Fy13 List of Materials Needed for Inspections s1

2016 LIST OF MATERIALS NEEDED FOR INSPECTIONS CHILD DEVELOPMENT HOMES

The following documentation will be reviewed to determine compliance with inspection criteria. Items in RED are either updated or new

A. The following items should be maintained in an Inspection Box (or binder) and available when the inspection team arrives on site: Item Ensure the inspection box (or binder) is standardized and organized # according to the listing below. Only include documentation from the previous 12 months unless otherwise indicated below. 1. Documentation of the Lending Library control system (e.g., inventory A.1.b.3 and log of check in/out of materials/equipment) that is in place. 2. Local CYP Fee letter A.1.a.2 3. QRB Meeting Minutes, letters of approval/denial of certification, etc A.1.c.4, A.1.c.8-10 4. QRB SOP A.1.c.4 5. NAFCC Accreditation SOP A.1.c.7 6. Subsidy SOP A.1.d.7 7. Background Check Responsibility Ledger B.1.a.1 8. Copy of the staff listing or organizational chart A.1.g.1 9. CY15 HQ inspection report with corrective actions B.2.a.1 10. Documentation of the annual MDTI with corrective actions B.2.b.1 11. Documentation of QA visits B.2.f.1-2 12. Parent Participation Plan C.1.a.1-2 13. Parent Involvement Board Advertisements C.1.a.3 B. The following documentation must be made available in a central location when the inspection team arrives: DD2652s or Fee Calculation Worksheets and current CYP Parent Fee A.1.a.1 14. Agreements 15. Documentation of any hardship waivers granted in the past 12 months A.1.a.3 Subsidy documentation, including what subsidies are authorized and A.1.b.2 16. how they are paid Documentation of the most recent monthly claim form for selected A.1.d.1, A.1.d.3, 17. providers to ensure core subsidies that are paid to providers are A.1.d.5, A.1.d.6 calculated correctly 18. IAT Inclusion Support Binder A.2.e.1-3 C. Inspectors will review the following information in CYMS and/or in the individual files: (CYMS reports may need to be run locally for inspectors upon arrival to the program) Children’s Files 19.  Current CYP Registration Forms A.2.a.1  Two emergency contacts A.2.a.2 CDH Employee Files  Annual health screening A.2.b.1-6  Influenza vaccine A.1.g.2  Education and Qualifications B.1.a.2-14 20.  Reference Checks A.3.f.1-3  CPR and First Aid Certificates A.3.e.1-16  Position Title and Number A.3.g.1-9

(Rev. 3-23-16 JM)  Military Affiliation  Background Checks ( Local or Base Check, SARP, FAP/FAR, CNACI, Local National Check)  Statement of Admissions  Orientation Training  Annual Training CDH Provider Files  Initial certification and re-certification records A.1.c.3  Date of Certification A.2.c.1-9 A.2.d.1  Annual Health Screening B.1.b.2-15  Influenza Vaccine B.1.c.2-17  Proof of current liability and auto insurance A.3.b.1-15  Application for Navy CDH Certification A.3.d.1-12  Pet immunization records A.3.c.1  CPR & First Aid certification B.4.a.1 B.2.c.1  Reference checks B.2.d.1  Family Interview B.2.e.1 21.  Military Affiliation for Provider and Spouse B.3.a.1-3  Statement of Admission  Background Checks for all qualifying individuals within the home (Local or Base Check, SARP, FAP/FAR, CNACI, SAP)  Orientation and Annual Training for CDH Providers  Completion of Modules  Medication Administration Training  Comprehensive fire inspection with corrective actions  Comprehensive safety inspection with corrective actions  Comprehensive Health/Sanitation Inspection with corrective actions  Documentation of Home Visit Records with corrective actions D. The following information will be reviewed with the T&C: Copy of the Training Plan and related documentation to meet required A.3.a.1-3 22. annual training requirements (e.g., annual/monthly training calendars, listing of monthly trainings, staff sign-in sheets, etc.)

(Rev. 3-23-16 JM) Materials Needed List Instructions

A: Items listed in Section A should be maintained in the inspection box (or binder) and be ready for inspection at all times. How to set up and maintain an inspection box:  Obtain a portable file box that supports hanging file folders. The pictures below are examples.

 Obtain hanging file folders with tabs. The pictures below are examples.

 Number tabs according to the Materials Needed List for your specific program. (E.g. 1, 2, 3, etc.)  File documentation corresponding to the number on the Materials Needed List for your program.  If any of the items on the list do not apply to your program, file an 8 ½” x 11” sheet of paper that states the item does not apply. Include the item number and title. Also explain why it does not apply. The pictures below are examples of how this should be accomplished.  Ensure the most current documentation is filed in front.  Update your documentation box on a regular basis or any time there are changes. One option is to go through your documentation box every Friday afternoon to ensure everything is current. B: Items listed in Section B should be provided to the inspectors upon their arrival. These items are not required to be maintained in the documentation box. Ensure the manager on duty is aware of the location of all inspection items. These items must be organized and easily accessible.  For #10, the individual SOPs must be tabbed with the standardized short title listed above. This will ensure that the inspectors review the most current SOP. C: The inspection team will run CYMS reports for the items in Section C when they arrive on site.

(Rev. 3-23-16 JM)