Brenda Vrba

"a" The provider shall follow safe sleep practices as recommended by the American Academy of Pediatrics for infants under the age of one. a. Infants shall always be placed on their back for sleep. b. Infants shall be placed on a firm mattress with a tight fitted sheet that meets Consumer Product Safety Commission federal standards. c. Infants shall not be allowed to sleep on a bed, sofa, air mattress or other soft surface. No child shall be allowed to sleep in an infant seat, car seat, swing, bouncy seat, or items not designed for sleeping. d. No toys, soft objects, stuffed animals, pillows, bumper pads, blankets, or loose bedding shall be allowed in the sleeping area with the infant. e. No...

“ e” No more than 16 children shall be present at any one time when an emergency school closing is in effect. If more than 8 children are present at any one time due to an emergency school closing exception, the provider shall be assisted by a department-approved assistant who is at least 18 years of age. • If only ne approved provider is present, no more than 6 of 8 children may be 24 months of age or younger and of these 6 children, no more than 3 are 12 months of age or younger.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 Findings:

If only one approved provider is present, no more than 6 of 8 children may be 24 months of age or younger and of these 6 children, no more than 3 are 12 months of age or younger. **Upon arrival to the childcare home, there was only one childcare provider in the home. Compliance staff verified the number of childcare children in the home and the provider reported 11. The other provider had left to pick up a preschool child. With one provider out of the home, the single provider was over numbers at 11 children. Also, the providers are at the allowable limit for infants in care. This also placed the single childcare provider over numbers for children who are 12 months of age and younger....

Check with the appropriate authorities to determine how the following local, state, or federal laws apply to you: • Zoning code • Building code • Fire code • Business license • State and federal income tax • Unemployment insurance • Worker’s Compensation • Minimum wage and hour requirements • OSHA • Americans with Disabilities Act (ADA).Walnut Street, Des Moines, IA 50319-0114

Safe Sleep- two infants were sleeping and swaddled. Swaddling is not necessary or recommended in the child care setting. The risks of swaddling include overheating, hip dysplasia, SIDS, and other accidental deaths. **Compliance staff viewed two infants in swaddles. Compliance staff talked with the provider that swaddles are not allowed in childcare. Compliance staff discussed safe sleep with both providers and the reasons why using a swaddle is not allowed.

“ c” The home shall have a minimum of two direct exits to the outside from the main floor. 1. If the second level or the basement of the home is used for the provision of child care, other than the use of a restroom, each additional child-occupied floor shall have at least one direct exit to the outside in addition to one inside stairway. 2. All exits shall terminate at grade level with permanent steps. 3. A basement window may be used as an exit if the window can be opened from the inside without the use of tools and it provides a clear opening of not less than 20 inches in width, 24 inches in height, and 5.7 square feet in area. The bottom of the opening shall be not more than 44 inches...

“c” The home shall have a minimum of two direct exits to the outside **The provider has placed children over the age of 1 in the basement at the base of the stairs. There is not an identified 2nd exit from the basement. The provider will relocate the cribs to the main floor, where there are two direct exits. Suggestions/Recommendations: If you have any questions about this letter, please reach out to compliance staff. Your current CCR&R representative is Jamie Needham. Her contacts are 712-579-7326 or jneedham@westcca.org Corrective Action Required: For all necessary update paperwork needs, please work on this and update your files by the end of March 2024. No documentation is necessary to...

Check with the appropriate authorities to determine how the following local, state, or federal laws apply to you: • Zoning code • Building code • Fire code • Business license • State and federal income tax • Unemployment insurance • Worker’s Compensation • Minimum wage and hour requirements • OSHA • Americans with Disabilities Act (ADA).Walnut Street, Des Moines, IA 50319-0114

“ a” A physician’s examination report for the provider and all members of the provider’s household aged 18 years or older. Acceptable physical examinations shall be documented on Form 470- 5152, Child Care Provider Physical Examination Report. All children residing in the household must have medical documentation outlined in 110.9(4) “d”, 110.9(4) “f”, and 110.9(4) “g”

“a” A physician’s examination report for the provider and all members of the provider’s household aged 18 years or older . Acceptable physical examinations shall be documented on Form 470-5152, **Co-Provider is in need of an updated physical.

An individual file is maintained for each staff assistant and contains: 1. Documentation from the department confirming the record checks required under subrule 110.11(3) have been completed and authorizing or conditionally limiting the person’s involvement with child care 2. A completed Form 470-5152, Child Care Provider Physical Examination Report. The examination shall include any necessary testing for communicable diseases; a discussion of recommended vaccinations; completed no more than six months prior to approval to assist or be a household member; completed by a licensed medical doctor, doctor of osteopathy, physician assistant or advanced registered nurse practitioner; and repeated...

Children’s Files. An individual file for each child shall be maintained and updated annually or when the provider becomes aware of changes. 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.Walnut...

Children’s Files. **Provider reported that she has sent home paperwork with all families to update. Some files were missing initial or updated physicals and immunization records.

“b” (1) Certificates Iowa’s Mandatory Child Abuse Reporter Training First Aid and Cardiopulmonary resuscitation. Provider shall maintain a valid certificate indicating date of training and expiration date. **Provider could not locate mandatory reporter training for both providers and the assistant. **Provider and co-provider's First Aid/CPR expired in March 2023. Suggestions/Recommendations: Mandatory Reporter training and First Aid/Cpr certificate information is all needed by July 25, 2023. These certificates can be sent to compliance through email at sburris@dhs.state.ia.us or by picture text to 712-435-0576. Providers need to ensure that one provider is not left in the home with more...

“ a” No more than 14 children not attending kindergarten or a higher grade level shall be present at any one timeWalnut Street, Des Moines, IA 50319-0114 Iowa Department of Health And Human Services Kim Reynolds Governor Adam Gregg Lt. Governor Kelly K. Garcia Director Findings:

“a” No more than 14 children not attending kindergarten or a higher grade level shall be present at any one time **Upon entry to the home, there was only one provider present with 14 children. Mrianda reported to Compliance staff that Brenda would be back soon. Within five minutes of compliance arrival, Brenda returned to the home with at 15th child. Brenda reported that her assistant had been in the home for her to leave, but then the assistant also head to leave due to an appointment. This placed one provider in the home with 14 children. This is over the allowed amount of children in the care of one provider. The limit is 8 preschool aged children at any one time for a C home.

Check with the appropriate authorities to determine how the following local, state, or federal laws apply to you: • Zoning code • Building code • Fire code • Business license • State and federal income tax • Unemployment insurance • Worker’s Compensation • Minimum wage and hour requirements • OSHA • Americans with Disabilities Act (ADA).Walnut Street, Des Moines, IA 50319-0114

“ b” (1) I-PoWeR records or certificates verifying required training completion: Prior to registration: • minimum health and safety training, approved by the Department, in required content areas • Iowa’s Mandatory Child Abuse Reporter Training Prior to registration: First Aid and Cardiopulmonary resuscitation. Provider shall maintain a valid certificate indicating date of training and expiration date. During each two year registration period, the provider shall receive a minimum of 24 hours of training from approved content areas. A provider shall not use a specific training or class to meet minimum continuing education requirements more than one time every five years A provider who...

An individual file is maintained for each staff assistant and contains: 1. Documentation from the department confirming the record checks required under subrule 110.11(3) have been completed and authorizing or conditionally limiting the person’s involvement with child care 2. A completed Form 470-5152, Child Care Provider Physical Examination Report. The examination shall include any necessary testing for communicable diseases; a discussion of recommended vaccinations; completed no more than six months prior to approval to assist or be a household member; completed by a licensed medical doctor, doctor of osteopathy, physician assistant or advanced registered nurse practitioner; and repeated...

Children’s Files. An individual file for each child shall be maintained and updated annually or when the provider becomes aware of changes. 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...