Contessa Miller

110.9(1)a

“Within six months of becoming registered, a physical exam report documented on form 470-5152, Child Care Provider Physical Examination Report, for all household members over the age of 18. Physical exams”

Rule not named in the record

“should be repeated every three years. Within six months of becoming registered, children 18 years of age or younger residing in the household must have: • Admission physical exam report.”

110.9(4)a

“Identifying information including, at a minimum, the child’s name, birth date, parent’s name, address, telephone number, special needs of the child, and the parent’s work address and telephone number.”

110.9(4)b

“Emergency information including where the parent can be reached, the name, street address, city, and telephone of the child’s regular doctor, and the name, telephone number, and relationship to the child of another adult”

110.9(4)c

“available in case of emergency. A signed medical consent from the parent authorizing emergency treatment.”

110.9(4)d

“For infants and preschoolers: An admission physical examination, on the first day of attendance, including past health history, status of present health, allergies and restrictive conditions, and recommendations for continued care when necessary. The date of the exam is not more than 12”

Rule not named in the record

“months before the child’s first day of attendance. For school-aged children: On the first day of attendance, a statement of health status signed by the parent or legal guardian or admission physical examination that is not more than 12 months from the child’s first day.”

110.9(4)e

“For infants and preschoolers: A statement of health signed by a physician submitted annually.”

Rule not named in the record

“For school aged children: An annual statement of health condition signed by the parent or legal guardian, annually from date of statement of health or admission physical.”

110.9(4)f

“For each school-age child, record of a physical exam completed at the time of school enrollment or since.”

110.9(4)g

“A signed and dated immunization certificate provided by the state Department of Public Health.”

110.9(4)h

“Written emergency plans for children with allergies. Must accompany child if away from facility.”

110.9(4)i

“Documentation signed by the parent which names persons authorized to pick up the child, their telephone number, and relationship to the child.”

110.9(4)j

“Written permission from the parent(s) for their child to attend activities away from the child development home.”

110.9(4)k

“Injury report forms to document injuries requiring first aid or medical care.”