TE_CYS-44_MDTI_APHN_CY15_Checklist_v1_20140224.xls
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Instructions
| CY15 CHILD, YOUTH & SCHOOL (CYS) SERVICES GARRISON MULTI-DISCIPLINARY TEAM INSPECTION (MDTI) CHECKLIST INSTRUCTIONS |
| 1. The instructions below are intended to briefly explain the checklists found on the Excel spreadsheets for this MDTI Checklist for APHN. These checklists should be used by the inspector to ensure all criteria are inspected as Met or Not Met. Use of N/A or Not Observed should only be used in extenuating circumstances for that facility or program. |
| 2. The following is an explanation of the structure of the CY15 inspection criteria |
A. Section level – The highest level of the criteria are the “Sections”. Child Development Centers (CDC), Family Child Care (FCC), School Age Centers (SAC) and Youth Program (YP) criteria are divided into three sections, 1) General Management (Section A), 2) Facilities, Health, Safety and Risk Management (Section B) and 3) Programming (Section C).
B. Subsection level – The sections are further categorized into “Subsections.” Example: A.1 Resource Management and Administration is a Subsection under General Management Section A.
C. Criteria level – Each subsection has multiple “Criteria.” The number varies from one subsection to the next. The criteria represent the overall program standards which have been determined by Office of the Secretary of Defense (OSD) to demonstrate “quality” across programs.
Example A.1.a. The program has implemented the fee policy in accordance with current DoD guidance.
There is at least one criteria under each sub-section and as many as 8. Each criteria is followed by the intent statement.
D. Component level – The “Component” level is new for CY15 and is the new term for the compliance item being inspected. The component level compliance items show how the program meets the criteria. The following is an example of one component under Criteria A.1.a. shown above:
Example A.1.a.1 Fees are determined by total family income (TFI).
There is at least one component under each criteria and up to twenty-six, depending on the number of components needed to demonstrate compliance with the criteria. Each component is followed by Guidance, which explains what is observed, reviewed or done by the inspector in order to determine if the program is in compliance with that component. There will also be some Components which have a Notes section that explain the percentage of files, or additional information needed to be consistent in determining compliance with the Component.
| 3. The MDTI Checklist for the inspector is divided into four checklists -- Family Child Care (FCC), Child Development Center (CDC), School Age Center (SAC) and Youth Program (YP). Each component should be evaluated as to whether it is met or not met. If not met, it will go on the Corrective Action Report (CAR) as a finding. The Guidance section will assist the inspector to know what to look for in determining compliance. The Notes section will also assist if there are records to review. |
| 4. Until an electronic version of the CAR is developed based on the new criteria, a CAR form is found on AKO at https://www.us.army.mil/suite/files/44298680 and can be filled in by the inspector until one is developed which will be more automatic. |
| 5. Items identified with a red background in the number cell are the immediate fix deficiencies that must be corrected as soon as identified. The remaining items are a 45 day fix time. Items which are repeats from previous inspections should be designated as repeats. |
| 6. The other inspector checklists are uploaded onto the AKO site under 01 Inspections folder/MDTI folder: https://www.us.army.mil/suite/files/44298680 |
| NOTE: The term "personnel" refers to staff, FCC providers, contractors, volunteers and others identified in the Secretary of the Army Directive. |
FCC APHN
| CY15 APHN HEALTH FAMILY CHILD CARE (FCC) CHILD, YOUTH & SCHOOL (CYS) SERVICES MULTI-DISCIPLINARY TEAM INSPECTION (MDTI) CRITERIA | ||||||
| CRITERIA NUMBER | FCC CRITERIA HOME INSPECTED_______________________ DATE INSPECTED_________ INSPECTOR________________ | MET | NOT MET | N/A | NOT OBS. | |
| A. | GENERAL MANAGEMENT | |||||
| A.1 | PUBLIC LAW 104–106—FEB. 10, 1996 |
§ 1791. Funding for military child care § 1793. Parent fees § 1797. Early childhood education program § 1791. Funding for military child care - It is the policy of Congress that the amount of appropriated funds available during a fiscal year for operating expenses for military child development centers and programs shall be not less than the amount of child care fee receipts that are estimated to be received by the Department of Defense during that fiscal year.
§ 1793. Parent fees - (a) IN GENERAL.—The Secretary of Defense shall prescribe regulations establishing fees to be charged parents for the attendance of children at military child development centers. Those regulations shall be uniform for the military departments and shall require that, in the case of children who attend the centers on a regular basis, the fees shall be based on family income.
(b) LOCAL WAIVER AUTHORITY.—The Secretary of Defense may provide authority to installation commanders, on a case-by-case basis, to establish fees for attendance of children at child development centers at rates lower than those prescribed under subsection (a) if the rates prescribed under subsection (a) are not competitive with rates at local non-military child development centers.
| § 1797. Early childhood education program - The Secretary of Defense shall require that all military child development centers meet standards of operation necessary for accreditation by an appropriate national early childhood programs accrediting body. | RESOURCE MANAGEMENT AND ADMINISTRATION | ||||
| A.1.e | MDTI/HQ/Health | The program establishes procedures for collecting and maintaining required documentation for child enrollment. | DoDI 6060.2 4.3.2; E5.2 |
DoDI 6060.3 4.2.10
AR 608-10 , 4–5.
| Intent: To ensure health and safety of enrolled children. | |||
| A.1.e.2 | 5.A.01 | Child files contain documentation of an annual review/re-registration and update of registration information. | |
| Guidance: Review CYMS Liability Waiver for signature and dated within the past 12 months. A current health Screening Tool and supporting documents signed and dated within the past 12 months. Health Assessment/Sports Physical is signed and dated within the past 12 months. | DODI 6060.2, January 19, 1993, |
AR 608–10, 4–31c; 4-8a(2)
| Notes: Review child files for children in care at the FCC homes inspected. | |||
| A.1.e.3 | 5.A.01 | Child files contain documentation of up-to-date immunizations. | |
| Guidance: Review CYMS Profile Print and Immunization record to verify all age applicable immunization's have a date or an exemption listed. Includes waiver document if waived. If child is within 2 weeks of needing immunization, review notification parent given that immunization due and care denied if not completed by deadline. CYMS can be used to verify immunizations, except in FCC homes where a copy of the immunizations is required. Use CYMS as the guide for what shots are needed. | AR 215-1: 8-25c.(10) |
AR 608-75
DoDI 6060.2 Encl 8 OS11 & HS2AR 608–10 • 15 July 1997 pg. 5
| Notes: Review child files for children in care at the FCC homes inspected. | ||
| A.1.e.4 | Child files contain documentation of current special needs if applicable. | |
| Guidance: If parent has checked "YES" on answers on DA 7625-1 or Tool 1, then the SNAP minutes and 7625-2 or 3 or completion of Tool 1 and 2 should be in the child's file. This should be at the CDC and random files at Parent Central. copy of the MAP must also be co-located (such as in the same plastic baggy) with the medication in the FCC Home. | 608-10, 4-6; C–98. Compliance item 2., |
AR 215-1; 8-25c(5)
| Notes: Run CYMS special needs report to know how many children in care -- consider special needs children when choosing FCC homes. Review child files for children in care at the FCC homes inspected. . | |||
| A.1.f | DoDI 6060.02 (DRAFT), ENCLOSURE 2, RESPONSIBILITIES | ||
| Section 3. HEADS OF THE DoD COMPONENTS. | 3. HEADS OF THE DoD COMPONENTS. The Heads of the DoD Components shall: |
r. Establish guidance and operating procedures to provide services for children with special needs in accordance with Reference (d).
(1) Require procedures for reviewing and making reasonable accommodation of children with special needs that do not fundamentally alter the nature of the program.
(2) Consider the needs of the child, the disability, and the environment of group care in child development facilities or home-based care, staffing needs and training requirements, and the resources of the program.
(3) Include CDPs as part of the multidisciplinary Inclusion Action Team that supports families of children with special needs.
r. Establish guidance and operating procedures to provide services for children with special needs in accordance with Reference (d).
(1) Require procedures for reviewing and making reasonable accommodation of children with special needs that do not fundamentally alter the nature of the program.
(2) Consider the needs of the child, the disability, and the environment of group care in child development facilities or home-based care, staffing needs and training requirements, and the resources of the program.
(3) Include CDPs as part of the multidisciplinary Inclusion Action Team that supports families of children with special needs. 9.A.12 The program establishes procedures for providing services to children with special needs. DoDI 6060.2 4.8;
DoDI 6060.3 4.2.9 DoDI 6060.4 E2.1.4 AR 608-18 1-25c.
| Intent: To ensure a process is in place to review and make reasonable accommodations for children with special needs. | ||||
| A.1.f.3 | N/A | A Special Needs Action Plan (Inclusion Action Plan) and Medical Action Plan, if applicable, is developed to provide written instructions concerning accommodations for each child/youth requiring accommodations. | ||
| Guidance: HQ: Ensure all required signatures on MAP. | ||||
| MDTI: Review MAPs of children requiri+E161ng accommodations to ensure they contain information on how the program will meet the child's needs, changes to the environment, specialized training, required staff: child ratios. A copy of the MAP must be attached to each Rescue medication located in the classroom or program. FCC operators are specifically trained and evaluated to care for children with special needs. | 608-10 chapter 4-2 (a), |
DODI 6060.2, January 19, 1993 (1.3)
AR 608-75 1-25
Caring for Our Children 3.5.0.1
| A.1.f.4 | Children who have been identified with a special need are provided services when reasonable accommodations can be met. | |||
| Guidance: An SNAP/Inclusion Action Team reviews the child's developmental and medical requirements, and makes the determination if reasonable accommodations can be met. Review minutes of SNAP meeting to verify process. May see adaptive equipment in program to meet needs of children/youth. | AR 608-10, l 3-13; 4–2. | |||
| A.2 | PUBLIC LAW 104–106—FEB. 10, 1996, § 1792. Child care employees | (a) REQUIRED TRAINING.—(1) The Secretary of Defense shall prescribe regulations implementing, a training program for child care employees. Those regulations shall apply uniformly among the military departments. Subject to paragraph (2), satisfactory completion of the training program shall be a condition of employment of any person as a child care employee. |
(2) Under those regulations, the Secretary shall require that each child care employee complete the training program not later than six months after the date on which the employee is employed as a child care employee.
(3) The training program established under this subsection shall cover, at a minimum, training in the following:
(A) Early childhood development.
(B) Activities and disciplinary techniques appropriate to children of different ages.
(C) Child abuse prevention and detection.
(D) Cardiopulmonary resuscitation and other emergency medical procedures.
(b) TRAINING AND CURRICULUM SPECIALISTS.—(1) The Secretary of Defense shall require that at least one employee at each military child development center be a specialist in training and curriculum development. The Secretary shall ensure that such employees have appropriate credentials and experience.
(2) The duties of such employees shall include the following:
(A) Special teaching activities at the center.
(B) Daily oversight and instruction of other child care employees at the center.
(C) Daily assistance in the preparation of lesson plans.
(D) Assistance in the center’s child abuse prevention and detection program.
(E) Advising the director of the center on the performance of other child care employees.
(c) COMPETITIVE RATES OF PAY—For the purpose of providing military child development centers with a qualified and stable civilian workforce, employees at a military installation who are directly involved in providing child care and are paid from no appropriated funds—
(1) in the case of entry-level employees, shall be paid at rates of pay competitive with the rates of pay paid to other entry-level employees at that installation who are drawn from the same labor pool; and
| (2) in the case of other employees, shall be paid at rates of pay substantially equivalent to the rates of pay paid to other employees at that installation with similar training, seniority, and experience. | PERSONNEL MANAGEMENT | PUBLIC LAW 104–106—FEB. 10, 1996, § 1792. Child care employees | |
| A.2.c | DoDI 6060.02 (DRAFT), ENCLOSURE 3, |
Section 3. ADMINISTRATION, FUNDING, AND OVERSIGHT OF MILITARY-OPERATED CDPs., Section 4. PERSONNEL., and Section 6. VOLUNTEERS 3. ADMINISTRATION, FUNDING, AND OVERSIGHT OF MILITARY-OPERATED CDPs. Unless otherwise noted, the requirements in this section apply to all DoD-operated CDPs.
content for" a. - f." not listed...
g. Immunizations. (4) Civilian employees (including specified regular volunteers) and FCC providers shall obtain appropriate immunization against communicable diseases in accordance with recommendations from the ACIP. The requirement for appropriate immunization is a condition of continued employment or active participation in the program or organization.
(a) This requirement is waived if a current immunization, a protective titer, or a medical exemption is approved and documented. A waiver for an immunization exemption may also be granted for religious reasons. Philosophical exemptions are not permitted.
(b) The DoD Component must provide guidance on the waiver process. The DoD Component must approve all waivers and documentation of the waiver kept on file.
(c) During a documented outbreak of a contagious disease, staff with a waiver will be excluded from the program for their protection and the safety of the other children and staff until the contagious period is over.
4. PERSONNEL. Installation-based CDP personnel and FCC providers shall meet the following requirements:
a. CDC Directors. CDC directors shall have at a minimum:
(1) A baccalaureate degree in child development, ECE, home economics (early childhood emphasis), elementary education, special education, or other degree appropriate to the position filled from an accredited college; or
(2) A combination of education and experiences, which provide knowledge comparable to that normally acquired through the successful completion of the 4-year course of study in a child-related field.
b. SAC Directors. Directors shall have at a minimum:
(1) A baccalaureate degree in a field of child or youth development, such as youth recreation, physical education, elementary education, secondary education, child development, psychology, social work, or other degree appropriate to the position filled from an accredited college; or
(2) A combination of education and experiences, which provide knowledge comparable to that normally acquired through the successful completion of the 4-year course of study in a child development or youth-related field.
c. Training and Curriculum Specialists. Each program within the CDP shall employ at least one training and curriculum specialist. Training and curriculum specialists shall have at a minimum:
(1) A baccalaureate degree with a major course of study directly related to child or youth development, ECE, or an equivalent field of study from an accredited college, or a combination of education and experiences, which provide knowledge comparable to that normally acquired through the successful completion of the 4-year course of study in the field of child or youth development or ECE.
(2) Knowledge of early childhood or youth education principles, concepts, and techniques to develop, interpret, monitor, and evaluate the execution of curriculum and age-appropriate activities.
(3) Knowledge of adult learning techniques and strategies and experience training adult learners.
(4) Ability to support DoD certification, accreditation, and staff credentialing (Child Development Associate (CDA), Associate of Arts (AA) Degree) by ensuring that required training is administered and successfully accomplished to meet statutory and program requirements.
d. FCC Administrators. FCC administrators shall have at a minimum:
(1) A baccalaureate degree with a major course of study directly related to child or youth development, family studies, or an equivalent field of study from an accredited university; or
(2) A combination of education and experiences, which provide knowledge comparable to that normally acquired through the successful completion of the 4-year course of study in the field of child or youth development or family studies.
e. CDP Direct Care Personnel, Support Staff, and FCC Providers. CDP direct care personnel and support staff, as a condition of employment, and FCC providers shall, as a condition of participation:
(1) Be at least 18 years of age.
(2) Hold a high school diploma or equivalent.
(3) Read, speak, and write English.
(4) Successfully pass a pre-employment physical, maintain current immunizations and be physically and behaviorally capable of performing the duties of the job.
6. VOLUNTEERS. All volunteers shall be screened, trained, and supervised in accordance with Reference (f), DoDI 1100.21 (Reference (v)), and DoD Component implementing guidance, as appropriate to their role. Volunteers may not be alone with children and are not counted in the staff ratio. All regularly scheduled volunteers shall be trained in: Required documentation is maintained in personnel files. AR 608-10, 3–18 ( m), 2–14., C–19. (18); Chapter 2 , Section III , 2–14.
AR 215-3, Chapter 16
| Intent: To ensure important information on personnel is readily available for review. | |||
| A.2.c.2 | 6.A.04 & 6.A.05 | Documentation of pre-employment and required health screenings for all personnel is maintained, including immunization requirements. | |
| Guidance: Initial health assessment for employees on-boarded within last year at CPAC; annual health assessment for employees on-boarded in previous years at program. Documentation is required for FCC home provider and support or substitutes. | AR 40-562; AR 40-5 |
AR 608-10 4-25; AR 215-3
B FACILITY, HEALTH, SAFETY AND RISK MANAGEMENT PUBLIC LAW 104–106—FEB. 10, 1996,
§ 1794. Child abuse prevention and safety at facilities
| B.4 | PUBLIC LAW 104–106—FEB. 10, 1996, | |||||
| § 1794. Child abuse prevention and safety at facilities | (d) SAFETY REGULATIONS.—The Secretary of Defense shall prescribe regulations on safety and operating procedures at military child development centers. Those regulations shall apply uniformly among the military departments. | FIRE AND SAFETY | ||||
| B.4.b | 9.B.07 | Programs maintain equipment to support a safe environment | DoDI 6060.4 E2.1.32 | |||
| Intent: Ensure all equipment is safe and meets standards | ||||||
| B.4.b.1 | 5.A.12 | SIDS and safe sleep precautions are practiced. | ||||
| Guidance: Back to sleep, no soft items, infants who cannot turn over are identified |
AAP states:
1. Infants should be placed on their backs to sleep unless documented medical exception. Placards on cribs with photos of infants to identify if the infant can/cannot turn over.
2. Babies placed on firm surface to sleep.
3. Keep soft objects and loose bedding out of the crib/sleep area. Pacifiers only allowed if not attached to clip or necklace.
4. Mobiles hanging above the crib are allowed until the child starts to pull up. No toys or equipment are allowed in crib.
NOTE: Medical/health equipment needed for Special Needs children can be granted local exception to policy by local APHN
ACTIONS TO TAKE:
1. Infant immediately placed on back.
2. Place infant on firm sleep surface.
3. Remove soft object/loose bedding from crib.
4. Unclip/detach pacifiers fastened with a clip or necklace.
5. Remove mobiles from above crib if child can pull up. Remove any toys/equipment from crib (w/exception of those approved for children with special needs). DoDI 6060.2 Encl 8 HS12
AR 608-10 C-33
Sudden Infant Death Syndrome (SIDS) Memo 15 Jul 09
| B.5 | PUBLIC LAW 104–106—FEB. 10, 1996, | |||
| § 1794. Child abuse prevention and safety at facilities | (d) SAFETY REGULATIONS.—The Secretary of Defense shall prescribe regulations on safety and operating procedures at military child development centers. Those regulations shall apply uniformly among the military departments. | F. HEALTH AND SANITATION | PUBLIC LAW 104–106—FEB. 10, 1996, |
§ 1794. Child abuse prevention and safety at facilities
| B.5.a | DoDI 6060.02 (DRAFT), | ||
| 10. CDC AND SAC STANDARDS OF OPERATION, FCC STANDARDS OF OPERATION, AND THE ERIS | D. Fire and Safety | ||
| The building, playground, and all equipment are maintained in safe, clean condition, are in good repair, and there are no observable safety hazards in the indoor and outdoor program space. | There is a comprehensive system in place that ensures a healthy and sanitary environment. | DoDI 6060.2 4.6.1 |
DoDI 6060.3 4.2 DoDI 6060.4 E4.7.1
| Intent: To ensure procedures and practices support the maintenance of a healthy environment. | |||
| B.5.a.1 | 5.C.01 | Daily custodial support is provided to ensure environment is clean and sanitary. NOTE: FCC does not have custodial staff, but home must be clean. | |
| Guidance: FCC providers have total responsibility for cleanliness of their homes. | DoDI 6060.2 E2.1.4 |
DoDI 6060.3 E2.1.3; 4.2.6 DoDI 6060.4 E2.1.13; E3.1.2.3
AR 608-10 5-37
OPORD 13-153 Annex A
| B.5.a.3 | DoDI 6060.02 (DRAFT), | |||
| 10. CDC AND SAC STANDARDS OF OPERATION, FCC STANDARDS OF OPERATION, AND THE ERIS | C. Health and Sanitation | |||
| The facility is cleaned daily, and as needed throughout the day. Food preparation areas, bathrooms, diapering areas, hand-washing facilities, and drinking fountains are sanitary. | Personnel wash hands at the appropriate times and follow proper hand-washing procedures based on posted handwashing signs. | |||
| Guidance: All personnel should follow the procedure for hand hygiene at the following times: Upon arrival for the day, after breaks, or when moving from one child care group to another; between assisting with teeth brushing; Before and after: Preparing food or beverages; Eating, handling food, or feeding a child; Giving medication or applying a medical ointment or cream in which a break in the skin (e.g., sores, cuts, or scrapes) may be encountered; Playing in water (including swimming) that is used by more than one person; After diapering or using the toilet or helping a child use a toilet; Handling bodily fluid (mucus, blood, vomit), from sneezing, wiping and blowing noses, from mouths, or from sores; Handling animals or cleaning up animal waste; Playing in sand, on wooden play sets, and outdoors; Cleaning or handling the garbage. Handwashing signs are posted at children's level for children's sinks. | AR 608-10 4-33; C-104 |
Caring for Our Children 3.2.2.1
| B.5.a.4 | 9.C.05 | Children/youth wash hands at the appropriate times. | |
| Guidance: Young children should be encouraged to follow the proper procedures with active involvement of staff in assisting/teaching them. Should see children/youth regularly following the procedure for hand hygiene at the following times: Upon arrival for the day, after breaks, or when moving from one child care group to another; Before and after: Preparing food or beverages; Eating, handling food, or ... Playing in water (including swimming) that is used by more than one person; After diapering or using the toilet ; Handling bodily fluid (mucus, blood, vomit), from sneezing, wiping and blowing noses, from mouths, or from sores; Handling animals or cleaning up animal waste; Playing in sand, on wooden play sets, and outdoors; Cleaning or handling the garbage. | AR 608-10 C-104 |
Caring for Our Children 3.2.2.2
| B.5.a.5 | 5.A.09 | Personnel follow universal precautions to prevent transmission of blood-borne diseases. | |
| Guidance: Observe that a training plan is in place to ensure staff and volunteers are knowledgeable of universal precaution procedures and these procedures are also available, in writing, for personnel and followed. Disposable latex or non-porous vinyl gloves are worn when adults come into contact with blood, including blood in feces, and articles contaminated with blood are carefully disposed of, or cleaned and disinfected, or sent home with parents in a plastic bag. Each FCC provider and at least one CYPA per age group has completed OSHA Blood borne pathogen training and certificate available. | AR 608-10 4-33 a(11) |
Caring for Our Children 3.2.3.4
| B.5.a.6 | 5.A.09 | Only provider-prescribed (level 1 or 2 provider which are the providers authorized to prescribe medications) and FDA approved medications are accepted that are antibiotics, antifungal, decongestants, emergency medications (Epi-pins and respiratory inhalers), behavioral or self-care items. Narcotics, antipyretics, etc. are not allowed.. Pain medication will be allowed by exception to policy only. Parental consent/signature is on medication administration card and documented correctly. |
| Guidance: All medications must be prescribed, including over-the-counter (OTC) medications which must also be labeled by the pharmacy with the required information. This includes rescue meds (Epi-pens, asthma inhalers, etc.). Authorization from parent on the medication administration card is required before medication can be given to children/youth in care. If observed, ensure the medication is prescribed. Check medications, including rescue medications, in classrooms observed and other rooms deemed appropriate. Ensure corrections from APHN inspections are corrected. |
ACTIONS TO TAKE:
1. Staff do not administer medications, including OTC, until authorized provider prescription, labeled by pharmacy/in original container, is obtained.
2. Contact parent to provide needed information immediately as medication cannot be given without the required authorization. AR 608-10 4-32; C-101; C-202 CYSS Memo "Health Practices in Child and Youth Settings" dated August 2005 Section 5 para 4;
CYSS Memo "Medication and Care Giving Health Practices in Child Development Services" dated July 1994
| B.5.a.7 | 5.A.08 | Parental permission for staff/providers to apply basic topical care items is obtained. | |
| Guidance: Sunscreen, lip balm, diaper cream, skin cream, etc. | AR 608-10 4-32. Child, Youth and School (CYS) Services Operational Manual, April 2013, |
2-8. Medication-Administration.
| B.5.a.8 | 5.A.08 | A minimum of two staff are trained in medication administration and at least one is on duty at all times. For FCC, Provider must have training if administering medication. | |
| Guidance: Any provider/staff who administers medication should complete a standardized training course that includes skill and competency assessment in medication administration. The trainer in medication administration should be a licensed health professional. Ensure that person(s) on staff that are administering meds have up-to-date training by a licensed health professional or the trainer has been certified to train by a licensed health professional. | AR 608-10 4-32 | ||
| B.5.a.9 | 5.C.01 | Medication is properly stored. | |
| Guidance: Rescue medication standard is at B.5.a.10. Other Medication is out of reach of children but within reach of personnel. Any prescription and over-the-counter medication should be dated and kept in the original container. All medications, refrigerated or unrefrigerated, should: 1) Have child-resistant caps; 2) Be kept in an organized fashion; 3) Be stored away from food; 4) Be stored at the proper temperature; 5) Be completely inaccessible to children/youth. Medication stored under refrigeration is contained in a sealed plastic bag or container when stored with food in FCC. For facilities, medication stored under refrigeration is contained in a sealed plastic bag or container and should be stored in a separate refrigerator from food. Where this is not possible, medicines will be stored in a closed box or similar container. |
ACTIONS TO TAKE:
1. Remove meds from reach of children
2. Remove prescription and OTC meds not in original container
3. Remove any meds without child resistant caps
4. Set up organized means to maintain meds
5. Store at the proper temperature
6. Contact parents for #2 and #3 AR 608-10 4-32x Army Child & Youth Services Policy Clarification May 2007 "Questions and Answers"
| B.5.a.10 | 5.C.03 | Rescue medications are secured, current, stored and administered as needed. |
| Guidance: Medication is out of reach of children but easily accessible to staff. Rescue medication should be dated and kept in original container and co-located with current MAP. NOTE: SAC/MST programs that have youth with permission from their licensed practitioner must have written process in place to verify the youth have their rescue medication and MAP on site. |
1. Rescue medications are stored in child's classroom/activity room, secured out of the reach of children but not locked (i.e., fanny pack with medication in zip-tied child-proof pocket.
2. Children/youth requiring rescue meds are not allowed to participate in the program without their rescue medication and MAP being on site.
3. Rescue meds accompany the child/youth outside, on field trips and during emergency evacuations. The standard is met if medication is easily within reach of staff hung by the exit door adjacent to the playground.
4. Rescue medications are stored within the facility with the child/youth to ensure immediate access.
5. At least one staff working with the child/youth is trained to administer the rescue medication.
ACTIONS TO TAKE:
1. Store meds appropriately
2. Deny care if medication and MAP not in place/current
3. Ensure medications accompany children/youth
4. Ensure provider/staff has immediate access to medications
5. Ensure at least one trained staff working with child/youth. AR 608-10 4-32x Army Child & Youth Services Policy Clarification May 2007 "Questions and Answers"
| B.5.a.11 | 5.C.01 | A list of children/youth with allergies and serious medical conditions is posted in the home/classroom/activity area and the Medical Action Plans (MAPs) are easily accessible to staff with the medication. The information on children/youth with food allergies is also posted in kitchen serving the children/youth. | |
| Guidance: Individual picture of child with allergies should be posted prominently in the home/classroom/activity area where staff/provider can view and/or wherever food is served. PII should be taken into consideration. Allergy listing needs to be posted in the kitchen as well as the classroom. Individual child's food allergies should be posted prominently in the kitchen where staff can view. In FCC home, only requirement is to post in kitchen. | DoDI 6060.2 E3.3.2 |
Army Child & Youth Services Policy Clarification May 2007 "Questions and Answers"
| B.5.a.12 | 9.D.08 | Proper diapering procedures are posted by all diaper areas and followed. | |
| Guidance: Procedures must be in accordance with national recommendations. Staff/Provider keeps bodily contact with the child during diapering at all times to ensure safety of child. Soiled diapers and clothing are changed promptly. Clean paper or cloths are used to cover diaper changing area for each child. Cleaning wipes are used. Covered trash cans are used for diapers and other soiled cloths. Staff washes hands after diapering. | DoDI 6060.2 Encl 8 HS15 |
AR 608-10 4-14 C-106
Caring for Our Children 3.2.1.4
| B.5.a.13 | Children/youth who appear to be ill or show visible signs of fever and are unable to participate in daily activities may be denied care. If child/youth has the possibility of contagious disease, there is an area for child/youth away from the other children/youth where ill child can await parent pick-up. | |
| Guidance: Review written procedures to denial of care to ensure proper procedures followed if seen in program. Children need to be well enough to participate in scheduled activities. : FCC home must be able to isolate sick children from others. Bed linen, towels, washcloths, and other items must be washed and sanitized. Room, toys and other items in the rooms must be cleaned and sanitized before being used by other children or discarded. CDC must have a designated isolation area with a hand sink and bathroom nearby for isolation of sick children. | DoDI 6060.2 Encl 8 HS1 |
AR 608-10 C-99
| B.5.b | DoDI 6060.02 (DRAFT), ENCLOSURE 3, | |
| Section 3. ADMINISTRATION, FUNDING, AND OVERSIGHT OF MILITARY-OPERATED CDPs | g. Immunizations. Children enrolling in or currently enrolled in DoD CDPs must provide written documentation of immunizations appropriate for the child’s age. Per AR 40-562/BUMEDINST 6230.15A/AFJI 48-110/CG COMDTINST M6230.4F (Reference (u)), immunizations recommended by the ACIP are required. |
(1) All records shall be updated at least annually and kept on file. Any child not enrolled in a school system where proof of currency of vaccination is required must provide proof of currency.
(2) Children enrolled in a local public school system and volunteer sports coaches are excluded from this requirement.
(3) A waiver for an immunization exemption may be granted for medical or religious reasons. Philosophical exemptions are not permitted. The DoD Component must provide guidance on the waiver process.
(a) A statement from the child’s health care provider is required if an immunization may not be administered because of a medical condition. The statement must document the reason why the child is exempt.
(b) If an immunization is not administered because of a parent’s religious beliefs, the parent must provide a written statement stating that he or she objects to the vaccination based upon religious beliefs.
(c) During a documented outbreak of a contagious disease that has a vaccine, the child who is attending the program under an immunization waiver for that vaccine, will be excluded from the program for his or her protection and the safety of the other children and staff until the contagious period is over. CDCs maintain equipment to support a healthy environment DoDI 6060.2 4.6.1 DoDI 6060.3 4.2 DoDI 6060.4 E4.7.1
| Intent: To ensure a sanitary classroom environment for staff and children. | ||||||
| B.5.b.2 | 5.A.11 | Individual bedding is washed at least once a week, or when soiled, and used by only one child between washings. | ||||
| Guidance: Cots/mats are sanitized when soiled or before use by another child. Interview provider on practices regarding cleaning bedding/cots/mats. Observe how cots/mats stored. Individual bedding is washed using the hot setting. Cots and mats are stored so they do not touch to prevent cross-contamination and when sanitized to allow air drying. | AR 608-10 4-33 | |||||
| B.5.b.3 | 5.A.11 | Mouthed toys are removed immediately and are washed and sanitized prior to being used by another child. | ||||
| Guidance: Toys that children have placed in their mouths and that are otherwise contaminated by body secretion or excretion should be set aside until they are cleaned by hand with water and detergent, rinsed, sanitized, and air-dried or sanitized in a mechanical dishwasher. Child should be allowed to complete playing with toy before removing the toy. Soft, stuffed toys or similar toys should also be washed after being in child's mouth and laundered using the hottest temperature possible.. | AR 608-10 4-13; C-107 | |||||
| B.5.b.4 | 5.A.11 | Equipment is cleaned weekly or when soiled. Toys are cleaned daily for children under 3 years old and weekly in older age groups. | ||||
| Guidance: Observe for: a) Frequent cleaning; and b) When necessary, an application of sanitizer or disinfectant. Interview provider on cleaning schedule. Examples include chairs, cribs, play structures, and out of doors play equipment and out of doors play equipment. | AR 608-10 4-33a(9) | |||||
| B.6 | NUTRITION AND FOOD SERVICE | |||||
| B.6.a | DoDI 6060.02 (DRAFT), | |||||
| 10. CDC AND SAC STANDARDS OF OPERATION, FCC STANDARDS OF OPERATION, AND THE ERIS | G. Nutrition and Food Service | |||||
| Unless documented circumstances approved by the DoD Component prevent enrollment, all programs must enroll in the USDA CACFP (United States Department of Agriculture Child and Adult Care Food Program). | The FCC program/facility administers the food program in accordance with United States Department of Agriculture (USDA) Child and Adult Care Food Program (CACFP) and DoD requirements. | DoDI 6060.2 E3.3.2; E3.6.2 |
DoDI 6060.3 E3.6.1 DoDI 6060.4 E4.13.1
| Intent: To ensure nutritious meals and snacks are provided in the programs. | |||
| B.6.a.8 | 5.A.02 | For children/youth with dietary accommodations / modifications for medical reasons, substitutions are made based on written documentation by the child/youth's primary medical care provider. Accommodations for religious reasons are accompanied by appropriate documentation. | |
| Guidance: Review procedures for dietary changes and confirm written documentation is on file. The substitutions should be included on the MAP. | DoDI 6060.2 E3.3.2 |
Army Child & Youth Services Policy Clarification May 2007 "Questions and Answers"
| B.6.a.9 | 5.B.06 | There is an effective accountability system in place for bottles. | |
| Guidance: Each bottle is labeled with the child's first and last name and date. Frozen breast milk may be maintained for 3 months and must be used within 24 hours of thawing. | AR 608-10 4-36; C-112; C-214 | ||
| B.6.a.10 | None | Bottles are not heated in a microwave. | |
| Guidance: Bottle warming practices must comply with Caring for Our Children (CFOC) guidelines. | AR 608-10, C–116. Compliance item 6 |
&LCY15 APHN FCC MDTI Checklist&CPage &P of &N&RVersion 1 2/24/14
CDC APHN
| CY15 APHN HEALTH CHILD DEVELOPMENT CENTER (CDC) CHILD, YOUTH & SCHOOL (CYS) SERVICES MULTI-DISCIPLINARY TEAM INSPECTION (MDTI) CRITERIA | ||||||
| CRITERIA NUMBER | CDC CRITERIA CDC NAME/BLDG #________________________ DATE INSPECTED_____________ INSPECTOR________________ | MET | NOT MET | N/A | NOT OBS. | |
| A. | GENERAL MANAGEMENT | |||||
| A.1 | PUBLIC LAW 104–106—FEB. 10, 1996 |
§ 1791. Funding for military child care § 1793. Parent fees § 1797. Early childhood education program § 1791. Funding for military child care - It is the policy of Congress that the amount of appropriated funds available during a fiscal year for operating expenses for military child development centers and programs shall be not less than the amount of child care fee receipts that are estimated to be received by the Department of Defense during that fiscal year.
§ 1793. Parent fees - (a) IN GENERAL.—The Secretary of Defense shall prescribe regulations establishing fees to be charged parents for the attendance of children at military child development centers. Those regulations shall be uniform for the military departments and shall require that, in the case of children who attend the centers on a regular basis, the fees shall be based on family income.
(b) LOCAL WAIVER AUTHORITY.—The Secretary of Defense may provide authority to installation commanders, on a case-by-case basis, to establish fees for attendance of children at child development centers at rates lower than those prescribed under subsection (a) if the rates prescribed under subsection (a) are not competitive with rates at local non-military child development centers.
| § 1797. Early childhood education program - The Secretary of Defense shall require that all military child development centers meet standards of operation necessary for accreditation by an appropriate national early childhood programs accrediting body. | RESOURCE MANAGEMENT AND ADMINISTRATION | ||||
| A.1.e | MDTI/HQ/Health | The program establishes procedures for collecting and maintaining required documentation for child enrollment. | DoDI 6060.2 4.3.2; E5.2 |
DoDI 6060.3 4.2.10
AR 608-10 , 4–5.
| Intent: To ensure health and safety of enrolled children. | |||
| A.1.e.2 | 5.A.01 | Child files contain documentation of an annual review/re-registration and update of registration information. | |
| Guidance: Review CYMS Liability Waiver for signature and dated within the past 12 months. A current health Screening Tool and supporting documents signed and dated within the past 12 months. Health Assessment/Sports Physical is signed and dated within the past 12 months. | DODI 6060.2, January 19, 1993, |
AR 608–10, 4–31c; 4-8a(2)
| Notes: Review 10% child files for children enrolled at the CDC. If hourly care, review 10% child files of hourly care children attending during inspection (minimum 3 or one from each age group attending that day). | |||
| A.1.e.3 | 5.A.01 | Child files contain documentation of up-to-date immunizations. | |
| Guidance: Review CYMS Profile Print and Immunization record to verify all age applicable immunization's have a date or an exemption listed. Includes waiver document if waived. If child is within 2 weeks of needing immunization, review notification parent given that immunization due and care denied if not completed by deadline. CYMS can be used to verify immunizations, except in FCC homes where a copy of the immunizations is required. Use CYMS as the guide for what shots are needed. | AR 215-1: 8-25c.(10) |
AR 608-75
DoDI 6060.2 Encl 8 OS11 & HS2AR 608–10 • 15 July 1997 pg. 5
| Notes: Review 10% child files for children enrolled at the CDC. If hourly care, review 10% child files of hourly care children attending during inspection (minimum 3 or one from each age group attending that day). | ||
| A.1.e.4 | Child files contain documentation of current special needs if applicable. | |
| Guidance: If parent has checked "YES" on answers on DA 7625-1 or Tool 1, then the SNAP minutes and 7625-2 or 3 or completion of Tool 1 and 2 should be in the child's file. This should be at the CDC and Parent Central. CYMS Report to be run to know how many children are in care. A copy of the MAP must also be co-located (such as in the same plastic baggy) with the medication in the child's classroom. | 608-10, 4-6; C–98. Compliance item 2., |
AR 215-1; 8-25c(5)
| Notes: Run CYMS special needs report to know how many children in care -- consider special needs children files reviewed are represented. Review 10% child files for children enrolled at the CDC. If hourly care, review 10% child files of hourly care children attending during inspection (minimum 3 or one from each age group attending that day). | |||
| A.1.f | DoDI 6060.02 (DRAFT), ENCLOSURE 2, RESPONSIBILITIES | ||
| Section 3. HEADS OF THE DoD COMPONENTS. | 3. HEADS OF THE DoD COMPONENTS. The Heads of the DoD Components shall: |
r. Establish guidance and operating procedures to provide services for children with special needs in accordance with Reference (d).
(1) Require procedures for reviewing and making reasonable accommodation of children with special needs that do not fundamentally alter the nature of the program.
(2) Consider the needs of the child, the disability, and the environment of group care in child development facilities or home-based care, staffing needs and training requirements, and the resources of the program.
(3) Include CDPs as part of the multidisciplinary Inclusion Action Team that supports families of children with special needs.
r. Establish guidance and operating procedures to provide services for children with special needs in accordance with Reference (d).
(1) Require procedures for reviewing and making reasonable accommodation of children with special needs that do not fundamentally alter the nature of the program.
(2) Consider the needs of the child, the disability, and the environment of group care in child development facilities or home-based care, staffing needs and training requirements, and the resources of the program.
(3) Include CDPs as part of the multidisciplinary Inclusion Action Team that supports families of children with special needs. 9.A.12 The program establishes procedures for providing services to children with special needs. DoDI 6060.2 4.8;
DoDI 6060.3 4.2.9 DoDI 6060.4 E2.1.4 AR 608-18 1-25c.
| Intent: To ensure a process is in place to review and make reasonable accommodations for children with special needs. | ||||
| A.1.f.3 | N/A | A Special Needs Action Plan (Inclusion Action Plan) and Medical Action Plan, if applicable, is developed to provide written instructions concerning accommodations for each child/youth requiring accommodations. | ||
| Guidance: HQ: Ensure all required signatures on MAP. | ||||
| MDTI: Review MAPs of children requiri+E161ng accommodations to ensure they contain information on how the program will meet the child's needs, changes to the environment, specialized training, required staff: child ratios. A copy of the MAP must be attached to each Rescue medication located in the classroom or program. FCC operators are specifically trained and evaluated to care for children with special needs. | 608-10 chapter 4-2 (a), |
DODI 6060.2, January 19, 1993 (1.3)
AR 608-75 1-25
Caring for Our Children 3.5.0.1
| A.1.f.4 | Children who have been identified with a special need are provided services when reasonable accommodations can be met. | |||
| Guidance: An SNAP/Inclusion Action Team reviews the child's developmental and medical requirements, and makes the determination if reasonable accommodations can be met. Review minutes of SNAP meeting to verify process. May see adaptive equipment in program to meet needs of children/youth. | AR 608-10, l 3-13; 4–2. | |||
| A.2 | PUBLIC LAW 104–106—FEB. 10, 1996, § 1792. Child care employees | (a) REQUIRED TRAINING.—(1) The Secretary of Defense shall prescribe regulations implementing, a training program for child care employees. Those regulations shall apply uniformly among the military departments. Subject to paragraph (2), satisfactory completion of the training program shall be a condition of employment of any person as a child care employee. |
(2) Under those regulations, the Secretary shall require that each child care employee complete the training program not later than six months after the date on which the employee is employed as a child care employee.
(3) The training program established under this subsection shall cover, at a minimum, training in the following:
(A) Early childhood development.
(B) Activities and disciplinary techniques appropriate to children of different ages.
(C) Child abuse prevention and detection.
(D) Cardiopulmonary resuscitation and other emergency medical procedures.
(b) TRAINING AND CURRICULUM SPECIALISTS.—(1) The Secretary of Defense shall require that at least one employee at each military child development center be a specialist in training and curriculum development. The Secretary shall ensure that such employees have appropriate credentials and experience.
(2) The duties of such employees shall include the following:
(A) Special teaching activities at the center.
(B) Daily oversight and instruction of other child care employees at the center.
(C) Daily assistance in the preparation of lesson plans.
(D) Assistance in the center’s child abuse prevention and detection program.
(E) Advising the director of the center on the performance of other child care employees.
(c) COMPETITIVE RATES OF PAY—For the purpose of providing military child development centers with a qualified and stable civilian workforce, employees at a military installation who are directly involved in providing child care and are paid from no appropriated funds—
(1) in the case of entry-level employees, shall be paid at rates of pay competitive with the rates of pay paid to other entry-level employees at that installation who are drawn from the same labor pool; and
| (2) in the case of other employees, shall be paid at rates of pay substantially equivalent to the rates of pay paid to other employees at that installation with similar training, seniority, and experience. | PERSONNEL MANAGEMENT | PUBLIC LAW 104–106—FEB. 10, 1996, § 1792. Child care employees | |
| A.2.c | DoDI 6060.02 (DRAFT), ENCLOSURE 3, |
Section 3. ADMINISTRATION, FUNDING, AND OVERSIGHT OF MILITARY-OPERATED CDPs., Section 4. PERSONNEL., and Section 6. VOLUNTEERS 3. ADMINISTRATION, FUNDING, AND OVERSIGHT OF MILITARY-OPERATED CDPs. Unless otherwise noted, the requirements in this section apply to all DoD-operated CDPs.
content for" a. - f." not listed...
g. Immunizations. (4) Civilian employees (including specified regular volunteers) and FCC providers shall obtain appropriate immunization against communicable diseases in accordance with recommendations from the ACIP. The requirement for appropriate immunization is a condition of continued employment or active participation in the program or organization.
(a) This requirement is waived if a current immunization, a protective titer, or a medical exemption is approved and documented. A waiver for an immunization exemption may also be granted for religious reasons. Philosophical exemptions are not permitted.
(b) The DoD Component must provide guidance on the waiver process. The DoD Component must approve all waivers and documentation of the waiver kept on file.
(c) During a documented outbreak of a contagious disease, staff with a waiver will be excluded from the program for their protection and the safety of the other children and staff until the contagious period is over.
4. PERSONNEL. Installation-based CDP personnel and FCC providers shall meet the following requirements:
a. CDC Directors. CDC directors shall have at a minimum:
(1) A baccalaureate degree in child development, ECE, home economics (early childhood emphasis), elementary education, special education, or other degree appropriate to the position filled from an accredited college; or
(2) A combination of education and experiences, which provide knowledge comparable to that normally acquired through the successful completion of the 4-year course of study in a child-related field.
b. SAC Directors.
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