Title Page
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Inspection Title
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Location
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Prepared by
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Conducted on
ADMINISTRATIVE INFORMATION FOR MANAGMENT AND STAFF
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Facility Director
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Assistant Director / Program Coordinator
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Current Probation and Parole Officer Assigned to Facility
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Probation and Parole Workspace
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Public Information Officer
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Type of Facility
- Female Treatment
- Female Supervision
- Female Inmate
- Male Treatment
- Male Supervision
- Male Inmate
- Sex Offender
- Coed
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Total Number of Beds in Facility
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Current Number of Total Residents
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Total Number of DOC Beds
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Current Number of DOC Residents
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Monthly Reports Sent to Contract Management Branch on Time
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Population Report Submitted Daily and Accurately (Capacity, Current DOC/Non-DOC, and Number Requested)
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Employee Files (Must be available to employees upon request)
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Employee Pre-Employment Background Checks, Age Requirement, and Signed Code of Ethics
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Employees On Supervision Approved by P&P, No Access to KOMS, and not at a RSC
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Director or Assistant Director Present for Inspection
ADMINISTRATIVE REQUIREMENTS FOR RESIDENTS
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24 Hour Awake Supervision (Must be female at a facility with female residents)
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Residents Not Placed in Position of Authority or Assigned Security Duties
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Facility has Fully Licensed and Approved Medical Provider
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Special/Alternative Dietary Options Offered
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Hygiene Products Provided as Needed
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Residents have Access to Legal Library and Legal Supplies as Needed
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Facility Takes, Updates, and Loads Offender Photos in KOMS per CPP 25.6
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Facility Sends and Receives Resident Mail per CPP 16.2
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Telephones Available for Residents
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Adequate Laundry Facilities
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Facility Temperature between 65 and 85 Degrees
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Non-Secured Facility Policy and Procedures and Course Catalog Available to Residents
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Visitation List Utilized
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AA and NA Offered to all Residents
POSTED DOCUMENTS
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Employee Compensation Posted (Minimum Wage)
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Resident Rights Posted
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Grievance Procedures Posted
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Visitation Schedule Posted
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Evacuation Plans Current and Posted
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Tobacco Restrictions for DOC Inmates Posted
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Choking Poster Posted (In kitchen)
FOOD SERVICE
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At least 3 meals served per day with at least 2 being hot meals, and no more than 14 hours between meals.
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Serving Line Sanitation
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Food Preparation Area Sanitation
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Kitchen Utensils Cleaned and Properly Stored
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Stove and Stove Hood Sanitation
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Oven Sanitation
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Deep Fryer Sanitation
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Meat Slicer Sanitation
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Microwave Sanitation
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Can Opener Sanitation
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Spice Bins and Scoop Sanitation / Storage
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Ice Maker and Scoop Sanitation / Storage
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Other Kitchen Equipment Sanitation (Mixers, Steamers, Warmers, etc...)
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Three Compartment Sink Sanitation / Operation
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Automated Dishwasher Sanitation / Operation
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Freezer Correct Temperature (O degrees or less)
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Freezer Sanitation
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Freezer Products at Least 6 Inches off the Floor, Labeled Properly, and Not Out of Date
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Freezer Lighting and Shield
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Refrigerator Correct Temperature (between 34 and 40 degrees)
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Refrigerator Sanitation
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Refrigerator Products at Least 6 Inches off the Floor, Labeled Properly, and Not Out of Date
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Refrigerator Lighting and Shield
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Thawing Meat Stored on Bottom Shelf
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Dry Storage Sanitation
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Dry Storage Products at Least 6 Inches off the Floor, Labeled Properly, and Not Out of Date
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Dry Storage Lighting
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Hand Washing Station Installed and Maintained / Operational, with Soap and Drying Device Available
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Thermometers Available on or near Severing Line
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Food on Serving Line at 136 Degrees or Higher
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Garbage Cans Cleaned and Covered
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Kitchen Personnel have clean clothing and hair restraints
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Kitchen Personnel are not eating or drinking in serving / prep areas
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Kitchen Workers properly supervised
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Kitchen Floors, Walls, and Celling are Clean and in Good Repair
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Kitchen Plumbing Issues (leaking faucets, pipes, etc...)
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Knife Organization and Accountability
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Kitchen Tool Organization and Accountability
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Kitchen Janitor Equipment and Toxic Items / Chemicals Organization and Accountability
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Overall Maintenance and Security of Kitchen and Dining Hall Area
SAFETY, SECURITY, AND SANITATION
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Fire Extinguishers are Functional and Inspected Monthly
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Emergency Lighting in Place and Functional
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Exit Signage in Place and Functional
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Electrical Boxes and Light Switches Covers in Place, in Good Condition, and unobstructed.
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Exits Free from Obstruction
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Hallways Free From Clutter and Obstruction
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Windows in Good Condition
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Celling Sanitation and Condition
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Tools, Supplies, and Other Hazardous Equipment Only Used by Residents Under Direct Supervision
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All Tools, Corrosive, Flammable, and Other Potentially Dangerous Supplies and Equipment Stored in a Locked Area
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Safety Data Sheets (SDS) are Available, Current, and Easily Accessible
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Non Kitchen Janitorial Equipment and Toxic Items / Chemicals Organization and Accountability
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First Aid Kits Available and Properly Stored
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Two Separate Entrances
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Toilets and Urinals Available for Residents
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Showers Available for Residents
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Sinks Available for Residents
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1 to 8 Ratio per Resident, Toilets/Urinals, Showers, and Sinks
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Overall Maintenance and Sanitation in Common Areas to include Classrooms, Visitation, and Conference Rooms
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Overall Maintenance and Sanitation in Non-Living Area Bathrooms
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Overall Maintenance and Sanitation of Facility Exterior
RESIDENT LIVING AREAS
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Living Area Amenities Provided (Bed, sheets, pillow, storage, and chair per DOC resident)
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Living Area Square Footage (50 ft.) per DOC Resident
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Room Lighting and Night Lights in Place are Functional
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Living Area House Keeping and Clutter
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Overall Maintenance, Plumbing, and Sanitation in Living Areas (To include bathrooms)
REQUIRED DOCUMENTATION AT TIME OF INSPECTION
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Certificate of Occupancy
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Fire Department Inspection
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Kitchen Hood Inspection
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Sprinkler System Inspection
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HVAC Inspection
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Boiler Inspection
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Fire or Emergency Drills
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Current Employee's CPR and First Aid Certification
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Health Department Inspection
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Certified Food Manager on Staff
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Menu Approved by Licensed Dietitian
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Vermin and Pest Control
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Facility Organizational Chart
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Facility Staffing Roster (All Positions Filled and Vacant)
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Facility Work Schedule
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Employee Required Training Program
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Employee Training Hours (At Least 16 Annually)
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DOC Resident Orientation (Signed by resident)
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List of All Programing Available at Facility (Include KYDOC approval letter, certificate, or memo)
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Program Facilitator Certification for each Program
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Daily Facility Log (48 consecutive hour period)
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Hourly Rounds Conducted (48 consecutive hour period)
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Documented Head Counts (At least 3 per Day, 1 per Shift)
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Resident Sign In and Out Log
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Drug Screening Log (At least 10% of DOC Population)
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Restriction on Weapons, Ammunition, Chemical Agents, or Related Security Equipment
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Extraordinary Occurrence Report Log
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Grievance Log
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Resident Recreation Schedule (1 Hour per Day Minimum)
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If applicable, 3 residents who are employed's signed obiligations and/or expectations from the facility.
AREAS TO MONITOR/FOLLOW-UP (IF NEEDED)
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Follow-Up #1
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Follow-Up #2
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Follow-Up #3
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Follow-Up #4