· government of bermuda ministry of health department of health the children act 1998 certificate...

lltm No. Mt MA Cll ·-- -· .... CDfNCIIon

~

.. ·---r

MI·M-- ...... jor- t11---O..te ollnopedlon: Re-t...,...lon Roqulnd YU NO "ya, Re-t ....... lon Dale:

FEE RECEIVED' If ya realpt numben

0/M/Year

Inspectors Signature: ______________________ _

IJ/DivC•rrJ(hil6c.Jtre>toondtnftfo/Forml/CCPk\iptC1~nUQtm -leU

' GOVERNMENT OF BERMUDA Ministry of Health

Oepar1ment of Health

CHILDRENS ACT 1998

CHILD CARE PROVIDERS INSPECTION FORM Facility Name: JUDITH SMITH

Name: Judith A. Smith

Registration No: 075 @

Address: 5 Footpath Lane, Pembroke

Telephone: 292.·6807

E-mail:

CPR EJ!plry:

On-Call Person:

I OIILDII!N

1. Happy

2. No Slllfl of Abuse

3. Oun

• OflfRATION

4. Meals prepared In CCP home

Cellular:

s Meals bt011aht packed from home and stored In refnaerator

6. Structu~ dally schedule

1. Adequate space for IIHplnc

B. lntemal and external play area ' ,.,_{,•/Mi. 9. Refrigeration temperature adequate

• HYG1EIIE

10 . Wnhes hands frequently

lL I Appropriate appnrance/clothlna

• H0Mt:W£JY

12. Oop are not allowed In house or play area

u. No loose wlrln1

14. ToysareYfe

lS. Water quality

t:/~rr/Chtld~rprcwedfr.nto/lolmtJCCPaotJpntiDflbU-'Uon"

Other:

Telephone:

WT OM

;/ -! v' I ----

Yes 0 / ~ ~~~" -

Yes r;t" Ho 0 c . I

v ---.

v . -· -

v / I

·-----· -

~-xns

• HOME SAFETY CONT'D Wf ~

~- +--I 16. ~c subs,lances ; ,e itored 1n a IO(k~d ca-b;et or above reath

117 Electflt oullets covered

!--;~ Door~ kept closed to outside, kotch~~. ~nd utility mom --r-_________ ..._ __ ~ ~ • Floors sound w/out splonte1ed wood or clacked tole

•'

20 I fire extinguisher occessible -----•. I

. I ~--~ 21 l Cribs, playpens in good condition -__P~Int pce~ne jagged~~""

22 FirSI •ld kit equipped and accessible - _ _l_j- __ -J ! I I

23 Safety g•tes at staifs and areos w/out solid doors for closure I

24 · Toys ore safe and cleaned at least once a week

25 l Adequate ventilation

t 26. Condition of ceiling, walls, floors, windows, doors, fly sen•;,;- --=---~ -t-:-----1 • HOUSEKEEPING

~--~·/_ ~- I i I

27 Home is aeneral1y dean 7;-t Sleeping area- cle_ a_n ___________ _

2~ Floors clean

30. Pl•y orea clean --- ---

-~~ ,; ~LJ

,. , Sa111Ury f~cltihes dean and ~an1t11ed, potttes. child•en·,· toi•et sl!ats, toilet J •

32 Parents provided with daly onlo on child - --

.ll Condition of furnishings, washable, good condoloon. safe

34 Kitchen smh clean

- ·f-1_ J r ~-~

35. Kitthl!n/lood p<eparitlon equipment ilea dein and adequate, on;oueulble to children -~~ - - - r-- r , 36 Condotoon of fur111s1Mncs. was!Noblto,sood condotion, safe

W POLICIES

J I Sick CMd Polley

3~

40

Oosetplrnc roticy

Oosaster Policy

~ PEST CONTROL

•1. Pest Control ellective, rodent proofing. free hom insect~

I\IIISCELlANfOUS

-4.! G,uOOr.t• cont;J tttrrs sound. Cf(\1n J.dC" ·1u ollf' tor.;;rc drt •llk~n

.Jj !ww.ar,t•/witSit• w.ut•r da\l)t)\af

.;.t t Jh·ltt.l~ ·""·'·

G•ooll.,-: A ,., - )00 • ea- .,

ttli~tL-. ·r ta•cc.a·f'r•t¥C.r'"''C'J'C ,.t/((r -'"' oe·t,.:.u·ttc .,.

c

_, ... !

,./ I I :

v

Total Score

Grade

70 - 11 0

/100%

69 andund•r

f't'Afl" L; ,.

ttem No. ,., MA Cit ~ .... .u Dal• for Cotrtdlon

·.,

'., ,._ t'

,.-1 , , .. 1r .. r-~ ., ...,., .-

.... -~

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GOVERNMENT OF BERMUDA Ministry of Health

Department of Health

THE CHILDREN ACT 1998

CERTIFICATE OF REGISTRATION

This is to certify that Judith A. Smith has been approved

a suitable person to be a Child Care Provider,

to be known as JUDITH SMITH with the following condition/ s:

1. Maximum number of pre-school age children is: 3

2. Child care is provided at : 5, Footpath Lane, Pembroke HM14

Registration #: 075 Issue Date: 3rd January 2018 Expiration Date: 3P1 December 2018

Chief Medical 0/flcer

( , 0 \ '1 ~NI~ I N l 01 Bl RI~ &..,A

Depilnment ol Health Central Government Laboratory

EH receipt # Laboratory No.

WATER ANALYSIS FORM

How would you like to receive your results: email 0 mail o telephone o

If you would like your results to be mailed to you, please print your name and mailing address clearly below - Inside box:

I Emoil add""'

Sample Details: (please complete fully)

Street name .{!tz.- ~!(o 7-

Postal Code Contact telephone no.

Reason for testing 0 No specific complaint

Parish

Sampling Point

, Examination Requested IJ Routine bncten ological

0 Routine chemical 0 Complaint (specily) - ----0 Follow-up analysis D Other (specify ) ___ _

0 Routine sampling programme Drinking Water- Type of Disinfection I Treatment

0 Chlorination • res Chlorine----

0 UV (Ultra-Violet Light)

0 Other

0 Reverse Osmosis

0 Not disinfected/ treated

Sample collected by . ~. {', j ) JC,~

Non-drinking Water 0 Seawater

0 Well

0 Other

Date and Time Collected

0 Swsmming pool

0 Spa/Jacuzzi

For EH/Laboratory Use Only Sample received at EH by Date and Time Received

Sample received at CGL by a .fua..cl~ Date and Time Received 2 ()...o-r "'2.. o I/ . Premises type 1/ll.rrut.J

Bottle size and type 2 50 :.. , fYl L JJ--u.o BactenoJogical Results Chemical Results

Total coliforms /lOOm! Chloride mgll

204-E. coli II OOml Hardness mg/1 as CaC03

s Heterotrophic plate count /ml Nitrate mg/l as NO)-N

pH

Water sample meets recommended bacteriological values for drinking water: o Yes a-No

This report reflects the water quality on lhe day of sampling only. The bacterial quality of Bermuda tank water Is variable -tank water should always be treated by disinfection before using for drinking and food preparation

(Senior) Public Health Analyst

9 : 5

2..0\...,

E A R T S A. V E R (~ F R /l E 10

eartsaver® ,~PR AEC

Danika J. Furbert

#'!

\

American Heart Association.

The abOve ondNodual ~as SUC~:esslully completed the ot>)C(to..es and skolts evaluatoons on ~nee With the cumculum oltne AltA Heartsaver Cfll AEO Program Opbooal completed mocsutes are thole HOT marked oul

Child Cl'll AEO lnlanl CPR boiM

~ Feb~ary ~017 February 2019 tswc t>ate Recommenoed Ren~wat Date

lttm No. Ml MA Cll .......... Dot• I«~

r- ----,.. __ _ Mo\· ...... - Cll---

Dote oltmpedlan: a.-r..,.a....,tt..,nd: TU NO lfyes.II~Oote:

FEE RECEIVED: lfya.......,._ 0/M/Ynr

Inspectors Signature:----------------------

tJ/r»~r~/ct.ildcattDfC\I'IIdcnnfo/lorml/HFtr.'Pfnr.nb&anlf.- -.d ;(fl~

4i --:pt~~ ~ ~dE-.

GGV£RNM£NT OF BERMUDA Minosrrv ol Health and Sen1ors


CHILDRENS ACT 1998

CHILD CARE PROVIDERS INSPECTION FORM Faclnty Name: JUDillt SMITH

Name: Judith A. Smith

Address: 5 Footpath Lane, Pembroke

Telephone: 292·6807 ../

E-mail:

CPR Ellplry: NOI'le on-Call Person:

I CHIUIIIOI

1. H~ppy

2. No Slsn of Abuse

3. Oean

• OI'EMTION

~ - Meals pr~red In CCP llclfM

Cellular:

s Me~ Is bfousht packed from home and stored In relnserator

6. Structured dally schedule

7. Adequate space for s1HP4"1

8. Internal and otemal plly area

9. Refrlletallon temperature adequate

• lfYGIIM

10. Washes hands frequently

11. } ~te appeam~ee/clothlni I HOMESNm

12. Gop are not allowed In house or play area

13. No loose wlrlns

1~. Toys are safe

15. Water quality

t://fU't(ltt/(t,llcftl•rprcv.cftonl\lofrcm.I/CCftt"tPCC11Cnb~n•h,•m

Realstratlon No: 075

Other:

Telephone:

wr DM

.

---- -- I I '

--· .. Yes D No D I

.... --- .; Yes D No 0 --4--·-!

I : --~ ·-

I I . . '

I

........ d JOt~

• HOME SAFETY CONrD

16 lto•oc substancl!la"' stored on • lockrd cabinet or above ruch

nj ElectriC outlets co~;.~;;;-- -------- ------ -

18 I Door> kept dosed to out1ode, kotchrn, and utohtv room ---·--~--

19. I floon sound w/out sphntrred wood or crocked tole

~ File extingui~her ~cct-nlble

1 21. 1 Cub>. plaype11s in good condotoon p•nt peehngJ'gg~d edgrs etc

21. I Forst aod tot equljlped and occessibir

WT OM --·--·-· t f _: ----- JL

I-

~·----!--- - . --+-i 23. 1 Safety gatel at staits and areas w/o_ut_s_o_ll_d_d_oo_,._l_o_r_d_osU<_e _________________ --~. __ -1

24. Toys are sale and cleaned at least once a Wffk

~ Adequate ventilation

[26.1 Condition of ceiling. walls, noo", windows, doors, fly meens

• HOUSEKEEPING

lJl Home ~~~erally clean ----2ft Sttteping area dean

t-· ----29. Floors dean

30 Ptav "'""dean

31 Samtary lacitiHcs ch?an and san1tt1ed, potttes, chddrcn·~ 1o•let seats. lodel

32 Parenti provided wolh daily onlo on child

B. Coodotion ollutnl\hongs. washablt', good coodotion, saiP - ---34. Mellen sinh dcitfl

35 Kitchen/food pr<'Jloration equ-nt aru cl~an and aclequatP lna<cesslblf! to chltd<Pn

36 Cond1hon of lurn,.htnes. washabl<> &ootl condohon sale

• POUCI£5

:;; S1<l Cl•ltl Folot~

lB. Desciplinc Policy

40. Dlsastrr Policy

• PESl CONlliOL

~ 1- Pest Control elfectrve, rodent proofing. free from insects

- MISC£lLAN£0U5

42 GJ.~rlJ.1p,e [Dnldlf1Cr!a. ~ouhil'. d t'dll, .t-.l't•QthUt.•, ~lor.tt:c ollt 'J t k•..t 1

4 ? ~l'W<ilt£'/w;~~:.le w.uc·r d1sp<1\ 11

J11l lll1t.'UMI JteJt

<>f•dltl&: ~ to - I tiC! • 10 - .. c 70-79

+ -1

--·-1- 1 --·

,---- -

----t-. - -.J

I I j - - -- _.,..,- ·--; =---=- ..

Total Score

Grade

0

! l

/100%

69 and under

(' ~ . lt~mNa.

Ml MA CA Rema•ks Paltfor tonmlon

" I ~

'; ,.~ i

' . ' - l i '

... . ' ,. •t ~ '·

...

GOVERJ'-JMEI\!T OF BERMUDA Ministry of Health, and Seniors




This is to certify that Judith A. Smith has been approved


to be known as JUDITH SMITH with the following condition/s:


2. Child care is provided at : 5, Footpath Lane, Pembroke HM14

Registration #: 075 Issue Date: 3rd January 2017 Expiration Date: December 3Pt 2017

Chief Medical Officer

MINISTRY of HEALTH and SENIORS Environmental Health P.O. Box HM 1195, City of Hamilton HM EX Phone: 441.278.5333

Name Judith A. Smith Address 5 Footpath lane

Pembroke HM 14

Date: 16th November 2016

QUANTITY DESCRIPTION

Balance Carried Forward

Annual Registration Fee Year 2016

DIRECT All ENQUIRIES TO:

Verona Darrell 441.278.5394 Email: [email protected]

TOTAL

INVOICE

Account #: CCP268 Invoice#: 16075

Net 30

AMOUNT

$0.00

$25.00

$25.00

MAKE ALL CHEQUES PAYABLE TO ACCOUNTANT GENERAL Mail to: Environmental Health P.O. Box HM 1195 City of Hamilton HM EX

THANK YOU FOR YOUR BUSINESS

. l Bermuda Government

Ministry of Health, Seniors & Environment

Department of Health P.O. Box HH 360 Hamilton HM BX

1/6/2017 09:49 Af.l Cashier !LZf T 'Ref ( 2£':-1 654 Reg 0775 :ran t•c· 1 '• . Cash Report. 170106-01 for 1/6/2(117

22 - Depa r tn:ent ::;f He a 1 ~11 Nurser/ Sd:-.o 1~ 8511.32170

J

Payer /lame .Judith A. Sr.~itn Notes Chi lei Care Provider Va1idation Number: 000498 $25. GG

Total Chec~ 6M8 Check No . 5147

L-.·~ .. -... -- .Have a ni re dav ~

$25.00 ~25 00,

I

l

Bermuda Government Ministry of Health, Seniors

& Environment De~artment of Health

P.O. Box HM 380 Hamilton H~i BX

-- -- -------- ---- -· Reprint

1/6/'Z017 09:4Y At~ ~,asrier 2278

1

J l.'fft u22: 1•(l1554 Reg (!22~ lran Nr_ 1447 Cash Report: 17010&-01 for l/6;201i

27 - Oepa•tment of Heaith Nursery ~choo 1 s 851i 32170 Payer Name Judith A. Smith 11ores Child Care P•·ovider Validation Number: 000498

1ota 1 Check Bf.ID Check No . 5147

- -- ... --· - -·--· -

Ha~E u ni c:e Ja;:

$25 .00

$25 .00 ( $25 ut)

It""' Na, Ml MA Cll - Dllefcw~

lloll ·-- w.-~lo<- ca-atdcol-O.teoff-lotl: lt .. IMpocllotlll*'!lllfecl: YD NO lfyet,lt ........... lotiOIIIe:

fVOV· 2L )o)l FEERE~EIVEO: lfya,_jpt..,mber: D/M(Year ------------

lnspectorsSisnature :b~......,""' ...... ~-'11'~""'AIJ-..,""---------------1J/DarCartlC1t4durfl)tCMdt•rnd/totmsJctPjftsPf'daonbbn•to•"' • .._., 101"

i GOVERNMENT OF BERMUDA

Ministry of Health Department of Health

CHILDRENS ACT 1998

CHILD CARE PROVIDERS INSPECTION FORM Fatlllty Name: SYLVIA DAY CARE

Name: Sylvia Smith

Address: 9 Welllnrton Back Road, St. Geol'le's

Telephone: 297·2115

E·mall:

Cellular:

CPR Expiry: 2/1/2013 fGts Z.OI?

On-Call Person: Sharon Smith

I otllOIIIN

1. Happy

2. No Sign of Abu5e

3. Oean

I Of'biA110111

~. Meals pr!!pated In CCP home

5 Meals bnlught packed from home and stoted In refriaerator

6. Structured dally schedule

7. Adequate space lor sleeplna

I. Internal and utemal play area

9 . Refriserallon temperat- adequate

• HYG1f;NE


ll~riate appearance/dothlna

I HOMEWETY

12. Doas are not allowed In house or play are•

u. No loose wlrln&

14. Toys are sale

15. Water quality

•:J/D.,c.art/Ch.acfc~nworidtfMio/lonnS/CCPtntPf('t~aU.,...,

Rerlstratlon No: on

Other:

- _..,

Telephone: 297-2125

WT DM

_j_ .. _j

No a' - - -

Yes 0

Yes 0 No r:( I ........ --. -----

J r.·~ -=.Jf s. di!-

RMIH101S

II HOME SAFm COHT'O Wf OM

16. 1 To•ic sub~a~eJ are stored in a lo<ked ubinet or above re~cll - - ···---· ·-rr-1 i I 1

17 · Ele<trk outletHOYetl!d

18 i Doo" kept dosed to outside, kitchen, and utility room

IJ91 Floors sound w/out splintered wood or cracked tile I ~ Fire c•tmguoshcr accessible

. 21 . Cribs, pi~ypPnung;od-condition - paint pPPhnatau@dedeHetc

I 22 I First aod kit equipped and accessible

In Safety gates at stain and areas w/out solid doors for dosure

24. Toys are safe and de1ned at least o~e a week

2S j Adequate venti11toon

1___:6. J Condition of cer ong. walls, floors, windows, doors, fly screens

II HOUSEKEEPING

I - I 27. 1 Home is generally clean

[..:!J Sleeping areaclean ------------~~

R=i j-

I I I I I

I 29 I Floors clean

i --;;:-1 Play area dean - -- --··-· ·---i---t---1

------ --31 Sanotary lac~ir"' de on nd sar llted pot lit'S, ch ldren s toil I ,al l to·~

;2 Pall'fl\S llfoYided wieh daily onlo on child ------ -- ·-- ---t--l~-1

J: Condo lion ollurn~>hongs, w. h b it', good condition, sale

34. ~itchmsonk.clr•n ·-- -- - -- !==:J.=J [35 . Kitchen/food prepatation equipment area clean ancl adequate, inaccessible to children j==r=J __ _

36. Condition of futneShlngS, w.lshabfe, good [OIIdilion, saf~ ' r J

• POUCIE5 - - I i ..,1 31 ~k Chrld Polley ~ 3a "'lfh~opiirn,Poli<y _ _ ___ • _ _ •• f- ·-~.---J 40 Dosaster Policy

II PE5T CONTIIOL

41. Pest Control ellectove, rodenl ptaofing. ltee hom Insects

MISCELlANEOUS

..: J [•tll hoij!.t' lDn1~uwr ~ wumt th•,m. ~tc.Jt "'.J'J...,.lt•, '"LIIH' •'I':'l~ .Ill-.. dt .111

~ ~ \ 4'W•ll't•/w.l\h.." wah•f dn~o~.11

·\•l i J:\l'tll.1~ .up., ..

Gro:d.n~: ~ 911 · lOCI II 10 - l'

Jlr~'f(a r/P· ·CIUtFCI'CvtCt•"'IICI/'(I!?'l/((~ r'C:f'C• Cr<l 11~•fc:•P"

( 70-79

Total Score

Grllde

D

/100%

69and under

"fttt'ILr'5.

ttemNa. Ml MA Cll ROINob Doto lo< Confttlon

;; bv,1S fL.JM '] 1'- 21

IJr"'I\C~·tiC"'• .. -artettC~to<('•"h:rerJTVCCt~ucu C"'· 1 -.•,•""t .,.,..,,.

I MINISTRY of HEALTH Environmental Health P .0. Box HM 1195, City of Hamilton HM EX Phone: 441.278.5333

...

Name Sylvia Smith Address 9 Wellington Back Road

St. George's GE 01

Date: 25 111 October 2017

QUANTITY DESCRIPTION Balance Carried Forward Annual Registration Fee Year 2018

DIRECT ALL ENQUIRIES TO: Verona Darrell 441.278.5394 Email: [email protected]

TOTAL

INVOICE

Account #: CCP267 Invoice #: 18077

Net 30

AMOUNT $0.00 $25.00

$ 25.00

MAKE All CHEQUES PAYABLE TO ACCOUNTANT GENERAL Mall to: Environmental Health P.O. Box HM 1195 City of Hamilton HM EX

To avoid debit collection please make payment within 30days of receipt of Invoice

- -·-----

Rep r 1 nt 11/7 /2tl7 i0:50 AH ( ashier 222c T/Ref C•t2SOO:b11 Reg 0225 Trar tJ,, S:i87 Cash REPOrt · 171107-01 for 1117.'2017

22 - Deopart.~ent of Health Nu rserY Schoa·s 851 . . 32170 Payer Name Syl /la Smith tJote5 Da~ Care Provider !m 1807i Validation ~u~ber : 003036 $25.00

Total Cash

- :;;::~~==~~~=--.;:- -

m ou (~ 25 ,.. .,

~ GOVl fiiiNH(NT OF B(RHUOA

Dep•nment of Heal !II Central Government labor.uory

~~c.t-<J.. 'tL/7 (-'lJ)'-'1

Laboratory No. EH recetpl #

3 ~(,"2,.1\'

WATER ANALYSIS FORM

How would you Uke to receive your results: email 0 mail o telephone o

If you would like your results lo be mailed to you, pleau print your name and mailing address clearly below - Inside box:

I I ·-"·"~ Sample Details: (please complete fully)

Surname

,.dttr\ Va t(u'P _ ~name ._

f irst name

S}, (u o rev--House No. Street name

f5i lf f\R l"l Postal COde Contact telephone n o. Sampling Point

Reason for ttsllng 0 No sp~ific complaint Eumlnallon Requuted 0 Roudne bacteriological 0 Complaint (specify) 0 Routine chemical 0 F~w-up analysis D Other (specify) dVRoutine samplinJP!O~me

Drlnktnc Waler ·Type or Dlslnfecllon I Trealmenl Non-drinking Water 0 Chlorina1ion • ~ Chlorine C Revmc Osmosis 0 Seawater C Swimming pool 0 UV (Ultra· Violet light) 0 Not disinfectcdl treated eWell C Spa/Jacuzzi C Other 0 Other

Sample colltcled by f f O 'fl/A 1)() I ~ {). { (I , $ Dale .ad Time Collected Nov 1 7 loll JO • tQ t:. 4 Jl'") "-..) For EM/Laboratory U1e Only

Sample received al EH by Dale and Time Received

Sample received at CGL by 1- t....(..) DaltllldTim~Rrcelnd L~. , . \'\ l 0 ·- I'-;" G• • • ......

Premises type .L.blt~l farf _ , Boldt stu and type L. ">-" on .. l ...,_ ' Bacteriological Resulb Chemical Results

Total cohforms I I OOml Chloride mgll

< I E. coli llOOml Hardness mgllas CaC01

< I Heterotrophic plale count lml Nnnlc mgll as N01·N

pH

Water sample meets recommended bacteriological values for drinking water: l!l"'Ves o No

This report reflects the water quality on the day of sampling only. The bacterial quality of Bermuda tank water Is variable- tank water should always be treated by disinfection before using for drinking and food preparation


~~-- --

·=

j ,~_. !' • I f '•

I I ~I' I • r •• I 1

II



' J111S 1s to t t"rllfv Tim! Sylvia Smith ha~ ]>,en appm1•• d a ~unable pnson 10 be a Cluld (an l'rm tdcr,

to b~ known as SYLVIA DAY CARE Wtth llt t- lnllowm~-: c•1ndttinn '

1. l\lax1mum numbl r of pre school agt chtklrcn •~ 3

2. Child c:uc Is pro1 1dcd 21 · 9, Wellington Back Road, St. Gt ·orgc '~ G E 01

Registration#: 077 Issue Date; 3'd January 2018 Expiration Date; 3P1 December 2018

ChiP{ Mrdlca l Officrr

I GOVERNMEN T OF BERMUDA

Minis!~ of Health Department of Health

DAY CARE PROVIDERS RE-REGISTRATION FORM

Children Act 1998

In order to update our Register, please fill in the information below. Listing the names and ages of each child in your care.

NAME . Smith

DA YCARE NAME I SYLVIA DAY CARE

ADDRESS GEOt

PHONE 297-2125

EMAIL

household?

'-On Call Person and Phone Number 1

• ~--- 1

LIST EACH CHILDS NAME AND AGE NAME AGE

.-. L 9 rt\ ()~\,l ._ . .... ~- 1 .....

1 5 m(\ h-f-, l \.

2 0 '0'1 Cih.t-\,_ . ----·-

If you are no longer operating as a Day Care Provider indicate by ticking the box below

0 No longer operating as a Day Care Provider

Please sign and return the form along with your annual fee to Environmental Health in the enclosed self addressed envelope (no stamp required) no later

ll'"'lfc>. Ml MA at ~ -fotCamaloll

!fw r•·r- ('}ttkl,;a.~ Q ~[/."-<< .;( ..uv;uthcl-. H) r_,J. ~rcUr h'io

flU·-- Mo\· Mijor- 01·0-.1-

Dale of IMJ>edlon' RR-Inspecllon Rtquw.d: \'U NO llyn. R•IMJ>edlon Dale:

&Lr k.~ D/M/Vear

FEE RECEIVED lfynrewlpt-. --------

/-) Inspectors Signature: _~_)Qt"-=:....;..fl;..W=:..' -'--------------

l//r»yQre/(hildQt~idJ:t.,to/fOfmi/CCP1nsPtftiiDf\l)~ftUtMm _...,~

~ GOVERNMENT OF BERMUDA

M1nbtry of Health Depanment of Health

CHILDRENS ACT 1998

CHILD CARE PROVIDERS INSPECTION FORM Fadllty Name: NIKEISHA SWAN Re&lstratlon No: 95

Name: Nlkelsha swan :J,u€ 7) ;,. ~(. tJ' 2?1} Address: 100 Somerset Road, Sandy's

Telephone: 516-8141 Cellular: Other:

E-mail: [email protected]

CPR Expiry: 7/1/2019

On-can Person: Ro•anne White Telephone:

I OIILDIIIN -- WT OM 1. Happy

2. No Sl&n of Abuse

3. Oean

• OI'EIIATION

No p/ ~ .. ,.

4. Meals p<epared In CCP home Yes 0

s Meals bfouaht padled from home and stored In refrlaerator Yes p.- No 0 --~0~ J -6. Structured dally schedule /

V"' -7. AdequatHp;u:e for sleepln1 I

II. tntemal and external play area ~ 9. ~efrlaeratlon temperature adequate v I H\'&1IN£

10. Washes hands frequently i/ 11. T Approprllte appearance/dothln& ,/ I I 110M! SAR1'Y

/ 12. Doas are not ~lowed In house or play area

13. No loose wlnns '" l,);lol.- i

14. Toys are wofe

15. WaterquaUty

•://~rt/ChMcarrprCMd~nnfa/fofTTitiCCP~nspt'CtiOftbbn•r'"m •m<H JOIS

I HOM£ SAFETY CONT'D WI' OM

16. loJCic substanc~s are stored in illockl:!d cabtnet or above reach

17 Electric outleu covered ' --18 Doors kept dosed to outsode, kitchen. ;nd utility room

19. floors sound w/outsplinte<ed wood or cracked tile -1~~ _... 20. · ft<e extrnguish« accessible

21 Cribs, playpens In good cond<1lon- paint peeling jagged edgrs etc . -1'- . . j

----_ _jr -- - -

22 First aid krt equipped and atces11ble

23 Salety eates at stai" and areas w/out solid doo<S lor closure

-~4 J Toys are s;le and cleaned at least once a week

I~ A~u~;;;--t- 26. Condition of ceiling. walls, floo<S, w~s~ doors. fly meens

II HOUSEkEEPING

Home Is generally clt>an

Sieepll>f.a<ea clean

rlootS<Iean

Play area clean - -- -

--f-

--~ ~

/ -l-~1 .-..!-------·

I I

' -'----1

27

28

29

30

31

32

))

34

35

Samt;~ry ladltties dean and samtlled, poUtf!s~ children~· to1•et !lt'a1i. tOilet ~-...,.--~-~I· -Parents provided wrth daily rnfo on child

Condrhon of lurnl\honcs. washable. &ood condrtron. sale

Krtche n srnks clean

Kitchen/food preparation equipment ;)rea clean and adoquall!, rnatte»lble to dllldren

36 Condit ron of lur~hongs. washable. sood condohon . ...,re

II POliCIES

J7 ~o<k Child P<> rcv

38 Drscrplon~ Pohcy

40. Dosaster Policy

II fEST CONTROL

41 Pest Control effective. rodt>nt proolins. flee from insects

• MISCEll.AN(OUS

42 Garb;)Re conta111er~ sound, ck!an ;tdrqualr stor~r,<> ;Mea d<'an

~war.r/w.,r tf"' wat('f drspO .al

4 4 (att>rnal anao,

Gntctln,: A !'0-100 8 to- 11

l!:"i'((.~·t f( r•tdlJfr.- · e,rer••~"~IC'/fc 'f'tlt.'((ror•c

----------

t · •. " ft <( ,·,? . /1,1: If'-";

c 7ll ~ J~

Tot~l Store

Gr~de

D

t__, . ~--T--j-1

J..

/100%

'9 and undor

t.+·_..,.

ttemNo. Ml MA Cll flem1rlu Dote Ia< Com!dlon

l"•lt.:•rl<•-••:· au·c::·~ ~ ••• , .. '" .. n.. ~ . If

~ &tuJ EH recetpl # Laboratory No .

· -': ~o·J"rnt-~r1 r, r~ r or Rrn•1unr~

Department of Heath Central Government laboratory

12(l2_( y(rY

3~ WATER ANALYSIS FORM

How would you like to receive your results: email Cl mail o telephone a

If you would like your results to be malted to you, please print your name and mailing address clearly below - Inside box:

Email address:

~ Sro.t\.lV1YlCUI) e qov ~ b /)/? -u -........,


Surname

5woP~ Establishment/House name

@ seNo. 1.Q.Q

Postal Code

Y Street ~arne Q d ... 1rnu~se-:r oa

Contact telephone no.

Reason for testing 0 No specific complamt

o Complaint (specify)

~-up analysis e sam_l'ling Drogramme

Drinking Water - Type of Disinfection I Treatment

0 Chlorination - res Chlorine: 0 Reverse Osmosis

j

0 UV (Uitra.Yiolet Light) 0 Not disinfected/ treated

0 Other

Sample collrf&!1'a_ llo U o.1ti ~

~lnamc 1K e ts h4

Samphng Point

Examination Requested 0 Routine bactenological

0 Routine chemical 0 Othc:r(spec•fy) ____

Non-drinking Water 0 Seawater 0 Swimmmg pool

0 Well 0 Spa/JacuZZI 0 Other

Date and Time Co~~d f; ,;) 1\.J? 'I ) ,!1 }/'h

LJ For EH/Laboratory Use Only -~

.,

Sample reeeived at EH by Date and Time Received

Sample received at CGL by Q 6ash.r Date and Time Received 'l Ot:(. l-C \ ,_ 2 ~4.1-Premises type C V.Uddtar P Bottle sizt and type

1 oo "" 1- :t:hi Q Bacteriological Resulcs ~.

Chemical Results

Total colifonns / 1 OOml Co ~.n,_...o.u. v "b 'au. u.:,~ ~!~~~

•unoride mgn

E. coli / IOOml ' Hardness mgll as CaCOJ

\ Heterotrophic plate count /ml Nitrate mgll as NO_,-N

pH

..... .. _ - . .. . . . g g

This report reflects the water quality on the day of sampling only. The bacterial quality of Bermuda tank water Is variable -tank water should always be treated by disinfection before using for drinking and food preparation

(Senior) Public Health Analyst ~~

Date ~ Dec_ (f

~

i#~ I

?;.-~ I

~. ~~.~~~·.·~j ~l~:-~<; .-.; ..... .. / ' '-..>' •

I'.., r ., . c· • o, I ., r ,f r· '. f < - r'"" r -~ r- "9 ,. /' I r'· I ...,..,r;k ~·-. .• / • I - • ~~I~ I ...... I' I ~ '!,.\; · , ~ ( ~ I- i 'i ...... : 'v I .... r .... ' _; .'"-· .•

1'1 in istry oi· 1-!ealr:h Department of I..Jea!th



l lm b to tuufy that Nikeisha s,·van h:IS b f.! trl ;lpprm ed

a smtabk person to be a Child Care ProvHicr,

to be known as NIKEISHA SWAN wnh the followmg condltton / s:

1. Maximu m numhl'r of pr<' school age· chiloren is· 3

2. (Juld c:m· ts prm•tded at : 100, Somerset Road, Sandy's MA 04

Registration#: 95 Issue Date: 3rd January 2018 £xpi1 at ion Date : 31 ~~ DerembPr 2018

\ ... J""· •· Ill ~· · J~ . . -:'~ •,.f . ,~ ~ .. ~\ ~ p -... -\

·----------(ilief Merliral O[[JCf'l

~~-No. Ml MA CJl ~ ll«<e '"' Comcllool

.-

-----:-

---------------- -· ----·---·- ---···--·----------·-' -·· ---. ·---r--·-- -··-·--·-------·-·-------- -· ---

' . -·-- -- --~--l---1----··-- -·--- -· . --------·-- ---·----· -·- _1_ ______ -·-·-'

·-----~ .. -- ---------------------~-·-----I

-----------------· ---· -· -- --·------------.-·----I ' I

----=r-}.-~- I ~-~~~-- - ~-~~~--~--~--=--~~~----·--·-----~-=----·--· • ' : : I I

-- ..:.....--------l. - ---·· - -

-------'-·---- T ----- --

' , _ ___. I . . ~ .. ·-- -··· ---

--·-'-·- _J. ________ _ -------- ,----------------

... - -1'---- --- --

- --·-------,- -- - ------~----. --

-- ----·--------.. , __ _ MA-....... - Cll---

Date of lll$fledlon: R~t-!Mpft11on lloqulfed: YU NO II yn, Re-!Mpft11on Dote:

FEE RECEIVED: II yeo recellrt ..,mber:

0/M/Year

lnsp~ctors Sisnature: -----------------------

1·/JD~yCart/ti'Miclc~r~pt~ldtl•fliO/fCftf't/((F.n'Pf"'ttCn~bnUorm fltwSf4 i t I ~

' GOVERNMENT OF BERMUDA Ministry of Health and Seniors

Depanment of Health

CHILDRENS ACT 1998

NEW - CHILD CARE PROVIDERS INSPECTION FORM i ---····-- ----··-·--·--·- ·-· ...•.. l .. ______ - ····--··-·---i FacUlty Name: . Realstratlon No:

I -----· ....•..• ---·-- ______ .l....:..::..__ -·--- ------,

NIKEISHA PAULETTLE SWAN ~ N~ ------·------ -- --·--- -1 1 Address: 100 Somerset Road, MA04

I ----·-~-·----- __ .._.

Telephone: ! ·-·------· ! E-man: [email protected]

1 Cellular: 516-1141 ~ I

. - ····i I. ·---··--•-·•···-

-(' :. Cl'll-~ . -·· ..... --------:-·-1 ·····-··----·--·-·r-

i I

--~- -------..!--l On-C.II Penon: Roxanne White 1 TRiephone:

• 1.

2.

3.

I

4.

s 6.

7.

a. 9.

• 10 .

1L

I I

12. ,. 13.

14.

15.

~ - Wf - DM CHIUIIIfN I Happy NoS~~- ..............

I Oean

onw•~~ ~-t-~=-~ ! I

oPatAllON Yes 0 I Meals ptepared In CCI' hom~

Meals brought packed lrom home a .. .. . _ __ ___ _ ~ - -

Structured dally sdledule

~D 0 I ; l - ---j----1 UlliiSloro•olnr~mJI~lgr lC> l..l No 0 +-~

Adequat~ space for ~Ins

Internal and ext~mal play aru

Relrlaeratlon temperature aclequat~

tmlfUIE

Washes hands frequently

I '

I : I l .-~

i

·- -,-· Appropriate appearanc:./dothln· I "'~··IH"-C"fUV\1111'6 J j l HOMESN£TY

Doss are not allowed In hous~ gr play area

No loose wiring

Toysare$llle

Water quality

l.//~yQJt/ttnldc~'~PfC"t'idtt~lo/ft'tms/CCrin.sDfC11tnblfnltfctm Rf"f1W!ct;01S

I HOME SAFID COHl'D

16 I Toxic sub.tances are stored In a locked cabinet or above reach . ---- -17 J Electric outlets covered

IB • Doors kept dosed to outside. krtchen, and utility room - -19 Floors sound w/out splintered wood or rrac~ed tile ---4--- --20 Fire extingursher accenible

21. Cubs, playpens on good conditron pa~nt peekng jagged edges etc

22 First ard kit equipped and accessible ------- -------23. Safety gates at stalls and areas w/out solid doors lor closure

~~WI _PM --1 i

--±~ ~-! .-

t- !_j I I -

.~ Toysaresalea~atleutonceaweek ----- !. H-25 Ad<!quate Vl!ntllatoon +'---~---; 26. - Condrtron of cei Ins. wall$, lloors, wrndows. door;,l~creeos j j f • HOUSEKUPING

27 Horne is aenerally clean :. __ i --~----' r ' 28 Sleeping area dean

29 Floors clean

30. 1 Play area clean

31 Sanotary lac otres dean and sanrt11ed, ponre~ choldoen's' toilet seats, toilet

32 Par~nts pro-.ded woth daily inlo on child

33 Condotoon ol lurnoshinns. washable. good condouon, sale

34 • Kl1then \ tnb tlcan

35 i Ki;rt;;.;iii>Ori preparalion I'QUipmenl area cl~an and adequate in;.;es!ible to children

36 co..,dlltl\1\ of furmsh :tli\~ w..t~ h~br~. gcod cond'tt~n. Ul~!

I POUCIES

37 Si<k Child Polley

38 Oisciplrne Policy

40. Disaster Polrcv

I PEST COHTIIOL

41. Pest ControleHec11ve, rodent proofing. lr~ from m~s

" MISC£LI.ANEOUS

42 Garh~r.t•(onto:unt"1 ~ ~ound. dt."an, adequa1c. storar.,rart•d d~an

43 Sewolft.•/W'f'\ll• w.,h•• di!.poi~l

4 4 [1r.1Cfnal CIICIU

Gncfm,: A 9tl - 100 • to-n c 70 -79

To1al Score

Grade

D

I I .

/100%

69;ondunder

Item He. Mt MA Cll tttomlirkt Dolo lOt CorrocUon

1"'1 bou

.:; 1""1 ·111 /. " ";'" 1 ~ :1."'"7

. ,. ....: ,,,. r

., • ,. ill ~ ~ • I

.:; t:"-A iJ C.\ ,._.Ill ol,_:lll Cl ~

/

-- -~ermuda Government

~~inistry of Health, Seniors & Environment

Department of Hea lth P.O. Box HM 380 Hamflton HM BX

Reprint '117/2017 12:44 PM Cashier 2228 '/Ref 0225004211 Reg 0225 Tran No 3995 :ash Report: 170717-01 for 7/1712017

2 - Department of Health ursery Schools 511.32170 3yer Name Nikeisha Swan Jtes Child Care Provfder 3lidation Number: 002333

$25 .00 ::===================================== Jta J rsh · --

Have a nice day!

$25.00 ($25.00)

J

r:m~ BasicPius CPR.AED. and F!r~t A'd fo· Ao.; ':s

k\\%~i:L~-- --has su=: e:ss• ... ,, ::.-:. eto:: a:,· : ::-:-e:•-· 1 ~..,.=-*'=

I he recu•re:J lllr.t:o:/.eo;f' I '"C' '" t":".•::! .tt ":.· !• ,. : -:;a-

~~ -- ~ hs1 =~:s.·l<l' MEDIC• FirstAid

··-··--· __ , __ -=~-~~:"11~-#tf.-. - ~t: _1.!-_l _ ----

--·------ -- : ;.~z: ~ -- --· - --· --· --- ~- _..:."' __ ?_ --

. --.,. -..... -.. --- - - - 0 - -· .,.._ -·· ..

---'": -~ -.. .. _:. -- ·-· -... .. . -- - -

•

(

~ Department of Health - Envirorunental Health • CHILD CARE PROVIDER APPLICATION ........... ..,.,.,.

PLEASE PRINT CLEARLY IN BLUE OR BLACK INK. Pl(:ase r(:ad the auached cheddist bc:fon: complc:nng thts form. Once complc:tc:d, n:rum the form to The: Chief

Envuunmc:ntal Health Officer, 6 Hermnagc Road, Devonshire FL 02 The maximum number of Drc-achool children nenniued to be cared for is three

PART I. GENERAL INFORMATION

?v(jddlc: Name: Last Name

Age Gender (Ml';le/Female)

~ Suc:c:t

Email: (\1 Home Number Ahcmanvc number

s What language IS spoken in the: home l:i.J.1!ngiish D Ponugucse 0 Other

(if you ~~rr non-lkrmudiVJ, pkue 11tt11ch 6JKIU6al krter or work permit)

Nationality: B1lcrrnudtan 0 Other

If Bermudian have you ever lived outside of Bermuda? 0 Yes (how long __ years) BNo

(If yes) Address I City I SUite/Counuy

- · (•1 .. 1127a.5333

Envltonmental Health Metro Building. 6 HermHage Road Devooshlte, FL 01

P.O. Boa HM 1185. Homlton HM EX. Bennuda

F ... I•14411232•1D41 C!-..i: rnvheatlh@gov OOl

Zip Code:

I EDUCAT! ON (S<"h....m. f'ollrt!:<"•, t'lc )

c:- !"\. I t ' .. ~ r ,

.§_tart Date t End D~tc 1 S(-p\ l('"\1!;~~

\ . - 1(~ ~ f '~I 1.. ~ I (

\ .... -~-; .-: ...._, - ( "\~ I .. ~~- ~C..,O , ' 1 ... , ~ '1\\n . .:

~- ... -:r-~.!..11 l •• -~~~~ : { ('.\\ -=-~~~ ~ .. , .ii - ·l:;r~ t '~ . ~- ·(~\~~ Date Started CURRENT EMPLOYMENT ' 1 I C(lmf>illl)'

( l 'nlc/Posmon)

Companr Date Staned/ Endcd (fide/ l'mmon)

rT,an.., 'II£> n \ r\ -i·r-r. r h 1- ,.- L, \-'1\ f". ~rY1 \{ 1.. '- • -"

M~<>~ ~- Q'-"'~ • ,\ , '""' ::"lr~.\~

---:::7 -- If' • • • -~-

' •. , \:'n ·tt1.'lp h0r• , I' ::± h4 r;.c. <"'~1~ r· .. ... ~ " \ , .... u.. c .... -! ... _. ..... . t .. c ... ,., I :- .- .. "' I M\ ( 1 < C ' • n I .r. -::\'Tr-c·h~ L,>rt· C'r ~"-.• ,C",.(' \ •. l l•' • . •. -,!h '! ·· , J Q ualtfic:uions: ~·\caJcmic/Profcsstonai /Tcchnical) Copies to be attached

f-.,.,- c· C -{">..,'-t_ •

I -

I PART II. POliCE RECORD & CHILD AND WELFARE CHECK I Ho\\ man\' p eople ln·c m \'OUr houscholdi' .....;,;__. Ltst all members of I'• JUt household, date uflnrth and rclauonshtp 10 \'OU. ·\II puson~ 18 r ears and older mU! t ftllm a l'ohcc Hdca•c l·orm.

L "'""-

·c tl .

JNa'me ·""

r I '

-~

- ll ...... :.. { .... -~···-l-1 .! ~ ~ .. ~·.! J

' I • ·• r--~ :!:5!.-"'!"1!".

~·-=' ~ -- Ll- J l ~~~~~ I

. •P.&T·:In..AJ)J)PJJION.tU.!NBORMA.TiaN t. Any c:onVIcllons in any crinunal or ovil proceedings in Bennuda or ant ocher jucisdicrion? 0 Y c:s ld-No If yc:s, give= dct:ails:

z. Have \ 'OU ever been referred to Child & Family Sc:rvtccs? 0 Y cs a--No If yes, gwc details:

3. Have= you been refused rq?juntion to act as a fo~tc:r parent? 0 Y cs ErNo 1f yes, gwe details:

4. Has a child of yours been chc: sub~c of action under child protection n rocc:dure.s? 0 Yes ii-No If yes, give: det:ails:

5. Have vou been involved 1n an all_egcd inddent of abuse or ne!!;lea of a child? 0 Yes a-No If yc:s, gwe details:

. PDtr W; em.nD ·eMIE· IPRC!l.WDER~INH0DM.<m0N ·~ ~.:. The maximum number of pre-school children permitted to be cared for is three (3).

Address(#, House Name)

Do yau have cPR & F"trSt Aide Certification? ~<rYes o No

On Call Person

Strc:et Postal Code

You arc: required co have: an on caD person in case: of emergency. They must be 18 years old or older. They cannot be a registered provider already caring for children.

Who will provide substitute care in your home? (They also need to be: CPR/ First Aid alified AND fill 1n a Police Rdeasc: Form

rtrSt I.-.-,___ ~

i.. ss (#, HOuse Name) e • ""''" • ' Postal Code

--- --·, L

~ I Age'

~

;,. -·

- ....... --- --------

\\'hat arc 1 he days and hours m wluch you plan to prm·tdc child care 111 your horne~

' '• \ 1\ '-.1 · • - • · • ', . ~ • ·• • ' '~ _r \\'hat age group u~ll'you care for~ \ I ,,

.. . , ' .. !

.\rc you nou· p!1wtdtng chtld care in your home' o Yes oNo I

Docs anyone 111 your household smoke;. D Yes o· No

Do you ha1·c any pel s? g·Yc5 D No

If yes, hou· many ard what k.tnd? : ' l CL\

Pnsuo• mar I!!: ~!m~id~o:d IIDfil Ill lltm•illl' dar nn: h)' ll:a~!'D n( iofillllil)' ill· btahb •!t dow aim•~:. Please rciUtl\ the completed Annual Day Care Provider Certification· by a Medical Practitioner Form ccni ~-ing that you arc lit to pro1·idc day care, ha1·c passed a drug lest, and arc cuttL·ntly appropriately . immunized. I In your own words state why you should he an applicant lo be regislcrcd as a Child C:1re PrO\·idcr. List any specific aehicvemenls, personal (JU:tlilics which would support yuur applicutiun. (Please : allach a piece uf paper if needed). .. - (~ ( 1 ~\i\\ (J · I,, C"'-(l , , • ., I I ~~ c ~_ ~.( .(' "' !::ll" ~ ,,.

\

C'A. '..,., \ :>\110' , .. ,_, ~ "' ~ ) r n. . (" ,. \ L-. \ (' ! ( J, ·-, l- •D- t· ~ { ·..)

I , y - I<""~\..- -. t. ~ \- )/ \' . "f- . •(_ \ - . ,• '·P ....-,-..e l ' 1 """11:'\l'tG-\,~ ..... J --*"(' \;rt' t ~~ ·If- • ()~ .. eh·, \d "f· ,.., . -:[ o -- .. -..... :-... c.,\ ,,\d. ~ \ '\ ... ,("\ ~_) J?~ ,. 'c,,~) -. C':'-· 0 s-v \.. e o.. • .L., c \ .,.:;.'\c\ \\. ~ ~ ...... , .. I.I.."~V~ . 0...~ 1\:. -1 \ '\ r

__) -~ ..:. '"-; V\.L~y'l t~•,, ~ .... -;:~ ,...,, n(•t ·rn~· ('1 ~ .. tt..'nl'l- ' I

f'" ' ·-... J .. -' "-lV , , ..

• .,. l.t'.t....vJ 1::<5 {) 1-Y' (:' n I~ r"'Ylc.cl ~ ~r.:\..~ ; Pc-, ~ ~ \.\ .. ; • .... r • - t } • ).>. J , ,. r-, ,.. .J. ~ .. ·' . I r ' ~I 1"1

' J • 1 ... <Y::~

-' I J •'

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. .............. \ .. ~J ... -: ~ . -. . . ~ .•. t ' ' "- ' • , ..... 1. \J'. ,. I

- : . ~. -I . I

L_

I PART v. CHARACTER REFERENCES I \\"nnen l.haracrer He fcrences arc ro be pro\·tded by the below mcnooncd indt\'tduals and anachcd 10 the apphc~uon nmh people musl be unrelated to you. _-\t least one of your rcfcrcocn must be able to teU us about your character, repuratmn and suitahilny to work wuh children. Thts person may be a fncnd, neighbour, cletj,')'pcrson or anyone else who knows you well. 'The second reference mav he from a former employer, lcachcr or the parcm of a child ,:ou ha\'c cared for. If \ 'OU haYC not worked or cared for children before, lm another fncnd, • or unrdatcd .

Declaration: In stgmn~; tlm apphcanon form, I con~uu fur the Dt·parrmcnr uf llt.thh w tunract the rcle1 am enuucs and mdn uluals Ill \ cnfl tht: tnform.JIIon prondtd on tlus apphcanon and 10 make en<jtut<s rdaun~ 10 that mform.tUun as rcasun~bll' nc<<:ssan·, solei~·

for the purpose of tins applrcauun ami 1he manucnancc n f am fC~'lstraunn tf ~r:mlc<l I lhcrcfurc. authonzc thc5c cnnncs and mdi\lduals tn pa~s all such mfonnanon to me l),·parrmem nf H cahh.

!'-tgnamrc- ffi\' ti'1A="";:.... _______ _ Dale- r~_:"~...QII.:•\ L..

llemHo. Mt MA Cll letnlfb Dote rcw Conecllon

No {Ht eK-hr~~W..She r j /lll .f1 rst' Cli tl k1+

101·-- MA·Molo<- Cll ·~-

Date ollftltlftllon: R•tnopKtlon Roqltlfed: Yl5 NO II yeo. R•lnspftllon Dote:

FEE RECEIVED· tfyesrteeipl nounllcr:

0/M/Year

Inspectors Signature: ______________________ _

IJ~.,C,rt/ChMattptDYtdttltlfaJtorms/(CP.ni~»ctlonbt.an._lottn .... ..., ,on

i GOVERNMENT OF BERMUDA


CHilDREN$ ACT 1998

CHILD CARE PROVIDERS INSPECTION FORM Facility Name: lltE KIDS CORNER

Name: Shirlene Talbot

Address: 12A Field VIew Lane, Pembroke

Telephone: S19·3688

E·mall:


()n.Call Person: Chantlce Butterfield

Cellular:

Re1lstratlon No: 094 --'--

Other:

'i o;..

Telephone: 519·3688

®

I CHilllflfM WT DM rnt 1/ 0 o 518n of Abuse v'/ 3. Cean V -----

• OI'UtAliON

4. M"als prepared In CCP hom" Yrs 0 No V

s Meals b<ousht flllcked from home and stored In refnserator Yes o/" Ne> 0

6. SlructUfed ~ scheduf" - / 7. Adequate spa~ for sleeplna ~ 8. Internal and ertemal play area / -

9. Refnaeratlon ternpen~ure adequate

• HYGHNE

10. Washes Nnds frequently ,/' u. I Appropriatuppeara~dothlna It/ -. I IIOMEWITY

Oop are not ollowed In hovse or pby area

11d No loose wlrlna

;;:~d Toys are safe

Water quahty - -- - ~

IJ/OI'r(are/(bildafrpJOVid~nnfo/1omuiCCP~nll)tctiOnbbn._form ...... tt?011

• HOME SAfffi CONrO

16 l lo~ic 'ub~t~'==~~n a locked c.abj;;el or a_bo_ v_e _re_a_c_h __________ _ ~ -~ 17 t Elettnc outlet~ covered

18 Door' kept do~ed to oul~lde, kotchen, an_d_u_lo_ha...;v_r_oo_ m _____ _

19 I Floors sound w/out ~plintered wood or cracked tile --' --- ---

20. Fore extinguisher acco,..oble .,. - --

21 CritH, playpens in cood condition- paint ped - N....!:....Uflnc,u r.ll.tv

inc iocced edges etc J ....... - ~~-

22 first aid kH equipped and ~ces~lble

23. Safety gates at stairs and areos w/out solid do· ----10rs tor closure ·-~~

24. Toys are ~fe and cleaned at least once a wee -

k -I 25. Adequilte ventilation

I 26. Condition ~walls, floors, window,, do -- l :~1-ors. fly screen$ - - - -----• HOUSEKEEPING

I 21 l uome~geneti!Uy<lean ~ - ·---

211. Slct>ptnB area dean

29 1

Floorsclean

---~-vl I -~~/1 J

--------! -

1 "" ...... . ~~--

i ~ ' +--I 30. , Plily area clean

31 Sanllary lacolilie• clean and unillted, pollies. children's' toilet sealS, toilet

32 Parents provoded wolh daily onfo on child

33 I Condition of furnishings, wa•hoble, good condition, safe -1 - ---

34. KIUhen ~tnh dt.•.an

35.

3b

~t~-1 kitchen/load pre~tion equipmcntilreil clean ilnd adequatr,lniltceuibleto chlldr_e_n ______________ -l-, ~ ~ Condollon ol hxnishing~. wa•habt<>, 8ood condition, safe V 1

• POUCIES - - -------.. _ ...... --i 37 SickChold Poli<y ~ • rR· -- - , v 38 Discipline Policy -~ - _ -- ---• ~ ~ -- ---- --1 ·7 40. Dososter Policy

I PEST CONTROL

~I. Prst Control effet:tive, rodent proofinc. free from iMects

a MtSCtllANEOUS

4~ G.tllMJ:t•cnul.tMII"I" 'AHnul. th<.w. tKfl'fllloltf' 'tOfOlf'f· ~u·a clran

-IJ :!wWoll:tJ'/ Wirtf• walrr rl~JXHa'

lll .:t f •h'IIIJ • .tft•ol'

Grad Inc: A 90-100 fl .o-n

/trur(.;,tl Kt- lc:'tJ:rvcn<'f ''f'l'cHc,rl~' • • ...,.("1 err ., • ·~~.-.

'1/ec.~y- ( (JVI-h-ol

c 70- 7!)

Total Score

Grade

D

v

v

/100%

69andunder

"'c' nd

ltnnHo. Ml MA Cll aematb Dole for Corftdlon

1 N-~'rtllltUt-"t:U~rt•t"'-tc ,,, ... ,,~.,. t/C(t··r~~rc1 ,,. ... ~r-l'Cr"'t'' ,..~.•r }I'

(ij EH receipt # Labonuo ry No.

-~ cov(flNMt N T or l tAMUDA

~ar~nt ol Health Central Gonrn....,nt Laboratory

WATER ANALYSIS FORM

How would you Hke to receive your results: email 0 mail o telephone CJ

If you would like your results to be mailed to you, please print your name and mailing address clurly below - Inside box:

~~ (p._L d.l .. L'('( a., -;a! /,of

~.~


Sumo me

-tl-.< /tdJ Establishment/House name

l2A House No Street name .., vtt - J"rc Parim

Posllll Code Contact telephone no Sampling Pomt

Ruson for testln1 0 No specific complaint Eumln1tlon Requested 19'1'i:outine hactcnolo gical

0 Complaint (specify)-----0 l)llow-up analysis

'l!f'Routine Slmplingprol'!mmc

0 Routine chemical

O Othcr(SJlecify) ----

Dri•klll& Wat.cr ·Type or Dlsla(ectlo• / Treat-•t Non-drinking Water D Chlorination - res Chlorine D Reverse Osmosis D Seawater 0 Sw1mmins pool

o UV (Ulm-Violct Lisht) 0 Not disinfected/ uutcd D Well o SpiiJacuui

0 Other D Other

Sample collected by /JA ~)~ f j h ,vtJ"i f2 Date and Time Collected 17 ;;,_,. 2 ( . 'Jd. T I II ; Jr-( For EH/Labor.tory Use Only 1

Sample rteelnd at EH by D11e 1nd Time Recelnd

Sample nnlved at CGL by a ...fuclu Dlle •nd Time Received 2..2 ~-v- 201, 1 r. I.W.. Pmnhnt7pt CIM.:tJ U.-i I~J:uj fr.ift-1· tlv." Bot tit stu a ad type 2... X I

0 (") ""' L J::l.u ·o

Baclerlologkal Results c•emkal Results Total colifonns 1100ml

>~20 Chloride mgll

E. coli IIOOml >"&0

Hardness mgll as CaCOl

Heterotrophic plate countlml Nitrile mafl as NO.,-N

pH

Water sample meets recommended bacteriological values for drinking water: o Yes l:l"No

This report reflects the water quality on the day of sampling only. The bacterial quality of Bermuda tank water Is variable - tank water should always be treated by disinfection before using for drinking and food preparation


r' .•

•i'J"\ I -. l

' IJ •• i ·1 ~ ~·n

\lScJ , ?101 " ~ - ..

; L· (''• ' ?11.s,.•, t:·J I ~p .• '?A lf' JO! IJ• lj ~ ;::>,l<:t5?.--l: s:JO/l

• J j_ ... ~ :;'J'?( q ~ ~ ;9·· ·. '? ' ~d

C! l; _;s ! 1:1~)· J!-3: ,'1~1111

'' · =;p • ! ' ~ • ~~ 'l

'C7/Zl J;, - --•Fl ~l ~ "~ j;2J t>C.1 I 'I cJ! ~ '7 ~il~ ~.:<l 1 1t~'' 1 ~ 1 .t, ~J >j• ,~ [_ 'l 7 J~ 'l

..lLI\- _j d3<:J

I _.,.

GOVERNMENT OF BERMUOA

MinistrY of Health Department of Health


Children Act 1998


NAME Shttlene Talbot

DA YCARE NAME THE KIDS CORNER

ADDRESS 12A Field View Lane Pembroke HM 18

PHONE ~688 51b-Co8;LSI CELL 54:9 3U5f!~ 5( b-t825

EMAIL

How many people live in your household? I CPR expiry date 12/1/2016

-~ On Call Person and Phone Number

LIST EACH CHILDS NAME AND AGE NAME AGE

- -- 3 .. --f- tir t

r . ---- -··-~-


D No longer operating as a Day Care Provider

"""' Ho. Ml MA Cll I~ Dote lot Cooncllan

C..Y--u 0 e.c..--N· - --=--

I· --~ . - ·. ..... - ~ QJ.S ye5>. - ,.. .,, .... (H) ~~-

~- (FJ .9.'-(~-

- ~---- --

~-

·-- ·--·-- ..--......... ,---··-- ---·---------------·-----·-··

-·!·--~--f.-.-...··--- - ·-·- ... - -· -- -·----- --- ....... _______ _ . i -....-----··-----·-· --------~- -----------

Ml ·-...,_ MA•MIJor- CJI·--

Dole of 1"'.""'1on: \ l JAJ-1 '2-o I <..o , R"'I...,.Uion 11-lnd: YU HO 11 ya,ltotolmpectlon Dote:

FEE RECEIVED: 11 yn ttce1pt -.

D/M/Ynr

~~~~ lnspedo., Signature: · · -l' 1/JOayC~If'((hlldUirf'DfCYiidftlftfO/,efmi/CCF~lPfCCCftb&lft .. fOfm ~-;C'l'

i ll ._j 1trJ ~OJ 7

GOVERNMENT OF BERMUDA Mmistry of Health and Semors


CHILDRENS ACT 1998

CHILD CARE PROVIDERS INSPECTION FORM Fadllty Name: THE KIDS CORNER Re11lstratlon No: 094

Name: Shirlene Talbot

Address: 12A Field VIew Lane, Pembroke

Telephone: ,...'J; OU.I of~c<S .J.. _

E·mall: _ .e::.l~- lo~'OO -=- -N~ Con.{-o..c...+ ....:sv-

Cellular: Other:

CPR Expiry: 12/1/2016 N~ ~.,t..f>d~

On.C..II Person: Chantlce Butterfield Telephone: 519·3688

• CHII.DIIIH

t. H~ppy

2. Ho Slsn ot Abuse

3. Oe~n

• Of'EMTION

4. Meal$ pr~red In CCP home Yes D No U 5 Meals brought packed from home and stored In refrf&e~tor Yes g Ho 0

6. Strudurl!d dally schedule

7. Adequate space for sleepin&

...!._ lntemaland~ema'ij>l~yarea NO - . t;;c fe1Z..At- -p I A-'4 a a l!'.a ... .A-Te

9. Relrlsent1iiil tempe~ture adequ~te

' lmiiEI'IE

10. Wuhes ~nds frequently

11. I App<oprlate ~ppea~nte/dothlns

I HOMESARTY ~

12 .. Dogs are not allowed In house or play area Nn Doc.~ P - -J.

13.

14.

15.

No loose wiring

Toys are sale

Waler quality

I ·J/f»'tO••!Ct·::.,Urftl't'YiidtftAfo/fcnn$/((~.,~tt1:'11.b&lnUo•m

WT OM ./ / -·~-

' r -

-·. -----

..,.,... --------

-· ... ---/ -

I 1/' I

/'

v

' 7

-.. "'.U;GJ!.

• HOME SAFETY CONT'O DM

116. Toldc substances arc stored ~n a lod:ed cabinet or abo\le rcil(h

17 Eh~ctrk outlets covered ~- -------------

18 Doors ~ept closed to ouUide, k.tchen. and ut •tv room

J9 Fl04:1rs JDund w/out sphntered wood or craded hie ~- - ---20. Fire exlingUishcr acccssrblc - I --- -----21 . Cribs, playpens in euod lOndihon- pamt p~eling Jacg~d ed£~1 etc r •· · ·.:: r· 1.

22 First aid kit equipped and accessible ___ ,.....____ 23 Safety gates at stairs and areas w/ou1 solid doors lor closure

_ __. I

24. Toys arc sale and cleaned at least once a week .... 25. . Adequate ventilation ~~~~---~~---26. Condition of ceiling. walls, floo"· window>. doors. fly i<reeni

II HOUSElllEPING

27 [ H-ome is generally clean _ - . -- - --~ -T -, ~ l_sle:r.llngareaclean _......______..______ - _ .... ~ - --d-c « :l' r. r _ .,_

29 I Floors clean

I 304 j Playafea- c- le_a_n __ ~-f_~~--_ ~.::--:~-~-- .t --~ ~· r-l-;: It~" ,_l-t!J ~P-QQ ~ ' 3l J samtary faohttcs cleoan and ~m1ued , po1hes. (hildren 1i

1 lollet w~•s.~ io;let - ~ ' .r 4 . ~j Parents pr~ided w1th daily tnlo on child __ -----1-- _., J~ Cond;toonollurnis~ng~~~~ble, goodcondition. sale __ _ _ _ -~-- ___ .L' ___J

~ ~ Kitchen s;nks clean I I I 35 __ , ~itchen(lood preparation equopment arPa clean and adequate. onaccesslble to children

~~ Condilion ol lurmsllongs washable, &ood conditio~>. sale

II POUCI~S

37 S'-k Child Pobc~ r -' • 1 , 1 '

38. Dis<iolinP Policy I I I r- I 1

40. Disaster Policy • • _ _ _ _ _ _ _ • _

II PEST COfmiOL

41. Pest Control elfethvt'. rodent proolong. free from insects

II MISC£LlAN£0US

42 ~~bar.~ cnnCtuntl ~ wontl~ dt.•tln. ,ld••quaCt•, !..lor-•~t· dtl'd tk• .. rJ

4 3 Scwar:e/w<J:51 tt w:ll('r rJrspos:~l

44 l•h•rnal ilfPil\

Cir.Mllt!j: "' 90 - 100 II B0 -19 ( 70-79

Total Score

Grade

b

o/

/100%

69and under

; tlemNo. Ml MA CA lemarb D11 .. for Cmrectkm

j.- ··-· r-·· I- ~ .. , --.J,

-r

~- _r

H5 I'"""C..L ru-: !> J/1 d ~c. ct -<'' '-' Q_ --.fro is

f, .- r S-en~ .::i s a+-J~,- ~b- ,+.o--r. Sh e.

ii

GC)VEk_f-..J!vi Ef',ii. ()F Bf:P,f\'ll J[) J.:\ l""tini~ try of Health, c;r,d Seniors

Department of health



This is to certify that Shirlene Talbot has been apprm•ed


to be known as THE KIDS CORNER with the following condition/ s:

1. Maximum number of pre· school age children is: 3

2. Child care is provided at: 12A, Field View Lane, Pembroke HM 18

Registration #: 094 Issue Date: 3rd January 2017 Expiration Date: December 31st 2017

• I ' I

• I

,. ' t-... ~ . A

. •• ;.=:..;, ./.' , .c r •• -e. ''-' , ~d~ ~ ~ ~t,·.......... ,...r-- •\.OV


'·· - 1'-· 1 '';--"l lr - ,. II I ·: · 1;i.:. .J rru1 ,!j;,; ,- ·1r.:.l r, I t- 1 -· ... • . •

II ! •• 'I •I, ~ 11

I L..' -~·~· J r

• . r

Phone 441 278 S333

Name Shirlene Talbot Address 12A Field View Lane

Pembroke HM 18


QUANTITY DESCRIPTION Balance Carried Forward


DIRECT ALL ENQUIRIES TO: Verona Darrell

441.278.5394 Email: vdarrell @gov_bm

.. '

TOTAL

INVOICE

Account #: CCP271 Invoice #: 16094

Net30

AMOUNT

$0.00

$25.00

$25.00

MAKE ALL CHEQUES PAYABLE TO ACCOUNTANT GENERAL Mail to: Environmental Health P .0. Box HM 1195 City of Hamilton HM EX


----~---------

Bermuda Go·.,ernmer.t Ministry of Hea 1 tf:>, S'eniors

& Environment Department of Health

P.O. Box HM 380 Hamilton HM BX

Reprint 1/16/2017 10:16 AM Cashier 2228 T/Ref 0225001734 Reg 0225 Tran No 1527 Cash Report: 170116-01 for 1/16/2017

22 ~ Department of Health Nursery Schools 8511.32170 Payer Name Shirlene Talbot Notes CCP 271 Validation Number: 000564 $25.00 --------------------------------------------------------------------------------Total Cash

$25.00 ($25.00)

I _ Have ~ nice day! J

11"" Ho. Ml Mil C11 lite ... <'-

...,, __ _ Mjl . ...... ....._

Dote of lnspecalon: ~e. Inspection ~.,...Ired : YU NO If yn. Re-ln_..lon Dole:

0/M/Year ._dJj.ll f_. I ..1::._ - _!~E RECEIVED: ---- ... _. __ _

Inspectors Signature: ~!J!'J <"' .1(. t //Da~tt/C~ilfHI'~ft""'o/fOtm•/CC'IM9ftte»nbll,.Uon,

IIYfl...alpt"""'lte"

Oate ,.,. Conmlon

CII · OIIicol-

.""""'*'8 JOI\

(i GOVFRNMENT Of 8FRMUIJA

Mintslry of Heallh

Department of Htallh

CHILDRENS ACT 1998

CHILD CARE PROVIDERS INSPECTION FORM Facility Name: NEll'S PLAY GROUP N ~ '1 'j-/2fl/1\ Registration No: 181

Name: Antanella Tucker

Address: 24 Tucklyn Terraces, Cherry Dale, Smith's

Telephone: 735·3266 Cellular: Other:

E·mall: [email protected]

• To~p,_,, DM

"""';~Z:!t.•OQ~·OO-noM-. M IA..L WT

11 Toloram n·1~-o-:-7\·:~ ' L.«WV --- - --· CPR Expiry: n-\1 J.t J (~ /11_- - I .fA ---- ------1. _/' "·Call Person: Mo Y :"!.~~- -. . - _/

0 - - - - . ---- _/ r i.~-- ~;m · ···--· __ --~ ~o Slsn of Abu.., -

j, Clean

I OP£JiAllON

. ~ -·kM_!~S P!.•!'!'~~ ~n ~!-_!l_o_m_e- - ___ -· __ · -----~~.,.-!:! __ -_No 7 ·-_-_-_ =-·-~ -+ ~eals brousht~~_!!l !'!~home ~~~~efrlsera!_!>~ p __ N~£"----- - -1 6. I Struct~d.aily schedule q,b '6.....d~~---_

.~C:~··~~for~-------.:A.Lt1 ---------/ A./A

-l V""' Internal and external pla...:.v_a_re_a _ _________ _

Refrlaerallon ttmperat~tre adequale ----------......... "'--• HYGIENE -- - - --· - ·----··--·--·· .. --------·- - ----- -· -

W~shes hands frequently ~

11. j'A;;o;;iateappearance/dolhlna ·----·~-=--=--==-==-----------J V" 10 .

• HOME SAfElY

-·· , • ., ..... « .... N ~"!J "'~<>! - _ _j 15. I Water quality :=I 12.

l.l.

14.

f ./ICJ'(Ott/C.hlldCITf1N~~/fOfMt/CCF-~r~~IIOiti>&IMtcwm Kf"ri'W'Ct 201!»

I HOME SAnTY CONTO

~.

1

I

5

-I

20.

21.

j Tolle ~ubst;nU!s are stor~d In a lotked cabinet or abo11• rea<h

Electrk: outlets conred

Doors kept dosed to outside, kitchen, and utility room

Floors sound w/out spHntered wood or a a eked tHe

Fife ellllngulsher a<celSible

Ctlbs, playpens in Rood condition - paint peeling jaaed edges etc ---- - --

22. First aid kit equipped and accessible ~Lt 23. Safety aates at stairs and arus w/out solid doors for dosure

'a Toys are safe and deaned •tleut once a week

~- Adequate ventilation

.

~ -·---- -- -- -·--- - -------- ------- - - -26. Condition of teilin&. walls, floors. windows, doors, ny saeens

- · ·-----r--~- -- - -___ ......... ____

I HOUS£KE£PIN6 ---··---------·---· ------------- 3±-"1 _27-~ ~ssenerallydean $%6 Pt:?f .,.- '9f'l.ccl ~- ----- ____ J

28. Sleeping area dean N 0 f hen. C4A o/:2\ ] 29. Floors clean

30. Play area dean --- __ _ __ • · - _

31. Sanlt•rv fadlllles dean and sanltlr~d. potties. chlklren's' tollet seats, toilet f-- ------

32. I Parents provided with dally info on chlkl

_ 33. CondltionoffurnlshinKS, washable,goodtonditlon, safe ____ -----· - · __

- ·---------- --- ---Kitchen/food prep•ratlon equipment •ru dean and ;adequate, lna<cessible to chilchn --- ---

----- --- ----------~~-.r.......JI.ooO:::-L---'

~II ~Polity ~ _

_ _ I Ol<dplin~PoiJ cy __ ~0 CJ;;&.e< ( otsaster!o_r_trv ________ ~---------

11 PEST COHn!OL

41. Pest Control effective, rodent prooflnL free from Insects

II MISC£UANEOU5

42. Garba&e containers sound, dean, adequate, storaae ;area dean

43 Sew"Befwaste water disposal

44. Extemal areas

Gndinl: A to-100 • IO-U

r/~v<•r•/Ct.lctutf'OtOWodtt"'fo/fcw'"s/CC•.,'Pf<tiOflb&aMfOI'"

-

·----- /

c 70-79

;;:/ /

T~Score ~/1DCJ% I Grade l(l!2:'_l

D s ttnd"'""' _...,101~

tt"'No. Ml MA Cit .........

_gj 2b

- J'IJ ·.2,,.. { 3'7 /' !.7

1/IDa'((Me/ChMdU"O'O'f'WCiff"'fG/fotfW\i/CCP•ntptctCN'IbUntltc•m

Dote for comet""'

....,J-Zy/1.)~ .

-XII~

GO\tERNMENT OF BERMlJDA Ministry of Health




This is to certify that Antanella Tucker has been approved

a suttable person to be a Child Care Provider,

to be known as NELL'S PLAY GROUP with the following condition / s:

1. Max1mum number of pre·school age children is: 3

2. Child care is provided at : 24, Tucklyn Terraces, Cherry Dale, Smith's FL 08

Registration#: 181 Issue Date: 3rd January 2018 Expiration Date: 31st December 2018

~ Chief Medical O/f1cer

llem Na. Ml MA CR _.,. o.te ror CGrn!cllan

-----~ ·-- ---- -- - -I I Lll,· ·-----~~

I ___ __._ ______ _ I

----~ I -----·---- l__ __ _ I

----·-1 -4- --~-=--c-H---- ----------

___ _j_ ___ _ I

·-------~----

1 -L__ _____ _

-: --1 I i I

I ----1 i----r-1- _____ _L_ ______ -

-- -+-- 0 ----W. ' .-----I 0

I -~+-l-+------------ --t----

1

-----=~·l--u--+,---- ---------------- ----~ ~ ! : I -~- -------

- •. -T--~--,------ ---------------------------- I -·- -- _ _:__ i - I - -r-· ----- ; I I -~=-------:---------- _! ______ _

~~:=++-tt· -. -------------=-==--~------=---_-_ ----- --------~---__ -_-_--__ -=m _-_------~-- ----_ --------r----------__ !--+-1 I ;

! I l I - ----~·------- ----...!....-.,..-- . I -· i I L l ·--------- o

1 , r --- ·-------· ~ I -Ml•_,.,........ ~ ........ -

~ R~l~lan R~lml' 1 ~ T -~0 f11 .;:;.1:;:;:-o.te:

1 FEE RECEIVED· 7 f•ryn·metpt....-,. Dote Dllnope<tlan:

/.2 ·II./ •I D/M/Year

lnspectorsSisnature: ~-1:/IFRyCart/Chidar•p•O'ridertnfo/lorms/CCFin'Ptdtonb~n•rD•m fl~l'd,xM'i

i GOVERNMENT OF BERMUDA Ministry of Health and Seniors


CHILDRENS ACT 1998

CHILD CARE PROVIDERS INSPECTION FORM r-F-ac-11-ity_ N_a_m_e_: _N_E_LL_'_S P~-; ~~~--------- ~ Registration -No: -;_~ -------~

!"'---------------- -----------·--····------·-·-----------·o ! Name: Antanella Tucker J ;-------- ----------- ---~------------ ----------·------- I

;;;·;_:s_c~~~:~-ce_s_. c_h_~J :~~:;:;;~~~--:==~~--j_at_· --~_:-r:-. --~~ ____ ---~~-----·[ ~ E-mal~ ne~s.ch~~~~~_.se_rv_ices_.b~-~!_~~~-~-~-- ______ T _______ _ __ _ _____ _j I CPR Expiry: 0 ! ~ ---------------- ----- --- -----+ - -- -- ------ -- ..J

; On-can Person: Molly Toloram 1 Telephone: I

I DltlDIIIN WT OM

1. Happy l l

2. No Sian of Abuse ----~-r~-~ 3. Clean .

I ~~

~r-=1 4. Meats prepar~ In CCP horne Yes IJ No if s Meal~ brouaht par:l<ed from home and 'tored In refrl1er.otor Ye5 Q"' No IJ

6. Strudured dally schedule /=r---~ 7. Adequate ~pace for sleepifll

---j---~ 8. Internal and external play area _.,_......,._ --.--..~-

9. Refrlseratlon temperature adequate l I lf'rCiiENE I

10. I Wa.t. .. hands frequently ~~~

U . I Appropriate appearance/dothlns ~L. I HOMEWm

!--;;_ -- - - '---Dol' are not allowed In house or play area

I· i 13. No loose wlrlnB

[24. Toys are safe

:_ ~-- Water quality - ·~- L_____~-

1://DayC.a••/C~i&dc''tPf~~,iflfo/fo•mVCCFinsprchcnbbn'-form •ew•w.mu

unf'1,r c- foff"TY r'='"'T'n V.'t nM

lb. loat< subs1.:tncc• dH.• SIO•C<J "'d IOCkL-d 4.d~fl~1 ur .. bu._~ rcctt.. i Ml MA lH N~~'rks 'Jan· lOf {r..-'I'{IJOh

J f .....

l:l tt()(..,f) Hht110 v.-/(1~~· )l)ill .~ ft"(. \'o UIJ t.• (•••'-~

o r.,e ca11ngu.sher .K C t! ~Si bl l·

-· --- ... --. ..----- &l'--- -- - . - ..----·· .. -- vo-~-- --., -- -·- . -----r-----: -- ---~

22 First ~id ~ o t equiwed and accessoble

23. Safety sates at stairs and areu w/out solid doors for dosur~

24 Toys are sale and cleaned at feast once a week

25. Adequate venUiallon

26. Condition of ceiling. walls, lloor5, windows, doors, fly screens I I HOUS£KUPING

27. Hom,. Is senerally tle•n

28. Sleeping •re• clean

29. floo<Sdun

30. Play area clean

31. SanU~ry facilities clean and sanlllted, potties, children's' toilet se;.ts, toilet

32. Par,.nts provided with dally Info on child

33. Condition of furnishings, washable, &ood condition, safe

34. Kitchen sinks clean

35. Kltch,.n/food preparation equipm,.nt .,,.. clean and adequate, lnaccesslbl,.to childr,.n

36 Condnlon of furnishin&>, washable, Bood condition, safe

I POUCI£S

37. Sick Child Polley

38. Oosclpline Polley

40. Dluster Polley

I P£ST CONTROL

41. Pest Control effective, rodent proofing. free from Insects

I MISaUANEOUS

42. Garbage cont~1ners sound. clean, ~u~t~. storage area d~m

43. ~•ce/waste w•ter disposal

44. htcrn<tl • re •s

Total Score I /100% I Gnolflnl: --A ~

Grade

I 10- e c 0 """" ornder

70-79

GOVERN~1ENT OF BERf'1UDA Ministry of Health, and Seniors




1bis is to certify that Antanella Tucker has been approved


to be known as NELL'S PLAY GROUP with the following condition/ s:


2. Child care is provided at : 24, Tucklyn Terraces, Cherry Dale, Smith's FL 08

Registration #: 181 Issue Date: 3rd January 2017 Expiration Date: December 31st 2017

c>-~~\Jt Chief Medical Officer

' MINISTRY of HEALTH and SENIORS Environmental Health P.O. Box HM 1195, City of Hamilton HM EX Phone: 441.278.5333

Name Antanella Tucker

Address P.O. Box HM 1358 City of Hamilton HM FX





DIRECT ALL ENQUIRIES TO: Verona Darrell 441.278.5394 Email: [email protected]

TOTAL

INVOICE

Account#: CCP274 Invoice#: 16181

Net 30

AMOUNT

$0.00

$25.00

I

I

$25.00

MAKE ALL CHEQUES PAYABLE TO ACCOUNTANT GENERAL Mail to: Environmental Health P.O. Box HM 1195 City of Hamilton HM EX


'

:

Bermuda Government ·· Ministry of Health, Seniors

& Environment Oepart~ent of Health

P.O. Box HM 380 Hamilton HH BX

Reprint 1/3/2017 04:12PM Cashier 2213 T/Ref 0225001617 Reg 0225 Tran No 1410 Cash Report: 170103-01 for 1/3/2017

22 - Department of Health Nursery Certification 8511.32170 Payer Name Antanella Tucker Notes 24 Tucklyn Terraces, Smiths Relicencing of Pre School - 2016-17 Validation Number: 000482 $25.00 ======================================== Total Cash Change

Have a nice day!

$25 .00 ($30.00)

$5 .00

II""'No. Ml MA a .......

MI·M--

Dole of lnsp.dlon: ~.-!Mpedlon R.....,lml YU NO

---_f~ ·/._!f..:_/6 FEE RECEIVED: / D/M/Year -----

lnspettorsSignature: ~~l:jfD;,v(.af~/(hildc.trtpf~VIdtr•t~fof'crrn'ICCttnlptC1ionb:anlfefn'!

.,... for Cornalon

MA·Mofo<- Cli-o-.-

II yes, ll<t-lftiiMUion Dot~:

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i GOVERNMENT Of BERMUDA

Ministry ol Health and Seniors Department ol Health

CHILDRENS ACT 1998

CHILD CARE PROVIDERS INSPECTION FORM Facility Name: NELL'S PlAY GROUP Rqlstratlon No: 181

Name: Antanella Tucker

Address: 24 Tucklyn Terraces, Cherry Dale, Smith's

Telephone: 735·3266 Cellular: other:

E-mail: [email protected]

CPR Expiry:

On-Call Person: Molly Toloram Telephone:

• CHilDIIOI wr DM ... - ·-1. Happy

2. No S .. n ol Abuse I

3. dean

• OPUtA'OON

4. Meals ptepared In CCP homt! Yes D No B' ' s Meals broucht packed from home lind stored In refrttmtor Yes C" No D

6. StruC1ured dally schedule ./ 7. Adequate space for sleeplns

•• lntemaland external play area

9. Relrlamllon temperature adeqnte

' HYGIIJfE

10. Washes hands freqll&'ntly

lL I Appropriate appearana!/dothlna · - -- I

• HOMESNm

12. Ooas are not allowed In hau~ or play area

u . No loose wlrl"'

14. Toys are sale

15. Water quality -----

I'J/D4'((6rt/Chtldc:Jrtl)rcwcttflflfO/Icrm!/CCFUlsPtniCI"'bQI\lfOIM Af'vfSfd 70t§

------------------------------- --·-·-------- - --·---- ]-wr ~--

• i HOME SAFETY COHT'P o: .. · 1 16.- G oxic subs.tanres are !llDJed in a locked cab~net or above rt!ach --+----

17 j Electric outlet> covered

18 I Doors kept tlo>ed to ouUide, kitchen, and utility room

__::_+ Floors sound w/oul splintered wood or cracked tile

I 20. Fire e•tingulsher accessible

~ l Cnb>. playpen. m good condition - paint peeling jagged edges etc ,--~

l 22 First aid kit e<!Uipped and accessible

23. I Safety gales al stai<S and areas w/out solid doo<S for closure

24. I Toys are 5afe and cleaned at least once a weetc:

____________ l _I --25 I. Adequate ventilation

-~~~~~~of ceilin~~~·· floors, window>, door~~Y >C~~e_n.:.__ I HOUSEICEEPING

---~------r- I I __ !

I I I

r z7. I Home is generally dean

I; - ;8- Jsleepong area clea~

~.::__~~~~- .

30. I Play area dean m ~-J Sanilary radiWes dean 1nd san__i1he~. ponies. c:hildren·s• toile1 seats. toilet - --!

32 1 Parent> provided with daily info on child j r-· j 33. I Condition of furnishinr.s, washable, good cond•t•on, >ale I r 34. I Kitchen sinks clean I ~i Kitch~n/food preparation l"QUipment area clriiln iilnd ad~ua1e, inauestible to chltdren

-------- I I I L----·--

- ---------,_:~di\ion of furnishinr,s, ~ashabl!', good condition, >ate

I POLICIES -.-. .------------------------ - ~~-1 I 37. l 5o(k Ch•ld Pohcv 1

~ Pi>CiplinP Policy I ~--i~~~.~~i~- .. -·--·-- ---'---'

I PEST CONTROL

41. Pest Control effective, rodent proofin& free from ln>ect>

R MISCtlLANtoUS

4.2 Garbar.e tontatttt·r~ ~oond, dean, adt."QUiUt.\ ~lotilt!c .iut.-a dt'tlft

43 SPWar.r/wau~ walt•• d•~po'!.od

44 £•1Prn.•• ..... ,,,

<lradln&: A ( 90-100 -' a 80-89 c 70-79

Total Scare

Grade

D

/100%

69 anclund~

Hem Na. Ml Mil C~ Re,..rks Dolo lor Correction

:J ch. 1 d r--0. ..J

-- - ------

,,-j r· ...J

~~

(; C)V[7l\ ['·,! 1·-~, EI~T 0 I HEP.J1l..Jr) ?\ l"'ini~try o{ Hea lth: Gnd ~enion

Departmelit cf Health



This is to certify that Antanella Tucker has been approved


to be known as NELL'S PLAY GROUP with the following condition/s:


2. Child care is provided at: 24, Tucklyn Terraces, Cherry Dale, Smith's FL 08

Registration #: 181 Issue Date: 3'd January 2017 Expiration Date: December 31st 2017

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MINISTRY of HEALTH and SENIORS Environmental Health

h\ .;.. -"'- ~... ~,

P.O. Box HM 1195, City of Hamilton HM EX Phone: 441.278 5333

Name Antanella Tucker

Address P .0. Box HM 1358

City of Hamilton HM FX

.Date: fGth Nov.ember 2016 -




DIRECT All ENQUIRIES TO ·

Verona Darrell

441.278 5394 Email· l t .~ l ( t

TOTAl

INVOICE

Account#: CCP274 Invoice#: 16181

Net30 -- .. AMOUNT

$0.00 $25.00

$25.00 -~~ - ----

MAKE All CHEQUES PAYABLE TO

ACCOUNTANT GENERAL

Mail to: [nvironm('ntal Health

PO BoxHMJJ9S

City of Hamilton HM EX



& Envi ronment Department of Health

P .0. Box HM 360 Hamilton HM BX

Reprint 1/3/2017 04:12PM Cashier 2213 T/Ref 0225001617 Reg 0225 Tran No 1410 Cash Report: 170103-01 for 1/3/2017

22 - Department of Health Nursery Cert ification 8511.32170 Payer Name Antanella Tucker Notes 24 Tucklyn Terraces , Smiths Relicencing of Pre School - 2016-17 Validation Number: 000482 $25.00 ---------------------------------------------------------------------------·-----Total Cash Change

Have a nice day!

$25 .00 ($30 .00)

$5.00

"""' No. Ml MA CJI "-~/c~a J<.-J.- ~u _uW.w

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--Mojor-Dolt of llllpe(tlon: :f2u f{ M 11- ll•lmpectlon lloquft4: ns NO II yes, ll•ltlopocllan Dolt:

FEE RECEIVED: II yn recolpt lUmber:

0/M/Year

'"'""~'"~'~' ~ IJ~~rr/O't.,UitiJPt ~~C110flbl.ln•torm

Dahl for c.n.a1o1t.

Cll ·~-

-]1!!1!

({i GOVERNMENT Of BERMUDA

Ministry of Health Oepanment of Health

CHILDRENS ACT 1998

CHILD CARE PROVIDERS INSPECTION FORM Fadllty Name: VICKERS NURSERY Re&irtration No: 184

Name: Cassandra VIckers

Address: 4 Leacraft Hill, Southampton

Telephone: 234-1706

E-mail:

Cellular:


On-tall Person: Norma Smith

' CltiUIMN 1. Happy

2. No Sign of Abuse

3. aean

' OPOATIOH

4. Meals prej~ared In CCP home

s Meals brouaht padted from home and stored It> reh~Cerator

'- Structured dally sdledule

7. Adequate space for sleeplns

I. Internal and externiltplil'f area

9. Rrfrlseratioft temperature adequale

I ltYGtDfE


..2_1· 1 Appropriate appeara~/dothln& I IIOMESAR'IY

12. Dogs are not allowed In house or play area -13. No IOOH wtrlns

14. Toys are safe

15. Water quality

1:/fD:ty{.Jte/Chlldurtptmidtt•nfo(rormsl(cP~nsEJKtiOnbl.ln•fonn

Other:

s C~IIJ~"'

Telephone:

WT PM

-· ' -·---= c o

/ ----Yes 0 / No 0 I

Yes o/ No 0 - . - I

--- --

J ' ,i,.~o~

,) f-

-

--...._]~~

• 16

II

18

19.

HOM£ SAFETY COHT'D

lo•K: subs1ances ar(! s1ored k't a kKkl!d ubiMt Of above re~ch

Ef.CIIiC oullets COYl!fed

Doors kepi dosed to outside, kitchen ~nd utility room

Floors sound w/out splintered wood or coacked tile

20 1 fire e•tlnguisher accessible

11 T Cri,;-~ns in good condition pamt peeling t•G&ed edRPS etc

22

23

24.

25

26

• 27

Fits! aod kit equipped and accessible

Safety gates at staors and areas w/out sohd doors lor closure

loys are sale and cleaned at least once a week

Adequate ventilation

Condition of cering. walls, floors, wmdows, doors, fly ween•

HOUSEKEEPING

Home Is generally clean

28 T Slee~g area dean

29 Floors clean

Pliy au.~ it dean

wr OM

"j l 1 •• 11

-~~~-j I • I I ;

I ;--- I I

l I I I l I

---------- ----------------r _ .. I r. I I I I --1- I I

30.

31

32

31

]4

i-- 1 _, Sa011ary lacmtie' clean and sanitlred poUies, ch<ldren'>' toilct seats. too'-:t I

-----~ ·~-Parents p!OIIlded woth da ly mfo on <hffd

Condihon of furnoshings, washable, good condition safe

Kl1then !tn'k~ dttan

___ .___, -- j__

I

[ lS. 1 ~ilchen/lood prep•ralion equopment atea dean and ~dequate, lnatcessoble lo child< en

I --==I --1 I I

J& 1 Condo loon ullumoshongs, washable good condition • .,,,.

I POUtiES

Sick Ch ld Polocy

31 Oompline Policy

40 Oosasteo Policy

# PI:ST tol'fTROl

41 Pest Control elfectove, rodent ptooling. hee hom insects

# MlSCHI.ANEOUS

42 Garba~r r:onlcl;nf't ~ '\:nunti . clrt,n. arlrqu.1•r. 't•or~a•' .:tff'.l d+'oln

4 .1 ~t""¥.tf!t•/w.ntt• w.ICt.•r dt~powt

tl4 hwnp.,;:~f ,.~~ ,.,.,

G<adlrl,i: A 90-100 e 10- lt

t·Ji()Jyf, -'•t/(t"'CCIIftrCYotf'• t'l 't/lt''"'1f(ff-f'H'fr'"C'Itl.l"''''' ~

i ' I I

-------1--H

c: 70-79

TotaiScor~

Grad~

D

/100%

69and under

, ...... ~

II..,.. No. Ml MA 01 Ae-~~n.~tks DllofOI' CGfttd....,

ur~.<•·-IC·~-6urrt:""\(t ·r-•ct•r -~'i(U rtfJfo:t"• ~""~"

~ .-~yr !llt..tt i •H Uf RrA t1\U)A

Dep>~rment of Health Central Goo;er"ment Laboratory

G.tllif t1{v( ·u/l

E H recctpt # .

Laboratory No.

·s .,-sz,/CJ

WATER ANALYSIS FORM

How would you like to receive your results: email 0 mail o telephone o

If you would like your results to be mailed to you, please print your name and mailing address clearly below -Inside box:

.f'tlltta (a.t..:(kJ tile~• ~.6..-a Ematl addre~s


Surname

1/({_kus /ll..ure l Establishment/House name

I( Str.;;] N- 1~6

House No

Postal Code ContKttelephonc no.

Reason for Cttdne 0 No specific cotnplaint

0 Complaintlspccify) -----0 Follnw-up analysis llv«<utine samDiint orot rammc

Drlnklnc Water- Typt of DlslnCtttlan /Treatment

o Chlorination • te$ Chlorine I 0 Reverse Osmost~ 0 UV I Ultra-Violet Light) 0 Not dtsmfeeted/treatcd 0 Other

Ftrst name

Jor.Jt -":::::J::.f-0.-..

.tt::fr /..;"' J ._t.. PDrish

Samplina Potrt

Eumlnatlon Requested e-1fnutinc bactc<iolngical 0 Routine chemical

0 Other lspecify) ----

Non-drinking Water 0 Seawater eWell

0 Other

0 Swimming pool 0 Spa/Jacuui

Sample collected by K'ft Vtvf 1. J ,.-rloN4 Q .. 1.,:,.-.> I Datcand Time Collected )(J < li ~I ':f/ ;. l.f2-

For EH/Laboratory Use Only Sample received at EH by Date and Time Received

l

Sample received at CGL by e........, Date and Tlmt Received t"'l..i)~lt tO:~~~ Premises type BoUlt size and type '2-"><I,.~ ~.\1 . ~ ..

Bacteriological Results Chcmiul Results Total coliforrns JIOOml (.~~· ~r~-...; Chlondc mg/1

V..:.• (_~ tl'"""c; E. coli /IOOml

..:..\ Hardness mgll as CaCOJ

Heterotrophic plate count /ml Nitrate mg/1 u NO,-N

pH

_,

This report reflects the water quality on the day of sampling only. The bacterial quality of Bermuda tank water Is variable- tank water should always be treated by disinfection before using for drinking and food preparation

(Senior) Public Health Analyst ~#(.__ Dale

6 DeL \'7

G()VtR.Nf·1EI\IT OF !~ER.MUDA Ministry of Health




Tlus Js to certify that Cassandra Vickers has been approved

a suitable person to be a Child Cue Provider,

to be known as VICKERS NURSERY with the foUowing condition/ s-


2. Child care is provided at ; 4, Leacraft HiU, Southampton SB 03

Registration #: 184 Issue Date: 3'd January 2018

Expiration Date: 3P1 December 2018

Chit!/ Mftllcol 0/fkf!r

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:--.) .-.... 1 ,.";! ,_.

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& Environment Department of Health

P.O. Box HH 360 Ham11ton HH BX

Reprint 11/10/2017 03:47 PH Cashier 2226 T/Ref 0225005677 Reg 0225 Tran No 5453 Cash Report: 171110·01 for 11/10/2017

22 - Department of Health Nursery Schools 8511.32170 Payer Name Cassandra VIckers Notes CCP275 · Invoice 18184 Validation Number: 003072 $25.00 ======:================================= Total Cash

Have a nice day!

$25.00 ($25.00)

GOVERNMENT OF BERMUDA



Children Act 1998


NAME Cassandra Vickers

DA YCARE NAME VICKERS NURSERY

ADDRESS 4 Leacraft Hill Southampton SB 03

PHONE 234-1706 I CELLJ 51 7-5054

EMAIL

How many people live in your household? l ~ CPR expiry date 18/1/2017

I On Call Person and Phone Number ; ---

LIST EACH CHILDS NAME AND AGE NAME AGE -

.. .. ,_, __ ·. .... ..


0 No longer operating as a Day Care Provider

Please sign and return the form along with your annual fee to Environmental Health in the enclosed self addressed envelope (no stamp required) no later than December 151

h 2017.

Signature: _d.,..-.:;.. ...... '~~~=-=-----

Phone: (+1 441) 278-5333

Environmental Health 6 Hermitage Road. Devonshire FL 02

P.O. Bo• HM 1195. Ham ton HM EX. Bennuda

Fa~e (+1 441) 232·1941 E-ma.i.vdarrell@gov bm

· government of bermuda ministry of health department of health the children act 1998 certificate...

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