INSPECTION CHECKLIST

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1 Capacity: 198 Owner: Children's Country Club, Sarno, Melb.,Inc Director: Tracy Bremmer Inspection Information Type: Routine Date: 08/03/2012 Arrival/Departure: 01:30 PM to 04:45 PM Staff Present: 5 Children Present: 47 INSPECTION CHECKLIST GENERAL REQUIREMENTS (65C ) 1. License Displayed/Citation Posted/Advertising , Licensed Capacity (6), 65C (2) & 65C (3)(f) & (g), F.A.C Minimum Age Requirements (2)(c) & 65C (3) Ratio Sufficient 65C (4)(a)(b) & (4)(a)(b) Ratios Age Group Observation Notes 1: Months (1:4) 1st 1:7 2 Years (1:11) 1st Naptime 1:10 4 Years (1:20) 1st Naptime 1:20 Mixed Group 1st Clsassroom 1:5 3 Years (1:15) 1st Naptime Description(s) A ratio of 1 staff for 4 children is required. There was/were 1 staff for 5 children observed. Counselor observed 5 infants in the infant room at the time of inspection. Another employee came in and brought the ratio into compliance. The employee stated that one of the teachers had called in sick. Due Date: Completed at time of inspection Violation Level: Class 2 65C (4)(a) The staff-to-child ratio, as established in s (4), F.S., is based on primary responsibility for the direct supervision of children and applies at all times while children are in care. (b)1. In groups of mixed age ranges, where children under one (1) year of age are included, one (1) staff member shall be responsible for no more than four (4) children of any age group, at all times. 2. In groups of mixed age ranges, where children one (1) year of age but under two (2) years of age are included, one (1) staff member shall be responsible for no more than six (6) children of any age group, at all times (4)(a) Minimum standards for the care of children in a licensed child care facility as established by rule of the department must include: 1. For children from birth through 1 year of age, there must be one child care personnel for every four children. 2. For children 1 year of age or older, but under 2 years of age, there must be one child care personnel for every six children. 3. For children 2 years of age or older, but under 3 years of age, there must be one child care personnel for every 11 children. 4. For children 3 years of age or older, but under 4 years of age, there must be one child care personnel for every 15 children. 5. For children 4 years of age or older, but under 5 years of age, there must be one child care personnel for every 20 children. 6. For children 5 years of age or older, there must be one child care personnel for every 25 children. 7. When children 2 years of age and older are in care, the staff-to-children ratio shall be based on the age group with the largest number of children within the group. (b) This subsection does not apply to nonpublic schools and their integral programs as defined in s (2)(d)1. In addition, an individual participating in a community service program activity under s (1)(e), or a work experience activity under s (1)(f), at a child care facility may not be considered in calculating the staff-to-children ratio. Page 1 of 7

2 5. Supervision 65C (5)(a)-(d), 65C (6)(f), 65C (4)(c)2. & 65C (2) Driver's License, Physician Certification & First Aid/CPR Training 65C (6)(a), 65C (6)(a) The driver's license is good until 10/18/2018 and physical good until 06/25/2013. Driver number 2 physical good until 06/25/2013 and need copy of driver license. Van #3 Vin 2B5WB35ZOIK has not been inspected and fire extinguisher needs to be recertified. 65C (6)(a) (a) When any vehicle is regularly used by a child care facility to provide transportation, the driver shall have the following: 1. A valid Florida driver's license, 2. An annual physical examination which grants medical approval to drive, and valid certificate(s) of course completion for first aid training and infant and child cardiopulmonary resuscitation (CPR) procedures 65C (4)(g) (g) Driver's license and driver physical examination documentation. A copy of the driver's license and the physician certification, or another form containing the same elements of the physician certification, granting medical approval to operate the vehicle, and valid certificate(s) of course completion for first aid training and infant and child cardiopulmonary resuscitation (CPR) procedures must also be maintained in the driver's personnel file. 7. Vehicle Insurance and Inspection 65C (6)(b)(c) & (10) Insurance for all 3 vans is good until 06/13/2013. Van # 3 Vin # 2B5WB35ZOIK needs to be inspected and the fire extinguisher needs to be recertificed. 65C (6)(b) All child care facilities must comply with the insurance requirements found in s (4), F.S. (c) All vehicles regularly used to transport children shall be inspected annually by a mechanic to ensure proper working order. Documentation by the mechanic shall be maintained in the vehicle (10) Minimum standards shall include requirements for child restraints or seat belts in vehicles used by child care facilities and large family child care homes to transport children, requirements for annual inspections of the vehicles, limitations on the number of children in the vehicles, and accountability for children being transported. 8. Seat Belts/Child Restraints 65C (6)(d)(e) Transportation 65C (6)(f),(g) Planned Activities 65C (7)(a) Field Trip Permission 65C (7)(b),& 65C (6) Child Discipline 65C (8)(a)(b), & (12) Discipline Policy 65C (8)(c) PHYSICAL ENVIRONMENT (65C ) 14. Facility Environment 65C (1)(a)(b)(c) Page 2 of 7

3 Description(s) Areas of the facility were found to be in need of cleaning. The counselor observed that the refrigerator needs to be cleaned out and the floor had stains. There was no bag in the trash can in the kitchen. The bath tub in one of the classrooms was filthy and had a cardboard covering on it with debri. The classrooms needed vacuuming. Due Date: 09/03/ C (1)(a)(b) (1) General Requirements. (a) All child care facilities must be clean, in good repair, free from health and safety hazards and from vermin infestation. (b) During the hours that the facility is in operation, no portion of the building shall be used for any activity which endangers the health and safety of children. (c) It is the responsibility of the director/operator to ensure all areas of the facility are free from fire hazards, such as, lint build up in heating and air vents, filters, exhaust fans, ceiling fans, and dryer vents. 15. Toxic Substances and Hazardous Materials 65C (1)(d)(f)(g) & (i) Supplies Labeled/Stored 65C (1)(f) Lighting 65C (2)(a)(b) & (c) Temperature and Ventilation 65C (2)(d) & (e) Indoor Floor Space (6), 65C (3)(a)-(e) & (g), & 65C (3)(a) Outdoor Area/Square Footage 65C (4)(a)(b) & (6) Outdoor Play Area 65C (4)(c) & (h) The latch on the main gate leading to the facility is broken. String is used to hold it together. 22. Fencing 65C (4)(d)(e) Counselor observed the latch on the front gate is broken and a string is used to hold the gate lock. 23. Individual Bedding 65C (5)(a)(c), 65C (8)(c) & 65C (3)(g) Bedding and Linens 65C (8)(c) Counselor observed dirty pillows and technical assistance was given to the employees to send the pillows home to be washed by parents. 25. Nap/Sleep Space Requirements 65C (5)(b) Exit Area Clear 65C (5)(b) Page 3 of 7

4 27. Crib Requirements 65C (5)(c)(d) Technical assistance given to provider not to put rockers in the baby cribs. Removed at time of inspection. 28. Toilets and Basins 65C (6)(a)(b)1(c) & (g) Potty Chairs 65C (6)(b) Bath Facilities and Supervision 65C (6)(d)(e) Bathroom Supplies and Equipment 65C (6)(f) Operable Phone 65C (7)(b) Fire Drills & Emergency Preparedness 65C (7) & 65C (5)(e) Not Applicable Last fire drill was on 6/14/2012 and an emergency preparedness has not been done for this year. Technical assitance was given to the director to have one done and the importance of emergency drills. 34. Window Screens 65C (8)(a) Proper Hand Washing 65C (8)(a)2, 4 & (b) Drinking Water Available 65C (8)(a) Sanitary Diapering 65C (8)(b) Diaper Disposal 65C (8)(b) Indoor Equipment 65C (9)(a) Outdoor Equipment 65C (9)(b) TRAINING (65C ) 41. Training Requirements (2)(d), & (3) Hour In-Service 65C (6)(a)-(d) Description(s) The ten hours of annual in-service training had not been completed for the fiscal year beginning July 1 and ending June 30 for staff as indicated on the attached Supplemental. See supplemental. Due Date: 09/03/ C (6)(a)-(d) (6) Annual In-Service Training. (a) All child care facility personnel must complete a minimum of 10-clock-hours or one CEU of in-service training annually during the state's fiscal year beginning July 1 and ending June 30. Page 4 of 7

5 (b) The annual 10-clock-hours or one CEU of in-service training concentrating on children ages birth through 12, must be completed in one or more of the following areas (college level courses will be accepted): 1. Health and safety, including universal precautions; 2. Infant and/or child CPR; 3. First Aid (may only be taken to meet the in-service requirement once every three years); 4. Nutrition; 5. Child development - typical and atypical; 6. Child transportation and safety; 7. Behavior management; 8. Working with families; 9. Design and use of child oriented space; 10. Community, health and social service resources; 11. Child abuse; 12. Child care for multilingual children; 13. Working with children with disabilities in child care; 14. Safety in outdoor play; 15. Literacy; 16. Guidance and discipline; 17. Computer technology; 18. Leadership development/program management and staff supervision; 19. Age appropriate lesson planning; 20. Homework assistance for school-age care; 21. Developing special interest centers/spaces and environments; or 22. Other course areas relating to child care or child care management. (c) Documentation of the in-service training requirement must be recorded on CF-FSP Form 5268, March 2009, Child Care In-Service Training Record, which is incorporated by reference, and included in the child care facilities' personnel records. CF-FSP Form 5268 may be obtained from the department website at A new in-service training record is required each fiscal year. The in-service training records for the previous two fiscal years must also be maintained at the child care facility for review by the licensing authority. (d) Mandated 40-clock-hour introductory child care training, Parts I and II, may be used to meet the annual in-service training requirement during the first fiscal year of employment. 43. Credentialed Staff 65C (7) & 65C (8) HEALTH REQUIREMENTS (65C ) 44. Communicable Disease Control 65C (1) First Aid Requirements 65C (2)(a)-(c) CPR Requirements 65C (2)(a)(b) Emergency Telephone Numbers 65C (2)(d) Accident/ Incident Notification and Documentation 65C (2)(d) Medication 65C (3) FOOD AND NUTRITION (65C ) 50. Meals and Snacks 65C (1)(a)-(d) Page 5 of 7

6 51. Meal and Snack Menus 65C (1)(d) Food Service 65C (3)(a) Bottles Sanitary and Labeled 65C (3)(c)-(e) Description(s) Bottles and sippy cups were not labeled with the child's first and last name. Technical assistance was given to the teachers in the infant room to label sippy cups/bottles for the infants in the room. Due Date: Completed at time of inspection 65C (3)(c)(d)(e), F.A.C. (c) There shall be no propped bottles. If a child cannot hold the bottle, then a staff person or volunteer must hold the bottle during feeding. There shall be no automatic feeding devices unless medically prescribed. Formula shall be refrigerated and handled in a sanitary manner at all times. (d) All bottles and sippy cups prepared and used continuously throughout the day or brought from home shall be individually labeled with the child's first and last name. Sippy cups and bottles brought from home shall be returned to the custodial parent or legal guardian daily. (e) Heated foods and bottles must be tested before feeding to ensure heat is evenly distributed and to prevent injury to children. 54. Sufficient Seating 65C (3)(f) Single Service Items 65C (3)(b) RECORD KEEPING (65C ) 56. Records (2), 65C (1)(a)(c) Children's Health/Immunization Records 65C (2)(a)-(c),(3)(c)3 & (9) Description(s) The immunization record was incomplete for the child(ren) listed on the attached Supplemental. The record did not document required vaccinations, signature of a physician, date of the immunization or the expiration date. See supplemental list. Due Date: 09/03/ C (2)(a)-(c),(3)(c)3. (2) Children's Health Requirements. (a) The child care facility is responsible for obtaining for each child in care a current, complete and properly executed Student Health Examination form DH 3040 (June 2002), which is incorporated herein by reference and may be obtained from the local county health department, from the parent or legal guardian or a signed statement by authorized professionals that indicates the results of the components of the Student Health Examination form are included in the health examination. The Student Health Examination shall be completed by a person given statutory authority to perform health examinations. (b) The Student Health Examination or the signed statement is valid for two years from the date the physical was performed. An up-to-date version must be on file for as long as the child is enrolled at the facility. (c) The child care facility is responsible for obtaining for each child in care a current, complete and properly executed Florida Certification of Immunization form Part A-1, B, or C, DH 680 (April 2009), or the Religious Exemption from Immunization form, DH 681 (July 2008), which are incorporated herein by reference, from the custodial parent or legal guardian. DH Form 680 and DH Form 681 may be obtained from the local county health department. Immunizations received out-of-state are acceptable; however immunizations must be documented on the Florida Certification of Immunization form and must be signed by a physician practicing in the State of Florida. Specific immunization requirements are Page 6 of 7

7 included and detailed in the most current edition of the "Immunization Guidelines-Florida Schools, Child Care Facilities and Family Day Care Homes" as promulgated by the Florida Department of Health. 65C (3)(c)3. 3. Annually, during the months of August and September, the child care facility director must provide parents with information detailing the causes, symptoms, and transmission of the the influenza virus. To assist providers the department developed a brochure, CF/PI , June 2009, Influenza Virus, Guide to Parents, which may be obtained from the department's website at (9) (9) ADMISSIONS AND RECORDKEEPING.-- (a) Minimum standards shall include requirements for preadmission and periodic health examinations, requirements for immunizations, and requirements for maintaining emergency information and health records on all children. (b) During the months of August and September of each year, each child care facility shall provide parents of children enrolled in the facility detailed information regarding the causes, symptoms, and transmission of the influenza virus in an effort to educate those parents regarding the importance of immunizing their children against influenza as recommended by the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention. (c) Because of the nature and duration of drop-in child care, requirements for preadmission and periodic health examinations and requirements for medically signed records of immunization required for child care facilities shall not apply. A parent of a child in drop-in child care shall, however, be required to attest to the child's health condition and the type and current status of the child's immunizations. (d) Any child shall be exempt from medical or physical examination or medical or surgical treatment upon written request of the parent or guardian of such child who objects to the examination and treatment. However, the laws, rules, and regulations relating to contagious or communicable diseases and sanitary matters shall not be violated because of any exemption from or variation of the health and immunization minimum standards. 58. Enrollment Information on File/Current 65C (3) Personnel Records (1)(b), 65C (4)(a), & 65C (4)(5) Background Screening Documents (3), (1), & (1)(a)(c), & 65C (4) Daily Attendance 65C (10) & 65C (5) Emergency Plan/Posted 65C (7)(d) ENFORCEMENT (65C ) 63. Access/Child Abuse or Neglect/Misrepresentation & 65C (9),(11) Received by: Ashley Wall Inspected by: Joyce Sebola-Semista Date: 08/03/2012 Page 7 of 7

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