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Southern Seven Head Start/ Early Head Start

Southern Seven Head Start/ Early Head Start · center has more than one session, drills are to be completed in each session. 2. Fill out drill forms and post current month on safety

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Page 1: Southern Seven Head Start/ Early Head Start · center has more than one session, drills are to be completed in each session. 2. Fill out drill forms and post current month on safety

Southern Seven Head Start/

Early Head Start

Page 2: Southern Seven Head Start/ Early Head Start · center has more than one session, drills are to be completed in each session. 2. Fill out drill forms and post current month on safety

Revised: 08/15, rm 2

TABLE OF CONTENTS

Incident Reporting System .............................................................................................. 4 Incident Report (IR) ......................................................................................................... 5 Incident Follow-up/Investigative Report (IFIR) ................................................................ 8 Monthly Emergency Drill ............................................................................................... 10 Emergency Drill Tracking Form ..................................................................................... 11 Emergency Plans .......................................................................................................... 12 Earthquake Drill ............................................................................................................. 14 Tornado Drill .................................................................................................................. 15 Lock Down/Intruder Drill ................................................................................................ 16 Fire Drill ......................................................................................................................... 17 Fire Drill Part 2 .............................................................................................................. 18 Bloodborne Pathogens Exposure Control Plan ............................................................. 19 Bloodborne Pathogens Exposure Control Plan for the Bus ........................................... 20 Bloodborne Pathogen Kit Inventory Checklist ............................................................... 22 Emergency Kit Inventory Form ...................................................................................... 23 First Aid Kit Inventory List .............................................................................................. 24 CPR/First Aid Training ................................................................................................... 25 Safety Committees ........................................................................................................ 26 Safety Committee Accident/Incident Review ................................................................. 27 Employee Safety Tracking Form ................................................................................... 28 Employee Personal Safety ............................................................................................ 29 On-Going Monitoring Procedure List ............................................................................. 30 Safety/Maintenance Checklist ....................................................................................... 32 Pest Control .................................................................................................................. 33 Equipment Maintenance Request ................................................................................. 34 Repair or Work Requisition ........................................................................................... 36 Request to Transfer or Destroy Records/Files .............................................................. 37 Request to Transfer or Destroy Equipment ................................................................... 38 Discarded Items ............................................................................................................ 39 Cleaning the Center ...................................................................................................... 40 Maintaining Equipment, Toys, and Supplies ................................................................. 41 Health & Safety Daily Cleaning/Inspection Checklist..................................................... 42 Health & Safety Daily Cleaning/Inspection Checklist (Extra Classrooms) ..................... 44 Equipment Cleaning Checklist – Part 2 ......................................................................... 46 Diapering ....................................................................................................................... 47 Handwashing ................................................................................................................ 48 Oral Hygiene ................................................................................................................. 49 Animals in the Center .................................................................................................... 51 Health and Safety Training of Staff ............................................................................... 53 Bleach Solution Schedule ............................................................................................. 54 Playground Checklist ..................................................................................................... 57 Daily Playground Maintenance List ............................................................................... 58 Daily Playground Safety Checklist................................................................................. 59 Center Safety Review .................................................................................................... 60

Page 3: Southern Seven Head Start/ Early Head Start · center has more than one session, drills are to be completed in each session. 2. Fill out drill forms and post current month on safety

Revised: 08/15, rm 3

Daily Departure of Children from the Center ................................................................. 61

Page 4: Southern Seven Head Start/ Early Head Start · center has more than one session, drills are to be completed in each session. 2. Fill out drill forms and post current month on safety

Revised: 08/15, rm 4

Southern Seven HS/EHS Service Area: Safety Procedure: Incident Reporting System References: Once immediate medical care has been provided and the contact of the child’s parent(s) or the stated emergency contact person has been made necessary reporting of the incident must take the following steps: 1. Complete the incident form. Follow instructions as listed on form.

• Level 1 – Incident report form is to be mailed to the Human Resources Administrator at the Administrative Office.

• Level 2 or 3 – Immediate telephone contact must be made with the Administrative Office. Contact the Human Resources Administrator. If you cannot reach the Human Resources Administrator, contact the Early Childhood Administrator or Early Childhood Director. Leaving a voice-mail message is NOT appropriate. You must speak directly with someone. a. Incident Report Form is to be immediately faxed to the Administrative Office. b. Early Childhood Administrator or Early Childhood Director are to report the incident

immediately by phone to the DCFS Licensing Representative and follow-up in 24 hours with a written incident report. DCFS Office, 2309 West Main, Suite 108, Marion, IL 62959, Phone: (618) 993-7057; Fax: (618) 993-5467.

c. Human Resources Administrator or designee will complete Follow-Up/Investigative Report within 5 days.

• Level 4 a. Minor incident may use the Level 1 procedure of mailing the incident form to the

Administrative Office. The form should be sent directly to the Human Resource Administrator. Example: an employee’s person property became damaged or lost.

b. For a major incident, make immediate telephone contact with the Administrative Office. Contact both the Human Resource Administrator and the Early Childhood Administrator. Leaving a voice-mail message is NOT appropriate. You must speak directly with someone. If none are available, ask the secretary for the Early Childhood Administrator. Example: a non-injury bus incident where children are present, a non-injury incident at the center where children are present. In cases where a government agency must assist, make those calls with the appropriate timing based on the degree of need i.e. 911. Immediately contact the State Police when a bus has an accident.

c. For a bus incident the Early Childhood Administrator will follow the same procedure listed above for Level 2 or 3.

For incident involving parents, volunteers, or staff contact the Human Resources Administrator.

Page 5: Southern Seven Head Start/ Early Head Start · center has more than one session, drills are to be completed in each session. 2. Fill out drill forms and post current month on safety

Revised: 08/15, rm 5

Southern Seven Health Department Incident Report (IR)

Please Print Person Involved (PI) in Incident: Employee:____ Child:____ Client:____

Other:______________________________

Last Name: ___________________________________ First Name: __________________________________ M.I. ____

DOB_____/_____/_____ Home Address:_____________________________________________________

City:________________________ State:_____ Zip:___________

Home Phone #: _________-___________ Message Phone #: _________-___________ Work #: _________-

__________ Sex: M or F

If PI is employee: Base Office: _____________________________ Job Title:

_____________________________________________________ If PI is child, Parent/Guardian

Name:________________________________________________________ Phone #:_________-_____________

Incident occurred on: _____/_____/______ at ____________A.M/ ____________P.M.

Address Where Incident Occurred:____________________________________________ City:__________________

State:_____ Zip:_________

Incident Level: 1 ____ 2 ____ 3 ____ 4 ____ (see reverse side of this report for level definition).

Name of Employee completing this report: ________________________________________________________

Date_______/_______/_______

Person contacted at Administrative Office: Name:___________________________________ Date_____/_____/_____ at

_______am/_______pm

Person contacted at Child’s/Client’s Home: Name:___________________________________ Date_____/_____/_____ at

_______am/_______pm

Contact Person’s Relationship to Child/Client: _____________________________________ Phone #:__________-

_____________

(1)Witness Name: _________________________Address: _____________________________________________

Phone #: _______-_________

(2)Witness Name: _________________________Address: ______________________________________________

Phone #: _______-_________

(3)Witness Name: _________________________Address: ______________________________________________

Phone #: _______-_________

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Description of Incident: Provide only factual information. Conclusions and judgments are reserved for investigating staff person. If the incident involves a client, do not copy or note the incident in the client’s chart. In case of injury/illness, only observations (not opinions) specific to client should be entered in chart. Medical services/advice should only be provided by non-medical staff in a medical emergency until 1st responders arrive. In no event shall PI be detained if primary care/emergency services needed. • Describe injury/illness? (i.e. strain, sprain, laceration, etc):

• What part of body was affected? (i.e. index finger on left hand, etc.):

• What was person doing when he/she was injured? (i.e. lifting box, etc.):

• What caused the injury/illness? (i.e. 40 lb. typewriter, etc.)

[See Reverse Side of this Form to Complete and for Instructions] • How did incident happen? (i.e. binder fell off shelf striking employee on left foot, etc.) • What unsafe circumstances contributed to the incident? (i.e. employee not wearing gloves, etc.) • Describe any unsafe act by another person that contributed to the incident? (i.e. unidentified motorist failed to

stop at intersection, etc.) • What nursing/1st aid services were rendered and by whom, to PI, if any? • Was ambulance/emergency services called? Yes _____ No _____ If yes, who responded? Agency Name: (1)____________________________________________________________________________________________________ Agency Name: (2)____________________________________________________________________________________________________ • Was PI or parent/guardian referred for/seek medical treatment? Yes _____ No ______ If yes, provide name of healthcare provider(s) and/or hospital(s) including address & phone #: Name:_____________________________________________________________________________________________

Page 7: Southern Seven Head Start/ Early Head Start · center has more than one session, drills are to be completed in each session. 2. Fill out drill forms and post current month on safety

Revised: 08/15, rm 7

________________ Address:________________________________________________________________________________ Ph.#__________-_____________ Name:_____________________________________________________________________________________________________________ Address:________________________________________________________________________________ Ph.#__________-_____________ • Was anyone accompanying the PI at the time of the incident? Yes ______ No ______ If yes, Name:____________________________________________ Relationship to person involved: __________________________________

Instructions for completion of Incident Report (IR) [Beginning at the top of the report form, fill in any blanks on the form that apply. In general, the employee most familiar with the incident should complete this report. The immediate supervisor shall ensure that this report is completed in a timely manner.] • PI = Person who is the subject of the incident. If more than one person is involved, complete IR for each person. • Example of Other is parent, vendor, client’s spouse, etc. • DOB = Date of Birth Incident Level:

1. Any minor injury/health condition that may/may not result in the application of 1st aid. This includes bruises, bumps, scrapes, bloody nose, knot on head, sprain, bruise or any visible marks. [Completed report should be sent to contact person at the Administrative Office via U.S. or interoffice mail]. Contact person is the HR/RM-A (or designee: SEPD or PSA) for all incidents except if it involves a Head Start Child in which case the contact person is the H/SNS (or designee: HS Assoc. or PSS).

2. Any moderate injury/health condition resulting in the person involved or his/her parent/guardian

seeking/referred for non-emergency medical treatment from a primary care provider. Call contact person same day. [Completed report to be faxed to contact person within 1 hour or as soon as possible].

3. Any serious injury/health condition requiring immediate emergency medical attention such as call to

911/ambulance. Must call contact person ASAP. [Completed report to be faxed to contact person within 1 hour or as soon as possible].

4. Any incident not involving an injury/health condition such as property damage, burglary/theft, workplace

violence, personal property or lost agency property (e.g. ID Badge, agency key, Personnel Policy Manual, etc.).

[If additional space is needed, attach sheet to this report]

Page 8: Southern Seven Head Start/ Early Head Start · center has more than one session, drills are to be completed in each session. 2. Fill out drill forms and post current month on safety

Revised: 08/15, rm 8

Southern Seven Health Department Incident Follow-up/Investigative Report (IFIR)

Please Print [This report to be completed within 5 business days of Level 2, 3 or 4 Incident by Investigative Officer (IO) [HR/RM-A or designee for all incidents except if it involves a Head Start Child in which case the H/SNS or designee shall complete]. Name of Person Involved (PI): _________________________________________________ DOI: ______/______/______ Name of IO Completing IFIR: ___________________________________________________ Date: _____/______/______ Witness Statements to be taken in this Section by IO. (See IR for list order of witnesses):

(1) ______/______/______ at ___________A.M./___________P.M:

(2) ______/______/______ at ___________A.M./___________P.M: (3) ______/______/______ at ___________A.M./___________P.M:

If no witnesses (or in addition to witnesses) is there anyone else who can offer corroborating evidence of incident? If so, Name:___________________________________________________ Statement: [If additional space is needed for statements, attach sheet to this report].

Any discrepancies in facts as reported by PI, witnesses or others? If yes, describe:

Has follow-up call been made to PI or parent/guardian (if child) to check on status? If so, by Whom: ______________________________________________ Date _______/_______/_______ If not, who will call – Name: ___________________________________________ When _______/_______/_______ What is status of PI? Does PI or parent/guardian (if child) need to be contacted again? If so, when ________/________/________ By Whom:_____________________________________________________________________. Any change in status of PI?

Is re-training/disciplinary action recommended if incident involved unsafe act by employee? [For HR/RM-A completion only]. If so, Employee Name: ________________________________________________________ What action is recommended?

Page 9: Southern Seven Head Start/ Early Head Start · center has more than one session, drills are to be completed in each session. 2. Fill out drill forms and post current month on safety

Revised: 08/15, rm 9

Additional Remarks:

________________________________________________________ ________/________/________ Investigative Officer Signature Date

Page 10: Southern Seven Head Start/ Early Head Start · center has more than one session, drills are to be completed in each session. 2. Fill out drill forms and post current month on safety

Revised: 08/15, rm 10

Southern Seven HS/EHS Service Area: Safety Procedure: Monthly Emergency Drill References: 1. Complete all drills (earthquake, fire, tornado, and lock down/intruder) each month. If

center has more than one session, drills are to be completed in each session. 2. Fill out drill forms and post current month on safety board and place previous

months form in the safety binder. 3. Document dates on emergency drill tracking form. This should also be posted on

safety board.

Page 11: Southern Seven Head Start/ Early Head Start · center has more than one session, drills are to be completed in each session. 2. Fill out drill forms and post current month on safety

Revised: 08/15, rm 11

Southern Seven Head Start/Early Head Start EMERGENCY DRILL TRACKING FORM

School Year: Center:___________________________ Site Supervisor:

Aug

Sept

Oct

Nov

Dec

Jan

Feb

Mar

April

May

June

July

Fire Drill

Tornado Drill

Earthquake Drill

Lock Down/Intruder Drill

Other:

Page 12: Southern Seven Head Start/ Early Head Start · center has more than one session, drills are to be completed in each session. 2. Fill out drill forms and post current month on safety

Revised: 08/15, rm 12

Southern Seven HS/EHS Service Area: Safety Procedure: Emergency Plans References: Fire Emergency Plan 1. When alarm sounds, children and staff will exit the classrooms through the closest

outside door. 2. An adult will lead the children while another will hold the door and follow the children. 3. Children and staff will proceed to the Designated Fire Drill Meeting Area in an orderly

manner (the designated area should be noted in the safety the binder and posted in each center)

4. A designated staff will take the roll book and emergency contact information for each child to assure that all are accounted for. Each family can be contacted if needed.

5. Do not get coats, toys, etc. 6. Designated staff will check halls, bathrooms and classrooms to make sure all children

and staff are out, and then join others. Close doors as rooms are checked. 7. Remain at designated area until ‘all clear’ or other instructions are given. Tornado Emergency Plan 1. When notified of danger, be prepared to take cover. 2. Teachers will assist children in exiting the room to the designated area and will line up

against the wall and assume the duck and cover position. 3. A designated staff will take the roll book and emergency contact information for each

child to assure that all are accounted for. Each family can be contacted if needed. 4. Teacher will call roll while Aide sees that all children are in proper position. 5. Designated staff will check rooms to make sure all are clear and then join the others. 6. Remain in this position until ‘all clear’ or other information is given. 7. When clear, remain calm and don’t exit the building until safety is assured. Earthquake Emergency Plan 1. When shaking begins, children and staff will take cover in the duck and cover position. 2. Teachers and Aides will see that all children are protected and then take cover

themselves. 3. A designated staff will take the roll book and emergency contact information for each

child to assure that all are accounted for. Each family can be contacted if needed. 4. Other employees and people in the building will assume cover and wait until the shaking

stops. 5. Teachers complete roll call to make sure all are accounted for. 6. Stay in classroom until all danger has been cleared or shaking has ceased. Be

prepared for after shocks. 7. Remain calm until emergency help arrives or instructed to do otherwise. 8. Wait until clear before trying to exit the building. 9. Staff assist in attending the children.

Page 13: Southern Seven Head Start/ Early Head Start · center has more than one session, drills are to be completed in each session. 2. Fill out drill forms and post current month on safety

Revised: 08/15, rm 13

Intruder/Lockdown Procedure For those sites located within the School Districts, Head Start classrooms will follow school procedures and instruction. These will be reviewed and drills completed within the school policy. For the other sites any Head Start Personnel who observe an individual in the building who appears suspicious should notify the Site Supervisors office immediately.

1. The Site Supervisor or designee will determine if it is a serious situation and then instruct the staff nearest the phone to call 911 if necessary.

2. Make sure the 911 operator understands that there is an intruder inside the building whether the intruder is armed, his/her last know location, and any descriptive information available. If possible, stay on the line until instructed to disconnect by emergency operator.

3. Signal other staff members by announcing a coded word specific to your site is in the building and Lock-Down is initiated.

4. The Teachers will move the children into an area of the room that is not visible from windows and doors if possible. The Teachers will lock windows, doors, lower blinds, turn out the lights, and take roll to ensure all children are accounted for.

5. Once Lock-Down is initiated, parents cannot sign out or pick-up their child until Lock-Down is ended.

6. Staff should continue to follow the above procedure until an “all clear” is signaled by Site Supervisor or designee.

Page 14: Southern Seven Head Start/ Early Head Start · center has more than one session, drills are to be completed in each session. 2. Fill out drill forms and post current month on safety

Revised: 08/15, rm 14

Southern Seven Head Start/Early Head Start EARTHQUAKE DRILL

Center: _______________________________ Date: ______________________ Time of Earthquake Drill: _________________ Evacuation Time: ____________ Number of Children Present: ______________ Weather Condition: ___________ Names of Staff Present: __________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ Was the building=s Earthquake System activated? Yes No Summary of Earthquake Drill Procedure: _____________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ Did all children gather at the designated location? Yes No List any unsatisfactory actions that should be corrected in future Earthquake Drill Procedures: ___________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ This Earthquake Drill Report shall be posted in a conspicuous location. Earthquake Drills shall be conducted at least monthly. Records shall be maintained for documentation of safety practices and preparation in case of disaster.

Page 15: Southern Seven Head Start/ Early Head Start · center has more than one session, drills are to be completed in each session. 2. Fill out drill forms and post current month on safety

Revised: 08/15, rm 15

Southern Seven Head Start/Early Head Start TORNADO DRILL

Center: _______________________________ Date: ______________________ Time of Tornado Drill: ____________________ Evacuation Time: ____________ Number of Children Present: ______________ Weather Condition: ___________ Names of Staff Present: __________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ Was the building=s Tornado System activated? Yes No Summary of Tornado Drill Procedure: _______________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ Did all children gather at the designated location? Yes No List any unsatisfactory actions that should be corrected in future Tornado Drill Procedures: ___________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ This Tornado Drill Report shall be posted in a conspicuous location. Tornado Drills shall be conducted at least monthly. Records shall be maintained for documentation of safety practices and preparation in case of disaster.

Page 16: Southern Seven Head Start/ Early Head Start · center has more than one session, drills are to be completed in each session. 2. Fill out drill forms and post current month on safety

Revised: 08/15, rm 16

Southern Seven Head Start/Early Head Start LOCK DOWN/INTRUDER DRILL

Center: _______________________________ Date: ______________________ Time of Lock Down/Intruder Drill: ___________ Evacuation Time: ____________ Number of Children Present: ______________ Weather Condition: ___________ Names of Staff Present: __________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ Was the building’s Lock Down/Intruder System activated? Yes No Summary of Lock Down/Intruder Drill Procedure: ______________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ Did all children gather at the designated location? Yes No List any unsatisfactory actions that should be corrected in future Lock Down/Intruder Drill Procedures: _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ This Lock Down/Intruder Drill Report shall be posted in a conspicuous location. Lock Down/Intruder Drills shall be conducted at least monthly. Records shall be maintained for documentation of safety practices and preparation in case of disaster.

Page 17: Southern Seven Head Start/ Early Head Start · center has more than one session, drills are to be completed in each session. 2. Fill out drill forms and post current month on safety

Revised: 08/15, rm 17

Southern Seven Head Start/Early Head Start FIRE DRILL

Center: _______________________________ Date: ______________________ Time of Fire Drill: _______________________ Evacuation Time: ____________ Number of Children Present: ______________ Weather Condition: ___________ Names of Staff Present: __________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ Was the building=s Fire Alarm System activated? Yes No (Note: All Fire Exit Drill Alarms shall be sounded on the Fire Alarm System) Was the Fire Department notified? Yes No (Note: Alarm Systems connected to the Fire Departments or watch services require prior notification) Did alarm test function properly? Yes No Summary of Fire Drill Procedure: ___________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ Did all children gather at the designated location outside of the building regardless of which exits were used? Yes No List any unsatisfactory actions that should be corrected in future Fire Drill Procedures: _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ This Fire Drill Report shall be posted in a conspicuous location. Fire Drills shall be conducted at least monthly. Records shall be maintained for documentation of safety practices and preparation in case of disaster.

Page 18: Southern Seven Head Start/ Early Head Start · center has more than one session, drills are to be completed in each session. 2. Fill out drill forms and post current month on safety

Revised: 08/15, rm 18

Southern Seven Head Start/Early Head Start CHILD CARE CENTER (Fire Drill Part 2)

MET

NOT MET

N/A

Doors Closet doors openable from inside? Restroom doors - Opening device available from outside of room for emergencies? All doors equipped with self-closers kept closed & not propped open? All doors equipped with self-closers close properly?

Equipment Maintenance Fire Alarm System is tested monthly. Date of Fire Alarm System Test____________________. Emergency lighting is tested monthly - 30 sec. Date of test___________________________________. Illuminated exit & directional signs are maintained in continuous operating condition.

Electrical Protective covers are provided for all outlets. Extension cords are not used for appliances. Outlets are not overloaded.

Exits & Exitways Exitways and corridors are maintained free of obstructions. Exitways are not blocked with cots during naptime

Kitchen Exhaust ducts and hoods free of grease accumulation. Exhaust fans clear?

Flammable & Combustible Liquids Prohibited in building unless stored in accordance with NFPA 30.

Cleaning Supplies Stored in locked cabinet and out of reach of children.

Furnace Room Combustible storage is not located in this room. There is no paper, wood, plastic, rubber or anything that can burn.

Trash Containers All trash containers are noncombustible.

Fire Drills Monthly fire drill was conducted.

Additional Comments: ___________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _______________________________ ___________________________ Name Date of Report

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Southern Seven HS/EHS Service Area: Safety Procedure: Bloodborne Pathogens Exposure Control Plan References: EACH CENTER HAS BEEN PROVIDED A COPY OF THE SOUTHERN SEVEN HEALTH DEPARTMENT BLOODBORNE PATHOGEN EXPOSURE CONTROL PLAN. Each Site Supervisor or Safety Committee will designate appropriately trained employees who will be responsible for the cleaning of any bodily fluids such as blood, vomit, etc. Those designated persons shall be listed in the Safety Award Notebook and posted on the Safety Bulletin Board at each center. Custodians or other assigned individual will be designated as the primary person to provide cleaning and disinfection of the contaminated area. Bloodborne Pathogen trained employees and/or volunteers who are designated to treat any child with bodily fluids, such as blood spills, vomiting, etc., or the infected area, must wear required protective equipment as listed below and dispose of the materials as required in the Bloodborne Pathogen Control Plan.

SUPPLIES/EQUIPMENT Each Site Supervisor will be responsible for maintaining a reasonable supply of the following: 1. Disposable latex examination gloves 2. Disposable spill kits 3. Disposable facemasks 4. Goggles with side shields

5. One or more of the following disinfectant materials: a. Clean and Go b. Citrase c. Chlorine bleach solution (at least 50 ppm concentration)

DISPOSAL PROCEDURE There are two types of potentially bio-hazardous material that will be dealt with by appropriately trained Head Start employees. 1. Regulated - including needles and other sharps; bandages, tissues or clothing saturated

with blood, etc. In case of an incident involving Regulated Bodily Fluids, appropriate PPE equipment must be worn and a disposable spill kit must be used. The contaminated material must then be placed in the red bio-hazard bag***. Contact the Head Start Health Services Associate for further disposal instructions. The Health Services Associate will contact the nearest Health Department Clinic to dispose of the Red bio-hazard bag.

2. Contaminated - including simple first aid, sanitary napkins, diapers, soiled clothing from toileting accidents, discarded gloves, discarded PPE equipment, masks, clothing, bandages with some blood on them, or vomit. In case of an incident involving Contaminated Bodily Fluid, appropriate PPE equipment must be used, such as, but not limited to, gloves, goggles, masks absorbent material. This PPE equipment should be properly disposed of in a securely sealed garbage bag (not red biohazard) and disposed of with the regular waste.

After each incident the infected area must be cleaned thoroughly and disinfected. The primary person for this task should be the custodian or other designated individual. There should be designated backup individuals documented.

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Southern Seven HS/EHS Service Area: Safety Procedure: Bloodborne Pathogens Exposure Control Plan for the Bus References: The following procedure must be followed to ensure the health and safety of Southern Seven Head Start Employees and Children riding school buses in the event of possible exposure to any infectious materials. Infectious materials include blood, vomit, and any other bodily fluids. Buses will be provided kits with necessary equipment for ensuring proper containment of infectious materials. Each kit will include the following items: Disposable Gloves (buses with a capacity of over 35 must store gloves in the front and rear of the bus); Disposable Face Masks; Protective Goggles; Bio-Hazard Spill Kit; Precise Disinfectant; Hand Cleaning Towelette; Paper Towels; Absorbent Material; and Plastic Trash Bags In the event of an accident involving infectious materials, the following procedure must be followed: 1. The bus must be pulled over at the first available location. 2. Bus Aide (any *person riding the bus with the responsibility of assisting the driver) will

address emergency immediately by temporarily controlling the problem. a. Bus Aide “must” wear disposable gloves. b. If situation warrants, the Bus Aide will also wear protective goggles and mask. Under

no circumstance should any person without Bloodborne Pathogen Training be riding the bus as the Driver’s Bus Aide. *Only Southern Seven Head Start Employees and Trained Volunteers should assist in such incidents.

c. “Bus Emergency” Procedure must be kept on the Bus at all times. 3. Hand cleaning towelette should be used to clean any body areas exposed to infectious

materials. 4. Bus will continue the route upon control of the emergency. For example, if the situation

requires no further assistance or additional emergency assistance arrives. 5. At completion of the route, Bus Driver will complete clean up, dispose of contaminated

material in appropriately sealed container, and disinfect contaminated area. a. Bus driver must wear gloves, protective goggles, and mask.

6. Any non-disposable equipment exposed to infectious material must be disinfected. DISPOSAL PROCEDURE 1. Soiled diapers, material with small amounts of blood; i.e. from bloody nose or small cut, and

any other materials containing body fluids, should be enclosed in a plastic bag, placed in the trash, then sealed and taken to an area not accessible to the children for disposal.

2. If the child’s clothes have been exposed to the infectious material, change upon arrival at the center. a. Place the clothes in a plastic bag and remove to an area not accessible to the children

and send home for cleaning. 3. If there is an accident involving a large amount of blood, seal all exposed materials in a Bio-

Hazard bag. a. Site Supervisor will contact the Director of Nursing or the Communicable Disease

Manager for further disposal instructions. 4. Bus driver will ensure items used for clean up are replaced on the bus.

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**RED BI0-HAZARD BAGS CANNOT BE THROWN IN NORMAL TRASH** SPECIFIC BUS PROCEDURES The first three steps should be used in all instances: 1. Pull bus over at first available location. 2. Bus aide address problem immediately. 3. Aide “MUST” wear disposable gloves. 4. If situation warrants, the aide will also wear protective goggles and mask. 5. ONLY Bloodborne Pathogen Trained Southern Seven Head Start Employees and

Volunteers will address problems.

MINOR BLOOD SPILLS 1. Provide temporary treatment to stop bleeding. Clean up any blood. 2. Use hand towelette to clean any body areas exposed to infectious material. 3. Seal all contaminated materials used to clean up blood in plastic trash bag. 4. Continue to end of route. 5. Bus driver will complete clean up, dispose of trash bag and disinfect exposed areas

in bus. Disposable gloves must be worn at all times. VOMIT 1. Clean infectious material off child and any area directly associated with child. If possible,

move child to another seat. 2. Use hand towelette to clean any body areas exposed to infectious material. 3. Seal all contaminated materials used to clean up in plastic trash bag. 4. Continue to end of route. 5. Bus driver will complete clean up, dispose of trash bag and disinfect exposed areas in bus.

Protective equipment must be worn at all times. This includes gloves, goggles, and mask.

LARGE BLOOD SPILL 1. Provide necessary treatment to stop bleeding. 2. Open “bio-hazard” kit to clean spill. 3. Use hand towelette to clean any body areas exposed to infectious material. 4. Seal all contaminated materials in red Bio-Hazard bag. 5. Continue to end of route IF CHILD DOES NOT NEED FURTHER MEDICAL TREATMENT. 6. Bus driver will complete clean up and disinfect exposed areas of bus. Protective

equipment must be worn at all times. This includes gloves, goggles, and mask. Red Bio-Hazard bag will have to be taken to nearest Southern Seven Health Dept. For disposal. Replace Bio-Hazard spill kit in bus.

BODY EXCREMENTS 1. Clean bodily excrements and/or fluids from child and any exposed areas. If possible, move

child to another seat. 2. Seal all contaminated materials used to clean up in plastic trash bag. 3. Continue to end of route. Bus Driver will complete clean up and disinfect exposed areas of bus. Disposable gloves must be worn at all times.

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Southern Seven Head Start/Early Head Start THE HEAD START BUSES & CENTER

BLOODBORNE PATHOGEN KIT INVENTORY CHECKLIST Center: _______________________ Center or Bus #:_____________ Date Inventoried: _______________

ITEM # REQUIRED

# ON

HAND

EXP. DATE

COMMENTS

Bus Emergency Procedure

1

N/A

Goggles

1

Universal Precaution Compliance Kit

1

Foaming Disinfectant Cleaner

1

Box of Latex Exam Gloves

1

Scoop

1

Emergency Clean Up (disinfectant powder)

1

Tall Kitchen Bags & Ties

Antiseptic Towelettes

2 Masks

2

Replace items after each use. Contact HS Central Office to replace items. Inventory prior to start up each year.

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Southern Seven Head Start/Early Head Start EMERGENCY KIT INVENTORY FORM

Center: __________________________ Classroom: ___________________________________ Date Inventoried: __________________ Initial of Person Completing The Inventory: __________

ITEM

# REQUIRED

# ON HAND EXP. DATE

COMMENTS

Bottled Water Jugs (in plastic bag or container on bottom)

Determined by size of class

Blankets

2

Flash Light w/batteries (in plastic on top)

2

Extra Batteries (in plastic bag) for Flashlight

6

Can Opener (not electric)

1

Wrench (keep in area easily accessed)

*1 per center

Radio w/batteries

*1 per center

Extra Batteries for Radio (in plastic bag)

8

Food (ie: crackers, canned fruit)

Determined by size of class

*Note: Anna, Metropolis, and Cairo will have two, one at each end of the building. ADDITIONAL ITEMS FOR EARLY HEAD START PROGRAMS Baby Wipes

As much as is needed per

child attending

Diapers

Formula

Baby Food

Sterilized Bottles

Note for all classrooms HS/EHS: Store extra water in kitchen or accessible storage area. Inventory & restock prior to start up each year (water, food & batteries) and in January. Check expiration dates and restock as needed. You may add other items that seem appropriate for your classroom. (ie. Activities, books, teething toys, etc.) Include a list of children and staff in your classroom with emergency information. Misc. – Paper plates, 3 oz. cups, bowls, plastic silverware, etc.

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Southern Seven Head Start/Early Head Start FIRST AID KIT INVENTORY LIST

Center: __________________________ Initial of Person Completing the Inventory: ___________ Date Inventoried: __________________

A Well Stocked First Aid Kit should be kept in the Center Office away from children. Under no circumstance should items such as Hand Sanitizer, Peroxide, or Bee Sting Relief be in the classroom. Bring children to the office for medical assistance, according to procedure. Stock supplies as used. Inventory in August and January. Restock if expiration is before next inventory date. CPR Masks located in each classroom.

ITEM # ITEM # 1st Aid Guide Gauze Roll Adhesive Bandages Hand Sanitizer (in office only) Adhesive Tape Instant Cold Packs Alcohol Prep Pads (in office only) Iodine Prep Pads Ammonia Inhalant Pads Pen/Pencil & Note Pad Antibacterial Ointment (in office only) Peroxide (in office only) Antiseptic Towelettes Safety Pins Burn Cream (in office only) Scissors Cotton Tip Applicators Sterile Sponge/Gauze Dressings Disposable Gloves Sting Relief Pads (in office only) Elastic Wrap Thermometer Eye Dressing Trash Bag Eye Wash Triangular Bandage Finger Splints Tweezers TRAVEL FIRST AID KIT INVENTORY LIST (Shall include all above supplies plus the following additional items – Children may not carry kit)

Antiseptic Cream Telephone #’s of Center & Children (Central Office, Emergency #’s on a laminated card)

Coins for Payphone (per DCFS regs) Water and Soap

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Southern Seven HS/EHS Service Area: Safety Procedure: CPR-AED/First Aid Training References: DCFS Licensing Standards – Section 407.110 The center shall have on duty at all times at least one staff member who has successfully completed training and is currently certified in first aid, cardiopulmonary resuscitation (CPR) and the Heimlich maneuver, and for centers serving infants, first aid for choking infants in accordance with the approved method specified in the Department of Public Health’s rules 77Ill. Adm. Code 520, The Treatment of Choking Victims. CPR certification must be specific for all age groups served, i.e. (birth to 12 months), child (one to eight years) and adult (eight years and older).

1. Training is provided on a monthly basis that center staff can register to attend. Dates are available on the training calendar.

2. S7HD employees that are CPR-AED/First Aid instructors through Shawnee Community College instruct the class. Employees can earn college credit for this class at no cost.

3. Upon successful completion of the class, employees are issued a card ensuring certification. The card is sent to the Administrative Office where a copy of the card is made for the employee’s central office personnel file. When it is received at the center another copy of the card should be made for the employee file at the center. Information should also be shared with center’s safety committee in order to complete employee safety tracking form.

4. Certification is good for two years. Although all staff would benefit from having this training, the following job titles should keep certification current:

• Bus Drivers • Home Based Teachers • Site Supervisors • Assistant Site Supervisors • Lead Teachers

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Southern Seven HS/EHS Service Area: Safety Procedure: Safety Committees References: Southern Seven Health Department Safety Committee

• This committee meets quarterly. • Incident Reports, safety concerns, and policies and procedures are among the

items discussed. • Head Start has three members on this committee: The Early Childhood

Administrator’s designee, the Head Start Member at Large, and the Head Start Liaison. The Head Start Liaison is a member of and represents the Head Start Safety Committee and the Member at Large represents the Program Planning Committee.

Southern Seven Head Start Safety Committee

• This committee meets quarterly. • Discuss Site Safety Issues, Incident Reports and ways to IMPROVE safety at

sites. • Review the Incident Review forms from each site to determine safety measures,

preventive measures and follow up • Each site is represented by the chairperson or designee from each local Head

Start Site Safety Committee. Site Safety Committee

• Each center has its own Safety Committee that monitors safety issues at the site. The committees meet monthly in a separate meeting or as part of the staff meeting.

• The Safety committee completes the accident / review form monthly to monitor accidents, seek preventive measure and make recommendation through work order submission or recommended changes. This form is kept in the safety binder at each site and brought to the Head Start Safety Committee for review, follow up and monitoring.

• The committee maintains a Safety Book. • The book documents the actions of the Safety Committee. It contains work

orders, safety minutes, safety questions and answers, Inspection Reports, and other documentation.

• The book is reviewed as part of Agency-Wide Safety Checks that occur annually.

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Southern Seven Head Start/Early Head Start SAFETY COMMITTEE ACCIDENT/INCIDENT REVIEW

DATE: ______________________ SITE: ___________________________ Total number of accidents/incidents reviewed: ___________ Level 1 (required first aid at center) Number of accidents/incidents: ___________ Level 2 (required medical attention) Number of accidents/incidents: ___________ Level 3 (required emergency medical attention) ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ Was an accident/incident report form completed for each accident? Yes ____ No _____ (If no, why not?) What were contributing factors? Could the accidents/incidents have been prevented? Please explain: What recommendations would you make? What was the follow-up action taken?

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Southern Seven Head Start/Early Head Start EMPLOYEE SAFETY TRACKING FORM

STAFF’S NAME

CPR-AED/FIRST AID

DATE (EXPIRES 2 YRS)

BUS

MONITOR TRAINING

CENTER SAFETY

ORIENTATION

DCFS REGULATION

OTHER

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Southern Seven HS/EHS Service Area: Safety Procedure: Employee Personal Safety References: A very important part of being an employee at Southern Seven Head Start/Early Head Start is interacting with the children. If not aware of their own physical limitations and surroundings, employees could place themselves in harms way. It is pertinent that we do not change the way we play and interact with our children. However, all employees should maintain an awareness of his/her surroundings and the consequences of misuse of equipment. It is important that all staff be aware of the following:

1. Our playground and classroom equipment is designed for children ages 3-5. Be aware of size and age limitations of all equipment.

2. KNOW YOUR OWN LIMITS. Only you know what you are physically able

to do or not do.

3. Finally, be aware that insurance and/or worker’s compensation may reject claims for injuries sustained by employees through use of equipment not designed for adults.

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Southern Seven HS/EHS Service Area: Safety Procedure: On-Going Monitoring Procedure List References: Facilities, Equipment, & Safety The following monitoring procedures are followed to comply with Federal Head Start Standards and other Regulatory Agency Guidelines in the area of Facilities, Materials, and Equipment. These include addressing non-compliances found through the monitoring process.

1. Facilities and playgrounds are inspected by the Site Safety Team daily and monthly using the Health and Safety checklist for potential dangers.

2. Facilities are inspected monthly by the Maintenance Coordinator and Early Childhood Director using the Safety/Maintenance Checklist. Repairs and Work Orders are submitted and tracked for completion to monitor timely repairs.

3. Commercial Kitchens are monitored by Environmental Health Staff quarterly.

4. Facilities are inspected yearly by DCFS Licensing Representative. 5. Head Start Facilities are inspected by the Fire Marshall. 6. Sprinkler systems, hood suppression systems, security alarms, etc. are

monitored regularly. 7. * for items 3 – 6, a copy is left with the Site Supervisor who forwards

them to the Early Childhood Director who in turn generates work orders if necessary based on results and keeps on file.

8. Safety reviews, which are a part of the Self-Assessment Process, are conducted twice per year by the Program Services Coordinator a monitoring and tracking process for assuring the daily and monthly checks are completed and all issues resolved.

9. Facilities are cleaned daily by Custodians, Staff, or a Contractor and monitored using the equipment cleaning checklist.

10. Carpets are deep cleaned and floors waxed yearly or as needed. 11. Inventory is completed every year of materials and equipment, including

condition of the equipment. Purchases are made as needed. 12. Work Orders for repair are completed, signed off on by the Site Supervisor

and submitted to the Maintenance Coordinator. Needs are prioritized and acted on in a timely manner.

13. Work Orders for moving equipment or materials are completed, signed off on and submitted to the Maintenance Coordinator. Items are inventoried if necessary.

14. Pest Control is conducted monthly by a exterminator when children are not present and monitored by the Safety Representative for each site. Parents are notified of monthly dates in advance of application.

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15. Buses and agency vehicles are maintained regularly. * see transportation policies and procedures for more detail

16. Daily Pre-trip and Post-trip inspections are performed and documented. 17. The Early Childhood Environmental Rating Scales and the Infant Toddler

Environmental Rating Scale is conducted twice per school year by the Site Supervisor as another means of assuring that sites, classrooms, bathrooms and playgrounds provide a safe and healthy learning environment.

18. The Health and Safety Screener is conducted at each site within 45 days from the start date of Early / Head Start.

19. Head Start services located in Public School buildings or other facilities not operated by Southern Seven will conduct the same monitoring protocols as listed above to assure facilities meet all Head Start Regulations and other health and safety measures.

a. Work orders will be generated through the building principal for completion by either S7HS staff or public school staff.

b. School will be provided with guidance as to the standards that must be met

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Southern Seven Head Start/Early Head Start SAFETY/MAINTENANCE CHECKLIST

Site (list below): Circle “OK” if it is in good working order.

Circle “Problem” if not and explain.

Work Order Submitted (circle one)

Date Repaired

or Replaced

INDOOR SAFETY Exit Lights OK Problem: YES NO

Emergency Lighting OK Problem: YES NO Electrical Outlet Covers OK Problem: YES NO

Fire Extinguishers OK Problem: YES NO Smoke Detectors OK Problem: YES NO

Fire Alarms OK Problem: YES NO Heating/Cooling Maintenance OK Problem: YES NO

Hazardous Extension Cords OK Problem: YES NO Overhead Lighting/

Ceiling Tiles OK Problem: YES NO

Outside Lighting OK Problem: YES NO Kitchen Fixtures OK Problem: YES NO

Bathroom Fixtures: Partitions, Sinks, Faucets, Toilets

OK Problem: YES NO

Safety Locks: Cabinets/Drawers OK Problem: YES NO

Door Locks/Closures OK Problem: YES NO Floor Tiles OK Problem: YES NO

Condition of Painted Surfaces OK Problem: YES NO Carpeting/Floor Mats OK Problem: YES NO

Allergens OK Problem: YES NO Air Filters OK Problem: YES NO

Windows/Screens OK Problem: YES NO PUBLIC SCHOOLS

Restrooms OK Problem: YES NO Bathroom Fixtures OK Problem: YES NO

OUTDOOR/ PLAYGROUND SAFETY

Outside Doors Shut/Locked OK Problem: YES NO Fencing/Gates OK Problem: YES NO

Equipment OK Problem: YES NO Debris OK Problem: YES NO

Surface/Ground Cover OK Problem: YES NO Wood Surface OK Problem: YES NO

No Mold/Mildew on Surfaces OK Problem: YES NO Tripping Hazards OK Problem: YES NO

Walkways (concrete, gravel, etc.) OK Problem: YES NO

Other (specify): OK Problem: YES NO Other (specify): OK Problem: YES NO

Maintenance Coordinator Signature:

Date of Inspection:

Site Supervisor Signature:

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Southern Seven HS/EHS Service Area: Safety Procedure: Pest Control References: Structural Pest Control Act (225 ILCS 235) is designed to cover indoor pesticide applications in schools. Public Act 91-0525 requires that public schools:

• Establish an Integrated Pest Management program, which incorporates the guidelines developed by IDPH by August 1, 2000.

• Appoint a school employee to oversee pest management operations and record keeping.

• Before a child is enrolled the daycare center shall provide summary of its pest management plan and uses of pesticides to the child’s parents or guardians.

• Establish parent/guardian notification procedures regarding the pesticide application schedule, providing notification at least two business, but not greater than 30, days prior to application.

IDCFS licensing regulations (407.370m,n) requires that licensed daycare center:

• The spraying of pesticides by a licensed pest control operator under the direct observation of a staff member to insure that residue is not left in areas accessible to children.

• Spraying shall be done while there are no children present in the facility. Southern Seven Head Start Procedure as follows:

1. The Early Childhood Director will schedule an appropriate time for pesticide

application with licensed pest control operator at a time when children are not present. Children are required to be kept out of treated areas for at least two hours after the application. Pesticide application will be conducted on Saturdays at Anna, Cairo, Mounds, Rustic, and Vienna Head Start Centers. Brookport, Egyptian, Goreville, Hardin, Jonesboro, Metropolis, and Pope County Centers are located in Public Schools and are governed by that School Districts pesticide policies. All storage buildings are sprayed at a minimum of twice a year.

2. The Site Supervisor, or designee, is the official contact person for any family’s questions regarding the pest control application process.

3. Parents will be notified of scheduled pesticide treatments through the monthly newsletters. The schedule will also be posted on the Safety Board. In the Parent Handbook, parents are notified of the pest control policy prior to their child’s enrollment.

4. A copy of the receipt is to be kept in the Safety Awards Binder. The original receipt is to be sent to the Account Systems Coordinator.

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Southern Seven HS/EHS Service Area: Safety Procedure: Equipment Maintenance Request References: When a concern is identified from the Health & Safety Daily Cleaning Inspection Checklist, Daily Playground Safety Checklist, the monthly Safety Maintenance Checklist or by a staff person, a Repair or Work Requisition needs to be completed. Staff should fill out the information requested on the Repair or Work Requisition. Staff should indicate if the request is a Safety/Emergency Condition, Safety/Non-Emergency Repair, or Routine. The definitions are as follows: Safety/Emergency Condition Conditions that cause imminent danger or do not allow for the center to operate in a safe manner. Plumbing (IE; sewer lines clogged or broken), heating and air (IE; unit not working and temperature not within safe range according to DCFS Regulations), commercial kitchen equipment (broken and emergency plan does not allow for safe alternative), fire, flood, electricity (outage for long period of time creating unsafe environment, imminent danger of fire or injury), leaks (that will cause more damage if not fixed immediately), broken windows or other issues that threaten security, security system (not surveillance system). Report immediately and schedule within 24-48 hours (sooner if possible) IF EMERGENCY CONDITION:

A. First contact Maintenance by cell phone or by calling the Administrative Office to locate Maintenance Staff.

B. If (A) cannot be reached, report to the Early Childhood Director or the Early Childhood Administrator by cell phone or text message.

C. If (A-B) are not available report findings to the Human Resources Administrator or Executive Director.

Safety/Non-Emergency Repair Conditions that are safety issues and need repair, but allow for alternative solutions and children can still attend in a safe environment. Plumbing (toilet not working but have alternative, dripping faucet), heating and air (unit not working properly, but temperature is within safe range), commercial kitchen equipment (repairs needed, but can change meals or use safe alternative plan), electricity (lights, switches, outlets not working, but no immediate danger), leaks (no immediate danger for children), broken windows that do not create an unsafe environment and surveillance system (cameras, monitors, etc.). Report immediately and schedule within one week (sooner if possible) Staff should complete the Repair or Work Requisition form. After completion this form is sent via fax, scanned & e-mailed to [email protected] or mailed through the intra-office mail to the Maintenance Staff.

After the request has been received, appropriate instructions will be given.

A. Maintenance will review request.

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B. Recommendations will be made for repair or acquisition of vendor services. C. Site Supervisor or appropriate Administrative Office person will be asked to

contact appropriate vendor. D. Purchase requisition will be completed. E. Appropriate vendors will be contacted for proposals or bids.

Routine Maintenance General repairs that can be performed while the children are present and do not require professional services or for equipment to be removed from the center (IE; replacing fluorescent lights, changing filters, small equipment repairs, mounting small items, etc) Report and scheduled within a month (sooner if possible) Scheduled Maintenance Repairs that cannot be performed in the presence of children, require professional services or require equipment to be removed from the center (IE; Floor care, furniture refinishing, pest control, major electrical or plumbing work). Schedule in advance, usually after or before Head Start hours, during the summer or during the month assigned to the individual site Preventive Maintenance Activities that will if completed regularly will prevent breakdown of equipment. Some of these duties can be performed by custodians if available or safety committee (IE; vacuuming condensers on commercial kitchen equipment, cleaning grease traps and hood vents, changing furnace filters, removing spots on carpets immediately, monthly safety reviews of exit lights, smoke detectors, emergency lights, etc.) WHAT DO I DO AND WHO DO I CALL if a problem exists with equipment such as Refrigerator, Freezer, Dish Washer, Washer/Dryer, Stove, Milk Cooler, Food Warmer, Window Air Conditioner? What if there are plumbing, flooding, furnace or air conditioning problems? BEFORE CALLING ANYONE: 1. Problem solve at the local level by Site Supervisor and staff.

_____ Can equipment or water be turned off to prevent more damage? _____ Is the electric plug connected? _____ Is the breaker thrown in the electric box? Can it be reset? _____ Have the inside and outside thermometer temperatures been compared? _____ Is the outside thermometer working properly? Is it stuck? _____ Has the compressor on the freezer or refrigerator been vacuumed? (preventive

maintenance for motor) _____ Is there a specific odor or unusual noise? _____ Are there other problem solving checks?

2. A report of findings that includes possible solutions is made by Site Supervisors, Assistant Site Supervisors or Lead Teacher and is given to Maintenance and the Early Childhood Director.

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Southern Seven Health Department/ Head Start/Early Head Start

REPAIR OR WORK REQUISITION Print or Write Legibly

Site #: Site: Date:

Name of Staff Person Completing Requisition:

Title:

Safety/Emergency Condition Safety/Non-Emergency Repair Routine Nature of problem (Describe in as much detail as possible; include one job per work order) _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________

Supervisor Signature: Date: Maintenance Staff Signature: Date:

MAINTENANCE EVALUATION Date P.O. Completed: ___________________ Comments: _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ Maintenance Staff Signature: Date:

WORK COMPLETION REPORT _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ Maintenance Staff Signature: Date:

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Southern Seven Health Department REQUEST TO TRANSFER OR DESTROY EQUIPMENT

Name: __________________________ Date: ______________________

Current location of equipment (site #) ____________ Equipment Description____________________________________________________ ______________________________________________________________________ (If no inventory tag is attached please give accurate description of equipment) Inventory tag #______________ Serial #___________________________

Transfer of Equipment Transfer to site ___________ Reason for transfer:______________________________________________________ ______________________________________________________________________ ______________________________________________________________________

Disposal of Equipment Reason for disposal:_____________________________________________________ ______________________________________________________________________ ______________________________________________________________________ Authorized by________________________________ Date ____/____/____ Site Supervisor Approved by ________________________________ Date ____/____/____ Fiscal Officer Date Item Picked Up: ____/____/____ Signature of person responsible for transfer/disposal:___________________________

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Southern Seven Health Department REQUEST TO TRANSFER OR DESTROY RECORDS/FILES

Name: __________________________ Date: ______________________

Current location of equipment (site #) ____________ Files/Records Description: ________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ Reason for Transfer/Removal: _____________________________________________ Transfer to Site #:______________ Removal to Storage Facility Authorized by________________________________ Date ____/____/____ Site Supervisor Approved by ________________________________ Date ____/____/____ Fiscal Officer Date Item Picked Up: ____/____/____ Signature of person responsible for transfer: __________________________________

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Southern Seven Head Start/Early Head Start DISCARDED ITEMS

Site: Date: Supervisor:

Description of Item:

Identification/Serial Number:

Reason(s) For Discarding (check one or more):

Broken (unrepairable) Cracked

Parts Missing Splintered

Not in Working Condition Obsolete

Other:

Return to the Maintenance Department at the Administrative Office

Southern Seven Head Start/Early Head Start DISCARDED ITEMS

Site: Date: Supervisor:

Description of Item:

Identification/Serial Number:

Reason(s) For Discarding (check one or more):

Broken (unrepairable) Cracked

Parts Missing Splintered

Not in Working Condition Obsolete

Other:

Return to the Maintenance Department at the Administrative Office

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Southern Seven HS/EHS Service Area: Safety Procedure: Cleaning the Center References: The following standards shall be followed in order to comply with DCFS regulations and to reduce the risk of illness: 1. Carpet areas shall be vacuumed daily. 2. Tables and chairs shall be wiped off daily with bleach water. Other toys, table

tops, furniture, and other similar equipment used by the children shall be washed and disinfected when soiled or contaminated with matter such as food, body secretions or excrement.

3. Dress-Up clothes and machine washable cloth toys shall be machine washed in

the center or Laundromat at least weekly and/or when contaminated. 4. Other toys such as manipulatives, blocks, trucks, puzzles, and other hard surface

toys shall be cleaned with bleach water monthly. 5. Each child’s locker or cubby shall be washed with bleach water weekly. 6. Mats or cots used by children should be wiped off with bleach water weekly and

air dried before stacking. If a child has been ill, the cot must be sanitized before it can be used again.

7. Water tables and toys used in water tables shall be emptied daily and cleaned

with a mild germicidal solution before being air-dried. Children and staff shall wash their hands before and after using the water table.

8. Toys and equipment that are placed in children’s mouths or are otherwise

contaminated by body secretions or excretions shall be set aside to be cleaned with water and detergent, rinsed, sanitized and air-dried before handling by another child.

9. Linens are to be washed daily. If head lice or other illness is occurring frequently in the center, more cleaning may be necessary. All major cleaning shall be done when children are NOT present. Bleach water is 1 part bleach to 10 parts water.

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Southern Seven HS/EHS Service Area: Safety Procedure: Maintaining Equipment, Toys, and Supplies References: It is the responsibility of ALL Site Staff to maintain equipment and supplies in a CLEAN and SAFE condition.

1. Staff must regularly clean toys and equipment and watch for dangerous items. Children can

be involved in this process if toys are added to a sensory table/soap and water experience.

2. Items that need repair should be fixed as soon as the problem is noticed. With a little preventative maintenance, equipment will last a long time – (If we don’t need to spend money on replacing expensive equipment, there will be more money to spend on new toys and more supplies.)

3. Children learn best when they are able to choose toys that are easily accessible with no missing pieces. Toys should be sorted into complete sets or by type of toy. For instance, small Lego pieces should be kept separate from large Lego pieces and blocks should be placed on shelves by size/shape rather than dumped into a storage bin.

4. It is important that children are involved in daily clean up routines. This is most likely to be a successful experience when children take out only the toys that they are using rather than dumping all the toys out at one time. Remember all children practice important cognitive skills when they sort items.

5. When inventorying at the end of the year, use the pre-printed inventory list of equipment. Delete items if they have been broken and discarded during the year (use DISCARD form). Add items to the inventory list as new equipment and toys are purchased through the year. Add to the inventory under the section (i.e. table toys/dramatic play area, books) so that the items can be easily located and added during inventory.

6. Staff are asked to identify items needed in the classroom. The priority is: • Items needed to meet licensing requirements or replace broken equipment. • Items that will enhance the educational experience for the children. • Items that we wish for even though there are sufficient materials available.

When looking for toys or equipment, don’t forget to look for donations from parents or purchases at yard sales. Be creative when looking for consumable materials for art projects. Remember that “in-kind” and “parent involvement” are also important to our program. Parents who are unable to donate time during the day may be able to repair items.

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Southern Seven Head Start/Early Head Start HEALTH & SAFETY DAILY CLEANING/INSPECTION CHECKLIST

Center: Month: Person(s) Completing: Checklist needs to be completed daily at a minimum. Please place the completed form in the Safety Binder at the end of every month and send a copy to the Early Childhood Director.

Equipment

Place a check () if the area is OK or a Red X if there is an issue that requires immediate correction or routine maintenance.

Week 1 Week 2 Week 3 Week 4 Week 5

M T W T F M T W T F M T W T F M T W T F M T W T F

Kitchen

Tables and Countertops Appliances

Food Prep Surfaces (before and after use) & Storage Areas

Floors & Mats

Door & Cabinet Handles (wipe down)

Sinks & Faucets (wipe down when soiled) Soap Dispensers (wipe down when soiled)

Doorknobs

Classroom

Inspect Carpets, Rugs, & Floors Door & Cabinet Handles & Classroom Furnishings

(wipe down)

Toys & Props that have been soiled (mouthed) Doorknobs

Classroom Pets (if applicable)

Bathroom & Diapering Areas

Toilet Seats & Handles (immediately if soiled) Toilet Bowls Doorknobs

Changing Tables (after each use)

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Equipment

Place a check () if the area is OK or a Red X if there is an issue that requires immediate correction or routine maintenance.

Week 1 Week 2 Week 3 Week 4 Week 5

M T W T F M T W T F M T W T F M T W T F M T W T F

Any Contaminated Surface (immediately)

Stall Partitions Floors

Sinks & Faucets (wipe down when soiled) Soap Dispensers (wipe down when soiled)

Miscellaneous

Linens, Sheets, & Blankets Bibs & Washcloths

Cleaning Material (cloths, mops) Check Hallways for Debris

Entryways and Exits Condition of Painted Surfaces & Floor Tile

Walkways Clear of Debris/Ice (if applicable)

Health or Safety

Concerns Identified Work Order

Needed Action Needed Date Work Order was Submitted

Work Order was Submitted by (initials)

YES / NO YES / NO YES / NO YES / NO YES / NO YES / NO YES / NO YES / NO YES / NO YES / NO YES / NO

Page 44: Southern Seven Head Start/ Early Head Start · center has more than one session, drills are to be completed in each session. 2. Fill out drill forms and post current month on safety

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Southern Seven Head Start/Early Head Start HEALTH & SAFETY DAILY CLEANING/INSPECTION CHECKLIST

(Extra Classrooms)

Center: Month: Person(s) Completing: Checklist needs to be completed daily at a minimum. Please place the completed form in the Safety Binder at the end of every month and send a copy to the Early Childhood Director.

Equipment

Place a check () if the area is OK or a Red X if there is an issue that requires immediate correction or routine maintenance.

Week 1 Week 2 Week 3 Week 4 Week 5

M T W T F M T W T F M T W T F M T W T F M T W T F

Classroom

Class ________ Inspect Carpets, Rugs, & Floors

Door & Cabinet Handles & Classroom Furnishings (wipe down)

Toys & Props that have been soiled (mouthed) Doorknobs

Classroom Pets (if applicable)

Class ________ Inspect Carpets, Rugs, & Floors

Door & Cabinet Handles & Classroom Furnishings (wipe down)

Toys & Props that have been soiled (mouthed) Doorknobs

Classroom Pets (if applicable)

Class ________ Inspect Carpets, Rugs, & Floors

Door & Cabinet Handles & Classroom Furnishings (wipe down)

Toys & Props that have been soiled (mouthed) Doorknobs

Classroom Pets (if applicable)

Page 45: Southern Seven Head Start/ Early Head Start · center has more than one session, drills are to be completed in each session. 2. Fill out drill forms and post current month on safety

Revised: 08/15, rm 45

Equipment

Place a check () if the area is OK or a Red X if there is an issue that requires immediate correction or routine maintenance.

Week 1 Week 2 Week 3 Week 4 Week 5

M T W T F M T W T F M T W T F M T W T F M T W T F

Classroom

Class ________ Inspect Carpets, Rugs, & Floors

Door & Cabinet Handles & Classroom Furnishings (wipe down)

Toys & Props that have been soiled (mouthed) Doorknobs

Classroom Pets (if applicable)

Class ________ Inspect Carpets, Rugs, & Floors

Door & Cabinet Handles & Classroom Furnishings (wipe down)

Toys & Props that have been soiled (mouthed) Doorknobs

Classroom Pets (if applicable)

Class ________ Inspect Carpets, Rugs, & Floors

Door & Cabinet Handles & Classroom Furnishings (wipe down)

Toys & Props that have been soiled (mouthed) Doorknobs

Classroom Pets (if applicable)

Class ________ Inspect Carpets, Rugs, & Floors

Door & Cabinet Handles & Classroom Furnishings (wipe down)

Toys & Props that have been soiled (mouthed) Doorknobs

Classroom Pets (if applicable)

Page 46: Southern Seven Head Start/ Early Head Start · center has more than one session, drills are to be completed in each session. 2. Fill out drill forms and post current month on safety

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Southern Seven Head Start/Early Head Start EQUIPMENT CLEANING CHECKLIST – PART 2

Center: ________________ Classroom: _________ Teacher(s): _______________ Checklist needs to be completed weekly, even if each item is not completed that week. Please place the completed form in the Safety Binder at the end of every month to be reviewed periodically. Fill in the month. Date and initial each entry.

Month:

Weekly Cleaning Week 1 Week 2 Week 3 Week 4 Week 5

Sanitize Toys

Wash Sheets & Blankets

Wash Any Cloth Material

(Including dress up clothes)

Clean Cubbies

Sanitize Cots & Mattresses

Arrange Cabinets

Clean Large Equipment

Page 47: Southern Seven Head Start/ Early Head Start · center has more than one session, drills are to be completed in each session. 2. Fill out drill forms and post current month on safety

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Southern Seven HS/EHS Service Area: Safety Procedure: Diapering References: Have the following supplies ready before bringing the child to the diapering area:

• Disposable wipes or fresh, wet paper towels • Diapers • Skin preparations prescribed by the child’s doctor or requested by the

child’s parent • A bottle each of soapy, clear and bleach water(1/4 cup bleach to 1 gallon

of water)(prepared daily) 1. Lay the child on the changing surface, taking care to minimize contact with the

child if his/her outer clothes are soiled. 2. Put on protective gloves. 3. Remove diaper and any soiled clothes. 4. Clean the child’s bottom from the front to the back with a fresh disposable wipe

or a damp paper towel. 5. Dispose of the disposable diapers, paper towels and diaper wipes in a covered

receptacle. Put soiled clothes and cloth diapers into a plastic bag to be sent home with the parents.

6. Remove disposable gloves. Wash hands or wipe hands with a pre-moistened antibacterial towelette.

7. Wipe child’s hands with pre-moistened towelette. 8. Place clean diaper on the child. Make sure the child’s clothing is clean and dry.

If not, change the child’s clothing. 9. Remove child from the changing table and wash child’s hands according to hand-

washing procedure. 10. Clean visible soil from the changing table with spray disinfectant and paper

towels or antibacterial wipes. 11. Clean and disinfect the diaper area with prepared spray in the following order: soapy

water, clean water, bleach water (1/4 cup bleach to 1 gallon of water). 12. Wash adult hands using the proper hand washing procedure.

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Southern Seven HS/EHS Service Area: Safety Procedure: Handwashing References: DCFS Licensing Standards; Head Start Performance

Standards 1304.22(e)(1)&(2) Proper Hand Washing Procedure for Adults and Children:

1. Wet hands under warm running water. 2. Lather both hands well and scrub vigorously for at least 15 seconds. 3. Rinse hands thoroughly under warm running water. 4. Dry both hands with a new single-use towel or automatic dryer. 5. For hand-held faucets, turn off the water using a disposable towel instead of bare

hands to avoid recontamination of clean hands. For children who are unable to wash themselves, staff shall wash using the above procedure. Children’s hands shall be washed routinely and frequently with soap and water at least the following times:

1. Upon arrival at the center. 2. Before and after each meal or snack. 3. After using the toilet or having diapers changed. 4. After handling pets or animals. 5. After wiping or blowing his or her nose. 6. After touching items soiled with body fluids or wastes. 7. Before and after cooking or other food experience. 8. After outdoor play time. 9. Before and after using the water table.

Staff & Volunteer hands shall be washed routinely and frequently with soap and water at least at the following times:

1. Upon arrival at the center. 2. After using the bathroom or helping a child use the bathroom. 3. After changing a diaper. 4. After wiping or blowing their nose, or helping a child to wipe or blow his/her nose. 5. After handling items soiled with body fluids or wastes. 6. After handling pets or other animals. 7. After handling or caring for a sick child. 8. Before and after eating or drinking. 9. Before preparing, handling or serving food. 10. Before dispensing any medication. 11. Before and after administering first aid. 12. When changing rooms or caring for a different group of children.

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Southern Seven HS/EHS Service Area: Safety Procedure: Oral Hygiene References: Head Start Performance Standards – 1304.23(b)(3) Have child wash his or her face immediately following meals and provide assistance when necessary, using an individual wet paper towel. Infants (before teeth emerge)

1. Infant shall be given water to drink after feeding. 2. Immerse the bristles of the infant’s toothbrush in cool water. 3. Using gentle strokes, clean infant's gums and tongue with the brush. 4. Rinse toothbrush under running water and place in cabinet. 5. Again give the infant water to drink.

Infants/Toddlers (after teeth emerge but before age two)

1. After feeding, place fluoride toothpaste on the bottom of a disposable cup to keep from contaminating the end of the toothpaste tube.

2. If child needs assistance, apply toothpaste to brush. 3. Gently brush teeth, gums and tongue with the brush. 4. Each child should be encouraged to clean their teeth themselves, assistance

should be provided as needed. 5. Rinse the brush thoroughly under running water and place in cabinet.

Toddlers and Children (after age two)

1. Place toothpaste on the bottom of a disposable cup to keep from contaminating the end of the toothpaste tube.

2. Child must use his/her individual soft-bristled toothbrush labeled with his/her name. Southern Seven Head Start will provide a toothbrush for each child at least twice a year or as needed. The soft-bristled toothbrush will allow every surface to be reached.

3. Clean the outer surface of each tooth by tilting the toothbrush at a 45 degree angle against the gum-line.

4. Move the brush back and forth, using short gentle strokes brushing 2-3 teeth at a time.

5. Repeat this motion on the inside, outside and chewing surface of the teeth. 6. To clean the inner surface of the front teeth, hold the brush vertically and use

gentle up-and down strokes over each tooth and surrounding gum. 7. Pay extra attention to the gum-line, hard-to-reach back teeth and areas around

fillings or any other restorations. 8. Brush the tongue from back to front to remove the odor-producing bacteria. 9. All staff serve as role models by brushing teeth properly after meals. 10. Toothbrushes shall be replaced when they have lost their tone.

Page 50: Southern Seven Head Start/ Early Head Start · center has more than one session, drills are to be completed in each session. 2. Fill out drill forms and post current month on safety

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Southern Seven HS/EHS Service Area: Safety Procedure: When Issues are Found in a Facility

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Southern Seven HS/EHS Service Area: Safety Procedure: Animals in the Center References: DCFS Licensing Standards

1. Healthy household pets that present no danger to children are permitted on the premises unless prohibited by local health regulations.

2. A licensed veterinarian shall certify that dogs and cats have been inoculated against rabies. This certification shall be obtained when the animal is acquired (if four month of age or older). Gerbils, hamsters, and guinea pigs are required to get a health certificate from a licensed veterinarian then they may be kept in the Head Start Center if allowed by local health regulations.

3. Animals and/or pets shall be properly housed, fed and maintained in a safe, clean and sanitary condition at all times. A responsible staff person shall be assigned to the care of any animal or pet on the premises.

4. If the pet has not been purchased from a licensed pet store, the animal must be quarantined for three days before having any contact with the children.

5. Immediate treatment shall be obtained for any child who sustains a bite or scratch from an animal, and the child’s parents shall be notified. In addition, the center shall notify the county animal control administrator or designated agent and follow the provisions of the Illinois Animal Control Act. Southern Seven Health Department’s Incident Report is to be filled out and sent to the Human Resources Administrator.

6. Domestic animals, birds or fowl shall not be permitted at any time in areas where foods are prepared or maintained.

7. The Head Start Center shall be free of stray animals which may cause injury and/or disease to children.

8. The presence of monkeys, ferrets, turtles, iguanas, psittacine birds (birds of the parrot family) or any wild or dangerous animal is prohibited in the Head Start Center.

Page 52: Southern Seven Head Start/ Early Head Start · center has more than one session, drills are to be completed in each session. 2. Fill out drill forms and post current month on safety

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Page 53: Southern Seven Head Start/ Early Head Start · center has more than one session, drills are to be completed in each session. 2. Fill out drill forms and post current month on safety

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Southern Seven HS/EHS Service Area: Safety Procedure: Health and Safety Training of Staff References:

Page 54: Southern Seven Head Start/ Early Head Start · center has more than one session, drills are to be completed in each session. 2. Fill out drill forms and post current month on safety

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Southern Seven Head Start/Early Head Start BLEACH SOLUTION SCHEDULE

Site Name ___________________Classroom ____________ Time Period ___/___/___ to ___/___/___ Change cleaning solution before each session and initial in daily square. Use ¼ cup bleach to one gallon of water.

August

Initial September

Initial

October

Initial

November

Initial

Monday

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Page 55: Southern Seven Head Start/ Early Head Start · center has more than one session, drills are to be completed in each session. 2. Fill out drill forms and post current month on safety

Revised: 08/15, rm 55

Southern Seven Head Start/Early Head Start BLEACH SOLUTION SCHEDULE

Site Name ___________________Classroom ____________ Time Period ___/___/___ to ___/___/___ Change cleaning solution before each session and initial in daily square. Use ¼ cup bleach to one gallon of water. December

Initial

January

Initial

February

Initial

March

Initial

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Page 56: Southern Seven Head Start/ Early Head Start · center has more than one session, drills are to be completed in each session. 2. Fill out drill forms and post current month on safety

Revised: 08/15, rm 56

Southern Seven Head Start/Early Head Start BLEACH SOLUTION SCHEDULE

Site Name ___________________Classroom ____________ Time Period ___/___/___ to ___/___/___ Change cleaning solution before each session and initial in daily square. Use ¼ cup bleach to one gallon of water.

April

Initial

May Initial

June

Initial

July

Initial

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Page 57: Southern Seven Head Start/ Early Head Start · center has more than one session, drills are to be completed in each session. 2. Fill out drill forms and post current month on safety

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Southern Seven HS/EHS Service Area: Safety Procedure: Playground Checklist References: A particular person, and back up person, should be designated to complete a safety check of the playground each day before children are permitted to play in the area. After the evaluation of the playground is completed using the Daily Playground Maintenance List, the designated person will initial the Daily Playground Safety Checklist and document any findings and action taken. These forms will be reviewed by the Site Safety Committee and appropriate action taken.

Page 58: Southern Seven Head Start/ Early Head Start · center has more than one session, drills are to be completed in each session. 2. Fill out drill forms and post current month on safety

Revised: 08/15, rm 58

Southern Seven HS/EHS Service Area: Safety Procedure: Daily Playground Maintenance List References: The purpose of the Daily Maintenance Inspection is to check for conditions that may change suddenly as a result of use, abuse or changing environmental conditions. This type of inspection does not take a long time to perform and can usually be accomplished by walking throughout the environment. Each time the designated person evaluates the safety of the Head Start playground for use by children, check for the items listed below and complete the Daily Playground Safety Checklist entry.

• Sticks, trash, needles, cigarettes, bottles, cans, pills, etc. (use gloves to pick potentially hazardous items).

• Evidence of animals.

• Sharp edges or corners of equipment in play area.

• Loose seats, wheels and handlebars on Tricycles, etc.

• Broken equipment or missing parts.

• Kinked, twisted or broken chains or swing seats.

• Loose bolts or uncapped ends of pipes or equipment.

• Wood equipment or timbers free of splinters or rough edges.

• Equipment stable with no loose parts or loose footings.

• Hard surfaces free from tripping hazards, including ground cover, twigs,

equipment.

• Inadequate levels of surfacing materials around equipment footings. Surfacing materials should be deeper around equipment than at edge of playground and should cover the foundation pieces of equipment. Use a rake to bring the ground cover back to the equipment or play a game with children using little rakes or buckets to cover the footings.

• Working gates in good condition.

Page 59: Southern Seven Head Start/ Early Head Start · center has more than one session, drills are to be completed in each session. 2. Fill out drill forms and post current month on safety

Revised: 08/15, rm 59

Southern Seven Head Start/Early Head Start DAILY PLAYGROUND SAFETY CHECKLIST

Month: Year:

Document in Findings and Actions Area the kind of inclement weather if it keeps children indoors.

Equipment

Place a check () if the area is OK or a Red X if there is an issue that requires immediate correction or routine maintenance.

Week 1 Week 2 Week 3 Week 4 Week 5

M T W T F M T W T F M T W T F M T W T F M T W T F

Sticks, trash, needles, cigarettes, bottles, cans, pills, etc. (use gloves to pick potentially hazardous items)

Evidence of animals Sharp edges or corners of equipment in play area

Loose seats, wheels and handlebars on Tricycles, etc. Broken equipment or missing parts

Kinked, twisted or broken chains or swing seats Loose bolts or uncapped ends of pipes or equipment

Wood equipment or timbers free of splinters or rough edges

Equipment stable with no loose parts or loose footings Hard surfaces free from tripping hazards, including ground cover, twigs, equipment

Inadequate levels of surfacing materials around equipment footings

Working gates in good condition

Health or Safety

Concerns Identified Work Order

Needed Action Needed Date Work Order was Submitted

Work Order was Submitted by (initials)

YES / NO YES / NO YES / NO YES / NO

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Revised: 08/15, rm 60

Southern Seven Head Start/Early Head Start CENTER SAFETY REVIEW

You will find an original copy of this form in your Safety Binder.

Page 61: Southern Seven Head Start/ Early Head Start · center has more than one session, drills are to be completed in each session. 2. Fill out drill forms and post current month on safety

Revised: 08/15, rm 61

Southern Seven HS/EHS Service Area: Safety Procedure: Daily Departure of Children from the Center References: The daily departure of children from the center shall be conducted in a way that protects each child’s physical and emotional well-being. Authorized

1. The staff shall refuse to release a child to any person, whether related or unrelated to the child, who has not been authorized by the parent or parents to receive the child. Persons not known to the staff shall be required to provide a driver’s license (with photo), a photo identification to establish their identity before the child is released to them.

2. When a child is released to a person authorized on the pick-up list, the center shall maintain a record of the person’s name and the date and time.

3. The time of each child’s departure from the center shall be noted on a daily

departure log and initialed, signed or otherwise documented by the person to whom the child is released.

Unauthorized

1. The staff shall refuse to release a child to any person, whether related or unrelated to the child, who has not been authorized by the parent or parents to receive the child or who appears to be under the influence of drugs or alcohol.

2. In the event of an attempted unauthorized pick up or staffs refusal to release a

child the Site Supervisor or designee should be notified immediately.

3. The Site Supervisor will contact the authorized parent of the child for further instructions.

4. If the situation becomes hostile 911 will be contacted.

5. The authorized parent may add or remove an individual form the pick-up list by

completed the transportation change form or by appropriate court documentation.