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Home › FL › Jacksonville › Evangeline Lee Family Day Care Home
Jacksonville FL 32244 · License #F04DU0365 · Home-based · Family Day Care Home
When they operate
Ages served
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19-03 · Technical assistance was provided regarding timely extinguisher certifications. Provider has until 4/10/2026 to attain a new certification
Specialist observed fire extinguisher with the certification expiration date of October 2025
Open Not marked corrected in the state record
Category: ratio. Open / not marked corrected.
Generated from this facility's specific inspection record
Data synced from Florida DCF, Office of Child Care Regulation on Jul 8, 2026 · Source records · Report an error
31-02 · Immunization Records FDCH/LFCCH Handbook
Counselor observed that the immunization record for child listed on the supplemental expired 2/26/23. Provider will obtain current form and submit to counselor. Counselor provided the following technical assistance: A. The operator is responsible for obtaining for each child in care a current, complete and properly executed Florida Certification of Immunization form, Parts A-1, B, and/or C, DH 680 (July 2010), or the Religious Exemption from Immunization form, DH 681 (July 2008), which are incorporated herein by reference in 65C-22.001(7)(o) and (p), F.A.C., from the custodial parent or legal guardian, within 30 days of enrollment. DH Form 680 and DH Form 681 may be obtained from the local health department. The parent/guardian of a child who has not received the age-appropriate immunizations prior to enrollment and who does not have documented medical or religious exemptions from routine childhood immunizations should provide documentation of a scheduled appointment or arrangement to receive immunizations. Providers must include a general statement in parent handbook/policies to inform parents/guardians, at time of enrollment, that some children in care may not have current immunizations. B. If the custodial parents or legal guardians fail to provide the above required documentation within 30 days of enrollment, the home shall not allow the child to remain in the program
Open Not marked corrected in the state record
Category: health medication. Open / not marked corrected.
32-01 · Health Records FDCH/LFCCH Handbook
Counselor observed that there was no student health examination on file for child listed on the supplemental. Provider will obtain current form and submit to counselor. Counselor provided the following technical assistance: A. The operator is responsible for obtaining for each child in care a current, complete and properly executed DH 3040, Student Health Examination form, incorporated by reference in 65C-22.001(7)(q), F.A.C. and may be obtained from the local county health department, or a signed statement by an authorized professional that indicates the results of the components of the form are included in the health examination from the custodial parent or legal guardian, within 30 days of enrollment. B. The Student Health Examination shall be completed by a person given statutory authority to perform health examinations. C. The Student Health Examination form or signed statement is valid for two years from the date the physical was performed and must be on file as long as the child is in care. D. If the custodial parents or legal guardians fail to provide the above required documentation within 30 days of enrollment, the home shall not allow the child to remain in the program
Open Not marked corrected in the state record
Category: health medication. Open / not marked corrected.