> For the complete documentation index, see [llms.txt](https://docs.caqualityearlylearning.org/printable-inspection-list-tool/llms.txt). Markdown versions of documentation pages are available by appending `.md` to page URLs; this page is available as [Markdown](https://docs.caqualityearlylearning.org/printable-inspection-list-tool/basic-checklist/site-and-safety-forms.md).

# Site and Safety Forms

This resource is only for CQEL members and is not to be redistributed. Please have interested programs contact CQEL at hello\@caqualityearlylearning.org

**Site Director:** \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**Date:** \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**Center Name:** \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**Basic Checks**

* [ ] The facility license is current and displayed. 
* [ ] The fire drill logs and fire extinguisher are up to date. 
  * [ ] The emergency plan is up to date
* [ ] An emergency evacuation route is posted in all rooms and at all exits.
* [ ] Medications are stored securely with a guardian consent form. 
* [ ] A first aid kit is readily accessible in each classroom. All having:
  * [ ] Sterile first-aid dressings
  * [ ] Bandages or roller bandages
  * [ ] Adhesive tape
  * [ ] Scissors
  * [ ] Thermometer
  * [ ] Tweezers
  * [ ] Antiseptic solution (hydrogen peroxide or isopropyl alcohol)
* [ ] Field Trip Policy Form is up to date
  * [ ] Drivers licensed and insured
  * [ ] Vehicles that are used to transport infants contain a first-aid kit
  * [ ] All parents have signed the acknowledgment of the Field Trip Policy Form
* [ ] Meal schedule posted for parents (Includes nutritionally-compliant food, food allergy, and dietary restriction accommodation)
* [ ] Disaster preparedness plan is up to date
* [ ] Monthly emergency drill logs are up to date
* [ ] Emergency plan for child injuries, illnesses, or missing persons plan is up to date
* [ ] Emergency contact information is up to date
* [ ] Lesson plans are up-to-date and organized 

**Date:** \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_        **Signature:** \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**Outdoor Checks**

* [ ] All play equipment is age-appropriate and in good condition.
* [ ] The yard is free of trash, yard debris, animal waste, and other objects that could harm or be misused by children 
* [ ] No choking hazards
* [ ] There is an area(s) of shade/shelter, area(s) for the children., and secure fencing around the yard.
* [ ] There are safe, shock-absorbing surfaces in any active play areas to prevent injuries in case of falls (Materials such as sand, deep mulch, or rubber mats.)
* [ ] There aren't any blind spots where a child could hide 
* [ ] The yard is free from tripping and strangulation hazards.
* [ ] Play equipment does not have any protruding or loose screws, sharp edges, or other hazards. 

**Date:** \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_        **Signature:** \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**Kitchen Checks**

* [ ] Fridge Temperature Log is up to date
* [ ] The menu schedule is posted 
* [ ] Students' Allergy List is posted
* [ ] Sharp objects, such as knives, are securely stored and out of reach of children
* [ ] Food is stored in air-tight containers
* [ ] Expired food has been thrown away

**Follow-Up Dates**

**Date:** \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_        **Signature:** \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**Inspection Findings:** \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**Completed on:** \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_  **Signature:** \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_


---

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