Heather Iezek

“ 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. Heather's fire extinguisher was not visible. She did move it while this worker was present.

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

“ 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 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. Heather's smoke detector in the kitchen was down and needs batteries replaced.

“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.

“a” All medicines and poisonous, toxic, or otherwise unsafe materials shall be secured from access by a child. Heather did have some cleaners/chemicals under her kitchen sink and bathroom sink and those cabinets were not secured. (Heather did move those while this worker was present.)

“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. Heather did not have the required disposable tweezers in her First Aid kit. (She did order some on Amazon while this worker was present.)

“ 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”

“ b” (1) I-PoWeR records or certificates verifying required training completion: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 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...

“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” Heather had a current provider physical but it was not on the approved HHS form. Heather did not have a physical for her husband.

“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 Prior to registration: First Aid and Cardiopulmonary resuscitation. Provider shall maintain a valid certificate indicating date of training and expiration date. Heather's First Aid and CPR is expired.

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...

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: An admission physical examination report signed by a licensed physician or designee in a clinic supervised by a licensed physician The date of the physical examination shall not be more than 12 months before the child’s first day of attendance at the child development home. The written report shall include past health history, status of present health, allergies and restrictive conditions, and recommendations for continued care when necessary. For a child who is five years of age or older and enrolled in school, a statement of...

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

“c” Combustible materials shall be kept a minimum of three feet away from furnaces, stoves, water heaters, and gas dryers. Heather had several items up against her furnace that need to be moved.

“ 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” Findings: An annual compliance check was completed on 3/12/24 and the following was out of compliance:

“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” Heather did have a physical but it was not on the approved HHS form. Her adult son also had a physical but it was not on the HHS approved form. This worker did provide her a copy of the form she needs to use.Walnut Street, Des Moines, IA 50319-0114 Iowa Department of Health And Human Services Kim...

“ 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.

"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 meetsWalnut Street, Des Moines, IA 50319-0114 Iowa Department of Health And Human Services Kim Reynolds Governor Adam Gregg Lt. Governor Kelly K. Garcia Director 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...

“ e” If more than eight children are present at any one time for a period of more than two hours, the provider shall be assisted by a department-approved assistant who is at least 14 years old, unless extra children are present as a result of an emergency school closingWalnut 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:

“e” . No more than 8 children preschool aged or younger is permitted however during inspection, it was found that Heather was carrying for 9 children for more than 2 hours

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

Limit. Except as provided in subrule 110.6(3), no greater number of children shall be received for care at any one time than the number authorized on the registration certificate.

The provider shall meets the following requirements: a. Gives careful supervision at all times. b. Exchange information with the parent of each child frequently to enhance the quality of care. c. Give consistent, dependable care and be capable of handling emergencies d. Be present at all times except when emergencies occur or an absence is planned, at which time care shall be provided by a department-approved substitute. When an absence is planned, the provider shall give parents at least 24 hours’ prior notice. e. Shall be free of the use of illegal drugs and shall not be under the influence of alcohl or any of the prescription or non-prescription drug that could impair their ability to...

The provider shall meets the following requirements: Gives careful supervision at all times. Upon arrival, Heather was outdoors with an infant and her own biological children. The door/window was open, however, other children were indoors napping while an unapproved person was in the household also cleaning.

“ 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 beWalnut Street, Des Moines, IA 50319-0114 Iowa Department of Health And Human Services Kim Reynolds Governor Adam Gregg Lt. Governor Kelly K. Garcia Director installed according to manufacturer’s recommendations. The provider shall test each smoke detector monthly and keep a record of testing for inspection purposes

“ n” Providers shall inform parents of the presence of any pet in the home. 1. Each dog or cat in the household shall undergo an annual health examination by a licensed veterinarian. Acceptable veterinary examinations shall be documented on Form 470-5153, Veterinary Health Certificate. This examination shall verify that the animal’s routine immunizations, particularly rabies, are current and that the animal shows no evidence of endoparasites (roundworms, hookworms, whipworms) and ectoparasites (fleas, mites, ticks, lice). 2. Each pet bird in the household shall be purchased from a dealer licensed by the Iowa department of agriculture and land stewardship and shall be examined by a...

“a” A safe outdoor play area shall be maintained in good condition throughout the year. The play area shall be fenced off when located on a busy thoroughfare or near a hazard which may be injurious to a child, and shall have both sunshine and shade areas. The play area shall be kept free from litter, rubbish, and flammable materials and shall be free from contamination by drainage or ponding of sewage, household waste, or storm water.

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

“b” The provider has a vague emergency preparedness plan. Plans for shelter in place or lock down in the event of an external threat are insufficient to ensure safety of children in care.

"b" No child shall be allowed to sleep in any item not designed for sleeping including, but not limited to, an infant seat, car seat, swing, or bouncy seat.

"a" and "b". Upon arrival to the home for inspection, an infant was observed asleep in a moving swing. Heather identified that she is familiar with safe sleep practices and that cribs were in the basement. Child was removed from the swing while worker was present.

“ 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”

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...

You do not currently have a department-approved assistant however you have indicated using someone in the recent past. This is not approved as training and background checks have not been completed

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...

During random sampling of children's files, 3 were found out of compliance with annual physical health examinations or statements.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 Suggestions/Recommendations: Required: You must with the Child Care Registration Unit to get any assistant you wish to use, approved by the Department If not within direct visual or hearing of children in care, a monitor must be used to provide level of superivsion. Please replace fire extinguisher with a 2A-10BC upon expiration. Documentation must be obtained for pet exams on...