Type: Routine Date: 07/07/2017 Arrival/Departure Time: 11:00 AM to 12:00 PM Staff Present: 1 Children Present: 5 INSPECTION CHECKLIST

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1 Large Family Child Care Home Information Name: Sustaita Large Family Day Care Home ID Number: L07FL0010 Address: 47 Eastwood Dr City: Palm Coast State: FL Zip Code: Phone Number: (386) Capacity: 12 Owner/Director/Staff Responsible: Jessica Sustaita Inspection Information Type: Routine Date: 07/07/2017 Arrival/Departure Time: 11:00 AM to 12:00 PM Staff Present: 1 Children Present: 5 INSPECTION CHECKLIST STAFFING REQUIREMENTS 01. Operator/Occupant/Advertising 65C (1)(c), 65C (2)(a) and 65C (3)(c), F.A.C. && , F.S. 02. Written Plan for Substitute rule 65C (2)(b), F.A.C. 03. Background Screening Requirements ss (2) (2)(a), && (13), F.S. && rule 65C (3) && (4), F.A.C. 04. Staff Training rule 65C (1)(a), 65C (3)(d)&(e) && (4), 65C (5) && (6), F.A.C. 05. Indoors and Outdoors Supervision rule 65C (2)(c)&(5) && rule 65C (7), F.A.C. HEALTH REQUIREMENTS 06. Animal Immunizations rule 65C (1)(a), F.A.C. Not Applicable This provider does not have animals on the premises. 07. Toxic, Hazardous Materials and Hazardous Items rule 65C (1)(b), F.A.C. 08. Smoking on Premise rule 65C (1)(c), F.A.C. Not Applicable There are no smokers on the premises. 09. Firearms and Weapons rule 65C (1)(d), F.A.C. 10. Play Areas Clean and Free of Litter rule 65C (1)(e), F.A.C. Page 1 of 5

2 11. Outdoor Time and Play Area Requirements rule 65C (1)(f)-(h) && rule 65C (11)(c), F.A.C. 12. Swimming Pools rule 65C (1)(i)(j), F.A.C. Not Applicable This provider does not have a swimming pool. 13. Appropriate, Safe and Sanitary Bedding rule 65C (1)(k)-(o), F.A.C. 14. Drinking Water and Single Service Disposables rule 65C (1)(p)(q), F.A.C. 15. Vermin/Pest Control rule 65C (1)(r), F.A.C. 16. Furnishings and Equipment rule 65C (1)(s), (2)(d), F.A.C. 17. Smoke Detector, Fire Extinguisher, Corded Telephone, Lighting, Temperature and Ventilation rule 65C (1)(s), F.A.C. 18. Nutritious Meals and Snacks Provided rule 65C (1)(t), F.A.C. 19. Handwashing rule 65C (2)(a) && (d)-(f), F.A.C. 20. Soiled Items rule 65C (2)(b), F.A.C. 21. Potty Chairs Cleaned and Sanitized rule 65C (2)(c), F.A.C. Not Applicable 22. Individual Towels and Wash Cloths rule 65C (2)(f), F.A.C. 23. Diapering Area Clean and Sanitized rule 65C (2)(g), F.A.C. Page 2 of 5

3 24. First Aid Kit rule 65C (3)(a), F.A.C. 25. Emergency Telephone Information rule 65C (3)(b)1, F.A.C. 26. Accidents, Incidents, Health Related Symptoms Documented and Shared With Parents rule 65C (3)(b) 2 && 3, F.A.C. 27. Fire Drills/Emergency Preparedness rule 65C (3)(b)4 through 7, && rule 65C , F.A.C. Comments Fire drill completed today in counselor's presence. 28. Communicable Disease Control rule 65C (4), F.A.C. 29. Prescription and Non-Prescription Medication rule 65C (5)(a)(c)(g)(h), F.A.C. Not Applicable This provider will not dispense medica on. 30. Documentation of Dispensed Medication rule 65C (5)(a)(b)(d)-(f), F.A.C. Not Applicable HEALTH RECORDS 31. Immunization Records rule 65C (1)(a) Comments All children's files reviewed. 32. Student Health and Records rule 65C (1)(b)(c), F.A.C. && s , F.S. 33. Enrollment Information rule 65C (2), F.A.C. ENFORCEMENT 34. Access to the Premises/Misrepresentation ss , F.S. && rule 65C (4), F.A.C. 35. Licensed Capacity ss (8), F.S. Page 3 of 5

4 LARGE FAMILY 36. License Posted rule 65C (3)(g), F.A.C. 37. Employee and Substitute Requirements rule 65C (2)(a)(e), F.A.C. 38. Supervision Requirements for Field Trips rule 65C (7)(b), F.A.C. 39. Driver Licensed/Vehicle Insurance rule 65C (8), 65C (a)(b), F.A.C. Not Applicable This provider does not transport children. 40. Seat Belts and Child Restraints rule 65C (8), 65C (8)(c), F.A.C. 41. Transportation && Supervision rule 65C (8), 65C (8), F.A.C. 42. Planned Activities rule 65C (9)(a), F.A.C. 43. Communication Equipment and Emergency Contacts rule 65C (8)(i)-(j), 65C (9)(b), F.A.C. 44. Child Discipline/ rule 65C (6), F.A.C. 45. Fire Safety rule 65C (11)(a), F.A.C. 46. Indoor Floor Space rule 65C (11)(b)1-4, F.A.C. 47. Toys, Equipment and Furnishings rule 65C (11)(b)5 && 6, F.A.C. 48. Outdoor Play Area rule 65C (11)(c)1 && 2, F.A.C. Page 4 of 5

5 49. Outdoor Equipment rule 65C (1)(h), F.A.C. 50. Emergency Plan/Posted rule 65C (3)(a)4., F.A.C. 51. Child Abuse or Neglect/Misrepresentation ss , F.S. && rule 65C (7), F.A.C. Received by: Jessica Sustaita Date: 07/07/2017 Inspected by: Jennifer Overley Date: 07/07/2017 Page 5 of 5

Type: Routine Date: 07/24/2017 Arrival/Departure Time: 12:15 PM to 01:35 PM Staff Present: 4 Children Present: 22 INSPECTION CHECKLIST

Type: Routine Date: 07/24/2017 Arrival/Departure Time: 12:15 PM to 01:35 PM Staff Present: 4 Children Present: 22 INSPECTION CHECKLIST Child Care Facility Information Name: Trinity Christian Academy ID Number: C09OR0692 Address: 2113 E South St City: Orlando State: FL Zip Code: 32803-6502 Phone Number: (407) 894-2237 Capacity: 75 Owner/Director/Staff

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Type: Routine Date: 08/30/2017 Arrival/Departure Time: 01:50 PM to 04:15 PM Staff Present: 8 Children Present: 56 INSPECTION CHECKLIST

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Type: Abbreviated Date: 06/26/2017 Arrival/Departure Time: 08:30 AM to 11:00 AM Staff Present: 14 Children Present: 89 INSPECTION CHECKLIST

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Type: Reinspection Date: 08/24/2017 Arrival/Departure Time: 01:50 PM to 02:09 PM Staff Present: 3 Children Present: 4 INSPECTION CHECKLIST

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Type: Routine Date: 08/16/2017 Arrival/Departure Time: 12:39 PM to 03:15 PM Staff Present: 17 Children Present: 82 INSPECTION CHECKLIST

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Type: Reinspection Date: 06/20/2017 Arrival/Departure Time: 12:12 PM to 12:24 PM Staff Present: 0 Children Present: 0 INSPECTION CHECKLIST

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Type: Abbreviated Date: 08/25/2017 Arrival/Departure Time: 10:04 AM to 11:50 PM Staff Present: 8 Children Present: 56 INSPECTION CHECKLIST

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Type: Routine Date: 08/07/2017 Arrival/Departure Time: 09:54 AM to 11:37 AM Staff Present: 8 Children Present: 63 INSPECTION CHECKLIST

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Type: Reinspection Date: 08/04/2017 Arrival/Departure Time: 10:56 AM to 10:57 AM Staff Present: 0 Children Present: 0 INSPECTION CHECKLIST

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Type: Abbreviated Date: 07/17/2017 Arrival/Departure Time: 09:47 AM to 12:55 PM Staff Present: 16 Children Present: 110 INSPECTION CHECKLIST

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Type: Abbreviated Date: 08/22/2017 Arrival/Departure Time: 10:06 AM to 10:43 AM Staff Present: 2 Children Present: 10 INSPECTION CHECKLIST

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Type: Reinspection Date: 08/07/2017 Arrival/Departure Time: 10:26 AM to 10:55 AM Staff Present: 0 Children Present: 0 INSPECTION CHECKLIST

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