Evaluation Tool: Youth Camps Program February 11, 2011 Version

STANDARD 1:
Regulatory Foundation / Evaluation Criteria / Comments / Rating
(0-2)
Ordinances / a. Has the Board passed ordinances referring to statutes and rules, as listed in the SCOPE of the Delegation Agreement? / O
b. Have ordinances been revised as needed to be consistent with current statutes and rules? / Y
c. If applicable ordinances were changed since the previous program evaluation, were they sent to MDH for review prior to their passage? / Y
d. Do ordinances describe enforcement tools and procedures, and grant authority for enforcement? / Y
e. Do ordinances reference plan review requirements if adult programs are provided (e.g. – Dual license)? / Y
f. (MDH only) Has MDH reviewed and responded in writing to its delegated partners regarding proposed ordinances or language changes to existing ordinances, within 30 days of receipt of those changes? / Y
Source Materials / a. Current, signed and dated ordinances
b. Delegation Agreement application
STANDARD 2: Trained Regulatory Staff / Evaluation Criteria / Comments / Rating
(0-2)
1. Inspection Staff / a. Does the Board employ qualified inspection staff as defined in the Delegation Agreement? / O
b. Are any less qualified staff (as described in the Delegation Agreement) limited to performing inspections that are not mandated by the Delegation Agreement? / Y
2. Agreements with Other Qualified Parties / If the Board has entered into agreements with other qualified persons to carry out its regular, delegated duties, did the Board obtain MDH’s written approval before entering into such an agreement? / Y
3. Additional Training / Describe the percentage of staff that have taken ICS classes (minimum of ICS 100 & 200.) / W
Describe other training that staff have received (e.g., MNTrac courses completed). / W
4. Staffing Transition Plan / a. Does the Board have a written plan that is submitted annually to MDH, to assure adequate program coverage and to address staffing transition in the event of unexpected staffing changes? / Y
b. Has that written plan has worked effectively during staffing transitions within the evaluation period? / W
c. Has the Board notified MDH within 10 business days of staff departures, when staffing is insufficient to perform the obligations of the Delegation Agreement? / Y
Source Materials / a. Position descriptions for all program staff
b. Organizational charts, with RS numbers, if applicable
c. Staff standardization documentation
d. Written staffing transition plan
e. Staff credentials and certifications (e.g., RS/REHS, CPO, CP-FS, CEHT)
f. Training records (e.g., MN Train records, if used)
STANDARD 3: Risk-Based Inspection Program / Evaluation Criteria / Comments / Rating
(0-2)
1. Inspection Forms / a. Do the Board’s inspection documents identify health and safety hazards and interventions? / Y
2. Inspection Frequency / Is inspection frequency based on MN Statute (annual inspection) being met? / O
3. Written & Implemented Policies / a. Has the Board developed a documented procedure to address corrective action? / Y
b. Has the Board developed a documented procedure that requires discussion of options for long-term control of health and safety hazards? / W
c. Has the Board developed a documented procedure that requires follow-up activities on health and safety violations? / Y
d. Has the Board developed a documented, implemented procedure on variance requests related to health and safety hazards, and interventions? / Y
e. Has the Board submitted to MDH any copies of variances granted, within 30 days of issuance? / Y
Source Materials / a. Copies of inspection reports/forms
b. List of licensed facilities
c. Inspection frequency data for the past three years
d. Documented procedures referenced in 3.a-d above
e. Other compliance forms or documents
f. Copies of variances, as requested
STANDARD 4: Uniform Inspection Program / Evaluation Criteria / Comments / Rating
(0-2)
1. Plan Review / a. Does the Board conduct and adequately document plan review for each new construction, renovation, or conversion of Youth Camps, including zoning approval if needed? / Y
b. Is documentation regarding plan review maintained in each file? / W
c. Is documentation maintained for water and sewer system approval as reviewed by the appropriate authority? / W
2. Licensing & Data Management / a. Are establishments issued licenses as required in MN Statute 144.72? / Y
b. Does the Board maintain a current list of establishments (including establishment name and address)? / Y
3. Inspections & Written Reports / a. Are inspections conducted by qualified inspection staff, as described in the Delegation Agreement? / O
b. Does the Board incorporate education into the inspection process? / Y
c. Are written reports complete and accurate, and do they describe compliance activities? / Y
d. Are statutes, rules and ordinances interpreted accurately and consistently? / Y
Source Materials / a. Files for randomly selected facilities
b. List of licensed establishments with assigned risk
c. Description of licensing category definitions and descriptions, including for all permanent and temporary establishments
d. Relevant ordinances, policies and guidance documents
e. Plan review reports, as requested
f. Educational or training materials relevant to uniform inspection that the Board wishes reviewed
STANDARD 5: Illness & Injury Investigation & Response / Evaluation Criteria / Comments / Rating
(0-2)
1. Protocol for Investigating Complaints / Does the Board utilize a procedure to investigate, respond to, and document Youth Camp complaints and injury? / Y
2. Complaints / a. Does the Board maintain a log or database for all complaints alleging injury, or health and safety hazards? / W
b. Does the Board follow-up on all injury, or health and safety hazard complaints within one business day? / W
c. Are investigation reports filed or linked to the records of the establishment? / W
d. (MDH only) Does MDH refer to its delegated partners any complaints that MDH receives concerning matters under their jurisdiction? / Y
3. Program Coverage / Does the Board have qualified staff available for emergency coverage on a 24-hour a day basis and have they provided an after-hours contact number to MDH? / Y
Source Materials / a. Procedures for responding to injury, or health and safety hazard complaints
b. Complaint log and relevant materials
c. After hours staffing policy and after-hours contact number
STANDARD 6: Compliance & Enforcement / Evaluation Criteria / Comments / Rating
(0-2)
Compliance & Enforcement / a. Does the Board identify and document violations according to statute, rule and ordinance? / O
b. Does the Board address the identified hazards by: (1) following up or using appropriate enforcement tools, including revocation or suspension, and (2) by maintaining adequate documentation throughout the enforcement process? / O
c. Does the Board resolve identified violations within a reasonable time? / Y
d. Does the Board maintain records according to its records retention policy? / Y
Source Materials / a. Records for randomly selected licensed establishments
b. Enforcement policies, procedures and tools
STANDARD 7: Industry & Community Relations / Evaluation Criteria / Comments / Rating
(0-2)
1. Work Groups / Does the Board participate in workgroups, advisory boards, task forces or committees that work to identify, correct, and prevent risk factors and health and safety hazards in licensed establishments? / Y
2. Educational Outreach / a. Does the Board lead or participate in activities that increase awareness of risk factors, health and safety hazards, and control methods to prevent illness or injury? / W
b. (MDH only) Has MDH been available to advise its delegated partners regarding issues covered under the Delegation Agreement? / Y
Source Materials / Any relevant materials the Board wishes to be reviewed.
STANDARD 8: Program Resources / Evaluation Criteria / Comments / Rating
(0-2)
1. Inspection Ratio (sufficient staffing) / a. Describe the current ratio of qualified inspection staff to the number of licensed establishments. / W
b. (MDH only) Does MDH evaluate its delegated partners’ compliance with the Delegation Agreement to ensure that their programs are adequate to assure compliance by regulated parties to requirements in statutes and rules? / Y
2. Inspection Equipment / Does the Board provide the appropriate inspection equipment to its qualified inspection staff? / W
3. Funding / Describe the source(s) of funding for this program. (Fees, General Fund, etc.)
4. Data Sharing / Does the Board maintain all licensing and inspection information in an electronic format and make it available to MDH upon request? / Y
5. Professional Development / Is funding provided for staff training, conference attendance, and other professional development activities? / W
6. Staff Safety / Does the Board provide staff with appropriate safety training and equipment? / W
Source Materials / a. Electronic licensing and inspection data
b. Staff credentials and certifications (e.g., RS/REHS, CPO, CP-FS, CEHT)
c. Organizational charts, with RS numbers, if applicable
ORANGE: Essential Program Elements - defined in statute and/or rule and in the Delegation Agreement / YELLOW: Required Program Elements - required by the Delegation Agreement / WHITE: Value-Added Program Elements - not required by law or the Delegation Agreement, but can help support core functions