Andrea Holman

“g” The home shall have at least one 2A 10BC rated fire extinguisher located in a visible and readily accessible place on each child-occupied floor.

“g” The home shall have at least one 2A 10BC rated fire extinguisher located in a visible and readily accessible place on each child-occupied floor. Andrea did have a fire extinguisher, but it was not visible and she did not have a sign identifying the location. This worker did provide her a stick to use.

“b” A first-aid kit shall be available and easily accessible whenever children are in the child development home, in the outdoor play area, in vehicles used to transport children, and on field trips. The kit shall be sufficient to address first aid related to minor injury or trauma and shall be stored in an area inaccessible to children. The kit shall, at a minimum, include adhesive bandages, bottled water, disposable tweezers, and disposable plastic gloves.

“b” A first-aid kit shall be available and easily accessible whenever children are in the child development home, in the outdoor play area, in vehicles used to transport children, and on field trips. The kit shall be sufficient to address first aid related to minor injury or trauma and shall be stored in an area inaccessible to children. The kit shall, at a minimum, include adhesive bandages, bottled water, disposable tweezers, and disposable plastic gloves. Andrea did have a first aid kit but it did not have any bandages, disposable gloves or water bottle which are all required items.

“b” The provider must have procedures in place for the following: 1. evacuation to safely leave the facility 2. relocation to a common, safe location after the evacuation 3. shelter-in-place to take immediate shelter where you are when it is unsafe to leave that location due to the emergent issue 4. lock down protocol to protect children and providers from an external situation 5. communication plan and plans for reunification with families 6. continuity of operations plans 7. Procedures to address the needs of individual children, including those with functional or access needs

“b” The provider must have procedures in place for the following: evacuation to safely leave the facility relocation to a common, safe location after the evacuation shelter-in-place to take immediate shelter where you are when it is unsafe to leave that location due to the emergent issue lock down protocol to protect children and providers from an external situation communication plan and plans for reunification with families continuity of operations plans Procedures to address the needs of individual children, including those with functional or access needs Andrea had a partial Emergency Preparedness Plan, but several areas had not been filled out. She does have an example of what needs to...

Children’s Files 470-5430 (Rev. 8/17) 1305 E. Walnut Street, Des Moines, IA 50319-0114 Iowa Department of Health And Human Services Kim Reynolds Governor Adam Gregg Lt. Governor Kelly K. Garcia Director

The file shall contain: a. Identifying information including, at a minimum, the child’s name, birth date, parent’s name, address, telephone number, special needs of the child, and the parent’s work address and telephone number. b. Emergency information including, at a minimum, where the parent can be reached, the name, street address, city and telephone number of the child’s regular source of health care, and the name, telephone number, and relationship to the child of another adult available in case of emergency. c. A signed medical consent from the parent authorizing emergency treatment. d. An admission physical examination report signed by a licensed physician or designee in a clinic...

The childrens file shall contain: An admission physical examination report signed by a licensed physician or designee in a clinic supervised by a licensed physician For children under the age of six, a statement of health condition signed by a physician or designee submitted annually from the date of the admission physical. For a child who is five years of age or older and enrolled in school, a statement of health status signed by the parent or legal guardian may be substituted for the physician statement. Andrea was missing an initial physical for one of the children in care. Sugge

“g” The home shall have at least one 2A 10BC rated fire extinguisher located in a visible and readily accessible place on each child-occupied floor.

“g” The home shall have at least one 2A 10BC rated fire extinguisher located in a visible and readily accessible place on each child-occupied floor. Andrea did have a fire extinguisher, but it was not the approved size.

Prior to issuance of a provider agreement, the provider shall complete two hours of Iowa’s training for mandatory reporting of child abuse as required by Iowa Code section 232.69. The provider shall maintain a valid certificate indicating expiration date. Findings: 470-5430 (Rev. 8/17) 1305 E. Walnut Street, Des Moines, IA 50319-0114 Iowa Department of Health And Human Services Kim Reynolds Governor Adam Gregg Lt. Governor Kelly K. Garcia Director An annual compliance check was completed on 3/7/24 and the following was out of compliance:

Prior to issuance of a provider agreement, the provider shall complete two hours of Iowa’s training for mandatory reporting of child abuse as required by Iowa Code section 232.69. The provider shall maintain a valid certificate indicating expiration date. Andrea could not locate her certificate for Mandatory Child abuse reporter training. Suggestions/Recommendations: A re-check is not needed at this time. Corrections need to be made by 3/28/24 and will be reviewed at the next annual compliance check. Please send pictorial verification of the items where specifically noted below.

“h” The home shall have at least one single-station, battery-operated, UL-approved smoke detector in each child-occupied room and at the top of every stairway. Each smoke detector shall be installed according to manufacturer’s recommendations. The provider shall test each smoke detector monthly and keep a record of testing for inspection purposes

“h” The provider shall test each smoke detector monthly and keep a record of testing for inspection purposes. Andrea did not have any documentation of monthly testing of smoke detectors. This was an area that was out of compliance at last year's annual check as well and this worker had provided her the correct form to use for documentation purposes last year.

“c” Medications shall be given only with the parent’s or doctor’s written authorization. Each prescribed medication shall be accompanied by a physician’s or pharmacist’s direction. Both nonprescription and prescription medications shall be in the original container with directions intact and labeled with the child’s name. All medications shall be stored properly and, when refrigeration is required, shall be stored in a separate, covered container so as to prevent contamination of food or other medications. All medications shall be stored so they are inaccessible to children. Any medication administered to a child shall be recorded, and the record shall indicate the name of the medication,...

“e” The provider shall establish procedures related to infectious disease control and handling of any bodily excrement or discharge or blood and breast milk. Soiled diapers shall be stored in containers separate from other waste.

“a” All medicines and poisonous, toxic, or otherwise unsafe materials shall be secured from access by a child. Andrea did have chemicals under the bathroom sink in reach of the children and it was not secured. She initially reported that the kids are too young to use the bathroom but she does provide care for her 6-year-old granddaughter who does in fact use the bathroom.

“c” Medications shall be given only with the parent’s or doctor’s written authorization. Each prescribed medication shall be accompanied by a physician’s or pharmacist’s direction. Both nonprescription and prescription medications shall be in the original container with directions intact and labeled with the child’s name. All medications shall be stored properly and, when refrigeration is required, shall be stored in a separate, covered container so as to prevent contamination of food or other medications. All medications shall be stored so they are inaccessible to children. Any medication administered to a child shall be recorded, and the record shall indicate the name of the medication,...

“e” The provider shall establish procedures related to infectious disease control and handling of any bodily excrement or discharge, or blood. Soiled diapers shall be stored in containers separate from other waste. Andrea does not have any such procedure and has not stored soiled diapers in a separate container from her other waste.

Emergency Plans 470-5430 (Rev. 8/17) 1305 E. Walnut Street, Des Moines, IA 50319-0114 Iowa Department of Health And Human Services Kim Reynolds Governor Adam Gregg Lt. Governor Kelly K. Garcia Director

Emergency Plans: plans in case of man-made or natural disaster shall be written and posted by the primary and secondary exits. The plans shall clearly map building evacuation routes and tornado and flood shelter areas.

“a” Fire and tornado drills shall be practiced monthly and the provider shall keep documentation evidencing compliance with monthly practice on file for the current year and the previous year.

“b” The provider must have procedures in place for the following: 1. evacuation to safely leave the facility 2. relocation to a common, safe location after the evacuation 3. shelter-in-place to take immediate shelter where you are when it is unsafe to leave that location due to the emergent issue 4. lock down protocol to protect children and providers from an external situation 5. communication plan and plans for reunification with families 6. continuity of operations plans 7. Procedures to address the needs of individual children, including those with functional or access needs

Emergency Plans: plans in case of man-made or natural disaster shall be written and posted by the primary and secondary exits. The plans shall clearly map building evacuation routes and tornado and flood shelter areas. Andrea did not have this at her primary or secondary exit. This was also an area out of compliance at last year's compliance visit.

“a” Fire and tornado drills shall be practiced monthly and the provider shall keep documentation evidencing compliance with monthly practice on file for the current year and the previous year. Andrea did not have any documentation of monthly practice of fire and tornado drills. This was also an area that was out of compliance at last year's compliance visit and this worker had provided her a form last year to use for documentation purposes.

“b” The provider must have procedures in place for the following: evacuation to safely leave the facility relocation to a common, safe location after the evacuation shelter-in-place to take immediate shelter where you are when it is unsafe to leave that location due to the emergent issue lock down protocol to protect children and providers from an external situation communication plan and plans for reunification with families continuity of operations plans Procedures to address the needs of individual children, including those with functional or access needs Andrea did not have an Emergency Preparedness plan. This was also an area that was out of compliance at last year's annual check.

The file shall contain: a. Identifying information including, at a minimum, the child’s name, birth date, parent’s name, address, telephone number, special needs of the child, and the parent’s work address and telephone number. b. Emergency information including, at a minimum, where the parent can be reached, the name, street address, city and telephone number of the child’s regular source of health care, and the name, telephone number, and relationship to the child of another adult available in case of emergency. c. A signed medical consent from the parent authorizing emergency treatment. d. An admission physical examination report signed by a licensed physician or designee in a clinic...

The file shall contain: 470-5430 (Rev. 8/17) 1305 E. Walnut Street, Des Moines, IA 50319-0114 Iowa Department of Health And Human Services Kim Reynolds Governor Adam Gregg Lt. Governor Kelly K. Garcia Director An admission physical examination report signed by a licensed physician or designee in a clinic supervised by a licensed physician For children under the age of six, a statement of health condition signed by a physician or designee submitted annually from the date of the admission physical. For a child who is five years of age or older and enrolled in school, a statement of health status signed by the parent or legal guardian may be substituted for the physician statement. A signed...

“g” The home shall have at least one 2A 10BC rated fire extinguisher located in a visible and readily accessible place on each child-occupied floor.

Prior to issuance of a provider agreement, the provider shall complete two hours of Iowa’s training for mandatory reporting of child abuse as required by Iowa Code section 232.69. The provider shall maintain a valid certificate indicating expiration date. Findings: This worker arrived at the home on 6/13/23 around 11:30am to find 1 child care children present. Andrea's adult daughter who resides in the home was also present along with 3 of her grandkids that also reside in the home and are of school age. The one child present for child care is also a grandchild who resides in the home

“a” The home shall have a nonpay, working land-line or mobile telephone with emergency numbers posted for police, fire, ambulance, and the poison information center. The number for each child’s parent, for a responsible person who can be reached when the parent cannot, and for the child’s physician shall be written on paper and readily accessible by the telephone. The home must prominently display all emergency information, and all travel vehicles must have a paper copy of emergency parent contact information

“b” Electrical wiring shall be maintained, and all accessible electrical outlets shall be tamper- resistant outlets or shall be safely capped. Electrical cords shall be properly used. Improper use includes running cords under rugs, over hooks, through door openings, or other use that has been known to be hazardous

“h” The home shall have at least one single-station, battery-operated, UL-approved smoke detector in each child-occupied room and at the top of every stairway. Each smoke detector shall be installed according to manufacturer’s recommendations. The provider shall test each smoke detector monthly and keep a record of testing for inspection purposes 470-5430 (Rev. 8/17) 1305 E. Walnut Street, Des Moines, IA 50319-0114 Iowa Department of Health And Human Services Kim Reynolds Governor Adam Gregg Lt. Governor Kelly K. Garcia Director

“i” Smoking and the use of tobacco products shall be prohibited at all times in the home and in every vehicle in which children receiving care in the home are transported. Smoking and the use of tobacco products shall be prohibited in the outdoor play area during the home’s hours of operation. Nonsmoking signs shall be posted at every entrance of the child care home and in every vehicle used to transport children. All signs shall include: 1. The telephone number for reporting complaints, and 2. The Internet address of the department of public health (www.iowasmokefreeair.gov)

“b” A first-aid kit shall be available and easily accessible whenever children are in the child development home, in the outdoor play area, in vehicles used to transport children, and on field trips. The kit shall be sufficient to address first aid related to minor injury or trauma and shall be stored in an area inaccessible to children. The kit shall, at a minimum, include adhesive bandages, bottled water, disposable tweezers, and disposable plastic gloves.

Emergency Plans: plans in case of man-made or natural disaster shall be written and posted by the primary and secondary exits. The plans shall clearly map building evacuation routes and tornado and flood shelter areas.

“a” Fire and tornado drills shall be practiced monthly and the provider shall keep documentation evidencing compliance with monthly practice on file for the current year and the previous year.

“b” The provider must have procedures in place for the following: 1. evacuation to safely leave the facility 2. relocation to a common, safe location after the evacuation 3. shelter-in-place to take immediate shelter where you are when it is unsafe to leave that location due to the emergent issue 4. lock down protocol to protect children and providers from an external situation 5. communication plan and plans for reunification with families 6. continuity of operations plans 7. Procedures to address the needs of individual children, including those with functional or access needs

An individual file is maintained for each child and updated annually or when there are changes. 470-5430 (Rev. 8/17) 1305 E. Walnut Street, Des Moines, IA 50319-0114 Iowa Department of Health And Human Services Kim Reynolds Governor Adam Gregg Lt. Governor Kelly K. Garcia Director

The file shall contain: a. Identifying information including, at a minimum, the child’s name, birth date, parent’s name, address, telephone number, special needs of the child, and the parent’s work address and telephone number. b. Emergency information including, at a minimum, where the parent can be reached, the name, street address, city and telephone number of the child’s regular source of health care, and the name, telephone number, and relationship to the child of another adult available in case of emergency. c. A signed medical consent from the parent authorizing emergency treatment. d. An admission physical examination report signed by a licensed physician or designee in a clinic...