Recreational Camp Inspection Report

NAME OF CITY OR TOWN

STATE SANITARY CODE: CHAPTER IV, MINIMUM SANITATION AND SAFETY

STANDARDS FOR RECREATIONAL CAMPS FOR CHILDREN, 105 CMR 430.000

RECREATIONAL CAMP FOR CHILDREN INSPECTION REPORT

NAME OF CAMP		ADDRESS
OWNER		OFF SEASON ADDRESS
CAMP DIRECTOR		INSPECTED BY
CAPACITY	WATER SOURCE	DATE OF INSPECTION

Regulation 105 CMR 430.000 The items marked below with an “X” indicate the violated provisions of 105 CMR 430.000.

Items marked with a “ü ” are satisfactory.

REGULATION X/ü VIOLATIONS/COMMENTS

.090	Written procedures available for the review of background of staff. Prior work history, references, and CORI and SORI information. Documents verifying background check being maintained. Staff have no unsupervised contact with campers until background check is approved, unless staff member whose background check is approved is present.
.091	All persons and staff receive orientation before working with children. Orientation plan in writing.
.093	Written procedures for reporting suspected incidents of child abuse and neglect.
.100	Counselors have required training and experience. Adequate ratio of counselors to campers.
.101	Camp director is on premises at all times. Staff aware of person who is responsible for the administration of the camp.	Age: _____________________ Training:
.102	Specialized or high risk activities supervised by counselors with evidence of appropriate training, experience and certification. Counselors present at all times.
.102	Aquatics activities supervised by an aquatic director with proper current certifications.	Age: ___________________ Certification:
.102	Adequate ratio of properly certified counselors to campers to supervise swimming.
.102	Adequate ratio of certified counselors to campers for the supervision of watercraft activities. All staff and participants wear U.S. Coast Guard approved personal flotation devices. Minimum of two counselors each in separate watercraft for white water, hazardous salt water or hazardous fresh water. Campers possess prior training certificate before participating in these watercraft activities.	Names:________________________________ ________________________________ Certification:

.102	Properly certified individuals provided for scuba diving activities.	Certification:_______________________________
.150	Health Records Required health records maintained for each camper and staff member.
.151	Maintaining medical log. Log readily available.
.153	Injury report form completed for each fatality or serious injury. Copy of report sent to MDPH.
.154	Residential Camp: Health history, report of physical exam, and immunization record, prepared and signed by licensed health care provider, furnished to camp by each camper and staff member prior to attending camp. Day Camp: Current medical history signed by parent or guardian, or by licensed health care provider to camp prior to attending camp.
.155	REQUIRED IMMUNIZATIONS Campers and staff under 18 years old Immunization Dose(s) X/ü MMR 1 Measles 2^nd dose required Polio (OPV or e-IPV) 3 4 doses required if mixed schedule vaccine given (IPV and OPV) Diphtheria and 4 Tetanus Toxoids DTaP/DTP/DT/Td and Pertussis Booster dose of Tetanus/diphtheria, (td) required if greater than 10 years since last dose. Hepatitis B: (for 3 children born (effective 1-1-99) after 1/92) Number of records checked___________	Campers and staff 18 years or older Immunization Dose(s) X/ü Measles 2* Mumps 1* Rubella 1 Diphtheria and 3 Tetanus Toxoids *unless born before 1957 Number of records checked___________
.159	Camp health care consultant. Signed written orders for use by health care supervisor.	Name: ____________________________
.159	Written camp medical policy. All staff provided with copy of such policy and trained in the program’s infection control procedures and implementation of the policy during staff orientation. Parents provided with copy of the policy pertaining to the care if mildly ill campers, administration of medication and procedures for emergency care prior to admitting a child to camp.
.159	Health supervisor provided.	Name:________________________________ Training:
.160	Proper storage of medication.
.160	Written approval from health care provider to administer medications.
.161	Infirmary provided. Designated area provided for isolation of child ill with communicable disease separate from the regular living quarters. (Residential Camp)
.162	Laundry facilities.
.163	Operator encourages campers and staff to reduce exposure to ultraviolet exposure from the sun.
.165	Tobacco use, if any, restricted to designated areas not accessible to campers. Designated area appropriate.
.190	Program activities and physical environment provided to meet needs of campers and does not pose a hazard to their health and safety.
.190	Campers released only to camper’s parent or individual designated in writing by parent.
.191	Written procedures for disciplining campers. Plan provided to parents and to each staff member when employed.
.201	Riflery program operated in safe manner. Firearms stored in locked cabinet. Ammunition stored in separate locked facility away from firearms. Shooting range located well away from other activities
.102	Firearm activities supervised by properly trained individual. Proper counselor to camper ratio.
.102	Proper ratio of counselor to campers at the archery range.
.202	Archery program located well away from other program activities and clearly marked. Equipment under lock and key when not in use.
.203	Personal weapons restricted.
.204	Waterfront and boating programs operated in safe manner. Swimming area in clean and safe condition. Camper’s swimming ability determined and campers confined to swimming areas consistent with the limits of their skills. “Buddy system” and “lost swimmer” plans established.
.204	Piers and other equipment in good repair.
.204	All watercraft equipped with U.S. Coast Guard approved flotation devices.
.204	Campers possess appropriate swimming certificate before being allowed to participate in either white water or hazardous salt water boating activities.
.205	Crafts equipment in good repair and properly installed.
.206	Playground and athletic equipment in good repair and of a safe design.
.206	Playground equipment designed to prevent injury and possibility of entrapment of extremities. Equipment securely anchored. Concrete or asphalt surfaces under equipment prohibited. Pliable or canvas seats on swings provided.
.207	Proper storage and operation of power equipment.
.102	All horseback riding instructors licensed in accordance with M.G.L. C. 128, S2A
.208	Horseback Riding Program. Licensed instructor, hard hats worn, minimum of 1 experienced instructor for every 10 riders.	Name:______________________________________
.209	Telephone provided with roster of emergency numbers including camp’s health care consultant.
.210	Written Contingency Plans. Fire evacuation plan, disaster plan, lost camper and swimmer plan, traffic control.
.211	Special contingency plans for day camps
.212	Emergency Procedures – Primitive, travel and trip camps.
.213	Emergency communication system.
.214	Gasoline, flammable substances and other hazardous materials properly labeled and stored in building not occupied by campers.
.215	Written statement of compliance from the fire department
.216	Smoke detectors provided.
.217	Tents, fire-retardant and non-toxic “USE NO OPEN FLAME” stenciled inside and out of tents if not fire retardant.
.250	Vehicles for transporting campers in compliance with M.G.L. c. 90, in particular ss. 7B and 7D and with the applicable regulations of Massachusetts Registry of Motor Vehicles.
.252	Qualifications of driver.	Age: __________________ Names:_____________________________________________________________
.300	Potable water supply provided; adequate quantity and pressure.	Private or municipal well______________________________________
.300	Adequate drinking water facilities provided and centrally located
.301	Plumbing maintained in good working order.
.302	Cross connections
.320	Food Service – Operated in compliance with 105 CMR 590.000 Sanitary Code Article X, Minimum Standards for Food Establishments. Required permit posted in food service facility.
.330	Nutritious meals served. Menus posted. Foods meet “Recommended Dietary Allowances” of Food and Nutrition Board, National Academy of Sciences.
.334	Adequately trained staff and equipment provided to ensure handicapped campers are eating nutritionally adequate meals.
.335	Operator provides proper methods of storing meals brought from home at safe temperature and protected from contamination. Meal provided to campers who arrive without a bag lunch.
.350	Solid waste disposal.
.360	Sewage disposal.
.370	Adequate numbers of toilets, sinks and showers provided.	# toilets:___________________ # showers:_________________ # sinks:___________________
.372	Toilets less than 200 feet from sleeping rooms. Toilet paper provided. Windows and other openings screened.
.375	Ventilation provided for toilet and shower room to the outdoors.
.376	Hot water at hand sinks, showers and bathtubs does not exceed 112 degrees
.377	Sanitary facilities maintained in clean condition.
.378	Adequate toilet, sink and shower facilities for special needs campers.
.400	Rodent and insect control.
.401	Weed and noxious plant control.
.431	Swimming Pools. Operated in accordance with 105 CMR 435.000, Minimum Standards for Swimming Pools. Pool permit posted.
.432	Bathing Beaches. Bacterial sampling done in accordance with 105 CMR 445.000. Results of testing available.
.450	Site location.
.451	Current certificate issued by the building inspector. Structures weathertight and waterproof.	Certification#:__________________________
.462	Screening provided for sleeping quarters and food service areas.
.453	Lighting provided for each kitchen, dining room, infirmary, toilet room and stairway.
.454	Floors maintained.
.455	Adequate egresses provided.
.456	Egresses free from obstructions.
.457	Shelters for day camp.
.458	Shelters for residential camps. Adequate square feet of floor space per person.
.459	Non-ambulatory campers housed on ground level; egresses leading to grade or ramp provided.
.470	Bed or cot provided for campers and staff. Bunk spacing. 40 ft²/bunk, 45 ft²/double bunk
.471	Sleeping prohibited in food areas.
.472	Bedding and towels laundered; common towels not allowed.

REGULATION NO.	THE SPACE BELOW DESCRIBES VIOLATIONS MARKED ABOVE

































































SIGNED________________________________Date:___________ Camp Director		SIGNED_____________________________Date:_________ Board of Health/Health Department