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Purpose of Visit Routine #2 Name of Facility Inspection Report License Number HOLLYWOOD KIDZ CARE Facility Address Phone 1610 S. 24 AVENUE HOLLYWOOD, FL 33020 954-274-8343 Owner / Operator Summer Program Date 04/27/2015 Capacity/Enrollment Children Present HOLLYWOOD KIDZ CARE, INC. / CARSWELL, CHERRY Yes Passed / Failed Revisit Mail / Call Back Violation Issued Administrative Fine Failed Yes N/A Yes Yes 36 20 % of Staff Files in : 17% % of Children Files in : 66% STAFF REQUIREMENTS 7-4 and 65C-22.006, One-Time Background Screening...................... Page 1 of 11

Sec. 7-4(b) A local criminal background check must be on file for all staff. A local criminal background check shall be secured upon employment of new staff. Please see the Supplement for the names of staff with no local criminal background check and obtain. 1 staff member did not have proof of completing background screening on file. Deadline - Immediate Sec. 7-4(a) The FDLE/FBI clearance letter must be on file for all staff. Please see the Supplement for the name(s) of staff whose FDLE/FBI clearance letter is not on file. Obtain the required documentation and place in the employee(s) file. 1 staff member did not have proof of completing background screening on file. Deadline - Immediate Sec. 7-4(j) The Affidavit of Good Moral Character secures the employee's assurance that they have not been convicted of specific crimes that bar child care employment. 1 staff member did not have proof of completing background screening on file. Deadline - Immediate Section 65C-22.006(4)(c) CF-FSP Form 5337, March 2009, Child Abuse & Neglect Reporting Requirements, must be signed annually by all child care personnel. 3 staff members did not have proof of signing the form The facility was reminded about this during the last inspection. Sec. 7-4(n) Within 3 days of employment, all child care personnel shall have a statement on file indicating that they have read the pamphlet "Child Abuse and Neglect in Florida." Please see the Supplement for names that do not have that statement on record. Ensure that the pamphlet is read and place a statement of confirmation in the employee(s) file. 1 staff member did not have proof of reading the pamphlet and signing statement. 7-4, 5 Year Background Screening................................ REMINDER: The background screening has expired for 3 volunteers who are college students and currently away at school. The director has been informed that the students cannot return to volunteer before they have been refingerpirnted and cleared. 7-3. and 7-4.01, Education Requirements............................. Credential expires 1-16-19. 7-4.02 and 65C-22.003, Personnel Training............................ Page 2 of 11

Sec. 7-4.02(a) Child care personnel must begin the 40-Hour Training within 90 days of employment. See the Supplement for staff without enrollment forms in the file. Please ensure staff begin training within the required time. 1 staff member who has been in child care for more than 90 days, did not have proof of beginning the 40-hour training on file. This was cited during the last inspection on 12-16-15. Section 65C-22.003(4)(a) A copy of the CF-FSP Form 5267 until October 1, 2010, or Training Transcript must be included in each staff member s child care personnel record and maintained at each child care facility. See Supplement for name(s) of staff missing training transcript(s). 1 staff member did no have a DCF training transcript on file. 7-4.04, Minimum Age Requirements............................... 7-4.05 Health Requirements.................................... This area, cited as out of compliance during the inspection on 12-16-14, was brought into compliance before the given deadline. 7-8, Substitute List........................................ 7-8.03, Personnel Records.................................... RATIOS/DISCIPLINE 7-4.06 and 65C-22.001, Ratios of Personnel to Children...................... Ratios Age Group Observation Notes 1:14 Mixed Group 1st Noncompliance- mixed group of ages 1 1:3 0-12 Months (1:4) 1:2 Mixed Group Mixed Group of an infant and a 1-year 2:15 Mixed Group 2nd Mixed Group of ages 2 thru 5 Page 3 of 11

Sec. 7-4.06(a) The following staff-to-children ratios apply at all times: AGE RATIO Staff/Children under 1 y.o. 1 : 4 1 y.o. 1 : 6 2 y.o. 1 : 11 3 y.o. 1 : 15 4 y.o. 1 : 20 5 y.o. or older 1 : 25 In mixed age groups including children under 2, the lower ratios apply. In groups of children 2 and above, the ratio is determined by the age of the majority of children in the group. In the event a majority cannot be determined because there is an even amount of children in the age groups in question, the staff-to-children ratio shall be determined by the younger age group. A staff-to-child ratio of [ 1 staff member ] for [ 14 children of mixed ages, including a 1-year-old () ] was observed in the classroom by the playground. Additional staff must be hired to maintain compliance, or reschedule current staff to meet requirements. A ratio of 1 staff member and 14 children, including a 1-year-old was observed in the classroom by the playground. The child was moved to another classroom once the monitor made the staff aware that the group was out of ratio. Deadline - Immediate 7-4.06, Ratios of Personnel to Children with Disabilities..................... 7-4.07, Child Discipline Written Policy.............................. 7-4.07, Child Discipline Appropriate Practices.......................... Sec. 7-4.07(b) All child care personnel at the facility must comply with the facility's written disciplinary practices and sign a statement that they have read and will comply with the policy. See the Supplement for the names of staff who did not have this statement on file. Ensure that staff read the facility's discipline policy and complete the required statement. 1 staff member did not have proof of reading and signing this form. 7-4.07, Parent Signature (Discipline)............................... FACILITY/STORAGE 7-5.01, Condition of Facility.................................... Page 4 of 11

Sec. 7-5.01(k) All areas of the facility must be kept in good repair. Areas of the facility were found to be in need of repair. Develop a system for ongoing monitoring to ensure repairs are made as needed. The panel of the doorjam for the front do is broken and needs to be repaired. inspection on 12-16-14. This was cited during the last All of the other issues cited during the previous inspection have been corrected. Sec. 7-5.01(k) All areas of the facility must be kept clean, safe, sanitary, and in good repair. Areas of the facility were found to not be clean, sanitary or well maintained. Develop a system for ongoing cleaning and maintenance. The area rugs throughout the facility need to be thoroughly cleaned and sanitized. inspection on 12-16-14. This was cited during the last The other issue cited during the previous inspection has been corrected. 7-5.01, Toxins/Hazardous Materials................................ 7-5.01, Facility Storage...................................... 7-5.01, Inside Temperature/Ventilation.............................. 7-5.01, Drinking Fountains/Water Coolers............................. 7-5.01 and 7-5.08, Phone/Emergency Numbers Posted...................... 7-5.01, Shoes Worn By Personnel/Children............................ 7-5.01, Minimum Number of Staff Members............................ INDOOR/OUTDOOR SPACE 7-5.02, Indoor Usable Play Space................................. 7-5.02, Equipment and Furnishings................................ 7-5.02, Activity Plan........................................ 7-5.04, Napping Space...................................... 7-5.04, Crib Requirements/Bedding................................ 7-5.03, Outdoor Play Space.................................... Page 5 of 11

Sec. 7-5.03(e) Concrete, asphalt, gravel and other similar non-yielding substances are prohibited beneath any piece of permanently installed play equipment. The playground lacked the required minimum of six (6) inches of resilient, impact resistant material under the equipment. Provide an adequate protective surface. More mulch is needed on the playground. This was cited during the last inspection on 12-16-14. Sec. 7-5.03(e) The outdoor play space shall be clean, free of litter, nails, glass, and other obvious hazards. The outdoor area was strewn with debris and other hazards. Clear the area of the debris and maintain the area with a daily check. The green plastic storage bin, the rake, the cot, and the broken/unsecure pieces of wood on the playground needs to be removed. Deadline - 04/27/2015 7-5.03, Outdoor Equipment.................................... Sec. 7-5.03(i) Play equipment such as climbing apparatus, slides, and swings shall be anchored firmly to prevent shifting, tilting, moving or falling. The [ 2 new playground structures ] was not securely anchored. Remove or secure this item. 2 new playground structures have been purchased for the facility. Both structures are not properly anchored and this poses a serious hazard to the children. The slide section is not anchored securely into the ground. Deadline - 04/28/2015 Sec. 7-5.03(i) All equipment must be installed safely and maintained in a safe condition. All play equipment shall be of substantial construction and free from rough edges, sharp corners, pinch and crush points, splinters, and exposed bolts. Ladders on slides must have a handrail. Equipment in the outdoor space is broken and needs to be repaired. Complete repairs and monitor equipment for safety. One of the rocking toys on the playground is installed right next to the tether ball pole. If a child is using the rocking toy and another child is trying to play tether ball, the child on the rocking toy will be struck in the head and knocked off the toy. The director was advised to remove the tether ball pole/ball or move the rocking toy to another area on the playground. 7-5.03, Swimming Pool...................................... TOILET/BATH FACILITY 7-5.05, Toilet/Bath Facilities................................... This area, cited as out of compliance during the inspection on 12-16-14, was brought into compliance before the given deadline. 7-5.05, Potty Chairs and Seats.................................. 7-5.05, Diaper Changing Procedures............................... Page 6 of 11

This area, cited as out of compliance during the inspection on 12-16-14, was brought into compliance before the given deadline. 7-5.05, Handwashing Facilities and Use............................. HEALTH PROGRAM 7-6.01, Written Instructions.................................... Sec. 7-6.01(a)(2) Written authorization is needed for a health facility or physician to provide medical treatment as necessary. Authorization to provide treatment was missing for children listed on the Supplement. Obtain authorization and retain on file. 2 children did not have the medical authorization form on file. 7-6.01, Parent Notification.................................... 7-6.01, First Aid Supplies..................................... 7-6.02, Communicable Disease Policy/Procedures........................ Sec. 7-6.02(b) Every facility is required to maintain on the premises a copy of a " Staff Manual About Aids and HIV Infection for Child Care Centers". Documentation is required to show that all personnel read the Manual within 5 days of employment. Staff as listed on the Supplement did not have verification the HIV Manual had been read. 1 staff member did not have proof of reading the manual and signing the statement. 7-5.07 and 7-6.02, Care of Sick Child............................... 7-6, First Aid/CPR Certification.................................. 4 staff members certified in CPR/First Aid; expiration dates are 7-2015, 5-2016, and 1-2017. NUTRITION 7-7.02 and 7-7.05, Alternate Nutrition Plan............................ 7-7.06, 7-7.09 and 7-7.10 Menus/Catering............................. Sec. 7-7.09(a) All licensed child care facilities which prepare meals on the premises must maintain a valid food certificate. The facility did not have a current food certificate. Obtain the required food certificate. The facility does not have a current food certificate. An inspection was conducted on 1/20/15, but it did not pass. As of this inspection, no revisit was conducted to correct the previous noncompliance areas. 7-7.07, 7-7.09 and 7-7.11, Food Protection and Service...................... Page 7 of 11

This area, cited as out of compliance during the inspection on 12-16-14, was brought into compliance before the given deadline. 7-7.07, 7-7.08 and 7-7.11 Feeding Procedure/Seating....................... 7-7, Nutritional Meals and Snacks................................ CHILDREN'S RECORDS 7-8.01, Enrollment Information.................................. Sec. 7-8 The SWIM CENTRAL Drowning Prevention Questionnaire form must be completed by parents upon entry of their child(ren) for care. The facility did not have a SWIM CENTRAL form completed for each child in care. See the Supplement for names of those that are missing forms and obtain. Several children did not have the Swim Central form on file. 7-8.02, Health Examinations/Health Maintenance........................ Sec. 7-8.02(a)(1) Written proof of a physical exam must be on file. The facility does not have health information for children noted on the Supplement. Obtain written verification of a physical exam and retain on file. 1 child did not have a physical on file. Deadline - 05/27/2015 Sec. 7-8.02(a)(1) Physicals must be updated every two years. The Physical Exam record is no longer current for children listed on the Supplement. Obtain an updated exam. 1 child did not have a current physical on file. Deadline - 05/27/2015 Sec. 7-8.02(a)(2) Each child must have a written statement on file confirming that immunizations are up-to-date or are in process. An up-to-date and age-appropriate immunization record was not current for the children listed on the Supplement. Information must be obtained. 1 child did not have a current immunization record on file. Deadline - 05/27/2015 7-8.04, Signed Statements.................................... Page 8 of 11

Sec. 7-8.04(a)(b)(c)(d) The facility must maintain signed statements by the parent or legal guardian that the facility provided the following information: child care facility brochure; disciplinary procedures; hours of operation; alternate nutrition plan. Please see the Supplement for names of children that are missing the statement(s) and obtain. Several children did not have a signed statement verifying that the parent received the "Know Your Child Care Facility" brochure on file. TECHNICAL ASSISTANCE: 7-7.01(e) A signed parental permission form is required prior to a child's participation in multicultural learning events that involve the sharing of home prepared foods. A permission form may include one (1) or more individual events, or all multicultural events for the year, if known. Deadline - TECHNICAL ASSISTANCE: 7-5.02(g)(5)(e) There shall be a written policy on physical activity participation signed by each child's parent and maintained on file at the facility, which describes the types and duration of physical activities (indoor and outdoor) provided, and recommended footwear and appropriate clothing. See the Supplemental for names of children that are missing the signed policy and obtain. Deadline - Section 65C-22.006(3)(c)4. Annually, during the months of August and September, the child care facility director must provide parents with information detailing the causes, symptoms, and transmission of the influenza virus. To assist providers the department developed a brochure, CF/PI 175-70, June 2009, Influenza Virus, Guide to Parents, which may be obtained from the department s website at www.myflorida.com/childcare. See Supplemental for the name(s) of child(ren) without a current flu brochure on file. 3 children did not have proof of receiving the Influenza brochure. 7-8.05, Medication Records.................................... 7-8.06, Accident/Incident Records................................. 7-8.09, Field Trip Notification/Permission............................. 7-8.10, Written Release Procedures................................ Page 9 of 11

Sec. 7-8.10(a) A password or number identifier known only to the parent and the person in charge at the facility shall be recorded on the No. 1 card, Child Care Enrollment Information Card or its equivalent. A password or number identifier is missing for children listed on the Supplement. Establish a password with the parent or legal guardian and add to the form. 1 child did not have a password on file. TRANSPORTATION 7-9, Annual Vehicle Inspection/Insurance............................. Expiration - 7-9 and 65C-22.001, Drivers Qualifications/Requirements..................... 7-9, Vehicle Capacity....................................... 7-9, First Aid Kit/Fire Extinguishers................................ 7-9, Child Restraint Devices.................................... LICENSE/CERTIFICATES 7-11, License/Inspection Reports................................. 7-5.06, Nighttime Child Care................................... 7-5.08, Fire Inspection Posted................................... Expiration - 5-8-15 7-5.08 and 7-8.07, Records of Fire Drill.............................. Fire drills conducted: - 12/18/14-1/8/15 (alternate route) - 2/17/15-3/12/15 Facility is in compliance in this area. 7-10, Insurance.......................................... Expiration - 8-17-15 Page 10 of 11

FACILITY'S RIGHT TO APPEAL UPON RECEIPT OF A NOTICE OF VIOLATION Section 7-11.11(g) of the Child Care Ordinance provides that upon receipt of a Notice of Violation, the facility may make a written request to the local licensing agency within fifteen (15) days from receipt of the Notice of Violation for a hearing to be scheduled before a county-appointed hearing officer to contest the issuance of the Notice of Violation. If the local licensing agency does not receive a written request for a hearing within the prescribed fifteen (15) days time frame, due to either the facility electing not to contest the Notice of Violation or the request not being timely made, the violation(s) set forth in the Notice of Violation shall be deemed to have existed and the owner or director of the facility waives the right to contest the substantive issues contained in the Notice of Violation at a later date. Additionally, the local licensing agency may issue an Administrative Fine in accordance with the Ordinance and/or take whatever action is deemed appropriate under the circumstances, including scheduling a hearing before a county-appointed hearing officer seeking suspension or revocation of the facility's license. Notwithstanding the above, if the local licensing agency elects to impose an Administrative Fine based upon the issuance of the Notice of Violation, the facility may contest the amount of any Administrative Fine imposed by the local licensing agency. If a request for a hearing on the Notice of Violation is made to the County, the local licensing agency may, in its discretion, elect to hold one hearing to address the Notice of Violation and the imposition of any Administrative Fine. Confidential Information Received by: Cherry Carswell Date: 04/27/2015 Confidential Information Inspected by: Donna Williams Time: 08:30 AM to 01:10 PM Page 11 of 11