked 77 1.*S6icc windows which`are,-o encd 'Li htinli<ade"uatc 3 j. 4. 1.2 Checklist for 24 months up to 36 months (O)indicates compliance observed by DHR Licensing Representative (I)indicates not in compliance X indicates not applicable *Name of teacher/room# *Age of children �- *Number of children *Number of staff Minimum E ui ment Re uired for Each Grou 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) Books-2 per child A device that plays a variety of age appropriate music Rhythm instruments-one for each child in the group Hompliving/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 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 Furnishings and Equipment *Diapering area *Sink,warm water,soap,paper towels *Plastic-lined covered containers *Tables ace and chair for each child *Cots/sheets and covers *Indoor thermometer/Out of reach of children Written dailv plan or schedule posted *Labeled storage space at child level *Shelving forequipment and supplies/anchored Designated activity areas Facilities *Electrical outlets covered *Barriers around heaters fans *Hazardous substances locked *Containers labeled *Medication locked *Screens on windows which are opened *Lighting adequate 13 Checklist for Preschool (age 21/2 years to school age) (O)indicates compliance observed by DHR licensing representative ( d)indicates not in compliance X indicates not applicable gin A *Name of teacher/room # *Age of children *Number of children *Number of staff Required Equipment(Ill, L,p.67-68) Mininium Equipment Requiredfor Each' Group�fChddren Art Easel Non-toxic playdough or clay Large non-toxic crayons/watercolor markers Large sheets of paper Non-toxic finger/coldmater paints-primary colors Scissors(blunt tip)-2 pr.Per 5 children Non-toxic glue or paste;tape Paint brushes four'1/2 and 1 inch in width Lducation-al and Creative Toys Large/medium building blocks-app.15 non-interlocking Small building blocks-app.100 non-interlocking Small cars,trucks,boats,etc.-6 Age appropriate puzzles-8(complete with all pieces) Interlocking manipulative play sets,different types-6 Matching games-6(no more than 2 electronic) Puppets-2 'Homvliving Area Child-size stove/sink(or combo) Small table and chairs/benches Cooking utensils/dishes(unbreakable) Doll bed or cradle Dolls(complete with all parts)-2 Doll clothes and blankets 19 Dress-up clothes for boys and girls 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—1 per child in group Nature Studv and Science Magnifying glass Magnets Nature collections Measuring and pouring equipment tionaf Furnishings and Equipment' *Tables ace and chair for each child *Cots.Sheets covers for each child *Indoor thermometer/out of reach Written daily Ian or schedule posted *Labeled storage space at child level *Shelving forequipment and supplies/anchored Designated activity areas Facilities *Electrical outlets covered *Barriers around heaters fans *Hazardous substances locked/ *Containers labeled *Medication locked *Screens on windows which are opened *Lighting adequate 14 Checklist for School-Me (O)indicates compliance observed by DHR Licensing Representative (Jr)indicates not in compliance (X)indicates not applicable *Name of teacher/room# }, *,Age of children *Number of children *Number of staff Minimum E ui ment&quired or Each Grou o Children Required 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 x " Suited to age of children-1 per 5 children Books suited to age of children-2 per child Non-toxic pkydough or modeling clay Non-toxic tem era paint Brushes �c Non-toxic crayons Paper(variety) Non-toxic glue or paste,tape Scissors 1C A device that plays a variety of age appropriate music 5C Interlocking manipulative play sets—1 per 5 children Additional Furnishings and Equipment *Tables ace and chair for each 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 Facilities *Electrical outlets covered *Barriers around heaters,fans *Hazardous substances locked *Containers labeled *Medication locked *Screens on windows which are opened. *Lighting adequate ti 15 Playground Checklist (O)indicates compliance observed by DHR Licensing Representative (I) indicates not in compliance (X)indicates not applicable Required Equipment(III.,I., p. 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 Balls-3 Climbing apparatus Crawl-through equipment Digging or sand area Toys for digging Tacilities *Outdoor play area enclosed by a fence or wall at least 4 feet in height *Fence or wall free of sharp edges *Gates secured *Shade and sun areas provided *Outdoor play area free of apparent hazardous conditions * Concrete/asphalt not used under equipment * Area well-drained * Equipment not designed to be portable,securely anchored *Stairs/steps have hand rails in child's reach 16