TE_CYS-19_CY15_Fire_Comprehensive_v_15_1_.xlsx

XLSX spreadsheet 425 KB Posted Feb 24, 2016

Attached to: BASE OPERATIONS SUPPORT SERVICES, U. S. ARMY GARRISON KWAJALEIN ATOLL (USAG-KA)
Solicitation number: W9124J-16-R-KWAJALEIN
Issued by: Department of the Army Materiel Command Mission and Installation Contracting Command Fort Sam Houston

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Risk Management

A Heading	Program	Section	Critical	ACYSE Checklist	Index
A Heading	A Heading	A Heading	A Heading	A Heading	2	AREAS COVERED BY THIS CHECKLIST - FIRE FACILITY _________________________ DATE___________ INSPECTOR___________________
A Heading	A Heading		A Heading	A Heading	3	Risk Management - Health
A Heading	A Heading		A Heading	A Heading	4		Health 1 - 3
A Heading	A Heading		A Heading	A Heading	5		Health Inspections 3- 4
A Heading	A Heading		A Heading	A Heading	6		Special Needs Accommodation Process (SNAP) 5 - 9
A Heading	A Heading		A Heading	A Heading	7		Infant Sleeping Practices and Procedures 10 - 14
A Heading	A Heading		A Heading	A Heading	8		Toddler and Preschool Nap and Rest Periods 15 - 17
A Heading	A Heading		A Heading	A Heading	9		Diapering, Toileting and Hygiene 18- 25
A Heading	A Heading		A Heading	A Heading	10		Handwashing 26 - 29
A Heading	A Heading		A Heading	A Heading	11		Medical Emergencies 30
A Heading	A Heading		A Heading	A Heading	12		Child Health Requirements 31 - 37
A Heading	A Heading		A Heading	A Heading	13		Staff/Providers Health Requirements 38 - 39
A Heading	A Heading		A Heading	A Heading	14		Administering Medication 40 - 47
A Heading	A Heading		A Heading	A Heading	15		Pets 48 - 52
A Heading	A Heading		A Heading	A Heading	16		Hazardous Plants, Materials and Equipment 53 - 57
A Heading	A Heading		A Heading	A Heading	17		Noise Levels 58 - 59
A Heading	A Heading		A Heading	A Heading	18		Lamps and Fixtures 60 - 62
A Heading	A Heading		A Heading	A Heading	19		Heating, Ventilation and Cooling System 63 - 68
A Heading	A Heading		A Heading	A Heading	20		Toys and Equipment 69 - 73
A Heading	A Heading		A Heading	A Heading	21		Plumbing Requirements 74 - 79
A Heading	A Heading		A Heading	A Heading	22		Floor Coverings 80 - 81
A Heading	A Heading		A Heading	A Heading	23		Maintenance 82 - 85
A Heading	A Heading		A Heading	A Heading	24		Custodial 86 - 87
A Heading	A Heading	A Heading	A Heading	A Heading	25	Risk Management - Fire 88 - 89
A Heading	A Heading	A Heading	A Heading	A Heading	26		Facility/FCC Home Fire Requirements 90 - 97
A Heading	A Heading	A Heading	A Heading	A Heading	27		Sprinkler Systems 98 - 104
A Heading	A Heading	A Heading	A Heading	A Heading	28		Fire Alarm Detection System (FADS), Fire Annunciator Panels and Pull Stations 105 - 111
A Heading	A Heading	A Heading	A Heading	A Heading	29		Family Child Care Smoke Alarms 112 - 115
A Heading	A Heading	A Heading	A Heading	A Heading	30		Fire Exits 116 - 127
A Heading	A Heading	A Heading	A Heading	A Heading	31		Fire Extinguishers 128 - 134
A Heading	A Heading	A Heading	A Heading	A Heading	32		Interior Finishes, Insulation, Corridor Construction Materials, Carpets, Area Rugs and Curtains 135 - 136
A Heading	A Heading	A Heading	A Heading	A Heading	33		Fire Drills and Evacuation/Contingency Plan Procedures 137 - 142
A Heading	A Heading	A Heading	A Heading	A Heading	34		Infant Evacuation Cribs 143 - 146
A Heading	A Heading	A Heading	A Heading	A Heading	35		Smoking 147 - 152
A Heading	A Heading		A Heading	A Heading	36		Risk Management - Facility 153
A Heading	A Heading		A Heading	A Heading	37		Facility Size 154 - 156
A Heading	A Heading		A Heading	A Heading	38		Roof 157
A Heading	A Heading		A Heading	A Heading	39		Building Entrance 158 - 162
A Heading	A Heading		A Heading	A Heading	40		Mechanical room 163 - 165
A Heading	A Heading		A Heading	A Heading	41		Heating, Ventilation and Cooling System 166
A Heading	A Heading		A Heading	A Heading	42		Electrical Wiring and Fixtures 167 - 172
A Heading	A Heading		A Heading	A Heading	43		Lamps and Light Fixtures 173 - 178
A Heading	A Heading		A Heading	A Heading	46		Hardware and Fixtures 179 - 185
A Heading	A Heading		A Heading	A Heading	47		Wall Treatments, Interior Walls, Window Treatments and Floor Coverings 186 - 189
A Heading	A Heading		A Heading	A Heading	48		Outdoor Porches, Patios and Decks 190
A Heading	A Heading		A Heading	A Heading	49		Outdoor Play Areas 191 - 201
A Heading	A Heading		A Heading	A Heading	50		Exterior Walkways, Parking and Roadways 202 - 208
A Heading	A Heading		A Heading	A Heading	51		Stairways and Ramps 209
A Heading	A Heading		A Heading	A Heading	52		Maintenance of Facilities, Installed Equipment, Grounds and Playground Equipment 210 - 211
A Heading	A Heading		A Heading	A Heading	53		Construction, Renovation and Alteration 212 - 216
A Heading	A Heading		A Heading	A Heading	54		Risk Management - Safety 217 - 221
A Heading	A Heading		A Heading	A Heading	55		Facility/FCC Home Safety Requirements 222 - 234
A Heading	A Heading		A Heading	A Heading	56		Furnishings 235 - 236
A Heading	A Heading		A Heading	A Heading	57		Risk Management - Child Abuse Prevention, Guidance, Discipline and Accountability for Children/Youth 238 - 239
A Heading	A Heading		A Heading	A Heading	58		Child Abuse Reporting Procedures 240 - 242
A Heading	A Heading		A Heading	A Heading	59		Established Procedures in the Event of an Allegation 243 - 245
A Heading	A Heading		A Heading	A Heading	60		Guidance and Discipline 246 - 249
A Heading	A Heading		A Heading	A Heading	61		Accountability of Children/Youth 250 - 259
A Heading	A Heading		A Heading	A Heading	62		Child Abuse Protective Procedures 260 - 264
A Heading	A Heading		A Heading	A Heading	63		Risk Management - Food & Nutrition
A Heading	A Heading		A Heading	A Heading	64		Menus 265 - 269
A Heading	A Heading		A Heading	A Heading	65		Meal Service (Kitchen) 270 - 278
A Heading	A Heading		A Heading	A Heading	66		Meal Service (Program) 279 - 297
A Heading	A Heading		A Heading	A Heading	67		Infant Feeding 298 - 315
A Heading	A Heading		A Heading	A Heading	68		Food Substitutions & Allergies 316 - 321
A Heading	A Heading		A Heading	A Heading	69		Food Preparation, Sanitation & Storage 322 - 339
A Heading	A Heading		A Heading	A Heading	70		Food Program Management 340 - 343
A Heading	A Heading	A Heading	A Heading	A Heading	71
A Heading	A Heading	A Heading	A Heading	A Heading	72
A Heading	A Heading		A Heading	A Heading	73
A Heading	A Heading		A Heading	A Heading	74	RISK MANAGEMENT - HEALTH		Met/Not Met
A Heading	A Heading		A Heading	A Heading	75
	All (CDC/FCC/SAC/MST)	APHN			76	1	ALL: Clinical Health inspections are performed and documented by specialized personnel with appropriate qualifications, i.e., Army Public Health Nurse. NOTE: Environmental Health/Industrial Hygiene Professionals may determine Garrison compliance with some of the standards on this checklist and may augment the APHN.
	All (CDC/FCC/SAC/MST)	EH			77	2	ALL: Environmental Health inspections are performed and documented by specialized personnel with appropriate qualifications. Environmental Health/Industrial Hygiene professionals or the equivalent are utilized. NOTE: Army Public Health Nurses may perform some of the inspections on this checklist and should augment the EH/IH Inspector. While the inspections could be accomplished individually, the best results have occurred when the inspectors work as a team.
A Heading	A Heading		A Heading	A Heading	78
A Heading	A Heading		A Heading	A Heading	79	HEALTH INSPECTIONS		Met/Not Met
A Heading	A Heading		A Heading	A Heading	80	INTENT: To ensure programs are operated in a sanitary manner supportive of good health practices, and the facility and grounds are free of health hazards. To ensure preventive medicine officials and center staff are knowledgeable of health and sanitation responsibilities and able to demonstrate those duties as appropriate. NOTE: Results of inspections are monitored and assessed for trends.
	All (CDC/FCC/SAC/MST)	EH/APHN		ACYSE	81	3	ALL: Monthly (CDC)/quarterly (SAC/MST) and annual (FCC) inspections by Environmental Health and Army Public Health Nurse (APHN) are completed. NOTE: Environmental Health will inspect based on sanitation standards (#a-p) and Army Public Health Nurse (APHN) will inspect for clinical standards (#q-x).
	All (CDC/FCC/SAC/MST)	EH			82		a. Walk through to identify (indoor) health hazards.
	All (CDC/FCC/SAC/MST)	EH			83		b. Food preparation (kitchen in both facilities and homes and in-room food centers), food transportation and delivery, and food service procedures.
	All (CDC/FCC/SAC/MST)	EH			84		c. Inspection of sanitary conditions including toilet facilities.
	CDC/FCC	EH			85		d. CDC/FCC: Staff diaper-changing and hand-washing procedures.
	CDC/FCC	EH			86		e. CDC/FCC: Diaper-changing areas.
	All (CDC/FCC/SAC/MST)	EH			87		f. Hand-washing procedures.
	CDC	EH			88		g. CDC: Isolation rooms.
	All (CDC/FCC/SAC/MST)	EH			89		h. Signs of animal contamination, such as evidence of insects and rodents.
	All (CDC/FCC/SAC/MST)	EH			90		i Correct mixing and use of sanitizing solution.
	All (CDC/FCC/SAC/MST)	EH			91		j. General level of housekeeping and custodial services.
	All (CDC/FCC/SAC/MST)	EH			92		k. Pets. NOTE: Excluding fish
	All (CDC/FCC/SAC/MST)	EH			93		l. Types of cleaning supplies used.
	All Facilities	EH			94		m. Review of custodial/cleaning contracts when required standards of cleanliness are not met.
	All (CDC/FCC/SAC/MST)	EH			95		n. Outdoor health hazards and cleanliness of outdoor activity areas.
	All (CDC/FCC/SAC/MST)	EH			96		o. Presence of pests/weeds and review of pest/weed control procedures.
	All (CDC/FCC/SAC/MST)	EH			97		p. Check staff for Food Handlers training, Food Sanitation Course, and ServSafe training per job description. NOTE: In order to be enrolled in CACFP, many states require direct in ratio staff to complete annual training in food serving and sanitation. This is typically two hours a year. Check with your state to see what the requirements are. For food staff, see item 50.
	All (CDC/FCC/SAC/MST)	APHN			98		q. Medication storage/administration procedures to include 100% check of rescue medications.
	All (CDC/FCC/SAC/MST)	APHN			99		r. Child and staff health records for compliance.
	All (CDC/FCC/SAC/MST)	APHN			100		s. Staff/Provider demonstrate competency for CPR/first aid/BBP, medication administration, communicable disease, and competency in following a medical action plan/care plan.
	All (CDC/FCC/SAC/MST)	APHN			101		t. Spot check staff knowledge of required health related SOPs, e.g., admission screening procedures.
	All (CDC/FCC/SAC/MST)	APHN			102		u. Spot check health of children.
	CDC/FCC/SAC	APHN			103		v. CDC/FCC/SAC: Tooth brushing and tooth brush storage procedures. NOTE: There is not a requirement to brush teeth; however, when the children do brush teeth, procedures meet sanitary requirement
	All (CDC/FCC/SAC/MST)	APHN			104		w. Review communicable disease prevention strategies, i.e., staff diaper changing and hand washing procedures. Review MAC plan for response to public health emergencies, i.e., flu outbreak.
	All (CDC/FCC/SAC/MST)	APHN			105		x. Review Special Needs Accommodation Process (SNAP) to ensure that the program is accommodating children and ensuring safe, appropriate care IAW SNAP recommendation (i.e., medical action plans/SNAP care plans/training/competency).
	All (CDC/FCC/SAC/MST)	APHN			106	4	ALL: Technical assistance is provided to CYS Services staff in health-related issues.
A Heading	A Heading		A Heading	A Heading	107
A Heading	A Heading		A Heading	A Heading	108	Special Needs Accommodation Process (SNAP)		Met/Not Met
A Heading	A Heading		A Heading	A Heading	109	INTENT: To utilize the CYS Services Health Screening Tool to identify children/youth with special needs . To ensure a ready team of professionals jointly determine CYS Services capability to provide services to children/youth with special needs. To ensure that whenever possible, reasonable accommodation allows placement of children/youth with special needs within CYS Services programs. All DA Form 7625-1 are sent to APHN and reviewed according to 608-75, 1-25 (4d). NOTE: The tools from the SNAP pilot sites are acceptable where found. The new Teen registration form states that parents only need to be given the 7625-1 if the answer is "yes" to the question about special needs.

The SNAP Team:

(a) Explores installation child care and youth supervision options for children/youth that have medical diagnosis that reflects life-threatening conditions, functional limitations or behavioral/psychological conditions.

(b) Determines child care and youth supervision placement considering feasibility of program accommodations and availability of services to support child/youth needs.

(c) Recommends placement setting that can reasonably accommodatethe child’s or youth’s individual needs without fundamentally altering the nature of the program. In rare cases, CYS Services may not be able to reasonably accommodate a child/youth with special needs.

	All (CDC/FCC/SAC/MST)	APHN	72 Hour		110	5	72 HOUR Fix Required	ALL: Children/youth are screened for special needs. Forms include: using the DA Form 7625-1 (Army Child and Youth Services Health Screening Tool), DA Form 7625-2 (Army Child and Youth Services Program Placement Checklist) and DA Form 7625-3. The tools from the SNAP pilot sites are acceptable where found.
	All (CDC/FCC/SAC/MST)	APHN	72 Hour		111			a. DA Form 7625-1, Army Child and Youth Services Health Screening Tool, completed by parent at initial registration and annually or as needed thereafter, by parent at re-registration. NOTE: The tools from the SNAP pilot sites are acceptable where found. The Teen registration form (CYS Services Youth Program Registration and Sponsor Consent form) states that parents will only be given the 7625-1 if the answer is "yes" to the question about special needs.
	All (CDC/FCC/SAC/MST)	APHN	72 Hour		112			b. DA Form 7625-2, Army Child and Youth Services Program Placement Checklist (APHN Review and Documentation) and applicable Medical Action Plans (MAPs) and/or Special Diet Statements (SDS) sent to APHN for review and signature and returned to Parent Central Services within 7-10 working days. NOTE: The tools from the SNAP pilot sites are acceptable where found.
	All (CDC/FCC/SAC/MST)	APHN	72 Hour		113			c. DA Form 7625-3, Special Needs Accommodation Process (SNAP) Team Care Plan, completed and reviewed annually as per AR 608-75. NOTE: The tools from the SNAP pilot sites are acceptable where found.
	All (CDC/FCC/SAC/MST)	APHN			114	6		ALL: Staff/Provider is provided information about special needs (i.e., CYMS report, special needs paperwork, MAPs, Special Diet Statements and SNAP Team Care Plan (where applicable) before the child/youth receives care. NOTE: Direct-care staff/providers should receive training, care plan, and other relevant information.
	All (CDC/FCC/SAC/MST)	APHN			115	7		ALL: Ensure all staff can demonstrate competency in caring for the identified special need per Special Needs Accommodation Process (SNAP) Care Plan. Example: A child with developmental delays--staff are able to support continuity of care to meet the SNAP goals.
	All (CDC/FCC/SAC/MST)	APHN	Critical		116	8	CRITICAL - Plan within 72 Hours	ALL: Medical Action Plans (MAPs) are completed by licensed independent practitioners, reviewed by the APHN, and provided to the appropriate CYS Services program. MAPs are updated annually by the health care provider according to the stamp or signature date. NOTE: Licensed independent practitioner is defined as doctors of medicine (M.D.), osteopathic physicians (D.O.), certified registered nurse practitioners (N.P.), and certified physician’s assistants (P.A.).
	All (CDC/FCC/SAC/MST)	APHN			117	9		ALL: The developmental, physical, emotional and chronological age of the child, as well as “reasonable accommodation,” are considered when determining proper placement for children.
A Heading	A Heading		A Heading	A Heading	118
A Heading	A Heading		A Heading	A Heading	119	INFANTS SLEEPING PRACTICES AND PROCEDURES			Met/Not Met
A Heading	A Heading		A Heading	A Heading	120	INTENT: To reduce the risk of SIDS by ensuring infants are placed on their backs to sleep. To ensure that cribs and bedding material are safe for infants. To prevent strangulation and head entrapment.
	CDC/FCC/KOS	APHN		ACYSE	121	10		CDC/FCC/KOS: There are cribs for all Infants until thirteen months and younger and meet the following criteria:
	CDC/FCC/KOS	APHN	72 Hour	ACYSE	122		72 HOUR Fix Required	a. All infants until thirteen months and younger are placed in a crib on their backs for sleeping. Mats/cots are not permitted. NOTE: For FCC and KOS, a portable crib is acceptable.
	CDC/FCC	APHN			123			b. CDC/FCC: Each infant in care more than 4 hours per day on a regular basis has an individually-dedicated crib.
	CDC/FCC/KOS	APHN			124			c. CDC/FCC/KOS: Cribs are placed at least 2 feet apart. NOTE: Cribs with solid headboards can be placed end to end until child is 9 months old.
	CDC/FCC/KOS	APHN			125			d. CDC/FCC/KOS: Cribs are arranged so that infants are placed to sleep head to toe (the heads of two children placed in adjacent cribs are as far apart as possible).
	CDC/FCC/KOS	APHN			126			e. CDC/FCC/KOS: The surface of the crib mattress is 20 inches or more from the top of the crib rail.
	CDC/FCC/KOS	APHN			127			f. CDC/FCC/KOS: Crib surfaces are smooth, free from splinters, sturdy, and easily cleaned.
	CDC/FCC/KOS	APHN			128			g. CDC/FCC/KOS: Sides of Infants’ cribs are in a locked position when cribs are occupied.
	CDC/FCC/KOS	APHN			129			h. CDC/FCC/KOS: If labeled with a child’s name and used by that child continuously, cribs will be sanitized daily or as needed. NOTE: Cots, mats, or cribs must be sanitized before being used by another child; for example after fire drills. For mats used for gross motor area, mats are cleaned when visibly soiled.
	CDC/FCC/KOS	APHN			130			i. CDC/FCC/KOS: Pillows or other items which could interfere with breathing are not placed in cribs. Nothing is hanging on the inside of the cribs, i.e., activity box or infant mirrors. NOTE: Mobiles hanging above the crib are allowed until the child starts to pull up. No toys or equipment are allowed in crib. Medical/health equipment needed for Special Needs children can be granted local exception to policy by local APHN
	CDC/FCC/KOS	APHN		ACYSE	131	11		CDC/FCC/KOS: All paperwork for infants until thirteen months is completed:
	CDC/FCC/KOS	APHN	72 Hour	ACYSE	132		72 HOUR Fix Required	a. Back to Sleep crib placards with the child's picture are prominently displayed above or outside each regularly-scheduled infant's crib in a clear sleeve that also contains the signed copy of the Parent Infant Sleep Position Agreement. NOTE: Pictures optional for hourly care and Kids on Site (KOS) children, but Parent Infant Sleep Position Agreement still required.
	CDC/FCC/KOS	APHN	72 Hour	ACYSE	133		72 HOUR Fix Required	b. CDC/FCC/KOS: Alternative sleeping positions are supported by a written statement by a physician or licensed independent practitioner indicating the nature of the medical condition and specific sleeping instructions are on file for infants that warrant side, stomach or elevated sleeping positions.
	CDC/FCC/KOS	APHN			134	12		CDC/FCC/KOS: Appropriate size of CYS Services Back to Sleep Sacks are used for sleeping infants in lieu of blankets while infants are in cribs. NOTE: If conditions permit, children may sleep without a sleep sack to avoid overheating.
	CDC/FCC/KOS	APHN			135	13		CDC/FCC/KOS: Crib mattresses meet needed specifications:
	CDC/FCC/KOS	APHN			136			a. Mattresses are firm and tight-fitting and fit the size of the crib.
	CDC/FCC/KOS	APHN			137			b. Mattresses are covered by a tight-fitting sheet.
	CDC/FCC/KOS	APHN			138			c. Mattresses have waterproof covers.
	CDC/FCC/KOS	APHN			139			d. No more than one mattress per crib is used.
	CDC/FCC/KOS	APHN			140	14		CDC/FCC/KOS: Bedding is laundered daily, after soiling, after use by child when a crib is shared, and, if the fire evacuation crib, after a fire drill.
A Heading	A Heading		A Heading	A Heading	141
A Heading	A Heading		A Heading	A Heading	142	TODDLER AND PRESCHOOL NAP AND REST PERIODS			Met/Not Met
A Heading	A Heading		A Heading	A Heading	143	INTENT: To provide rest necessary for growth and development, eliminate environmental contamination, and prevent disease transmission.
	CDC/FCC/KOS	APHN			144	15		CDC/FCC/KOS: There are mats/cots for each child 13 months and older that meet required specifications:
	CDC/FCC/KOS	APHN			145			a. There is one cot or mat for each infant/child thirteen months and older.
	CDC/FCC	APHN			146			b. CDC/FCC: Children in care on a regular basis have an individually-designated (labeled) mat or cot.
	CDC/FCC/KOS	APHN			147			c. CDC/FCC/KOS: Mats/Cots are placed at least 2 feet apart.
	CDC/FCC/KOS	APHN			148			d. CDC/FCC/KOS: Mats/Cots are arranged so that children sleep head to toe (i.e., this head to toe arrangement places the heads of two children as far apart as possible).
	CDC/FCC/KOS	APHN			149	16		CDC/FCC/KOS: Each child's bedding is stored separately from other children's bedding, either on the cot/mat or in individually-labeled cubbies.
	CDC/FCC/KOS	APHN			150	17		CDC/FCC/KOS: Mats/Cots and bedding (sheets and blankets) are cleaned and sanitized weekly or immediately when soiled, or after use by child when a cot/mat is shared.
A Heading	A Heading		A Heading	A Heading	151
A Heading	A Heading		A Heading	A Heading	152	DIAPERING, TOILETING AND HYGIENE			Met/Not Met
A Heading	A Heading		A Heading	A Heading	153	INTENT: To reduce environmental and personal contamination from disease-producing organisms.
	CDC/FCC/KOS	APHN		ACYSE	154	18		CDC/FCC/KOS: Caring For Our Children: National Health and Safety Standards (CFOC 3.2.1.4) diapering guidelines are followed.
	CDC/FCC	APHN		ACYSE	155			a. Procedures are posted in each module/classroom with children who require diapering. NOTE: Updated CYS Services diapering posters located on the CYS Services Professional AKO Website are displayed above/near all diaper-changing stations.
	CDC/FCC/KOS	APHN		ACYSE	156			b. Staff/Provider keeps bodily contact with the child during diapering at all times to ensure safety of child.
	CDC/FCC/KOS	APHN			157			c. Disposable diapers are used exclusively except for medically-validated exceptions.
	CDC/FCC/KOS	APHN		ACYSE	158			d. Soiled diapers and clothing are changed promptly. Soiled clothing placed in secured plastic bag and stored separately from clean clothing until returned to parent.
	CDC/FCC	APHN		ACYSE	159			e. Soiled diapers are stored in foot-operated, covered containers with plastic liners. Containers are emptied as needed and cleaned and sanitized daily using bleach solution. NOTE: Diaper genies for FCC are acceptable.
	CDC/FCC/KOS	APHN			160			f. Staff are not required to use gloves. NOTE: Gloves must be available for any staff/provider who wishes to use them. Caregivers have the choice to use gloves for diaper changing as required by the Occupational Safety and Health Administration (OSHA). Gloves used have smooth surface with no rough seams on the outside.
	CDC/FCC/KOS	APHN			161			g. If gloves are used for diapering, proper handwashing and gloving procedures are used IAW DoDI 6060.2 (ref: Caring For Our Children: National Health and Safety Standards guidelines). NOTE: The use of gloves is optional.
	All (CDC/FCC/SAC/MST)	EH		ACYSE	162	19		ALL: Toilet rooms and fixtures are sanitary and odor free.
	All Facilities	EH			163	20		ALL Facilities: Toilets are caulked to floor. NOTE: For new construction and repair work, use NSF or USDA-approved sealant/caulking.
	CDC	APHN			164	21		CDC: Sinks are located in infant and toddler child activity rooms/modules.
	All (CDC/FCC/SAC/MST)	APHN		ACYSE	165	22		ALL: Personal items e.g., toothbrushes, towels, and similar items labeled and not stored or used in common.
	All/KOS	APHN			166	23		ALL/KOS: Disposable items e.g., cups and utensils not reused.
	All/KOS	APHN			167	24		ALL/KOS: Dirty linen separated and inaccessible to children/youth.
	CDC	EH			168	25	Emerging	CDC: Adult "booties" are not used in infant rooms. NOTE: Observations in Army infant programs have determined that the use of "booties" has led to non-hygienic floor conditions and accidents/injuries caused by the practice of wearing booties. However, Infants need to have "tummy time" to meet growth and development milestones. Infant programs can designate contained play surfaces for infant play on which no one walks with shoes. Staff can wear shoes or slippers that are worn only in the designated infant play area. When documented evidence exists of hazardous materials in soils at munitions plants, chemical plants, depots and arsenals, then single-use, disposable "booties" may be used.
A Heading	A Heading		A Heading	A Heading	169
A Heading	A Heading		A Heading	A Heading	170	HANDWASHING			Met/Not Met
A Heading	A Heading		A Heading	A Heading	171	INTENT: To reduce environmental and personal contamination from disease-producing organisms.
	All/KOS	APHN	Critical	ACYSE	172	26	CRITICAL - Plan within 72 Hours	ALL/KOS: Staff/Providers wash hands with soap and water before handling food, after handling body secretions, before and after feeding a child, after handling pets, before and after diapering and toileting children, and before and after administering medication.
	All/KOS	APHN		ACYSE	173	27		ALL/KOS: Children/youth wash hands with soap and water before and after eating, after toileting, before participating in water play and cooking activities, after handling pets, and after outdoor play and diaper changes. See Caring for Our Children CFOC 3.2.2.2 for handwashing procedure. NOTE: The three towel method for infants not able to hold up their heads is currently being researched. If approved by Center for Disease Control, this method will be acceptable.
	All (CDC/FCC/SAC/MST)	APHN		ACYSE	174	28		ALL: IMCOM G-9 CYS Services-issued Hand Washing Procedures signs are posted in activity rooms/modules and bathrooms.
	All (CDC/FCC/SAC/MST)	EH			175	29		ALL: Hand sanitizers are not used anywhere in CYS Services facilities and programs IAW Health Practices in Child and Youth Settings, Aug 2005. NOTE: In temporary KOS without running water in child care room, the use of hand sanitizer for staff and children over the age of 24 months is allowed. For those under 24 months of age, the use of Infant Hand and Face wipes (instead of hand sanitizer or diaper wipes) is allowed. However, hands washed after diaper changing and before/after eating must be done at sink with soap and water. For field trips, It is permissible to have 2-4 oz. bottle in the first aid kits for field trips when water source not available. Children should wash hands when arrive at destination.
A Heading	A Heading		A Heading	A Heading	176
A Heading	A Heading		A Heading	A Heading	177	MEDICAL EMERGENCIES			Met/Not Met
A Heading	A Heading		A Heading	A Heading	178	INTENT: To provide appropriate approved actions during medical emergencies and minor illnesses after a child /youth has been admitted into the CYS Services program. To allow program staff to respond appropriately to potential health problems/requirements of children/youth in care. Trainers should routinely "spot check" staff/providers to ensure they remain competent in CPR/1st Aid/Blood-Borne Pathogens procedures. The CYMS Profile Print may be used for parental consent.
	All (CDC/FCC/SAC/MST)	All Health			179	30		ALL: A signed parental consent for child/youth to receive emergency medical/dental care is on file and renewed annually.
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A Heading	A Heading		A Heading	A Heading	181	CHILD HEALTH REQUIREMENTS			Met/Not Met
A Heading	A Heading		A Heading	A Heading	182	INTENT: To reduce vaccine-preventable diseases. Current and complete health assessment will indicate allergies, diet, and other special precautions necessary to ensure all required information is provided. To exclude children with communicable diseases and reduce risk of disease transmission. To allow children who are mildly ill, but feel well enough to participate in daily program activities, to remain in care provided they do not pose a health risk to others. To exclude children with communicable diseases and reduce the risk of disease infection.
	CDC/FCC/SAC	APHN			183	31		CDC/FCC/SAC: CYS Services programs maintain documentation of age-appropriate immunizations for CDC/FCC/SAC programs according to Army policy:
	CDC/FCC/SAC	APHN	Critical		184		CRITICAL - Plan within 72 Hours	a. Immunization records are kept in child’s record in the program where child is in care and at Parent Central Services. NOTE: If Parent Central Services is located in same building as a program, one copy of the file at Parent Central Services is sufficient. Legible copies of records scanned into CYMS would be acceptable.
	CDC/FCC/SAC	APHN			185			b. Immunization waivers for medical reasons have documentation from the licensed independent practitioner. NOTE: Child will be excluded from care in the event of an outbreak of an immunization-prevented communicable disease. Documentation in CYMS if immunizations are waived.
	CDC/FCC/SAC	APHN			186			c. Immunization waivers for religious reasons must be by an endorsement from an authorized religious authority of the religion. NOTE: Child will be excluded from care in the event of an outbreak of an immunization-prevented communicable disease.
	CDC/FCC/SAC	APHN	Critical		187	32	CRITICAL - Plan within 72 Hours	CDC/FCC/SAC: CYS Services Health Assessment/Sports Physical Statement (HASPS) are completed as required: NOTE: Licensed independent practitioner is defined as doctors of medicine (M.D.), osteopathic physicians (D.O.), certified registered nurse practitioners (N.P.), and certified physician’s assistants (P.A.). Well baby/well child examinations, school physical, or other physical exams, as well as electronic medical exam reports may be used when attached to the completed front page of the CYS Services Health Assessment and the last page with parent signatures. Best practice is to have the doctor's stamp in addition to the signature. In lieu of stamp where not available, having the clinic, doctor's name and phone number printed would be acceptable.
	CDC/FCC/SAC	APHN	Critical		188		CRITICAL - Plan within 72 Hours	a. For children/youth participating in programs other than sports, CYS Services Health Assessment/Sports Physical Statement (HASPS) is completed by parents and licensed independent practitioner within the past calendar year or within 30 days following enrollment or upon expiration.
	CDC/FCC/SAC	APHN	Critical		189		CRITICAL - Plan within 72 Hours	b. CYSFP: CYS Services Sports HASPS is completed by parents and licensed independent practitioner, with participation recommendation for all sports checked "yes," within the past calendar year or as a condition of enrollment or upon expiration. NOTE: If there is no current medical statement or it expires within the chosen season, the child/youth will be allowed to register with the following conditions: a. A current medical statement will be provided prior to the first practice or the child/youth will not participate in practice or games until it is provided. They are still on the team, can attend meetings, receive uniforms and observe the practice/games, OR b. An appointment is scheduled to renew the medical statement at the time of expiration, AND c. Parent Central will place a tickler in CYMS under the child/youth household as a reminder that the parent needs to bring the new medical statement within 15 days of the physical. In both cases: d. Parents sign a letter of understanding that if a new medical statement is not received within 15 days of the expiration that the child/youth can no longer participate until the updated medical statement is received. If a school physical is used and the first/last pages of HASPS are attached, Section C of the HASPS should be lined through with "See Attached" annotated.
	CDC/FCC/SAC	APHN			190			c. CYS Services Health Assessments are updated annually by parents (for an additional two years). NOTE: A new health assessment is required the fourth year (i.e., required year 1, 4, 7, 10, etc.)and whenever the child's health changes.
	All (CDC/FCC/SAC/MST)	APHN			191	33		ALL: Designated employees observe each child/youth for signs of illness upon arrival and before parent leaves. NOTE: Temperatures are not routinely taken as a screening mechanism for influenza or other contagious diseases. Temperatures are taken with an oral digital thermometer. There is no expectation of documentation.
	All (CDC/FCC/SAC/MST)	APHN			192	34		ALL: Basic symptoms where children appear ill or show visible signs of fever are excluded.
	All (CDC/FCC/SAC/MST)	APHN			193			a. Fever, accompanied by behavior changes or other signs or symptoms of illness. Temperature in excess of 101 F axillary for children four years of age and younger (axillary or oral temperature methods may be used for children five years of age and older). NOTE: During influenza season, exclusion criteria is having a fever (100 degrees Fahrenheit axillary or oral) AND at least one (1) respiratory symptom, such as runny nose, cough, congestion, sore throat, intestinal upset, and diarrhea. Children under three months of age may be denied admission with a temperature in excess of 100.5 F as indicated in AR 608-10.
	All (CDC/FCC/SAC/MST)	APHN			194			b. Inability to participate in daily activities.
	All (CDC/FCC/SAC/MST)	APHN			195			c. Culture-proven strep infections per doctor's note that have not been under treatment for at least 24 hours.
	All (CDC/FCC/SAC/MST)	APHN			196			d. Illness results in a greater need for care than the staff can provide without compromising the health and safety of the other children.
	All (CDC/FCC/SAC/MST)	APHN			197			e. Changes in behavior (such as lethargy or drowsiness).
	All (CDC/FCC/SAC/MST)	APHN			198			f. Skin rashes, itchy skin, itchy scalp not currently under treatment by a licensed independent practitioner.
	All (CDC/FCC/SAC/MST)	APHN			199			g. Complaints of pain or of not feeling well.
	All (CDC/FCC/SAC/MST)	APHN			200			h. Other signs or symptoms of contagious illness, such as drainage from eyes, chicken pox, persistent cough, vomiting, severe diarrhea. NOTE: A persistent cough is prolonged coughing that interrupts the child's activity and/or participation in CYS Services activities. Diarrhea is an increased number of abnormally loose stools in comparison with the child’s usual bowel habits and cannot be contained in the diaper.
	All (CDC/FCC/SAC/MST)	APHN			201			i. Children/youth are not excluded for middle ear infection; or thrush, yeast, and diaper area infections providing they feel well enough to participate in program activities, are not communicable, and comply with any medication administration requirement.
	All (CDC/FCC/SAC/MST)	APHN			202	35		ALL: Children/youth who are mildly ill are allowed to remain in care provided they feel well enough to participate in daily activities and do not pose a health risk to others.
	All (CDC/FCC/SAC/MST)	APHN			203	36	Emerging	ALL: Exclusion criteria/policies and parent responsibility to notify CYS Services of exposure to communicable diseases are included in the parent handbook.
	All (CDC/FCC/SAC/MST)	APHN			204	37		ALL: Parents and health consultant are notified of medical emergencies, communicable diseases outbreaks, or acute illness as specified.
A Heading	A Heading		A Heading	A Heading	205
A Heading	A Heading		A Heading	A Heading	206	STAFF/PROVIDERS HEALTH REQUIREMENTS			Met/Not Met
A Heading	A Heading		A Heading	A Heading	207	INTENT: To reduce the risk of disease transmission and ensure staff have the stamina and physical capabilities to care for children.
	All (CDC/FCC/SAC/MST)	APHN			208	38		ALL: Staff and providers have satisfactory health assessments according to most recent guidance:
	All (CDC/FCC/SAC/MST)	APHN			209			a. Staff and providers have satisfactory health assessments, utilizing DA Form 3437, prior to first day of work including required immunizations. NOTE: These assessments are not kept in staff files at CYS Services, but may be kept in folder at CPAC.
	All (CDC/FCC/SAC/MST)	APHN			210			b. Documentation in CYS Services files is a letter/memo from a licensed independent practitioner or Occupational Health clinic indicating the employee/provider/regularly-scheduled volunteer is: 1) Communicable Disease free; 2) Immunizations are up to date; 3) Able to walk, bend, stoop, lift 40 pounds, and stand for prolonged periods; 4) Fit for duty, as per AR 40-562 and CDC/ACIP recommendations. NOTE: Actual physical forms are not maintained by CYS Services. Initial verification of employee meeting health requirements may be included in background checklist from CPAC. Per AR 608-10, 4-25, a and b, Communicable disease risk assessment (a risk analysis of communicability) must be done by licensed independent practitioner when considering personnel action. The risk assessment must consider: (1) how the disease is transmitted; (2) The duration of the risk; (3) The severity of the risk; and (4) The probability of the transmission of the disease-causing harm.
	All (CDC/FCC/SAC/MST)	APHN			211			c. Staff/providers/regularly-scheduled volunteers have an annual health review (Occupational Health) assessment documented, including required immunizations as per AR 40-562 and CDC/ACIP recommendations. NOTE: Temporary inability to meet these standards must be medically documented. Permanent inability to meet these standards with CYPA and cooks will be coordinated through CPAC to follow process for official reassignment /dismissal/medical retirement.
	All Facilities	APHN			212	39		ALL Facilities: There is a procedure coordinated within Preventive Medicine that provides for clearing food service workers for return to duty when out due to illness. NOTE: CYS Services staff can coordinate with the Environmental Health staff to determine the best course of action at their respective installations.
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A Heading	A Heading		A Heading	A Heading	214	ADMINISTERING MEDICATION			Met/Not Met
A Heading	A Heading		A Heading	A Heading	215	INTENT: To provide an opportunity for children/youth with common childhood diseases requiring medication, children/youth with chronic illnesses requiring ongoing medication, and special needs children/youth requiring special medications and/or caregiving health practices to attend CYS Services programs. To support readiness by preventing an interruption of duties of parent Soldiers when their children are in care. To ensure a process is in place to ensure security and tracking of medications.
	All (CDC/FCC/SAC/MST)	APHN			216	40		ALL: Administration of medications are in accordance with policy:
	All (CDC/FCC/SAC/MST)	APHN			217			a. Programs have an approved medication list signed by the supporting Chief Army Public Health Nurse and Medical Treatment Facility Pediatrics POC. The approved medication list will only include antibiotics, antihistamines, decongestants and anti-fungal. The approved medication list will be included in the Health SOP. IAW federal guidelines, decongestants are not approved for children under four years of age unless accompanied by a doctor's prescription.
	All (CDC/FCC/SAC/MST)	APHN			218			b. Medications not on the approved medication list have a medication exception to policy memo from the supporting APHN. NOTE: IMCOM G-9 CYS Services Standardized Medical Action Plan can be an acceptable equivalent to the memo for rescue medications i.e. EPI Pen, Albuterol inhaler or nebulizer, Benadryl or Tylenol.
	All (CDC/FCC/SAC/MST)	APHN			219			c. The administration of medicines is limited to full-day, part-time, or part-day children; and for those special needs children in hourly care and MST youth that have been through the SNAP process. NOTE: See AR 608-10, CYS Memo "Medication and Care Giving Health Practices in Child Development Services", dated July 1994 and "Health Practices in Child and Youth Settings," Aug 2005.
	All (CDC/FCC/SAC/MST)	APHN			220			d. Prescribed medications (non-rescue medication) (i.e., antibiotics) are approved by a licensed independent practitioner, are in the original container, have a prescription label, and a start and end date. Prescribed medications not on approved medication list have a medical exception to policy memo signed by APHN.
	All (CDC/FCC/SAC/MST)	APHN	Critical		221		CRITICAL - Plan within 72 Hours	e. Prescribed medications from the approved medication list (i.e., Non-rescue medications) are current and stored centrally or in classrooms. These medications are secured and in a locked medication box. Medication that requires refrigeration is stored in a locked box in the refrigerator.
	All (CDC/FCC/SAC/MST)	APHN	Critical		222		CRITICAL - Plan within 72 Hours	f. CDC/FCC/SAC: Medication administration is accurately documented on a medication card DA Form 5225-R. NOTE: Notation should be made each day/time as to whether the medication was: Given, Missed (reason why), Not Given (reason why - Refused, Absent, Sick, Side Effect), and initials of care provider administering. For PRN medication, the medication card is only filled out if given.

	All (CDC/FCC/SAC/MST)	APHN			223	41		ALL: ALL: Nonprescription (over-the-counter) medications are only administered when ordered by a licensed independent practitioner for a specific child/youth, for specific circumstance with a start and end date. Plus the program must have written permission of the parent or legal guardian IAW AR 608-10.
	All (CDC/FCC/SAC/MST)	APHN		ACYSE	224	42	Informational	Number of instances of child/youth receiving wrong medication, or failure to give needed medication in the last fiscal year. Also number of instances child/youth received incorrect food and milk. NOTE: A serious incident report is written and noted in CYMS.
	All (CDC/FCC/SAC/MST)	APHN	72 Hour		225	43	72 HOUR Fix Required	ALL: Rescue medications are secured, current, stored and administered as needed.
	CDC/SAC	APHN	72 Hour		226			a. CDC/SAC: Rescue medications are stored in child’s classroom, secured out of the reach of children, but not pad locked (e.g., store medication in a back-pack/fanny-pack with a reusable child proof lock or tie).
	All (CDC/FCC/SAC/MST)	APHN	72 Hour		227			b. Children/youth requiring rescue medication are not allowed to participate in the program without their rescue medication and Medical Action Plan being on site. NOTE: SAC/MST programs that have youth with permission from their licensed independent practitioner and parents to self carry/self administer must have a written process in place to verify the youth have their rescue medication with them (DA 5225-R and Medical Action Plans are kept at the program.)
	All (CDC/FCC/SAC/MST)	APHN	72 Hour		228			c. Rescue medications accompany the child/youth outside, on field trips, and during emergency evacuations. NOTE: If all the children are not on playground together, the medication bag should be on hook by the door so it is easily accessible from either staff on inside or outside. If the door locks and staff outside cannot easily get to the medication on the hook on the inside, the medication should be on a hook on the outside of the door.
	All (CDC/FCC/SAC/MST)	APHN	72 Hour		229			d. Rescue medications are stored within the facility with the child/youth to ensure immediate access. NOTE: If the child/youth can self-medicate, the child/youth may transport the medication. For SAC/MST facilities that centrally locate medications, ensure medication can reach child/youth within two minutes. Availability of documentation of monthly drills validating being able to meet the two-minute limit will be required.
	All (CDC/FCC/SAC/MST)	APHN			230			e. Prescribed rescue medications as defined on the Medical Action Plans are only administered when ordered by licensed independent practitioner (MD & DO, NP, PA) for a specific child/youth, with written permission of the parent or legal guardian. NOTE: When over-the-counter (OTC) drugs are listed on a MAP they are considered a prescribed medication.
	All (CDC/FCC/SAC/MST)	APHN			231			f: Over-the-counter medications used as a rescue medication (i.e., Acetaminophen, Ibuprofen, Dipenhydramine) are approved by a licensed independent practitioner, are in the original container, have a prescription label, and a start and end date.
	CDC/FCC/SAC	APHN			232	44		CDC/FCC/SAC: Basic care items are labeled with child’s first and last name; and written, dated and signed permission slip from the parent/guardian stating reason for use, frequency, and location of application. Basic care item administration is documented on a basic care item form. Basic care items are approved by the Army Public Health Nurse with concurrence of the Medical Treatment Facility Pediatric POC and are limited to topical items used for prevention of sunburn, diaper rash, teething irritation, lip balm, insect repellants and lotions. Toothpaste does not need to be documented. NOTE: Apply according to manufacturer's instructions. IAW FDA guidance, Benzocaine products should not be used on children younger than two years. All medications must be current.
	All (CDC/FCC/SAC/MST)	APHN			233	45	Emerging	ALL: CYMS is used to track rescue medication expiration dates.
	All (CDC/FCC/SAC/MST)	APHN			234	46		ALL: Medications are returned to the parent when no longer needed or expired. If programs cannot send these medications home with parents, then medications should be given to APHN for disposal. NOTE: If APHN not able to dispose of medication, a plan of disposal is developed between APHN and the CYS Services program.
	All (CDC/FCC/SAC/MST)	APHN	Critical		235	47	CRITICAL - Plan within 72 Hours	ALL: CYS Services staff/providers demonstrate competence in administering medications, including oral, patches, eye, ear and nose drops and rescue medications, inhaler, Epi-pen. NOTE: Diastat and Glucagon administration policy is still awaiting approval, so not yet authorized. One method of assessing competence is to have trainer or director utilize the scenarios developed by IMCOM CYS Services.
A Heading	A Heading		A Heading	A Heading	236
A Heading	A Heading		A Heading	A Heading	237	PETS			Met/Not Met
A Heading	A Heading		A Heading	A Heading	238	INTENT: To provide developmental experiences for children while preventing disease transmission between pets and children. To prevent high-risk situations involving children and pets with unpredictable or unsafe behavior.
	All Facilities	EH			239	48		ALL Facilities: Facility-based pets maintained on a permanent basis are inspected by Veterinary Services or qualified designee on a monthly basis, with the exception of fish and fish tanks. NOTE: If a pet in in the facility for over a month, they are considered permanent.
	All Facilities	EH			240	49		ALL Facilities: Pets are contained in appropriate cages/enclosures/areas when not included in an activity.
	All Facilities	EH			241	50		ALL Facilities: Sanitary conditions of the pets are maintained and monitored by the Environmental Health staff as part of the monthly inspection for CDC and quarterly inspection for SAC/MST.
	All (CDC/FCC/SAC/MST)	EH			242	51		ALL: Parents are notified at registration if animals are in the facility/home or any time a new animal is added to the center/home.
	All (CDC/FCC/SAC/MST)	EH			243	52		ALL: Pets bred or trained for attack, and pets known as dangerous (predators, venomous reptiles, and spiders) as determined by Veterinarian are prohibited. For health reasons, the following are not in programs: wolf-dog hybrids, reptiles and amphibians, psittacine birds (inclusive of parrots, parakeets, budgies, and cockatiels), and ferrets. NOTE: Tadpoles can be in programs for science observations but once become frogs, should not remain.
A Heading	A Heading		A Heading	A Heading	244
A Heading	A Heading		A Heading	A Heading	245	HAZARDOUS PLANTS, MATERIALS, AND EQUIPMENT			Met/Not Met
A Heading	A Heading		A Heading	A Heading	246	INTENT: To prevent exposure to hazardous plants which children may chew, consume or handle. To prevent burns, shock, electrocution, and fire ignition and loss of service caused by misuse or tampering. Local fire and safety personnel will determine if OCONUS equipment is satisfactory. To prohibit hazardous heat sources which could generate a fire. To prevent the introduction of highly-toxic materials or materials of unknown hazard into center. To prevent accumulation of unneeded and unserviceable materials and clutter which create exiting, movement, and fire ignition hazards.
	All Facilities	EH			247	53		ALL Facilities: Staff are trained on the proper use and handling of hazardous materials as deemed appropriate by installation Safety.
	All (CDC/FCC/SAC/MST)	EH			248	54		ALL: Equipment is available to protect staff when using hazardous materials, i.e., goggles, gloves, etc.
	All Facilities	EH			249	55		ALL Facilities: Safety Data Sheets (SDS) are approved by Preventive Medicine/Installation Safety office and are on file in the facility.
	All (CDC/FCC/SAC/MST)	EH		ACYSE	250	56		ALL: Devices used for heating are used appropriate:
	All (CDC/FCC/SAC/MST)	EH			251			a. Heating appliances, open fire places, portable space heaters, and electric heaters are not used as heat sources. NOTE: Appliances used for heating infant formula and breast milk are excluded.
	CDC/FCC/KOS	EH		ACYSE	252			b. CDC/FCC/KOS: Bottle warmers are operated IAW manufacturer's recommendations and are out of reach of children, including power cords. NOTE: Microwaves not used to heat bottle or food for infants. NOTE: Bottle warmers which use a small amount of water that evaporates while the bottle heats (about 3-4 minutes) are acceptable. A bottle warmer with an alarm is also helpful.
	CDC/FCC/KOS	EH		ACYSE	253		Emerging	c. CDC/FCC/KOS: Crock pots are not used in CYS Services programs. Research indicates heating bottles is not necessary for infants. If warming the milk is done, either bottle warmers which use a small amount of water that evaporates while bottle heats (about 3-4 minutes) or putting bottle under warm water is acceptable.

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File details come from the government source that posted it. Updated Nov 14, 2017.