Tatiana Clayvon

a. Number for each child’s parent, a person who can be reached when the parent cannot and child’s physician is written on paper and readily accessible by the working telephone. Tatiana needs to update her emergency numbers to include all currently enrolled children.

h. Each smoke detector is tested monthly, and a record is kept for inspection purposes. Tatiana missed a few months of documenting her drills. Tatiana needs to resume monthly testing.

n. All dogs and cats have annual examinations. Records of the exams are on file and must verify that routine immunizations are current and animal is free of endo and ecto parasites. Form 470-5153, Pet Health Examination Veterinary Health Certificate, is on file. Tatiana's two dogs need updated health examinations documented on required HHS form.

b.The first-aid kit shall, at a minimum, include adhesive bandages, bottled water, disposable tweezers, and disposable plastic gloves. Tatiana needs tweezers and gloves for her first aid kit.

a. Fire and tornado drills are practiced monthly and documentation kept on file for the current year and previous year. Tatiana missed a few months of documenting drills. Tatiana needs to resume monthly written documentation.

(1) a : Within six months of becoming registered, a physical exam report documented on form 470-5152, Child Care Provider Physical Examination Report, for all household members over the age of 18. Physical exams should be repeated every three years. Within six months of becoming registered, children 18 years of age or younger residing in the household must have:Admission physical exam report.Immunization certificate.For school age: Documentation of physical exam completed at time of school enrollment or since that time. Tatiana needs updated physician's statement on required HHS form. Tatiana's husband needs updated physician's statement on required form. Tatiana's son Jaceon needs updated...

(4) e : For infants and preschoolers: A statement of health signed by a physician submitted annually. One child needs updated physical for their file. 4. Any corrective action plans, provisional license, and safety plans-steps to get into compliance Tatiana needs to send verification of the above items to Kathy by 10/13/2025. Items can be emailed to kathy.huinker@hhs.iowa.gov or texted to 563-949-6971. 5. Special Notes/recommendations None noted. 470-5431 (02/25) 321 E 12th St., Des Moines 50319 Iowa Department of Health And Human Services CHILD CARE ANNUAL EVALUATION HHS Child De

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” 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

“ 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...

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

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...

e,g. Child files: Physicals and immunizations.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: I encourage you to work with Child Care Resource and Referral for ongoing child care needs. Lori Mueller Child Care Consultant Child Care Resource & Referral of Southeast Iowa Community Action of Eastern Iowa lomueller@caeiowa.org T: 563-362-8226 500 E 59th St.| Davenport, IA 52807| www.iowaccrr.org Corrective Action Required: Tatiana needs to update her emergency numbers to include all enrolled children. Tatiana texted this worker...

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 safe outdoor play area shall be maintained in good condition throughout the year. The play area shall be fenced off when located on a busy thoroughfare or near a hazard which may be injurious to a child, and shall have both sunshine and shade areas. The play area shall be kept free from litter, rubbish, and flammable materials and shall be free from contamination by drainage or ponding of sewage, household waste, or storm water.

“ 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:

a. Household physicals: Brayden. Suggestions/Recommendations: Tatiana needs to either remove the trampoline from the children's play area or put new netting up. Tatiana needs physical for household member Brayden.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: A follow up visit will not be required, however Tatiana needs to send verification of the above items to Kathy by 2/1/2024. Items can be emailed to khuinke@dhs.state.ia.us or texted to 563-949-6971. I encourage you to work with Child Care Resource and Referral for...

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” 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

“ 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...

a Contact numbers for children/ parent / doctor / emergency contact Tatiana needs to have emergency person and their phone number posted on her contact sheet. All other information was correctly completed on this form.

b Electrical - Safety Caps or Tamper resistant outlets Tatiana needs to install a safety cap on the outlet directly behind the recliner in the daycare room.

n PETS Tatiana needs to have a physical exam / shot verification for both dogs, Lilo and Kehlani. Tatiana reported that these are scheduled for mid-December 2022. These must be completed on form 470-5153 Pet Health Examination Veterinary Health Certificate

“a” A safe outdoor play area shall be maintained in good condition throughout the year. The play area shall be fenced off when located on a busy thoroughfare or near a hazard which may be injurious to a child, and shall have both sunshine and shade areas. The play area shall be kept free from litter, rubbish, and flammable materials and shall be free from contamination by drainage or ponding of sewage, household waste, or storm water.

a Outdoor space Tatiana needs to remove the tent in her backyard. There is also a blue/silver pipe about 12 inches long that will need to be removed. This was placed on the tent laying on the ground. There are 2 balls that that were ripped up that need to be disposed of. The grill needs a cover on it. The trampoline needs the netting on one side put back up. The trampoline needs to be secured to the ground, as it can be physically lifted up and is not secured at this time.

“ 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”

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...

c, e, g, j Child files Tatiana needs to have a signed medical consent from the parent authorizing emergency treatment. This is needed for CM, KS, LS, and AS. Tatiana needs to have a statement of health signed by a physician submitted annually. This is needed for MJ Tatiana needs to have a signed and dated immunization certificate provided by the state Department of Public Health. This is needed for AJ, MJ, KS, LS, and AS Tatiana needs to have permission from the parent for child to attend activities away from the child development home. This is needed for CM, KS, LS, and AS Suggestions/Recommendations:Walnut Street, Des Moines, IA 50319-0114 Iowa Department of...