PZ - Franklin Daycare Documents - 5.225110
Dionna Franklin H-2017-0047
CUP Daycare group
4657 N. Price Ave
Meridian, Id 83646
Please see additional forms for my request for Conditional Use Permit. I believe these
are needed at some point.
1. Child Care Health and Safety Inspection Passed 4/28/17
2. Notice of Background Clearance for Dionna Franklin 3/15/17
3. Dionna Franklin CPR & first aid expires 4/02/18
4. Notice of Background Clearance for Dylan Franklin 4/03/17
5. Dylan Franklin CPR & first aid expires 11A 7
6. Juvenile Justice Records for Dylan Franklin 3/2/17
7. Notice of Background Clearance for Ryan Franklin 4/3/17
8. Juvenile Justice Records for Ryan Franklin 3/2/17
9. Home Emergency Plan exits x 2
10.Evidence of Property Insurance showing Fire coverage is included
11. Notice of Background check for Tony Franklin 5/08/17
12. Copy of blank child care fire and disaster drill log
13. Emergency evacuation/disaster plan (also use YIKES emergency response plan)
14. Fence proposal (being done this week)
CENTRAL
•• DISTRICT
HEALTH
DEPARTMENT
540c 1 i) 50 ec-{ ,10.
Child Care Health and Safety Inspection
FACILITY NAME ,°' 'i':t,x t A" , }. n';
FACILITY # ..� ( i ,,+`"
EHS# ;a,-'
DATE: i
PROVIDER NAME:
--.EMAIL:,,, ' m dt- :"�? _, -,_ (
'pH#'" .�
ADDRESS: r I^ (�".c'"
CITY ;CL>.. STATE ZIP Q .
ACTIVITY: ❑ INITIAL
CK ANNUAL ❑ FOLLOW-UP
❑ INVESTIGATION ❑ TRAINING
❑ UNANNOUNCED ❑ SAMPLES
ICCP ❑ ICCP-STATE ❑ ICCP-CITY ❑
STATE ONLY ® CITY ONLY ❑
IN -HOME ❑ CENTER ❑ GROUP
RELATIVE ❑ FAMILY ❑
ONSITE FOLLOW-UP DATE:
VCR DUE DATE:
# CHILDREN PRESENT '1 1 # PROVIDERS CHILDREN ; # STAFF
INSP. TIME (MIN.)
EMP./CHILD RECORDS EDUCATION 04 CP$C EDUCATION PROVIDEWO
TRAVEL TIME (MIN.) C
The items marked with an "X" identify the violations or problems that need to be corrected. Child Care Health Consultant Referral? Y +;, N. j
Description
X
Comments/Correction Required
on
corD e
1
PROVIDER AGE / SUPERVISION
2
PEDIATRIC RESCUE BREATHING CPR/FA
3
CHILD -STAFF RATIO
4
STAFF/CHILDREN EXCLUDED WHEN ILL
"'
5
IMMUNIZATION RECORDS
r
# Enrolled: (includes provider's children)
6
EMERGENCY COMMUNICATION
7
SMOKE DETECTOR, FIRE EXTINGUISHER, EXIT
8
FIRE SAFETY EVACUATION PLAN, POSTINGS ,
t
. ,,.
9
DISASTER AND EMERGENCY PLAN V '.
., • b
1 S.
10
FOOD SOURCE/FOOD THAWING
11
FOOD HANDLING/PERSONAL HYGIENE '
12
FOOD TEMPERATURES/THERMOMETERS
13
FOOD STORAGE/CROSS CONTAMINATION P
14
FOOD CONTACT SURFACES/ SANITIZING
15
DISHWASHING/SANITIZING
16
UTENSIL STORAGE
17
MEDICINES/HAZARDOUS SUBSTANCES V,'`
�° 9
18
GARBAGE COVERED/REMOVED
19
PLUMBING/SEWAGE DISPOSAL
`20
WATER SUPPLY/WELL SAMPLED ,
21
HANDWASHING FACILITIES
22
DIAPER CHANGING FACILITIES
23
FIREARM STORAGE
24
WATER HAZARDS (POOLS, CANALS...) f
25
SMOKING/ALCOHOL CONSUMPTION 0?
26
SLEEPING -PLAY AREAS, RESTROOMS CLEANVI
, p
' r
27
HEAT, LIGHT & VENTILATION
28
OUTDOOR PLAY AREAS %4
29
ANIMAL, PET HEALTH/VACCINATION
30
GENERAL SAFETY
31
TRANSPORTATION SAFETY"
COMMENTS:
Referral Date:
Payment Date:
Inspection Passed Date: *-, , ti
Inspection Not Passed ❑ Date:
Investigation Res ❑ Date: Investigation Not Resolved ❑ Date:
Unsubstantiated ❑ Substantiated ❑
Signatures
I X t,""
X
r
Date E-mailed /faxed to IDSTARS:
Person in Charge HealthAuthority
WHITE COPY— Health District YELLOW COPY —Provider rev 8/2016jh;.
1�• IDAHO D E P A R T M ENT OF
•
� HEALTH &WELFARE
C.L "BUTCH" OTTER - Governor BUREAU OF AUDITS & INVESTIGATIONS
nit
RICHARD M. ARMSTRONG — Director Criminal History 1720 WestgaA2
teDr., Ste A2
Boise' ID 83704
PHONE 208-332-7990
TOLL FREE 1400-340-1246
FAX 208-332-7991
Dionna Franklin
4657 N. Price Ave 03/15/2017
Meridian, ID 83646
NOTICE OF CLEARANCE
Applicant: Dionna Franklin Verification Number:698636
The Department has completed its background check and the applicant has passed effective
03/13/2017. No disqualifying crimes or relevant records were revealed. The agency issuing your
license or certification may request that you provide them with the specifics of any information
here revealed.
NO RECORDS FOUND
The background check is fingerprint based and includes information obtained from the state and
national criminal databases, Idaho Driving Records, Idaho Child Abuse Registry, Idaho Adult
Protection Registry, Sex Offender Registry, Idaho Nurse Aide Registry and state and national
Medicare/Medicaid Provider Exclusion Lists.
If there are any questions about the process or results, contact the criminal history unit at (208)
332-7990, or toll free at 1-800-340-1246. Additional information about the criminal history background
check process and applicant status is available at the web site: https://chu.dhw.idaho.gov.
Sincerely,
Nancy Bochsier
Nancy Socnsts'
Page 1 of 1
Certification Card
Dionna Franklin
has successtuliy completed and competently performed
the required knowledge and skill objectives for this program.
ASHI-Approved Certification Card
Dan Hohler
Authorized Instrtrctor (Print Name)
852962
04/02/2016
208 249-7157 e
Training Cenler Phone No.
Registry No. 04102/2018
Expira9iron Data
67795
Training center I.D.
AMEIUCAM a and shill objectives to a cur-
�wj� '}� holder has guarantee future perlortnarke. w imply
6��4��T�is This
aautho ized ASHI Instructor. dCerfiftaecr does riot grad ntee future
{II:�I+T� sure w credenor,Ung. C ,me r oment corers all age groups and conforms to the 2010 MA Guidelines
t recommendations. Certification period mayad.
FaSTfT UT� not
for CPR and ECC. and othar evidence -based treatmen i
exceed 24 months from class completion date. More frequent reinforcement of stalls rs recommended.
IDAHO DEPARTMENT OF
HEALTH &WELFARE
C.L. "BUTCH" OTTER - Governor
RICHARD M. ARMSTRONG — Director
Dylan Franklin
4657 N. Price Ave
Meridian, ID 83646
NOTICE OF CLEARANCE_
Applicant: Dylan Franklin
BUREAU OF AUDITS & INVESTIGATIONS
Criminal History Unit
1720 WestgateDr., Ste A2
Boise, ID 83704
PHONE 208-332-7990
TOLL FREE 1-800-340-1246
FAX 208-332-7991
The Department has completed its background check and the applicant has passed effective
03/31/2017. No disqualifying crimes or relevant records were revealed. The agency issuing your
license or certification may request that you provide them with the specifics of any information
here revealed.
NO RECORDS FOUND
The background check is fingerprint based and includes information obtained from the state and
national criminal databases, Idaho Driving Records, Idaho Child Abuse Registry, Idaho Adult
Protection Registry, Sex Offender Registry, Idaho Nurse Aide Registry and state and national
Medicare/Medicaid Provider Exclusion Lists.
04/03/2017
If there are any questions about the process or results, contact the criminal history unit at (208)
332-7990, or toll free at 1-800-340-1246. Additional information about the criminal history background
check process and applicant status is available at the web site: https://chu.dhw.idaho.gov.
Sincerely,
Carrie Connell
Carrie Connell
Page 1 of 1
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Training Center Name Minidoka Memorial Hospital ILEA
1224 8th Street
TC
info Rupert ID 83350 20PA36-0481
Course
Location BLS Rules - Renaissance High School
Instructor inst. ID #
Name Lee Britt IOIW376329
Holder's ( nn �
3ianature ' [
.'_];'xne�iaae Heart Max'M!on rmndnnawa sue terow�BaCarin moeararxs. ea-fat-
Juvenile Court: Adra f!� Le Service Probation Office:
Address: l 306- W , kalol► S4 Address:
City, State Zip: &,, I0 �R 3 7D4 City, State Zip:
In accordance with Idaho Code Section 39-1105, every individual thirteen (13) years of age to eighteen (18) years of age who has
unsupervised direct contact with children in a day care setting or who is regularly on the premises of a day care facility must complete a
criminal history background check that includes a check of the juvenile justice records of adjudications of the magistrate division of the
district court, county probation services, and department records("juvenile justice record").
In accordance with the above Idaho Code, I am requesting a search of all juvenile justice records for the minor child
Identified below:
Name of Minor Child: J %1 JOn (hr! SChild's Date of Birth:
7-a4/-
Parent/Guardian: -Z-oaqy4l ona a E as hlln_ Phone: 736- 7
Address
Af
^� City State ZIP Code
r
Signature of Parent/GuardianQonno-) / Date .313jdoll
Daycare Facility Name: L; Mr C,& ()IJ S
Signature of
Minor ID G"nt` Date 13/ ri017
TO BE COMPLETED BY JUVENILE COURT
,<No records revealed
❑ Records Attached
TO BE COMPLETED BY JUVENILE PROBATION
❑ No records revealed
❑ Records Attached
Date of Search ✓ - 247 Court Clerk Signature or Initials.Ali
Please return this record request to the parent or guardian as listed above,
New Licensing Application Packet - State Daycare Licensing Page 26 of 31
� �• IDAHO DEPARTMENT OF
•
� HEALTH& WELFARE
C.L. "BUTCH" OTTER - Governor BUREAU OF AUDITS & INVESTIGATIONS
RICHARD M. ARMSTRONG — Director Criminal History Unit
1720 WestgateDr., Ste A2
Boise, ID 83704
PHONE 208-332-7990
TOLL FREE 1-800-340-1246
FAX 208-332-7991
Ryan Franklin
4657 N. Price Ave 04/0312017
Meridian, ID 83646
NOTICE OF CLEARANCE
Applicant: Ryan Franklin
The Department has completed its background check and the applicant has passed effective
03/3112017. No disqualifying crimes or relevant records were revealed. The agency issuing your
license or certification may request that you provide them with the specifics of any information
here revealed.
NO RECORDS FOUND
The background check is fingerprint based and includes information obtained from the state and
national criminal databases, Idaho Driving Records, Idaho Child Abuse Registry, Idaho Adult
Protection Registry, Sex Offender Registry, Idaho Nurse Aide Registry and state and national
Medicare/Medicaid Provider Exclusion Lists.
If there are any questions about the process or results, contact the criminal history unit at (208)
332-7990, or toll free at 1-800-340-1246. Additional information about the criminal history background
check process and applicant status is available at the web site: https://chu.dhw.idaho.gov.
Sincerely,
Carrie Connell
Carrie Connell
Page 1 of 1
Juvenile Court: _Ada Oo, Ta senile at ff
Serer i CeS
Address: 6_ T) �� 4'�12Y�. &
Probation Office:
Address:
City, State Zip: t } Ld g ,3--n City, State Zip:
A iI)d a
In accordance with Idaho Code Section 39-1105, every individual thirteen (13) years of age to eighteen (18) years of age who has
unsupervised direct contact with children in a day care setting or who is regularly on the premises of a day care facility must complete a
criminal history background check that includes a check of the juvenile justice records of adjudications of the magistrate division of the
district court, county probation services, and department records("juvenile justice record").
in accordance with the above Idaho Code, I am requesting a search of all juvenile justice records for the minor child
identified below:
Name of Minor Child: Rtfa,3 � C hO,,,- f ror) Lhn Child's Date of Birth:
5-
Parent/Guardian: /on q 4- 0Janna F-f anX(to Phone: a09- $9 735 %
Address: Price A V e
1y) er ; ran
City State ZIP Code
Signature of Parent/Guardian - Date 3/ & ;�2o 1 %
Daycare Facility Name:
Signal
Minor
TO BE COMPLETED BY JUVENILE COURT
;�No records revealed
❑ Records Attached
TO BE COMPLETED BY JUVENILE PROBATION
❑ No records revealed
❑ Records Attached
Date of Search ✓ "z _) -7 Court Clerk Signature or Initials 4.11
Please return this record request to the parent or guardian as listed above.
New licensing Application Packet - State Daycare Licensing Page 16 of 31
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Why
EVIDENCE OF PROPERTY INSURANCE I no i r»�i n
-THIS EVIDENCE OF PROPERTY INSURANCE 15 ISSUED AS A'MATTER OFINFORMATION ONLY AND CONFERS NO RIGHTS UPON THE
ADDITIONAL INTEREST NAMED BELOW. THIS EVIDENCE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE
COVERAGE AFFORDED BY THE POLICIES BELOW. THIS EVIDENCE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE
ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE ADDITIONAL INTEREST.
AGENCY Ltd 6E
FIG FINANCIAL INSU
5648 E Franklin Road
Nampa, ID 83687
DOMMED
Dionna Franklin
Tony Franklin
4657 N Price Ave
Meridian, ID 83646-6695
COMPANY
Safeco General Insurance Company of America
PO Box 2726
Spokane, WA 99216-2199
LOAN NUMBER
11801511
EFFEMMOATE EXPMMATW PATE
05/27/2016 05/27/2017
THO RSPLACES POKW WWOR E OATED:
POUCYNUMOEN
CONRNUED UNTIL
TOM N= IF G EOM
PROPERTY INFORMATION
Bwee ng Ioca ed at
4657 N PRICE AVE
MERIDIAN, ID 83646
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.
NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
EVIDENCE OF PROPERTY INSURANCE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS
SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
f!nV=Aa=1hWnC MAT1nW ovens WOO A... I I nweun I I nn- I I ---
COVERAGE/PERLS/FORMS
AMOUNTOFNSURANCO
OEOUCn=
Dwelling
265,000
500
Dwelling Replacement
Yes
Other Structures
25,500
Liability
300,000
Loss Assessment
3,000
Mold Remedlation
10,000
Mechanical Breakdown Coverage
50,000
Building Ordinance or Law Coverage
25,500
AQDIS
9%
nna please see above your current insurance coverage on your home. This policy has fire coverage
uded the policy. Please let me know if there Is anything else that I can be of further assistance with.
cAN0 Tr
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE
DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.
NAMEANDADORES4
IDAHO HOUSING $ FINANCE
PO BOX 7899
BOISE, ID 83707
27
ADOMMAL INSURED
MOMBAGEB
ITS SUCCESSORS ANDIOR I LOAN M
AUT"OM= REPRESENTATIVE
Travis B. Walker
LENDERSLOSSPAYAe1.E I UMSPAY@E
The ACORD name and logo are registered nwke of ACORD
Printed by CHW an F"my 15, 2017 at 04:53PM
IDAHO DEPARTMENT OF
HEALTH &WELFARE
C.L. 'BUTCH" OTTER - Governor
RICHARD M. ARMSTRONG — Director
Tony Franklin
4657 N. Price
Meridian, ID 83646
NOTICE OF CLEARANCE
Applicant: Tony Franklin
BUREAU OF AUDITS & INVESTIGATIONS
Criminal History Unk
1720 WestgateDr., Ste A2
Boise, ID 83704
PHONE 208-332-7990
TOLL FREE 1-800-340-1246
FAX 208-332-7991
The Department has completed its background check and the applicant has passed effective
05/08/2017. No disqualifying crimes or relevant records were revealed. The agency issuing your
license or certification may request that you provide them with the specifics of any information
here revealed.
NO RECORDS FOUND
The background check is fingerprint based and includes information obtained from the state and
national criminal databases, Idaho Driving Records, Idaho Child Abuse Registry, Idaho Adult
Protection Registry, Sex Offender Registry, Idaho Nurse Aide Registry and state and national
Medicare/Medicaid Provider Exclusion Lists.
05/16/2017
If there are any questions about the process or results, contact the criminal history unit at (208)
332-7990, or toll free at 1-800-340-1246. Additional information about the criminal history background
check process and applicant status is available at the web site: https://chu.dhw.idaho.gov.
Sincerely,
Lori Hiatt
Lori Hiatt
Page 1 of 1
Child Care Center Fire and Disaster Drill Log
Hold fire drills monthly and disaster drills semi-annually.
FIRE DRILLS
DISASTER DRILLS
Date
Time of
Day
Day of
Week
Time it took
to evacuate
Number of
children
Problems encountered
or comments
For the year:
jCm� tivnnC�
0
v
o
du;��Cy
0
o ai
3
C O
� N z
0
�Y
W
w Qi
QU�o
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r
2 �
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C6
T
D Fence Inc.
5764 Staaten Ave.
Boise, ID 83709
208-830-8528
PROPOSAL
PROPOSALS SUBMITTED TO a
PHONE
DATE
STREET
JOB NAME
CITY
'2-
JOB LOCATION
STATE AND ZIP CODE
DATE OF PLANS
JOB PHONE
We hereby submitspecifications and estimates for
C
We Propose hereby to furnish material and labor - complete in accordance with above specifications, for the sum of:
dollars $
Payment to be made as follows:
i
-
Authorized
Signature
Note -This proposal maybe withdrawn
by us if not accepted within days-
--,Signature:
. .........
Date of Acceptance Signature:
leslie halvorson Search Mail Search Web dionna fr... ( Account Info co Sign Out Home
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Fwd: Status on fence Franklin Wednesday, May 10, 201711:00 AM
Drafts (2)
From: "dionna franklin" <dionnadaycare@sbcglobal.neb
Sent
To: "Joshua Beach" <jbeach@meridiancity.org>
Spam
[Empty] Raw Message Printable View
Trash
[Empty]
Fence is approved to make Eft by HOA, this is email from them.
My Folders
[Edit] Dionna Franklin
Archive
Begin forwarded message:
Deleted Messag...
From: Leslie Halvorson deslieH@pgrJs[x>inte.com>
DYLAN
Date: May 3, 2017 at 11:44:06 AM MDT
To: dionna franklin <dionnadavcare@sbcalobal-n
NEWHOME2016
Subject: RE: Status on fence
Notes
Hi Dionna,
ryanschool
The fence has been approved.:) I still need to get approval for the shed. I don't know that you
need approval for the landscaping in your back yard.
Sent Messages
Leslie
sent
—Original Message-----
taylor
From: dionna franklin ImaiIto:dionnadaycare@sbcalobal.netl
Sent: Wednesday, May 03, 201710:04 AM
To: Leslie Halvorson <LeslieH@par inte.com>
Subject: Re: Status Fence
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