Lynn Goerdt

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”

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...

b. Assistants/Physicals: Jeff, EllynWalnut 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: I encourage you to continue working with Child Care Resource and Referral for ongoing child care needs. Child Care Resource & Referral of Northeast Iowa 2728 Asbury Road, #215 Dubuque, IA 52001 563-557-1628 Corrective Action Required: Lynn needs updated physicals documented on HHS form 470-5152, Child Care Provider Physical Examination Report, for household member Jeff. Lynn needs updated physicals documented on HHS form 470-5152, Child Care...

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

“ 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...

n Pets Zoe needs to have a physical on form 470-5153 Pet Health Examination Veterinary Health Certificate. Suggestions/Recommendations: Lynn is very organized. Corrective Action Required: An in person follow up is not needed; however, photo documentation of completed item will need to be provided to this worker no later then April 18th, 2023. This can be emailed to this worker at therbst@dhs.state.ia.us or by text at 563- 590-1536 Lynn can continue to utilize CCRR, Cherie Kennedy as a support at 563-557-1628 Lynn can continue to utilize CCNC, Kelsey Hill as a support at 563-556-6200 Lynn can continue to utilize the food program, Robin Klima at 563-927-4629 Non-compliance with any of the...