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Evaluation Form (7) 'ALABAMA DEPARTMENT OF HUMAN RESOURCES Revised 3/2020 CHILD CARE CENTER LICENSING EVALUATION RENEWAL Health and Safety Guidelines items marked with an asterisk* Nam7el enter: Dates) of Evaluation: �C C Address: ab C Da e(s) f Follow-up: AVe-, ���SO►r1 �s purpose of Visit: TcZW Telephone #: (as`) c I ( � Director: Licensee: County: II t(A-,V 2Pi O. Day Night ubsidy Licensed Capacity: Day� S Night Days of Operation: D Night b�_r Age Range: - Night! / Hours of Operation: DAX ���• g t License umber: o e: py, i� 7600o O - Observed by DH1 ice sing 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 From: �. "It 16To; Z Licensee/Staff in charge ' Deficiencies Noted: Yes XNo D Licensing Re esentati� e: Sections to be completed at the discretion of the DHR Licensing Representative. o a) o o REGULATIONS C o o REGULATIONS C C o 0 Q 0 o a o Q U o o U 1 «- z Z c1a 1® Z Z .Facilities (II. C., pages 16-23) *e. Space for ill or injured child r 1. Indoor area(II.,C.,4.,pages 16-19) *f. Items used by ill child disinfected *a. Exclusive use of activity areas ® *g. Storage space for teacher's supplies *b. Designated space for each grouping of children ® *h. Office space provided ��► *c. Bathrooms located on same level/under same roof i. Ventilation,lighting,heating(pages 17-18) (I) 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 (3) One tub(portable plastic acceptable) * (3) Thermometer in each area used by children 0 * (4) Fixtures child size or adjusted for easy use * ass (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 1 ! U U U U REGULATIONS m CU v REGULATIONS T � v a ° ° Q o ° a U � C) Y Q Z Z o O Z Z * 3. Swimming and Wading at the Center(II., (6) Outside doors kept closed C.,6.,pages 20-21) * (7) Lighting adequate for activities AN 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: * (I) Center-free of apparent hazards q (a) one:staff for each child younger than 2%: years of age * (2) Hazardous substances under lock and key or * (b) one staff for every 4 children ages 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. i * (5) Stairways have hand railings in child's reach * (5) Ratios determined by youngest child in the pool * (6) Clear glass doors marked at child level * (6) Persons counted in ratios meet child care Oppworker qualifications/in the pool at all times X I * (7) Medicines and drugs kept under lock and key or (7) Staff provided to supervise children in combination lock,separate from harmful items f �ool area,,but not in pool q1 * (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 * (1 I) 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 ds * (2) Required ratios met as stated on page 24 i * (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 *a. Off-street loading/unloading provided 4. Away from center activities (II., page 21) *b. Separate areas for children younger than 2%:(may NOTE. The Department of Human Resources be achieved by scheduling) does not Inspect activities away from the cente f r, including swimming and wading activities. The D *c. Outdoor area adjoins or is safely accessible licensee shall assume full authority an responsibility for away from the center activities. *d. Outdoor play area free of apparent hazardous conditions U U N N N O C C t) U [REGULATIONS Q Q o a REGULATIONS a U U Q O U C O O U OC O Z Z Z Z 5. Furnishings and equipment (II.,C.,8., T'jj.. taff with infant-child CPR and first aid pages 21-23) See Checklists nt 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 C� *1. No staff on duty more than 8 continuous S ,J hours on a regular basis * a. 0 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 1 to 7 5. Infant/Toddler-Program (II.,D., 2.,pages 2&29) * d. 24.months up to 36 months 1 to 8 a: Learning/growth activities:(page 26) * e. 2%years up to 4 years 1 to 11 (1) Encouraged to play with a variety of toys * f. 4 years up to school age 1 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 while awake �J and observed *2. Children younger than 2Y2 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 C infants/toddlers each day ZI diapered J * c. Substitute staff available (5) No child diapered on the floor I * 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 i * 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, I 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 S * (1) 0 up to 18 months 1 to 5 (11) Potty chairs emptied,rinsed,disinfected after each use * (2) 18 months up to 2%years 1 to 14 ® * (12)Diapering area separate from food service area * (3) 2%years and older 1 to 36 c. Napping/resting(page 27) 2 REGULATIONS C: C U C.) Q Q CU REGULATIONS CU c E E . a Q a - U c Q O 0 U Q Z Z 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 *physician (15) Foods eaten from a dish * (5) Staff recognize differing needs of toddlers/allow to follow their own sleep patterns (16) Dishes,bottles unbreakable 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 5 emergency exitsitioned to allow space for access or * (19) Food not used as reward or punishment * (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 � * environment,no pillows,quilts,comforters,etc. (22) Individual paper towels for each washing and drying * (6) No infant put to sleep on sofa soft mattress 6. Preschool/School-age Program J (II.,D.,3.,pages.29-32) * (7) For toddlers,clean bottom sheets and top a. Learning/growth activities coverings weekly,more often if needed (pages 29-3U) e. Feeding(page-28-29) (1) Schedule posted * (1) Formula,food for infants if provided by center, planned with parent or physician (2) Variety of indoor/outdoor activities * (2) If formula provided by center,ready to feed, (3) Time outdoors daily when weather permits properly stored and handled i * (3) Meals and snacks comply with requirements (4) Staffpermidencourage conversation among � ! , children � * (4) If formula provided 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 supplement/enhance daily plan Small hard candies,nuts not served to children under four * (7) No child required to watch TV or videos * (7) Foods that may cause choking prepared s p appropriately for the child (8) Videos previewed by staff for appropriateness * (8) Feeding schedule according to child's needs s (9) Sexually explicit,violent,frightening materials prohibited * (9) Infants held for bottle feeding b. Napping/resting(page 30) (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 n to tv a) C C -Q U U REGULATIONS Q a " fU 1° E E a REGULATIONS Q c°) Q o o a U U Q 0 Z Z Z z (3) Rest period at least 45 minutes,not more than : 2%hours (]5) Children seated while eating * (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 *if needed (18) Children's hands washed before meals S* ( S. and snack and after toileting emergency Cots positioned to allow space for access or * (19) Staff hands waed before food ency exit 5 sh preparation and service,and after as 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 * (21). Individual paper towels for each washing and dryingS __ c. Toiletiug(page 30) * (22) Catered meals and snacks meet requirements Is * (1) According to each child's needs,each child's e. Disciplihary Practices 33 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 on pages eals a d snacks comply with USDA guidelines * (4) No discipline associated with food,naps, or bathroom procedures * (3) Fluid milk served,no powdered milk for drinking (5) No physical restraint as punishment * (4) No child deprived of meal -snack (6) No punishment administered by another child * (5) Special dietary needs in accordance with written f. Staff-Parent Communication(page 33) instructions * (6) Meals and snacks provided by the center (1) Discipline,behavior problems discussed with parent ch I) ending machines prohibited in areas used by. (2) Center open to visits from parents at any C time J 3 * (8) Small hard candies,nuts not served to children under four (3) Parents informed of right to visit * (9) Foods that may cause choking prepared (4) Staff available for communication/appropriately for the child conferences * (10) Portions of food suited to child's needs,second. portions available 1 (5) Parents notified of complaint procedures * (11) Unbreakable or single-use dinnerware used (6) Parents provided with information on influenza * (12)Single-use cups or glasses or a drinking fountain provided for water 9. Health information(pages 33-36) * (13) Drinking water offered during the day * (1) No ill child admitted * (14) Food served on individual dishes or napkins, not directly on table (2) If a child becomes ill or'is injured,he/she is separated from group,but continuously supervised, S U U CU C C CU U U REGULATIONS E E Q REGULATIONS E CL U Q O U U Q U o 0 Z Z Z Z * (3) Parent of ilUinjured child notified immediately (e) Children and staff wash hands after and required to come for child I S handling animals * (4) if parent cannot be reached or illness/injury J *h. Emergency Preparedness and Response severe,emergency medical attention is obtained •.7 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 5 (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) Med ilea tion/1�Iedical.Procedures(pages 34-35) licensee shall assume full authority and responsibility for away from the.centeractivities. Does.tlfe center's staff giv medication/medical pracedures? Yes No4 �] * (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 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 *d. Checklists kept on file for current year plus 2 * g� (t) Locked storage provided for medication additional years * (g) Medication returned to parent or disposed of *e. Center responsible for picking up child at 9 when no longer needed designated location and delivering child to %>4 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 * (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'/z 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 1< 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) Doors locked when vehicle is moving A C C tU N U U REGULATIONS CL a v m ICU 0 E E Q REGULATIONS CL a U Q o U Q o U z Z .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) * (4) Driver and all passengers secured when vehicle is moving 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 R installed according to manufacturers instructions, X V 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, installed according to manufacturer's instructions, 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. X *a. Medical exam and TB test on file at time of employment * (d) Each child 6 and older,the driver,and each * adult passenger secured in an individual seat belt, b• Staff with symptoms of contagious properly anchored to the vehicle. disease/condition not in center *h. Vehicle safety check done annually,signed by mechanic and dated,filed in center Character and`Suitability 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 *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 dministrati:o'n'(11:, H:, a :es 52-56 *d. Photo ID required when releasing child to unfamiliar,designated person 1. Applicant/licensee(page 52) Staff(II:, F., pages 41-46) a. Licensee assumes full authority and q sponsibility for meeting and maintaining ' Minimum Standards5 - 1. Qualifications(pages.4142). 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 * Child care workers/teachers meet requirements for d. Written operating CCDF training within 90 days(if applicable) S 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 policies do not contradict Minimum Standards *f. Substitute staff meet qualifications of staff for whom substituting (4) Changes in operating policies provided to parents and to DHR 7 U U C C C C Z ca N N REGULATIONS o o Q REGULATIONS C a Q U C.) Q O U Q CO p U O w. Z Z O 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 a. The following reported to DHR REigr 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 after child has left the center - (4) Change in chief executive officer of corporation S * (2) Records filed alphabetically or members of board �J * (5) Alterations to center or grounds (3)Inactive files maintained separately S * (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 Syear plus two additional years: b: The-following reported to DEIR=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 x 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 or gas service .J * (6) Any litigation involving the center 4 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 01 * (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 * (10) Any incident in which the health,welfare,or *e. Corrective/adverse action notices safety of a child is at risk S I j * (11)Any disastrous events *f. Most recent fire inspection report *c. Child abuse/neglect reported as required by law *g. Most recent health department inspection report and food permit or written permission for 1 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) O R C C -0 U U REGULATIONS Q 'Q U ° f0 E Q REGULATIONS CL a U � Q U Y Q Z Z ° O Z Z * (4) Poison control center * (2) Required ratios for day time maintained while children are awake(see page 23) * (5) Substitute help * 3 ( ) At least one staff,at least 19,meeting child *• care worker qualifications,with CPR and 1st 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;;L9 * (5) Each staff assigned responsibility for same children nightly -pages 5'7-58) * (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 careafter•7:00-p:m.? * (9) At least two staff in center whenever Yes ❑ No children are present/required ra� los met Does the center provide care after midnight? Yes 0 No * (10) Lighting maintained so children are visible while sleeping 1. Equipment and furnishings b. Nightly activity schedule posted (page 58) *a. In centers operating past midnight,cribs or cots, ` (1) Outdoor time available during daylight hours fitted with a waterproof mattress shall be provided for X each child * (2) Staff assist each child as needed,in dressing and grooming *b. In centers operating past midnight,there shall be at e. 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 e/ to school n a. Staffing.(pages 57-58) * (2) Evening meal served to children in attendance (I:) Staff-child ratio for sleeping children: A. 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 1>1 * (2) Each child bathed separately * (c) 2%-up to 4 years 1 to 18 * (3) Each child supervised while bathing — 1 17 (d) 4 years and older 1 to 25 4 * (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. Signature of licensee or designated staff Date 9 Emergency Preparedness and Response Plans Checklist l G • VI (O)indicates compliance observed by DHR Licensing Representative 1 I S/l Z (d)indicates not in compliance (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�us"ed to prepare for fhe 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 (�,m M;60► * Tornadoes * Flash flooding * Major snowfall * Blizzards - * Ice storms 1/ * Earthquakes *Lockdown or evacuation due to threats of violence *Location and use of-fire extinguishers *Evacuations due to; *#Documentation of the following quarterly drills; * Hazardous materials ✓ * Fire * Spills - `f * Gas leaks * Tornado * Bomb threats * Lockdown * Fire 46 * Relocation *Infectious disease emergencies *Telephones for on-site and off-site use *Loss ofpower,water,or heat *Location of the first aid and emergency supply kits '*Other threatening situations The disaster plan shall include details or: 1 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 f *Submitted to the Department , /r *Supplies needed for shelter in place procedures {� *Copies provided to all parents/guardians tl/ *Transportation disaster.procedures f *Staff training/reassignment as appropriate ; *#Plan updated yearly too *Contact with local emergency management officials to Checklist for Infants (0)indicates compliance observed by DHR Licensing Representative (d)indicates not in compliance (X)indicates not applicable *Name of teacher/room# • *Age-of children g *Number of children *Number of staff Minimum.E ,ui„ment Re uired or Each rou o*.Children Washab(e soft'cnli fo"`s-2 per'-child -' Push and ull toys-1 0 A device that plays a variety of age appropriate music Age approoriate books-2 er child Large balls(8+inches-I Nestin -and stacking to-')sets Washable bab doll-1 Musical to--I Colorful ictures and osters Activi boxes,such as busy boxes-3 x a enn area .: *Sink,warm water,soap,paper towels *Plastic-lined,covered container Tub( ortable lastic a acce table *Feedin chairs *Cribs/2 feet of s ace between occu ied cribs *Waterproof mattress,sheets *Indoor thermometer/Out of reach of children *Shelving forequipment and su lies/anchored *Individual,labeled storage space for each child *Furniture child size,clean,good condition *Cribs in accordance with US Consumer Product Safety Act of 2008 I ;_._ i * Etecttical outlets'covered"' *Barriers around heaters,fans *Hazardous substances locked *Containers labeled *Medication locked *Screens on windows which are opened *Lighting adequate 'DP O�k VCL g tote �t�jo Checklist for Toddlers a e 18 months-21/Z ears (0)indicates compliance observed by DHR Licensing Representative (+r)indicates not in compliance (X)indicates not.applicable *Name of teacher/room# 1 *Aga of children ! *Number of children Lill *Number of staff Minimum.E ui_merit Re wired or Cach droup,of Children q Lar a non-fozic cra oas%markers Paper(variety) Non-toxic Pla dou h Colorful piffures and posters A device that plays a variety of age appropriate music Musical.toys..—2 .. i _ Pu sh'and'ull`to s-2 .. .. .. , .-... _ - .,. .Large cars,trucks,boats,etc.-2 Sit-on riding toy-2 'Lar a soft bag-2 Quiet Play Books-2`er'cliild - A e a ro riate puzzles-2(complete with all pieces) Ne"in and stacking toys-2 sets - Iyott;wooden buildiA ,biccks(a roximatel 20 noncinterlockin ) i . _ Bab- dolls-2 coin letewi'th a1C nits ' Doll clothes and blankets Doll bed-1 Toy tele hones—2 Pots,pans,buckets,large plastic spoons Child-size stove Dress-up clothes Additional Fuin6hingi:andp.quioin *Dia erin"aiea *Sink,warm water,soap,paper towels *Plastic-lined,covered container Tub(portable plastic type acceptable) *Potty chairs cleaned/disinfected/emptied *Feeding chairs or table and chairs *Cribs/cots 40 1 " ;Waterproof mattress(es),sheets,coverings *Indoor thermometer/Out of reach of children *SlfeMng forequipment and supplies/anchored *Fumiture child size,clean,good condition *Individual,labeled storage space for each child les *Electrical outlets coveieih *Barriers around heaters,fans *Hazardous substances locked *Containers labeled *Medication locked *Screens on windows which are opened *Lighting adequate 12 Checklist for 24 months up to 36 months (0)indicates compliance observed by DHR Licensing Representative (I indicates not in compliance X indicates not aplAicable *Name of teacher/room# *A a of children *Number of children *Number of staff Minimum Equipment Required for Each,Group.of jChil en, Large non-toxic crayons/markers Paper Non-toxic finger-paints in primary colors Scissors(blunt-tipped) B-60'ks-1per child A device that plays a variety of age appropriate music Rhythm instruments-one for each child in the group 7�r Baby dolls__Y(complefe Child-size stove and sink Cooking utensils and dishes Doll bed Doll clothes and blankets Dress up clothes Toy telephones—2 7CJB lding blocks=approziinately�50 non}nterlocking.s,trucks,boats,etc.—3 Age appropriate puzzles-4(complete with all pieces) Interlocking manipulative play sets of different types—3 sets *Dia grin 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 daily plan or schedule 26sted s *Labeled storage space at child level. 9 *Shelving forequipment and supplies/anchored Designated activity areas f *Elecfiical outlets covered *Barriers around heaters,fans *Hazardous substances locked *Containers labeled *Medication locked *Screens on windows which are opened *Lighting adequate 1� _Checklist for Preschool (age 21/2 years to school ate) (0)indicates compliance observed by DHR licensing representative ( 1)indicates not in compliance X indicates not applicable *Name of teacher/room ITO, *Age of children 163 1 LlS *Number of children *Number of staff Non-toxin playdough or clay Large non-toxic crayons/watercolor markers 0 Large sheets of paper Non-toxic finger/cold water paints-primary colors Scissors(blunt tip)-2 pr.Per 5 children 0 _ 8 O Non-toxic glue or paste;tape - -Paint brushes four 1/2 and 1 inch in width Large�medium;6uilding,liiocks app.1�non-interlocking ``' Small building blocks-app. 100 non-interlocking O 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 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 Dress-up clothes for boys and girls Storage for dress-up clothes d Unbreakable mirror-full length Toy,telephones-2, Age Appropriate chddren's 666ks-2 per child' A device that plays a variety of age appropriate music a Rhythm instruments-1,per child,in group Iola m m (ass .., -... g fY g g :.� ...�: Magnets ® D Nature collections D Measuring and pouring equipment P� 0 *Ta61e`s'ace and chair for each ohild ,..- *Cots.Sheets,covers for each child !(!( *Indoor thermometer/out of reach Written daily plan or schedule posted i *Labeled storage space at child level 0 *Shelving forequipment and supplies/anchored Designated activity,,areas Facilities.-7"V'� *Electrical outletscovered" *Barriers around heaters,fans *Hazardous substances locked/ *Containers labeled *Medication locked o *Screens on windows which-are opened *Lighting adequate. 1d Checklist for School-Age (O)indicates compliance observed by DHR Licensing Representative (,If)indicates not in compliance (X)indicates not applicable *Name of teacher/room# *Age of children ` r *Number of children Alaw *Number of staff Minmu»m,E ui :ment Re uired ,or Each Group of Children t - 69 `Ji' -saw uzzle-lDer 5'childreri""' 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 a e of children-2,per child Non-toxic playdoughormodelin .cla 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—I per 5 children - !Ta-�I-' s ace and chair`for each'ctiildCots/sheets/covers for each child who nap77 *Indoor thermometer/out of reach Written dail lan or schedule osted *Labeled storage space,at child level *Shelving forequipment and supplies/anchored Desi nated activi areas Imam a *Electrical'ou[le[s covcied ' *Barriers around heaters,fans *Hazardous substances locked *Containers labeled *Medication locked *Screens on windows which are opened *Lighting Adequate I I 15 Playground Checklist (0)indicates compliance observed by DHR Licensing Representative (+r)indicates not in compliance (X)indicates not applicable Required , p.69 Minimum Equipment Required for groups of twenty-five child n Qrfg,r otthe playground Location or age group �l Wheel vehicles to sit on and maneuver-2 O Wheel vehicles to pull or push-2 0 0 Balls-3 Climbing apparatus o Crawl-through equipment Digging or sand area = d O 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 *Shade and sun areas provided O *Outdoor play area free of apparent hazardous conditions * Concrete/asphalt not used under equipment O o * Area well-drained O * Equipment not designed to be portable,securely anchored *Stairs/steps have hand rails in child's reach U 5 �vti c�iK C,0_V 0__� t I 16