Information

  • Site

  • Conducted on

  • Prepared by

  • Location

Facility

  • Facility Name

  • Address

Admin

  • Is there a signed copy of the GSA Revocable License for Non-Federal Use of Real Property (GSA Form 1582) available on file?

  • Is there a copy of a valid City, State, or local Child Care operating license posted in the center?

  • Has the center been scored using the Child Care Center Design Guide Scoring Tool?

  • Is there an action plan established and is the field office taking corrective action to raise the score to at least 70?

  • Did the center score at least 70?

  • Is there documentation that the Child Care staff is properly cleared through a background check process?

Emergency

  • Is the center’s Emergency Plan current (reviewed and updated within one year)?

  • Is the center’s Emergency Plan included in the overall building Occupant Emergency Plan (OEP)?

  • Is an emergency practice drill conducted on a monthly basis?

  • Is documentary evidence available?

  • Are duress buttons in Child Care center operational?

Health & Safety

  • Is the child care center being cleaned to the standards in the GSA National Custodial Specification, Child Care chapter?

  • Is the drinking water tested for lead (frequency per the PBS Drinking Water Policy)?

  • Is documentary evidence available?

  • Are lead concentration levels higher than EPA’s acceptable levels?

  • Have remedial or containment actions have been taken to prevent exposure?

  • Are the facility and finishes (walls, floors, finger pinch guards, etc.) safe (no sharp edges, protruding hardware or missing parts), clean and in good repair?

  • Is there a copy of a certified playground safety inspector’s report?

  • Is there compliance with GSA’s accident reporting procedures?

Maintenance

  • Is there a playground inspection and maintenance program in place?

  • Is all government provided equipment maintained (ie, playground equipment, kitchen appliances, etc)?

  • Is there a plan and funding in place for cyclical repair and alteration projects (ie, painting every 3-5 years)?

PROGRAM COMPLIANCE

  • Program Compliance

  • Program Reviewer

  • Field Office Representative

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.