Loading...
Evaluation Form (6) Revised 3/2020 ALABAMA DEPARTMENT OF HUMAN RESOURCES CHILD CARE CENTER LICENSING EVALUATION ANNUAL Health and Safe Guidelines Items marked with an asterisk* Name of Center: Date(s) f Ev luation: L. 1 � c� cou d la 4Zb Address: L� 'l' Date(s) of Fo low-up: County: L\alr Y_Q Purpose of Visit: Rri n ual Telephone #: (�S� �� (p� Director: Le An � n License ay Night YJ Excepted Licensed Capacity: Day/ Night x Days of Operation: Day�e ,Night Age Range: Day Night Day/] Night�j g g Hours of Operation: �, 3d aV ✓\ License Number: V oo v Code' 36 IF#" Effective Dates of License' ® - Observed by DHR Licensing Representative S - Certified by Licensee/Staff in charge From: ® To: D -Discussed with Licensee/Staff in charge . 9' �� X-Not Applicable-Not reviewed with Licensee/Staff in OZ 1 / � charge Deficiencies Noted: Yes o D 'cen 'ng presentat' Sections to be completed at the discretion of the DHR Licensing Re entative. U U tU" U U N C _. U U REGULATIONS Q- ° -a REGULATIONS a Q E o CL o CL U Q U Q U Z Z U Z Z Facilities (II. C., pages 16-23) b. Hazard prevention(page 18)(Indoor area) 1. Indoor area(II.,C.,4.,pages 16-19) * (1) Center free of apparent hazards *a. Bathrooms located on same level/under same roof O * (2) Hazardous substances under lock and key or C combination lock/Containers labeled J (1) One flush toilet for each 15 children O * (3) No firearms or ammunition kept or allowed S in center except law enforcement (2) One hand-washing sink for each 15 children * (4) Stairways have hand railings in child's reach Of (3) One tub(portable plastic acceptable) * (5) Clear glass doors marked at child level * (4) Fixtures child size or adjusted for easy use * (6) Medicines and drugs kept under lock and key or combination lock,separate from harmful items 0 U U a a) a Q ca 2 ca U Ca REGULATIONS L — — C a- — Q REGULATIONS C_ E °- U O U Q Q V Z Z U Z Z * (7) Barriers around heaters,radiators,fans b. Wading structures less than 2 feet in depth: accessible to children (page 21) * (8) Exposed electrical outlets have protective covers C * (1) At least one staff with CPR&first aid at J each wading structure * (9) Consumption of alcohol or use of non- * (2) Required ratios met as stated on page 24 prescription narcotic or illegal substances prohibited * (10) Smoking or use of tobacco prohibited on * (3) At least two staff at each wading structure premises * (11)Bio contaminants shall be stored and disposed of * (4) Clean water provided each day/Wading properly structure emptied when not in use 2. Outdoor area(II.,C.,5., pages 19-20) See Checklist 5 * _a. Off-street loading/unloading provided * b. Separate areas for children younger than 2% 4. Away from center activities (II (may bea achieved by scheduling) C.,7.,page 21) * c. Outdoor area adjoins or is safely accessible NOTE; The Department of Human * d. Outdoor play area free of apparent hazardous Resources does not inspect activities away conditions from the center, including swimming an wading activities. The licensee shall 3. Swimming and Wading at the Center assume full authority.and responsibility for (II.,C.,6.,pages 20-21) away from the center activities a. Pools two feet or more in depth(pages 20-21) Child Care Program (II., D., * (1) Lifeguard at poolside at all times pool is in pages 24-37) use * (2) Lifeguard Training Certificate,First Aid *1. Required ratios maintained at all Certificate,CPR Certification on file times * (3) Lifeguard not counted in ratios * a. 0 up to 18 months 1 to 5 (4) Staff-child ratios for children in the pool: * b. 18 months up to 2%years 1 to 7 X. * (a) one staff for each child younger than 2%years * c. 24 months up to 36 months 1 to 8 of age * (b) one staff for every 4 children ages 2%Z years up * d. 2%2 years up to 4 years 1 to 11 to 4 years v * (c) one staff for every 6 children ages 4 years up to * e. 4 years up to school age 1 to 18 6 years 0 * (d) one staff for every 10 children ages 6 years and /� * f. School age up to 8 years 1 to 21 older. [/ * (5) Ratios determined by youngest child in the pool * g. 8 years and older 1 to 22 * .(6) Persons counted in ratios meet child care worker *2. Children younger than 2%:grouped qualifications/in the pool at all times separately from older children * (7) Staff provided to supervise children in pool area, 3. Staff coverage(page 25) but not in pool * (8) If any part of a child's body is in the water,child * a. All children supervised at all times C considered in pool J * (9) Pool enclosed with fence or solid wall at least 4 * b. Staff in each room during nappingtresting feet in height,constructed to prevent accessibility by children * c. Staff able to see all the children 2 U U U U U � � ( N 1z REGULATIONS .Q REGULATIONS Q U Q O U Q o O o O Z Z Z Z d. Ratio during napping/resting:(page 25) * (4) Toddlers seated while eating * (1) 0 up to 18 months 1 to 5 * (5) Child's hands washed before and after snacks,after diapering,toileting * (2) 18 months up to 2%years I to 14 * (6) Staffs hands washed before food preparation and service,after assisting with toileting,after diapering * (3) 2'/�years and older -I to 36 * (7) Individual paper towels for each washing and drying *e. Staff with infant-child CPR and first aid present during all hours of operation 4. Infant/Toddler Program(II.,D.,2., 5. Preschool/School-age Program pages 26-29) D.,3.,pages 29-32) a. Learning/growth activities:(page 26) a. Learning/growth activities(pages 29-30) * (1) Cries/signs of distress investigated immediately b. Diapering/toileting:(pages 26-27) b. Napping/resting(page 30) * (1) Staff use Universal Precautions after diapering ` * (1) Cots cleaned and clean bottom sheets and and contact with bodily fluids top sheets/covers provided before used by another �1 child * (2) Staff wash hands after diapering each child * (2) Clean sheets/covers provided weekly, more often if needed * (3) Staff use clean disposable gloves for diapering each child/for each diaper change * (3) Cots positioned to allow space for access * or emergency exit (4)Diapering area separate from food service area c. Napping/resting(page 27) c. Toileting (page 30) * (1) Infants placed on back to sleep unless physician's *(1)according to each child's needs,each child's statement indicates otherwise hands washed d. Cribs,cots,and bedding(pages 27-28) *(2)Staff use Universal Precautions after C toileting and contact with bodily fluids J * (1)_,Two feet of space between occupied cribs d. Feeding(pages 30-32) * (2) Cots positioned to allow space for access or * (1) Children in attendance served breakfast or emergency exit a.m.snack,lunch,p.m.snack * (3) For infants,clean bottom sheets daily or more * (2) Meals and snacks comply with patterns often if needed,sheets fit snugly USDA guidelines pages 29-30 * (4) Soft material prohibited in infant's sleeping * (3) Small hard candies,nuts not served to C environment,no pillows,quilts,comforters,etc. children under four �J * (5) For toddlers,clean bottom sheets and top x * (4) Foods that may cause choking prepared coverings weekly,more often if needed I ® appropriately for the child e. Feeding(pages 28-29) * (5) Children not allowed in kitchen * (I) Meals and snacks comply with requirements * (6) Children's hands washed before meals and snack and after toileting * (2) If formula provided by parent,labeled, * (7) Staff hands washed before food refrigerated preparation and service,and after assisting with toileting or contact with bodily fluid * (3) Infants held for bottle feeding/No bottles propped * (8) Individual paper towels for each washing and drying - U U U U Z REGULATIONS c� C a m E ELREGULATIONS Q U Q U Q U o o U o 0 Z Z Z Z e. Disciplinary Practices(page 32) e. Supervision in center vehicles(page 39) f. Staff-Parent Communication(page 33) * (1) Staff-child ratio met for children younger than lawful school-age,driver not counted g. Health information(pages 33-36). * (2) Children of lawful school age and older, fewer than 15 transported with only the driver / * (1) No ill child admitted * (3) For 15 or more children of lawful school .y( age,one staff in addition to driver " * (2) If a child becomes ill or is injured,he/she is * (4) For 30 or more children of lawful school separated from group,but continuously supervised S age,two staff in addition to driver * (3) Parent of ill/injured child notified immediately * (5) No child left in a vehicle without adult and required to come for child supervision * (4) If parent cannot be reached or illness/injury * (6) Staff accompany each child under 2'/z severe,emergency medical attention is obtained from vehicle to care of designated person (5) Nledication/Nledical Procedures(pages 34-35) * (7) Staff visually supervise each child 2% and older from vehicle to care of designated Does he center's staff give medication? person 1p'Yes No E Safety precautions in vehicles(pages 39-40) *(a) Medication administered only with written * (1) Stationary seating for child,each child authorization from parent -5 seated while vehicle is moving *(b) No blanket authorization forms for medication * (2) Doors locked when vehicle is moving *(c) Medication in original container,labeled/ C * (3) Children not transported in front seat of Measuring device provided J vehicle with passenger side air bag *h. Emergency Preparedness and Response Plans * (4) Driver and all passengers secured when (page 36-37) vehicle is moving See Checklist page 9 * (a).Each child under 1 year or weighing less than 20 pounds secured in rear facing child Transportation (II.,E., pages 38— restraint,installed according to manufacturers instructions,maintained in good condition 40) 1. Transportation provided by the Center * (b) Each child under 5 years or weighing (pages 38-40) less than 40 pounds secured in forward facing child restraint,installed according to Does the center's staff provide transportation? manufacturer's instructions,maintained in good ❑ Yes X.No condition. NOTE. The Department of Human Resources * (c) Each child under 6 years secured in a does not inspect activities away from the center, booster seat installed according to manufacturer's including swimming and wading activities.The instructions,maintained in good condition. licensee shall assume full authority and responsibility for away from the center activities. * (d) Each child 6 and older,the driver,and each adult passenger secured in an individual seat *a. Transportation checklists used as required belt,properly anchored to the vehicle. I I i�� *b. Designated staff complete and sign checklist *g. Vehicle safety check done annually,signed by mechanic and dated,filed in center *c. Checklists kept on file,for current-year phis 2 5. Transportation provided by additional years parent/guardian(page 40) *d. Center responsible for picking up child at designated *a. Each child accompanied into and out of location and delivering child to designated person center 4 U U N C U U Ri U fCII U REGULATIONS CL — Q D- o Q REGULATIONS o o Q. U 0 Q z Z z° Z *b.,Each child signed in and signed out O * (8) Final disposition of any child abuse/neglect investigation involving licensee, staff,employee,volunteer *c. Any child who arrives by walking or bus,signed in * (9) Any incident in which the health,welfare, by staff or safety of a child is at risk *d. Photo ID required when releasing child to *.(10)Any disastrous event unfamiliar,designated person Staff(11., F., pages 41-46) *c. Child abuse/neglect reported as required by See Staff Checklist law Character and Suitability (11., G., *d. Licensee and all staff,employees,volunteers cooperate with DHR on any child abuse or neglect pages 47-51) investigation 3. Admission Procedures(pages 53-54) Administration (11., H., pages 527 *a. Number/Age range of children in care C 56) conforms to number and ages specified on license J 4. Children's Records(pages 54-55) See checklist 1. Applicant/licensee(page 52) 5. Center Records(page 55) 2. Reports to-the Department(pages 52-53) The following records kept on file for the current year plus two additional years: a. The following reported to DHR ljr to occurrence: *a. Daily attendance records on all staff and children * (1) Change in ownership *b. Transportation checklists * (2) Change in location �` *c. Vehicle safety check X (3) Change in Director of center S *d. Sign in/sign out sheets (4) Change in chief executive officer.of corporation 6. Documents to be posted(pages 55-56) or members of board * (5) Alterations to center or grounds j a. Most recent license,permit,or approval, * (6) Major change or extension of hours or program b. Public notice form * (7) Change in address or telephone number C. Most recent licensing evaluation b. The following reported to DHR within 24 hours,. *d. Most recent deficiency report written report within 5 days: * (1) Any illness/injury of child or staff requiring c *e. Corrective/adverse action notices professional or emergency medical treatment J *" (2).Any death occurring in the center or during C *f Most recent fire inspection report away from center activities .J * (3) Major damage to facility, *g. Most recent health department inspection report and food permit or written permission for catering food * (4) Interruption of the center's electrical,.telephone G *h. Menu for meals and snacks/dated or gas service J * (5) Any litigation involving the center *i. Name and telephone number for: Fire department/Law enforcement/Medical assistance/- Poison control center/Substitute help . * (6) Any traffic accident involving day care children *j. Emergency Preparedness and Response Plans . using"transportation provided by the center - * (7)Any arrest of licensee,staff,employee,volunteer *k. Name of director/staff person in charge 5 m W . a) U L) c c CU ctt m � REGULATIONS o 0 0 < c o 0 Z Z Nighttime Centers(IL,I.,pages 57-58) In addition to the regulations set forth for day care centers,centers providing nighttime care(after 7 p.m.)shall meet the following regulations or modifications Does the center provide care after 7:00 p.m:? ❑ Yes No Does the center provide care alter midnight? ❑,Yes No 1. Equipment and furnishings *a. In centers operating past midnight,.cribs or cots, fitted with a waterproof mattress shall be provided for each child *b. In centers operating past midnight,there shall be at least one bathing facility for every 15 children 2. Child Care Program (pages 57-58) - a. Staffing(pages 57-58) r (1) Staff-child ratio for sleeping children: * (a) 0 up to 18 months . I to 5 * (b) 18 months up to 2%z 1-to 14 * (c) 2% up to 4 years 1 to 18 * (d) 4 years and older 1 to 25 *(2) Required ratios for day time maintained while children are awake(see page 23) *(3) At least one staff,-at least 19,meeting child care worker qualifications,with CPR and 1st aid in center during hours of operation *(4) All children supervised at all times *(5) Each staff assigned responsibility for same children nightly *(6) At least one staff in each room of sleeping children The deficiencies noted have been discussed with me: Failure to correct the deficiencies can be the basis foradverse 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 ' the responsi i 'ty of the licensee to operate in compliance with the Minimum.Standards. 2 i Lokhezo Signature of Licen e/D signated Staff Date 6 Emergency Preparedness and Response Plans Checklist M�j'bj -- ( O)indicates compliance observed by DHR Licensing Representative t.N(ZP (,r) indicates not in compliance ( S ) indicates certified by staff in charge(use only for#plan updated yearly,written documentation must be on file) Procedures i Documentation 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: *Weather emergencies/natural disasters; *C rent emergency plans and procedures * Severe Thunderstorms * Tomadoes * Flash flooding * Major snowfall * Blizzards * Ice storms * Earthquakes *Lockdown or evacuation due to threats of violence *Location and use of fire extinguishers *Evacuations due to; * ocumentation of the following quarterly drills; * Hazardous materials Fire * Spills * Tornado * Gas leaks * Lockdown * Bomb threats * Relocation * Fire *Infectious disease emergencies elephones for on-site and off-site use *Loss of power,water,or heat *Location of the first aid and emergency supply kits *Other threatening situations DetAs Plan Availability 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 *Reunification with parents *Su itted to the Department *Supplies needed for shelter in place procedures opies provided to all parents/guardians *Transportation disaster procedures —IV *Staff training/reassignment as appropriate *#Plan updated yearly *Contact with local emergency management officials 7 Checklist for Infants/Todd-lers (O) indicates compliance observed by DHR Licensing Representative Or indicates not in compliance (X)indicates not applicable *Name of teacher/room# *Age of children *Number of children *Number of staff —AAditiona I Fu rnishin'�i ` *Dia erin area *Sink,warm water,soap,paper towels *Plastic-lined,covered container Tub(portable plastic type acceptable) *Feeding chairs *Cribs in accordance with US Consumer Product Safety Act of 2008 *Cribs/2 feet of space between occupied cribs *Waterproof mattress,sheets *Indoor thermometer/Out of reach of children *Shelving for equipment and supplies/anchored 01, *Individual,labeled storages ace for each child *Furniture child size,clean,good condition *Potty chairs cleaned/disinfected/emptied(Toddlers only) *Electrical outlets covered *Barriers around heaters,fans *Hazardous substances locked *Containers labeled *Medication locked *Screens on windows which are opened *Lighting adequate Checklist for 24 months up to 36 months (O)indicates compliance observed by DHR Licensing Representative ($)indicates not in compliance X indicates not applicable *Name of teacher/room# *Age of children *Number of children *Number of staff ' MI r.RUM I _ *Diapering area *Sink,warm water,soap,paper towels "Plastic-lined covered containers *Table space and chair for each child *Cots/sheets and covers *Indoor thermometer/Out of reach of children Written daily plan or schedule posted *Labeled storage s ace at child level *Shelving fore ui ment 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 g ' Checklist for Preschool/School-Age (0)indicates compliance observed by DHR Licensing Representative (1)indicates not in compliance (X)indicates not applicable k r ® ytCGa *Name of teacher/room# N *Age of children *Number of children *Number of staff dd *Table space and chair for each child Q *Cots.Sheets,covers for each child *Indoor thermometer/out of reach D Written daily plan or schedule posted *Labeled storage space at child level 0. *Shelving forequipment and supplies/anchored Designated activity areas: Facilities *Electrical outlets covered *Barriers around heaters,fans *Hazardous substances locked/ *Containers labeled *Medication locked p *Screens on windows which are opened X *Lighting adequate Playground Checklist (0)indicates compliance observed by DHR Licensing Representative (I) indicates not in compliance (X)indicates not applicable Y �� *Outdoor play area enclosed by a fence or wall at least 4 feet in height *Fence or wall free of sharp edges *Gates secured 0 0 *Shade and sun areas provided 0 0 *Outdoor play area free of apparent hazardous conditions r * 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 9