Nickie Cole

“a” All medicines and poisonous, toxic, or otherwise unsafe materials shall be secured from access by a child Nickie did have a prescription bottle of medication on a table that was accessible to children. She did not have any children in care today but this would have been accessible. Nickie did move that while this worker was present. Suggestions/Recommendations: I encourage you to work with Emmeka Hawkins with Child Care Resource and Referral if you have any ongoing compliance or training needs. Emmeka Hawkins can be reached at 563-499-1853 Thank you for your service in providing childcare in your community. Corrective Action Required: A re-check is not needed at this time. Corrections...

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” Providers shall inform parents of the presence of any pet in the home. 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). Nickie has 3 cats. One cat had the annual pet exam on the approved HHS form. Two of the other cats had a recent exam but not on the approved HHS form.

“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 Findings: An annual compliance check was completed on 6/11/25and 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

“ 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 child 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 address of the department of public health (www.iowasmokefreeair.gov)

“ 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...

“h” The provider shall test each smoke detector monthly and keep a record of testing for inspection purposes. Nickie did not have any documentation of monthly testing of smoke detectors. She does already have the form to use but has not been documenting them. This was also an area where she was out of compliance at last years check. We discussed the need to check the smoke detectors every month and document that accordingly.

“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) Nickie did not have a no smoking sign at the secondary entrance. (she did recently remodel and noted she had not yet put...

“n” Providers shall inform parents of the presence of any pet in the home. 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). Nickie did not have a pet exam for her dog. This was also an area that was out of compliance at last years check. She was provided the correct form to use at last years check...

“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.

“b” The First Aid kit shall, at a minimum, include adhesive bandages, bottled water, disposable tweezers, and disposable plastic gloves. Nickie did not have a water bottle or disposable tweezers in her First Aid kit. This was also an area that was she was out of compliance with at last year's check.

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.

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. Nickie did not have this at her secondary exit. (she had recently remodeled and needed to get it reposted)

“a” Fire and tornado drills shall be practiced monthly and the provider shall keep documentationWalnut Street, Des Moines, IA 50319-0114 Iowa Department of Health And Human Services Kim Reynolds Governor Adam Gregg Lt. Governor Kelly K. Garcia Director evidencing compliance with monthly practice on file for the current year and the previous year. Nickie did not have any documentation of practicing of monthly fire and tornado drills. She does already have the form to use but has not been documenting them. This was also an area where she was out of compliance at last year's check. We discussed the need to practice those monthly and document that accordingly.

“ 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, 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” Nickie and her husband were both missing a physical exam. This was also an area where she was out of compliance at last year's check and this worker had provided her the appropriate forms for documentation.

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...

“ 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. Nickie did not have a fire extinguisher for the second floor.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

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

“ 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...

“ 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.

“n” Providers shall inform parents of the presence of any pet in the home. 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). The dog's pet exam had expired.

“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. Nickie did not have these policies.

“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.

“b” The First Aid kit shall, at a minimum, include adhesive bandages, bottled water, disposable tweezers, and disposable plastic gloves. She did not have the disposable tweezers or water bottle.

“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

“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. Nickie did have some documentation but not for every month.

“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. Nickie did not have an emergency preparedness plan.

“ 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. Nickie did not have a physical for herself of her husband.

“b” (1) I-PoWeR records or certificates verifying required training completion: Prior to registration: Iowa’s Mandatory Child Abuse Reporter Training Nickie's Mandatory child abuse reporter training had 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: 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. 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,...

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...

“b” (1) -provider stated she did not have the full 24 hours of trainingWalnut 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: referral made to CCR&R to help with training hours. provider also wanted information on becoming a B home. Corrective Action Required: Non-compliance with any of the mandated requirements listed above may lead to the cancellation or revocation of your Child Development Home Registration. Please take whatever steps are necessary to completely address each of the violations noted above. It is essential you...

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

“ 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.

“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. -Provider states she does not record the child and the medication given. 3.

“c” Medications shall be given only with the parent’s or doctor’s written authorization. Each prescribed medication shall be accompanied by a physician’s or pharmacist’s direction. Both nonprescription and prescription medications shall be in the original container with directions intact and labeled with the child’s name. All medications shall be stored properly and, when refrigeration is required, shall be stored in a separate, covered container so as to prevent contamination of food or other medications. All medications shall be stored so they are inaccessible to children. Any medication administered to a child shall be recorded, and the record shall indicate the name of the medication,...

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’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 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...

Children’s Files. -provider states that she does not have an injury report form to document injuries Suggestions/Recommendations: 1. provider will start keeping a log of smoke detector testing 2. provider will start keeping log of medication given to a child 3. provider will have a written procedure for child illnesses 4. Provider will have a log if giving any medications to children 5. provider will be given injury report form to document injuries. Corrective Action Required: Non-compliance with any of the mandated requirements listed above may lead to the cancellation or revocation of your Child Development Home Registration. Please take whatever steps are necessary to completely address...