Kathy Winbush

“ 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. Kathy was recently provided two fire extinguisher's by CCR&R. The one on the main level is not currently visible so she needs to move it or have a sign. The one for the lower level was not yet taken downstairs.

have been completed and authorizing or conditionally limiting the person’sWalnut Street, Des Moines, IA 50319-0114 Iowa Department of Health And Human Services Kim Reynolds Governor Adam Gregg Lt. Governor Kelly K. Garcia Director involvement with child care. Findings: An annual compliance check was completed on 12/12/24 and the following was out of compliance:

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

Standards. Conditions in the home are safe, sanitary, and free of hazards. Kathy is currently an approved Category B provider. However, she recently moved to a new residence. She recently submitted a change application for the change of address. She is not able to do childcare in the lower level of the new home as a Category B provider she does not have a secondary exit. Her new application did also request a change to Category A. She would be able to use the basement space as a Category A provider. Kathy does need to add a railing to the stairs leading to the basement and secure a few items. She reported a plan to have her brother do some of that work and she has spoken with the landlord...

“ 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

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

“ p” The provider shall have written policies regarding the care of mildly ill children and exclusion of children due to illness and shall inform parents of these policies.

“a” 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. Kathy did have the form for emergency numbers for police, fire and ambulance written out, she just needs to post it.

“b” All accessible electrical outlets shall be tamper-resistant outlets or shall be safely capped. Kathy had a couple of outlets that need to be capped.

“d” Approved safety gates at stairways and doors shall be provided and used as needed. Kathy does have a safety gate for the stairway but it needs to be installed.

“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. Kathy was missing a smoke detector in the lower level of the home where she plans to have children play and she needs to install one at the top of the stairs. She was provided 2 by CCR&R she just needs to install them.

“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: The telephone number for reporting complaints, and The Internet address of the department of public health (www.iowasmokefreeair.gov) Kathy was provided no-smoking signs by CCR&R but she had not yet posted them.

“p” The provider shall have written policies regarding the care of mildly ill children and exclusion of children due to illness and shall inform parents of these policies. Kathy did not have this written policy.

“q” The provider shall have written policy and procedures for responding to health-related emergencies. Kathy did not have this written policy.

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.

“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 theWalnut Street, Des Moines, IA 50319-0114 Iowa Department of Health And Human Services Kim Reynolds Governor Adam Gregg Lt. Governor Kelly K. Garcia Director primary and secondary exits. The plans shall clearly map building evacuation routes and tornado and flood shelter areas. Kathy had developed this plan, but it was not posted at her primary and secondary exit.

“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 Kathy had started her EPP but had not completed it.

“ 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: 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...

“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” Kathy did not have a provider health exam. She did report a recent physical but did not have any documentation. Kathy also did not have a current physical and immunization record for her grandson who resides in the home.

“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 Kathy could not locate her certificate for Mandatory Child Abuse Reporter training. Children's files were not reviewed as she has not had any children in care for approximately one year. CCR&R has provided her the forms needed for the children's files for when she resumes care. It should be noted that Kathy just moved to a new residence a few weeks ago. She has not been providing childcare for nearly a year. She has not had time to fully set up the items...

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” 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

“ p” The provider shall have written policies regarding the care of mildly ill children and exclusion of children due to illness and shall inform parents of these policies.

“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. Kathy's smoke detector in the kitchen was not up She did not have any documentation from 2022 or 2023 of monthly testing of smoke detectors. Although she reports not being open to child care in 2023 she is to maintain records for inspection purposes.

“p” The provider shall have written policies regarding the care of mildly ill children and exclusion of children due to illness and shall inform parents of these policies. She reported she did not have these required policies. She did have a form provided to her by CCRR in order to use to develop such policies.

“q” The provider shall have written policy and procedures for responding to health-related emergencies She reported she did not have these required policies. She did have a form provided to her by CCRR in order to use to develop such policies. She will need to send pictorial verification once established.

“a” All medicines and poisonous, toxic, or otherwise unsafe materials shall be secured from access by a childWalnut Street, Des Moines, IA 50319-0114 Iowa Department of Health And Human Services Kim Reynolds Governor Adam Gregg Lt. Governor Kelly K. Garcia Director There were some chemicals in the kitchen within reach of the children.

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.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. She did not have this at her secondary exit.

“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. She did not have any documentation from 2022 or 2023 of monthly fire and tornado drills. Although she reports not being open to child care in 2023 she is to maintain records for inspection purposes including the prior year.

“ 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: 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...

“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” She could not find her physical that needs to be on the HHS approved form. Her daughter is 18 and needs to have an updated physical on the approved HHS form. She needs an updated physical for her son.

“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 Kathy could not locate her verification of Mandatory Child Abuse Reporter training.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: Kathy needs to ensure that accessible electrical outlets shall be tamper-resistant outlets or shall be safely capped. Kathy needs to put up her smoke detector...