ightlight christian Sdoptions Home inspection Checklist ‘ye oflome: __ foster Care __GroupHome Date of nepection: ame: Eat: Address Provider 0 ay/tete/tp County: Home Phone CellPhone: cation: Certification formation: ___Capacty 1 Preference ag eral Conlon andy Yes_[ Wo [Comments | Regulation] RueTPoRey PREY _| Mimarsou chemi oc aoe rea aa H3107 | youngster iren as ge/deveipmentaly appropiate, 7.100. 20 RCO) P98: ZB. 2 Prdts wich ould ease psig or contamination a not toredin areas [ewer | sere food store or prepared Window wet must be covered, FaczasiBe To cn reweod staked o socked nomore than 3 thes eat Hh -ETBBOE E | Aifod shel for sores pprved by the heath authority and Tal Be Pe.12t | stored prepares and sere in sacha manera toe wholesome ad sae for human consumption. ont pateurzed mi sallbe serve. Home pressure ‘anne ts vegetables oF ess cannot be served Fut, vegetables seats maybe focen7.-70R, U2 ECO ; PAID? tiquor's eked ar cease tote crn nce -EZZS:ET ES; | Smeotne prohibit oir care ome and vebces, 7, ODS FATAL AOF A tps rane shares anlotcborr ee ado hese foster cren a age and evelopmenaly appropriate, or they ae supers’ fl ne “Toilets, eons and Pousho ams are racaabeaorTha Toe Inanuacture's abe ReTaEgT _| Mime lb ear aati grade arng Fo Nba | topnarmocyinsiuctons PJ120 H2 7-108.) AGE FE™—| A medeation log must be maaned for eth ose hid Gwe WEB TE | ret ad supplies ha be ea avalableh the Ty fester home [7,680.3 49 64 | Water, om any source ater an aeguar munkipl water supply, ra be tered way for complance with wate ually repuson Curent i [7 tab 26 POT |e centteatestllbe latin the proters tia 100.3 Sgt Ts eA PS [EA0B. Te the famity fester ome shall eqvpped wih adequate Tigi est vente? P5107 6 & D | and plumbing ncn hot nd ead running wate) or safe and comfortable cceupangy. 7.708, 2p # C4) 5. 10F FPF | Astaiway contig more han fou seps hallbe eubped wit andra € Tyr‘ated are tized Tor staways wth more thn Tur Seps when caring or Foster chidren les than two years of age os developmentally appropriate or needed F708), | Wier pas oratr animals are preset adaltonal pretation sal ba Taken 3.104 #2 | roensure thei safety, hygiene, and santry odors. Cogs and cats shall be vaccinated a required by state law o as designate by veteran ETO. aig [Aamilyfosterhome or ceiving autorty shall ensure hat each chide 9.124 84 | pronded wth one transportation necessary for iplemerting tha foster he’s family service plan fe. vss, therapies, mesial ear, and in cases of an emergeng) F708. 1G _| Alvis used transporting Foster dilren wil be rsured end maintained in 99.1204 C | accordance wth colorado law Documentation fcrrent auto nsurance kept inthe pode fie. 13, 70. Ar [al foster parents, or respite care providers shal be prope censed ir 9.130 #D | accordance with Colorado Law Cpls of diver lenses shal e kept inthe providers file. Noone under the age of 18 shall transport faster clea, Foster parents sal follow al eure Colrado Chil Patsenger Safety Lava, hich can be fund at war creatzcolorada com. F10G,AG —[A‘amilyfosterhame shall not alow more passengers te vehicle tan eve FEOF #G | are seat bets and al veils shal be enclosed and have olin dons Physical Requlrements Yes [No_[ Comments | Regulotin/ RulePotey 0B. 22. | Any weapos earns avril, bows, antng ke, era be Gyre stg | ursrung/unioadedandinockes containers that are stored ov of reach of foster chidren. reams which ae solely omamental are an excepton. “Ammunition end arows stall be stored In separate locked containers. Weapons shall ot be tanspertd in any vehi in whieh foster ehdren are lo preset, ‘rls the weapons noperabe and inacesrble, Law enforcement rofessonas are xem f theiremployment requires them 10 eary a Weapon, ADB. Ze | here shall be otcoor play space ee om hazards. decks, ees, fences, Pgiee| #4. | and secured rains with nls thon 75 square fet of protected space per ‘hid. The foster care provider or designee sal ensure proper supervision uring outdoor pay and needed wl devin a safety lan fr supervision of i ‘the child ithe space it protected /fenced ie appropiate os ane outdoor ply equipment habe made avaiable Tor BRE. er mye "10%.22 | Atleast 35 square feet of usable, Ivabie Indoor space shailbe made avaiable or 101G3 | exch chi. Al fooring mus be easly cleaned and al terior walls shall be ‘constructed o solid materi ad re from oles. Appropriate matrals and ‘cuipment shal be mae avaiable fr both active an uit play. T7OG_3z | nnshed basements sabe accesso to ater chen unlae they are paid #23 | property supenised. "728.22 ___[ Abasement whichis regulary ased forthe case of chilken habe eavipped PAI Es | with more thanone ext such ext maybe an ecessble window SIE BE, Esterar door shallbemastsinesin such amanner hat would low nyoTrieior door albe designed to prevent children fom being tapaed “A saltabl, quiet, welt place Yor study salle provided together with he necessary prvions shall be mas available for school-aged children, EGP FF ATPS [there shall bea minimum of <0 square tet offer space for each fostr chi 8 bec, and beds should be placed atleast wo fet apart when arranged in parallel Ever child salle provide separate pace to store ie/her cating and ‘belongings. [7.78 2z Ta comlorsble be eat orerib n'a cea, wellvenilied Voom whER Ts AOE FAIS FEB | customary used forather purposes suchas atchen, ining room lor bsthraom shall be availabe for al chron nthe home ‘Allibs ae sed to inspecionforsafty and tabi By he rexaurce wor Immobiters mast be property sae in dop-sie cbs unt the erbzelfcan be replaced. No dro ie is witb allowed for foster ciren ter December 28,2012 [9B BY | Two sheets ond sabe warm coverings are provided Tor each foster oh [Siar | Stsre changed wee rma emenh needed Noctis towed remain eepingina wet bed ree. ac fester chil shal be rowed wit adequate seep wear anda Gomalete sw [U0 % G4 | cflean sleepwear shall be avable nthe avert tata change necessary [1708-81 pal Foster chlden over the age of 18GE82 fae shall a sleepin the sare room G3 {ss uneated alts foster prentzar other household members) on euler bass -ETDB- BY BT Sieping room Yor unrelated aren hall sot be shaved wah chien ofthe Ist G3 ‘opposte sex when one chi is ver the age of our Foster ibings of the ‘opposite ex who ae aver the age of four can share room ony withthe ‘rtm approval of hecerutying autor an the county desgnes Wreten Alocumentatin af hs autharteation most be maintained both te foster hes ase ie and the providers le. Teen parent may share room with thei hier “FOBT FEU) No more tha two Wfant under the age of wa yours whether, Sdoptve, latin orfesteshallb cated for infamy foster home athe same time [7708.21 BT | infants shal be provided wth smarting enviroment designed to silat a. thaisenses. alles ae not to be roppes during Teedngs. F7-706.31 P9UWT Oapersshalbe changed as equred ad wed diapers shal Beceane@or ub Asposes of consent with the practices of goad hygiene 1108.11 [Thea fovter home sal ecure hat foster chen ar proved wh P5128 Aa | necessary and approprate toler ems inciting cley, nda towel waselths, toothbrushes, oothgaste, comb and shape." = Electrical ote overs shale stalin when foster chiren ondar Wenge OF twee are incae. [108.72 Safety sve lead to a ing pool hal be aszesed bythe wear [P05 FIL | worearor, necessary, addressed by the county or state heath department, and documented nthe provider fe Hot tbs must be eovered and oked TEE Tz Frese children are rat alowed on vampolnes withoct wten appre rom 185% Bre | tho bilo parent) or countyThe Foster Toy home shal not be use Tra rental income buses, dul foster care fit, ora business which might be hazardousto the heath, safety, moras or welfare af the children inca. ‘mobile Home sal haveat las iwo ex, Dette, ands proper intaled and stabiined. FreSefery Yes_[ No [Comments | Regulation] Rle/Potey 7,198.25 |The foster care provider sal ensure that al previo Tented Tre havards Joa ole tA | (suchas defective electrics appliances, flammable mater et) have been corretecoreininated, 7.708, 25__ |The family foster home sall contain at Teast one fve pound ULapproved fe 3 lob A | extinguisher, with aratngat 24, 1086, which kept in ahighyvisble/accesible location [708 TE | Working smoke detecor most be ataled on each evel ofthe Tam foster [PHC | home and near sleeping ares. 7.706. 2 | Noa space heaters, open fame gs oF ol stoves, Fo plates, and uncvented Jeg (Ole 4 | heaters shall be used inthe family foster home fr heating purposes No eectie space heaters shal be used for permanent heating purpose, FOE. Z| Flammables, aerosol pints, insectides, chicas, and other dangerous [P2107 & | materials must be locked or stored a lcstion inaccessible to foster children, Flames mist be stored in an approved container. bree. Radiators, registers, replaces, wood-burning stoves, steam pipes, and/or hot letov a F_| watersips tat ove seo haar ar screened or theme protected TREES |Hammanl meterats must not be ord ner furace, hot water eater, or Pale | ctherheating devees. (%.708.2S | candles and other burable objects are not peritied in foster Gidrers dleepng [ator | seas Foster children are not permitted to smoke in ther sleeping or storage [2708.75 ait routes sal be cleay Weniied tol Toner cian, Ws not peed to Flo HE | uselocksortatening to prevent ree escape from any room uzedby the foster chien 7,708. >S [Exc routes hal be Kept ree of discarded Furnare, farhngs, Tandy aks of [FBIwTH-T | newspapers or magazines, or anything that could interfere wth the prompt evacuation of the family foster home, Fire is wil be completed querteri and docamentedin providers fe Foster Home Ste Yes [No | Comments | Regulation? Rule/Potcy 7.108. 2 3 | The fy fosterhome must be located n an area that Sacesable To Fealh P51 A | resources, pubic and private utes, adequate and safe water supplies, sewage spose and fire and pole protection. Pertinent emergency and agency phone ‘numbers must be pasted nthe home 77°55 The family foster Fore compbes with the Taal orig depariment requirements -FI°G-TS PHU The family foster home, incudingindoor and outdoor space, shall be maintained 2 Ina clean end safe condition freeform hazards to health and safety,Peeg a “The fam foster Fore subject to hapecton by ihe resource worker Tor Pgs certieation purposes. Allareas of the home, including the residence, surrounding rounds, basement, ati, storage buikings, garage, andor earprtshallbe inspected, Foster Home Malntenance Yes [Wo | Comments Regulation Rule/Patey 7.108. 24 WE “The fl foster home shall be Keptin good repak ond maintained safe, #0 lea, and sanitary conden. "7-708. Be] PHO | Ares ofthe arly Forter home alae to forar Cres eis #6 {incuding equipment, materals and furnishings] shall be tury, of sfe onstruction ad fre of haar P78, TAPAIC | Al reso the family fester hore sallbe Kept re Tam the seamoation oF aC Sirfeant amount of non eerntal materi sh ishing, newspapers or ‘magennes that cou poses fre or heath har. TBE FT AYE Provisions are made forthe colecton storage, and diosa oT aah a pve #0 the nfstatonofrodents, ‘ier ouehold Reamer Yes__[No_[ Comments ieguation/Role/Potey ‘Current photograph ofthe amily in thei certieation We Health evalustions submited forallhourahold member of the family oer home, icuding adopted cideen E PPE WS PAO | Each foster parent must be cere In COR an Fst Ad > Forty-seven hours of intial traning in ist year of foster cae Twenty-seven ours of pre-certfeation traning + twenty hours ongoing taining) completed by exch patent. Training must be relevant to the forterng of children. (nal CPR/Fst Ad traning cannot be counted toward raining hours in the fst year.) TB Twenty hours of ongoing traning completed annually by each parent. Tani plo & ‘must be relevant to the fostering of children. If certified as a Therapeutic Foster Home thity-two hour af annual ongoing traning is required, CPR/Fiet Aid recertification can count towards ongoing veining hours GT “Admlesion of foster child to a fami foster nome shall bey Keeping wih he pases ‘stated purpose ofthe family foster home's current wttten admission pal, which is kept in their provider le ach foster chiles fie must ndude copes ofall of he appeal documentation listed on the Foster Parent Fle Check.‘The Home Inspection Check ist was developed basa on State Regulations and County Reguation. we understand that Nightlight Christian Adoptions shall deny, suspend, revoke, or make probationary my certilicate de to failure to ‘pair or otherise comply with any of the preceding requtements when a defector noncompllance vith such requirement has been noted by the certifying representative and brought tothe attention ofthe applicant in writing Foster Parent Signature Date Foster Parent Signature Date Resource Worker Signature Date