Family_Home_Day_Care_Annual_Licensing_Checklist by niusheng11

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									                                                                                              Licensing Services
                                                                                         Family Home Day Care
     Community Services 
                                                                                      Annual Licensing Checklist 
                                                                                                                                        
  
 1 Provide FHDC Agency details
     FHDC Agency name:

     FHDC Agency address:

     City:                                                             Postal Code:

     Contact name:

     Phone number:                                                     Fax number:

     Number of Home Day Care providers:                                _______________________________________________________

     Location(s) of Play group space: __________________________________________________________________________________________

     Fire inspection report date:                                      Health inspection report date:
     (dd/mm/yyyy)                                                      (dd/mm/yyyy)

     Insurance expiry date:
     (dd/mm/yyyy)



 2 Provide licensing details
     Licensee name:

     Mailing address:

     City:                                                             Postal Code:

     Contact name:

     Phone number:                                                     Fax number:



     Licensing Officer name:

     Inspection date:                                                  Number of pages: _________       ________________________
     (dd/mm/yyyy)



 3 Proceed to FHDC Annual Licensing Checklist on page 2




www.gov.ns.ca/coms                                      Page 1 of 12                                           LIC-733 28032011 V.01
                                                                               Family Home Day Care Annual Licensing Checklist
                                                                                   C - Compliant   NC – Non Compliant   N/A – Not Applicable 
 Section 1 – Agency Records                                                      H/A   C   NC      N/A   Comments

 The agency has the following posted in a conspicuous place in the
 agency: (45(2))
      the agency’s license (6) & (44(3)(a)(i))
      a copy of the licensee’s behaviour guidance policy (44(3)(a)(ii))
      a list of the names of the current members of the parent
      committee (44(3)(a)(iii))
      minutes of the most recent parent committee meeting posted no
      later than 2 weeks after the date of meeting (49(1)(2))
 Agency has a parent handbook which contains:
 A statement that the following are posted at the agency: (44(3)(a))
      License for agency
      Behavior guidance policy
      Parent committee members
 A statement that the following are posted in the family day care
 home: (44(3)(b))
      Act and Regulations
      Parent Handbook
      Most recent parent committee minutes
      Most recent inspection report
      Behavior guidance policy
      Current menu
 Agency has written confirmation that parents have received the
 parent handbook. (44(5))
 The agency has a record that a notice of significant changes that
 could impact the license has been provided to the parents of each
 child enrolled in the program. (46(1)(2)(3))
 Agency has a record that it conducts annual assessments of care
 providers and family day care homes under its management. (14(f))
 The driver of a vehicle operated by or for the licensee to transport
 children must deliver each child transported in the vehicle to:
 (51(1)(a)(b)(c))
      the care provider
      parent of the child or person authorized by the parent in writing
 A Licensee that provides transportation for enrolled children is
 responsible for the safety of the children while in transit. (51(2))
 Policy and Procedures
 The facility has written policies on the permitted and prohibited
 behaviour guidance practices (19(1)(2))
 Parent Committee Meetings
 A parent committee must be established no later than 3 months after
 the date the agency approved the first family day care home under
 its management. (47(3)(a))
 A parent committee must be composed of at least 5 members:
 at least 3 parents of currently enrolled children, 1 representative of
 the Licensee and 1 representative of staff who provide regular care
 to children. (47(4)(a)(b)(c))

www.gov.ns.ca/coms                                                      Page 2 of 12                                        LIC-733 28032011 V.01
                                                                           Family Home Day Care Annual Licensing Checklist
                                                                               C - Compliant   NC – Non Compliant   N/A – Not Applicable 
 Section 1 – Agency Records - continued                                      H/A   C   NC      N/A   Comments
 The facility has a record that two parent committee meetings were
 held in the past year. (48(1))
 At least 2 weeks prior to date of parent committee meeting, agency
 director must: (48(3))
      give written notice of the meeting to the parents of all enrolled
      children (48(3)(a))
      provide a notice of the meeting to the care provider in each
      family day care home managed by the agency and request that
      it be posted in a conspicuous location in the family day care
      home (48(3)(b)(c))
 The notice must inform the parents that they may add items along
 with any matters of interest to the meeting’s agenda that includes
 the following: (48(4)(5))
      the safety, care and well-being of the children (48(5)(a))
      the status of facility’s or agency’s license (48(5)(b))
      the programs provided by the licensee (48(5)(c)(d))
      the equipment and materials available to children (48(5)(d))
      Staffing patterns and staff qualifications (48(5)(e))
 Copy of minutes to be kept on file and copies given to all care
 providers associated with the agency (49(2)(c))
 Health and Safety
 A Licensee must follow Provincial guidelines for promoting and
 maintaining health. (28(3))
 Date of inspection(Agriculture) ______________________________
 A Licensee must follow Provincial guidelines for promoting and
 maintaining safety. (28(3))
 Date of inspection (Fire) ___________________________________




www.gov.ns.ca/coms                                                  Page 3 of 12                                        LIC-733 28032011 V.01
                                                                              Family Home Day Care Annual Licensing Checklist
                                                                                   C - Compliant   NC – Non Compliant       N/A – Not Applicable 
 Section 2 – Agency Staff Records                                                H/A   C   NC      N/A   Comments

 Complete the below chart to determine and verify the following:
      Agency records confirm that the family home consultant has a
 level 2 or 3 classification and 2 years’ experience working in an early
 learning and child care program (41(2)(a)(b))
       o ECE and 2 years experience valid prior to May 1, 2012
            (41(1)(a)(b))
      Agency records confirm that each employee has an updated
 satisfactory provincial Child Abuse Register check (43(2)(3))
      Agency records confirm that each employee has an updated
 satisfactory criminal record check (43(1)(3))
      Agency records confirm that each employee that works with
 children has a valid first aid certificate that includes infant CPR
 training (14(e))
     Agency has a record, signed and dated that the consultant was
 provided training on the Behaviour policy before they began their
 employment (19(2)(a)(d))
     Agency has a record, signed and dated annually by the
 consultant, stating that the consultant has read the Behaviour policy
 (19(2(c)(d))
                                                                             1               2             3            4                 5

 Agency Staff Initials:

 Position:

 Training: (if applicable)
 (Level 2 or 3 or ECE and 2 years experience)
 Child Abuse Registry:

 Criminal Record Check:

 First-Aid Training:
 (expiry date)

 Behaviour Guidance Policy:
 (signed and dated annually)




www.gov.ns.ca/coms                                                     Page 4 of 12                                             LIC-733 28032011 V.01
                                                                              Family Home Day Care Annual Licensing Checklist
                                                                                C - Compliant   NC – Non Compliant       N/A – Not Applicable 
 Section 3 – Agency Care Provider Records                                     H/A   C   NC      N/A   Comments

 Agency has signed service agreement with all approved homes
 (15(1)(f))
 Care Providers have adequate commercial general liability insurance
 (15(1)(c))
 Complete the below chart to determine and verify the following:
      Agency records confirm that each care provider has an updated
 satisfactory provincial Child Abuse Register check. (43(2)(3))
      Agency records confirm that each care provider has an updated
 satisfactory criminal record check (43(1)(3))
      Agency records confirm that each care provider that works with
 children has a valid first aid certificate that includes infant CPR
 training (28(1))
      Agency has a record, signed and dated that the care provider
 was provided training on the Behaviour policy before they began
 their employment (19(2)(a)(d))
     Agency has a record, signed and dated annually by the care
 provider, stating that the care provider has read the Behaviour policy
 (19(2(c)(d))
     Care Provider is at least 18 years old (42(1))

 Care Provider must do all of the following: (42(2)(a)(b)(c)(d))
      Complete an approved family home day care training course no
      later than 1 year from date of home approval
      Complete annual professional development workshops
                                                                          1              2             3             4                 5

 Care Providers Initials:

 Child Abuse Registry:

 Criminal Record Check:

 First-Aid Training:
 (expiry date)

 Behaviour Guidance Policy:
 (signed and dated annually)

 Training:




www.gov.ns.ca/coms                                                 Page 5 of 12                                              LIC-733 28032011 V.01
                                                                          Family Home Day Care Annual Licensing Checklist
                                                                             C - Compliant   NC – Non Compliant   N/A – Not Applicable 
 Section 4 – Play group locations inspected
      Playgroup location and Civic Address
 1
 2
 3
 4
 5
 Play group space                                               H/A   1      2   3   4   5   Comments
 Agency provides regular play groups. (14(c)(v))
 Note: “Regular play groups” means monthly play groups.
 Agency provides a lending library (14(c)(iv))
 The facility has a record of its daily program and the daily
 program meets all of the following requirements: (18(2)(a-
 d))
      developmentally and culturally appropriate
      foster and enhance cognitive, creative, physical,
      emotional, social, and language development
      address the individual and group needs of the
      children
      provide a safe and nurturing environment for children
 Emergency Evacuation and Fire Safety Procedures
 Each agency director who provides play groups at their
 location for children enrolled in the agency’s family home
 day care program must comply with section 50. (50(5))




www.gov.ns.ca/coms                                                Page 6 of 12                                        LIC-733 28032011 V.01
                                                                            Family Home Day Care Annual Licensing Checklist
                                                                                C - Compliant           NC – Non Compliant        N/A – Not Applicable 
 Section 5 – FHDC homes inspected
        Care Provider Name                                 Care Provider Civic Address
 1
 2
 3
 4
 5
 Ratio & Group Size calculation                                 H/A     1       2   3       4       5   Comments
  One caregiver to every 6 children (any age), max group
 size of 6. (34(1))
 Note: No more than 2 infants and 3 toddlers (34(6))
 One caregiver to every 3 infants, max group size of 3.
 (34(1))
 One caregiver to every 8 school age children, max group
 size of 8. 34(1)
              Home 1                      Home 2                           Home 3                                 Home 4                  Home 5
     Children                    Children                         Children                               Children                  Children     Number
       Infant                      Infant                           Infant                                 Infant                    Infant
      Toddler     Number of       Toddler     Number of            Toddler      Number of                 Toddler     Number of     Toddler       of
     Preschool     Children      Preschool     Children           Preschool      Children                Preschool     Children    Preschool   Children
     School age      (present)   School age      (present)        School age            (present)        School age   (present)    School age    (present)




      Total =                     Total =                             Total =                             Total =                   Total =




www.gov.ns.ca/coms                                                Page 7 of 12                                                        LIC-733 28032011 V.01
                                                                           Family Home Day Care Annual Licensing Checklist
                                                                               C - Compliant   NC – Non Compliant     N/A – Not Applicable 
 Section 6 – Physical Observation-FHDC homes                                   H/A                         Comments
                                                                                     1   2     3   4   5
 Information for Parents
 The family day care home has the following posted in a conspicuous
 location: (44(3)(b))
      Act and Regulations
      Parent Handbook
      Most recent parent committee minutes
      Most recent inspection report
      Behavior guidance policy
      Current menu

 Building and Equipment Requirements
 The Playroom space provides natural lighting through a window or
 windows with a glass area of at least 10% of the total floor area.
 (20(1)(b)) & (20(8))
 A facility must be accessible and must not be located above the 2nd
 floor of a building. (20(3)) & (20(8))
 Space includes a sleeping area for infants’ that is supervised at all
 times when infants are present. (20(4)(d)(iii))& (20(8))
 Family home day care program must provide the following daily:
 (18(3))
      A rest time
      Period of outdoor activity
      Opportunities for physical activity
 A family home day care must be equipped with indoor play equipment
 and toys that are: (21(1)(a)(b)(c))
      Developmentally appropriate, safe and sanitary;
      Accessible for independent selection; and
      Available in a quantity and variety to engage all children in each
      group of children served.
 Each toddler and pre-school child who is in attendance at a family day
 care home during the daily rest period must be provided with:
 (21(3)(a)(b))
      An assigned cot or rest mat with a washable and moisture-
      resistant cover
      A sheet and blanket that are clean and of sufficient warmth
 All cribs or portable cribs must meet standards of Cribs and Cradles
 Regulations made under the Hazardous Products Act. (21(4))
 Strollers used to transport infants must be equipped with a sun shade
 and a safety belt. (21(5))
 Highchairs or infant seats must be equipped with a safety belt. (21(6))
 There are no Playpens, jolly jumpers or baby walkers. (21(7))
 Outdoor Play Space and Equipment
 An outdoor play space used by a family home day care program must
 be accessible to all enrolled children, including those with diverse
 abilities. (24(1))



www.gov.ns.ca/coms                                                  Page 8 of 12                                          LIC-733 28032011 V.01
                                                                            Family Home Day Care Annual Licensing Checklist
                                                                                C - Compliant       NC – Non Compliant     N/A – Not Applicable 
 Section 6 – Physical Observation – FHDC homes - continued                     H/A   1    2     3      4    5   Comments
 Family home day care program must provide and outdoor play area
 that is: (24(2))
      On the premises of the family day care home and enclosed by a
      fence that is at least 1.2m(4ft) high; or
      Within a reasonable distance of the family day care home and
      that has been determined by the agency to be safe and
      appropriate.
 An outdoor play space used by children in the family home day care
 program must be supervised in accordance to the staff to children
 ratios and group sizes set out in sec 34 for family home day care.
 (24(3))
  
  
 Section 7 – FHDC Records                                                      H/A                              Comments
                                                                                     1    2     3      4    5
 Daily Records
 The FHDC has daily attendance sheets recording the time of arrival &
 departure of each child. (32(1)(2))
 The FHDC maintains a daily logbook to record information about any
 absence of a child due to illness and any unusual or special events.
 (33)
 The FHDC has daily records for all infants and toddlers including:
 (32(4)(a)(b))
      Information about any unusual occurrence and other pertinent
      information that does not relate to a daily occurrence
      Space for parents’ to write special instructions or information
 The FHDC makes these records available for parents each day and
 retains these records for at least 6 months. (32(5))
 Nutrition – Menus
 Each child who is in attendance during a regular meal period must be
 provided with a meal. (25(8)(a))
 Each child who is in attendance before or after a regular meal period
 must be provided with a snack. (25(8)(b))
 A care provider must develop and follow menus. (26(1))
 A menu must be kept on file for 12 months. (26(2))
 Substitutions are noted, must be of equal nutritional value to the
 original menu item and kept on file for 12 months. (26(3)(a)(b)(c))
 Breast milk or formula provided by a parent for an infant must be
      Labeled to specify name of infant, date received and contents
      (27(1)(a))
      Refrigerated at 4.0 C or lower (27(1(b))
      stored in accordance with Provincial guidelines (27(1)(c))
 Food provided by a parent for an infant must be dated, refrigerated if
 required and used or discarded before the expiry date. (27(2))
 Infants who cannot hold a bottle must be held for bottle feeding.
 (27(3))
 Infants must not be fed in a crib or by bottle propping. (27(4))


www.gov.ns.ca/coms                                                   Page 9 of 12                                              LIC-733 28032011 V.01
                                                                                Family Home Day Care Annual Licensing Checklist
                                                                                  C - Compliant       NC – Non Compliant     N/A – Not Applicable 
 Section 7 – FHDC Records - continued                                            H/A   1    2     3      4    5   Comments
 Menu planning is the responsibility of the care provider. (26(1))
 Health and Safety
 Each FHDC must be kept in a clean and sanitary condition at all times.
 (28(4)(a))
 Each indoor play area must be suitable ventilated and free from odour.
 (28(4)(b))
 Care providers must wash their hands before and after diapering or
 toileting a child and before and after food preparation. (28(4)(c))
 Toys used by infants and toddlers must be cleaned and sanitized at
 least twice weekly or more often if necessary, checked daily for broken
 pieces or other hazards. (28(4)(d)(i)(ii))
 Toys used by Preschool and School age must be cleaned and
 sanitized at least weekly or more often if necessary. (28(4)(e))
 Each highchair, cot, crib, and mat must be sanitized on a regular basis
 and before being used by another child. (28(4)(f))
 The counter of the diapering area must be disinfected after each
 diapering. (28(4)(g))
 The family day care home has at least 2 First Aid Kits approved for
 emergency treatment. (28(4)(h))
 A first aid kit, list of children in attendance and the children’s
 emergency contact information must all be taken on outings with
 children. (28(4)(i))
 A safety belt must be used for an infant when the infant is in a
 highchair, infant seat, or stroller. (28(4)(j))
 Medical supplies, drugs, medications and dangerous or noxious
 materials must be properly labeled and safely stored. (28(4)(k))
 A care provider who agrees to administer medication must do the
 following; (29(a)(b)(i)(ii)(iii)(iv))
     Obtain prior written instructions signed by child’s parent
     Keep written record of each dose, (date ,time administered,
     amount given and child’s name)
     Initialed by care provider after dose is administered
  A care giver is to accept only medicine that is brought to the family
 day care home by the parent and that is supplied in the original
 container, in the case of patent medicine, or in a container supplied for
 the purpose by a pharmacist, in the case of prescribed medicine.
 (29(c))
 In the event of an accident, other incident, communicable disease that
 affect or could affect the health, safety or well being of a child, the care
 provider must: (30(2)(a-e))
     immediately secure any necessary medical assistance
     keeps a record that parents and Licensee are notified
     Prepare incident report which summarizes incident and the actions
     taken and signed by care provider and parent
     Keeps copy on child’s file




www.gov.ns.ca/coms                                                   Page 10 of 12                                               LIC-733 28032011 V.01
                                                                          Family Home Day Care Annual Licensing Checklist
                                                                              C - Compliant       NC – Non Compliant     N/A – Not Applicable 
 Section 7 – FHDC Records - continued                                        H/A   1    2     3      4    5   Comments
 Fire and Emergency
 The care giver has established emergency rules and procedures
 including evacuation plan and escape routes to be used in case of fire
 or other emergencies. (50(1))
 Evacuation plan is posted at each designated playroom exit and each
 exit from the family day care home. (50(2))
 Evacuation plan must include all of the following; 50 (3)(a)(b)(c)(d)
     A current list of emergency telephone numbers including 911,and
     the local hospital emergency dept and poison control
     the specific duties of care provider
     A diagram of all rooms in the day care home with exits noted.
     The location of the safe meeting place, which must be outside and
     known to children and care provider
 The care provider carries out monthly emergency evacuation drills.
 (50(4))
  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  


www.gov.ns.ca/coms                                                Page 11 of 12                                              LIC-733 28032011 V.01
                                                                             Family Home Day Care Annual Licensing Checklist
                                                                                C - Compliant       NC – Non Compliant        N/A – Not Applicable 
 Section 8 – Children’s Records                                        H/A                                Comments
                                                                               1    2     3     4     5
 Children’s files are kept confidential, complete and organized.
 (31(3))
 Children’s files are stored safely and securely and kept for two
 years after a child leaves the home. (31(4))
 Complete the below chart to determine and verify that the facility maintains every item listed in each child’s record.
                                               1                         2                      3                         4                  5
           Family Home #
 Child’s Initials

 Application form includes:
 (31(1)(a))
 (i) child’s name & date of birth
 (ii) parents name, home address,
 phone numbers, e-mail
 (iii) physician’s name, address,
 phone number
 (iv) emergency contact info
 (v) names of persons to whom
 child may be released

 Admission date
 (31(1)(b))

 Health Questionnaire
 (31(1)(d)) [A]

 Immunization complete
 (31(1)(d)) [H]

 Medication
 (31(1)(e)) [A]

 Emergency form signed
 (31(1)(g)) [A]

 Outing form signed
 (31(1)(g)) [A]

 Progress reports
 (excluding school age)
  (31(1)(i)) [A]

 Incident reports
 (31(1)(h)) [H]

 Parent Handbook
 (31(1)(c))

 Special requirements
 (31(1)(f))

 Withdrawal date & reason
 (31(2))

  


www.gov.ns.ca/coms                                                  Page 12 of 12                                                 LIC-733 28032011 V.01

								
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