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Evaluation Form (6) Revised 3/2020 ALABAMA DEPARTMENT OF HUMAN RESOURCES CHILD CARE CENTER LICENSING EVALUATION RENEWAL Health and Safe Guidelines items marked with an asterisk* Name of Center: Date(s) of Evaluation: 5s ' _VJ/ �c C Address: b Da e(s) f Follow-up: Purpose co Visit: cL Telephone #: (a S�) l C.¢ Director: Licensee: �Gt,. S County. 'C t5�,V- Day Night &4ubsidy Licensed Capacity: Day Night Days of Operation: Dffbyl , Night Age Range: ��S Night Hours of Operation: Day License u760 mber: o e: ((�� oo - Observed by DH fcetising Representative S - Certified by Licensee/Staff in charge Effective Dates of License: D - Discussed with Licensee/Staff'in charge X -Not Applicable-Not reviewed with �ZpTo: From: �. '' Z Licensee/Staff in charge Deficiencies Noted: Yes &NO DHR Licensing Re esentativ e: Sections to be completed at the discreti a DHR Licensing Representative. a� a� a) a) a) REGULATIONS Ca coma v REGULATIONS cc Q E Q .Q a U U Q O V Qa o o V o o ' Z Z cbc �f Z Z Facilities (I1. C.,Pages 16-23) *e. Space for ill or injured child b� d7 ej r.54 r pgt 1. Indoor area(II.,C.,4.,pages 16-19) *f. Items used by ill child disinfected { *a. Exclusive use of activity areas 0 *g. Storage space for teacher's supplies , *b. Designated space for each grouping of children ® *h. Office space provided ,��g1► *c. Bathrooms located on same level/under same roof i. Ventilation,lighting,heating(pages 17-18) (1) one flush toilet for each 15 children * (1) Heating/air conditioning provided ! (2) one handwashing sink for each 15 children * (2) Temperature 68-82 at child level 1 (3) One tub(portable plastic acceptable) * (3) Thermometer in each area used by children \ * (4) Fixtures child size or adjusted for easy use * (4) Thermometer out of reach of children *d. One handwashing sink with warm running water, * (5) Outside windows that are opened are soap,paper towels in each room where children are screened diapered 11 va_1.%,f `Li^Cyr CVQ U U REGULATIONS m -0 v REGULATIONS c� m v a-CL o. O o Q O O CL V U Q Z Z 0 o Z Z * (6) Outside doors kept closed 3. Swimming and Wading at the Center(II., C.,6„pages 20-21) * (7) Lighting adequate for activities a. Pools two feet or more in depth(pages 20-21) * (8)_ Lighting adequate at nap/rest time to allow * (1) Lifeguard at poolside at all times pool is children to be seen in use *j. Operational telephone for center business only ® * (2) Lifeguard Training Certificate,First Aid Certificate,CPR Certification on file *k. DHR notified if telephone is out of order or if * (3) Lifeguard not counted in ratios number changes I. Hazard prevention(page 18)(Indoor Area (4) Staff-child ratios for children in the pool: * (1) Center.free of apparent hazards (a) one staff for each child younger than 2%s years of age * (2) Hazardous substances under lock and key or * (b) one staff for every 4 children ages 2%2 combination lock years up to 4 years * (3) Containers labeled * (c) one staff for every 6 children ages 4 years up to 6 years * (4) No firearms or ammunition kept or allowed in * (d) one staff for every 10 children ages 6 center except law enforcement years and older. * (5) Stairways have hand railings in child's reach i * (5) Ratios determined by youngest child in l� the pool * (6) Clear glass doors marked at child level * (6) Persons counted in ratios meet child care worker qualifications/in the pool at all times * (7) Medicines and drugs kept under lock and key or �� * (7) Staff provided to supervise children in combination lock,separate from harmful items �� ool area,but not in pool r/xf * (8) Barriers around heaters,radiators,fans * (8) If any part of a child's body is in the accessible to children water,child considered in pool * (9) Exposed electrical outlets have protective covers * (9) Pool enclosed with fence or solid wall at least 4 feet in height,constructed to prevent * (10) Consumption of alcohol or use of non- accessibility by children prescription narcotic or illegal substances prohibited * (11) Smoking or use of tobacco prohibited on b. Wading structures less than 2 feet in depth: premises (page 21) * (12) Bio Contaminants shall be stored and disposed of properly m. Center kept clean/Cleaning done daily(pages 18- * (1) At least one staff with CPR&first aid at 19) each wading structure * (1) Floors,bathroom fixtures cleaned/disinfected * (2) Required ratios met as stated on page 24 * (2) Carpets vacuumed daily * (3) At least two staff at each wading structure * (3) Cleaning does not interfere with children's * (4) Clean water provided each day activities 2. Outdoor area(II.,C.,5.,pages 19-20) * (5) Wading structure emptied when not in use See Checklist i *a. Off-street loading/unloading provided 4. Away from center activities (II., I page 21) *b. Separate areas for children younger than 2%z(may NOTE: The Department of Human Resources I be achieved by scheduling) does not Inspect activities away from the center, D including swimming and wading activities. The *c. Outdoor area adjoins or is safely accessible licensee shall assume full .authority an i responsibility for away from the center activides. *d. Outdoor play area free of apparent hazardous .`"" conditions i U U S C C REGULATIONS E E a REGULATIONS Q U � Q U Y Q ° o 0 Z z Z Z 5. Furnishings and equipment (II.,C.,8., *j. Staff with infant-child CPR and first aid pages 21-23) See Checklists present during all hours of operation Child Care Program (II., D:, pages *k. Second staff available when 7 or more 24-37) children present/required ratios met *1. Required ratios maintained at all times *I. No staff on duty more than 8 continuous hours on a regular basis _ * a. 0 up to 18 months 1 to 5 *m. Staff free from other duties while working �5with the children * b. 18 months up to 2%z years t to 7 5. Infant/Toddler Program (II.,D., 2., pages 26-29) * d. 24 months up to 36 months 1 to 8 a. Learning/growth activities:(page 26) * e. 2%z years up to 4 years 1 to 11 (1) Encouraged to play with a variety of toys * f. 4 years up to school age I to 18 (2) Time outdoors daily,when weather permits * g. School age up to 8 years 1 to 21 * (3) Freedom of movement outside cribs daily * h. 8 years and older 1 to 22 * (4) Placed on tummy part of time white awake and observed *2. Children younger than 2%z grouped separately (5) Staff talks to each child and encourages from older children response * a. Exception for group 24-36 months * (6) Cries/signs of distress investigated immediately * b. Exception for individual children's needs b. Diapering/toileting:(pages 26-27) *3. Staff counted in ratio only when giving full * (1) Clean,dry diapers/clothing provided attention to the children 4. Staff.coverage (page 25) * (2) Wet/soiled diapers/clothing changed promptly * a. All children supervised at all times * (3) Changing area cleaned and disinfected * b. Staff assigned responsibility for same * (4) No child left unattended while being infants/toddlers each day diapered * c. Substitute staff available + (5) No child diapered on the floor * d. Director authorized to conduct center business * (6) Each child's hands washed after diapering * e. Staff person in charge when director is absent, * (7) Staff use universal precautions when authorized to conduct center business diapering * f. Staff in each room during napping/resting * (8) Staff use clean disposable gloves for diapering each child/for each diaper change * g. Staff able to see all the children * (9) Wet/soiled diapers placed in covered, plastic-lined container and disposed of daily * h. Ratio during napping/resting(page 25) * (10) Individual,disposable wipes used at each diaper change,disposed of properly * (1) 0 up to 18 months 1 to 5 * (11) Potty chairs emptied,rinsed,disinfected after each use * (2) 18 months up to 2%z years 1 to 14 ® * (12)Diapering area separate from food service area * (3) 2%z years and older 1 to 36 c. Napping/resting(page 27) I REGULATIONS m � o ATIONS REGUL 0 to C: 0 o a CL E E Q U Q ° a �. �j � Z Z Q ° o 0 Z Z * (1) Infants allowed to form own sleep patterns * (12) Toddlers seated while eating * (2) Infants placed on back to sleep unless physician's * (13) Child encouraged to experiment with statement indicates otherwise `��✓ self-Feeding,utensils provided * (3) Infants who can easily turn placed on back but * (14) Disposable utensils used only with close allowed to adopt preferred position supervision * (4) No positioning device used unless specified by (15) Foods eaten from a dish physician * (5) Staff recognize differing needs of toddlers/allow (16) Dishes,bottles unbreakable to follow their own sleep patterns 'S d. Cribs,cots,and bedding(pages 27-28) * (17) Drinking-water offered to toddlers * (1) Two feet between occupied cribs * (18) Child not forced to eat emerge cy eCots positioned to allow space for access or * (19) Food not used as reward or punishment xit * (3) Cribs/cots cleaned and disinfected and sheets and covers washed before used by another child (20) Child's hands washed before and after snacks,after diapering,toileting * (4) For infants,clean bottom sheets daily or more * (2 1) Staffs hands washed before food often if needed,sheets fit snugly preparation and service,after assisting with toileting,after diapering * (5) Soft material prohibited in infant's sleeping *. (22) Individual paper towels for each washing environment,no pillows,quilts,comforters,etc. and drying - S * (6) No infant put to sleep on sofa soft mattress 6. Preschool/School-age Program S (II.,D.,3.,pages.29-32) * (7) For toddlers,clean bottom sheets and top a. Learning/growth activities(pages 29-30) coverings weekly,more often if needed e. Feeding(page 28-29) (1) Schedule posted * (1) Formula,food for infants if provided by center, (2) Variety of indoor/outdoor activities planned with parent or physician * (2) If formula provided by center,ready to feed, (3) Time outdoors daily when weather permits properly stored and handled * (3) Meals and snacks comply with requirements (4) Staff permit/encourage conversation among children r (4) If formula ptovided by parent,labeled, refrigerated (5) Staff give individual attention to each child daily * (5) Bottles sent home or contents discarded at end of day (6) Radio,TV,videos used only to supplementlenhance daily plan * (6) Small hard candies,nuts not served to children * (7) No child required to watch TV or videos under four * (7) Foods that may cause choking prepared appropriately for the child (8) Videos previewed by staff for appropriateness * (8) Feeding schedule according to child's needs (9) Sexually explicit,violent,frightening materials prohibited (9) Infants held for bottle feeding b. Napping/resting(page 30) 1 (10) No bottles propped * (1) Staff recognize differing needs of children (11) When able,infants allowed to sit in feeding chair (2) Rest period for children in attendance more than 5 hours I A C C -Q a) d) N t9. CU C REGULATIONS a Q " f0 cu 2 E E a REGULATIONS Q- Q U c Q o c°� Q Uo �. z z o 0 z z * (3) Children not transported in front seat of vehicle with passenger side air bag 2. Records on staff(pages 42-44) (See Staff Checklist) is moving and all passengers secured when vehicle *a.Records on staff kept confidential * (a) Each child under 1 year or weighing less than 20 pounds secured in rear facing child restraint, b. Records on file at time of employment installed according to manufacturers instructions, maintained in good condition c. Records on staff maintained at least two years after person has left * (b) Each child under 5 years or weighing less than *d. Records filed alphabetically 40 pounds secured in forward facing child restraint, f installed according to manufacturer's instructions, ��(1 maintained.in good condition. *e. Inactive files maintained separately * (c) Each child under 6 years secured in a booster seat installed according to manufacturer's instructions, 3• Health (page 45) maintained in good condition. *a. Medical exam and TB test on file at time of i employment * (d) Each child 6 and older,the'driver,and each ® / *b. Staff with symptoms of contagious adult passenger secured in an individual seat belt, • disease/condition not in center properly anchored to the vehicle. J *h. Vehicle safety check done annually,signed by mechanic and dated,filed in center Character and Suitability (II., G.,pages 47-51) 5. Transportation provided by *1. Character and suitability review conducted parent/guardian (page 40): on required persons(every 5 years) *a. Each child accompanied into and out of center *a. Persons with determination of unsuitable character terminated 5 *b. Each child signed in and signed out *b. Licensee informs DHR of any criminal convictions or current char es *c. Any child who arrives by walking or bus,signed in by staff Administration a_ es 52-56 *d. Photo ID required when releasing child to unfamiliar,designated person 1. Applicant/licensee(page 5-2) Staff(II., F., pages 4`1-46) a. Licensee assumes full authority and responsibility for meeting and maintaining Minimum Standards 1. Qualifications(pages 41-42) b.Licensee provides operating funds a. Center director meets qualifications c. Licensee designates director and delegates b. Child care workers/teachers meet qualifications and authority and responsibility for operation and have 12 hours of training within 30 days of employment management of center to director 5 * Child care workers/teachers meet requirements for d. Written operating CCDF training within 90 days(if applicable) P g Policies established c. Aides/assistant teachers not counted in ratio (1) Copy of operating policies provided to parent at time of child's enrollment *d. Service staff not counted in ratio unless they meet qualifications and are giving full attention to children (2) Copy of operating policies submitted to DHR *e. Driver at least 19,valid driver's license (3) Operating p g policies do not contradict Minimum Standards *f. Substitute staff meet qualifications of staff for whom substituting ( Changes in operating policies provided to parents ts and to DHR 7 U U C C C C N M CU CU REGULATIONS E o Q REGULATIONS- E E Q 0 Q o 0 Q C) C o c Z Z Z o Z 2. Reports to the Department(pages 52- b. Age range of children in care conforms to 53) ages specified c. Requirements for drop-in care met a. The following reported to DHR prior to occurrence: 4. Children's Records(pages 54-55) (See Children's Checklist) * (1) Change in ownership *a. Children's records and information about children and their families kept confidential * (2) Change in location *b. Individual records on each child on file on first day of attendance (3) Change in Director of center (1) Children's records maintained 2 years S after child has left the center S (4) Change in chief executive officer of corporation * (2) Records filed alphabetically P or members of board * (5) Alterations to center or grounds s (3)Inactive files maintained separately * (6) Major change or extension of hours or program 5. Center Records(page 55) * (7) Change in address or telephone number The following records kept on.file for the current year plus two additional years: b. The following reported to DHR-within 24 hours, *a. Daily attendance records on all staff and written report within 5 days: children * (1) Any illness/injury of child or staff requiring *b. Transportation checklists professional medical treatment * (2) Any illness/injury of child or staff requiring *c. Vehicle safety check 1 emergency medical treatment * (3) Any death occurring in the center or during *d. Sign in/sign out sheets away from center activities * (4) Major damage to facility 6. Documents to be posted (pages 55- * (5) Interruption of the center's electrical,telephone e_— 56) or gas service * (6) Any litigation involving the center a. Most recent license,permit,or approval * (7) Any traffic accident involving day care children b. Public notice form using transportation provided by the center * (8)Any arrest of licensee,staff,employee,volunteer *c. Most recent licensing evaluation * (9) Final disposition of any child abuse/neglect *d. Most recent deficiency report investigation involving licensee,staff,employee, volunteer 5 * (10) Any incident in which the health,welfare,or *e. Corrective/adverse action notices safety of a child is at risk * (11)Any disastrous events *f. Most recent fire inspection report *c. Child abuse/neglect reported as required by law *9. Most recent health department inspection report and food permit or written permission for catering food *d. Licensee and all staff,employees,volunteers *h. Menu for meals and snacks/dated cooperate with DHR on any child abuse or neglect investigation i. Name and telephone number for:(page 56) 3. Admission Procedures(pages 53-54) * (1) Fire department *a. Total number of children in care,including children * (2) Law enforcement on the premises,children in transit,children on field trips conforms to number specified * (3) Medical assistance(ambulance or rescue) i i U U O O O O f-CC U N U REGULATIONS c U REGULATIONS U � a O UU Q O Q a o Z Z Z Z * (4) Poison control center * (2) Required ratios for day time maintained while children are awake(see page 23) * (5) Substitute help * 3) A( t least one staff,at least 19,meeting child J\f` *. care worker qualifications,with CPR and Ist aid in �. Emergency Preparedness and Response Plans center during hours of operation *k. Name of director/staff person in charge * (4) All children supervised at all times Nighttime Centers (II.9-1.9 * (5) Each staff assigned responsibility for same children nightly pages 57-58) * (6) At least one staff in each room of sleeping children In addition to the regulations set forth for day * (7) Staff able to see all the children at all times care centers, centers providing nighttime care (after 7 p.m.) shall meet the following regulations or modifications * (8) All staff awake and alert to needs of children Does the center provide car fter 7:00 p:m.? * (9) At least two staff in center whenever Yes ❑ No children are present/required ratios met Does the center provide care after midnight? Yes ❑ No r--';1 * (10) Lighting maintained so children are visible while sleeping LX 1. Equipment and furnishings b. Nightly activity schedule posted (page 58) *a. In centers operating past midnight,cribs or cots, 0 (1) Outdoor time available during daylight hours fitted with a waterproof mattress shall be provided for /�,/ each child * (2) Staff assist each child as needed,in dressing and grooming *b. In centers operating past midnight,there shall be at c. Food(page 58) least one bathing facility for every 15 children 2. Child Care Program (pages.57-58) * (1) Breakfast served to children going directly t/ to school x a. Staffing(pages 57-58) * (2) Evening meal served to children in 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 " (I) Clean water provided for each child * (b) 18 months up to 2%: t to 14 * (2) Each child bathed separately * (c) 2%:-up to 4 years 1 to 18 * (3) Each child supervised while bathing * (d) 4 years and older 1 to 25 * (4) Individual 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 re onsibility of the licensee to operate in compliance with the Minimum Standards. l�aD Signature of licensee or designated staff Date i 9 1 EmerLyency Preparedness and Response Plans Checklist t�5 . (0)indicates compliance observed by DHR Licensing Representative t�' (-1 indicates not in compliance AA (S ) indicates certified by staff in charge(use only for#plan updated yearly,written documentation must be on file) 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; *Current emergency plans and procedures Severe Thunderstorms .A * Tom does e * Flash flooding * Major snowfall T\ * Blizzards 4'v * Ice storms * Earthquakes *Lockdown or evacuation due to threats of violence *Location and use of fire extinguishers .fa *Evacuations due to; P I *#Documentation f the foll ing quarterly drills * Hazardous materials * Spills it i * Gas leaks ornado + * Bomb threats ockdown i * Fire * Relocation *Infectious disease emergencies *Telephones for on-site and off-site use *Loss of power,water,or heat*Other threatening situations *Location of the first aid and emergency supply kits f . I The disaster pliin shall include details for: The Emergency Preparedness and Response Plans should be: *Shelter in place or evacuation +` vai le to all staff and employees ((rI 4 � *Assisting infants and children with special needs and/or � � *P st in a Conspicuo place health conditions *Reunification with parents i ubmitted to a art en P•k *Supplies needed'for shelter in place procedures a *Copie o al ar is/gu *Transportation disaster procedures *Staff training/reassignment as appropriate *#Plan updated yearly *Contact with local emergency management officials i In L U N _a) tt1 0 t6 C C -0 REGULATIONS Q Q `-' a QCU E E Q REGULATIONS Q V U Q 0 U CL y-. Q 0 0 U C O Z Z. Z Z 2/( ) Rest period at least 45 minutes,not more than * (15) Children seated while eating * urs 5 (4) If a child who does not sleep after 45 minutes, * (16) No child forced to eat quiet activities permitted * (5) Cots cleaned and clean bottom sheets and top * (17) Children not allowed in kitchen sheets/covers provided before used by another child * (6) Clean sheets/covers provided weekly,more often * (18) Children's hands washed before meals if needed , and snack and after toileting * (7) Cots positioned to allow space for access or * (19) Staff hands washed before food emergency exit preparation and service,and after assisting with toileting or contact with bodily fluid * (8) At least one staff present in each room * (20) Disposable gloves used for diapering * (9) Staff able to see all children (2 1) Individual paper towels for each washing and drying c. Toiletin;(page 30) (22) Catered meals and snacks meet requirements * (1) According to each child's needs,each child's e. Disciplinary Practices(page 32) hands washed * (2) Staff use Universal Precautions when diapering * (1) Discipline appropriate to age and or handling bodily fluids developmental level of the children d. Feeding(pages 30-32) * (2) No corporal/physical punishment * (1) Children in attendance served breakfast or a.m. * (3) No verbal abuse snack,lunch,p.m.snack * (2) Meals and snacks comply with USDA guidelines * (4) No discipline associated with food,na s on pages 29-30 P or bathroom procedures * (3) Fluid milk served,no powdered milk for drinking (5) No physical restraint as punishment * (4) No child deprived of meal or snack (6) No punishment administered by another child * (5) Special dietary needs in accordance with written instructions f. Staff-Parent Communication(page 33) * (6) Meals and snacks provided by the center 3 (1) Discipline,behavior problems discussed / with parent * Vending machines prohibited in areas used by children (2) Center open to visits from parents at any time 5 * Small hard candies,nuts not served to children under four (3) Parents informed of right to visit * (9) Foods that may cause choking prepared appropriately for the child (4) Staff available for communication/ conferences * (10) Portions of food suited to child's needs,second (5) Parents notified of complaint procedures portions available * (11.) Unbreakable or single-use dinnerware used (6) Parents provided with information on influenza * (12)Single-use cups or glasses or a.drinking fountain g. Health information(pages 33-36) provided for water * (13) Drinking water offered during the day * (1) No ill child admitted * (14) Food served on individual dishes or napkins, * (2) If a child becomes ill or is injured,he/she not directly on table is separated from group,but continuously supervised, C C p U U REGULATIONS 'Q 0 o U Q REGULATIONS o o a U Y Q Z Z ° O Z Z * (3) Parent of ill/injured child notified immediately (e) Children and staff wash hands after and required to come for child ✓ handling animals * (4) If parent cannot be reached or illness/injury *h. Emergency Preparedness and Response severe,emergency medical attention is obtained Plans(page 36-37) See Checklist * (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 o1 Human Resources does— health - department as required not inspect activities away from the center, including swimming and wading activities. The (8) bledication/Medical Procedures(pages 34-35) licensee shall assume full authority and responsibility for away from the.center activities. Does the center's staff giv medication/medical .procedures? Yes a No ] * (a) Medication administered only with written Does the center's staff provide transportation? authorization from parent Yes El No * (b) No blanket authorization forms for medication *a. Transportation checklists used as required * (c) Medication in original container,labeled *b. Designated staff complete and sign checklist * (d) Measuring device provided *c. Driver signs checklist,indicating he/she has checked each seat * (e) Medication administered by designated staff S *d. Checklists kept on file for current year plus 2 * additional years (f) Locked storage provided for medication * (g) Medication returned to parent or disposed of *e. Center responsible for picking up child at when no longer needed designated location and delivering child to designated person * (h) Time and date medication is given is documented in writing,kept in child's file/copies 5 E Supervision in center vehicles(page 39) available to parents on request (9) Hygienic practices(page 35) * (1) Staff-child ratio met for children younger than lawful school-age,driver not counted * (a) Toilet articles labeled and stored separately * (2) Children of lawful school age and older, fewer than 15 transported with only the driver * .(b) Used paper towels,wipes,tissues are disposed 4S (3) For 15 or more children of lawful school of immediately following use age,one staff in addition to driver * (c) Toilet paper provided for use by children and * (4) For 30 or more children of lawful school staff age,two staff in addition to driver * (d) Extra children's clothing available * (5) No child left in a vehicle without adult supervision (10) Animals on the premises(pages 35-36) * (6) Staff accompany each child under 2%from vehicle to care of designated person (a) Aggressive animals not kept in center or on ' (7) Staff visually supervise each child 2%and grounds older from vehicle to care of designated person (b) Animals that could pose a threat to health and * (8) Driver checks each seat at each location to safety kept away from children verify no child is left on the vehicle. (c) Certificate of rabies vaccination on file for g. Safety precautions in vehicles(pages 39740) animals (d) Animals confined,cages kept clean,food and * (1) Stationary seating for child,each child 6waiteravailable seated while vehicle is moving * (2) Doors locked when vehicle is moving 6 Checklist for Infants (0) indicates compliance observed by DHR Licensing Representative I indicates not in compliance (X)indicates not applicable a *Name of teacher/room# *Age of children *Number of children *Number of staff Minimum E cci ment Re wired or Each , row o Children WElm asliable soff erib toys- �er child _ v Push and ull to s-1 A device that la s a varie of awe a ro riate music Awe a ro riate books-2 er child Lazne balls(8+inches-I Nestin and stacking toys-2 sets Washable bab doll-1 Musical to -1 Colorful ictures and osters Activi boxes,such as bus boxes-3 enn`area *Sink,warns water,soap,paper towels *Plastic-lined,covered,container Tub(portable plastic a acce table) *Feeding chairs *.Cribs/2 feet of s ace between-----Died cribs *Water roof mattress,sheets *Indoor thermometer/Out of reach of children *Shelvine fore ui ment and su lies/anchored *Individual,labeled stora e s ace for each child *Furniture child size,clean,-ood condition *Cribs in accordance with US Consumer Product Safety Act of 2008 ° *Electrical outlets'codeted *Barriers around heaters,fans *Hazardous substances loc7�77 ked *Containers labeled *Medication locked *Screens on windows which are o ened *Lightin adequate - - 1 77 C'.,J "D P 1 11-W O S SWUM i i i r Checklist for Toddlers (age IS months-21/Z years) 0 indicates compliance observed by DHR Licensing Rep resentative (d)indicates not incompliance ' (X)indicates not applicable *Name of teacher/room# TV1 *Age of children ! *Number of children *Number of staff Minimum E ui .ment Re_.wired or Ea0i Grou of Children Car-6 aon toxic cTa ons/markers Pa er(variety) Non-toxic Pla dou h Colorful pidutres and posters A device that plays a variety of age appropriate music Musical toys.-2 . PuWwd ull`to s Lar a cars,trucks,boats,etc.-2 Sit-on riding toy-2 Large soft balls-2- Books-2 06r child A e appropriate puzzles-2(complete with allpieces) Nesting and stacking toys-2 sets Non-wooden buildine:blocks(a roximately 20 non-interlockine) 0 Bab dolls 2'(coir lefe with all £S Doll clothes and blankets Doll bed-1 Toy telephones—2 Pots,pans,buckets,laze plastic spoons Child-size stove cy Dress-up clothes *Dia grin area 'Sink,warm water,soap,paper towels 'Plastic-lined,covered container Tub(portable plastic type accd table) Torty chairs cleaned/disinfected/emptied 0 77 *Feeding chair(s)or table and chairs 'Cribs/cots *Waterproof mattress(es),sheets,coverin *Indoor thermometer/Out of reach of children *Shelving for equipment and supplies/anchored ® ` *Furniture child size,clean,good condition *Individual,labeled storage space for each'child EM Electrical of fleti covcretl *Barriers around heaters,fans . *Hazardous substances locked *Containers labeled 0 1 71' *Medication locked *Screens on windows which are opened *Lighting adequate 12 Checklist for 24 months UD to 36 months. (0)indicates compliance observed by DHR Licensing Representative (-1)indicates not in compliance X indicates not applicable I *Name of teacher/room# *Age of children *Number of children *Number of staff MinimumE ui .mentRequired for Each Group of_Chiiten_ 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 Baby dolls-2(complete with atlparts)" Child-size stove and sink or combination Cooking utensils and dishes Doll bed i Doll clothes and blankets Dress up clothes I 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 1! lill LI 11 1 1 1 SIS t *Diapering area - *Sink,warm water,soap,paper towels *Plastic-lined covered containers *Tables ace and chair for each child *Cots/sheets and covers til *Indoor thermometer/Out of reach of children Written daily Ian or schedule posted *Labeled storage space at child level. *Shelving forequipment and supplies/anchored Designated activity areas *Electrical outlets covei=ed *Barriers around heaters,fans *Hazardous substances locked *Containers labeled *Medication locked i *Screens on windows which are opened t *Lighting adequate i I !1 f f 13 *Numberof children7-7 *Number of staff Required Equip Racs �*f+emso...r Eac/+, G { ro• •u ; o-fChild�ren Em Non-toxic playdoug-h or clay _.. >'... Large • 1xic crayons/watercolor mark-Large Theet�—of paper Non-toxic finger/cold water paints-prim—a _ry colors Scissors(blunt tip)-2 pr.Per 5 children Non-toxic glue or paste;tape E(IUeatlOnakand: eative`1Oys "� � 1 1 • 1 • 11 11 1e JI'l-WIT.411Small cars,trucks,boats,etc�6 Matching games-6 _ -_--- Interlocking manipulative play sets,different types-6 /more than 2 electronic) Ifoinell��nQQ=Areal x � �. z} ,$ � xWSmall �S table 1 I'Cooking utensils/dish�s(unbreakable) ----� Doll bed or cradle Dolls(complete with all parts)-2 Doll clothes and blankets and girls Dress-up clothes for bo;T ,Storage for-dress-up clothes mirror-full -Toy telephones-2. ©-_--� Litexat�r� - Izs. s...t�'..x". JY-.yr y';- ,i ivfY., .'•`�.s t`�tt'�jy Yr y '* k. .�e �''2..... ,3 > .i, - .Measuring and pouring equipment ��U[ �tudy'.antlIeIICC Nature collections ®�— --_—_ . , Additional'larmsBingsanc�Equipment;ji"� �t,�f•a���n,.:�= 5�;:. i`.:;� ,��u��.�-��.�rx.�,.:�<<��... ' "Cots.Sheets,covers1 each 1 *11ndoor -�Written daily plan o sch _ ----- thermometer . . -WO — ----- *Labeled storage space at child level MM • . 1 1 .. • 1 -� S�---_- *Electrical outlets-66',kned *Barriers around heaters,fans *Hazardous substances locked *Conlair�erslabeled A ©----- Checklist for School-Au (O)indicates compliance observed by DHR Licensing Representative (I indicates not in compliance (X)indicates not applicable *Name of teacher/room# *Age of children a` rs *Number of children *Number of staff Minimum E ui "merit Required for Each Group of Children Games:choose indoor or table games Suited to a e of children-I er 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 playdo6gh or modeling clay Non-toxic tempera paint Brushes Non-toxic crayons Pa cr(variety) Non-toxicglue or paste,tape Scissors A device that plays a variety of age a ro riate music Interlocking manipulative la sets—l per 5 children T*Table-s 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 storages ace at child level 117 1*Shelviniz forequipment and su lies/anchored Designated activity areas *Electi=ical outlefs covered � _ *Barriers around heaters,fans *Hazardous substances locked *Containers labeled *Medication locked 1-1� 1 - 1 *Screens on windows which are opened *Lighting adequate i i 15 Playground Checklist (O)indicates compliance observed by DHR Licensing Representative (I)indicates not in compliance (X)indicates not applicable � . , IN Minimum Equipment Required for groups of twenty-five ch!i!Iffdr ore er�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 0 Climbing apparatus Crawl-through equipment Digging or sand area _ Toys for digging 0 *Outdoor play area enclosed by a fence or wall at least 4 feet in height *Fence or wall free of sharp edges *Gates secured L *Shade and sun areas provided *Outdoor play area free of apparent hazardous conditions ► i * 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 �Y" '�Vie. � t i 16