Momma Lezs Playhouse

In review of the program's records, it was determined that requirements for written permission from the parent/guardian for a field trip or routine trip were not met as listed in number(s) 1 below: 1. Written parental permission was not secured for field trips and/or routine trips off the premises. 2. The written permission was missing the child’s name. 3. The written permission was missing the date(s) of the trip(s) (field trips only). 4. The written permission was missing the destination(s) of the trip(s). 5. The written permission was missing the departure and return time(s) of the trip(s) (field trips only). 6. The written permission was missing the signature of the parent. sa i Department of ~ Children & Youth ae 7. The written permission was missing the date on which the permission was signed. 8. The written permission was missing a statement notifying parents how their child will be transported. 9. Permission forms for routine trips were not being updated annually. 10. Written parental permission forms for field trips and/or routine trips were not being maintained on file for at least one year from the date of the trip. 11. Other: [ ]. Submit the program’s corrective action plan to verify compliance with the requirements of this rule. Corrective Action Plan Due: 04/04/2026

In review of the children's records, it was determined that information had not been secured from the parent/guardian on the JFS 01234 “Child Enrollment and Health Information For Child Care”, as required, for the items in number(s) 14 below: 1. No enrollment form was completed for at least one child 2. The current JFS 01234 was not completed for at least one child 3. Complete child information 4. Complete parent information 5. Complete emergency contact information 6. Complete physician information 7. Information regarding the parent list 8. Health information 9. Additional information for all boxes checked “yes” 10. Emergency transportation information 11. Parent/guardian’s signature 12. Diapering Statement 13. Acknowledgement of Policies and Procedures 14. Enrollment form for at least one child was not updated by either the parent or the administrator 15. Enrollment form for at least one child was not signed by the administrator 16. Other [ ] Submit the program's corrective action plan to the Department to verify compliance with the requirements of this rule. Corrective Action Plan Due: 04/04/2026

During the inspection, it was determined that the program did not have a first aid kit [onsite/ on the vehicle/ on a field trip] as required, that included all items listed in the appendix A of the rule. The kit(s) were missing the item(s) or the item(s) were not replaced after use and/or expired listed in number(s) 1 below: 1. One roll of first-aid tape; 2. Individually wrapped sterile gauze; squares in assorted sizes; 3. Sterile adhesive bandages in assorted sizes; 4.Tweezers; 5. Gauze rolled bandage; 6. Triangular bandage; 7. Rounded end scissors; 8. Tooth preservation system or fresh chilled liquid milk in which to transport a lost permanent tooth, including a written reference indicating location of the refrigerator/freezer where milk is stored if a tooth preservation system is not part of the first aid kit (for programs serving school age children only); 9. A working digital thermometer; 10. Disposable non-latex gloves; 11. A working flashlight; 12. An instant cold pack that has not been activated or ice, including a written reference indicating location of the refrigerator/freezer where the ice is stored if an instant cold pack is not part of the first aid kit; 13. Sealable leak-proof plastic bags in assorted sizes or double bagged plastic bags that can be securely tied for materials soiled with blood or bodily fluids; 14. Pocket mask or face shield, appropriate; for all ages of children in care, for cardiopulmonary resuscitation (CPR) administration; 15. Soap or waterless sanitizer (field trip or transporting away from the program only); 16. Bottled water (field trip or transporting away from the program only). Correct the violation and submit the program's corrective action plan to verify compliance with the requirements of this rule. Corrective Action Plan Due: 04/04/2026