Ronda Bissen

“a” No more than eight children not attending kindergarten or a higher grade level shall be present at any one time **The provider had 10 preschool aged children in her care on the date of the visit. The provider reported that she had taken on a couple of drop in children, but then others showed up that she did not know would be at care on this date. One child was to be there for two hours due to a parent's medical appointment. Discussion with the provider that she needs to stay in ratio with preschool aged children as a category B childcare development home.

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.

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.

Standards. Conditions in the home are safe, sanitary, and free of hazards. **There is a higher amount of clutter in the home. In July 2024 at the compliance visit, compliance staff discussed the need to remove some of the clutter in the childcare area. In August 2024, compliance staff returned to the home and there had been progress made in reducing the amount of clutter. This current visit, compliance staff noted the dining room table was full of laundry, this had been somewhat cleaned off at the last visit to provide space for children to eat meals and snacks. The kitchen counters were very cluttered again, this leads compliance staff to question food preparation practices and ability due...

“ 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

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

“a” The home must prominently display all emergency information, and all travel vehicles must have a paper copy of emergency parent contact information **The provider has a listing of children and information in her stairway, but it does not appear that this information has been updated for some time.

“c” Combustible materials shall be kept a minimum of three feet away from furnaces, stoves, water heaters, and gas dryers **The provider has several items that are around her furnace. These items need to be moved away from the furnace to avoid a potential fire hazard.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

“n” 4. All animal waste shall be immediately removed from the children’s areas and properly disposed of. Children shall not perform any feeding or care of pets or cleanup of pet waste. **There was feces on the floor of the bathroom. Children had been in and out of the bathroom during the visit.

“a” All medicines and poisonous, toxic, or otherwise unsafe materials shall be secured from access by a child **In the living room/dining room area there are shelves that have air freshener and other items that could be harmful to children. In the kitchen, there are cleaning supplies on the counters. Compliance staff observed the children and watched the children move chairs around. This is an easy way for any of them to see an item and be able to reach the item that can cause harm.

“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.

“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. **The provider has not documented monthly drills and smoke detector checks for some time. Discussion with the provider about the steps that she takes to complete drills. She reports a monthly activity, but no 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. **Compliance staff checked four child files, one file was missing an updated physical examination. Suggestions/Recommendations: If you have any questions regarding this letter, please contact compliance staff. Your CCR&R representative is Dawn Powers. Her phone number is 712-579-4590. Her email is dpowers@westcca.org Your CNCC is Nora Evans. Her contact number is 712-828-1386 and her contact email is nora.evans@pottcounty- ia.govWalnut Street, Des Moines, IA 50319-0114 Iowa Department of Health And Human Services Kim Reynolds Governor Adam Gregg Lt. Governor Kelly K. Garcia Director Corrective Action Required: In regards to being over numbers...

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. **The provider's home is cluttered. Discussion with the provider regarding the kitchen counters being full of containers and dishes. There is not an area where the provider is able to adequately prepare meals for the children. There is a smaller table in the dining room area along with a full sized table, but both tables are full of items. Children were walking around with food, as there is no stable place for them to sit and eat. The dining room shelves had aerosol cans that were in the reach of children, these items should not be in the reach of children in care. A can of bug killer was on a shelf in the living...

“ 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 **Provider was unable to locate the pet form for the cat.

“ a” A physician’s examination report for the provider and all members of the provider’s householdWalnut Street, Des Moines, IA 50319-0114 Iowa Department of Health And Human Services Kim Reynolds Governor Adam Gregg Lt. Governor Kelly K. Garcia Director 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 **The provider and her household members are in need of updated physicals for the home file. The provider's expired in December 2023.

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...

An individual file is maintained for each staff assistant **The assistant is in need of updating the mandatory reporter training; the last certification has expired for this assistant.

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. **The provider had files on all of the children in care. The provider was missing intake information from two children; no emergency consent to treat, no intake form, no authorization for pick up. Suggestions/Recommendations: If you have any questions regarding this letter, please reach out to compliance staff. Your CCR&R representative is Dawn Powers. Her contact number is (712) 579-4590.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 Corrective Action Required: In regards to your home environment, the childcare areas of your home...

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” Findings:

“d” A current household child needs a current physical. Suggestions/Recommendations: Please contact CCR&R for ongoing support and recommendations. Corrective Action Required: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 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 correct all above-mentioned violations. Please do not hesitate to...

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...

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.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 b. Emergency information including, at a minimum, where the parent can be reached, the name, street address, city and telephone number of the...