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Safety and Emergency Response Documentation - Group …

DEPARTMENT OF CHILDREN AND FAMILIES Division of Early Care and Education DCF-F-CFS0543 (R. 10/2019) Safety AND Emergency Response Documentation Group CHILD CARE CENTERS Use of form: Use of this form is voluntary; however, completion of this form meets the requirements of DCF (3)(b)4. and (4)(j) of the Wisconsin Administrative Codes. Instructions: Child care center personnel shall enter the requested information when each item is completed. If your facility is equipped with a fire protection (sprinkler) system, attach signed fire protection maintenance records from a qualified monitoring agency. Name Group Child Care Center Facility ID Number Year A.

A. FIRE DETECTION / PREVENTION SYSTEM INSPECTION Fire alarms and smoke detectors shall be tested monthly. In the spaces provided below, enter the date, the time and the result of each monthly test. JAN . FEB . MAR : APR ... C. FIRE EXTINGUISHER INSPECTION Each fire extinguisher on the premises of a center shall be inspected and tagged once a ...

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